Katrina Millhagen - BSc,PgDip AT,MA in Art Psychotherapy
Supervision is an irreplaceable part of therapeutic practice, in order to offer clients the best possible therapy and for the therapist to have a place in which to consider and reflect on practice. It is about engaging the therapist to look at their clients. Considerations include, does the client know what they are engaging in with the therapist? Our clients are well informed about what this undertaking may involve and is there an agreement on what to address? Is what is being addressed clearly understood by both; is the therapy on the course or has it taken some different direction and other aspects were added into the process?; what is the therapist's impression and feelings about the explorative process ?; where are therapist and client in the process?; what is actually going on in the therapeutic relationship?; how are therapist and client looking at this; has there been a review?; could explorations open a wider perspective?
Peter Hawkins and Robin Shohet in Supervision in the helping professions have written a clear text on supervision and this has always been a valuable reference for me. The seven-eyed model is very helpful. The model is relational because it focuses on the relationships between client, therapist and also a supervisor and is systemic because it focuses on the interplay between each relationship and their context within the wider system. There are many aspects to supervision that include transference & countertransference; aspects which belong to therapy and not to supervision; defensiveness on a therapist's part or personal blindspots. Supervision is about offering a reflective process of the work that is undertaken with clients and supporting and strengthen the therapists in their practice. Brigid Proctor was referenced in Hawkins and Shohet and referred to the need to help a supervisee feel received, valued, understood, as only then will the therapist feel safe enough to review and challenge him/herself.(p.36.)
Within the modality of art psychotherapy supervision addresses also how to incorporate image making into the process of a psychotherapeutic relationship. Questions and discussion in art therapy included the way an image could be either sidelined by not addressing images adequately and verbal psychotherapy takes over, or, how the image gets more space and attention and consequently verbal psychotherapy has too little time. In art psychotherapy, the images need the full attention and reflect the nonverbal aspects of the art processes. The creative art processes and psychotherapeutic explorations allow an opening and a new outlook on self and life. J.Shaverien wrote about the supervision of art psychotherapy 2007 and included how important reverie is with images. G Mc Neilly wrote about group art therapy in 2006 and spoke about the dynamic struggles of conscious and unconscious oppositional forces playing out continuously, both among clients and the artworks. This he said can lead to harmony and splitting and useful exploration.
There are the relational aspects of therapist and client that needs the attention of the supervisor. It can be described as a rich ground through which the therapy work can be illuminated. I always found Stephen Mitchell 2000 on relationality: from attachment to intersubjectivity important. One example he gives is of working through projections and allowing clients to speak their minds and being able to hold this as the therapist and respond well p.142. He described struggles around 'hate' and the emergence of warmer feelings and laughter in an illuminative way.
Irvin Yalom, an existentialist practitioner advocates for therapists to bring themselves into the therapeutic relationship and to give feedback to clients and hear their feedback. He supports the relational aspects in the encounter of therapy and also in a supervisory context. Loves Executioner and tales about psychotherapy highlight so much about transference and countertransference, assumptions and also blindspots.
A supervisory arrangement is between a supervisee who brings clinical work to a supervisor, who then supervises this work. Adequate time has to be available to cover a Supervisee's client caseload. At least 1.5 hours per month is therefore usually set aside for supervision.
The supervisee is encouraged to prepare for supervision in advance with questions or aspects that s/he wishes to share. There may be some clear issues that wish to be addressed or some aspects that feel positive or show the progress of a clients work. There could also be some issues like that something is unclear for the supervisee about a client. Sessions may leave the supervisee with a sense of puzzlement that may then need exploration in supervision. I share with a supervisee that I want to get to know a sense of clients and their therapeutic relationship through supervision so that I can begin to gain an understanding of the therapist's internal responses and reflections. I explain that I am interested to hear about what was shared or not shared and to explore this more where appropriate.
I explain to the supervisee that I want to be supportive of their practice and that I may suggest reading or further considerations. My interest is to support my supervisee's in their therapeutic work in order to help endorse, enrich as well as sustain good work. I do not see my role as a supervisor as effective through criticism, but see my role as a witness of their therapeutic work through which one can contemplate, consider and ponder over what is taking place. I encourage a supervisee to take, where appropriate, personal issues into their own therapy so that an unfolding and strengthening is able to take place.
Where I think therapeutic practice falls short of good client care or inadequate ethics are adhered to, I share this. I like to encourage open reflection and considerations of such issues. I endorse a revisit of those client issues. If I continue to observe that something is not addressed by the supervisee, I raise this.
I see my role as enabling supervisees to endorse their approaches and effectively work with clients. This includes being part of a supervisee's learning and to help refine awareness.