Abstract
Background: Psychotherapy supervision is an educational practice offering neophyte psychologists ethical oversight, professional development, and multiple competencies. The supervisory relationship is fundamental to the supervision pedagogy. However, research in South Africa and internationally has documented negative supervision experiences. The relational and emotional responses in the psychotherapy supervision relationship contribute to this training problem. These emotional responses can be understood through the concept of countertransference.
Aim: The aim of this study was to explore supervisors’ and supervisees’ experiences of psychotherapy supervision and the emotional responses within the supervisory relationship.
Approach: The research was an exploratory qualitative study located in the constructivist-interpretivist paradigm. Two participant groups were recruited. In the first group (supervisors) nine who were registered as either clinical or counselling psychologists in South Africa had worked as psychotherapy supervisors in training contexts. In the second group (supervisees) nine psychologists, also registered as clinical or counselling psychologists, were recruited and they needed to have completed their professional training within the 3 years prior to their participation in the study. Individual semi-structured interviews were conducted with each participant, leading to two separate datasets. Interpretative phenomenological analysis was used to analyse each dataset (supervisors and supervisees). Thereafter, the themes from each dataset were consolidated to create superordinate themes that made an integrated account of supervisor and supervisee experiences of either offering or receiving psychotherapy supervision, respectively.
Findings: Each dataset provided three themes. The supervisor themes outlined: (1) boundaries between the personal and professional, (2) accountability, responsibility, and protection of supervisees, and (3) competence, internalised representations of supervision, and the personhood in the supervisory relationship. The supervisee themes highlighted: (1) the expectations in psychotherapy supervision, (2) the role of evaluation, power differentials, and compliance in the supervisory relationship, and (3) the overlap of the personal and the professional. The first superordinate theme explored the negotiation of boundaries in the supervisory relationship. The second superordinate theme noted the supervisory façade. The
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third superordinate theme grappled the pedagogical implications for countertransference and interpersonal relatedness.
Original contributions: The research provides an understanding of the emotional responses of the supervisor-therapist-client triad and the need for a new concept to understand these relational dynamics of the psychotherapy supervision relationship in the professional training context. The superordinate theme of the supervision façade demonstrated the interpersonal and relational power within psychotherapy supervision by noting that, when a supervisee’s performance of compliance and the supervisor’s wavering competence collide, the pedagogical function of psychotherapy supervision becomes compromised. This conceptual contribution impacts evaluation, training, and professional development.
Practical and theoretical implications: The practical implications of this study foreground the gaps in the professional training of psychologists in South Africa. Professional training needs to foster a balance amongst the three primary functions of psychotherapy supervision but this needs to be informed by the ethical, pedagogical, and managerial aims of supervision. Moreover, criticality and context-sensitive practices should inform supervision practice in professional training of psychologists.
Recommendations: The research outlines the need for reformation and formalisation of policies and the standards of practice. This includes institutions needing to establish clear boundaries amongst stakeholders and introduce supervision induction activities about expectations, operational practices, contracts, and transparent evaluation, all of which might need to be aligned with the minimum standards of training as prescribed by the Health Professions Council of South Africa. The study identifies a gap for research into racial discrimination within psychotherapy supervision in professional training in South Africa.