About two weeks ago, I completed my finals and second year placement for the first semester. Since then I’ve been enjoying some rest and relaxation (R & R) which is especially nice after having had several intense weeks.
Today, I will cover the topic of the supervisor-supervisee relationship because it is a particularly important one in the life of a social worker in training. The supervisor not only sets the tone, content and pace of the work during your internship but she also has the critical role of guiding the you, the trainee, on how to do the work.
In addition, in the process of instructing the supervisee, the superior will inevitably discover some tender spots for you, the student (especially if she is good at what she does) and will need to figure out how/when to address those so as to assist you in becoming more self-aware and self-attuned.
These are all critical skills which in turn enable to the training clinician to not only be more present for the client but to also prevent her/his own issues from inadvertently interfering with the therapeutic process.
As an example, one thing that came up for me during supervision was my difficulty in confrontation. This was evident in things like when I had to convey to a client the attendance rules of the clinic be it in a “warning” letter or during a conversation that I had with one during a session.
I was not as direct or clear as I should have been in conveying this type of information. Instead of simply stating that after missing three consecutive appointments, their case would be closed and I would no longer be able to see them, I was rather unclear.
This was my way of trying to avoid confronting the client. The next part of the work then becomes for me to figure out where this discomfort and/or fear of confrontation stemmed from so as to address this and to have this no longer be an issue for me.
I have since learned how this unease has come about, but the knowledge does not eliminate the fact that for now, it takes some conscious practice and effort for me to overcome my discomfort with confrontation. My assumption is that this issue will subside with time.
Another recent illustration of something that came up for me was that my supervisor noticed in the review of my process recordings that I seem to have a pattern of “coming to the defense of the person who is defending the client.”
The key learning for me is that I need to first validate the client’s feelings before clarifying or pointing out a possible alternative view of what someone may be doing on their behalf.
In other words, if a close relative expressed concern for client A and this irritated client A, I should first validate client A’s feelings of irritation by showing that I understand how the relative’s concern would have felt annoying under those circumstances.
It is only after this validation that I may then explain to client A how in a loving relationship it is also quite understandable for one person to express concern for the other, or something to that effect.
With respect to the motivation for my pattern of rising to the defense of the person supporting my client, my supervisor proposed an interpretation that I may be doing this because I needed someone to do this on my behalf as I was growing up.
While initially, I needed time to think about this, I realized later that her interpretation was right on the mark. In sum, the training process of becoming a clinical social worker or therapist makes you learn a lot about yourself… as you work on helping to heal others, you inevitably find and work on healing your own wounds as well.
Have you found this to be the case as you went and/or are going through your training? Please share your thoughts and comments. I really appreciate them 🙂
Wishing you all a Happy and Healthy New Year!
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Hi Dorlee….this is a very honest and open post. It takes courage to reveal vulnerabilities – and in my opinion it’s a sign of a good leader. We humans sure are complicated, aren’t we? It sounds like you are an excellent role model for being open to self awareness. Thanks for your insights. ~Terry
Hi Terry,
Yes, this part of the work/training to become a social worker is difficult and takes courage…but at the same time, you feel that it allows you the gift of some much needed growth that you would not have been aware of beforehand.
I am most grateful for having the supervisor I have, as well as supportive friends like you, as I embark on this challenging journey!
Thanks so much for your kind feedback,
Dorlee
Hi Dorlee, this is such a good example of “the work” inherent in what we do. Supervision can make or break a placement, and it also sounds like you were very open and self-reflective. These will serve you in good stead not only with your clients, but when you begin to supervise your students!
Did I note a Freudian slip, when you wrote “In addition, in the process of instructing the supervisee, the superior will inevitably discover some tender spots for you”? Did you mean to write “superior” rather than “supervisor?” This may give you a sense of how I supervise my interns. 🙂
Hi Mike,
Thanks so much. It is reassuring to hear that what I am going through is not only helpful for now but will be good for down the road.
Regarding the “superior” slip, that was an interesting observation on your part. Actually, as I recall, at the time I wrote this post, I viewed the term superior as identical to the word boss or supervisor and wanted to provide some variety in my text.
That said, now in retrospect, superior does not feel like the ideal alternative term for supervisor because it sounds like I may be over-emphasizing the difference in our roles…
I agree completely with Terry about your courage–both in your openness in supervision, your self-reflection, and your honesty in this post.
I’ve had many similar moments over the years with my supervisors (and been on the opposite side of the experience, as a supervisor).They can be uncomfortable, but they are well worth it.
Good supervision can make us feel very vulnerable. A good supervisor creates a place where this can happen. This is a parallel process to what happens in therapy itself. The feelings of vulnerability that you had are what your clients can feel with you. So the learning you are going through has two elements to it, it teaches you about yourself as well as about the therapy you are conducting.
If you’re interested in learning more about the parallel process of clinical supervision, here’s a podcast about it with Dr. Larry Shulman:
http://www.socialwork.buffalo.edu/podcast/episode.asp?ep=5
Thank you. I never really thought of my self-reflection and openness to share my journey as taking courage…particularly because I seem to be going through a more vulnerable period right now.
It is most reassuring to hear that you too have felt vulnerable at times going through supervision.
That is an interesting observation – that my clients may be feeling at times as vulnerable with me as I feel with my supervisor.
This raises a question for me as to whether a therapist may err on occasion in making a client feel too vulnerable…
Thankfully, I had the resources to pull myself together and/or get through it despite the pain but someone else with a different psychological make-up may have felt too overwhelmed with their emotions to do so without some assistance…
Thanks so much for info about Dr Shulman’s podcast on the parallel process of clinical supervision. I will definitely check it out. You always have such great resources to recommend!
I definitely think that therapists err on occasion in evoking too much vulnerability for a client. If the therapeutic alliance is strong then this can be worked through, but I’ve also seen it result in clients dropping out of treatment.
For this reason, understanding a client’s ability to tolerate emotion and specifically, vulnerability, becomes a critical task during assessment.
Hmm…Now, I’m starting to wonder if I may have made this mistake with two of my clients of mine who used to come see me on a regular basis but who have been coming on an every other week basis for the last several weeks.
While I had raised/ questioned them on whether the topic of the session prior to the missed session had been painful etc. and had received acknowledgment of this for one of the missed occasions, I did not realize this may mean I need to adjust my approach and/or slow down with them.
But now that I have gone through this experience of feeling vulnerable with my supervisor and have your input on this process, my gut feeling is that I should have made some changes.
Wow, you really can learn so much from the parallel process of supervision.
May I ask, Nancy, how do you assess a client’s ability to tolerate emotion and vulnerability?
Thanks so much!
LOL, You do come up with the best questions, Dorlee!
I suspect you will could get a range of responses from your readers on this one. I’ll share a bit about how I do it. But let me start by saying that the clients that I have generally worked with have significant problems with tolerating emotion, especially vulnerability–most of my clients suffered significant abuse from people who were supposed to be trustworthy, so being vulnerable with someone who is in a position of power is especially scary. In addition, many of my clients have not had a chance to develop emotional regulation skills that don’t create problems for them now, so we may end up spending some time working on developing these skills. The bottom line is that I spend a lot of time checking this issue out because of the clients I generally work with. Other clinicians may emphasize this because they haven’t needed to do so.
During my beginning contacts with someone, I usually ask people how they handle uncomfortable feelings in their day to day lives. In addition, with some of my more complex trauma clients I have used Briere’s Inventory of Altered Self-Capacities( http://www.johnbriere.com/iasc.htm) which includes an affect dysregulation scale. And then I rely on observation: how people interact with me in the session, what they share about their feelings in the here and now with me, how they are able to tolerate doing here and now feelings with me that aren’t as difficult. Can people stay with their feelings, describe, them, describe their body sensations (be mindful and share their experience as they have it, in response to my questions)? Or do they skip over that stuff, change the subject, etc?
If we have a session where it seems like vulnerability is triggered I will talk about post session reactions that come up for people, including the desire to skip the next session (which is often a fear that we’ll go even deeper). I let people know it would be okay for us to take the next session in a much more laid back way if they feel like we need to do that. I very much try to make therapy a collaborative process where we learn together about the pace that works for someone.
I could go on and on and on about this issue–and I’ll spare you that! 😉
Thanks so much, Nancy, for sharing some of the steps involved in assessing a client’s ability to tolerate emotion and feelings of vulnerability.
This was most helpful. I feel that this is a very important skill for me (or any therapist in training) to develop.
With much warmth and appreciation for all your guidance,
Dorlee
Just wrote a long comment, but it seems to have disappeared. I’ll try again just in case.
Good supervision is always so important, especially as an intern. I’m fortunate to have a great supervisor now, who challenges me but is also very supportive. I also had a great supervisor my first year as an intern, though my second year supervisor I can only describe as a sadistic witch who liked to make interns cry 🙂 But what can I say, it was a learning experience and I got through it.
Confrontation, for me, is the number one thing that has gotten easier with time. It was very difficult for me as an intern. I’ve gotten much less timid with experience. Recently I’ve gotten several new clients, some of whom are rather resistant. I’ve found myself able to point out their contradictory behavior, or to be upfront with them regarding our expectations and requirements, in ways that I wouldn’t have a year ago.
Being aware of your areas for improvement, and being able to talk about them, is so important in developing as a worker (though clearly you know that!)
Thanks so much for visiting and sharing some of your experiences and valuable input.
It sounds like your second year of supervision as an intern was just awful…but thankfully both before and since then, you have had great supervisors.
How wonderful that confrontation became easier with time for you. I think this shows growth on your part as well as increased confidence in your role.
The greater ease you exhibit also suggests that confrontation may also become easier for me with time 🙂
Actually, I can already see some light at the end of the tunnel b/c I no longer have to “prepare” myself prior to confronting a client, as I used to at the beginning of this internship.
Talking about the process I am going through and the required areas for improvement has been enormously helpful – particularly because of all the wonderful support and feedback you and others are giving me.
Thanks again!
Hi Dorlee,
I am so impressed with your self-reflective capacity and your generosity in sharing your process.
I agree wholeheartedly that the process of training to be a social worker can be a healing experience for the student. I will take it a step further; you said that as you work on helping to heal others, you inevitably find and work on healing your own wounds as well. This is not only true for students; it is also true for the most seasoned clinicians. When we are truly invested in self awareness and our own professional growth, then we continue to learn, grow, change and heal our wounds throughout our careers.
I still learn about myself through my work with my clients (and with my graduate student supervisees)after almost 30 years of clinical practice. When I uncover areas of vulnerability, I do the growth work I need to do to overcome it. If I am encouraging my clients to take the risks involved in working through their issues, then I have to be willing to do my own work as well.
Best wishes for a rewarding new year,
Andrea
Hi Andrea,
Thanks so much for having been willing to share that this healing work is something that you are doing, even after 30 years of experience.
I had (wrongly) assumed that therapists only need to work on healing their wounds during their training and/or first few years of work.
Is this because complete healing takes a very long time and/or certain stories/events that occur for clients may still trigger previously healed (or thought to be healed) wounds ?
Best wishes for a happy and healthy new year,
Dorlee
Hi Dorlee,
The short answer to your question is “yes and yes”. 🙂
There are many layers to healing and new life stages bring new challenges. Traumatic memories can be activated by clients, significant others and new life circumstances. It can be an issue that never came up before or a new aspect of a familiar issue. There can also be a new readiness to address a previously unresolved issue as a result of decreased stressors and/or increased coping capacities.
Growth work is a life long process, even when the bulk of one’s traumatic experiences have already been reprocessed to adaptive resolution. We are all works in progress!
In addition, when you bear witness to other people’s pain for a living, there is always the potential for vicarious traumatization that will require healing.
Keep asking the great questions!
Warmly,
Andrea
Hi Andrea,
Thanks so much for clarifying 🙂
Today, I had the experience of a traumatic memory being triggered by a client which illustrates quite clearly what you are saying…
While we are all works in progress, I assume/hope that the degree/frequency of pain that one experiences with time is less than what one feels when one first enters the field.
Warmly,
Dorlee
Hi Dorlee,
As we grow as professionals, heal from our own wounds, and develop the capacity for compartmentalization, it usually gets easier over time. However, there are sometimes things that come up that cause a higher degree of struggle again for a while.
The bottom line is that it is realistic for you to feel hopeful that the degree and frequency of pain will lessen over time. 🙂
Warmly,
Andrea
Hi Andrea,
I understand…
I’m also relieved to hear that the degree and frequency of pain will lessen over time 🙂
Warmly,
Dorlee
DorleeM, thanks for this post. In Feb. 2011 I am presenting at the Colorado Counseling Association’s annual conference. The title of my workshop is Here There Be Dragons: Mapping Personal Histories for Mental Health Professionals. Your post will, in part, inform my content for this workshop and I’ll be sure to give you credit (and hopefully send some traffic your way)!
Hi Tamara,
I’m most flattered that my post seems to have played an inspirational role for your upcoming presentation and most appreciate your plans on making mention of this 🙂
Wishing you the best of luck!
Thanks again,
Dorlee
Hi, Dorlee. It’s a whole year later and I’m back just scanning your posts on self care. I’ve over-extended myself this winter and needing a few reminders on when to say “no” and when to say “yes.” Just wanted you to know that your writing continues to be an excellent “tune-up” on this topic! Have a great day!
Hi Tamara,
It’s so nice to see you. Sorry to hear that you have been over-extending yourself the past few months…at the same time, I’m glad that you find some relief and benefit to stopping by and visiting here 🙂
Do take the time for self-care; it’s SO important for you and for all the people you provide care for; it’s what enables you to truly be there for them…
Be well,
Dorlee