Skin conditions such as psoriasis, eczema, and skin cancer often have a substantial psychologic and social impact on our patients. Some of these patients limit their life because they feel self-conscious about their symptoms. Sometimes, greater life satisfaction comes from accepting that perhaps some symptoms will remain or recur, even in an individual who responds well to treatment. This acceptance involves acknowledging the existence of symptoms, thereby allowing the patient to pursue a meaningful life that is not overly limited by their potential presence. This is not only liberating for the patient but also for the medical professional, who can sometimes feel pressured by patients’ unrealistic expectations to achieve symptom reductions that are not possible. We discuss how to talk with patients about their expectations regarding treatment and whether relief of symptoms is a necessary component to living a better life. Helping patients to find the right words to explain their visible symptoms to others can sometimes help them feel less self-conscious in public settings and thereby more comfortable going out into the world to pursue a meaningful life.

The supervision of assessment has been greatly neglected in the literature. A model of supervisee development, from novice tn master assessor, is presented. The model focuses on the development of the ability to integrate data into a coherent formulation of the person being tested. Appropriate supervision depends on a matching of the supervisor's behavior to the supervisee's needs, as specified by the supervisee's current level of development. This development is dramatized by improvements in interpreting specific data points and in the recognition of larger patterns in the data. This skill acquisition occurs within the affective context of the supervisor-supervisee relationship as the interaction elicits both inter-and intrapersonal issues.

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