Relational processes and the emergence of harmful supervision events: A narrative analysis of a single case

Abstract

Background Harmful supervision practices have been found to be fairly common in clinic supervision. Although a number of possible factors linked to harmful supervision have been identified, the relational processes and dynamics associated with the emergence of harmful supervision events still remain largely unexplored. Aim This study explores a case of harmful supervision with the aim of understanding relational factors that contributed to the difficulties encountered. Both the supervisor's and supervisee's perspectives are considered. Method Narrative inquiry was used to analyse supervisor and supervisee interviews. Interviews focused on reconstructing supervision stories associated with critical incidents. Findings Poor orientation to the goals and tasks of supervision and the early undermining of the supervisee's experiences appeared to set up a negative relational process. This led to a cycle of escalating anxiety, amplification, avoidance and non‐disclosure on both sides of the supervisory dyad. In turn, this seemed to contribute towards the emergence of a pseudo‐supervisory alliance. Given the erosion of trust, unresolved issues constantly re‐emerged. The relational processes associated with the case are explored using Jessica Benjamin's Recognition Theory.

A qualitative examination of trainee perspectives on cognitive behavioural supervision

“…This task can be difficult due to the inherent power differential within the dyad, which can lead to trainees experiencing fear of repercussions in terms of negative evaluations by their supervisors. If trainees intentionally fail to disclose ongoing problems, there can be negative consequences on patients' progress and outcomes (Ladany et al, 1996), as well as on the supervisors who have legal responsibilities for their trainees' patients (Cartwright, 2019).…”

“…A strong supervisory alliance is crucial as it has been associated with increased trainee openness to disclose difficulties encountered with clients (Falender, 2014;O'Donovan and Kavanagh, 2014;Wilson et al, 2016). Supervisors must create an environment where trainees feel safe or comfortable discussing problems and mistakes, as effective supervision often depends on trainees' disclosure of their difficulties (Cartwright, 2019;Callahan and Love, 2020;Falender, 2014;Johnston and Milne, 2012;Mehr et al, 2010). This task can be difficult due to the inherent power differential within the dyad, which can lead to trainees experiencing fear of repercussions in terms of negative evaluations by their supervisors.…”