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What is the Difference Between
Personal Therapy and Person-of-the-Therapist Supervision?
Brent J. Atkinson, Ph.D. |
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Article 4.1 in the AAMFT code of ethics cautions
supervisors to make every effort to avoid dual relationships that could
impair their professional judgement or increase the risk of
exploitation, and lists the dual roles of supervisor and therapist as
one such possible relationship. However, over the years, a number of
prominent family therapists have suggested that good supervision always
involves some qualities that are therapy-like (Aponte, 1994; Atkinson,
1997; Kantor & Mitchell, 1992; Storm, 1991; Tomm, 1993) This is
particularly true when supervision focuses on exploring the therapist's
experience with clients (including automatic internal and behavioral
reactions), rather than just focusing on how to apply theory and
technique to the practice of assessment, interviewing, case planning,
and so on. Like good therapy, good supervision promotes introspection,
attention to one's emotional reactions, and exploring ways to alter
reactions when they interfere with one's goals.
So what makes supervision different than personal therapy? For me, there
are two aspects of supervision that distinguish it from personal
therapy. First, there are some activities in supervision that are
totally distinct from activities that occur in therapy. These activities
include learning what to do next as a therapist, where and how to direct
therapy, what to give attention to, and what to ignore. In my work as a
supervisor, about half of the time in supervision is spent on these
activities. The other half of the time in supervision is focused on
exploring various reactions and internal experiences therapists have
when they are with clients. It is here that supervision can sometimes
become confused with therapy, unless understandings and expectations
between supervisor and therapist are clear.
When I function either as a therapist or supervisor, I am careful to
create explicit understandings regarding goals and responsibilities. The
contract in therapy is very different than the contract in supervision.
When clients begin therapy with me, they are generally asking me to help
them resolve distress they are experiencing in their personal lives, or
to assist them in finding greater fulfillment in their lives. In
contrast, when therapists come to me for supervision, they are asking me
to help them improve their professional functioning. In therapy, I
assume a certain level of responsibility for helping clients find a way
to function better in their personal lives. In supervision, neither
therapists or I are interested in such an agreement. Any improvement in
the therapist's personal life during supervision is incidental to the
process of becoming a better therapist. Supervision sometimes may be
therapeutic, but it is not therapy unless supervisor and therapist agree
that the supervisor will help the therapist resolve sources of distress
in the therapist's personal life. I do not make such agreements, and
generally, therapists are not interested in them either.
Therapist's are, however, sometimes interested in discussing aspects of
their personal histories or present circumstances in supervision,
particularly if it occurs to therapists that some of the reactions they
are having with clients parallel the ones they are having (or have had)
in their own lives. Therapists are also often interested in improving
specific skills related to their ability to be sensitive to the nuances
of their emotional states and cognitions, and want to use supervision as
a context for practicing. These are activities I will do in supervision.
In fact, I encourage therapists to use a certain portion of supervision
for such activities if they believe that doing so will improve their
skills as therapists (as I generally do). This is not personal therapy,
but it does involve exploring reactions and circumstances that are
sometimes highly personal. It might become personal therapy if the
reactions and circumstances explored were contributing to or triggered
by personal distress in a therapist's life, and if the supervisor agreed
to work with the therapist on the goal of resolving the personal
distress. This is an agreement I will not make.
When a therapist's level of personal distress is interfering with their
professional functioning, or if a therapist shows interest in receiving
help in resolving personal distress, I refer the therapist for personal
therapy. Most of the time a referral is not necessary. Therapists are
simply interested in developing their fullest potential to know
themselves well and to use this increased self awareness as a resource
in their work with clients. This doesn't mean that supervision doesn't
contribute to a greater sense of fulfillment in a therapist's personal
life. It often does. Any time a person becomes more sensitive to their
internal reactions or more interpersonally skillful in any context,
there may be side-benefits in their most intimate relationships. It's
just important to be clear that an increase in a therapist's personal
fulfillment is not the goal of supervision, and even if a therapist
experiences profound personal growth as a result of supervision, the
ultimate goal is not complete until this growth is used as a resource
for his/her work with clients.
In seeking to be careful about potential exploitation in supervision, it
is not enough to caution against the dual relationships of
supervisor/therapist and supervisee/client. There is potential for
exploitation any time there is an imbalance of risk in relationships
(Atkinson, 1993). The supervisory relationship is no exception,
especially when supervision includes an exploration of the therapist's
internal experience during therapy sessions. For a discussion of the
risks in person of the therapist supervision, and safeguards for
preventing exploitation, see Atkinson (1997).
References
Aponte, H. (1994). How personal can training get? Journal of Marital and
Family Therapy, 20, 3-15.
Atkinson, B. (1997). Informed consent for person of the therapist
supervision. In C. Storm and T. Todd (Eds.), The reasonably complete
systemic supervisor resource guide. Boston: Allyn-bacon Publisher.
Atkinson, B. (1993). Hierarchy: The imbalance of risk. Family Process,
32, 167-170.
Kantor, D., & Mitchell, E. (1992). Letter to the editor. The
Commission on
Supervision Bulletin, V(2).
Storm, C. (1991). Changing the line: An interview with Edwin Friedman.
The Commission on Supervision Bulletin, IV(3).
Tomm, K. (1993). Defining supervision and therapy: A fuzzy boundary? The
Commission on Supervision Bulletin,, VI(1).
Superv\ther-sup, 6/22/96
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