Clinical Supervision Quotes

How long to see results?” Diomedes asked. “I can’t answer that,” I said. “You know that as well as I do. It takes as long as it takes. Six months. A year. Probably longer—it could be years.” “You have six weeks.” Stephanie drew herself up and crossed her arms. “I am the manager of this unit, and I simply cannot allow—” “I am clinical director of the Grove. This is my decision, not yours. I take full responsibility for any injuries incurred upon our long-suffering therapist here,” Diomedes said, winking at me. Stephanie didn’t say anything further. She glared at Diomedes, then at me. She turned and walked out. “Oh, dear,” Diomedes said. “You appear to have made an enemy of Stephanie. How unfortunate.” He shared a smile with Indira, then gave me a serious look. “Six weeks. Under my supervision. Understand?” I agreed—I had no choice but to agree. “Six weeks.” “Good.” Christian stood up, visibly annoyed. “Alicia won’t talk in six weeks, or sixty years. You’re wasting your time.” He walked out. I wondered why Christian was so positive I would fail. But it made me even more determined to succeed. CHAPTER SIX I ARRIVED HOME, FEELING EXHAUSTED. Force of habit made me flick on the light in the hallway, even though the bulb had gone.

She was a new world - a place of endless mysteries and unexpected delights, an enchanting mixture of woman and child. She supervised the domestic routine with deceptive lack of fuss. With her there, suddenly his clothes were clean and had their full complement of buttons; the stew of boots and books and unwashed socks in his wagon vanished. There were fresh bread and fruit preserves on the table; Kandhla's eternal grilled steaks gave way to a variety of dishes. Each day she showed a new accomplishment. She could ride astride, though Sean had to turn his back when she mounted and dismounted. She cut Sean's hair and made as good a job of it as his barber in Johannesburg. She had a medicine chest in her wagon from which she produced remedies for every ailing man or beast in the company. She handled a rifle like a man and could strip and clean Sean's Mannlicher. She helped him load cartridges, measuring the charges with a practised eye. She could discuss birth and procreation with a clinical objectivity and a minute later blush when she looked at him that way. She was as stubborn as a mule, haughty when it suited her, serene and inscrutable at times and at others a little girl. She would push a handful of grass down the back of his shirt and run for him to chase her, giggle for minutes at a secret thought, play long imaginative games in which the dogs were her children and she talked to them and answered for them. Sometimes she was so naive that Sean thought she was joking until he remembered how young she was. She could drive him from happiness to spitting anger and back again within the space of an hour. But, once he had won her confidence and she knew that he would play to the rules, she responded to his caresses with a violence that startled them both. Sean was completely absorbed in her. She was the most wonderful thing he had ever found and, best of all, he could talk to her.

In his clinical work with both trans boys and girls at UCLA, however, Newman failed to follow his own words and often ended up overseeing transitions for his child patients, precisely because such “intensive individual therapy for the child and counseling for the family” had absolutely no anti-trans effect. He tended to see the onset of adolescence as the practical threshold at which there was no point in pursuing psychotherapy anymore to change a patient’s gender identity. “Georgina,” one of the trans girls he saw regularly in the 1960s, therefore began to live full time as a girl when she turned fifteen. With Newman’s guidance as supervising psychiatrist, as well as the permission of her parents and school officials, she was able to transfer to a new school in the Los Angeles area, legally change her name, and complete high school as Georgina, while continuing to visit UCLA for estrogen therapy.

The supervisory relationship provides the context and the environment wherein the learning process takes place and lays the foundation for the work that will occur in supervision. The quality of the working relationship between the supervisee and supervisor is one of the key components determining the outcomes of clinical supervision. The effectiveness of these relational interactions largely depends on the kind of person the supervisor is and his or her ability to establish and maintain a good connection with the supervisee.

I have been challenged, as a supervisor, to adjust my thinking about needing to be “all-knowing” to a position of “not knowing” and greater curiosity. Although I don’t see myself as a particularly intuitive or creative person, guidance while a supervisee has enabled me, as a supervisor, to implement interactive, creative, and sometimes evocative methods in supervision. The use of Satir’s sculpting and coping stances and other Gestalt techniques in group supervision has been very illustrative.

WE ALL VIEW THE WORLD around us through a unique set of lenses. Much of how we see clinical supervision comes from our own experiences, which have informed our current ideas, beliefs, and practices. Engagement in supervisory conversation invites us into a process about how we can learn to see things differently with “super-vision” – new eyes, new perceptions, new visions. Supervision then becomes a new way of seeing, a super way of visioning (Carroll, 2011). What would happen if we looked at ourselves, our supervisees, our clients, the multiple systems, and all the intertwining relationships in different ways? By sharing our perspectives, I believe that together we can co-create multiple ways of seeing and thinking about the practice of systemic clinical supervision.

A Chicago study of 20,000 infants, all from poor families, all under the supervision of local welfare clinics, revealed that at nine months of age the artificially fed infants were 50 times more likely to die than those who were still breastfeeding.

How in practice do I know – or believe to know – that the requisite progress has been made so that I can recommend the trainee for associate membership? The answer is as subjective as it is brief, and the strength of my conviction depends on my being able to answer three questions in the affirmative. They are in ascending order: (a) Would I send him a patient? (b) Would I send him a patient whom I myself would take on for analysis? (c) Would I entrust myself to him or her for analysis? This last ‘criterion’ should not be taken to be more than a fleeting thought.2

The analyst’s vulnerability has to be greater even than the vulnerability any other patient has to learn to accept. It is a good thing for an analyst to learn early that every patient suffers from the analytic process, but the vulnerability that the analyst must learn to accept goes beyond the humility that every physician must find toward the mystery of wounding and healing. The

The analyst’s specific discovery, beyond her or his initiation as patient and physician, is of a certain helplessness in the face of the unconscious. Only a period of helplessness at the hands of the unconscious can promote openness to the unconscious’s own solutions that is the analyst’s stock in trade. Such radical openness is never achieved through a graded series of gentle shocks. Rather, it is almost always the effect of at least one sudden, unexpected wounding, what James Hillman has called “betrayal.” And,

a too rapid need for meaning can serve as a defense against meaning’s emergence. One

Supervision, he says, is really a shared fantasy of what is actually going on – it is the result of a “trainee trying to imagine what he and his patient have been doing together and the supervisor (plus case seminar participants) trying to imagine it too.” Supervision works best, he says, “if all parties remain aware that what they are jointly imagining is not true.

Working with graduate students laid the foundation for my approach to clinical supervision. My commitment was to initiate the students into the counselling profession, to help them to develop the required theoretical and practical skills, to grow in self-awareness, to develop the relational skills that provided a sense of safety and security for those seeking help, and to gain confidence as an effective helper. It became clear to me that providing clinical supervision did not follow a linear path but rather had many twists and turns.

In brief, supervision entails several elements: developing the supervisee’s professional skills, supervisee gaining in self-awareness, protecting the client, and mentoring and evaluating the supervisee’s services to clients. These elements are fostered within a learning alliance between supervisor and supervisee[.]

Another competency-related phenomenon is the supervisee feeling that he is an imposter and fearing being found out. They feel that it will only be a matter of time before they are found out to be the imposters that they believe themselves to be. This occurs particularly when the supervisee’s actual competency exceeds that of their felt competency.

I hold a Master's degree in Counseling and a Doctor of Philosophy degree in Counselor Education and Supervision from the University of Texas at San Antonio.I have provided consultation and training to a variety of graduate students enrolled in the clinical and mental health program as a professor in the Graduate Counseling Program at The University of Texas at San Antonio.I have over 9 years of experience providing mental health and addictions-related counseling services to adolescents, adults, and elders in a variety of different settings.

David Kent’s story shows that regular exercising improves, not only your physical well-being, but also your mood. Studies have shown that exercising can treat mild to moderate depression as effectively as antidepressants. In one study, James Blumenthal, a clinical psychologist at Duke University, assigned sedentary adults with major depressive disorders to one of four groups: supervised exercise, home-based exercise, antidepressant therapy, or a placebo pill. After four months Blumenthal found that patients in the exercise and antidepressant group had the highest rates of remission. In his conclusions, he stated that exercise has more or less the same effect as antidepressants.

In one study, James Blumenthal, a clinical psychologist at Duke University, assigned sedentary adults with major depressive disorders to one of four groups: supervised exercise, home-based exercise, antidepressant therapy, or a placebo pill. After four months Blumenthal found that patients in the exercise and antidepressant group had the highest rates of remission. In his conclusions, he stated that exercise has more or less the same effect as antidepressants.

research team in Italy examined bipolar patients during the time when they were in this stable, inter-episode phase. Next, under careful clinical supervision, they sleep-deprived these individuals for one night. Almost immediately, a large proportion of the individuals either spiraled into a manic episode or became seriously depressed. I find it to be an ethically difficult experiment to appreciate, but the scientists had importantly demonstrated that a lack of sleep is a causal trigger of a psychiatric episode of mania or depression.

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