“Is it okay to ask…?”

Beyond Caseload Updates: Expanding the Conversation in Clinical Supervision 

Case-based discussions

-- about formulation, treatment planning, managing risk, or overcoming roadblocks in therapy – undoubtedly constitute a substantial part of the typical psychologist’s supervision agenda. And rightly so: these conversations are essential for maintaining high standards of competency, effectiveness and ethics in our clinical practice. But supervision is like one of those multi-tool Swiss army knives, and sticking to caseload updates is akin to using the nail file for everything when you’ve got all those other useful things tucked away inside that shiny red handle. 

I love it when supervisees say “I’ve got something a bit different today” or “I’m not sure if this is the right place to bring this, but…”. Here are my suggestions for five topics that move beyond the usual case updates and will add value to your supervision and to the clients you serve.

The psychologists’s self 

Each of us brings our own values, experiences, and beliefs into the therapy room, and exploring the ways in which these get activated when we are at work helps us to become more aware of our blind spots. It’s impossible not to have emotional responses to the people we work with but it is not always easy to acknowledge these. If countertransference can be reframed as a valuable source of clinical information, rather than as evidence of our shortcomings as psychological therapists, and if we can use supervision to examine our emotional triggers, we foster our capacity to regulate ourselves with self-compassion. Attending to the person behind the professional in supervision also buffers against stress, burnout and vicarious trauma, for example. 

Professional confidence and identity development 

The dreaded imposter syndrome is familiar to many of us. A desire to “get it right” because we care deeply, and an intense training programme that involves high levels of pressure to achieve and more or less constant assessment, can both contribute to this. No amount of experience immunises us against feelings of self-doubt, and supervision can be a great place to reflect on the kind of psychologist you want to be, to explore changing values and priorities, and to scaffold those moments where our own inner critics get the better of us. Supervision can also be a space for planning and mentoring around longer-term career goals: by providing feedback on strengths and areas for development, suggesting training or research opportunities, and connecting you with wider networks, your supervisor can be a valuable ally in fostering a sense of direction and the motivation to pursue it. 

Organisational and systemic factors 

Understanding the organisational ecosystems in which we live and work, how they make us feel, and the roles we get pulled and pushed into, is another valuable topic for clinical supervision. Talking about these dynamics in supervision can help us to step back and make sense of what’s happening in the systems around us, and to plan any actions needed to protect ourselves and others against these pressures and to effect change from the inside. 

Cultural and diversity awareness 

Noticing differences in identity, privilege and experience – both visible and invisible – is at the heart of therapeutic relationship-building. Supervision can help us stay curious about the ways in which our identity shapes the way we conceive our clients’ experiences, fostering more inclusive, culturally sensitive and competent services. We don’t have to ‘know everything’: a sense of humility, a willingness to think deeply, and a supervisory relationship that offers safety and reflective capacity are an excellent start.

Supervision of supervision 

Last but not least, supervision is an excellent place to bring dilemmas and challenges from our work as clinical supervisors. Managing relational dynamics with a supervisee whilst keeping client welfare, best practice, and organisational context firmly in mind is a complex task – no less so than direct client work – and it’s so helpful to be able to think things through with an experienced supervisor. This focus on the process of supervision also provides an important quality assurance mechanism for the profession. 

-Becca

Book supervision with Becca HERE