Supervision

Psychotherapy supervision involves the joint examination of a psychotherapist's or trainee's client work together with a supervisor. The aim is to support the supervisee's professional learning, development, and occupational wellbeing. In training for the profession, supervision has traditionally served a quality assurance function.

Psychotherapy is the exploration of a client's expression — its meanings, emotional content, and the referential relationships between them. It is important for the therapist to find their way to 'where the client is'. Psychotherapy is work toward understanding what kinds of objects the client is engaged with, how movement from one object to another proceeds, and what the central problematic configurations and ways of coping with them are. The aim is to find contact and participation with the client's problematic experiences, so that possibilities for change in how they are approached can open up.

This task requires theory about the problem being treated, models of change, methods, and treatment goals (Valkonen, 2012; Wampold, 2002, 2010). Theoretical frameworks are tools for examining and structuring the client's expression and phenomena arising in the therapy process. Theory helps focus the work, identifying and prioritising configurations and themes important to psychotherapy from the material the client produces. Valkonen (2012) has described this as navigation using a map and its associated symbols — theoretical concepts — through the terrain of the patient and therapeutic relationship.

Psychotherapy supervision also requires theoretical concepts and maps to guide the progress of the work. The psychotherapy supervisor has developed a framework — or several different orientations — through their training, life experience, and reflection on their own practice. Drawing on these, they listen, empathise, observe, and interpret the client's and therapist's expression, interaction, and the emotions and other phenomena of the therapy process. The supervisor applies both their empathic understanding and the conceptual frameworks of their orientations in examining the material brought to the supervision session and in commenting on the supervisee's observations, reflections, and questions.

Case supervision can be based on the supervisee's verbal description of their client's situation, actions, events during sessions, and the quality and course of interaction. The supervisee describes their own feelings and thoughts arising during the therapy session, after it, or over the course of a longer therapy process. In addition to verbal descriptions and reflections, direct audio and video recordings of sessions and their transcriptions can serve as material for psychotherapy supervision. By watching and listening to recordings, one can follow the stages of the collaborative relationship developing between the client and the therapist: how the client positions themselves in the interaction and tells their story, how the therapist reaches the client's expression and responds to it, how the client receives this.

The psychotherapy supervisor supports the supervisee in the conceptual gathering and case formulation of the material brought to supervision. The aim is to identify the configurations and modes of action maintaining the client's problems and symptoms in order to sharpen the focus of the work. The concepts of Dialogical Sequence Analysis were developed in the context of psychotherapy supervision and are well suited to this purpose. (Soile Tikkanen, 2020)