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Supervision
I offer supervision to therapists or trainees at the rate of £45 per 50 minute session. Here are some points on Gestalt supervision.
Gestalt therapy is an existential therapy that emphasizes existence as people experience it and de-emphasizes abstract explanatory schema. Gestalt therapy methodology is phenomenological, using and refining immediate experience or felt sense rather than interpreting the unconscious.
Gestalt therapy supervision use phenomenological focusing and experimentation to clarify the exact experience of supervisor, supervisee, and clients. Supervisees are helped to put aside inferences, assumptions, interpretations, theoretical beliefs, and so forth so they can be impacted by the obvious ("the given"). Special attention is given to the awareness of the awareness process, especially to how awareness is limited or distorted, and to awareness of the here-and-now contact between therapist and client, and between supervisor and supervisee.
Gestalt therapy thinking is based on field theory (Yontef, 1993). A field analysis regards all phenomena through the lens of a "field". Fields are complex wholes composed of multiple forces interacting in the here and now (principle of contemporaneity) and changing over time (process). In field theory, all phenomena are considered as processes changing over time rather than as static structures. Phenomena are not known absolutely -- but can be known only from some perspective.
Gestalt therapy supervision encompasses as much of the whole field and its multiple interrelating aspects as possible (e.g., biological, social, individual, family, cultural). The supervisor helps the supervisee relate to the entire context in which they operate and the various factors that come into play. This includes appreciating the inevitable existence and phenomenological validity of different perspectives. Using field process thinking, Gestalt therapy emphasizes contemporaneous relations in the field as they are experienced at any one time and as they develop over time ("process"). In the field, process approach development or action over time is emphasized over static, structural thinking.
In field theory all existence is relationship, from electrical charges of subatomic particles through the cosmic movement of star systems. Human identity is a matter of relationship between "me" and "not me", between self and other. In Gestalt therapy theory contact between organism and environment is considered the "simplest and first reality" (Perls, Hefferline, and Goodman, 1951/1994).
Gestalt therapy personality theory is a radical ecological field theory. Most theories assume the separate existence of individuals and environment and then add interaction. Not so in Gestalt therapy, in which the individual and the environment are considered only phenomenological differentiations of the organism/environment field (Perls, Hefferline, and Goodman, 1951/1994, p. 3; Yontef, 1993). A Gestalt therapy understanding always relates individuals to a context or field - in Gestalt therapy there is no other meaningful way to understand a person. From birth onward, people for their sense of self through relationship to others.
The basic unit of relationship is contact. Contact is what one is in touch with and is the basic unit underlying both awareness and motoric behavior (Perls, et al., 1951/1994). Gestalt therapy aligns around two forms of contact: Awareness and relationship. The goal is increased awareness (being in contact with self and other), the medium is contact between therapist and client and between supervisor and supervisee. True to the existential and phenomenological basis of Gestalt therapy, the Gestalt therapist makes contact on the model of an existential dialogue.
Dialogic Relationship in Supervision
The heart of Gestalt therapy is its view of the nature of the contact between therapist and client. The therapeutic relationship in Gestalt therapy is based on a special form of contact called the existential dialogue (Hycner, 1985, 1991; Jacobs, 1989, 1992; Yontef, 1993). This relationship has three major characteristics. 1) Inclusion: The therapist empathically experiencing the closest possible approximation to the experience of the client and thereby confirming the client's human existence. 2) The empathic understanding is communicated through the therapist's genuine, congruent, authentic, and caring presence and genuine and unreserved communication. The therapist shows warm acceptance and respect and is appropriately transparent, vulnerable, congruent, and authentic. 3) The Gestalt therapist is committed to dialogue, surrendering to the between. This is a form of contact without aiming, with truth and healing emerging from the interaction rather than already known by therapist or client.
Gestalt therapy supervision is a modified form of dialogue, one that helps the supervisee dialogue with clients. In Gestalt therapy, meeting the client and facilitating the client's growth is the only goal. The client is an end in him or herself and not a means to an end. Although Gestalt therapy has a dialogic attitude toward supervision, supervision also has the goal of the supervisee serve the needs of his or her clients. To some extent this makes the therapist a means to an end rather than an end in him or herself and the I-thou interspersed with more I-it than in the psychotherapy dialogue. However, The Gestalt therapy supervisor makes the relationship as dialogic as possible.Components of Supervision
Supervision has the goals of meeting societal and agency needs, the growth of the therapist, and the protection and growth of clients. The work is done through administrative, educative, and consultative components. The concentration of the three components varies according to context and stage of learning.
Administrative Component in Supervision
Administrative supervision from a Gestalt therapy perspective is a process of creative adjustment, i.e., helping the supervisee adjust to the system and also giving support and guidance for responsible fighting for social change both within the agency and within society. The supervisor helps supervisees bring their viewpoint to the larger field. Neither blind conformity nor blind rebellion is condoned.
Supervision is creative adjustment
Through boundary processes people engage in creative adjustment, i.e., adjust to the environment and also adjust the environment to the self. "All contact is creative adjustment of the organism and environment (Perls et al., 1951/1994, p. 6)". People must adjust to the environment in which they live, else they are outcast, dysfunctional, or are a hazard to others. But, merely adjusting to the environment is conformity without creativity. People also need to adjust the environment to them, i.e., shape the environment so that it conforms to human needs and values.
Gestalt therapy focuses on awareness of the awareness process, i.e., what one is aware of, what important information or feelings are not allowed to come into figural awareness, and precisely how people control what is allowed to come to awareness. Immediate experience is a clear sensing or contemporaneous knowing of the obvious, the "given", (i.e., what stands out as figure), and the meaning, (i.e. the relationship between the figure and its background). In health, figure formation and action taken are organized by the dominant contemporaneous need. By the phenomenological work of differentiating what is immediately experienced from fixed statements about experience, the process of interrupting awareness and action based on awareness comes into awareness and becomes open to conscious choice.Supervision-Educative function
The educative component of supervision is centered on the teacher or supervisor imparting knowledge to the supervisee. In this mode the supervisor has a plan of what the supervisee needs to know to facilitate professional development. This includes what the supervisee needs to know to treat his clients, what the supervisee needs to know for professional development, and any particular knowledge, expertise, or special interest of the supervisor. Although Gestalt therapy is distinctly experiential, didactic teaching is an indispensable part of Gestalt therapy supervision. For example, Gestalt therapy philosophy and methodology is a supervision teaching topic with both Gestalt and non-gestalt supervisees.
Consultation in Supervision
The consultation component of supervision is supervisee centered. It is oriented to the supervisee's growth and to assisting the supervisee with specific problems, issues, and concerns. These are usually about clients. This segment is the most experiential and the most focused on the therapist/supervisee as a person. Its three dominant topics of understanding are: 1) therapy systems and methodology; 2) client character structure and therapeutic requirements; and, 3) self-understanding (especially countertransference).
Each therapist must have an understanding of psychotherapy process (i.e., methodology), the character and needs of each particular client, and self-understanding. Each therapist needs to have a good understanding of factors generic to all psychotherapy, but also needs a clear and integrated understanding of the particular form of therapy they practice. A Gestalt therapist obviously needs to know the clinical and metatheory of Gestalt therapy in addition to generic factors.
Consultation especially focuses on understanding particular clients and particular clinical issues. Although many issues that need to be explored run across patient categories, understanding the client is of prime importance. The supervisor helps the supervisee gain a full four dimensional picture of each client, including character structure, social history, expected course of therapy, cautions, and particularities of treatment. The understanding needs to be in-depth rather than simplistic, and account for changes over time rather than static.
The consultation process must also help the supervisee to understand their own process, including their preferences, values, needs, the degree and type of dedication to the task of helping clients, their perspectives on relations (e.g., dialogue or fostering transference), and their stance on the importance of client self-determination. According to the theory of Gestalt therapy, good therapy cannot be done unless the therapist understands his or her own biases and emotional reactions, including but not limited to countertransference.
In Gestalt therapy, all emotional reactions are not considered either transference or countertransference. Emotional reactions to the client's work and the interactions with the client that are in awareness and present-centered, albeit influenced by the therapist's background history, need to be differentiated from emotional reactions triggered by the interaction with the client that are determined by forces from the therapist's past and relatively out of awareness. Having an emotional reaction to the client that is motivated unknowingly by a characteristic of the therapist or someone in the therapist's background is very different than a reaction that is largely reactive to what is actually happening. One of the biggest dangers to clients is when the therapist has an emotional reaction, especially a defensive one, and does not know and admit it.
The most obvious examples are when the therapist has a warm, sad, protective, or affectionate response to the client. When it is countertransferential, the response might be because of codependence or the client resembling someone in the therapist's past. When out of awareness, it might be a part of forming an inaccurate picture of the client, failure to make a timely interventions, or even an indulgent attitude enabling client irresponsibility and failure to grow. On the other hand, when the therapist accurately sees the client and knowingly is affected, e.g., feeling warm, affectionate, and so forth, a verbal or nonverbal expression of this feeling can be extremely important to the client.
Clinical example: A supervisee reported a feeling of cold resentment and withholding toward a client. Description revealed a very needy client who repeatedly presented crises, expected solutions from the therapist, did not take responsibility for work in or out of therapy, acted pathetic and helpless, and repeatedly left the therapist with a message of having let her down. The client was a borderline client and many therapists would have a feeling of shame or failure, resentment, guilt, and so forth in response to her. For this young trainee there were not only the feelings of frustration that came from the poor boundary regulation of the therapeutic relationship, but a strong countertransferential element in that the client was very much like the therapist's mother.
When the supervisee realized that the client elicited unfinished business with their mother, they were able to separate the transferred feelings and work on them in their psychotherapy. But this was not enough. Learning about the dynamics, boundaries, sequence of treatment with the borderline client enabled him to be present in a way that was more contactful, making clearer the therapeutic frame and limits, and make interventions (empathic reflections, interpretations, and guided experiments) that were more effective in getting the client more centered and in a better position to do the necessary therapeutic work.
Another form of self-understanding that consultation clarifies is recognizing the therapist's limitations and strengths so that practice can be limited to what is within the therapist's training and competence, clients properly informed of these limits, and when the client's needs are beyond the therapist's training and ability, self-understanding can guide the therapist to either refer such clients to other therapists and/or get special training and/or supervision as needed.
Gestalt therapy consultation helps supervisees broaden their thinking to include different perspectives and alternative interventions. Consultation from a Gestalt therapy perspective has brings to figural awareness alternative ways of understanding and/or intervention, either already existing or spontaneously created. A special characteristic of Gestalt therapy practice and supervision is the creating of phenomenological experimentation. Gestalt therapy and Gestalt therapy supervision cannot be manualized without doing violence to its very nature (Yontef, 1995).The Therapeutic Relationship and the Goals of Supervision
Supervision has the goals of the growth of the therapist and the growth and protection of clients. Continued growth of the therapist is a major supervision objective at all levels of experience and competence. While administrative supervision might be considered successful if the therapist reaches a fixed or mandated standard, consultation is oriented to open-ended growth. But consultation is also supervision and the growth work of the therapist is constructed around improvement of client services, i.e., the increased effectiveness, satisfaction, and creativity of the therapy.
Growth in supervision and therapy is through the medium of relationship. In consultation, as in therapy, the Gestalt therapy attitude about relationship is to be as dialogic and horizontal as possible consistent with the primary goals. It is the responsibility of the supervisor/consultant to set an atmosphere conducive to learning. This includes acceptance of the person of the supervisee, even while working with weaknesses, flaws, and lack of self-support. The conducive atmosphere encourages striving for excellence through experiencing and experimenting -- rather through imitation and/or perfectionistic harshness.
A safe learning environment is one in which the supervisee feels safe and cared for and leaves supervision sessions with a more accurate and accepting sense of self as person and therapist. To the degree that this is not the case, the atmosphere is not safe and learning is diminished. Of course, when the supervisee does not meet minimal standards, the establishment of such a psychologically safe environment is quite difficult.
The growth of the therapist through the supervisory dialogue is a model for the growth of the client through the therapeutic dialogue. The consulting and therapeutic relationships in Gestalt therapy both have the same characteristics of dialogue: Inclusion/empathy, presence, and commitment to dialogue. The supervisor is attuned to the experience of the supervisee, and through him or her, the experience of the patient. The supervisor is attuned to what the supervisee experiences in the supervision session and also in the session with the client.
Of course, supervisee growth, client growth and protection, and agency requirements can conflict and bring about a tension that affects the supervisory relationship. But the supervisor can continue to be empathic, authentically present, facilitate dialogue even through this tension.
Since there is usually at least a minimal hierarchical relationship between supervisor and supervisee, and hopefully the supervisor does know more than the supervisee, supervision can be a fertile ground for growing shame (Yontef, 1993; 1996). Shame, the globalized sense of not being enough, can be enhanced or decreased in supervision -- depending largely on the attitude of the supervisor.
The Gestalt therapy supervisor is present as a person, not just as an authority -- present with warm authentic, and disclosed presence and genuine and unreserved communication. It is important that the supervisor's flaws be allowed to show and be acknowledged by the supervisor so that a vertical relationship is not established, i.e. one in which the supervisor is inordinately elevated into charismatic stature and the supervisee demoted to a lower caste -- admiring the supervisor's flawlessness. The vertical relationship is a potent shame trigger. When the supervisor is present as a person and the supervisee's experience explicated and respected, then a real dialogue is possible.
In a supervisory or therapeutic dialogue, the supervisor or therapist does not aim and control the interaction, but rather is committed to dialogue, to surrendering to what transpires between the participants. The factor of not aiming is modified by administrative supervision and client protection requirements. However, the Gestalt therapy supervisor maximizes the dialogue and makes the relationship as non-authoritarian as possible.
The philosophy of Gestalt therapy takes a very strong stand on respect for differences: The phenomenological base of Gestalt therapy requires respect for multiple valid realities. Even though the supervisor may have a distinct point of view and a responsibility for the client's welfare, the supervisor in the Gestalt therapy model must respect supervisees' felt sense of the situation with the client, sense of what support is needed in supervision to increase their therapeutic effectiveness, and the fact that each therapist has a somewhat different set of values, skills, creative supports, weaknesses, and so forth.
Self-examination is indicated when supervisees come to resemble a supervisor too closely. If the therapist is to help the client identify with themselves, then the therapist has to be able to do the same. The job of supervisors is to encourage clear differentiation between themselves and supervisees.
In order to improve supervisees' effectiveness as therapists, personal self-esteem must be enhanced and their confidence as therapist increased. An important part of this process is the supervisees learning to have self-esteem while acknowledging flaws. Shame-prone supervisees will need help with their shame and with understanding the shame process if they are to be able to be honest about weaknesses and still not be lost in shame or shame defenses (Yontef, 1993; 1996). Of course, it is necessary to distinguish between flaws and weaknesses needing remediation and those to be accepted.
Beyond the process of meeting minimal standards and understanding the orientation of the supervisor, the supervisee needs help in developing his or her own unique style of therapy. Gestalt therapists take a strong stance in favor of encouraging creative professionals and not skilled technicians. That means that there is not a right way to do therapy, and not all therapists can or should do therapy with the same style. Moreover, the style of a therapist evolves over time and needs creative adaptation to individual clients and settings. This contrasts with a any view of orthodoxy and/or manualization.
Gestalt therapy is an integrative framework for therapists. Some who are supervised by a Gestalt therapist but are not Gestalt therapists may have a different framework. But a framework is needed, preferably one that allows integration of insights, data, techniques, and so forth from a variety of sources.
In Gestalt therapy supervision this framework is constructed, not introjected; organismic framework construction requires assimilation. As therapists assimilate, as they apply their healthy aggression to destructing the material they are taught and struggle to make sense of their clients' character, the therapy process, and their own reactions, they will optimally develop their own personal framework for integration -- one that recognizes their strengths, weaknesses, interests, and values. Supervisees who are able to organismically regulate themselves are more likely to facilitate the same in their patients.
I believe that the responsibility and authority for the consultation work of supervision are shared by supervisor and supervisee. While there are administrative supervisory responsibilities that cannot be delegated, the educative and consulting components can be shared and in Gestalt therapy are shared.
The ultimate organizing idea of supervision is, of course, the welfare of the client. Supervisees and supervisors have responsibilities in this task that are not shared. Supervisees have the responsibility of bringing into supervision accurate and representative data, especially of difficulties, and defining their own needs to the supervisor. Supervisors have the responsibility of giving honest and clear feedback, suggestions, and evaluation. Both have the responsibility of recognizing ethical and competence limits.
However, there is more flexibility when the supervision is primarily consultative and there is no administrative responsibility. When a supervisee wants deeper exploration and is at an advanced competence level as a therapist and has sufficient experience as a client in psychotherapy, spending time in consultation on psychotherapeutic endeavors can be quite beneficial.
It often happens that the supervision moves from the description of the client, to discussion of the interaction, to realization of a countertransference block of the supervisee. Working with this in the direct, Gestalt therapy experiential manner can be very effective. In certain circumstances there are advantages to having experiential exploration in the supervision process. Working experientially can dissolve blocks in therapist functioning that would not be resolved by therapy alone or by more didactic or intellectualized approaches to consultation. On the other hand, having the data of the supervisee's functioning as therapist opens certain avenues of exploration of personal functioning that might not be obvious in the usual therapeutic context.Methodology of Gestalt Therapy Supervision
Supervision is largely working with supervisees in order to address the needs of clients. It is helping therapists to better help clients. This is done in administrative supervision, educative supervision, and consultation. The major categories of education and consultation are understanding the character of the patient, understanding therapeutic methodology and application to the particular patient, and explicating countertransference.
It is in line with the theory of Gestalt therapy that the boundaries be made clear between supervisor and supervisee. This includes expectations, requirements, goals, methods, time frame, evaluation procedures, consequences, and so forth. A clear structure is necessary to enable the flow of free and creative process, for freedom and creativity require structure and discipline. When the general direction of the supervision is agreed on, then the supervisee is given maximum freedom to direct the supervisory work and apply the principles according to his or her own unique values, personality, and contemporaneous needs.Experiential Method: Preference for Description
Gestalt therapy supervision favors descriptive methods rather than intellectualized explanatory method. Supervisees are trained to separate the continuum of immediate experience (awareness) from assumptions and explanations. This is consistent with the phenomenological and field theory base of Gestalt therapy. Immediate experience is descriptive and includes straightforward observations of internal sensations, categorical and vitality affects, and external observations. Phenomenological work involves focusing on and reporting the continuum of awareness. This focusing is the methodological heart of both Gestalt therapy and Gestalt therapy supervision.
Of course, Gestalt therapist supervisors use the usual talk-about procedures that most supervisors use. However, our preference is to be experience-near, horizontally dialogic, and experientially experimental.
Role-playing is frequently used in individual and group supervision and can be very effective. The supervisee can play the client and the supervisor or another group member can be therapist. Various forms of role reversal can be used. This technique can enable the supervisor and supervisee to transmit more holistically detailed information than summary statements. The supervisor being therapist in the role-playing communicates a more complete and subtle picture than is possible with more abstract methods.
In role-playing, various group members can take a turn with different approaches to being therapist, while the therapist can play his or her patient and experience an approximation of what it is like. Role-playing enables supervisees to experiment with new approaches, experience how it feels, then can work on the technique or their feelings and modify the technique before experimenting directly with the client.
Sometimes clients volunteer to have a session at a consultation group. All of the superiority of direct observation is present, plus the possible gains for the client of getting feedback from persons other than the therapist. Naturally the feedback to the client is done with discretion and there is usually a separate feedback session with the therapist after the client leaves. The chief drawback on this method is the anxiety and potential shame experience of both therapist and client and the difficulty of making these arrangements. The safety and effectiveness of this method depends on the discernment and sensitivity of the supervisor and the group.
As in therapy, creativity and experimentation in supervision is encouraged with focus on the here and now. For example: Young male therapist talked about a client he seemed to be frustrated with. He talked about the patient's character, behavior, and history. The client was a young borderline with a background of being abused and still in a dysfunctional mode of functioning.
The supervisee's face was tight -- like a mask -- his voice clipped. Supervisor: "What are you experiencing right now?" With some intermediate experiential facilitation the supervisee realizes that he was frustrated and angry at the client, and feeling ashamed of that. His tight musculature and voice were signs of defense against shame affect. Further exploration revealed two introjected assumptions, but that were previously beneath his threshold of awareness. He believed that he should be caring and not feel frustrated with a client; he believed that he should be able to quickly move any client beyond their stuck point. In his eyes he had failed on both counts, hence the feeling of shame.
Both beliefs were contrary to his actual experience with the client and contrary to the supervisor's belief that therapists have feelings and it is not their job to move clients. The supervisee found it helpful to have the shame expressed, and discover that the supervisor felt much more positive toward the supervisee than the supervisee felt toward himself and also found another belief system to think about. Over a period of time the supervisee's harsh self-demands were discussed as well as what was reasonable to expect in learning to do therapy, how to treat borderline patients, what was reasonable to expect in the course of such therapy, and how to understand his own feelings as a therapist.Role of Theory in Supervision
Gestalt therapy's reputation for being pejorative about the value of intellectual discussion makes it important to clarify the role of theory in Gestalt therapy supervision. I believe that an adequate level of theoretical understanding is indispensable for a Gestalt psychotherapist, and an even higher level of theoretical understanding is required for a supervisor or trainer of psychotherapists. Gestalt therapy that is effective and safe must be guided by understanding the basic principles. Without knowing the paradoxical theory of change, field theory, phenomenology, dialogic existentialism, the principle of contemporaneity, organism/environment field, contact boundary and boundary disturbances, figure/ground formation and destruction cycle, role of experimentation, the Gestalt therapy theory of anxiety and impasse, and so forth, trainees are likely either to do a hodgepodge "eclectic" therapy, turn Gestalt therapy into a form of encounter group or undisciplined behavior modification, or even into a diluted and undisciplined psychodynamic variant. For the Gestalt therapist supervising non-gestalt therapists, a firm theoretical understanding is necessary to build a bridge between the Gestalt therapy perspective and that of the non-gestalt supervisee and to translate between the various systems and systems' languages.
Theory is not only a guide to the methodology of the therapy system, but also to the needs of persons with particular character structures, or the needs of particular contexts. It can also be a guide to the needs of a supervisee or trainee. For example, a trainee who had difficulty getting and providing a clear focus on important issues when working with clients, benefited from a phenomenological focus in supervision and therapy on his awareness continuum and his obsessive interruption with small details. Learning about the phenomenological perspective (e.g., bracketing, recognizing the obvious, stay with immediate experience and allowing explanatory understanding to come later) helped him understand better how to work with clients.Parallel Process
As the work proceeds in supporting the therapist, focusing on and protecting the client, there often arises parallels between the dynamics of the client-therapist relationship and that of the supervisor-supervisee relationship. The therapist sometimes does to the supervisor what the client does to him/her, and conversely, the therapist often does to the client what the supervisor does to him or her. Hopefully this latter is more benevolent parallel process, but not always. For example, a sarcastic supervisor may result in the therapist being sarcastic with the client. Another example: A supervisee repeatedly brought up difficulties with a particular client and asked for suggestions. To each suggestion the supervisee's response was "Yes, but ..." Then I suggested he role play the client. Lo and behold: The client clearly asked for help and then said "Yes, but ..." in response to all attempts to help. In this case the therapist was too "helpful" instead of exploring process and elicited the same behavior from the supervisor. The supervisor needed to explore what was happening in the supervision process to facilitate the therapist doing the same with his client.
Sequence of Supervision
Supervision is a process, it develops over time. It matures with the experience of the supervisee, the assimilation by the supervisee of what the particular supervisor has to offer, and the ripening of the supervisory relationship. The stages are not clearly and definitively delineated in Gestalt therapy theory, but here we can present a preliminary discussion of the process.
Supervision often moves from a predominantly administrative, authority-based supervision to a more education-oriented supervision and then on to pure consultation. The degree of oversight necessary for students obviously differs from that necessary for experienced clinicians. A licensed therapist who comes to a privately engaged consultant has a very different supervisory relationship than a graduate student with an assigned administrative supervisor in an agency.
The beginning phase goes from the first contact until there is a clear working relationship in which structure is established and there is at least a minimal level of trust. The clearer and better the foundation at the beginning, the more support there will be for education and consultation to succeed.
Structural clarification includes the mundane, e.g., time and place for supervision sessions, whether the supervision will be over the entire caseload of the supervisee or intensive supervision of a part of the caseload. What will be the source of data?
It is important at the beginning of supervision to clarify requirements, expectations, goals, and the evaluation process. Among the issues of evaluation that need clarification are: What will be evaluated and by what criteria, when and how will evaluations be made, who will make them, to whom will they be reported, how will the evaluations be communicated to the supervisee, will the supervisee have a chance to react before it becomes a part of his or her record, will the supervisee have the opportunity to evaluate the supervisor and/or the evaluating process? Will evaluations be geared to minimal standards, or will excellence also be noted? What are the consequences that flow from the evaluation? In some settings evaluating criteria have been changing from patient welfare to how few sessions the therapist can get by with. When criteria are not in the welfare of the patient or fair to the supervisee, efforts to change the system is part of the responsibilities of both the supervisor and supervisee.
Ideally the early journey of supervision moves toward mutuality and cooperation in working together. The more clearly the structure is established in the beginning of supervision, the more middle and later phases of supervision can focus on education and consultation with a minimal intrusion of authority issues. The Gestalt therapy supervisor in the consultant mode has the question "How can I help?". It is best if the supervisee takes the most active lead in setting the focus. The supervisor and supervisee dialogue and focus to find what is useful and what is not useful for that particular supervisee at this particular time in this particular context.
As structure is established in this beginning phase, as the dialogue begins and advances, trust is built and standards set ("How do you know when you do a good job?"). Ideally expectations become more realistic, a more trusting relationship develops, and the supervisory work becomes more sharply focused on advancing knowledge, addressing weakness, and building on strengths.
The supervisee gains in clarity about his or her responsibility for defining need, asking for the kind of help needed, and for being receptive to the help when offered. Both supervisor and supervisee learn to respect the supervisee's need for autonomy and individuality. The supervisee learns that the process and effort of supervisor, supervisee, and patient needs to be respected and outcome alone is not an adequate standard for judgment. In all phases, both supervisor and supervisee need to monitor what is helpful, what feels bad but is helpful, and what is hurtful and injurious.
As in therapy, various forms of resistance arise in the beginning phase of supervision.Interferences
Resistance, impediments, and barriers are a vital part of the life process. Without resistance there is no life. In Gestalt therapy the client's avoidance of awareness (resistance to awareness) is one of the most important processes that is brought into awareness. By identifying these processes and identifying with them, the choices the client makes no longer have to be made by habit and without awareness, they can be made with full awareness and discrimination of needs and dangers. This is also true in supervision.
Unrealistic expectations by supervisor, supervisee, or agency impede the learning of the supervisee and diminishes the quality of psychotherapy practice. One example is wanting, or needing to give simplistic or magic answers to complex issues. If either the supervisor gives or the supervisee accepts easy answers, it obscures and distracts from the hard work of exploring, learning, experimenting.
One interference with learning is to avoid working on understanding difficult client, issues, or countertransference by simply getting rid of difficult clients and avoiding supervisory work that might lead to increased self-support of the therapist and improved quality of treatment for the client. Sometimes supervisees will avoid improving understanding and practice by dismissing the lack of progress of a client as due to diagnosis, e.g., because he or she is a borderline or has a narcissistic personality disorder.
Another interference is the need to be admired and have disciples. Although the supervisee can have this difficulty, e.g., with clients, in this context the interference is by the supervisor. Many supervisors who have this narcissistic need be adulated and looked up to, cannot acknowledge the need. Thus, parallel to the countertransference of a therapist taking positive transference as if literally true because of the therapist's need for confirmation and narcissistic gratification from the client, the supervisor can take the admiration of the supervisee as if literally true out of the need to be a charismatic leader.
An obvious interference with good supervision, is the supervisor not wanting to be a supervisor or the supervisee not wanting to be supervised. This is especially likely in agency settings where the supervision is an extra burden on the supervisor, as opposed to the privately engaged consultant, and an imposed requirement for the supervisee.
Of course, the basis of these forms of interference, and the many others not discussed here, involves the expected full range of personality and situational variables, e.g., narcissistic vulnerability, shame and guilt, and so forth.
This has been a detailed look at what Gestalt supervision may entail. There may well be further considerations not included here. There are often very subtle balances to hold in these relationships. There remains , I hope, the ability and non-defensiveness to always look at these balances.
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