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Theses Doctoral

A Qualitative Investigation of the Nature of ‘Informal Supervision’ Among Therapists- in-Training

Coren, Sidney Alexander

The primary aim of this study was to investigate the ways that beginning therapists utilize ‘informal supervision’, the process wherein therapists in training engage individuals who are not their formally assigned supervisors in significant conversations about their clinical work. Because the research literature on formal supervision does not adequately acknowledge the frequent use and significance of informal supervision, this study sought to provide a comprehensive understanding of why therapists in training seek informal supervision, what they get out of it, how informal supervision differs from formal supervision, and how it influences trainees’ clinical work and their developing therapeutic identity. Participants were 16 doctoral trainees in clinical and counseling psychology programs. Semi-structured interviews were conducted and analyzed using the Consensual Qualitative Research (CQR) method.
Eleven domains emerged from CQR analysis, and results suggest that informal supervision is a valid practice by which trainees in clinical and counseling doctoral programs in psychology develop clinical and professional competencies. The valuable practice of informal supervision was evident in a multiplicity of arenas: in seeking informal supervision, trainees received validation, reassurance, and emotional support. Additionally, trainees used informal supervision to openly and authentically discuss personal anxieties and self-doubt, strong countertransference reactions to patients, and salient clinical challenges and mistakes. Trainees who used informal supervision gained insight into their clinical work, explored diverse approaches to clinical interventions, and increased their capacity to access and use their personal reactions to patients to further their clinical work. Results also revealed important differences between formal and informal supervision, specifically that informal supervision provides trainees with a unique and important space to discuss clinical interactions that lead them to feel emotionally dysregulated, overwhelmed, confused, concerned, upset, and drained – i.e., those aspects of experience that are often not disclosed or are carefully curated in their presentation to formal supervisors – so that they could better understand and use their personal reactions to influence their clinical work. Regarding the former, i.e., personal challenges of clinical work, trainees revealed their personal anxiety, self-doubt, uncertainty, and shame frequently and non- defensively in informal supervision. Lastly, results showed that participants’ concerns about using informal supervision are considerable, and include anxiety about breaking APA’s ethics codes regarding patient privacy and confidentiality
Recommendations are proposed for clinical practice and clinical training, including an ‘ethical’ proposal to integrate informal supervision as an important avenue for trainees’ clinical and personal development throughout their training, and thus legitimize its practice. Clear and innovative ethical guidelines regarding the use of informal supervision that are consistent with the APA’s ethics codes are outlined, and future directions are discussed.

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More About This Work

Academic Units
Clinical Psychology
Thesis Advisors
Farber, Barry A.
Degree
Ph.D., Columbia University
Published Here
October 24, 2017