The reflective educator

Comfort and challenge: a thematic analysis of female clinicians' experiences of supervision

OBJECTIVE

The supervision of counsellors, counselling psychologists, and psychotherapists is generally perceived to be an invaluable component of training and practice. The present study analysed this process to explore the meanings of supervision and to consider implications for clinical practice and training.

DESIGN

This study presents the accounts of 19 psychological therapists who experienced supervision while working at a London-based women's therapy centre.

METHOD

Demographic information was collected by questionnaire, and semi-structured interviews were conducted to explore aspects of the supervisory experience. The qualitative data were thematically analysed.

RESULTS

Supervision has complex and paradoxical meanings, and it impacts on clinical counselling practice in multifarious ways. Dominant themes highlighted were the usefulness of supervision, specifically support, empowerment, and joining; fear of exposure in supervision versus gaining new information; the comfort versus the challenge of supervision; and supervision as a containing space.

CONCLUSIONS

An experiential model of supervision was developed from the data. This model complements existing models in the field. It could be evaluated and used alongside existing models in various training and supervision contexts. Findings are discussed in relation to the literature on clinical supervision.

Characteristics, beliefs, and practices of community clinicians trained to provide manual-guided therapy for substance abusers

The successful dissemination of empirically supported addiction therapies to community providers requires an appreciation of the characteristics of those practitioners who might be willing participants in this process of technology transfer. Clinicians (N = 66) from 11 community treatment programs associated with six research-clinic partnerships of the National Drug Abuse Clinical Trials Network volunteered to be trained in Motivational Interviewing or Motivational Enhancement Therapy (MET/MI) and were assessed prior to training. The sample of clinicians was heterogeneous in education and credentials, had a high level of counseling experience, reported using a wide range of counseling techniques and orientations, but had limited prior exposure to MET/MI or to the use of treatment manuals of empirically supported therapies. In general, many of the clinicians reported beliefs and techniques that were consistent with their stated theoretical orientation and recovery status. Relatively few participants reported relying on one dominant orientation or set of techniques.

Historically grounding the practice of psychology: implications for professional training

The author explores 3 ways the history of psychology can be made relevant to professional training in clinical psychology. Focusing on the practitioner-scholar model of clinical professional training, he argues that 3 central facets of historical understanding can be wedded to existing goals of professional training: (a) providing an interdisciplinary context for psychology, (b) addressing concerns about humans in the field, and (c) mediating theory-practice tensions that often exist in professional training. Suggestions are also made for encouraging historical understanding as essential to fostering critical self-reflection among students preparing for careers in professional psychology.

Challenges in defining and developing the field of rural mental disorder preventive intervention research

An overview of selected issues and challenges in defining and developing the field of rural preventive intervention research is presented. One fundamental challenge is to clarify the distinguishing characteristics of prevention science in rural contexts. Other challenges are evident in the need to address: the lack of consensus on conceptual and methodological approaches to this field, limited empirical study to date, the tremendous diversity of rural populations, and inconsistencies in the usage of the term "rural". This article suggests the organization of a work group to formulate and implement a clear research agenda. In addition, several general questions are discussed that, if addressed, might serve to better define and further develop the field. These questions concern the implications of multiple approaches to prevention science in rural contexts, the classification of rural populations, the functional relevance of rural residence in the etiology of specific disorders, the application of extant etiological models to interventions designed specifically for rural populations, the conduct of rural area prevention needs assessments, the development of models for collaboration between intervention researchers and rural community stakeholders, and strategies to engage rural residents in preventive interventions.

Treatment manuals in clinical practice

Hickling and Blanchard (1997) [Behavior Research and Therapy, 35, 191-203] summarize the results of treating PTSD patients with a highly structured treatment manual. Presenting a 'clinician's reaction' they argue for the added value of modifying treatment manuals based on the therapist's clinical experience and claim that manuals do not provide complete treatment of patients' multiple problems. In response, I reiterate that actuarial prediction is usually superior to clinical judgment, address the treatment of co-morbid psychopathology, underscore the importance of specific therapist skills in implementing manual-based treatment, and point out ways in which manual-based treatment can be more flexible and individualized than Hickling and Blanchard imply.