I have been leading supervision/practice management groups for over twenty-five years. Recently, I was steering a supervision group and found myself astonished by the depth of the character work done by the group participant. As I reflected upon this extraordinary group session, I asked myself how this level intrapersonal and interpersonal work came to be. This particular group meets every other month for 6 hours. What were the ingredients that created this process?
My first thought was a safe container had been constructed. I firmly believe that there must be something greater than the notion of the group leader launching the foundation of the group culture. I want to understand more about the creation and fundamental components of this safe container.
Is it that the group has been meeting for many years? Is it that the membership has been steady for a while? Is it the level of commitment that the group members brought to the table? The answer to these questions felt like that was not enough. These facts may be pieces of the puzzle, but did not seem like an explanation that connected to the depth of work during this particular meeting.
So, what are the quintessential elements of creating the safe container for mental health practitioners to reveal themselves, their work, and their business practices? How do the group enable attendees to expose themselves and their work at the deepest level? In this group, the exposure level is raised due to the requirement that they bring clients, on occasion, to the group for live supervision. Talk about the level of vulnerability required in this act. They know that live supervision is far less focused with the client and more concerned with the therapist. Clients are mostly a mirror through which exposes the interpersonal process, character, and handicraft of the supervisee.
My objective for this Intervision article is to gather other supervisors to weigh in with a response to the following question. What do they think are the key ingredients of a high functioning supervision group?
After this particular group meeting, here were my musings on the matter. First, I try to abide by this adage attributed to Alex Redmountain as much as possible. “Less judgment and more curiosity. “ I arrive here in my work by believing that each client whether they be a patient or supervisee behaves in a manner that is driven by the following notion. Whatever they do, they do it for the best of all possible reasons. Usually, I do not understand their motivation, but I am consistently interested in discovering their dynamics in order to help their behavior make sense to them and me.
The construction of their world and their associated behavior has to feel appropriate for each individual. Does this mean that I am nonjudgmental? Hell, NO! My judgments serve to fuel my questions and guide my interventions. My aim is to comprehend the appropriateness for them to live and act in such a manner. I believe that this philosophy creates a protected and inviting venue in which the supervisee has the environment to dig deeper into the etiology of their actions.
Secondly, I look for the common connections in everyone’s work in an effort to string the group together like Christmas lights. One of Irving Yalom’s curative factors in his seminal work on Group Psychotherapy was universality. There are commonalities in the intrapersonal construction of mental health practitioners as well as related elements to how they are impacted by their work in psychotherapy. I push relentlessly to foster mutuality in the room. Competition is fine, but cooperation and equanimity is a healthier and safer road for a group to traverse. I will not create a pecking order for the therapists in my supervision group. Competition may be good to motivate them in the construction of their practices. However, if not attended to, it can be highly divisive force hindering an open and caring group process. Competition appears to be more automatic and a lack of cooperation inhibits the development of a safe container.
Thirdly, I attempt to model and facilitate a significant level of empathy. This tone is an effort to insure the development of the maximum level of empathy in the room. Failure of empathy creates negative space between participants. Safety emanating from empathic identification allows supervisees to discuss difficult practice issues such as: client contracts, special deals with clients, money struggles, collection problems, extending credit, sliding scales, missed sessions, etc. It will also create the environment in which their fear of success or failure, their capacity to create a thriving practice, their uncertainties with connecting with a co-therapist, exposing their craft, and the particular work that is most frightening for each supervisee to expose. For example, Erotic countertransference, insensitivity, greed, sadism, and the vast array of negative reactions to clients are all facets of what must find their way into the supervisory group process. This will help to produce a successful and effectual psychotherapist.
Two other ingredients are also a part of my initial list/thoughts on this question of forming the safe container. I expect presence of all the members of the supervision group. What is presence? Bugental described it as the composition of two elements. The first is inter-subjectivity, which is the capacity to tune into oneself and understand what you are experiencing in that moment. The second element is the capacity for emotional expression. These two factors bring each and every member into the process. With all present and accounted for, the group is whole and functioning on all cylinders. This has the potential to make it safe for all. There is no one hanging back with judgments and contempt for another member. The presence of all makes it safe for all.
Ok, last ingredient and then I am going to leave it to my respondents to weigh in about the missing pieces from my ingredient list. I also require authenticity, an extension of presence. With everyone present and interacting, genuine engagement becomes the crux and heart of the group process. With this core in the group culture trust and honesty will be formed and sustained.
So, let me go back to my primary question for writing this case practice issue. What makes a safe container to further the professional and personal development of the person of the therapist? I know that there are many supervisors out there providing critical training for “young” therapists. Are the ingredients of the supervision group different that a therapy group? What do you agree with or disagree with in my list? What would you add to my list of key components? What are the necessary and sufficient conditions for creating the ideal environment to stimulate and nurture the growth of our supervisees?
I am excited by this question and look forward to the responses of my colleagues on this question Share the craft!