Jan Skjerve

Nondisclosure in psychotherapy group supervision: The supervisee perspective

The aim of this study was to investigate aspects of nondisclosure in a sample of 55 student therapists, working within a group format of supervision. The study constituted one part of a larger study, with the other, parallel part addressing nondisclosure in supervisors. The participants were recruited from seven university-based training clinics in Norway and Denmark. The supervisees answered a questionnaire comprising 11 items about nondisclosure in supervision. The items were answered in a yes/no format, and the respondents were invited to provide examples and justifications for their answers to each item. The examples and justifications provided were analysed in accordance with Hill’s guidelines for consensual qualitative research. The study confirmed significant nondisclosure by supervisees in a number of important areas. A high percentage found it difficult to talk about topics related to the supervisory relationship, fearing that they would hurt their supervisor or be met with criticism or interpretation. They were also reluctant to talk to their supervisors about professional matters, particularly related to the perceived incompetence of their supervisors and their expectancy of non-constructive criticism. They felt that their supervisors withheld feedback on their work, as well as advise on what to do, and would like more of this. Several of them thought of the lack of feedback as a conscious strategy helping the students to find out for themselves. A rather striking finding was that a high number of students experienced that the groups became more closed throughout the supervision, and blamed their supervisors for inadequate handling of the group process. This is an issue that needs further exploration.Supervisee non-disclosure in psychotherapy group supervision: The supervisee perspective

Supervision of Inexperienced Therapists

Abstract This paper is based on a qualitative study of supervision of inexperienced trainees. Eighteen supervisor-student dyads were interviewed listening to the same sequences of a tape from a supervisory session. They were also given a semi-structured interview relating to general aspects of supervision. The purpose of the study was to provide understanding of supervision that questionnaires may not make apparent, and to explore them in relation to supervision issues. It appeared that most supervisors had an ideal of a symmetrical position and tried to refrain from being didactic or instructive. This position was mostly appreciated by the trainees. The findings are discussed in relation to the emphasis on didactic training for inexperienced trainees in supervision literature, particularly with regard to possible contextual variables influencing how the trainee perceives and reacts to supervision.

Veiledning av veiledning: Hva er viktig i veilederutdanning?

Reichelt, S. & Skjerve, J. (2004): Supervision of supervision: What is important in supervisor training? Nordisk Psykologi, 56 (2), 107–127 Supervision of supervision is an important part of training programs for supervisors. In this article we take a closer look at how to carry out supervision of supervision. We are describing conditions we consider important for a good learning process, such as significant qualities of the supervisor of supervisors, the format of the supervision and supervisory methods. A main point is that supervisors in training usually are experienced professionals. Appropriate supervisor roles and methods are discussed in relation to this, and in relation to the specific tasks and goals in this setting. It is argued that a group format is particularly suited for supervision of supervision, and an instrument for evaluation of the work in the groups are presented.

Topic-focused analysis of verbal interaction in a case of integrative therapy with a young woman presenting with symptoms of depression

ABSTRACT It is increasingly recognised that single-case analysis makes a valuable contribution to the evidence base for psychotherapy, alongside other methodologies. Such analyses make it possible to investigate the unfolding process of change in therapy, and develop an understanding of change factors that contribute to outcome. One of the key challenges for the psychotherapy research community is to develop methods for descriptive single-case analysis that are simple to apply, and allow comparison across cases collected in different contexts. Topic Change Process Analysis represents a practice-relevant framework that is descriptive, flexible and widely applicable. The present paper presents an analysis of brief integrative/eclectic therapy received by a young woman struggling to come to terms with emotional instability and depressive episodes. Analysis of topic areas, topic shifts, response patterns within topics and changes in perspective makes it possible to identify key processes which resulted in a positive outcome for this client. The implications of these findings for practice, and future research, are discussed.

Topic change processes in psychotherapy: a case study approach

ABSTRACT A method for the analysis of transcripts from individual psychotherapy sessions is presented. The method, Topic Change Process Analysis (TCPA), is a qualitative and exploratory approach focusing on therapist-client interaction, on how such interaction influences topic changes during the therapy, and the possible contribution of the changes to the final therapeutic outcome. The method is descriptive. This makes it possible to explore the therapeutic processes in therapies with different theoretical orientations and to interpret the findings from different theoretical angles. The material from the analysis can be used to construct case stories covering topic changes occurring during a psychotherapy process.

Mutual assumptions and facts about nondisclosure among clinical supervisors and students in group supervision: A comparative analysis

In the two preceding papers in this issue of Nordic Psychology the authors report findings from studies of nondisclosure among student therapists and clinical supervisors. The findings were reported separately for each group. In this article, the two sets of findings are compared, so as to draw a picture of mutual assumptions and facts about nondisclosure among students and supervisors.

Veilederkompetanse: Oppgaver og utfordringer i veilederrollen

Reichelt, S. & Skjerve, J. (2004): Supervisor competence: Tasks and challenges in the supervisor role. Nordisk Psykologi, 56 (2), 75–91. The clinical supervisor is expected to master a very complex role. Participating in the development of training programs, we have missed a specification of the tasks comprised in this role. In this article they are described and analysed, based upon social role models of supervision, empirical studies of the supervisory process and clinical experience. In training programs for supervisors, competent handling of this list of tasks is the goal for the developing supervisor. The supervisor must continually make decisions concerning focus and interventions as part of the process. A main point in the article is that it does not suffice to be skilled in techniques or methods of supervision to contribute to a stimulating and supporting process for the supervisee. The supervisor must be reflective of and engaged in the role to make good decisions.

Veilederkompetanse og veilederutvikling: Et hjelpemiddel for vurdering

Skjerve, J. & Reichelt, S. (2004): Supervisor competence and supervisor development: A tool for evaluation, Nordisk Psykologi, 56 (2) 92–106. Models of supervisor development are briefly described and discussed. Only one scale of supervisor development has been published, focusing on identification with and commitment to the role of supervisor, rather than on the tasks of supervision. An alternative to a developmental model is models describing increasing competence in handling the tasks of supervision. Such models tend to ignore an important theme—the developing supervisors critical reflections upon his own function. In the scale of supervisor competence presented in this article, we have included items concerning focus of supervision, attitudes towards different tasks, emotional reactions related to be a supervisor and familiarity with different methods and formats of supervision. The main purpose of the scale is to give the supervisor in training feedback on his own function, not to measure the level of competence.

Topic-focused analysis of verbal interaction in a case of integrative therapy for depression and emotional turmoil.

The value of single-case analysis as contribution to the evidence base for psychotherapy is increasingly recognized. Single-case analysis makes it possible to investigate the unfolding process of change in therapy and develop an understanding of process factors that contribute to outcome. One main challenge in the field is to develop methods for descriptive single case analysis that are simple to apply and allow comparison across cases collected in different contexts. Topic-based single case analysis (TCPA) represents a practice-relevant framework that is flexible and widely applicable. This article presents an analysis of brief integrative therapy conducted by a very experienced female therapist drawing from a complex variety of therapeutic approaches. The client was a man in his late thirties in an emotional turmoil, having recently been through a heavy depressive period, and was still feeling depressed and emotionally unstable. Analysis of topic areas, topic shifts, response patterns within topics, and changes in perspective made it possible to identify key processes and key patterns of the therapy which resulted in a considerable relief for the client. The implications of these findings for practice, and future research, are discussed. Tema enfocado analices de interacciones verbales en un caso de terapia integrada para la depresión y el desorden emocional Más y más se está reconociendo el valor del análisis de caso solo como contribuyente a la evidencia para la psicoterapia. El análisis de caso solo permite investigar el proceso de cambio en la terapia y el poder desarrollar un entendimiento de los factores de proceso que contribuyen a los resultados. Un gran reto en el campo es desarrollar métodos para el análisis descriptivo de caso único que sean simples de aplicar y que permitan comparaciones a través de casos obtenidos en diferente contextos. Análisis de tema enfocada en caso único (Topic-based single case analysis; TCPA; por sus siglas en inglés) representa un marco teórico basado en práctica que es flexible y ampliamente aplicable. Este artículo presenta un análisis de la terapia integrada breve dirigida por una terapeuta experta utilizando varios enfoques terapéuticas complicados. El cliente fue un hombre, al final de sus treinta años, que se encontraba con confusión emocional, habiendo estado recientemente por un periodo depresivo fuerte, y todavía sintiéndose depresivo y emocionalmente inestable. Análisis de áreas temáticas, cambios de tema, el patrón de respuesta dentro de temas, y cambios de perspectiva hicieron posible identificar procesos claves e modelos claves de la terapia que resultaron en alivio considerable para el cliente. Las implicaciones de estos hallazgos para la práctica, e investigaciones para el futuro, son discutidas.

Topic-focused analysis in a case of integrative psychotherapy with a father fearing his own anger

Abstract Even though evidence-based knowledge is considered the foundation of clinical practice, many clinicians question the clinical relevance of published research. Clinicians increasingly define themselves as having an integrative stance, in contrast to the tendency for most research to be based on clearly defined psychotherapies. Qualitative single case studies make it possible to generate knowledge about what actually occurs in integrative therapy. Topic change process analysis (TCPA) is used in the analysis of brief integrative therapy conducted by a very experienced psychotherapist drawing on a complex variety of therapeutic approaches. The client was a man in his late thirties, worrying about his strong anger, particularly related to one of his children. Analysis of topic areas, topic shifts, response patterns within topics and changes in perspective made it possible to identify key processes and key patterns of the therapy which resulted in a very positive outcome for the client. Implications of these findings for practice, and future research, are discussed.