Sue Wheeler

The impact of clinical supervision on counsellors and therapists, their practice and their clients. A systematic review of the literature

In 2005 the British Association for Counselling and Psychotherapy (BACP) commissioned a systematic review of the research evidence related to the impact of supervision on counsellors and psychotherapists, their practice and their clients. This paper reports on some of the findings of this review, specifically from articles published in this area since 1980. Detailed inclusion and exclusion criteria were agreed. EPPI-Reviewer software was used to organise and analyse the articles that met the inclusion criteria. This article reviews 18 individual published studies. The quality of evidence is variable, but supervision is consistently demonstrated to have some positive impacts on the supervisee.

How honest do counsellors dare to be in the supervisory relationship?: An exploratory study

Abstract A study was conducted to investigate the extent to which psychodynamic counsellors feel able to disclose sensitive issues in supervision. Ninety-six counsellors in supervision responded to a questionnaire that asked about supervision arrangements, the supervisory working alliance, and the likelihood of disclosing issues such as erotic feelings towards clients and discomfort with the supervisor. Results showed that supervisees were likely to disclose more in individual rather than in collective supervision, when their supervisor was someone whom they themselves had chosen rather than had allocated to them, and when they were supervised independently of the setting in which they counselled rather than in-house. There was a positive correlation between the quality of the supervisory working alliance as experienced by the supervisee and the extent of his or her disclosure. Implications of counsellors feeling inhibited from disclosing particular issues in supervision, and the impact on the quality of ...

‘A baptism of fire’: A qualitative investigation of a trainee counsellor's experience at the start of training

Abstract Background: Belief in the effectiveness of professional counselling and psychotherapy training is widespread and generally unquestioned. Few studies have attempted to understand the changes experienced by trainees, or identified which aspects of professional training programmes assist them in the process of becoming therapists. Aims: to investigate how a trainee counsellor changes at the start of training, and to identify which aspects of a professional counsellor training programme were helpful in instigating and supporting change. Method: the experience of one trainee counsellor, Margaret, was captured through three semi-structured interviews conducted at the beginning, middle and end of her first term. The data were subjected to systematic qualitative analysis. Findings: Margaret experienced significant change during her first term. Each interview revealed a different phase of her development. The core categories were: becoming something new (week 3); growth in therapeutic confidence (week 6);...

What makes a good counsellor? An analysis of ways in which counsellor trainers construe good and bad counselling trainees

As part of an investigation into criteria used by counsellor trainers to distinguish between good and bad students of counselling, experienced counsellor trainers were asked to complete a repertory grid. Each trainer was asked to list five good counsellor trainees and five not so good or bad counselling trainees they had worked with, as elements for the grid. Repertory grid forms were provided by the researcher with spaces for ten constructs which were elicited from the trainers in the standard triadic manner. For each elicited construct subjects were asked to rate each trainee on a five point scale. Twenty-seven correctly completed grids were collected. The 262 constructs elicited were conflated into 22 semantically similar categories by the researcher and independent raters. The data was subjected to statistical analysis using the Statistical Package for the Social Services (SPSS). Overall the constructs that were most frequently used in describing trainees were open-closed, personable/aloof, secure-insecure, professionally skilled-unskilled. The mean differences for scores of good and bad trainees for each of the 22 conflated constructs were calculated. The greatest mean difference related to professional competence. The 22 conflated constructs were subsumed into three categories, and the mean of the difference between ratings for good and bad trainees within each category was calculated. Counselling related competence showed the greatest mean difference. Implications for counselling course curricula and the selection and assessment of counsellor trainees are discussed.

Personal therapy: An essential aspect of counsellor training, or a distraction from focussing on the client?

As part of a research project investigating therapist/counsellor orientation and the therapeutic alliance with anorexic or bulimic clients, data was collected not only on therapist orientation but also on training, supervision and personal therapy of the counsellors. While no significant correlation was found between length of training or supervision and the therapeutic alliance score, there was a significant negative correlation between the amount of personal therapy the counsellors had had and the measure of the therapeutic alliance achieved with their clients. Further investigation produced other studies on personal therapy and effectiveness of counselling, in which at best no positive correlation was found between personal therapy and outcome, and at worst, personal therapy was negatively correlated with outcome.These research findings challenge the assumption often made that personal therapy is a desirable if not essential aspect of counsellor training. The arguments for and against personal therapy being included in the training of counsellors are discussed.

What shall we do with the wounded healer? The supervisor's dilemma

Abstract This paper discusses the supervisors responsibility in addressing the vulnerability or wounds of the therapist. Supervisors have much to keep in mind as they conduct their work, not least the client for whose benefit supervision is deemed to be an essential aspect of good practice. Their responsibility towards the client often entails careful exploration of the experience of the counsellor, both through their counter-transferential response to the client and their own personal circumstances. The extent to which the supervisor has a mandate to discuss the psychological well-being, personal difficulties, or organizational conflicts of their supervisee depends on both contractual agreements and the working alliance. The need to recognize counter-transference responses is generic but when they highlight the internal conflicts of the counsellor, the supervisor must decide how far they can or should pursue the unravelling of such conflicts. Therapist difficulties (Schroder & Davis, 2004) provide a framework for understanding ways in which therapeutic practice is affected by the emotional response of the therapist.

Nature or nurture: are therapists born or trained?

A great deal of time, effort and money is involved in the training of counsellors; hence it is most important that the selection process discriminates between those candidates who are likely to achieve the standard required at the end of the training and those who are not. This paper discusses some of the issues pertinent to the selection of candidates for training as counsellors. It considers the question of whether counsellors are born or made, in other words whether anyone can be a good counsellor given the right training or whether they have to be suitable before they start. The paper uses Kohutian concepts to address issues of narcissism, as well as considering equal opportunities and personal development.

Do counselling supervisors want or need to have their supervision supervised? An exploratory study

In response to a survey of counselling supervisors, 70 practitioners provided information about their practice as supervisors of counsellors and supervisors of supervisors. Questions were asked about the practice of supervision for supervision and attitudes towards the BAC Code of Ethics and Practice for Supervisors requirement that supervisors have access to supervision for their supervisory work. All but six of the respondents claimed to have supervision for supervision. In response to questions about the helpfulness, general importance, ethical importance and desirability of supervision for supervision, for which a bipolar visual analogue scale was provided, mean scores were all above 70%, indicating that there was considerable satisfaction with supervision for supervision requirements. Factor analysis revealed only one factor including all four questions. Questions were asked about contracts with supervision supervisors. A total of 55.7% used the same supervisor for their clinical work and supervision. In response to a question about issues raised in supervision, four categories accounted for the majority of comments: boundaries, competence of supervisees, training and ethics.

The hardest words: Exploring the dialogue of suicide in the counselling process — A discourse analysis

Increasing suicide rates among specific groups of the population have led to the publication of suicide reduction targets and guidelines applicable to all mental health professionals, including counsellors. It is now widely expected that mental health workers possess skills and knowledge in the assessment of suicide risk. This research study used a discourse analysis approach to analyse 16 counselling transcripts generated from assessment interviews with suicidal ‘client actors’. Clients generally only referred to suicide by metaphors. Counsellors’ responses to suicidal clients were primarily reflective. There was little evidence of a suicide risk assessment being undertaken in the counselling discourse. Implications for suicidal clients, counsellors and the counselling profession are discussed and further areas for research highlighted.

Practice-based supervision research: A network of researchers using a common toolkit

Abstract Aim: Given that various systematic reviews of supervision literature have revealed how little is known about supervision, that studies are not usually routed in practice, and that a multitude of diverse measures are used, the primary aim of this project was to support and encourage practitioner research related to supervision using a prescribed common set of instruments. Method: Funded by the British Association for Counselling and Psychotherapy (BACP), a Supervision Research Practice Network (SuPReNet) was established. A toolkit (a series of measures) that could be used routinely by practitioners was selected following the assembly of available measures of supervision and an assessment of them. Findings: The appraisal, conducted by the three authors, yielded five core measures, free for anyone to use, and accessible through the SuPReNet website. The measures are being piloted through a practice research network at a university counselling and psychotherapy research clinic where supervision data ...