Excellent supervision: the residents' perspective.

Former residents rated their videotaped psychotherapy supervision sessions on how helpful their supervisors were as teachers during the session. Residents' and experts' ratings of the same videotape were compared and found to have no significant correlation. However, male residents were less critical than either female residents or experts. Former residents were also interviewed. Supervisors were rated as excellent when they were accepting and also when they provided guidance about highly charged clinical dilemmas. Discussion of the impact of the residents' personal experiences on the clinical encounter was also rated high and is best understood from an adult developmental perspective. The findings reveal the lasting value of sympathetic supervisors acknowledging personal concerns and are likely mirrored in all clinical settings.

What do excellent psychotherapy supervisors do?

OBJECTIVE: The author's goal was to discover strategies used by psychotherapy supervisors judged to be excellent teachers. METHOD: In an earlier study, experienced teachers of psychotherapy rated the level of excellence of 34 different supervisors in 53 videotaped supervision sessions. In this study, the authors examined the transcripts of the nine videotapes assigned the highest ratings as well as three videotapes assigned mid-level ratings and three videotapes assigned low ratings in the previous study. In analyzing these transcripts, the authors drew from their experience with the complete set of videotapes. RESULTS: Supervisors with high ratings allowed the resident's story about the encounter with the patient to develop. They consistently tracked the most immediate aspects of the resident's affectively charged concerns. Most of their comments were directed toward helping the resident further understand the patient and were specific to the material presented in the session. The resident was invited to speculate about the material, and technical words were used sparsely. Discussions about the relationships between resident and patient and between supervisor and resident were in the context of the resident's concerns. Supervisors with mid-level ratings were less disciplined in tracking the resident's concerns and inhibited the development of the resident's story. Supervisors with low ratings paid little or no attention to the resident's issues. CONCLUSIONS: The ability to track residents' concerns is at the center of supervisory activities rated as excellent. The resident provides data about what occurred, and new knowledge is constructed in the supervisory interaction. These findings provide an empirical basis for orienting supervisors to supervision.

Quantitative assessment of the behavior of psychotherapy supervisors.

OBJECTIVE: The aim of this study was to explore the behavior of psychotherapy supervisors by using the Psychotherapy Supervision Inventory. METHOD: The authors used the Psychotherapy Supervision Inventory to rate 53 videotaped supervision sessions of 34 different supervisors. They also used the variable of the rater's perception of the excellence of the supervisor as a teacher. The data were subjected to a cluster analysis and a K-means analysis. Discriminant function analyses were applied to the comparison of the behavior of 19 supervisors with two different residents and the behavior of all 34 supervisors with residents in three different years of training. The relationship between rater-perceived excellence and Psychotherapy Supervision Inventory scores was analyzed by using stepwise multiple regression. RESULTS: There was a high level of agreement among the four raters' judgments of supervisors' excellence. Empathy accounted for 72% of the variance in rater-perceived excellence and focus on the therapist accounted for an additional 5%. When empathy was dropped from the equation, experiential orientation accounted for 60% of the variance in ratings of excellence, clarification and interpretation accounted for an additional 16%, and depth accounted for another 3%. CONCLUSIONS: In the context of established relationships, supervisors have stable behavior patterns. Rater-perceived excellence is related to the supervisor's focusing on the resident's immediate experiences and making many synthesizing comments in depth. The Psychotherapy Supervision Inventory can be used to orient supervisors to supervision and provide feedback about their behavior.

A reliability assessment of the Psychotherapy Supervisory Inventory.

The authors investigated the reliability of the Psychotherapy Supervisory Inventory scales, which rate behaviors of supervisors on the basis of observation of supervision sessions. The scales assess focus on the therapist and the patient, intellectual and experimental orientation, number of clarifying and interpretive comments, intensity of confrontation, depth of exploration, verbal activity level of the supervisor, dominance of the supervisor and the therapist, comfort and tension levels, and empathy of the supervisor. Intraclass correlation coefficients were significant for all scales, indicating that trained observers can agree in distinguishing supervisory behaviors. These scales can be used in further research and for feedback to supervisors.