Existing research from the fields of education, cognitive science, neuroscience, and psychoanalytic psychotherapy points us toward possibilities for the future of psychoanalytic supervision. This research suggests that we need to go beyond communicating abstract knowledge and make our supervisory relationships more experiential, participatory, relationship-focused, and personal in order to teach usable knowledge, develop complex psychotherapeutic skills, and facilitate emotional and relational development in our supervisees. The author concludes that a relational model of supervision fits this pedagogical profile. After grappling with our resistances to change, the author hopes that more psychoanalytic supervisors will make use of a relational model of supervision, as well as drawing upon new technologies and neuroscience-based teaching techniques.
Four of Rodolfa et al.'s (2005) competencies in professional psychology-relationship, self-reflection, assessment-case conceptualization, and intervention-are key for the psychodynamic psychotherapist. Relationship lies at the heart of what is understood to be curative about psychodynamic psychotherapy. Self-reflection implies a complex and highly developed process that includes but goes beyond Rodolfa et al.'s and Kaslow, Dunn, and Smith's (2008) definitions. Competent assessment, diagnosis, and case conceptualization entails making inferences about unconscious processes by observing the client and also one's own experience, and integrating these inferences with theory. Effective psychodynamic intervention is derived from what the psychotherapist has experienced, processed, and conceptualized about the relationship with the client and about the client's internal object world. An extended vignette shows these competencies emerging in a psychotherapist-in-training, facilitated by an intense interaction with a supervisor. Although the supervisory and clinical tasks are different, the supervisor provides a relationship experience that models these same competencies for the supervisee and catalyzes their development in the supervisee.
For the novice clinician, the task of learning how to conduct psychotherapy is both personally and professionally challenging. Trainees, who may be quite competent at teasing out psychological complexity in the classroom or in case conference, may find themselves adrift in the therapy room. Seemingly straightforward clinical interventions are found to be less so in actual practice, and interpersonal skills, which may have served trainees well in their personal lives, may be strained in their attempts to develop an effective therapeutic relationship. By its very nature, psychotherapy is a complex interpersonal process that requires the clinician to incorporate theory and evidence-based practices in a systematic, yet flexible, manner to enhance client collaboration and to promote understanding and cognitive and behavior change. The training process is further complicated by the multiple, and often competing, approaches that may be taken in treatment.Psychotherapy-based supervision orders the learning process by providing a coherent approach to therapy in which knowledge, theory, and technique derived from a specific orientation inform the conduct of treatment and provide a clear focus for supervision. Further, techniques used in therapy may be tailored and used as learning strategies in supervision, for instance, attending to dreams in psychodynamic supervision or assigning homework in cognitive therapy 57
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