Metacognitive Reflection in Supervision: the Role of Supervision in Addressing Health Inequities

Psychotherapy to emphasize self-directed recovery for persons with serious mental illness: Contributions from metacognitive reflection and insight therapy (MERIT).

“…MERIT has been proposed as a good training model to advance cultural competency with a critical reflection approach (Zalzala & Gagen, 2023). As described by Hamm, Leonhardt, et al (2022), MERIT-oriented supervision should include encouraging the trainee to notice and respond to internal and external barriers to psychotherapy, reflecting on the trainee’s experience of a client, themselves and the dyad’s relationship, as well as helping trainees foster joint reflection.…”

“…As described by Hamm, Leonhardt, et al (2022), MERIT-oriented supervision should include encouraging the trainee to notice and respond to internal and external barriers to psychotherapy, reflecting on the trainee’s experience of a client, themselves and the dyad’s relationship, as well as helping trainees foster joint reflection. Zalzala and Gagen (2023) highlighted how these elements of MERIT-oriented supervision directly contribute to increased awareness of and give meaning to the trainees’ internal experiences, support conversations around diversity and equity, and encourage critical reflection of possible biases impacting care. Notably, MERIT encourages an egalitarian, nonhierarchical partnership in which the provider is an equal participant, and the client is an expert on themselves, thus critical reflection should be given by the trainee in supervision about potential sociopolitical context and beliefs held by the trainee and/or client that may be influencing the client’s presentation and/or psychotherapy.…”