Nondisclosure and distortion in psychotherapy supervison.

Abstract

This study was conducted to explore patterns of disclosure of psychotherapy trainees to their supervisors. Specifically, trainees' conscious concealment and distortion of events and feelings that occurred in therapy sessions was investigated. Subjects (N = 93), most of whom were in doctoral programs in clinical psychology, completed a 66item Supervision Questionnaire (SQ) in reference to a supervisor with whom they were working at that time. Results indicated that most supervisees, while usually presenting an honest picture of the interaction with patients, also, at least some of the time, consciously distort and/or conceal some material; as many as 30-40% of supervisees withhold information (e.g., perceived clinical errors) at moderate to high levels of frequency. The findings suggest that nondisclosure, distortion, and concealment may be an inevitable aspect of supervision. Supervision is a critical element of virtually all psychotherapist training in psychology and related fields. As there are many different models for psychotherapy, so too are there different mod-This article is based on a paper presented at the Society for Psychotherapy Research:

Predoctoral interns’ nondisclosure in supervision

“…In this study, we focus on willful withholding. The three empirical studies on supervisee intentional nondisclosure in supervision (Ladany et al, 1996;Webb & Wheeler, 1998;Yourman & Farber, 1996) found that supervisees typically withhold important information from their supervisors. These studies surveyed supervisees with a range of training and experience; however, no studies have examined the phenomenon of nondisclosure from the perspective of trainees who are in the culminating internship year of their doctoral program (predoctoral interns).…”

“…personal issues unrelated to supervision, clinical mistakes, evaluation concerns, and sexual feelings toward clients (Ladany et al, 1996;Webb & Wheeler, 1998;Yourman & Farber, 1996). We thus wondered whether predoctoral interns' nondisclosures would differ from those noted by trainees with a wider range of experience.…”

“…When supervisees withhold important information from supervisors, opportunities for therapist development are missed and client welfare may be jeopardized (Ladany, Hill, Corbett, & Nutt, 1996;Yourman & Farber, 1996).…”

“…From empirical data (Ladany et al, 1996), we know that supervisees sometimes do not disclose to their supervisors because the information is deemed irrelevant, they feel threatened or vulnerable, or they have concerns about the supervisory relationship (e.g., poor supervisory alliance, supervisor's perceived incompetence). Another plausible explanation is avoidance of shame (Alonso & Rutan, 1998;Farber, 2006;Yourman, 2003;Yourman & Farber, 1996), given that supervisees often struggle between wanting to appear competent and fearing that they will be found out as imposters (Harvey & Katz, 1985). Another possible reason relates to the evaluative nature of the supervision relationship (e.g., Bordin, 1983).…”

The Journal of Counselor Preparation and Supervision Volume 4, Number 1

“…Only three empirical studies discussing the impacts of shame and shameproneness on the process of supervision could be found. These studies linked psychotherapy trainee shame-proneness to overall less satisfactory experiences of supervision (Doherty, 2005) and psychotherapy trainee non-disclosure to shame-related avoidance (Ladany, Hill, Corbett, & Nutt, 1996;Yourman & Farber, 1996).…”