Trauma-informed supervision of trainees: Practices of supervisors trained in both trauma and clinical supervision.

Abstract

It is increasingly evident that all clinicians, including trainees, will encounter trauma-exposed clients (Henning et al., 2021). Unfortunately, the practice of trauma-informed supervision (TIS) essential to supporting their work is not yet well articulated, particularly TIS for trainees, and many supervisors lack training in both trauma and clinical supervision (Henning et al., 2021). Accordingly, we interviewed 9 supervisors who had formal training in trauma work as well as clinical supervision (didactic and supervised supervision). We used semistructured interview questions to solicit specific examples of their in-session thoughts and actions when supervising a trainee seeing a trauma-exposed client. Consensual qualitative analysis (Hill, 2012) yielded 3 domains: their intentional planning, including presession review of a client session; in-session observations and decision-making that emphasized emotion regulation and active learning strategies; and positive impacts on the trainee and the supervisory relationship, with varied impacts on the supervisor's own emotion regulation. Supervisors' reports of their in-session thoughts and actions reflected core TIS principles as well as evidence-based best practices of clinical supervision, suggesting an integration of their clinical knowledge (trauma content) to inform their supervision practice (learning processes).

Absorption vulnerability: A new look at compassion fatigue.

“…Ideally, clinicians work to regulate at the moment (inside or outside of the session) at the first sign they are exceeding their window of tolerance. Borders et al (2023) qualitative study on trauma-informed supervision identified helping counselors maintain their own grounding and emotional regulation as a clinical priority. The first step to regulation is interoception, or awareness of one's internal states and bodily sensations (Connell et al, 2018).…”

“…Keen awareness of clinicians’ own vulnerabilities and how defensive reactions may impact their clients and their sessions together is a key component of professional self-monitoring. All clinicians, including graduate students, should attend their AV due to the reality that they are likely to be exposed to clients with significant trauma histories in their internship experiences (Borders et al, 2023). Currently, the main treatment recommended for clinicians and graduate students in addressing indirect trauma exposure is self-care.…”