Sexual attraction toward clients, use of supervision, and prior training: A qualitative study of predoctoral psychology interns.

Interviews were conducted with 13 predoctoral psychology interns about an experience of sexual attraction toward a client, use of supervision to address the sexual attraction, and prior training regarding sexual attraction. Results indicated that sexual attraction to clients consisted of physical and interpersonal aspects. Therapists believed they were more invested and attentive than usual to clients to whom they were sexually attracted, and they indicated that sexual attraction created distance, distraction, and loss of objectivity. In terms of supervision, only half of the participants disclosed their sexual attraction to supervisors, and supervisors seldom initiated the discussion. Furthermore, trainees found it helpful when supervisors normalized the sexual attraction and provided the opportunity to explore feelings in supervision. Finally, trainees believed their training programs did not adequately address therapist sexual attraction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of perceived competence in professional psychology.

Appraised levels of general professional competence for 126 trainees in professional psychology by supervisors who had worked closely with the students. After rating the students, supervisors were asked to describe the dominant characteristics of "outstanding" and "incompetent" trainees. The most commonly mentioned quality of outstanding practitioner-trainees was high intelligence. The most commonly mentioned characteristic of incompetent trainees was lack of knowledge. A rating schedule composed of the 28 most commonly used terms was then employed by supervisors in rating students the following year. Four factors—Professional Responsibility, Interpersonal Warmth, Intelligence, and Experience—emerged from analysis of intercorrelations among variables. Intercorrelations of factor scores with ratings of overall competence showed that behaviorally oriented supervisors gave less weight to warmth in evaluating general competence than did supervisors with psychodynamic or eclectic viewpoints. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Addressing professional competence problems in trainees: Some ethical considerations.

Psychologists working as graduate student educators and clinical supervisors often encounter trainees who manifest problems of professional competence. At times, faculty members and supervisors may experience role conflict, ambiguity, and anxiety about how to respond to trainee competence problems. Psychologists engaged in the education, training, and credentialing of trainees are ethically and professionally obligated to balance their developmental and gatekeeping roles with respect to trainees. A discussion of several systemic concerns related to psychology's approach to competence problems is presented along with 3 expert commentaries that further elucidate the core issues from the vantage point of education, training, and licensure. Several recommendations for enhancing cooperation and excellent practice among psychologists who train and credential are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dangerous liaisons: Sexual intimacies in supervision.

The existing literature concerning supervisor–supervisee sexual intimacies was reviewed before proposing a conceptualization of sexual contact in the supervisory relationship. Three definitions of sexual contact (sexual harassment, sexual involvement, and sexual discrimination) are presented. The nature of the supervisory relationship is defined by comparison with other professional relationships (instructor–student and therapist–client). The process of supervisor and speculation about vulnerabilities of trainees to sexual advances by supervisors are discussed in terms of the developmental model of therapist training. The damaging effects of sexual contact between supervisors and supervisees are discussed and suggestions for improved graduate education are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family therapy training: Quo vadis?

Family therapy training programs have proliferated in recent times, without guidelines or much research. The clinical skills and personal characteristics that supervisors look for in trainees are a strong sense of the self, the ability to form systemic concepts at complex levels, and responsible clinical judgment. Personal training and experience outweighs the importance of professional background. A prior foundation in the social sciences and consolidation of basic professional training are emphasized. Concerns about superficial training at brief workshops are discussed. Defining competency and ensuring minimum standards are essential to protect the public and the credibility of family therapy. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Focus supervision: Management format for supervision practices.

Although supervision practices have received some attention from clinicians and researchers, they have also created new challenges for clinical practicum supervisors and coordinators. Because graduate-level trainees have learned more about supervision, they expect more from their supervisors; conversely, supervisors have sought limits on their comprehensive roles. This article outlines a supervision model consisting of 2 tiers: general and focus supervision. General supervision covers the global range of clinical cases, whereas in focus supervision, trainees address specific clinical skills and topics. The process of designing and implementing this model is described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Style differences of beginning supervisors: An interactional analysis.

An interactional analysis system, A. Blumberg's (1970) system for analyzing supervisor–teacher interaction (BIA), adopted from research in teacher education, was used to characterize beginning supervisory style. Two dimensions were considered: (a) the amount of variance in supervisory interaction behaviors in a group of beginning supervisors and (b) the stability of interactional behavior of individuals across 2 interviews, each with 2 trainees. 24 supervision interviews, each with 2 trainees from each of 12 beginning doctoral students, were videotaped and later analyzed with the BIA. A repeated measures 2-way ANOVA was used to analyze the BIA scores. Results indicate that the interview content differed significantly between supervisors on 7 of the 11 BIA variables and that individuals differed significantly across 2 interviews on 3 of the variables. It is concluded that beginning supervisors have individual predilections for supervisory behaviors that are stable across interviews with different trainees. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shame and guilt in psychotherapy supervision.

Examines the vulnerability to shame and humiliation of clinical trainees, particularly as it emerges in the course of psychotherapy supervision. It is contended that shame in supervision is generated from 4 major contributing factors: (1) the learning regression, (2) the patient population, (3) the supervisor's management of the supervisory hour, and (4) transference and countertransference in supervision. Suggestions are given for reducing the shame that might compromise the professional well-being of neophyte clinicians and their supervisors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy trainees' experience of counterproductive events in supervision.

The authors conducted interviews with 13 psychotherapy trainees about a counterproductive event that occurred in individual supervision, which was defined as any experience that was hindering, unhelpful, or harmful in relation to the trainee's growth as a therapist. A qualitative analysis revealed that trainees typically attributed their experiences of counterproductive events to their supervisors dismissing their thoughts and feelings. All trainees experienced a negative interaction with their supervisors following the counteractive event, yet most did not believe their supervisors were aware of the event's counterproductive nature. All trainees believed the counterproductive event weakened the supervisory relationship and led to a change in the way they approached their supervisors. Although trainees typically thought the counterproductive events negatively affected their work with clients, most did not disclose their counterproductive experience with their supervisors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do supervisors modify psychotherapy supervision according to supervisees' levels of experience?

Administered a questionnaire concerning goals, expectations, and procedures of supervision to 10 supervisors who had 1st-yr practicum students, 13 supervisors with 2nd-yr externship students, and 8 supervisors with interns who had at least 2 yrs prior clinical experience as psychotherapists. All Ss had an average of 10 yrs clinical experience and 5 yrs experience as supervisors. Results show no significant differences among the 3 groups of Ss who were supervising trainees with different levels of clinical development and skill, suggesting that supervisors may not modify their manner of providing supervision in accordance with supervisees' levels of experience. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training interns to respond to sexual dilemmas.

Previous research has documented that psychologists receive little training in responding to sexual dilemmas in psychotherapy. The authors describe 2 training experiences focusing on the personal, professional, ethical, and legal issues involved in sexual attraction between psychologists and clients. Small group discussions were particularly useful as trainees were able not only to receive educational material but also to examine their feelings and behaviors when they experienced sexual attraction. A conference format providing didactic information was especially helpful to new psychology trainees. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Graduate-level education and training in child sexual abuse.

The purpose of this article is to further graduate-level education and training in child sexual abuse. Two graduate-level courses that focus on child sexual abuse are considered as well. The following points are made: (a) Training in child sexual abuse should be incorporated into professional training programs; (b) research and theory courses on child sexual abuse are indicated; (c) the topic of child sexual abuse should be mainstreamed into existing practica; (d) the multidisciplinary nature of the field necessitates consideration of resources and references beyond those specific to psychology as well as professional engagement with individuals from many disciplines; and (e) training in child sexual abuse elicits strong emotional responses in trainees and others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trainees' experiences of role conflict and role ambiguity in supervisory relationships.

The nature and extent of counselor trainees' experiences with role difficulties were examined in the context of supervision. Role ambiguity arises when trainees are unsure of supervisory expectations for their performance or evaluation; role conflict arises when trainees encounter opposing expectations for their behavior. The Role Conflict and Role Ambiguity Inventory was developed and validated with trainees and supervisors in practicum, internship, and postinternship settings. Results indicate that the inventory is both reliable and valid. As hypothesized, role difficulties were predictive of more work-related anxiety, general work dissatisfaction, and dissatisfaction with supervision. Beginning trainees reported higher levels of role ambiguity than did more experienced trainees. Role conflict seems to be problematic only for advanced trainees, for whom ambiguity is minimal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On supervision: Reflections of a Latino psychologist.

The clinical supervisory relationship can be used to help psychotherapy trainees develop a more integrated sense of a multicultural and professional self. In this paper, the author shares some of his own training experiences in supervision and their influence on his supervision style. Examples from supervisory sessions are given to demonstrate how issues of race, gender, class, and sexual orientation can be used to advance both the supervision and the treatment. Candid discussions around the transferential and countertransferential issues in the supervision and the treatment can improve the supervisee’s capacity to integrate cultural identity into the developing sense of professional self as a therapist. This process also contributes to the clinical understanding of the person being treated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training implications of harmful effects of psychological treatments.

The goal of this article is to delineate training implications regarding harmful effects associated with psychotherapy. The authors strongly recommend that trainees be made aware of (and encouraged to examine carefully) the potentially harmful treatments that have been recently identified (Lilienfeld, 2007). Consistent with a broad perspective on evidence-based practice, it is also argued that additional guidelines for the prevention and repair of harmful impacts can be derived from psychotherapy research on process (technique and relationship) and participant (client and therapist) variables. For example, rigid adherence to the application of psychotherapy techniques can be a potentially harmful therapist behavior that necessitates careful training on the nature and flexible use of interventions. Furthermore, the authors suggest that trainers and supervisors tentatively consider training implications linked to clinical observations and theoretical assertions, such as the premature use of clinical interpretations, with the assumption that more confidence in such therapeutic guidelines can be gained when they are supported by multiple knowledge sources (empirical, clinical, conceptual). Finally, training implications related to the monitoring of harmful effects in terms of treatment outcome and process are demarcated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical and legal aspects of clinical supervision.

We review guidelines for providing supervision for trainees and employees, an expected part of the job for many psychologists, many of whom carry out their supervisory duties with only a cursory awareness of the ethical and legal pitfalls that may accrue. The guidelines are drawn from ethical principles, other documents promulgated by various sectors of professional psychology, and relevant legal cases. Specific suggestions are given for supervisors and training institutions to ensure appropriate supervision. The incorporation of training in supervision in all doctoral programs in professional psychology is recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development and validation of the Supervisory Styles Inventory.

Conducted a series of studies to develop and validate the Supervisory Styles Inventory (SSI) with parallel versions for supervisors and trainees. The instrument and validation procedures were based on a conceptual model of interrelated sources of variability among supervisors. Four separate analyses consistently revealed 3 factors among the perceptions of heterogeneous samples of trainees and experienced supervisors, which suggests that supervisory style is multidimensional. Scales constructed from these factors—Attractive, Interpersonally Sensitive, Task Oriented—demonstrated robust reliabilities and construct validity. In one study, SSI scales discriminated within and between expert supervisors with different theoretical orientations working with the same supervisee. These results were consistent with other evidence that a highly task-oriented style is endorsed by cognitive-behavioral supervisors, a highly interpersonal style by psychodynamic and humanistic supervisors. Furthermore, these supervisory styles seem to be differentially related to trainees' level of experience—supervisors are more task oriented with beginners, more attractive and interpersonally sensitive with interns. All 3 styles were strongly associated with trainees' reported willingness to work with different model supervisors and satisfaction with supervision. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identifying and reducing risk factors related to trainee–client sexual misconduct.

Sexual misconduct involving therapists-in-training and their clients is addressed. Personal and situational factors that may constitute risk factors for the development of inappropriate sexual activity between trainees and their clients are identified. Although there may be certain characteristics that put particular students at risk for such involvement, the authors believe this risk is more strongly related to systemic, programmatic, and pedagogic characteristics of the environments in which students train. Examples include, respectively, the decline of concern over transference and countertransference, failure to include education about client–therapist sexual attraction and the consequences of sexual misconduct in graduate psychology curricula, and the reluctance of supervisors to deal straightforwardly with trainees' sexual feelings. Suggestions for reducing risks for client–therapist sexual misconduct are directed toward these situational factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical supervision in Canadian academic and service settings: The importance of education, training, and workplace support for supervisor development.

A national sample of Canadian psychologists who provide clinical supervision in academic or service settings (n?=?156) was surveyed regarding their background preparation for clinical supervision, satisfaction with current supervisory load, and workplace support for supervisory activities and development. With respect to supervisor training and development, the authors found that (1) almost two-thirds of the Ss received no formal training in supervision, (2) most initially felt inadequately prepared to supervise trainees, (3) subsequent self-study of supervision was perceived as helpful, and (4) self-study was associated with administrative encouragement for professional development. Exploration of supervisory load and workplace support showed that (1) a large majority of Ss were satisfied with their load, (2) satisfaction did not differ across academic and service settings, and (3) supervisors in service settings were more satisfied with opportunities for peer support around supervision. Ss called for more training in supervision and increased amounts of time on the job to devote to supervision. The need for increased training in supervision at all levels, continuing professional education, and workplace enhancements to facilitate supervision are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patients' sexual behavior and sexual harassment: A survey of clinical supervisors.

How do clinical supervisors respond to supervisees' reports of sexualized or sexually harassing behaviors by patients? A survey of experienced supervisors was conducted to answer this question and to determine the incidence of such reports. A substantial number of participants reported receiving at least 1 report of patient sexual harassment of a supervisee. Reports ranged from persistent inappropriate sexual comments to physical sexual assaults. Supervisors' responses ranged from supervisory discussions to active interventions. Clinical supervisors must acknowledge the potential for supervisees to be sexually harassed by patients and incorporate strategies to deal with harassment in their training programs. (PsycINFO Database Record (c) 2011 APA, all rights reserved)