The Internalized Mentor

Jul 28 / Jillian Papineau, PhD.

The Internalized Mentor.

I am still learning. ― Michelangelo, age 87

There will always be a role for supervision in the life of the professional counsellor. Early on, supervision tends to be more involved, more specific, more intense. With time and experience, the counsellor gains independence and autonomy. It is hoped they also gain the reflective skills necessary to self-supervise when reasonable. The supervisor at this point becomes internalized as a mentor whose voice and wisdom is called upon from within by the counsellor. This article is designed to support your reflective practice, and ultimately, enhance the voice of your internalized mentor during times you need it most.

As you read on, consider reflecting on the following questions: What does supervision mean to you? Do you recall your first supervision session? What did you feel on your way to meet your supervisor for the first time? Did you ever feel vulnerable in supervision and how did you manage this? Who has been inspirational to you on your journey of becoming a counselling practitioner? What is it about them that inspired your journey?

Introduction: A brief history
This isn't boring. I used to think supervision was boring. That is until I learned what it truly is. Extending far beyond the confines of administrative red tape, supervision has the potential to be far more powerful and transformative. The context of supervision is just as fascinating and once you begin to explore, it's hard to stop. Think of Freud. The "original" supervisor. Freud met with his team of psychoanalysts in his home on a weekly basis to discuss challenging clients and different clinical directions for the therapists to consider. Expected to be "blank slates", the psychoanalysts explored their own issues and experiences that could potentially sully the therapy hour. In this sense, supervision provided an opportunity to reflect, develop self-awareness, and become better clinicians for clients. The concept of supervision has since come a long way to be considered a distinct clinical competency, requiring specific training, and truly becoming integral to the structure of the profession.

Clinical supervision can be well defined as "an intervention provided by a more senior member of a profession to a more junior colleague or colleagues who typically (but not always) are members of that same profession. This relationship is evaluative and hierarchical, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s); monitoring the quality of professional services offered to the clients that she, he, or they see; and serving as a gatekeeper for the particular profession the supervisee seeks to enter (Bernard & Goodyear, 2014, p. 9). A solid understanding of supervision is fundamental to professional growth and development. Counsellors and supervisors should be wary of the fact that a central purpose of supervision is to protect client welfare and support counsellor growth. It is this multifaceted approach that makes the practice of supervision to feel a bit like an art and a science. How do supervisors ensure quality client care, while simultaneously supporting counsellor growth and development in a notoriously emotionally heightened and anxiety provoking field? This is what makes supervision anything but boring.

Many clinicians can fondly think back on their first experiences in supervision. Unfortunately, there are also many clinicians who can look back on experiences in supervision with less fondness. The hierarchical and evaluative nature of the supervisory relationship has the potential to be transformative if done well, or detrimental if not. Therapists have reported increased levels of self-confidence, a greater ability to conceptualize cases, and a deeper understanding of therapy when working with a supervisor in a positive manner (Hill & Knox, 2013). Negative supervisory experiences were found to decrease efficacy, developed more guarded supervisees who were less likely to disclose events to supervisors, and led to weakened alliances (both in supervision and therapy). Poor supervision alliances result in increase stress, self-doubt, feelings of powerlessness (Hill & Knox, 2013). The impact of the supervisory relationship can certainly be far reaching -- so much so that the impact of supervision can be felt by clients! Clients have reported greater satisfaction with services provided by supervised therapists than by those who are not (Hill & Knox, 2013). When reflecting on previous experiences in supervision (as supervisor or supervisee), it is important to consider the many emotions that may arise. Reflecting on the moments that have been helpful lends to an understanding how one learns best and why. Reflecting on challenging experiences also provides valuable insight -- Insight into vulnerability, authenticity, power, control, and safety among a plethora of other possibilities.

Context
To add to the complexity of this competency, clinical supervision embodies several main functions that one should be aware of in order to effectively supervise. At any time, a supervisor may be called to act as a mentor, coach, consultant, administrator, or some combination of these! This requires an inherent understanding of both the role of the supervisor, as well as the needs of the supervisee.

Until recently -in fact, far too recently- clinicians provided supervision based on their prior clinical experiences as therapists (Desmond, et al., 2011). This resulted in a plethora of supervisors relying on their past experiences as supervisees to guide their supervision interventions and ultimately, pass down bad habits to new generations of clinicians (Bernard & Goodyear, 2014). As the professional competency legitimizes, so has training expectations for supervisors. Specifically, psychotherapy supervisors with the College of Registered Psychotherapists of Ontario (CRPO) are required to have both five years' clinical experience and a minimum of 30 hours of clinical training. Furthermore, a competency based understanding of supervision is well in the works, with dozens of specific competencies and best practices requiring mastery to be considered providing effective clinical supervision (CCPA, 2018).
In research of our own, we followed a handful of psychotherapists emerging in their new roles as clinical supervisors (Mannella, 2018). These therapists had varying degrees of previous clinical experience, yet all shared the same level of newness to practicing as clinical supervisors. Furthermore, only half of these clinicians had formal training in supervision, as it was not yet a requirement in Ontario. The most striking finding throughout this research process was a shared theme of growth through reflection experienced by every participant interviewed. These emerging supervisors all experienced growth in their new role resulting from reflecting on their challenges. Absolutely: the textbooks and prior clinical experiences supported their development. However, it was a reflective process that consolidated the learning into a holistic and integrated practitioner (see Figure 2). This process of growth identified a need for both challenge and ... pause.
The practitioners had to find the time and ability to pause in their experiences to reflect and make sense of their realities. While the initial supportive resources of their trainings, texts, and peers were utilized in a survival sense, it was only upon further reflection that the clinicians truly developed in a transformative manner.
This process made way for the understanding that growth and reflection do go hand in hand. Furthermore, it is an individual process and one that necessitates reflection. This process of growth and learning is necessary in overcoming challenges. It may certainly call upon the internalized resources yet ultimately, requires the full attention and commitment of the clinician - supervisor or supervisee.

Who looks outside dreams, who looks inside awakens
― Carl Jung

The concept of reflection is referred to more often in literature as of late. However, critical reflection is a far more intricate and involved process than perhaps commonly thought. Reflection does not just involve reflecting back on your day's events. It necessitates an in-depth process of meaning making which ultimately should lead to change - change in the way we act or simply in the way we know. Being able to reflect critically ultimately means one has processed an event or experience, understands the meaning of the event in the greater scheme of things, and now knows how they interrelate with others. Even if we choose to act in the same way should we encounter the same event, we are now acting with new knowledge stemming from the reflective process (McAuliffe, 2006). As clinicians, the reflective process is so important. It processes experiences, interactions, and events with the ultimate purpose of developing new meaning and knowledge that informs our behaviours going forward. A reflective practice is a way of living.

There are many models of reflective practice in existence (some of which we will review below). With time, a clinician shifts their way of meaning making from a passive to more active and reflective process (See Figure 4). Here, they engage their internal wisdom, experiences, and knowledge to make sense of clinical conundrums. Far gone are the days of needing specific direction. Ultimately, to engage in this practice as supervisor or supervisee, you are asked to shift your way of thinking to (McAuliffe, 2006; Scaife, 2010):

  1. Welcome multiple perspectives or ways of seeing
  2. Move inside to understand your own held truths
  3. Value ambiguity over specificity

    While three points are fairly easy to write out and remember, these can be daunting to practice - especially for new clinicians who crave certainty and structure!

It is important to remember that a reflective practitioner is one who is open to various possibilities. They explore potential and maintain a willingness to consider other experiences (McAuliffe, 2006). They also possess -and continue to refine- a deep understanding of their own values, beliefs, opinions, and experiences as they interact with the other, society, and/or notion (McAuliffe, 2006).

Perhaps my favourite metaphor to describe an experienced reflective practitioner is one who embodies a board of directors. They consider the opinions and beliefs of other important perspectives and ultimately, use this carefully curated guidance to make an informed decision for themselves, by themselves. As clinicians, we may have many perspectives present at our internal board of directors meeting. There may be a seat for our concerns, prior learnings, a parent, and/or one for the sage supervisor that continues to be stored as a mentor. As you build a reflective capacity, it is important to remember that it takes practice. This is not simply something you do for a few moments in a day. This is very much a way of living and a stance to approach others in life. You are positioning yourself to continually look inward, consider, and contemplate. It asks a lot of you but also returns tenfold.

There are a plethora of reflective models in existence; all developed with the intention of supporting and providing structure to a reflective practice. These models guide individual practitioners through a reflective process of self-discovery and exploration of experiences to ultimately make sense of meaning and change. This change that is experienced is typically transformational in that the practitioner cannot return to their previous way of being. They have learned something so deep within themselves that the learning cannot be forgotten or undone. In this sense, engaging in a reflective practice is an ultimate commitment to self-development.
Final Thoughts
This article is aptly referred to as a "beginning conversation". Clinical supervision as a competency is certainly gaining more focus and shifting into an established zone in research. However, the work is far from complete and our application of theory to practice is only now catching up to the literature. We do know that clinical supervision provides incredible value to both the new and experienced practitioner alike. We know that clients can benefit from higher quality clinical care when their counsellor receives supervision. We also know that supervision looks quite different across the span of a profession. As a clinician develops with experience, so does their ability to reflect inwards and call upon their previous experiences in supervision to guide their current clinical work. This article reviews the importance of a reflective capacity when calling upon an internalized mentor for supervision but also begs the question: how might we encourage a reflective capacity to support ongoing growth and development in the strained mental health sector? I look forward to continuing this conversation, growing, and reflecting alongside this beautiful profession. To forever learning.
About the Author
Jillian has a passion for life-long growth and learning. Having completed her Ph.D. with a research specialization in supervision and clinician development, Jillian explored the many life experiences that culminate to make us who we are as a whole person. As a result, her unique approach to training and supervision was born. Jillian works with supervisees to harness their strengths, learn from challenges, and continue life’s journey in their preferred way. Jillian provides counselling, supervision, and consultation services to organizations looking to improve their supervision processes with a strong focus on integrating reflective practices.
In the words of Jillian: To forever learning.

References

Bernard, J. M., & Goodyear, R. K. (2014). Fundamentals of clinical supervision. Boston: Allyn and Bacon. 
Canadian Counselling and Psychotherapy Association (CCPA). (2013). Detailed Certification Requirements. In Canadian Counselling and Psychotherapy Association. Retrieved from: http://www.ccpaaccp.ca/en/certificationdetailed/#supervision.
College of Registered Psychotherapists of Ontario (CRPO). (2014). Professional Practice Standards For Registered Psychotherapists. Retrieved from: http://www.crpo.ca/home/the-regulations/#Professional Practice Standards for RPs. 
Contrastano, C. M. (2020). Trainee’s perspective of reciprocal vulnerability and boundaries in supervision. Journal of Psychotherapy Integration, 30(1), 44–51.
Corey G. & American Counseling Association. (2010). Clinical supervision in the helping professions : a practical guide (2nd ed.). American Counseling Association.
Desmond, K. J., Rapisarda, C. A., & Nelson, J. R. (2011). A qualitative study of doctoral student supervisory development. Journal for International Counselor Education, 3, 39-54. Retrieved from http://digitalcommons.library.unlv.edu/jice 
Driscoll, J.J. (2007) Supported reflective learning: the essence of clinical supervision? in Practising Clinical Supervision: A Reflective Approach for Healthcare Professionals (2nd edition). London: Bailliere Tindall. Pp 27-50.
Halpern, H. (2009) Supervision and the Johari Window: A Framework for Asking Questions, Education for Primary Care, 20:1, 10-14, DOI: 10.1080/14739879.2009.11493757
Hill, C.E & Knox, S. (2013). Training and Supervision in Psychotherapy: Evidence for effective practice. In M.J Lambert (Ed) Handbook of Psychotherapy & Behavior Change (6th edition) pp. 775-811). N.York: Wiley. 
Mannella, J. (2018). The Developing Psychotherapy Supervisor: The Experience of Change and Growth in the Early Years. University of Ottawa.
Rønnestad, H., & Skovholt, T. (2013). The developing Practitioner: Growth and stagnation of therapist and counsellors. East Sussex: Routledge.
Scaife, J. (2010). Supervising the reflective practitioner: An essential guide to theory and practice. London: Routledge. 
Skovholt, T. M., & Trotter-Mathison, M. (2011). Counseling and psychotherapy: Investigating practice from scientific, historical, and cultural perspectives. The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals (2nd ed.). New York, NY: Routledge.
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