Your new practicum supervisor has a psychodynamic orientation, but you've always practiced cognitive-behavioral therapy.
Or, maybe you've become accustomed to a supervisor who shows up on time, directly answers your questions and gently guides your client interactions. But your new supervisor shows up late for meetings, is unorganized and contradicts your diagnoses.
Welcome to the world of conflict many students face when they move from one practicum or internship rotation to another.
"Every supervisor--and every clinician--has a different take on their orientation and on the way they practice it," says Sydney Kroll, a third-year clinical psychology doctoral student at Baylor University. "It was easy at first to see these differences in a negative light rather than learning from them."
But as Kroll and other students have discovered, trainees can use the varying approaches to their advantage by gleaning new insights into psychological interventions and approaches in treating their clients.
In addition to differing theoretical orientations and styles, trainees--who may have up to four supervisors at one time in a practicum or internship experience--also sometimes struggle with new supervisors who are unclear of their expectations or brush off their concerns or questions.
To help avoid such conflicts, students may need to clarify their own expectations of supervisors and the supervisory experience, but also be open to learning new techniques.
"Supervisors really love openness, an eagerness to learn, receptivity to feedback, trainees who are alert and who really know the literature and have been thinking about it," says Carol Falender, PhD, co-author with Edward P. Shafranske, PhD, of "Clinical Supervision: A Competency-based Approach" (APA, 2004). "They like supervisees who raise questions and are thoughtful in their approach. They also like trainees who are straightforward if they think they have made a mistake."
Experts and veteran students offer trainees the following tips to adjust and prepare for a new supervisor:
Clarify expectations. First, clarify your and the new supervisor's goals and expectations for your internship or practicum so you know what is expected of you, and they know what is expected of them, experts say.
To identify expectations, Gabby Oroza--a third-year clinical psychology doctoral student at the University of Texas Southwestern Medical Center at Dallas--recommends talking with other students who've had your new supervisor. For each supervision experience, she learns how, for example, her assessment supervisors--those in charge of supervising students during psychological testing--want cases presented, whether they want progress reports done before or after supervision meetings, and how long to spend on the conceptualization of treatment options. Some supervisors want trainees to spend a lot of time considering the roots of the problem and treatment options; others may not want as much, Oroza explains.
Susan Steibe-Pasalich, PhD, director of the University Counseling Center at the University of Notre Dame, says her center has created a competencies document of skills and expectations for interns and practicum trainees. For example, center staff expect trainees to be knowledgeable about at least one theoretical orientation used for therapy, the APA Ethics Code, interventions and what therapists might encounter in culturally and ethnically diverse populations.
Also, a sample contract of expectations for the supervisor-supervisee relationship is available in the Falender and Shafranske book.
Be prepared. Treat a meeting with your supervisor like a class by coming organized and prepared to talk about your cases.
For example, Falender recommends that trainees conduct literature searches before they begin treatment with their clients to ensure they know of the empirically supported, successful--and unsuccessful--approaches and interventions.
Also, keep a record of questions that come up during the week to ask your supervisor, experts say. In fact, when a supervisor perceives the trainee as interested in feedback and suggestions regarding professional development, trainees report a better experience in supervision, according to a study in the April 1987 issue of Professional Psychology: Research and Practice (Vol. 18, No. 2, pages 172-175).
Discuss theoretical orientations. Practicum students often will encounter supervisors with various theoretical orientations, such as a cognitive-behavioral therapy or a psychodynamic approach. For some students, this is no problem, since many students come in to practica without any orientation, says Steibe-Pasalich. Others, however, may have to grow accustomed to viewing clients through new theoretical lenses and weighing new treatment options.
Trainees can still use opposing orientations in practicum or internship to their advantage, experts say.
"I love the opportunity to try to understand my supervisor's worldview--to try it on--and take from it the pieces that fit for me," says Brian Mistler, a third-year doctoral student in counseling psychology at the University of Florida.
The differing orientations can help shape your identity as a therapist, adds Kroll, who recently switched from a primarily cognitive-behavioral supervisor to one that is more relational and process-focused.
"While this was a huge stressor initially, it has turned out to be one of the best experiences I have had in my clinical training," Kroll says.
She's ultimately become more comfortable following her supervisor's advice of relying more on her reactions to the relationship with her client rather than on the specific techniques she's learned in her courses. She still disagrees with him, however, on the extent to use techniques versus relational processing in sessions.
"This process taught me that there is no one way to do therapy," Kroll says, "and allowed me the chance to begin developing my own unique voice as a therapist."
Adjust to a new supervisor's style. The supervisor's approach to therapy often is similar to how they choose to supervise you. For example, some supervisors view themselves as teachers and mentors. Others may view themselves as communication facilitators between clients and students.
Oroza, for one, has learned she needs to adjust to every supervisor's personality. For instance, she once left a note on a supervisor's door when the supervisor failed to show for a meeting. The supervisor told her never to leave notes on her door again.
Oroza found it best to avoid defensive responses to such reactions from her supervisor. "I would just say, 'I'm sorry, how would you prefer me to do it in the future?'" she says.
Work out conflict. Such situations as clashing personalities, ethics or orientations may lead to conflict. But many students avoid talking about a problematic situation since the supervisor is the person in charge of evaluating them. By doing so, they miss out on the learning opportunity of better understanding how the conflict affects them, according to psychologist Steven Gross, PsyD, in his study in the June issue of Professional Psychology: Research and Practice (Vol. 36, No. 3).
In fact, students who seem most frustrated with supervisors are often the ones who feel uncomfortable voicing their needs, says Lisa Burckell, a fourth-year psychology doctoral student at Stony Brook University. "Most supervisors are open to discussing goals and addressing concerns, whether the student needs additional feedback or a student would like to discuss how a research study might inform treatment," Burckell says.
Friction can stem from supervisors missing a supervision session or trainees feeling as if a supervisor brushed off their questions or concerns. For resolving the conflict, Gross suggests in his article an honest, nondefensive dialogue about the event and the resulting assumptions and feelings.
Falender encourages trainees to tell their supervisor something like, "'I didn't feel comfortable what happened in the last hour, and I want to discuss that again.'...Most supervisors would respect someone who told them that," she says.
Be willing to learn. Perhaps the best way to avoid conflict, experts say, is for students to go into supervision with an open mind and eager-to-learn attitude.
"The one thing that I found to be a big help was being able to accept before entering the relationship that things would be different and being open to that," Oroza says.
And while students may dislike a supervisor, they can still benefit from the experience.
"Any one of them might be wonderful and any one not so helpful," Steibe-Pasalich says. "Even if you think the supervisor won't be helpful, usually there's something that you can learn from her or him--even if it is simply gaining insight about a particular supervisor behavior that doesn't work for you or learning to articulate a supervisory approach that doesn't fit you."
As Kroll prepares for a new year of supervisors, she's grateful for the differences. "We have such an amazing opportunity as graduate students in that we get multiple perspectives to help us grow and develop as clinicians," Kroll says. "We need to take the pieces of all these experiences and incorporate them into our unique identities."
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