In this post, I want to talk about developing an autonomous practice as therapists gain more experience, and how this evolves in the supervision setting.


Do you remember – or are you there now – the first few client sessions, and how terrifying it felt? Am sure your first sessions went better than you remember or expected them to go.

It is not unusual to get “impostor syndrome” – that feeling that we are doing a job that we are really not qualified to do; or we feel we are not good enough to be helping someone with their deepest, darkest, most difficult struggles.

But the fact is, we have worked hard in getting the training we need to be able to do this job we call therapy. So we are not impostors, we are well equipped to do the job.


Supervision is a place where we can build this confidence, and move away from feeling like an “impostor” to feeling confident and capable of helping people in their time of distress.

When we first start off in our placements, we need a lot of support from our supervisor.

We might be focusing in sessions on how to keep ourselves grounded, even in light of very distressing emotions and conversations. This might take all our energy at first.

Our supervisor’s job here will be to contain and hold us, helping us think about what is going on for us in sessions, and guiding us in what might be the best intervention for this particular client.

In due course, we will start to “let go” of our supervisors hand a bit more, trusting ourselves more and more as we see more clients and get more experience.

Slowly, we are becoming more confident and secure in who we are becoming as therapists. Developing our own identity as professionals.

We don’t need our supervisor to tell us what interventions to use or when.

We might now need to start thinking more about why we chose certain interventions and what effect this has had in the therapeutic relationship and the client.

Reflective practice deepens and autonomy is emerging.

The supervisory relationship must change accordingly in order for autonomy to further develop.


Move forward a few years, you are now in private practice.

What you need now looks very different to what you needed during those first sessions.

A more collegiate, collaborative relationship forms with your supervisor.

 


You might need a new supervisor to break that link from trainee to fully qualified, or your supervisor might just get it and you stay with them (I speak from experience!)


 

A more collegiate relationship means that your supervisor is in a position to still contain and hold when needed, but will most likely challenge you a bit more in regards to critical thinking and reflecting about your work, how you are keeping yourself up to date with CPD and other training, as well as how you are keeping safe in regards to ethics and professional boundaries with clients.

Of course, all of these should also happen when we start in placement, but these become more obvious as we let go of depending 90-100% on our supervisor for support with interventions and the basics, to depending more on our knowledge and experience and using the supervision space for more in-depth work.

Autonomy develops further when we feel confident in our work but still rely on an objective observer’s – our supervisor’s – outlook on what we are communicating about our client sessions and what this brings up in us.

We are still human, we still “miss” the nuances due to being “in” the therapeutic relationship with our client, and the keen eye of a supervisor is great for clearing up blind spots or clarifying aspects of the relationship with the client that will help us as therapists and therefore help our clients.


Follow this link for a video describing this process.

Feel free to share it with your colleagues, supervisees, supervisors and others.


The more we talk about what supervision should be about, what it should cover, and how it should support therapists in their private practice, the better equipped we all will be, and we will provide the a better service to our clients!


What to expect from supervision – Autonomous Practice

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