Psychotherapy Articles

Psychotherapy Articles

Editor’s notes: This article is an adjunct to the article Abuse in Academia linked here. This article explores how disclosure plays a fundamental role in post-trauma resiliency for psychology trainees and how disclosure can function as critical information for development or decision making.

Supervision is an essential part of training for the growth of psychologists. Consequently, a strong supervisory relationship is fundamental for both trainee and client welfare. The function of supervision is multifaceted, ranging from personal growth to clinical and professional development (Bernard & Goodyear, 2019). A trainee’s ability to feel safe in disclosing ethical dilemmas, blind spots, reactions, and gaps in training depends on their comfort with self-disclosure. Determining what is appropriate trainee self-disclosure is a difficult task as supervisors do not need to know personal details about their trainees. However, supervisors are responsible for the ethical treatment of the clients receiving services under their license. Therefore, disclosure may be necessary to better understand what the potential ethical concerns are for the trainee.

The Supervisory Relationship and Self-Disclosure in Students and Psychology Trainees

It has been documented that the better the supervisory relationship between supervisor and psychology trainee, the more likely it is that the trainee will self-disclose in supervision (Mehr & Daltry, 2022). The supervisory relationship can be developed in a myriad of ways, such as shared goals, trust or bond, and tasks (Gibson et al., 2019; Gunn & Pistole, 2012). This is achieved through developing goals and expectations at the start of the relationship, discussing a remediation process if these expectations are not met, and providing frequent feedback to the trainee (Kersting, 2005).

Other theorists posit there are five components to good supervisory relationships: 1) support, 2) trust, 3) respect, 4) time, and 5) investment (Campoli et al., 2016). Trauma-informed support, more specifically, can be offered through administrative tasks, educational didactics, and providing space for the student using both formal (i.e., scheduled time) and informal (i.e., impromptu conversation) approaches (Ross-Nash, 2021). Trust is reciprocal, meaning it requires both trust in the supervisor from the trainee, and trust from the supervisor to the trainee (Campoli et al., 2016). Relevant and appropriate self-disclosure, boundary setting, and providing or receiving feedback all lend to the trust that is necessary for a strong supervisory relationship. Respect can be shown from supervisors by evaluating notes thoroughly and through being punctual, consistent, and present in their supervisory role. Additionally, recognizing and articulating a trainee’s strengths in conjunction with identifying growth points can demonstrate a supervisor’s respect for the trainee’s development. Navigating conflict with kindness, self-examination, and curiosity, rather than being defensive or superior can lend well to a respectful supervisory relationship (Nelson, 2008). Time is the fourth quality of a strong supervisory relationship. It can often feel like there is never enough time to cover all that is needed in the supervision hour, especially with newer trainees. Triaging client’s safety and trainee’s skillset to approach the presenting problem can help prioritize how to spend time in supervision (Campoli et al., 2016). The last concept shared by Campoli and colleagues (2016) is investment from the supervisor. A supervisee who feels cared for and whose growth feels important to the supervisor will likely feel safer to self-disclose in the relationship.

Self-Awareness About Self-Disclosure in Students and Psychology Trainees

Psychotherapy is an incredibly unique career; few other professions require such an intimate understanding and mastery of a sense of self. When on an airplane, for example, passengers do not wonder about the concerns of the pilot as long as the plane lands. With psychotherapy, however, the anxieties of a clinician could significantly impact the outcome of treatment.

Therapist self-awareness is an essential part of psychotherapy (Williams et al., 2008), and can often dictate the outcome of therapy. Therapist self-awareness impacts cultural competency, ethical behaviors, and the ability to recognize scope of practice and potential limitations. Insight into a therapist’s strengths, weaknesses, biases, and even personal trauma history can help therapists navigate complex therapeutic interactions that may illicit counterproductive reactions. According to the American Counseling Association’s 2005 Code of Ethics, fostering self-awareness in therapists can help provide more effective care for their patients and clients (Warren et al., 2010).

For trainees, it is especially critical to have frequent check-ins regarding emotional well-being given the combined stress of being a graduate student and a psychology trainee. For supervisors of clinicians-in-training, blind spots and personal boundaries are important to assess and explore to protect the interests of the trainee and the client. This can be a difficult balance to achieve given the importance of following ethical guidelines. Supervision requires an artful finesse, embodying teacher, therapist, role-model, disciplinarian, and expert, all while encouraging the student to remain non-defensive, confident, and curious (Gizynski, 1978).

Ethics Code for Self-Disclosure in Students and Psychology Trainees

The Ethical Principles of Psychologists and Code of Conduct states:

Psychologists do not require students or supervisees to disclose personal information in course- or program-related activities, either orally or in writing, regarding sexual history, history of abuse and neglect, psychological treatment, and relationships with parents, peers, and spouses or significant others except if (1) the program or training facility has clearly identified this requirement in its admissions and program materials or (2) the information is necessary to evaluate or obtain assistance for students whose personal problems could reasonably be judged to be preventing them from performing their training- or professionally related activities in a competent manner or posing a threat to the students or others. (American Psychological Association, 2018, Section 7.04).

Due to the subjective nature of the second part of this ethics code, supervisor’s thoughts regarding disclosure from trainees should not be taken lightly. Consultation, self-awareness, and clinical judgement are required to make such decisions. Instances where this code may be relevant is if a trainee has a similar mental health disorder as a client, potentially leading to negative clinical implications (i.e., working with eating disorder clients when a trainee has been observed to or disclosed engaging in their own eating disorder). Another time a supervisor may inquire about a trainee’s personal experiences is if a trainee indicates or shares a belief or lack of competency about working with a client effectively (i.e., discloses internalized homophobia and working with a client of the LGBT+ community). At some point, the supervisor must reflect on what additional training is needed for the trainee, while also considering what is in the best interest of the client. Moreover, there is a need to better understand a supervisee’s reaction in order to best support them and the client. Consequently, self-disclosure is sometimes necessary to make that decision due to the risk supervisors take when working with and supervising psychology trainees. Ideally, the supervisory relationship will be strong and such disclosure will feel safe to be shared. If remediation is necessary, a strong supervisory relationship will not feel punitive and instead, feel ethical and conscientious.

Trauma-Informed Supervision with Students and Psychology Trainees

Trauma-informed supervision considers the history, context, and background that each trainee brings into the supervisory space. Parallel processes can occur from supervisor to trainee, and then trainee to client. This demonstrates that the supervisor has an impact on the client, even though they may never meet (Martin et al., 2022). Creating an atmosphere of trust, collaboration, and autonomy will encourage the trainee to feel safe in sharing and self-disclosing. This will better inform and deepen the supervisor’s case conceptualization and clinical recommendations for a client’s treatment. It will also allow the supervisor to tailor their supervision to the trainee’s individual needs, reactions, and beliefs to aid them in their growth as a future mental health professional.

Dr. Zoe Ross-Nash (she/her) earned her PsyD in Clinical Psychology at Nova Southeastern University and completed an APA accredited internship at the University of California, Davis in the Eating Disorder Emphasis. Dr. Ross-Nash is currently an assistant professor at Ponce Health Sciences University and a licensed psychologist in private practice. Ross-Nash won the Division 29 Student Excellence in Clinical Practice Award in 2022 and is the Editor for Electronic Communications for the division, after serving three years as the associate editor. Zoe's clinical interests include trauma, eating disorders, wellness, mentorship, and advocacy. She is originally from Allendale, New Jersey and earned her bachelor's degree in Psychology with a minor in Human Service Studies and Dance from Elon University. In her spare time, Zoe likes to practice yoga and ballet, read and write poetry, and try new restaurants with her loved ones.

Cite This Article

Ross-Nash, Z. (2024, April). Trauma-informed supervision and disclosure from supervisees. Psychotherapy Bulletin, 59(2). 4-7.

References

American Psychological Association (2018) Rules and procedures. Ethics committee of the American Psychological Association.

Bernard, J. M., & Goodyear, R. K. (2019). Fundamentals of clinical supervision (6th ed.). Pearson Education.

Campoli, J., Cummings, J., Heidt, C., O’Connell, M. E., Mossière, A., & Pierce, A. (2016, June). Top 5 components of “good enough” supervision. [Web article]. Retrieved from https://societyforpsychotherapy.org/top-5-components-good-enough-supervision

Gibson, A. S., Ellis, M. V., & Friedlander, M. L. (2019). Toward a nuanced understanding of nondisclosure in psychotherapy supervision. Journal of Counseling Psychology, 66(1), 114–121. https://doi.org/10.1037/cou0000295

Gizynski, M (1978). Self-awareness of the supervisor in supervision. Clinical Social Work Journal, 6(3) p. 202- 210. doi: 0091-1674/78/1500-0202500.95

Gunn, J. E., & Pistole, M. C. (2012). Trainee supervisor attachment: Explaining the alliance and disclosure in supervision. Training and Education in Professional Psychology, 6(4), 229–237. https://doi.org/10.1037/a0030805

Kersting, K. (2005). Learning to supervise. American Psychological Association.

Martin, G., Litherland, G., & Duys, D. K. (2022). Trauma-informed supervision experiences: A preliminary phenomenological study. The Qualitative Report27(10), 2061-2078. https://doi.org/10.46743/2160-3715/2022.5533

Mehr, K. E., & Daltry, R.M. (2022). Supervisor self-disclosure, the supervisory alliance, and trainee willingness to disclose. Professional Psychology: Research and Practice, 53(3), p. 313317. https://doi.org/10.1037%2Fpro0000424

Nelson, M. L. (2008, September). Conflict in supervision: Avoidable or useful? [Web article]. Retrieved from https://societyforpsychotherapy.org/conflict-in-supervision-avoidable-or-useful

Warren, J., Morgan, M. M., Morris, L-N., & Morris, T. M. (2010). Breathing words slowly: Creative writing and counselor self-care—the writing workout. Journal of Creativity in Mental Health, 5, 109-124. https://doi.org/10.1080/15401383.2010.485074

Williams, E. N., Hayes, J. A., & Fauth, J. (2008). Therapist self-awareness: Interdisciplinary connections and future directions. In S. D. Brown & R. W. Lent (Eds.), Handbook of counseling psychology (pp. 303–319). John Wiley & Sons, Inc..

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