Title: An Intern's Experience of Clinical Supervision in Group Work with Substance Abusers
Abstract: The Significance of Clinical Supervision The ability to identify, contextualize, and restructure countertransference experiences defines line between ethical and non-ethical interaction for a professional committed to implementation of theory and practice. Clinicians who lack effective clinical supervision could begin to dread personal interactions with clients because of anxiety about clients and generalized feelings of distress, anxiety, embarrassment, and desperation (Carsky, 2012, p. 76). Clinical supervision provides a framework by which transference and countertransference issues may be redirected into a strength-based, realistic discussion that supports various aims:1. Personal and professional growth;2. An honest reflection of self as well as self through therapeutic process;3. Positive therapeutic outcomes;4. Establishing an operational definition of transference and countertransference;5. Creating a baseline framework by which to assess and reassess client progress, goals, and action steps toward goals; and6. A decreased likelihood of compassion fatigue and burnout (Carsky & Yeomans, 2012; Kavanagh, Spence, Wilson, & Crow, 2002). Cognitive-Analytic Therapy in Supervision In order to accomplish aforementioned tasks, clinical supervision must be implemented within context of a structured technique rooted in theory. Cognitive-Analytic Therapy (CAT) is a practical method of brief context therapy that provides a good framework for clinical supervision. CAT supervision focuses on increased self-awareness and understanding of therapy process (Marx, 2011, p. 416). Through examining the many voices that are internalized from caregivers and wider culture (Marx, 2011, p. 403) in both self and client, worker can identify, define, and manage transference and countertransference issues during individual and group therapeutic processes. CAT uses relational interaction to identify of repetitive patterns of thinking, activity, and evaluation that originally served to manage unbearable emotions (Marx, 2011, p. 409). CAT also encourages supervisees towards reformulation, recognition, and revision of their own issues and cycles within context of therapeutic relationship. When applying this therapeutic technique to clinical supervision process, clear contextual lines are drawn from facilitator's being to action or reaction of client's being, thereby confronting counter/transference issues through clinical intervention. My Experience as a Social Work Supervisee I will use my own experience as an example. Before entering Springfield College Master's of Social Work (MSW) program, I had a five-year career as a Certified Alcohol and Drug Counselor (CADC). During that time, I lacked clinical supervision for approximately four years. During first year without clinical supervision, I provided group counseling twice a week to approximately forty males diagnosed with substance dependence disorders within structure of an inpatient therapeutic community. The work was difficult. Group members neither confronted nor supported each other. Clients would ask frivolous questions repeatedly simply to speak individually with me, because I was one of few women to which they had access. By end of my second year as a practicing CADC, I became sluggish prior to each group. I suddenly felt tired and easily irritated. I found my clients to be annoying and developed a strong dislike toward many of them. I found them to be selfish, and constant demand for instant gratification became an emotional strain. Compassion fatigue had consumed me cognitively, physically, and emotionally. Transference issues were relatively ignored unless they became blatant. Subtle issues, such as clients' reluctance to speak in group due to fears of a lack of confidentiality, or their difficulty accepting direction from a relatively young female, were difficult to identify. …
Publication Year: 2013
Publication Date: 2013-10-01
Language: en
Type: article
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