Understanding clinical issues in student supervision: A psychodynamic practitioner researcher approach

George Karpetis

    Research output: Chapter in Book/Report/Conference proceedingConference Paper published in Proceedingspeer-review


    As a result of the professional dichotomy between ‘micro’ and ‘macro’ social work practice (Maschi, 2011), a multi-theoretical or even a-theoretical framework is often suggested for the field practice supervision of social work students. This framework employs sociocultural and/or administrative theoretical approaches in order to assess and deal with client psychosocial problems; often at the expense of a deeper understanding of the clinical issues (and ultimately of the psychopathology) of the clients (Karpetis, 2010; Karpetis, 2011). In the present study, the author presents critical incidents from his group student supervision practice, aiming to underlie the importance of the clinical understanding for the psychosocial problems of the clients. A further aim of the study is the evaluation of the effectiveness (learning experience for the students) of the clinically minded supervision practice. 
    The author employs the psychodynamic approach in order to understand the causes of the clients’ psychosocial and mental health problems. Psychodynamics accept the primacy of emotions on human behaviours (Rustin, 2003) and regard client psychopathology and emotional problems as the developmental outcome of the internalized experiences of the clients’ primary relationships. In fact, client psychopathology is understood as the effect primary relationships have on the personality structure, defensive patterns and ultimately the ways s/he clients relates to other people. Psychopathology is further understood through direct or passive forms of aggression (usually unconscious) that is directed against one’s relationships and brings about problems for the accomplishment of the developmentally appropriate social roles (Karpetis, 2012).The provision of a ‘therapeutic relationship’ according to which the effects of aggression on the client’s current relationships is understood, reduces client symptoms and leads to improved social role functioning. 
    The supervision process is illustrated in time sequence and in accordance to the main clinical issues discussed. Students present anamnestic process recordings of an interview with a client. Student mishandling of cases, or failures in dealing with client problems are identified as practice mistakes that need to be corrected. Students are primarily assessed according to their willingness and ability to learn from practice mistakes. Student emotional problems or personality issues are not commented since the supervision setting deters therapeutic interventions and there is no student ‘request for therapy’. Supervisor interventions that aim to create and maintain the ‘therapeutic supervision setting’ promote learning and increase field practice effectiveness for the students. 
    Student active or passive forms of aggression during supervision are connected to the relationship (absence of trust) with the supervisor as well as to group and the institutional dynamics. Students trust those supervisors who feel clinically competent and also take clinical responsibility for the cases the students work with. Both effective and ineffective interventions of the supervisor will be connected to (i) his training and practice experiences (2) the institutional dynamics and (iii) his countertransference. Student resistance to learn will be connected to their relationship with the supervisor (unconscious aggression) as well as to their developmental needs that primarily stem from a meta-adolescent idealization of the students’ own internalized parental figures (therefore of the supervisor) and of themselves.
    Original languageEnglish
    Title of host publicationAdvances in Clinical Supervision Innovation & Practice
    Subtitle of host publicationConference Monograph
    EditorsChristine Senediak
    Place of PublicationParramatta, Australia
    PublisherThe New South Wales Institute of Psychiatry
    Number of pages5
    ISBN (Print)978-0-9923822-0-9
    Publication statusPublished - 2013
    EventAdvances in Clinical Supervision Innovation & Practice - Sydney, Australia
    Duration: 4 Jun 20136 Jun 2013


    ConferenceAdvances in Clinical Supervision Innovation & Practice


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