Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-19T10:46:33.026Z Has data issue: false hasContentIssue false
  • English
  • Français

Getting to the Heart of Clinical Supervision: A Theoretical Review of the Role of Emotions in Professional Development

Published online by Cambridge University Press:  18 February 2009

Chiara Lombardo ,
Derek Milne  and
Rachael Proctor
Chiara Lombardo*
Affiliation:
Newcastle University, UK
Derek Milne
Affiliation:
Newcastle University, UK
Rachael Proctor
Affiliation:
Newcastle University, UK
*
Reprint requests to Chiara Lombardo, School of Medical Education Development, The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: The importance of supervision is increasingly recognized, yet it remains little understood, impairing research and practice. Specifically, the CBT supervision model provides a relatively “heartless” account of professional development, which may undermine its effectiveness. Method: A theoretical review of emotions in supervision and learning is provided, to summarize relevant theoretical and empirical literature. The objectives are to clarify the role of emotions in CBT supervision, and to use this understanding to outline an emotionally-attuned model, illustrating its application to two critical aspects of CBT supervision (the development of a learning alliance and enhancing professional competence). Conclusion: The reviewed literature (theory and research evidence) supports the explicit and systematic incorporation of emotions into CBT supervision. Conceptually, this can be achieved by integrating Lazarus's (1991) general theory of emotion with the CBT model. The illustrations of this augmented model indicate its value in understanding and managing both the “rupture-repair” cycle that can affect the supervisory alliance, and the “deskilling-development” pattern that appears to be necessary for the acquisition of competence. We propose that CBT supervision might usefully be guided by our expanded model, as this affords greater internal consistency and may be more effective educationally.

Keywords

Emotionlearningclinical supervisiontherapeutic alliancetrainingprofessional development
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 37 , Issue 2 , March 2009 , pp. 207 - 219
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alliger, G. M., Tannenbaum, S. I., Bennett, W. J., Traver, H. and Shotland, A. (1997). A meta-analysis of the relations among training criteria. Personnel Psychology, 50, 341–360.CrossRefGoogle Scholar
Atkins, J. (2002). The emotional dimension of learning. Learning in Health and Social Care, 1, 59–62.Google Scholar
Beck, A. T. (1996). Beyond belief: a theory of modes, personality, and psychopathology. InSalkovskis, P. M. (Ed.), Frontiers of Cognitive Therapy (pp. 1–25). London: Guilford Press.Google Scholar
Blackburn, I-M., James, I. A., Milne, D. L., Baker, C., Standart, S., Garland, A. and Reichelt, F. K. (2001). The revised Cognitive Therapy Scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431–446.CrossRefGoogle Scholar
Boekaerts, M. (1996). Coping with stressful situations in a learning context. In De Corte, E. and Weinet, F. E. (Eds.), International Encyclopaedia of Developmental and Instructional Psychology (pp. 623–626). Oxford: Elsevier.Google Scholar
Bordin, E. S. (1979). The generaliseability of the psychodynamic concept of the working alliance. Psychotherapy: Theory, Research and Practice, 16, 252–260.CrossRefGoogle Scholar
Cacioppo, J. T. and Gardner, W. L. (1999). Emotion. Annual Review of Psychology, 50, 191–214.Google Scholar
Castonguay, L. G., Goldfried, M. R., Wiser, S., Raue, P. J. and Hayes, A. M. (1996). Predicting the effect of cognitive therapy for depression: a study of unique and common factors. Journal of Consulting and Clinical Psychology, 64, 497–504.CrossRefGoogle ScholarPubMed
Colquitt, J. A., LePine, A. and Noe, R. A. (2000). Toward an integrative theory of training motivation: a meta-analytic path analysis of 20 years of research. Journal of Applied Psychology, 85, 678–707CrossRefGoogle ScholarPubMed
Dewar, B. J. and Walker, E. (1999). Experiential learning: issues for supervision. Journal of Advanced Nursing, 30, 1459–1467.CrossRefGoogle ScholarPubMed
Dewey, J. (1955). Experience and Education. New York: Macmillan.Google Scholar
Durham, R. C., Chambers, J. A., Power, K. D., Sharp, D. M., Macdonald, R. R., Major, K. A., Dow, M. G. T. and Gumley, A. (2005). Long-term outcome of cognitive behaviour therapy clinical trials in central Scotland. Health Technology Assessment, 9, 1.CrossRefGoogle ScholarPubMed
Ekman, P. and Davidson, R. J. (1994). The Nature of Emotions: fundamental questions. Oxford: Oxford University Press.Google Scholar
Faith, M. and Thayer, J. F. (2001). A dynamical systems interpretation of a dimensional model of emotion. Scandinavian Journal of Psychology, 42, 121–133.CrossRefGoogle ScholarPubMed
Fleming, I. and Steen, L. (Eds.) (2004). Supervision and Clinical Psychology: theory, practice and perspectives. Hove: Brunner-Routledge.CrossRefGoogle Scholar
Follette, V. M. and Batten, S. V. (2000). The role of emotion in psychotherapy supervision: a contextual behavioural analysis. Cognitive and Behavioural Practice, 7, 306–312.Google Scholar
Fridja, N. (2000). Emotion. In Pawlik, K. and Rosenzweig, M. R. (Eds.), International Handbook of Psychology (pp. 207–223). London: Sage Publications.Google Scholar
Friedman, D. and Kaslow, N. J. (1986). The development of professional identity in psychotherapists: six stages in the supervision process. In: Kaslow, F. W. (Ed.), Supervision and Training: models, dilemmas, challenges. New York: Howarth.Google Scholar
Follette, V. M. and Batten, S. V. (2000). Cognitive and Behavioral Practice, 7, 306–312.Google Scholar
Gagné, R. M. (1984). Learning outcomes and their effects: useful categories of human performance. American Psychologist, 39, 377–385.Google Scholar
Goldstein, I. L. (1993). Training in Organizations: needs assessment, development and evaluation. Pacific Grove, CA: Jossey-Bass.Google Scholar
Gould, N. (2000). Becoming a learning organisation: a social work example. Social Work Education, 19, 585–596.CrossRefGoogle Scholar
Hook, K. and Bunce, D. (2001). Immediate learning in organisational computer training as a function of training intervention: affective reaction and session impact measures. Applied Psychology: An International Review, 50, 436–454.CrossRefGoogle Scholar
James, I. A., Allen, K. and Collerton, D. (2004). A post-hoc analysis of emotions in supervision: a new methodology for examining process features. Behavioural and Cognitive Psychotherapy, 32, 507–513.Google Scholar
James, I. A., Blackburn, I-M., Milne, D. L. and Reichelt, F. K. (2001). Moderators of trainee therapists’ competence in cognitive therapy. British Journal of Clinical Psychology, 40, 131–141.CrossRefGoogle ScholarPubMed
James, I. A., Milne, D., Blackburn, I-M. and Armstrong, P. (2006). Conducting successful supervision: novel elements towards an integrative approach. Behavioural and Cognitive Psychotherapy, 35, 191–200.Google Scholar
Kolb, D. A. (1984). Experiential Learning. New Jersey: Prentice Hall.Google Scholar
Kokkonen, M. and Pulkkinen, L. (2001). Examination of the pats between personality, current mood, its evaluation, and emotion regulation. European Journal of Personality, 15, 83–104.CrossRefGoogle Scholar
Ladany, N., Friedlander, M. L. and Nelson, M. (2005). Critical Events in Psychotherapy Supervision: an interpersonal approach. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Lazarus, R. S. (1991). Progress on a cognitive-motivational-relational theory of emotion. American Psychologist, 48, 819–834.CrossRefGoogle Scholar
Lazarus, R. S. (1993). Psychological stress in the workplace. In Candrall, R. and Perrewe, P. L.. (Eds.), Occupational Stress: a handbook. New York: Taylor and Francis.Google Scholar
Lazarus, R. S. (2000). How emotions influence performance in competitive sports. The Sport Psychologist, 14, 229–259.Google Scholar
Lazarus, R. S. and Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.Google Scholar
Liese, B. S. and Beck, J. S. (1997). Cognitive therapy supervision. InWatkins, C. E.. (Ed.), Handbook of Psychotherapy Supervision (pp. 114–133). New York: John Wiley and Sons Inc.Google Scholar
Lombardo, C. (2007). The role of emotions in training and clinical supervision of professionals working in community mental health services: an exploration of the Lazarus model. Unpublished PhD thesis, School for Applied Social Sciences, Durham University.Google Scholar
Lorr, M. (1984). Bi-polar Form (POMS-BI): profile of mood states. San Diego: Educational and Industrial Testing Service.Google Scholar
Lovell, C. W. (2002). Development and disequilibration: predicting counsellor trainee gain and loss scores on the Supervisee Levels Questionnaire. Journal of Adult Development, 9, 235–240.CrossRefGoogle Scholar
Macdonald, J. (2002). Clinical supervision: a review of underlying concepts and developments. Australian and New Zealand Journal of Psychiatry, 36, 92–98.CrossRefGoogle ScholarPubMed
McNeill, B. W., Stoltenberg, C. D. and Romans, J. C. (1992). The integrated developmental model of supervision: scale development and validation procedures. Professional Psychology: Research and Practice, 6, 504–508.Google Scholar
Magnavita, J. J. (2006). In search of the unifying principles of psychotherapy: conceptual, empirical and clinical convergence. American Psychologist, 61, 882–892CrossRefGoogle ScholarPubMed
Milne, D. L. (2006). Developing Clinical Supervision Research through Reasoned Analogies with Therapy. Clinical Psychology and Psychotherapy, 13, 215–222.Google Scholar
Milne, D. L. and James, I. A. (2002). The observed impact of training on competence in clinical supervision. British Journal of Clinical Psychology, 41, 55–72.CrossRefGoogle ScholarPubMed
Milne, D. L. and Westerman, C. (2001). Evidence-based clinical supervision: rationale and illustration. Clinical Psychology and Psychotherapy, 8, 444–457.CrossRefGoogle Scholar
Reichelt, S. and Skjerve, J. (2002). Correspondence between supervisors and trainees in their perception of supervision events. Journal of Clinical Psychology, 58, 759–772.CrossRefGoogle ScholarPubMed
Reilly, C. E. (2000). Response: the role of emotion in cognitive therapy, cognitive therapists, and supervision. Cognitive and Behavioral Practice, 7: 343–345.CrossRefGoogle Scholar
Rogers, A. (1996). Teaching Adults. Philadelphia: Open University Press.Google Scholar
Roth, A. and Fonagy, P. (1996). What Works For Whom? London: Guilford Press.Google Scholar
Saarikoski, M. and Leino-Kilpi, H. (2002). The clinical learning environment and supervision by staff nurses: developing the instrument. International Journal of Nursing Studies, 39, 259–267.Google Scholar
Safran, J. D. and Muran, J. C. (2000a). Negotiating the Therapeutic Alliance: a relational treatment guide. New York: Guilford Press.Google Scholar
Safran, J. D. and Muran, J. C. (2000b). Resolving therapeutic alliance ruptures: diversity and integration. Journal of Clinical Psychology, 56, 233–243.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
Severinsson, E. I. and Hallberg, I. R. (1996). Clinical supervisors’ views of their leadership role in clinical supervision process within nursing care. Journal of Advanced Nursing, 24, 151–161.Google Scholar
Skovholt, T. M. and Ronnestad, M. H. (1992). The Evolving Professional Self: stages and themes in therapist and counsellor development. Chichester: Wiley.Google Scholar
Stoltenberg, C. D. and McNeill, B. W. (1997). Clinical supervision from a developmental perspective: research and practice. InWatkins, C. E.. (Ed.), Handbook of Psychotherapy Supervision (pp. 184–202). Chichester: Wiley.Google Scholar
Vygotsky, L. S. (1978). Mind in Society: the development of higher psychological processes. Cambridge, Mass: Harvard University Press.Google Scholar
Warr, P. B., Allan, C. and Birdi, K. (1999). Predicting three levels of training outcome. Journal of Occupational and Organizational Psychology, 72, 351–375.Google Scholar
Warr, P. B. and Downing, J. (2000). Learning strategies, learning anxiety and knowledge acquisition. British Journal of Psychology, 91, 311–333.Google Scholar
Watkins, C. E. (1997). Handbook of Psychotherapy Supervision. Chichester: Wiley.Google Scholar
Wells, A. (1997). Cognitive Therapy of Anxiety Disorders. Chichester: Wiley.Google Scholar
Zorga, S. (2002). Supervision: the process of life-long learning in social and educational professions. Journal of Interprofessional Care, 16, 265–276.CrossRefGoogle ScholarPubMed
Zuroff, D. C. and Blatt, S. J. (2006). The therapeutic relationship in the brief treatment of depression: contributions to clinical improvement and enhanced adaptive capacities. Journal of Consulting and Clinical Psychology, 74, 130–140.Google Scholar
Submit a response

Comments

No Comments have been published for this article.