What comes to mind when you hear the word “clinical supervision group”? For many clinicians, the imagery may relate to a very intellectual exercise. A case is presented and the group members apply clinical theories. Perhaps they even vie for the best interpretation. This common expectation is intimidating. After all, it’s not unusual for people to fear:

  • competition
  • not being smart enough
  • not having enough experience to participate
  • the possibility of being judged

However, I find that the most effective clinical supervision groups to strengthen and deepen clinical work are those that encourage the use of self.

What Does “Use of Self” Mean?

To help highlight this concept, let’s consider what happens when one group member is presenting a clinical case. In most such situations, the other members are:

Watching the presenter

This may, for example, include them noticing the presenter’s body language.

Listening

Listening to more than what’s being said, the members assess and appraise the presenter’s tone, cadence, emotion, and excitement.

Noting thoughts and feelings that arise during the presentation

These can be thoughts or feelings towards the presenter, towards themselves, or towards the players being presented.

Noting personal memories that arise during the presentation

This process can include more abstract musing like dreams, fantasies, or images.

When the presenter completes the presentation, members are encouraged to share the experiences and observations they noted above during the presentation. Ideally, this is done in a non-judgmental and non-critical way. In other words, as a group member, you are essentially sharing yourself with the room. Any response or reaction is valid; there is no right and wrong. In fact, responses inspired by “use of self” just might provide an abundance of insight into what is going on in the case. This is because such responses are particularly genuine and emotional in nature.

Your use of self — your emotional communications — are going to help the presenter identify their countertransference and the patient’s transference.

What About Theory and Interpretation?

No, we certainly do not throw theory, interpretations, and other related feedback to the wind. However, by becoming comfortable with and skilled at the use of self, you’ll find that there is not the first priority. Theory is important, but emotional communications will provide the deepest possible meaning in a group setting. It is important to welcome theoretical input — along with recommendations for helpful articles and suggested interventions. But do not lose sight of the most welcome input of all: emotional communications provoked by the use of self.

Self-Awareness/Self-Disclosure

Self-awareness is a crucial part of authentically and ethically engaging in the use of self in a therapy-related setting. This can often manifest in something called “relational self-disclosure.” This refers to a clinician disclosing feelings in the ways mentioned above — e.g. thoughts, memories, observations, etc. — in relation to others in the setting.

Sharing about a felt sense of connection can provide news perspectives through which to observe the process. It also cultivates a deeper feeling of intimacy for the participants — further enhancing the likelihood of new viewpoints and discoveries to happen. A vibe of trust and transparency can be fostered.

Growth in Clinical Supervision Groups

I have frequently discussed the common fears and concerns clinicians may have about supervision groups. They are genuine and serious. However, equally as serious and genuine are the myriad opportunities for growth and evolution in these settings. As you can see from above, there are valid reasons to initially feel hesitant about fitting in when a varied group of clinicians is presenting theories and findings. Even so, this is fertile ground for self-improvement, self-awareness, and self-care. And all those benefits share a “use of self.” Let’s talk. Please contact me to discuss possibly joining my supervision group soon.