27 March 2020

Professional Therapeutic Supervision in the Time Of COVID 19

It seems almost redundant to refer to “professional supervision” as “professional therapeutic supervision” as one would hope that all professional supervision would be therapeutic for the supervisee. Unfortunately, I have heard more than enough tales of supervision being reduced to operational checklists, and “tick and flick” exercises in various agencies, that I feel the distinction is required. Professional supervision should assist the growth of the supervisee both in terms of her or his immediate requirements and her or his long-term development as a practitioner. It has professional, conceptual and emotional components, and the supervisee should feel contained by the supervisor and the supervision itself.

And, in this crisis in which we find ourselves, how much more is that style of supervision required now? How much more do practitioners working with clients who are concerned about/ dealing with the actualities of COVID-19 need that style of containment?

In every therapeutic conversation I participated in this week, COVID-19 was discussed. In every supervision I provided this week, COVID-19 was discussed. A very competent therapist whom I supervise also supervises other therapists at her place of work. Her supervisees provide therapy to refugees who are typically traumatised and now are facing another large bout of trauma brought about by the threat of COVID-19. She spoke of the emotional strain of supporting her supervisees at the same time as being privately concerned about her own family, elderly parents, whether her children should still be at school and when could her family retreat to the quarantined safety of home together. And yet, she kept those musings private while she attended to the anxieties of others. That is serious containment.

Another colleague of mine is a Director of Social Work in a major metropolitan hospital. In the “all of staff” meeting this week, she told her staff that in the coming months they all needed to:

  • have one hour of professional supervision a week.
  • include in the supervision a discussion of concerning matters, as well as their own ongoing emotional responses to the COVID-19 crisis, a discussion of any personal health and/or emotional issues that would render them to be more vulnerable in the coming months, and
  • develop a self-care plan to be shared with their supervisor and team leaders should they be overwhelmed and require some downtime.

The Director, of course, will be supervising the supervisors so that they can provide that level of conceptual and emotional containment and support to their supervisees. This entire system is what I would call a “systemic holding environment” (Gibney, 2005).

The staff who are supported by my competent colleagues are fortunate to have such clinical leadership available to them. In these dark days, we can only hope that more therapists in more agencies find themselves in such a containing context.

For yourself, as a therapist dealing with the regular anxieties compounded with the existential dread of this time, please make sure you have a supervisor capable of giving you a profound level of support.

Paul B. Gibney Ph.D.