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• Therapist, supervisor and institution responsibilities. • The ethical dimension.


3. The relationship between the supervisee, the supervisor, etc. • The relationship between the patients and the therapist-supervisee.


• Between the therapist and the supervisor.


4. Supervision in institutions The process of supervision may take place


in an institution (a training and/or assistance institution). In that case, the institution stands as a very important element in the relationship, because the institution is the place where patients, supervisees and supervisors meet each other. It is necessary to analyse the relationship between the supervisor and the supervisee; between the supervisee and the team of supervisors, and between the supervisees, the supervisors and the institution.


5. Potential problems a. Supervisee’s and supervisor’s blind spots.


b. Diffi culties in the communication between the supervisee and the supervisor.


c. Specifi c limitations of the supervisee exposed by certain patients.


d. Supervisee’s reaction to the feelings of the patient towards him/her.


e. Inadequate emotional response of the supervisee and/or supervisor.


My experience as a supervisee 1 As a “supervisee”, I chose, not necessarily


consciously, diff erent supervision methods: The most traditional one, individual supervision; supervision of the same patient with diff erent supervisors; group supervision; live supervision (supervising a family and with a small team of peers, and supervision from behind a one-way glass); with many peers and teachers from behind a one-way glass; psychodrama supervision; etc. Such variety of supervisors and


supervision methods greatly enriched my experience as a supervisee. I believe that, during the training process, it is very useful to see how other therapists work, how they face their job and how they benefi t from multiple experiences. As a supervisee, I realised that certain


patients progressed more satisfactorily under the supervision of a specifi c


14


supervisor. In other words, I learned how important the person of the therapist is in therapeutic processes. I learned that there is no such thing as impartiality.


Example 1 She was a survivor of a group of people


who disappeared during the Argentinean dictatorship. At a certain time, this young woman


became the girlfriend of the son of a psychotherapist who was a very good friend of the supervisor. That psychotherapist had died. The supervisor inadvertently started to play the role of her friend, and from that moment, in my opinion, supervision was not useful anymore. On that occasion, in order to protect my patient, I decided to stop supervising my patient with that supervisor. It was a very hard decision, because the supervision had been great for a long time. But then, the process got complicated. In my opinion, the supervisor became inadequately involved in the case. Therefore, I changed the supervisor. That situation raised an ethical question that made me think about the patient and led me to make a decision to protect her.


Example 2 In a context of live supervision involving


families, I was behind the glass as a member of the team. On two occasions, I had socially met the families we were observing. But due to the layout of the offi ce, I couldn’t leave and avoid the whole thing. I felt terrible. Long after, a member of one of the


families asked me if I was behind the glass. As families are not provided with information of this nature, I told him I wasn’t. But I felt that was a problem. Again, in that situation, ethics were involved.


Example 3 In a workshop, the visiting therapist


received a family for consultation. In the room there were at least 300 people. We watched the consultation on a closed- circuit TV. The family knew there was a team watching them. But they didn’t know that we were a crowd... I felt and thought that I wouldn’t like to


have my family watched by 300 people they did not pick.


The situations in examples 2 and 3 above


strongly aff ected me. When working as a professional psychotherapist, I was very careful to


avoid those situations I experienced as a supervisee.


Supervision in Uruguay


Some macro contextual features Uruguay is a very small country. We


are just three and a half million people. Between 1973 and 1985, there was a civic- military dictatorship. The dictatorship was an event that greatly aff ected our country. It disrupted the temporal fl ow of everyday life. This violent attack severely damaged the relationship that held all members of the society together. From this perspective, who was aff ected?


The whole community went through the dictatorship. Nobody was really isolated, we were all connected, linked, even the ones that were more distant or seemed to live in an island. Therefore, the hardships endured by a person or a group of people in our country aff ected the whole community. However, each individual organised his or her environment according to his or her structure, and backgrounds and his or her own life. These macro contextual marks


directly aff ect our working methods and supervision.


Examples I. The one-way glass was perceived by more than one patient as a persecutory panopticon. Patients used to say: “it looks like the system used by the police for scrutinising criminals and/or political prisoners”. Fear remains until today among people. In those cases, I tried to find a way to calm patients down: for example, I used to offer them to search the office if they felt like it.


II. It is very hard, if not almost impossible to preserve anonymity. These conditions forced me not to fi lm sessions and I fi nd it very diffi cult to use technology as I did when I studied in Mexico.


III. If I work with a team, at the beginning of the fi rst visit I introduce all the therapists who will be behind the glass to the family. Then, I try to avoid any type of contact between the therapists and the family. If the family and/or any member of the team feel uncomfortable about any member of the family or vice versa, I tell the member of the team to leave and not to take part in the therapeutic process.


Context February 2012


Supervision, a place to learn a profession: Psychotherapy


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