Heidi Hutman, Michael Ellis & Shangyun Zhou, “Supervisees’ Perspectives of Inadequate, Harmful, and Exceptional Clinical Supervision: Are We Listening?”

This article defines elements of “harmful”, “inadequate” and “exceptional” supervision based on qualitative research. This expanded on the work of Ellis, noted above. Supervisees who reported harmful experiences described supervisors as neglectful and callous, etc. Harmful supervision reflected “supervisory practices that result in psychological, emotional, and/or physical harm or trauma to the supervisee… The two essential components of harmful supervision are: (a) that the supervisee was genuinely harmed in some way by the supervisor’s behaviours, or (b) the supervisor’s behaviour is known to cause harm, even though the supervisee may not identify the behaviours as harmful (Ellis et al., 2014, p. 440).”

The researcher identified aspects of harmful supervision as follows: supervisor professional neglect, an unsupportive supervisory relationship, giving harsh or disparaging feedback/evaluation, misuse and abuse of power, emotional dysregulation, and unsafe environment. Supervisor professional neglect involved supervisors who completely disregarded or failed to fulfill professional and ethical responsibilities, resulting in harm to the supervisee. An unsupportive supervisory relationship describes relationally and emotionally unsupportive supervisors who were oblivious to the supervisees’ emotional needs, resulting in harm. Harmful interactions sometimes included harsh or disparaging feedback or evaluation involving excessive criticism, belittlement, and/or public shame or humiliation. These circumstances resulted in supervisee self-doubt, insecurity, or self-silencing, causing harm to the supervisory relationship and the supervisee. Supervisors’ misuse and abuse of power was described as intentional or unintentional exploiting of supervisees, crossing boundaries, and taking advantage of their positions of authority.  Harmful supervision also took the form of emotional dysregulation (supervisors who were unable to control or regulate their emotions), including acting with verbal or physical anger and/or aggression. In some instances, the supervisor’s inability to self-regulate resulted in “extreme anxiety” for the supervisee. Finally, an unsafe environment involved supervisors making supervisees feel shamed and fearful of discipline.

In contrast, “inadequate supervision” included inappropriate feedback, unavailability, and unresponsiveness. This supervision was described as subpar experiences without direct harm to the supervisee or their clients. Six categories emerged: failure to provide appropriate feedback, supervisor lack of availability, supervisor inattentiveness or unresponsiveness to supervisee needs, poor boundaries, lack of monitoring of supervisee clinical performance, and clinical incompetence issues. Failure to provide appropriate feedback involved a lack of guidance, including not receiving feedback when needed, receiving unhelpful feedback, or dismissive or overly critical feedback. Supervisor inattentiveness or unresponsiveness to supervisee needs involved supervisors who were overly task-focused, those who had unreasonable expectations, and generally unsupportive supervisors. Some supervisors also had poor boundaries, demonstrating an excessive focus on themselves and their own needs, and were unable to manage multiple roles. Some supervisors were perceived to lack the skills and knowledge to provide competent supervision. Finally, inadequate supervision consisted of a lack of monitoring supervisees’ work with clients. This included lack of awareness of supervisee cases and a disconnect from what the supervisee was doing clinically.

Exceptional supervision involved supervisee safety, clinical paradigm shifts, and modelling of specific techniques or theories.  Exceptional supervision has been described as a composite consisting of supervisors (a) clearly exceeding criteria for minimally adequate supervision; (b) implementing extant clinical supervision best practices; (c) developing and maintaining a collaborative professional supervisory relationship that maintains appropriate professional boundaries and exemplifies humility, respect, genuineness, mutual caring, transparency, and flexibility; and (d) attaining and using a deep understanding of and respect for supervisees’ (and their clients’) cultural identities to promote their sense of empowerment, profound insight, and professional development. Exceptional supervision was split into four categories: relational empowerment, paradigm shift, skill enhancement, and illuminating unconscious emotional bias. Relational empowerment involved supervisors who used the supervisory relationship as a vehicle for empowerment and reflected supervisors who (a) provided a genuinely safe and collaborative supervisory environment, (b) validated supervisee experiences, and (c) optimized supervision based on their developmental needs. Paradigm shift describes supervisors who assist supervisees in developing profound, foundational conceptual changes in their work through new perspectives or insights. Skill enhancements describe supervisors who enhance supervisees’ knowledge and application of specific clinical competencies through incisive feedback. The final category – illuminating unconscious emotional bias – describes supervisors who illuminate supervisees’ emotional reactions to clients to increase effectiveness, demonstrating support and empathy as they make supervisees aware of these issues.

Heidi Hutman, Michael Ellis & Shangyun Zhou, “Supervisees’ Perspectives of Inadequate, Harmful, and Exceptional Clinical Supervision: Are We Listening?” (2023) 51:5 Counseling Psychologist 719.