Supervision Essentials for

the Critical
Events in
Psychotherapy
Supervision
Model
 Clinical Supervision
Essentials Series
Supervision Essentials for Psychodynamic Psychotherapies
Joan E. Sarnat
Supervision Essentials for the Integrative Developmental Model
Brian W. McNeill and Cal D. Stoltenberg
Supervision Essentials for the Feminist Psychotherapy Model of Supervision
Laura S. Brown
Supervision Essentials for a Systems Approach to Supervision
Elizabeth L. Holloway
Supervision Essentials for the Critical Events in Psychotherapy
Supervision Model
Nicholas Ladany, Myrna L. Friedlander, and Mary Lee Nelson
Clinical Supervision Essentials
HANNA LEVENSON and ARPANA G. INMAN, Series Editors

Supervision Essentials for

the Critical
Events in
Psychotherapy
Supervision
Model
Nicholas Ladany, Myrna L. Friedlander,
and Mary Lee Nelson

American Psychological Association • Washington, DC

Copyright © 2016 by the American Psychological Association. All rights reserved. Except
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out the prior written permission of the publisher.
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Psychological Association.
Library of Congress Cataloging-in-Publication Data
Names: Ladany, Nicholas, author. | Friedlander, Myrna L., author. | Nelson,
Mary Lee, author.
Title: Supervision essentials for the critical events in psychotherapy
supervision model / Nicholas Ladany, Myrna L. Friedlander, and Mary Lee
Nelson.
Description: Washington, DC : American Psychological Association, [2016] |
Includes bibliographical references and index.
Identifiers: LCCN 2015050631 | ISBN 9781433822513 | ISBN 1433822512
Subjects: LCSH: Psychotherapists—Supervision of. | Psychotherapy—Study and
teaching. | Psychotherapists—Training of.
Classification: LCC RC459 .L335 2016 | DDC 616.89/14—dc23 LC record available at
http://lccn.loc.gov/2015050631
British Library Cataloguing-in-Publication Data
A CIP record is available from the British Library.
Printed in the United States of America
First Edition
http://dx.doi.org/10.1037/14916-000
 To our families
Randa, Nisrine, Mona, and Farah
Lou and Lee
Randy and Eric
 Contents

Foreword to the Clinical Supervision Essentials Series ix

Introduction 3
Chapter 1. Overview of the Critical Events Model 11
Chapter 2. Ambiguity and Conflict in the Supervision
Relationship: It’s All About the Roles! 37
Chapter 3. Addressing Skill Difficulties, Deficits, and
Competency Concerns 57
Chapter 4. Working Through Parallel Processes and Heightening
Multicultural Awareness: Two Critical Events
for the Price of One 85
Chapter 5. Using the Critical Events Model in Practice
and Training 111
Suggested Readings 125
References 129
Index 137
About the Authors 145

vii
 Foreword to the Clinical
Supervision Essentials Series

W e are both clinical supervisors. We teach courses on supervision of

students who are in training to become therapists. We give work-
shops on supervision and consult with supervisors about their supervision
practices. We write and do research on the topic. To say we eat and breathe
supervision might be a little exaggerated, but only slightly. We are fully
invested in the field and in helping supervisors provide the most informed
and helpful guidance to those learning the profession. We also are commit-
ted to helping supervisees/consultees/trainees become better collaborators
in the supervisory endeavor by understanding their responsibilities in the
supervisory process.
What is supervision? Supervision is critical to the practice of therapy.
As stated by Edward Watkins1 in the Handbook of Psychotherapy Super­
vision, “Without the enterprise of psychotherapy supervision, . . . the prac-
tice of psychotherapy would become highly suspect and would or should
cease to exist” (p. 603).
Supervision has been defined as
an intervention provided by a more senior member of a profession to
a more junior colleague or colleagues who typically (but not always)
are members of that same profession. This relationship

77 is evaluative and hierarchical,

77 extends over time, and

1 Watkins, C. E., Jr. (Ed.). (1997). Handbook of psychotherapy supervision. New York, NY: Wiley.

ix
 FOREWORD TO THE CLINICAL SUPERVISION ESSENTIALS SERIES

77 has the simultaneous purposes of enhancing the professional function-

ing of the more junior person(s); monitoring the quality of profes-
sional services offered to the clients that she, he, or they see; and serving
as a gatekeeper for the particular profession the supervisee seeks to
enter. (p. 9)2

It is now widely acknowledged in the literature that supervision is a

“distinct activity” in its own right.3 One cannot assume that being an excel-
lent therapist generalizes to being an outstanding supervisor. Nor can one
imagine that good supervisors can just be “instructed” in how to supervise
through purely academic, didactic means.
So how does one become a good supervisor?
Supervision is now recognized as a core competency domain for psy-
chologists4,5 and other mental health professionals. Guidelines have been
created to facilitate the provision of competent supervision across pro-
fessional groups and internationally (e.g., American Psychological Asso-
ciation,6 American Association of Marriage and Family Therapy,7 British
Psychological Society,8,9 Canadian Psychological Association10).

2 Bernard, J. M., & Goodyear, R. K. (2014). Fundamentals of clinical supervision (5th ed.). Boston, MA: Pearson.
3 Bernard, J. M., & Goodyear, R. K. (2014). Fundamentals of clinical supervision (5th ed.). Boston, MA: Pearson.
4 Fouad, N., Grus, C. L., Hatcher, R. L., Kaslow, N. J., Hutchings, P. S., Madson, M. B., . . . Crossman, R. E.
(2009). Competency benchmarks: A model for understanding and measuring competence in professional
psychology across training levels. Training and Education in Professional Psychology, 3 (4 Suppl.), S5–S26.
http://dx.doi.org/10.1037/a0015832
5 Kaslow, N. J., Rubin, N. J., Bebeau, M. J., Leigh, I. W., Lichtenberg, J. W., Nelson, P. D., . . . Smith, I. L.
(2007). Guiding principles and recommendations for the assessment of competence. Professional Psychol­
ogy: Research and Practice, 38, 441–51. http://dx.doi.org/10.1037/0735-7028.38.5.441
6 American Psychological Association. (2014). Guidelines for clinical supervision in health service psychology.
Retrieved from http://www.apa.org/about/policy/guidelines-supervision.pdf
7 American Association of Marriage and Family Therapy. (2007). AAMFT approved supervisor designa­
tion standards and responsibilities handbook. Retrieved from http://www.aamft.org/imis15/Documents/
Approved_Supervisor_handbook.pdf
8 British Psychological Society. (2003). Policy guidelines on supervision in the practice of clinical psychology.
Retrieved from http://www.conatus.co.uk/assets/uploaded/downloads/policy_and_guidelines_on_
supervision.pdf
9 British Psychological Society. (2010). Professional supervision: Guidelines for practice for educational psychol­
ogists. Retrieved from http://www.ucl.ac.uk/educational-psychology/resources/DECP%20Supervision%20
report%20Nov%202010.pdf
10 Canadian Psychological Association. (2009). Ethical guidelines for supervision in psychology: Teach­
ing, research, practice and administration. Retrieved from http://www.cpa.ca/docs/File/Ethics/
EthicalGuidelinesSupervisionPsychologyMar2012.pdf

x
 FOREWORD TO THE CLINICAL SUPERVISION ESSENTIALS SERIES

The Guidelines for Clinical Supervision in Health Service Psychology11

are built on several assumptions, specifically that supervision

77 requires formal education and training;

77 prioritizes the care of the client/patient and the protection of the public;
77 focuses on the acquisition of competence by and the professional devel-
opment of the supervisee;
77 requires supervisor competence in the foundational and functional
competency domains being supervised;
77 is anchored in the current evidence base related to supervision and the
competencies being supervised;
77 occurs within a respectful and collaborative supervisory relationship
that includes facilitative and evaluative components and is established,
maintained, and repaired as necessary;
77 entails responsibilities on the part of the supervisor and supervisee;
77 intentionally infuses and integrates the dimensions of diversity in all
aspects of professional practice;
77 is influenced by both professional and personal factors, including values,
attitudes, beliefs, and interpersonal biases;
77 is conducted in adherence to ethical and legal standards;
77 uses a developmental and strength-based approach;
77 requires reflective practice and self-assessment by the supervisor
and supervisee;
77 incorporates bidirectional feedback between the supervisor and
supervisee;
77 includes evaluation of the acquisition of expected competencies by the
supervisee;
77 serves a gatekeeping function for the profession; and
77 is distinct from consultation, personal psychotherapy, and mentoring.

The importance of supervision can be attested to by the increase in

state laws and regulations that certify supervisors and the required
multiple super­v isory practica and internships that graduate students
in all professional programs must complete. Furthermore, research has

American Psychological Association. (2014). Guidelines for clinical supervision in health service psychology.
11

Retrieved from http://www.apa.org/about/policy/guidelines-supervision.pdf

xi
 FOREWORD TO THE CLINICAL SUPERVISION ESSENTIALS SERIES

confirmed12 the high prevalence of supervisory responsibilities among

practitioners—specifically that between 85% and 90% of all thera-
pists eventually become clinical supervisors within the first 15 years
of practice.
So now we see the critical importance of good supervision and its
high prevalence. We also have guidelines for its competent practice and an
impressive list of objectives. But is this enough to become a good super-
visor? Not quite. One of the best ways to learn is from highly regarded
supervisors—the experts in the field—those who have the procedural
knowledge13 to know what to do, when, and why.
Which leads us to our motivation for creating this series. As we looked
around for materials that would help us supervise, teach, and research clin-
ical supervision, we were struck by the lack of a coordinated effort to pre­
sent the essential models of supervision in both a didactic and experiential
form through the lens of expert supervisors. What seemed to be needed
was a forum where the experts in the field—those with the knowledge and
the practice—present the basics of their approaches in a readable, acces-
sible, concise fashion and demonstrate what they do in a real supervisory
session. The need, in essence, was for a showcase of best practices.
This series, then, is an attempt to do just that. We considered the major
approaches to supervisory practice—those that are based on theoretical
orientation and those that are metatheoretical. We surveyed psycholo-
gists, teachers, clinical supervisors, and researchers domestically and inter­
nationally working in the area of supervision. We asked them to identify
specific models to include and who they would consider to be experts in
this area. We also asked this community of colleagues to identify key issues
that typically need to be addressed in supervision sessions. Through this
consensus building, we came up with a dream team of 11 supervision
experts who not only have developed a working model of supervision but
also have been in the trenches as clinical supervisors for years.

Rønnestad, M. H., Orlinsky, D. E., Parks, B. K., & Davis, J. D. (1997). Supervisors of psychotherapy:
12

Mapping experience level and supervisory confidence. European Psychologist, 2, 191–201.

13Schön, D. A. (1987). Educating the reflective practitioner: Toward a new design for teaching and learning in
the professions. San Francisco, CA: Jossey-Bass.

xii
 FOREWORD TO THE CLINICAL SUPERVISION ESSENTIALS SERIES

We asked each expert to write a concise book elucidating her or

his approach to supervision. This included highlighting the essential
dimensions/key principles, methods/techniques, and structure/process
involved, the research evidence for the model, and how common super-
visory issues are handled. Furthermore, we asked each author to elucidate
the supervisory process by devoting a chapter describing a supervisory
session in detail, including transcripts of real sessions, so that the readers
could see how the model comes to life in the reality of the supervisory
encounter.
In addition to these books, each expert filmed an actual supervisory
session with a supervisee so that her or his approach could be demonstrated
in practice. APA Books has produced these videos as a series and they are
available as DVDs (http://www.apa.org/pubs/videos). Each of these books
and videos can be used together or independently, as part of the series or
alone, for the reader aspiring to learn how to supervise, for supervisors
wishing to deepen their knowledge, for trainees wanting to be better super-
visees, for teachers of courses on supervision, and for researchers investi-
gating this pedagogical process.

About This Book

In this book, Supervision Essentials for the Critical Events in Psycho­
therapy Supervision Model, Ladany, Friedlander, and Nelson describe
a practice-based, process-oriented approach that is theoretically and
empirically informed; their goal is to flesh out what it means to be a
responsive supervisor in dealing effectively with the complexity of the
supervisory encounter. Using a pantheoretical model founded within a
sound supervisory relationship, the reader is taken through a series of
steps designed to help the clinical supervisor (and supervisee) handle
(and hopefully resolve) several common, but challenging, supervisory
dilemmas—such as how to address role conflict and ambiguity, how to
handle trainees with deficits, how to work with parallel process, and how
to be sensitive to multicultural issues. The key principles and techniques of
this “task analytic approach” are vividly conveyed through a multitude of
supervisory examples. Reading this book is like having these experienced

xiii
 Supervision Essentials for a Systems Approach to Supervision

supervisors, sophisticated researchers, and superb teachers whispering

in your ear regarding what strategies are most effective at critical choice
points (“critical events”) in the supervision work. This is a must-read for
those, regardless of orientation or discipline, who want to enhance their
capacity for using facilitative moment-to-moment interactions within the
supervisory hour.
We thank you for your interest and hope the books in this series enhance
your work in a stimulating and relevant way.

Hanna Levenson and Arpana G. Inman

xiv
Supervision Essentials for

the Critical
Events in
Psychotherapy
Supervision
Model
 Introduction

T he critical events in psychotherapy supervision model (Ladany,

Friedlander, & Nelson, 2005), also known as critical events in
supervision, is intended for supervisors and supervisors in training of
mental health practitioners. In this book, we focus on the essentials of
our model with the intent of providing a general introduction to our
approach as well as clinical applications of particular dilemmas. These
dilemmas include handling role conflict and ambiguity, addressing skill
difficulties and deficits, working through parallel processes, and height-
ening multicultural awareness. Interested readers can find discussions of
several other critical events (e.g., managing countertransference, resolving
gender-related misunderstandings, addressing problematic attitudes and
behavior) in Ladany et al. (2005).
Our practice-based approach is theoretically and empirically
informed. The critical events are applicable across theoretical approaches;

http://dx.doi.org/10.1037/14916-001
Supervision Essentials for the Critical Events in Psychotherapy Supervision Model, by N. Ladany,
M. L. Friedlander, and M. L. Nelson
Copyright © 2016 by the American Psychological Association. All rights reserved.

3
 The Critical Events in Psychotherapy Supervision Model

however, the bases of the interpersonal aspects of our approach are reflec-
tive of interpersonal, contemporary psychoanalytic, and humanistic
approaches to supervision (Bromberg, 1982; Friedlander, 2012, 2015;
Gill, 2001; Greenberg, 1983; Sarnat, 2016; Skovholt & Rønnestad, 1992).
We assume that the client, supervisee, and supervisor are all active par-
ticipants in the understanding of supervision and therapy processes. Our
supervision empirical and theoretical work, along with the work of others,
also influenced our selection of dilemmas or critical events.

OVERVIEW OF THE BOOK

The first chapter introduces the task-analytic paradigm on which the
model is based. In it, we define the key principles of our model (e.g., define
the relationship using the supervisory working alliance model), the meth-
ods and techniques (e.g., interventions and purposeful interactions that
the supervisor may use to engage the supervisee), and the structure and
processes of supervision, all of which are illustrated with case examples
throughout the rest of the book. These case examples provide ways to
handle common supervisory issues, such as addressing supervisee com-
petency concerns, conflicts, and multicultural concepts in supervision, as
well as the interplay among and between these issues.
Although supervision entails accomplishing numerous tasks, we tar-
get specific events or episodes in which there is a critical task to be worked
through. In Ladany et al. (2005) and in subsequent writings on the critical
events model, we identified 10 critical events that include (a) remediat-
ing skill difficulties and deficits, (b) heightening multicultural awareness,
(c) negotiating role conflicts, (d) working through countertransference,
(e) managing sexual attraction, (f) repairing gender-related misunder-
standings, and (g) addressing supervisees’ problematic attitudes and
behaviors. In Chapters 2, 3, and 4, we focus on four critical events: work-
ing through role conflicts (Chapter 2), addressing skill deficits and com-
petency concerns (Chapter 3), and working through parallel process and
heightening multicultural awareness (Chapter 4). In addition, Chapter 4
illustrates the manner in which two events can overlap.

4
 Introduction

Chapter 5 offers additional thoughts on our model. In particular, we

consider how the critical events model can be used to train supervisors
and consider elements of effective and ineffective supervision that go
beyond the model. Moreover, we provide a section on research of the
model and how the model can be researched in the future. Chapter 5
also includes close analysis of Nicholas Ladany’s videotaped supervisory
session with a clinical trainee.1 The book also includes a list of suggested
readings, along with information about how these readings can serve the
reader interested in additional aspects of our model.

PERSONAL JOURNEYS
To further provide context to our supervision model, we offer a summary
of our personal journeys to becoming a supervisor. For us, becoming an
expert supervisor is a professional lifelong endeavor that is aspirational
rather than achievable.
Nicholas Ladany: Dr. Ladany has had the good fortune to have writ-
ten about his road to becoming a professional supervision scholar, educa-
tor, and practitioner (Ladany, 2004, 2010). Reflecting back, there seem to
be three general themes that can characterize his emergence specifically
as the supervision practitioner. The first theme is learning how to do by
reading and studying. He never had a supervision course. However, as
a doctoral student he was able to study with two faculty whose areas of
work were in supervision: Michael Ellis and Micki Friedlander. Having
the opportunity to work with two top supervision scholars was without a
doubt an extraordinary learning opportunity. In fact, his work in super-
vision research preceded his actual experiences as a clinician. By review-
ing supervision theory and research, and then through having faculty
mentors who encouraged his participation in supervision scholarship, he
was able to develop at least a theoretical and empirical understanding of
the supervision enterprise. In particular, he learned how to look critically

1 Critical Events in Psychotherapy Supervision DVD is available from APA at http://www.apa.org/pubs/

videos/4310956.aspx.

5
 The Critical Events in Psychotherapy Supervision Model

at the supervision literature and tease out findings that were practically
relevant from those that were more likely to be anecdotal.
The second theme to Dr. Ladany’s road to becoming a supervision prac-
titioner is learning what not to do from incompetent and abusive super­
visors. As he has learned over time, he is not alone in experiencing poor to
harmful supervisory experiences (e.g., racist, sexist, homophobic, narcissis-
tic, and/or psychopathological supervisors). What at first he thought was his
personal jadedness has led him to believe that his experiences may reflect a
larger reality. In other words, as he has talked about and studied supervision,
he has come to learn that many supervisees experience poor to harmful
supervision. In fact, he has estimated that about a third of the time super­
visors are effective, a third of the time they are benign, and a third of the
time they are incompetent—perhaps a sad state of affairs for the field, but
he also thinks that this reflects what is true of most professions (physicians,
lawyers, plumbers). The difficulty is that for supervisors and therapists, psy-
chological harm can be the result of poor performance.
Alternatively, learning what to do from watching highly effective super-
visors is a third theme to his road to becoming a supervision practitioner.
This learning approach comes from two sources. The first is personally
experiencing expert supervisors from the perspective of a supervisee. As
mentioned earlier, Mike Ellis and Micki Friedlander were academic men-
tors of Dr. Ladany in relation to supervision research. They were also expert
supervisors for him as he learned the craft and science of therapy. The com-
mon elements of both, along with only a few others, involved the develop-
ment of a strong alliance along with an interpersonal approach to therapist
growth. In a similar manner, when training supervisors, Dr. Ladany has
witnessed similar things in those that are most effective. In essence, the
alliance and an interpersonal approach serve as the foundation upon which
supervisee growth occurs.
In sum, the three broad themes or experiences have led Dr. Ladany
to be the supervision practitioner he is today and ultimately informed
the development of the authors’ critical events in supervision model.
Dr. Ladany believes true expertise is more an aspiration than an end result.
As such, his hope is that he continue to work toward being an effective
supervisor as much of the time as possible.

6
 Introduction

Micki Friedlander: Dr. Friedlander’s first exposure to supervision

was a 1979 seminar on supervision theory during her doctoral studies.
Reflecting the profession at that time, the seminar focused primarily on
what supervisors do, with little attention to how supervisees respond or
how the supervisory relationship is developed. As a teaching assistant
the following semester, Dr. Friedlander supervised a group of four stu-
dents who were actually in her doctoral cohort but not as experienced
clinically as she was. This was the most difficult supervision experience
of her 35-year (and counting!) career because the dual roles of the stu-
dents and Dr. Friedlander and her lack of expert status interfered greatly
with what she hoped to accomplish with the students. With one super-
visee in particular, she had a firsthand experience of a role conflict event,
but she was not to fully understand what was going on between the two
of them until much later.
At the time Dr. Friedlander was enthralled with psychoanalytic
psychotherapy, and although she had read about “parallel process,” it
seemed quite mystifying. Her “sup of sup” supervisor, Harold Pepinsky,
who was light years ahead of his time in scholarship as well as train-
ing, told Dr. Friedlander at the end of this summer practicum that he
saw his role not only as helping her learn to supervise but also con-
taining her anxiety about doing so. This was an eye opener! The mir-
roring of supervision and therapy processes has never failed to amaze
Dr. Friedlander.
Her “journey” since that first supervision experience reflects an inte-
gration of practice with research. Early in her academic career, she became
fascinated with the relational aspects of supervision. Viewing supervision
as an influence process similar to Strong and Matross’s (1973) model
of psychotherapy as interpersonal persuasion, Dr. Friedlander stud-
ied supervisors’ evaluations of trainees whose self-presentations were
either defensive or counterdefensive about their clients’ progress (Ward,
Friedlander, Schoen, & Klein, 1985), the results of which reflected her
experience as a trainee and a supervisor. That is, supervision is a catch-22—
supervisors tend to view trainees who expose their weaknesses as more
socially skilled but evaluate trainees who describe their successes with
clients as more self-confident.

7
 The Critical Events in Psychotherapy Supervision Model

Although informative, Dr. Friedlander’s early research did little to

illuminate how supervisors use the process of supervision to facilitate
supervisees’ clinical skill development. Consequently, she set out to dis-
cover the qualities that constitute supervisory style, a term she had often
heard in practice but whose meaning was nebulous. By analyzing inter-
views with 20 experienced supervisors about their “general approach to
supervision,” Dr. Friedlander and a colleague (Friedlander & Ward, 1984)
constructed parallel versions of the Supervisory Styles Inventory, which
revealed, in cross-validated factor analyses, the multidimensionality of
style: Whereas the “attractive” style reflects the supervisor’s friendliness,
warmth, and supportiveness, the “interpersonally sensitive” style reflects
the supervisor’s perceptiveness, intuitiveness, and commitment, and the
“task oriented” style reflects a style that is didactic, prescriptive, goal-
driven, and evaluative.
Recognizing that all three supervisory styles reflect desirable approaches
to the supervision process, Dr. Friedlander turned her attention to com-
plications in the supervisory relationship, which led to several investiga-
tions of role conflict (Friedlander, Keller, Peca-Baker, & Olk, 1986; Ladany
& Friedlander, 1995; Olk & Friedlander, 1992) and conflictual supervisory
relationships (Nelson & Friedlander, 2001). All of this relationally focused
research, which reflected her personal experience over the years of supervis-
ing beginning trainees in master’s and doctoral practica, culminated in the
critical events model, which she and colleagues developed to conceptualize
and study the specific strategies, interventions, and behaviors that constitute
an explicitly interpersonal style of supervision.
Lee Nelson: Dr. Nelson is and has always been a teacher. Across pro-
fessional settings, from high school to community college to university
environments, she has taken profound satisfaction from assisting with
the intellectual and emotional development of her students. Her primary
motivation for pursuing a PhD in psychology was the promise of training
psychotherapists and counselors. Moreover, her research interests have
always been directed toward understanding and improving training rela-
tionships and conditions. Thus, from the beginning of her doctoral level
career, she pursued training in and research on the supervision process.

8
 Introduction

As a graduate student she involved herself primarily with Elizabeth

Holloway’s work on coding supervision process, understanding how
factors such as supervisor theoretical orientation and sex of supervisor
and supervisee influence the interplay of power and involvement in the
supervision interaction. This work impressed upon her the importance
of implicit messaging in supervision and psychotherapy. As a student of
interpersonal/relational theory, she recognized that a supervisor’s mes-
sages, both explicit and implicit, have the power to influence supervisee
behaviors with clients and patients through the parallel process. She
adopted the adage (which she regularly teaches): “Do unto others as you
would have them do unto others.” A highly evaluative, controlling super-
visor will beget an evaluative, controlling therapist. Through advanced
training in psychoanalytic psychotherapy, Dr. Nelson began to hone her
skills as a therapist and supervisor, with a sharp focus on the process, as
well as content, of her clinical interactions. She is also a scientist and can’t
help but interrogate most definitions that are placed before her. She has
come to realize that the “magical” term parallel process, wherein experi-
ence is passed from therapy relationships to supervision relationships and
vice versa, is nothing more than an example of the behavioral foundation
of Bandura’s social learning process. We “try on” what we see modeled.
In the 1990s Dr. Nelson was influenced greatly by the concept of reflec-
tivity and involved herself with Susan Neufeldt’s work on how it occurs in
supervision. Dr. Nelson believes that assisting supervisees to reflect (i.e.,
spend time becoming aware of and learning about how they interact with
clients and patients and how to use their interactions) is a key element
of supervision. Thus, when she teaches supervision, she emphasizes the
reflective process and how to facilitate it.
Because she became a supervisor at a time when the research litera-
ture on supervision was scant, Dr. Nelson’s most profound early influence
came from Mueller and Kell’s (1972) classic text Coping With Conflict. They
addressed the natural conflict inherent in supervision as a function of the
therapeutic, yet evaluative, nature of the relationship, arguing that resolu-
tion of this natural conflict is a key challenge in the supervisory process.
This notion has always influenced Dr. Nelson’s work, as both a supervisor

9
 The Critical Events in Psychotherapy Supervision Model

and a supervision researcher. Her later work has focused on how super­
visors and supervisees experience conflict and how excellent supervisors
go about preventing and mitigating negative outcomes of conflict with
supervisees. Through observation of and reflection on the supervision
process, excellent supervisors directly address interpersonal tensions, take
ownership of their contribution to the tensions, and work to repair super-
visory alliance ruptures. Dr. Nelson’s interest in the approach to this text
and in the companion DVD described earlier stems from her strong con-
viction that a key skill in quality supervision is the ability to identify and
address explicit, as well as implicit, sources of conflict in the relationship.

10
 1

Overview of the
Critical Events Model

Supervisor: . . . Elise,1 what other cases do you need to talk about today?
Supervisee: (hesitantly) Well, I did get a message from Frank—remember
the new client I saw last week? (pause) He said in his message that he
wouldn’t be keeping any future appointments—that he’s not ready for
therapy yet.

F or the supervisor, this is a choice point. Should he ask Elise more

about this client and, if so, should they discuss whether a follow-up
phone call is necessary or should they discuss what occurred—or failed to
occur—in the intake session that led to the client’s decision not to return
for therapy? Alternately, should the supervisor focus on Elise, the super-
visee, whose hesitancy in disclosing the client’s decision suggests some

1 With the exception of Tiffany (see Chapter 5), all case examples used throughout this book are
composites and have been disguised to protect confidentiality.
http://dx.doi.org/10.1037/14916-002
Supervision Essentials for the Critical Events in Psychotherapy Supervision Model, by N. Ladany,
M. L. Friedlander, and M. L. Nelson
Copyright © 2016 by the American Psychological Association. All rights reserved.

11
 The Critical Events in Psychotherapy Supervision Model

discomfort? If so, is Elise simply uncomfortable with the client’s decision

to drop out or is she also uncomfortable revealing the client’s decision
to her supervisor? Ideally, all of these issues should be addressed. The
dilemma is which path to take—where to start and toward what end.
Supervisors often face choice points like this one when working with
novice supervisees, as well as with more advanced supervisees in practi-
cum or internship, and even with experienced, postdegree psychothera-
pists. How a supervisor decides which path to follow is highly contextual.
That is, the decision depends not only on the supervisee’s training level
but also on other characteristics of the supervisee (e.g., skill level, degree
of self-awareness, openness), factors related to the clinical setting (e.g.,
institutional policies, length of the waiting list), factors related to the
supervision itself (e.g., the duration and strength of the working relation-
ship, the congruence of their theoretical approaches to clients) and, of
course, factors related to the client and his personal circumstances.
Choice points like this one make psychotherapy supervision challeng-
ing. One option that many supervisors take, especially when they and their
supervisees carry a large client caseload and time is limited, is simply to
prescribe how to handle the case. Taking this approach, the supervisor in
this situation might say something to Elise like, “That’s too bad. We can
certainly find you another new case for next week. Meanwhile, close out his
chart and write him a letter, encouraging him to call for another appoint-
ment in the future if he changes his mind.” This authoritarian, case man-
agement approach fulfills the oversight function of supervision but does
little to further the supervisee’s development of professional competence.
In contrast, the supervisor who takes an interpersonal, or process-
oriented, approach to supervision is doing more than overseeing her
supervisee’s cases. Rather, in interpersonal supervision there is a dual
focus—not only is the supervisor helping the supervisee to develop pro-
fessional competencies by discussing his or her work with clients, but also
he or she is modeling these competencies within the supervision rela-
tionship itself. Moreover, it is precisely this responsive attunement to
both client and supervisee that makes supervision rewarding as well as
challenging. The challenge is in managing the back-and-forth focus, for
which at times the supervision relationship is in the foreground and the

12
 Overview of the Critical Events Model

therapeutic work is in the background, and at other times the therapy

takes center stage, with the supervision relationship in the background.
Supervision is particularly rewarding when it all comes together: when a
supervisee recognizes precisely how to use his or her positive experience
with a supervisor to inform the kind of relational experience he or she is
striving to develop with clients.
In this book, we take a close look at how the intertwined supervisory
and therapeutic relationships can help supervisees become responsive
counselors, social workers, and psychotherapists. We call our interpersonal
approach to supervision a critical events model because our focus is on
working through the kinds of issues that are commonly problematic for
supervisees. In this contextual model, supervision—like psychotherapy—
is seen as evolving through successive tasks whose cumulative impact,
successful or not, determines the ultimate outcome. Some supervision
tasks, such as initiating the relationship (“getting to know you”) and
defining the goals and parameters of supervision, tend not to be prob-
lematic. However, when a dilemma or an impasse arises—either within
the supervision relationship itself or in the supervisee’s work with one
or more clients—the resolution of that dilemma or impasse takes center
stage. The complexity arises when resolving the critical event necessitates
a shift in focus from the therapeutic relationship to the supervision rela-
tionship or vice versa.
Our objective in developing the critical events model was to provide
supervisors and supervisors in training with guidelines and illustrative
examples for resolving commonly occurring critical events in psycho­
therapy supervision. The next sections of this chapter provide an overview
of the model in general terms.

THE EVENTS PARADIGM: A CONTEXTUAL APPROACH

Since the 1970s, theory and research on the supervisory process has bur-
geoned in all of the mental health disciplines. Unfortunately, the literature
has not provided the kind of knowledge that supervisors need for their
actual, day-to-day work with psychotherapy supervisees. It is generally
understood that the overarching purpose of supervision is to develop

13
 The Critical Events in Psychotherapy Supervision Model

professional competencies (Falender & Shafranske, 2004), including

learning to be attuned and responsive to clients (Friedlander, 2012, 2015),
accurately conceptualizing clients’ problems (Blocher, 1983), applying a
variety of empirically supported treatment approaches, and developing
client-specific treatment plans (Bernard & Goodyear, 2014). Despite this
common understanding of the goals of supervision, how and under what
conditions these objectives can best be accomplished has not been estab-
lished in the supervision literature.
Although little is known about how to get from point A to point B in a
supervision session, we do have some general knowledge, broadly construed,
about effective and ineffective supervision (Ellis et al., 2014). For example,
research has shown that role conflict can be detrimental to the supervisory
relationship (Ladany & Friedlander, 1995; Nelson & Friedlander, 2001) and
that to avoid conflict, experienced supervisors work to be explicit about
supervisees’ role expectations throughout the supervision process (Nelson,
Barnes, Evans, & Triggiano, 2008). We also know that supervisees especially
value working with “interpersonally sensitive” supervisors (Friedlander &
Ward, 1984, p. 541; Shaffer & Friedlander, 2015), and that strong super-
visory alliances play a role in supervisees’ satisfaction with supervision
(e.g., Ladany, Ellis, & Friedlander, 1999). More pertinent process questions
are still unanswered, for example: How do effective super­visors minimize
role conflict, and how do they behave in session to address ruptures in the
supervisory alliance? How and under what circumstances do interperson-
ally sensitive supervisors address their supervisees’ personal difficulties?
We can begin to answer questions like these by considering the con-
text of supervisory processes: that is, what it means—on a behavioral
level—to be a responsive supervisor (Friedlander, 2012, 2015). Respon-
siveness requires a different approach when the supervisee is a novice and
feels “over her head” versus when the supervisee is fairly advanced and
has similar feelings. Responsiveness requires behaving differently with a
supervisee who made an egregious ethical violation versus with one who
is in the midst of a personal crisis. Responsiveness requires behaving dif-
ferently depending on whether or not a supervisee has consciously been
seductive in response to a client who is sexually provocative.

14
 Overview of the Critical Events Model

As humans, we are naturally contextual. That is, we make decisions

and act based on our appraisals of each successive context that we encoun-
ter. As supervisors, to be maximally responsive to our supervisees, we need
a wealth of contextual information—about the culture, the setting, the
client, the supervisee, and more—to inform our actions. To decide how to
handle challenging supervisory situations, such as how to address an ethi-
cal violation with a supervisee or how to work with a problematic super-
visee, supervisors need a set of guidelines to recognize and then evaluate
the dilemma to choose the most effective strategy in a particular context.
The events paradigm offers supervisors some guidelines to choose
what needs to be discussed in supervision (the content) as well as the
kinds of sequential, interpersonal behaviors that can bring about change
(the process). By viewing the supervisory process as a series of meaning-
ful events with specific, definable tasks and goals, supervisors can select
the interpersonal strategies that have the greatest possibility of resolving
challenging situations.

VIEWING PSYCHOTHERAPY AND SUPERVISION

AS A SERIES OF TASKS WITHIN EVENTS
In both supervision and psychotherapy, there are meaningful steps along
the way to problem resolution: steps that can be anticipated, planned for,
carried out, and then evaluated. It may require several (or many) sessions
to achieve a single objective, such as working through a trauma (therapy)
or learning a new clinical technique (supervision), and within a therapy or
a supervision session more than one objective can be addressed.
Let’s start by considering the process of psychotherapy. Over time and
as a therapist gains clinical experience with diverse clients, she or he begins
to think about the process of change in chunks—phases, if you will—
rather than seeing it as a discontinuous blur of questions and answers,
facts, and suppositions. The therapist comes to feel the rhythm of a session
as well as the rhythm of change. The therapist can see herself or himself
working on something specific within a session and coming back to it in a
different way over the course of treatment. The therapist also learns that,

15
 The Critical Events in Psychotherapy Supervision Model

occasionally, something occurs that is particularly powerful—the “aha”

of the client’s insight or a poignant moment of intimacy—an event that
moves the therapy forward in new and potentially unexpected ways.
Perceiving the therapeutic process as a sequence of events occurs natu-
rally with time and with clinical practice. As they gain experience, therapists
begin to think about each session, or portion of a session, as an episode in
a story. Each episode or event has a beginning, middle, and end, in which
one or more specific “tasks” are worked on and, it is hoped, accomplished.
In other words, therapists do not make moment-by-moment decisions
about the ultimate path to follow to arrive at the ultimate therapeutic goal,
such as to reduce the client’s depression. Rather, these momentary deci-
sions are informed by a sense of how to accomplish the task at hand, be it
to assess the client’s motivation for change, make it safe for the client to
discuss troubling feelings, or review the client’s gains to date. It is simply
unrealistic to work any other way.
In other words, psychotherapy is made up of proximal (e.g., feel safe
discussing troubling feelings), intermediate (e.g., make new social con-
nections), and distal (e.g., reduce depression, enhance life satisfaction)
goals. Similarly, supervision is made up of proximal (e.g., examine expec-
tations for the practicum), intermediate (e.g., learn how to end therapy
sessions on time), and distal (e.g., enhance professional competence)
goals. And as in psychotherapy, obtaining these goals requires the accom-
plishment of a series of tasks that are worked on episodically.
To illustrate, consider the earlier example with Elise, the supervisee
whose client, Frank, decided to drop out after the first session. The primary,
distal goal of supervision with Elise, to learn to be a competent psycho­
therapist, is not addressed globally in any one supervision session. Rather,
the supervisor has proximal and intermediate goals. In Elise’s case, the inter-
mediate goal may be to learn how to handle dropouts, and more generally
to learn how to motivate clients to engage in psychotherapy or to learn how
to address a client’s resistance. To achieve each of these intermediate goals,
the supervisor and supervisee work on specific “tasks” within and across
supervision sessions by discussing one or more specific clients. Working
on the goal of learning how to address resistance, the first supervisory task

16
 Overview of the Critical Events Model

might be for Elise to understand Frank’s decision to drop out. The task
would be carried out by reviewing Frank’s history and closely reviewing
the intake session. Then, after coming to some understanding of Frank’s
decision, the next supervision task might be in service of an intermediate
goal, to conceptualize client resistance—in general terms—from several
theoretical perspectives. Finally, in yet another supervision episode, work-
ing on the intermediate goal of addressing client resistance, the task might
involve role playing a session in which Elise addresses a client’s ambivalent
motivation for change.
In the events paradigm, the identification of, the working through, and
the accomplishment of a specific task—in other words, the task analysis—
are essentially what defines the event. Events in supervision are common
and predictable, just as they are in psychotherapy. For example, when the
supervisory relationship begins, the initial event typically is devoted to
the goal of developing a supervisory alliance, with the associated tasks
of getting to know one another, clarifying the roles and expectations
for supervision, and reviewing agency policies. Generally when super­
vision ends, the final task involves evaluating the supervisee’s profes-
sional competencies.
Some supervision textbooks discuss important common tasks, but
in this book we focus specifically on critical events in supervision: events
that tend to be particularly challenging for both supervisee and super­
visor. Each chapter offers guidance in the form of a task analytic process
model for resolving different dilemmas in supervision. However, before
discussing this model of supervision in more detail, it is important to
understand the origins of the task analytic model. The next section pro-
vides a more detailed description of task analyses in psychotherapy and
supervision.

THE TASK ANALYTIC MODEL

During the past 20 to 30 years, the events paradigm for researching inter­
personal behavior in the psychotherapy context has taken hold in the lit-
erature. Although there are various approaches to studying meaningful

17
 The Critical Events in Psychotherapy Supervision Model

therapy events, the most common is called task analysis. Applying the
approach of industrial psychologists for defining, studying, and mea-
suring the accomplishment of tasks in a work environment, psychotherapy
researchers study tasks within critical events in individual as well as couple
and family therapy. In short, task analysis is a rational–empirical method
for using theory and clinical wisdom to develop and investigate a concep-
tual model of interaction with a specifiable, in-session outcome.
As explained earlier, the task analytic model assumes that therapy
(and supervision) consists of tasks to be accomplished or dilemmas to be
resolved, and the cumulative process of accomplishing these tasks within
a supportive relationship results in good outcomes. To illustrate, a psycho­
therapy event might involve the task of understanding a client’s “problem-
atic reaction” (Rice & Saperia, 1984, p. 29) to something that occurred in
her life. Another therapy event might involve resolving some kind of intra-
psychic conflict (Greenberg, 1983) or unfinished business (Greenberg &
Foerster, 1996) that a client identifies. All of these—exploring problematic
reactions, intrapsychic conflicts, or unfinished business—are important
tasks that often are addressed in therapy because they are what therapy
is about.
Of course, the kinds of tasks to be worked on in therapy depend on the
client’s circumstances and the therapist’s theoretical approach. However,
some tasks are common for virtually all clients and therapists, regard-
less of the setting, theoretical approach, or problems being addressed. For
example, different therapists and clients, in different settings and with
different issues, might need to clear up a misunderstanding between them
(Rhodes, Hill, Thompson, & Elliott, 1994) or repair a rupture in their
relationship (Safran & Muran, 1996).
Despite commonalities across therapies, a particular task may be
approached differently depending on the particular therapeutic system
involved. For example, in individual therapy, a common task is explor-
ing symptoms. Typically, a cognitive–behavioral therapist would explore
a client’s symptoms quite differently than would a psychodynamically
oriented therapist, even though understanding a client’s symptoms is a
meaningful proximal goal for both therapists.

18
 Overview of the Critical Events Model

An important aspect of task analysis is that “successful” events—the

point in the session or sessions during which the task at hand is resolved
or accomplished—are assumed to proceed similarly, with the caveat that
differences in the process can have important practical implications. Here
is another point where individual differences and context come into play.
Take, for example, the task analytic study of “sustaining engagement”
events in conjoint family therapy (Friedlander, Heatherington, Johnson, &
Skowron, 1994). In this study, task resolution was defined as a behavioral
shift such that family members who initially were reluctant to engage with
one another in solving a specific problem broke through their impasse and
began actively discussing and working on the problem together. In this
study, in all of the “unsuccessful” events but in none of the “successful”
ones, the families were headed by single parents. This observation sug-
gests that the task analytic model that the researchers discovered might
be valid only for two-parent families; different processes may be involved
when therapists try to encourage “sustained engagement” in single-parent
families (Friedlander et al., 1994).
A final consideration is that successfully resolved tasks require a strong
interpersonal relationship. How a therapist or supervisor addresses a given
task may vary depending on the stage of the working relationship and the
degree to which the alliance is solid. Because the processes of change in ther-
apy and supervision tasks often involve challenge, clients and supervisees
alike need to see the social context as safe, a place to take risks and grow.
Typically, a task analysis begins with identifying an event, such as the
portion of a session when a misunderstanding arises between supervisor
and supervisee, and its related task (in this case, resolving the misunder-
standing). The event and associated task should be ones that are common
occurrences and ones that can bring about change in the client or super-
visee. A common example in psychotherapy is a rupture in the therapeu-
tic alliance (Safran & Muran, 1996) and its corollary in the supervisory
alliance (Friedlander, 2015). In both contexts, the task of “repairing” a
ruptured alliance is essential to providing the client/supervisee with an
important, new relational experience that allows the therapy/supervision
to progress more smoothly.

19
 The Critical Events in Psychotherapy Supervision Model

Whether the context in which critical events occur is psychotherapy or

supervision, the task analytic model has three basic components: marker,
task environment, and resolution (Greenberg, 1986). First, in the context
of supervision, the marker is a statement or behavior on the part of the
supervisee that signals a need for work on a specific task. The marker often
is a single statement, such as Elise’s response to her supervisor’s question
about what client they should talk about next: “Well, I did get a message
from Frank. . . . He said in his message that he wouldn’t be keeping any
future appointments—that he’s not ready for therapy yet.” The marker
might also be a segment of dialogue that lasts several minutes or a behav-
ior that the supervisor notices and considers important to address, such
as when a supervisee is chronically late to her supervision sessions. In
the first instance, Elise’s comment “marks” the need to discuss her client’s
decision to drop out after the first session. In the second instance, the
supervisee’s chronic lateness “marks” the need to discuss expectations or
ground rules for supervision.
Second, the task environment includes the “performances” on the
part of the client/supervisee and the “operations” (Greenberg, 1986) on
the part of the therapist/supervisor. Performances and operations refer to
the steps along the way to accomplishing the task at hand: for example,
understanding a client’s decision to drop out or eliciting and then nego-
tiating expectations for supervision. These steps along the way are the
various interactional sequences that promote the successful accomplish-
ment of the task. In the case of the chronically late supervisee, the inter­
actional sequences within the task environment might involve exploring
the supervisee’s feelings about being supervised, focusing on the super­
visory alliance (goals, tasks, bond), attending to parallel processes (per-
haps the supervisee’s client is always late to the therapy sessions), and/or
evaluating the supervisee’s professional attitudes.
Finally, the resolution, which occurs at the end of the event, refers to
the outcome or accomplishment of the task at hand. A successful resolu-
tion reflects a new understanding, an integration of conflict, a plan for
action, and so forth. By definition, the lack of a resolution means that
the task has not been accomplished. In unsuccessful events, the task

20
 Overview of the Critical Events Model

environment lasts until either the focus of conversation changes or the

session itself ends. In the case of Elise, a successful event might involve a
better understanding of Frank’s decision to drop out and a new under-
standing of how to assess a client’s motivation for change in an intake ses-
sion. In the case of the chronically late supervisee, a successfully resolved
event might involve a new understanding of the need for supervision and
the supervisor’s expectations.

IDENTIFYING CRITICAL EVENTS

AND TASKS IN SUPERVISION
Although supervision has many commonalities with therapy, it can be dis-
tinguished in three major ways: It is evaluative, it is not voluntary, and it
is explicitly educational (Ladany, 2013). Because supervision has a unique
set of interpersonal dynamics, specific elements in the supervision process
are necessarily different from those that characterize the psychotherapy
process. For this reason, the identification and research of task analytic
models of supervision should be qualitatively different from task analytic
models of psychotherapy.
In developing the task analytic model of critical events in supervision,
we integrated our clinical experience as supervisors with extant theory
and research on supervision. Our intent was to develop an approach that
would be heuristically appealing and practically meaningful for super­
visors and supervisors in training, and we anticipated that researchers
could use the model to study significant mechanisms of change in the
supervision process. Essentially, the model is like a template for identi-
fying and researching critical supervision events. We chose the various
events discussed in this book (e.g., role conflict, skill deficits) because they
tend to occur frequently and are particularly challenging. However, there
are many other supervision events that could be identified and researched
using our task analytic template (Ladany et al., 2005).
Before illustrating the model more fully, we would like to lay out
our assumptions. First, our process model is pantheoretical. Conse-
quently, a supervisor working with a supervisee who wants to develop her

21
 The Critical Events in Psychotherapy Supervision Model

mindfulness skills for conducting acceptance and commitment therapy

can use our model as readily as a supervisor working with a supervisee
whose interest lies more within the psychodynamic tradition. Similarly,
the task analytic model applies to supervision of counseling and psycho­
therapy within any professional discipline—psychology, psychiatry,
marital and family therapy, social work, mental health counseling, school
guidance, or nursing. Our second assumption is that the model is explic-
itly interpersonal. As mentioned, we view interactions and relationship as
central to working through critical events in supervision. A third assump-
tion is our belief that an emphasis on supervisees’ learning, growth, and
development requires more than case management. We do not see case
management as the sole, or even primary, purpose for supervision, and we
do not consider the supervisor to be a “trainer” in the sense of directing or
evaluating a therapist’s adherence to a manualized treatment. The fourth
assumption, as explained earlier, has to do with our view of the super­
vision process as a sequence of meaningful events or episodes, each of
which has an identifiable beginning, middle, and end. Although many
events begin and are completed within one session, some events neces-
sitate two or more supervision sessions, and some are interrupted and
returned to later. Finally, we assume that the events we selected to high-
light in this book are critical ones: that is, they are challenging and have
implications for achieving important supervision goals.
In brief, a task analysis refers to the process of addressing specific
critical events that tend to occur in supervision and are important for
supervision outcomes, and the term task refers to what the supervisor
is attempting to accomplish in a specific critical event. For instance, one
critical event is the portion of a supervision session devoted to discuss-
ing a supervisee’s countertransference; the task within the event is to
better understand the countertransference and how to use it to clinical
advantage with the client. As we discuss in more depth in the following
section, the marker, task environment, and resolution, the three phases
in the task analytic process model, are embedded within the supervisory
working alliance. In Figure 1.1, the task analytic process model of super-
vision is illustrated.

22
 Overview of the Critical Events Model

Figure 1.1

Prototypical critical event in supervision. Adapted from Critical Events in Psychotherapy

Supervision: An Interpersonal Approach (p. 12), by N. Ladany, M. L. Friedlander, and
M. L. Nelson, 2005, Washington, DC: American Psychological Association. Copyright
2005 by the American Psychological Association.
 The Critical Events in Psychotherapy Supervision Model

SUPERVISORY WORKING ALLIANCE: THE

FOUNDATION OF INTERPERSONAL SUPERVISION
The working alliance, one of the most frequently studied constructs in
the supervision and psychotherapy literature, is arguably the foundation
for effective supervision. In terms of definition, the supervisory working
alliance consists of three components: (a) an agreement between super­
visor and supervisee on the goals of supervision, such as improving spe-
cific technical skills, enhancing the supervisee’s conceptualization ability,
or increasing the supervisee’s awareness of countertransference in ther-
apy; (b) an agreement between supervisor and supervisee on the tasks of
supervision, such as focusing on the supervisee’s feelings toward her cli-
ents; and (c) a strong emotional connection or bond between super­visor
and supervisee (Bordin, 1983).
The alliance, like any interpersonal relationship, grows over time. For
the relationship to strengthen rather than falter, supervisor and supervisee
must negotiate what should take place in supervision and to what end. To
illustrate, if one goal of a supervisee’s practicum supervision is to enhance
his recognition of countertransference in working with his clients, he and
the supervisor must agree, either implicitly or explicitly, that this goal is
meaningful. They must also agree on how to accomplish the goal (i.e.,
the supervision tasks), such as reviewing tapes together and exploring the
supervisee’s feelings toward every client with whom he or she works. Of
course, various tasks could be chosen to expand the supervisee’s recog-
nition of countertransference, but unless the supervisee and supervisor
agree, to a meaningful extent, on how this awareness should come about
(i.e., what should occur and when), the accomplishment of the goal could
be compromised.
From the perspective of the alliance, it can be assumed that impasses
of one sort or another reflect implicit or explicit disagreements between
supervisor and supervisee about the nature of goals or the process of
accomplishing them. These kinds of impasses define the kinds of critical
events we describe in subsequent chapters of this book.
The importance of the supervisory alliance is well documented.
Studies have shown that a favorable supervisory alliance is predictive of

24
 Overview of the Critical Events Model

supervisees’ competency with multicultural issues (Ladany, Brittan-Powell,

& Pannu, 1997); effective evaluation (Lehrman-Waterman & Ladany,
2001); flexibility in terms of collegial, interpersonally sensitive, and task-
oriented supervisory styles (Ladany, Walker, & Melincoff, 2001); facilitat-
ing supervisees’ self-disclosure (Ladany, O’Brien, et al., 1997); supportive
gender-related events (Walker, Ladany, & Pate-Carolan, 2007); liking for
the supervisor (Melincoff, 2001; Melincoff, Walker, Tyson, Muse-Burke,
& Ladany, 2001); supervisee self-efficacy (Efstation, Patton, & Kardash,
1990); and satisfaction with supervision (Ladany, Ellis, & Friedlander,
1999; Shaffer & Friedlander, 2015). On the other hand, an unfavorable
supervisory alliance is related to supervisees’ experiences of role ambigu-
ity and role conflict (Ladany & Friedlander, 1995); nondisclosure of rel-
evant material (Ladany, Hill, Corbett, & Nutt, 1996); insecure attachment
(Riggs & Bretz, 2006); negative supervisory experiences (Ramos-Sánchez
et al., 2002); anxiety (Mehr, Ladany, & Caskie, 2015); and vicarious trau-
matization (Fama, 2003). Moreover, supervisees tend to view the super-
visory alliance as unfavorable when they see their supervisors behaving
unethically (Ladany, Lehrman-Waterman, Molinaro, & Wolgast, 1999; Nel-
son & Friedlander, 2001).
Highlighting the importance of the alliance in working through criti-
cal events, some research indicates that supervisees tend to rate the alliance
unfavorably when they have experienced gender discrimination (Bertsch
et al., 2014; Walker et al., 2007) or other counterproductive incidents in
supervision (Gray, Ladany, Walker, & Ancis, 2001). At times, impasses in
supervision originate not in disagreements about the goals and tasks but
in the quality of the emotional bond. Like the working alliance in psycho­
therapy, the bond is crucial to the supervisory alliance and reflects the
extent to which the supervisor is responsive to the supervisee’s evolving
needs (Friedlander, 2012, 2015). A strong bond is characterized by mutual
liking, warmth, trust, and respect. Arguably, the quality of the emotional
bond is a limiting factor in the extent to which a supervisor can suggest or
impose challenging supervision goals and tasks.
Because the bond is strengthened when the supervisor is respon-
sively understanding and empathic (Friedlander, 2015), the importance

25
 The Critical Events in Psychotherapy Supervision Model

of empathy in supervision cannot be overstated. Unfortunately, many

supervisors may be highly empathic psychotherapists but lack the same
level of caring concern for their supervisees, especially when an impasse
occurs between them. The bond can be compromised when a supervisor’s
zeal leads her or him to overlook or misjudge a supervisee’s vulnerability
in the face of a poor evaluation or a disagreement between them. Like
clients, supervisees need supportive reassurance to accept and eventually
to assimilate critical feedback. It is daunting for supervisees to feel disdain
from their supervisors when those very supervisors speak about their own
clients with compassionate concern.
In our interpersonal model of supervision, the supervisory alliance is
the foundation for working through critical events, just as the therapeutic
alliance is the foundation for challenging clients to change. As mentioned,
we construe the supervisory and the therapeutic alliances as reflective of
one another in a figure/ground configuration, where at times the super-
visory alliance is the focus of the session (the figure) and the supervisee’s
alliance with her or his client(s) is not under discussion (i.e., the ground).
At other moments, the supervisory alliance is not under discussion (the
ground); rather, the focus (or figure) is the supervisee’s relationship with
her or his client(s).
Typically, the supervisory alliance is the figure early on in supervision.
The alliance also becomes the figure when conflicts—impasses or ruptures—
surface in the relationship. At other moments in supervision, the strength
of the alliance fluctuates depending on the event at hand. In the context of
a strong supervisory alliance, a supervisor is likely to be effective in chal-
lenging his or her supervisee, but when the alliance is weak, challenges may
be seen as harsh or even insulting. When a supervisee seems overwhelmed
or distressed by what is taking place in a supervision session, moving the
supervisory alliance from the ground to the figure is essential. Depending
on the supervisee’s level of confidence or self-efficacy as a therapist, it may
be helpful for the supervisor to “check in” with the supervisee about their
relationship before proceeding to discuss the supervisee’s work with spe-
cific clients. Repeatedly failing to “check in” with a vulnerable supervisee
could well damage the supervisory work and, ultimately, the professional
development of the supervisee.

26
 Overview of the Critical Events Model

Identifying the Marker

In the task analytic model, the marker initiates the event at hand. Simply
put, the marker refers to a statement, a series of statements, or a behavior
that “marks” the supervisee’s need for a specific kind of response on the
part of the supervisor. Just as the marker in a therapy event signals to the
therapist that a particular issue (i.e., task) needs to be addressed, such as
the client’s resistance to completing homework assignments, the marker
in a supervision session signals to the supervisor that a particular action
or focus is needed at that moment.
Sometimes the marker is readily apparent, such as when a supervisee
directly asks the supervisor for help with a particular client or the super-
visee brings up a professional concern or a desire to practice a specific
technical skill. At other times, the marker is more subtle and thus easily
overlooked. In other words, the marker may not be what the supervisee
says or even what she or he does, as much as what she or he does not say or
does not do. Some examples include arriving late to supervision, coming
unprepared to discuss any clients, or repeatedly failing to record therapy
sessions. In group supervision, the marker might be a consistent lack of
participation in the group or a sarcastic response to feedback from a peer.
The marker might also involve an interaction with a client that the super-
visor observes in a recording of the supervisee’s session. The marker might
also be a defensive posture when certain topics are on the table in super-
vision, such as when the supervisor inquires about the supervisee’s case
notes. In these situations, it is crucial for the supervisor to tread lightly to
avoid a rupture in the supervisory alliance, which will only complicate the
successful resolution of the critical event.
Although different markers may indicate similar problems, different
problems can manifest themselves with similar markers. As an example,
role conflict (Chapter 2) could be “marked” by the supervisee’s passive
withdrawal in the supervision session, coming late to supervision appoint-
ments, or continually failing to record her therapy sessions. Yet these same
markers might not be indicative of role conflict with the supervisor but
rather the supervisee’s need to recognize and understand a parallel process
(Chapter 4). In some situations, the marker phase of the critical event can

27
 The Critical Events in Psychotherapy Supervision Model

be prolonged. This phase does not end until the supervisor is clear about
precisely what needs to be addressed at that point in the session.

THE TASK ENVIRONMENT:

WORKING THROUGH THE EVENT
After the marker is understood by the supervisor, the task environment
takes center stage. Essentially, when broken down into its three parts, the
task environment (see Figure 1.1) is a series of interactional sequences that
are both the supervisor’s operations (interventions or strategies) and the
supervisee’s performances or reactions (cf. Greenberg, 1986). Although
the sequences that make up a task environment differ for different critical
events and depend on the supervisee’s readiness for change and devel-
opmental level as a professional, there are some common interactional
sequences that characterize a distinctly relational approach to supervi-
sion (Shaffer & Friedlander, 2015), including sequences that reflect the
processes of exploration, clarification, and working through. For exam-
ple, in a countertransference event, the interactional sequences in the task
environment most likely involve exploration (of the therapy relationship
and the supervisee’s feelings), a direct focus on the countertransference
(clarification), followed by an interpretation and working through of the
parallel process (Ladany et al., 2005).
Table 1.1 defines 11 interactional sequences that can characterize the
operations and performances within the task environment of a critical
supervision event. Naturally, these sequences are not mutually exclusive
(a focus on countertransference usually involves exploration of feelings),
and the list is not exhaustive of all possible sequences that characterize
critical supervision events.
A recent program of research with these interactional sequences (Shaf-
fer & Friedlander, 2015) showed that five of the 11 sequences constitute a
single, relational factor. In other words, five key sequences were identified
empirically as being most purely relational: focus on countertransference,
exploration of feelings, focus on the therapeutic alliance, attend to parallel
process, and focus on the supervisory alliance. In two studies, these five
sequences (based on a sample of supervisees’ frequency ratings on a new

28
 Table 1.1
Common Interaction Sequences in the
Task Environments of Critical Events
Sequence Definition
Focus on the Discussion of aspects of the relationship related to agreement on the
supervisory tasks and goals of supervision (including evaluation), as well as to the
alliance* emotional bond between supervisor and supervisee. May either be a
“checking in” about the alliance or an explicit discussion about what is
taking place or should take place in supervision, including a focus on
the supervisee’s or the supervisor’s feelings about their relationship.
Focus on the A discussion about what is taking place between the supervisee and client
therapeutic (i.e., the kinds of interactions that occur, the strength of the therapeutic
process* alliance, and how the client sees the supervisee’s behavior in relation to
self and vice versa).
Exploration of Typically, but not exclusively, a here-and-now focus. Feelings can be
feelings* expressed about the client, the therapeutic relationship or process,
about the supervisee’s progress in training, or about personal issues.
Focus on Discussion of how and why the supervisee’s feelings and/or personal issues
counter­ are “triggered” by a client’s behavior or attitude.
transference*
Attend to A discussion that draws attention to similarities between a specific thera-
parallel peutic interaction and the supervisory interaction. Parallel processes
processes* may originate in either interaction and be mirrored in the other.
Focus on self- A discussion of the supervisee’s sense of confidence in his or her therapeutic
efficacy skills (either specifically or globally), sense of self as a professional, or ability
to function in various roles (e.g., as therapist, student, supervisee, colleague).
Normalizing A discussion of how the supervisee’s experience (either as a therapist, colleague,
experience or supervisee) is typical and developmentally expected or appropriate.
Focus on skill Discussion of the how, when, where, and why of conceptual, technical, and
interpersonal skills. May include role playing or a discussion of how to
apply theory to specific therapy interventions.
Assessing Evaluating the degree to which the supervisee is knowledgeable in areas
knowledge relevant to the cases(s) under discussion. Knowledge bases include
ethics, research, and theory as applied to practice.
Focus on Discussion of the supervisee’s self-awareness in relation to individuals who
multicultural are similar and different in terms of gender, race, ethnicity, age, sexual
awareness orientation, religion, disability, family structure, or socioeconomic status.
Focus on Discussion of the supervisee’s performance in therapy, in supervision,
evaluation and as a professional. May involve a discussion of feedback, critical and
positive, either summative or formative.

Note. *Interactional sequences in the Relational Behavior Scale (Shaffer & Friedlander, 2015).
Reprinted from Critical Events in Psychotherapy Supervision: An Interpersonal Approach (pp. 15–16),
by N. Ladany, M. L. Friedlander, and M. L. Nelson, 2005, Washington, DC: American Psychological
Association. Copyright 2005 by the American Psychological Association.

29
 The Critical Events in Psychotherapy Supervision Model

measure, the Relational Behavior Scale [RBS]), were uniquely predicted

by supervisors’ “interpersonally sensitive” style of working with supervisees.
Moreover, RBS scores were significantly associated with (a) a strong super-
visory alliance and (b) supervisees’ positive experience of the supervisor
in the session in which relatively more RBS behaviors occurred. Taken
together, these results strongly support the theoretical under­pinning of
the critical events model.
In the chapters that follow, we turn our attention to the interactional
sequences that we believe are most likely to result in a successful resolu-
tion of the critical events under discussion. The 11 interaction sequences
may be carried out in various ways depending on a variety of contextual
factors, including gender, culture, personality/style, the supervisee’s devel-
opmental level, the clinical context, state of the supervision relationship,
and so forth. For this reason, the sequences for each event described in
the following chapters are suggested but not prescribed ways for resolv-
ing critical events. Moreover, the kinds of sequences or interventions that
a supervisor chooses to use within each interaction sequence of the task
environment may differ from the interventions of another supervisor. For
example, when using the sequence exploration of feelings, one supervisor
might ask the supervisee how he or she felt when the client was silent for
an extended period of time, or the supervisor might ask the supervisee to
describe his or her experience of the client as they watch a portion of the
recorded session together. Alternately, a supervisor might use different
interventions with different supervisees. With a focus on countertransfer-
ence, the supervisor might ask one supervisee if he or she ever felt simi-
larly with people in his or her personal life, and in working with a different
supervisee, the supervisor might inquire directly about other clients or
what his or her emotional reactions bring to mind. In a gender mis­
understanding event, when the supervisor is using the assessing knowledge
sequence, she or he might ask the supervisee to take a feminist perspective
on the client’s life story. In a skill deficit event, the supervisor’s focus on
skills might involve role playing or asking the supervisee to explain why
she or he used a particular intervention at a particular time.
We also want to point out that the various sequences in a task environ-
ment are not altogether discrete and at times the process is a recursive one

30
 Overview of the Critical Events Model

(note the arrows between the various interactional sequences in Figure 1.1).
What is consistent, however, is the continuous forward movement through
the task environment toward some kind of “working through,” which opti-
mally leads to a successful resolution of the task at hand.
To illustrate, in Figure 1.2 the marker for a managing sexual attraction
event is the supervisee’s comment that she feels attracted to her client.
Once the supervisor recognizes this marker as signaling a sexual attrac-
tion event, the task environment proceeds through the four interactional
sequences of exploration of feelings, focus on the supervisory alliance,
normalizing experience, and focus on countertransference, with their
recursive nature indicated in Figure 1.2 by arrows. To illustrate the process
model, Figure 1.2 depicts a linear progression of stages, but in actuality the
order of these stages—and even their nature—is likely to differ based on a
complex interaction of supervisee, supervisor, client, clinical setting, and
strength of the supervisory alliance.

THE RESOLUTION: THE END OF A CRITICAL EVENT

When all elements of the task environment come together successfully,
the event ends with a resolution, the proximal outcome of the specific
supervisory task at hand. Successful resolutions reflect an enhancement
in (a) self-awareness, (b) knowledge, (c) skills, or (d) the supervisory alli-
ance. By self-awareness, we mean the supervisee’s recognition of precisely
how her or his own prior life experiences, expectations or biases, feelings,
behaviors, and/or beliefs influence her or his work with clients. Knowl-
edge has to do with the theoretical, empirical, and practical understanding
that a supervisee gains through graduate training and clinical experience.
Skills refers to interpersonal, technical, or conceptual capabilities related
to psychotherapy; they range from micro skills (interventions such as
reassurance, asking open questions, making summations, and reflecting
feelings) to complex therapeutic skills (e.g., conducting an empty-chair
dialogue). The supervisory alliance refers to enhancing the emotional con-
nection between supervisor and supervisee, coming to an agreement on
supervisory goals and tasks, and/or addressing a rupture in the super­
visory working relationship.

31
 Figure 1.2

Example of a sexual attraction event. Adapted from Critical Events in Psychotherapy

Supervision: An Interpersonal Approach (p. 17), by N. Ladany, M. L. Friedlander, and
M. L. Nelson, 2005, Washington, DC: American Psychological Association. Copyright
2005 by the American Psychological Association.

32
 Overview of the Critical Events Model

The exact nature of any resolution is closely linked with the task at
hand in a given supervision event. Thus, a resolution might involve greater
self-awareness (in a countertransference event, for example) or planning
for action (e.g., in a multicultural awareness event). Essentially, the reso-
lution involves coming back to the original concern or point of entry into
the event, signaled by the marker. In short, events with successful resolu-
tions are those in which the task at hand is accomplished. For example,
in a successfully resolved countertransference event, the supervisee has a
new appreciation for his or her emotional reactions to the client in light
of his or her own personal background or experience and explains to the
supervisor a new strategy for working with the client in light of this new
self-awareness.
Of course, not all tasks are successfully resolved. Those that are partially
resolved or that are unsuccessful tend to lack closure. Clearly unresolved
tasks are those in which the supervisory session ends with tension, anger,
or withdrawal. In other situations, the event’s conclusion may be less
clear, such as when the supervisee agrees to follow the supervisor’s sug-
gestions but does so without a clear commitment or when the super­
visor addresses the supervisee’s feelings but, sensing resistance, shifts the
conversation to another topic altogether. A poor conclusion to a critical
event can be just as unsettling for a supervisee as it is for a psychotherapy
client and arguably for the supervisor as well.

Identifying Critical Events

Although the literature on critical events in supervision is limited,
authors have written about some important recurring themes in psycho­
therapy supervision, many of which are universal. From this literature and
our own experience as supervisors, we previously identified 10 critical
events, with the following tasks: remediating skill difficulties and deficits,
heightening multicultural awareness, negotiating role conflicts, work-
ing through countertransference, managing sexual attraction, repairing
gender-related misunderstandings, addressing problematic attitudes and
behavior (Ladany et al., 2005), facilitating supervisee insight, enhancing
career counseling skills, and facilitating a corrective relational experience

33
 The Critical Events in Psychotherapy Supervision Model

(Ladany, 2006; Ladany et al., 2012; Ladany & O’Shaughnessy, 2015). In

this book, we add working through parallel processes as an additional
critical event. Although this list is by no means exhaustive, these kinds of
tasks tend to be the most common and challenging ones that take place in
psychotherapy supervision.
What can be particularly challenging is when one event leads to another
event, which needs to be resolved before returning to working through the
original one. For example, a session that begins with a countertransference
event (“marked,” for example, by a supervisee’s comment that she or
he feels “angrier than [she or he] should” toward a new client) could well
turn into a role conflict event after the supervisor asks the supervisee to
consider the personal basis for the strong reactions. If the supervisee feels
that the supervisor’s inquiry is personally intrusive, this rupture in the
supervisory alliance needs to be repaired before there can be a successful
resolution to the original countertransference difficulty with the client.
Alternatively, what begins as a critical event in supervision, say the
supervisee’s “problematic attitude” after receiving directive feedback from
the supervisor, might well turn into a critical event related to the super­
visee’s therapeutic work with clients. This switch might occur, for exam-
ple, if in discussing her or his general lack of confidence as a therapist, the
supervisee discloses that her or his client has made sexual overtures to the
supervisee. In a more critical situation like this one, it would be important
to focus on the sexual attraction event within the therapy before returning
to a discussion of the supervisee’s problematic attitude in supervision (i.e.,
one trumps the other).
In this book, we focus on one-on-one, face-to-face supervision,
although critical events clearly also take place in group supervision. Each
chapter begins with research and theory relevant to the critical event
under discussion. Next, we suggest a conceptual model for addressing
each kind of event, in which the supervisory task at hand is marked by
various possible behaviors or comments on the part of the supervisee.
As described earlier and illustrated in the foregoing figures, each process
model contains a marker, task environment (with suggested interactional
sequences), and resolution. Following the description of each model
are abbreviated transcripts that illustrate successful or unsuccessful task

34
 Overview of the Critical Events Model

resolutions. Alongside the dialogue are the participants’ perceptions,

intentions, and reactions as the event is ongoing. At the conclusion of each
chapter, we discuss some special considerations, which are note­worthy
issues that may arise in working through each kind of critical event.

FINAL THOUGHTS BEFORE VENTURING FORWARD

As we explained earlier and continue to emphasize: Context is key. That
is, critical supervisory events do not occur in a vacuum. Like clients and
therapists, supervisors and supervisees bring to the table a variety of
backgrounds, personal experiences, and salient concerns that result in an
exciting, yet sometimes bumpy, process of supervision. To capture the
complexity of these contextual dynamics, our illustrative cases have vary-
ing characteristics of supervisors and supervisees, settings, and formats of
therapy and supervision. In this way, we have strived to demonstrate the
wide application of our model in hopes of encouraging readers to con-
sider the diversity of supervision practice across fields of specialization.
One important point needs to be stressed at the outset. Supervisees
are expected to come to supervision with an openness to the supervisory
process and with at least rudimentary skills, knowledge of psychotherapy
processes, and some degree of self-awareness. When a supervisee lacks
these essential characteristics, it behooves the supervisor to recognize the
supervisee’s shortcomings as soon as possible in their work together so
as to address them responsively and responsibly. Sometimes this can be
done as a critical event but other times, such as when a supervisee lacks
even rudimentary skills, could involve remediation before clinical inter-
actions occur.
We realize that the personal/emotional aspect of supervision tends
to be poorly understood by beginning supervisees, and the process of
self-discovery can be threatening even for experienced supervisees. For
this reason, a crucial aspect of supervision is clarification of role expec-
tations at the outset. Indeed, informed consent for supervision that
includes clear role expectations is required (see Guidelines for Clinical
Super­vision in Health Service Psychology, American Psychological Asso-
ciation, 2014) to circumvent role conflict or ruptures in the supervisory

35
 The Critical Events in Psychotherapy Supervision Model

alliance. Clarification of expectations is essential so that from the outset,

the supervisee understands and agrees that his or her personal concern or
background may become a focus of the supervision conversation, but the
goal of such a conversation is not to change the supervisee’s personality
structure or to work through his or her personal problems. Rather, the
goal of this kind of supervision conversation is to address specific personal
barriers that may be impeding the supervisee’s work with clients or hin-
dering his or her productive participation in supervision.
Any discussion of professional behavior should be conducted with a
clear delineation of professionalism. Although this book is not an ethics
casebook, our case descriptions and discussions may well raise pertinent
ethical issues. For this reason, we encourage supervisors to consider their
respective professional ethical codes and guidelines.
We believe that good supervision of good therapeutic work is good
supervision of good therapeutic work, regardless of whether it is called
counseling or psychotherapy. For this reason, we use the term supervisee
rather than trainee to include postdegreed practitioners who are receiv-
ing supervision. For ease of reading, we vary the gender of supervisor
and supervisee, but in all cases the choice of gender is arbitrary. Further,
because we believe that the field’s differentiation of “counseling” from
“psychotherapy” is neither precise nor meaningful, we use the term psycho-
therapy for purposes of consistency. Ultimately, we acknowledge the rich-
ness of the many professional disciplines in which the supervision of
psychotherapy is provided and researched.

36
 2

Ambiguity and Conflict in the

Supervision Relationship:
It’s All About the Roles!

A rguably, nowhere is there a greater need for supervisor responsive-

ness than when there occurs a break, or rupture, in the supervisory
working alliance (Friedlander, 2015). In contrast to the critical events
we have discussed thus far—skill deficits and problematic attitudes and
behavior—critical events involving the supervisor’s and supervisee’s respec-
tive roles in their relationship can take center stage even when there is no
ongoing discussion of clients. To complicate matters further, role con-
flicts can overtake a conversation about the supervisee’s clinical work in
the blink of an eye. Ignoring the conflict will likely make the supervision
process quite tense and uncomfortable for both parties. At its worst, fail-
ure to resolve a role conflict can irretrievably damage the supervisory alli-
ance and negatively affect the welfare of the supervisee’s clients (cf. Nelson
& Friedlander, 2001; Ellis et al., 2014).

http://dx.doi.org/10.1037/14916-003
Supervision Essentials for the Critical Events in Psychotherapy Supervision Model, by N. Ladany,
M. L. Friedlander, and M. L. Nelson
Copyright © 2016 by the American Psychological Association. All rights reserved.

37
 the Critical Events In Psychotherapy Supervision model

What do we mean by role conflict? This term and a similar construct,

role ambiguity, were adapted from industrial/organizational psychology
to the context of psychotherapy supervision by authors who pointed out
that, like workers in any job environment, supervisor and supervisee need
clear and unambiguous guidelines for their respective roles, both in relat-
ing to one another and in carrying out their job tasks (Friedlander, Keller,
Peca-Baker, & Olk, 1986). Role ambiguity occurs when a worker is unclear,
unsure, or confused about what her or his supervisor expects. Role conflict,
on the other hand, occurs when the supervisee has specific expectations for
herself or himself and/or the supervisor, but these expectations contradict
those of the supervisor. The Role Conflict and Role Ambiguity Inventory
(Olk & Friedlander, 1992) offers specific examples of role conflict (e.g.,
“My supervisor told me to do something I perceived to be illegal or unethi-
cal and I was expected to comply”) and role ambiguity (e.g., “I was not
certain about what material to present to my supervisor”) in supervision.
It is easy to see that role ambiguity is most likely to occur with novice
supervisees, who come to supervision for the first time or who are being
supervised in a clinical setting (such as an inpatient psychiatry unit) that
is new for them. Indeed, research with the Role Conflict and Role Ambi-
guity Inventory supports this supposition (Olk & Friedlander, 1992). In
contrast, because by definition role conflict occurs when supervisee and
supervisor have opposing expectations for what is to take place between
them, critical events related to role conflict are most likely to surface with
relatively more advanced supervisees.
Consider, for example, a supervisee whose previous supervisors focused
only on case management or how to follow an evidence-based treatment
manual. When the supervisee’s new supervisor asks about the supervisee’s
personal experiences with racial discrimination, the supervisee is distressed
because he has no idea how such a highly personal discussion could pos-
sibly advance his clinical skills. As another example, a supervisee, new to
conducting conjoint family therapy, is hesitant to disclose her outrage with
the parents in one of her cases because she is worried that the supervisor
would see her as incompetent and thus unsuited to work with the family.
The resolution of ambiguity is a fairly straightforward process of
clarifying expectations, but the resolution of conflict is more complex and

38
 Ambiguity and Conflict in the Supervision Relationship

arguably more challenging. At the very least, resolution of a role conflict

involves direct communication about the opposing expectations and it often
involves backtracking, clarifying intentions, disclosing personal material,
compromising, and apologizing. All of these processes are difficult enough
for people to engage in when they share social power, but in the supervision
relationship there is an unambiguous hierarchy, and the evaluative, gate-
keeping function of supervision is ever present, particularly in the minds of
supervisees. For this reason, role conflict in supervision can be pernicious.
In the following sections, we illustrate and discuss critical events related to
role ambiguity and role conflict. The markers for each kind of event can show
up in the context of a discussion about what should take place in supervision
or in the midst of a conversation about the supervisee’s work with one or more
clients. When conflict or ambiguity events begin in the absence of a specific
clinical discussion, they tend to be marked by behavior on the supervisee’s
part that reflects his or her expectations (or lack thereof) for the supervision
process, such as being chronically late or coming to supervision unprepared,
when his or her paperwork (clinical reports, process notes) is incomplete, or
when he or she requests something specific of the supervisor (e.g., “Do you
want to review my tapes before we meet each week?”). More often, however,
these kinds of events are initiated within the context of a clinical discussion.
In the three examples that follow, we pick up on the supervision of Elise
(from Chapter 1), whose client dropped out after their first session. Using
the same supervisee in all three examples, we begin with an illustration of a
successfully resolved role ambiguity event, followed next by two role conflict
events, one that is unsuccessful and one that has a successful resolution
(see Figure 2.1).

EXAMPLE OF A SUCCESSFULLY
RESOLVED ROLE AMBIGUITY EVENT

Marker
Supervisor: So what other cases do you need to talk about today?
Supervisee: [hesitantly] Well, I did get a message from Frank—remember
the new client I saw last week? [pause] . . . He said in his message that he

39
 the Critical Events In Psychotherapy Supervision model

Figure 2.1

Process model of a role conflict event.

40
 Ambiguity and Conflict in the Supervision Relationship

wouldn’t be keeping any future appointments—that he’s not ready for

therapy yet. [realizes she needs to discuss this client but unsure what to focus
on; worried about being seen as lacking for having lost the client]
Supervisor: Any ideas on why he dropped out? [unsure whether to focus on
Elise’s feelings or on her intake skills]
Supervisee: I’m not sure. . . . Should I go get the tape of my session with
him for us to look at together? [wants to please the supervisor]
Supervisor: We could do that. Would that be most useful for you at this
point? [still searching for a focus]
Supervisee: I don’t know. [pause] It might be, but I don’t know. . . . Is it
okay that I don’t have a good reaction to it all? [realizes she should bring up
some negative feelings she’s having about the case]

At this point, the marker is evident. Elise is stymied by what she should
talk about in supervision related to a client whom she will no longer be
seeing. She is unclear whether expressing her feelings about the client is
appropriate or even if doing so would be helpful, and because she is frus-
trated (perhaps even angry) at the client, she is unsure whether her reaction
is justified and, even if it is, whether the supervisor wants to—or should—
hear about it.

Task Environment
The supervisor has now recognized that Elise’s hesitance has to do with
not knowing what he expects of her in supervision. He judges that the
issue is Elise’s lack of understanding of the supervision process and her
role as a supervisee in deciding which of several paths to follow to be
of most benefit to her learning. Responsive to what he views as Elise’s
ambiguity about how they should work together most productively, the
supervisor sees this moment as an opportunity to consider her expecta-
tions and subsequently to clarify his own expectation that Elise take more
initiative in supervision.

41
 the Critical Events In Psychotherapy Supervision model

Exploration of Feelings
Supervisor: Elise, are you saying you’re wondering whether we can talk
about your feelings toward Frank? And maybe your feelings about any cli-
ent? [focusing on the supervisory alliance by clarifying Elise’s expectations]

Supervisee: Yes, I guess I am. I know I need to think about just why he
dropped out and what I did wrong in the intake. I don’t know what’s most
important. [still trying to please as well as to communicate her lack of under-
standing of what’s expected of her by the supervisor]

Supervisor: All of these are, potentially! I want to let you know, though,
that I very much welcome a discussion about your feelings toward your
clients, even if they have dropped out unexpectedly, like Frank did. After
all, as therapists, we can’t be helpful if we’re not aware of our strong reac-
tions, don’t you think? [chooses to ignore Elise’s self-blame in favor of clari-
fying his view of the supervisory process and also putting himself in her shoes
(i.e., modeling and normalizing her experience)]

Supervisee: Yes! I agree. I just didn’t know where you wanted me to start.
[explains her need for more direction]

Focus on the Supervisory Alliance

Supervisor: Actually, let’s put feelings about Frank aside for a moment
and talk about how supervision should go from each of our perspectives.
It’s understandable that you’re concerned about this. [focuses on the super-
visory process, normalizing Elise’s experience of supervision]

Supervisee: Right. The only other supervisor I had just wanted to review
all my cases. I guess I got the impression from her that I should keep my
feelings out of it. I wasn’t sure what you thought about that. [still fearful
of asking directly for what she wants, not knowing if her need to examine her
feelings is an appropriate topic for supervision]

Supervisor: Well, I’m glad you mentioned it, then. A therapist’s feelings
toward a client are critically important in my view, regardless of whether
you’re doing experiential therapy or CBT. So that’s where I’m different

42
 Ambiguity and Conflict in the Supervision Relationship

from your previous supervisor, I suppose. [reinforces Elise’s disclosure of

the source of her anxiety]

Supervisee: Great. [feeling somewhat reassured]

Supervisor: But there’s a larger issue here, not just whether or not to focus
on your feeling reactions to your clients. I’d like you to be the one to decide
where we should start as we talk about any one of your cases. With Frank,
for example, I could see it being just as helpful to discuss your feelings as
to review what went on in the intake. Or, actually, we could get to your
feelings by doing that. [clarifies his expectation that Elise take more charge
of their discussion]

Supervisee: Yes, I can see that! Of course. But [pause] . . . what if we just
focus on my feelings and then I might not know what I did wrong with
him? [tentative, worrying that she might make the wrong choice]

Supervisor: You can leave that worry to me. I’m not suggesting that you
do all the deciding about what we focus on, and rest assured that if I think
you’ve missed something important, I won’t be shy about bringing it up!
(smiling) [reassures her that the supervision process is a shared responsibility]

Resolution
Supervisee: Yeah, I’m glad of that. [feels somewhat relieved of the pressure
to figure out what needs to be discussed]

Supervisor: For example, I’m not even so sure that you did anything
“wrong” with Frank. Didn’t his voice message say that he wasn’t ready for
therapy “yet”? [responsive to Elise’s potential for self-blame]

Supervisee: Right, it did.

Supervisor: So maybe part of my job will be to point out to you what you
might be mistakenly blaming yourself for? [further clarifying his role]

Supervisee: (laughs) Well, that’s a relief!

Supervisor: (laughs)

43
 the Critical Events In Psychotherapy Supervision model

Supervisee: So, what I think I’d like to do now is tell you how upset I am
about Frank dropping out. [feeling empowered to direct their discussion]

Supervisor: (smiles) Let’s go for it! [reinforces Elise’s initiative]

In this successfully resolved event, the supervisor recognized that role

ambiguity, rather than passivity, was behind Elise’s reluctance to decide
how to discuss her case in supervision. In recognizing the marker for role
ambiguity, the supervisor was well aware that Elise was a beginning super-
visee and that she had had little prior experience either as a therapist or
as a supervisee.
Yet the dialogue could well have led to an alliance rupture caused by
role conflict if the supervisor had seen Elise’s hesitance as a characterolog-
ical problem rather than simply as uncertainly about what was expected of
her in supervision. In the next example, we illustrate how differently the
discussion may have played out if Elise’s role ambiguity were misunder-
stood by the supervisor as passivity.

EXAMPLE OF AN UNRESOLVED
ROLE CONFLICT EVENT

Marker
Supervisor: Any ideas on why he dropped out?

Supervisee: I’m not sure. . . . Should I go get the tape of my session with
him for us to look at together?

Supervisor: We could do that. Would that be most useful for you at this
point?

Supervisee: I don’t know. [pause] It might be, but I don’t know. . . . Is it

okay that I don’t have a good reaction to it all?

Supervisor: Your reaction to Frank is one thing, but I’m stymied by your
lack of preparation for our discussion. I can’t help but wonder if Frank’s
dropping out might have something to do with your not being fully

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 Ambiguity and Conflict in the Supervision Relationship

prepared for him either. [frustrated at what he sees as Elise’s passivity and
wants her to see the potential parallel in her clinical work]
Supervisee: (silent) [feels criticized, silenced]
Supervisor: Okay, let’s review your intake with Frank. [decides to take
charge, thinking he can show Elise how passive she was with her client]
Supervisee: Okay. [upset, yet willing to go along with the supervisor’s
direction]

While at this point Elise is feeling personally attacked, the supervisor

is unaware of her feelings toward him, instead viewing her as becoming
increasingly passive in their interaction. What started out as role ambigu-
ity for the supervisee has now become role conflict. That is, Elise expected
the supervisor to decide where to focus their discussion, but he has now
challenged her competence by indicating that she was not prepared for the
intake with her client. The interaction between them has become fairly tense.

Supervisor: So, can you recap what happened in the intake with Frank?
[feeling increasingly frustrated, believing that a focus on the therapeutic pro-
cess will be more productive]
Supervisee: He began, right from the beginning of the session, giving me
his entire life history, which is full of trauma. His brother shot both his
parents when he was a teenager, and then Frank was sent to live with some
relatives he didn’t know very well. [unsure what to discuss, decides to pre­
sent the client’s issues]
Supervisor: Wow, what a story! Has he ever had treatment before? How
did you end the session? [quite disturbed to hear this history, thinking that
the client might be ambivalent about entering therapy; decides to assess how
well Elise handled the client’s ambivalence and whether she discussed the
potential value of therapy given all the trauma the client revealed]
Supervisee: I don’t know what you mean. We did make an appointment
for this week. [trying to avoid being criticized again yet not understanding
what he means about how she “ended the session”]

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 the Critical Events In Psychotherapy Supervision model

Supervisor: I mean, did you talk with him at all about what it might mean
to open up all these old wounds of his in therapy? [even more frustrated
with Elise at this point, thinking that he will give her a hint about what she
should have done in the intake]
Supervisee: I guess I didn’t. [feels chastised]
Supervisor: So it’s not surprising that he decided not to commit to treatment.
[wanting to make a point]
Supervisee: I guess so. [aware of the supervisor’s frustration and believes
that he expects her to own her error]
Supervisor: What have you learned from this? [trying to assess Elise’s abil-
ity to reflect on her experience]
Supervisee: I guess I should have talked with him about how hard therapy
might be and see if he really wanted to start, if he really wanted to relive
what happened to him as a child. [decides that she needs to agree with him
to avoid being criticized further]
Supervisor: Exactly. [satisfied, believing that she has now seen her error]

Here the rupture to the alliance is quite evident, with the supervision
session becoming increasingly tense. However, the supervisor does not rec-
ognize the marker of a role conflict event. The supervisor is frustrated with
Elise, and she is feeling judged harshly, perhaps unfairly, by the supervisor.
When the supervision session began, she needed support and encourage-
ment to air her frustration about losing the client, as well as some space to
begin to understand what may have gone wrong or what she might have
done differently in the intake with this client to assure his commitment to
treatment. At this point, realizing that the supervisor is quite concerned
about the client’s welfare, Elise decides to redirect their interaction to be
more in line with what she perceives the supervisor expects from her.

Supervisee: Do you think I should call him back? I could bring up some
of these issues or at least let him know that he can come back if he wants
to. [trying to figure out what he wants her to do]

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 Ambiguity and Conflict in the Supervision Relationship

Supervisor: What do you think would be best? [wanting to empower Elise,

beginning to realize that he has been somewhat critical]
Elise: I’m afraid that if I do that, he won’t say anything. I really don’t think
he is ready to talk about all that happened to him. [taking a risk by offering
her perspective on the client’s resistance]
Supervisor: So why don’t you write him a letter, letting him know that
you got his message and that he’s welcome to come back to the clinic in
the future. [decides to take charge, thinking that continuing the discussion of
this client is not likely to be productive, that he should just tell Elise what is
needed in line with clinic policy]
Elise: I can do that. I will do that. [wanting to be compliant, then realizing
that to please him, she needs to sound more self-assured]

The supervisee is highly aware of being judged and found lacking. She
is confused about how or if she can turn the situation around with her
supervisor, and right now she is only interested in doing what she thinks
he expects her to do. This role conflict event is thus unresolved. Because
the supervisor did not recognize the marker, the event never proceeded to a
task environment. Although he did focus on the supervisory alliance, there
was no successful resolution. Rather, the supervisor simply moved on.

Supervisor: Why don’t we talk about another case, one that is ongoing?
[deciding that it will be more productive to switch gears and discuss a case
that Elise feels better about]
Supervisee: Sure. Which one of my clients do you want to hear about?
[relieved that she no longer needs to discuss the client who dropped out]

Elise continues to try to please her supervisor, having decided that he

has an agenda that she needs to figure out to please him. While relieved
that they have moved off the previous topic, she is feeling frustrated and
hurt by what has taken place so far between them. Her intention at this
point is simply to get through the rest of the hour without letting the
supervisor see her distress. And she has no idea what to do with her client.

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 the Critical Events In Psychotherapy Supervision model

In this vignette, the role conflict event was unresolved. Supervisor and
supervisee went on to discuss another client, with their unease with one
another continuing to shadow the remainder of the supervision session
and, perhaps, subsequent supervision sessions.
What makes this event a role conflict rather than simply a conflict?
In an event that involves resolving an overt conflict, there is a clear dis-
agreement (“I think . . .” versus “I disagree. I think it’s . . .”), whereas in a
role conflict event there is tension, generally covert, because each person
expects something different to occur in the relationship with the other
person. In the current example, Elise expected support from the super-
visor and to receive guidance to understand why her client may have
dropped out and what she could learn from this unfortunate experience.
The supervisor, on the other hand, expected Elise to take ownership of the
supervision process by initiating a clinically rich discussion of her clients
and clearly asking for what she needed from supervision.
Because of the contradictory expectations, the supervisor became
quite frustrated with the supervisee, and as his frustration grew, he
became more convinced that the problem was Elise—namely, her passiv-
ity and lack of clinical skill. Not only did he not recognize the marker for
role conflict, but also he was unaware of how his own behavior and atti-
tude were contributing to the growing rupture in their alliance. Although
well aware of his own discomfort and somewhat aware of Elise’s dis­
comfort, he had no idea that he contributed to the rupture in his approach
to the supervisee by blaming her for being unprepared for supervision and
equally unprepared for her session with the client. Unfortunately, as Elise
became more submissive, the supervisor became more direct and domi-
nant, which only served to increase her submissiveness. Unfortunately, the
gender dynamics in this event played a significant role, as the combination
of male supervisor/female supervisee along with the power dynamics of
supervision often result in a supervisee being silenced and feeling unable
to please the supervisor or “get it right” (Friedlander, Blanco, Bernardi, &
Shaffer, in press).
Later, when the supervisee related the client’s extreme trauma his-
tory, the supervisor judged her even more harshly. Understandably, his

48
 Ambiguity and Conflict in the Supervision Relationship

focus shifted to worrying about the client’s welfare in the wake of what
he now concluded to have been a poorly conducted intake. However,
note that he learned little about what had taken place in the therapy ses-
sion. When we look closely at the dialogue, we see that Elise, criticized
by the supervisor for being unprepared and feeling upset that she had
apparently mishandled the intake, actually provided minimal informa-
tion about the case.
All told, the supervisee learned little from this supervisory session
other than she had made a grievous error with her client and that her
supervisor was demanding and hard to please. It is highly unlikely that
Elise, feeling judged, would address the rupture in the supervisory alli-
ance, regardless of how uncomfortable she felt. What is likely is that with-
out a repair, the course of supervision from this point onward will be
unpleasant for both parties. Indeed, a rupture in a supervisee’s working
alliance with a client is all too easily replicated in the supervisory alliance,
particularly when the supervisor becomes so concerned about the client
that he fails to be responsive to the supervisee (Friedlander, 2015). This is
precisely what happened in this case.

EXAMPLE OF A SUCCESSFULLY RESOLVED

ROLE CONFLICT EVENT
As depicted in the following illustration of this same case, the five most
“purely” relational sequences in our model are an obvious choice in a role
conflict event. Moreover, no critical event other than role conflict—and
perhaps countertransference—is more likely to necessitate use of the most
clearly relational of our 11 sequences. Indeed, any of the other events we
have identified in this book can “turn into” a role conflict event if supervi-
sor and supervisee have contradictory expectations for their roles in the
supervisory process.
Now, let’s reconsider Elise’s supervision. This time, rather than see
Elise’s increasingly submissive responses as being attributable to her pas-
sive character or poor clinical skills, the supervisor recognizes her hesitant
and submissive responses as a marker of role conflict.

49
 the Critical Events In Psychotherapy Supervision model

Marker
Supervisee: Do you think I should call him back? I could bring up
some of these issues or at least let him know that he can come back if
he wants to.
Supervisor: What do you think would be best?
Supervisee: I’m afraid that if I do that, he won’t say anything. I really don’t
think he is ready to talk about all that happened to him.
Supervisor: So why don’t you write him a letter, letting him know that
you got his message and that he’s welcome to come back to the clinic in
the future.
Supervisee: I can do that. I will do that.

At this point, with discussion of the client seemingly concluded, the

supervisor recognizes the marker of a role conflict event. Deciding to work
toward a resolution of this rupture to their alliance, the supervisor shifts
focus, and the task environment now begins.

TASK ENVIRONMENT

Focus on the Supervisory Alliance

Supervisor: [pause] Leaving Frank’s case aside for the time being, I’m
thinking that we should perhaps talk about what’s going on now, between
us two? [tentatively suggests a focus on the supervisory alliance]
Supervisee: Okay . . . ? [somewhat wary]
Supervisor: I’m feeling uncomfortable about how our discussion has
been so far today. Do you feel it too? [modeling immediacy, realizing that
Elise is unlikely to bring up her feelings without his “permission” to do so]
Supervisee: I guess. . . . Yes, I do feel uncomfortable. I’m not sure why,
though . . . ? [feeling bold enough to agree that she’s uncomfortable as well]

50
 Ambiguity and Conflict in the Supervision Relationship

Supervisor: Well, I’m thinking that you’ve gotten quieter and I’ve got-
ten more directive. It’s not the way I’d like it to go between us, ideally. I’d
much rather you take the lead in orienting our discussion. [states his own
expectation in hopes that Elise will do the same, carefully labeling behavior
“quieter” so as to avoid making her more uncomfortable]
Supervisee: Yes, you said that earlier. [feeling the need to say something but
unsure how to respond]

Exploration of Feelings
Supervisor: Could you let me know your reaction to that? [realizing that
she’s well aware of his behavior, exploring her feelings]
Supervisee: Umm . . . [pause] Well, to be honest, I didn’t feel so good
about it. I mean, I did bring up this client at the beginning of supervision.
I “took the lead” when I did that.
Supervisor: Yes, you did. [responds minimally, hoping Elise will say more
about what’s bothering her]
Supervisee: You said I was unprepared for supervision, just like I was
unprepared for the client. But I wasn’t unprepared for him. [feeling defen-
sive, reluctant to state her anger and hurt]

Focus on the Supervisory Alliance

Supervisor: So, that comment of mine is what started us off on the wrong
foot today? [seeks clarification of Elise’s perceptions of the rupture; realizing
she is not willing to label her feelings, describes the rupture in mild terms]
Supervisee: Yes, I guess so. [the words “started us off on the wrong foot”
seem acceptable enough to admit to]
Supervisor: I appreciate your frankness, Elise. Not easy to do! Before I put
my foot in my mouth again (both laugh nervously), what were you hoping
we’d talk about today? I’m not sure I communicated to you clearly enough

51
 the Critical Events In Psychotherapy Supervision model

my expectation that you come to supervision with what is most important

to you each week. [indirectly apologizes for his part in the alliance rupture
and seeks to clarify their mutual expectations]
Supervisee: Maybe not . . . but I did want to talk about my reaction to
Frank and also to try to figure out why he decided not to come back. I
think I expected something different. [beginning to assert her disappoint-
ment in how the supervision session is going]

Supervisor: From me? [clarifies, realizing how hard it is for Elise to express
her negative reaction to him]

Supervisee: Well, yeah. [hesitantly agrees but not secure enough to comment
further]

Supervisor: So you were expecting more support, not criticism from me.
[labels their discrepant expectations, using the word “criticism” to give her
permission to indicate that she perceived his comment as critical]

Elise: Yeah, exactly. [beginning to relax a bit]

Attend to the Parallel Process

Supervisor: Hmm. . . . Well, I missed that; I certainly did. I’m having a
strange thought right now though. . . . I’m wondering if you and Frank
got off on the wrong foot, too, like you and I did today? [draws attention
to the ruptures in both alliances]

Supervisee: (pause) That’s interesting! What do you mean? [quite curious

now but also wary that she might be blamed]

Supervisor: I jumped to some conclusions about you without check-

ing them out. I assumed you wanted something specific from me but
I didn’t give you room to let me know, and you . . . [owning his part in
the rupture]

Supervisee: (interrupting) . . . did the same thing with Frank! Wow!

[excited to see the parallel process]

52
 Ambiguity and Conflict in the Supervision Relationship

Supervisor: What are you thinking now? [giving her space to express her
understanding of the parallel process]
Supervisee: Now that I think about it, I was so sure, from his history,
that he’d want and need therapy, that I didn’t give him the space to really
consider what that meant, I mean to consider if he’s ready to bring up all
that past trauma from his childhood. [expanding her ideas freely now, feel-
ing bolder]
Supervisor: And I was so sure about you! But I thought only about what
I wanted and expected from you, not what you wanted and expected from
me! [continuing to own his part in their rupture]
Supervisee: This is amazing! (laughs) [genuinely relieved and hopeful that
their relationship is now on better footing]
Supervisor: Isn’t it? (smiles) Why do you suppose we re-created it here?
[realizing from her laughter that Elise is now more comfortable, exploring her
deeper understanding of the parallel process]
Supervisee: I saw you as the “Supervisor,” capital “S,” and easily got intimi-
dated because underneath I was worried that I’d really messed up with
Frank. [comfortable enough now to express her genuine worry about her
competence]
Supervisor: Yes, that fits! And Frank saw you as . . . ? [continuing to explore
Elise’s understanding of the parallel process]
Elise: He saw me as “Therapist,” capital “T”! [begins to enjoy the discussion]
Supervisor: . . . and was intimidated? [tentatively probing Elise’s under-
standing of the client’s experience of her]
Supervisee: I guess so! [no longer feeling defensive about her work with the
client]
Supervisor: And supervision, like therapy, is intimidating. Sometimes I
forget that, since it’s been so long since I was a grad student myself! [owns
his part in the rupture; by indicating that supervision is “intimidating,” he
takes the sting out of Elise feeling “intimidated” as a person]

53
 the Critical Events In Psychotherapy Supervision model

Resolution
Supervisee: It’s amazing how much better I feel now!
Supervisor: Me too! I’ll try to give you more space in the future and not
just assume you want something you may not want from me. [modeling
rupture repair]

Supervisee: And I’ll try not to get so easily intimidated by your questions!
[fully engaged at this point]

Supervisor: Great—you’ll use your voice, like you just did, I hope?

Supervisee: Absolutely!

In contrast to the previous, unsuccessful handling of the same event,

the supervisor has acknowledged his role in the alliance rupture and that
Elise’s feelings of intimidation tend to be part and parcel of the super­
vision experience. Next, the supervisor calls Elise’s attention to the paral-
lel process (i.e., her “jumping to conclusions” about her client, Frank),
which may have intimidated him, and the supervisor’s “jumping to con-
clusions” about Elise’s lack of preparation for supervision, a comment
that clearly intimidated her. Both supervisor and supervisee were amused
by this covert parallel process, and the ensuing lighthearted interaction
suggests that their alliance has been restored. With a successful resolu-
tion to the event, they can now turn their attention back to discussions
of Elise’s clinical work.
As illustrated in both the role ambiguity and the role conflict events,
problems in the supervisory relationship arise because of unclear or con-
tradictory expectations for supervision on the part of the supervisee and
supervisor. In the role ambiguity event, the supervisor recognized that
Elise’s submissive behavior toward him was contextual; that is, it was
caused by a need for clarity about her expected role as a supervisee. By
contrast, in the role conflict event the supervisor failed to consider the
contextual influence of Elise’s submissive behavior, considering it to be
highly problematic not only in supervision but also in her clinical work.
In the unresolved illustration, the supervisor raised Elise’s defenses by

54
 Ambiguity and Conflict in the Supervision Relationship

implying that she was deficient, whereas in the resolved illustration, the
supervisor attended directly to the supervisory alliance and demonstrated
a willingness to reduce his social power by admitting his part in the rup-
ture and acknowledging Elise’s feelings of intimidation as part and parcel
of being a supervisee.

SPECIAL CONSIDERATIONS: ROLE AMBIGUITY

AND CONFLICT IN GROUP SUPERVISION
Thus far in this chapter, we have considered only individual supervision.
However, it is easy to see that in the context of group supervision, the
potential for role conflict is heightened because of the multiple relation-
ships that supervisees have with their peers. The flow of supervision can
be easily disrupted when supervisees in a group have interpersonal dif-
ficulties with one another or different statuses, such as gender and race
(cf. Friedlander et al., in press). In any group, clinical skills are likely to be
unevenly distributed, and supervisees are likely to be highly aware of one
another’s strengths and weaknesses. For this reason, offering and receiving
feedback to one another about clinical work can cause tension within the
group, particularly when there are covert external forces (e.g., competi-
tion for assistantships) that are affecting their relationships or when they
expect only to hear praise and confirmation from their peers.
Ruptures to the group alliance can also occur when the supervisor
points out a supervisee’s personal issues in a round-robin, “hot seat” kind
of group process. For this reason, we suggest that in the absence of a strong
sense of safety and clear norms for risk taking and confidentiality, super­
visors should function primarily in their educative and collegial roles in
the group, saving the therapeutic and evaluative functions of supervision
for their individual relationships with supervisees.
Indeed, it is often the case that a supervisor works with supervisees
individually as well as within a group. Role conflict can be particularly
troublesome in this situation or in any situation in which there are dual
relationships between supervisor and supervisee. It is common for super-
visors in an academic program to have multiple relationships with their

55
 the Critical Events In Psychotherapy Supervision model

supervisees, whom they may teach in seminars, work with on research

projects, or advise in an administrative capacity. It is particularly challeng-
ing (yet necessary) to separate these various roles.
We believe that it is essential for supervisors, more so than supervisees,
to be highly mindful of the potential for role conflict so that they can
explain the differing role expectations to their supervisees. Supervisees
need to know that to keep the multiple roles distinct, it is advisable not to
discuss course work or a research project during the supervision hour and
not to refer to personal issues discussed during supervision (e.g., counter-
transference or vicarious traumatization) in other academic contexts.

CONCLUSION
In other professions, the goals and processes of supervision tend to be
straightforward and administrative, and the managerial and evaluative
aspects of supervision tend to be clear to all parties. In the mental health
field, however, a supervisor needs to strike a balance between ensuring
client welfare and promoting the supervisee’s professional growth. Unfor-
tunately, at times these dual responsibilities are at odds.
Moreover, by its nature, clinical work places extraordinarily com-
plex demands on supervisees and their supervisors. Supervisees tend
to be highly sensitive to the intimate clinical material they hear in their
daily work with clients, and their degree of openness and willingness to
explore their reactions to this material has a strong influence on the ease
and depth of the supervisory relationship. With support from supervisors
and a nuanced and contextual understanding of the various role demands
of supervision, supervisees can reap great benefit from fluid shifts in focus
from their clients to themselves and back again.

56
 3

Addressing Skill
Difficulties, Deficits, and
Competency Concerns

O ne of the primary goals of supervision is to foster skill and com-

petency development. Although acquiring basic therapeutic skills
such as active listening and advanced empathy is challenging enough,
competency is a vast umbrella encompassing areas of personal and
professional growth, diagnostic and conceptualization ability, personal
awareness, reflective practice, and professional demeanor (Fouad, 2014).
Supervisors are responsible for monitoring all aspects of skill develop-
ment and competency. Moreover, they are gatekeepers for the profes-
sion and charged with the challenging task of advising a supervisee to
leave the profession if he or she is unable to demonstrate adequate lev-
els of skill and competency. In this chapter, we address skill and com-
petency development and the thorny issue of inadequate supervisee
performance.

http://dx.doi.org/10.1037/14916-004
Supervision Essentials for the Critical Events in Psychotherapy Supervision Model, by N. Ladany,
M. L. Friedlander, and M. L. Nelson
Copyright © 2016 by the American Psychological Association. All rights reserved.

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 The Critical Events in Psychotherapy Supervision Model

“SKILLS” DEFINED
We conceptualize skill development within three primary domains:
technical skill, interpersonal skill, and conceptual skill. Technical skills,
including using appropriate body language and vocal tone, paraphrasing,
labeling feelings, summarizing, and identifying meaning, are all taught
to beginning therapists before they advance to meeting with clients.
However, when beginners progress from role playing to seeing actual
clients, the real test of their skill development begins. Thus, supervisors
working with novice therapists must attend to their supervisees’ ability
to use the specific skills regularly and appropriately. Early practicum
courses are where much supervision related to skill development takes
place. Supervisors at this level are often in the instructor role, helping
supervisees remember and practice the basic skills intentionally. Should
a supervisee be unable to demonstrate the use of basic skills, even with
the help of the supervisor’s instruction and coaching, a skill deficiency
may be present.
Although interpersonal skill certainly involves aspects of technical
ability, the interpersonal domain incorporates aspects of the whole person
of the therapist. Supervisees must recognize early on that they are expected
to be interpersonally responsive. Their role is not simply to diagnose and
treat a disorder; rather, it is to be psychologically and emotionally present
in the room with a vulnerable human being. One might say that the ability
to provide Rogers’ (1951) facilitative conditions (unconditional positive
regard, respect, and empathy) is the core of interpersonal skill.
Problems with skill acquisition may reflect skill difficulties or
skill deficits. We view a skill difficulty as present when a supervisee is
undergoing a developmentally appropriate challenge in learning a skill,
whereas a skill deficit is present when a supervisee seems particularly
immobilized in learning a skill. Supervisees at the advanced practicum
level who fail to demonstrate skills they should have demonstrated ear-
lier in training (such as rapport building) are of particular concern.
Supervision focused on skill acquisition and demonstration of facilita-
tive conditions involves support for the supervisee, modeling for the

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

supervisee the conditions the supervisee must offer the client, and help-
ing the supervisee embrace mistakes and ambiguity. All these strategies
are aimed at addressing a supervisee’s skill difficulty in the interpersonal
realm. Should the supervisee seem unable to overcome initial perfor-
mance anxiety or set aside her or his discomfort with ambiguity long
enough to name emotions and stay present with the client’s experience,
the supervisor may be facing a skill deficit that requires more intense
intervention and/or remediation.

PROCESS MODEL:
SKILL DIFFICULTIES AND DEFICITS

Marker
Markers of skill difficulty include behaviors such as asking too many
closed questions rather than open-ended ones; failure to reflect feeling,
content, and meaning; providing premature reassurance; and failure to
address cultural differences early in the counseling relationship. Other
examples include persistently responding to clients in a friendly or chat-
like manner, providing reassurance rather than empathy, and barrag-
ing clients with closed questions. Effective skills can be practiced and
improved over time, provided a supervisee is open to learning and emo-
tionally flexible.
The supervisor should suspect a skill deficit, however, when a super-
visee seems unable or unwilling to practice the required behaviors. A
marker of skill deficiency might show up later in a practicum or train-
ing sequence as evidence that the supervisee is unwilling or not ready
to appropriate the necessary skills. A common marker of supervisee skill
deficiency is the reply “That isn’t me” in response to a supervisor’s concern
that after weeks or months of work, a skill is still not being demonstrated.
A supervisee who claims that he plans to provide only one particular type
of structured therapy, such as cognitive–behavioral (CBT) or reality ther-
apy, may be attempting to hide his interpersonal deficits behind a mask
of feigned professionalism that is intended to belie skill deficits. Such skill

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 The Critical Events in Psychotherapy Supervision Model

deficiency is a sign of the supervisee’s cognitive and/or emotional rigidity,

and that rigidity needs to be addressed.

Task Environment and Resolution

As with many challenges in supervisee development, the interactional
sequence focus on evaluation is necessary but not sufficient. The super-
visee must understand precisely what type of skill is not present in her or
his clinical work and that an inability to demonstrate the skill will result is
unfavorable evaluation. For this reason many training programs require
students to videotape their work with clients so that the skills supervisees
are and are not demonstrating can be evaluated.
When a simple skill difficulty has been ruled out and it becomes
clear that a skill deficit is present, it is critical to begin by identifying the
source of the deficit. The task is to name the identified skill deficit and
inquire about what underlies the deficit. It could be that the supervisee
has simply not been able to operationally define the skill and translate it
into observable behaviors. What does it mean to label feelings? Does the
supervisee have an adequate feeling vocabulary? Is the supervisee con-
fused about when to offer a reflection of feeling? Does she or he feel that
it is inappropriate to “invade” the client’s space by naming the client’s
feelings? Does the supervisee fear working with feelings based on a con-
cern about becoming overwhelmed by them? Or is it that the supervisee
defends against discussing feelings because it has historically been unsafe
for him or her to do so?
Only when the root cause of the deficit has been uncovered can an
appropriate supervision intervention be selected and implemented. In many
cases, exploration of feelings may be necessary to understand what under-
lies a supervisee’s difficulty using a particular skill. Moreover, a focus on the
supervisory alliance may be called for if the supervisee becomes defensive in
the process of receiving evaluative feedback from the supervisor.
Resolutions related to skill difficulties occur when the supervisee’s
behavior reflects learning and willingness to work with new skills. If
a supervisee continues to resist the supervisor’s attempt to help her

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

develop particular skills, the skill difficulty event is considered unre-

solved (see Figure 3.1).

EXAMPLE OF A SUCCESSFULLY RESOLVED

SKILLS DEFICIT EVENT
Using the task analysis model described in the first chapter, we now
describe an example of a technical skill deficit, rooted in the supervisee’s
lack of interpersonal skill, and the supervisor’s approach to addressing the
deficit. The following interaction takes place during a formative evalua-
tion session wherein the supervisor gives direct feedback to a supervisee
on her use of a specific skill: reflecting feelings. The supervisor is a White
woman in her mid-50s with 25 years of therapy and supervision experi-
ence; the supervisee is an African American woman in her early 30s who
is in her first practicum in a university setting. The supervision relation-
ship is cordial and generally positive. Supervisor and supervisee already
addressed their racial differences and agreed to discuss any issues that
might arise in relation to those differences.

Marker
The supervisor has repeatedly been having difficulty coaching her super-
visee to use feeling statements. In this case, one marker is clear—a lack
of feeling statements in the supervisee’s responses to the client, as indi-
cated on multiple behavioral tracking forms of therapy sessions. That the
supervisee has been unresponsive to the supervisor’s coaching is a second
marker that signifies a skill deficit.

Task Environment
Focus on Evaluation
Supervisor: So, as we have discussed over the past several weeks, I am still
not seeing a lot of feeling reflections in your work. It may be time for us to
have a discussion about this and what is making it hard for you to do that.

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 The Critical Events in Psychotherapy Supervision Model

Figure 3.1

Process model for addressing a skill difficulty event.

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

I sense that you are really struggling to label your clients’ feelings and am
wondering what that is like for you. [tries to deliver feedback while honoring
the supervisee’s experience]

Supervisee: (defensively) I’m just not sure that feelings are important in
therapy.

Supervisor: Can you tell me more about what you mean? [elicits meaning]

Supervisee: I think therapy should be about identifying goals and strat-

egies to reach those goals. I am not sure about the value of feelings in
therapy. I think we are there to help clients solve their problems, not to get
involved in crying sessions. [responds defensively]

Supervisor: Okay. So you believe that identifying your clients’ feelings and
responding to them empathically may not be necessary for good therapy
to take place. In fact you see getting into feelings as a waste of time. [models
reflection of content and meaning]

Supervisee: Yes I do. I just can’t understand why that is important.

Here the supervisor faces a choice point. She can delve into a conver-
sation about why feelings are important in counseling, thus remaining on
a cognitive level with the supervisee. Alternately, she can take a bolder step,
moving toward addressing feelings within the supervisory relationship.

Focus on Supervisory Alliance

Supervisor: It seems like it must be uncomfortable for you to talk about
this with me. [invites supervisee to focus on their relationship]

Supervisee: Yes, because I don’t dwell on feelings much. Life is like a series
of puzzles to be solved, so I’d rather look at it that way. [backing away from
the invitation]

Supervisor: So to be sitting here with me, a White supervisor who is bring-

ing up feelings, really takes you out of your comfort zone in more ways
than one. I mean, maybe it seems to you that I am trying to impose my
White values on you . . . ? [operating on a hunch, the supervisor speculates

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 The Critical Events in Psychotherapy Supervision Model

about racial difference as a source of tension related to working with feelings

in supervision]

Supervisee: That may be part of it. I mean, I had to grow up Black in a

very White neighborhood and city. I never had the luxury of being able
to have feelings in social settings because I had to appear competent and
in control. I’ve never allowed myself to cry in front of White people. [now
accepts the intervention and engages]

Supervisor: You were afraid maybe that opening up your feelings would
expose you to criticism or ridicule? [models reflection of feelings]

Supervisee: Absolutely. I never felt that I had the luxury the White stu-
dents had to cry in public or in class or to appear to “not know” what was
going on. I pride myself on looking like I know what was going on. So I’ve
never given myself permission to express or discuss feelings. I couldn’t
afford it. [feels heard and engages more fully]

Supervisor: And here I am, a White supervisor, so if we go together, or

you go with your White client into the realm of feelings, it brings up those
old feelings and fears.

Supervisee: Yep.

Exploration of Feelings
Supervisor: I’m realizing that you just revealed the feeling of fear to me
and the concerns behind that feeling. How does it feel to do that right
now? [models further focus on feeling]

Supervisee: It’s weird . . . and pretty scary.

Focus on the Supervisory Working Alliance

Supervisor: You’re concerned that I might judge you for doing the very
thing I’m asking you to do . . . ? What an awful bind to be in, Tasha. I’m so
sad that being in this culture has made you feel like that. I’m even sadder
that you may feel like that with me, too. [brings the conversation back to
the alliance]

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

Supervisee: It’s okay. I actually feel pretty okay with you. [indicates trust]

Supervisor: You had said it felt scary, so I wasn’t sure.

Supervisee: Well, I mean it’s scary in a general sense but not so much
with you. I trust you. [reflects on the general quality of the alliance, that it
is rooted in trust]

Supervisor: So how did it feel to have me label your feelings just now?
[explores feelings in the here and now]

Supervisee: It felt really good, like you were open to me and understanding
me. [acknowledges benefit from having her feelings reflected]

Focus on Skill
Supervisor: Can you see how that kind of labeling might benefit a client?
[tries to evaluate the effect of the intervention]

Supervisee: Yes I can now. But how do I do that like you did it?

Supervisor: Well, let’s start right here. How do you think I’m feeling right
now? [invites supervisee to practice the skill]

Supervisee: I think you are feeling pretty relieved that I just got your
point. (laughs)

Supervisor: That was AWESOME! You are exactly right. That didn’t seem
so hard now, did it? [validates supervisee’s success in demonstrating the
desired skill]

Supervisee: Not really. (laughs) [recognizes her own capacity to reflect

feelings]

Supervisor: It seems like you had the feeling right on the tip of your mind
but this time you gave yourself permission to say it. Do you think you can
practice more of giving yourself permission to do that with your clients?
[further validates the supervisee and recommends practice]

Supervisee: I can try.

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 The Critical Events in Psychotherapy Supervision Model

Resolution
Supervisor: Good. Let’s see how you do with it this week, okay? We know
you can do it. [acknowledges the supervisee’s capacity, which has just been
demonstrated]
Supervisee: Okay . . . it’s going to take some work and focus. [commits to
working on the skill]
Supervisor: And breathing through it. [provides support]
Supervisee: And breathing through it.

In this interaction the supervisor models the very skill the super-
visee needs to develop to illustrate its value for the supervisee. That is, the
supervisor acknowledges the supervisee’s struggles as an African Ameri-
can and related fear of negative evaluation from a White supervisor until
the supervisee feels understood. Addressing the supervisee’s fear within
the context of the supervision relationship deepens the interaction and
allows the supervisee to express her feelings in a safe interpersonal con-
text. The supervisor then invites the supervisee to label the supervisor’s
feelings, which the supervisee does successfully. The supervisor endorses
the supervisee’s ability to reflect the supervisor’s feelings and invites her
to try it more with clients.

ADDRESSING PROBLEMATIC EMOTIONS,

ATTITUDES, AND BEHAVIORS
Skill difficulties and deficits are but one aspect of supervisee compe-
tency that must be addressed in supervision; there are other competency
concerns that can interfere with the normal progression of a therapist’s
professional development. In 1999, authors Forrest, Elman, Gizara, and
Vacha-Haase distinguished between incompetence and impaired perfor-
mance in therapist development. They used the term impaired to describe
a supervisee who had once exhibited competence but who encountered
circumstances that interfered with his or her ability to demonstrate com-
petence, whereas incompetent refers to the state of never having developed

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

competence. In the course of working with supervisees, supervisors

encounter supervisees who are impaired as well as supervisees who can-
not establish competency. Given the conflation of the terms impaired and
disabled we avoid the use of the term impaired to describe problematic
supervisee behavior. Instead, we use the term problematic.

Crisis in Confidence
Critical incidents related to competence are among the dilemmas most
frequently discussed in supervision (Chen & Bernstein, 2000), particu-
larly with novices (Rabinowitz, Heppner, & Roehlke, 1986). According
to Hogan (1964), crises in confidence are common in therapists who
have established initial relationships with their clients but are still unsure
about how to manage the complexity of therapeutic intervention. Indeed,
Mallinckrodt and Nelson (1991) found that students in their second
practicum rated their working alliances with their clients significantly
lower than they did when they were in their first practicum. These authors
concluded that this discrepancy represented a normal and expected drop
in confidence as supervisees began to recognize the realities and complexi-
ties of therapeutic intervention.
Because crises in confidence usually reflect temporary difficulties
rather than incompetence, supervision typically involves normaliz-
ing supervisees’ feelings about being overwhelmed and helping them
develop therapeutic strategies to help them manage their cases. Often
a client’s improvement can remedy a temporary loss of confidence in
the supervisee. Occasionally, however, a supervisee may have a client
who is simply not going to improve. This is particularly the case when a
client has a chronic mental illness that is resistant to both medical and
psychotherapeutic interventions. Supervisees who are exposed to severe
pathology in their clients can become discouraged and begin to doubt
their abilities. Supervision in this kind of situation involves assisting
the supervisee to recognize the limits of therapy effectiveness and not
to take such situations personally. However, because developing thera-
pists do need success experiences, it is important that supervisors work
to ensure that their supervisees, particularly novices, are assigned cases

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 The Critical Events in Psychotherapy Supervision Model

in which they can feel effective. It is also important for supervisors to

identify and acknowledge supervisee success with all clients, regardless
of the magnitude of the success.

Interpersonal and Characterological Difficulties

Whereas work-related stressors (crises in confidence, emotional exhaus-
tion, and vicarious traumatization) result in problematic thoughts and
feelings, supervisees with ongoing interpersonal and characterological
difficulties come to their supervisors’ attention because of problematic
attitudes and challenging interpersonal behaviors. Although many
psychotherapists enter the field with “baggage” related to trauma and
thwarted needs in their personal histories (Barnett, 2007), problems arise
when therapists, unaware of their unconscious needs and motivations, act
inappropriately with clients, peers, and supervisors.
The aim of training in the psychoanalytic field is to help supervisees
become aware of unconscious experiences so they can be understood, used,
and managed as therapists work with clients. However, in many training
settings, this type of insight is not the goal. Whether or not a supervisee is
prompted to explore painful formative experiences, the outcomes of these
early relationships can exercise a powerful influence on professional rela-
tionships. Moreover, attitudes learned in formative settings can negatively
affect how therapists in training relate to others. For instance, a therapist
who has been shaped to believe that every question has a right or wrong
answer may have difficulty negotiating the ambiguity and complexity of
most clients’ difficulties. The defining elements in serious difficulties with
a supervisee are the supervisee’s resistance to understanding or his her
impact on others, including clients, and an unwillingness to change.

Process Model: Addressing Problematic Attitudes and Behavior

Marker
Supervisees with serious characterological difficulties are unlikely to
discuss them or easily accept their validity or importance. Furthermore,

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

because characterological problems vary in intensity, the markers of a

problematic attitude or behavior critical event are more difficult to deci-
pher. A supervisee with entrenched personality difficulties may become
extraordinarily uncooperative or hostile, may triangulate and “split” vari-
ous supervisors and advisors by complaining vociferously to one about
the other, or withdraw precipitously from the supervisory relationship.
Markers may also become evident in group supervision, staff meetings,
or the broader professional setting (e.g., with support staff, clients in the
waiting room, or peers in common areas).
Of course, characterological difficulties also may surface in a super-
visee’s work with clients. Indeed, because people with serious relational
problems often do not recognize these difficulties in themselves, markers
can be signaled only by observation. For this reason, observations across
situations (i.e., in therapy, in supervision, with peers, or in classes and
seminars) are essential. In the absence of consistency across situations,
it would be unwise to assume that a supervisee’s lack of sensitivity with
clients signals a characterological problem rather than an interpersonal or
therapeutic skills deficit.
One common marker of characterological difficulties is a super­visor’s
excessive worry about a supervisee. Moreover, such worries and related
consultations, extra supervision meetings, extra observations, and
additional evaluations may take up an inordinate amount of a super-
visor’s time. The supervisor may become gradually more preoccupied
with the realization that something about the supervisee’s interactions
with others is not healthy or functional. Sometimes the supervisor may
feel consistently reactive to a particular supervisee’s behavior in a way
that is not familiar to the supervisor or mirrors the supervisor’s reac-
tions to clients and/or to supervisees who have been identified as having
characterological problems. In extreme cases, supervisors may respond
in ways that surprise themselves, such as with sudden anger, confu-
sion, defensiveness, exasperation, or feelings of inadequacy around the
supervisee. Distinguishing between a supervisee’s profound skill defi-
ciency and a serious personality disorder that will make it necessary to
“counsel” a supervisee out of the profession is a particularly difficult
challenge. It is possible that what looks like a personality disorder may

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 The Critical Events in Psychotherapy Supervision Model

be a stubborn interpersonal style that is actually amenable to change

given proper intervention.

Task Environment and Resolution

The task in these kinds of events is to address (not change) the supervisee’s
problematic behaviors, attitudes, and feelings. It is important to distin-
guish between skill difficulties and skill deficits, but it is also important
to distinguish between a crisis in confidence or something more serious
(e.g., vicarious traumatization). If the supervisee is simply having a crisis
in confidence, a simple exploration of feelings and attending to the super-
visee’s needs may be all that is necessary. Listening carefully to the super-
visee to uncover the source if his or her distress is critical, and allowing
him or her to vent or process frustrations and stressors related to dealing
with clients may result in improvement.
Focus on the supervisory alliance is also critical. In many situations
involving challenging supervisee behaviors, an alliance rupture (Fried-
lander, 2015; Nelson, Gray, Friedlander, Ladany, & Walker, 2001) may
have taken place. A rupture is defined as the outcome of a misunderstand-
ing or conflict between supervisor and supervisee that has been left un-
addressed and unresolved. In a rupture situation both parties experience
discomfort in their interaction, and either or both may be unaware of
the source of the discomfort. Regardless of whether a supervisor clearly
understands the precipitant of the relational discomfort, it is impor-
tant to address and process the discomfort. The discomfort may be a
carry-over from an event in the therapy relationship, necessitating that
the supervisor focus on the therapeutic process and attend to parallel
process. Often a frank discussion of the source of conflict can diffuse the
interpersonal distress and clarify what one or both parties need to do to
avoid future misunderstandings.
Regardless of the cause of a challenging supervisee’s behaviors, the
supervisor must also evaluate her or his knowledge and skill. Thus, sequences
involving assessing knowledge, focus on evaluation, and focus on skill may
be important to a successful resolution of a problematic behavior event (see
Figure 3.2 for addressing a prototypical event of this kind).

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

Figure 3.2

Process model for addressing a problematic supervisee behavior event.

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 The Critical Events in Psychotherapy Supervision Model

EXAMPLE OF A SUCCESSFULLY RESOLVED

PROBLEMATIC BEHAVIOR EVENT
In the following interaction, the supervisor is a 45-year-old White man,
and the supervisee is a 40-year-old White woman, a former high school
teacher who is comfortable giving assignments and expecting clients to
cooperate.

Marker
The marker in this example is the supervisor’s observation that the super-
visee fails to see that her excessive and problematic directiveness may be
affecting a client’s attendance in therapy. The supervisor suspects that the
supervisee has a need for control that may be affecting her ability to accept
and explore her client’s current set of choices.

Supervisor: Hi, Leslie. How did things go with Lauren this week?

Supervisee: Oh, she didn’t show. Not sure why. So I haven’t seen her this
week.

Supervisee: So it sounds like you haven’t spoken with her about the
no-show?

Supervisee: Nope. I’m getting kind of tired of her . . . what would I call
it? Insolence, I guess is the best way to describe it. She just seems to have
no respect.

Here the supervisor gets a glimpse of the problem in the supervisee’s

own words. She seems to see the client’s lack of openness to her direc-
tion as “insolence.” This view into the supervisee’s seemingly entrenched
need to be an authority contributes to the supervisor’s hypothesis that
her directiveness may be more of a characterological problem than a skill
deficit. He decides to test his hypothesis by offering the supervisee a direct
suggestion. If she responds positively, he may be looking at a simple skill
deficit. If she resists, he may be looking at a characterological issue.

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

Task Environment
Focus on Skill
Supervisor: I know she has been challenging for you, but I think it would
be good to make contact and find out why she didn’t come in. Okay?
[assumes a directive stance yet checks in with the supervisee]
Supervisee: I mean, she comes in and sits and just looks at me defiantly.
She gives one-word answers to my questions. It feels like she is a non­client,
so I’m not surprised she didn’t come in. I wouldn’t be surprised if she
didn’t come back at all.
Supervisor: Still, I think it would be a good idea to . . . [maintains a
directive stance]

Here the supervisor as tried direction twice to influence the super-

visee (to no avail). The focus on skill continues.

Supervisee: (interrupts) I know that she has a bad history, but that’s no
excuse for not participating in the very thing you have asked for. I know
what she needs and that is to break up with this guy who has no job, who
sits around the house all day playing video games while she goes to work
and takes classes. When I ask her why she stays, she refuses to answer me.
It’s like, “Look, girlfriend, I am trying to help you here, and you are not
participating. What do you want from me?” I get so exasperated. [responds
defensively]

The supervisee’s response to the supervisor’s intervention confirms

his hunch that he is dealing with her personality pattern rather than a
skill deficit. In the following section, he pursues exploring the problem in
greater depth.

Exploration of Feelings
Supervisor: It’s just so frustrating that she won’t accept your guidance.
[recognizing the supervisee’s resistance to focusing on her skills, shifts to
explore her feelings in relation to the client’s resistance]

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 The Critical Events in Psychotherapy Supervision Model

Supervisee: I told her last time we met that being a client means talking.
I also told her that she needs to realize that she is making her own bed by
staying with this guy and that she is depressed because she won’t pull her-
self up. Being a client means you have got to be willing to change, and she
isn’t willing to change OR to be a client. So I’ve had it with her.
Supervisor: You feel like you want to fire her. [reflects the supervisee’s feel-
ings of frustration]

Supervisee: Yes. I absolutely do. It has been 3 years for her with this guy,
and he hasn’t worked since he quit taking the community college classes.
And their rent is way too high. I can’t believe she signed up to pay so much
when she doesn’t make enough to support both of them. She should have
known he’d be a freeloader. So she is making some very bad decisions. And
I have asked her what she thinks about her decision making, whether she
thinks she makes good decisions, and she says yes. (throws up her hands)
How can someone be that clueless? I told her that her decisions have got-
ten her into this mess, but she just won’t listen. And she won’t talk. So
what am I supposed to do when a client won’t be a client? [vents further
frustration]

Supervisor: It’s beginning to sound like you think she should behave the
way you want her to and the fact that she won’t take your advice leaves
you feeling very stuck. [reflects the source of the supervisee’s frustration,
demonstrating understanding of her feelings]

Supervisee: Exactly!

Assessing Knowledge
Supervisor: I know we’ve spoken before about your guiding theory or
theories, and I’m wondering what theory is guiding you in your work with
her. [seeks to understand how the supervisee is conceptualizing her approach
to the client]

Supervisee: Well, my main theory is solution focused but I’m also want-
ing to use some CBT with clients, so I think eventually my theory will
combine the two.

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

Supervisor: So it’s important to you that clients make plans to change

what they are doing so that they can reach their goals. [personalizes the
supervisee’s meaning]

Supervisee: Yes, and she won’t. She sits and looks at me and won’t engage
in doing what is clearly in her best interest.

Supervisor: And that is . . . leaving the boyfriend? [clarifies]

Supervisee: Yes. (looks expectantly at the supervisor)

Supervisor: That sure seems like your goal . . . but it doesn’t seem like her
goal. [tests to see how well supervisee really understands solution-focused
therapy]

Supervisee: Yes but it should be her goal! (laughing and throwing up

her hands)

Focus on the Therapeutic Process

Supervisor: You know, one of the key aspects of solution-focused therapy
is that the client needs to be the one who identifies the goal or goals for
counseling. Another key aspect is that the therapeutic alliance must be
strong before goal setting can be successful. (teaching) So I’m wondering
how you feel about the strength of your relationship with her. [focuses on
the supervisee’s experience of her alliance with the client]

Supervisee: Isn’t that obvious? Her insolence is preventing us from having

a very good relationship. Furthermore, I don’t see how she can have good
relationships with people in general with an attitude like that. She acts like
a defiant child, and I am definitely not in the mood to work with defiant
children. I have had two of my own (laughing) and that is enough. Plus I
was a teacher for 14 years. I went back to school to get away from defiant
children! (still laughing) I know very well what it is like to have to face
someone down, and I can do it, but I didn’t come here because I wanted to
have to keep doing it. I came here to learn to work with people who want
to change. [has a simplistic understanding of her relationship to the client,
with little awareness of how her interpersonal style may be affecting the client]

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 The Critical Events in Psychotherapy Supervision Model

Focus on Skill
Supervisor: You know, a lot of people come to therapy because they want
help but it turns out they may not be ready to change, not yet anyway.
[teaches]
Supervisee: Sorry, but I don’t buy that. You don’t come to therapy and pay
someone unless you want to change or unless you are looking for a
fight and you are willing to pay for it. I think this client is looking for
a fight. It sounded like she always fought with her mother, and now
she fights constantly with her boyfriend. I don’t think she should come
into therapy wanting to fight with me, but it seems like she does some-
times. She is just so exasperating. Did I tell you that last session she sat
for like 10 minutes without saying anything? Is that the way to treat your
therapist? [actively resists the supervisor’s intervention]
Supervisor: So she’s used to being in conflict, and now she’s in conflict
with you. [reflects, trying to model understanding]
Supervisee: I suppose so, but you’d think she’d have some respect, you
know? I mean I am not her mother, God forbid, though I’m almost old
enough to be. She needs to learn to have some respect. I get very impatient
when younger people don’t show respect. I was quite strict with my stu-
dents when I taught high school, which is why I was let go. I don’t know
how these young principals get the idea you should allow your students
to chew gum in class. I am glad they let me go anyway so I could make a
career change. But anyway, I don’t see how these young clients think they
can get away with being so defiant in therapy. I thought doing therapy
would be different. (tears up)

Exploration of Feelings
Supervisor: Seems like it’s really, really hard for you not to feel respected.
[reflects]
Supervisee: Yes. (cries softly) Yes. God, I’m sorry. I should be on task.
(grabs a tissue)
Supervisor: We are on task, Leslie. (gently)

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

Supervisee: No we aren’t! We should be talking about my clients.

Supervisor: We are talking about your feelings about your client and how
it hurts you so much that she won’t be the kind of client you had hoped
you’d be seeing.
Supervisee: God, I hope there aren’t many of her out there. Maybe I
should talk about one of my other clients today. Sorry I am not doing
what I’m supposed to do in supervision. [begins to recognize a strain with
the supervisor]

Focus on the Supervisory Alliance

Supervisor: You are being who you are right now, here with me, with your
intense disappointment, and this is just what we should be doing here.
[validates supervisee’s behavior]
Supervisee: Hey, I don’t need counseling. I’m sorry.
Supervisor: Have you ever had counseling?
Supervisee: No. I haven’t really needed it. I am tough, always had to be,
which is why this is so embarrassing. (grabs another tissue).
Supervisor: I really appreciate your willingness to be genuine right now.
(moment of silence) [reflects on the here and now, validating the supervisee’s
behavior]
Supervisee: This feels so strange and really embarrassing. [recognizes that
intimacy in the here and now is a new and uncomfortable experience for her]
Supervisor: Something tells me that this is a new feeling—that you have
permission to just let down and be with your feelings of helplessness and
disappointment, as well as the discomfort that comes from sharing these
feelings with me. [reflects feelings and meaning]
Supervisee: I am not supposed to (a) have these feelings and (b) embar-
rass myself and you by exhibiting them in here.
Supervisor: So as much as I’d like you to hear that it is okay for you to
have your feelings right now, you aren’t comfortable hearing me say that.
[wonders if the supervisee can take an observer perspective]

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 The Critical Events in Psychotherapy Supervision Model

Supervisee: No. I am not.

Supervisor: Okay. That’s okay. [demonstrates acceptance of the supervisee’s
need to not be pushed, hoping to model acceptance]
(another moment of silence)
Supervisee: (more tears)
Supervisor: Yeah. Lots of stuff there. Mmhmm. [reiterates permission to
be in the moment]
Supervisee: Yeah. (finishes crying)

Exploration of Feelings
Supervisor: What’s going on for you now? [inquires about here-and-now
experience, modeling responsiveness]
Supervisee: I’m not sure. This is a new feeling, kind of relief. I feel like I
have failed some kind of test . . . but I feel better.
Supervisor: What kind of test have you failed? [elicits supervisee’s self-
observation]
Supervisee: I’m supposed to be composed and professional at all times.

Focus on the Supervisory Alliance

Supervisor: That’s an awfully tall order. [challenges supervisee’s negative
self-assessment]
Supervisee: Yeah, but this is a professional setting, and I should be profes-
sional here. I didn’t mean to disrespect you. [attempts to repair the rela-
tionship that she feels she has damaged]
Supervisor: I just experienced you being very professional, and I did not
feel disrespected. You bravely owned your feelings of disappointment
and had the courage to express them fully with me. As therapists working
together, that is a very sophisticated kind of professionalism. [normalizes
the supervisee’s expression of feelings and reframes her behavior as productive]
Supervisee: That is so different.

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

Supervisor: What do you think enabled you to do that? You were so sure
you didn’t want to let down. [leaves the discussion open to focus on supervisee
experience of supervisory relationship]
Supervisee: I was just so upset, I’m not sure I could help it. But you told
me it was okay to do it or not to do it. That was strange. It was like I
could choose without seeming to be disrespectful. [focuses on supervisory
relationship]
Supervisor: So seems like you needed and on some level wanted to feel
like you could be the one to decide what to do. “It was going to be okay
with me either way?” [reflects]
Supervisee: Yeah. That is so strange.
Supervisor: How is it strange? [models how to draw out a feeling]
Supervisee: To feel like whatever I decide is okay and that we’re good no
matter what I decide. If I didn’t do what my mother expected—always—
I was told I was being disrespectful.
Supervisor: So in your experience there is typically a right way and a
wrong way to go about things and if you didn’t do as you were told, you
came to believe that was being disrespectful. Here you were able to just go
with what you needed rather than try to do the “right” thing. [validates
supervisee’s right to express a need, concomitantly illustrating the nature of
the problematic dichotomous thinking]

Attend to Parallel Process

Supervisee: Yeah. It felt so different to be able to choose. I wonder if I need
to do that for my client, just not expect her to solve her problems the way
I think she should. [demonstrates an awareness of the parallel process and a
change in her understanding of the therapeutic process]
Supervisor: Yes, it’s funny how that parallel works.

Focus on Skill and Focus on the Therapeutic Process

Supervisor: How would you communicate to her that you don’t have that
expectation? [brings the focus back to a therapy skill]

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 The Critical Events in Psychotherapy Supervision Model

Supervisee: First, I would stop asking her why she stays with the boy-
friend, as if I think she is getting it wrong. I think I communicate some
exasperation to her when she comes back and complains about something
he has done. Maybe I need to just let her have her feelings for a while.
Supervisor: How will you demonstrate that you are willing to let her have
her feelings? [invites supervisee to operationalize her intent]
Supervisee: I suppose just be with her when she talks about them.
Supervisor: Maybe empathize, label the feelings. [makes a suggestion]
Supervisee: . . . label them, yeah. Be with her in them. [indicates accep-
tance of the suggestion]
Supervisor: Let her decide what to do?
Supervisee: Yeah. I wonder if she will decide on her own.
Supervisor: Could be. Sounds like you think it’s worth a try. [allows super-
visee to own the impetus for change, hoping the supervisee will do the same
for the client]
Supervisee: Yeah.

Focus on Evaluation
Supervisor: It seems like this business about having to do the right thing
or risk being disrespectful has been an ongoing issue for you for a long
time, and I have some concern that it may continue to dog you in your
future work. [reviews supervisee issues and expresses concern about their
potential ongoing challenge for the supervisee]
Supervisee: It has, forever. Do you think I need therapy? [expresses recep-
tiveness to change]
Supervisor: I think it would make your development as a therapist a heck
of a lot easier, Leslie, and that you’d become much more skilled as a result
of seeing what it’s like on the other side.
Supervisee: Oh Lord, this upsets my whole apple cart.

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 Addressing Skill Difficulties, Deficits, and Competency Concerns

Supervisor: Maybe with some therapy you will find that there aren’t as
many rotten apples in there as you thought there were. [validating the
supervisee’s personhood]
Supervisee: (laughing) Maybe so.

Resolution
Supervisor: Would you like me to give you a couple of names of therapists
I think you would feel safe talking to about this?
Supervisee: Sure. If it can help me succeed, I’ll do it.
Supervisor: I think it has the potential to help you develop as a therapist
and as a person.
Supervisee: Thank you. This has been a hard conversation for me and
probably for you too.
Supervisor: Hard but worth it, I hope. What about this conversation has
been useful?
Supervisee: I suppose I need to learn to give my clients more room to
decide things on their own. I guess I may have a need to be in charge that
doesn’t work so well in therapy, and I probably need to explore that. That
tendency got me in trouble when I was teaching, too. I think I should talk
to someone about it. I didn’t see it quite this clearly before. So thanks.
Supervisor: You are quite welcome, Leslie. Do you think you can call your
client now and see if she’s coming back?
Supervisee: Okay. I’ll do that now. Should I ask her if I did something to
make her feel uncomfortable talking to me? Oh, God, that would be so
hard. [initiates an intervention idea, asking if it would be the “right” thing]
Supervisor: What do YOU think? [returns the “decision ball” to the super-
visee’s court]
Supervisee: I think I should.
Supervisor: (smiling) Good for you! [expresses confidence in the super-
visee’s judgment]

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 The Critical Events in Psychotherapy Supervision Model

Early in this interaction, the supervisor feels some exasperation with

his supervisee regarding the rigid role expectations she has for her clients
and herself. As Leslie begins to rant about her client, the supervisor is
uncertain about whether Leslie’s character structure is so rigid that she
will be unable to benefit from supervision. The supervisor makes a stra-
tegic decision to use the supervisory process to model responsiveness (cf.
Friedlander, 2012, 2015), thereby showing the supervisee how to provide
a facilitative clinical context within which a client feels permission to be
open about feelings and choose a course of action.
This supervisory task is successfully resolved and the supervisee’s
character structure is shown to be not as rigid as the supervisor initially
feared. In “real life,” of course, this process model might actually take
longer than it does in this vignette. It might require most of a session or
continue throughout two or more sessions. The length of the process ulti-
mately depends on the ability of the supervisee to receive it and respond to
it. Regardless of length, supervisors should return to what their supervisee
has learned about interpersonal process and how that may apply to her or
his work with a particular client or clients in general—the focus eventually
returning to a better understanding of the therapeutic process and thus
skill development to facilitate that process.
Near the end of the above scenario is the endorsement of the notion of
seeking personal psychotherapy. Referral of a supervisee for psychotherapy is
a common practice, and personal therapy for developing therapists is valued
throughout the profession. In cases in which serious impairment is deter-
mined, therapy may be one condition of training probation.

SPECIAL CONSIDERATIONS:
COUNSELING “IN” AND “OUT”
There are numerous creative approaches to help a supervisee improve his
or her performance, including additional clinical coursework, intensified
supervision, greater direct observation and consultation, and personal
psychotherapy. Assisting a supervisee to undertake remedial procedures
may be considered a “counseling in” process aimed at retaining the super-
visee in his or her program or placement.

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Although supervisors have a duty to provide creative opportunities

for supervisees to change and grow, supervisors’ responsibility to pro-
tect the welfare of current and future clients is paramount. Over time
a supervisor and/or training program may conclude that a supervisee’s
interpersonal difficulties are characterological in nature and beyond
remediation. Because counseling and therapy are grounded in the process
of personal and interpersonal change and because supervisee’s intractable
interpersonal patterns have the potential to harm clients, it may be neces-
sary to advise the student to discontinue her or his mental health training.
“Counseling out” should be as supportive a process as possible, assisting a
supervisee to recognize that the demands of the profession are not a good
fit for her or him. The process should include a frank discussion of the
supervisee’s limitations and the failure of remediation attempts to alter
those limitations, along with active encouragement of the supervisee’s
exploration of other potential career paths.
The process of counseling a supervisee out of the profession is a last
resort, a gatekeeping measure built into the training process to ensure the
protection of the public. In the interest of informed consent (see Guide-
lines for Clinical Supervision in Health Service Psychology, American Psy-
chological Association [APA], 2014), supervisees should be fully aware
at the outset of their training that should they encounter obstacles in the
training process, they are afforded due process, or the right to a “fair hear-
ing.” Due process in psychotherapy training is a structured set of remedies
that are built into the training process should obstacles occur.
Training sites and academic programs should provide supervisees with
informed consent documents that outline program or agency expecta-
tions, timing and type of evaluations, and the extent to which supervisees
are allowed to respond to evaluations (APA, 2014). These documents
should provide definitions of inadequate progress toward specific compe-
tencies and details about the remediation process. The documents should
clarify that procedures will be followed in the case of inadequate progress
or problematic behavior. Due process documents also describe in detail
procedures for addressing supervisee grievances. In the case of prelicen-
sure supervision in a private practice, due process definitions and pro-
cedures can be detailed in the supervisory contract. Forrest et al. (1999)

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provided a thorough examination of problematic supervisee attitudes

and behavior, as well as the procedures that informed the creation of due
process documents in clinical training programs across the United States.
The provision of due process information to supervisees at the outset of
their supervision experience protects everyone, including the training
program, the supervisor, the supervisee, and the clients.

CONCLUSION
Learning to be a professional therapist is a daunting task, the enormity
of which may be lost on novice and early-career supervisees. Encounter-
ing one’s lack of skill or awareness in the process of becoming a therapist
can be frightening and often threatening for supervisees. Supervisors are
key to assisting supervisees to accept their current state of development
and commit to further learning. Whether a supervisor is concerned about
simple skill difficulties, skill deficiencies, crises in confidence, vicarious
traumatization, or problematic attitudes behaviors, the supervisory rela-
tionship is an important vehicle for promoting supervisee understanding,
growth, and even healing. Some of the critical interpersonal supervision
sequences described in this section included exploration of feelings,
attend to parallel process, and focus on the supervisory alliance, interven-
tions that might not be included in every supervisor’s compendium of
approaches. However, we believe that this interpersonal stance can cre-
ate pivotal experiences for supervisees that can be both instructional and
motivating.

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 4

Working Through Parallel

Processes and Heightening
Multicultural Awareness:
Two Critical Events for
the Price of One

A s we mentioned in Chapter 1, critical events do not necessarily occur

in a linear fashion, such that a new event waits for a previous event to
finish. Rather, events often overlap and can intertwine with other events.
To illustrate this phenomenon, we use this chapter to discuss a new, pre-
viously unpublished critical event, working through parallel processes,
and illustrate its overlap and link with a multicultural awareness event,
an event that interested readers can find more fully addressed in Ladany,
Friedlander, and Nelson (2005).
Before moving forward, we need to distinguish a supervisor’s focus
on parallel process as an interactional sequence in our model and working
through parallel processes as the task in a parallel process event. As shown
later in this chapter, attend to parallel process is a salient interactional
sequence, which we define as a “discussion that draws attention to simi-
larities between a specific therapeutic interaction and the supervisory

http://dx.doi.org/10.1037/14916-005
Supervision Essentials for the Critical Events in Psychotherapy Supervision Model, by N. Ladany,
M. L. Friedlander, and M. L. Nelson
Copyright © 2016 by the American Psychological Association. All rights reserved.

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 The Critical Events in Psychotherapy Supervision Model

interaction. Parallel processes may originate in either interaction and be

mirrored in the other.” A parallel process event consists of multiple inter-
actional sequences, including of course, attend to parallel process. We dis-
cuss these distinctions in the case examples later in the chapter.
We begin the chapter with an overview of the literature on parallel pro-
cess. We then provide a process model for working through a parallel process
event, followed by an illustrative case. We then review a heightening multi-
cultural awareness event and demonstrate how it can overlap with a parallel
process event. We offer this illustration because critical events often overlap
(i.e., a new event often does not occur only after another event is resolved).
Searles (1955) first described a supervisory situation whereby the
supervisor may be having supervisor countertransference reactions coming
from the therapy relationship. He referred to this concept as the reflection
process. Building on Searles’ formulation, Ekstein and Wallerstein (1958,
1972) identified a phenomenon that they called parallel process (p. 177),
whereby similar transference-countertransference processes were occurring
in therapy and supervision. In addition, these authors noted that the paral-
lels could be coming upward from the therapy relationship or downward
from the supervisory relationship. In time, other authors built upon the
constructs (e.g., Friedlander, Siegel, & Brenock, 1989; Gross Doehrman,
1976; Ladany, Walker, Pate-Carolan, & Gray Evans, 2008; Mothersole, 1999;
Sripada, 1999; Tracey, Bludworth, & Glidden-Tracey, 2012; Walker, 2003).
In relation to our critical events model, we define parallel processes as
dyadic reactions that occur in supervision that mirror dyadic reactions in
psychotherapy (or vice versa) and are meaningful for supervisee learning.
Reactions consist of thoughts, feelings, and behaviors on the part of the
supervisor, therapist, and client(s) about which each participant may have
varying degrees of awareness. Parallel processes can be initiated in therapy
and transferred to supervision or vice versa. In addition, the bidirectional
parallel processes can be proximal in that they occur in the subsequent
supervision or therapy session, or distal in that they occur after multiple
supervision or therapy sessions. Finally, as we define it, parallel processes
can be worked through when the supervisor facilitates a corrective rela-
tional experience for the supervisee, as explained later.

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Parallel processes should be distinguished from general processes

that appear similar in therapy and supervision. In other words, paral-
lel processes should be meaningful and illustrative of challenges that
are occurring in supervision and/or therapy. For example, the fact that
both supervisors and supervisees, like therapists and clients, talk with
one another does not mean that “talking” is a parallel process because
the simple act of talking lacks specific meaning in either context. In a
similar vein, a situation in which a supervisee working with an anxious
client presents as anxious in her supervision session is not necessarily
indicative of a clinically meaningful parallel process. A supervisee’s high
anxiety may simply be characteristic of the individual. However, in as
much as the supervisee’s anxiety is based on or triggered by the client’s
anxiety, a parallel process has occurred. It is up to the supervisor to help
the supervisee distinguish the clinical meaningfulness of the identified
parallel process.
Research on parallel process has largely been conducted using case stud-
ies (Alpher, 1991; Friedlander et al., 1989; Grant, Schofield, & Crawford,
2012; Gross Doehrman, 1976; Jacobsen, 2007; Ladany & Inman, 2012;
Ladany et al., 2008). The phenomenon has also been examined through sur-
veys (Raichelson, Herron, Primavera, & Ramirez, 1997) and sophisticated
quantitative models (Tracey et al., 2012). Across these investigations, paral-
lel processes, which early authors considered to be unconscious, have been
observed, and the phenomenon seems to be meaningful for supervisors
across theoretical orientations.
For parallel process events to be meaningful, supervisors need to be
open to identifying and examining the phenomenon. Supervisees whose
supervisors are unaware, unconvinced, or unwilling to consider parallel
processes are likely to lose out on the learning opportunities and clinical
benefits provided by an understanding of parallel processes. Even if supervi-
sors are skeptical of the unconscious basis for parallel process, consider that
supervisees are in a one-down position in supervision but a one-up position
in their therapy relationships (Friedlander, 2015; Friedlander et al., 1989;
Tracey et al., 2012). These opposing relational positions (i.e., submissiveness
versus dominance) can result in a mirroring effect on a behavioral level.

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In the following section, we discuss a process model for assisting

supervisees to work through parallel process reactions. We also illustrate
two parallel process events, one that is unsuccessfully resolved and one
that suggests a positive outcome.

PROCESS MODEL: WORKING THROUGH

PARALLEL PROCESSES

Marker
Markers of parallel process events can originate from any member of
the supervision or therapy dyad. The supervisor may notice that the
supervisee is behaving in a manner that is uncharacteristic. For example,
a supervisee may react to the supervisor in an unusually sarcastic fash-
ion. Alternatively, in a particular supervision session, a supervisee may
appear especially anxious, outside the range of her or his typical level
of anxiety.
In both situations, the supervisor should ask about the presentation
style of the supervisee’s client to determine whether a parallel process
may be occurring. Alternatively, the supervisor may be aware of a client’s
difficult interpersonal style and then reflect on whether the supervisee’s
behavior in supervision mirrors that style.
When supervisees are explicitly afforded the opportunity to consider
the parallel process phenomenon as part of their role induction to super-
vision, the marker may be a direct comment about the possible occur-
rence of the phenomenon. In these cases, a supervisee may speculate
about the possible occurrence of a parallel process, and the supervisor
can follow up by initiating the task environment. Alternatively, a marker
may come from a supervisor’s self-reflection on his or her own reactions
to the supervisee and whether these reactions are mirrored in the therapy
relationship. For example, a supervisor may note that he is becoming
overly directive during a supervision session but only recognizes his own
uncharacteristic behavior after observing the supervisee’s directiveness
with her client.

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 Parallel Processes and Multicultural Awareness

Task Environment and Resolution

After the identification of the marker, the task environment typically
involves these interactional sequences: focus on the supervisory alliance,
focus on the therapeutic process, exploration of feelings, attend to parallel
process, and normalize experience. Compared to the task environments
for other critical events, the interactional sequences may be more numer-
ous in a parallel process event, essentially because multiple relationships are
addressed. As shown in the following case example, additional sequences
can be anticipated depending on the type of parallel process (e.g., focus on
multicultural awareness).
By definition, a parallel process event requires a noticeable shift in the
supervisory work: that is, the supervisor behaves responsively to the super-
visee by changing the focus from a discussion of therapy to a discussion of
what is occurring in supervision (Friedlander, 2012, 2015). For example,
when a supervisee appears unusually tired or stressed, it behooves the
supervisor to notice this change and “check in” about whether the super-
visee’s experience has something to do with what is occurring between
them in supervision. Such inquiry is unlikely to prompt a role conflict if,
as part of the supervision role induction and informed consent, the super-
visee understands that supervision involves exploring his personal experi-
ence to disentangle and understand parallel processes. This check-in may
simply involve asking the supervisee if processing more deeply what has
occurred in his therapy relationships is acceptable before initiating the
task environment of the event.
With at least a tacit agreement, the supervisor can move to the
sequence focus on the therapeutic process. This sequence involves asking
the supervisee about a particular client whom she may find challenging.
From there the supervisor can inquire about her reactions to her client,
particularly her affective reactions. Moreover, the supervisor could ask the
supervisee to consider how her client may be feeling and reacting to what
is occurring between them.
In the following example, the supervisor asks the supervisee to recall
a previous session. However, a similar query could be used to explore the
supervisee’s reactions while observing a video recording of the therapy

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 The Critical Events in Psychotherapy Supervision Model

session during supervision session (e.g., a modified interpersonal process

recall; Kagan [Klein], & Kagan, 1997).
Often it is the supervisor who recognizes the mirroring between
therapy and supervision, but with experience, the supervisee may be
the first one to notice the parallel process. In either situation, the super-
visor attends to the parallel process by discussing the similar emotional
reactions and/or behaviors that are occurring in both dyads.
Alternatively, the supervisor could facilitate a corrective relational
experience with the supervisee that in turn is transmitted downward
to the therapy work. In supervision, a corrective relational experience
involves an intrapersonal shift in the supervisee’s understanding of an
event that is taking place in supervision (Ladany et al., 2012). For example,
rather than respond to the supervisee’s uncharacteristic and heightened
anxiety by dismissing it as “just a bad day” or by focusing on a different
issue altogether, the supervisor may ask the supervisee to explore the
anxiety reaction further for the source and let the supervisee “sit with”
the anxiety. It is possible, that in turn the supervisee would encourage
her client to “sit with” heightened anxiety. Depending on the supervisee’s
experience with parallel processes, the supervisor may normalize the
experience.
We have found that the identification of parallel processes is often
accompanied by an ah-ha experience that can be at once pleasant and
disorienting, particularly when the parallel process is outside the super-
visee’s awareness. The change in awareness and subsequent changes in the
supervisee’s approach to therapy are an integral part of the resolution of
this critical event. The process model appears in Figure 4.1.
Of course, the prototypical example of a parallel process event is one
in which a particular relational dynamic begins in the supervisee’s therapy
relationship and his corrective relational experience occurs subsequently
in his relationship with the supervisor. Alternatively, the supervisor’s
behavior could initiate a corrective relational experience for the super-
visee by an exploration of feelings, moving to a focus on the therapeutic
process, and finally with the sequences attend to the parallel process and
normalize the experience.

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 Parallel Processes and Multicultural Awareness

Figure 4.1

Example of a parallel process event.

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 The Critical Events in Psychotherapy Supervision Model

EXAMPLES OF UNSUCCESSFUL AND SUCCESSFUL

PARALLEL PROCESS EVENTS
The following case illustrates two parallel process events with the same
individuals. The supervisor is a 40-year-old White woman who has 10 years
of experience as a supervisor and 15 years of experience as a therapist. The
supervisee, Arcadio, is a 25-year-old Latino man in his second year of a
doctoral program. He has a physical disability that requires him to use a
wheelchair.
Arcadio’s two clients are Sylvia, a 28-year-old Latina who presents
with generalized anxiety disorder (i.e., excessive worrying, headaches, dif-
ficulties at work), and Irene, a 45-year-old White woman with a significant
visual impairment that requires the use of a service dog. Irene presents
with anxiety after a car accident in which she was a passenger.
The setting is a community mental health clinic. The event begins at
the start of the supervision session.

Supervisor: So, what would you like to learn today? [typical opening ques-
tion for this supervisor, who immediately focuses on the “task” aspect of the
supervisory alliance]

Supervisee: I’m not sure what to start with. I feel like I’ve got so much
going on with all my clients these days. It’s difficult to keep things
straight.

Supervisor: Tell me more.

Supervisee: I think it’s just that time of the semester where lots of things
are due in classes. Paper and exam time, my client load has increased,
you know.

Marker
Supervisor: Sounds a bit overwhelming. [notices that Arcadio’s presenta-
tion is different from past supervision sessions, where he tended to be more
even in his affect; leaves it open to see which direction he will take]

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Supervisee: Yeah, more than a bit! I’m also not sleeping well, worried
about things. I used to do this occasionally but now it’s affecting my sleep.

Supervisor: That is a lot. That doesn’t sound like you. [probes]

Supervisee: It’s not. I mean, at times this has happened in my life, but this
past week leading up to our meeting has been rough.

Supervisor: Do you think there is anything about our meeting that may
be triggering this for you? [assesses whether his uncharacteristic behavior
may be due to their past interactions]

Supervisee: (puzzled) No, not that I can think of. I’ve always enjoyed com-
ing here for supervision.

Supervisor: But something seems different . . . ? [probes for a fuller

description]

Supervisee: I suppose.

At this point the supervisor considers that Arcadio’s distorted (e.g.,

transferential) reaction is a marker of a parallel process event. The event
moves next to the task environment.

Task Environment
Focus on the Supervisory Alliance
Supervisor: I appreciate your honesty. Perhaps we can step back a moment
and consider how things are going in our supervision sessions. Sound
okay? [refocuses the work on the goals and tasks of the alliance, anticipating
that the need to be particularly empathic moving forward]

Arcadio: Sure.

Supervisor: Good. We began the session by my asking what you’d like to

discuss today, and you followed up with talking about having lots going
on, which led to us discussing how you having been feeling overwhelmed.
Sound about right? [clarifies, checking mutual perceptions]

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 The Critical Events in Psychotherapy Supervision Model

Supervisee: (smiles) Yeah. Captured perfectly!

Supervisor: I’m wondering if it’s okay if we get specific about some of
the overwhelming facets of your life, particularly in relation to your client
load. [negotiates an agreement on the session’s tasks]
Supervisee: That’s fine. It’s funny, when you call it a client “load,” it sounds
more than it is.
Supervisor: How so?
Supervisee: Well, I’ve only got four clients. One hasn’t started, and one is
finishing up. We’ve talked about the one finishing up in our past sessions,
and I feel pretty good about how things went with him.
Supervisor: Then how about we talk about the other two? [negotiates
the task]

Focus on the Therapeutic Process

Supervisee: That works. First there’s Irene, who was in a car accident a
few weeks ago, and she is having PTSD reactions lately.
Supervisor: Like what?
Supervisee: She feels tense when she’s in a car, hypervigilant and worried.
She’s reported bad nightmares. I’m not sure it’s full-blown PTSD but cer-
tainly some of the key symptoms are there.
Supervisor: Was she driving the car when the accident occurred?
Supervisee: (slightly smiles) No. She’s actually blind.
Supervisor: Oh, I didn’t know.
Supervisee: When the accident happened she was most upset about her
service dog, who fortunately was not injured in the accident. My second
client is Sylvia, who’s been having symptoms that include excessive worry-
ing and headaches. It’s affecting her work with what I think is generalized
anxiety disorder.

At this point the supervisor, in a desire to help Arcadio, may have

decided to provide him with informational resources on the treatment

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of generalized anxiety disorder (GAD), as well as recommend some

approaches he could use in his session with Sylvia. In other words, the
supervisor could take a didactic approach by directing Arcadio how to
manage this case in hopes that this lengthy discussion would generalize
to his work with other clients with GAD. However, with a focus on skills
(conceptual, technical), the opportunity to help Arcadio use his inner
experience with the client to inform his interventions would have been
lost. Moreover, as shown later, the corrective relational experience would
not have occurred. Thus, the parallel process event would not have been
resolved successfully.

Supervisor: It sounds like you have done a nice job assessing and diag-
nosing both of your clients. Tell me more about what it’s like to be in the
therapy session. For example, when you’re with Sylvia, what’s happening?
Supervisee: Typically, she talks a lot about all of her worries. And she
jumps from one topic to another. I can barely get a word in.
Supervisor: What’s that like for you? [realizes the need to be more specific]
Supervisee: It’s very frustrating. I have things I want to say, but I don’t
want to be rude and interrupt. And she keeps going on and on. First she
talks about her boss, who she’s having problems with. He doesn’t seem to
be treating her well. Then she’ll jump to talking about her father, who has
Alzheimer’s and is in a nursing home. And how difficult he is to be around
and how her sister won’t help her take care of him. And this goes on to
other topics. By the end of the session I’m all anxious and tense and feel
as though we haven’t gotten anywhere. Oh, she also spends a great deal of
time talking about her worries about her kids.

As Arcadio is describing his client, the supervisor picks up on his

anxious affect. She also recognizes a potential link between the client’s
emotional state and Arcadio’s presentation. The moment Arcadio begins
spinning out, similar to the client, is the same moment the supervisor
decides to intervene by exploring Arcadio’s feelings in the here and now,
in hopes that this intervention will facilitate a successful resolution.

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Exploration of Feelings
Supervisor: Arcadio. Let me interrupt you a moment. I want you to try
something, okay? [by asking permission, the supervisor demonstrates how
to attend to the alliance before moving forward]

Supervisee: Okay.

Supervisor: How are you feeling right now?

Supervisee: Well, there’s just so much that I feel I need to tell you about
what she’s presenting with. [describes his thoughts, not his feelings]

Supervisor: Hold on a moment. I want you to do me a favor and just sit

with what you’re experiencing. Don’t say anything. Just let yourself feel
whatever you are feeling right in the moment. [models a here-and-now
intervention that the supervisee can use with clients]

Supervisee: Okay.

Supervisor: Good. Just be present with whatever feelings are coming up.
(long pause) What are you feeling right now?

Arcadio: Anxious, nervous, a little scared.

Supervisor: Can you say more about these feelings?

Supervisee: It’s weird, I’m not sure why I feel scared. Like something
bad is going to happen. I know nothing bad will happen—intellectually.
It’s more a gut feeling. I need to remember the mindfulness work I’ve
done.

Supervisor: How might that work right now?

Supervisee: Just breathe and be in the moment. Focus on my breathing.

Supervisor: Okay. That sounds good. Go ahead. [models patience]

Supervisee: (briefly closes his eyes, exhales) That’s a little better.

Supervisor: Good. It sounds like the anxiety was taking over, and you’ve
now found a way to counteract it and become more present. [wants to be

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sure Arcadio has found a way to contain the anxiety before moving forward
to raise the possibility of a parallel process]

Supervisee: Definitely.

Attend to Parallel Process

Supervisor: You know, Arcadio, I’ve noticed that today you seemed a
little more anxious than you typically are in supervision. It was unique
compared to our past supervision sessions. And at the same time you’ve
mentioned a couple of clients who are rather anxious. Do you see any
similarities in how they have presented to you in therapy and how you’ve
felt today in supervision?
Supervisee: Definitely! Is this the “parallel process” that we talked about
in class?
Supervisor: It seems so, at least to me. What’s that like to identify it?
Supervisee: I’m a little taken aback. Now I feel a little . . . embarrassed.
How could I have missed it?

Often supervisees who experience parallel processes for the first time
are struck by how obvious it all is. The shift in thinking that accompa-
nies this awareness is relieving but also embarrassing, particularly for
supervisees who tend to perform well in general. Thus, it is important
for supervisors to normalize the experience to enable it to be recognized
in the future.

Normalize the Experience

Supervisor: It’s always a little disorienting to experience parallel process
for the first time.
Supervisee: Wow, definitely.
Supervisor: And that’s to be expected. The only way to learn about things
sometimes is by experiencing them.
Supervisee: I suppose. It’s also very exciting to see it firsthand.

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Supervisor: Indeed. So what can be learned from this experience? [want-

ing to help him translate this learning moment to actions he can use in his
next therapy sessions]

Focus on the Therapeutic Process

Supervisee: Wow. It seems like a lot. First, I will be more patient with
Sylvia.
Supervisor: How do you mean?
Supervisee: Maybe “patient” isn’t what I mean. I’ll be more likely to inter-
rupt her, just the way you cut me off. And I really liked how you were with
me in the moment. It helped me reflect on what I was actually feeling.
[demonstrates awareness of the parallel process]
Supervisor: Do you think she will respond in a similar manner?
Supervisee: Probably not. She’ll probably just run me over.
Supervisor: She may try. So unlike you, who is more likely to be able to sit
with feelings in the moment, it may take more attempts with her.
Supervisee: Yeah, you’re probably right. So I should just keep interrupting
until she gets it?
Supervisor: What do you suppose? [empowers him to think it through
himself ]
Supervisee: Well, if I interrupt her too much, she may say enough of this
and bolt.
Supervisor: Then you may have to lower your expectations of her abil-
ity to gain a similar level of insight in the same amount of time. [directly
instructs about responsiveness]
Supervisee: Definitely.

Resolution
Supervisor: Anything else left to discuss in relation to the parallel process?
[models responsiveness—how to “check in” with a client]

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Arcadio: I don’t think so. This has helped a great deal.

Supervisor: Wonderful.

The event ended with what seemed to be a successful resolution. How-

ever, as noted later in this chapter, the resolution was only a partial one. That
is, at the end of the session, the supervisor noted a “slight nagging” feeling
but put it aside in the excitement about having successfully worked through
a parallel process event. When we pick up this case again, it will become clear
what her nagging feeling meant. However, first it is important to review
another type of critical event: heightening multicultural awareness.

HEIGHTENING MULTICULTURAL AWARENESS

The critical events model (Ladany et al., 2005) includes heightening multi-
cultural awareness as an important task within supervision. Since the 2005
publication of our book, multicultural counseling and psychotherapy
have received increased attention in the literature. However, there contin-
ues to be a dearth of new scholarship in this area of supervision (Ancis &
Ladany, 2010; Ladany & Inman, 2012). For purposes of this chapter, we
provide an overview of a multicultural critical event, with some updates
based on the literature since 2005.
For our purposes, multicultural factors include age, gender, race, eth-
nicity, sexual orientation, ability status, social class, religion, and family
structure, as well as the intersectionality of all these multicultural fac-
tors. In Ladany et al. (2005), we devoted one chapter to gender-based mis-
understandings. To date, two studies examined gender-related events and
their relation to supervisees’ experiences of the supervisor (Bertsch et al.,
2014; Walker et al., 2007). For case illustrations and detailed descriptions
of gender-based critical events, see Ladany and Friedlander (2014) and
Friedlander, Blanco, Bernardi, and Shaffer (in press). For purposes of the
current chapter, we include gender as one multicultural factor among
other sociocultural differences.
Supervisor multicultural competence includes three components:
knowledge (e.g., knowledge of multicultural therapy competencies,

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multicultural supervision theory), self-awareness (e.g., about gender

identity, racial identity), and skills (e.g., culturally sensitive supervisory
interventions) (Ancis & Ladany, 2010). Multicultural supervisor com-
petence is essential for facilitating a successful resolution in a multi­
cultural awareness event.
The marker of a multicultural awareness event can be obvious, as in
the case when the demographics of members of the triad (client, super-
visee, supervisor) are starkly different, or more subtle, such as when the
multi­cultural differences are not visible (e.g., sexual orientation, ethnicity,
ability status, family structure) or outside of awareness. The task environ-
ment consists of interaction sequences that typically include exploration
of feelings, assessment of multicultural knowledge, focus on multicultural
awareness, focus on skill, normalizing the experience, and focus on the
supervisory alliance.
As noted previously, critical events typically do not occur in isolation.
In fact, they likely overlap and connect in a myriad of ways. We now move
back to the parallel process case with Arcadio and consider how a multi-
cultural awareness event can overlap with a parallel process event.

EXAMPLE OF A SUCCESSFULLY RESOLVED

MULTICULTURAL AWARENESS EVENT
At the beginning of the foregoing case, we see that multicultural knowl-
edge, awareness, and skill are essential in this context, inasmuch as the
supervisor is a White woman, the supervisee is a Latino man who is in a
wheelchair, and his clients include an able-bodied Latina woman and a
White woman with a visual disability. With such differences, the super-
visee’s mention of gender, race, and/or disability (or his complete lack
of attention to these!) may be the marker of a heightening multicultural
awareness event.
That is, although the supervisor facilitated the working through of a
parallel process event, the potential need to raise the supervisee’s multi­
cultural awareness should not be ignored. The following illustrates a
multicultural awareness event that came about in Arcadio’s subsequent
supervision session.

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Recall that the previous session ended with both supervisor and
supervisee feeling fairly positive about their interaction. The super­
visor continued on with her day, yet continued to reflect on the session.
Although she felt that it had gone well, she could not shake her nagging
feeling at its conclusion. Recognizing this feeling as potentially indicative
of her own countertransference, she decided to consult with a colleague.
During this consultation, the colleague commented that there seemed
to be a host of multicultural issues at play and asked whether any of these
were addressed. Because the supervisor generally felt comfortable bringing
up multicultural issues with her supervisees, she was surprised to realize
that she had not done so in her previous session with Arcadio. Suddenly
she became acutely aware of the source of her “nagging feeling.” Recently,
she had been diagnosed with macular degeneration, an illness of the retina
that can cause blindness. No one other than her partner knew her diagno-
sis. She then connected her fear of going blind with Arcadio’s client, Irene,
who became blind following a car accident. Keeping this insight in mind,
in her next supervision session with Arcadio, the supervisor began as usual:

Supervisor: What would you like to learn today?

Supervisee: Well, I’m not sure we can top last week, but I feel good about the
way I was able to deal with Sylvia, my client with GAD. My other client, Irene,
had to cancel our appointment because the car service that was coming to
pick her up didn’t show up on time. I’m really disappointed about that.

This is another choice point. The supervisor could facilitate a dis-

cussion of the parallel process with Sylvia to see how Arcadio handled
the subsequent therapy session with this client. Alternatively, the super­
visor could attend to Arcadio’s disappointment about Irene’s cancellation.
Because of her insight about the failure to discuss Irene’s disability during
the previous supervision session, the supervisor decides to attend to the
latter issue and begins by asking Arcadio to explore his disappointment.

Supervisor: Say more about your disappointment.

Supervisee: I don’t know. Everything went so well with Sylvia. I was able
to try out helping her stay in the here and now and she seemed to get

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something out of it. I was all ready to see Irene, and then I find out that
she cancelled at the last minute. It feels like one step forward and one
step back.

Marker
The supervisor has little information at this point to decide whether this
is the initiation of a critical event. Further exploration eventually reveals
the marker of a multicultural awareness event.

Supervisor: Arcadio, I’ve seen you after clients have cancelled before, and
you typically don’t respond this way. What do you think might be going
on? [points out his incongruence]
Supervisee: I’m not sure. It’s just a big letdown, like I’ve let Irene down.
Supervisor: How so? [notices Arcadio looking at the floor] How are you
feeling right now?
Supervisee: There’s like a sadness and a fear all rolled into one.
Supervisor: Sadness and fear. [simply repeats to encourage him to elaborate]
Supervisee: Yeah, sad because I wasn’t able to help her but also there’s
something about her that triggers a fear in me, and I don’t know why.
Supervisor: That’s interesting. Keep going with the fear and any image that
comes to your mind. [unsure whether this is Arcadio’s countertransference or
an indication of his lack of multicultural awareness]
Supervisee: It’s almost like a fear of contamination. And I keep picturing
her service dog. I love dogs, but for some reason this anxiety wells up when
I picture Roscoe. That’s the dog’s name. He’s got the sweetest tempera-
ment, so there is no real reason to be afraid of him.
Supervisor: What does this dog represent for you, do you think? [begin-
ning to think that his reaction may have more to do with disability than with
his feeling about the dog]

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The supervisor lets Arcadio sit with his question. It’s a rather power-
ful question for supervision, as it is identical to what might be asked of
a client.

Arcadio: He’s a service dog. So he represents being of service to someone

who is disabled. I know that’s obvious, but I’m not sure where you’re going
with this. I’m in a wheelchair. A service dog is nice but not something I
really need.

At this point the marker is clear to the supervisor. She begins to won-
der about Arcadio’s multicultural knowledge, particularly in relation to
disability. In previous sessions they discussed Arcadio’s disability, as well
as disability as a multicultural identity variable. The supervisor views
Arcadio as rather adept and knowledgeable about disabilities but thinks
he may be limited in terms of self-awareness. Thus, she initiates the task
environment of a multicultural awareness event.

Task Environment
Focus on Multicultural Awareness
Supervisor: That’s true, I suppose. But perhaps we can step back for a
moment. Last week when we met, you mentioned, along with feeling
anxious, that you felt some fear in relation to your clients. I’m confident
in your knowledge about multicultural issues, particularly in relation to
disabilities. However, even when we’re knowledgeable, sometimes we still
have blind spots. [this mention of “blind spots” was unintentional, however,
a propos]
Supervisee: How do you mean?
Supervisor: What kind of disability does Irene have?
Supervisee: She’s blind, but I’m not blind. I’m in a wheelchair, which I
think you can see. [sarcastic, as he perceives her question as related to parallel
process]

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Supervisor: Yes. Blind is not something we strive to become [perceiving

Arcadio’s sarcasm as defensive, wants to facilitate his insight]
(pause)
Supervisor: . . . any more than we strive to be in a wheelchair.
Supervisee: Oh God, I can’t even imagine what it would be like to be
blind. And in a wheelchair!
Supervisor: I suppose it’d be mighty scary.
Arcadio: Definitely. (pause). Wow. Do you think that may be where my
feelings are coming from?
Supervisor: Perhaps. What do you suppose?
Supervisee: Well, it fits. I’ve never imagined myself becoming blind. I fig-
ured God gave me enough to deal with by putting me in this chair. That
would be horrible to also be blind. I’m not sure I could take it.
Supervisor: So the fear makes sense and possibly distracts you from the
therapy process with Irene.
Supervisee: You’re going to find this funny, or maybe not so funny. I just
realized that Irene probably doesn’t know that I’m in a wheelchair. [shows
his ability to take his client’s perspective, an important skill]
Supervisor: Of course! Makes sense! [delighted at his insight]
Supervisee: It never really came up, and it was nice not to have someone
come in and look at me in the chair for once. Instead, she was just there
to be with me. But it also was probably a lost opportunity to connect with
her from a disability perspective.
Supervisor: You’re on the right track now, I think now. [reinforces his self-
awareness]
Supervisee: Thank you.
Supervisor: So, now that you are more aware of how disability issues may be
playing out with Irene, how might you handle that in your next session with
her? [wants to give him an opportunity to display his multicultural expertise]

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Focus on the Therapeutic Process and Focus on Skill

Supervisee: Well, for starters we could talk about it. I could bring up my
disability and how we both have physical disabilities and what that is like
for Irene to know. It would give me a chance to assess her multicultural
identity in relation to her disability and consider how our two identities
interact. I also need to be sure not to overplay the idea that just because we
both have disabilities, that our reactions have to be the same.
Supervisor: Go on.
Supervisee: Well, I have a good idea about what it’s like to be in a wheel-
chair but really don’t know what it’s like to be blind.
Supervisor: And what about your racial difference from her?
Supervisee: Good point. We are different there as well, so we could discuss
that . . . and also our gender differences.
Supervisor: So there are potentially a number of multicultural variables
to go over with her. At the same time, she presents with anxiety, so that
can’t be forgotten. [wants to facilitate an integrated conceptualization (i.e.,
diagnosis in the context of disability)]
Supervisee: Of course. How do I balance it all?
Supervisor: Well the first thing that has to happen is that Irene needs to
show up for a session!
(Both chuckle)

Focus on the Supervisory Alliance

Supervisor: Before we go there, I want to check in with how our work
has been for you so far today? [does not want to overlook the possibility of
his discomfort related to their discussion of his disability, thereby modeling
cultural sensitivity]
Supervisee: Well, another whirlwind of insight! I’m grateful I’ve had this
opportunity to work in this way. I’m also embarrassed and frustrated that
I didn’t see the multicultural piece last week. Especially since that’s all I
talk about outside of supervision!

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Normalize the Experience

Supervisor: And like last week, I want you to know that the feelings of
embarrassment and frustration are a normal reaction to recognizing
things that are out of our awareness. Does that make sense?
Supervisee: Yes, but I hope this gets easier.
Supervisor: I’m not sure it ever does, but the more you do it, the quicker
you’ll come to the insight. Just the other day I was dealing with a clini-
cal issue that was in my own blind spot and had to seek consultation.
It’s something I’m typically aware of, but not this time. The consultation
helped and I was able to move on.

At this point the supervisor chose to disclose some, but not all, of her
recent personal challenges and how this insight following their previous
session made her realize that she had overlooked Arcadio’s lack of atten-
tion to the obvious multicultural issues. A supervisor’s disclosure of her
own clinical struggles is powerful; it can help a supervisee reveal more of
her own struggles and thereby strengthen the supervisory alliance (Ladany
& Walker, 2003). Moreover, disclosure demonstrates to a supervisee how
a well-timed self-disclosure in therapy can benefit a client. However, in
this case the supervisor decided not to disclose the specifics of her visual
impairment because she considered the information to be too personal
and likely to be more in the service of the supervisor than the supervisee.

Supervisee: That’s good to know, that with all your experience you still
have to deal with things.
Supervisor: Well, actually, I’ve been struggling with whether or not to
tell you this. It’s personal for me, of course. I wavered between moving
our conversation off of what was most important, you and the client, to a
discussion about how my own personal struggle with my vision might be
getting in the way of my being helpful as a supervisor to you with this case.
Supervisee: Jeez! I can see that. Thanks for letting me know that you, too,
sometimes don’t know what to do when!

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Supervisor: Of course! In our field, the learning opportunities are never

ending, which is what makes this job so exciting.

Because working on multicultural issues in supervision can be emo-

tionally draining, it is wise to focus on the supervisory alliance to see
whether supervisor and supervisee are on the same page. In addition, it
is good to sum up what was learned during the session thus far and how
the supervisee can generalize the supervision work to the therapy session
(resolution).

Focus on the Supervisory Alliance

Supervisor: But now let’s get back to an important question you asked
earlier. You asked how to decide when to focus on the multicultural issue
and when to focus on the anxiety work. [focuses on the task component of
their alliance]
Supervisee: Yes, there’s so much to cover. What would you suggest?
Supervisor: What’s it like when clients bring in multiple presenting con-
cerns? [empowers Arcadio to answer his own question]
Supervisee: Go with where the client takes us. [indicates knowledge of
responsiveness]
Supervisor: Yes, and in this case, Irene should give you an indication
about where she wants to head in therapy. So far, she’s made it clear that
she wants to focus on her anxiety, and there are a variety of behavioral
interventions to help with that. And we can certainly talk more about
some of those in supervision, as well as what you’ve tried in the past and
how it’s worked. Also, you know specific multicultural interventions that
you can use in your work with her.

Resolution
Supervisee: That sounds good. I definitely feel good about the multi­
cultural variables. I’d like to talk more about some of these behavioral
interventions.

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 The Critical Events in Psychotherapy Supervision Model

At this point in the supervision session, Arcadio’s multicultural

awareness was heightened. At the end of this event, his comment suggests
a marker for a different critical event, addressing a skill difficulty (i.e., his
request for assistance to help him work more effectively with his client’s
anxiety). At this point, the supervisor could begin another task environ-
ment, similar to the one described in Chapter 3.
However, there was an additional parallel process that occurred that
was minimally broached in this last supervision event. This parallel pro-
cess involved the supervisor’s indecision about disclosing her impending
disability to the supervisee and the supervisee’s decision to keep knowl-
edge of his disability from the client. Although the supervisor could have
explained at length the fears that she was in the midst of experiencing, she
determined that this disclosure would not have facilitated Arcadio’s learn-
ing, and indeed she disclosed this deliberation directly. By exposing her
own clinical struggle, she modeled another parallel process that facilitated
Arcadio’s learning, and she did so without her personal issue pulling for
Arcadio’s sympathy.
If the supervisor had not been aware of the multicultural issues at
play, or if she had responded poorly to the multicultural issues, the multi-
cultural event would have been unresolved. Moreover, additional diversity
factors in this case illustration, namely gender and race, may prove worthy
of future supervisory discourse. Thus, across and within three sessions
of supervision we could witness events related to four supervision tasks:
working through parallel process, heightening multicultural awareness,
and remediating a skill difficulty. Addressing these tasks in event after
event is like a wave that we, as supervisors, must surf, and do our best not
to fall off.

SPECIAL CONSIDERATIONS: “SUP OF SUP”

In this chapter, we primarily focused on the manner in which parallel
processes occur between the therapy supervision dyad and the therapy
dyad. We have also been witness to parallel processes occurring in the dyad
with a supervisor and a supervisor in training, the therapy supervision

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dyad, and the therapy dyad. To be sure that the amount of complexity
among these three dyads accelerates at each level, the same critical events
approach can be used at each level and can begin at the highest level.
As a simple example, consider a client who presents with significant
anxiety that does not get explored by the therapist. The therapist, in her
role as supervisee, presents as uncharacteristically anxious in super­
vision, a behavior that is similarly overlooked by the supervisor and per-
haps also experienced by the supervisor. Next, the supervisor presents to
her or his supervisor (the “sup of sup”) as particularly anxious. It then
becomes the role of the supervision supervisor to attend to the parallel
process with the therapy supervisor, who in turn, it is hoped will send it
down the chain of dyads. Because there appears to be no empirical work
conducted in this area, the multiple parallel processes may be a fruitful
direction for future research.

CONCLUSION
As multiple critical events become intertwined, it behooves the super­
visor to parse the events to better understand the significance and focus of
supervisory interventions. Managing multiple events is a supervisory skill
in and of itself. In the next and final chapter, we recommend how to use
our critical events in supervision model to enhance supervisory practice.

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 5

Using the Critical Events Model

in Practice and Training

I n the concluding section of this book, we expand on the practice impli-

cations of the critical events in psychotherapy supervision model, first
by discussing the supervision session described in this book’s companion
video Critical Events in Psychotherapy Supervision,1 and then by consider-
ing a variety of effective and ineffective elements of supervision practice.
Next, we suggest ways in which supervisors can be trained to learn about
using the model. Finally, we discuss research-related approaches to how
the model can be studied.

1 Available for purchase at http://www.apa.org/pubs/books/4310956.aspx/.

http://dx.doi.org/10.1037/14916-006
Supervision Essentials for the Critical Events in Psychotherapy Supervision Model, by N. Ladany,
M. L. Friedlander, and M. L. Nelson
Copyright © 2016 by the American Psychological Association. All rights reserved.

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THE CRITICAL EVENTS IN SUPERVISION

MODEL IN ACTION
For this section, we refer to the video demonstration of the critical events
model. The critical event described in the companion video is working
through countertransference (Ladany, Friedlander, & Nelson, 2005). In
this demonstration the trainee, Tiffany, brought to supervision challenges
related to a client’s potential use of medical marijuana. Nicholas Ladany
served as her consulting supervisor.
Tiffany identified one client in particular whose presentation was trig-
gering reactions related to her family of origin, particularly her brother, who
has a history of drug abuse, and the negative consequences that resulted from
his addiction. Within the first 3 minutes of the session, Tiffany began describ-
ing her personal background and reactions in relation to this client, express-
ing a desire to sort how much her concerns were “personal versus clinical.”
Thus, the marker in this event appeared in the initial minutes of
the session. Her recognition that her concerns were of a personal nature
indicated that the task for this event would be to work through counter-
transference. Although the construct countertransference originated in the
psychoanalytic literature, we recognize the broader definition, applicable
across theoretical approaches, reflecting the personal challenges that super-
visees experience brought about by their clinical work (Ladany et al., 2005).
Once the marker was identified, the session moved into the task envi-
ronment phase of the critical event. The first interactional sequence was a
focus on the therapy process. That is, we began with a discussion of how
the client came across to the supervisee and noted challenges attributable
to the client’s seeming delay in maturity (e.g., came across as at least 5
years younger than his chronological age). We then spent considerable
time on the second interactional sequence, a direct focus on the super-
visee’s countertransference, specifically the supervisee’s role in her family
of origin (e.g., caretaker). The sequence exploration of feelings followed,
during which the supervisee was able to tap into some intense feelings of
loss and sadness, many of which stemmed from her relationship with her
brother. At points we also used the sequence focus on the supervisory alli-
ance to check in to see whether the work in which we were engaged was

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 Using the Critical Events Model in Practice and Training

helping the supervisee. Tiffany indicated that she was willing to continue
the work we had begun (reflecting our agreement on the tasks compo-
nent of the supervisory alliance). Throughout the event, Dr. Ladany relied
on empathizing with Tiffany’s experience in the supervision session to
strengthen the bond component of the alliance.
The final interactional sequence was attending to parallel process.
The supervisor disclosed that he was having an internal conflict in the
moment; that is, he was wondering if he should advise the supervisee how
to proceed with her case. This happened to mirror the very question Tiffany
had—should she advise the patient on whether or not it was wise to use
marijuana for medicinal purposes? During this discussion of the paral-
lel process, Tiffany was able to identify her own internal conflict about
whether or not to tell the client what to do.
These interactional sequences closely match those that were identified
in our original model for a working through countertransference event
(Ladany et al., 2005). In the current demonstration, focusing on the super-
visory working alliance was an additional interactional sequence. In this ses-
sion, the alliance emerged from the figure to the ground largely because of
the depth and amount of family-of-origin discussion in which Tiffany was
willing to engage. In other words, Dr. Ladany continued to check in with
Tiffany to ensure that the tasks of the session were mutually agreed upon
and she believed she was being heard. Although Tiffany seemed willing to
do so, the supervisor believed that it was important to touch base to ask her
if it was acceptable for her to move to deeper levels of work. This checking
in was a way in which the supervisor specifically attended to the agreement
on tasks component of the supervisory working alliance.
The final phase, the resolution, occurred in the last 8 minutes of the
session. During this period in the event, Dr. Ladany asked Tiffany about
how the insight she seemed to gain during the supervision session might
influence her therapeutic process with her client. The purpose of this dis-
cussion was to ground the supervision work in learning about therapeutic
responsiveness.
Tiffany was able to identify that the primary component of the resolu-
tion was an increase in her self-awareness. She indicated a belief that this

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change in self-awareness would help her “be more present” with her client,
and her internal struggle would be less likely to come to mind during her
session: that is, it would present less of a distraction from the therapeutic
process. We also explored how this new realization might help Tiffany with
future clients. Although the countertransference event was “resolved” in a
way that seemed productive, Tiffany acknowledged that additional work
on these issues in her own personal therapy would be important for her.
In sum, the session adhered to the critical events model fairly well.
Not only were the interactional sequences consistent with previous theo-
rizing, but also the five sequences were those that Shaffer and Friedlander
(2015) identified as the most relational ones in our model (exploration of
feelings, focus on the therapeutic process, focus on countertransference,
attend to parallel process, and focus on the supervisory alliance).
Of course, although it is advantageous that the session worked out so
well, it is important to note that not all events result in a successful resolu-
tion like this one. Even with successful resolutions, the supervisor should
reflect on the work and consider what might have been preferable. For
example, in the session with Tiffany, upon reflection, the supervisor won-
dered how helpful it was to push Tiffany to consider her “worst case sce-
nario” if her patient should decide to use marijuana. Although this focus
may have helped her obtain some needed insight at that particular point,
less emphasis might have saved some time for other important super-
vision work. Nonetheless, he hoped that, as is often the case in psycho-
therapy, unidentified or unfinished work in a supervision session opens
the door for future meaningful work in supervision.

EFFECTIVE AND INEFFECTIVE SUPERVISION

The practice of psychotherapy supervision is at once an art and a science,
and theoretical models in supervision have only begun to capture aspects
of the complexity. Theoretical models are part of the story that deter-
mines the effectiveness and ineffectiveness of supervision. Expanding
on Ladany’s (2013) elements of effective supervision, a variety of critical
factors can be examined by scholars and reflected on by practitioners as
important considerations when gauging the effectiveness of supervision.

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In terms of effective supervision, the following factors should be

considered:

1. Recognize the power of the supervisory relationship. In the critical events

in supervision model, we define the relationship from the perspective
of the supervisory working alliance. Over time, the strength of the
supervisory relationship has demonstrated an important contribu-
tion to a variety of supervision process and outcome variables (e.g.,
Ladany & Inman, 2012).
2. Use models of counseling and psychotherapy supervision. We believe it
is a mistake to depend on psychotherapy models (e.g., psychoanalytic
supervision) as the sole informant or primary approach for conduct-
ing supervision. Rather, models created specifically for supervision,
ones that recognize the unique processes inherent in supervision,
are likely lead to better supervisory outcomes. Although we describe
and illustrate the critical events in psychotherapy supervision in this
book, there are other models worthy of consideration, including two
from APA’s Clinical Supervision Essentials Series: McNeill and Stol-
tenberg’s (2016) integrated developmental model and Holloway’s
(2016) systems approach to supervision model.
3. Recognize conditions in supervision that are unique and different from
psychotherapy. First, supervision is inherently educational. Despite its
relational elements, it is a didactic endeavor in which the super­visor’s
primary function is to teach. Second, another primary function is
evaluation, in that supervisors serve as gatekeepers for the mental
health professions. Third, in most cases, supervision is an involuntary
mandate for supervisees. As such, the autonomy to leave the relation-
ship that characterizes psychotherapy does not pertain to supervision.
4. Engage in role induction. As noted in Chapter 2, providing super­
visees with the expected roles and responsibilities at the beginning
of the supervision experience can alleviate potential challenges later.
Because of the potential for poor or harmful supervision experiences
to occur (Ellis et al., 2014; Nelson & Friedlander, 2001), it is impor-
tant not to assume that because a supervisee has received supervision
previously, she knows what is expected of her.

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5. Distinguish between supervision and psychotherapy. Although at times

the processes that occur in supervision can appear identical to those
that take place in therapy (e.g., exploration of feelings), supervisors
should not confuse the goals of supervision (e.g., increased self-
awareness to better understand a client) with the goals of psycho-
therapy (e.g., increased self-awareness to improve functioning).
6. Attend to supervisee-focused and client-focused outcomes. Sometimes
it is easy for supervisors to focus on client well-being without attend-
ing sufficiently to a supervisee’s learning. At times an exclusive client
focus may be indicated, such as when a client is suicidal. That said,
supervisors should resist the urge to attend solely to the client without
regard to the supervisee.
7. Become aware of covert processes in supervision. Research in super­
vision (e.g., Mehr, Ladany, & Caskie, 2015) suggests that supervisees
often keep clinically relevant material from their supervisors, pos-
sibly out of fear of negative evaluation. Nondisclosure of relevant
material can clearly hinder client care as well as hamper a super-
visee’s learning.
8. Develop an understanding of the ethical and legal issues pertinent to
supervision. Supervisors must contend with issues that differ from
those related to therapy; such issues include vicarious liability, confi-
dentiality, and multiple roles. It would behoove supervisors to become
well-versed in the ethics and legalities of supervision without assum-
ing that knowledge of legal and ethical issues in therapy is sufficient.
9. Evaluate using best practices. In part, this element of effective super­
vision is aspirational. To date, no best practice evaluation measures
with sound psychometric properties have been developed or validated.
Thus, supervisors are left with doing their professional best to ensure
that the two components of evaluation (goal setting and feedback) are
provided with the utmost of care.
10. Strive for multicultural competence. The psychology literature from the
early 21st century continues to demonstrate a variety of multicultural
challenges between supervisors and supervisees (e.g., microaggres-

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sions) that are similar to those between therapists and clients. Thus, it
behooves supervisors to remain abreast of new and emerging develop­
ments in the professional multicultural literature.
11. Recognize the importance of parallel processes. We discussed this ele-
ment at length in Chapter 4. To reiterate, supervisors should have an
understanding of how parallel processes occur and be comfortable
with bringing parallel processes to their supervisees’ awareness.
12. Tend to administrative responsibilities. Often the greatest challenge for
a supervisor is to balance the “teacher” and “counselor” roles. In addi-
tion, there are a variety of administrative responsibilities to which
supervisors must attend, such as note taking, supervisee monitoring,
and assorted paperwork.
13. Recognize the importance of group supervision and peer supervision.
Although our focus has been individual supervision, there is an emerg-
ing literature on how group supervision and peer supervision can
serve as salient supplemental supervision activities (Avent, Wahesh,
Purgason, Borders, & Mobley, 2015; Burnes, Wood, Inman, & Welikson,
2013). Supervisors should be aware that not only can the group fur-
ther the learning goals of supervision but the group processes also can
hinder learning, particularly when there is unacknowledged diversity
within the group (cf. Friedlander et al., in press).
14. Obtain training and supervision of supervision. There remains a sig-
nificant gap between the importance that training programs place on
the development of therapy skills as compared with the development
of supervisor skills. Often novice supervisors are able to develop skills
only through professional development opportunities. It has yet to be
determined whether these professional development activities are suf-
ficient for developing supervisor competence. In particular, a key ele-
ment is for supervisors to enhance their self-awareness in relation to
their supervisory work, something that traditional professional devel-
opment workshops minimally address. We encourage supervisors to
seek ongoing supervision of supervision throughout their professional
lives, and when supervisors discover blocks in their work, they should

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enhance their ongoing supervision of supervision as well as seek ther-

apy to better serve their supervisees and their supervisees’ clients.

In contrast to effective supervisor practices, ineffective supervisor

practices are important to consider as what not to do in supervision. In
addition, it is important to recognize that the supervisees can contribute
to poor supervision outcomes. We categorize these ineffective supervision
elements as supervisor factors, supervisee factors, and dyadic factors.
Along with elements that reflect effective supervisory practices, there
are other factors to consider. First, supervisors have been known to mis­
apply a developmental model, resulting in supervisees feeling infantilized.
In other words, some supervisors mistakenly assume that all new super-
visees need a great deal of structure and feedback, without considering
that many novices enter training programs with significant skills. Con-
versely, the assumption that advanced supervisees need little support can
result in missed learning opportunities, particularly in specific areas in
which a supervisee has little knowledge despite being fairly experienced
and sophisticated in general conceptualization ability.
As noted, evaluation at times poses challenges to supervisors. In some
ways providing critical feedback seems antithetical to the empathic and
nonjudgmental approach that is the hallmark of responsive psycho­
therapy. Nonetheless, supervisors should be cautious about providing
exceptionally positive evaluations for all supervisees because in doing so
they forgo the gatekeeping role. Of course, as mentioned, supervisors often
are hampered by a lack of reliable and valid instruments for evaluating
supervisee competence.
Third, there are supervisors who are multiculturally misguided or
bigoted in their approach to others, including supervisees, clients, staff,
and members of the community. Supervisees readily pick up on their
supervisors’ biased beliefs and recommendations that reflect multi­cultural
incompetence, such as sexism, racism, and homophobia (Walker et al.,
2007). Given historical multicultural training differences in counseling
and therapy programs, it is not unusual that supervisees come to super­
vision with more and better multicultural training than do their super­
visors, which can result in negative supervision experiences.

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Our focus has been on elements of supervisor behavior that can

positively or negatively affect the work of supervision. Undoubtedly,
however, supervisees also play a significant role. In terms of supervisee
factors related to ineffective supervision, we have identified four fac-
tors. First, the supervisee’s openness to learning and receptivity to feed-
back are critical for learning to occur. Second, the supervisee needs to
have the capacity to learn helping skills and be trained in helping skills.
Future models of therapy training may do well to spend more than
one or two semesters in helping skills training. Parenthetically, help-
ing skills are the few skills that hold promise in relation to evaluation
(Hill & Lent, 2006). Third, supervisees need to have a capacity for deep
self-awareness and self-reflection. To learn from supervisors, as well as
from one’s own experiences, supervisees need to have the ability and
devote the time to understand themselves in relation to the therapeu-
tic work. Fourth, supervisees need to have the capacity for knowledge
acquisition. That said, knowledge alone (e.g., theories, research, statis-
tics, etc.) is not sufficient for becoming a competent psychotherapist. In
fact, training programs may be overemphasizing knowledge acquisition
and underemphasizing skill development, which is the sine qua non of
competence as a psychotherapist.
The final set of factors related to the ineffectiveness of supervision per-
tains to dyadic factors, of which we have identified three. As noted, a strong
supervisory working alliance is a foundational aspect that contributes to
the effectiveness of supervision. Similarly, a problematic alliance can be
the death knell of supervision work, related to a variety of negative out-
comes, including nondisclosure of relevant clinical material, dismissive-
ness of a supervisor’s recommendations, and generally unproductive time
spent in supervision. Second, supervisors who are exclusively focused on
clients’ outcomes are unlikely to help supervisees learn and, in fact, may
lead supervisees to become resistant and unresponsive. Finally, we caution
supervisors who may be inclined to have case discussions predominate in
their supervision sessions. Supervision sessions that solely involve review-
ing case notes, with little or no attention to the professional development
goals and tasks of supervision, are inherently inadequate and potentially
harmful (e.g., Friedlander, 2015).

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THE CRITICAL EVENTS IN SUPERVISION MODEL:

TRAINING SUPERVISORS
The training of supervisors has gained increased attention in professional
development circles over the past decade; however, specific evidence about
best practices is limited. In this section we offer one method of training
supervisors in applying the model. This method can be applied in two
ways. First, we consider how the model can be used to review supervision
work that has occurred (i.e., reflecting back), and second, we examine how
to help supervisors become comfortable with the model during a super­
vision session and when anticipating upcoming supervision sessions (i.e.,
reflecting forward).

Reflecting Back
To learn from supervisory experiences, we advocate a looking-back
approach. The first step is to become familiar with the common criti-
cal events that occur in supervision (e.g., addressing skill deficits) and
then reflect back on the types of critical events that have occurred in one’s
actual supervisory work. For example, if a skill deficit was recognized in
a previous session, such as helping a supervisee learn the Gestalt two-
chair technique, the supervisor could first think about the strength of the
supervisory working alliance with the supervisee before and during the
event. As an aid in doing so, the supervisor could use the Supervisory
Working Alliance Scale (Ladany et al., 2008). Simply responding to each
item may in and of itself help a supervisor consider what he should be
attending to in relation to his alliance with a specific supervisee. Next, the
supervisor could attempt to identify the marker that signaled the initia-
tion of the event (e.g., the supervisee asked how to perform a Gestalt two-
chair technique because he thought it may help one of his clients). Then
the supervisor would consider the types of interactional sequences that
occurred during that event (Table 1.1 could serve as a reference point).
The interactional sequences may be identified from memory, case notes,
or from a review of the recorded supervision session(s).
Once the interactional sequences have been identified, the super­
visor could compare the sequences used with the ones deemed typical for

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each critical event in our model. Discrepancies may point to interactional

sequences that could have been used (e.g., a supervisor may be reminded
of normalizing the supervisee’s experience). Finally, the supervisor could
contemplate the extent to which that event was resolved in terms of the
alliance and the supervisee’s self-awareness, knowledge, and skills. For
example, a supervisee may have significantly increased his knowledge of
the Gestalt two-chair technique but demonstrated limited skills in apply-
ing it, indicating a partially resolved event. Moreover, a broader look at the
supervision outcomes could occur (Ladany, Walker, Pate-Carolan, & Gray
Evans, 2008). Based on this entire analysis, the supervisor could then
consider how to assist the supervisee in subsequent supervision sessions.

Reflecting Forward
A second approach to learning how to apply the critical events model is to
anticipate various critical events and identify the necessary components.
We found this approach particularly useful in supervision workshops. For
example, we often show a portion of a therapy session and ask participants
to assume the role of supervisor and identify the possible critical events
that could occur in the next supervision session. We have them identify the
potential markers, followed by the interactional sequences that are likely to
be effective. Finally, we have them consider the types and range of potential
event resolutions. Participants can be provided with Figure 5.1 and asked
to fill in these components on the figure. Another learning option is to use
the companion video, described earlier, in which the critical events model
is illustrated with a live supervision case.

RESEARCHING THE CRITICAL EVENTS IN

PSYCHOTHERAPY SUPERVISION MODEL
As noted, the development of the critical events model in psychotherapy
supervision was, and continues to be, empirically informed by supervision
scholarship. Traditionally, task analytic approaches use two approaches
toward the development and validation of models (Greenberg, 1983, 1986;
Greenberg, Heatherington, & Friedlander, 1996). In one approach, the

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 THE CRITICAL EVENTS IN PSYCHOTHERAPY SUPERVISION MODEL

Figure 5.1

Template for training supervisors in the critical events model.

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 Using the Critical Events Model in Practice and Training

scholar identifies a recognizable task that has theoretical and empirical

support. An example in the supervision literature is heightening multi­
cultural awareness, which has garnered considerable support for its
importance. Next, based on the literature, a conceptual model is created.
For many of the critical events we identified and modeled, this was the
approach taken.
A second approach to developing and validating the critical events
model is rational–empirical in nature (Greenberg et al., 1996). In this
approach, a model is derived inductively based on the intense study of a
sample of successful or unsuccessful events, from which the salient inter-
action sequences in the task environment are identified. In our original
book (Ladany et al., 2005), we suggested that researchers use a rational–
empirical approach to test the various critical events using qualitative
and quantitative methods. From this research, refinements of the model
can occur.
A good example of how our model was tested was a study conducted
by Bertsch et al. (2014), who examined gender-related critical events and
their links to outcomes. Overall, these authors found that four of the inter-
actional sequences (focus on the therapeutic process, exploration of feel-
ings, focus on skills, and focus on self-efficacy) were related to the extent of
the resolution of the event (i.e., self-awareness, skills, and the supervisory
alliance but not knowledge). This study offers an important approach to
testing the critical events model.
Another example in which the critical events model was tested was
a study conducted by Shaffer and Friedlander (2015). In this work, the
Relational Behavior Scale was developed, which measures how super­
visees perceive the use of five of the 11 interactional sequences. The focus
on the five interactional sequences was based on the authors’ desire to
examine the most relational of the interactional sequences. Initial evi-
dence suggests that the measure is empirically supported based on their
findings of a link between supervisees’ perceptions of relational sequences
and the supervisory alliance and evaluation of the supervisor.
We encourage future researchers to continue to explore the adequacy
of the models of critical events we identified using the rational–empirical

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 THE CRITICAL EVENTS IN PSYCHOTHERAPY SUPERVISION MODEL

approach. For example, for the role conflict and ambiguity event in Chap-
ter 2, we noted that exploration of feelings and focusing on the supervisory
alliance were two prominent interactional sequences that could lead to a
successful resolution. Using actual data of supervisory work, researchers
would compare successful and unsuccessful role conflict and ambiguity
events to determine the types and order of the most salient interactional
sequences, as well as if they match up to the a priori model. In addition,
using larger samples quantitatively could offer further evidence for the
efficacy of the model. In sum, future researchers can use these approaches
to determine how well our models work and discover new models for
additional consideration.

CONCLUSION
We hope that our model offers experienced supervisors and supervisors in
training a heuristic model that is theoretically and empirically informed,
clinically appealing, and practical. Throughout our work on this model,
our intent has not changed. We encourage readers to help us refine this
evolving model of supervision practice through research and clinical
experiences that test the model to reach out to us for comment.

124
 Suggested Readings

F or those interested in further developing their understanding of the

critical events in psychotherapy supervision model and the supervision
enterprise, we offer the following readings along with a brief description
of the content of these readings.

Ekstein, R., & Wallerstein, R. S. (1958). The teaching and learning of psychotherapy.
New York, NY: Basic Books.
A seminal work in the supervision literature that continues to offer insights
into the supervision enterprise, including concepts such as parallel process.
Ladany, N., & Friedlander, M. L. (2014). Sex and gender in professional psychol-
ogy and training in professional psychology and training. In B. Johnson &
N. Kaslow (Eds.), Oxford handbook of education and training in professional
psychology (pp. 419–436). New York, NY: Oxford University Press.
Specifically examines the role of sex and gender on supervision and training.
Ladany, N., Friedlander, M. L., & Nelson, M. L. (2005). Critical events in psycho-
therapy supervision: An interpersonal approach. Washington, DC: American
Psychological Association.
An in-depth look at the critical events in psychotherapy supervision model
that illustrates a full range of critical events and expands upon the manner in
which the model can be studied.

125
 suggested readingS

Ladany, N., Hill, C. E., Corbett, M. M., & Nutt, E. A. (1996). Nature, extent, and
importance of what psychotherapy trainees do not disclose to their supervisors.
Journal of Counseling Psychology, 43, 10–24.
An original investigation on nondisclosures in supervision that provides
clinical examples of meaningful secrets that supervisees keep from their
supervisors.
Ladany, N., & Inman, A. G. (2012). Training and supervision. In E. M. Altmaier,
J. C. Hansen, E. M. Altmaier, & J. C. Hansen (Eds.), The Oxford handbook of
counseling psychology (pp. 179–207). New York, NY: Oxford University Press.
A recent review of the counseling and psychotherapy supervision literature.
Ladany, N., & Walker, J. A. (2003). Supervision self-disclosure: Balancing the
uncontrollable narcissist with the indomitable altruist. Journal of Clinical
Psychology, 59, 611–621.
Offers a model for supervisor self-disclosures.
Ladany, N., Walker, J. A., Pate-Carolan, L., & Gray Evans, L. (2008). Practicing
counseling and psychotherapy: Insights from trainees, clients, and supervisors.
New York, NY: Routledge.
Provides a guidebook for practicum trainees and supervisors with process and
outcome variables in supervision linked to process and outcome variables in
counseling and psychotherapy.
Olk, M., & Friedlander, M. L. (1992). Role conflict and ambiguity in the super-
visory experiences of counselor trainees. Journal of Counseling Psychology,
39, 389–397.
Offers the original conceptualization and scale validations of the constructs
role conflict and ambiguity.
Bertsch, K. N., Bremer-Landau, J. D., Inman, A. G., DeBoer Kreider, E. R., Price,
T. A., & DeCarlo, A. L. (2014). Evaluation of the critical events in supervision
model using gender related events. Training and Education in Professional
Psychology, 8, 174–181.
Support for the critical events model was reported in this qualitative study
of supervisees, which revealed four kinds of gender-related critical events
(gender discrimination, gender identity, attraction, and power dynamics) and
specific interactional sequences (e.g., exploration of feelings) used by partici-
pants’ supervisors during these events. Only the gender discrimination event
was associated with more unfavorable supervisory alliances.
Friedlander, M. L. (2012). Therapist responsiveness: Mirrored in supervisor
responsiveness. The Clinical Supervisor, 31, 103–119.
This article describes the intertwining of the therapeutic relationship and
the supervisory relationship in terms of supervisors’ responsiveness to the

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 suggested readingS

continually shifting needs of supervisees and their clients. Responsiveness is

illustrated by the supervisor’s approach to a supervisee who was highly effec-
tive with one client but who was floundering with another client.
Friedlander, M. L. (2015). Use of relational strategies to repair alliance ruptures:
How responsive supervisors train responsive therapists. Psychotherapy, 52,
174–179.
This article uses the critical events model to discuss and illustrate supervisor
responsiveness when a supervisee experiences a rupture to the therapeutic
alliance with a client. The case example also illustrates how a supervisor’s fail-
ure of responsiveness to the supervisee’s crisis in confidence can evolve into a
rupture within the supervisory alliance.
Friedlander, M. L., Blanco, S., Bernardi, S., & Shaffer, K. S. (in press). Empower-
ing female supervisees: A feminist, multicultural and relational perspective.
In M. Keitel & M. Kopala (Eds.), Handbook of counseling women (2nd ed.).
Thousand Oaks, CA: Sage Publications.
This chapter describes and illustrates how supervisors, operating within a
feminist, multicultural, and relational framework, can empower female super-
visees in both individual and group supervision using interactional strategies
from the critical events model. In a summary of recent literature on gender in
supervision, two critical events studies on gender events are described.
Ladany, N., Friedlander, M. L., & Nelson, M. L. (2005). Critical events in psycho-
therapy supervision: An interpersonal approach. Washington, DC: American
Psychological Association.
This book introduces the critical events model of supervision and uses exten-
sive case material and dialogue to illustrate the task analytic method for resolv-
ing each of seven commonly occurring critical events: repairing gender-related
misunderstandings, heightening multicultural awareness, managing sexual
attraction, remediating skill difficulties and deficits, negotiating role conflicts,
working through countertransference, and addressing problematic attitudes
and behavior.
Nelson, M. L., & Friedlander, M. L. (2001). A close look at conflictual supervisory
relationships: The trainee’s perspective. Journal of Counseling Psychology, 48(4),
384–395. http://dx.doi.org/10.1037/0022-0167.48.4.384
The authors investigated negative supervision experiences. Among their find-
ings, supervisees found the most negative supervisor experiences involved
supervisors who were not invested in the supervisory relationship and were
unwilling to work on role conflicts. Supervisees also experienced significant
stress and self-doubt as a result of these experiences. Finally, supervisees found
support from peers or their therapists during this difficult time.

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 suggested readingS

Shaffer, K. S., & Friedlander, M. L. (in press). What do “interpersonally sensitive”

supervisors do and how do supervisees experience a relational approach to
supervision? Psychotherapy Research.
Two studies in this article introduce the Relational Behavior Scale, which
assesses supervisees’ perceptions of the five most relational of the 11 inter-
actional sequences within the critical events model: exploration of feelings,
focus on the therapeutic alliance, focus on countertransference, attend to par-
allel process, and focus on the supervisory alliance. Support for the critical
events model was found in that more frequent use of these behaviors partially
explained the relation between perceptions of the supervisory alliance and
evaluation of the supervisor within a specific session.
Walker, J. A., Ladany, N., & Pate-Carolan, L. M. (2007). Gender-related events
in psychotherapy supervision: Female trainee perspectives. Counselling and
Psychotherapy Research, 7, 12–18.
The authors examined supportive and unsupportive gender-related events as
experienced by women supervisees. The most common supportive gender-
related events pertained to assistance with integrating gender in client con-
ceptualizations and processing transference and countertransference that were
gender related. The most common unsupportive gender-related events involved
the supervisor stereotyping the trainee or dismissing gender-related events.

128
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 Index

Abusive supervisors, 6 evaluations, 7

Administrative responsibilities, 117 example, 11–12, 16–17, 20, 21
Ah-ha experience, 90 outcomes, 116
Ambiguity, 37–56, 40f, 124 progress, 7
Anxiety, 90, 109 resistance, 17
Assessment, 74–75 self-presentations about, 7
Attitudes. See Problematic attitudes trainees on, 7
Attractive style, 8 Closure, 33
Authoritarian approach, 12 Coding supervision process, 9
Common tasks, 17, 18
Bandura, Albert, 9 Competencies, 13–14, 57
Behavior. See also Problematic core, x
behaviors domain, x
mirroring effect, 87 multicultural, 99–100, 116–117,
professional, 36 118
Bertsch, K. N., 123 Conceptual model, 123
Best practices, 116 Conceptual skill, 58
Confidence, crisis in, 67–68
Case management approach, 12 Conflict, 14, 27. See also Role conflicts
Change, 15–17 resolution of, 9–10, 38–39
Characterological difficulties, 68, in supervision relationship,
69–70 37–56, 40f
Check in, 26, 89 Conjoint family therapy, 19
Choice points, 11–12 Context
Clients, 13, 14. See also Role ambiguity; approach, 13–15
Role conflicts; Supervisory event, 13–15
alliance; Tasks; Therapeutic importance of, 35
relationship Conversation, 36

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Coping With Conflict (Mueller and Ellis, Michael, 5–6

Kell), 9–10 Elman, N., 66–67
Core competency domain, x Emotional bond, 25–26
Corrective relational experience, 90 Emotions. See Problematic emotions
Counseling Empathy, 26
models, 115 Ethical issues, 116
out process, 83 Evaluation
in process, 82–83 client, 7
psychotherapy distinguished focus on, 61, 63, 80–81
from, 36 task environment focus, 61, 63
special considerations, 82–84 using best practices, 116
Countertransference, 22, 28, 29t, Events. See also Resolution; Task
34, 112 analysis; Task analytic model
Covert processes, 116 contextual approach, 13–15
Crisis in confidence, 67–68 countertransference, 34
Critical events, 4 paradigm, 13–15
definition of, 17 sexual attraction, 31, 32f, 34
end of, 31–35, 32f as successful, 19
gender-related, 123 tasks within, 15–17
identifying, 21–22, 23f, 33–35 as unsuccessful, 19, 20–21
as prototypical, 23f Experience
Critical events in psychotherapy normalizing, 97–98, 106
supervision model task environment, 97–98, 106
in action, 112–114
contextual approach, 13–15 Facilitative conditions, 58–59
overview, 3–10, 11–36, 23f, 29t, 32f, Fair hearing, 83
111–124, 122f Feedback, 118
researching, 121, 123–124 Feelings
template, 122f exploration of, 42, 51, 64, 73–74,
training, 120–121, 122f 76–77, 78, 96–97, 124
Critical feedback, 118 task environment, 51, 73–74,
76–77, 78–79, 96–97
Developmental model, 118 Forrest, L., 66–67, 83–84
Discrimination Friedlander, Myrna, 5–6, 7–8, 85, 99,
gender, 25 114, 123
racial, 38
Dropouts, 16–17 Gender
Due process information, 83–84 critical events, 123
discrimination, 25
Effective supervision, 114–119 dynamics, 48
Effective supervisors, 6 as multicultural factor, 99
Ekstein, R., 86 Gestalt two-chair technique, 120–121

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Gizara, S., 66–67 Kell, B. L., 9–10

Goals, emotional bond limiting, 25 Knowledge
Group alliance, 55 assessing, 74–75
Group supervision definition of, 31
importance of, 117 task environment assessment,
role ambiguity in, 55–56 74–75
role conflict in, 55–56
special considerations, 55–56 Ladany, Nicholas, 85, 99, 114
Guidelines, x–xi Legal issues, 116
Guidelines for Clinical Supervision in
Health Service Psychology, xi
Mallinckrodt, B., 67
Marijuana, 112–114
Handbook of Psychotherapy Marker, 20, 34
Supervision (Watkins), ix
definition of, 27
Hogan, R. A., 67
identifying, 27–28
Holloway, Elizabeth, 9
multicultural awareness, 100,
102–103
Impairment, 66–67
parallel process, 88, 92–93
Impasses, 24, 26
problematic attitudes, 68–70
Incompetence, 66–67
problematic behavior, 68–70, 72
Incompetent supervisors, 6
process model, 68–70, 88
Ineffective supervision, 114–119
role ambiguity, 39–41, 40f
Informed consent
documents, 83–84 role conflict, 27, 44–49, 50
role conflict circumvented by, 35–36 skill deficit, 59–60, 61
Interactional sequences, 28–31, 29t, skill difficulty, 59
113, 120–121, 123 Matross, R. P., 7
Interpersonal difficulties, 68 Mirroring, 87, 90
Interpersonally sensitive style Mueller, W. J., 9–10
definition of, 8 Multicultural awareness
overview, 12–13 components, 99–100
sequences predicted by, 28–30, 29t example, 100–108
supervisees valuing, 14 factors, 99
Interpersonal relationship, 19 focus on, 103–104
Interpersonal skill, 58 gender as factor of, 99
Interpersonal style, 69–70, 88 as heightening, 99–100
Interpersonal supervision, 24–28. See marker, 100, 102–103
also Supervisory alliance overview, 99–100, 109
Interpersonal tensions, 10 as resolved, 100–108
Intrapsychic conflicts, 18 task environment, 100, 103–107
Multicultural competence, 99–100,
Journeys, 5–10 116–117, 118

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 index

Nelson, Lee, 8–10, 67, 85 Problematic emotions, 66–70, 71f

Neufeldt, Susan, 9 Problematic reactions, 18
Nondisclosure, 116 Process model
Normalization marker, 68–70, 88
of experience, 97–98, 106 parallel, 88–90, 91f
task environment, 97–98, 106 problematic attitudes, 68–70, 71f
Novice supervisees, 38 problematic behavior, 68–70, 71f
resolution, 70, 71f, 89–90, 91f
Observations, 69 skill deficits, 59–61, 62f
Operations, 20 skill difficulties, 59–61
Oversight, 12 task environment, 70, 71f, 89–90,
91f
Parallel processes, 7, 9, 27. See also Professional behavior, 36
Multicultural awareness Professional competencies, 13–14
attending to, 52–53, 79, 97, 113 Professionalism, 36
definition of, 85–87, 89 Psychotherapy
examples, 90, 91f, 92–99 conditions, 115
importance of, 117 counseling differentiated from, 36
marker, 88, 92–93 within events, 15–17
model, 88–90, 91f models, 115
overview, 85–90, 91f, 109 process, 15–17
research, 87 supervisee, 82
resolution, 89–90, 91f, 98–99 supervision as different from, 21,
as successful, 92–99 115, 116
task environment, 52–53, 79, tasks, 15–17, 18
89–90, 91f, 93–98
as unsuccessful, 92–99 Racial discrimination, 38
Peer supervision, 117 Rational-empirical model, 123–124
Pepinsky, Harold, 7 RBS. See Relational Behavior Scale
Performances, 20 Reflecting back, 120–121
Personality disorder, 69–70 Reflecting forward, 121
Personal journeys, 5–10 Reflection process, 86
Probation, 82 Relational Behavior Scale (RBS),
Problematic attitudes, 34, 66–70, 28–30, 29t, 123
71f Relational experience, 90
Problematic behaviors Relational positions, 87
addressing, 66–70, 71f Relationships, 55–56
example, 72–82 Repairing, 19
marker, 68–70, 72 Research
overview, 66–70, 71f critical events in psychotherapy
resolution, 72–82 supervision model, 121,
task environment, 73–80 123–124

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 index

parallel processes, 87 research, 8

role conflicts, 8 as resolved, 49–50
Resistance, 17 supervisory relationship
Resolutions influenced by, 14
of conflict, 9–10, 38–39, 49–50 as unresolved, 44–49
definition of, 20–21 Roles
multicultural awareness event, expectations, 35–36
100–108 induction, 115
overview, 20–21, 31–35, 32f overview, 37–56, 40f
parallel processes, 89–90, 91f, 98–99 Ruptures, 18, 19, 26, 35–36, 37
of problematic behavior, 72–82 definition of, 70
process model, 70, 71f, 89–90, 91f example, 36
of role ambiguity event, 39–44, 40f to group alliance, 55
of role conflict, 49–50
self-awareness as component of, Searles, H. F., 86
113–114 Self-awareness. See also Multicultural
sequences influencing, 70 awareness
skill deficit, 60, 61–66, 62f definition of, 31
skill difficulties, 60–61 example, 113–114
as successful, 33 as resolution component,
task environment, 54–55, 60–61 113–114
of tasks, 19 Self-discovery, 35–36
Responsiveness, 14 Self-presentation, 7
Role ambiguity Sequences. See also Interactional
definition of, 38 sequences
example, 39–44, 40f, 124 interpersonally sensitive style
in group supervision, 55–56 influencing, 28–30, 29t
marker, 39–41, 40f resolution influenced by, 70
as resolved, 39–44, 40f in task environment, 30–31
in supervision relationship, 37–56, Sexual attraction event, 31, 32f, 34
40f Shaffer, K. S., 114, 123
task environment, 41–43 Single-parent families, 19
Role Conflict and Role Ambiguity Skill acquisition, 58–59
Inventory, 38 Skill deficiency, 58
Role conflicts Skill deficits
definition of, 38 definition of, 58
examples, 44–55, 124 focus, 65
in group supervision, 55–56 marker, 59–60, 61
informed consent circumventing, overview, 84
35–36 process model, 59–61, 62f
marker, 27, 44–49, 50 resolution, 60, 61–66, 62f
overview, 37–39 task environment, 60, 61, 63–65

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 index

Skill difficulties overview, ix–xiv

definition of, 58 peer, 117
marker, 59 personal/emotional aspect of, 35–36
overview, 84 psychotherapy as different from,
process model, 59–61 115, 116
resolutions, 60–61 special considerations, 55–56
Skills, 57 of supervision, 117–118
definition of, 31, 58–59 as tasks, 15–17
focus on, 65, 73, 76, 79–80, 105 therapy distinguished from, 21
overview, 58–59, 84 Supervision relationship. See also
task environment, 73, 76, 79–80, Ambiguity
105 in background, 12–13
Social learning process, 9 conflict in, 37–56, 40f
Strategies. See Task environment focus, 12–13
Strong, S. R., 7 in foreground, 12–13
Students, 7 role ambiguity in, 37–56, 40f
Successful events, 19 therapeutic work and, 12–13
Supervisees. See also Choice points; Supervisors, 13. See also Choice points;
Role ambiguity; Supervisory Multicultural awareness; Role
alliance; Tasks ambiguity; Training
definition of, 36 abusive, 6
factors, 119 effective, 6
interpersonally sensitive supervisors example, 11–12, 16–17, 20, 21
valued by, 14 factors, 115–118
novice, 38 incompetent, 6
outcomes, 116 interpersonally sensitive, 14
problematic attitude of, 34 watching, 6
psychotherapy, 82 Supervisory alliance. See also Group
relational positions influencing, 87 alliance; Ruptures
therapeutic relationship helping, 13 components, 24
Supervision. See also Group supervision definition of, 24, 31
as catch-22, 7 focus on, 42–43, 50–52, 63–65, 70,
conditions, 115 77–78, 93–94, 105, 107, 124
conversation, 36 importance of, 24–25
as core competency domain, x overview, 24–28
definition of, ix–x role expectations influencing, 35–36
as effective, 114–119 task environment, 50–52, 63–64,
within events, 15–17 77–78, 93–94, 105, 107
factors, 115–118 Supervisory process, 15
importance of, xi–xii Supervisory relationship
as ineffective, 114–119 beginning of, 17
models, 115 event, 17

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 index

power of, 115 role ambiguity, 41–43

role conflict as detrimental to, 14 sequences in, 30–31
task, 17 skill deficit, 60, 61, 63–65
Supervisory style, 8 skill focus, 73, 76, 79–80, 105
Supervisory Styles Inventory, 8 supervisory alliance focus,
Supervisory working alliance. See 50–52, 63–64, 77–78,
Supervisory alliance 93–94, 105, 107
Sup of sup, 108–109 therapeutic process, 75, 79–80,
Sustaining engagement, 19 94–95, 98, 105
Symptoms, 18 Task oriented style, 8
Tasks, 34–35
Task analysis as common, 17, 18
definition of, 18 emotional bond limiting, 25
models influenced by, 121, within events, 15–17
123–124 identifying, 21–22, 23f
Task analytic model psychotherapy as, 15–17
assumptions, 21–22 of repairing, 19
components, 20–21 as resolved, 19
origins of, 17–21 supervision as, 15–17
overview, 17–21 supervisory relationship, 17
validity of, 19 therapy addressing, 18
Task-analytic paradigm, 4 as unresolved, 33
Task environment as unsuccessful, 33
definition of, 28 Technical skills
evaluation focus, 61, 63 deficit, 61–66, 62f
experience, 97–98, 106 definition of, 58
feelings exploration, 51, 73–74, example, 61–66, 62f
76–77, 78–79, 96–97 Therapeutic alliance, 19. See also
knowledge assessment, 74–75 Group alliance
multicultural awareness, 100, Therapeutic process
103–107 focus on, 75, 79–80, 89, 94–95,
normalization, 97–98, 106 98, 105
operations, 20 task environment, 75, 79–80,
overview, 28–31, 29t 94–95, 98, 105
parallel process, 52–53, 79, Therapeutic relationship
89–90, 91f, 93–98 rupture in, 18, 19
performances, 20 supervisees helped by, 13
problematic behavior, 73–80 Therapeutic work, supervision
process, 30–31 relationship and, 12–13
process model, 70, 71f, 89–90, Therapist, 15–17. See also Therapeutic
91f relationship
resolution, 54–55, 60–61 Therapy. See Psychotherapy

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 index

Trainees, 7, 36 Unfinished business, 18

Training Unsuccessful events, 19, 20–21
critical event model, 120–121, 122f
informed consent, 83 Vacha-Haase, T., 66–67
obstacles, 83
obtaining of, 117–118 Wallerstein, R. S., 86
overview, 120–121 Watching, of supervisors, 6
probation, 82 Watkins, Edward, ix
reflecting back influencing, 120–121 Working alliance. See Supervisory
reflecting forward influencing, 121 alliance
template, 122f Working through, 31
Two-parent families, 19 Worst case scenario, 114

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 About the Authors

Nicholas Ladany, PhD, is the dean of the School of Leadership and Educa-
tion Sciences at the University of San Diego. He previously served as dean
of the School of Education and Counseling Psychology at Santa Clara
University in Santa Clara, California; director of the Counseling Program
at Loyola Marymount University in Los Angeles, California; chair of the
Department of Education and Human Services and program coordinator
and director of doctoral training of the Counseling Psychology Program
at Lehigh University in Bethlehem, Pennsylvania; and has served as a faculty
member at Temple University and the University of Maryland, College Park.
He received his doctorate from the University at Albany, State University of
New York, in 1992. Dr. Ladany has more than 80 publications and has con-
ducted more than 240 national and international presentations in more
than 20 countries in the area of counseling and psychotherapy supervision
and training. In particular, his primary research interest and activity include
such issues as the working alliance, self-disclosures and nondisclosures,
multicultural training, ethics, and social justice. He has served as an associ-
ate editor of Psychotherapy: Theory, Research, Practice, and Training and as a
member of the editorial boards of the Journal of Counseling Psychology, The
Counseling Psychologist, and Counselor Education and Supervision. He has
published five books, including Practicing Counseling and Psychotherapy:
Insights From Trainees, Clients, and Supervisors; Critical Events in Psycho-
therapy Supervision: An Interpersonal Approach; and Counselor Supervision
(4th ed.).

145
 ABOUT THE AUTHORS

Myrna L. Friedlander, PhD, is a professor in the Counseling Psychology

PhD program at the University at Albany, State University of New York,
where she served as training director from 1999 to 2016. She has super-
vised master’s and doctoral students for more than 35 years and published
more than 140 book chapters and journal articles, including several self-
report instruments and observational coding systems, primarily related to
the processes of psychotherapy and supervision. In 2006 she coauthored
Therapeutic Alliances With Couples and Families: An Empirically Informed
Guide to Practice. A fellow of the American Psychological Association,
Dr. Friedlander has served on the editorial boards of six journals and
received awards for her lifetime contribution to research by the University
at Albany, the Society for Counseling Psychology (American Psychological
Association), and the American Family Therapy Association. A licensed
psychologist in New York State, she has been in independent practice for
more than 30 years.

Mary Lee Nelson, PhD, is retired and serving as an adjunct professor at the
University of Missouri–St. Louis, where she teaches supervision theory,
research, and practice. She previously was visiting professor of counsel-
ing and family therapy at the University of Missouri–St. Louis; profes-
sor and department chair of counseling psychology at the University of
Wisconsin–Madison; and associate professor of counseling in educational
psychology at the University of Washington. Dr. Nelson also served as staff
psychologist in student counseling services at the University of Oregon,
University of Washington, and University of Missouri–St. Louis and main-
tained a private practice in Seattle, Washington. She currently is a licensed
psychologist in the state of Missouri. Dr. Nelson conducted research and
published articles on interpersonal process in supervision for more than
20 years. She has served on the editorial boards of The Counseling Psy-
chologist, Psychotherapy Research, The Clinical Supervisor, and the Journal
of Counseling and Development.

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