[CantExplain]

Hi everyone!

Many (most? all?) therapists have a supervisor: an experienced therapist they can ask for advice. Sometimes this is, or has been, T's T.

So what do people know about this process? Does T ever say, "My supervisor says...", or "That's a tricky one. I'll have to check with my supervisor"?

My Ts never mentioned supervision in any way, and I haven't seen much mention of it here. But Zooropa says it does happen.

What's your experience?

[Yoda]

I have known my T for a long time and for awhile she was supervised by a physician but she left that position and now works unsupervised. Since she is unsupervised she cannot bill medicare so I have to pay cash but there really is no difference in how she treats me in therapy either way. (My T has a master's degree)

[Wysteria]

Hey Can't Explain,
My T is actually a T's T...he helps supervise other T's...I asked him once if had a T and he said not right now and that he had other sources for relieving anxiety and re-centering etc. I do know that he does talk to other T's and when he needs advice he is open to asking for it, and does consult with my pdoc specifically on my care...

Don't know if that helps or not...

Hugs,
WB

[Rapunzel]

Supervision is required for therapists in internship status, which includes student therapists and post-graduate therapists who are not yet independently licensed. Many states require two years of post-graduate experience before independent licensure. If your therapist is under supervision, he or she should have explained that to you as part of the disclosure when you started working together. Also, fully licensed therapists may be working for someone or as part of a treatment team, and should also disclose that information.

The supervisor can't provide supervision and therapy to the same person at the same time. That would be a huge boundaries problem, and unethical, although the supervisor would also be a licensed therapist or other licensed mental health professional.

I haven't gone to a therapist who was currently under supervision, but have had therapists talk about past supervisors. Looking back, I used to refer to my supervisor much more frequently when I was a student than I have lately. I'm not sure if that is because I'm more independent now, or if it is because since graduation I have worked in residential or inpatient settings where it is more of a treatment team approach. I still make sure that my individual clients understand that I have a supervisor. I wouldn't tell my clients about my own therapy or refer to my therapist, though. Although, in this less than ideal world, I haven't had supervisors who take supervision very seriously since graduation. I can't go to my therapist and talk specifically about my clients, but I do talk to my therapist about professional issues. I've felt like my own therapist was a lot more help professionally than my supervisor. But the purpose of the relationship is completely different.

Working under supervision does have the advantage of making insurance or medicare/medicaid coverage easier, since an intern works under the supervisor's license. There was one job I interviewed for where they wanted interns for that reason, and told me that once I was licensed I wouldn't be able to see certain clients because I wouldn't be on those insurance panels, and probably wouldn't be able to get on them because certain insurance panels are closed and not adding therapists. So that is a real issue.

I'm not sure how helpful this is. Did I answer any of your questions? It can be confusing when I try to answer posts from the perspective of a client and from the perspective of a therapist at the same time, yet I am both, and see it both ways.

My T is in private practice in the UK, and is a member of the BACP and NCP, which apparently require monthly professional supervision to ensure ethical requirements are met, etc. It's not something we've ever talked about, as of yet, and she's never referred to a 'supervisor' or someone she would consult... Her insights in session are usually so dead-on I can't imagine her doing much but checking in, I don't feel like she's ever feeding someone else's opinion back at me. And, I have no idea if she has or has had therapy herself - though I think a lot of therapists do get therapy along the way to compliment their training?

[homealone]

#4;
Rapunzel, " The supervisor can't provide supervision and therapy to the same person at the same time. That would be a huge boundaries problem, and unethical, although the supervisor would also be a licensed therapist or other licensed mental health professional. "

I had a PhD practitioner take off one week with me, so she could go out of town to see her therapist for consultation I was told. I always assumed she was engaged in a very infrequent psychotherapy with a higher trained peer to remain grounded and opine professionally with as part of her treatment with me. If I recall, I signed a release so she could discuss my case, but I am not completely certain anymore.

Irregardless of the ethical dynamics of that networked therapeutic relationship, I always found great safety in that arrangement, and never thought it difficult to allow her time off from our routine for her treatment (?).
For all I actually knew, she could have been off fishing, but it seemed there was more therapeutic focus once she returned rather than relaxed from vacation perhaps.

I strongly believe in practitioner peer oversight with case review, and have no problem with disclosure to any other practitioners. (who understands hippa)
Tom S. in Tn.

[Kacey2]

In my DBT program they have consultation (which is made up of 3 t's and a pdoc-all DBT certified) that meets every week for 90 minutes. It is a treatment team approach. Yah it completely sucks because it doesn't feel like you can trust your t with confidential material. There is always that thought in the back of my mind that he will disclose it to them. And I have absolutely no control over that. I wasn't aware of the consultation when I started DBT and by the time I found out it was too late......I was already attached to my t and couldn't leave. To their credit I wasn't in any condition to even think about that. If I was aware of all that is entailed in DBT I would not have agreed to the program.

[BlessedRhiannon]

My T is in private practice and has been for over 10 years. She does not have a supervisor per se, but does have a group of other therapists that she meets with weekly.

[SoupDragon]

My understanding is that it is essential for T's to have supervision in order to ensure appropriate boundaries are maintained - it must be hard working with someone long term and making sure the relationship remains purely therapeutic and does not cross into friendship.

My T has once mentioned supervision - that is when I expressed concern about T's welfare when I was sharing something and T siad not to worry about them as they had regular supervision.

[purple_fins]

"What do you know about Ts supervision? "

I know absolutely nothing about this... and I've been seeing her for almost 4 years. I never ask her questions-- don't feel it's appropriate.... even so, I am curious about that and many other things too.

I am ever amazed, that many here know so much about the T's they see-- how is that so? Is it appropriate? how does knowing such details contribute to ones path towards inner-peace? does it help in the trust aspect?... I wonder..... I wonder...

fins

[BlessedRhiannon]

Originally Posted by purple_fins

"What do you know about Ts supervision? "

I know absolutely nothing about this... and I've been seeing her for almost 4 years. I never ask her questions-- don't feel it's appropriate.... even so, I am curious about that and many other things too.

I am ever amazed, that many here know so much about the T's they see-- how is that so? Is it appropriate? how does knowing such details contribute to ones path towards inner-peace? does it help in the trust aspect?... I wonder..... I wonder...

fins

I only know that my T meets with other T's because it was part of the disclosure package I received when I first started seeing her. Since she may discuss her clients with these other T's, I had to sign a waiver for that. Plus, trust is a big issue for me, so it's important for me to know, in general, who she might be discussing my case with. I don't need names, "other T's" is enough.

As far as knowing a lot about my T, I don't know all that much, really. Just basics...not much more than is posted on her website bio. I think it is helpful, for me at least, to know some personal stuff about my T, so that I can relate to her as a person.

[CantExplain]

Originally Posted by SoupDragon

My understanding is that it is essential for T's to have supervision in order to ensure appropriate boundaries are maintained - it must be hard working with someone long term and making sure the relationship remains purely therapeutic and does not cross into friendship.

Now that I've had some time to think about it, I remember my current T did refer to supervision on one occasion. She said:

"When I was in training, my supervisor said to me: It's your job to sit on the edge of the hole and offer help, not to get into the hole with them."

So she needed advice about boundaries.

[eclogite]

Originally Posted by BlessedRhiannon

My T is in private practice and has been for over 10 years. She does not have a supervisor per se, but does have a group of other therapists that she meets with weekly.

I think this is the set up with mine as well. Once I had an appointment following their meeting.

[skysblue]

I know 2 T's personally plus my own T. I believe that after they're licensed, they no longer need supervision. They may consult on a case but it's not required. And all 3 of these T's accept insurance including Medicare.

My T has had me sign a release when I was going to see the substitute T. So, I know she's not talking about me with anyone. And even then she reviewed with me what she would share.

But before they're fully licensed, I think they have to have 100's of hours of supervision.