Neurodiverse Supervision
I provide supervision for neurodiverse practitioners or practitioners who work with neurodiverse clients.
Neurodivergent practitioners
Working as a neurodivergent practitioner requires a high level of understanding of their neurodiverse symptoms. While I provide the standard aspects of supervision in addition I support the practitioner
- In understanding themselves, their neurodivesity
- Learning to manage their neurodiversity in and outside of the session
- Managing a practice
- With their learning – essay writing, preparation for exams
Neurodivergent clients
In addition to that, I specialise working with neurodivergence. I support the supervisee with how to work with neurodivergent clients.
- How to develop a treatment plan which includes the neurodivergent aspect?
- How to recognise the neurodivergent symptoms?
- How to interpret their behaviour?
- How recognise their sensory overload?
- How to raise awareness of their neurodiversity?
- How to manage their neurodiversity?
My philosophy as a supervisor
The supervisory relationship in my view is a supportive one, it is a place to be in a relationship and to be stretched. Provide the balance of support with a developmental edge. If there is not a holding place, a built relationship, the supervisee would not be able to share honestly. ‘Seeking to create a relationship which will foster the supervisee’s professional growth, I need to be the kind of person with whom she can feel safe enough to express even her deepest fears and doubts.’ (Mearns 1990) The balance of support and challenge described by Mearns (1990) is one of the main pillars of my philosophy as a supervisor.
Kadushin’s theory of the three functions of supervision (Educative, Supportive, and Managerial) provides an excellent guideline to hold this balance. Figure 1. The way I use this – I think of them in balance as a set of scales, on one hand, is support and on the other hand is a challenge which includes a managerial function as well. Figure 2.
On one hand a supervisor’s holding is important. To establish a trusting understanding relationship to enable the supervisee to share her internal experience. To create a place where the supervisee can share her issues and dilemmas and experience togetherness. Enable the supervisee to think out loud and help to find her thoughts and own answers. To normalize, the supervisee’s experience, by sharing my own or sharing other supervisee’s experience while holding the confidential boundaries that other people experienced something similar in a given situation.
On the other hand development is necessary.
While I see the supervisory relationship kind and supportive, it is also important to offer developmental challenge and knowledge, teach pieces of theory or an ethical frame in certain cases.
When the relationship starts at the supportive level it builds the foundation to move on to the developmental and challenging edge. When I discover ethical gaps or issues in managing the practice then I need to move to a managerial/normative role (Kadushin 1976) to ensure the supervisee’s work is appropriate and falls within defined ethical standards.
Treat and teach edge
With a level of holding the supervisee can be challenged at the right level. As a supervisor ‘I might act as a facilitator who helps to identify the supervisee’s professional difficulties, proactive countertransference and transferential issues’ however I often find myself exploring the supervisee’s issues and discussing the implications of difficulties the supervisee experience in her practise and support her in considering options for working these through.’ (Chinnock 2011).
While the relationship and emotional connection provides the foundation in the supervisory relationship, I believe challenge and developmental information also pays an important part. Providing knowledge and theory helps the supervisee to make sense of her changes and growth as a practitioner with different therapeutic issues.
What kind of developmental edge do I provide as a supervisor?
It depends on the supervisee’s needs. I seek clarity of the level of the supervisee as a practitioner, of her knowledge gaps and existing skills. To assess the supervisee’s development level is important for me as it determines the work.
Professional Development
I use Erskine’s theory of Models for Professional Development as a compass to navigate a level of support and balance required in general. I choose the appropriate supervisory style according to the supervisee’s developmental stage. I alter the proportion of support and challenge, also different types of support and challenge are required in different developmental stages. Occasionally the supervisee might request more support or more challenges which differ from normal, or developmentally reach a different stage which is important to recognize, and I alter my approach in the work.
Early stage
The early stage involves refining observational skills and correlating these observations. Gaining techniques, knowledge, information and perspective from the supervisor’s years of experience. The supervisee requires support and the emphasis is on confidence building and skills development. At this stage, the supervisor might need to teach concepts that have already been taught in order to facilitate the supervisee’s recognizing he’s on her application to a particular client.
Intermediate stage
The intermediate stage involves treatment planning and skill refinement. The key priorities are to develop a level of self-reflection and understand the supervisee’s thinking process. In this stage focusing on contracting enables the supervisee to impact her own development and to start to deal with countertransference issues.
Advanced stage
In the Advanced stage, the supervisee develops multiple theoretical frames of reference and selects different treatment plans. This is the point where the supervisee is seen to have a good amount of clinical experience and can apply theory in terms of diagnosis and treatment direction. (Erskine 1982) I don’t always feel that I have a choice about which style to use with a supervisee. Rather, the style feels called forth by the situation. Chinnock (2011)
One of the important aspects of developmental direction is to support the supervisee to develop an identity and independent thinking. A level of confidence where she doesn’t get worried or feel guilty. When she brings her countertransference to supervision and is able to explore her intrapsychic reactions and processes and through this learn to use these understandings to treat the client. I am paying attention to the supervisee’s confidence level and choosing the type of support or challenge according to that. I tend to hold back from offering solutions unless it is useful in some cases. I rather enable the supervisee to understand more and work out what is happening with the client, to bring out her own understanding. I support the supervisee in developing a self-belief where she can rely on her own resources and has confidence in her own abilities. At other times I need to know things or provide more direction and introduce an accurate theory. It is important to know when to step up and offer the supervisee knowledge, to be potent and in some cases exercise authority. I am describing a sensitive and attuned supervisor who has an interest in the developmental stage of the supervisee. It is important to allow the supervisee to find her own mind and her own thinking and identity.
In action and On action
Another developmental edge which I like to focus on is to develop a reflective practice which is the cornerstone and requirement for most professional practice and training. Schon (1983) distinguishes between reflection on action and reflection in action. Professionals need however to be able to make moment by moment decisions during their practice. ‘This capacity to step back and take a meta perspective or helicopter view during practice to think on one’s feet in order to make moment to moment decisions that inform practice in the process, that showed the first as reflection in action. Practitioners need more than theoretical or technical competence to be effective practitioners they need to engage in professional artistry.’ Beinart and Clohessy (2017) The supervisee might not be aware of the level of her own skills to apply reflection in action rather than after action. This is one of the main points of the developmental edge applied differently in different developmental stages.
Taking a meta-perspective
One of the pillars of my philosophy is to expand my view, which means to develop a ‘helicopter view’ a meta-perspective. ‘The ability to switch perspectives to be able to focus on the client that the supervisees are describing; to focus on the supervises and their process; to be able to focus on my own process and the here and now relationship with the supervises; to be able to see the client within their wider context and help the supervises do likewise.’ Hawkins and Shoet (1992)
Ethical practice
Practising ethically and applying the ethical principles all through the practise is the last point of my philosophy. The ethical principles are providing guidance of appropriate behaviour and protecting the supervisor, the supervisee and client during practise. I use a Thomson’s ethical principles in my supervisory practice.
Beneficence: a commitment to promote the supervisee’s and client’s well-being.
Which means to act in the best interests of the supervisee based on professional assessment.
Autonomy: respect for the supervisee’s right to be self-governing
This principle emphasises the importance of developing a supervisee’s ability to be self-directing within therapy and all aspects of life. Respect the client’s autonomy. The principle of autonomy opposes the manipulation of clients against their will, even for beneficial social ends.
Fidelity: Being faithful to promises made and to ‘right’/ proper practices. Attention to this principle helps supervisors to think carefully about what they can reasonably promise to supervisees during the contracting process with care taken not to go beyond what is possible. Eg. confidentiality
Justice: Ensuring that people are treated fairly. ‘fair-opportunity rule’ requires that the supervisee be provided with sufficient assistance to overcome any disadvantaging conditions resulting from her or his learning abilities or difficulties, or social context. Eg. providing more supervision to a struggling supervisee versus equity to all; no discrimination.
Non-maleficence: Striving to prevent harm. The needs of one person or group may be privileged over another, eg children and families. The supervisee has an ethical responsibility to strive to mitigate any harm caused to a client even when the harm is unavoidable or unintended.
Being trustworthy: is regarded as fundamental to understanding and resolving ethical issues.
Self-respect: fostering the practitioner’s self-knowledge, integrity and care for self. The principle of self-respect means that the supervisee appropriately applies all the above principles as entitlements for self.