Developing a Systemic Supervision Lens

Developing a systemic supervision lens 

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The seven eyed model, developed by Hawkins & Shohet (1985) integrates relational and systemic aspects of supervision inviting a focus on the relationships between client, therapist and supervisor. The model is called “Seven Eyed” because there are 7 distinct foci to be examined when reflecting on the therapeutic/workplace process.  The Systemic Supervision Lens (SSL) developed by Clinical Supervision Services, has been informed by the 7 eyed model. I begin here by giving an overview of the 7 eyed model and then provide an easy way to consider these eyes using the SSL approach within supervision.


Here is a quick descriptive guide to the different eyes:

 

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1.     Client focus – Attune to the client. What is their experience of the therapeutic process?
 
2.     Strategies – What strategies/intervention is being used by the supervisee (clinician) – why has s/he chosen that particular way of working with this client? 
 
3.     Relationship – Client-therapist relationship.  What influences the ‘here-and-now’ relationship between therapist and client? What is the flavour of the therapeutic relationship and how might this be a vehicle for change in therapy? 
 
4.     Supervisee’s response eye – The supervisee’s emotional response to the work (impact of countertransference).  What is the supervisee feeling towards the client? Consider what these feelings generate and the impact on therapeutic work.
 
5.     Parallel process eye  – How is the clinical relationship reflected in the supervisory relationship? Is the way the supervisee presents to supervision a ‘mirror’ to the way the client presents in therapy?
 
6.     Supervisor’s response eye –  What is the supervisor’s response to the material presented in supervision – both content and process  (how the supervisee presents the material)?  (By reflecting on S/or self-processes it can help the supervisor gain insight into parallel process and consider the client “relationship-by-proxy”). 
 
7.     Wider system – Consider wider system: Culture, location, history, influencing factors.


The Systemic Supervision Lens and its applicability in supervision practice 


How to use this 
You can apply this framework to any format of supervision where the supervisee provides a description of the presenting issue – either within a clinical or organisational context. When referring to “client” in this context, it can be the client seeking change regarding a mental health concern, or a workplace requesting an organisational intervention. 

Step 1: Ask the supervisee to provide some background information to the issue being presented:

What do you need help with?

What is your question for supervision?

Step 2: Get as much background information needed to provide a context to the presenting issue.

(Maione, P. 2011. Help me Help You: suggested guidelines for Case Presentation. Contemporary Family Therapy, 33, 17 – 24)


The process of supervision exploration………..

1.    Client lens

Take a relational position and invite the supervisee to consider the experience of the client coming to therapy. What brings the client to the service? 

What does the supervisee imagine the client is experiencing/thinking/feeling and wanting from treatment?

What action/behaviour is needed to help the client? What helps and/or hinders the client to behaviourally make change?

 

2.    Supervisee lens

Listening to the account of the session, consider the relational focus between client and supervisee/therapist/practitioner.

Cognitive Response:

o   How is the supervisee presenting the case? 
o   What theory/ies influence supervisee thinking? How might this thinking impact formulation and treatment?
o   Should a diagnostic formulation be considered? What questions can I ask the supervisee to help him/her determine their formulation?

Affective Response: 

What emotions am I noticing as the supervisee describes the presentation? Notice body language (a change in speech; a sigh; tightened posture) – all changes to the way the supervisee presents the case/issue is possibly telling you something about their emotional reactions to the case/issue.  This might suggest transference and countertransference providing additional information.  Often noticing and reflecting on reactions helps unpack implicit relational dynamics that could either help or hinder change.

Questions/reflections like: “I noticed when you started to describe treatment your body appeared to tighten….. or I noticed when listening to the recording of the session (or viewing this interaction), the tone and pitch of your voice changed? I’m interested what was happening for you at that time in the session? What might that tell you about ……..”

 

Behavioural Response:

Consider what the supervisee needs/wants to do in order to proceed in therapy/practice?

What intervention strategies can be applied? Model of therapy/change?

How will these strategies be introduced and evaluated? 



3.    
Supervisor lens

Just like the supervisee, the supervisor will be impacted by the story presented in supervision. The supervisor firstly needs to  ‘think like a supervisor’ considering the developmental level of the supervisee and what she/he can feasibly do in treatment. The supervisor needs to hold in mind both models of supervision (e.g. social role model; developmental model) in addition to considering therapeutic modality for intervention (e.g. CBT; Systemic; Coaching/Positive Psychology etc).



Cognitive Response:

Consider hypotheses guiding formulation about this presentation:

What ‘themes’ am I noticing in this presentation? 

What questions can I ask in supervision to help the supervisee further explore and better understand the client/issue?

Are there common themes that present in supervision? What might this be telling me? 

What model/s of therapy am I using to help understand:-

o   The question for supervision

o   Systemic issues

o   Interventions 

 

Affective Response:

What am I noticing about my reaction to the material being presented?

What might this be telling me? How do I share my thoughts/feelings and how might sharing these facilitate the supervisee’s therapeutic work?

Am I noticing a parallel process in the way the supervisee describes the clinical session and the way the supervisee presents in session? What does this tell me?

How do I share my reflections in a way that will help the supervisee in their work (and perhaps also, help manage therapeutic boundaries)? 


Behavioural Response:

Supervision needs to be transformational - meaning that the supervisee needs to leave the session with ‘news of difference’ (either better understanding clinical formulation and/or devising a clear intervention.  Questions to ask as supervisor include:

What do I need to do/communicate in order to help my supervisee? 

Do I need further information? If so, what kind of information (e.g. diagnostic; treatment strategies; knowledge about the wider system/organisational information etc.)?

Do I need to help the supervisee? If so, how, what and why? 

The above reflections should take place as an exploratory and reflective discussion to facilitate supervisee self-reflection within supervision. 


Using a genogram https://www.therapistaid.com/therapy-guide/genograms and ecogram https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532287/ will further ‘thicken the therapeutic and supervisory story’ and add further valuable information to better understand the client’s ‘back-story and narrative’

By knowing this narrative, the supervisee will be better placed to action an intervention that is meaningful to the client based on a clear assessment, formulation and intervention. 

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And lastly, for those that have trained with Clinical Supervision Services this year we hope that you have found our courses enjoyable and useful to your practice.  For those that visit the website we hope to have the pleasure of your attending one of our courses in 2021 – either virtually, via e-learning or face to face when we resume training in the classroom again!  Take care, rest, be mindful, breath and stretch …. enjoy the holiday period and stay safe…. 

Best wishes, 

Christine

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Christine Senediak

Director, Clinical Supervision Services and Sydney Family Therapy Training Institute

December 2020


Christine can be contacted through her website at: 

www.clinicalsupervisionservices.com.au


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