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Resident perception of psychotherapy supervision

1976; Elsevier BV; Volume: 17; Issue: 1 Linguagem: Inglês

10.1016/0010-440x(76)90068-7

1532-8384

Melvin S. Gale,

Innovations in Medical Education

MAJOR ASPECTS of the psychiatry resident’s supervision are first, 1 the rapport between supervisor and student, and second, the actual material taught. The question of the relative importance of these two components has been discussed for many years in the literature. Bibring,’ in 1937, summarized two views on the matter: (1) that supervision of control analyses should be didactic instruction in technique only, assuming therefore that the rapport between the candidate and supervisor was of secondary importance, and (2) that the supervisor should focus his attention on helping the candidate with his work difficulties, assuming that candidate-supervisor openness and rapport were of primary importance. More recent writings on supervision all tend toward the latter emphasis on the student-supervisor relationship. Some authors feel that one important aspect of supervision is confronting the student with his blind spots,2 his work problems.“.4 and his defenses against learning. 5 For such confrontation, which partially resembles psychotherapy, to be an effective tool, a trusting rapport is required. Other authors carry this therapeutic model further, claiming that the supervisor should not only make the student aware of his difficulties, but should also use the supervisory time for obtaining insight into conflicts6 and attempting to resolve them.7 This latter group elevates the therapeutic aspects of supervision to a very high level of importance. A somewhat mediating view is held by those writers who feel that the focus of the supervision should vary, at times being relatively straight-forward and didactic, and at times dealing with the student’s anxieties, the focus to vary according to the student’s anxiety levelR*g or stage of learning.6 Some see dealing with personal anxieties and the increased self-knowledge arising therefrom as a precursor to learning,R*‘o while others view such self-knowledge as a higher form of learning with which to better understand one’s contribution to the doctorpatient relationship.6*g A different facet of the supervisor-student rapport question is raised by those who feel that identification with the supervisor is a major factor in the learning that takes place.4v6 Grotjahn” believes that identification is the sole basis for learning. Fleming6 sees identification rather as the important first step in learning. The role of the student-supervisor relationship in such identification is obvious. Thus, despite a wide range of views as to the scope of supervision, most opinion supports the view that a good supervisor-student relationship is essential for the