A meta-ethnography of contributory factors to self-disclosure in clinical supervision, and a grounded theory study exploring the processes of supervising trainee clinical psychologists with lived experience of mental health difficulties

Apostol, Alina 2024. A meta-ethnography of contributory factors to self-disclosure in clinical supervision, and a grounded theory study exploring the processes of supervising trainee clinical psychologists with lived experience of mental health difficulties. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Research on clinical supervision has grown considerably, particularly in recognising the critical role of disclosure between supervisees and supervisors. Recent years have witnessed a surge of interest in understanding how supervisees sharing their lived experiences impacts the supervisory relationship. Research shows that the relationship between supervisee and supervisor can influence the effectiveness of supervision, as well as the wellbeing of the supervisee and the quality of clinical practice. Research has increasingly focused on understanding the complex interplay between supervisee disclosure and the lived experiences of both practitioners and service users. On one hand, there is a growing acknowledgment of the prevalence of mental health difficulties among practitioners, including clinical psychologists and trainees, emphasising the importance of addressing stigma and creating supervisory environments that encourage disclosure. On the other hand, supervisors are torn between the responsibility of creating safe spaces for supervisee disclosure, while also assessing supervisee professional development and competencies, all while managing their own reactions. Within the context of a clinical psychology training programme, the supervisory relationship plays a crucial role in the dynamics of clinical training and lived experience within clinical supervision. The absence of clear supervisory guidance on managing lived experience within mental health professions emphasises the need for structured support frameworks and a deeper understanding of supervisory processes. Amidst these complexities, two studies presented in this paper aim to shed light on the many layers of disclosure and lived experience within the context of clinical supervision. The insights provided offer valuable guidance for both researchers and practitioners working in the field of clinical supervision. Specifically, each study offers valuable insights for supervisors and supervisees to nurture the supervisory experience of the next generation of mental health practitioners and shape a more inclusive environment for all. The first paper presents a qualitative meta-synthesis, exploring the contributing factors influencing supervisee disclosure during clinical supervision. Through a rigorous synthesis of existing literature using the principles of meta-ethnography, the study discovers the nuanced interplay between the supervisor factors, supervisee factors, and contextual factors. Exploring the complexities of supervisee disclosure from the supervisee perspective, the review sheds light on the critical role supervisors play in creating a safe and supportive environment conducive for open communication and self-reflection. The importance of clear communication, trust-building, and supervisor’s approach in responding to the supervisee disclosure is also emphasised. Conversely, the second paper explores the supervisory process from the perspective of supervisors, particularly focusing on the process of supervising trainees with lived experience of mental health difficulties (i.e., lived-experience). Through a qualitative analysis based on the constructivist grounded theory method, the study reveals the internal processes that supervisors navigate while supervising trainees with lived-experience. Similar to the first study, the second study highlights the importance of establishing a supportive supervisory relationship and environment within clinical supervision. Also, this study found that supervisors of trainees with lived-experience tend to adopt a therapeutic approach, acknowledging and addressing the unique needs and challenges faced by these trainees. Essentially, it was found that by creating a supportive supervisory relationship and environment, supervisors facilitate trainee disclosure and foster professional development and wellbeing, enriching the quality of clinical supervision. The findings further stress the importance of prioritising the wellbeing of supervisees while embracing the diversity of their experiences. Moreover, the study highlights the need for ongoing evaluation and reflection within supervision training programs, ensuring that supervisors are equipped with the knowledge and skills necessary to support trainees with lived-experience effectively. Beyond their individual contributions, these studies collectively advocate for a shift in clinical supervision practices, one that exceeds traditional models of hierarchical authority and embraces a more egalitarian and therapeutic approach. Recommendations for clinical practice are discussed, focusing on the needs and experiences of supervisees, including those with lived-experience. Both papers highlight the importance of supervisors cultivating environments that promote authenticity, trust, and resilience, ultimately promoting self-disclosures and enhancing the quality of clinical supervision and support provision. The frameworks developed seek to guide supervisors in facilitating disclosures during supervision sessions, enhancing supervisory competencies and enriching the training experience of future clinical psychologists. Further, study findings advocate that the supervisor training curricula should incorporate topics such as therapeutic supervision, to better prepare supervisors for the complexities of clinical supervision, particularly around supervising and supporting those with lived-experience. Furthermore, the discussions highlight the importance of both supervisors and training programmes considering the impact of allocated placements and client work on trainees with lived-experience. Supervisors should be mindful of potential triggers and stressors that may arise during placements, striving to create environments that are conducive to trainees' wellbeing and professional development. Equally, training programmes should carefully consider lived-experience when matching trainees with placements that align with their interests and strengths, as well as providing additional support and resources where needed.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	20 August 2024
Last Modified:	20 Aug 2024 13:47
URI:	https://orca.cardiff.ac.uk/id/eprint/171499

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