Supervision vs. therapy

Supervision vs. therapy, superficially supervision and therapy may appear to be the same thing, and it is very easy for the two to become confused in the mind of the supervisor. The simple answer to this is the old refrain ‘maintain boundaries’ but maintaining boundaries is difficult without clarity of what those boundaries are. In this blog we will examine the key similarities and difference to help establish and maintain appropriate boundaries.

Supervision vs. therapy – Similarities

1)    Collaboration – both therapy and supervision are essentially collaborative processes.  They are both focused upon a goal, what this goal is may vary considerable, but in both situations, it is wise to have such a goal and have it explicit so that both parties can work towards it.

2)    Intimacy, rapport and non-judgemental attitude – there are certain attitudinal commonalities between the therapy approach and the supervision approach. Both practices require a degree of intimacy and rapport in the exchange of information, one which can only truly be achieved by adopting the Rogerian stance (Rogers 2012) of acceptance of who the client or supervisee is without moral judgement of their ways of thinking and behaviours. This is often more challenging in supervision when models of work and schools of therapy can provide a framework which acts almost like a moral stance.

3)    Confidentiality – As with point 2, the maintenance of confidentiality is a basic requirement of both therapy and supervision as the protection it provides facilitates open discussion. It is worth noting that with both disciplines there are times when confidentiality may be breached.

4)    Reflective space – Both Supervision and therapy encourage reflection and provide a space in which this can be done.

5)    Theoretical underpinning – Both therapy and supervision have a theoretical underpinning which may be shared. A school of therapy which employs a solution focused model (Nunnally 1993).  is likely to use solution focused approaches in supervision, just as Rogerian counsellors (Rogers 2012) are likely to use Rogerian approaches in supervision and Cognitive Behavioural therapist (CBT) (Friedberg, Gorman, & Beidel 2009) will supervise to both reinforce the CBT model and use it to overcome challenges.

Supervision vs. therapy – Differences

1)    Outcomes – Perhaps the single most important difference between therapy and supervision are the outcomes they are looking for. Therapy aims to resolve a problem which exists for the individual presenting (i.e. the client) whereas supervision is seeking to improve the quality of therapy, although it may do this by helping the supervisee to resolve specific problems. The therapy goal is usually clearly defined, with an implied or explicit point of remission, supervision by comparison may have multiple goals but is an ongoing process of perpetual improvement.  Therapy is about repair; supervision is about enhancement.

2)    Mental health – Another way in which supervision differs from therapy is that it takes a very different approach to the client/supervisee’s mental health. As previously noted therapy will usually have a defined goal, which most often will be helping the client to re-attain healthy equilibrium, either in general or in relation to a specific problem. However, supervision takes a more relaxed ’monitoring’ approach to the supervisee’s mental well-being, only raising issues if they are likely to impact upon patient outcomes or result in burn-out. Therapy is actively seeking mental health, supervision acts as a preventative against the decline in mental health.

A clearer understanding of the issues which make supervision and therapy both similar and different should enable the supervisor to maintain their supervisory boundaries and thus be a better supervisor.


Supervision vs. therapy -References

Friedberg, R. D., Gorman, A. A., & Beidel, D. C. (2009). Training psychologists for cognitive-behavioral therapy in the raw world: A rubric for supervisors. Behavior Modification, 33(1), 104-123.

Nunnally, E. (1993). Solution focused therapy. In Casebook of the brief psychotherapies (pp. 271-286). Springer US.

Rogers, C. (2012). Client Centred Therapy (New Ed). Hachette UK.