Subordinate theme one: “Supervisor” implies a kind of hierarchy

Many participants talked about the theme of power and hierarchy: inside the therapy room, in the supervision space and the power felt from services and settings to third parties. All of these stakeholders seemed to have an effect on the participants’

experience of integrative practice and bringing integrative practice to supervision. This lead to emergent themes based on these hierarchies and the theme of supervisees often

feeling less empowered. These where then subsumed under P5’s phrase “supervisor, implies a kind of hierarchy”.

Particularly of note is the sense that each participant feels they can only bring some practice to the supervision room, with some feeling they have to omit or censor their work. In this way, this theme is closely linked to the “censoring” and “am I doing the right thing” themes outlined below. The theme adds to my sense that currently these integrative practitioners feel they must fit themselves into whatever service or

supervision setting they find themselves in to the detriment of their integrative identities.

“And then I was really reluctant with my supervision to be saying well actually I’m doing a load of coaching work today, I don’t think I was really doing, you know, the sort of grief counselling work because, even though in my view it was part of the same thing (S;mm), but there’s always this thing on the part of the service, to always bring it back to the bereavement, always bring it back to the bereavement, because the service is part of the NHS, it’s funded for a certain course of work and people are sent through IAPT through to get bereavement work, but as with anything like this, there’s a multiple load of things going on for people.” P3, line 212

In the above extract P3 outlines their “reluctant” feeling at bringing their coaching work to supervision, with their reasoning that coaching could be construed as outside the boundaries of the service. I wonder if is possible that they see the supervisor as a guardian of the service boundaries and that P3 feels they are not practising within the bounds of the bereavement service. The power here is linked back through P3’s background experience of the structures of IAPT and the NHS and there is a sense of the strength of the power structures politically and economically from a hierarchy that cannot be challenged on an individual level. The conflict for the participant seems to be that their reality is that clients’ needs are “multiple” and to offer the best practice they feel coaching is key to this. Perhaps there is some guilt at disobeying the power structures around them. P3 also has experience of operating as a coach and coach therapist in other settings, so these power structures in IAPT may feel alien. Elsewhere, in their transcript, there is the notion of being “caught” doing something they should not, which I discuss in more detail in the theme “am I doing the right thing?” below. P4 discusses a different setting, but a similar dynamic in how the power of the service effects supervision in the next extract.

“Although it’s a coaching company, everyone has this underpinning of some mindfulness background and some psychotherapeutic training erm so our discussions do integrate everything, but we tend not to really think about, too much about the therapy because the woman who directs the company very sort of, for insurance purposes and all that is very cautious about combining therapy with coaching so actually in those supervisions, particularly the group

supervision we stay away from talking therapeutically about a client” P4, line 682

P4’s above account implies that the varied, integrative experience of their supervision group is utilised to an extent, but that therapy is mostly disavowed by the group facilitator and supervisor. Again, there is a sense of powerful vested interests affecting the ability to provide integrative practice. What is unclear is how much integrative work is practiced with clients and whether this is censored out for supervision or if it is curtailed in the therapy room. P4’s background as a trainee counselling psychologist must play a part here and it could be imagined that omitting therapeutic factors like the therapeutic relationship from supervision could be difficult.

“Erm I think we do feel vulnerable about sharing our practice. I think the very term ‘supervisor’ implies a kind of hierarchy where somebody can come in and tell you, you’re doing the wrong thing and that is implicit in the role” P5, line 735

P5 picks up on the feeling that the supervisor is the ultimate power structure in the supervisory space, highlighting the descriptive phonology in the word “supervision”

and the implied hierarchy inherent in the prefix “super”. The vulnerability in the face of this power seems to feel inevitable for P5 with the use of the word “we” implying that every supervisee experiences this feeling. Elsewhere in P5’s transcript there is sense that these power imbalances can be negated by the supervisor and supervisee making a concerted effort to facilitate the supervisee’s autonomy. It seems that there is a balance to be found for P5 and that others would like to feel less scrutinised or anxious about potential criticism.

“but sometimes supervisees can abdicate responsibility or feel infantilised by the way supervisors say things and again that’s why I really love the thinking environment way of working, because one of the core conditions is around equality, so I don’t assume that my thinking is better than theirs. I may have more experience and knowledge, but I don’t assume that I know better, but if someone was clearly behaving in a way that’s unethical then obviously I would need to say that.” P5, line 763

Further on in P5’s interview there is an advocacy for a particular type of supervision, that works to address the child to parent relationship that they see in the

supervision space. They see “equality” as a desired state in the supervision space and their experience of being a supervisor in integrative supervision perhaps creates a view of both sides of the power dynamic and a wish for it to be more balanced. P5’s range of experience as both coach and therapist can be seen in this segment with the advocacy for solutions to dilute power dynamics in supervision.

The imbalances, dynamics and relationships described in the above extracts form a thematic essence of power or “an implied hierarchy” as central to participants’

experience. Participants seem to feel this power not only in the supervisory relationship, but across their relationships in the settings in which they work. This theme links to the wider superordinate theme in that there appears to be an influence over the

practitioners’ work, particularly how integrative they feel they are able to be with clients depending on how powerful they feel in their own supervisory relationships. It seems that when integrative practitioners feel directed or stymied by their supervisors, anxiety and anger can arise which is discussed in more depth in the next theme

summary below.

4.3.2 Subordinate theme two: Picking the bones. All participants talked about