Three heads are better than one: Psychiatry trainees' experiences of a psychotherapy written case supervision group with three co-supervisors

OBJECTIVE

The aim of this project was to evaluate the experiences of Royal Australian and New Zealand College of Psychiatrists (RANZCP) trainees in a regional centre who participated in a psychodynamic psychotherapy written case supervision group with three co-supervisors.

METHOD

A web-based survey was sent to RANZCP trainees. Descriptive statistics were performed, and written feedback was analysed.

RESULTS

A total of 8 of 10 eligible trainees completed the survey. All respondents stated that the group met their training needs. The average rating of feeling understood by supervisors was 91 (maximum 100). Positive feedback was received about the variety and breadth of experience provided by the co-supervisors. Trainees felt that 1:1 supervision was important to complement group supervision.

CONCLUSIONS

The supervision group model with three co-supervisors is competently meeting the training needs of RANZCP trainees as well as providing a deep learning experience. This model may be of use in other services, particularly in regional settings.

Identifying Ruptures and Repairs in Alliance-Focused Training Group Supervision

Group supervision presents unique opportunities for psychotherapy trainees to deepen their understanding of alliance ruptures and repair strategies. Trainees can explore challenging clinical moments and benefit from diverse perspectives and support. Group supervision also provides trainees with multiple opportunities to experience ruptures and repairs firsthand in their interactions with the supervisor and other group members. More research, particularly research using observer-based methods, would enhance our knowledge of rupture and repair processes in group supervision. In this study, seven sessions of Alliance-Focused Training, a group supervision that specifically aims to improve trainees' abilities to recognize and negotiate ruptures, were coded for alliance rupture markers and repair strategies using a modified version of the Rupture Resolution Rating System (3RS). Excerpts of the coded sessions were used to illustrate AFT process in the absence of ruptures, and in the context of ruptures between the supervisor and trainees, between trainees, and between a trainee and the group. There were no clear examples of ruptures between trainees. The ruptures between the supervisor and the trainees were deemed to have only a minor impact on the alliance, and these minor ruptures were at least partly addressed. Based on the coding, themes related to supervisor authority, complex and subtle ruptures, and the use of metacommunication within the AFT group were discussed. The findings of this exploratory study suggest that the 3RS can be useful for measuring process in group supervision, and that greater attention to group process and ruptures within the group holds promise for enhancing the effectiveness of AFT.