I still remember feeling lost and confused when I finished my M.phil in clinical psychology, and stepped into the world of endless opportunities to carve my own way in this abstract field of mental health. My two years of supervised clinical training gave me direction and exposure to the clinical world but it was mostly in a controlled environment. I didn’t feel confident enough to see clients on my own or work with them independently in the consultation room. Without a supervisor I was lost both professionally and clinically. After working independently for a few months, I joined a multidisciplinary hierarchical institution where I was not only supervising trainees, but also being supervised by senior consultants. This lifted my confidence and made me aware of my limitations and strengths. It helped me understand my interest areas and my inclination towards an attachment based psychotherapeutic approach than a restrictive CBT ( Cognitive Behavioural Therapy) approach. It also gave me the reflective space to understand my own professional journey. Thanks to this experience, I understood the importance and need for professional growth and development through continuous supervision.
In countries like the United Kingdom, Australia, USA and Canada where mental health is better streamlined, clinical supervision is a mandate. One needs to undergo a stipulated number of hours of supervision to be certified in a certain kind of psychotherapy. However, in India, where the field remains largely unregulated, we are still very new to the concept of continuous supervision.
As Bernard and Goodyear (2014) says,“clinical supervision is an ongoing supportive learning process for clinicians of all levels to develop, enhance, monitor, and, when necessary, remediate, professional functioning”. The goals of supervision may range between being normative (i.e., ensuring quality and case management), restorative (i.e., providing emotional and coping support) and formative (i.e., promoting therapeutic competence), and may ultimately lead to effective and safe psychotherapy practice.
Finding the right supervisor
Though supervision is important, finding a supervisor can be quite a daunting task. While looking for a supervisor, it’s important to first identify your own goals in supervision. Are you looking for a supervisor with a certain speciality and similar interests? Are you looking for a supervisor who can provide you with a reflective space to work on yourself? Are you looking for a supervisor who can provide a framework for your practice and help you with setting all the professional processes of your practice? The clearer you are about your needs from supervision, the easier it will be for you to find a supervisor. It is also important to have clarity that supervision is different from personal therapy. Goals of supervision should be professional rather than personal. A good supervisor will be able to help you draw that line for you in the supervision space. Secondly, talk to your peers and colleagues with a similar approach and style of working about their experiences with various supervisors. You will be able to get a fair idea about the functioning of various supervisors and approach them accordingly. Thirdly, in choosing a clinical supervisor it is important to look at their clinical style and personality. The qualities of your supervisor will give you an idea how well you are able to work with them. It may be helpful to consider the qualities of your previous mentors that you really liked and appreciated, even if they were not from your professional field. It is important to see if the supervisor’s communication styles click well with
you. How would you like the feedback and the progress to be communicated to you? Are you comfortable with the communication style of your supervisor or are you feeling judged or criticized? An experienced supervisor should assess your working style during the initial contact but you can also use the opportunity to see if their style is agreeable to you. The best style for a successful professional relationship is one in which you feel respected and considered and allows you to set a plan and process for providing and receiving feedback from one another.
Lastly, you need to consider the logistics. You might be able to find the best supervisor, but if schedules are not worked out it will not be sustainable. This includes the continuous availability of the supervisor for a period of time to begin with, the mode of supervision and the cost of the supervision sessions. If the supervisor is not available on a regular basis it will reduce the effectiveness of the supervision. Like in therapy, it takes time to develop rapport with your supervisor. Supervision might seem like a significant time and financial investment, but if your supervision space checks all your requirements for growth and learning you’ll find that it’s worth your time and money. In short, supervision plays an important role in professional development and growth. I encourage all the mental health clinicians looking for a clinical supervisor to pause and reflect over what they are seeking from the supervision space before they proceed. As a supervisee and supervisor myself, it’s worth the investment to widen your horizon to step up the professional ladder.
Radha Ramaswamy is a practitioner and trainer of Theatre of the Oppressed (TO), a participatory theatre pedagogy widely used across the world for social and personal change. Following her training in Theatre of the Oppressed at the Seattle-based Mandala Center for Change, Radha founded the Centre for Community Dialogue and Change (CCDC) in Bangalore in 2011. CCDC is committed to making this powerful and versatile tool for creative change accessible to individuals and communities everywhere. To this end Radha offers workshops and trainings across different cities in India and abroad, working with students, teachers, health professionals, women’s groups, senior citizens, and other communities of people. She has collaborated with many institutions of higher learning on theatre-based projects, and presented papers and conducted workshops in several conferences on education, teacher training, and mental health.
Dr Prabha Chandra is senior professor of psychiatry and dean of faculty of behavioural sciences, at the The National Institute of Mental Health and Neuro-Sciences (NIMHANS), Bangalore. She is the president elect of the International Association for Women’s Mental Health, a past executive member of the Marce International Society and co-author of the World Psychiatric Association (WPA) curriculum on intimate partner and sexual violence, as well as the WPA Position statements on perinatal psychiatry and violence against women. She is also a co-author of the recent Lancet Commission for mental health and violence against women.
An active researcher with 17 funded grants as principal investigator, she has also edited several books on women’s mental health and palliative care. Dr Chandra was heralded as a champion for women’s mental health by Lancet Psychiatry. She started the first dedicated perinatal psychiatry service and Mother Baby Unit in Asia and also organised the first ever Marce International conference in a low and middle income country ( LAMIC), in Bangalore, India. She is also a consultant to the World Health Organisation and The United States Agency for International Development for implementation of perinatal mental health programmes in LAMIC.
Dr Ashlesha Bagadia is a perinatal psychiatrist and family psychotherapist with over two decades of experience in mental health. She has completed higher training in Perinatal and Women’s Mental Health, Family Systems Psychotherapy and Mentalisation Based Treatment.
She has a keen interest in bringing advanced psychotherapy skills to India and making it accessible to areas with limited resources. She hopes to make clinical skills that may originate from western theories, more culturally relevant and adaptable to local settings. She has been conducting workshops and courses with a view to help clinicians make meaningful connections, grow through stronger peer interactions and better collaborative care.
Poornima Mahindru is a clinical psychologist and psychotherapist in the field of mental health for over a decade. In the course of her professional journey she has experienced a dearth of opportunities to upskill herself. She strongly believes that mental health professionals need constant training and learning to provide quality care to their clients.
At The PARC, she will design workshops and training programs – in collaboration with national and international experts – to increase the Indian mental health community’s access to high quality training.
She carries vast experience of working in premier organisations like Manipal University and NIMHANS and has been in the leadership roles in private neuropsychiatric hospitals. She currently practices with The Green Oak Initiative where she specialises in perinatal mental health and personality disorders and provides clinical and professional supervision for mental health professionals
Dr Shaibya Saldanha is practising gynaecologist and co-founder of Enfold Proactive Health Trust, an orgnisation that addresses gender and sexuality with a special emphasis on child sexual abuse, through education, training, research, advocacy, and tangible support.
Dr Saldanha was formerly associate professor at the department of obstetrics at St John’s Medical College, Bangalore. At present she is a training consultant to the state government of Meghalaya on maternal and child health.
Dr. Anthony W. Bateman is a psychiatrist and psychotherapist. He is consultant to the Anna Freud Centre, London, Visiting Professor at University College, London and Honorary Professor in
Psychotherapy at University of Copenhagen.
He developed Mentalization Based Treatment ( MBT ) for borderline personality disorder and
studied its effectiveness in research trials. Adapted versions are now being used in multi-centre trials for antisocial personality disorder, eating disorders, and drug addiction. He was an expert member of National Institute for Clinical Excellence (NICE) development group for treatment guidelines for Borderline Personality Disorder in UK and was Chair of the National Guideline Development Group for Eating Disorders.
He has authored 16 books including Psychotherapy for Borderline Personality Disorder: mentalization based treatment and Mentalization Based Treatment for Personality Disorder: a practical guide (2016) (with Peter Fonagy), numerous book chapters, and over 150 peer reviewed research articles on personality disorder and the use of psychotherapy in psychiatric practice.
Pavitra Jayaraman believes that mental health belongs in all conversations and even more so in clinical settings. She is building The PARC to ensure that mental health is an important aspect in all health experiences through training, communication and community engagement.
In her previous role she built the content operations for White Swan Foundation for Mental Health – a knowledge centred non-profit – that curated complex information on mental health for workplaces, adolescents, parents, teachers and the elderly in six Indian languages through several offline and digitals platforms. Pavitra is also an independent journalist and communications consultant. She has worked with NDTV where she reported on politics and health and with Mint as a long form features writer.