Thursday, September 23, 2010

The Application of Knowledge and Skills

There is an old, and probably apocryphal, story about a very wealthy businessman whose great love in life was paddle steamboats. This man was so rich that he had managed to accrue a small but nevertheless very costly collection of antique paddle steamers, all very old and mainly acquired in the Mississippi Delta, and conveyed to the river near his home at considerable further expense.

However, this particular multi-millionaire was also not rash about spending money - and even though he liked to indulge his hobby, he certainly didn't want to think that he wasn't spending his money wisely.

The day came when his favourite steamboat stopped working. The engine ground to a sudden halt, and the paddle stopped turning and the man was beside himself with dismay. "Get me the best paddle steamboat engineer in the world and get them here fast!" he called to his assistant. As it happened, the best paddle steamboat engineer in the world lived around the corner from the millionaire and a car was sent to fetch him that very afternoon.

The engineer, a wizened old man of about 83, stepped onto the boat, went straight down to the engine room and busied himself by feeling along the rusty and creaking old steam pipes with his hands. After about 15 minutes of carefully inspecting the tired old pipes with his tired old hands, he stopped. While leaving one hand on a particular spot on a pipe he took out of his pocket what looked like a thin metal hammer as used for cracking nuts, lifted his other hand off the pipe and struck it deftly, once with the hammer. With a mighty cough, the old steamboat clanked back into life and chugged away as strongly as it ever had. The engineer smiled at the businessman and handed him a piece of paper saying "my invoice".

The businessman, who was also smiling looked at the invoice and his smile turned into a frown. "Ten thousand dollars!" he cried "are you serious? All you did was hit a pipe with a small hammer!".

"Oh, I'm sorry", said the engineer, "let me itemize the invoice for you properly" - and scribbled this on the paper with a pencil:

For hitting the pipe with a hammer: 1 dollar.
For knowing exactly where to hit the pipe with a hammer: 9999 dollars.

Counsellors, therapists and clinical supervisors amass a great deal of knowledge during their trainings and then while carrying out their clinical work. But that knowledge, of itself, is useless if you don't know precisely when and how to apply it in practice.

The really good practitioners are the ones who know just how to hit the pipe in the right spot. They may not always be as expensive as those who don't - but they really should be highly valued.

Tuesday, September 14, 2010

Inception - A New Way to Understand Dreaming?

Last night I had a dream that I went to the cinema for the first time in neary 12 months. I sat in a large, spacious auditorium, with a massive, crystal clear screen, state-of-the-art cine projectors and a sound system to make the road crew of U2 green with envy.

In this glorious movie-drome, I watched the latest Hollywood blockbuster Inception, one of the most visually dazzling movies of the 21st century, and I sat there awe-inspired and enraptured with the rest of the audience, from the opening credits to the final frame of the last reel.

Well, that was the dream. The reality was that I did go to the cinema to watch Inception last night, but it was shown in a tiny projection room probably best used for preview screens or art-house movies in foreign languages, on a screen that seemed barely bigger than my TV set at home, and through a lens that had a very large white mark, that covered about 1/3rd of the centre of the screen. The picture jumped around the screen, there was constant scratch line running down the right hand side of the image, and the sound was so thin that a rustle of a sweet paper 5 rows ahead of me almost drowned out the dialogue. The audience (not more than 15 people) got so bored with the show that at least 2 of them got out their iPods and started chatting online.

Now to the movie itself. It may have been visually stunning - and I have to admit that I was impressed with some of what I saw on the screen - although I would have been more impressed if I could see it properly. But I was not impressed with the Hollywood mumbo-jumbo that passed for dream psychology. OK, it was only a movie but instead of wallowing in Christopher Nolan's latest blockbuster, I found myself getting more and more irritated by what I saw as 2010's biggest load of cinematic codswallop, so far. We'll all have our opinions on the movie, and they may differ widely - and that's fair enough.

And, the interpretation of dreams in counselling and their significance for the client is also an area of wide debate amongst counsellors and psychotherapists. Some say that dreams are important areas for discussion and should be actively addressed - the client should be asked to write down a dream, if they remember it and encouraged to discuss it in the session. Others say that dreams should only be discussed if the client specifically wants to discuss them, and others say they have no place at all in the counselling room.

Some say that the dreams themselves have very specific meanings, and others say that the dream needs to be interpreted only by the client - and what makes sense to them is the real interpretation. The viewpoints will, of course, vary depending on the models of therapy being used by the therapist.

To get you started on reading about dream interpretation, I have added 2 more PDF's to the Therapy Resources page. One is the full text of Sigmund Freud's classic (1910) book "The Interpretation of Dreams" and the other is a chapter on Gestalt dream interpretation from a much more recent book (2006) by Fredick L Coolidge "Dream Interpretation as a Psychotherapeutic Technique". I hope you find them interesting. Whether they make any more sense than the screenplay of "Inception" is something you may prefer to decide for yourself.

As for the movies - I complained about my experience and got complimentary tickets for another film. I think I'll try Fritz Lang's black and white silent movie classic: Metropolis (1927). At least I won't have to worry about the dialogue not making any sense.

Thursday, September 9, 2010

Flying Solo - Not to be Advised for Pilots or Counsellors

According to yesterday's The Independent newspaper, Ryanair's Chief Executive Michael O'Leary has said he will be writing to the aviation authorities to ask permission to use only one pilot per aircraft on short-haul flights.

Mr O'Leary's logic is that the additional co-pilot is superfluous in modern jets - and it will save his airline money to eject them. He went so far as to say that the second pilot was only there to "make sure the other fella didn't fall asleep and knock over the controls". Mr Leary backed up his argument by saying that trains only had a single driver, at times, and this could cause a crash if the driver had a heart attack.

He went on to say that in 25 years, wtih over 10 million flights, Ryanair had only one recorded incident of a pilot having a heart attack - and he managed to land the plane safely.

It got me thinking about counselling practice and the need for a "co-pilot" in the form of a clinical supervisor. Maybe it is just a waste of experienced and qualified personnel - not to mention the supervisee's hard-earned cash - to fly the "plane" - being the client in metaphorical terms.

After all, not many client's really "crash" that badly, do they? And when they do there's not really that much of a bang. I was once told that no one had ever been sued for counselling malpractice in Ireland - so let's face it, even if there is a crash the dust cloud will probably pass over our heads.

I hear of counsellors flying their own "planes" all of the time. I have even heard of counselling students who have never had the benefit of clinical supervision. So it must be OK to risk it alone in the therapeutic skies - mustn't it?

To Mr O'Leary: the day you stop putting co-pilots into your aircraft is the day I stop flying on your aircraft. It's unsafe, it's bad practice and two heads are far better than one. The passengers feel safer and the whole trip is likely to be smoother and less fraught with stress, anxiety and panic.

To all counsellors not using supervision - consider becoming cabin crew.

Tuesday, September 7, 2010

Who is Clinical Supervision For?

The other day, I gave a full day lecture on using clinical supervision in counselling and psychotherapy and I think it went well, overall.

It was just that, right at the end of the day, a student, whom I hadn't met for about 5 years when he attended an "Introductory Counselling Workshop" told me that he had been receiving clinical supervision for the past 4 years and that -contrary to the point I had been pressing home since the start of my lecture - he had been given to understand that it had nothing to do with the well-being of the client, but that it was purely about the development of the supervisee.

I have to say that, even after more than 20 years as a lecturer in the field (and occasionally in the classroom) I'm still pleased that I can have an open mind to an alternative viewpoint. In this case, though, I was a little "thrown" by the point being made, especially as it was done with the type of certainty only found in the most inexperienced professionals.

I was even more disconcerted by the fact that I had spent at least 2 hours offering up definitions and models of clinical supervision that hopefully left no-one in any doubt that the process was aimed at ensuring the best possible clinical practice was present when the practitioner met the client.

The problem with jargon is that it can be used to mean whatever you want it to mean. In the fields of counselling and mental health work phrases like "supervision", "mentoring", "personal development" and "professional development" get thrown around and mixed up faster and more vigorously than the plastic numbered balls in a Lotto machine.

The way I was taught to understand the meaning of the term "clinical supervision" is quite literal:

Clinical - "Of or relating to the bedside of a patient, the course of his disease, or the observation and treatment of patients directly: a clinical lecture ; clinical medicine" and Supervision - 1. "To direct or oversee the performance or operation of", 2. "To watch over, so as to maintain order, etc."(Both definitions from Dictionary.com)

So, my understanding of clinical supervision is that it directly relates to the treatment of patients (clients) and is used to oversee the work of the trainee or inexperienced (or sometimes highly experienced) practitioner - whether they may be a counsellor, psychotherapist, nurse, doctor or other health worker - while they are actively engaged in client work.

it's not always about maintaining order, and it is sometimes about the practitioner directly - but at the end of clinical supervision - at least when I do it - is always a client, and their best interests.

Browse the static pages above to find out more about what clinical supervision is and how it works.

Getting Started in Clinical Supervision

Welcome to my new blog and clinical supervision resources website - The Counselling Supervisor.

I have been practicing, teaching, training and writing on the subjects of psychotherapy, counselling, clinical supervision and mental health for more years than I care to remember - and my career in mental health work began as a trainee (cadet) nurse in a large psychiatric hospital in Merseyside,in the UK way back in 1972, when I was a mere lad of 16.

In those days, clinical supervision was a thing of the future. Psychiatric nurses got on with the job to the best of their ability, they didn't have the time nor often the inclination to talk their work with patients over with an interested, yet objective third party - unless they could find a friendly colleague who had the time to chat. It was a haphazard and unstructured process that sometimes led to the novice nurse being given unhelpful and/or confusing guidance.

It was only when I began training in psychotherapy, much later in my mental health career, that I came across the concept of formalized and structured clinical supervision.


I am pleased to be in a position to be able to pass on some of my hard-won experiences as a therapist, a supervisee and a clinical supervisor.

So, welcome to "The Counselling Supervisor" and I hope that you will find the posts and resources on this website of value and of interest as you pursue your own professional journey.

If you have any comments or questions about counselling, psychotherapy or clinical supervision that you feel I can help with, don't hesitate to let me have them - I will be delighted to hear from you.

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