Picking A Supervisor
Posted by Dr. Vollmer on March 5, 2015
Residents, psychiatric residents that is, pick supervisors to help them learn psychotherapy. From medical student to hard-working internship to inpatient psychiatry, these residents jump off a cliff into outpatient psychiatry land, which requires learning a completely new skill set. Acuity decreases, and the long journey of psychotherapy begins. The skills required to manage emergency situations, skills which are honed over many years, are no longer needed. Instead, the skills of patience, careful listening, thoughtful hypotheses, and a cerebral mode of being, rather than an action mode of being are required. For some, this transition is the reward of many years of training. For others, it is simply terrifying. And for a few, this is “old fashioned psychiatry” with skills that are “hardly useful.” As their second academic year comes to a close, they are faced with the uncertain task of finding a supervisor, a psychiatrist who can shepherd them through their development as a psychotherapist. They want to learn, but they do not want to feel the shame of not knowing. They are faced, as they hover thirty, with the humiliation of being a student, a pupil who knows little, but is expected to grow rapidly. The anxiety, for some, is large, whereas for others, it is yet another hurdle in their long road of professional development. So, how do they choose their teacher: by reputation, by their curriculum vitae, and/or by the chemistry they feel when they have seen these teachers in other settings such as journal clubs or lectures? Or, is the system broken? Maybe the supervisor should choose the student, based on the supervisor’s judgment of which student would have the most growth potential? Or, as I said in a previous post, maybe supervision is not the best way to teach psychotherapy. Maybe they need to have a psychotherapy boot camp, where, with the help of a facilitator they can rely on each other to struggle through the fog of psychotherapy. Or, maybe they need to learn some basic concepts of technique before launching into seeing outpatients? Maybe they need to read, and write papers, to demonstrate knowledge of psychotherapy before seeing outpatients? At the moment, that is not how the system works. The resident picks their teacher, making it so charismatic teachers, those who the residents perceive to be nonjudgmental, are highly sought after, leaving the less assertive residents with the quieter, less charming supervisors. Maybe the system works, despite its flaws. Maybe, though, this is a time for big data, a time to be more scientific about what works. It is a thought.