Teaching Effective Supervision of Child and Adolescent Analysis: Enriching the Candidate’s Clinical Experience

145 Pages·2014·1.6 MB·English

by  Anita G. Schmukler

Teaching Effective Supervision of Child
and Adolescent Analysis

Teaching Effective Supervision of Child
and Adolescent Analysis
Enriching the Candidate’s
Clinical Experience
Edited by Anita G. Schmukler and
Paula G. Atkeson
Rowman&Littlefield
Lanham•Boulder•NewYork•Toronto•Plymouth,UK
AppendixAadaptedfrom“Trainee’sEvaluationofCounselingSupervisor,”inuse
attheCounselingCenter,TowsonUniversity,andformulatedforthepsychoanalytic
supervisoryexperience.Usedwithpermission.
AppendixBandCusedwithpermissionofTheBaltimore-WashingtonInstitute
forPsychoanalysis.
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Teachingeffectivesupervisionofchildandadolescentanalysis:enrichingthecandidate’sclinical
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Includesbibliographicalreferencesandindex.
ISBN978-1-4422-3179-5(cloth:alk.paper)--ISBN978-1-4422-3180-1(electronic)
I.Schmukler,AnitaG.,1941-editor.II.Atkeson,Paula,editor.[DNLM:1.ChildPsychology.2.
Psychotherapy--organization&administration.3.AdolescentPsychology.4.PersonnelManage-
ment.5.Psychotherapy--education.WS350.2]
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2014014286
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Contents
IntroductiontoTeachingEffectiveSupervisionofChildand
AdolescentAnalysis vii
AnitaG.Schmukler
1 CreatingaSupervisoryFramework:Models,Methods,andMastery 1
DeniaG.Barrett
2 SupervisingtheAssessment 15
StephanieD.SmithandPaulaG.Atkeson
3 TeachingEffectiveSupervisionofCandidatesinTheirWork
withtheParentsofChildandAdolescentPatients 27
PaulaG.Atkeson
4 HelpingSupervisorsWorkwithTransferencesand
CountertransferencesinChildandAdolescentAnalysis 39
AnitaG.Schmukler
5 TeachingSupervisoryTechniqueinWorkingwithFantasies,
Play,andDreams 55
AnitaG.SchmuklerandMarySickles
6 EthicalAspectsofSupervisionofWorkwithChildrenand
Adolescents:PotentialsandPitfalls 69
LeeI.AschermanandSamuelE.Rubin
7 SupervisionandtheChallengesofTermination 89
JillM.Miller
Epilogue:ChallengesinChildandAdolescentPsychoanalytic
Supervision 97
CalvernNarcisi
v
vi Contents
AppendixA:Candidate’sAssessmentofSupervisor 103
AppendixB:GuidelinesforAnalyticSupervisor’sReports 107
AppendixC:GuidelinesforPsychotherapySupervisor’sReports 109
AppendixD:CurriculumforContinuingEducationCoursefor
Supervisors—SupervisionofCandidatesinTheirWorkwith
theParentsofChildandAdolescentPatients 111
AppendixE 119
Index 127
AbouttheContributors 131
Introduction to Teaching
Effective Supervision of Child
and Adolescent Analysis
Anita G. Schmukler
Child and adolescent analysts learn to work effectively in training programs
that include seminars, case conferences, and experience in working with
childrenandparentswhilesupervisedbyexperiencedcliniciansandpersonal
analysis.Supervisionofachildoradolescentpatientusuallytakesplaceonce
weekly (for each child in treatment), and the discussion revolves around
work that takes place during the session with the child patient and in meet-
ingswithparentsaswell.Thecandidate–supervisorrelationshipextendsover
years, from the beginning of a particular child or adolescent treatment until
the work concludes. Multiple issues arise in this unique teaching process.
Surprisinglyourliteraturehasnotaddressedthisinasubstantivemanner,and
thisvolumeisanefforttostimulatefurtherthinkinginthiscomplexarea.
For nearly a century, the work of supervision in child analysis has been
conducted primarily in a private setting. The supervisor may be assigned by
the institute or selected by the candidate in child and adolescent analysis,
depending upon the procedures of a particular training facility. While this
aspectoftrainingispivotal,littlehasbeenwrittentodescribetheprogression
ofthedevelopmentofachildanalysttobecominganeffectivesupervisor,or,
indeed, theprocess of that whichtakes placeduringthesupervisionof child
andadolescentanalysis.Thisvolumeisintendedtoaddresssuchmattersand
to raise questions that can be addressed in study groups and seminars. The
paucity of literature on supervision in child analysis should not obscure the
fact that the subject has been studied in some detail, particularly in work-
shops,seminars,andstudygroups,inwhichchildanalystspresentchallenges
in supervising students to peers and stimulating, productive discussions en-
vii
viii AnitaG.Schmukler
sue. Some of the issues addressed include: working with the student whose
first response is to medicate, before he or she has an opportunity to fully
evaluate the patient and assess the family situation; working with the very
experienced clinician who is working to understand, for the first time, an
analyticperspective;workingwithstudentswhodonotunderstandtheimpli-
cations of transference and countertransference in the treatment situation;
and dealing with ethical issues that arise during the analysis of children and
adolescents. A further area of examination is to help the supervisor who is
communicatingwithhisorhercandidatebytelephoneorInternet.Whilewe
have not included a separate chapter on this subject, several authors will
devote some time to examining the impact of work by telephone upon the
supervisoryprocess.
TheStudyGrouponSupervisioninChildandAdolescentAnalysis,spon-
soredbytheAmericanPsychoanalyticAssociation,hasmetsemiannuallyfor
nearlyadecade,andsomeoftheideasforthisvolumearosefromthecogent
examplesofferedbymembersofourgroup.Inthiscontext,wewishtothank
our study group: Anita G. Schmukler and Paula G. Atkeson (co-chairs),
Denia Barrett, Howard Benensohn, E. Kirsten Dahl, Helene Keable, Ruth
Karush, Kenneth King, Julio Morales, Calvern Narcisi, and Noah Shaw.
While some have elected to write chapters for this volume, all members of
the group have contributed by offering cogent examples from their clinical
experience in our rich and productive discussions. In wrestling with notions
of how to provide the most effective supervision in problematic cases, we
have created this volume, a type of workbook, to which we trust that the
diligentreaderwillcontinuetoexplorethesecrucialissues.
Oureffortsinthisdirectionareintendedtoopendiscussionofthepsycho-
logical phenomena what take place between candidate in child analysis and
child patient, candidate and parents, and candidate and supervisor. In think-
ingaboutconsciousandunconsciousdeterminantsofwhatoccurinthedeli-
cate interactions between analyst, child, parent, and supervisor, we recog-
nized that much can be gained from both consultation with an objective,
neutralindividual(s)andmeetingwithgroupsofpeers.Thisvolumeaddress-
es amyriadof issuesthat arisein such supervisorysituations. Itisclear that
each of these areas is worthy of further study, so that we can work with
increasingeffectiveness,sheddingclarityonpreviously unexaminedclinical
areas.
This volume will be of value to child analysts, supervisors, candidates,
and to all who treat children psychologically. Supervision is a core segment
of learning to treat children in analysis and helping supervisors to work
effectivelyisthereforeanessentialcomponentofourwork.
Theopeningchapter,byDeniaBarrett,describesModelsofSupervision.
With some frequency, analysts of children work in the ways in which they
weretaughtbytheirsupervisorsandseminarleaders.Thevastareaofexam-
IntroductiontoTeachingEffectiveSupervisionofChildandAdolescentAnalysis ix
ining alternative modes of teaching one to work clinically has been largely
unexplored. A study of this material raises questions about our familiar
modes of communicating with students, and this necessarily increases our
awarenessofwhatleadssupervisiontobeeffective,incontrasttothatwhich
leadsstudentswhoflounderandfailtoacknowledgetheirplight.Clearlyitis
not simply the quality of supervision that determines the outcome of a stu-
dent’straining,butsincesupervisionispivotal,itisessentialthatthisaspect
of the clinician’s education be optimal. Identifying students who might be
better suitedto another formof work isalsopart of thesupervisor’stask. In
this context, meetings of supervisors of each candidate offer an opportunity
for supervisors to discuss whether problems with a specific candidate relate
to the type of supervision, the nature of the case, the student’s challenges in
learningtheworkofchildandadolescentanalysisorthestudent’sdifficulties
inworkingwithparents.
Effective supervision has the potential to affect the candidate’s way of
working with children and their parents in a profound manner, and this, in
turn, affects generations of children whose treatment has the potential to
shape their development in subsequent stages following the conclusion of a
childoradolescentanalysis.
Inchapter2,theassessmentforpsychoanalysisiscrucialinthetreatment.
Stephanie D. Smith and Paula G. Atkeson address this crucial aspect of
supervision. The absence of attention to engaging in effective assessment
maybecompared to thepediatrician’streatingachild or adolescent without
first determining the diagnosis and the factors leading to her or his illness.
Whileatfirstglancethissoundsludicrous,inthecontextoftreatingchildren
with“playtherapy,”itistoooftenoverlooked.Acarefulassessmentpermits
thechildanalysttoofferanalysiswhenitcanbemostproductiveandtooffer
alternativetreatmentswhenmightbemostbeneficialforthechildoradoles-
cent. The work of the supervisor in assessment is to help the candidate to
identify children who would benefit most from analysis, to work collabora-
tively with parents, and to help the candidate identify resistances to begin-
ning treatment in the child, the parent, and the candidate him- or herself.
When one is reluctant (for conscious or unconscious reasons) to begin an
intensivetreatment,obstaclesmultiply.Theeffectivesupervisorcanidentify
resistancesandhelpthecandidatetoworkeffectively.
Chapter 3, written by Paula G. Atkeson, provides a detailed account of
helpingthesupervisorinchildandadolescentanalysistoworkwithparents,
acrucialaspectofclinicalworkwithchildrenandadolescents.Itisuponthis
aspect of our clinical experience that a case may go on to an excellent
conclusion or fail precipitously. In working with parents, what information
fromthechildoradolescent’streatmentisshared,whatisprotected,andhow
doweunderstandthedelicatebalance?Whattakesplacewhenthecandidate