Supervision in Psychiatric Practice

Dr. Laura Roberts: (00:14)

Hi, I'm Dr Laura Roberts, Books Editor-in-Chief for the American Psychiatric Association, and welcome to the APA books podcast. Today we're going to be talking about a wonderful book, Supervision in Psychiatric Practice that was edited by Dr Sallie De Golia and Dr Kathleen Corcoran. Dr De Golia is a psychiatrist and a specialist in the treatment of mood and anxiety disorders. She is a clinical professor at Stanford University's Department of Psychiatry and Behavioral Sciences and just a magnificent educator. Dr Kate Corcoran is a psychologist also in the Department of Psychiatry at Stanford. She is a clinical associate professor who works really closely with the clinical psychology training programs and is a really just a phenomenal colleague and I'm really excited to share with you a little bit about this wonderful book that they've put together and just came out has gotten rave reviews already. I think it's going to be the definitive book on clinical supervision that exists in our field.

Dr. Laura Roberts: (01:21)

So it's my great honor to talk with you today, both of you. And let me just say hello to you, Dr Sally De Golia.

Dr. Sallie De Golia: (01:31)

Hello, thank you for having us.

Dr. Laura Roberts: (01:32)

Yeah. Great to have you. And hello to you, Dr Kate Corcoran.

Dr. Kathleen Corcoran: (01:36)

Thank you.

Dr. Laura Roberts: (01:37)

Yeah. So what experience have you had from psychology to what would principally be a psychiatric audience?

Dr. Kathleen Corcoran: (01:46) 

Yeah, I think it was, well, first of all it was really a lot of fun to do this and to be thinking about some. Most of it, there's so many commonalities between obviously psychology and psychiatry. And then also thinking about some of the differences and one of our chapters was actually on what is it like to be a supervisor a non MD supervisor when you're supervising in a residency program or other programs. And I think it was helpful. I come from mostly a psychotherapy perspective and so kind of bringing that into the book and there has been more research and training on supervision from a psychological perspective. I think it's been part of our, sort of the professional society has been pushing supervision training for a number of years and our graduate students are expected to learn supervision. And that's something, that's one of the competencies that's expected. So there's been a lot of thought and writing that's been done on that within psychology. So it was really helpful to kind of go back to a lot of that material and to be thinking about how some of that would apply within a psychiatry perspective. But I learned so much in this process.

Dr. Sallie De Golia: (02:55)

And I was so grateful to have a psychologist, in particularly you, working with me because you do bring a huge richness that was really, really helpful. So particularly around the psychotherapy aspects, but having, having been in a lot of supervision workshops or whatever your requirements are for a psychologist, that was just really, really helpful. I think the combination of us together really worked well.

Dr. Kathleen Corcoran: (03:24)

Absolutely.

Dr. Laura Roberts:: (03:26)

So when you think about how you hope people will use the book, can you comment a little bit about that? Uh, obviously supervisors are people who wish to become supervisors, but how about learners who are at earlier stages of training? What was your thinking about that?

Dr. Sallie De Golia: (03:45)

I think it, I mean, it is accessible to a huge audience. You know, psychiatrists, psychologists, mental health professionals have all sorts of physicians. Medical docs who are in collaborative care kind of situations. And we really touch on all these different issues. But I think it really I think is very useful from the beginner supervisor to somebody who's been supervising for years and hasn't actually read about, in some ways what they're actually doing, making it more explicit, which I think is super helpful for them as mentors or teaching other, you know, their junior faculty to become supervisors. I think it's helpful in that way for them. And to just self-assess as supervisors. Uh, I think it's really helpful and I hope that trainees read this book and they'll pick parts that relate to them, but supervision is so mystifying as a trainee, you know, they, have no idea what to expect and sometimes supervisors will explain it and often they don't. And so for a trainee, I think it just helps demystify the process and um, help them relax a little bit and recognize the value and the sort of the parameters of supervision and what they can expect.

Dr. Laura Roberts:(05:16)

Yeah. And maybe a little bit more about what they, right, what they can expect, what the value will be in their career, what their goals are.

Dr. Kathleen Corcoran: (05:24)

How they can enhance the supervision experience themselves. I think by going in, knowing what they want or trying to advocate for themselves in different ways. And so there are two chapters that were written specifically for the supervises and I think they're great chapters that would be helpful. And I also think the book is structured in a way where advanced supervisors can pick it up and read one or two chapters and think about ways that they can enhance their own supervision or reflect on their own supervision style. I found for myself when we were working on this that, I felt like I was becoming a richer, better supervisor in the process. Really thinking very thoughtfully about the supervision process, about how to structure supervision very much also how to make sure it's a very active process where we're using role-plays and videos and not just talking about cases but instead really bringing the material, sort of live material into supervision. And so I found that incredibly helpful just for myself and I hope that advanced supervisors will feel that same way and certainly more junior supervisors. I think we'll be able to read Sally's first chapter that goes through the whole supervision process and learn so much from that. And then also just pick up a chapter here or there when they feel ready to incorporate these other ideas.

Dr. Laura Roberts: (06:43)

How did you pick the people that you did for the chapters? It's a pretty broad, remarkable group of people and some chapters are solo authored and some clearly have the voices of many people that you've brought together. And yet the entire book has, as you described, a sense of flow. I would say. You know, this tremendous sense of cohesiveness in the accessibility, the visual, everything about it. I think it feels like a very cohesive project. But how did you select the authors that you did to prepare the chapters ?

Dr. Kathleen Corcoran: (07:21)

That with another, I think quite organic process when Sally and I would get together and think about these different chapters and try to think about some different experts in the areas and some of our colleagues who we knew did really wonderful work in these areas. We wanted to make sure there was somewhat international representation as well. So we had people from Canada as well as the United States.

Dr. Sallie De Golia: (07:45)

Yeah, I think we just, you know, sometimes I would ask another colleague who knew some people who are expert in certain areas and through that, and the other aspect is we involved certainly as coauthors some trainees. And in fact a medical student wrote one of the chapters which I was really excited about. Obviously working with experts in that area who co-wrote and were senior authors. But, so it was also great to see mentoring happening within writing the book. But I think through our experience we happen to know a lot of different people and tapped on various people and frankly I was having been the first book, I didn't know what was going to be like to ask people and see, you know, would you please write a chapter. People were really excited. They were, I mean, I can't think of one person who said no actually. I can think of one person who said no.

Dr. Laura Roberts: (08:52)

Well, other than your chairman nudging you to do this book, which I have to acknowledge, to the audience.

Dr. Sallie De Golia: (08:59)

It was a little bit of a nudge.

Dr. Laura Roberts: (09:03)

Why did you think that this particular topic or this particular book at this particular time would have some value to the field?

Dr. Sallie De Golia: (09:12)

Well, I have to say the nudging came at the right time because I have been really excited about thinking about teaching and how that happens within supervision, which is such a huge area for mental health professionals and how we learn. And you know, when you asked it just hit at the right time. And I was really excited cause I knew there just wasn't that much out there. I mean there's been a lot of research on supervision and much more over the last couple of decades, but mostly around psychotherapy supervision in the different areas of psychotherapy. And I've been really interested in supervision across the board as a psychiatrist. How do we supervise in a psychopharm clinic or on the CL unit, in the inpatient units? And there may be some stuff out there. there's certainly no books on that. And so this was very exciting to start to pull this all together. And very timely cause they're has started to be some workshops in these national organizations around supervision for psychiatrists. I know psychologists have that different experience with it, but psychiatrists don't get trained in how to supervise, let alone obviously how to teach. So it was very exciting.

Dr. Kathleen Corcoran: (10:39)

I think one thing that was exciting for me when Sally came and approached me about collaborating on this book was the idea that it would be a really practical manual for supervision. And not just talking about the more theoretical aspects, but really try and understand how can we be the best supervisors possible, what are the strategies that will be helpful and making a book that would be very approachable I think to our audience. So I thought that was very exciting.

Dr. Laura Roberts: (11:04)

Yeah, no, it really, it really turned out beautifully and it was an ambitious structure and I love structure when I think about how to accomplish something in the form of a book. And you had eight parts, you had introduction, you had supervision formats, supervision techniques, clinical supervision venues, nonclinical supervision venues, special issues in supervision, which was a long set of chapters, legal and ethical issues in faculty development. Right? And then there was just a final section. And so putting it all together. So can you just say, how did you arrive at this rather remarkable structure and including kind of some shadow issues, some issues that aren't at the front of mind for many practitioners?

Dr. Sallie De Golia: (12:00)

Honestly I think it just fell out of us. I mean it really, I think because we wanted to do a broad based book, we really just kind of looked at all the possibilities and I don't know, it just seemed to kind of be evident.

Dr. Kathleen Corcoran: (12:23)

It did and I think we had a lot of conversations about what it was like to be supervisors ourselves and what were some of the issues that we faced in that when we spoke with colleagues that people talked about. And it really did feel like it came together quite kind of organically.

Dr. Laura Roberts: (12:39)

Well that reminds me then, I need to ask about your process. So you all talked together about the idea of the book and then what did you do?

Dr. Sallie De Golia: (12:49)

I think this was the best part of the book actually. Kate and I got to know each other very well through this process. Not having, I mean really colleagues, but not really, barely working together. Um, and we met or actually through mostly phone or zoom. We met every single week for a year for at least an hour and just talked through every aspect from the initial sort of vision of the book through the whole editing process. And it was actually really fun and it was structured also, we made sure that we hopefully kept on time.

Dr. Kathleen Corcoran: (13:39)

We spent a lot of time at the beginning trying to think about that structure. So the chapters that we wanted in the book and then within each chapter, kind of what structure, how we wanted all of the chapters to flow. Cause that's really important to us, that there'd be continuity and consistency across the book and that it feel that readers could pick up one chapter at a time but also feel like it flowed. And so we spent a lot of time on those initial....

Dr. Sallie De Golia: (14:02)

We did. And I have to say when we got a, we still though didn't quite know how it was gonna flow cause we hadn't written our own chapters. So, it wasn't until we actually got the first one or two chapters that we were like, oh, I see. So it was organic in many different ways, so we got better at being clearer.

Dr. Kathleen Corcoran: (14:27)

And we read every single chapter many times.

Dr. Sallie De Golia: (14:30)

Yes, we kind of split it down the middle and then we'd be the primary whatever the chapters were we were the primary. But we both read each and we'd come together and talk through each point. It was quite a process.

Dr. Kathleen Corcoran: (14:48)

It was a process and it was fun, much of time. Yeah.

Dr. Sallie De Golia: (14:53)

But I do recall being told that once, this is certainly my first book, but when you write a book that it is like delivering a baby. Now I have to say it wasn't quite the same, but it was, it was a baby. I mean, I remember the day we, I brushed off, I had the manuscript UPS and it did feel like we were sending our baby away. Of course I didn't have the address where it was going. I had to text Kate. But anyway, it was fun. Yeah.

Dr. Laura Roberts: (15:23)

Well this book is called Supervision and Psychiatric Practice and the subtitle is Practical Approaches Across Venues and Providers. Uh, it's written and edited by Sally De Golia, and Kate Corcoran. And I just think it's a beautiful book. I want to thank you for this contribution to the field and I can hardly wait for what's next. That's great. Perfect. Absolutely perfect. I think actually what's interesting is that you guys ended up covering collaboration and not to be scared to do your first book in addition to just the content around this great book.

Dr. Sallie De Golia: (16:08)

I mean really, truly, it was a great process.