Front Matter
Publication: Supervising Individual Psychotherapy: The Guide to “Good Enough”
Supervising Individual Psychotherapy
The Guide to “Good Enough”
Supervising Individual Psychotherapy
The Guide to “Good Enough”
Edited by
Katherine G. Kennedy, M.D.
Randon S. Welton, M.D.
Frank E. Yeomans, M.D., Ph.D.
Note: The authors have worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family.
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Copyright © 2023 American Psychiatric Association Publishing
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First Edition
Manufactured in the United States of America on acid-free paper
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ISBN 978-1-61537-424-3 (print), 978-1-61537-425-0 (ebook)
American Psychiatric Association Publishing
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Washington, DC 20024-2812
Library of Congress Cataloging-in-Publication Data
Names: Kennedy, Katherine G., editor. | Welton, Randon S., editor. | Yeomans, Frank E., 1949– editor. | American Psychiatric Association, issuing body.
Title: Supervising individual psychotherapy : the guide to “good enough” / edited by Katherine G. Kennedy, Randon S. Welton, Frank E. Yeomans.
Description: First edition. | Washington, DC : American Psychiatric Association Publishing, [2023] | Includes bibliographical references and index.
Identifiers: LCCN 2022049309 (print) | LCCN 2022049310 (ebook) | ISBN 9781615374243 (print) | ISBN 9781615374250 (ebook)
Subjects: MESH: Psychotherapy—education | Preceptorship—methods | Internship and Residency—organization & administration | Psychiatry—education | Mentors
Classification: LCC RC480.5 (print) | LCC RC480.5 (ebook) | NLM WM 420 | DDC 616.89/14—dc23/eng/20221230
LC record available at https://lccn.loc.gov/2022049309
LC ebook record available at https://lccn.loc.gov/2022049310
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
Contributors ix
Acknowledgments xv
Katherine G. Kennedy, M.D.
Randon S. Welton, M.D.
Frank E. Yeomans, M.D., Ph.D.
Part I
Becoming a “Good Enough” Supervisor
1 Introduction: Am I Qualified to Supervise? 3
Randon S. Welton, M.D.
Katherine G. Kennedy, M.D.
2 Psychotherapy Supervision in Context: Historical and Theoretical Perspectives 11
Clifford Arnold, M.D., M.A.
Daniel Knoepflmacher, M.D., M.F.A.
3 The Supervisee’s Experience 21
Katherine G. Kennedy, M.D.
Randon S. Welton, M.D.
4 The Supervisor–Supervisee Relationship 33
Katherine G. Kennedy, M.D.
Randon S. Welton, M.D.
David A. Adler, M.D.
5 Ethical Issues in Psychotherapy Supervision 51
Kevin V. Kelly, M.D.
6 Practical Methods That Foster Supervisor Growth 65
Erin M. Crocker, M.D.
Sindhu A. Idicula, M.D.
Randon S. Welton, M.D.
Part II
How to Supervise Psychodynamic Psychotherapy
7 The Process of Psychotherapy Supervision 83
Monica Carsky, Ph.D.
Frank E. Yeomans, M.D., Ph.D.
8 Setting Goals for Psychotherapy Supervision 101
Randon S. Welton, M.D.
Katherine G. Kennedy, M.D.
Frank E. Yeomans, M.D., Ph.D.
9 Using Process Notes and Audio and Video Recordings in Psychotherapy Supervision 111
Katherine G. Kennedy, M.D.
Theunis O. de Boer, B.A.
Randon S. Welton, M.D.
Frank E. Yeomans, M.D., Ph.D.
10 When Psychotherapy Supervision Is Virtual 121
Seamus Bhatt-Mackin, M.D., C.G.P.
Aimee Murray, Psy.D., L.P.
Magdalena Romanowicz, M.D.
Anne E. Ruble, M.D., M.P.H.
David R. Topor, Ph.D., M.S.-H.P.Ed.
11 Supervising Integrated Psychotherapy and Pharmacotherapy 135
David Mintz, M.D.
Marina Bayeva, M.D., Ph.D.
12 Termination of Psychotherapy Supervision 149
Rebecca Nejat, M.D.
Natasha Chriss, M.D.
Part III
Factors That Affect Psychotherapy Supervision
13 Race, Culture, and Ethnicity in Psychotherapy Supervision 165
Dionne R. Powell, M.D.
14 Gender Influences in Psychotherapy Supervision 187
Rosemary H. Balsam, FRCPsych (Lond),
MRCP (Edinburgh)
15 Supervision of Psychotherapy With Lesbian, Gay, Bisexual, and Transgender Patients 199
Stewart Adelson, M.D.
Jack R. Keefe, Ph.D.
Frank E. Yeomans, M.D., Ph.D.
16 Psychotherapy Supervision for the Treatment of Substance Use Disorders 217
Kimberly R. Stubbs, M.D.
Yi-lang Tang, M.D., Ph.D.
17 Supportive Psychotherapy Supervision in the Acute Care Setting 231
Annabel C. Boeke, M.D.
David Veith, M.D.
Alison E. Lenet, M.D.
Deborah L. Cabaniss, M.D.
Appendix: 3-Step Supportive Psychotherapy Manual 245
18 Supervision of Cognitive-Behavioral Therapy 251
Donna M. Sudak, M.D.
Evgenia Royter, D.O.
Part IV
Challenges in Psychotherapy Supervision
19 The So-Called Difficult Supervisee 267
Allison Cowan, M.D., DFAPA
20 Psychotherapy Supervision During Major Life Transitions 281
Tina Kaviani, M.D.
Adam Brenner, M.D.
21 Sexual Issues in Psychotherapy Supervision 295
Alyson Gorun, M.D.
June Elgudin, M.D.
Christian Umfrid, M.D.
22 Dealing With Death and Suicide in Psychotherapy Supervision 309
Michael F. Myers, M.D.
23 When Lines Get Blurred 323
Cecil R. Webster Jr., M.D.
24 Legal Considerations in Psychotherapy Supervision 337
Maya G. Prabhu, M.D., LL.B.
25 Addressing Exhaustion and Burnout in Psychotherapy 351
Supervision
Randon S. Welton, M.D.
Katherine G. Kennedy, M.D.
Mary C. Vance, M.D., M.Sc.
Index 363
Contributors
Stewart Adelson, M.D.
Clinical Associate Professor, Weill Medical College of Cornell University, New York, New York; Adjunct Assistant Clinical Professor, Columbia University Vagelos College of Physicians & Surgeons, New York, New York; Senior Visiting Fellow, Yale Law School, New Haven, Connecticut
David A. Adler, M.D.
Professor of Psychiatry and Medicine, Tufts University School of Medicine; Senior Psychiatrist, Department of Psychiatry, Tufts Medical Center, Boston, Massachusetts
Clifford Arnold, M.D., M.A.
Child and Adolescent Psychiatrist, COMCARE of Sedgwick County, Wichita, Kansas
Rosemary H. Balsam, FRCPsych (Lond), MRCP (Edinburgh)
Associate Clinical Professor of Psychiatry, Yale Medical School; Staff Psychiatrist, Department of Mental Health & Counseling, Yale University; Training and Supervising Analyst, Western New England Institute for Psychoanalysis, New Haven, Connecticut
Marina Bayeva, M.D., Ph.D.
Fellow in Hospital-Based Psychotherapy and Psychoanalytic Studies, Austen Riggs Center, Stockbridge, Massachusetts
Annabel C. Boeke, M.D.
PGY4 Psychiatry Resident, Columbia University Department of Psychiatry/New York State Psychiatric Institute, New York, New York
Adam Brenner, M.D.
Professor of Psychiatry and Distinguished Teaching Professor, and Vice Chair for Education and Residency Training Director in Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
Deborah L. Cabaniss, M.D.
Associate Director of Residency Training and Professor of Clinical Psychiatry, Columbia University Department of Psychiatry/New York State Psychiatric Institute, New York, New York
Monica Carsky, Ph.D.
Clinical Assistant Professor of Psychology in Psychiatry and Senior Fellow, Personality Disorders Institute, Weill Medical College of Cornell University; Adjunct Assistant Professor, New York University Postdoctoral Program in Psychoanalysis and Psychotherapy; Faculty, Institute for Psychoanalytic Training and Research, New York, New York
Natasha Chriss, M.D.
Clinical Assistant Professor of Psychiatry, Weill Cornell Medicine, New York, New York
Allison Cowan, M.D., DFAPA
Associate Professor and Deputy Training Director, Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
Erin M. Crocker, M.D.
Clinical Associate Professor and Residency Training Director, Department of Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Theunis O. de Boer, B.A.
Medical Student, Northeast Ohio Medical University, Rootstown, Ohio
June Elgudin, M.D.
Resident Physician, Department of Psychiatry, Weill Cornell Medical College, New York, New York
Alyson Gorun, M.D.
Assistant Professor of Clinical Psychiatry, Weill Cornell Medical College; Assistant Attending Psychiatrist, New York–Presbyterian Hospital, New York, New York
Sindhu A. Idicula, M.D.
Associate Professor of Psychiatry and Pediatrics, Associate Program Director, and Director of Psychotherapy Education, Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas
Tina Kaviani, M.D.
Assistant Professor of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
Jack R. Keefe, Ph.D.
Research Fellow and Clinical Supervisor, Psychiatry Research Institute at Montefiore Einstein, Albert Einstein College of Medicine, Bronx, New York
Kevin V. Kelly, M.D.
Clinical Professor of Psychiatry and of Ethics in Medicine, Weill Cornell Medicine; Medical Officer, New York City Fire Department, New York, New York
Katherine G. Kennedy, M.D.
Assistant Clinical Professor of Psychiatry, Yale University, New Haven, Connecticut
Daniel Knoepflmacher, M.D., M.F.A.
Vice Chair of Education, Director of Residency Training in Psychiatry; Assistant Professor of Psychiatry, Weill Cornell Medicine/New York–Presbyterian, New York, New York
Alison E. Lenet, M.D.
Assistant Clinical Professor of Psychiatry, Columbia University Department of Psychiatry/New York State Psychiatric Institute, New York, New York
Seamus Bhatt-Mackin, M.D., C.G.P.
Director, Program for Clinical Group Work, VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC); Staff Psychiatrist, Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans Clinic, Durham Veterans Affairs (VA) Medical Center; Consulting Associate, Duke University Department of Psychiatry and Behavioral Sciences, Durham, North Carolina
David Mintz, M.D.
Director of Psychiatric Education, Associate Director of Training, and Team Leader, Austen Riggs Center, Stockbridge, Massachusetts
Aimee Murray, Psy.D., L.P.
Assistant Professor, Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota
Michael F. Myers, M.D.
Professor of Clinical Psychiatry, Department of Psychiatry & Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York
Rebecca Nejat, M.D.
Clinical Assistant Professor of Psychiatry, Weill Cornell Medicine, New York, New York
Dionne R. Powell, M.D.
Clinical Assistant Professor of Psychiatry, Weill Cornell Medical College; Assistant Attending Psychiatrist, New York–Presbyterian Hospital, New York, New York; Training and Supervising Analyst, Psychoanalytic Association of New York and the Columbia University Center for Psychoanalytic Training & Research
Maya G. Prabhu, M.D., LL.B.
Chief Consulting Forensic Psychiatrist, Connecticut Department of Mental Health and Addiction Services, Division of Forensic Services; Associate Professor, Division of Law and Psychiatry, Department of Psychiatry, Yale School of Medicine; Clinical Associate Professor of Law, Yale Law School, New Haven, Connecticut
Magdalena Romanowicz, M.D.
Associate Professor, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
Evgenia Royter, D.O.
Psychiatry Resident, Tower Health-Phoenixville Hospital, Phoenixville, Pennsylvania
Anne E. Ruble, M.D., M.P.H.
Director of Psychotherapy Training and Associate Program Director, Adult Psychiatry Residency, Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland
Kimberly R. Stubbs, M.D.
Volunteer Faculty, Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
Donna M. Sudak, M.D.
Professor of Psychiatry, Drexel University; Program Director, General Psychiatry Residency, Tower Health-Phoenixville Hospital, Phoenixville, Pennsylvania
Yi-lang Tang, M.D., Ph.D.
Associate Professor, Department of Psychiatry and Behavioral Sciences, Emory University; Substance Abuse Treatment Program, Atlanta VA Medical Center, Decatur, Georgia
David R. Topor, Ph.D., M.S.-H.P.Ed.
Deputy Associate Chief of Staff for Education, Veterans Affairs Boston Healthcare System; Associate Professor, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
Christian Umfrid, M.D.
Assistant Professor of Clinical Psychiatry, Weill Cornell Medical College; Assistant Attending Psychiatrist, New York–Presbyterian Hospital, New York, New York
Mary C. Vance, M.D., M.Sc.
Director of Behavioral Health, Pacific Area, United States Coast Guard, Alameda, California; Assistant Professor of Psychiatry and Scientist, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, Maryland
David Veith, M.D.
Chief Psychiatry Resident, Columbia University Department of Psychiatry/New York State Psychiatric Institute, New York, New York
Cecil R. Webster Jr., M.D.
Lecturer in Psychiatry, Harvard Medical School McLean Hospital, Boston, Massachusetts
Randon S. Welton, M.D.
The Margaret Clark Morgan Professor and Chair of Psychiatry, Northeast Ohio Medical University, Rootstown, Ohio
Frank E. Yeomans, M.D., Ph.D.
Clinical Associate Professor of Psychiatry and Director of Training at the Personality Disorders Institute, Weill Medical College of Cornell University, New York, New York; Adjunct Associate Clinical Professor of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons Center for Psychoanalytic Training and Research, New York, New York; President, International Society of Transference-Focused Psychotherapy, Vienna, Austria
Acknowledgments
Editing this collection of chapters by so many brilliant and thoughtful authors has been an honor and a privilege. Thank you to my co-editors and to all of the contributors—some of whom are my past supervisors and supervisees—for indulging my questions, accepting my feedback, and, at times, using your better judgment to override my edits. I am also deeply grateful to every one of my former supervisors, from whom I have learned so much, and to my former supervisees, from whom I have learned even more. Finally, I could never have accomplished this effort without the love, support, and dinner-making skills of my family—Ted, Kiley, and Teddy. My wish for this book is that new supervisory discussions are sparked and new supervisors inspired.—KGK
As we complete this book, my gratitude is more than I can express. I want to thank my parents—David and Deanna—for always believing in me; my wife—Michelle—for always being by my side; and my kids—Sean and Shannon—for the joy and purpose they bring to my life. I am unbelievably honored to have worked with my co-editors on this project and am still surprised that they let me tag along with them on this journey. To all of our contributors: Thank you for putting up with me. Lastly, I want to thank my former supervisors and supervisees: You have taught me more than I can remember and have inspired me more than I can say.—RSW
First, I would like to thank my co-editors, who initiated this volume and did the heavy lifting, and the talented group of authors, who have made the book what it is. Because supervision never ends, the list of the supervisors who have inspired me gets longer as the years go on. Among these, I would especially like to acknowledge Otto Kernberg, Paulina Kernberg, Ann Appelbaum, Herb Schlesinger, Richard Munich, Michael Stone, Michael Selzer, my colleagues in our ongoing weekly co-supervision, and especially Carlos, my longest and most reliable supervisor. Finally, my thanks go to the many patients who have taught me to better appreciate the far reaches of the heart and mind and have helped me to try to bring that knowledge to those I teach.—FEY
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Supervising Individual Psychotherapy: The Guide to “Good Enough”
Pages: i
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Published in print: 28 April 2023
Published online: 5 December 2024
© American Psychiatric Association Publishing
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