Graduate Student Corner with Nicole Cain
Newsletter Editor Nicole Cain
Long Island University - Brooklyn
Long Island University - Brooklyn
Applying Interpersonal Theory to Clinical Supervision
Nicole Cain
Long Island University - Brooklyn
Our graduate student representative, Mike Roche, asked me to write an essay about how I incorporate interpersonal theory into my approach to clinical supervision with my graduate students. While I’m still relatively new to supervision, I would like to offer some observations about how interpersonal theory has guided my supervision of clinical trainees.
One of my most influential supervisors (and also my research mentor) was Dr. Aaron Pincus. I remember early on in my clinical training, Aaron told me that when you enter the therapy room with a client, you also take into the room with you the advice and wisdom of your supervisor as well as what your supervisor has learned from his/her own supervisors. I have always taken great comfort in knowing that I have Aaron’s expertise with me in any given therapy session. But I also feel fortunate to have the wisdom of his mentors such as Jerry Wiggins and Lorna Smith Benjamin in the room with me as well. Now that I have begun to supervise the clinical work of my own graduate students, I find that I still rely on Aaron’s wisdom as well as the writings of Wiggins, Benjamin, and Sullivan to guide me.
For graduate students, some of the first challenges of doing therapy with clients are learning how to sit with a client, how to listen, and how to foster the therapeutic relationship. Listening often gets misconstrued as passivity, but I work with my supervisees to show them that what they are often “listening” for is any interpersonal communication occurring in the client’s behavior, tone of voice, gestures, and symptoms. This “listening” occurs through their active participation in the ongoing therapeutic relationship. The participant observer role (Anchin & Pincus, 2010) is often challenging for trainees new to therapy. It is both humbling and daunting to recognize that the therapeutic relationship is in fact an interpersonal situation in which both interactants are contributing overtly and covertly through their interpersonal communications.
As a supervisor, I recognize that supervision is also another interpersonal situation that the trainee engages in and that my role as a participant observer in supervision is to actively listen to the clinical material as well as offer observations about the interpersonal communications that are occurring in the therapeutic relationship. I challenge my supervisees to describe both the overt and covert processes happening in the therapy while also being mindful of their own interpersonal needs and motives.
I find that the Interpersonal Circumplex (IPC; Leary, 1957) is a useful nomological net to use in supervision to help trainees understand psychopathology and the therapeutic process. In the clinic where I supervise, all clients fill out the Inventory of Interpersonal Problems (IIP; Horowitz et al., 2000) at the beginning of their treatment. We use the client’s IIP data to inform case conceptualization as well as treatment planning. I teach my students how to use the IPC to inform their interventions and their understanding of the issues that may arise in the therapeutic relationship. For example, the IPC provides conceptual anchors and a lexicon to systematically describe interpersonal processes, such as interpersonal signatures, or consistent agentic and communal behavioral responses that a client may have in response to the perceived agentic and communal characteristics of others in an interpersonal situation (Pincus & Wright, 2011). For trainees, using the IPC to identify and describe their client’s interpersonal signatures offers a complex snapshot of how the client likely perceives self and other and helps the trainee to design treatment interventions to best target maladaptive interpersonal signatures.
In addition, the IPC offers a way for trainee therapists to understand how their client may perceive them and how they may in turn respond to their client via the principles of interpersonal complementarity (Kiesler, 1983). For example, a client may be responding to therapist warmth with fear, suspicion, anger, or indifference. This may unsettle a beginning therapist, but if they understand these interpersonal processes via the IPC and interpersonal complementarity, then they are able to intervene in more meaningful ways.
I’m also aware of how interpersonal complementarity impacts supervision. As a supervisor, I’m usually interpersonally friendly dominant, while the trainee is often interpersonally friendly submissive. This indicates a high degree of interpersonal complementarity in our interpersonal situation, but as a supervisor, I want my supervisee to learn to become more confident in their clinical ability and so I try to foster their agency by sometimes being more interpersonally submissive. This gives them a chance to be more agentic with me, which will help to foster their agency in the therapeutic relationship as well.
Finally, I encourage all of my supervisees to read Benjamin’s (2003) writings on Developmental Learning and Loving Theory (DLL). Anchoring trainees in this theory allows them to begin to understand and identify the developmental antecedents of and the “copy processes” that maintain the maladaptive interpersonal signatures they are noticing in their clients. Benjamin (2003) gives trainees a way to describe what is happening to the client so that the client can begin to understand and change.
As an interpersonal situation, therapy will not always go smoothly. I find that interpersonal theory offers a useful organizational framework for trainees to understand the necessary and ever present “bumps in the road.”
References
Anchin J. C., & Pincus, A. L. (2010). Evidence-based interpersonal psychotherapy with personality disorders: Theory, components, and strategies. In J. J. Magnavita (Ed.), Evidence-based treatment of personality dysfunction: Principles, methods, and processes (pp. 113-166). Washington, DC: American Psychological Association.
Benjamin, L. S. (2003). Interpersonal reconstructive therapy: Promoting change in nonresponders. New York, NY: Guilford Press.
Kiesler, D. J. (1983). The 1982 interpersonal circle: A taxonomy for complementarity in human transactions. Psychological Review, 90, 185-214.
Leary, T. (1957). Interpersonal diagnosis of personality. New York: Ronald Press.
Pincus, A.L., & Wright, A.G.C. (2011). Interpersonal diagnosis of psychopathology. In L.M. Horowitz & S. Strack (Eds.), Handbook of interpersonal psychology (pp. 359-381), Hoboken, NJ: Wiley.
Nicole Cain
Long Island University - Brooklyn
Our graduate student representative, Mike Roche, asked me to write an essay about how I incorporate interpersonal theory into my approach to clinical supervision with my graduate students. While I’m still relatively new to supervision, I would like to offer some observations about how interpersonal theory has guided my supervision of clinical trainees.
One of my most influential supervisors (and also my research mentor) was Dr. Aaron Pincus. I remember early on in my clinical training, Aaron told me that when you enter the therapy room with a client, you also take into the room with you the advice and wisdom of your supervisor as well as what your supervisor has learned from his/her own supervisors. I have always taken great comfort in knowing that I have Aaron’s expertise with me in any given therapy session. But I also feel fortunate to have the wisdom of his mentors such as Jerry Wiggins and Lorna Smith Benjamin in the room with me as well. Now that I have begun to supervise the clinical work of my own graduate students, I find that I still rely on Aaron’s wisdom as well as the writings of Wiggins, Benjamin, and Sullivan to guide me.
For graduate students, some of the first challenges of doing therapy with clients are learning how to sit with a client, how to listen, and how to foster the therapeutic relationship. Listening often gets misconstrued as passivity, but I work with my supervisees to show them that what they are often “listening” for is any interpersonal communication occurring in the client’s behavior, tone of voice, gestures, and symptoms. This “listening” occurs through their active participation in the ongoing therapeutic relationship. The participant observer role (Anchin & Pincus, 2010) is often challenging for trainees new to therapy. It is both humbling and daunting to recognize that the therapeutic relationship is in fact an interpersonal situation in which both interactants are contributing overtly and covertly through their interpersonal communications.
As a supervisor, I recognize that supervision is also another interpersonal situation that the trainee engages in and that my role as a participant observer in supervision is to actively listen to the clinical material as well as offer observations about the interpersonal communications that are occurring in the therapeutic relationship. I challenge my supervisees to describe both the overt and covert processes happening in the therapy while also being mindful of their own interpersonal needs and motives.
I find that the Interpersonal Circumplex (IPC; Leary, 1957) is a useful nomological net to use in supervision to help trainees understand psychopathology and the therapeutic process. In the clinic where I supervise, all clients fill out the Inventory of Interpersonal Problems (IIP; Horowitz et al., 2000) at the beginning of their treatment. We use the client’s IIP data to inform case conceptualization as well as treatment planning. I teach my students how to use the IPC to inform their interventions and their understanding of the issues that may arise in the therapeutic relationship. For example, the IPC provides conceptual anchors and a lexicon to systematically describe interpersonal processes, such as interpersonal signatures, or consistent agentic and communal behavioral responses that a client may have in response to the perceived agentic and communal characteristics of others in an interpersonal situation (Pincus & Wright, 2011). For trainees, using the IPC to identify and describe their client’s interpersonal signatures offers a complex snapshot of how the client likely perceives self and other and helps the trainee to design treatment interventions to best target maladaptive interpersonal signatures.
In addition, the IPC offers a way for trainee therapists to understand how their client may perceive them and how they may in turn respond to their client via the principles of interpersonal complementarity (Kiesler, 1983). For example, a client may be responding to therapist warmth with fear, suspicion, anger, or indifference. This may unsettle a beginning therapist, but if they understand these interpersonal processes via the IPC and interpersonal complementarity, then they are able to intervene in more meaningful ways.
I’m also aware of how interpersonal complementarity impacts supervision. As a supervisor, I’m usually interpersonally friendly dominant, while the trainee is often interpersonally friendly submissive. This indicates a high degree of interpersonal complementarity in our interpersonal situation, but as a supervisor, I want my supervisee to learn to become more confident in their clinical ability and so I try to foster their agency by sometimes being more interpersonally submissive. This gives them a chance to be more agentic with me, which will help to foster their agency in the therapeutic relationship as well.
Finally, I encourage all of my supervisees to read Benjamin’s (2003) writings on Developmental Learning and Loving Theory (DLL). Anchoring trainees in this theory allows them to begin to understand and identify the developmental antecedents of and the “copy processes” that maintain the maladaptive interpersonal signatures they are noticing in their clients. Benjamin (2003) gives trainees a way to describe what is happening to the client so that the client can begin to understand and change.
As an interpersonal situation, therapy will not always go smoothly. I find that interpersonal theory offers a useful organizational framework for trainees to understand the necessary and ever present “bumps in the road.”
References
Anchin J. C., & Pincus, A. L. (2010). Evidence-based interpersonal psychotherapy with personality disorders: Theory, components, and strategies. In J. J. Magnavita (Ed.), Evidence-based treatment of personality dysfunction: Principles, methods, and processes (pp. 113-166). Washington, DC: American Psychological Association.
Benjamin, L. S. (2003). Interpersonal reconstructive therapy: Promoting change in nonresponders. New York, NY: Guilford Press.
Kiesler, D. J. (1983). The 1982 interpersonal circle: A taxonomy for complementarity in human transactions. Psychological Review, 90, 185-214.
Leary, T. (1957). Interpersonal diagnosis of personality. New York: Ronald Press.
Pincus, A.L., & Wright, A.G.C. (2011). Interpersonal diagnosis of psychopathology. In L.M. Horowitz & S. Strack (Eds.), Handbook of interpersonal psychology (pp. 359-381), Hoboken, NJ: Wiley.