A Guide to Effective Supervision

As I reflect on the supervision I provide to others learning EFT, several observations quickly become apparent. First, there are significant parallels between the qualities that make me effective as a therapist and those that make me a good supervisor. In supervision I aim to provide a safe, supportive environment for supervisee’s to learn and grow, as they take risks to reveal themselves through their work. Second, I want to be genuine and transparent. While I can offer key guidance in practicing this model I have also encountered many of the same challenges that others face on the path to becoming an accomplished EFT therapist. And I am comfortable with my status as both a develop-ing guide and a continuing learner. Finally, I follow the process of the work I am observing and strive to describe it clearly and succinctly. How well is the therapist adhering to the model? When and how does he deviate? Does this reflect a lack of under-standing, skill, or an internal block of the therapist; or some combination of them all?

Supervision and the learning process
Learning EFT is a challenge because, like any experiential therapy, it requires not just a thorough understanding of the theory and intervention frameworks, but also the ability to be in the moment-by-moment experience with clients. It works best when we study the model, but don’t try overly hard in the session to adhere to a strict step-by-step process. I want to leave room for the therapist to have his own style of practicing EFT; the model is broad enough to accommodate a variety of therapeutic styles. After all, it’s the activation and reworking of attachment needs – not the charisma of the therapist – that helps couples grow. As an experiential therapy, EFT requires a careful balance between following and guiding clients, helping them work at the leading edge of their attachment emotions and needs. This fluidity between following, by carefully tracking emotional expression on the one hand and leading by reflecting, reframing, setting enactments, etc., is one of the more difficult aspects of learning EFT.

Starting Out
In providing EFT supervision, I am aware that I’m tuning into a therapy in progress, so I want to learn about the therapist’s style and skill level while providing guidance in case formulation and interventions. The therapist is taking a risk by sharing her work and asking for guidance, so my supervision style is respectful and supportive while being as clear as possible. We work on the supervision alliance by discussing at the outset the supervisee’s learning style, establishing learning objectives, assessing the current level of expertise and noting strengths and challenges in her overall development as a therapist. I acknowledge at the outset that it’s often easier to make suggestions as an outsider to the therapy than to see them in the heat of the moment with the couple.

I believe in a growth tendency in EFT practice as in other aspects of life and want to communicate my belief in the therapist’s capacity for development. Learning EFT is an evolving process of deepening understanding of the theory and process of therapy, improving one’s skill with the interventions and using one’s self to attune to and follow the rich attachment-related emotions involved in creating more secure relationships. I begin with the belief that with practice and guidance, the therapist will develop and grow.

Respect, Support and Encouragement
It is crucial to actively look for moments to applaud, particularly with less experienced therapists. I want the therapist to recognize what she does well and to feed her confidence whenever possible. When I hear a formulation or intervention that’s delivered well, I name it and tell her how good it is. I may then suggest a way of making a good intervention even better – with an image, or using RIIISC to evoke more emotion in the moment. I might say, “I love how you picked up on his non-verbal communication there and brought him deeper into the moment. Could you add the attachment frame by helping him see that he’s found all these ways to distance from his pain and it’s kept him feeling hurt and alone in this marriage?” The more a therapist struggles, the more focused I am regarding the specific skills and how to improve them. For example, a recent core skills participant who had sent me tapes of her work and was clearly struggling with the model was becoming discouraged and questioned her capacity to learn it. I sent her a lengthy email in which I encouraged her to stay with the process, shared some of my own challenges in learning the model and clarified the ways in which I saw her struggling – neglecting to utilize an attachment frame and missing opportunities to identify and work with primary emotions – and suggested specific ways to improve her work, including more tape review, watching training tapes while identifying the interventions and noting the use of attachment language and shifts from secondary to primary emotions.

As I listen to a session, I determine where they are in the process of therapy. If it’s early stage 1, I want to get clear on the cycle myself and reflect on whether the therapist is beginning to see it – particularly as it’s activated in the session – and can communicate it to the clients. I generally diagram the cycle and share it with the therapist with as much detail regarding the perceptions, behaviors, emotions and unmet attachment needs as I can add. In late stage 1 work, I look for the therapist to begin eliciting and working with attachment emotions and needs and help the clients to share this with each other through enactments. I listen for ways the therapist can help clients get a vivid picture of their own and each other’s experience. There may be something in the vocal tone or inflection, or a gesture that the therapist can use to access, identify, differentiate and share emotional processes. When listening to stage 2 sessions I listen for how attachment needs and fears are expressed and how the therapist can intensify their expression through effective heightening. Since many therapists struggle with heightening emotion in the moment, I frequently share images and metaphors that occur to me while listening. I then coach the therapist in providing the framework for clients to take risks to share their vulnerabilities with each other, often giving step-by-step guidance for setting up an enactment.

In making suggestions, I’m constructive and encouraging. If I believe the therapist has missed a key piece of the process I describe the interaction and present an alternative way of viewing the process. For instance if the therapist is moving into restructuring work without having achieved de-escalation, I’ll tell him what I hear that suggests the couple is not de-escalated, while stating clearly what is needed to achieve de-escalation and how to recognize it’s been achieved. Or upon hearing an intervention that is missing, ill-timed or poorly delivered, I guide by labeling the intervention, giving the rationale for it and demonstrating it. For example, I recently commented to a supervisee: “They don’t yet see their cycle, how they try to stay safe in all the attacking and distancing ways. Can you clarify it for them? I might say, ‘You have found no other way to live with all his disapproval so you’ve moved away to a safe distance to keep yourself in one piece and it’s left him completely unsure whether you’ll ever come back. He fears maybe you’ve already cashed out.’ And to him: ‘It’s terrifying to step into thin air so you do anything to avoid it – who wouldn’t? But your efforts to get her to respond tell her that you are not safe so she moves away from you and it’s just killing you inside.’”

Evaluation of Progress
I want to be specific in providing evaluative feedback on the therapist’s work so that he can address the areas that need further work. While I want to support and encourage, the clearer I can be about the therapist’s difficulties, the better he is able to focus his efforts to develop his skills. I’ll also suggest ways to improve his work. In evaluating a therapist’s work I leave plenty of room for him to have his own style; after all, although he’s using a model, he’s also using himself as he uses the model. And this is what makes EFT so exciting and appealing to me as a therapy model: As therapist and supervisor, it engages me at a deeply personal level as I see the basic human need for secure attachment playing out. It is compelling, real-life drama, and it’s gratifying to see therapists grow in their capacity to help couples create these enduring connections.