Clifton Edward Watkins, Jr.

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• Ph.D.
• Professor at University of North Texas

Objective: The first substantive article to address cultural humility in psychotherapy supervision appeared in a 2016 issue of this journal. The aim of this review is to update that 2016 article, providing a conceptual-practical and empirical status report about cultural humility’s increasing integration into psychotherapy supervision. Methods: A h...

The authors make the case for using a written instead of a spoken supervision agreement at supervision’s outset in order to provide clarity and education about supervision, supply an accessible document that supervisees can readily reference, sidestep memory issues that negatively affect the supervision process, and enable dyadic collaboration that...

The supervision agreement (also referred to as a contract), while long mentioned as an important part of psychoanalytic supervision, has yet to be addressed in any substantive or concrete way in the psychoanalytic supervision literature. What exactly is a psychoanalytic supervision agreement? Why does it matter? What are its components? How do you...

Becoming a psychotherapy supervisor is no easy feat, and conceptual/practical material and empirical data suggest that beginning (compared to more advanced) supervisors are at their most vulnerable and most apt to struggle with issues of identity, confidence, self-efficacy, and competency development. Beginning supervisors can benefit from being he...

The supervision rupture literature has emphasized supervisor rupturing behavior and reparative actions. But supervisees engage in rupturing actions, too. How might their rupturing behavior impact the supervisor/supervisory relationship? And what do supervisors do about supervisee ruptures in order to move forward? I subsequently (re)consider the ru...

Steps have been taken to understand cultural processes within supervision. A recent qualitative analysis established a framework that summarized themes for how supervisees experience helpful, hindering, and missing events in multicultural supervision with predominantly White supervisees (Wilcox, Winkeljohn Black, et al., 2022). This analysis builds...

Present volume represents the authors' interest in sharing their practical experience in working with adults, children, and adolescents. Each work (nine contributions in all) expresses the theoretical vision and practical way of intervening with different categories of clients.

Hoggan’s taxonomy of transformative learning outcomes, while applied to the psychotherapy supervisee, has yet to be applied to the psychotherapy supervisor; we subsequently provide that application. The beginning supervisor development period, often identified as the most difficult and potentially problematic, involves struggles to define a supervi...

The concept of insight has been approached through the prism of several psychotherapeutic approaches and is a variable of interest in the field of psychotherapy and supervision. During psychotherapy training and supervision, cultivating and practicing insight in trainees will contribute to personal development and increase the effectiveness of psyc...

Cultural humility is important in supervision; however, studies have primarily sampled White supervisees. Racially and ethnically minoritized trainees experience microaggressions during their training, yet cross-racial supervision is less often studied. We examined a moderated mediation model to test whether the supervisory working alliance mediate...

IncorporacIón de la humIldad cultural y las pautas de humIldad cultural en la relacIón de supervIsIón de la psIcoterapIa: un compromIso y una promesa IncorporatIng cultural humIlIty and cultural humIlIty guIdelInes Into the psychotherapy supervIsIon relatIonshIp: a pledge and a promIse c. edward Watkins ORCID: http://orcid.org/0000-0001-9137-5526 _...

We are happy to share with you our guidebook about the quintessentials of competency-based supervisor training and, in doing so, also present a systematic competency-based program for conceptualizing and conducting supervisor training.

Clinical supervision is a cornerstone of clinical training, and supervision experiences are associated with important outcomes (e.g., stronger working alliances and more trainee disclosures in supervision). Psychology has made strides in understanding how cultural processes unfold in supervision, with the multicultural orientation (MCO) model garne...

Fourth edition of conference proceedings, giving focus to child and adolescent psychotherapy studies.

This study started from the observation that after completing training in a therapeutic orientation, some trainees turn to other supervisors, with a background in other therapeutic orientation and registered with other training providers. The supervisee has the right to choose the supervisor, and the supervisor has the right to accept or not to sig...

The Supervision Pyramid provides an effective supervision tool that attends to the supervisee, the client, and the supervisor. It is divided into four levels: identifying the problem; exploring and elaborating on what is learned; experimentation and consolidation; and solving the problem with the goal of the supervisee’s increased capacity to i...

Supervision theories or models have traditionally not been centered on cross-cultural supervision (e.g., American clinical supervisors working with international trainees). To this end, this qualitative study sought to explore cross-cultural supervision from the perspective of clinical supervisors. A total number of 10 supervisors participated in...

In our reaction to Ballantyne (current issue), we consider a question we view as important when considering applied work on intellectual humility: What motivates us to be intellectually humble, and how does our cultural context influence our motivations? In particular, we reflect on the potential benefits and costs of intellectual humility. Compare...

I subsequently summarize the quintessentials of my talk, “Core Quintessentials of Psychoanalytic/Psychodynamic Supervisory Thought and Action: In Three Parts”, presented to the British Association for Psychoanalytic/Psychodynamic Supervision, 8 October 2022. I give focus to three ever fundamental, foundational areas: (a) the anchoring convictions t...

This study examined whether fracturing of specific facets of the therapeutic alliance—goal, task, and bond—were more likely to be associated with a therapeutic alliance rupture by evaluating 988 psychotherapy sessions for ruptures. Furthermore, we used the frequency of alliance ruptures to predict treatment outcome in a sample of outpatient psychot...

The beginning period of psychotherapist development has been conceptually and empirically identified as the most difficult and potentially problematic. The budding therapist is struggling to define a therapist identity, settle into the role of being a “helper,” and come to grips with being a helper who can “heal.” That struggle, I contend, is at it...

How do psychotherapy supervisors most effectively integrate issues and concerns about multiculturalism and social justice (MSJ) into the supervisory experience? Concrete examples of how to best address this integration are needed, and this article provides one such example. The authors propose multicultural streaming as one approach to orient super...

Research has demonstrated that therapists’ multicultural orientation (MCO)—consisting of cultural humility, cultural comfort, and cultural opportunities—is key to client outcomes. The primary method for training psychotherapists is clinical supervision, and recent quantitative research provides preliminary support for the importance of MCO in clini...

The multicultural orientation framework (MCO), which has shown empirical promise as a pragmatic way to enhance cultural understandings in psychotherapy, appears equally important for psychotherapy supervision: Emerging conceptual/practical work and a bourgeoning base of empirical studies support MCO’s contribution to supervision processes and outco...

Cultural humility, first introduced a quarter century ago, has increasingly emerged over the last decade as a concept of considerable importance: it has been touted as playing a crucial role in potentially enhancing the relationship in both psychotherapy and supervision, its practice being heartily embraced and roundly recommended. But are those re...

We contend that a particular form of self-efficacy beliefs-specifically referred to as relation-inferred self-efficacy beliefs-often gets activated in beginning supervisees, can potentially pose supervision problems from the outset and, consequently, is best addressed by supervisors early on. Relation-inferred self-efficacy beliefs refer to what su...

Third coordinated volume in series, with ten chapters about child and adolescent psychotherapy studies

Supervision with international supervisees is both cross-cultural and cross-linguistic in nature. This study explored international supervisees’ experiences during the clinical supervision process, with 10 international supervisees (5 females, 5 males; Mage=31.60) participating in a qualitative study. Four themes were identified: (1) challenging as...

Ruptures have long been an issue of concern in the supervision literature: They have the potential to compromise, if not derail and destroy, the entirety of the supervision relationship. Two basic steps – opening up discussion about and collaboratively processing the rupture – have been identified as central to increasing the likelihood of successf...

The organisation and supervision of a group of therapists, during a long period of time, are commitments that the supervisor thinks about both before starting the activity with the group and throughout the existence of the group. Supervision models can provide a mental map accordingly used by the supervisor in the journey with each supervisee, but...

Second coordinated volume in series, with seven chapters about child and adolescent psychotherapy studies

Psychotherapy supervision research, while reflecting empirical advances across the decades, also reflects unfulfilled promise. We subsequently consider why that is so, examining some of the roadblocks that seemingly have prevented supervision research from moving most fruitfully forward. It is our contention that rich seeds of supervision research...

Supervision has been called the “signature pedagogy” of psychotherapy, and recent literature has emphasized the importance of multicultural processes in supervision. Despite the recent advances in the area of multicultural orientation, much of the existing work on the application of multicultural orientation to clinical supervision, however, has be...

Book gives focus to using the supervision pyramid in supervision. Book reflects Dr. Vîşcu's work in Romania and her efforts to advance supervision as a professional practice.

The Supervision Pyramid can be used as a supervision tool for individual and group supervision. The Pyramid is first presented, explained to supervisees, and then applied during supervision sessions. During these sessions, Pyramid advantages and disadvantages are also emphasized.

This chapter offers a list of transversal competencies, which are necessary for competent therapy and supervision practice. The first directions for competency standards were provided by the Bologna Declaration and the Quebec Secondary School. The therapist and clinical supervisor Competencies Schema proposed here underlines specific skills that ca...

Chapter 9 reflects changes and challenges that have arisen at the national and international levels because of the Coronavirus fight. All professional activities - therapy, supervision, and training - have had to change environments to survive. Online platforms have offered the perfect means by which to implement these changes. However, the persona...

Supervision is an event co-worked by the supervisor and the supervisee. It demands the involvement of both actors in using proper educational and professional development tools. The Supervision Pyramid Watkins, Callahan and Vîşcu (2020) is one such facilitative tool, potentially useful in stimulating supervisees’ personal and professional developme...

Social constructivism (Lev Vîgotsky) and cognitive constructivism (Jean Piaget), important sources in education, also have relevance for clinical supervision. The Supervision Pyramid has proven to be a constructivist learning tool. The first level of the SP can be conceptualized as reflecting deconstruction, the next two levels as reflecting constr...

During the supervision process the supervisor has at hand different tools, based on dialogue and questions, to help the supervisee in solving supervisory issues. The Supervision Pyramid, proposed as a helping tool in the supervisory process is also based on the dialogue with the supervisee. Thus, for each of the four levels of the Supervision Pyram...

The supervision relationship can undergo conflict and ruptures. This chapter defines the terms of rupture and rupture repair and identifies supervisor actions that can make rupture repair more likely. The Supervision Pyramid is used to explain the rupture reparative process.

Supervision and education share similarities, which are readily reflected in writings about learning, evaluation, and teaching. Pedagogical evaluation methods can be useful in supervision; we subsequently consider how that is so. Focus is also given to reflection, a critical competency for the work of therapist, supervisee and supervisor.

Humility has been increasingly recognized and elaborated upon as a critical variable for effective supervision practice. Just as humility is considered to be a foundational life virtue, it may be a foundational supervision virtue as well. But we lack for any justifying support base of humility/supervision research to affirm that being so. Might the...

What follows are my reactions to the humility publications authored by McMahon (2020), Jones and Branco (2020), Gutierrez et al. (2020), and Beinart (2020). I (a) heartily embrace McMahon’s (2020) five touchstones for fostering supervisor humility development and indicate why I view them as so valuable; (b) dub Jones and Branco’s (2020) broaching a...

Could it be that parallel process is more a product of ‘wild analysis’ than reasoned reflection? I consider that question subsequently, selectively reviewing parallel process case examples and anecdotes across the last six decades. Extending an earlier parallel process examination (Watkins, 2017), I look further into a host of published case anecdo...

Objective: The objective of this review was to answer the question, What do supervisors actually do in promoting transformative change in the beginning therapist supervisee? New therapist trainees, lacking treatment skills and a sense of “therapist identity,” are prone to experience self-doubt, feel anxious and demoralized, and think of themselves...

Humility has been increasingly recognized and elaborated upon as a critical variable for effective therapeutic practice and training. But all considerations thus far have focused virtually exclusively on supervisor or therapist humility, the psychotherapy trainee’s humility going unexamined. What role might humility play in the trainee’s own therap...

I earlier proposed common factors, common processes, common practices supervision perspective, identifying a number of cross-cutting, trans-theoretically applicable, practice-defining supervision commonalities. In what follows, I update that earlier proposal, detailing ways in which the perspective has since evolved. Ten different areas of supervis...

Provides seven chapters about child and adolescent psychotherapy studies

Psychotherapy supervision, as an ever-evolving signature pedagogy, is briefly described, its essentials summarized.

What do clinical supervision research reviews across the last 25 years tell us? That question is subsequently examined. Based on database and literature searches, 20 reviews appearing from 1995 through 2019 were identified for survey examination; consistencies, inconsistencies and other defining features were determined across reviews; and the surv...

We take up three fundamental considerations: (a) regardless of supervisory perspective adopted, there is a common process to supervision session process; (b) supervision is a cyclical affair across sessions and, oftentimes, even within sessions; and (c) beginning supervisor trainees, whatever the supervisory perspective to which they will eventuall...

What are the binding commonalities that demark and define any and all psychoanalytic supervision perspectives? What do we all do as psychoanalytic supervisors that practically matters? Furthermore, might there be a unifying model that anchors those binding commonalities together into a supervision meaning-making, explanatory framework? In this two-...

We contend that supervisor humility, a critical variable for effective supervisory practice, has a particular impact on the rupture repair process and its implementation; it may well be preeminent in determining whether any supervisor repair effort meets with success or failure. Building on our earlier supervisor humility/rupture repair proposals,...

Although recognized as highly crucial to supervision practice (e.g., Tummala-Narra, 2004), culture has been addressed minimally in the psychoanalytic supervision literature. Calls to remedy that limitation have been made and making culture matter has been identified as a most pressing need for psychoanalytic supervision. But how then do we as super...

As a complement to multicultural competence, the multicultural orientation (MCO) perspective has been proposed as a pragmatic way to enhance cultural understandings about psychotherapeutic dynamics, processes, and outcomes. Consisting of three core components—cultural humility, cultural comfort, and cultural opportunities—the MCO is considered rele...

In this introduction to the special issue “Supervisee Perspectives on Supervision Processes,” we provide a theoretical grounding and overview the research context of the articles across the special issue. With respect to theory, the articles in this special issue are conceptualized as reflecting key intersecting input, process, and output variables...

Counseling/Therapy Interventions for Children and Adolescents

I subsequently (a) consider three mega-shifts in supervisory thinking — supervision as system, supervision as relationship, and supervision as developmental process — that seemingly have affected all that supervision is and all that supervision will forever be, and (b) then identify ever crucial, mega-shift-consistent supervision essentials that ar...

We propose that supervisor humility is a critical variable for effective supervisory practice, fundamental, foundational, and potentially transformational in its impact. We examine humility, and the different types of humility (e.g., intellectual humility), that can impact supervision practice. Supervisor humility is considered to be supportive of...

Some key supervision research findings are summarized, and a research model is proposed.

Attention is given to identifying and addressing ruptures in the supervision relationship.

Supportive psychotherapy may no longer be neglected, but its supervision process surely is. Because supportive psychotherapy supervision is so vital to competent therapeutic practice; can be a highly challenging, demanding form of supervision to implement; and can involve its own set of unique challenges, that very uniqueness needs to be addressed...

Might Practice Self (or therapist identity) formation in clinical supervision be profitably conceptualized as a transformative learning process? In this article, drawing on Mezirow’s (2000, 2003, 2006, 2012) transformative learning theory, we consider that question. We give particular focus to Mezirow’s ten-phase process of transformation, whereby...

Just as patients' internal representations of the therapist can play an important role in the treatment process, might supervisees' internal representations of the supervisor similarly play an important role in the supervision process? I subsequently consider that question, proposing that: (a) supervisees' internal supervisor representations have t...

The Integrative Therapist (the Society for the Exploration of Psychotherapy Integration newsletter) presents a series of structured interviews on the topic of psychotherapy training, asking 14 SEPI members to respond to three particular questions about the teaching and learning of psychotherapy. My responses to those three questions follow.

Though still young in its development, a foundation of research is emerging regarding admissions, curriculum, and research training in psychology. It is unclear, however, the degree to which this foundation informs the actions of psychology educators and training programs. We review the emerging evidence, giving specific focus to the following 3 ar...

Any psychologist in the course of his or her professional career will affect thousands of lives. It stands to reason then that the training of psychologists is, in its own way, a systems-level intervention with tremendous social impact. In the ideal world, training, like other interventions, would be grounded in evidence. But what exactly do we kno...

In this third installment of our review on the science of training, we examine empirical articles associated with two pan-training areas, supervision and competency, before considering the capstone predoctoral training experience of internship. Critical issues considered include supervision effectiveness, differences and diversity in supervision, c...

Following a brief review of the evidence available at the time, Christensen and Jacobson (1994) concluded that professional training was unwarranted on the basis of client outcomes. As a result, they advocated for psychologists to focus on program development, training, and supervision while promoting an expansion of paraprofessional-, peer-, and s...

Adapting the therapeutic pyramid (Fife, Whiting, Bradford, & Davis, 2014) to supervision, the supervision pyramid is presented and described. A simple meta-model of the broad-band conceptual organizers of supervisor contribution, the supervision pyramid consists of three transcendant commonalities: Supervisor skills and interventions, the superviso...

I subsequently (a) consider three mega-shifts in supervisory thinking — supervision as system, supervision as relationship, and supervision as developmental process — that seemingly have affected all that supervision is and all that supervision will forever be, and (b) then identify ever crucial, mega-shift-consistent supervision essentials that ar...

Might the generic model of psychotherapy (Orlinsky & Howard, 1985, 1987) be profitably analogized to supervision? Might we propose a generic model of psychotherapy supervision that provides a valuable framework for (a) trans-theoretically conceptualizing the commonly practiced supervision process essentials, (b) organizing the ever-evolving body of...

If unification is a fifth pathway to psychotherapy integration, how is that pathway reflected in our supervisory efforts? What might be some essentials of a unification-informed psychotherapy supervision? I consider those questions subsequently. Whereas a unified psychotherapy perspective continues to be increasingly articulated (e.g., Henriques, 2...

Three extended examples of educationally corrective experiences case dialogue

Las experiencias educativamente correctivas como un factor común en la supervisión de la psicoterapia: un breve informe Así como existe la experiencia del tratamiento correctivo en psicoterapia (Goldfried, 1991, 2012), ¿podría haber una experiencia correctiva con fines educativos en la supervisión de la psicoterapia? Posteriormente, considero esa p...

Value conflicts between supervisees and supervisors can adversely affect supervisee development, service provision, and the supervision relationship. However, the role of value conflicts in supervision has been minimally considered. Building on the Farnsworth and Callahan (2013) model for addressing client-clinician value conflict, we propose a sup...

Change strategies/principles, a well-recognized and accepted component of therapeutic practice, have yet to be comparably considered in psychotherapy supervision. Can there be educational change strategies/principles for psychotherapy supervision? I take up that question subsequently. I contend that supervision is forever a principle-driven activit...

Might there be a unifying model that anchors and binds together those very commonalities presented in PART I?In Part II of this poster presentation, I consider that question. I propose and elaborate upon the Contextual Psychoanalytic Supervision Relationship Model (an update/revision of Watkins/Callahan [2016]) —a theoretically-grounded model that...

Although increasing attention has been directed toward considering the common ground of psychoanalytic treatment, we lack for comparable attention to the common, unifying ground of psychoanalytic supervision. What are the binding commonalities that demark and define any and all psychoanalytic supervision perspectives? What do we all do as psychoana...

Combines full text of APA Poster I and Poster II into a single handout.

We have lacked for a common, unifying vision of supervision. In this presentation, I consider one such vision: A common factors, common processes, common practices psychotherapy supervision perspective. I (a) give attention to those critical commonalities that seemingly matter most across any and all forms of supervision and (b) propose a meaning-m...

Attachment theory, which has demonstrated application in caregiver-child, romantic, and psychotherapeutic relationships, also appears to be supervision relevant. But bad blood between attachment theory and psychoanalysis may well have hampered considering the relevance of attachment theory for psychoanalytic supervision. This project sought to inve...

In this brief communication, we offer one perspective – the contextual psychoanalytic supervision model (CPSM) – on how psychoanalytic supervision works. The CPSM, a supervisory extrapolation of Wampold’s contextual psychotherapy relationship model, accentuates four psychoanalytic supervisor–supervisee relationship variables as crucial and change i...

Abstract for Part I: Recently, much attention has been given to a unified psychotherapy and its practice; however, focus on supervision of those learning the techniques is lacking. What might be some elements of a unification-informed psychotherapy supervision? What core variables contribute to a productive versus unproductive supervision experienc...

Allegiance, long regarded as a significant variable in psychotherapy and psychotherapy research, has been ignored in the psychotherapy supervision literature. It is our contention that allegiance is similarly significant for psychotherapy supervision. In this brief communication, we define supervisor allegiance, consider its impact on supervision o...

A much hallowed concept, parallel process has been referred to as supervision’s signature phenomenon, having now been a part of psychoanalytic and psychotherapy supervision for over 60 years. But I propose that much of parallel process is a fiction, and in what follows, I consider why I believe that to be so. Though promising, parallel process rese...

¿Cómo trabaja la supervisión en la psicoterapia? Contribuciones de conección, concepción, lealtad, alineación, y acción ¿Cómo trabaja la supervisión en la psicoterapia? ¿Y por qué algunos bajo supervisión se benefician y otros no? Estas preguntas son consideradas y el Modelo de la Relación en Supervisión Contextual (Contextual Supervision Relations...

Just as the analyst’s self-perspective is critical to effective analytic process, the supervisor’s self-perspective is accordingly critical to effective supervision process. But the supervisor’s self-perspective has received virtually no attention as a listening/experiencing per- spective in the psychoanalytic supervision literature. In this paper,...

In this article, I examine the question “What are some essentials of a self psychology perspective on the supervisory process?” I subsequently make an effort to (1) identify and review self psychology supervisory materials that have appeared over the last 35 years; (2) determine the primary messages, salient themes, and crucial features that define...

Convergencia en la supervisión de psicoterapia: Una perspectiva de factores comunes, procesos comunes y prácticas comunes La literatura sobre la supervisión transteórica y de factores comunes es limitada. A pesar de que las similitudes en supervisión son reconocidas, no es común ver perspectivas transteóricas y de factores comunes siendo bien expre...

Eight active supervision scholars provide their perspectives on priorities for advancing research in clinical supervision. Based on proposals they presented at an invited symposium held during the 11th International Interdisciplinary Conference on Clinical Supervision, the authors propose research questions around multicultural identities, supervis...

In this article we contend that supervisor humility is a critical variable in making rupture repair increasingly likely and give consideration to how that is so. Humility is defined and its research is briefly summarized. Humility's definition is then applied to supervision, specific ways by which supervisors display humility in the supervision rel...

As a core component of multicultural orientation, cultural humility can be considered an important attitude for clinical supervisees to adopt and practically implement. How can cultural humility be most meaningfully incorporated in supervision? In what ways can supervisors stimulate the development of a culturally humble attitude in our supervisees...

What is the role of cultural humility in psychoanalytic supervision? In this article, we address that question. While culture has been recognized as central to supervision practice (e.g., Tummala-Narra, 2004), the psychoanalytic supervision literature remains highly limited in addressing issues related to culture and diversity. In what follows, we...

Having now completed its first century, psychoanalytic supervision has been and continues to be regarded as the cornerstone of psychoanalytic education; it is the primary means by which (1) psychoanalytic ideology becomes translated into practical product, and (2) budding analytic practitioners develop and grow in their therapeutic skills and profe...

In what primary ways has psychoanalytic supervision evolved over the course of its 100-year plus history? In this paper, I address that question by: (1) sketching out some of the historical differences that have been identified as characterizing the patient-centered, supervisee-centered, and relational-centered supervision perspectives; (2) placing...