Ranawat,
Dana Novak (1/08) Mentalization in psychotherapy supervision: Assessing the
transmission of reflective functioning (Lisa Samstag, Ph.D.; Nicholas
Papouchis, Ph.D.; Philip Wong, Ph.D.)
The capacity for reflective functioning,
or mentalization, is the ability to think about one's own and others' mental
states. It has been shown to be an important factor in psychological
development as well as in the success of psychotherapy (Diamond, et al., 1999;
Fonagy, Steele, & Steele, 1991; Slade, Grienenberger, Bernbach, Levy, &
Locker, 2005). Despite the importance of RF in psychotherapy, there is little
understanding about the role of mentalization in the supervisory process. This
study sought to expand the understanding of mentalization to include the
supervisory process. The study examined the transmission, or learning, of
mentalization between supervisor and trainee over time, as well as the factors
that influence that process. The literature has shown that the relationship
between supervisor and trainee is the most influential factor in determining
supervision satisfaction (Ladany, et al., 1999; Ramos-Sanchez, et al., 2002)
and the common mechanism for trainee development (Holloway, 1987). Adherence to
a common factors model by supervisors has also been posited to be an important
aspect of clinical supervision (Lampropoulos, 2001; 2002). Literature on
difficulties encountered in supervision cite trainee anxiety as an obstacle to
clinical knowledge (Ellis, et al., 2002; Halgin, 2002; Rubin, 1989). For these
reasons, the role of the supervisory alliance rated by both the trainee and
supervisor as measured by the Supervisory Working Alliance Inventory, the
supervisor's adherence to common factors within the supervisory process as
measured by the LIU Psychotherapy Adherence Scale, and the trainee level of
anxiety as measured by the State-Trait Anxiety Inventory were assessed, as were
levels of reflective functioning for trainee and supervisor as measured by the
Reflective Functioning Scale. Participants were doctoral candidates in clinical
psychology and their supervisors and were assessed at two time points in order
to assess the change in trainee mentalization over a four month period. Results
indicated that neither supervisor adherence to common factors, trainee level of
anxiety, alliance as rated by either trainee or supervisor, nor the level of
supervisor reflective functioning were predictive of the level of trainee
reflective functioning. Nor was there any significant change found in trainee
reflective functioning over time. Discussion on these results focused on the
generalizability of measuring reflective functioning within the supervisory
setting, questions about what clinical supervision is requiring of trainees and
supervisors, and the applicability of mentalization in the supervision of
novice clinicians.
