~ written by Alison Evans, Pamela Duckerin & Robert Marx
Between April 2018 and April 2019, 48 trainees, from Improving Access to Psychological Therapies (IAPT) services, were trained in Mindfulness-based Cognitive Therapy. The training was a multi-centre collaboration. This blog post describes our experience of the supervision aspect, which came with both challenges and rewards.
The supervision aspect of this project was shared and supported amongst several centres, including the Mindfulness Network. Supervision was embedded as an important and pivotal part of the training. After completing the training workshops, trainees co-facilitated two MBCT courses in their service with supervision. The requirement was for 4 hours of supervision per course, so 8 hours in total for each trainee, with supervision being delivered remotely in most cases. The second of these courses was recorded for assessment using the MBI:TAC, with the trainees required to reach a minimum of competence.
What stood out for us
There were many principles and ways of working that carried across the supervision. However, there was a recognisable shift in the supervision for the first course to the second one, so we would like to offer a brief summary of some of the core aspects of supervision for each stage of the trainees’ journey. In this context the use of recordings as part of supervision was greatly encouraged. In the second round of supervision, trainees were being recorded for their MBI:TAC assessment which brought in a different dynamic.
Core aspects of supervision during the first MBCT course
- Managing expectations of what MBS is and helping supervisees to understand its nature
- Trainees were encouraged to record the whole of both 8-week groups which led to technological issues of recording their teaching
- The practicalities of the curriculum and its different components
- How to ‘enquire’
- Working with the anxiety of stepping into new territory of a very different way of working than many of them had been used to in individual CBT work
- Shifting from the busy, often ‘driven doing’ of the IAPT service directly into the more ‘being’ mode of both teaching and supervision
- Developing and maintaining a personal mindfulness practice
- Working with often challenging practicalities within the setting
- Forming of co-facilitator relationships
- Forming of a ‘good’ supervisory relationship that balances support, learning and ethical considerations
- The importance of the attitudinal frameworks – coming back to underlying principles
Core aspects of supervision during the second MBCT course
- The big ‘ASK’ and anxiety of assessment
- More detailed nuances of the practices and exercises
- How to ‘enquire’ (again!)
- Working with the striving mind v being in the emergent moment
- Dropping more into embodiment – finding times of being in the midst of life and teaching
- Not forgetting personal mindfulness practice and mindfulness in life
- Working with life events, shifts and changes
- Keeping the participants in mind
- Working with technical challenges of recording the group
- Supervisory relationships were more established as was the understanding and flow of supervision.
Trainees were asked for feedback at different stages of supervision – making comments such as, “there is a genuine warmth and gentleness from her no matter how difficult things were. She kept it real with kindness.” Another said: “The support that she gave has made a massive impact on my personal and professional development. I always looked forward to our sessions. She gave me confidence in accepting things ‘just as they are’.”
There was a total of four group supra-vision sessions over the duration of the project for each site. The intention behind group supra-vision throughout the project was to give a place and time to come together as supervisors to: connect, not get swept away by the enormity of the task or systemic challenges and support each other in offering high–quality supervision as best we could. Group supra-vision helped us to keep a wider perspective: to hold a longer view of how this group of teachers might grow and develop over this time and beyond the duration of the training, to hold the embodiment and practice of mindfulness with groundedness and steadiness and to provide a model for how supervisors could be with supervisees. We supported each other with compassionately offering supervision that also had clarity and enhanced development and confidence, consolidating the skills learned in training and applying them in practice. Having the site training leads present offered a connection with the training programme that seemed to offer care for the individual, the possibility of checking out training course structures and requirements, and a more seamless incorporation of supervision as part of the training process.
What have we learned?
So much, even as experienced supervisors, this project offered new learning experiences, e.g. supporting supervisees on a very rapid learning journey (to reach ‘competence’ on all 6 domains of the MBI-TAC on their second taught group), using recordings, the nuances of delivering MBCT within IAPT, how much we can learn from each other as supervisors. I think as a group we were fairly convinced of the importance of MBS but this was evident to us. We saw very clearly how different contexts and stages of training require a different emphasis and supervision needs to work within the context. So, for this project, there was lots of skills building, lots of support in building confidence, clear and specific feedback on teaching skills all to be held with patience and kindness. The connection and value of collaboration across centres and bringing trainers and supervisors together in joined up ways added value to the process and seemed to enhance the joy of working within this project.
And we have some questions we are pondering
How much supervision is needed in early teaching?
How to hold the assessment process within supervision? How to balance bringing in skills development and the MBI:TAC, and not tip into a more striving mode.
What happens beyond the training course in terms of supervision?
Could the value of group supra-vision be used in other contexts?
Might supervisees benefit from knowing a bit more about MBS before they begin?
We feel privileged to have been part of this project and thank all of the other site leads and supervisors from across the UK.
This blog post was written by:
Alison Evans based on the themes from meetings and group supra-visions
Pamela Duckerin, one of the supervisors based on her experiences as one of the supervisors
Robert Marx, supervisor and project lead