Supervision of Psychotherapy for Psychosis: A Meaning-Making Approach

Despite its importance in the provision of mental health treatment, the availability of high-quality clinical supervision faces numerous threats in the public sector. Access to high-quality supervision may be especially important for therapists providing services to persons with psychosis. Here, we detail one supervisory approach that has been developed with these considerations in mind; namely, the supervision approach associated with the recovery-oriented integrative therapy metacognitive reflection and insight therapy. We detail three aspects of this approach that have broad appeal and could be easily incorporated into other psychotherapy approaches which include (a) reflecting with supervisees about their experience of the patient, themselves, and the therapeutic relationship, (b) helping supervisees respond to patients' pain and fragmentation with interventions that promote challenge and joint meaning-making, and (c) dealing with threats to this process from both internal pressures within supervisees as well as those posed externally from their agencies. Limitations of this approach and future directions are discussed. Impact Statement Clinical supervision is an important part of delivery of mental health treatment, and is especially essential for students and early career psychotherapists providing treatment to individuals experiencing psychosis in public sector settings. This article details key tasks for supervisors in assisting these therapists to provide high-quality care that move beyond current available published practices.