The Case of Double Supervision: A Resident's Perspective on Common Problems in Psychotherapy Supervision

The author, while in psychiatric residency training (PGY-3), presented an individual psychotherapy patient to two clinical supervisors, who acted formally as consultants, over a six-month course of treatment. There were fundamental differences of opinion between the supervisors concerning the psychotherapy. In addition, during a case conference, another senior psychiatrist acting as discussant offered a third and generally divergent view of the patient's psychopathology and treatment. The results emphasize the extent to which residents may receive inconsistent and contradictory advice from their clinical supervisors and raise important questions concerning the proper role and practice of psychotherapy supervision in residency training.