Supervision and Self-Care in Trauma Therapy
Today there is an ever-increasing demand for effective trauma therapy. Our American clinical history on this matter leaves much to be desired. John N. Briere and Cheryl B. Lanktree offer important suggestions on how to use clinical supervision and self-care in your clinical work with clients suffering from serious psychological trauma. Here in a nutshell is what they noted. For a more detailed review, please read the cited material on your own.
Supervision and self-care include the following:
- Supervisors work on emotional reactions common in trauma therapy;
- Guidance and working through unhelpful thoughts, feelings and behaviors;
- Use of clinical documentation as a metaphor for structure and true liability protection;
- Problematic boundary issues;
- Obtaining social-emotional support from others, especially a clinical team;
- Participating in personal psychotherapy as needed;
- Using mindfulness skills (especially T. Brach’s 2013 RAIN process) in trauma work – both with clients and as self-care;
- As a reminder RAIN includes Recognition, Acceptance, Investigation, and Non-Identification when dealing with highly stressful immediate experiences;
- Maintaining a personal practice of effective self-care in your work and in your life outside of work.
In addition, they note specific and repeated clinical interactions that help clients but may also deplete emotional and energetic resilience in therapists. These include attention to:
- Caretaker issues – supports, emotions, energy;
- General environmental and relational safety;
- Specific risks regarding dangerous behaviors;
- Anxiety, depression, grief, anger and other emotionally dysregulating conditions;
- Poor sell-concept, low self-esteem, and various self-identity problems;
- Various acting out and acting in situations;
- Suicidal and self-harm risks and behaviors;
- Consequences of various attachment problems and deficits;
- Social, school, and family adjustment conditions;
- Various somatization complaints; and,
- Psychosexual preoccupation, stress, and behaviors.
It is quite obvious that while working with these serious conditions and symptoms, trauma therapists would remain at considerably high risk for vicarious traumatization. Thus, the need to maintain regular effective clinical supervision and good self-care practices are of utmost importance to psychological survival of the therapist.
For more information refer to Lanktree, C. B. and Briere, J. N. (2017). Treating Complex Trauma in Children and Their Families: An Integrative Approach. Los Angeles,CA: SAGE Publications, pp. 220-246.
By Anthony R. Quintiliani, PhD., LADC
From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont
Author of Mindful Happiness