Psychotherapy Supervision in a Liberated Context

Written By Danielle Currin, Ph.D., on behalf of the Atlanta Behavioral Health Advocates

Before starting my second year of graduate school, I was asked to decide my theoretical orientation for my therapy practicum. This choice could have been overwhelming with all the possible orientations that exist in the field, but my program streamlined it to three options: cognitive-behavioral, acceptance and commitment, and psychodynamic. Those represented “the big three” in my mind, while other orientations, like interpersonal therapy and humanistic therapy, were sprinkled throughout my training. Meanwhile, frameworks like liberation or critical psychology were relegated to the classroom, introduced by specific supervisors I was mostly randomly assigned to, or not mentioned at all.

Source: Kampus Production/Pexels

These frameworks seem to be getting more attention recently, and their emphasis on context, oppression, and equity is not only wonderful to see but also necessary for any clinician treating human beings who live in today’s world. For clinicians who did not gain exposure to these frameworks during their own training, however, it can seem intimidating to open discussions about them with trainees. What does it mean to bring these frameworks and perspectives into the context of supervision?

One of the most well-known frameworks that emphasizes context is liberation psychology, which can take many forms, from an academic extension of critical race theory to a clinical practice used with clients of varied backgrounds and identities. It can be defined as “the use of psychological science to address and dismantle oppressive and discriminatory systemic practices” (Singh & Gudiño, 2023). This includes acknowledging cultural and spiritual leaders, embracing global differences in the view of psychology and therapy, and generally shifting away from the default Western and White perspectives (Bryant, 2024).

Not easily categorized as a manualized treatment to follow, liberation psychology is better considered as a tool to shape a clinician’s approach to therapy. Research has supported its inclusion in trauma interventions (Bryant, 2024), group therapy for chronic pain (Salvo et al., 2023), and acceptance and commitment therapy (Gingles, 2021), to name a few applications. An early clinician looking for a theoretical orientation may resonate with liberation psychology not as a set of specific skills to teach clients but as a filter to use when they work with clients.

Choosing a theoretical framework to use as the basis for clinical work is a big part of the professional development of a psychotherapist. Research has shown that some primary influences on this decision are the personality of the trainee, the resources and options available to the trainee, and the primary framework utilized at the place of practice (Liao et al., 2022; Petko et al., 2016). These internal and external influences can either work together or against one another as a trainee is selecting a framework that fits their beliefs and goals.

Students and early career psychologists who want to prioritize something like cultural influences and systemic oppression in their clinical work may find themselves in settings with few resources or supervisors who have any knowledge of these frameworks. As such, they must advocate for themselves to gain training or, in some cases, even exposure to modes of thinking outside of their institution’s primary orientations. They may even be expected to educate their supervisors about what it truly means to consider context in psychotherapy.

Supervision is an essential space for early clinicians to learn and grow and thus must be considered in any discussion of implementing culturally responsive perspectives and interventions in mental healthcare. The role of a supervisor is multifaceted, including encouraging, challenging, and liberating the trainee to bring them to a space of understanding and owning their own therapist identity (Watkins, 2020).

At its core, this is not so dissimilar to the process of therapy that the trainee encounters with their own clients. In fact, using a therapeutic lens in supervision is a common model implemented with trainees, in which the supervisor models the theoretical orientation that the trainee is expected to follow (Basa, 2017). Notably, even if the supervisor does not strictly endorse this particular model of supervision, they may naturally incorporate some of these elements into their meetings with trainees because of their personal theoretical orientation. For a supervisor who does not follow context-focused psychology, bringing these aspects into the hands-on training they provide for their trainees can take a more concerted and conscious effort.

Acknowledgement of one’s own experiences, biases, and assumptions regarding oppression and discrimination (personally, in general, and regarding psychology and psychotherapy) is an essential first step in embracing culturally aware frameworks. Sharing these with the trainee and encouraging them to reciprocate has the potential to be very uncomfortable, but a welcoming, open, and vulnerable space contributes to a foundation on which to build a shared understanding of the contexts in which the supervisor, the trainee, and the trainee’s clients exist. From this comes the opportunity to open the door to discussions about how those contexts impact the various relationships at play.

Therapy Essential Reads

Phenomenology in Psychotherapy

When Your Client Gets Ready to Die on You

We can make changes as individual supervisors that have an impact on ourselves and our trainees, but there is also systemic change that needs to happen. As such, we can also:

• Attend and participate in workshops and talks on unfamiliar topics
• Foster productive discussions around historical and contemporary issues of oppression in psychology with colleagues
• Create workshops and talks in collaboration with experts as we gain knowledge and confidence in sharing our perspectives
• Incorporate our understanding of context into our own work with clients: Consider how systems of oppression may interfere with a client’s willingness to participate in a session or how our own implicit biases may change the way we interact with different individuals on our caseload
• Become advocates for having more of these discussions in our institutions

As supervisors, one of the many influences we have on our trainees is helping them develop their clinical and professional identities. By acknowledging that none of us live in a bubble and embracing uncomfortable discussions and frameworks we may not have been taught, we can contribute to the future by making psychotherapy accessible and relevant to as many people as possible.