Why Group Supervision Matters When Working with Complex Trauma and Dissociation
by Carla Jones.
I find working with complex trauma to be some of the most meaningful work I do as a psychologist. But this work can also be some of the most demanding.
Whilst it could be easy to blame vicarious trauma for this work being demanding (and I certainly don’t want to diminish the role that it can play!), I often feel most of the demand comes from myself. This, combined with the constant moral injury of trying to squeeze clients into specific diagnostic and deficit-focused boxes so that they can have adequate support, can slowly crush your soul if you do not receive adequate support.
This is where supervision becomes invaluable.
The challenges of working with complex trauma
Complex trauma rarely presents as a single issue.
Clients may move between states of hyperarousal and shutdown, struggle to access emotions, experience significant shame, or find it difficult to trust the therapeutic relationship. Some may experience dissociative symptoms that are subtle and easily overlooked, while others may present with more overt experiences of depersonalisation, derealisation, memory difficulties, or distinct parts.
As clinicians, we are often required to hold multiple formulations simultaneously, balancing safety, stabilisation, attachment needs, trauma processing, and everyday functioning. And also to provide as much support as possible to a client in less than 60 minutes.
This complexity can leave practitioners asking questions such as:
- Am I understanding what is happening for this client?
- Is this trauma-related, dissociative, neurodivergent, or something else? Or all of the above???
- Am I holding appropriate boundaries?
Importance of Supervision
Okay yes, it’s a part of our professional competencies as psychologists, and it is consistently emphasised that we need to seek consultation or supervision generally, let alone when working with presentations that require specific knowledge. But supervision is not simply about risk management or ticking a box. Without opportunities for reflection and support, clinicians may become more vulnerable to feeling stuck, overwhelmed, avoidant, overprotective (cue: Mariah Carey’s Hero), or uncertain in their work.
Good supervision helps clinicians:
- Strengthen case conceptualisation and translating knowledge into case-specific implementation strategies. (1)
- Recognise blind spots and assumptions
- Monitor the impact of countertransference to improve client outcomes (2)
- Navigate therapeutic ruptures and challenges (2)
- Reduce the risk of compassion fatigue and increase compassion satisfaction (3)
- Increase confidence (4)
The unique value of group supervision
Group supervision is often referred to around Haven as “Group Supe”. Although I somewhat like to think of it as “Group Soup”. I picture it like a whole bunch of ingredients that get thrown in (worries, conceptualisations, trials and errors, practical suggestions, reflective questions etc) that get blended together to make something hearty and warming! Something that will sustain you through your practice, but also fuel you to think about things differently.
Individual supervision remains an important part of professional development. However, group supervision offers unique benefits that can be particularly valuable when working with trauma and dissociation.
Learning from diverse perspectives
Group supervision allows practitioners to hear multiple formulations, interventions, and ways of understanding complex presentations. Often, another clinician’s question or observation can open up a perspective that may not have been considered otherwise.
Reducing professional isolation
Group supervision reminds clinicians that they are not alone in the challenges they face. While our clients are all unique, their challenges often overlap with others, just the same as how our difficulties in practice are often experienced by other psychologists. Hearing colleagues share similar experiences can normalise uncertainty and foster a sense of professional connection. There’s also a sense of unburdening that can occur here, and this can be so beneficial for your ability to remain balanced in your practice.
Building clinical confidence
Psychologists can feel underprepared when clients present with significant dissociation or complex trauma histories, and this can surprise you at any time (i.e. when you have a client who comes in and has not disclosed a trauma history, then they dissociate immediately in intake). A group learning environment allows clinicians to develop confidence through observation, discussion, and collaborative problem solving. Over time, therapists often become more comfortable recognising trauma responses, working with dissociative processes, and responding flexibly in the therapy room. Processing failures in supervision can also lead to increased self-efficacy! (4)
Deepening reflective practice
Getting practical pointers is great, and there is absolutely time for that in group supe/soup! But this space also encourages clinicians to examine their own responses, assumptions, emotional reactions, and therapeutic patterns. Group settings can be particularly powerful for this process, as different perspectives often illuminate aspects of the work that may otherwise remain unnoticed.
Cost effective
To be practical for a moment, group supervision is great bang for buck!
A Haven commitment to group supervision
We know that working with complex trauma is rich, and not something that gets enough airtime. It requires ongoing nurturance, and we think group supervision is a great way to enhance your practice. The field continues to evolve as research expands our understanding of trauma, attachment, neurobiology, dissociation, and recovery, and group supervision can help you to stay up-to-date. Ongoing supervision provides a structured way to continue learning, refining skills, and remaining responsive to the needs of clients.
With our group supervision sessions, there is a commitment not only from Den Abreu to guide and facilitate, but also from your peers who are mindfully investing in themselves and their practice. This is a commitment to develop new skills, practice in an effective, affirming and culturally sensitive way, but also to take care of themselves while doing this incredible work.
So if this sounds like it could serve you, get involved in our upcoming group supervision sessions. Or feel free to reach out via welcome@havenpsychology.com.au or on 1300 442 836 if you have any questions!
References
- Gilboa-Schechtman, E., 2024. Case conceptualization in clinical practice and training. Clinical psychology in Europe, 6(Spec Issue), p.e12103.
- Hayes, J.A., Gelso, C.J. and Hummel, A.M., 2011. Managing countertransference. Psychotherapy, 48(1), p.88.
- Laulita, R., 2020. The effects of clinical supervision and self-efficacy on compassion fatigue and compassion satisfaction in helping professionals (Doctoral dissertation, Murdoch University).
- Wilson, H.M., Davies, J.S. and Weatherhead, S., 2016. Trainee therapists’ experiences of supervision during training: A meta‐synthesis. Clinical Psychology & Psychotherapy, 23(4), pp.340-351.
