The good, the bad, and the less than ideal in clinical supervision: a qualitative meta-analysis of supervisee experiences

ABSTRACT .  With qualitative studies increasingly published on different aspects of supervision, this qualitative meta-analysis synthesized existing qualitative research and explored what aspects therapy trainees find helpful and unhelpful in individual supervision. A sample of 29 studies (755 participants) was selected by conducting a systematic literature search and a critical appraisal process to ensure a suitable level of methodological rigor. Data analysis followed a descriptive and interpretative framework. Results yielded 6 main meta-categories: three in the helpful aspects domain (i) Supervisor establishes a secure learning environment, (ii) Supervisor demonstrates ability to facilitate learning, and (iii) Supervisor demonstrates willingness and ability to acknowledge and negotiate differences; and three in the unhelpful aspects domain (i) Supervisor demonstrates behaviour that lacks sensitivity, accountability, and ethical consideration, (ii) Supervisor fails to create a safe and supportive environment, and (iii) Supervisor demonstrates limitations in the appropriate maintenance and sharing of knowledge and skills. Influenced by the quality of the supervisory alliance, supervision can be helpful, but it may also be experienced as unhelpful and potentially harmful. Issues of power and diversity need to be negotiated in a manner that maintains ethical and professional standards of practice and care. Implications for supervision training, practice, and research are discussed.