Clinical Supervision of Child Therapists : No Downward Extension

PsycCRITIQUES - Clinical Supervision of Child Therapists: No Downward Extension

Clinical Supervision of Child Therapists: No Downward
Extension
A review of

Helping Others Help Children: Clinical Supervision of Child Psychotherapy
by T. Kerby Neill (Ed.)
Washington, DC: American Psychological Association, 2006. 235 pp. ISBN 978-1-
59147-404-3. $69.95

Reviewed by
Camille J. Randall
Somewhere in a U-Haul between Baltimore, Maryland, and Lawrence, Kansas, I morphed
from a postinternship research and clinical associate into (poof!) a postdoctoral fellow. I
was deemed capable of supervising graduate trainees providing comprehensive school-
based mental health services to school-age children with severe emotional and behavioral
presentations. Since that time, I have spoken with other early career psychologists who
have experienced similar wonderment: “Who decided that I am qualified to lead others?

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PsycCRITIQUES - Clinical Supervision of Child Therapists: No Downward Extension
I'm barely here myself!” Becoming comfortable with making independent decisions as a
clinician is one thing; engaging others in case conceptualization and providing critical
feedback is quite another.
Although many graduate programs provide elective courses in clinical supervision, these
tend to be oriented toward adult or generalist populations. Savvy trainees who foresee
supervisory responsibilities in their future may enroll in such courses or seminars, thereby
having advance opportunities to think about transactional processes, hierarchic concerns,
means of feedback, and methodological shifts in relationship to trainee experience and
clinical sophistication. I might have realized more initial comfort in this role had I had this
formal opportunity to consider these supervisory functions in the abstract, ahead of time.
However, in retrospect, several factors central to supervision of child psychotherapy were
operative (e.g., systemic stance, collaborative perspective, contextual knowledge) and, I
argue, should not be underemphasized in the larger supervisory whole. T. Kerby Neill
conceives similarly.
Child therapy is not a simple downward extension of adult processes and methods. Neither
is supervision of child therapy. T. Kerby Neill, in his contribution to and editorial selections
for Helping Others Help Children: Clinical Supervision of Child Psychotherapy, appreciates
the distinction between what may be salient for generalist supervision (see Ladany,
Friedlander, & Nelson, 2005) and what is vital in child and adolescent supervision.
Foremost, this text emphasizes the collaborative stance of many psychotherapeutic models
and empirically supported treatments for childhood presentations.
Effective treatment for young clients cannot be accomplished without the consideration
and involvement of key others in their lives. Not only must supervisees be competent in
conveying nonspecific (or common) factors, they must also be able to accomplish in-
session tasks prescribed by particular therapies. Supervisees should also be able to

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PsycCRITIQUES - Clinical Supervision of Child Therapists: No Downward Extension
engage caretakers in follow-through, must effectively communicate with other agents (e.
g., school personnel, day care providers, probation officers), and—more important—must
be willing to expand the therapeutic scope beyond the identified child client. Several
chapters in Neill's volume comprise specific modalities (many of which are empirically
supported treatments) embodying this notion: filial therapy, cognitive–behavioral therapy
for childhood anxiety disorders, multisystemic therapy (Henggeler, 2001), early-onset
conduct problems, and expanded school mental health.
In addition, Neill's volume appreciates the influence of clinical context in supervising child
clinicians. This particular strength distinguishes it from supervision sources that more
narrowly address treatment process or model fidelity. Although these aspects of clinical
training are important, even the most seasoned clinical supervisors will be challenged
outside typical clinical training venues (e.g., graduate programs and medical centers) if
they are unprepared for the challenges and idiosyncrasies presented within disparate
treatment venues (e.g., schools, community mental health centers, and homes). Neill and
his competent contributors seek to prepare supervisors for what exists outside of typical
outpatient and academic bounds.
Although Neill's first chapter addressing a systems approach to supervision nicely
considers process variables in supervisory relationships, process considerations are
particularly well voiced in a chapter discussing cross-cultural issues. Similarly, the role of
nonspecific factors in effective therapy with children is revisited in the chapter discussing
play and filial therapy. In reading these chapters, supervisors will discover many
prescriptive ideas to enliven sessions with trainees, regardless of theoretical orientation or
primary modality of practice.
Additional strengths of Helping Others Help Children include attention to the advocacy
roles supervisors may take within agencies and organizations and reference sections that

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PsycCRITIQUES - Clinical Supervision of Child Therapists: No Downward Extension
include recent empirical citations and critical papers. Weaknesses are few, although two
are worthy of mention. Given cost-saving mechanisms inherent in school and community
mental health venues, clinical trainees are often asked to lead psychosocial groups of up to
10 children. Aside from process and treatment fidelity, successful group leadership hinges
on strong behavior management skills and strategies, as well as attention to interpersonal
dynamics. A chapter addressing supervision of group psychosocial skills groups would
therefore be a worthwhile addition to future editions of this text. The chapter on ethics,
too, may benefit from additional examples and models of decision making in future
editions.
Even if it was not available when I first began “helping others help children,” I am certainly
pleased to have Neill's volume in my professional library today. It stimulated ideas about
how to better work with, provide feedback to, and inspire the trainees and master's-level
therapists I currently supervise in three different settings (university outpatient clinic,
elementary school, and community agency). I foresee Helping Others Help Children
becoming a valuable resource for other clinical supervisors with a child specialty, novice as
well as seasoned. In addition, this would be a useful primary text for a graduate-level
seminar, as well as a constructive reference for the libraries of clinical training programs,
internship sites, and postdoctoral settings. Helping Others Help Children is practical and
prescriptive, which, in many ways, is much like the efficacious therapies for children it
espouses.
References

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PsycCRITIQUES - Clinical Supervision of Child Therapists: No Downward Extension
q Henggeler, S. W. (2001). Multisystemic therapy. In S. I. Pfeiffer & L. A. Reddy
(Eds.), Innovative mental health interventions for children: Programs that work
(pp. 75–85). New York: Haworth Press.
q Ladany, N., Friedlander, M. L., & Nelson, M. L. (2005). Critical events in
psychotherapy supervision: An interpersonal approach. Washington, DC: American
Psychological Association.
PsycCRITIQUES
May 30, 2007, Vol. 52, Release 22, Article 8
1554-0138
© 2007, American Psychological Association

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