Experience feedback on participation in a structured, psychodynamic supervision centered on the clinician-patient interaction: Are oncologists ready to talk about themselves?

Abstract

Oncology clinicians are expected to have a certain insight in interactional dynamics when communicating with patients. Supervision of oncology clinicians by psycho-oncologists is an important means to enhance this insight. However, research on supervision in the oncology setting remains very scarce with most of the few studies failing to describe the supervisory process.

Objectives

To evaluate the experience of oncology physicians, who participated in a structured, psychodynamic supervision centered on the clinician-patient interaction.

Methods

Medical oncologists (n = 10) who benefited from three individual supervisions following a one-day reflexivity training were asked to report on their experience of the supervision, which specifically addressed interactional dynamics of the cases presented, focusing on countertransference reactions and links to clinicians’ repetitive relational patterns and biography. The semi-structured interviews were conducted by an experienced psychologist, who was not implicated in the training, and based on a guide addressing facilitators and barriers to engage in supervisions and the lived experience of supervisees.

Results

Facilitators and barriers to engage in supervision were related to the supervisor, the supervisees, and contextual elements. Trust towards the supervisor, who demonstrated a capacity to adapt to the supervisee and knowledge of the institutional context, without having any professional ties with the supervisees, played a facilitating role. While the supervisees’ openness to be confronted with their own psychological struggles also facilitated engagement, transferential reactions towards the supervisor had positive and negative effects. The principal barrier felt by some supervisees was the confrontational approach of this type of supervision. Most participants reported a positive experience of the supervision, which was perceived as useful, interesting, valorizing and enriching. However, one participant indicated not having benefited from supervision expressing important discomfort to talk about himself.

Conclusion

A structured, psychodynamic- and interaction-oriented supervision is a psychologically challenging experience for oncology clinicians. However, if certain prerequisites concerning the supervisor and the context can be granted and if supervisees can engage in such a supervisory process, they clearly benefit from the experience; participation, based on a well-informed and voluntary consent, is thus an implementable and promising means to address clinicians’ own psychological contributions to problematic patient interactions.