The development of expertise in child psychotherapy requires growth in both clinical skill and self-awareness. Trainees depend on the guidance of their supervisors to sort through the many complex issues presented by children and their families, to define and develop their own unique styles, and to overcome the inevitable mistakes and disappointments that come with learning to master any challenging discipline. The ability to identify and work through parallel process is one supervisory skill that can be invaluable in facilitating the trainee's growth and preventing supervisory impasses.
Parallel process is an unconscious process that takes place when a trainee replicates problems and symptoms of patients during supervision. A typical example is for a trainee working with a rebellious, acting-out adolescent to begin testing the supervisor's limits and challenging his/her authority. The reenactment of the therapeutic dynamics has the underlying aim of causing the supervisor to demonstrate how to handle the situation. It also gives the supervisor a dose of the trainee's reality. Parallel process can work in the opposite direction when aspects of the supervisory relationship are mirrored in the patient-therapist transference.(1) In some cases, therapeutic impasses may be resolved when the therapist begins to adopt the supervisor's attitudes and behaviors while dealing with the patient.(2)
While there is some literature on parallel process in supervision of adult cases, there is little describing the process with children and families. Several recent articles(3-5) discuss unique aspects of countertransference in work with children, but they do not mention parallel process. This paper will review types of parallel process, discuss several case examples, propose ways in which the phenomenon differs in child versus adult therapy, and recommend methods for intervention.
UPWARD PARALLEL PROCESS
In upward parallel process, the dynamics originate in the child and are replicated by the therapist in the supervisory relationship.
Two student therapists whom I was supervising were seeing sisters in individual play therapy. The sisters had been in foster placement for many years, and they were confused about who their real parents were and where they would be placed. The plan was for them to live with their grandmother in another state. They had never met their grandmother, did not feel attached to her, and held onto the hope that they would stay with their foster mother. Symbolic of their confusion about the parental roles, they referred to their foster mother as "momma grandma," while calling their natural grandmother "Doris."
The student therapists felt torn about the placement decision and shared the hope that the children could stay with the nurturant, familiar foster mother. As they continued to see the girls in individual play therapy sessions (which the girls needed because of their separate histories of abuse, trauma, and neglect), the girls started to disrupt their individual sessions by bursting out of their rooms and joining each other in play.
The students did not know how to handle this behavior and were confused about their respective roles in resolving the problem. Just as the children had no sense of structure, boundaries, or belongingness to any one parent or therapist, the students did not know where the children belonged. In a parallel process, they allowed the children to blur the boundaries of their separate sessions and stood by helplessly, not knowing who was supposed to take charge and provide the structure, direction, and clarity the children needed. Likewise, by the time they brought the issue to supervision, they were not sure whether to discuss this in their individual supervisory sessions or to schedule a special joint session with me. They were evading the problem in supervision and discussing it between themselves in a way that made it difficult for me to delineate their respective roles. …