IJSP Number 7, 2025

International Journal of Supervision in Psychotherapy, Number 7, 2025 Page | 68 clinicians. An international survey of about 4000 psychotherapists [30] reported that when asked to indicate the influence of 14 factors on their overall development as a therapist, "Getting formal supervision or consultation" ranked alternately second or third to "Experience in therapy with clients." Novice therapists (< 1.5 years of therapy experience) ranked it first [30, p. 223]. Besides the estimates of salience, the frequency of its use shows the importance of supervision. As expected, given their training trajectory, Novice therapists and Apprentice therapists (1.5-3 years) engage in supervision; however, it is notable that Graduate therapists (3-8 years) and Established therapists (8-23 years) continue to use supervision, 71.0 percent and 61.1 percent respectively, and over 41 percent of Senior therapists (23-54 years) reported currently receiving supervision (Rønnestad et al., 2024, p. 8.). Continued participation provides one measure of its role in professional development, but what about the actual impacts of supervision on the psychotherapist-in- training or supervision or consultation on the practicing psychotherapist? Ellis and colleagues [3. 4 . a nd others [1. 1 9. 2 1. 2 3. p rovide a global snapshot of the quality of clinical supervision in the United States, Ireland, South Africa, and South Korea. The survey results reflect variability, including bad and harmful supervision. For example, a high incidence of inadequate supervision, which entails failing to meet the criteria of minimally adequate supervision [3. , and harmful supervision, which includes supervisory practices that result in psychological, emotional, and/or physical harm or trauma, was reported in a comparative study between the United States and Ireland [5. . Results revealed that 79.2% of supervisees in Ireland and 69.5% in the United States were adequately supervised, and 40.3% in Ireland and 25.2% in the United States had received harmful supervision. In addition, 92.4% of supervisees in Ireland and 86.4% in the United States reported receiving inadequate supervision at some point in their careers, and 51.7% in Ireland and 39.7% in the United States indicated receiving harmful supervision. On a positive note, 51% of respondents in Ireland and 55% in the United States reported receiving exceptional supervision. This may be characterized as a collaborative, growth- fostering relationship attuned to the supervisee's developmental needs; however, some supervisees report having received both harmful supervision as well [21. Surveys of psychotherapists conducted by Rønnestad, Orlinsky and colleagues [25. 26. 2 7. 3 0. 3 1. a nd of supervisees [21. p rovide entry points to examine the specific impacts of clinical supervision during the training and throughout a psychotherapist's career. Although a discussion of Rønnestad and Orlinsky’s research program is beyond the scope of this article, we discuss their findings about two cycles of clinician experience, i.e., Healing Involvement and Stressful Involvement , that affect professional development and treatment. Then, we consider the impact of "developmentally positive supervision" [31. o n promoting clinical engagement and professional growth. Two cycles of therapeutic work and growth appear to converge in the training phase and throughout the development of the psychotherapist. Healing Involvement , an empirically derived, higher order dimension, "reveals the nature and extent to which therapists perceive themselves as skillfully, warmly and effectively interacting with the patients; capable of coping constructively if difficulties arise; and deeply interested and absorbed in their work" [28, p. 1442]. This experience incorporates elements of the therapeutic relationship and involves basic relational skills, agency, an affirmative relational style, and constructive coping [6. . Such experiences likely bolster satisfaction and self-confidence and encourage continued clinical engagement and skill development.