IJSP Number 7, 2025

International Journal of Supervision in Psychotherapy, Number 7, 2025 Page | 70 should be given the opportunity to experience their work as predominantly Healing Involvement and minimally as Stressful Involvement " [30, p. 224]. The aim of providing positive clinical experiences during training requires, in part, careful assessment of the individual supervisee's clinical readiness and "entrustability" [35, 17] and selection of cases aligned with the supervisee's present skill level and experience. Further, highly skilled, competent supervisors, adequate clinical supervision time, training tuned to the unique client population(s) served, and social support within the training setting are needed to support trainee development. The findings of Ellis and colleagues (as previously discussed) take on added significance considering the conclusions of Orlinsky, Rønnestad, and colleagues. The adverse effects of clinical work dominated by Stressful Involvement are exponentially exacerbated in settings of Inadequate Supervision , particularly in the case of Harmful Supervision . Such a 'worst case' scenario constitutes a precarious situation that poses significant risks for patient welfare, the trainee, and the training institution. Although it would logically follow that inadequate supervision, lousy supervision, or harmful supervision impacts therapy outcomes and patient welfare, it has not been adequately studied, and, therefore, the premise has not been empirically established. CLINICAL SUPERVISION: HELP OR HINDRANCE The quality of clinical supervision provided during clinical training contributes in countless ways to the trainee's effectiveness as a psychotherapist. At the surface of supervised clinical work, the supervisor (1) ensures that accurate clinical understanding and diagnosis have been performed; (2) therapy goals have been identified, consistent with the patient's needs, motivation, and capacities; (3) an evidence-based treatment approach has been developed; (4) entrustability in the supervisee's ability to conduct the treatment has been confirmed; and (5) procedures are in place to consistently observe and monitor client welfare and provide evaluation, feedback, and training to the supervisee. Below the surface of the required supervision components and activities are the relational, interpersonal, and values dynamics that contribute to the supervisory relationship and impact the development of a viable and sustaining supervision alliance [8, 17]. We suggest that the supervisor's lived-out commitments to integrity, ethics and science-informed practice, and to the welfare of clients and trainees, together with interpersonal skills and professional competence (both as a clinician and supervisor), are essential to establishing developmentally positive supervision. Adequate or exceptional clinical supervision is required to support the supervisee in managing the challenges of learning to conduct psychotherapy. Clinical supervision becomes the 'container' for the supervisee to process their personal, emotionally charged experiences and advance their learning as a novice psychotherapist. This supervisory 'holding' environment is particularly the case when trainees are engaged with challenging patients and in complex clinical situations that might be classified as Distressing Practice [28] in which Stressful Involvement overshadows rewarding experiences of Healthy Involvement . A highly respectful and collaborative supervisory relationship and alliance is required to support the trainee and to manage the clinical challenges. Conditions of inadequate supervision or harmful supervision make such