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. Author manuscript; available in PMC: 2023 Sep 21.
Published in final edited form as: Clin Superv. 2022 Sep 21;41(2):107–126. doi: 10.1080/07325223.2022.2125918

The Association Between Political Climate and Trainees’ Supervision Experiences and Needs

Kevin S McCarthy 1, Carla Capone 2, Jennifer Davidtz 3, Nili Solomonov 4
PMCID: PMC9858147  NIHMSID: NIHMS1839319  PMID: 36686038

Abstract

This study examined whether political climate influenced trainees’ clinical work, supervisory experiences, and supervisory alliance. Data were collected from 366 trainees in a nationwide survey. Most trainees believed the political atmosphere affected clients to some degree. Over half reported political dialogue with supervisors, more often when political affiliation was similar. Supervisory alliances were most positive when trainees were aware of their supervisors’ political beliefs, regardless of agreement. Trainees wanted supervisors to provide greater awareness of multicultural issues and political climate in their clinical work. We recommend that supervisors invite trainees to discuss political effects on their clinical work.

Keywords: Supervision, psychotherapy, political events, education and training

The influence of politics has always been inescapable, but rarely has it been as divisive and in the forefront of most peoples’ minds as in recent times. Starting in 2016, there has been rapid upheaval of longstanding policies and practices, a rise in the prominence of polarizing figures, and challenges to personal health and freedoms. These political changes have been occurring worldwide, resulting in great instability and turmoil. In 2020 alone, US citizens contended with an exchange of aggressive military actions between Iran and the US (Toosi, Lipmann, & Morgan, 2020), a divisive primary season ahead of the national election (Balz, 2020), the management of a global pandemic killing hundreds of thousands (Borger et al., 2020; Yan & Holcombe, 2020), economic collapse and record unemployment (World Bank Group, 2020), racial strife and injustice (Wilkie & Macias, 2020), and the presidential election being contested both legally and by violent revolt (Washington Post Staff, 2021). These political troubles have persisted (Gura, 2022; Totenberg & McCammon, 2022). Nearly half of American citizens believe that the country will become more destructive in dealing with disagreements (Jackson, 2021; Newhouse & Benenson, 2022).

Since 2008, the American Psychological Association (APA) has conducted an annual nationwide survey on stress and mental health, Stress in America. In 2017, stress levels significantly increased for the first time in ten years; they remained high and unchanged in the most recent iteration in 2021 (APA, 2021). Women, racial and ethnic minorities (REM), immigrants, and sexual minorities have also continually reported the highest levels of stress (APA, 2021). Furthermore, interpersonal conflict around politics is more frequent and has led to the end of many of relationships (Chen & Rohla, 2018).

This political climate, which we define by heightened motivations around political behavior, drastic policy changes and strong emotional reactions to them, and interpersonal tension in conversation and the media, has been associated with increased demand for mental health services and changes in psychotherapy outcomes (McCarthy & Saks, 2019). The same patterns occurring in the general public occur among clients presenting for psychotherapy, with significantly rising interpersonal tension since the 2016 election, especially among Millennials and REM individuals (McCarthy & Saks, 2019). The effect of the political atmosphere has even been documented among children and adolescents (DeJonckheere et al., 2018; Wray-Lake et al., 2018) and in child psychotherapy (Prout et al., 2019). The therapeutic relationship and in-session processes have been significantly impacted by the political climate, as reported by both patients and therapists (Solomonov & Barber, 2018, 2019). More discussion of political themes is occurring in psychotherapy than before, and a majority of clients wished for greater political discussion in their sessions (Solomonov & Barber, 2018). In about two-thirds of therapies, therapists either directly or implicitly disclosed their personal political affiliation (Solomonov & Barber, 2018, 2019). Finally, the therapeutic alliance between client and therapist was moderated by their perceived political similarity, therapists’ political disclosure, and the client’s beliefs about how helpful political discussion could be (Solomonov & Barber, 2018, 2019).

Given that experienced clinicians are reporting difficulty adjusting to the changes demanded by the political situation (Aafjes-van Doorn et al., 2020; Solomonov & Barber, 2019), it is likely that beginning therapists and trainees are struggling in their work even more without the benefit of years of practice. In training, most clinical theories and techniques taught to students focus on how factors within individuals and families, not external events, are related to strong emotions and psychopathology (Consoli et al., 2016). Even systemic and multicultural perspectives (Kearney, 2018; Redding, 2020) may still leave the trainee struggling to decode the meaning of ongoing and rapidly evolving political events of which they themselves are a part. Supervisors of these trainees have few recommendations to offer about navigating conversations about the effects of politics in these times (Debiak, 2020; Farber, 2017; Shumway, 2016; Spangler et al., 2017). The effect of political climate on clinical training and supervision has not been investigated to date. Understanding trainees’ experiences in this context and identifying their needs could improve clinical supervision and translate into meaningful clinical recommendations for both trainees and supervisors. Such improvements can ultimately lead to improved client outcomes.

The aim of the current research was to investigate trainees’ perceptions of the effects of the political environment on experiences in supervision and their work with clients. We attempted to address five research questions about the degree to which trainees believed their clinical work was affected by political climate, their beliefs about their responsibility to correct client bias or misinformation, their experiences of discussion of political reactions in clinical work with their supervisor, their perceptions of their supervisors’ own political beliefs, and their perceived needs in supervision around political climate.

First, we wanted to investigate the question do supervisees perceive an effect of the political climate on their clinical work with clients? Previous research that has shown that clients are increasingly distressed due to political climate (McCarthy & Saks, 2019), that over half of clients and therapists discussed political climate in their therapy (Solomonov & Barber, 2018, 2019), and that experienced clinicians reported their work was affected by the political climate (Aafjes-van Doorn et al., 2020; Solomonov & Barber, 2019). Therefore, we hypothesized that (1a.) supervisees would report a significant impact of the political climate on their clinical work and supervision. We further anticipated that (1b.) trainees with more clinical experience would report a greater impact of politics on clinical work, and we followed up by investigating whether trainees with experience before 2016 saw more influence of political climate on their work then those beginning after 2016. We also hypothesized (1c.) more liberal trainees would report observing stronger effects of political climate than their more conservative colleagues, given the direction of the political shift. We did not have any hypothesis about whether the strength of the supervisory alliance would correlate with trainees’ beliefs about political climate affecting clinical work (1d.)

Next, we asked do supervisees feel responsibility to address bias or misinformation expressed by their clients in session? We hypothesized that (2a.) trainees would endorse a high degree of responsibility to confront misinformation due to a strong emphasis on multicultural training in doctoral psychology programs (Clauss-Ehlers et al., 2019). We further hypothesized that (2b.) training year would be less associated with a sense of responsibility to correct client statements of bias or misinformation in the session because we thought more experienced trainees would respond with greater flexibility to uncomfortable conversations with their clients (Davis et al., 2018; Tuckwell, 2002). We did not have any hypothesis for whether trainee political affiliation would influence pressure to correct bias and misinformation (2c.), as what qualifies as factual information has been contested by both conservative and liberal individuals (Lazer et al., 2018). We also had no hypothesis as to whether supervisory alliances would be affected by trainees’ attitudes toward correcting bias (2d.). We did expect that (2e.) trainees endorsing a greater impact of political climate on their work would also believe themselves more responsible to correct bias.

Third, we asked are trainees discussing effects of political climate with supervisors and what attitudes and beliefs affect this occurrence? We hypothesized that (3a.) most, but not all, trainees would have had discussion of political effects on their work, given that over half of therapists and clients report having experienced an effect of politics on their therapy (Solomonov & Barber, 2018, 2019). We expected that (3b.) more experienced trainees and (3c.) more liberal trainees would have been more likely to discuss political climate with supervisors. In line with clients and therapists reporting more positive alliances when conversations about political climate occurred in therapy (Solomonov & Barber, 2018, 2019), we believed that (3d.) there would be stronger supervisory alliances when political climate had been discussed with supervisors, probably due to the help or acknowledgement trainees felt through such discussion. We further hypothesized that the extent to which trainees believed politics affected their clinical work (3e.), and that they should correct bias (3f.), would also be associated with a greater likelihood of supervisory discussion of political climate.

We followed up on these hypotheses by asking trainees to report whether their supervisors performed certain behaviors in supervision regarding political climate and the trainees’ work (e.g., drew my attention to the effect of politics on a client; noted relevant diversity factors that contributed to a client’s reactions to political events; listened to my personal experiences about or reactions to political events outside of the session). We intended these analyses to be exploratory and descriptive.

Fourth, we wanted to inquire to what extent do trainees’ perceptions about political similarity with their supervisor influence supervision? We thought that (4a.) most trainees would believe they shared political similarity with their supervisors, given the trend toward more progressive political views in the field (e.g., Avissar, 2009; Redding, 2001; Solomonov & Barber, 2019). We had little reason to expect that perceived political similarity would differ by training year (4b.), but we did expect that (4c.) trainees with a more liberal affiliation would be more likely to endorse their supervisors as politically similar to themselves. We did anticipate that (4d.) perceived political similarity would be associated with stronger supervisory alliances. We did not have hypotheses for whether beliefs about the effect of political climate on work with clients (4e.) or the responsibility to challenge misinformation (4f.) would be related to beliefs about political similarity. We anticipated that (4g.) perceived political similarly would be related to a higher likelihood of having had discussion in supervision about political climate and clinical work, similar to what Solomonov and Barber (2018, 2019) observed in clients and therapists who discussed political climate in therapy.

Fifth, we inquired do trainees have continuing or unmet needs from their supervisors in their supervision regarding an effect of political climate on their clinical work? We hypothesized that (5a.) over half of trainees would report wanting more discussion of political climate, given the documented desire of clients and therapists to do so in therapy (Solomonov & Barber, 2018). We believed that (5b.) training year would not be associated with needs for discussion of political climate in supervision, as even experienced clinicians report struggling with handling politics in therapy (Aafjes-van Doorn et al., 2020; Solomonov & Barber, 2019). We believed that (5c.) greater political conversation in supervision would be desired by trainees who were more liberal. We hypothesized that (5d.) having greater desire for political discussion in supervision would be related to lower supervisory alliances in so far that trainees were describing an unmet need. We thought that trainees (5e.) who reported more influence from politics in their clinical work or (5f.) who felt greater pressure to correct bias would see a need for more political discussion in supervision due to an unmet or ongoing sense of necessity. Lastly, we hypothesized that (5g.) trainees who reported a conversation about politics and clinical work with their supervisor or (5h.) who shared a political affiliation with their supervisor would want more discussion, potentially due to their comfort with their supervisor around such topics.

We followed up on these hypotheses by exploring whether trainees wanted more (or less) of specific supervisor behaviors in supervision regarding political climate. We intended these analyses to be descriptive and did not have any hypotheses about them.

Finally, we explored the question, are there differences in trainee beliefs and experiences by location, training site orientation and setting, client age, and time of survey completion? We did not have specific hypotheses for these potential moderators.

Method

Participants

Three hundred sixty-six doctoral psychology trainees provided data in two separate cohorts: 266 (72.4%) in the spring of 2020 and 101 (27.6%) in the fall of 2020 during the election. Table 1 depicts the demographic characteristics for the entire sample. The majority of respondents identified as women and as European American, but over 40% of those reporting their identity described themselves as another gender or as an REM. Average age of participants was 28.8 years (SD = 6.3, n = 262). Trainees represented twenty-two states (AL, AR, CA, CO, FL, GA, ID, IN, LA, MA, MD, MN, MO, MS, NH, NJ, NY, OH, OR, PA, WA, WI).

Table 1.

Descriptive Statistics for Demographic Variables and Training Experiences of Supervisees

Demographic Categorya n % Training Experiencea n %
Gender (n = 260) Format (n = 337)
 Female 197 75.8  Individual Only 96 40.4
 Male 54 20.8  Group Only 15 4.5
 Non-Binary or Transgender 9 3.5  Individual and Group 186 55.2
Race or Ethnicity (n = 258) Orientation (n = 311)b
 Asian 22 9.0  Directive 147 47.3
 African American 10 3.9  Exploratory 99 28.6
 Latino/a 21 8.1  Biopsychosocial 22 7.1
 Indigenous 2 0.8  Integrative 53 17.0
 European American 190 73.6 Setting (n = 80)
 Multiracial 13 5.0  Community Mental Health 36 45.0
Geographic Region (n = 256)  Outpatient 24 30.0
 Northeast 99 38.7  Partial Program 5 6.3
 Southeast 35 13.7  Inpatient 15 18.8
 Midwest 39 15.2 Client Life Stage (n = 218)c
 West 83 32.4  Older Adult 13 7.5
Congressional Representative (n = 255)d  General Adult 96 41.1
 Democratic 195 76.5  Veteran 14 6.9
 Republican 41 16.1  College 32 18.5
 Mixed District 19 7.5  Children or Adolescents 80 37
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a

Trainees were asked to describe themselves and their training characteristics using open-ended questions (e.g., what is your gender?). Identities and experiences are therefore those trainees felt most salient. Subsample ns may not match the total N of the sample.

b

Directive treatment consisted of cognitive, behavioral, or ACT, DBT orientations; exploratory was psychodynamic, interpersonal, person-centered, or experiential; biopsychosocial was assessment, neuropsychological, or developmental; integrative was integrative, eclectic, or more than one orientation. Seven persons (2.3%) stated they additionally practiced systems, 6 (1.9%) cultural, and 3 (1.0%) trauma-focused approaches, almost always co-occurring with another orientation (e.g., relational-cultural approach).

c

Participants could select more than one option to describe the age group of the population with which they worked (e.g., children and adults). Percentages for this question are out of the 218 trainees who responded and may not add to 100%.

d

Congressional districts and the political party of the 2018 representative for that district were determined through reported ZIP code.

Trainees described their own political opinions on a visual analog scale, where 0 was very conservative and 100 was very liberal. They held more liberal political orientations, with an average affiliation of 75.6 (SD = 21.0, n = 310). Additionally, most trainees resided in areas that voted Democratic in the 2018 election, as determined by the political party of the congressional representative for the ZIP code reported by the trainee (see Table 1). There were no significant differences between spring and fall cohorts on any demographic variable (all ps >.15).

Supervisees also described their training experiences (see Table 1). Most served adults in an outpatient ambulatory setting and received both individual and group supervision. Those in some specializations reported specific diverse populations, forensics, serious mental illness, drug and alcohol use, integrated medical services, and rural mental health. Directive treatment (i.e., CBT, DBT, or ACT) was the most frequent orientation practiced by trainees, although exploratory (i.e., psychodynamic, person-centered, or experiential), biopsychosocial, and integrative were also represented among training experiences. There were no significant differences between spring and fall cohorts on any training characteristic variable (all ps > .46).

Measures

Poll on Effects of Political Climate on Clinical Work and Supervision.

We adapted the poll on political climate in therapy by Solomonov and Barber (2018, 2019) for this study (i.e., we altered questions to be about the effect of political climate on the trainees’ work with clients and about the supervisory relationship rather than the therapy relationship). To assess beliefs and experiences around political climate, clinical work, and supervision, trainees answered the following questions:

  1. To what extent, if any, has politics affected your work with clients? (0 = not at all, 6 = to a very great extent)

  2. To what extent do you feel it is your ethical responsibility to address bias or misinformation expressed by your clients? (0 = not at all, 6 = to a very great extent)

  3. Have you and your supervisor discussed any effect of politics on your clients? (−1 = no, 0 = unsure, 1 = yes)

  4. Do you and your supervisor share similar political views? (0 = definitely not, 4 = definitely yes)

  5. Would you like to discuss any effect of politics on your clients more with your supervisor? (−1 = no, 0 = unsure, 1 = yes).

Trainees also read a list of 14 actions their supervisors may have done in supervision around the effects of political climate on clinical work (e.g., drew my attention to the effect of politics on a client; noted relevant diversity factors that contributed to a client’s reactions to political events; listened to my personal experiences about or reactions to political events outside of the session). They then endorsed whether they recalled their supervisor doing such actions (0 = not at all, 6 = to a very great extent) and whether they wanted their supervisor to do these actions more or less frequently (−2 = much less, 0 = no difference, 2 = much more). Due to pressure to capture trainees’ experience during the historical political changes at the time, we did not conduct a psychometric validation study of the survey but rather relied on face validity of the questions and previous testing by Solomonov and Barber (2018, 2019) for existing items.

Brief Alliance Scale (Crits-Christoph et al., 2011)

Trainees rated the quality of their current supervisory alliance using 100-point visual analogue scales by completing the following four statements:

  1. Thinking of your primary supervisor at your practicum or internship (0 = I do not feel heard, understood, and respected, 100 = I feel heard, understood, and respected)

  2. What I want to work on and talk about (0 = we do not work on or talk about, 100 = we work on and talk about)

  3. My supervisor’s approach is (0 = not a good fit for me, 100 = a good fit for me)

  4. Overall, (0 = there is something missing in the supervision, 100 = the supervision is right for me).

This measure has been used reliably in community-based research to capture clients’ experiences of the alliance and to provide feedback to therapists about the relationship (Crits-Christoph et al., 2011). The internal consistency (Cronbach’s α) for the four items in the supervisory alliance subscale was .91. Overall, trainees reported strong, positive supervisory relationships with an average score of 78.3 (SD = 21.3, n = 337). Supervisory alliance did not share a significant correlation with trainee political affiliation (r [309] = −.04, p = .50).

Procedure

IRB approval for this study was obtained through Chestnut Hill College. In March-April and November-December 2020, we sent out email requests through professional listservs for doctoral psychologists and trainees (e.g., Society for the Advancement of Psychotherapy [APA Division 29]; North American Society for Psychotherapy Research; National Council for School of Professional Psychology; Association of Psychological Training Clinics) and state psychological associations. To increase geographic representation, we made direct contacts with eight faculty in doctoral psychology training programs in rural or underrepresented areas (e.g., programs in the Rocky Mountains and Great Plains regions). Participants followed a link to the survey website, provided informed consent, and then completed the questionnaire. At the end of the survey, participants were asked whether they wished to take part in a 1-in-10 chance raffle for a $10 Amazon gift card. No trainee participated in the study more than once. Study data are available through request.

Data Analysis

Descriptive statistics were computed for all variables (see Table 2). All statistical associations between trainee beliefs and supervisory experiences were computed as Pearson r correlation coefficients (for continuous-level variables; Research Questions 1, 2, and 4) and Spearman rs correlation coefficients (for ordinal-level variables; Research Questions 3 and 5) (see Table 2). Testing of all follow-up hypotheses were conducted using t- or F-statistics. Scores for desired topics in supervision were analyzed through single-sample t-tests against the value of 0 (the scale anchor no difference). To control the false discovery rate for multiple comparisons, the p-values reported in this article were corrected using the Benjamini-Hochberg (1995) method. All p-values were then upwardly adjusted so that their statistical significance may be interpreted by the convention p < .05.

Table 2.

Descriptive Statistics and Correlations Among Trainee Beliefs and Experiences Around Political Climate and Supervision

Beliefs and Experiences
Beliefs and Experiences M (SD) n Training Year Political Affiliation Alliance Effect Responsibility Discussion Similarity
Effect of Politics 2.77 (1.39) 318 .13* .17** −.08 - - - -
Responsibility to Correct Bias 3.01 (1.25) 317 −.05 .16** −.11 .24** - - -
Discussion With Supervisor 0.19 (0.93) 269 .14* .06 .20** .38** .05 - -
Political Similarity to Supervisor 3.70 (0.93) 319 .05 .54*** −.12 .11 .17** .25*** -
Desire for Discussion 0.01 (0.87) 269 −.01 −.07 .03 .38*** .21** .30*** .14*
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Note. For effect-coded variables Discussion With Supervisor and Desire for Discussion, descriptive statistics are weighted averages and correlations are Spearman’s rss. For correlations with continuous variables, all dfs > 307. For correlations with ordinal variables, all dfs > 254. Research questions can be referenced by rows (1 through 5) and specific hypotheses by columns (a. through h.)

*

p < .05.

**

p < .01.

***

p < .001.

Results

Do Trainees Perceive an Effect of Political Climate on Their Clinical Work With Clients?

The average trainee described the political climate as influencing their work to some extent (see Table 2). Twenty percent (n = 64/318) stated that their work was not at all affected, whereas 12.3% (n = 39/318) believed the political environment had a great or very great impact on their work. As hypothesized, greater endorsement of the belief that political events affected clinical work was significantly associated with trainees’ training year, albeit at a small effect (r [317] = .13, p = .03). In a follow-up test, trainees who had experience providing clinical services before 2016 (M = 3.33, SD = 1.47, n = 114) reported a greater influence of politics compared to trainees who began training after 2016 (M = 2.47, SD = 1.24, n = 201; t [313] = 5.55, p = .002, d = 0.30). Also as hypothesized, belief that political events affected clinical work shared a small correlation with a more progressive political affiliation (r [308] = .17, p = .005). There was no significant relation between beliefs about the influence of political environment and the supervisory alliance (r [317] = −.08, p = .16).

Do Supervisees Feel Responsibility to Address Bias or Misinformation Expressed by Their Clients in Session?

The average trainee stated they felt to some extent it was their ethical responsibility to address bias or misinformation expressed by clients (see Table 2). Only 9.1% (n = 29/319) stated not at all, and 11.3% replied to a great (n = 24/319) or very great extent (n = 12/319). Contrary to our hypotheses, beliefs about ethical responsibility were not related to training year (r [316] = −.05, p = .46) but were associated with a more liberal political outlook (r [307] = .16, p = .007). Greater sense of responsibility to correct perceived bias correlated with beliefs about the effect of politics on therapy (r [315] = .24, p < .002) and the supervisory alliance (r [316] = −.11, p = .07).

Are Trainees Discussing Effects of Political Climate With Supervisors and What Attitudes and Beliefs Affect This Occurrence?

Over half (n = 149/269) of trainees had discussed with their supervisor how the political climate affected their work (see Table 2). Trainees who had spoken in supervision about the political climate were more likely to be further in their training (rs [269] = .14, p = .03) but, contrary to our hypothesis, were not any more likely to endorse one political affiliation over another (rs [254] = .06, p = .37). As hypothesized, trainees who had spoken with their supervisors about political climate and therapy believed more strongly that political reactions had affected their work (rs [269] = .38, p = .002). Surprising to us, beliefs about responsibility to correct bias (rs [268] = .05, p = .46) were not associated with whether discussion of political climate occurred in supervision. Supervisory alliance was correlated with the likelihood of having had a conversation about politics and clinical work in supervision (rs [269] = .20, p = .004), such that higher alliances were seen among those who had discussed political climate in supervision.

In follow-up of these hypotheses, participants endorsed whether 14 potential topics of their supervisor occurred in their supervision (see Table 3). Among the topics on the list, trainees believed that supervisors attended most to diversity factors, listened to trainees’ experiences of clients with different viewpoints, and normalized patient reactions to political events. The least attention was given to the more proactive topics (i.e., participating in advocacy efforts together and encouraging in-session discussion of political reactions) as well as more proscriptive actions (i.e., challenging clients’ beliefs around political reactions or discouraging political discussion).

Table 3.

Trainees’ Recall and Desire for Specific Topics in Supervision

Recall
 Desire
Topic of Supervision M SD n M SD n
Client With Different Viewpoints 2.83 1.67 239 0.21*** 0.55 200
Advice or Suggestion 2.39 1.46 250 0.48*** 0.68 206
Parallels Between Politics and Behaviors 2.12 1.36 252 0.45*** 0.77 208
Effects of Politics on Clients 2.21 1.40 255 0.56*** 0.74 211
Diversity Factors 3.15 1.65 253 0.58*** 0.77 211
Personal Reactions 2.54 1.60 252 0.25*** 0.60 208
Advocacy Events 1.46 1.13 252 0.14*** 0.58 207
Encouraging In-Session Discussion 1.48 0.94 256 0.15*** 0.48 212
Dismissed or Ignored Politics 1.40 1.02 252 −0.02 0.58 206
Normalizing 2.72 1.50 251 0.24*** 0.55 206
Importance of Politics in Supervision 1.82 1.22 254 0.43*** 0.68 210
Reducing Client Anxiety 2.20 1.32 251 0.59*** 0.71 206
Discouraging Discussion in Supervision 1.36 0.92 253 −0.03 0.59 207
Challenging Client Beliefs 1.38 0.80 251 0.18*** 0.60 206
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Note. Values for topics desired to discuss in therapy are significant when they exceeded zero (“No Difference”) in either direction (negative, wanted less; positive, wanted more).

***

p < .001

Do Trainees’ Perceptions About Political Similarity With Their Supervisor Influence Supervision?

The majority of supervisees (63.0% [n = 201/319]) believed their supervisor definitely or probably shared their political views, 28.0% (n = 89/319) were uncertain, and another 9.1% (n = 29/319) were probably not and definitely not in agreement with their supervisor (see Table 2). Training year was not associated with perceived political similarity (r [318] = .05, p = .47). Shared political views were strongly associated with trainees’ political affiliation (r [309] = .54, p < .001), such that supervisees tended to believe themselves and their supervisors to be more liberal overall. Perceived political similarity was not associated with the extent to which trainees believed politics affected their work (r [317] = .11, p = .08) but was with higher personal expectations to correct bias (r [316] = .17, p < .004). A nonsignificant linear relation existed between alliance and perceived political similarity (r [318] = −.12, p = .05) but upon inspection, those who definitely knew their supervisors’ political affiliation, regardless of whether they agreed or not, had significantly higher alliances than those who were uncertain or had not broached political similarity (see Figure 1). The likelihood that the trainee and supervisor discussed political climate in their supervision was related to perceived political similarity (rs [269] = .25, p = .001).

Figure 1. Curvilinear Relation Between Supervisory Alliance and Perceived Political Similarity With the Supervisor.

Figure 1

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Note. Bar height represents model-estimated mean scores. Error bars show standard errors.

Do Trainees Have Needs in Supervision Regarding an Effect of Political Climate on Their Clinical Work?

Whereas we had predicted most trainees would want additional discussion of political climate and clinical work in their supervision, 37.9% (n = 102/269) said they were so inclined, 37.8% (n = 99/269) said they did not, and 22.0% (n = 102/269) were uncertain. Neither training year (rs [269] = −.01, p = .75) nor political affiliation (rs [254] = −.07, p = .31) were correlated with desire for more political discussion in supervision. As hypothesized, those wanting more discussion of political events were also generally more likely to endorse beliefs that politics affected their work (rs [269] = .38, p = .001) as well as greater sense of pressure to correct bias (rs [268] = .21, p = .01). Quality of supervisory alliances were not correlated with a desire for more political discussion about politics and clinical work in supervision (rs [269] = .03, p = .58), suggesting that alliances were not affected by the perception of an unmet need. However, both the likelihood that discussion had previously occurred (rs [269] = .30, p = .001) and trainees’ perceived political similarity to their supervisor (rs [269] = .14, p = .03) were associated with a wish for more political discussion in the supervision.

To follow up these hypotheses, we used single sample t-tests to test whether participants reported wanting significantly more or less discussion of each of the 14 potential supervisory topic in Table 3 (i.e., whether the mean score for a topic differed from zero). Trainees expressed desire to speak more about almost every topic. What trainees wanted most from their supervisors was increased awareness of how political climate and diversity factors affected clients and advice on managing client reactions to the political environment.

Exploration of Site, Population, and Cohort Differences

We used F-statistics to test for differences in trainees’ beliefs about the impact of politics on clinical work, responsibility to correct perceived bias, discussion of politics with their supervisor, and desire for additional discussion in supervision by political region (i.e., party of congressional representative), training site orientation (i.e., directive, exploratory, biopsychosocial, or integrative), training setting (i.e., community counseling center, inpatient facility, outpatient practice, or partial program), client life stage (i.e., older adults, general adults, veterans, college students, adolescents, or children) and cohort (i.e., spring or winter). Only significant findings and their follow-up contrasts are reported. Theoretical orientation influenced trainees’ beliefs about the influence of politics in therapy (F [3, 293] = 6.55, η2 = 0.06, p = .01). Respondents with a biopsychosocial (M [SE] = 2.23 [0.30]) or directive (M [SE] = 2.53 [0.11]) orientation believed that political climate affected their work significantly less than trainees with a psychodynamic (M [SE] = 2.96 [0.15]) or integrative (M [SE] = 3.40 [0.20]) orientation. Orientation was also associated with whether trainees discussed political climate with their supervisors (F [3, 244] = 5.22, η2 = 0.06, p = .004). Supervisees of a directive theoretical orientation (49.2%) but not those of a biopsychosocial orientation (55.9%) were significantly less likely to have had discussed political climate with their supervisors when compared to psychodynamic (61.2%) or integrative (59.2%) trainees. Political region, training setting, client life stage, and cohort did not lead to significant differences in any variable (all ps > .15).

Discussion

Our findings suggest that the political climate affected trainees’ clinical training experiences and therapeutic work with patients at the time this study was conducted, in agreement with other research on political climate and therapy (Prout et al., 2019; Solomonov & Barber, 2018, 2019). Given the continuing discord in political climate (Gura, 2022; Totenberg & McCammon, 2022), it is likely these effects persist. Region, training setting, and client age were not associated with whether trainees viewed political climate affecting their clinical work or supervision, suggesting the political climate may have broadly influenced how trainees experience clinical training. Though there have been studies examining supervision in the light of traumatic events and systemic factors (e.g., Bauwens & Tosone, 2010), to our knowledge, this is the first to focus on the fast-evolving influence of the current political atmosphere on clinical training.

The large majority of trainees reported that the political environment mattered to some degree to their patients. Ways that political climate may have manifested in clients’ presentations might have been increased stress due to policy changes, uncertainty in the future of governance, and conflict in interpersonal relationships (e.g., McCarthy & Saks, 2019; Solomonov & Barber, 2018, 2019). Inside the therapy, trainees might not know what to do when clients bring up political material or might struggle with feelings toward their clients around differing political opinions. Trainees, especially those with experience working with clients before 2016, expressed that the effect of political climate on clinical work was greater in the past few years. This trend that trainees are observing may indicate a change in the nature of how politics affects clients and clinical training, or could be part a cyclical pattern, as some theorists have suggested that clinical work responds to the times in which it is practiced (e.g., Young-Bruehl, 2011). Perhaps more conservative clients and trainees struggled in previous decades when more liberal politics were predominant. This phenomenon may have been overlooked in the past, given the tendency toward more progressive views in the field (Avissar, 2009; Redding, 2001; Solomonov & Barber, 2019) and our finding that beliefs about the political climate affecting clinical work were associated with a more liberal trainee political affiliation and a greater responsibility to correct client misinformation.

At the same time, one in five trainees thought the political climate had no effect on their clinical work. Theoretical orientation may influence the work that trainees do with clients, as beliefs about the influence of politics on clinical work and discussions of political reactions in supervision were less prevalent among trainees in more directive approaches (e.g., CBT or DBT). Such orientations may focus more on symptom relief or specific goal attainment, whereas more exploratory orientations (e.g., psychodynamic or person-centered) may consider clients’ problems more holistically. In directive treatments, clients’ political reactions be content for intervention (e.g., testing anxious thoughts about politics or practicing assertiveness in political debates) or may even bring the treatment away from a specific target (e.g., clients wanting to address political matters in an exposure treatment for an anxiety disorder, perhaps as an avoidance behavior). Supervisors may help trainees to acknowledge clients’ reactions to political climate while still keeping to a structural protocol.

Over half of trainees reported that they had had discussion of the effects of political climate on their clinical work with their supervisors. Trainees reported the most common supervisory topics around politics were discussion of differences, whether in diversity factors or in political opinion, and support around managing reactions to political climate. Discussion about political climate in supervision may be in response to felt need on the part of the trainee, as it was more likely to have occurred when trainees saw more of an influence of politics on their work. Discussion was also more likely to have occurred when the trainee perceived political similarity with their supervisor and when their alliance was stronger. Greater comfort in the supervisory relationship may facilitate these conversations or may even be a result of having them. Obviously, these finding are correlational and may exist in the reverse direction. Discussing politics in the supervision may lead trainees to find more of an influence of politics in their clinical work, and this effect could even be iatrogenic.

In contrast to previous studies, we did not find a consistent significant relation between the supervisor alliance and trainee-supervisor political similarity (Solomonov & Barber, 2018, 2019). However, when trainees perceived either definite agreement or definite disagreement about political beliefs, there were greater alliance levels compared to when trainees were not certain or not knowledgeable about their supervisors’ political affiliation. Transparency may help facilitate supervisory alliance in this climate. However, supervisors should be aware of the power in the relationship (i.e., feelings of similarity or dissimilarity) when working with trainees around political issues (Green & Dekkers, 2010; Murphy & Wright, 2005).

A large minority of trainees, but not as many as we predicted, wanted more discussion of the political climate and clinical work in their supervision. A similar percentage of trainees did not wish for more such discussion. Topics in supervision that trainees most strongly desired were attention to client diversity factors and ways to notice and manage political reactions. Desire for discussion about political climate in supervision was higher among trainees who held stronger beliefs that politics affected clinical work and who had discussed political climate with their supervisors. Trainees who view their work to be influenced by politics may find these discussions helpful and the need for them ongoing. Wanting more discussion was related to the trainee and supervisor sharing similar political opinions, again perhaps due a level of comfort in the relationship. However, the alliance was not affected whether the trainee desired more discussion of political climate in supervision, suggesting that good supervision may not need to include such conversation. Interestingly, training orientation was not associated with the desire for more discussion, even though orientation had been associated with beliefs about how much trainees saw politics affecting their work and whether discussion of political climate occurred in the supervision. Perhaps regardless of orientation, trainees appreciate their supervisor being open to any connections among political climate, clinical work, and supervision.

Limitations and Future Directions

We collected data in doctoral psychology programs across the US to increase the representativeness of our sample. This approach was moderately successful, as students from all regions of the country were included in both samples. At the same time, the samples were typical for a sample of clinicians, with limited diversity (i.e., primarily White, female, progressive, and working in more urban and liberal areas of the country; Solomonov & Barber, 2019). Trainees with other demographic characteristics may have different experiences of how political climate affects clinical work and training. Additionally, our analyses did not address effects of politics on work with specific vulnerable populations (e.g., immigrants and refugees) who are more likely impacted by political events and therefore have different needs from their trainee therapists. Unfortunately, we did not ask a question about trainees’ interest in political events or how much they follow current affairs, which may have influenced their perception on the impact of politics on clinical work. We did not collect longitudinal data in this study, and future studies will be needed to determine changes over time in trainees’ perceptions. We focused solely on trainees’ experiences and needs for supervision in this current political climate. Supervisors may have a more developmentally informed, longer-range vision for what might be helpful to their trainees, and soliciting their opinions about political climate in psychotherapy could inform a more comprehensive understanding of what is needed to support trainees and clients in the attainment of their goals. Relatedly, we focused on trainees’ self-report of clients’ experiences. Future research could expand this work by investigating dyads of trainees and clients and testing convergence in reported in-session experiences. We designed the poll to capture the effects of politics on trainees’ experiences in a timely manner. It was not developed as a psychometric measure. Future studies could test whether these findings replicate used a validated and reliable measure designed to test the effects of politics on clinical training. Findings were descriptive and correlational, and many of the effects were small. Caution belongs in any interpretations and conclusions.

Supervisory Implications

Based on our results, supervisors might invite conversation about the effects of political events on therapeutic processes. Otherwise, trainees might feel that they need permission to discuss these topics or that they should avoid discussion of these topics altogether. Supervisors’ attunement to their trainees’ and their own beliefs about politics and clinical work might enhance the trainees’ work with clients and the quality of supervision (Cheon, 2009; Gray et al., 2001).

Inviting a discussion of political climate and clinical work in supervision may also provide a supportive space for trainees to discuss these topics as needed. Supervisors might help trainees attend to their feelings and reactions when politics enter therapy, prevent burnout and facilitate a compassionate therapeutic stance, and manage discomfort when the client brings up political content that is emotionally activating or objectionable to the trainee (Davis et al., 2018; Hayes et al., 2019; Merriman, 2015).

For trainees conducting a structured protocol, supervisors might help them accommodate clients’ reactions to political events while staying on target with the treatment plan. This balance may be beneficial in managing the therapeutic alliance, which can be strained when legitimate concerns are ignored (Zickgraf et al., 2016).

Finally, supervisors may help trainees in supervision navigate difficult discussions with clients about politics by borrowing from a multicultural orientation (Davis et al., 2018). Trainees may learn best when the supervisor models multicultural humility, focuses therapy on patients’ values and positive strengths, and helps trainees manage reactions when treating those with differing backgrounds or political beliefs (Davis et al., 2018; Tuckwell, 2002).

Acknowledgments

Nili Solomonov was supported by NIMH grant K23 MH123864.

Biographies

Kevin S. McCarthy, Ph.D., is an Associate Professor at Chestnut Hill College and Clinical Associate Professor at the University of Pennsylvania where he trains and supervises doctoral psychologists and psychiatric residents. His interests are in psychotherapy process and outcome and the teaching of psychotherapy. He is Past President of the North American Society for Psychotherapy Research.

Carla Capone, M.S., is a clinical psychology doctoral student at Chestnut Hill College. Her interests include borderline personality disorder, substance use, and severe mental illness. She has had practical experiences at a medication-assisted treatment (MAT) center for opioid dependence, a psychological assessment clinic, and most recently an urban college counseling center.

Jennifer Davidtz, Ph.D., is an Associate Professor in the College of Psychology at Nova Southeastern University, where she is also the Director of Internship Training for the Psychology Services Center. She provides clinical supervision to doctoral students and interns and “supervision of supervision” to postdoctoral residents. Her interests include community psychology and social justice, clinical training and therapist development, and the treatment of serious mental illness, borderline personality disorder, and complex posttraumatic and dissociative conditions.

Nili Solomonov, Ph.D., is an Assistant Professor of Psychology in the Department of Psychiatry, Weill Cornell Medicine. She serves on the Steering Committee of the North American Society of Psychotherapy Research, advancing issues related to trainees’ engagement and support resources. She also supervises social workers and psychologists who provide psychotherapy in the community as well as psychotherapy clinical trials.

Footnotes

The authors have no known conflicts of interest to disclose.

Contributor Information

Kevin S. McCarthy, Chestnut Hill College, Perelman School of Medicine, University of Pennsylvania

Carla Capone, Chestnut Hill College.

Jennifer Davidtz, Nova Southeastern University.

Nili Solomonov, Weill-Cornell Medical College.

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