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This paper describes the flexible application of existential-humanistic (E-H) and relational approaches to supervision when working with adolescents with life-threatening illness. Powerful therapeutic work can occur through the balance of utilizing practical therapeutic interventions─including open-ended questions regarding existential anxieties, use of countertransference and somatic reactions, reflecting on values and priorities, dream interpretation, learning from each emotion, creativity, and what is psychological health─and understanding how an illness is processed through the patient’s unique cultural, family, medical, and relational history. The relational approach provides a balance to the E-H therapy emphasis on individuality in its focus on the complexity and adhesiveness of how early relational patterns and expectations are repeated throughout life. The E-H approach, on the other hand, provides a richness and depth to adolescents’ anxieties and desire for freedom and choice. The language of agency, uncertainty, groundlessness, and responsibility can be particularly relevant to the turbulence of this developmental stage. The ultimate goal of supervision is that the supervisor becomes part of the supervisee’s “internal chorus” along with other teachers, therapists, and mentors when dealing with future clinical challenges.

Relational and Existential-Humanistic Supervision and Therapy for Adolescents with Life-Threatening Illness: From Cocoon to Butterfly