Supervision

Front 1

What state was the first to license counselors-and what year was this?

Back 1

VA, 1975

Front 2

How important is supervision?

Back 2

VERY important. We could not be a profession without supervision. Part of a profession is specialized training and supervision

Front 3

What does it mean for a field to have a "signature pedagogy"?

Back 3

Engagement- engaging in learning dialogue
Uncertainty- specific outcomes and focus are unclear in the beginning
Formation- thought processes are shaped by supervisor

Front 4

Supervision definition:

Back 4

Supervision is an intervention provided by a more senior member of a profession to a more junior member(s) of that same profession.

This relationship is:
--evaluative and hierarchical
--extends over time
--Has the simultaneous purposes of enhancing the professional functioning of the more junior person(s); monitoring the quality of professional services offered to the clients that they see; and serving as gatekeeper for those about to enter the particular profession

Front 5

What helps us learn?

Back 5

Clear understanding of what constitutes an incorrect response or an error in judgment

Immediate, unambiguous, continuous feedback when such errors are made

Front 6

Supervision vs. TEACHING

Back 6

-Imparting new skills, evaluation/gatekeeping
-No protocol or set lesson, individually derived for each student

Front 7

Supervision vs. COUNSELING

Back 7

Both address behaviors, thoughts, feelings and internal processes
-Therapeutic work in supervision must relate to their counseling processes, counseling is not evaluative

Front 8

Supervision vs CONSULTATION

Back 8

Helping recipient work more effectively as a professional
Consultation has no hierarchy, consultation can be more time-limited, consultation is freely sought after

Front 9

Purposes of Supervision

Back 9

Foster professional development

Ensure client welfare

Rehabilitate impaired professionals

Teach supervisee to self supervise

Enhance professional functioning (set clear reachable goals)

Front 10

Consultation Definition

Back 10

A process in which a human service professional assists a consultee with a work-related (or caretaking-related problem) with a client system, with the goal of helping both the consultee and the client system in some specified way

Front 11

Generic Model of Consultation

Back 11

Stage 1: Entry-- what is going on in that system, getting acquainted and starting relationship

Stage 2: Diagnosis-- defining the problem, setting goals, generating interventions

Stage 3: Implementation-- choosing interventions, implementing plan, evaluating the plan

Stage 4: Disengagement-- evaluation, planning post consultation meetings, reducing involvement and following up, ending relationship

Front 12

Mental Health Collaboration

Back 12

Improve mental health outcomes for clients, enhance skill and understanding

Front 13

Educational Collaboration

Back 13

changes in knowledge, skills, attitudes, or behaviors at one or more levels: child, adult, or system

Front 14

Key ingredients for effective supervision

Back 14

- contract for supervision
- set goals
- methods for evaluations-tapes, etc,
- evaluation instruments
- feedback from supervisor
- summative and formative evaluation

Front 15

Professional Impairment

Back 15

troublesome reversal in performance or an inability to meet the requirements of a component of a training program (usually the clinical part)

Examples: never attaining adequate clinical skills, boundary violations, misuse of power, diminished clinical judgment, substance abuse, limited empathy, low impulse control, anxiety, cultural insensitivity

Front 16

As supervisors you are paying attention to:

Back 16

-Client welfare
-Supervisee Welfare
-Your responsibilities

Front 17

Due Process

Back 17

Procedure that ensures that notice and hearing must be given before an important right can be removed


ex) W&M and Augusta State Example

Front 18

Informed Consent (way of providing due process-for clients and supervisees)

Back 18

Clients
Risks and benefits of treatment, logistics of treatment, type of counseling, counselor’s scope of practice (student, etc.),
Info about supervision, who will watch tapes, etc.

Supervisees
What will happen in supervision, requirements, evaluation, supervisor’s scope of practice, will counseling be required

Front 19

Malpractice

Back 19

Harm to another individual due to negligence consisting of a breach of a professional duty or standard of care
As a supervisor you must know and follow the law as well as the profession’s ethical codes

duty to warn

Front 20

What is needed to prove malpractice?

Back 20

A professional relationship must have been established

The therapist’s (or supervisor’s) conduct must have been negligent and have fallen below a standard of care

The client (or supervisee) must have suffered harm or injury which must be demonstrated

A causal relationship must be established between the injury and the improper conduct

Front 21

Direct Liability

Back 21

when the supervisor's actions were the direct cause of harm

supervisor did not perform adequate supervision

supervisor suggested and documented an intervention that was the cause of harm

Front 22

Vicarious Liability

Back 22

the supervisor is found liable even though the actions were not suggested by the supervisor

Front 23

Moral Principles

Back 23

Autonomy (being responsible for one’s behavior and freedom of choice)
Beneficence (contributing to well-being of others)
Nonmaleficence (above all, do no harm)
Justice (fairness)
Fidelity (promotion of honestly and fulfilling commitments)
Clinical and cultural factors:
knowledge and thought about individual factors

Front 24

Theories impact:

Back 24

Worldview
View of change
What you focus on in counseling/supervision
Behavior within each session

Supervisory theories impact the multiple processes of both supervisee and client

Front 25

Graph of you as a practictioner

Back 25

6. Assumptive World
5. Theoretical Orientation
4. Style Role
3. Strategy Focus
2. Format
1. Technique

Front 26

Psychodynamic theory

Back 26

Alliance and parallel processes come from this theory

Early focus on client moving to focus on the supervisee

3 dimensions
-Supervisor’s authority (knowledge vs. collaboration)
-Supervisor’s focus (client, supervisee, or rx. between supervisor and supervisee)
-Supervisor’s primary mode of participation (roles and styles of supervision)

Front 27

Person Centered

Back 27

Direct access to the content of your own work was crucial to your reflection

Rogers believed supervision was a modified form of counseling

Continuum of work

Supported supervisee toward growth in self-confidence and understanding

Facilitative conditions and relationship are paramount

Necessary AND sufficient?!?

Front 28

Cognitive Behavioral

Back 28

Both adaptive and maladaptive behaviors are learned and maintained through their consequences

Automatic thoughts are influential, although they are not usually noticed
Cognitive distortions reflect anxiety (thoughts that limit or exaggerate reality)

Agreed-upon agenda, clear goal setting, and follow up of progress

Assessment is important

Use of treatment manuals and empirically validated treatments

Supervisee is responsible for learning

ABCDE (activating event, belief about the event, consequence of belief, disputing belief, new effect)

This can be used for supervisee development, as well as taught to them to use with their clients

Front 29

ABCDE

Back 29

(activating event, belief about the event, consequence of belief, disputing belief, new effect)

cog-behavioral

This can be used for supervisee development, as well as taught to them to use with their clients

Front 30

Propositions of CBT supervision…

Back 30

Proficient performance is more a function of learned skills than “personality fit”- teach appropriate behaviors and extinguish inappropriate behaviors

Therapist’s professional role consists of identifiable tasks, each with specific skills. Supervision should assist in developing, applying and refining them

Skills are defined behaviorally and can be learned and unlearned

Learning theory should be a part of supervision

Front 31

Systemic

Back 31

Attention to family, therapy, and supervisory systems

Supervision for family therapy should be theoretically consistent with the practice of therapy

Your experience IN a family impacts you as a family counselor – supervision should focus on this experience

Use of strategic interventions in supervision

Live supervision and reflecting teams

Isomorphism

Front 32

Constructivist-overview

Back 32

Truth is a construction grounded in social interactions and informed by verbal behavior

Multiple truths exists

Our truths stem from our own experiences

Equality between supervisee and supervisor

Focus on strengths

Front 33

Constructivist- narrative

Back 33

People are storytellers to organize past behavior and influence future behavior

Supervisor’s role is to assist the supervisee in editing the client’s story AND help supervisee develop his or her own professional story

Write, edit, and revise stories

Knowing vs. curiosity

Front 34

More Constructivist-solution focused

Back 34

Focuses on enabling the client to get what they want rather than on what is wrong with them

Clients know what is best for them

There is no single way to view things

Focus on what is possible and changeable

Curiosity is essential

Rather than teaching, supervisor helps supervisee to focus on strengths

Resistance is understood within the supervisory process – establish a collaborative relationship

Focus on strengths instead of faults

Work toward small changes

Achieve what is possible

Accept that there is no one right way to intervene

Front 35

Stage developmental models: IDM

Back 35

IDM uses a step-by-step approach to increase the supervisee’s growth moving from a highly structured supervision to nondirective structure

Student must complete all the requirements of that particular stage to pass into the next stage

Quantitative changes within each developmental level and reflecting qualitative changes between each stage

Front 36

Three structures of IDM

Back 36

Self-other awareness
Motivation
Autonomy

Front 37

How many levels of IDM?

Back 37

4

Front 38

8 Domains of IDM professional functioning

Back 38

1. Intervention skills
2. Individual differences
3. Interpersonal assessment
4. Assessment techniques
5. Client conceptualization
6. Theoretical orientation
7. Treatment plans and goals
8. Professional ethics

Front 39

IDM interventions

Back 39

Facilitative interventions

Enable supervisee to maintain control in relationship

Elicit affective response

Self-exploration

Validation

Authoritative interventions

Maintain control for supervisor in relationship

Giving advice/suggestions

Teaching/information giving

Confronting

Front 40

More Stage Developmental: Hunt's Cognitive Complexity

Back 40

How people think, reason, and understand an environment

Developmental models view supervision as an evolutionary process

Stages of development in this process have defined characteristics and skills

Supervision methods adjusted to fit the skill level of supervisees as they grow professionally

Front 41

Hunt's Conceptual Developmental Stages:

Back 41

0.0 – ambiguity cannot be tolerated, resist external imposition
1.0 – behaving in socially acceptable way, dichotomous thinking (good/bad)
2.0 – open to other’s ideas, concerned with self and other’s thoughts and feelings
3.0 – interdependence between one’s self and environment, avoidance of dependency

Front 42

Counselor Behaviors in Hunt's Conceptual Development

Back 42

A – concrete thinking, robot counseling, high structure, uncomfortable with ambiguity
B – separates facts, opinions, and theories, shows sensitivity, mostly accurate active listening
C – counseling is a process, adapting innovations, match and mismatch with flexibility, balance of support and challenge

Front 43

Two things that need to be equal in a supervision environment

Back 43

developmental level and level of structure

Front 44

Stage 1: Entry

Back 44

Phase One: Exploring Organizational Needs

Phase Two: Contracting

Phase Three: Physically Entering the System

Phase Four: Psychologically Entering the System

Front 45

Phase 1 of Entry Stage

Back 45

Why am I here?
Exploring Organizational Needs

To consult or not to consult?

Who are you?
What is likely to happen?
What will be the result?
What can go wrong?

Front 46

Phase 2: of Entry Stage

Back 46

Contracting

Reason for contracting:
To clearly define expectations of both consultant and consultee

Elements of a contract:
goals
time frame
responsibility of consultant & agency
boundaries
review and evaluation

Front 47

Phase 3 of Entry Stage

Back 47

Physically entering the system

Moving into “work space”
Getting to know employees of organization
Adapt to organization’s schedule
Have those affected by consultation informed about the consultant’s role

Front 48

Phase 4 of Entry stage

Back 48

Psychologically entering the system

The gradual acceptance of the consultant by members of the organization in which consultation is being performed
Consider the process level (how organization functions) and personal interaction (how people within an organization function)

Front 49

During Phase Four a Consultant Should. . .

Back 49

Create trustworthiness by. . .
Demonstrating understanding
Using power appropriately
Respecting confidentiality
Exhibiting credibility

Front 50

Stage II: Diagnosis

Back 50

Phase One: Gathering Information
Phase Two: Defining the Problem
Phase Three: Setting Goals
Phase Four: Generating Possible Interventions

Front 51

Phase 1 of Diagnosis Stage

Back 51

Gathering Information

Deciding to proceed
Selecting dimension
Deciding who will be involved in data collection
Selecting the data collection methods

Front 52

Phase 2 of Diagnosis Stage

Back 52

Defining the problem

How many factors affect the problem?
How has the problem developed over time?
What past events are causing the current problem?
How are future expectations related?

Front 53

Phase 3 of Diagnosis Stage

Back 53

Setting Goals

The process of shaping, a movement toward concreteness and specificity from a broader, more general perspective

Front 54

Phase 4 of Diagnosis Stage

Back 54

Generating Possible Interventions

Intervention- a force that attempts to modify some outcome. In consultation, interventions are actions or activities that, when put together in a systematic manner, make up a plan to achieve a goal

Front 55

Stage III

Back 55

Implementation

Phase One: Choosing an Intervention
Phase Two: Formulating a Plan
Phase Three: Implementing the Plan
Phase Four: Evaluating the Plan

Front 56

Phase 1 of Implementation Stage

Back 56

Choosing an intervention

Select one or two interventions that have a high probability of being successful

Take advantage of decision consultation

Front 57

Types of Interventions

Back 57

Individual Interventions
Dyadic and Triadic Interventions
Interventions for use between groups
Interventions for the entire organization

Front 58

Phase 2 of Implementation Stage

Back 58

Formulating the plan

Plan- a detailed step-by-step method, formulated before hand, for doing something.
Considerations-
What (objective)
Where (locale of implementation)
When (time frame)
How (methods, procedures, sequence)
Who (who is responsible for what)

Front 59

Phase 3 of Implementation Stage

Back 59

Implementing the Plan

Help consultee be flexible
Reassure and prepare consultee
Offer technical assistance during this time
Exercise caution toward dependency

Front 60

Phase 4 of Implementation Stage

Back 60

Evaluating the Plan

Evaluation- the collection of data/information about the implementation to determine its effectiveness in meeting the specified goal
--implementation evaluation
--outcome evaluation

Front 61

Stage IV

Back 61

Disengagement

Phase One: Evaluating the Process of Consultation
Phase Two: Planning Post-consultation Matters
Phase Three: Reducing Involvement and Following-up
Phase Four: Terminating

Front 62

Phase 1 of Disengagement Stage

Back 62

Evaluating the Process

Determine process and effects of consultation

Assess accountability and improvements in service

Add knowledge to the field of consultation

Front 63

Two types of evaluation: Formative and Summative

Back 63

Formative: evaluation of the process of consultation
-perform evaluations at the end of each phase of consultation

Summative: the evaluation of outcomes or products

Front 64

Phase 2 of Disengagement Stage

Back 64

Planning Post-Consultation Matters

Review planning process:
-determining objectives
-establish procedures
-defining steps
-assigning responsibility
-testing for feasibility, cost -effectiveness and capabilities

Front 65

Phase 3 of Disengagement Stage

Back 65

Reducing Involvement and Follow Up

Reducing Involvement-
gradual reduction in consultants contact with consultee and organization, which prevents abrupt termination


Follow-up-
the process of periodically checking how well the results of consultation are being maintained over time and how the organization is performing post-consultation efforts

Front 66

Phase 4 of Disengagement Stage

Back 66

Terminating

Terminating provides closure in a formal and ritualistic manner
-leave consultee satisfied in process and accomplishments
-tie up unresolved issues before leaving
-beware of the issues of dependence and depression

Front 67

Two of the most common pathways in the integrative model approach are:

Back 67

1. Technical eclecticism- borrowing of techniques
from various theories
2. Theoretical integration- refers to a conceptual or
theoretical creation beyond a mere blending of
techniques

Front 68

Process Developmental

Back 68

Reflection is crucial to counselor development
Just experiencing new events does not, in and of itself, produce growth
Also, reflection must be guided – to support and challenge perspectives

Front 69

Process Developmental: Loganbill, Hardy, and Delworth

Back 69

Characteristic attitudes toward: world, self, and supervisor
Counselor will cycle through each stage, increasing level of integration at each cycle
8 issues of development: competence, emotional awareness, autonomy, theoretical orientation, respect for individual differences, purpose and direction personal motivation, professional ethics

Front 70

Stagnation

Back 70

black/white thinking, lack of insight, dependent on supervisor

Front 71

Confusion

Back 71

disorganization, conflict, instability, recognition that the answer does not come from the supervisor

Front 72

Integration

Back 72

A new cognitive understanding

Front 73

Life-span Developmental Model

Back 73

6 phases
Lay helper: identifies problem quickly, gives advice, over involved, sympathy vs. empathy

Beginning student: dependent anxious, black/white thinking

Advanced student: what “right” answer, conservative and cautious, consolidation of learning

Novice professional: post-graduation, integrates personality in treatment, becomes more relaxed

Experienced professional: become authentic, flexible

Senior professional: modesty ensues, loss is a theme

Front 74

Social Role Models: Discrimination Model

FOCI and 3 ROLES

Back 74

Foci
Intervention skills
Conceptualization skills
Personalization skills

3 roles
Teacher
Counselor
Consultant

Front 75

Discrimination Model

Back 75

Helpful in suggesting conceptualization of supervisee skills and supervisor role

Atheoretical, so it can be easily combined with other theories

Front 76

What Theory works best?

Back 76

Efficacy

Front 77

4 common curative factors

Back 77

40% Client Factors (remission, inner strengths, goal directedness, motivation, personal agency, fortuitous events, social support, faith)
15% Expectancy/Placebo/Hope (credibility)
15% Techniques/Models (questions, feedback, reframing, interpretation, modeling, info)
30% Therapeutic Relationship Factors
(empathy, warmth, respect, genuineness, acceptance, encouragement of risk-taking)

Front 78

Parallel Process

Back 78

Supervisee is experiencing feelings or processes from a client and taking them on in supervision

Front 79

Isomorphism

Back 79

Content and process are matched between supervisor/supervisee and supervisee/client

Front 80

Triangles

Back 80

most stable, yet dynamic relational structure

Client, counselor/supervisee, supervisor

Coalition between supervisee/supervisor

Coalition between client/counselor
Supervisee, supervisor (1), supervisor (2)

Front 81

Working Alliance

Back 81

Goals – what are we working on
Tasks – how are we working on the goals
Bonds – emotional and relational bond

Front 82

How does working alliance impact?

Back 82

Impacts supervisee willingness to follow instructions

Impacts willingness to disclose
Impacts supervisee’s relationship with clients

Impacts the navigation of role conflict and ambiguity

Impacts ability for supervisor to address conflicts