Missouri State University Counseling Programs Supervisor Training Fall, 2007

Program Outline  Introductions  Developmental Model of Supervision  Four Functions of a Supervisor  Characteristics that Enhance Supervision  Supervision and Ethics - Boundaries  Tarasoff and Risk Assessment  Supervision vs. Psychotherapy  Attributes of Good Supervision  Supervisee Evaluation

Introductions  Who Are you?  Where are you from?  Please give a brief “commercial” for your site.  Who are you supervising?  How can we best help you to do your job as site supervisor?

Developmental Model of Supervision  Stoltenberg & Delworth (1987) – an Integrated Developmental Approach (four developmental levels across time): Dependency Stage – trainee doesn’t utilize supervisor feedback for fear of “doing something wrong”; completely reliant on supervisor for direction and decision-making

Dependency-Autonomy Conflict – trainee makes strides in independent thinking; still unsure and dependent upon supervisor Conditional Dependency Stage – trainee experiences an increase in self-determination; feels more confident in work, but some self-doubt persists Master Counselor Stage – trainee experiences competence as a therapist; successfully incorporates theory and practice Developmental Model of Supervision (cont’d)

Four Functions of a Supervisor  Monitor Client Welfare  Enhance supervisee growth within stages  Promote transition from one stage to the next  Evaluate supervisees

Core Characteristics that Enhance Supervision (Sussman, 2002)  A strong working alliance between supervisor and supervisee  An atmosphere of trust and safety  Shared interest in supervision and an interest in the learning and development of a competent therapist  Provision of a framework for understanding the theoretical and technical underpinnings of the treatment process

 Supervisor and supervisee self- disclosure – permission to acknowledge mistakes in therapy  Provision of appropriate supervisor pacing and leading of supervisee which provides direction to the time-limited supervisory experience Core Characteristics that Enhance Supervision (cont’d)

Supervision and Ethics - Boundaries  Attention to appropriate boundaries addresses the majority of areas within codes of ethics  Supervisees often need assistance establishing and maintaining appropriate boundaries

Tarasoff Decision  “When a therapist determines, or pursuant to the standards of his/her profession should determine, that his/her patient represents a serious danger of violence to another, he/she incurs the obligation to use reasonable care to protect the intended victim.”

Tarasoff Reporting Checklist  Remind the patient that he/she signed a consent form at the start of treatment outlining instances when you will need to break confidentiality. Threatening to harm another person or persons is one of those instances.  Contact your supervisor immediately.  Contact the police in the jurisdiction of the identified victim(s). Give only information necessary to ensure safety of potential victims (i.e., your name, patient’s name, content of the threat)

 When you have the identified victim(s) name and phone number, attempt to contact them to alert them to the potential harm.  Document all actions (in detail) in the patient’s chart.  Send a letter to the identified victim(s) with pertinent info about your call to them and what other precautionary measures you took.  Put a copy of the letter in the patient’s chart; keep a hard copy for yourself Tarasoff Reporting Checklist (cont’d)

 Debrief the event with your supervisor, team, or other professionals.  Attempt to repair the therapeutic relationship with the patient, if possible. Provide a non-violence behavioral contract to the patient if involvement is continued. Tarasoff Reporting Checklist (cont’d)

Risk Assessment: Things Associated with High Risk  Intent (specific plan; means)  History (previous acts of violence; Hx of homicidal threats; childhood antisocial behavior; abuse Hx; recent provocation)  Behavior (tension/agitation; bizarre behavior)  Personality Characteristics (poor impulse control; aggressiveness; mood lability)

 Diagnosis (drugs/alcohol; paranoia; delusions; mania; antisocial personality)  Demographic Factors (being male; low SES) From R. Williams, “Clinical Supervision: Framework for Success” Risk Assessment: Things Associated with High Risk (cont’d)

Supervision vs. Psychotherapy  While good supervision can be therapeutic, it is not therapy  Codes of ethics emphasize the boundary between the two

Attributes of Good Supervision  The capacity to enhance the trainee’s self-confidence through support, autonomy, support  The capacity to model a strong working alliance  Provision of an environment to give and provide useful evaluations  Trainer has knowledge of multiple formats of supervision

 Supervision is adaptable and flexible (adaptable over time)  Excellent communication, from case conceptualization to theoretical underpinning to interpersonal clarity  Contains a sense of equilibrium and a sense of humor from Falender & Shafranske (2004) Attributes of Good Supervision (cont’d)

Supervisee Evaluation  The Counselor-Trainee Progress Assessment  Done repeatedly throughout a student’s program  Assesses a wide domain of skills and relates them to standards