Clinical Supervision Models PRESENTED BY: SHANNON M. ELLER, LPC, LMFT, RPT, CPCS, NCC BRIGHTER TOMORROWS CONSULTING, LLC 1815 NORTH EXPRESSWAY—SUITE B; GRIFFIN, GA PHONE: (770) , FAX: (770)

Ethical Standards Around Supervisory Process Usual, Customary, Reasonable (UCR); Supervisor responsibility ; Vicarious liability: 1. form of strict, secondary liability that arises under the common law doctrine of agency, 2. respondeat superior – the responsibility of the superior for the acts of their supervisee (the responsibility of any third party that had the "right, ability or duty to control" the activities of a violator). Clinical Supervision Models

Ethical Dilemmas Competency Expertise Referral Termination Abandonment Clinical Supervision Models

Ethical Dilemmas Counselor Welfare Impairment Ethical Complaints Use of Technology (social media, internet/web services) Supervision vs Consultation Clinical Supervision Models

Ethical Standards Multicultural Issues Knowledge Awareness Skills Sets Sensitivity Respect Clinical Supervision Models

Knowledgeable Experienced Effective Communicators Synthesizers Relational Confident Flexible Systemically Oriented Clinical Supervision Models Attributes of Good Supervision

The greatest good you can do for another is not just to share your riches, but to reveal to him his own. -Benjamin Disraeli Clinical Supervision Models

You cannot teach a man anything. You can only help him discover it within himself. -Galileo Galilei Clinical Supervision Models

Current Research/ Literature Multicultural Considerations Individual, Triadic, Group Clinical Supervision Models

Foundations: Foundations: Educator Supervisor Consultant Group Discussion Role Plays Performance Domains: Interventions Conceptualization Personal and Professional Development Clinical Supervision Models

Supervision A means of transmitting the skills, knowledge, and attitudes of a particular profession to the next generation of that profession. This relationship is evaluative, extends over time, and Has the simultaneous purpose of enhancing the professional functioning of the junior member(s), Monitoring the quality of services offered, and Serving as a gatekeeper for those who are to enter the particular profession. Bernard & Goodyear(2004) Clinical Supervision Models

Theory-Based Models Influenced by supervisor’s theoretical orientation Focus on specific counseling skills from different theoretical orientations Murphy & Kaffenberger, 2007 Developmental Models Beginning, intermediate, advanced From rigid and shallow to competence and self-assured Stoltenberg & Delworth, 1987 Interpersonal Process Recall Integrative Models; Social Role Models Three supervisory roles, three areas for skill-building Discrimination Model Bernard, 1979 Parallel Process Clinical Supervision Models

Clinical Responses What makes good supervision? What is “bad” supervision? Clinical Supervision Models

Good Supervision is: Flexibility about theory, technical principles, and trainee’s learning style Respectful attitude, supportive and non- judgmental Openness, Curious, Relaxed and Patient Clinical Supervision Models

Poor Supervision Styles Administrative vs Clinical Job Seniority vs Knowledge/Skills Confrontational vs Challenging Negative vs Positive Critical vs Supportive Clinical Supervision Models

Negative trainee (T) experiences with supervisors (S) (T) came to supervision prepared to discuss cases and review tapes, but the (S) used the entire session to self-disclose and process a recent event that the (S) had experienced. (S) shut off the (T)’s therapy session tape and asked, “Why are you showing this to me?” (T) asked for more supportive feedback rather than just feedback about mistakes, and the supervisor declined to provide that kind of supervision. Clinical Supervision Models

“Good Supervisory Experiences” She really gave me permission to think about things without pressuring me to do anything.” “What was so great was that my S. was really affirming of…my ability to speak clearly…. I felt like she appreciated those abilities that I had taken pride in the past and which I had felt, I just hadn’t felt were being recognized at all, at any level.” “Maybe his [the S’s] being willing to hear what I had to say, maybe it modeled, maybe I should consider what he has to say.” Clinical Supervision Models

Discrimination Model (B&G) Basic assumptions Supervisors must assume different roles with supervisees Roles are chosen on the basis of a number of factors (Educator, Counselor, Supervisor) Developmental stage Theoretical orientation Presenting issue Clinical Supervision Models

Discrimination Model Basics Developmental vs Evaluative Focus Developmental vs Evaluative Focus Supervisor first attends to focus areas: Supervisor first attends to focus areas: Intervention skills Intervention skills Conceptualization skills Conceptualization skills Personalization skills Personalization skills Clinical Supervision Models

Supervisory Working Alliance Supervisory alliance predicts: Supervisees’ willingness to disclose Client perception of therapeutic alliance Supervisory alliance related to: Supervisor ethical behavior Use of effective evaluation practices Supervisor self-disclosure (professional) Clinical Supervision Models

Supervision Best Practices Ability to convey principles and concepts with clarity Ability to think out loud in order to model clinical inference process Willingness to allow supervisees to view supervisor’s own clinical work Clinical Supervision Models

Supervision Best Practices Relies on the supervisory working alliance Effective clinical relationship with supervisees based on common factors. Integration of own personal and professional development and growth processes. Sharing stakeholder position in supervision process. Clinical Supervision Models

Barriers to Good Supervision Power Struggles/ Poor Boundaries Lack of Safety/Trust Differences in Theoretical Orientation Personality Differences/ Personal Issues Lack of Rapport/ Positive Regard One-Up/One-Down Mentality Poor Structure/Distraction Clinical Supervision Models

Promoting Safety and Trust (Confidentiality and Privacy) Respect for clients Respect for rising clinician as colleague Respect for process Respect for profession Clinical Supervision Models

Types of Clinical Evaluation Formative feedback (informal/ongoing) Summative feedback (formal/terminal) Two core problems Defining competence Conflicts with self-concept as a “helper” Can result in avoidance of evaluator role Clinical Supervision Models

Verbally, Non- Verbally, Written, Modeling During Supervision (in session, throughout training, at end) Strengths Areas of Improvement Practical Suggestions Clinical Supervision Models

Roles of Supervision Educator: Instruction, Questioning, Reinforcement Mentor: Encouragement Guide: Demonstration and Modeling Evaluator: Assessment Clinical Supervision Models

Evaluation Methods Live vs Self-Report Advantages Disadvantages Clinical Supervision Models

Live (In-Vivo) Observations Bug-in-ear Bug-in-eye Telephone contact Two-way mirror Greek chorus Live observation Co-facilitation Clinical Supervision Models

Clinical Staffing Audiotape Videotape (IPR) Case Conceptualization Progress Note/ Tx Plan Review Advantages/ Disadvantages Clinical Supervision Models

Types of Supervision Individual Dyadic Triadic Group Advantages/Disadvantages Clinical Supervision Models

Case Scenarios Finding Your Own Style Clinical Supervision Models