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Over the last decade, competency-based models have breathed new life into the education and training of professional psychologists, including their clinical supervision. For the field-based clinical supervisor, the implications of these changes are not always apparent. In this context, the present chapter the following functions: an information-disseminating function, by unpacking for supervisors how a competency-based paradigm might influence key aspects of supervision namely, establishing supervision goals and formalizing a supervision contract ; a reflective function, by inviting and challenging supervisors to carefully consider the merits and demerits of the paradigm and its alignment to their own supervisory practices ; and finally a supportive function, by providing guidelines, templates, and resources that may help supervisors adopt the paradigm.

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Establishing supervision goals and formalizing a supervision agreement : a competency-based approach. They suggest that contracting should occur in supervision, data should be collected and used for the normative and formative functions of supervision e. Supervisors should communicate formative feedback and promote supervisee self-assessment, and manage tension between formative and summative evaluation.

These effective supervision practices are elaborated from those described by Falender, Shafranske, and Ofek Or do you have live, video or audio review of supervision? If you are using only supervisee self-report, consider if there is a way to directly access or provide co-therapy with your supervisee.

It is very essential to observe your supervisee at least once during each training segment a requirement for psychologists under the Committee on Accreditation Regulations. Form a visual mental image of your best supervisor — visualize that person in as much detail as you can, remembering appearance, style, interactions, and any other dimensions you can recall.

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  7. Then think of words describing this individual. You will probably find that the words you generate correspond very closely to the literature on best supervisors, although they will probably not be comprehensive. Increased attention has turned to inadequate and harmful supervision.

    Supervisees surveyed reported very high rates of inadequate supervision in numerous studies e. Harmful supervision is defined by Ellis and others as supervisor actions directly harming the supervisee and actions known to cause harm although the supervisee may not identify them as such. More than half of the supervisees had received harmful clinical supervision at some point.

    Because of the power differential inherent in clinical supervision, supervisees are not likely to initiate discussion of supervisor competence or ethical concerns. In their most recent study, Ellis and colleagues describe examples that include the supervisor threatening the supervisee physically, having a sexual relationship with the supervisee, sharing drugs, or being aggressive or abusive with the supervisee.

    All of these are negligent supervision — not only is it harmful to the supervisee, it can cause significant harm to the clients being served by virtue of the supervisee not receiving appropriate supervision, the supervisee having experienced harm, thus placing the client s at high risk.

    These examples and this study reinforce the clear and urgent need for training in clinical supervision and for guidelines that provide for appropriate practice. Without specific training, individuals who simply begin supervising are generally not engaging in intentional and systematic supervision. Nor do they value the supervision process.

    The supervisee enters supervision for the first time. She is eager and a little anxious, and is unsure what the supervisor expects. The supervisor is welcoming, encourages the supervisee to discuss her previous experience and what she is hoping to learn in this setting, and provides structure and encouragement to her. Together they plan two goals and tasks for each to perform.

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    The supervisee particularly wants to gain additional competence in Parent-Child Interaction Therapy PCIT , and would like feedback about her skill development. The supervisor describes how it would be possible to observe her several times and give feedback. Her second goal relates to the impact of child trauma on her personally, and how to manage that when she sees a traumatized client; in the next session they will develop specific goals relating to that, which may include self-care.

    The supervision relationship is a complex one. This relationship provides the platform for sharing, disclosure, and mutual problem-solving. Most supervisors rely almost or totally exclusively on supervisee disclosure: what supervisees tell the supervisor about the client s and the session. We caution that there are many factors that implicitly impact what supervisees recall and disclose. Also, remember that relationships take time to develop — sometimes it is estimated to take from one to seven supervision sessions.

    And abundant data supports the idea that without a secure supervisory relationship, the supervisee does not disclose as much client or session information. Trust is a critical part of the supervisory relationship. Exercise: Think of a supervisee that you are currently supervising or about to begin supervising. For practice, role-play the supervisor-supervisee alliance formation process with a colleague. The types of areas to be covered in role invocation include the expectations and ground rules of supervision, starting with such basics as:.

    The supervisor may also elicit from the supervisee expectations for the supervisor. Thorough role invocation is an excellent part of establishment of the supervisory relationship. Although supervision is collaborative, there is the reality of the power differential,that is, the supervisor holds the power to evaluate the supervisee and is the gatekeeper who decides whether the supervisee is suitable to progress to the next level of training and to enter the profession.

    To improve competence, the supervisor might suggest readings e. Role play between the supervisor and the supervisee is also highly effective — with the supervisor playing the role of the client and then reversing to play the role of the supervisor.

    Learning Outcomes:

    The supervision progression is built on the foundation of a supportive relationship that encourages growth empowerment and trust so that issues of countertransference can be identified and explored, and creativity and innovation supported. For the supervisee, the relationship seems to evolve from dependency to growth of trust, on to individuation or the evolution of the relationship, and on to that of colleagues.

    Boundaries are very important in clinical supervision. Maintaining appropriate boundaries and not moving into the personal therapy domain is a central element of effective supervision.

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    The other element that is often shortchanged or ignored is the evaluative function, which provides a context and an ethical and professional structure to the relationship. Supervisors often do not evaluate or give corrective feedback essential components of supervision practice for fear of disrupting the supervisory relationship.

    Clinical Supervision A Competency Based Approach

    Evaluation should also be viewed as constructive, with frequent, ongoing input on the direction of the intervention and therapy. It should not be a distant hallmark at the end of the training sequence. Give brief feedback every supervision session on strengths and areas perceived to be in development. This brief feedback is anchored to the goals that were collaboratively developed. New goals are developed as each one is achieved. This introduces a significant transparency into the supervision process in that it gives the supervisee every chance to grow and improve, as well as to clarify aspects of behavior or interventions that may have been misunderstood in supervision.

    Feedback — corrective, positive, or negative — is a critical part of supervision. Assessment and self-assessment are essential ingredients of the alliance, as is instilling the concept of two-way feedback wherein feedback will be a part of every supervision session; supervisees should be encouraged to give ongoing feedback to supervisors as well. Supervisee feedback could be as simple as asking if there are other things the supervisee wishes were covered, or providing a simple checklist and asking the supervisee if all these were accomplished in the supervision session e.

    In the fifth supervision session of a second-year student, the supervisor became concerned that the supervisee seemed to be using a very directive approach, constantly telling the adult client what to do. It was not clear to the supervisor this was the best approach, but he wanted to discuss it with the supervisee. How would it be best to introduce the topic? Think of several ways you could do this. A major factor is the supervisory alliance that has been established. Possible approaches are 1 reflection on how the therapy is going, 2 expression of curiosity about why that particular approach is being used, or 3 asking how the supervisee is feeling in the session with the client, and what self-reflection she will engage in to discuss processes and feelings.

    Think of approaches you currently use and identify which are most effective. How do you enhance self-reflection? How do you vary your approach with different supervisees? What are some of the variables you take into consideration? Think about the issue that if you become very directive, you will be modeling the very behavior you do not want the supervisee to engage in. How could you adopt a reflective approach? They suggest that supervisees engage in review of their own sessions, and then discuss the audio or video review in supervision with supervisors using principles of Motivational Interviewing MI.

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    Open-ended questions provide for a conversational approach that allows trainees to reflect on their own progress, and it encourages trainees to decide to make changes i. Giving voice has similarly been referred to as self-assessment. Self-assessment also is enhanced by a reflective process — waiting until the supervisee and for that matter, the supervisor are not reactive — upset, angry, distressed — and then stepping back and reflecting on what happened, what the alternatives are, what feeling states were elicited, and how the supervisee could respond when such issues arise going forward.

    Supervisors can practice reflecting rather than judging. In cognitive-behavioral supervision, the contract can be constructed around requirements specific to the setting and competencies to be attained. Evaluation can focus on the competency document as can frequent and ongoing feedback and assessment. The supervisory contract which is supplemental to the basic supervisory agreement or responsibility statement required in some states is a means of articulating the roles, responsibilities, expectations, and requirements of the training period.

    From this discussion, goals and tasks can be developed and stated. Before you begin this section, think about your preferred supervisory format.