Putting on the face: A qualitative study of power dynamics in clinical supervision

Nine master’s-level counselors (recently graduated) were interviewed about their experiences with power in clinical supervision. Using the consensual qualitative research (CQR) method (Hill, Thompson, & Nutt Williams, 1997), the authors derived five general categories: power resides in the supervisor’s expertise, supervisor error erodes his or her power, misuse of power elicits self-preservation, supervisor demonstrating trust in the supervisee’s abilities empowers the supervisee, and supervisor transparency reduces power. Power dynamics appeared to be most salient in situations where the supervisee experienced a negative supervisory event. Implications for training and research are discussed.     

Harmful supervision: A commentary

ABSTRACT

Supervision is an important component of professional learning, growth, and development in the helping professions. It is at the heart of professional practice on a career-long basis for some professions and a significant element in education and internship for others. Regardless of how long it continues in a professional’s career, it is a practice that is expected to model effective relationship building, the sensitive giving and receiving of feedback, and the careful management of power and difference. In this article, these expectations form a perspective through which a series of narratives of harmful supervision are reviewed.     

Narratives of harmful clinical supervision: Introduction to the Special Issue

ABSTRACT

Despite the ethical mandate “do no harm,” harmful clinical supervision seems to be occurring internationally among mental health disciplines at an alarming rate. Harmful supervision appears to be largely unacknowledged, unrecognized, and not understood, especially from the supervisees’ perspective. This Special Issue presents 11 anonymous narratives written by supervisees across four mental health disciplines and four continents, plus three reaction articles from supervision experts. The introduction article delineates the rationale for and procedures utilized in obtaining the narratives. The closing article synthesizes the Special Issue contributions, offering conclusions, implications, and recommendations to address harmful supervision systemically across disciplines and internationally.     

Narratives of harmful clinical supervision: Synthesis and recommendations

ABSTRACT

Scarce information exists that considers supervisees’ experiences of harmful supervision despite research that indicates occurrences at startling rates (e.g., Ellis, Creaner, Hutman, & Timulak, 2015). This Special Issue attempts to serve as a starting point for stimulating conversation, action, and change around harmful supervision practices across disciplines and internationally. Specifically, in this article we aim to synthesize the introductory, narrative, and reaction articles (Ammirati & Kaslow, 2017; Beddoe, 2017; Ellis, 2017; Ellis, Taylor, Corp, Hutman, & Kangos, 2017; Reiser & Milne, 2017). In addition, we offer implications and recommendations to minimize the occurrence of and redress harmful supervision.     

Trauma-informed supervision: Historical antecedents,current practice,and future directions

ABSTRACT

In this article, the author traces the development of the current emphasis on trauma-informed practice and care in behavioral and mental health treatment. Using the discrimination model of clinical supervision, the author then discusses the application of trauma-informed principles to supervision. Relevant research is cited, and case examples are employed to illustrate critical roles, responsibilities, and tasks. Challenges and future directions also are identified.     

The Potential for a More Clinical Approach to Child Welfare Supervision to Promote Practice and Case Outcomes: A Qualitative Study in Four States

This article describes qualitative findings from a mixed method study of the impact of implementing clinical supervision in four public child welfare agencies. Particular emphasis is on the development of learning organizational cultures, promotion of self-reflective and evidence-informed practice, and outcomes-focused approaches to working with families. Themes identified from 15 focus groups with supervisors are provided, in terms of their use of clinical techniques, observed changes in supervisor and worker practice, and client outcomes attributed to the project. This study provides a rationale for clinical supervision in the child welfare setting, and the linkage between it and desired outcome achievement.     

Identifying the core competencies for clinical supervision at a youth-focused social services agency

ABSTRACT

The purpose of this article is to present a framework outlining competencies required for effective clinical supervision within the context of community-based multidisciplinary service agencies. The clinical supervision competency framework was developed through a literature review and input from the supervisors and senior managers of a community-based youth-focused service agency. The framework includes nine domains of clinical supervision competencies. Within each domain, the competencies are further categorized into Values, Knowledge, and Skills. Practical implications of the clinical supervision competency framework for multi-disciplinary, community-based agencies are discussed.     

Humility in clinical supervision: Fundamental,foundational, and transformational

We propose that supervisor humility is a critical variable for effective supervisory practice, fundamental, foundational, and potentially transformational in its impact. We examine humility, and the different types of humility (e.g., intellectual humility), that can impact supervision practice. Supervisor humility is considered to be supportive of supervision best practices by (a) enhancing multicultural competence, (b) fortifying the supervisory alliance, (c) rendering receptivity to supervisee feedback more likely, and (d) fostering engagement in peer consultation. Brief case examples are used to show humility in action.     

The self-reported use of research in clinical practice: A survey of occupational therapists in Sweden

Background: Today, healthcare providers and occupational therapists are increasingly required to rely on evidence-based practices. In both outpatient and inpatient settings, the use of research-based practices can be identified using the Research Utilization Measure questionnaire. Aim: This study explores how occupational therapists in Sweden perceive research utilization. Method: The Research Utilization Measure was sent to 807 randomly selected occupational therapists in Sweden, and the response rate was 59% (n = 472). Results: The majority of respondents (56%, n = 256) reported use of research-based knowledge in their practice “very or rather often”, although 49% (n = 225) of the therapists noted that they “very seldom or never” discussed research findings with their managers. Differences in answers for most items were related to degree of education and length of experience. Occupational therapists with higher education levels more often reported use of research in their clinical practice and therapists with greater experience less often reported use of research in their clinical practice. Conclusion: Education seems to influence the degree to which occupational therapists rely on research to inform their practices. A future challenge for managers and occupational therapists is to create strategic discussions on how to implement treatment that is based on current research.     

An application of the model of human occupation to fieldwork supervision and fieldwork issues in NSW

Occupational therapists in New South Wales (NSW), both clinicians and academics, find themselves in the position of adapting to the continually increasing demands for sufficient fieldwork opportunities for students. There are now four occupational therapy undergraduate programmes in NSW presenting further challenges for the supply of fieldwork placements. In response to this situation, the NSW Fieldwork Issues Group was formed to address issues arising for all involved. This paper is a result of initial attempts by members of the group to identify and explore the major issues confronting fieldwork supervisors, in order to develop some strategies for managing the changes taking place in NSW. In an effort to clarify the issues involved, a variety of models were considered and the 'model of human occupation' was applied. This paper presents, briefly, the reasons for choosing this model and details its potential application to issues facing fieldwork supervisors in NSW and the implications for fieldwork supervision within the occupational therapy profession as a whole.     

Clinical supervision and counseling psychology in the Republic of Ireland

Against the background of political, social, economic, and cultural factors, we present an overview of clinical supervision within counseling psychology in the Republic of Ireland (ROI). Clinical supervision has been an integral aspect of counseling psychology training in the ROI since its inception, and more recently it is being promoted as a professional support over the course of the counseling psychologist's career. Within this context, we discuss the current status of clinical supervision, including the major developments, key policies, and best practice principles. Recommendations regarding the future direction of clinical supervision in the ROI and globally are also offered.     

Broaching as a strategy for intercultural understanding in clinical supervision

Broaching cultural similarities and differences with genuine, respectful inquisitiveness is an important supervisory intervention. Broaching allows supervisors to acknowledge the relevance of cultural identities and invite supervisee dialogue. Through dialogue, supervisors are tasked with openly receiving what is said by supervisees and working through ideas to maximize the effectiveness of supervision. In this practical article, broaching as an intervention in supervision is described. The importance of clinical supervision, the intercultural nature of supervision, sample broaching prompts, and recommendations for supervisors are also included.     

大市场监管模式下基层食品安全监管能力分析——以江西省为例

目的:了解机构改革后大市场监管模式下江西省基层食品安全监管能力现状。方法:采用普查法,调查江西省822个乡镇市场监督管理分局的基本情况和房屋建设、装备资源、人力资源情况。结果:共有基层监管人员5 917名,监管对象总数为42万家,平均每名监管人员承担71家的现场检查任务。总体房屋面积达标率为62.9%,装备配备率8.48%;装备达标率仅为4.89%。男女比例4.08∶1;年龄段以45~55岁为主;具有大专以上占78%,食品医药类专业仅占到7.3%。结论:大市场监管模式下基层乡镇力量虽然有了明显增加,但存在装备严重不足、监管人员老化、专业能力不强等问题,需加大财政投入,推行基层所标准化建设,合理制定专业人才引进计划,强化顶层设计。     

Supporting evidence-informed policy making in rehabilitation: A logic framework for continuous improvement of rehabilitation programs

Because of important health and population trends, rehabilitation is a key health strategy of the 21^st century, and efforts are being made towards a broader integration of rehabilitation into health systems worldwide. In the scope of the call for action Rehabilitation 2030, WHO recommends a logic model approach for monitoring and evaluating national efforts at the systems level. In this paper we argue that as strengthening rehabilitation in health systems will require countries to implement a range of new programs, sound logic models designed to monitor and evaluate rehabilitation programs at service level are needed as well. We therefore propose in this paper an overarching logic model for monitoring and evaluating rehabilitation programs, including feasible indicators, options for their operationalization and considerations about data analyses. Our overarching logic model for monitoring and evaluation at service level is suitable to structure national clinical quality management for continuous improvement, to inform policy making and programming at the national level, and to serve as a reference framework for research. The model will serve as a starting point for developing other logic models that fit specific features of rehabilitation programs in diverse settings and countries.     

The utility of the revised Fit,Stigma, and Value Scale with counselor trainees: implications for enhancing clinical supervision

ABSTRACT

The authors tested the hypothesized model fit between the three-dimensional factor structure of the revised Fit, Stigma, and Value (FSV) scale, a screening tool for appraising barriers to attendance in counseling, with a national sample of 369 counselor trainees from 57 CACREP-accredited programs. Results of a second-order confirmatory factor analysis supported the three-dimensional factor structure of the revised FSV Scale and the presence of a higher-order factor. Researchers also identified demographic differences in counselor trainees’ sensitivity to the FSV barriers. Results and implications of the utility of the revised FSV Scale for enhancing the practice of clinical supervision are discussed.     

10/ Peer Supervision in the Community Mental Health Center:

This chapter is divided into three major sections. The first pan delineates six models of supervision that are frequently used in a community mental health setting. The second section spells out some of the possible administrative considerations and concerns regarding supervision in family service agencies, mental health centers, social service organizations, and similar counseling environments. The last segment of this chapter describes a novel supervision model which I have called "peer supervision carried to the extreme". This model has been used in a community mental health center in the Rocky Mountain region. This model is analyzed and its advantages and disadvantages are explicated. It is the conclusion of this author that the "peer supervision carried to extreme" format is viable, but only under certain specific conditions which in the short run may make the model less attractive to community mental health centers.     

2017年北京市石景山区公共卫生\

目的以上海市杨浦区为例,了解公共场所“双随机”监管模式的效果。方法使用上海市杨浦区2018—2019年公共场所数据,分析2018年和2019年的日常监督与“双随机”监督的不合格率、2018年监督对象在不同监管模式下2019年的处罚情况,用以反映“双随机”监管模式的效果。结果2018年(χ² = 58.04,P < 0.05)和2019年(χ² = 79.24,P < 0.05)“双随机”监督的不合格率高于当年日常监督的不合格率; 2018年日常监督的次年处罚率(10.74%)与2018年“双随机”监督的次年处罚率(15.65%)之间差异无统计学意义(χ² = 1.81,P = 0.18)。结论“双随机”监管模式比日常监督更容易发现监督对象的问题,但监管效果仍需巩固。