Should the Clinical Supervisor Be the Administrative Supervisor?

Abstract

This article presents the clinical supervisor as administrative supervisor dual role as both an ethical issue and a current practice in counselor supervision. The author examines the two supervisor roles as well as the pros and cons of supervisors assuming the dual role with a supervisee. Finally, the author proposes how both administrative and clinical supervision can be ethically and effectively delivered in various counseling settings given their financial struggles and managed care climate.     

The Fifth International Interdisciplinary Conference on Clinical Supervision

Doctoral students in counselor education and supervision programs take a course specific to clinical supervision as part of their doctoral course work. The transition from supervisee to supervisor occurring during this course can be challenging, as it is frequently the first time that students are asked to provide supervision to counselors in training. The purpose of this qualitative research was to gain information about the process of doctoral students' development from supervisees into supervisors. Significant themes emerged from the data related to the transition of becoming supervisors: the importance of creating the supervisory relationship and the need for further supervisory skills.     

Expert site supervisors’ cognitions when working with counselor trainees

We examined expert site supervisors’ supervision cognitions while preparing for, conducting, and evaluating their supervision sessions with master’s-level counseling students via concept mapping. Experts’ cognitions were summarized in four areas: Supervisory Relationship, Conceptualization of Supervision and Supervision Interventions, Administrative/Logistical Considerations of Supervision, and Assessment of Supervisees and Their Practice. We discuss results and offer implications for research, practice, and training.     

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.     

Structured peer group supervision of school consultation:A case study

Structured peer group supervision (SPGS) supports applied skill growth for novice mental health professionals. Whereas previous SPGS research has focused on counseling, consultation is a core competency for school psychologists, with unique features meriting consideration during SPGS. This case study describes the influence of SPGS on applied communication and problem-solving skills of nine graduate students taking a school consultation course. Structured interviews measured participants’ perceptions, including information about how SPGS influenced consultation skills. Thematic coding revealed positive impacts of SPGS on communication skill development, and as logistical and conceptual support. Implications for school consultation training and practice are discussed.     

The Clinical Supervisor-Practitioner Working Alliance

Abstract

The focus of my presentation this morning is the core dynamics and skills of the supervisor-practitioner working alliance, or what I will refer to as the working relationship. I will present a model that suggests that the use of certain communication, relationship and problem-solving skills by the supervisor can influence the development of a positive working relationship with the supervisee, and that this working relationship is the medium through which the supervisor influences the practitioner. I stress the words “influence” because a central assumption of this approach is that both supervision and direct practice are interactional in nature. The supervisor and the supervisee each play a part in the process. The outcome of supervision is the result of how well each contributes to the process. This morning's presentation focuses on the supervisor's role. One of the discussions is the concept of the “parallel process.” While the role of the supervisor and the purpose of supervision are quite different from counseling and therapy, nevertheless there are striking parallels in the dynamics and skills. There is a suggestion that “more is caught than taught” and that our supervisees watch us very closely. Whether we like it or not, whether we are aware of it or not, our supervisees learn more about practice from the way we work with them than from what we say about their actual practice. Supervision is not therapy. In fact, supervisors who are seduced into a therapeutic relationship with their supervisees actually model poor practice since they lose sight of the true purpose of clinical supervision and their role in the process.     

Nutrition education and counseling: knowledge and skill levels expected by dietetic internship directors

Development of nutrition education and counseling skills is important in the educational preparation of dietitians. A national survey of dietetic internship directors was conducted to determine competency levels expected of students at the start of an internship, internship training given, and further preparation students need in 32 knowledge/skills areas deemed essential for delivery of nutrition education and counseling services. Completed questionnaires were received from 66 of 102 (65%) internship directors surveyed. The majority of directors expected only basic preparation for group nutrition education and individual counseling knowledge/skills areas. Internship training in nutrition education competencies was "moderate" to "extensive," whereas preparation in nutrition counseling competencies was more likely to be "extensive." Directors perceived the internship to provide adequate preparation in all but the advanced practice skills, such as behavior modification and motivational strategies, for which further preparation was recommended. The majority of internship directors reported that more than 25% of the intern practice experience was in patient counseling, with less experience in group instruction. Implications for undergraduate dietetic education are discussed in relation to internship directors' expectations as well as to present and future trends in the dietetic profession.     

Assessment of genetic testing and related counseling services: current research and future directions

With the recent completion of the sequencing of the Human Genome, genetic testing will increasingly become available for a greater number of medical conditions, many of which are those that manifest in adulthood (e.g., various cancers, cardiovascular disease, diabetes) or for which little or no treatments are available (e.g., Alzheimer disease). Genetic services, defined here as those relating to genetic testing and counseling, will be with helping more individuals deal with medical information that affects their health directly, as opposed to affecting primarily the health of their offspring. This paper reviews the existing research in the genetic testing and counseling literature and presents an evaluation framework outlining the intended outcomes of genetic services. The purpose of this framework is to provide an overview of the potential outcomes of these services and highlight constructs for future research in this area. In addition, other issues that will affect the assessment of genetic services are raised, using examples from the existing literature. Ultimately, the goal of this paper is to highlight and suggest directions researchers can take to produce the information needed to guide genetic testing and counseling practice. Moreover, as genetic knowledge is increasingly applied towards the prevention and treatment of various common, chronic disease conditions, genetic information will have implications for providers outside of the traditional medical genetics realm, such as primary care providers and public health practitioners. A better understanding of the outcomes of genetic testing and counseling will provide a basis from which to ensure an appropriate application of genetic information by all those who eventually provide care and "genetic" services.     

Genetic counseling in Catholic hospitals. Facilities must provide guidance to keep pace with new knowledge and techniques

As advances in the knowledge of human genetics change the practice of medicine, Catholic healthcare facilities will, according to ethicists, be increasingly obliged to provide genetic counseling services to their patients. Facilities should ensure that counselors make genetic information available in a context in which no pressure, overt or subtle, is exerted to use that information in a way that may violate an individual's value system. Some hospitals may, for example, set up a separate genetic counseling department, which does not diagnose or treat genetic disorders but does facilitate access to these treatments when patients need them. Effective counseling requires accurate, current knowledge about tests and treatments, as well as about theological discussions and Church decisions on the subject. Counselors also need to be aware of some typical misconceptions people have about genetic disease. Catholic hospitals should also work with other Catholic organizations to influence legislation addressing human genetic issues, especially when such legislation addresses reproductive rights.     

Prioritizing questions and methods for an international and interdisciplinary supervision research agenda: Suggestions by eight scholars

Eight active supervision scholars provide their perspectives on priorities for advancing research in clinical supervision. Based on proposals they presented at an invited symposium held during the 11th International Interdisciplinary Conference on Clinical Supervision, the authors propose research questions around multicultural identities, supervisor expertise, supervision models, and research methods. Although neither a comprehensive nor exhaustive list of priorities, the authors hope the article encourages dialogue across disciplines and countries that expand understanding of clinical supervision practice and supervisor education.     

Field Instructor Perceptions in Group Supervision

Abstract

Recent studies on group supervision in social work and psychology have begun to build a systematic knowledge base on the benefits and challenges of group supervision from the perspective of students. Missing from the empirical data are supervisor perspectives on group supervision. In an attempt to address this gap, this qualitative exploratory study reports on the experiences of five field instructors who offered group supervision to 20 social work students. Although primarily focused on field instructors' perceptions, students' perspectives are also included especially when the two groups either strikingly paralleled or differed from one another.

The study findings identified a number of related factors that affect the creation of a productive learning environment including: (1) extragroup factors such as students' previous histories with each other, and varying times for beginning the practicum, (2) managing difficult group member behaviours such as “the non-reflective students,” “the consultant, not learner,” and those students who cannot take risks, and (3) balancing the intersection of individual supervision and group supervision. From the analysis of the findings, the researchers propose practice principles and future research directions.     

Disclosure—and Lack Thereof—in Individual Supervision

Disclosure is a central component of the supervision process for supervisees and may, at times, also be a vital intervention for supervisors. I review the theoretical and empirical literature on disclosure and nondisclosure in individual clinical supervision, from both supervisees’ and supervisors’ perspectives. The review is focused primarily on supervisee nondisclosure, supervisor disclosure, and supervisor nondisclosure, and concludes with implications and recommendations for practice and research.     

Line Management Supervision in the Helping Professions: Moving from External Supervision to a Line Manager Supervisor Model

Clinical supervision is a fundamental component in key fields of practice; counseling, social work, and health, for example. However, there are increasing numbers of organizations whose focus is to engage and support clients to manage their lives effectively, but which are not required by mandate to provide supervision for their staff. This article shares the experiences of five supervisors working in just such a “helping” organization, which has moved from an external supervisor to a line manager supervisor model.

The participants share their stories about clinical supervision from a line manager perspective and reflect on the part supervision could play in supporting staff who work in the helping professions.     

Clinical supervision in speech-language pathology and audiology in the United States: Development of a professional specialty

In this article, the authors describe the development of clinical supervision in audiology and speech-language pathology in the United States from its recognition as a distinct area of practice to its current status. The authors describe roles and responsibilities of supervisors as well as approaches to supervision. They include information about key policy statements, practice guidelines, credentials, requirements, and ethical and legal considerations related to clinical supervision. The article also includes recent developments in training, technology, and advocacy, as well as future directions and challenges in supervision.     

Teaching interpersonal skills in family practice: results of a national survey.

The increasing recognition of the importance of a well-developed set of interpersonal skills to the competent family physician has resulted in a rapid growth in the formal teaching of interpersonal skills within family practice residencies. Of the 168 programs responding to a national survey of family practice residencies, 88 percent indicated that they have formal programs in interpersonal skills. It is estimated that there are well over 500 family practice faculty members who have special responsibilities in teaching interpersonal skills. While most programs address the component skills of the interpersonal process (eg, demonstrating empathy, information gathering, information giving, and psychological intervention), it is of concern that only about half offer explicit training in patient education (53 percent), specific types of counseling (eg, family counseling, 55 percent), or some of the specific interpersonal skills important in team practice and practice management (eg, supervisory skills). One of the most striking findings was that 88 percent of the reporting programs use videotechnology, with 77 percent of these planning to increase their use. Although most programs evaluate their interpersonal skills training using both indirect and direct assessment methods, only 25 percent attempt to use patient outcome as a measure of teaching effectiveness.     

The anatomy of a dietetic counseling interview

Dietetic students in a course on interviewing skills were given an opportunity to practice interviewing, first with "coached," volunteer clients, then with real clients. Their interviews were taped and later analyzed as to content and approach. In trying to develop rapport during the "relationship-establishing" phase of the interview, the students asked questions which required mininal self-exploration by the client to answer (closed questions), five times as often as any other type of question. For effective counseling which results in changed behavior by clients, skills in counseling which develop an understanding of clients' feelings must be learned and implemented in counseling settings.     

Clinical Supervisor Value Conflicts: Low-Frequency,but High-Impact Events

Although therapist value conflicts are well-documented in the counseling and psychotherapy literature, only a few researchers have attempted to comprehensively identify the scope of supervisor value conflicts. In this study, 17 clinical supervisors participated in focus groups exploring the types of situations that pose value conflicts, how they affect supervisors, and how they address them. Inductive data analysis yielded seven types of situations that create value conflicts: worldview differences; power differentials; managing disputes; clinical versus administrative roles; individual differences; threatened professional standards; and reconciling supervisee and client welfare. Themes are described, and training, practice, and research recommendations are provided.     

Bicycle helmet counseling by pediatricians: a random national survey.

A random sample of 1201 pediatricians who are members of the American Academy of Pediatrics completed questionnaires regarding bicycle injury prevention counseling. Of the 871 pediatricians in the sample who provide health supervision, 80% reported that they discuss bicycle helmet use with their patients at least once before the patient reaches the age of 12 years. Provision of bicycle helmet counseling did not vary significantly by pediatricians' age, gender, or practice location. The most important predictor of provision of bicycle helmet counseling was professional experience with injured children, including having had a patient who experienced a serious injury or death due to a bicycle accident in the last year.