Clinical Supervision the Subject Supervisor

Clinical Supervision

The subject supervisor has been an LPCS for since April this year and an ACS since 1996 up to this year for a total of 20 years. He first trained under DiAnne Borders at the UNC-G and worked with interns from the WFU and emerging LPCs until he obtained a supervision license.

He likes best watching his supervisees' skills, confidence and professional identity grow. He enjoys passing the responsibility on to them, particularly in recognizing that his unique style as a counselor will be passed on to them in another form or way. On the other hand, he does not feel too pleased with making the "make-or-break" decision on who has it and who does not. There was only one such experience, fortunately. It was an awful experience for them and for me but it would ultimately redound to the safety of mental health. The subject supervisor served as one of DiAnne Borders' subjects in one of her earliest research studies. Borders came in to UNC-G when the subject was just starting his supervision work. He completed two formal supervision courses.

He perceives the role of the supervisor as that of a teacher, a counselor, and mentor. He compares a supervisor to the Medieval apprenticeship artist or artisan. The Master trains the apprentice by teaching him the "what's" and the "why's" of the trade or profession in real life. He thinks that providing feedback is a skill that every student must learn. Feedback is a useful basis for correcting problems or filling needs. He believes that an excellent therapist is not necessarily a good supervisor. His concept of a good clinical supervisor is one who possesses enthusiasm and the ability to travel, particularly with the supervisee in a developmental journey as key element. A good clinical supervisor is a cheerleader, one who encourages supervisees to take risks wisely and to explore new things. Another important trait is adequate training as both a counselor and a supervisor. He must possess the skill of both.

His ideal model of supervision possesses a map of the territory and a direct link between the map and the territory of their journey together. Supervision is a developmental or growth process, which the ideal model should support. The Master must flex and shift in meeting the developing needs of the supervisee. The absolute ideal consists of a combination of the Discrimination Model of Bernard, the Developmental Model of Stoltenberg and Delworth, and the person-centered model of Rogers.

The subject is a Masters-level biologist who specializes in estuary ecology. He was particularly interested in embryology, physiology and microbiology. His training in ecology developed his appreciation for the science of development and served as groundwork for his love for systems and the systems theory. His consequent training in Gestalt and the systems theory is now put to use in his counseling and supervision tasks. He also benefited from a whole-semester "apprenticeship" at UNC-G and the relationship that grew from it. These are the theoretical tenets he sees as underlying his concept of a model supervisor.

His sees his ideal as fitting his current and past experiences as supervisor. With the help of a colleague, he created a training manual for supervisors. He has also conducted workshops now offered by his former trainees. In other words, he perceives his professional development as having achieved his whole idea of clinical supervision. He sees it as the keystone of clinical mental health work. He adds that a supervisor does not stop being a supervisee because he does not stop learning. He cannot have all the answers.

Theory and Practice, Function

Clinical supervision is defined as an intensive, interpersonally-focused relationship wherein the supervisor facilitates the development of the therapeutic skills and competence of the supervisee (Bernard & Goodyear, 1992 as qtd in Smith, 2011). Supervision is a complex activity, characterized by multiple interests and multiple roles (Maddux and Mohr, 2011). It focuses on the supervisee's well-being and professional well-being, the welfare of the client, and the protection of the profession. At the same time, it occupies multiple roles, i.e., helper vs. evaluator and teacher vs. counselor. It is the fifth most common activity among practicing clinical psychologists and the second most commonly practiced among psychotherapists (Maddux & Mohr).

Supervision chiefly focuses on the quality of practice offered by the supervisee to clients (Smith, 2005). It is composed of three aspects, namely, administrative, education, and support. Administration is a normative aspect; education is formative; and support is restorative. The supervisor's authority comes from his positions in agencies and the continuity of the practice of his profession. His fundamental concern is the quality of service he offers the client. The client stands at the center of things, quantitatively and qualitatively. The same holds true to consultant or non-managerial supervision. This notion is the central component of trainee supervision. The interests of the community as a whole come next. The supervisor must balance individual wishes with those of others in the community. Sarah Banks (1995 as qtd in Smith) identifies the four basic principles in social work and informal and community education. These are respect for, and promotion of, individuals' rights to self-determination, promotion of welfare and well-being, equality, and distributive justice (Smith).

Models of Clinical Supervision

These are the Developmental Model of Stoltenberg and Delworth, the Functions Model by Kadushin, Key Issues Model by Gilbert and Clarkson, Training Models of Holloway, Process Models by Hawkins and Shohet, and the Therapy-Specific Models (Smith, 2011; NFATT, 2005). The Developmental Model consists of four levels, representing the four stages of human development. These are child in Level 1, adolescent in Level 2, early adulthood in Level 3, and maturity in Level 4. Level 1 is self-centered, Level 2 is client-centered, Level 3 is process-centered, and Level 4 is process-in-context-centered. The Functions Model presents the functions of supervision as educative, supportive, and managerial. The Gilbert and Clarkson Model presents key issues. These are reduction of harm, ethics or professional practice, skills or techniques, a conceptual framework, transference and counter-transference, developmental issues, personal issues, treatment or goals, and assessment. Holloway's Training Models utilize a supervision process matrix. Hawkins and Shohet's Models focus on the therapist's counter-transference, the here-and-now process, and the supervisor's counter-transference. And the Therapy-Specific Models' structure, processes and techniques resemble those of a therapy session. Examples are cognitive therapy, cognitive analytical therapy and psychodynamic therapy (Smith).

Characteristics of a Good Clinical Supervisor

A good supervisor possesses the same qualities of a good teacher and a good counselor (Borders, 1995). He is empathic, real, open and flexible. He recognizes the supervisee as a separate individual with his own identity and differences. He is comfortable with and performs the authoritative and evaluative functions, which go with his role. He is committed to the growth of the supervisee. He sees his own strengths as well as limitations He has a sense of humor, which comes handy especially during difficult times in their work. Professionally, he is knowledgeable and competent. He has extensive training and broad experience in counseling. He uses different types of intervention according to the supervisee's learning needs, learning style, and personal characteristics. He also pursues continued growth through education, self-evaluation and feedback. A good supervisor has the professional skills of a good teacher. He functions as effectively as a good teacher, good counselor and consultant. As such he is able to make informed choices on what role to play at a given time as regards a particular supervisee (Borders).

Recent studies found that an interpersonal characteristics and positive personal values and attitudes are the most important characteristics of a good clinical supervisor (Mataiti, 2008). Other preferred characteristics are clinical competence, education, teaching and learning, safety and organizational capabilities. The findings of these studies underscore the importance of a practicing clinician's basic human relationship needs before a supervisee can feel safe with him and support him and for a harmonious relationship can form. Regardless of the level of experience, a clinician is always a learner. A clinical supervisor who possesses these highly value traits will also be positively viewed and accepted by clinicians (Mataiti).

Practical Traits of a Good Supervisor

He knows the job of every person he oversees (Joslin, 2008). If he does not, he should learn it. He should lead by example. He should practice what he preaches. He makes things better than they are. He must have patience and keep his cool so that subordinates and superiors will respect him. He realizes that respect is an earned privilege, not a right. He knows his team's strengths and weaknesses well. He knows the organization's policies and procedures. He is sociable but not social so that he remains objective. And he serves as the voice between the employee and upper management (Joslin).

The Effective Supervisor

Current medical literature lists the skills and qualities of an effective supervisor. He gives his supervisee responsibilities for clients' care (Kilminster, 2000). He provides them with opportunities to implement procedures, to evaluate clients, to get involved in the care or management of a client, and gives appropriate direction and constructive feedback. In certain countries, an effective supervisor possesses basic teaching skills, facilitation skills, negotiation and assertiveness skills, counseling and appraisal skills, mentoring skills, and knowledge of learning resources and certification requirements (Kilminster).

The most important aspect of the role of an effective supervisor is giving supervisee responsibility and the opportunity to practice it (Kilminster, 2000). Supervisees come to view the supervisor as a colleague and this leads them to become self-directed. Some supervisees consider teaching skills and techniques, interpersonal style and professional competence the most important characteristics of an effective supervisor. An effective supervisor shows empathy, is supportive, and exhibits flexibility, instruction, knowledge, interest in supervision and good tracking of supervisees. He is interpretative, respectful, focused ad practical. In contrast, an ineffective supervisor is rigid, shows little empathy and provides low support. He fails to consistently track supervisee concerns, teach or instruct. He is indirect and intolerant. He is close-minded. He lacks respect towards individual differences. He is non-collegial, seldom compliments and encourages. He is sexist, and is weak in deficient in evaluating (Kilminster).

Both supervisors and supervisees point to certain supervision events as helpful in making a supervisor effective (Kilminster, 2000). These include direct guidance on clinical work, shared problem-solving, reassurance and theory practice linking. Feedback and the provision of advice and a role model are also critical. Training is both valuable and necessary for supervisors to become effective or ideal (Kilminster).

Other issues that surface in effective or ideal supervision are time, race, gender and sexuality (Kilminster, 2000). Dealing with the difficulty of finding time for supervision may require better planning and time management as well as extra time for clients or supervisees. Supervision always involves a power relationship between the supervisor and supervisee. It is inevitable for individual social position and circumstances to come in, such as race, gender, social class and sexuality. Women and Black people are frequently subordinated in many situations of supervision. These issues affect the supervisory relationship. Studies suggested mentoring by someone from a similar social background may make supervision more effective for these special groups or sectors. The mentor should be matched with the personal and social characteristics of the clients or supervisees. The effective or ideal supervisor understands issues of power and social categorization, such as institutional racism. Some programs address the aspects of multicultural working and the supervisor should take advantage of these. He understands that trans-cultural relationships assert transforming effects. An effective supervisor is, thus, culturally sensitive as well (Kilminster).