Bernard's Discrimination Model of Clinical Supervision

Introduction to Clinical Supervision

Mental health practitioners' clinical supervision began similarly to the practice of "apprenticeship" in other fields. Apprentices or pupils possessing basic skills and knowledge would become proficient in their work through observation, assisting the accomplished professional, and receiving feedback. The prevailing belief was that, since the "master" excelled at the job, his or her supervisory and teaching skills would be equally strong. However, this is not always true. Experts in the field have recognized that, despite counseling and clinical supervision having much in common — including the ability to engage in effective interpersonal relationships — these two tasks employ unique and distinct skills. In other words, an expert clinician will not inevitably be an expert supervisor without additional training and experience in supervisory skills and knowledge. Moreover, the specialist-apprentice supervision concept creates a power hierarchy that positions the specialist or coach as the "authority" in the field; this dynamic receives no support in current literature on supervision and training (Smith, 2009).

It has also been established that clinical skills and knowledge cannot be transferred as easily as the trainer-apprentice model implies (Falender & Shafranske, 2004). Observation of master clinicians at work is undoubtedly a valuable training tool; however, it does not suffice in helping pupils develop the skills required to become accomplished clinicians themselves. Student reflection on the supervision process, the counseling relationship, and their own work facilitates genuine development. Consequently, clinical supervision has more recently been gaining recognition as a multifaceted supervisor–supervisee exchange, with supervisory theories and models being developed to provide it with a coherent framework.

Among the most widely researched and adopted integrative supervision models today is Janine Bernard's Discrimination Model, originally proposed by Bernard in 1979. The model comprises three distinct supervision foci — intervention, personalization, and conceptualization — and three potential supervisor roles: teacher, consultant, and counselor (Bernard & Goodyear, 2014). At any given moment, a supervisor can respond in any one of nine ways (3 foci × 3 roles). For instance, the supervisor may assume the teacher's role while focusing on a specific intervention the supervisee employed during a client session, or may assume the counselor's role with a focus on the supervisee's work conceptualization. Because the response is always specific to the supervisee's needs, it shifts across roles within sessions.

The supervisor first assesses the supervisee's ability within a given focus area and then selects the appropriate role from which to respond. Goodyear and Bernard (2014) advise mental health supervisors to refrain from responding from the same role or focus out of personal preference, habit, or comfort. Rather, supervisors must ensure their chosen role and focus address the supervisee's most pressing needs for that particular situation. This paper reviews the Discrimination Model together with its key elements: supervision, roles, and foci.

Purpose and Best Practice Guidelines for Supervision

The term clinical supervision refers to the creation of personalized supervisee learning plans to be applied when supervisees are working with clients. The systematic method by which supervision is delivered is termed a "model." Both the Counseling Supervision Curriculum Guide and the 1990 Standards for Clinical Supervision affirm that knowledge of supervision models is critical to ethical counseling practice. Practices, procedures, and beliefs associated with supervision began to emerge as experienced therapists expressed the desire to train novices. Early training, however, emphasized the efficacy of a specific theoretical orientation — for example, behavioral, client-centered, or psychodynamic therapy — and norms of supervision were often conveyed indirectly through apprenticeship routines. As supervision became more focused, three types of models emerged: (1) integrated models, (2) orientation-specific models, and (3) developmental models.

The principal purposes of clinical supervision include:

Initiation of Supervision. Supervisors engage in rigorous informed-consent practices during the first supervision session. They clearly articulate definite supervising parameters and facilitate a discussion pertaining to the supervision process, in order to foster a strong supervisory working relationship.

Goal-Setting. Supervisors co-develop supervision goals with their supervisees, emphasizing goals that directly benefit the client–supervisee therapeutic relationship and the efficiency of services offered. They purposefully address and evaluate goals in every supervisory session.

Feedback. Supervisors offer continuous and regular feedback, in addition to direct, on-the-spot feedback as necessary. They attend to the multiple feedback sources available to their supervisees.

Conducting Supervision. Supervisors follow correct professional standards — including licensure, accreditation, and certification regulations — when deciding on the modality and frequency of supervisory sessions. They cultivate and maintain a safe, structured, and supportive supervision environment and employ a variety of supervisory interventions. They select group or triadic supervision arrangements based on supervisee and client needs, not primarily on time efficiency. They also apply technology-based approaches that improve the supervision process and student development, and they actively and continuously evaluate the supervision course in both post-degree and academic supervision contexts.

The Supervisory Relationship. Supervisors recognize that their relationship with supervisees is central to supervision effectiveness and to the supervisee's development and growth. They engage intentionally with supervisees to cultivate a productive working alliance and supervisory relationship, while addressing cultural and ethical concerns that bear on that relationship.

Advocacy and Diversity Considerations. Supervisors recognize that all supervisory functions contain a multicultural dimension, and they incorporate multicultural factors into their supervisory approach. They also encourage supervisees to infuse advocacy and diversity considerations when working with clients.

Ethical Considerations. Supervisors make supervisees aware that both parties are required to abide by the ethical guidelines and codes mandated by the American Counseling Association (ACA), the Association for Counselor Education and Supervision (ACES), and other relevant ACA divisions. Supervisors continuously monitor their own competence in supervising and take appropriate action when necessary. They acknowledge that client welfare is their foremost responsibility and act accordingly. They take care not to compromise the supervisory relationship through inappropriate dual relationships with supervisees, and they conduct continuous supervisee performance evaluation and assessment, including an appraisal of both limitations and strengths.

Supervision Format. Supervisors employ different supervision formats — such as individual, triadic, group, and colleague or peer review supervision — in ways that follow accreditation standards and credentialing body regulations, fulfill supervisee needs, are appropriate to context, and adequately address client needs. Format selection is not driven by what proves most convenient for the supervisor.

Documentation. Supervisors maintain records that provide an accountability system for supervisory practice (Borders et al., 2011).

The Discrimination Model Described

Goodyear and Bernard's Discrimination Model is described as "a-theoretical." The model combines three supervisor roles with three focus areas. Supervisors can assume the teacher's role when directly lecturing, instructing, and informing their supervisees. They can assume the counselor's role when helping supervisees identify personal blind spots or weaknesses, or recognize the ways in which they unconsciously become "hooked" by a particular client's problem. When a supervisor relates as a colleague or peer in a co-therapy process, he or she is functioning in the consultant's role. All three roles are task-specific when identifying supervision issues, and supervisors must remain sensitive to unethical dependence on dual alliances. For example, the rationale behind adopting the counselor's role is recognition of unresolved problems that cloud a therapeutic association; if such issues require ongoing counseling, the supervisee should pursue this work with their own personal therapist.

The Discrimination Model also underscores three focus areas in skill building: conceptualization, personalization, and process. "Process" issues explore how communication is carried out — for instance, does the supervisee resonate with the feelings the client expresses? Could the application of paradox help the client become less resistant? Did the supervisee reframe or alter the situation? "Conceptualization" issues address how well a supervisee can explain their decision to apply a particular theory to a given case — that is, how effectively they view the "big picture" — along with the rationale they provide for deciding on the next course of action. Personalization refers to counselors' use of their own personhood in the therapeutic process, such that everyone involved is present non-defensively in the therapeutic relationship. For instance, a therapist's natural body language may inadvertently intimidate certain clients, or a therapist may not recognize that a client has developed a physical attraction toward them (Leddick, 1994).

The Discrimination Model is predominantly a training model. It assumes that practitioners naturally tend to focus on some roles and issues more than others. By identifying one's habitual practice, a supervisor can then consciously attend to the remaining categories. In this way, a supervisor will select interventions geared to the supervisee's needs rather than to the supervisor's own learning style or preferences.

Three Foci: Process, Conceptualization, and Personalization

Intervention skills, personalization skills, and conceptualization skills are the three recognized focus areas of the Discrimination Model. Intervention skills in the context of clinical counseling supervision encompass every observable counselor behavior that characterizes counseling as a deliberate interpersonal activity. These skills range from the most straightforward gesture — such as a head nod — to the delivery of a complex counseling plan or technique.

A subtler dimension tracked by supervisors in clinical settings is the supervisee's conceptualization skills. These include the ability to select an appropriate intervention, to interpret what the client is presenting, to identify and systematize client themes, and to establish both process and outcome goals.

Finally, supervisors also attend to personalization skills evident when observing counselors at work. This focus area may be defined as the capacity to use oneself appropriately as a counselor; it incorporates traits such as intrapersonal cohesion, interpersonal warmth, the ability to draw on the strengths of one's cultural characteristics, and un-defensiveness. While some personalization and conceptualization skills may be directly observed, they will more often be interpreted by supervisors and will initially require counselor–supervisor dialogue to become clear.

Process represents the way supervisees go about conducting their counseling sessions — in other words, what supervisees actually do during sessions. It extends from the foundational skill of active listening to more complex skills such as behavioral interpretation.

Conceptualization refers to the supervisee's depth of understanding of themselves, the client, and the counseling process — including the identification of patterns and the formulation of hypotheses or theories to explain and resolve the client's problem. It encompasses the ability to make sense of information presented by the client, to isolate themes, and to distinguish what is therapeutically necessary from what is not.

Personalization focuses on the impact that supervisees have on the counseling process by virtue of their personal attributes — for example, personality traits and inter- and intra-personal dynamics. Personalization denotes the totality of everything trainees bring personally to their counseling role, including their personality, humor, cultural background, and empathy toward others.

Conclusion

The activity of clinical supervision is inherently complex. Skilled clinical supervisors must embrace the domain of psychological science as well as those of trainee development and client service. They must understand the connections among these different knowledge bases and be capable of applying them to individual cases. This paper has reviewed Goodyear and Bernard's supervisory Discrimination Model with the aim of increasing readers' theoretical knowledge and thereby strengthening the foundation of supervisory competence. As noted throughout, several supervision models are in use: while the reach of some has been limited, others have resonated with many practitioners, thrived, and evolved. Regardless of one's chosen supervisory approach, a sound theoretical foundation is essential.

Goodyear and Bernard's (1992) Discrimination Model summarizes both the advantages and disadvantages of supervision models centered on psychotherapy. When the supervisor and supervisee share the same theoretical orientation, modeling is maximized as supervisors teach, and theory becomes more fully integrated into practical training. Process issues can predominate, however, when orientations conflict, run parallel, or clash (Leddick, 1994).

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