Evaluate Clinical Supervision Models and Roles
Definitions of Supervision, Theoretical Frameworks and “Models” of Supervision, Methods and Techniques, AND Contextual Factors
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DEFINITIONS
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DEFINING CLINICAL SUPERVISION: Best Practices in Clinical Supervision
The Association for Counselor Education and Supervision (ACES), Best Practices in Clinical Supervision:
“ACES leadership believes that counseling supervisors in all settings carry responsibilities unique to their job roles. Such responsibilities may include administrative supervision, clinical supervision, or both. In some settings (e.g., schools), counseling supervisors also may have responsibility for program supervision” (ACES, 2011, p. 1).
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Defining Clinical Supervision, Best Practices in Clinical Supervision, continued
Administrative supervision refers to those supervisory activities which increase the efficiency of the delivery of counseling services, whereas clinical supervision includes the supportive and educative activities of the supervisor designed to improve the application of counseling theory and technique directly with clients. Program supervision is generally defined as having a systems focus with program improvement and counselors' professional development as its purpose.
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Defining Clinical Supervision
“Supervision is an intervention that is provided by a senior member of a profession to a junior member or members of that same profession. This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the junior members(s), monitoring the quality of professional services offered to the clients she, he, or they see(s), and serving as the gatekeeper of those who are to enter the particular profession” (Bernard & Goodyear, 1998, p. 6).
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Other Definitions and Requirements to Know
How does the State Licensing Board for your profession/discipline define supervision and supervisor?
What does the State Licensing Board require for you to supervise post-master’s supervisees seeking full licensure?
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Defining Clinical Supervision
“Supervision is an intensive, interpersonally focused, one-to-one relationship in which one person (the supervisor) is designated to facilitate the development of competence in the other person (the supervisee)” (Loganbill, Hardy, & Delworth, 1982, p. 4)
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Defining Clinical Supervision
Others define competency based clinical supervision as “..an approach that explicitly identifies the knowledge, skills, and values that are assembled to form a clinical competency and develops learning strategies and evaluation procedures to meet criterion-referenced competence standards in keeping with evidence-based practices and requirements of the local clinical setting” (Falender & Shafranske, 2007, p. 233).
“Emphasis is on the ability to apply knowledge and skills in the real world and use performance outcomes as criteria for evaluating supervisees and programs” (Falender & Shafranske, 2008, p. 7).
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Defining Clinical Supervision, continued
Quality clinical supervision is founded on a positive supervisor–supervisee relationship that promotes client welfare and the professional development of the supervisee.
You are a teacher, coach, consultant, mentor, evaluator, and administrator; you provide support, encouragement, and education to staff while addressing an array of psychological, interpersonal, physical, and spiritual issues of clients.
Ultimately, effective clinical supervision ensures that clients are competently served. Supervision ensures that counselors continue to increase their skills, which in turn increases treatment effectiveness, client retention, and staff satisfaction.
(Substance Abuse and Mental Health Services Administration, n.d., Introduction section, para. 1).
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Supervision May Take place/include:
Clinical Supervision may take place with an individual (individual supervision), with a group (group supervision), if permitted by state regulations, educational institutional requirements, and so forth, supervision may take place with two (2) supervisees (triadic supervision).
There are various models or theoretical frameworks that supervisors may use in supervision. Sometimes supervisors may combine different models of supervision.
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Theoretical Frameworks and Models of Supervision
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THEORETICAL FRAMEWORKS AND MODELS OF SUPERVISION
“Clinical supervision is the construction of individualized learning plans for supervisees working with clients. The systematic manner in which supervision is applied is called a "model“ (Leddick, 1994, para. 1)
Developmental Models
Orientation Specific Models OR Psychotherapy-Based Models
Social Role Models
(Sometimes may be referred to as Integrated Models)
Competency-Based Models
NOTE: The names used to describe and categorize the different “Types” or Models of Supervision, has varied across time, and also in the literature. Hence, this will be “suggested.” Let’s just say we are open to this AND we will consider this in our review of the literature, both past, current, and future. Thanks Team! Stay open, and eager, to learn more.
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Developmental Models
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Developmental Models
Developmental models of clinical supervision: propose that supervisees pass through several developmental stages with which supervisors should be aware and attend to.
Integrated Development Model (IDM)
Stoltenberg and Delworth (1987)
Began as 3 levels of supervisee/counselor development: Beginning, Intermediate, and Advanced. At each level, “the authors noted a trend to begin in a rigid, shallow, imitative way and move toward more competence, self-assurance, and self-reliance for each level” (as cited in Leddick, 1994).
Each level contained 3 processes
1) self-and-other awareness, (2) motivation, and (3) autonomy
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Development Models, Integrated Developmental Model (IDM) continued
Level 1(Beginning) supervisees are generally entry-level students/interns high in motivation, but high in anxiety and fearful of evaluation/feedback.
Lacks confidence, highly self-conscious with performance, anxious about evaluation, demonstrates confusion about behaviors appropriate for professionals, discomfort motivates actions, highly dependent on modeling and directive in supervision (Stoltenberg, McNeill & Delworth, 1998)
Level 2 (Intermediate) The counselor generally emerges a year or two after graduation, with consistent supervision during this time. Counselors become increasingly comfortable with a range of skills and may begin to explore various approaches and current trends.
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Continued, IDM
Level 3 (Advanced) Counselors at this level empathize with and understand their client’s view of the world which allows them to explore important information while discarding the irrelevant. Autonomy increases at this level and the supervisory relationship becomes more collegial.
The eight dimensions are:
1. intervention skills
2. assessment techniques
3. interpersonal differences
4. client conceptualization
5. individual differences
6. theoretical orientation
7. treatment goals and plans
8. professional ethics
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Developmental continued
The Skovholt and Ronnestad Model
Emphasis is on lifespan, relative to therapist development. 20 themes that characterize therapist development.
Stage 1: Competence
This is commonly thought of as the “common sense” stage of development. At this stage the new counselor uses the knowledge and experiences they already have.
Stage 2: Transition to Professional Training
(First year of graduate school)
Stage two counselors are in their first year of graduate school. They are likely enrolled in beginning counselor courses and are learning theories of psychotherapy. This may be combined with technique training. They are being presented with new ideas and thought processes.
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Skovholt & Ronnestad Model continued
Stage 3: Imitation of Experts
(Middle years of graduate school)
Grad school counselors are mimicking their instructors and supervisor. They are typically open to new ideas and are beginning to become conceptual.
Stage 4: Conditional Autonomy
(Internship)
Counselors are now working as professionals. Their skill level is increasing, their techniques are becoming more refined and their conceptual world is expanding.
Stage 5: Exploration
(Graduation - lasts 2-5 years)
Counselors become analytic and think beyond traditional training. They cast aside previously introduced material.
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Skovholt & Ronnestad Model continued
Stage 6: Integration
(lasts 2-5 years)
During this stage, counselors work toward autonomy and independence. They develop theories and approaches that fit their personality and belief system.
Stage 7: Individuation
(lasts 10-30 years)
During stage seven the counselor refines their concept of psychotherapy. They expand upon knowledge and become more authentic.
Stage 8: Integrity
(lasts 1-10 years)
The counselor continues to expand upon their knowledge base. They integrate new interventions and develop a sense of independence. They are able to apply theory and apply principles that are effective while eliminating those that are not.
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Other note on Ronnestad and Skovholt
Ronnestad and Skovholt Previously referred to as “Stages” instead of phases.
See their 2003 article, The Journey of the Counselor and Therapist: Research Findings and Perspectives on Professional Development
Six Phases, and 14 themes used to describe main processes of counselor and therapist development.
First 3 Phases (The Lay Helper, The Beginning Student Phase, and The Advanced Student Phase) roughly correspond with the levels of the IDM.
The remaining three phases are The Novice Professional Phase, The Experienced Professional Phase, and the Senior Professional Phase.
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Social Role Models
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SOCIAL ROLE MODELS (or Integrated Models)
Technical eclecticism tends to focus on differences, chooses from many approaches, and is a collection of techniques. This path calls for using techniques from different schools without necessarily subscribing to the theoretical positions that spawned them. In contrast, theoretical integration refers to a conceptual or theoretical creation beyond a mere blending of techniques. This path has the goal of producing a conceptual framework that synthesizes the best of two or more theoretical approaches to produce an outcome richer than that of a single theory (Haynes, Corey, & Moulton, p. 124).
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Social Role Models, continued
Bernard’s Discrimination Model
Combines 3 supervisory roles (teachers, counselors, consultants) with 3 skill building areas of focus (process, conceptualization and personalization)
Process: examines how communication takes place
Conceptualization: examines how well supervisee can explain applications of theory to practice (e.g., diagnosis, case formulation, treatment approaches matched to diagnosis)
Personalization: how the supervisees uses their “sense of person” in treatment/therapy (understanding of body language, grooming, presentation, style, etc.)
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Psychotherapy-Based (or Orientation-Specific Models)
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Orientation-Specific/Psychotherapy Based Models (a few examples)
Psychodynamic Model of Supervision
Person-Centered Model of Supervision
Cognitive-Behavioral Model of Supervision
Feminist Model of Supervision
Solution-Focused Model of Supervision
Family Therapy Model of Supervision
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COMPETENCY-BASED MODELS
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Competency-Based Supervision
Core aspects are respect for empirical evidence and a deep-seated regard for the scientific method. To make a meaningful and enduring contribution to psychology, competency approaches to supervision and training must give due weight to attitude-value competencies, including due recognition to contextual factors such as power, privilege, and culture
(Falender & Shafranske, 2007, as cited in Gonzalez & Calvert, 2014, p. 206).
Gonsalvez, C., & Calvert, F. L. (2014) Competency-Based models of supervision: Principles and applications, promises and challenges. Australian Psychologist, 48. pp. 200–208.
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Competency-Based Supervision
Falender and Shafranske Premise: All models of supervision are intended to develop competencies. This approach is said to provide framework and method to initiate, develop, implement, and evaluate processes and outcomes of supervision.
Personal traits, values, and pre-existing competencies are a foundation, with which to build. (2004)
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Methods and Techniques for Clinical Supervision
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Methods & Techniques for Clinical Supervision
Review of audio-taped interviews.
Supervisor listens and provides feedback later.
Supervisor and Supervisee both listen to selected sections.
Review of Video tapes.
(Same as above)
Role Play a clinical situation
Cofacilitate a session
Model a technique as supervisee observes.
Participant Observer—Observe supervisee
Direct Supervision/Live supervision
Supervisor sitting in on session(s)
By one way mirror, televised or recorded observation.
Case discussions with supervisee
Review Cases
Group Supervision
Peer supervision
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Contextual Factors
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OTHER FEATURES OF CLINICAL SUPERVISION: CONTEXTUAL FACTORS
CULTURE
Culture is one of the major contextual factors that influence supervisory interactions. Other contextual variables include race, ethnicity, age, gender, discipline, academic background, religious and spiritual practices, sexual orientation, disability, and recovery versus non-recovery status. The relevant variables in the supervisory relationship occur in the context of the supervisor, supervisee, client, and the setting in which supervision occurs (Source: SAMHSA)
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OTHER CONTEXTUAL INFLUENCES CLINICAL SUPERVISION
Other Contextual Influences/Factors, e.g.
Settings
Different experiences in supervision
Ethics and law
Level of experience
Group, individual/triadic supervision
Time/Scheduling of supervision
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Resources (alphabetical only)
Aasheim, L. (2012). Practical clinical supervision: An experiential guide. Springer.
Association for Counselor Education and Supervision. (2011). Best practices in clinical supervision.
Bernard, J. M. (1979). Supervisor training: A discrimination model. Counselor Education and Supervision, 19, 60-68.
Bernard, J. M., & Goodyear, R. G. (2004). Fundamentals of clinical supervision (3rd ed.). Pearson Education.
Bernard, J. (1979). Supervisor training: A discrimination model. Counselor Education and Supervision, 19, 60-68.
Bernard, J. M., & Goodyear, R. K. (1998). Fundamentals of clinical supervision (2nd ed.). Allyn & Bacon.
Borders, L. D., & Brown, L. L. (2005). The new hand of counseling supervision. Lahaska Press.
Borders, L. D., DeKruyf, L., Fernando, D. M., Fernando, H. L., Hays, D. G., Page, B., & Welfare, L. E. (2011).
Borders L. D. (2014). Best practices in clinical supervision: Another step-in delineating effective supervision practice.
American Journal of Psychotherapy, 68(2),
Center for Credentialing Education (2016). Approved clinical supervisor training.
http://www.cce-global.org/Credentialing/ACS/Training
Falender, C. A., and Shafranske, E.P. (Eds). (2008). Casebook for clinical supervision: A competency-based approach.
American Psychological Association.
Falender, C. A., & Shafranske, E. P. (2007). Competence in competency-based supervision practice: Construct and
application. Professional Psychology: Research and Practice, 38, 232-240. doi:10.1037/0735-7028.38.3.232
Falender, C. A., & Shafranske, E. P. (2004). Clinical supervision: A competency-based approach. American Psychological
Association.
Gonsalvez, C., & Calvert, F. L. (2014) Competency-Based models of supervision: Principles and applications, promises and challenges. Australian
Psychologist, 48, pp. 200–208.
Haynes, R., Corey, G., & Moulton, P. (2003). Clinical supervision in the helping professions: A practical guide.
Brooks/Cole.
Holloway, E., & Wolleat, P. L. (1994). Supervision: The pragmatics of empowerment. Journal of Educational and
Psychological Consultation, 5(1), 23-43.
Lazovsky, R., & Shimoni, A. (2005). The working contract between the onsite mentor and school counseling students
during internship—contents and processes. Mentoring & Tutoring: Partnership in Learning, 13(3), 367-382.
doi: 10.1080/13611260500105857
Leddick, G. R. (1994, April). Models of clinical supervision. ERIC EDO-CG-94-08.
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Resources continued
Littrell, J. M., Lee-Borden, N., & Lorenz, J. A. (1979). A developmental framework for counseling supervision. Counselor
Education and Supervision, 19, 119-136.
Loganbill, C., Hardy, E., & Delworth, U. (1982). Supervision: A conceptual model. Counseling Psychologist, 10, 3-42.
Martin, F. A., & Turner, J. P. (2020). Clinical supervision in the real world: A practical guide to ethics, legal issues, and
personal development. Routledge.
Neufedlt, S. A. (1999). Supervision strategies for the first practicum (3rd ed.). American Counseling Association.
Perera-Diltz, D. M., & Mason, K. L. (2012). A National survey of school counselor supervision practices: Administrative,
clinical, peer, and technology mediated supervision. Journal of School Counseling, 10(4).
Pérusse, R., Goodnough, G. E., & Noël, C. J. (2001). A national survey of school counselor preparation programs: Screening methods, faculty
experiences, curricular content, and fieldwork requirements. Counselor Education & Supervision,
40(4), 252-262.
Rogers, J. L., Lautar, C. J., & Dunn, L. R. (2010). Allied health students’ perceptions of effective clinical instruction. The
Health Care Manager, 29(1), 63–67.
Ronnestad, M. H., & Skovolt, T. M. (1993). Supervision of beginning and advanced graduate students of counseling and
psychotherapy. Journal of Counseling and Development, 71, 396-405.
Ronnestad, M. H., & Skovholt, T. M. (2003). The journey of the counselor and therapist: Research findings and
perspectives on professional development. Journal of Career Development, 30, 5-44.
Skovolt, T. M., & Ronnestad, M. H. (1992). The evolving professional self: Stages and themes in therapist and counselor
development. Wiley.
Stoltenberg, C. D. (1981). Approaching supervision from a developmental perspective: The counselor complexity model.
Journal of Counseling Psychology, 28, 59-65.
Stoltenberg, C. D., & Delworth, U. (1987). Supervising counselors and therapists. Jossey-Bass.
Stoltenberg, C. D., McNeill, B., & Delworth, U. (1998). IDM supervision: An integrated developmental model for
supervising counselors and therapists. Jossey-Bass.
Stoltenberg, C. D. (2005, November). Enhancing professional competence through developmental approaches to
supervision. American Psychologist, 60(8), 857-864. http://dx.doi.org/10.1037/0003-066X.60.8.85
Substance Abuse and Mental Health Services Administration (SAMHSA). (n.d.). Clinical supervision and professional
development of the substance abuse counselor: Treatment Improvement Protocol Series (TIP) 52.
https://www.ncbi.nlm.nih.gov/books/NBK64845/pdf/Bookshelf_NBK64845.pdf
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