Post on 27-Dec-2015
Developmental Supervision Using Developmental Supervision Using the IDM the IDM
John Laux, Ph.D., PCC-s, LICDCJohn Laux, Ph.D., PCC-s, LICDC
School Psychology, Legal Specialties, & School Psychology, Legal Specialties, & Counselor Education Counselor Education
The University of ToledoThe University of Toledo
Discriminate between Discriminate between ClinicalClinical Supervision & Supervision & DevelopmentalDevelopmental SupervisionSupervision
Understand the First Two Understand the First Two Stages of Integrated Stages of Integrated Developmental Model of Developmental Model of Supervision IDMSupervision IDM
What is Supervision?What is Supervision?
SupervisionSupervision
over-seeing, looking over someone’s over-seeing, looking over someone’s shoulder to check on them;shoulder to check on them;
and also ‘super’ in the sense of and also ‘super’ in the sense of outstanding or special, helping outstanding or special, helping someone to extend their professional someone to extend their professional skills and understanding.skills and understanding.
http://www.faculty.londondeanery.ac.uk/e-learning/supervision/what-is-supervisionhttp://www.faculty.londondeanery.ac.uk/e-learning/supervision/what-is-supervision
Clinical & Developmental Clinical & Developmental SupervisionSupervision
Clinical & Developmental Clinical & Developmental SupervisionSupervision
DevelopmentDevelopment ongoing professional ongoing professional learninglearning
Clinical/performanceClinical/performance clinical clinical governance and standard setting.governance and standard setting.
Clinical & Developmental Clinical & Developmental SupervisionSupervision
Who does what?Who does what?
• Clinical/performanceClinical/performance supervision is the supervision is the sole domain of the sole domain of the site supervisorsite supervisor
• DevelopmentalDevelopmental supervision is done by supervision is done by bothboth the the university supervisoruniversity supervisor and and the the site supervisorsite supervisor. .
Clinical & Developmental Clinical & Developmental SupervisionSupervision
How to tell them apart:How to tell them apart:• Who is the focus?Who is the focus?
Answer the question, “Are we talking about Answer the question, “Are we talking about the client/student or the supervisee?”the client/student or the supervisee?”
• Example 1.Example 1. I have a high no-show rate after the initial I have a high no-show rate after the initial
session. How do I increase my productivity?session. How do I increase my productivity? Susan keeps missing appointments. How can I Susan keeps missing appointments. How can I
work to increase her motivation for work to increase her motivation for counseling?counseling?
Clinical & Developmental Clinical & Developmental SupervisionSupervision
Client/student or supervisee?Client/student or supervisee?
• Example 2.Example 2. Richard’s parents want to know how they Richard’s parents want to know how they
can improve his study skills both at home can improve his study skills both at home and at school. What interventions do you and at school. What interventions do you suggest I recommend for these parents? suggest I recommend for these parents?
I am not a parent. I feel comfortable I am not a parent. I feel comfortable working with students, but I am scared working with students, but I am scared about meeting with parents and guardians. about meeting with parents and guardians.
Clinical & Developmental Clinical & Developmental SupervisionSupervision
Faculty and graduate assistants do Faculty and graduate assistants do not provide Clinical Supervision.not provide Clinical Supervision.• Why not?Why not?
So, what do faculty do during So, what do faculty do during practicum and internship?practicum and internship?
IDM SupervisionIDM Supervision
An Integrated Developmental Model An Integrated Developmental Model of Supervisionof Supervision
-Stoltenberg, McNeil & Delworth-Stoltenberg, McNeil & Delworth
3 Levels of Development3 Levels of Development
Level 1 Therapist (Practicum)Level 1 Therapist (Practicum)
Level 2 Therapist (Internship-Newly Level 2 Therapist (Internship-Newly
Licensed-Licensed-
Independence) Independence)
Level 3 Therapist (Independence on)Level 3 Therapist (Independence on)
Overarching StructuresOverarching Structures
Self & Other AwarenessSelf & Other Awareness MotivationMotivation AutonomyAutonomy
Specific DomainsSpecific Domains
Intervention SkillsIntervention Skills AssessmentAssessment Interpersonal AssessmentInterpersonal Assessment Client ConceptualizationClient Conceptualization Individual DifferencesIndividual Differences Theoretical OrientationTheoretical Orientation Treatment Plans & GoalsTreatment Plans & Goals Professional EthicsProfessional Ethics
So You’ve Agreed to Be A Site So You’ve Agreed to Be A Site SupervisorSupervisor
What Does the Typical What Does the Typical Practicum Student Know?Practicum Student Know?
Overarching Structures—Level 1Overarching Structures—Level 1
Self & Other AwarenessSelf & Other Awareness
• About whom is the student thinking About whom is the student thinking upon entering the counseling room?upon entering the counseling room?
Overarching Structures—Level 1Overarching Structures—Level 1
Self & Other AwarenessSelf & Other Awareness
• Focus is on personal effectiveness, skillsFocus is on personal effectiveness, skills
Overarching Structures—Level 1Overarching Structures—Level 1
Anxiety/fear
Overarching Structures—Level 1Overarching Structures—Level 1
Concerned about supervisor’s evaluation.Concerned about supervisor’s evaluation.
Overarching Structures—Level 1Overarching Structures—Level 1
MotivationMotivation
Overarching Structures—Level 1Overarching Structures—Level 1
MotivationMotivation• Usually high. Usually high. • Focused on going from beginner to Focused on going from beginner to
expert.expert.• Want to move from anxiety to comfort.Want to move from anxiety to comfort.• Want to learn the “best” theory, Want to learn the “best” theory,
techniques or approaches.techniques or approaches.
Overarching Structures—Level 1Overarching Structures—Level 1
AutonomyAutonomy• Heavily dependent on supervisorHeavily dependent on supervisor
What to do/say in sessionWhat to do/say in session
Overarching Structures—Level 1Overarching Structures—Level 1
AutonomyAutonomy• Heavily dependent on supervisorHeavily dependent on supervisor
How to use supervisionHow to use supervision
Level 1 Intervention Skills Level 1 Intervention Skills CompetenceCompetence
Want understandable set of skills in a Want understandable set of skills in a structured framework they can structured framework they can imitate.imitate.
Latch on to an orientation & become Latch on to an orientation & become a devotee (usually 1a devotee (usually 1stst one they read one they read or CBT)or CBT)
Every issue becomes a nail.Every issue becomes a nail.
Level 1 Assessment Level 1 Assessment TechniquesTechniques
Tend to prefer Tend to prefer interview methods interview methods or standardized or standardized methods. methods.
Have little critical Have little critical skills. I.e., fail to skills. I.e., fail to consider client consider client response set or response set or motivation.motivation.
Level 1 Interpersonal AssessmentLevel 1 Interpersonal Assessment
Use personal reactions as Use personal reactions as assessment tool & barometer of data assessment tool & barometer of data received.received.
Level 1 Client ConceptualizationLevel 1 Client Conceptualization Focus is on specific aspects of clients’ Focus is on specific aspects of clients’
story & exclude other relevant data.story & exclude other relevant data.
Tend to over- or under-pathologize.Tend to over- or under-pathologize.
Level 1 Individual DifferencesLevel 1 Individual Differences
to interpret clients’ MC via own cultural to interpret clients’ MC via own cultural lenses.lenses.
Assume that if they have common traits Assume that if they have common traits then the client’s worldview is the same as then the client’s worldview is the same as their own. their own.
OROR Assume that if they have dissimilar traits Assume that if they have dissimilar traits
then the client’s worldview is the vastly then the client’s worldview is the vastly different from their own. different from their own.
Level 1 Theoretical OrientationLevel 1 Theoretical Orientation
Seeking the one-truth. When found, Seeking the one-truth. When found, become disciples.become disciples.
Level 1 Treatment PlanningLevel 1 Treatment Planning
Difficult to Difficult to conceptualize conceptualize treatment from treatment from intake to discharge.intake to discharge.
Focus is on keeping Focus is on keeping clients.clients.
Tx planning may be Tx planning may be general or cookie general or cookie cutter/manualized.cutter/manualized.
Level 1 Treatment PlanningLevel 1 Treatment Planning Focus is Focus is
on on keeping keeping clients.clients.
Tx planning may be general or cookie-cutter or manualized
Level 1 Professional EthicsLevel 1 Professional Ethics
Rigid application & rote Rigid application & rote memorization.memorization.
Need guidance in interpreting and Need guidance in interpreting and applying.applying.
Supervising the Level 1 TherapistSupervising the Level 1 Therapist
Structure!!!!Structure!!!!• Both supervision & their clinical work.Both supervision & their clinical work.
Supervising the Level 1 TherapistSupervising the Level 1 Therapist
Break feedback down into Break feedback down into manageable/observable chunks.manageable/observable chunks.
Supervising the Level 1 TherapistSupervising the Level 1 Therapist
Simplicity & slow speed. Simplicity & slow speed.
Supervising the Level 1 TherapistSupervising the Level 1 Therapist
Encourage self-examinationEncourage self-examination
Supervising the Level 1 TherapistSupervising the Level 1 Therapist
How?How?• ObservationObservation• Skills trainingSkills training• Role playsRole plays• ReadingsReadings• Group supGroup sup• Balance ambiguityBalance ambiguity• Create conflictCreate conflict• Cont. educationCont. education
Supervising the Level 1 TherapistSupervising the Level 1 Therapist
Be supportiveBe supportive Be prescriptiveBe prescriptive Tie theory to diagnosis to treatmentTie theory to diagnosis to treatment Initiate growthInitiate growth
Transitioning to Level 2Transitioning to Level 2
Practicum to InternshipPracticum to Internship
100 hours (minimum) under their 100 hours (minimum) under their belt. belt.
Transitioning to Level 2Transitioning to Level 2
Motivation: Motivation: • may decrease for new may decrease for new
approaches/techniquesapproaches/techniques Autonomy: Autonomy:
• may desire more than is warranted.may desire more than is warranted. Awareness: Awareness:
• Begins to move toward client, away Begins to move toward client, away from self.from self.
Overarching Structures—Level 2Overarching Structures—Level 2
Self & Other AwarenessSelf & Other Awareness• Less on self, more on client via empathyLess on self, more on client via empathy• Potential for Potential for over-identificationover-identification
Overarching Structures—Level 2Overarching Structures—Level 2
Vacillation between autonomy & Vacillation between autonomy & dependency.dependency.
Overarching Structures—Level 2Overarching Structures—Level 2
Dependency/autonomy struggle Dependency/autonomy struggle affects motivation.affects motivation.• Want independence but question self Want independence but question self
when in tough/new situations.when in tough/new situations. Evidence of struggle in supervision Evidence of struggle in supervision
Level 2 Intervention Skills Level 2 Intervention Skills CompetenceCompetence
More comfort w/wide range of More comfort w/wide range of intervention skills, but…intervention skills, but…
Skills aren’t integrated w/theory.Skills aren’t integrated w/theory.
Level 2 Assessment Level 2 Assessment TechniquesTechniques
Improvement in diagnostic criteria & Improvement in diagnostic criteria & assessment instruments, but…assessment instruments, but…
Level 2 Interpersonal AssessmentLevel 2 Interpersonal Assessment
Ability to be self-aware & monitor Ability to be self-aware & monitor own cognitive/affective reactions is own cognitive/affective reactions is compromised due to over compromised due to over identification.identification.
Level 2 Client ConceptualizationLevel 2 Client Conceptualization
Case conceptualization is more Case conceptualization is more complex but subject to over complex but subject to over identification with client.identification with client.
Level 2 Individual DifferencesLevel 2 Individual Differences
More willing to acknowledge More willing to acknowledge influence of socio/cultural & influence of socio/cultural & environmental influences on environmental influences on behavior.behavior.
Vacillate between global one size fits Vacillate between global one size fits all approaches and the idea that all approaches and the idea that every client is unique.every client is unique.
Level 2 Theoretical OrientationLevel 2 Theoretical Orientation
Less rigidly aligned with one theory Less rigidly aligned with one theory willing to explore other theories. willing to explore other theories.
Level 2 Treatment PlanningLevel 2 Treatment Planning
May lose sight of need for jointly May lose sight of need for jointly formulating treatment plans with formulating treatment plans with clients.clients.
http://www.youtube.com/watch?http://www.youtube.com/watch?v=BYLMTvxOaeEv=BYLMTvxOaeE
Level 2 Professional EthicsLevel 2 Professional Ethics
Ethics better understoodEthics better understood• May view as imposition or limitation on May view as imposition or limitation on
practice that could be violated & practice that could be violated & justified by exceptions.justified by exceptions.
Supervising the Level 2 TherapistSupervising the Level 2 Therapist
““Therapeutic Adolescence.”Therapeutic Adolescence.”• Seek balance Seek balance
between guidance and support.between guidance and support. between autonomy and challenge.between autonomy and challenge.
Supervising the Level 2 TherapistSupervising the Level 2 Therapist
Client Assignment:Client Assignment:• Usually get more pathological clients Usually get more pathological clients
who are less open to trying out newer who are less open to trying out newer sets of skills. sets of skills.
Case assignment should be Case assignment should be presenting problems in and out of presenting problems in and out of trainee comfort zone. trainee comfort zone.
Supervising the Level 2 TherapistSupervising the Level 2 Therapist
InterventionsInterventions• Ongoing support & concern for Ongoing support & concern for
supervisee development.supervisee development.• Talk about own past difficulties.Talk about own past difficulties.• Prescriptive: provide multiple options & Prescriptive: provide multiple options &
get supervisee input. Encourage get supervisee input. Encourage autonomous choices. autonomous choices.
• Explain your rationale for your decisions.Explain your rationale for your decisions.
Supervising the Level 2 TherapistSupervising the Level 2 Therapist
InterventionsInterventions• Encourage alternate client case Encourage alternate client case
conceptualizations. conceptualizations. • Encourage increased self-awareness of Encourage increased self-awareness of
counter-transference & manipulations.counter-transference & manipulations.