Missouri State University

Counseling ProgramsSupervisor Training

Fall, 2007

Program Outline

Introductions Developmental Model of Supervision Four Functions of a Supervisor Characteristics that Enhance Supervision Supervision and Ethics - Boundaries Tarasoff and Risk Assessment Supervision vs. Psychotherapy Attributes of Good Supervision Supervisee Evaluation

Introductions

Who Are you? Where are you from? Please give a brief “commercial” for your

site. Who are you supervising? How can we best help you to do your job

as site supervisor?

Developmental Model of Supervision

Stoltenberg & Delworth (1987) – an Integrated Developmental Approach (four developmental levels across time): Dependency Stage – trainee doesn’t utilize

supervisor feedback for fear of “doing something wrong”; completely reliant on supervisor for direction and decision-making

Dependency-Autonomy Conflict – trainee makes strides in independent thinking; still unsure and dependent upon supervisor

Conditional Dependency Stage – trainee experiences an increase in self-determination; feels more confident in work, but some self-doubt persists

Master Counselor Stage – trainee experiences competence as a therapist; successfully incorporates theory and practice

Developmental Model of Supervision (cont’d)

Four Functions of a Supervisor

Monitor Client Welfare Enhance supervisee growth within

stages Promote transition from one stage to the

next Evaluate supervisees

Core Characteristics that Enhance Supervision (Sussman, 2002)

A strong working alliance between supervisor and supervisee

An atmosphere of trust and safety Shared interest in supervision and an interest

in the learning and development of a competent therapist

Provision of a framework for understanding the theoretical and technical underpinnings of the treatment process

Supervisor and supervisee self-disclosure – permission to acknowledge mistakes in therapy

Provision of appropriate supervisor pacing and leading of supervisee which provides direction to the time-limited supervisory experience

Core Characteristics that Enhance Supervision (cont’d)

Supervision and Ethics - Boundaries

Attention to appropriate boundaries addresses the majority of areas within codes of ethics

Supervisees often need assistance establishing and maintaining appropriate boundaries

Tarasoff Decision

“When a therapist determines, or pursuant to the standards of his/her profession should determine, that his/her patient represents a serious danger of violence to another, he/she incurs the obligation to use reasonable care to protect the intended victim.”

Tarasoff Reporting Checklist

Remind the patient that he/she signed a consent form at the start of treatment outlining instances when you will need to break confidentiality. Threatening to harm another person or persons is one of those instances.

Contact your supervisor immediately. Contact the police in the jurisdiction of the

identified victim(s). Give only information necessary to ensure safety of potential victims (i.e., your name, patient’s name, content of the threat)

When you have the identified victim(s) name and phone number, attempt to contact them to alert them to the potential harm.

Document all actions (in detail) in the patient’s chart.

Send a letter to the identified victim(s) with pertinent info about your call to them and what other precautionary measures you took.

Put a copy of the letter in the patient’s chart; keep a hard copy for yourself

Tarasoff Reporting Checklist (cont’d)

Debrief the event with your supervisor, team, or other professionals.

Attempt to repair the therapeutic relationship with the patient, if possible. Provide a non-violence behavioral contract to the patient if involvement is continued.

Tarasoff Reporting Checklist (cont’d)

Risk Assessment: Things Associated with High Risk

Intent (specific plan; means) History (previous acts of violence; Hx of

homicidal threats; childhood antisocial behavior; abuse Hx; recent provocation)

Behavior (tension/agitation; bizarre behavior)

Personality Characteristics (poor impulse control; aggressiveness; mood lability)

Diagnosis (drugs/alcohol; paranoia; delusions; mania; antisocial personality)

Demographic Factors (being male; low SES)

From R. Williams, “Clinical Supervision: Framework for Success”

Risk Assessment: Things Associated with High Risk (cont’d)

Supervision vs. Psychotherapy

While good supervision can be therapeutic, it is not therapy

Codes of ethics emphasize the boundary between the two

Attributes of Good Supervision The capacity to enhance the trainee’s

self-confidence through support, autonomy, support

The capacity to model a strong working alliance

Provision of an environment to give and provide useful evaluations

Trainer has knowledge of multiple formats of supervision

Supervision is adaptable and flexible (adaptable over time)

Excellent communication, from case conceptualization to theoretical underpinning to interpersonal clarity

Contains a sense of equilibrium and a sense of humor

from Falender & Shafranske (2004)

Attributes of Good Supervision (cont’d)

Supervisee Evaluation

The Counselor-Trainee Progress Assessment

Done repeatedly throughout a student’s program

Assesses a wide domain of skills and relates them to standards