Optimizing the Team Through Supervision

James Schepper PhD, LPC, CAADC, CCS, CSOTS

Livingston County Catholic Charities Clinical Director

Presenter:

Functions of a Clinical Supervisor As Described by TIP 52

Teacher: Assist in the development of knowledge and skills by identifying learning needs, determining strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth.

Functions of a Clinical Supervisor As Described by TIP 52

Teacher: Assist in the development of knowledge and skills by identifying learning needs, determining strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth.

Consultant: Provide alternative case conceptualizations, oversight of work to achieve mutually agreed upon goals, and professional gatekeeping for the organization and discipline.

Functions of a Clinical Supervisor As Described by TIP 52

Teacher: Assist in the development of knowledge and skills by identifying learning needs, determining strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth. Consultant: Provide alternative case conceptualizations, oversight of work to achieve mutually agreed upon goals, and professional gatekeeping for the organization and discipline.

Coach: In this supportive role, supervisors provide morale building, assess strengths and needs, suggest varying clinical approaches, model, cheerlead, and prevent burnout.

Functions of a Clinical Supervisor As Described by TIP 52

Teacher: Assist in the development of knowledge and skills by identifying learning needs, determining strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth.

Consultant: Provide alternative case conceptualizations, oversight of work to achieve mutually agreed upon goals, and professional gatekeeping for the organization and discipline.

Coach: In this supportive role, supervisors provide morale building, assess strengths and needs, suggest varying clinical approaches, model, cheerlead, and prevent burnout.

Mentor/Role Model: The experienced supervisor mentors and teaches the supervisee through role modeling, facilitates the counselor’s overall professional development and sense of professional identity, and trains the next generation of supervisors.

Functions of a Clinical Supervisor As Described by TIP 52

Teacher: Assist in the development of knowledge and skills by identifying learning needs, determining strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth. Consultant: Provide alternative case conceptualizations, oversight of work to achieve mutually agreed upon goals, and professional gatekeeping for the organization and discipline.

Coach: In this supportive role, supervisors provide morale building, assess strengths and needs, suggest varying clinical approaches, model, cheerlead, and prevent burnout.

Mentor/Role Model: The experienced supervisor mentors and teaches the supervisee through role modeling, facilitates the counselor’s overall professional development and sense of professional identity, and trains the next generation of supervisors.

With the advent of ROSC (Recovery Oriented System of Care), supervisory

responsibilities are expanding!

Growing Realm of Supervision

Therapists

Growing Realm of Supervision

Case Managers

Therapists

Growing Realm of Supervision

Peer Coaches

Case Managers

Therapists

Growing Realm of Supervision

COMPETENCIES FOR SUBSTANCE ABUSE TREATMENT CLINICAL SUPERVISORSTobi Russell LPC, LLP, NCC, CAADC, CCS-M, BCETSDirector, Rochester Hills Counseling

Competencies Covered

Understand the role of clinical supervision as the principal method for monitoring and ensuring the quality of clinical services

Understand the multiple roles of the clinical supervisor, including consultant, mentor, teacher, team member, evaluator, administrator

Be able to articulate one’s model of supervision

Be familiar with modalities of clinical supervision

Be familiar with adult learning theory and learning styles

Ask yourself these questions

Can I use clinical supervision models to explain what I do in supervision?

Am I comfortable in the multiple roles of evaluator, administrator, mentor, teacher, and consultant?

Do I model seeking and giving feedback to improve skills and performance?

Do I have established boundaries and effective strategies for conflict resolution with supervisees?

Are you able to have difficult conversations addressing job performance and/or clinical issues?

Are you able to manage your time to meet expectations and deadlines?

What is Clinical Supervision?

Ideally it is: A social influence process that occurs over time, in which the

supervisor participates with supervisees to ensure quality clinical care.”

Effective supervisors observe, mentor, coach, evaluate, inspire, and create an atmosphere that promotes self-motivation, learning, and professional development. They build teams, create cohesion, resolve conflict, and shape agency culture, while attending to ethical and diversity issues in all aspects of the process.

Such supervision is key to both quality improvement and the successful implementation of consensus and evidence-based practices (CSAT, 2007, p. 3.)

The Need for Balance

Three Levels of Supervisor Development

Level 1 Supervisor

Is anxious regarding their role

Is naïve about assuming the role of supervisor

Is focused on doing the “right” thing

May overly respond as an “expert”

Is uncomfortable providing direct feedback

Three Levels of Supervisor Development

Level 2 Supervisor

Shows confusion and conflict

Sees supervision as complex and multidimensional

Needs support to maintain motivation

May fall back to being a therapist with the counselor

Overfocused on counselor’s deficits and perceived resistance

Three Levels of Supervisor Development

Level 3 Supervisor

Is highly motivated

Can provide an honest self-appraisal of strengths and weaknesses as supervisor

Is comfortable with evaluation process

Provides thorough, objective feedback

Supervision Development Questions

How much do you know about supervision?

How much experience have you had supervising counselors?

How much supervision have you received?

What types of supervision did you receive?

How much experience do you have supervising counselors?

Experiences as supervisor and supervisee: amount and type

What has that supervision consisted of?

What is your supervision style? Influential Dimension

What is your supervision style? Symbolic Dimension

What is your supervision style? Structural Dimension

What is your supervision style? Replicative Dimension

What is your supervision style? Counselor-in-treatment dimension

What is your supervision style? Information-gathering Dimension

What is your supervision style? Relationship Dimension

What is your supervision style? Strategy Dimension

What is your supervision model?

Caption

Focus is on the dynamics of the supervisee's relationships and on his or her self-awareness of these dynamics. The supervisor’s role may be like that of a “therapist” who encourages insight, self-exploration and reality testing.Transference & countertransference are addressed to help the supervisee understand reactions to the client and to the client’s transference. Influence of client-counselor reactions on the course of therapy are examined.

Psychodynamic Model

Unresolved personal conflicts – Supervision is therapeutic in that issues such as internal conflicts are explored as they relate to clinical work. Parallel process – Counselor interactions with the supervisor that parallels the client’s behavior with the counselor are addressed. By exploring these parallels the counselor may gain an understanding of the role personal issues play in the supervisory relationship.

Psychodynamic Model

Challenges cognitions and misperceptions Identifies cognitive distortions, irrational assumptions, and self-defeating patterns. Sets goal of modifying cognition, focus on beliefs and thoughts and how they affect emotions and behaviorAssumes that both adaptive and maladaptive behaviors are learned and maintained through their consequences

Cognitive and Behavioral Model

Adult learning theory Recognizes everyone’s potential to learn; supervisor becomes a teacherFocuses on how a counselor’s cognitive picture of his or her own skills affects his or her ability as a counselorSupervisee becomes familiar with cognitive-behavioral concepts and techniques and learns how to apply them with clients

Cognitive and Behavioral Model

Adult Learning Theory

Tend to self-direct their learning.

Are generally motivated to learn due to for their own internal factors, rather than external forces.

Have many roles to play in life that affect the time and energy they devote to learning.

Have life experiences that can serve as resources for new learning.

Have a task- or problem-centered approach (seek to learn or understand something because they need/want to use it immediately).

Have a unique learning style

Learning Styles

Adult learners each have different ways in which they perceive, organize and process information

One way of categorizing learning styles is:

Auditory: listening (likes lectures, CD-roms, and videos)

Visual- seeing (likes demonstrations, videos, and reading assignments)

Kinesthetic- doing (likes role-play exercises and practices)

Assessing Learning Style

Index of Learning Styles Questionnaire (ILS)Learning Style InventoryWhat’s Your Learning Style?A Learning Style Survey for CollegeWhat are My Learning Strengths?Learning Styles

Adult Learning Theory

Knowles' assumptions

The need to know — adult learners need to know why they need to learn something before undertaking to learn it.

Learner self-concept —adults need to be responsible for their own decisions and to be treated as capable of self-direction

Role of learners' experience —adult learners have a variety of experiences of life which represent the richest resource for learning. These experiences are however imbued with bias and presupposition.

Readiness to learn —adults are ready to learn those things they need to know in order to cope effectively with life situations.

Orientation to learning —adults are motivated to learn to the extent that they perceive that it will help them perform tasks they confront in their life situations.

based on Knowles 1990:57

Modeling and observation - Supervisor demonstrates cognitive-behavioral methods in the supervisory relationship

Assignments /homework is given by supervisorSupervision is structured, focused, and educationalSupervision parallels counseling with a client

Cognitive and Behavioral Model

Blends insight and behavioral change – Supervision combines understanding of why something works with learning how to do it (blends skills and theory)Change is a constant and inevitable – Everyone changes at his or her own pace, but everyone does changeDevelopmental needs–Acknowledgment of the stages of counselor development to build a supervisory relationship based on unique needs

Blended Model

Context plays a role – When deciding an approach to take in supervision context must be taken into accountIndividualized approach used– Everyone has unique needs and responds best to interventions that meet those specific needsExplores solutions, not causes – Focuses on the salient issues to avoid dwelling on the problem, resulting in higher self-efficacy and esteem

Blended Model

Resources and References

Bernard,J.M., & Goodyear, R.K. (2004). Fundamentals of Clinical Supervision (3rd Ed.). Boston: Pearson Education.

Borders, L.D., & Leddick, G.R. (1987). Handbook of Counseling Supervision, Alexandria,VA: Association for Counselor Education and Supervision

Center for Substance Abuse Treatment (CSAT) (2009). Clinical Supervision and Professional Development of the Substance Abuse Counselor. Treatment Improvement Protocol (TIP) Series 52. DHHS Publication No. (SMA) 09-4435. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Durham,T. (2006). Clinical Supervision: A 5-Day Course. Silver Spring, MD: Danya International.

Durham,T. & Landry, M. (2004). Clinical supervision: A five day course –Participant workbook. Silver Spring, MD: Danya International.

Resources and References

Read more: Knowles' andragogy: an angle on adult learning http://www.learningandteaching.info/learning/knowlesa.htm#ixzz2bmgP4kJg Under Creative Commons License: Attribution Non-Commercial No Derivatives

Knowles,M. (1975). Self-Directed Learning. Chicago: Follet.

Knowles,M. (1984). The Adult Learner: A Neglected Species (3rd Ed.). Houston, TX:Gulf Publishing.

Leach,M., Stoltenberg, C., McNeill B.& Eichenfield G. (1997). Self efficacy and counselor development:Testing the integrated developmental model. Counselor Education and Supervision,37(2), 115. Retrieved September 16,2010, from Alumni - ProQuest Psychology Journals. (Document ID: 23593422).

Lindbloom, G., Ten Eyck, T.G., & Gallon, S.L. (2005). Clinical supervision I: Building clinical supervision skills (3rd ed.). Salem, OR:Northwest Frontier ATTC.

Resources and References Marini,I, and Stebnicki, M.A. (2009). The Professional Counselor’s Desk

Reference. NY: Springer Publishing.

Northwest Frontier Addiction Technology Transfer Center. (2005, July). Counselor as educator-Part 1: How do adults learn? Addiction Messenger, 8 (7).

Northwest Frontier Addiction Technology Transfer Center. (2005, August). Counselor as educator-Part 2: Learning styles-teaching styles. Addiction Messenger, 8 (8).

Northwest Frontier Addiction Technology Transfer Center. (2005, December). Clinical supervision-Part 3: Creating a learning environment. Addiction Messenger, 8 (12).

Porter,J. & Gallon, S. (2006). Clinical Supervision II: Addressing Supervisory Problems in Addictions Treatment. Salem, OR: Northwest Frontier Addiction Technology Transfer Center.

Resources and References

Powell,D.J. & Brodsky, A. (2004). Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods (Rev.Ed.) San Francisco, CA: Jossey-Bass.

Powell, D. J. (2004). Clinical supervision in alcohol and drug abuse counseling: Principles, models, methods (2nd ed.) San Francisco: Jossey-Bass.

Stiehl,R. and Bessey, B. (1994). The green thumb myth: Managing learning in high performance organizations – A successful strategy for trainers and managers. (2nd Ed.) Corvallis, OR: The Learning Organization.

Stoltenberg,C. (1993). Supervising consultants in training: An application of a model of supervision. Journal of Counseling & Development, 72(2),131-138. Retrieved 9/8/2010 from Academic Search Alumni Edition database.

Resources and References

Stoltenberg,C. D. (1997). The integrated developmental model of supervision: Supervision across levels. Psychotherapy in Private Practice, 16, 59-69.

Stoltenberg,C.D., McNeill, B. and Delworth, U. (1998) IDM supervision: An integrated developmental model of supervising counselors and therapists. San Francisco: Jossey-Bass.

FUNPractical Activities to Encourage, Support, and Train Staff

Benefits of FUN Group Supervision Group Activity:

1.Provides Staff to enhance their professional skills,

2.Allows for Staff to interact and build teamwork,

3.It helps the Supervisor with identifying Staff skills.

EXAMPLE: Trait Theory Exercise

Trait Theory ExerciseMaterials: use the trait test and result description.

These can be obtained from http://ciosmail.cios.org:3375/readbook/cal/cal.pdfCommunication, Affect & Learning in the Classroom: Virginia Peck Richmond, Jason S. Wrench, Joan Gorham. Chapter 14.

Benefits of the exercise:1. Develops an understanding of a staff members processing skills.2. Develops understanding of differences between staff members.3. Helps teach staff concerning: FUNDAMENTAL ATTRIBUTION ERROR

The belief that everyone relates to the world the same way I do.

Or the administrative fallacy of “If I can do it, everyone can do it.”

Trait Theory ExercisePROCESS: 1. Have Staff complete the test, score it and identify their temperament.

2. Have Staff group together according to temperaments and discuss together.

3. Have each group prepare to share 3 things concerning their group:

a. Describe the strengths of their temperament,

b. Share one area that deeply stresses their temperament, and

c. What animal or pet best describes their temperament and why.

4. As Supervisor discuss the benefits of a team and how different temperaments enhance the mission of the agency.

Melancholy

Positives

Philosophical

Thoughtful

Analytical

Serious and Purposeful

Self-sacrificing to close friends

High Standards

Faithful & Devoted

Compassionate

Organized

Not-so-positive

Moody & Depressed

Isolative & Withdrawn

Sensitive to guilt

Skeptical & critical

Easily hurt (martyr)

Trusts few people

Dislikes groups

CHOLERIC

Positives

Natural leader

Not easily discouraged

Independent & Self-sufficient

Motivates

Goal Oriented

Organized

Thrives on competition/opposition

Utilizes relationships

Not-so-positive

Bossy & Controlling

Quick-tempered (anger)

Unsympathetic

Little Tolerance & Demanding

Manipulates

Micro-manager

Impatient toward perceived inadequacies

Relationally selectively ranked

SANGUINE

Positive

Cheerful and Bubbly

Life of the party

Great sense of humor

Talkative & likes stories

Sincere & Enthusiastic

Always Active

Creative and colorful

Inspires others to join

Lots of friends & Loves people

Spontaneous

Not-so-positive

Compulsive Talker

Undisciplined

Capricious Priorities

Decisions based on feelings

Easily distracted

Shifting emotions

Despises being alone

Interrupts & doesn't listen

Forgetful & makes excuses

PHLEGMATIC

Positives

Easy going and relaxed

Consistent

Sympathetic & Kind

Competent & Steady

Avoids Conflict

Pleasant with a dry sense of humor

Good listener

Has good number of friends

Doesn't get upset easily

Not-so-positive

Avoids responsibility

Indecisive

Not goal oriented

Lacks self-motivation

Careless/Indifferent to the point of Lazy

Resists Change

Quiet & unengaged

Resents being pushed

JAMES SCHEPPER PHD, LPC, CAADC, CCS, CSOTSLIVINGSTON COUNTY CATHOLIC CHARITIESJAMES@LIVINGSTONCATHOLICCHARITIES.ORG

Tobi Russell LPC, LLP, NCC, CAADC, CCS-M, BCETSDirector, Rochester Hills Counseling