Supervision at a Distance
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Transcript of Supervision at a Distance
Supervision at a Distance
Ohio Psychological Association October 30, 2008
Communications & Technology Committee
Ken Drude, PhD; Audrey Ellenwood, PhD; Ky Heinlen, PhD, LPCC-S; Michael Lichstein, PhD,
Paule Steichen Asch, PhD
http://www.ohpsych.org/commtech.aspx
Learning Objectives Define distance supervision and some technical aspects
Review current literature on guidelines for supervision (distance & f2f)
Learn how the current APA Code of Ethics can be applied
Learn results of a recent survey Discuss what guidelines need to be developed to address concerns – invitation to participate
Distance Supervision
Providing clinical supervision through technology based, non-face-to-face means including the following:
Landline and cell phones Email, chat (real time online) Text messages to cell phone & Instant messages
Video teleconferencing Web pages
What is Clinical Supervision?
Interaction between supervisee and supervisor:
Discuss cases in-depth Supervisor becomes knowledgeable of critical information about a client
Instructs or models how to deal with issues
Assists in developing interventions Monitor’s students and clients progress
Types of Supervision Work supervision Training supervision Psychological umbrella supervision Mental health worker supervision Administrative supervision
*4732-13-03 of the Administrative Code
Board Requirements of Supervision - 1
Supervisor shall:• Be competent to provide services supervisee provides
• Determine the supervisee’s competencies
• Be responsible for the “psychological diagnosis, psychological prescription, and psychological client supervision of all clients.”
Board requirements of Supervision – 1
(continued)
• Keep records of supervision
• “Have direct knowledge of all clients served by his/her supervisee”
Board Requirements of Supervision - 2
Supervisor shall for training supervision:
• Schedule individual face to face supervision for no less than 5% of the weekly client contact time.
• “Have a written agreement describing the goals and content of the training experience, including clearly stated expectations”
Distinction Between Consultation & Supervision
Consultation• Consultee responsible for treatment and client
• Collegial relationship
• Consultant may have limited information
Supervision•Supervisor responsible for treatment and client•Superior-subordinate relationship•Supervisor needs to have all available client information in
General Requirements of Supervision-Competence
What is Competence?
Competence is a standardized requirement for an individual to properly perform a specific job. It encompasses a combination of knowledge, skills, and behavior utilized to improve performance. More generally, competence is the state or quality of being adequately or well qualified, having the ability and a core set of values to perform a specific role.
Competence Is …
Habitual and JudiciousInvolves: Use of communication, Knowledge, Technical skills, Clinical reasoning, Emotions and, Values
“Reflection in daily practice for the benefit of the individual and community being served.” Epstein & Hundert (2002)
APA Benchmarks of Competency
Reflective Practice Self-Assessment
Scientific knowledge-methods Relationships Individual-cultural diversity Ethical-legal standards-policy Interdisciplinary systems
APA Benchmarks Functional Competencies
Assessment, diagnosis, case conceptualization
Intervention Consultation Research/evaluation Supervision, teaching Management - administration
Current Practices in Distance Supervision
Limited documented practices, more anecdotal accounts
Telephone and e-mail most common practices
Televideoconferencing increasingly being used
Supervision Survey Demographics
Research approved by CSU IRB
Participants were solicited through a variety of mental health listservs
Invitations to participate were posted in June & July
50 people went to the survey link and
25 people completed the survey
Licensure of respondents
57.9% 31.6% 10.5%
Status of providingDistance supervison 50% currently provide
45.5% provided in the past
22.7% are considering providing
Practice of Distance Supervision
Number of supervisees: 58.8% had 1-2 17.6% had 3-4 23.5% had 5
Number of hours per week in supervision: 33.3% less than 1 hour 26.7% 1-2 hours 20% 3-4 hours 20% 5 hours
The Supervisee
Lived in & practiced in state (71.4%)
Lived outside the state & practiced in state (4.8%)
Lived outside state & practiced outside state (28.6%)
Forms of Supervision provided:
Practices Utilized in Supervision
Secure service w/encryption (46.2%)
Supervisee records sessions (15.4%)
Clients informed supervision online (38.5%)
Using Distance SupervisionAs an Adjunct to Face-to-Face
71.4% indicated they also provide some face-to-face supervision
28.6% indicated they do not see supervisee
Skills Needed to ProvideSupervision at a Distance Navigating online Basic typing and spelling skills Ability to express self in the written word
Ability to express concepts/ideas without the use of non-verbal cues
Excellent communication skills Take a course on technology skills
Practice Facility
Clinical Supervisor
•Secure two way interactive technology
• Internet based e-mail
•Chat rooms for interaction
•WEB based TV staffing sessions
•Electronic bulletin Boards for scheduling
•Encrypted services
Web based case review/electronic medical records
Chat room for discussion of case studies
Supervision via ITV
(Group or Individual)
Individual face-to-face supervision with onsite supervision
Supervisee At A Distance
Flow Chart Of Supervision At A Distance
Adapted from Miller et. al. 2008
Case DiscussionsVignettes of Distance Supervision
Key factors –Quality Supervisory Relationship Supervision enhances natural developmental process of supervisee
Use both a theoretical and experiential base to supervision
Assure a consistent and coherent technical framework for supervisees
Supervisees need to be adequately trained in the technology used for supervision.
Key factors –Quality Supervisory Relationship (Cont.)
• The selection of technologies should be based on appropriateness for clinical services, patients and supervision• Supervisors need to ensure the security of all client information• Continuous self-evaluation as well as evaluation of technology services used needs to be monitored (Miller et. al, 2008)
Cautionary statements Using Distance Supervision as an Adjunct Telepsychology supervision may
limit a supervisees level of personal contact with supervisor
Supervisees may not get time they need to grow in supervision
Problems with technology access can interfere with supervision
Confidentiality is an issue Requires the supervisee to be more self-directed
Looking ahead to guideline considerations
What components of distance supervision need to be incorporated into guidelines?