Chapter 2: DEFINITIONS

Clinical Supervision

Powell and Brodsky (2004) define supervision as "a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical, and supportive." A similar definition from Haynes, Cory, and Moulton (2003) states that “A primary aim of supervision is to create a context in which the supervisee can acquire the experience needed to become an independent professional.” Fitting in with these definitions is one by Haynes, et al. (2003) which asserts supervision is “artful, but it's an emerging formal arrangement with specific expectations, roles, responsibilities, and skills.”

In its full context, supervision is made up of relationships, or connections, between:

• Supervisor
• Supervisee
• Clients
• Clinical setting or client's home
• Cultural influences, including age, gender, race, religion, gender identity, educational level, income, etc.
• Discipline being practiced (clinical social work, counseling, marriage and family therapy, etc.)

[QN.No.#1.Which of these is NOT part of a relationship or connection in supervision:]

These relationships make up a complex whole. To fully understand the whole, the broad span of each part needs to be considered first, and then the interplay between them. On a practical level, none of these can be fully understood, but should at least be given as much thought as is reasonable and necessary.

Looking at the clients, they're "in the system," or in therapy for a reason. Often there is hesitation--or even resistance--to therapy. The therapy may have been brought on by trauma or other hurtful event which has caused anger, fear, or anxiety. These may be focused on the therapist or social worker, the paperwork or one of myriads of other entities that may be only superficially relevant. Even hopes for the future may play a dissonant role at times.

Looking at the supervisee, there are also hesitations and uncertainty. Lack of confidence in her role, feelings of both optimism and inadequacy, desire to please both the client and the supervisor, and fear of failure are only a few of them. Her own personal baggage and strengths--past or current dysfunctional homes, cultural background, prejudices, worldview, and values--have potential impact on her success.

Looking at the supervisor--you--you'll be challenged by multiple functions and roles, the need to combine affective and supportive elements for your supervisee, optimistic and uncertain feelings about the role of supervisor and the process of therapy or intervention, and worries--large or small--about whether the supervisee is competent to work with a difficult family or client. You also have your own baggage and strengths that will influence your proficiency as a supervisor.

Other elements in the context also influence the supervisory process. The local community and its attitudes and values as they relate to cultural, social, and economic circumstances influence how your supervisee (and you, in a less prominent way) can most effectively air or hinder the process.

Another way to look at supervision from the supervisor's viewpoint is that you're looking with experienced eyes at the work of the supervisee, being professionally discriminating but also a sensitive instructor. As supervisor, you can not only voice heart and significance of the therapeutic and social processes, but you can also model them.

Although there are technical aspects to be considered in overseeing the supervisee's work, if he's to grow in competency you'll also need to be somewhat artful. It's your responsibility to direct your supervisees into able professionals, either as a therapist or as a social worker (Bernard and Goodyear, 2004).

Supervision is not dominance of a professional over a student. Rather, it's a participation of the professional with the student in the student's clinical work to ensure the quality of that work. If you're to be effective you will:

• Observe
• Mentor
• Coach
• Evaluate
• Inspire
• Build teams
• Create cohesion
• Resolve conflicts
• Ensure ethical practices

While doing all of these things, you'll try to create an aura between you and your supervisee that will foster learning, self-motivation, and professional development. Doing these is essential for not only improvement in quality, but for effectual applications of both evidence- and consensus-based practice (Center for Substance Abuse Treatment, 2007). Although clinical supervision is really a separate professional proficiency, standards and proper training seem to have been considerably neglected because many clinicians have never had official training in clinical supervision (Scott, Ingram, Vitanza, & Smith, 2000). Delivering skillful and valuable clinical supervision goes beyond the set of skills needed for providing therapeutic assistance to behavioral health clients. Quite simply, being a good clinician will not automatically lead to being a good clinical supervisor.

[QN.No.#2.If you are a good clinician, you will undoubtedly be a good supervisor.True/False]

Clinical Supervision can also be a procedure that creates an opportunity for the assessment of the supervisee’s interactions with a client, insuring that the highest quality of care is given. This is a powerful, collaborative procedure that includes the ingredients of good training and mentorship and aims to make it possible for the supervisee to cultivate, attain, and maintain a top-notch practice.

The procedure gives an opportunity for consistent secured time for assisted, in-depth thought on clinical practice and professional issues. The reflective process can result in positive changes in the supervisee’s work. In this way, clinical supervision both empowers and sustains individuals in practice and will likely continue on during the clinician’s entire career. (Division of Behavioral Health Services, 2008)

Competency-Based Supervision

Sullivan and Glanz (2000) identified five approaches to supervision that were both practice- and theory-based. These are mentoring, peer assessment, peer coaching, action research and differentiated supervision. Smith (2011) described the managerial and consultative (or professional) approaches. Others have mentioned humanistic (Starak, 2001), integrative (Waskett, (2009), and the objective (Gonsalvez, et al., 2011) approaches. Because the competency-based approach is the one generally referred to in this course, these other approaches will not be defined here.

The competency-based supervision is one of the most cited approaches (Falender and Shafranske (2004). It includes concepts that are also part of other approaches. If you practice competency-based supervision, you will:

• Identify which competencies are both profession- and setting-specific.
• Perform a beginning assessment of the values, knowledge and skills of the supervisee.
• Lay the foundations for a satisfactory supervisory relationship.
• Build a supervision contract that includes continual evaluation and feedback.