Chapter 6: THE SUPERVISEE
The Supervisee
It's one thing to know your status and responsibilities as a supervisor, and to know what skills and knowledge your supervisee must gain under your sponsorship. It's another thing to know (perhaps "remember"?) what it's like to be a supervisee, and to guide them in their own experiences and stages of development, through their resistances into a variety of competences. This involves an evolution in the relationship between you and your supervisee. This section will give you some light on these aspects of supervision
THERAPEUTIC DEVELOPMENTAL STAGES OF A SUPERVISEE
Not only is there a developmental evolution in the supervisor-supervisee relationship, but the supervisee will experience therapeutic development within herself. It's important for you to be aware of how supervisees earn and establish a spirit of learning, how skills are developed over time, and the process of developing as part of an organization. Improvement in the supervisee's service delivery occurs best when she has freedom to practice new skills in an environment of mentoring and support rather than one of critical judgment (Center for Substance Abuse Treatment, 2007). Cole (2001) reports four therapeutic development phases for the supervisee:
- Learning the basics of what the supervisee should do
- How to begin to understand the client
- How the client and the supervisee can collaborate to increase the client's productive functioning
- The supervisee learns to trust himself to be a beneficial agent of healing in a therapeutic relationship
Three developmental stages, each followed by a period of transition transition, were given by Cox, Phibbs, Wexler, Riemersma, and Bauman, Eds. (1990). Although the numbers differ from those given by Cole (2001), you can see similar stages of development.
- Novice Stage: The supervisee is not sure what to say to the client, but believes that the client's survival is dependent on what the supervisee says. The supervisee is very dependent on the supervisor, wants to be shown techniques, and has difficulty synchronizing text book knowledge and practical applications. Focuses on issues rather than on the client, emphasizes "doing." Your task as the supervisor in this stage is to give general structure which may include procedures, forms, journaling, and reading materials.
- Transition Period: Counter-transference issues will occur with almost every client. Supervisees will improve on matching intentions and interventions. They will begin to understand the deeper and more abstract components of doing therapy, but will still struggle with what to do. Your supervisor tasks will include helping supervisees understand things such as how the client may interpret body language (e.g., folded arms) and the impact it may have on them, and to give positive reinforcement to the supervisees' strengths and encourage them to develop their own theoretical framework.
- Intermediate Stage: Supervisees become more aware of their own personal issues, and likely feel somewhat overwhelmed by the client's problems. The goal of this stage is to be able to work with the client even though the exact outcome is unknown, and to learn to use their own self (or "being," if you prefer) effectively in therapy sessions. Sometimes this requires some personal therapy. As supervisor, you can encourage journaling, and help supervisees look more closely at counter-transference issues. At this stage supervisees may express some self-righteousness and there is danger of client abuse at some level; you need to uncover this and work with the supervisees on it. You and the supervisees need to be aware of their beliefs. A good question to ask in a supervisory session is what the supervisee did in a session that they liked or were especially aware of.
- Transition Period: Supervisees will experience increased confidence and comfort with both "being and doing," but may have problems connecting universal concepts between cases. Increased flexibility is needed in regards to what specific directives are being followed; support without advice on your part as supervisor is generally the most helpful process. Supervisees might not need to discuss individual case specifics as much as before, if at all. In fact, they need to realize that they don't need to see every single client and that it's often most appropriate to transfer a client to another therapist. Your task at this stage is to reinforce therapeutic skills and encourage further skill development.
- Advanced Stage (Self-supervision): At this stage, supervisees are able to focus on their overall role and the complete process of therapy and the therapeutic relationship. They may be considering specialization in one area, and are preparing for license exams. Your supervisor tasks include incorporation of knowledge, role understanding, personal style, intentions, and responsibility. Supervisees need to be able to find their own answers; you can encourage advanced training through workshops, books, etc. Help supervisees conceptualize all treatment process phases. You'll focus now on generalities instead of specific cases, and will help supervisees develop their personal counseling style and theory. Explore, integrate, and articulate what the supervisees believe.
- Transition Stage to Professional: The supervisee makes the final transition from an uncertain, inadequate, and incongruous beginning to a confident, competent, and congruent professional. They will be preparing for licensing exams by overcoming fears and resistances, as well as reviewing facts and therapy methods. Your job is to aid them in exam preparation, termination with you as supervisor, and aiding a personal ritual for this transition.
CRITICAL ISSUES SUPERVISEES EXPERIENCE
Sometimes it helps to guide supervisees through the development stages and transitions by being aware of critical issues they experience during the process. According to Loganbill, Hardy, and Delworth (1982), these issues are:
- Competence - skills and techniques
- Emotional awareness - knowing oneself, awareness of feelings
- Autonomy - self directedness
- Identity - theoretical consistency, conceptual integration
- Respect for individual differences - tolerant, non-judgmental acceptance of others
- Purpose and direction - structuring a therapeutic direction, setting appropriate goals
- Personal motivation - awareness of the satisfaction and personal meanings inherent in practicing therapy
- Professional ethics - values
Within this process they identify your supervisory functions as:
- Monitoring client welfare
- Enhancing growth within stages
- Promoting transition from one stage to the next
- Evaluating the supervisee
[QN.No.#70. Your supervisory functions in guiding a supervisee through critical issues in their developmental stages include:]
PROBLEM SUPERVISEES - RESISTANCE IN SUPERVISION
Even the most willing and compliant supervisee will probably have moments in which they resist supervision and your supervisory efforts. These occasional occurrences are not a problem. They are a problem if they delineate the whole process.
Resistant Behaviors
Supervisees resistant behaviors may boil down to two things:
- They don't want to do something that they were told to do.
- They feel they're ready to deal with situations that you don't believe they're yet equipped for.
Resistance is not uncommon. It may be annoying or even disruptive, but it's not synonymous with "bad behavior" or being a "bad person." Instead, it occurs because of the supervision process dynamics, and often is actually a fitting response to supervision (for example, if you slip into having therapy sessions instead of supervision sessions). Sometimes resistance is simply a response to anxiety; as supervisor you can deal with the anxiety, thus reducing or eliminating the need for resistance (Bradley and Gould, 2002). Liddle (1986) came to the conclusion that the main goal of resistant behavior is self-protection against a perceived threat. A common threat is the fear of being inadequate--that the supervisee will not be able to measure up to the supervisor's expectations and standards. Or the supervisee may be anxious because of the evaluation portion of supervision. They may fear that a negative evaluation will lead to dismissal or to not being given needed recommendations. Another cause of resistance may be that supervisees don't accept the validity of supervision. They may perceive their skills to be at least equal, perhaps even superior, to the supervisor's skills. Another potential cause is a reaction to loss of control. This can develop into a power struggle between supervisee and supervisor. Additionally, supervisees may be threatened by change and thus respond with defensive behaviors. Regardless of the form of a resistant behavior, it's a coping mechanism with the goal of reducing anxiety. A common form of supervisee resistance is playing games. Four supervisee game categories were defined by Kadushin (1979).
- Manipulating levels of demand. The supervisee tries to manipulate the level of demands placed on her by the supervisor. This category includes inhibiting supervisory evaluative focus. Flattery may be used for this purpose.
- Making the supervisor-supervisee relationship ambiguous. The supervisee may play a game of self-disclosure to expose herself rather than her counseling skills.
- Reducing power differences. The supervisee may try to show that the supervisor is "not so smart," and will focus on his own knowledge. If this game is successful, the supervisee can diminish some of the supervisor's power.
- Controlling supervision. Supervisees may develop questions that will switch supervision away from their performance. Or they may ask for unnecessary preblockedions for dealing with clients, look for reassurance through reports of how poorly work is coming along, or sharing only information selected to acquire a positive evaluation. An angry or hostile form of control includes blaming the supervisor for the supervisees' failure.
In addition to the four game categories, Bauman (1972) spoke of five types of resistance, which may be equated to game categories and compared with those given above:
- Submission: Supervisees act as though the supervisor has all the answers.
- Turning the Tables: Supervisees try to direct focus away from their skills.
- "I'm No Good": Supervisees plead fragility and seem brittle in order to keep the supervisor from focusing on painful issues.
- Helplessness: A dependency game where supervisees absorb every speck of information the supervisor gives.
- Projection: Supervisees blame external problems for their ineffectiveness.
[QN.No.#71. Supervisees sometimes are resistant to supervision. There are at least five kinds of resistances, which may also be equated to categories of games they might play. These generally do NOT include:] Specific games supervisees may play, with steps you can take to avoid being part of the game, include (Malone, 2009; Munson, 1979):
- Us Against Them: The supervisee attempts to gain control in order to carry out her own agenda and beliefs by trying to form an alliance with the supervisor against the agency. Try to redirect the supervisee's efforts to working well within the organization.
- You Are the Best Supervisor Ever: Emotional blackmail for the purpose of reducing the supervisor's power. Maintain correct boundaries and keep the goals in focus to prevent falling into the trap.
- A Little Therapy, Please: Supervisees try to manipulate the supervisor into focusing and solving their problems to distract them from the professional work. You can reframe the personal problems into the clinical work, and--if necessary--refer the supervisees to their own counseling.
- But We Are Friends: This is a manipulative action to get the supervisor off course and not hold the supervisee accountable for his actions. Stay out of the game by recalling that the role of "friend" was not a part of the supervisory contract.
- I Am Big Like You: This is another game for the supervisee to gain power. The supervisee will not feel obligated to do anything the supervisor might wish, since they're truly peers. You may need to remind the supervisee that it's your responsibility to evaluate his performance.
- You Don't Have All the Answers: Another form of "I Am Big Like You." Allow the supervisee to shine in areas where she's competent, and--when appropriate--share the platform of expertise, reminding both of you that you're team members.
- I Have an Agenda: A deluge of questions in the supervisory meeting is designed for the supervisee to control the meeting and prevent the supervisor from addressing the supervisee's weak areas. You'll need to interrupt the deluge and spell out your own agenda. There is usually room for some negotiation regarding to what questions will be addressed.
Counteracting Resistance
Knowing that resistance is common, and being aware of the games a supervisee may play to demonstrate that resistance is one thing. Knowing how to counteract that resistance is another. The process is not simple. However, your ability, as supervisor, to take resistance and turn it into a supervisory advantage may be the hallmark for determining success or failure in supervision (Bradley and Gould, 2002). The major factors that affect the methods used are:
- The relationship
- How the relationship is viewed
It's essential that the supervisory relationship be grounded in respect, trust, rapport, and empathy (Borders, 1989). If the supervisor views the relationship as the focal point in supervision, then a full exploration of conflicts will be followed. If the supervisor views the therapeutic works as the focal point of supervision, then the exploration of conflicts will likely be more limited. The literature offers a variety of ways to deal with resistance:
- Identifying the source of anxiety (or threat); then brainstorming to find suitable strategies for dealing with the conflict (Liddle, 1986)
- Refusing to play games--sharing awareness of game-playing with supervisees and focusing on inherent disadvantages in game-playing, not on the dynamics of the supervisee's behavior (Kadushin, 1979)
- Positive reframing to empower the supervisee, increase the supervisee's self-esteem, and to model effective ways of coping with feelings, thoughts and behaviors (Masters, 1992)
[QN.No.#72. Ways to deal with supervisee resistance include:] Bauman (1972) mentioned several techniques, the success of any being dependent on the interaction between the supervisor and supervisee and their personalities:
- Direct confrontation through describing and interpreting the supervisee's resistance
- Feedback
- Clarification by using restatement to help the supervisee understand his behavior
- Generalizing resistance to other setting to remove the focus from the supervisory relationship and aid the supervisee to recognize her unsuitable behaviors
- Ignoring resistance, although this should be done only if the behavior can be eliminated by so doing
- Role-playing and alter-ego role-playing, to help identify the cause of resistant behavior; this may initially be quite threatening
- Audio- or video-taping supervision sessions
If these methods don't help, you may need to do a bit of "creative brainstorming" with the supervisee about how to get his needs met. The possibilities include:
- Therapy
- Mediation for conflict resolution
- Development of realistic goals that don't overwhelm supervisees or negatively impact their self-esteem
All instances of supervisee resistance, and the attempts to counteract it and their results should be documented.
SUPERVISEE COMPETENCIES
Quite a bit of space was given to list competencies of supervisors. Supervisee competencies, while just as important, can be listed more succinctly. Tomm and Wright (1979) give a fair list that summarizes information about supervisee development already discussed:
- General Case Management: Complying with agency responsibilities
- Therapeutic Relationships: Establishing and maintaining ongoing relationships with clients
- Perceptual: Therapist’s ability to observe interactions
- Conceptual: Therapist’s ability to integrate observations with theory
- Structuring: Therapist’s ability to adequately direct therapy
- Intervention: Therapist’s ability to purposefully behave in a strategic manner to facilitate change
- Professional Development: Using resources to promote growth as a professional clinician; the focus of competency development changes depending on the developmental phase of the clinician’s growth process.
------------------------------------------------------------------------------------------------------------------ Question 70. Your supervisory functions in guiding a supervisee through critical issues in their developmental stages include: a) Monitoring client welfare b) Curtailing movement towards autonomy that is too fast c) Enhancing growth within stages d) a and b e) a and c f) b and c Objective 12a. Name two possible resistant behaviors of a supervisee. Question 71. Supervisees sometimes are resistant to supervision. There are at least five kinds of resistances, which may also be equated to categories of games they might play. These generally do NOT include: a) Submission b) Projection c) Arguing d) Helplessness e) All of the above f) None of the above Objective 12b. Name two of the ways to counteract that resistance. Question 72. Ways to deal with supervisee resistance include: a) Identifying the source of anxiety (or threat); then brainstorming to find suitable strategies for dealing with the conflict b) Play the games they do, but better to model the inherent disadvantages in game-playing c) Positive reframing to empower the supervisee, increase the supervisee's self-esteem, and to model effective ways of coping with feelings, thoughts and behaviors d) a and b e) a and c f) b and c
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