A Qualitative Investigation of Student and Supervisor Perceptions of Live Supervision in Genetic Counseling

Live supervision of genetic counseling students is critical for ensuring quality client care and student clinical skill development. However, no research has investigated students' and supervisors' experience of this primary supervision method. In this study, separate focus groups of students and supervisors discussed their perceptions of the nature and impact of live supervision. A modified Consensual Qualitative Research method (Hill et al. (1997) Couns Psychol 25:517–572) was used to analyze the data. Results suggest that live supervision is an essential and effective method that promotes student skill development and professional development for both students and supervisors. There is a lack of formal training regarding supervision; most learning is trial and error. Students worry about being evaluated, and supervisors wonder if they are providing supervision effectively. Both samples emphasized that client care should not be compromised. Participant recommendations for improving live supervision are described, and suggestions are made for future research.     

A Survey of Clinical Supervision in Genetic Counseling

Three hundred and thirty-five full members of the National Society of Genetic Counselors completed a survey concerning the nature of clinical supervision for genetic counseling students. Slightly over half (54.3%, n = 182) had provided clinical supervision within the past 5 years. Of those who supervised, 66.7% had 5 years or less supervision experience, and 55% had supervised 10 or fewer students. The majority became supervisors because they enjoy teaching and contributing to the profession. Common reasons for not supervising include no local graduate program, and had never been asked to supervise. Live supervision is the most prevalent student evaluation method: every supervisor reported providing one-on-one oral feedback, and 47.3% indicated that they always provide feedback immediately following a counseling session. The most frequent challenges involve students who lack technical knowledge and who fail to incorporate feedback. Training, policy, and research implications are discussed.     

The competent psychoanalytic supervisor: Some thoughts about supervision competences for accountable practice and training

What are the competences required to satisfactorily practice effective or “good enough” psychoanalytic supervision? In this paper, I would like to consider that question. Over the past approximate 15-year period, increasing attention has been directed toward more specifically identifying and defining the components of competent psychoanalytic practice. But any parallel attention toward identifying and defining the components of competent psychoanalytic supervision practice has, in comparison, been sorely limited if not virtually absent. If we are to best practice competent psychoanalytic supervision and best train future psychoanalytic supervisors for competent practice, effort needs to be made to concretely delineate the competences that are requisite for such practice. In what follows, I present and adapt six broad-based families of internationally relevant supervision competence areas for use in psychoanalytic supervision: (1) knowledge about/understanding of psychoanalytic supervision models, methods, and intervention; (2) knowledge about/skill in attending to matters of ethical, legal, and professional concern; (3) knowledge about/skill in managing psychoanalytic supervision relationship processes; (4) knowledge about/skill in conducting psychoanalytic supervisory assessment and evaluation; (5) knowledge about/skill in fostering attention to difference and diversity; and (6) openness to/utilization of a self-reflective, self-assessment stance in psychoanalytic supervision. Although by no means an exhaustive list, 30 supervision competences (five per family) are proposed as significant for guiding competent psychoanalytic supervision practice and supervisor training, and a brief explanatory comment is offered in support of each broad-based family of competences.     

The Potential of Animal-Assisted Therapy Within the Supervisory Alliance

Chandler identified eight generalized benefits of animal-assisted therapy (AAT) for a person’s growth. These beneficial areas include (a) motivation, (b) distress tolerance, (c) alternative form of nurturance, (d) physical soothing, (e) genuine acceptance, (f) interactional enjoyment, (g) increased trust, and (h) increased encouragement to overcome barriers. Homestead identified supervision ideals, skills, and barriers within the supervisory alliance. If supervision is negative, this experience may disrupt the supervision relationship, process, and requirements. If not properly addressed, potential harm may come to the supervisee, supervisor, and possibly the client’s welfare. This review will identify how these eight areas of AAT may benefit the supervisory alliance to ensure the best care for the supervisee, supervisor, and the client.     

The Experience of Leader-Led Peer Supervision: Genetic Counselors' Perspectives

As we proceed through our professional lives, it is essential that we challengeourselves in order to continue to develop our genetic counseling skills. Conferences, workshops,post-graduate courses, journal clubs, and involvement in professional organizations havebecome the traditional methods of continuing education for post-graduate geneticcounselors. While these forums address the need to stay updated on scientific orinformation-based topics, there is little available to counselors to promote growth incounseling skills. A group of Boston-based genetic counselors describe how their leader-ledsupervision group has established a setting to meet the needs of its members both forsupport and continued counseling training. We outline here the evolution of this group andhow it has become a valued part of our professional lives. We feel that the model of leader-ledpeer supervision holds great value in helping genetic counselors continue to enhancetheir interpersonal skills in a supportive, safe, and challenging environment. It is our hopethat others will elect to form similar groups in their own communities, thereby creating newopportunities for growth within the genetic counseling profession.     

Within‐session supervision communication in the training of clinical psychologists

There is little research evaluating within‐session supervision communication in the training of clinical psychologists. This study evaluated the perception of 37 interns and 49 patients regarding communication between supervisor and intern during the therapy session. Most supervisors used such communication infrequently. While some interns and patients viewed call‐ins or walk‐ins as intrusive and unhelpful, the majority did not. Indeed, some valued the feedback. No association was found between the use of call‐ins or walk‐ins and patient reports of therapist behaviours or intern reports of supervisory style. It is concluded that within‐session communication is not deemed as necessary by most supervisors, who should remain cautious in their use of such communication, unless patient care is compromised.     

How Does the Analytic Supervisor Teach Group Therapy?

This paper presents a detailed account of the role of the analytic supervisor of group therapy. In addition to overseeing the teaching of clinical skills, the analytically-oriented supervisor monitors the dynamics of the supervisee and the supervisory relationship itself. Unconscious processes may both interfere with, and shed light on what is occurring in the treatment. The author suggests that a collaborative relationship characterized by safety and mutual reflection promotes learning. The distinctions between analytic and nonanalytic supervision of groups are discussed.     

A Leader-Led Supervision Group as a Model for Practicing Genetic Counselors

With the stage set by the overview of supervision models in the previous paper, thispaper now presents the development and evolution of a currently ongoing leader-ledsupervision group for experienced genetic counselors. I discuss the procedures forgetting started; the creation and maintenance of the contract; typical issues and themesconsidered; the format for case presentation; and the overall growth of the group and itsmembers.     

When educational supervision meets clinical supervision: what can we learn from the discrepancies?

The authors question the taken-for-granted notion of supervision. Their concerns arose out of an attempt to introduce 'clinical' supervision into academia as a way of addressing an increasing number of the ethical issues which confront lecturers. They recognise that knowledge can impact adversely on students and that lecturers at times find themselves compromised. They settled on supervision as an organisational space in the domain of power in which to address the distress they observed. However, through their different experiences of supervision, they soon found themselves talking past each other. When clinical supervision meets educational supervision, several anomalies are brought to the fore. The authors draw on Foucault's notion of discourse, and of knowledge as power, in order to foreground these and conclude by cautioning against an uncritical acceptance of supervision as an ethical practice. They believe there is a benefit in bringing together the two discourses of clinical and educational supervision for further discussion.     

Positive experiences of doctoral-level supervisors-in-training conducting group-format supervision: a qualitative investigation

Experiential learning opportunities are powerful in shaping positive supervisor behaviours. We were interested in examining the positive experiences of supervisors-in-training during their first practice experience as supervisors. Our study was guided by two research questions: (a) what are the experiences that supervisors-in-training viewed as positive during the course of providing clinical supervision to master's-level counselling trainees? and (b) how did these positive experiences contribute to their professional development? We employed a variation of the consensual qualitative research method developed by Hill, Thompson, and Nutt-Williams (1997) and interviewed 10 supervisors-in-training regarding their positive experiences in supervising master's-level counselling trainees. The results included five major categories of positive experiences: (a) the positive value of feedback; (b) enhanced confidence in using a wider variety of supervision tasks and procedures; (c) the impact of the experience on other aspects of professional practice; (d) increased familiarity with the multiple roles of the supervisor; and (e) for some, increased comfort navigating co-supervision dynamics. Each of these categories included subcategories. We discuss our findings within the context of supervision training in graduate education.     

Dynamic accountability in clinical training and supervision: Three orienting ideals

Despite the growing interest on making clinical practice accountable, research on how specific components of professional competence are relevant in actual training/supervision practice is as yet unspecified. This study explores this dynamic aspect of professional supervision. Three supervisory dyads, composed by an experienced supervisor and a doctoral counseling psychology student were used in the study. A qualitative, ethnomethodology-informed design was used to discursively analyze 16 significant episodes (SEs) in actual supervision meetings. This was complemented by 16 follow-up interviews. Three interpretative repertoires – ‘ideals’ – influencing participants’ accounting practices were identified: efficacy, responsiveness, and authenticity. The article discusses how structural (competency-based) and dynamic (practice-based) approaches to accountability can be combined to guide the appraisal of relevant professional competencies.     

Stage and Contextual Approaches to Development in Professional Supervision

This paper discusses supervision as a means of professional and personal development in adulthood and analyzes its relevant mechanisms and processes. By using several theoretical concepts of development the stage and contextual approaches to supervision are discussed. While the stage approach describes the movement of supervisee, supervisor, and supervision relationship along perceivable and predictable stages, the contextual approach understands the development of an adult as a progression towards increased differentiation and integration of some of its functions, to which experiences, the context of one's life, and one's own activity contribute a great deal.     

Confronting Confrontation in Clinical Supervision: An Analytical Autoethnography

Through an analytic autoethnography, the authors detail an experience of confrontation within the context of supervision of supervision. In the coconstructed narrative, the authors describe the events taking place before, during, and after the confrontation experience from the perspective of both the faculty supervisor and beginning doctoral‐level supervisor. Finally, the authors provide an analysis of the narrative based in supervisory models and theories of change.     

Supervisor social skill and supervision outcome

Background: The practice of clinical supervision is considered an effective procedure to achieve a variety of professional outcomes for supervisees. Supervisory alliance mediates many of the learning outcomes thought important for effective supervision. Therefore, it is important to identity supervisor characteristics that relate to the capacity to develop a positive supervisory alliance and achieve supervision outcome. Aim: Supervisor interpersonal skill was investigated as a characteristic involved with both supervisee assessment of supervisory alliance and learning outcomes of supervision. Method: Forty supervisors completed assessments for interpersonal skill and provided 8 sessions of supervision to 50 supervisees. Supervisees completed assessments for supervisory alliance and supervision evaluation. Findings: Supervisor interpersonal skill predicted supervisee rated supervisory alliance and supervision outcome. Implications: Supervisor interpersonal skill is important for the capacity to develop a positive supervisory alliance and manage the learning environment of supervision.     

Managing stress or enhancing wellbeing? Positive psychology's contributions to clinical supervision

One of the key functions of clinical supervision as practised by health professionals such as psychologists includes the restoration of wellbeing, but there are few guidelines in the supervision literature on how to go about this. Research into concepts from the field of positive psychology such as work engagement, sense of coherence, self‐efficacy, flow and resilience has begun to provide detailed understanding of workers' happiness, health and betterment. These findings provide possible directions for supervision interventions that go beyond traditional review of self‐care and stress‐management strategies and seek to extend the wellbeing of the supervisee. This article explores the application of positive psychology to enhance the wellbeing of practitioners such as psychologists, who often work in inherently difficult work environments such as the mental health field. Specifically, a narrative approach is proposed as one possible method and practical examples are offered to demonstrate how positive psychology may be applied in the practice of clinical supervision.     

A Study of Clinical Supervision Techniques and Training in Substance Abuse Treatment

Data from 57 clinical supervisors in licensed substance abuse treatment programs indicate that 28% had completed formal graduate course work in clinical supervision and 33% were professionally licensed or certified. Findings raise concerns about the scope and quality of clinical supervision available to substance abuse counselors.     

Cybervision: Virtual peer group counselling supervision — Hindrance or help?

This study explored the use of text‐based computer‐mediated communication in counsellor supervision. ‘Cybervision’ is an innovative collaboration between counsellors and computer technology. The study reports on the use of clinical case presentation by e‐mail and the discussion of cases in text‐based chat rooms. The inquiry, conducted from a qualitative research perspective, seeks to explore the potential effectiveness of Cybervision along with its advantages and disadvantages. Prior to each supervision session, the supervisee presented case concerns by e‐mail and later received 60 minutes supervision from the remaining three group members adopting the role of supervisor. As a form of co‐operative inquiry, the personal experience of research participants was investigated and reported, highlighting key themes and issues relating to the absence of face‐to‐face contact. In all cases, participants reported that Cybervision effectively influenced and informed the clinical practice of the counsellor. Participants quickly and successfully formed a meaningful group where support, challenge and feedback were expressed and valued. The ‘disinhibition’ effect of on‐line contact was found to support open and honest communication. Feelings were communicated in this environment with surprising ease. The consistent emergence of useful parallel processes was another significant finding.