What's not being said? Recollections of nondisclosure in clinical supervision while in training

The aim of this qualitative study was to retrospectively examine nondisclosure in individual supervision while in training. Interviews were conducted with supervisees two years post-qualification. Specific nondisclosures were examined and reasons for these nondisclosures were explored. Six in-depth semi-structured interviews were conducted and data analysis drew on Consensual Qualitative Research. The findings revealed four categories relating to: (i) the nature of the difficulty; (ii) reasons for nondisclosure; (iii) the supervisory relationship; and (iv) facilitative factors. The quality of the supervisory relationship was a significant element in nondisclosure. A key recommendation was that role induction for supervisees should be incorporated into training programmes to assist supervisees in learning how to use supervision more effectively. Limitations of the study and further research are provided in light of current findings.     

Trainee nondisclosure in supervision: What are they not telling you?

Aims: The purposes of this study were to examine: (1) the content of and reasons for trainee nondisclosure in supervision, and (2) the influence of trainee anxiety and perception of the supervisory working alliance on amount of nondisclosure and willingness to disclose. Method: As the focus of the study was a single supervision session, qualitative and quantitative data were collected from 204 trainees about their most recent supervision session. Results: Within the single supervision session on which they reported, 84.3% of trainees withheld information from their supervisors. Trainees reported an average of 2.68 nondisclosures occurring in the session, with the most common nondisclosure involving a negative supervision experience. Trainee perception of a better supervisory working alliance was related to less nondisclosure and greater overall willingness to disclose in supervision. Higher trainee anxiety was related to greater nondisclosure and lower overall willingness to disclose in supervision. Implications: The implications of the findings for the practice of supervision are discussed and areas for further research are suggested.     

A Qualitative Investigation of Supervisees' Experiences of Triadic Supervision

Although triadic supervision has existed for some time, few studies have focused on this form of supervision or its effectiveness. In this qualitative study, the experiences of 6 master's‐level students from a counselor education program who participated as supervisees in triadic supervision were explored using in‐depth, open‐ended interviews. The data analysis resulted in 5 major categories, which are discussed. Implications of the findings for clinical supervision and further research are also addressed.     

The career construction interview and literary analysis

The aim of this study was to examine what changes occurred in a career construction interview (CCI), what elements contributed to these changes and how reflexivity was fostered. Two clients and two counselors participated in interpersonal process recall (IPR) interviews (Larsen, Flesaker, & Stege, 2008) to review CCI interviews they had previously participated in. The CCI was reported based on the construction and reconstruction that took place during the interview. The IPR interviews were analyzed qualitatively by means of the grounded theory method. Then the two CCI's were submitted to literary analysis based on Greimas's narrative semiotics (Vilhjálmsdóttir & Tulinius, 2009) in order to determine whether and in what way the counselor missed something during the interview. The article concludes that the CCI is very effective but could be made even more so if the counselors received more training in literary analysis, more specifically narrative semiotics.     

督导重要事件对新手咨询师专业成长的影响

目的：了解个别督导过程中重要事件的类型、内涵及对新手咨询师专业成长的影响。方法：采用重要事件法，访谈4对受督者和督导师，并用共识性质性研究法分析。结果：有益重要事件包括督导关系、概念化、历程化、个人化4大类；督导促进了新手咨询师干预技巧能力、治疗计划目标等8个专业领域的成长。结论：督导对于新手咨询师专业成长非常重要。各类督导事件对于新手咨询师的促进作用并不均衡。     

The relationship of supervisor and trainee gender match and gender attitude match to supervisory style and the supervisory working alliance

Background: Gender‐related events have the potential to impact the supervisory relationship. Gender events might be related to the match between supervisors and supervisees on variables such as gender or gender attitudes. Method: In this study, we sought to determine whether gender match and gender attitude match were related to supervisory style and the supervisory working alliance in 94 supervisory dyads using four instruments: the Gender Attitude Inventory; Operationalisation of Gender Match; Supervisory Styles Inventory; and the Working Alliance Inventory/Supervision. Results: Progressive dyads (in which supervisors have more liberal attitudes about societal issues and culturally defined roles for women than their supervisees) were perceived by supervisors as more task‐oriented than parallel‐high dyads (in which supervisors and supervisees both had liberal attitudes). Implications for counselling supervision are discussed.     

Photo-synthesis: Facilitating Goal Setting in Supervision Using Images and Creativity

ABSTRACT

One of the most important aspects of clinical supervision is goal-setting. In the early stages of supervision, supervisees may find it difficult to connect authentically with their supervisors due to the inherent power differential in supervision. Difficulty connecting may be exacerbated when students are attempting to set goals regarding their areas for growth. Based on literature reviewed on the counselor-client relationship, the authors posit that using images may increase vulnerability between supervisors and supervisees. Additionally, the authors introduce relational-cultural theory as a framework for connecting authentically through creative images. The authors present examples of using images in individual and group supervision, specifically employing The Coaching Game made by Points of You.     

Recording supervision: Educational,therapeutic, and enhances the supervisory working alliance?

Aims: To explore the impact of listening to an audio‐recording of their latest supervision session on supervisees. Method: Participants recorded a supervision session, listened to it and were interviewed about this experience of listening to it within seven days of listening to the recording. The phenomenological interviews informed by the researcher's knowledge were analysed using grounded theory. Participants: Fifteen participants with 0–20 years’ experience, representing person‐centred, CBT, psychodynamic and integrative approaches, and qualifications ranging from student to doctorate formed the theoretical sample. Findings: Listening to the audio‐recording allowed participants to re‐experience their thoughts and emotions. Participants recalled and re‐experienced events which had been forgotten, unnoticed or (arguably) repressed. This re‐experiencing was usually less emotive than in real‐time; but suppressed emotions could be more intense. As participants integrated both these noticed and unnoticed events, they were able to accept what had been unacceptable, gaining self‐awareness, which was potentially therapeutic. Noticing what had been unnoticed permitted insights into many aspects of therapy and supervision, which was more than just ‘reflection‐on‐action’. Conclusion: Listening to an audio‐recording of the latest supervision may be educational for any supervisee; it may be therapeutic by facilitating challenge of maladaptive beliefs and behaviours; and it also seems to strengthen the supervisory working alliance.     

督导重要事件对新手咨询师专业成长的影响

目的：了解个别督导过程中重要事件的类型、内涵及对新手咨询师专业成长的影响。方法：采用重要事件法,访谈4对受督者和督导师,并用共识性质性研究法分析。结果：有益重要事件包括督导关系、概念化、历程化、个人化4大类;督导促进了新手咨询师干预技巧能力、治疗计划目标等8个专业领域的成长。结论：督导对于新手咨询师专业成长非常重要。各类督导事件对于新手咨询师的促进作用并不均衡。     

Videoconference to supervise early intensive behavioral intervention: A preliminary evaluation of acceptability

At present, early intensive behavioral intervention (EIBI) for children with autism spectrum disorders is the intervention that has the strongest empirical support. EIBI requires frequent supervision by qualified professionals. Norway, like many other countries, has a shortage of qualified supervisors, particularly in rural regions. This study used a reversal design to investigate how supervisors and supervisees perceive the quality of EIBI supervision and the local team's preparedness when supervision was provided either on-site or via videoconference. Calculations were made on how much time could be saved on travel when part of the supervision was provided via videoconference. There were no significant differences in the supervisors' and supervisees' ratings of on-site and videoconference supervision. Moreover, the supervisors found the local EIBI teams to be better prepared when supervision was provided via videoconference, and the videoconference supervision meetings were shorter. The study discusses the implications of these findings for the accessibility of EIBI and case capacity and proposes some areas for further research.     

On regression and supervision

The centrality of the supervisory relationship to the professional development of supervisees may encourage dependency needs and regressive wishes. This process may undermine the delicate balance in supervision between an optimal didactic tension and an atmosphere of calmness and security. The present paper advises supervisors to take into account the gap in power and interests between their supervisees and themselves, and the temptation that may arise within them to use their supervisees' regression in order to avoid resistance. Such awareness will help them make controlled and appropriate use of such analytic powers and maintain the balance between supervisees' “regressive selves” and “mature selves.” In addition, a perception of supervisory relations as a space of mutual alternating regressive states is offered as an important aspect of supervisor–supervisee communication.     

Toward the science‐informed practice of clinical supervision: The Australian context

Although supervision of clinical practice is mandatory for trainee psychologists, surprisingly little is known about the key ingredients of effective supervision and the relationship between supervision and patient outcomes. The purpose of this paper was to review current regulations that shape supervision in Australia and explore the links between these regulations and the components of effective supervision. Although recent developments including supervisor training and other quality control programs are an indication of progress, there are several empirical and conceptual issues in the supervision literature that require resolution. The second part of this paper identifies the gaps in the supervision literature and suggests steps to advance the development of a mature science of clinical supervision. The main areas requiring attention include the identification of the mechanisms by which supervision produces change in supervisees and their patients, the refinement of measurement methods and instrumentation, and the need to pursue collaborative research that maximises the generalisability of research findings.     

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.     

Supervision in aamft accredited programs: Supervisee perceptions and preferences

Abstract

To assess supervisees' perceptions of supervision in AAMFT accredited programs, 72 supervisees from 14 degree programs responded to a questionnaire asking them to describe the supervision they were receiving and what they preferred. The majority reported perceiving their supervision as a mixed didactic-experiential style. Subjects were also asked to describe their perceived actual and preferred supervision on six dimensions. The findings showed that from supervisees' point of view, the quality of supervision in accredited programs is good, that some supervisees do not receive once per week supervision, and that the majority did not receive the style of supervision they preferred.     

The Science and Art of Integrating Psychodrama and Bernard’s Discrimination Model

This article presents the useful technique of Jacob L. Moreno’s psychodrama in counselor education supervision training. This article addresses how psychodrama can be used with student supervisors who are not sure which of Bernard’s discrimination model roles they are using in supervision. Bernard’s model uses three roles that help supervisors function successfully in their relationships with supervisees. Psychodrama may help student supervisors decide what action would be the most appropriate in a given supervision session. Student supervisors may also benefit from psychodrama in processing internal conflict they may experience in their supervisory role. Faculty members training new supervisors may use these techniques to help their student supervisors gain more awareness on how they view their relationships with supervisees.     

The Sexual Orientation Matrix for Supervision

SUMMARY

The Sexual Orientation Matrix for Supervision (SOMS) was created in order to assist supervisors and trainers in preparing supervisees to work with lesbian, gay, and bisexual (LGB) clients. The SOMS was developed around two core concepts: (1) degree of heterosexual bias, and (2) degree of acceptance of LGB orientations and behavior. Supervisors can employ the matrix to explore both their own and their supervisee's levels of comfort, knowledge, and experience in working with LGB clients including same-sex couples. This article describes the development of the matrix, an exploration of the concepts underlying this tool, and an explanation of how to use the matrix, including suggested tasks for supervision of therapists working with same-sex couples.     

Toward science‐informed supervision of clinical case formulation: A training model and supervision method

Case formulation is a core competency in the practice of clinical psychology and although many component skills can be taught in lectures, supervised clinical practice is a key step in moving from knowledge about case formulation to knowledge of formulation. The present paper outlines a model of science‐informed clinical practice and the ways in which clinical supervision may play a role. In addition, a methodology for assessing and benchmarking skills in case formulation is described to assist clinical psychology training programs to provide supervisees with normative feedback about their skills in case formulation. In so doing, the supervision of case formulation can become more informed by science and responsive to evaluation.     

Supervisors' and Supervisees' perceptions of the effectiveness of family therapy supervisor interpersonal skills

Abstract

This study surveyed a randomly selected group of Approved Supervisors of the American Association for Marriage and Family Therapy (n=318) and their supervisees (n=299) on their perceptions of the effectiveness of several supervisor interpersonal skills. Both supervisors and supervisees had high ratings for the majority of the interpersonal skills and rated “respects the supervisee” most effective. Trends in supervisors' and supervisees' responses were assessed for (a) theoretical orientation, (b) supervision setting, (c) gender, (d) number of years supervising family therapists (for supervisors), and (e) number of years practicing family therapy (for supervisees).     

Can boundary crossings in clinical supervision be beneficial?

Published studies have addressed boundary violations by clinical supervisors, but boundary crossings, particularly those deemed positive by supervisees, have not received much attention. Eleven trainees in APA-accredited doctoral programs in clinical and counseling psychology were interviewed regarding positive boundary crossings (PBCs) they experienced with clinical supervisors. Interview data were analyzed using Consensual Qualitative Research. Examples of PBCs included socializing with supervisors outside the office, sharing car rides, and supervisor self-disclosure. Typically, supervisees did not discuss the PBC with their supervisors because they were uncomfortable doing so, felt that the PBC was normal, or felt that processing such issues was not part of the supervisor’s style. Most supervisees viewed the PBCs as enhancing the supervisory relationship and their clinical training; however, some participants reported that the PBCs created role confusion. The results suggest that there are legitimate reasons for supervisors to be scrupulous about their boundaries with supervisees; however, supervisors who hold rigid boundaries can deprive supervisees of deeper mentoring relationships or a more authentic emotional relationship that can be valuable to supervisees learning how to provide psychotherapy.