CLINICAL SUPERVISION:

INTEGRATED HEALTH PSYCHOLOGY

TRAINING I

Developing our selves in the role of training psychologists.

WHAT HAS MADE GOOD SUPERVISION FOR YOU IN THE PAST?

WHAT HELPS YOU GROW?

Group Discussion

SOME RESEARCH ON QUALITIES OF GOOD SUPERVISORS ARE…

1. Openness to discussion

2. Availability 3. Ability to offer

support 4. Understandin

g

5. Ability to provide meaningful feedback

6. Expertise 7. Flexibility 8. Empathy 9. Ethical

CLINICAL SUPERVISION Supervision is a distinct professional practice employing a collaborative relationship. Supervision role has both facilitative and evaluative component Supervision reaches towards the goal of enhancing the professional competence and science-informed practice of the supervisee Supervisors have a role monitoring the quality of services provided and protecting the public.

SEVEN CORE DOMAINS OF HEALTH PSYCHOLOGY SUPERVISION1. Supervisor Competence2. Diversity & Cultural Humility/Responsive

Care3. Supervisory Relationship 4. Professionalism 5. Assessment/ Evaluation/ Feedback 6. Developing Professional Competence 7. Ethical, Legal, and Regulatory Considerations

ETHICAL CONSIDERATIONS IN SUPERVISION

“Valuing and modelling ethical behavior and adherence to

relevant legal and regulatory parameters in supervision is essential to upholding the

highest duty of the supervisor, protecting the public.”

ETHICAL CONSIDERATIONS IN SUPERVISION Supervisors model ethical practice and decision making and conduct themselves

in accord with ethical guidelines.

1. Supervisors support the acculturation of the supervisee into the ethics of the profession

2. Supervisors ensure that supervisees develop the knowledge, skills, and attitudes necessary for ethical and legal adherence.

3. Supervisors are role models for ethical and legal responsibility.

ETHICAL CONSIDERATIONS IN SUPERVISION 1. Supervisors uphold their primary ethical and legal obligation to

protect the welfare of the client/patient.2. Supervisors provide clear information about the expectations

(Supervisor Agreement/Contract) see article on supervision in health psychology (read aloud).

3. Supervisors maintain accurate and timely documentation of supervisee performance related to expectations for competency and professional development.

4. Supervisors receive training regularly on supervision (6 hs per lisc. Renewal Cycle.)

HEALTH PSYCHOLOGY: IHPTP SUPERVISORS SKILLS 1. Assessment: Screening, functional assessment, diagnostic assessment, clinical

triaging, biopsychosocial factors. 2. Treatment Planning: 1. Developing context of support and change, 2. Identifying key

treatment goals and overlapping objectives, 3. Session length, session amount, dose response curve, 4. Define success.

3. Cultural Humility: 1. Developing skills of self-reflection about cultural location, 2. Skills in cultural Awareness, 3. Culturally responsive interventions, 4. Cultural sensitivity, 5. Cultural knowledge.

4. Treatment Implementation/Clinical Relationship: Shadowing, video, audio recording, discussions.

5. After Care Planning and Relapse Prevention PlanningTermination: 1. Start with termination conversations, 2. Internalization of change, 3. Addressing loss and grief, 4. Developing after care and relapse plan.

6. How to Fxn as a beh. health consultant: Provider, Nurses, Patient, and Organization. 7. Interdisciplinary Skills: Team development, communication, follow through, cultural

differences between professions.

SUPERVISORS HAVE MULTIPLE ROLES These can include teacher, coach, cheerleader,

consultant, collaborator, mentor, counselor (while not stepping into the role of therapist) and

disciplinarian. Effective supervision adapts the roles needed by each student at a

given time in their development.

SUPERVISOR APPROACH ADAPTS TO CLINICAL NEED Choose how you Supervise Based on Developmental Needs: At any given moment a supervisee may have a different developmental need. Matching your intervention style to the current developmental need can help supervision be more effective.

1. Directive Supervision: When the supervisee has limited experience, is struggling with an aspect of their role, is impacted emotionally or safety issues to address.

2. Coaching Supervision: When the supervisee has a basic competence, is managing their duties effectively and is managing the clinical role in their relationships well.

3. Consultant;/Collaborator: When the supervisee is fxn highly and is able to dialog effectively about clinical realities.

MODES OF SUPERVISION Group Supervision: Groups of trainees explored and discuss cases, develop a learning context and support one another’s growth. Direct Supervision: When the supervisor is present for the clinical service delivery. Individual Supervision: A clinical supervisor and a supervisee work together to develop clinical plan’s, discuss cases and support professional development. Tape/Video Tapes: Recordings of sessions are reviewed in clinical supervision and discussed as opportunity for learning and growth. Notes and Process Discussion: Reviewing notes and dialog as reported by supervisee or documentation.

MAJOR MODELS OF CLINICAL SUPERVISION Developmental Supervision: Takes the approach of adapting supervision techniques to the developmental level of a clinician. This has both an arch of development across a training year and the process of training from beginning to ongoing growth. Theory Based Supervision: Theory based supervision supports the growth in the development of the application of a clinical theory to a client, type of client or in clinical work. Supervisee Focused Supervision: Seeks to train the supervisee in the emotional skills of becoming a therapist. The focus is on the emotional and skill development of supervisee. The supervisor and supervisee relationship is central focus.

MAJOR MODELS OF CLINICAL SUPERVISION Patient Focused Supervision: Focuses supervision on the interventions used with a client. The supervisee brings in their clinical work and the focus is on helping the patient. The supervisor supervisee relationship is secondary to clinical work. Competency Based Supervision: Is a trans-theoretical approach that uses core competencies that are vital for effective clinical work as an anchor for training in supervision. It starts with a behaviorally anchored identified competency and develops learning experiences that develop those competency.

DEVELOPMENTAL SUPERVISION MODELS – IDM Integrated Development Model: One of the most researched developmental models of supervision is the Integrated Developmental Model (IDM) developed by Stoltenberg (1981). Level 1 supervisees are generally entry-level students who are high in motivation, yet high in anxiety and fearful of evaluation; Level 2 supervisees are at mid-level and experience fluctuating confidence and motivation, often linking their own mood to success with clients; Level 3 supervisees are essentially secure, stable in motivation, have accurate empathy tempered by objectivity, and use therapeutic self in intervention. (Falender & Shafranske).

http://www.marquette.edu/education/grad/documents/Brief-Summary-of-Supervision-Models.pdf

DEVELOPMENTAL SUPERVISION MODELS – IDM Integrated Development Model: One of the most researched developmental models of supervision is the Integrated Developmental Model (IDM) developed by Stoltenberg (1981). Level 1 supervisees are generally entry-level students who are high in motivation, yet high in anxiety and fearful of evaluation; Level 2 supervisees are at mid-level and experience fluctuating confidence and motivation, often linking their own mood to success with clients; Level 3 supervisees are essentially secure, stable in motivation, have accurate empathy tempered by objectivity, and use therapeutic self in intervention. (Falender & Shafranske).

http://www.marquette.edu/education/grad/documents/Brief-Summary-of-Supervision-Models.pdf

SUPERVISOR VALUES CLARIFICATION EXERCISE1.Make a list of core values of as clinical

supervisor as a group (List Together on Board).

2.Brake into small groups of 2-4 and discuss why these values matter to you.

3.Write a brief letter to your self on how you would like to be remembered in your supervisee’s minds when they move on from your supervision.