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LPC Core Issues in Effective Clinical Supervision

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This is part 2 of 5 in a 30 hour lecture series on Clinical Supervision for Mental Health Professionals. This was made for the Approved Clinical Supervisor Certificate through the NBCC. ThiThis …

This is part 2 of 5 in a 30 hour lecture series on Clinical Supervision for Mental Health Professionals. This was made for the Approved Clinical Supervisor Certificate through the NBCC. ThiThis interactive workshop focuses on the major elements of being an effective Clinical Supervisor. In this workshop, participants will learn about the different aspects of being an effective Clinical Supervisor. Participants will learn the difference between effectiveness versus ineffective supervision, and will discuss factors involved in high quality supervision. Program Development and Quality Assurance will be covered in great detail, going over key aspects of program development methods such as long range planning, service delivery issues and a comprehensive look at quality assurance methods and issues. Finally issues of burnout prevention and supervisor developmental issues will be discussed. Teaching methods include lecture, interactive exercises and group participation/discussion.

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  • 1. Core Issues in Effective Clinical Supervision Glenn Duncan LPC, LCADC, CCS, ACSCopyright © 2012, Advanced Counselor Training Do not reproduce any workshop materials without express written consent.
  • 2. What do Good Supervisors Do? Reading – It is essential that supervisors keep up with the literature and be prepared to guide supervisees to appropriate literature. - practice specializations have exploded since the mid 1990’s and it is very possible that you’ll have people with multiple sub- specialties as supervisees. - It is the supervisor’s responsibility to keep up with the literature and the specialization of supervisees. - It is the supervisor’s responsibility to keep up with practice guidelines, and be knowledgeable about supervisee ethical and legal guidelines.
  • 3. What do Good Supervisors Do? Writing – this is writing other than the normal expected guidelines of one’s job function. This could include drafting reports, grant writing, writing articles for publication, or writing for presentation to staff or others. - Supervisors can be effective role models by recommending things they have written to their supervisees.
  • 4. What do Good Supervisors Do? Watching – Supervisors need to be keen observers, using the same observational skills that are necessary for good clinical practice. - Not all observations need to become the focus of the supervision, but supervisors need to be aware of more than what their supervisees present to them. - Supervisors who rely completely on input from supervisees for judgments and decision making are at a disadvantage in the supervisory process.
  • 5. What do Good Supervisors Do? Listening – crucial for supervisors to possess. Supervisors need to be active listeners who not only listen but are able to provide enough direct information to help the supervisee. Talking – this is usually done through discussions with the supervisee. Talking about materials, talking about issues relevant to the supervisee’s work with the client.
  • 6. Rate Your Strengths and Weaknesses inEach Area Reading – Writing – Watching – Listening – Talking –
  • 7. Exercise – Effective/Ineffective• In a small group, get together and assign one person as the group secretary in order to write down traits that the group comes up with.• Think back to previous supervisors. What traits did you find in previous supervisors that made them effective/good supervisors?• What traits did you find in previous supervisors that made them ineffective/bad supervisors?
  • 8. Traits of an Effective Supervisor• Clinical knowledge, skills, and professional experience.• Having been supervised and having had supervision of one’s supervision.• Professional education and training.• Good teaching, motivational, and communication skills.• A desire to pass on knowledge and skills to others.• A sense of humor, humility, limits and balance in life.• A concerned, sensitive and caring nature.• Good helping skills, observational skills, and affective qualities (empathy, respect, concreteness, action orientation, confrontation skills, immediacy).• Openness to fantasy and imagination.• Ability to create a relaxed atmosphere.• Willingness to examine one’s own attitudes and biases.• Respect among peers and colleagues.• Crisis management skills.
  • 9. Traits of an Effective Supervisor• Willingness to learn from others and introspectiveness.• Good time management and executive skills.• Familiarity with legal and ethical issues, policies, and procedures.• Cognitive and conceptual ability.• Physical, emotional, and spiritual health, with energy and ambition.• A serious commitment with accompanying enthusiasm.• Concern for the welfare of the client.• Concern for the growth of the supervisee.• A sense of responsibility.• A non-threatening, non-authoritarian, diplomatic manner.• Tolerance, objectivity, fairness, and openness to a variety of styles.• Ability to convey professional and personal respect for others.• Ability to advocate effectively on behalf of the counselor, the client, and the agency.• Survival skills and longevity in the organization.• Decision making and problem solving skills.
  • 10. Traits of an Ineffective Supervisor• Poor Modeling of Professional and Personal Attributes • Occurs when supervisors are untrained or poorly prepared to supervise. • Supervisors who lack effective teaching strategies. • Supervisors who are unavailable or lacked time for supervision (or while in supervision allowed disruptions, or otherwise seemed distracted). • Supervisors who lack expertise, or discussed their own work too much. • Supervisors who are apathetic, lazy or uncommitted to the profession. • Supervisees feeling that the supervisor did not trust them. • Supervisors who ignore conflicts within the supervisee/supervisor relationship. • Supervisors who are uninterested in self training to improve their own supervisory skills. • Supervisors who are morally and/or ethically corrupt.
  • 11. Traits of an Ineffective Supervisor• Unbalanced Supervision • Supervisors not covering all elements of the supervisory experience such as too much focus on administrative duties, not enough focus on clinical duties. • Focusing too much on details to the exclusion of larger themes.• Developmentally Inappropriate Supervision • Not being sensitive to the developmental needs of the supervisee. • Showing intolerance of differences. • Not allowing the supervisee to have separate views or styles from the supervisor. • Supervisors who are authoritarian, encouraging conformity, punishing divergence from the ‘party line’. • Too much or too little affirming and corrective feedback. • Overemphasis on the shortcomings of the supervisee without giving a balanced approach.
  • 12. Some Central Principles of Supervision• Supervision is a central part of all social service programs and all State licensure requirements.• Supervision can help enhance staff retention & morale.• Everyone has a right and a need for supervision (even if licensure states you don’t need supervision anymore, i.e., end licensure professionals).• Supervisors need the support of agency administrators.• The supervisory relationship is the environment in which ethical practice is developed and reinforced.• Supervision is a skill in and of itself that has to be developed.• Supervision requires balance between administrative and clinical tasks.
  • 13. Central Principles of Supervision Culture and other contextual variables influence the supervisory process. Successful implementation of EBP’s requires ongoing supervision. Supervisors are responsible as gatekeepers to the profession.
  • 14. Suggestions For Novice Supervisors Learn the agency policy and procedures, as well as HR procedures as quickly as possible. Request a 3 month “settling in” period in which you are allowed to learn about your new role and develop your supervisory style. Learn about your supervisees during this time. Learn methods for assisting staff to reduce stress, resolve conflicts, deal with competing priorities, etc. Obtain training in supervisory methods. Find a mentor. Shadow a supervisor you respect to help you learn the ropes. Ask often “How am I doing?” “How can I improve?” Have regular weekly meetings with your administrator.
  • 15. Suggestions For Novice Supervisors Remember one of the principle reasons for supervision is to ensure quality services are provided, “to protect the welfare of the client and the integrity of the clinical services”. Supervision has a primary focus on the relationship. Utilize your sense of humor and to role model that everyone makes mistakes. Model taking care of yourself spiritually, emotionally, mentally and physically.
  • 16. Factors involved in high-quality Supervision Disclosure with Supervisors• Essential to effective supervision is the ability to establish a good supervisory alliance, with trust and communication.• Supervisory disclosures directly influence the emotional bond component of the supervisory alliance by communicating trust.• Supervisor self-disclosures may model and encourage supervisee self-disclosures.• Common areas of supervisory non-disclosures: negative reactions to supervisors, personal issues, evaluation concerns, clinical mistakes, and general clinical observations.• Common reasons given for non-disclosures: supervisee viewed the information as unimportant, too personal, involving feelings that were too negative or feared that the supervisory alliance was not strong.• Most common area of supervisor non-disclosure – negative reactions to the supervisee’s professional (clinical and/or administrative) performance. This is most often withheld b/c of supervisee professional or personal readiness for the feedback.
  • 17. Factors involved in high-quality Supervision Mentoring• Mentoring is usually a separate relationship from the supervisory relationship, though it has been perceived by many supervisees as stemming from the supervisory relationship.• The mentor is somebody who provides the protégé with knowledge, advice, challenge, counsel, and support in the protégé’s pursuit of becoming a full member of a particular profession.• The mentor serves as a teacher, adviser, and role model.• Mentoring is distinguished from supervision by virtue of its volitional quality (i.e., it is typically sought out by the protégé), lack of an evaluative or legal component associated with supervision, and a longer duration.• Supervisees who reported having mentors tended to advance more rapidly in their careers, reported enhanced professional identity development and career satisfaction
  • 18. Factors involved in high-qualitySupervision Conflict Resolution – three areas of conflicts:• Conflicts over style of supervision – (direction and support given)• Conflicts over theoretical orientation or therapeutic approach – (occurring more often and not as easy to come to a resolution)• Conflicts over personality issues between the supervisor and supervisee – (most frequently reported and most difficult to resolve)• Key element reported in high quality supervision was that supervisors identified problems and initiated discussion of them.• Another key element was how the supervisor responded to complaints, responded to the supervisees raising issues of conflict, or responded to negative feedback by the supervisee. Negative, angry responses from supervisors = bad.
  • 19. Exercise – Supervision SelfAssessment Please answer the following questions as honestly as possible, and be prepared to discuss your answers in the large group.1. What do I believe about how change occurs for people?2. What are the crucial variables in training and supervision?3. How do I measure success in supervision?4. How do I contribute to that success?5. What is the hardest type of person to effectively supervise? Why?6. What is the easiest type of person to effectively supervise? Why?
  • 20. Essential Supervisor Qualities• Clinical Skills and Expertise.• Supervisors must believe they have something of value to impart on others, and must possess the qualities of a good clinician.• Those who stop seeing clients can: become too distant from the action, lose their clinical edge, and can forfeit their credibility as counselors.• Through continued client contact, supervisors can stay up to date on current clinical thinking and retain credibility among supervisees.
  • 21. Essential Supervisor Qualities• Passion for Counseling• Supervisors need a passion for the job … that is one needs to continue to have the desire to help the person needing help and the belief that one can make an impact on people’s lives.• Passion brings out the following qualities in a supervisor: they challenge, inspire, enable, model, and encourage more. This passion inspires supervisees to exhibit the same type of passion for their jobs.• How to maintain one’s passion?
  • 22. Organizational/Profession Qualities• Does the organization you currently work for support the need for clinical supervision?• Is management supportive of the training/developmental needs of their clinical staff and of their supervisory staff?• What is the political milieu of the community in which you work? The County? The State? Are their opportunities or obstacles that come from these sources?
  • 23. Program Development & Quality Assurance • Program Development Methods • Long Range Planning • Goal of long range planning is to develop areas of program development. • Phase 1: Needs assessment. Brainstorming sessions that should include all levels of staff board members. • Phase 2: Organizing raw brainstorming data into aggregate areas of programmatic and administrative focus for the organization. For example at HDAP our Long Range Plan is culled into 7 areas: 1) Services Delivery; 2) Agency Operations: Personnel; 3) Agency Operations: Financial; 4) Marketing and Communications; 5) Alliances and Affiliations; 6) Governance; and 7) Funding Source. Development and Fundraising
  • 24. Program Development & Quality Assurance • Program Development Methods • Services Delivery • Services Delivery should identify assessed program needs and develop a long range plan to improve and monitor clinical services and overall program development. • Services Delivery should cover the agency’s for client engagement, enhancing access, and retention in treatment. Outcomes measures for these areas should be developed or, if developed, monitored by quality assurance committee/personnel. • Services Delivery should cover the agency’s clinical practice guidelines. Which type of clinical services are offered, are they science based/best practice services and methods of delivering services (e.g., utilizing motivational interviewing). • Clinical supervisor should understand concepts of clinical fidelity and adaptability when running prevention/clinical services (how closely should the programming be adhered to, how much flexibility do staff have within a program to adapt to the original designer’s intended design).
  • 25. Program Development & Quality Assurance • Quality Assurance • Long Range Plan, QA guidelines and areas: • Long Range Plan (and policies/procedures) should have the outline for the development (and implementation of) professional quality assurance guidelines. • Quality assurance policies should outline guidelines, forms, and instruments to monitor client outcomes, clinical performance, client satisfaction. • Samples of different QA policies could include, but not limited to: Admission policy, Assessment tools, Client Care, Co-occurring Client Needs, Discharge Planning, Medication, Urine Monitoring, Client Satisfaction, Mission and/or Vision Statement, Sanitation and Infection Control, Program Development, Staffing, Training, Treatment Philosophy, Treatment Planning, Security, Staff Credentialing, Client Termination, just to name a few. 
  • 26. Program Development & Quality Assurance • Quality Assurance • QA advocacy and affiliations: • Supervisors must advocate for the target client population, which could include advocating within the program and throughout the entire continuum of care. • Supervisors must maintain relationships with referral sources and other community programs in order to maintain, expand, enhance, and expedite services delivery. • HDAP Long Range Plan Affiliation Statement Plan: “To maintain current and develop new alliances and affiliations with other Hunterdon County organizations in order to enhance service delivery and to maintain HDAP as an integral part of substance abuse service delivery in Hunterdon County. Such affiliations will also to eliminate any potential redundancy in services offered, to maximize the effective use of public funds.”
  • 27. SUGGESTED STEPS IN ESTABLISHING AREFERRAL NETWORK1. Identify all potential service needs of the client population and categorize them. Be comprehensive.2. Identify reliable resources within the region. Possible sources of information include resource directories, referral lists from community service programs, local health units, colleagues, etc.3. Decide which agencies are appropriate to work with as referral resources.
  • 28. SUGGESTED STEPS IN ESTABLISHING AREFERRAL NETWORK4. Approach each agency: • Identify the appropriate person to contact.• Find out if a letter of introduction is appropriate.• Set up a meeting, if appropriate.• Learn the agencys policies and procedures, i.e., know their norms and forms. If an initial meeting is not appropriate, simply visit the agency and observe. - Select agencies which are sensitive to clients gender, race, sexual orientation, ethnicity, etc., and the financial needs of the client population. - Discuss the specific needs of the client which have to be met and the demographics of the client population.
  • 29. SUGGESTED STEPS INESTABLISHING A REFERRALNETWORK5. Each agency selected for the referral network should be listed with similar, standard information. - Name, address, hours of availability, phone numbers - What services are provided - Experience with special populations (e.g., developmentally disabled, PLWA, MICA) - Appointment needed; waiting list - Cost, e.g., sliding scale for self-pay, etc. - Insurance accepted - Staffing - MDs, RNs, counselors, etc.
  • 30. SUGGESTED STEPS INESTABLISHING A REFERRALNETWORK6. Upon follow-up, evaluate the agencys ability to help the client. Answer the following questions: - Did the agency meet the clients needs in a timely fashion? - What obstacles hindered the agency from assisting the client? - What were the results of your advocacy efforts? - Was the client satisfied with the service?7. If possible, develop a system for periodic visits, literature exchanges and on-going monitoring and evaluation of services. Also, insure that the referral list information and contact people are current. The referral list should be updated periodically.Adapted from DOH/AIDS Institute Pre-and Post-Test Counselor Manual.
  • 31. SUGGESTED STEPS INESTABLISHING A REFERRALNETWORK Developing Contacts - Every meeting, conference and training is a networking opportunity. - For every agency to which you routinely refer, you should identify and develop a personal relationship with one contact person. That is the person you call when a client is in need of that organizations’ services. - Take every opportunity to meet people in the field, and ask for their business card. Always carry your business cards on you. - After you meet someone and get their card, give them a call within a week to get some information about their agency.
  • 32. Networking at Work Networking at Work  Build outward, not inward. Dont waste time deepening connections with people you already know. Get in touch with people in other teams or business units.  Go for diversity, not size . Rather than aiming for a massive network, build an efficient one. This requires knowing people who are different from you, and from one another.  Go beyond familiar faces . Identify the "hubs" in your company—people whove worked on a variety of teams and projects—and ask them to connect you to others.
  • 33. Social Networking – Why Do It? Here are a few reasons that come to mind around why therapists might be socially networking.  Reconnect and stay connected to friends.  Get connected to other therapists to share resources.  Expand your network and resources for your clients.  Help develop a secondary business alongside your private practice.  Help build your private practice.
  • 34. Social Networking – Policy Decisions  Feel free to be on social network like Facebook or Twitter. But do not “friend” your clients and do not allow your clients to “friend” you.  Develop a social media policy. Share it with your patients and ensure they understand its highlights in session. Even if you don’t use or intend to use any of these tools, you should nonetheless have a social media policy that states as much.  Anything that is publicly available online is food for thought. If a client has a public blog or journal, the client should be aware that their therapist may be reading it.  Setting and maintaining clear boundaries is always the hallmark of a professional therapeutic relationship. Let such boundaries always guide your decision making with any new online tool or technology.  Share your decisions with your patients up-front.
  • 35. Social Networking – Large Group Exercise  What are your thoughts on social networking?  Are you on Facebook, if so what is your Facebook address … ah just kidding!  Are you on Twitter, why/why not?  Are you on Linkedin, why/why not?  Have you had any problems with social networking as it relates to your clients, if so how did you handle the problems?  My social networking: http://www.linkedin.com/in/glennduncan  http://www.twitter.com/hdapnj  http://www.facebook.com/hdapnj  1 personal/profesional, two business related.
  • 36. Advocacy Advocacy is the logical extension of quality treatment planning, linking, coordination and monitoring in that these four functions provide the case manager with the information to determine what barriers and gaps in services are encountered by the client when "choosing, accessing or using service providers." Two categories of advocacy are common in case management practice: client or case advocacy and class advocacy . - Client advocacy refers to those activities that are undertaken on behalf of a specific client. - Class advocacy refers to those activities that demand changes in "systems or service programs" to meet the needs of the larger consumer population.
  • 37. Advocacy TacticsAdversarial tactics may result in: A disruption of service to the client which would jeopardize the treatment plan. Loss of a beneficial working relationship between providers. Loss of any special considerations that may have been formally or informally negotiated in the past.
  • 38. Advocacy TacticsCollaborative tactics may result in: Collaborative working relationship between providers. Less stress and a more pleasant work atmosphere for case manager and clients. Services for clients which may be more integrated and smoothly functioning. Sharing of needed resources among providers. The ability to educate, persuade, bargain and negotiate in a non-confrontational manner is integral to quality advocacy.
  • 39. Implementing Clinical Supervision vs.Organizational Readiness• What are the goals of the organization? To what extent does staff understand and match these goals?• What is the organization’s formal and informal hierarchical structure? Who makes decisions? How are these decisions made? How open is the organization to ensure that all staff are respected and treated as valuable members of the clinical team?• What systems for continuing staff education and training are in place? How sound and effective is the staff performance appraisal system? What are staff’s opportunities for growth and professional development?• What are the organization’s current challenges (staffing, management, financial)?
  • 40. Implementing Clinical Supervision vs.Organizational Readiness• What are the staff’s current levels of proficiency (attitudes, skills, and knowledge)?• What resources (time, financial) are available to implement a clinical supervision system? What additional resources are needed?• What are the State licensure regulations regarding the minimal requirements for supervision and how do these regulations compare to what exists within the organization?• How aware is the organization of the need for clinical supervision? To what extent has management considered this need? Has a plan of action been designed as yet? What stage of implementation is the plan? What resources are available/needed to maintain the implementation plan?
  • 41. Clinical Practice Improvement Steps to ensure continuous improvement in clinical practice and supervision• Improvement Cycle. Have supervisors and clinical faculty teams take a look at what areas of clinical and supervisory practice needs to be improved. Areas deemed weak are areas where improvements can start. The areas identified will go through process guidance, process monitoring, and outcomes management.• Process Guidance. The development of clinical and supervisory practice guidelines in the areas deemed as clinical and/or supervisory weaknesses.• Process Monitoring. Developing structured process monitoring methods. These methods must be specific to the needs of the weaknesses and allow for feedback, so that when fed back, prompt adjustments to supervision and clinical practice can occur.• Outcomes Management. Standardized methods of performance benchmarks which are upheld by supervisors and administration consistently, for the most effective use of empirical data.
  • 42. SWOTT Analysis• Strengths• Weaknesses• Opportunities• Threats• Trends
  • 43. SWOTT Analysis Group Exercise1. How does Clinical Supervision look at your organization currently?2. How would you like to change this current status?3. Utilize a SWOTT Analysis on an organization of one of your group members. You will cover the strengths that exist currently, the weaknesses that exist, the opportunities exist, the threats to implementing change, and any general trends that exist in the milieu of our field.4. Using this SWOTT analysis, what sticks out as an outline to potential change within your organization?
  • 44. How to Maintain One’s Passion1. Stay focused on the client: remember that the client is the whole reason we are in this field, and the whole reason for all counseling and most supervisory activities.2. Find Balance and Variety in Life: by taking care of oneself, by having interests outside of work, we can maintain a perspective on our work so that it is not so consuming and setbacks are not so devastating.3. Provide for diversity and fun on the job: Everyone needs to take risks, seek out new challenges, take on different types of cases, learn through study, reading and training experiences. Maintaining fun on the job is also an important characteristic.
  • 45. 7 Suggestions for Maintaining Passion andStamina1. Selectivity: Selectivity refers to the practice of intentional choice and focus in daily activities and long-term endeavors. It means setting limits on what one can and cannot do and, in the process, being deliberate in ones tasks and purposeful in ones mission. Careful choices about what is and what is not possible or doable in client scheduling and treatment planning, therefore, assist in cultivating and maintaining counselor stamina.2. Temporal Sensitivity: This implies that time is not only something to be managed or manipulated well (e.g., working within deadlines, arriving to and ending counseling sessions "on time"), but also something that is viewed realistically and respectfully. This means viewing time as a precious commodity as well as a collaborator rather than as an adversary. Stamina is promoted and maintained when counselors are sensitive to the realistic or natural limits of time and seek to work cooperatively and respectfully within such limits.
  • 46. 7 Suggestions for Maintaining Passion andStamina3. Accountability: Accountability-and credibility-refers to respecting and working within professional guidelines, upholding ethical standards, and the ability to explain and defend ones actions based on practice consistent with theory and research findings. Without the use of such maps or compasses, the practitioner relinquishes his or her professional competence and jeopardizes client welfare.
  • 47. 7 Suggestions for Maintaining Stamina4. Measurement and Management: This ingredient of counselor stamina stipulates that the counselor makes conscientious, careful, and ongoing efforts to conserve and protect those resources he or she values. In addition to time, these resources might include: - objects (e.g., certificate, award, books) - conditions (e.g., rewarding work, quality intimate relationship, ethical boundaries) - personal characteristics (e.g., thoughtful, hopeful, assertive, leadership skills) - energies (e.g., income, specialized knowledge, stamina)• Stress can occur when these resources are threatened or lost, or when investments are made that do not reap the anticipated level of return.• One method for cultivating and preserving resources is to identify and consult with at least one trusted colleague on a regular basis, one who can serve as a confidant and supporter.• In addition to seeking on-the-job support, measuring and managing off-duty time and activities seems to be crucial for enhancing stamina. One Study reported that 64% of the mental health professionals who responded to a survey stated that focusing their attention on family and friends or hobbies rather than on the job was the primary coping strategy used to combat job stress and burnout.
  • 48. 7 Suggestions for Maintaining Stamina5. Inquisitiveness: A certain degree of inquisitiveness concerning the complexities of human configurations and a desire to participate in meaningful conversations with others are regarded, by some, as essential for helping professionals.• Cultivating and sustaining stamina, therefore, involves a disposition of wonder or curiosity about human behavior and the unique experiences of individuals.• A second dimension of Burnout, as defined by the Maslach Burnout Inventory (MBI) is depersonalization. This refers to "an unfeeling and impersonal response toward recipients of ones service, care, treatment, or instruction".• In addition to being curious about client experiences and the adventure of counseling, counselor stamina involves a curiosity about developments in the profession of counseling and the general psychotherapy field, and an intentional pursuit or study of such developments.
  • 49. 7 Suggestions for Maintaining Stamina6. Negotiation: One’s ability to be flexible, to engage in give and take, without "giving in."• In addition, clinical and other professional decisions and actions are purposeful (or well grounded); informed by standards of care, theory, and research; and not conducted haphazardly or arbitrarily.• Understood in another way, counselors need to be responsive to and cooperate with others, while simultaneously remaining steadfast to and upholding certain values, guidelines, or standards.
  • 50. 7 Suggestions for Maintaining Stamina7. Acknowledgment of Agency: In this context agency refers to something much different: an intangible, dynamic force; the "life blood" of a person; and the trait or condition whereby instrumentality (or ones purpose) is manifested.• In this sense, agency may be likened to intrinsic motivation, "the inherent tendency to seek out novelty and challenges, to extend and exercise ones capacities, to explore, and to learn”.• A counselors acknowledgment of agency, therefore, suggests that in the midst of challenging and often stressful work, the practitioner is able to look for, catch sight of, and make use of the undeniably persistent strength, resourcefulness, and will of the human spirit (within the practitioner and within his or her clients).• Acknowledgment of agency, therefore, honors, affirms, and cultivates the common and ordinary adaptive resources within clients and uses practitioner self-efficacy.
  • 51. 7 Suggestions for Maintaining Stamina The MBI Surveys address three general scales:• The MBI-Human Services Survey measures burnout as it manifests itself in staff members in human services institutions and health care occupations such as nursing, social work, psychology, and ministry.1. Emotional exhaustion measures feelings of being emotionally overextended and exhausted by ones work.2. Depersonalization measures an unfeeling and impersonal response toward recipients of ones service, care treatment, or instruction.3. Personal accomplishment measures feelings of competence and successful achievement in ones work. If you (the supervisor) feel burnout in any of these areas, you should immediately seek supervision and/or consultation in order to evaluate one’s personal needs for training/education, receive and discuss feedback on supervisory job performance, and implement your own professional development plan.
  • 52. Turning Stress into an Asset Recognize worry for what it is . Stress is a feeling, not a sign of dysfunction. When you start to worry, realize its an indication that you care about something, not a cause for panic. Focus on what you can control . Too many people feel bad about things they simply cant change. Remember what you can affect and what you cant. Create a supportive network . Knowing you have somebody to turn to can help a lot. Build relationships so that you have people to rely on in times of stress.
  • 53. Exercise – Maintaining One’s Passion• What steps do you take to “take care of yourself”, what are some of your other interests outside of the job?• What are some of the things you do to prevent burnout?• How do you contribute to providing a fun atmosphere on the job? If you don’t, why not?
  • 54. Learning Objectives for Supervisors1. Advanced knowledge in mental health, alcoholism/drug abuse, demonstrated by completion of advanced training or academic study in a graduate degree program in the behavioral sciences.2. Familiarity with a variety of treatment approaches used in the mental health, alcoholism/drug abuse field.3. Operational experience with a variety of treatment approaches used in the mental health and alcoholism/drug abuse field.4. Operational knowledge of emerging technologies as they impact and can be used in the therapeutic and supervisory relationship.5. Familiarity with models of clinical supervision and ability to compare these models.
  • 55. Learning Objectives for Supervisors5. Ability to articulate one’s own model of clinical supervision and to relate it to one’s model of counseling.6. Knowledge and skills in clinical supervision, demonstrated by a statement of philosophy of clinical supervision, attendance at training in supervision, and familiarity with a variety of models of supervision. Skills to be demonstrated include familiarity with various methods of oversight and intervention (such as phone-ins, audio or videotaping, bug-in-the-ear, or one-way mirror).7. Affective qualities necessary to establish an educational, consultative, supportive, and therapeutic relationship with a supervisee.8. Ability to deal with a supervisee’s psychological and emotional issues, especially with respect to recovery and personal growth processes, as they relate to the supervisee’s work.
  • 56. Learning Objectives for Supervisors8. Advanced skills in the evaluation of supervisee’s skills and in the ability to communicate that evaluation to supervisees. Providing criticism in a constructive, educational, and therapeutic manner is an essential skill in supervision.9. Understand and use of pharmacological interventions and interactions for both mental health and substance related disorders. Understanding which pharmacological interventions could have a negative synergistic impact with clients who have co-occurring problems (e.g., the use of addictive benzodiazepines by a client with co-occurring anxiety and substance use issues)10. Understand the limitations and appropriateness of assessment and evaluation tools utilized in the mental health and addiction fields.
  • 57. Leadership vs. Management vs. Supervision• To establish trust with co-workers and subordinates• To serve as the team leader.• To define and set departmental and organizational goals and communicate these goals companywide.• To inspire staff by encouragement and motivation.• To communicate enthusiasm and capability.• To keep up staff morale, including one’s own.• To take appropriate risks and to be decisive in action.• To possess the ability to change in response to the needs of the organization and marketplace.• To have vision, drive, clear judgment, initiative, poise, and maturity of character.• To command enthusiasm, loyalty, sincerity, courtesy, and confidence.• To exercise control through inspiration rather than command.
  • 58. Leadership vs. Management vs. Supervision• To get work done through staff.• To make effective use of departmental resources.• To get results in achieving stated goals and objectives.• To control through command.• To identify, analyze, and solve problems.• To adapt to change and the growing needs of the organization.• To organize work as needed to get the job done.• To intervene to bring about positive results.• To see all aspects of operations.
  • 59. Leadership vs. Management vs. Supervision• To know the responsibilities of staff.• To communicate clearly these responsibilities to staff.• To utilize effectively the performance appraisal system to get maximum productivity of staff.• To write clear job descriptions for all staff.• To manage time effectively for oneself and staff.• To delegate responsibilities of all staff.• To promote employees’ professional development. “The superior leader gets things done with very little motion. He imparts instruction not through many words but through a few deeds. He keeps informed about everything, but interferes hardly at all. He is a catalyst, and although things would not get done as well if he were not there, when they succeed he takes no credit. Because he takes no credit, credit never leaves him.” – Lao-tsu, 6th Century B.C.
  • 60. Leadership vs. Management vs. Supervision• Grade your Leadership Style, Management Style, Supervision Style by giving each point on the previous 3 slides a numeric grade for each bullet point on that slide.• A=5 B=4 C=3 D=2 F=1• Add these numbers up and divide by the number of bullet points on each slide.• Leadership Slide (1st Slide of 3) = 11 Bullet Points• Management Slide (2nd Slide of 3) = 9 Bullet Points• Supervision Slide (3rd Slide of 3) = 7 Bullet Points• You do not have to share this grade with anybody else.• Write down one point from each slide that you need to improve on (if more than one, choose the one you need to improve the most). Be prepared to discuss why you chose this point, and what steps you can take to start improving on this skill.
  • 61. Parallel Process• Parallel process, a concept borne out of the psychoanalytic movement, becomes evident in that the transference-countertransference interaction that takes place in the therapy session, reoccurs in the transference-countertransference interaction between the supervisor and supervisee.• For example, a supervisee comes into supervision feeling powerless to help the client enact any change. After discussion of the client the supervisor finds out that the client recently has told the counselor that he is more depressed, and has hopeless that his situation will ever change.• Parallel process is seen as a two way concept, in other words, the process could start in the supervision dyad and transfer to the therapy dyad by means of the therapist acting out situations in supervision in the therapeutic process.
  • 62. Parallel Process ExerciseYou are the clinical director in the agency described in the consultationexercise. You and your executive director have decided to hire backthis employee (Frank, the one who felt discriminated against and whofelt abused by the former clinical supervisor). This worker has taken ona coordinator position within the company and now has a supervisorycapacity within the program in which he works.After 8 months on the job, a staff member approaches you stating thatshe has concerns about Frank. This staff member also had problemswith the previous clinical director and felt abused by this previousclinical director, the same way Frank did. Given this employee’s hyper-sensitivity to abusive supervisory relationships, she feels compelled totell you about Frank’s supervisee who has come to her with allegationsof abuse by Frank.
  • 63. Parallel Process ExerciseThe staff person stated that this supervisee (whom that staff personhas befriended and sees outside of work) has come to her and toldher that Frank is an abusive supervisor. This staff person has graveconcerns about Frank and wants the situation resolved, especially ifFrank is to supervise other people in the future.You finally speak to the supervisee Ellen (as she has hesitated tocome to you even though you have given her an open door policy).She comes to you alleging abuses of power (stating that shesometimes feels like an intern or a client, and Frank often commentsthat he has the ability to control the destiny of her future employment),and abuses of trust (Frank will change rules set up between them, willdismiss her point of view). Ellen stated that on a scale of 1 to 10, shefeels the abuse is a 9. She stated supervision is traumatic, and Ellenis feeling anxiety and depression in supervision with Frank.
  • 64. Parallel Process Exercise Besides your initial reaction of wanting to shoot yourself for making the decision to hire Frank back in the first place, you start to see the parallel process happening in this situation, occurring on 2 different levels. The first level is Frank, sensitive to being in an abusive supervisory relationship has apparently helped to recreate a perceived supervisory relationship. The second is the organizational process of repeating the trauma that has occurred in the past. Fighting your desire throw up your hands to say “ah just forget it” and start perusing the Sunday Star Ledger, you need to take action on this situation.
  • 65. Parallel Process Exercise Questions1. What actions need to be taken with Ellen and Frank?2. Are there any other actions that need to be taken with other staff members, or within the organization as a whole? If so what would you do at this point?3. How can you avoid repeating the process that played itself out previously in this organization?
  • 66. Bibliography• Bernard, J. M. & Goodyear, R. K. (2009). Fundamentals of Clinical Supervision, 3 rd Ed. Allyn and Bacon, Boston, MA.• Brooks, L. (2011). Therapists, why are you social networking? Pychcentral.com http://psychcentral.com/blog/archives/2010/05/15/therapists-why-are-you-using-social-networking Accessed 09/16/11.• Cape, J. & Barkham, M. (2002). Practice improvement methods: Conceptual base, evidence- based research, and practice-based recommendations. British Journal of Clinical Psychology, 41, pp. 285-307.• Center for Substance Abuse Treatment. (2009 ). Clinical Supervision of the Substance Abuse Counselor. Treatment Improvement Protocol (TIP) Series 52. (HHS Publication No. SMA 09- 4435). Rockville, MD: Substance Abuse and Mental Health Services Administration.• Falender, C. A. & Shafranske, E. P. (2004). Clinical Supervision: A Competency-Based Approach. American Psychological Association, Washington, DC.• Grohol, J.M. (2011). Google and Facebook, Therapists and Clients, Pychcentral.com http://psychcentral.com/blog/archives/2010/03/31/google-and-facebook-therapists-and-clients Accessed 09/16/11.
  • 67. Bibliography• Hepworth, D., Rooney, R. H., & Larsen, J. A. (1996). Direct Social Work Practice: Theory And Skills (5th ed.). Belmont, CA: Wadsworth Publishing.• Maslach, C. & Jackson, S. (1986). Maslach Burnout Inventory. California, Consulting Psychologists Press.• Osborn, C. J. (2004). Seven salutary suggestions for counselor stamina. Journal of Counseling and Development, 82(3), pp. 319-328.• Powell, D. J. (2008) Implementing a Clinical Supervision System, Counselor Magazine. http://www.counselormagazine.com/columns-mainmenu-55/44-clinical-supervision/791-imp• Powell, D. J. & Brodsky, A. (2004). Clinical Supervision in Alcohol and Drug Abuse Counseling. Jossey-Bass Publishers, San Francisco, CA.