Chapter two developmental and process models with narration


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A lecture about models of clinical supervision in mental health

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Chapter two developmental and process models with narration

  1. 1. Chapter Two • Supervision Models – Theory Driven • Humanistic-Relationship Oriented – Developmental • Integrated Developmental Model – Process • Discrimination Model
  2. 2. Developmental Approaches to Supervision • Counselor skill levels change over time • Change may be conceptualized in a number of ways – Psychosocial development – Cognitive and Social learning theory • Developmental Models help the supervisor to identify the needs of the supervisee – And how to best address them • Developmental Models = “Case Conceptualization” of the Supervisee
  3. 3. Integrated Developmental Model • Three Structures that provide markers in assessing professional growth – Self/Other Awareness – Cognitive and Affective • Is the Supervisee capable of “theory of mind” experiences – Motivation – The Supervisee’s interest, investment, and effort expended in clinical training and practice – Autonomy – The degree of Supervisee independence
  4. 4. IDM: Four Stages of Development • Level 1: Limited training and/or experience in the field – Motivation: Strong, very anxious, focused on skill acquisition – Autonomy: Dependent; needs structure, positive feedback, little confrontation – Awareness: High self-focus; limited self awareness; anxious about evaluation
  5. 5. IDM: Four Stages of Development • Level 2: Transitional; still student-intern level – Motivation: Fluctuations in confidence – Autonomy: Fluctuations; “adolescent” stage; may show resistance to supervision – Awareness: Greater empathic skills; May struggle with balance – Note: Can be a turbulent stage; similar to “middle stage of psychotherapy;” helps to have a sense of humor
  6. 6. IDM: Four Stages of Development • Level 3: Personalizing Approach to Therapy; new professional – Motivation: Consistent; some doubts, not immobilizing – Autonomy: Solid belief in competence; supervision is collegial – Awareness: Health self awareness; able to attend to self and client needs simultaneously
  7. 7. IDM: Four Stages of Development • Level 3i: Integrated: Level 3 Characteristics Across most domains • Domains: Intervention skills Assessment Techniques Interpersonal Assessment Client Conceptualization Individual Differences Theoretical Orientation Treatment Plans/Goals Professional Ethics
  8. 8. IDM: Facilitative Interventions • Cathartic: Elicit Affective Reactions • Catalytic: Open ended questions to elicit self exploration or problem solving • Supportive: Validations of the Supervisee
  9. 9. IDM: Authoritative Interventions • Prescriptive: Advice and Suggestions • Informative: Providing Information • Confronting: Pointing out discrepancies in Affect, Behavior, and/or Attitudes
  10. 10. IDM: Supervisee Schemata • Knowing In Action: – The Supervisee’s Automatic Responses, Behaviors, Attitudes • Reflection In Action: – The Supervisee’s capacity to be aware of what is occurring in the session • Reflection On Action: – The Supervision process supplements the RIA, which may or may not have occurred
  11. 11. Supervision Process Models • Simple or Complex Ways of understanding how supervision occurs – Psychotherapy based models are concerned with passing on a particular approach to psychotherapy – Developmental models are concerned with the learning process of the supervisee
  12. 12. Discrimination Model • Foci of Supervision X Role of the Supervisor – Foci = Particular Skills of the Supervisee • Intervention Skills • Conceptualization Skills • Personalization Skills – Roles = Appropriate Posture to Accomplish Supervision Goals • Teacher • Counselor • Consultant
  13. 13. Focus and Role Interactions Focus of Supervision Teacher Counselor Consultant Intervention Skills Supervisor models skills through role play with Supervisee Supervisor may use empathic responses to elicit Supervisee feelings Supervisor provides resources (e.g. Mood Charts) for Supervisee to use Conceptualization Skills Supervisor reviews transcripts with Supervisee, identifying client Signs, Symptoms, and Issues Supervisor notes Supervisee Cognitive Distortions and Processes their Impact on Therapy Supervisor provides resources concerning theories not well know to Supervisee
  14. 14. Focus and Role Interactions Focus of Supervision Teacher Counselor Consultant Personalization Issues Supervisor, in reviewing recording, points out exchanges that indicate incongruencies Supervisor empathically explores Supervisee’s feelings in this area Supervisor provides feedback concerning how well (or poorly) Supervisee handled the relationship from an ethical perspective
  15. 15. Focus and Role Interactions • Supervisors tend to use Teaching role with Novice Supervisees – Evolve toward Consulting role as Supervisee becomes experienced • Supervisors tend to focus on intervention and conceptualization skills with Novice Supervisees – Evolve toward Personalization issues as Supervisee becomes experienced
  16. 16. Framework for Supervisory Styles • Supervisors Goals tend to be: – High on Support; Low on Direction • Supervisees Want Supervisors to be: – High on Support AND Direction HIGH SUPPORT LOW SUPPORT HIGH DIRECTION Supportive Teacher Directive or Expert Teacher LOW DIRECTION Counselor Consultant
  17. 17. A Final Thought… • Common Factors Model – There are factors in supervision that are common to those in counseling, teaching, and ALL relationships – Lampropoulos (2003) proposed: The Relationship Support/Relief from Tension etc. Instillation of Hope Self-Exploration, awareness Rationale/Ritual Exposure & Confrontation Acquisition & Testing of New Learning Mastery of New Knowledge
  18. 18. One More Final Thought… • Supervision, like Therapy is a Conversation • “Conversation” implies Conversion – Conversion of Mind – Conversion of Affect – Conversion of Behavior – Conversion of Heart – Conversion of Soul