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Supervision 2017 -10 Creative Methods of Observation in Clinical Supervision


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Supervision 2017 -10 Creative Methods of Observation in Clinical Supervision

  1. 1. 10 Creative Methods of Supervision Instructor: Dr. Dawn-Elise Snipes, PhD Executive Director:, Counselor Education and Training Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
  2. 2. Objectives  Describe 10 methods of observation  Explore the benefits and ways to use group supervision to enhance learning CEUs available at All
  3. 3. Drawbacks to Indirect Methods  A counselor will recall a session as he or she experienced it. If a counselor experiences a session positively or negatively, the report to the supervisor will reflect that.  The report is affected by the counselor’s level of skill and experience.  The counselor’s report is affected by his or her biases and distortions (both conscious and unconscious).  The report does not provide a thorough sense of what really happened in the session because it relies too heavily on the counselor’s recall.  The supervisee may withhold clinical information due to evaluation anxiety or naiveté.  There is a time delay CEUs available at All
  4. 4. Guidelines that apply to all methods of direct observation  Simply by observing a counseling session, the dynamics will change, but if you observe the counselor frequently, you will get a fairly accurate picture of the counselor’s competencies.  You and your supervisee must agree on procedures for observation to determine why, when, and how direct methods of observation will be used.  The counselor should provide a context for the session.  The client should give written consent for observation and/or taping at intake, before beginning counseling.  Clients need to be notified of an upcoming observation by a supervisor before the observation occurs.  Observations should be selected for review (including a variety of sessions and clients, challenges, and successes) because they provide teaching moments CEUs available at All
  5. 5. Guidelines that apply to all methods of direct observation  When observing a session, you gain a wealth of information about the counselor. “What is the most important issue here for us to address in supervision?”  A supervisee might claim client resistance to direct observation, however, “client resistance” is more likely counselor anxiety.  The supervisee should know at the outset of employment that observation and/or taping will be required as part of informed consent to supervision. CEUs available at All
  6. 6. Methods of Observation Include  Videotapes (3 ways)  Audiotapes  Co-facilitation  Live observation (present)  Live observation via closed-circuit video  One-way mirror supervision  Role playing  Hypotheticals  Process recording  Case Presentations CEUs available at All
  7. 7. Working with Video and Audio Tapes  Clear goals must be set to determine why, when, and how videotaped sessions will be conducted  Interactive processes recorded on tape should be related to the actual counseling session, its goals, and the memories of the session and the rationale for the intervention should be explored  Tape segments should be selected for review because they provide teaching moments not pretexts for scoring critical points CEUs available at All
  8. 8. Videos cont…  The supervisor should provide gradual feedback, not a litany of judgments, and allow time between segments discuss and assimilate feedback  It is vital to have signed releases from patients prior to taping  Risk-management considerations in today’s litigious climate necessitate that tapes be erased after the supervision session. Tapes can be admissible as evidence in court as part of the clinical record. Since all tapes should be erased after supervision, this must be stated in agency policies. CEUs available at All
  9. 9. Creative ways to use video and audio tapes  Videos  Running the video in fast-forward to convey a heightened image of the counselors and clients body movements  Turn down the audio to try to fill in what is being said on the basis of nonverbals  Cover the counselor and observe the client to guess what the counselor is doing and vice versa.  Focus on the counselor’s nonverbals  Audio and Video  While reviewing the tape prior to supervision, the supervisor might do voiceover dubbing questions for the supervisee onto the tape  Review the tape and stop after a client statement. Ask the counselor to respond. (can be useful in group supervision too) CEUs available at All
  10. 10. Co-facilitation and Live Observation Considerations  It is time-consuming  It is obtrusive and alters the dynamics of counseling  It can be anxiety provoking for both counselor and client  If the session is not also videotaped, there is no record of the session to review later CEUs available at All
  11. 11. Guidelines for cofacilitation & live in-person observation  The supervisor should begin the session with a pledge of confidentiality  Prior to the session the supervisor and supervisee should briefly discuss the background of the session, salient issues and plans for the session  The supervisor should take notes during the session as a means of recalling key issues to be discussed later CEUs available at All
  12. 12. Cont…  The supervisors interventions during the session should be limited to no more than three or four comments  Feedback should be given to the counselors as soon as possible after the session  If a group session is led by two counselors to supervisor should meet with the to supervisees jointly  Cofacilitation should be used in conjunction with videotaping whenever possible CEUs available at All
  13. 13. Other Methods  Live observation via closed-circuit video and one-way mirror supervision  Time consuming, but less obtrusive  Opportunity to intervene  Hypotheticals (Dr. Phil, Intervention…)  Requires additional time  No ability to follow up CEUs available at All
  14. 14. Case Presentations Are useful in groups and individual supervision Should be built around problems and solution- oriented questions to be answered Should move from client information to dynamics, prognosis, and treatment plan Allow the supervisor to Observe the counselor's actions Determine their impact on the client Assess the counselor's clinical reasoning process Help the counselor improve treatment delivery CEUs available at All
  15. 15. Case Presentation Problems  Too many presentations into short of a time  Focusing on a specific problem instead of giving a case overview  Material is not contextualized  Supervisee dynamics interfere with free and open discussion of the case  There are expectations for interventions beyond the capabilities of the counselor CEUs available at All
  16. 16. Role Playing  An alternative to observing the clinician and an actual counseling session  Ideal for practicing skills  An opportunity to learn-by-doing in a safe environment and receive helpful feedback CEUs available at All
  17. 17. Other Methods  Process recording  Written account of everything that was said and done in session  Only from supervisee point of view  Intentional and unintentional errors and omissions  Can be used with video to compare salient points CEUs available at All
  18. 18. Group Supervision Benefits  It provides a cost-effective way of supervising more people in the same time  It offers each counselor a reality testing of her perceptions through peer validation  Learning is enhanced by diversity of people in the group  Groups create a working alliance among counselors that engenders a sense of psychological safety  Groups provide the opportunity for multiple people to review and “see” things on the tapes CEUs available at All
  19. 19. Cont…  The group process facilitates learning by setting up a microcosm of the larger social environment  Group disclosure enhances the potential for self-disclosure, confrontation, and opportunities for growth  Empathy and sharing of interests are available to a greater extent than in individual supervision  When the group works together over time personal growth on the part of the individual members can be reinforced possibly by the group  Alternative clinical approaches and methods are available to a far greater extent than a single supervisor can offer  The potential for constructive feedback is greatly expanded CEUs available at All
  20. 20. Processes in Group Supervision  Cohesiveness  A sense of we-ness  A shared frame of reference  Tolerance of diverse opinions  Movement toward common goals  Like any group leader, the task of the supervisor is to help the group identify its norms, and to model appropriate qualities, behaviors, and skills CEUs available at All
  21. 21. Summary  Methods for Observation 1. Videotapes 2. Audiotapes 3. Co-facilitation 4. Live observation (present) 5. Live observation via closed-circuit video 6. One-way mirror supervision 7. Role playing 8. Hypotheticals 9. Process recording 10. Case Presentations CEUs available at All