Models and Techniques of Clinical Supervision

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Models and Techniques of
Clinical Supervision
Glenn Duncan LPC, LCADC, CCS, ACS

Definition of Clinical Supervision
“An intervention provided by a more senior member of a
profession to a more junior member or members of that
same profession. This relationship is evaluative, extends
over time, and has the simultaneous purposes of enhancing
the professional functioning of the more junior person(s),
monitoring the quality of professional services offered to the
client(s) she, he or they see(s), and serving as a gatekeeper
of those who are to enter the particular profession” (Bernard
& Goodyear, 1998; p. 6).

Components of Clinical Supervision Def.
Relationship: Supervision is primarily, and most importantly, a relational
situation between a senior and more junior member of a given profession
(Watkins, 1997).
• All of the supervisory approaches listed in this article recognize the
importance of the supervisory relationship.
• Without the relationship, all the tasks, skills, and other tools of
supervision will either be less effective or not effective at all.
• It is the belief of this writer that the relationship is so important, that key
aspects of the supervisory relationship need to be looked and studied.

Components of Clinical Supervision
Def.
Evaluation: A core function of supervision is evaluation of supervisees.
• This evaluation takes the form of telling supervisees what their strengths
and weaknesses are, what areas need to be developed, enhanced or
improved, and monitoring supervisee client care (Watkins, 1997).

Def.
Evaluation: Tasks involved in comprehensive supervisee evaluation:
1. Assess supervisee’s performance of tasks and/or clinical functioning by interviews,
observations, review of case records, use of periodic evaluation tools, and client feedback.
2. Assess supervisee’s preferred learning style, motivation and suitability for the work setting.
3. Institute an ongoing formalized, proactive process that identifies supervisees’ training
needs.
4. Actively involve supervisees in reviewing goals and objectives, and reinforce performance
improvement in specific areas.
5. Assess supervisees’ professional development level, cultural competence, and proficiency
in the addiction counseling field.
6. Communicate agency expectations about the job duties and competencies, performance
indicators, and criteria used to evaluate job performance.
7. Communicate that supervision is a two-way feedback mechanism with each party providing
feedback to one another, including constructive sharing and the resolution of
disagreements/disputes.
8. Communicate feedback clearly, timely, monitoring and updating supervisee on performance
improvement of deficiencies.

Def.
Extends Over Time: This is one of the key distinctions between
supervision and consultation.
• Consultation is usually a time limited event, and often times is not
evaluative in nature.
• Supervision is more of a process where the supervisee has the time to
professionally learn and grow.
• This time can last from months to years, depending on the level of the
supervisee, organizational influences and the like (Watkins, 1997).

Def.
Enhancing Professional Functioning: A primary function of
supervision is to help the supervisee become more proficient
regarding becoming an LPC, and utilizing evidence based
treatment models.
• Conceptualizations as to what is important for the clinician to
master in order to strive towards becoming an expert therapist
vary depending on the theorist.

Def.
Serving as Gatekeeper: This is a function that is consistent with the
monitoring function of supervision.
• If supervisee performance continues to jeopardize client care, the
supervisor acts as the agent of change for that supervisee (whether that
be additional training and education, recommendation of personal
counseling, progressive disciplinary actions, or even in extreme cases
termination from employment or field placement).
• Whatever the decision, it is the supervisor who is responsible for making
that judgment and serving as the gatekeeper (Watkins, 1997).

Def.
Monitoring Quality of Professional Service: Supervisors are ultimately
responsible for the treatment client’s receive. A supervisor’s first
responsibility is for the welfare of the client, then the supervisee, finally
the organizational structure of the facility in which they work.
1. At what point does a supervisor wait for “acceptable” performance from a
supervisee?
2. At what price to the client?
• A supervisor should intervene immediately and take action as necessary
when a supervisee’s job performance appears to present problems
and/or put the client at risk.
• Without proper and vigilant monitoring of supervisee performance, client
care can be compromised or even jeopardized (Knapp & VandeCreek;
as cited in Watkins, 1997).

Def.
Monitoring Quality of Professional Service (job performance issues):
• Supervisors will actively participate in the following administrative
functions to maintain high standards of clinical care:
1. Hiring (which includes background, criminal, licensure/certification
verification, references, etc.)
2. Termination (ensuring due process has occurred and the correct
policy and procedures have been followed in this the termination
process.
3. Performance recognition (catching people doing something right).
4. Progressive disciplinary action (according to the policies and
procedures of your organizations and the standards of care).
5. Other personnel decisions

Def.
Monitoring Quality of Professional Service (pharmacological treatment):
• Supervisors need to ensure supervisees are trained and knowledgeable in the
latest pharmacological interventions for mental health disorders.
• Supervisors need to ensure supervisees are trained and knowledgeable in the
latest pharmacological interventions for substance use disorders (such as
methodone, naltrexone, suboxone, and vivitrol among others).
• Supervisors should be aware of their own biases (if any) surrounding these
interventions and ensure that if a bias exists, it is not passed on to supervisees.

Style, Theory and Technique
Pretest
1. How would you describe your style of supervision?
2. How do you approach supervision with a new supervisee?
3. What methods do you use to oversee your supervisee? Do these
methods differ depending on the supervisee, if so how?

Style in Supervision
• Style is the patterns we use in attempting to communicate with
others.
• Style consists of the recurring and consistent focus supervisors
emphasize in supervision, the manner in which they state their
theoretical orientation, the philosophy and practice of
supervision they hold, and how they convey this to their
supervisees.
• Common elements of style include voice volume, voice tone,
facial expressions, posture, use of arms and hands, examples
given, organization and structure of sessions, physical setting of
sessions, theories used, points chosen to intervene in
discussion, how suggestions are made, and what suggestions
are offered.

Observing One’s Style
• The best way to observe a supervisor’s style of supervision is
through viewing audiovisual recordings of supervisory sessions.
• Supervisors should be exposed to the work of other supervisors
in order to develop their styles.
• The supervisor needs to develop an orientation or frame of
reference to supervision that incorporates his/her style. This
relates to the focus of the supervisory relationship (i.e., the
focus should be that the primary responsibility is to the client).
Practitioners who are having difficulty with their job may attempt
to deal with this by attributing the difficulties to problems they
are having with the supervisor. It is the supervisor’s
responsibility to keep the focus on the client under discussion.

Main Styles
• Active Style of Supervision – the active style consists of being direct with
the supervisee and asking specific questions, answering questions
directly, and offering interpretations. Active supervision is problem
focused, based on exploring alternative interventions, focused on client
dynamics, and speculative about outcomes.
• Reactive Style of Supervision – This is a more subdued and indirect
style. It involves asking limited general questions and not giving
answers. Reactive supervision focus on the process of treatment,
explores issues about interaction, and tends to focus on the practitioner
dynamics, providing a forum for practitioners to struggle with their own
solutions.

SubStyles
• Philosopher – This is when a supervisor takes the everyday material from
a supervisee and become philosophically abstract with their feedback.
For example, a frustrated supervisee on a case will get the response “It
takes 10 years before a therapist begins to know what he’s doing”. While
making a philosophical point, supervisee’s can become easily frustrated
with the lack of clear direction from the supervisee.
• Theoretician – These supervisors believe the mastery of theory leads to
good practice. Case material will be used as a means to understanding
theory.

SubStyles
• Technician – Technician style is dealing with the details of case
problems and relates them to technical skills. The emphasis
here is on what should be done, and this style is more problem
focused and interactionally oriented.
Technical Strategy takes 3 forms
- Planning – planning strategies and techniques that can be
used in cases.
- Explanation – telling the practitioner what to say to the
client.
- Description – after the fact exploration of the material.
Here the supervisor’s task is to explore
interventions and get the supervisee to
differentiate the intent of a given
intervention and the actual effect that
occurred.

Client and Supervisee Improvement as a
result of Supervisory Milieu
Client improvement, as a measure of the supervisory experience, is related to
what and to what percentage?
1. The Quality of the Therapeutic Alliance/Working Alliance. (30% of the change).
2. Extratherapeutic Factors. (40% of the change). These include the counselor’s
strengths and capacity for growth, the support systems and the setting the
supervisory relationship takes place. The stage of readiness for change of the
supervisee. Supervisor factors such as a motivating style. Learning styles, work
environment and many other factors.
3. Hope and Expectancy. (15% of the change). Issues of optimism, self-efficacy
and expectancy. Supervisor factors are important here by providing support,
partnership, empathic communication, empowerment and an environment where
the supervisee feels cared for and supported. Supervision is forward focused, not
past obsessed.
4. Models and Techniques of the Supervisor. (15% of the change).

The Integrated Developmental Model
(Stoltenberg & Delworth, 1998)
Stoltenberg & Delworth identified eight growth area domains for
supervisees:
1. Intervention skills competence
2. Assessment techniques
3. Interpersonal assessment
4. Client conceptualization
5. Individual differences
6. Theoretical orientation
7. Treatment plans and goals
8. Professional ethics

The Integrated Developmental Model
(Stoltenberg & Delworth, 1998)
This model depicts the developmental levels of both clinicians and
supervisors according to 3 basic structures:
• Autonomy – the ability to make independent decisions, the degree of
supervision required, and self-confidence.
• Self and Other Awareness – fears, anxieties, and uncertainties, and how
certain behaviors affect the client and others.
• Motivation – process of counseling, desire to help others, and learning of
strengths and weaknesses.

Level 1 Clinician Characteristics
• It is believed that Level 1 clinicians take in paradigms of therapy and
match them against their own personal experiences. Thus the paradigm
that best fits their own personal experiences is the one normally used.
They tend to overuse one model.
• Thus level one clinicians develop simplistic understanding of complex
structures, and may generalize behaviors and develop “types” of clients,
not allowing for individual differences.
• Level 1 clinicians are primarily focused on themselves. This focus on self
includes their own anxiety about being a clinician, their lack of skills and
knowledge, and the likelihood that they are being regularly evaluated.

• These preoccupations can have a negative impact on therapy in that less
energy is available to focus on the task at hand with the client.
• Cognitively, Level 1 supervisees are concerned with learning new
information, performing the newly acquired skills, and understanding the
process of therapy in a suitable manner.
• This leaves little room for the clinician to be focused on the client and
understanding the client’s perspective.
• Has cookbook answers, limited treatment plans, lacks integrated ethics,
lacks self awareness, emulates role model, anxiety is motivator.

Level 1 Clinician Supervision
Issues
• Be sensitive to supervisee anxiety.
• Promote autonomy.
• Encourage risk-taking.
• Expose supervisees to different models.
• Help supervisees to conceptualize.
• Use role play, application, and presentations.
• Address strengths as well as areas of needed growth (but strengths
first).
• Be aware of trainees learning styles:
1. Internal (they can make things happen) vs. External (other
forces in control of events).
2. Active (learn by doing, give them independent
assignments) vs. Vicarious (benefit from directive skill building
and modeling).
3. Oral (learning best through discussion) vs. Written (learning best
through written information).

Issues
• View clinicians with mirror work, videotapes, co-facilitating.
• Relying on self-reports or even process recordings (techniques
which will be discussed in more detail later), would not be
sufficient because Level 1 clinicians cannot always perceive
accurately what they are doing in a session with a client.
• Expose supervisee to numerous orientations and models (skills
training).
• Training different skills can help the therapist gain confidence
and move the therapeutic environment forward.

The Transition from Level 1 to 2
• Resolution of Level 1 issues allows the supervisee to move into Level 2. This
transition can be facilitated, or hindered, by the supervision environment.
• This developmental sequence occurs within domains, so we may expect to find
differential growth across domains. (For example, substance use clinical work,
these domains would consist of the 12 core functions (domains) and there are
core competencies within each domain that must be mastered).
• This differentiation may be a function of more of a focus on some domains
rather than others during prior supervision, resulting in greater growth in these
domains than others (e.g., hiring a staff member who worked in a TC setting
who may have much more experience with group techniques, and encounter
and confrontation techniques, and less experience with assessments, individual
treatment and less confrontational techniques such as motivational
interviewing).
• The supervisee's personal characteristics may be better suited to particular
domains of practice, and there may be more rapid growth in those domains.

• Level 2’s are envisioned as making a transition across various domains, from a
primarily self-focus to a client centered, from dependence on the supervisor to a
sense of independent functioning, and from high levels of motivation to fluctuating
levels of motivation.
• This can be a tough time for both supervisor and supervisee, marked by periods of
disruption, resistance, ambivalence, and instability.
• These factors can lead to deeper chasms between supervisee and supervisor, or
could result in a deeper understanding of clinicians’ skills and personal
characteristics.
• Motivation fluctuations are another hallmark of this stage of development. The
confidence that accompanies perceptions of self-efficacy in clinical practice can be
shaken by the increased knowledge of the complexity of the recovery process.
• This could become evident with differences in clinician performance depending on
which client, not completing tasks requested by the supervisor, or questioning their
career choice.

• This could become evident with differences in clinician performance
depending on which client, not completing tasks requested by the supervisor,
or questioning their career choice.
• The transition issues for this level of trainee revolve around the goal of
personalizing an orientation to professional practice. A self-understanding that
can develop from learning how one's personal characteristics interact with
clinical practice issues forms the basis for the work of Level 3.
• As the Level 2 therapist transitions to Level 3, a more consistent conditional
autonomy will appear. This supervisee is better able to understand the
parameters of his or her competence, and the dependency-autonomy conflict
will fade.
• They are better at conceptualizations, better at theory, focus more on the
client, better formed ethics, better cultural awareness, greater awareness and
confusion.

Issues
• The task of the supervisor with Level 2 clinicians is to provide a
balance between supporting and mentoring the supervisee, and
fostering independence and self-assurance within the clinician.
• Structured interventions, such as those listed for Level 1
clinicians, can be less frequent for Level 2 clinicians. However,
given that the level 2 clinician may be taking on new types of
clients that they have not encountered before, structured
interventions should be skill dependent.
• In order to enhance the growth of Level 2 clinicians, they should
be challenged to provide the reason for providing certain
interventions with clients.
• Challenging a clinician and forcing them to articulate their
conceptualizations of the client, the interventions they chose,
and possible alternatives, are important during this time.
• Sandwiching feedback is important.

• Level 3 clinicians are able to fully empathize with, and
understand the client’s perspective on the world.
• Client conceptualizations, environmental cues, and personal
reactions (transference and countertransference issues) will be
more easily recognized.
• This stage is also marked by a better understanding of human
behavior and the therapeutic process.
• Motivation that vacillated during Level 2 development now
approaches a more stable level.
• Autonomy increases during this stage of development.
• They have the following: a deeper client understanding,
understanding of their own limits, accepting of supervisor with
different orientation, broad ethical knowledge, able to switch
tracks with clients, appropriately uses self in therapy.

Issues
• Role of supervisor is to guide the supervisee toward mastery and
integration of all domains, from assessment to treatment to aftercare.
• Although the utility of supervision still remains for this level of therapist,
the implementation of it becomes considerably more collegial, and
there becomes a much less differentiation of expertise and power in the
supervisory relationship.
• For the Level 3 clinician, structure in supervision usually comes from
the supervisee, rather than the supervisor. That is, this level of clinician
knows what they need from supervision at any given time.
• Supervision takes on the facilitative tone (support, caring, confrontation
when needed) as opposed to the structured one (specific interventions
such as live observations).
• A common form of supervision with Level 3 therapists is collegial,
informal group supervision.
• While they can work with a level 2 or even 1 supervisor, they really
need a level 3 supervisor.

Supervisor Developmental Tasks
• Level 1: anxious about supervising, relies on how he/she was
supervised in the past as a model for their supervision, anxious about
having to provide feedback, plays the “expert” role, invested in
supervisees following their model of therapy. Trouble with level 2 and
3 supervisees.
• Level 2: resembles level 2 therapist regarding confusion and conflict,
sees supervision as multidimensional, has fluctuating motivation,
focuses more on the supervisee, may engage in doing therapy with
supervisees, works best with level 1 supervisee but o.k. with level 2’s.
• Level 3(i): motivation becomes stable and consistent as the supervisor
is interested in improving his/her performance, supervisor is
functionally autonomous but may seek supervision. Supervisor is able
to make honest appraisals of his/her strengths and weaknesses. Level
3 supervisors can work equally well with diverse supervisees but may
have preferences for level 3’s. Is a level 3 counselor.

Clinician and Supervisor
Characteristics Exercise
Jeff is a therapist who has been working in your organization for 3 ½ years.
He views himself theoretically oriented in cognitive behavioral therapies and
feels that this is a model that best fits his client population (outpatient
drug/alcohol clients). He is a clinician who views outpatient drug/alcohol
treatment from a strict abstinence point of view. You recently sent you and
your staff to an intensive training on new ways of treatment planning, which
incorporated the use of ASAM 3 criteria, Prochaska and DiClemente’s Stages
of Change Model, and Motivational Interviewing. This presentation viewed
treatment planning as a fluid construct that really depended on the motivation
level of the client. This model of treatment planning posited that if you as the
clinician have a treatment goal of abstinence, and the client is in
“precontemplation” regarding his drinking problem, then the treatment goal is
an inappropriate one, and should be geared more towards the client gaining
an understanding as to whether substance use is a problem or not, as
opposed to the “action” goal of abstinence.

At that moment in the presentation, Jeff got into a confrontation with
the lecturer regarding the lecturer’s stance on “harm reduction” work
with clients when the appropriate and accepted modality of working
with drug/alcohol clients is through abstinence based work and 12-
step programming. A brief, yet heated discussion of the pros and
cons of working with a client as opposed to against the client’s level of
motivation ensued. Jeff was unable to conceive the possibility that
there are other routes towards getting a person on the path of
sobriety than the one he subscribes to.
Four days have passed since then, and it is your first supervision
session with Jeff. Before entering supervision with him, you sit down
to note what had occurred just recently in the seminar, and what you
wanted to address with him regarding the seminar.

1. What level of clinician is he according to the Stoltenberg and
Delworth Developmental Model? How will your determination of
clinician level impact the way you decide to handle this situation?
2. Given what has occurred during at the seminar with Jeff, how are
you going to enter this supervision session with him?
1. How does your own theoretical orientation regarding the treatment
of drug/alcohol clients, and your perception of that model of
treatment planning, impact on your intervention(s) with Jeff?

The Discrimination Model of
Supervision (Bernard, 1979, 2009)
Supervisors will tailor their responses to the particular supervisee’s
needs (thus the name Discrimination) Supervisors Focus on
supervisees’:
1. Conceptualization skills include the supervisee’s ability to make some
sense of the information that the client is presenting, to identify themes
that occur in counseling, and to discriminate what is essential
information from what is nonessential. These are mainly
conceptualization skills that fall under assessment.
2. Process skills refer to the observable activity of the supervisee.
Process is probably a poor phrase to use, since processes can also
refer to the internal realities of the clinician, or the examination and
analysis of internal realities.
3. Personalization skills include the contributions of the supervisee as an
individual. This incorporates aspects of the person such as their
personality, cultural background, sensitivity towards others, and sense
of humor.

Roles and Aspects of this Model
• The Discrimination Model identifies three roles that the supervisor needs to adopt
in order to facilitate the development of the clinician: teacher, counselor, and
consultant.
• The teacher role is taken by the supervisor to determine what is the necessary
skill and knowledge base required for the supervisee in order to become more
proficient. 5 activities encompassing the teacher role are:
1. Evaluate observed counseling session interactions.
2. Identify appropriate interventions.
3. Teach, demonstrate, or model intervention techniques.
4. Explain the rationale behind specific strategies and/or interventions.
5. Interpret significant events in the counseling sessions.

• The counselor role is taken by the supervisor when interpersonal or intrapersonal
realities of the supervisee are addressed. 5 activities encompassing the
counselor role are:
1. Explore supervisee feelings during counseling session or supervision session.
2. Explore supervisee feelings concerning specific technique and/or interventions.
3. Facilitate trainee self-exploration of confidence and/or worries in the counseling
session.
4. Help the supervisee define personal competencies and areas for growth.
5. Provide opportunities for trainees to process their own feelings or defense.

• The role of consultant occurs when the supervisor allows for a more collegial,
less hierarchical atmosphere, allowing the supervisee to share responsibility for
his/her learning. In short, it is the development of autonomy for the supervisee. 5
activities encompassing the teacher role are:
1. Provide alternative interventions and/or conceptualizations for the supervisee.
2. Encourage supervisee brainstorming of strategies and/or interventions.
3. Encourage supervisee discussion of client problems and motivations.
4. Solicit and attempt to satisfy supervisee needs during the supervision session.
5. Allow the supervisee to structure the supervision sessions.

The Holloway Systems Model
(1995)
• The purpose of the Systems Approach is to provide a
framework and a language based on the empirical,
conceptual, and practical knowledge to guide the supervisory
process.
• The Structured Approach of Supervision (SAS) views the
primary goal of supervision as the establishment of an
ongoing professional relationship between the supervisor and
supervisee.
• The supervisor designs specific tasks and teaching tactics
related the supervisee’s professional development.
• The SAS model has five specific goals:

(1995)
1. The goal of supervision is to provide an opportunity for the
supervisee to learn a broad spectrum of professional attitudes,
knowledge, and skills in an effective and supportive manner.
2. Successful supervision occurs within the context of a complex
professional relationship that is ongoing and mutually involving.
3. The supervisory relationship is the primary context for facilitating the
involvement of the learning in reaching the goals of supervision. The
essential nature of this interpersonal process bestows power to both
members as the form the relationship.
4. For the supervisor, both the content and process of supervision
become an integral part of the design of instructional approaches
within the relationship.
5. As the supervisor teaches, the trainee is further empowered by
acquiring the skills and knowledge of the professional work, and
gaining knowledge through experiencing and articulating
interpersonal situations.

(1995)
1. The Supervisory Relationship. The Supervisory relationship is
divided into 3 sections: 1) interpersonal structure of the relationship
(the dimensions of power and involvement); 2) phases of the
relationship (relationship development specific to the supervisees);
and 3) supervisory contract (the establishment of a set of
expectations for specific tasks and functions).
2. The phases of the relationship are subdivided into three parts: 1)
beginning phase; 2) mature phase; and 3) terminating phase.
3. The supervisory contract involves the clarity of expectations from the
supervisor and the supervisee. The clarity of these expectations
directly impacts the supervisory relationship and the learning
objectives. Thus the dyad is not only identifying specific tasks, they
are also defining the parameters and boundaries of the supervisory
relationship

(1995)
• Tasks of Supervision. The tasks of supervision are the
professional knowledge necessary for the clinician to perform.
Categories of teaching skills for supervisees include: 1)
counseling skills; 2) case conceptualization; 3) professional
role; 4) emotional awareness; and 5) self-evaluation.
• Functions of Supervision. Holloway (1995) describes the
functions of supervision as the roles of the supervisor. The
five functions that the supervisor takes on while working with
the supervisee are: 1) monitoring/evaluating; 2)
instructing/advising; 3) modeling; 4) consulting; and 5)
supporting/sharing.

(1995)
• Each of the 5 tasks and 5 functions can interact with one
another, allowing for a total of 25 total combinations (e.g., the
function of modeling, combined with the task of self-
evaluation).
• Still, 4 contextual factors also have to be factored into this
model:
1. Supervisor Factors
2. Trainee Factors
3. Client Factors
4. Institutional Factors
5. Political Factors

Competency-Based Supervision
(Falender & Shafranske, 2004)
• All models to supervision are intended to develop
competence. A competency-based approach provides an
explicit framework and method to initiate, develop, implement,
and evaluate the processes and outcomes of supervision.
– Falender & Shafranske (2004) believe personal traits, values, and pre-
existing interpersonal competencies are some of the bases upon which
the foundation of clinical expertise (and depending on these features
clinical biases) are developed.
– Next, education and life experiences contributes to the acquisition of
knowledge, skills, abilities and values that help to initially forge the
conceptualizations and socialization to the profession.
– Clinical training then provides the integrative learning experiences in
which skills, abilities, knowledge and values interact, form learning
trends, and with practice (under supervision or sometimes even without
supervision), become clinical competencies.

– Competencies are specific external standards of professional functioning
(an acquisition of skills and understanding).
– Central to a competency-based approach is the identification of learning
goals and objectives that lead to the development of measurable
competencies.
– Competencies are developed through reflection, conceptualization,
planning, practical experience and experimentation within a structured
learning environment.

The critical role of supervision in a competency based is the following:
1. The supervisor must have working knowledge of the specific evidence
based treatment methodologies that they will be using with their
supervisees.
2. In working with the supervisee, supervisors must help the supervisee in
identifying the knowledge, skills, and values that form the basis of
competency in a particular evidence based training (EBT).
3. Supervisors will then utilize specific learning strategies and evaluation
procedures to sequentially build the supervisee’s skills appropriate to the
supervisee’s clinical setting.
4. High quality competency based supervision requires direct observation of
supervisee’s counseling, the use of performance feedback and
individualized coaching, and the utilization of practice scenarios and role
playing.
5. Feedback and coaching consists of discussing techniques utilized, skill
when implementing strategies/techniques, and discussion of any strategies
that are incompatible with the EBT.

The Blended Model of Supervision
(Powell,1993, 2004)
• Philosophical Foundation of the Blended Model
1. People have the ability to bring about change in their lives with the assistance of
a guide.
2. People do not always know what is best for them, for they may be blinded by their
resistance to and denial of the issues.
3. The key to growth is to blend insight and behavioral change in the right amounts
at the appropriate time.
4. Change is constant and inevitable.
5. In supervision, as in therapy, the guide concentrates on what is changeable
6. It is not necessary to know a great about the cause or function of a manifest
problem to resolve it.
7. There are many ways to view the world.

(Powell,1993, 2004)
• Two Other Foundations of the Blended Model
1. Stage of Development – the supervisee’s (and supervisor’s) level of training,
experience, knowledge and skill.
2. Contextual Factors – characteristics of the client, counselor, supervisor, and
setting that affect the environment of supervision.
• The Blended Model is a supervisory process that blends insight-oriented with
skills-oriented approaches.
• The Blended Model utilizes these foundations, along with it many descriptive
dimensions in order to structure its view of clinical supervision when working with
the substance abuse counselor.

(Powell,1993, 2004)
• Key components to the Blended Model of Supervision
1. When defining your approach to supervision you must begin with an awareness of
your personality, your style of leadership and teaching, and your underlying issues.
Thus your own self is the first level of development.
2. You must define your concept of health, your core philosophy of change.
3. The descriptive dimensions (shown next) further defines your approach to supervision.
4. Contextual factors in which supervision is conducted shapes your approach to
supervision (e.g., age, recovering/non-recovering, ethnicity, gender, educational
background, etc.).
5. You determine the extent to which you will address affective and behavioral issues in
supervision, based, in great measure, upon the stage of counselor development (and
in this teacher’s opinion) and the strength of the working alliance.

Blended Model - Influential and
Symbolic Dimensions
Influential Dimension
• This dimension has the premise that supervisee’s are influenced
both affectively and behaviorally, depending on the individual’s
stage of development, needs, and cognitive abilities.
• Beginning clinicians will look for basic helping skills, and
advanced clinicians will address more theoretical, and
interpersonal issues.
Symbolic Dimension
• The blended model emphasizes primarily manifest content,
viewing the unconscious (or latent) symbolic material as
interesting but nonessential to bringing about desired changes.

Blended Model - Structural Dimension
Structural Dimension
• The blended model emphasizes a very structured approach with
beginning clinicians, emphasizing mastery in the 12 core functions.
• As the supervisee grows, the structural component shift from proactive
(on the supervisor’s part) to reactive (on the supervisee’s part). The
supervisee has increasing responsibility for directing the course of
supervision (e.g., talking about burnout, or future personal growth
issues).

Blended Model - Replicative and
clinician in Treatment Dimensions
Replicative Dimension
• clinicians do behave in supervision in an isomorphic (parallel) manner to
clients in therapy. However, in the blended model, this is rarely
addressed … except as these issues interfere with clinical functioning.
Clinician in Treatment
• The blended model does not view therapy as an essential ingredient in
the clinician’s supervision, and holds it to be inappropriate for the
supervisor to provide such therapy.

Blended Model – Information Gathering
Dimension
Information Gathering Dimension
• This is the belief that the supervisor must gain as much information as
possible on the counseling style of early (level 1 and 2) clinicians. Direct
observation is essential for this process.
• As the clinician grows in three developmental structures (motivation, self
and other awareness, and autonomy-independence), the supervisor can
utilize more insight-oriented issues and thus utilize more indirect
information gathering techniques.

Blended Model - Strategy Dimension
Strategy Dimension
• The blended model provides for the teaching of technique and theory,
either simultaneously or in alternation, depending on the developmental
level of the clinician.
- Early clinicians may need the focus to be on the 12 core areas and
therapeutic relationship techniques (e.g., active listening skills).
- People skilled in other areas, such as marriage and family
therapy, may need emphasis on the different models of recovery
and intervention techniques unique to this field.

Blended Model – Jurisdictional and
Relationship Dimensions
Jurisdictional Dimension
• The blended model sees jurisdiction over the client and
supervisee as resting ultimately with the supervisor, who cannot
escape the ethical and legal implications of every supervisee
and every client.
Relationship Dimension
• The blended model views the supervisory relationship as
directive for early (level 1 and 2) clinicians. This relationship
becomes less directive as the clinician gains experience.

Blended Model – Expanded Supervisor
Dimensions (Powell, 2004)
Expanded Supervisor Dimensions
• The Journey Dimension – Does the supervisor concentrate on the
process of deepening supervisees (Level 3’s who are going
downward and inward for reflection and introspection). Or do
supervisors concentrate on developing (Level 1’s growing upward
and outward in their professional development).
• The Internalization Dimension – Does the supervisor seek to aid
the supervisee in developing wisdom and integrating therapeutic
behaviors and attitudes (Level 3). Or do supervisors help to isolate
external philosophies of the supervisee and help them understand
the compartmentalization of these external philosophies as they
affect their practice (Level 1).

Blended Model – Expanded Supervisor
Dimensions (Powell, 2004)
Expanded Supervisor Dimensions
• The Listening Dimension – Does the supervisor listen with the heart
(Level 3) or with the head (Level 1)
• The Questioning Dimension – Does the supervisor pose questions
(Level 3) or answers (Level 1).

Other Models of Supervision
Other Models of Clinical Supervision
• Psychodynamic Model of Supervision
• Cognitive-Behavioral Model of Supervision
• Family Therapy Model of Supervision
• Person-Centered Model of Supervision
• Feminist Model of Supervision
• Solution Oriented Model of Supervision

Random Licensure Fact of the Day
• LPC/LAC DCA Licensure requires that every licensee put their
license number on any promotional or marketing materials,
including business cards.

Supervisor vs. Supervisee Exercise
You were just hired as a consultant clinical director. Your private practice allows you to be
consultant to this organization as a part-time clinical director of 2 different organizations.
Before coming into the job, you were not told who else is employed in a supervisory
capacity at the agency. Tom is one of your supervisees now, and he is currently
supervising three other clinicians, in his function as the outpatient supervisor. You
supervise Tom and two others, both of whom run different departments in the agency. Tom
was a recent hire, approximately six months ago, and is 28 years old and has his LPC. This
is Tom’s first supervisory position. Tom just acquired his LPC 7 months ago.
Tom, who was hired 6 months prior to you coming on board, comes to you in supervision to
discuss an issue that had been going on since he entered the organization. The issue is
one of his supervisees is resistant to Tom. One supervisee, Jason, outwardly states he will
not follow some of Tom’s suggestions. Jason has been working in the field of mental health
for 8 years and has his master’s in counseling psychology, but is has never pursued his
licensure. Just this past week Jason told Tom he does not need supervision, and does not
want supervision from “somebody younger than some of the scars on his body. Yes Jason
can be quite descriptive sometimes.

Tom’s other two supervisees are young clinicians, just out of college 1 year (both with
master’s in counseling degrees, both unlicensed). Tom states supervision with them is not
problematic. When Tom first presented this issue, you had thought it could be due to the
fact that he is new to the position and Jason had been in the position for over 8 years.
What Tom does not know is that Jason applied for the supervisory position, but did not get
it, due to the fact that he was unlicensed.
In the past you have checked in with all three clinicians as to how things are going with
Tom, and the answers received from Jason is that Tom’s suggestions are at times over
simplified, and if more suggestions are required, Tom becomes rigid and defensive. He
also stated that Tom doesn’t appear to have a good grasp of many different therapeutic
approaches, and when Jason wants to talk about utilizing more appropriate, confrontational
approaches, Tom answers back with “some motivational, sissy crap suggestions.” Both you
and Tom are seeing that the difficulties aren’t due to an issue of adjusting into a new staff,
as there is a definite lasting problem. Tom comes to you wanting to know what to do as he
is frustrated. All staff within this program have definite strengths and bring a lot of good
help to the clients they serve.

Questions
1. What level of supervisee is Jason according to the IDM? What level of
supervisor is Tom?
2. Are any of the dynamics you see expected given the level of
professional development in both your clinical supervisor and his
supervisees?
3. What suggestions do you have for Tom?
4. Is it appropriate that Tom know that Jason applied for his job, but did not
get it? Why or why not?
5. Is there an issue here regarding Tom as supervisor? If so what? What
is the corrective action plan you would suggest to the organization?

Supervision Interventions
• Borders and Leddick (1987) listed six reasons for choosing different
supervision methods.
1. The supervisee’s learning goals.
2. The supervisee’s experience level and developmental issues.
3. The supervisee’s learning style.
4. The supervisor’s goals for the supervisee.
5. The supervisor’s theoretical orientation.
6. The supervisor’s own learning goals for the supervisory experience.

Supervision Interventions
• Supervision methods will need to take into account:
1. The supervisee’s stated goals and known supervision needs.
2. How far down the training-supervision-consultation axis the
supervisee has traveled.
3. Most importantly, supervision methods will reflect the
supervisor’s vision of supervision more than the supervisee’s.

Supervisor Vision
• The convictions held by the supervisor about how supervisee’s become
competent practitioners.
• Regardless of its origin or validity, the supervisor’s vision will inspire the process
of supervision.
Structured Supervision vs. Reflective Supervision
• Structured supervision are those techniques (e.g., live supervision) in which the
supervisor dictates to the supervisee proper techniques and methods of clinical
interactions with the client.
• Reflective supervision is less structured supervision where the goal is to increase
supervisee thoughtfulness and ability to reflect on their work as they increase in
their skill.

Structured vs. Unstructured
Interventions
• Highly structured supervision can be seen as an extension of training
while highly unstructured supervision can be viewed as approaching
consultation.
• Structured interventions are supervisor directed and involve a reasonably
high amount of supervision activity.
• Unstructured interventions may be supervisor or supervisee directed and
require more discipline on the part of the supervisor for letting learning
take place without directing it.
• Most supervisee’s will benefit from both types of interventions at different
points in their professional development.

Group Supervision - Defined
• Bernard and Goodyear (2009) define group supervision:
“Group supervision is the regular meeting of a group of
supervisees (a) with a designated supervisor or supervisors, (b) to
monitor the quality of their work, and (c) to further their
understanding of themselves as clinicians and the clients with
whom they work, and of service delivery in general.
These supervisees are aided in achieving these goals by their
supervisor(s) and by their feedback from, and interactions with,
each other.”

Group Supervision - Types
There are different types of group supervision
1. Case consultation: This involves one member of a group presenting
a case to others in the group for the purpose of clarification,
feedback, help, collaboration, technique discussion, etc.
2. Peer supervision: This involves a group of similarly trained or skilled
individuals (e.g., all addiction counselors, or most clinicians at a
certain developmental level). This group meets regularly for mutual
supervision; and may or may not consist of a group leader
(supervisor) depending on the setting (e.g., private practice vs.
licensed facility).
3. Team supervision: Usually agency/facility setting supervision with a
defined leader or leaders; can be intra-disciplinary or interdisciplinary,
and can involve various skill levels (e.g., students to level 3
clinicians).

Group Supervision - Size
• Group supervision should not be so large that members are shortchanged in the
attention they receive.
• Group supervision should not be so small that the disruptions caused by dropouts
or absences does not negatively impact the group.
• Researchers studying group size have recommended the size of the average
group being at the low end 4-6 and at the top end 12.
• LPC: “group supervision means the ongoing process of supervising no more than
six mental health counselors at one time in a group setting by a qualified
supervisor.” 13:34-10.2

Group Supervision - Benefits
1. Economics of time, costs and expertise.
2. Opportunities for vicarious learning. When supervisees observe peers
conceptualizing and intervening with clients, vicarious learning can
occur with other supervisees not presenting/speaking. Past research
has shown that novice (level 1) supervisees who observe their peers
performing/talking about performing a particular skill are more likely to
show skill improvement and increased self-efficacy than those who
instead observed only an expert.
3. Breadth of client exposure. Group supervision enables supervisees to
be exposed to a broader range of clients than any one person’s
caseload could afford.

4. Supervisee feedback of greater quantity, quality and diversity. Other
supervisees can offer perspectives that are broader and more diverse
than what a single supervisor could provide. Quality increases due to
the fact that novice supervisees are likely to employ language that is
more easily understandable by other novices than is the language used
by the supervisor.
5. More comprehensive picture of the supervisee. The group format
enriches the ways a supervisor is able to observe a supervisee (e.g., a
supervisee may be blocked in some way when discussing their own
work with a client, but may be very insightful when helping others’ in
their work with clients. This can provide a different perspective on a
supervisee’s needs (and why they may be occurring) than would occur
in individual supervision.

6. The opportunity for supervisees to learn supervision skills.
7. The normalization of supervisees’ experiences. Many times novice
(level 1) supervisees believe the challenges they face may only be
occurring with them, or in their own reactions to clients or other aspects
of their work. To see others struggling with, or encountering similar
issues can decrease anxiety and provide reassurance.

Group Supervision - Limitations
1. The group format may not permit individuals to get what they need. 1)
supervisees with heavier caseloads may not get the time to review all the cases
they need; 2) less skilled group members may receive more supervision
attention than more skilled group members.
2. Certain group phenomena can impede learning. Personality conflicts between
supervisees or between supervisees and supervisors, inter-member competition.
3. The group may devote too much time to issues of limited relevance to, or
interest for some group members. It is the supervisor’s responsibility to ensure
that all group members perceive they are getting something out of group.
4. Group supervision does not have a parallel process to individual supervision.
While group supervision could potentially help one out with their group
processes, (depending on the modality) a large portion of discussions in group
supervision is regarding individual work with clients.

Group Supervision – Supervisory
Tasks
1. Assume an active stance in the group; one that steers a careful course between
over- and under-control.
2. Assert yourself as necessary to redirect the group; impose limits and so on.
3. Listen to and then following the group, challenging direction as necessary.
4. Be able to choose the right fights when inevitable conflicts emerge between
supervisees or within the group itself.
5. Communicate clearly just what you want to happen. Be confident, but not
authoritative (dictatorial).
6. As the leader be able to process the groups interaction style and level of
development. This processing helps you to understand where members are at and
what direction you need to be going with the group.

Case Management vs. Supervision
• Case Management
o The focus is on the client, what they need in treatment.
o Issues such as client placement, treatment plans, clinically observed
behaviors.
o What is needed for the client in the continuum of care, aftercare.
o In a case management session, a supervisor and supervisee may review
many cases.

• Clinical Supervision
o The focus is on the supervisee, what do they need to be proficient.
o While client care issues are discussed, the focus remains on what does the
counselor need to know, what skills need to be developed in order to be
proficient.
o The focus is on counselor skill development.
o There may be more acute focus on one case. Live material (video, audio,
supervisor’s observation through co-facilitation, one way mirror, bug in the
ear, bug in the eye, or other similar type methods will be incorporated into the
supervision session.

• Case Management. The fundamental characteristics of the case
management process focus on the client and include the following:
o Information gathering about the client
o Interdisciplinary
o Talk about client placement
o Discuss coordination of services
o Case reviews
o Case management absorbs time and detracts from clinical supervision –
which can directly impact client care.
o Case management is administrative oversight, but is often mislabeled as
clinical (group) supervision.

• Clinical Supervision. In contrast, the fundamental characteristics of clinical
supervision focus on the counselor and include the following:
o Assessment and feedback of the counselor
o Intra-disciplinary individual (and sometimes) group supervision
o Client care
o Clinical skill development
o In-depth case presentations
o Clinical supervision is an ethical/legal duty set aside from case management
o A supervisor has “ethically and legally defined responsibilities (a duty of care) that
demand careful consideration when interacting with clients, supervisees, colleagues,
employers, and society at large”
o The clinical work of supervisors and counselors directly (and sometimes powerfully)
influences the lives of others
o Clinical supervisors are obligated to: 1) be alert; 2) address competing demands; and
3) be cognizant of potential consequences of decisions and advice
o Personal quality control reduces errors in judgment that could potentially lead to
problems and clinical liability issues.

Case Conferencing & Focus of
Supervisor
• Challenge for the supervisor occurs with needing to think like a
supervisor rather than a therapist.
• Most seasoned practitioners tend to continue to be fascinated by therapy
issues, thus focusing on client issues rather than the learning and
developmental needs of the supervisees.
• How much time do you spend in supervision focusing on client behaviors
vs. supervisee behaviors.
• What goals and outcomes do you have for each individual you are
supervising? Are these different from therapist to therapist?

Some Case Presentation Guidelines
Case Presentation Guidelines:
• Decide how much time is to be allotted for each person presenting, and
assign somebody as the “timekeeper”.
• All staff on the case presentation team should be fully aware of the
procedures surrounding case presentations.
• The case presentation method should be built around problem- and
solution-oriented questions to be answered.
• The supervisee should be granted time to prepare the case for
presentation and the presentation should be organized an focused.

Case Conferencing Distractions
Some common distractions during case presentations:
1. Not enough or too many presentations within the case conference time
frame.
2. Over focusing on a specific problem instead of giving a case overview.
3. Anecdotal material/presentation that is not conceptualized or structured
by the clinician.
4. Supervisee dynamics that interfere with free and open discussion of the
case.
5. Expectations for interventions beyond the capabilities of the clinician.

Group Supervision – Final Thoughts
Some basic questions before embarking on group supervision:
1. Will it be defined as supervision or peer consultation?
2. What methods will be used to get counselors to risk exposure in group
supervision, and how will anxiety about such risk be handled?
3. Will, or how will, competitiveness be handled?
4. How will you deal with different backgrounds and skill levels of group
participants?
5. How will overtly reticent group members be handled?
6. Will the group have an impact on other elements of the agency or
organization?
7. How large will the group be? Day and Time?
8. How will feedback be channeled, or occur within the group?

Group Supervision – Final Thoughts
Some basic questions before embarking on group supervision (continued):
9. How will the goals of group supervision differ from the goals of
individual supervision?
10. How will the feedback of group supervision differ from the feedback
given in individual supervision, if the group and individual supervisors
differ? How will this difference be handled by each supervisor, and by
the agency?
11. What kind, and what amount of record keeping will occur?
12. Should the supervisor present cases?
13. How will poor presentations be handled?
14. Will the group be time limited or open ended?
15. What limits will be set on the group, and how will they be presented?

Group Supervision Exercise
You are currently supervising 6 mental health counselors (which you pat
yourself of the back for maintaining fidelity with the LPC regulations).
Each clinician has their own unique style and presentation dynamic, that
is sometimes different than their presentation in individual supervision.
Your group of LACs is a mix of those clinicians clearly still in the
beginning stages of clinical development (Level 1 clinicians according to
the IDM) and some who are moving along the clinical continuum (Level
1-2 depending on the skill set). The clinician of focus currently in the
group supervision session is Anita (which you have secretly renamed
Anita Lotta Supervision). In individual supervision she presents as
anxious, timid, unsure of herself and needing a lot of prescriptive
feedback and reassurance. In short she’s a high maintenance unit.

However, in group supervision, her presentation takes on a much
different flavor. She presents as confident, often giving feedback and
suggestions, some of the very same suggestions she has struggled
accepting and implementing in your individual supervision with her.
When she presents cases, she is beginning to develop a pattern of only
presenting success stories and in the past presentation did not even
have a question for the group. Another group member saw this latter
pattern also and asked about why she presented the case if she didn’t
have a question. Anita became defensive, stating everything has been
resolved from her caseload in individual supervision and then ubruptly
stopped talking and finishing her case presentation.

1. What is your role in that moment with Anita in the group supervision; how
do you handle the sudden tension?
2. When in the next individual supervision session with Anita, what are
going to be your primary tasks (topics of discussion) for that session with
her?
3. Going forward, what is your assignment to her for the next group
supervision session (when it is her turn to present again, which could be
2 group sessions from now)? If it is not her turn to present in the very
next group supervision, and issues were left unresolved in the last group
supervision session, what is your expectation of her, if any, in the next
group?

Self-Report
• The most commonly used form of supervision.
• Self-report has many problems attached to it.
• Without direct observation, you forfeit the opportunity for independent
judgment regarding the client.
• Without direct observation, you forfeit the opportunity to illustrate directly
from the case in question, how to draw inferences from the client and
from the session.

Self-Report (cont.)
• Studies have shown that over 50% of issues evident in taping of
sessions, were not reported by trainees in supervision.
• Wynne et. al., 1994, showed that experienced supervisees showed only
a 42% recall rate for main ideas expressed in session, and 30% recall
rate for supporting ideas expressed in session with a client.

Process Notes
• The use of any form of systematic written documentation of the cases
being presented in supervision.
• Process notes suffer the same pitfalls as does self-report.
• Process Note Outline For Supervisors:
1. What were your goals for this session
2. Did anything happen during the session that caused you to reconsider
your goals? How did you resolve this?
3. What was the major theme of the session? Was there any content that
you consider critical?
4. Describe interpersonal dynamics between you and the client during
the session?

Process Notes (cont.)
5. How did the individual differences between you and the client (e.g.,
gender, ethnicity or race, developmental level) affect the session?
6. How successful was the session? Were your initial goals achieved?
7. What did you learn (if anything) about the helping process from this
session?
8. What are your plans and goals for the next session?
9. What specific questions do you have for your supervisor regarding
your work with this client?

Audio Taping
• It is the supervisor’s responsibility to outline the plan as to how audio
taped supervision will take place.
• With beginning supervisees, you may listen to a whole audio tape
before supervision in order to get an overview of the supervisee’s
ability, and you’ll have control over what part of the tape you’ll want to
focus on in supervision.
• With more advanced supervisees, pre-selected segments can be
chosen for a variety of reasons:
1. To highlight the most productive part of the session.
2. To highlight the most important part of the session.

Audio Taping (cont.)
3. To highlight the part of the session where the supervisee is struggling
the most.
4. To underscore any number of content issues, including metaphors and
recurring themes.
5. To ask about confusing part of the session.
6. To focus attention on the point in the session where interpersonal or
cross-cultural dynamics were either very therapeutic or very strained.

Audio Tape Format
• While many formats can be used, a typical format consists of letting a
supervisee choose a part of a session in which they felt confused, lost,
overwhelmed, or frustrated.
• Have supervisee state the reason for selecting this part of the session for
discussion in supervision.
• Briefly state what transpired up to that point.
• Explain what he or she was trying to accomplish at that point in the
supervision.
• Clearly state the specific help desired from the supervisor.

Videotape
• Focus videotape supervision by setting realistic goals for the supervised
therapy session.
• Relate internal process across contexts (i.e., what the therapist
experiences in the session is important to discuss in supervision).
• Select tape segments that focus on remedial performance (i.e.,
corrective feedback should be on performance that the therapist has the
ability to change).

Videotaping (cont.)
• Use supervisor comments to create a moderate evaluation of
performance (i.e., tracking your feedback to see if progress towards the
goal is made across supervision sessions).
• Refine supervision goals moderately (feedback given in supervision may
be hard to initiate in the actual therapy session).
• Maintain a moderate level of arousal (make sure the supervisee is
stimulated to grow without becoming overly threatened).

Interpersonal Process Recall
• The supervisor and supervisee view a prerecorded videotape of a
counseling session together.
• At any point in which either person believes that something of importance
is happening on tape, the tape is stopped.
• The supervisor does NOT adopt a teaching role and instruct the trainee
about what might have been done.
• Supervisor needs to allow the supervisee the psychological space to
investigate internal processes to some resolution.

Live Supervision
• Live supervision was initiated by Jay Haley and Salvadore Minuchin in
the late 1960’s.
• Live supervision combines direct observation of the session with some
method that enables communication with the supervisee.
• Highest safeguard of client welfare, but is very time consuming for the
supervisor.
• More complete picture of therapist and client than can be captured in
videotape (e.g., static camera angles)
• Allows for excellent and at times immediate feedback loop for the
supervisee.

Methods of Live Supervision
• Bug in the Ear (BITE) is a wireless earphone worn by the supervisee that allows
feedback from the supervisor at any point in time, without the “interruption” of the
therapy session.
• Monitoring is where the supervisor observes the session and intervenes directly
into the session if there is perceived difficulty. Supervisor takes over when coming
into the session.
• In Vivo is similar to monitoring, except the supervisor comes in and consults with
the supervisee in front of the client(s), allowing the client(s) to have access to all
information.
• Phone-ins and Consultation Breaks. Interruption of therapy by either a phone call
or a break of therapy session. With phone-ins, the therapist does not have the
chance to clarify what the supervisor is suggesting.

• Bug in the Eye (BITE)
• An alternate of bug in the ear, is an interactional platform using of some
type of video technology to serve the same purpose as the audio feed in
the supervisees ear (sometimes referred to as bug in the eye).
• This can be utilized in many forms such as a television monitor placed
behind the client, so it is out of sight of the client’s vision but provides
instant, ongoing feedback to the supervisee much in the same way as
the audio feed in the ear would do.

• Yu took this interactional platform and developed it using IPADs and Google doc
(or any other type of similar service or application).
• The supervisee has a tablet device such as an IPAD on their lap and reads the
feedback given by the supervisor. If the sessions are being recorded, the
feedback is saved on the application to be reviewed later when the supervisee is
watching the session recording.
• Yu (2013) has further developed this idea and has a website www.isupelive.com
that bypass internet programs (such as Google doc) and applications by using a
proprietary software to record these interactions.
• Using iSupe requires a computer or tablet device by the supervisor, a tablet
device utilized by the supervisee and requires an internet connection. A
supervisor license must be purchased ($50) and each supervisee requires a
license ($5).

Supervision - HDAP
1. Group Supervision
2. Individual Supervision
3. Live Supervision
4. Process Recordings (for required students)
Hunterdon Drug Awareness Program
Live Supervision

Live Supervision - HDAP
In 2005, Hunterdon Drug Awareness Program incorporated live
supervision at a cost of just over $2,000
• High resolution, yet discreet, camera: $854
• Omni-directional Audio Microphone: $129
• (2) All in one 13” Monitor/VCR’s: $710 (2 x $355)
• Cabling to network: $102
• Installation Labor: $400
Total Cost for Permanent Live Supervision: $2,185
Ability to permanently, discreetly
supervise your employees live: Priceless

Ranking of Techniques
• Munson (2002) ranks the most to least useful supervision techniques, with 1
being the most useful and 10 being the least useful:
1. Live joint interviews
2. In-ear listening devices
3. One-way mirror observation
4. Videotapes – live material
5. Videotapes – commercially produced
6. Audiotapes – live material
7. Audiotapes – commercially produced
8. Discussion of case material
9. Process Recordings
10. Role-play

Bibliography
• Bernard, J. M. (1979). Supervisor Training: A Discrimination Model.
Counselor Education and Supervision, 19, pp. 60 – 68.
• Bernard, J. M. (1997). The discrimination model. In Watkins, C. E. Jr.,
Handbook of Psychotherapy Supervision. New York, John Wiley &
Sons, Inc.
• Bernard, J. M. & Goodyear, R. K. (2013). Fundamentals of Clinical
Supervision, 5th
Ed. Pearson, Boston, MA.
• Borders, L. D. & Leddick, G. R. (1987). Handbook of Counseling
Supervision. Counselor Education and Supervision, Alexandria, VA.
• Durham, T. G. (2009) Clinical Supervision: A Twenty-Module Course
(Participant Workbook: Utilizing 5-2: Case Management Vs.
Supervision).
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Competency-Based Approach. American Psychological Association,
Washington, DC.

Bibliography
• Holloway, E. L. (1992). Supervision: A way of teaching and learning. In S. D. Brown & R. W.
Lent (Eds.), Handbook of counseling psychology. New York: John Wiley.
• Holloway, E. L. (1995). Clinical Supervision: A systems Approach. Sage, Thousand Oaks,
CA.
• Holloway, E. L. (1997). Structures for the analysis and teaching of supervision. In Watkins,
C. E. Jr., Handbook of Psychotherapy Supervision. New York, John Wiley & Sons, Inc.
• Martino, S. (2010). Strategies for training counselors in evidence-based treatments.
Addiction Science & Clinical Practice, 5(2), 30-39.
• Meichenbaum, D. (2001). Anger management: A cognitive-behavioral developmental
perspective. Lecture presented at the Cap Cod Institute, 08/13/01 – 08/17/01.
• Martino, S. (2010). Strategies for training counselors in evidence-based treatments.
Addiction Science & Clinical Practice, 5(2), 30-39.

Bibliography
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Bibliography
• Wynne, M. E., Susman, M., Ries, S., Birringer, J., & Katz, L. (1994). A method for
assessing therapists’ recall of in-session events. Journal of Consulting
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• Yu, A. (2013). www.iSupeLive.com: “The Future of Live Supervision.” [online:
Accessed May 30, 2013]. Also referenced was information from
http://www.isupelive.com/?page_id=272.

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