This presentation explored core aspects of supervision for health psychologists. This presentation focuses on relationships, training the treating professional, addressing cultural factors and giving feedback to interns/trainees.

1. ClinicalSupervision
Training
PART II – Developing Clinical Supervision Competence in
Integrated Health Care Settings

2. Supervision
Discussion
 You supervise several practicum students assigned to you. One
supervisee recently received a referral for a patient who is abusing
alcohol and marijuana and has seen the patient for two sessions. The
student states to you he is having difficulties in treating this patient as
he has his own history of substance abuse, and the patient’s pattern
of use reminds him of his past use. He comes to supervision
distressed.
 Taking into account the student’s personal challenges in this case, how
do you respond?

3. Section 1 –Training
Treating Professionals

4. FLOW is a state
of mastery
where challenge
and skill are
equally matched.
When we are
anxious we need
more skill.When
we are board
more challenge.

5. In growth as a
clinicianand a
supervisor we
move from the
struggle of
learning to the
flow of meaning,
purpose and
connection.

6. Learning is
fundamentally
a radical act of
transformation
that needs a
context of
support and
challenge…

7. Supervisors
wear many
hats…
These can include teacher, coach, cheerleader,
consultant, collaborator, mentor, counselor
(while not stepping into the role of therapist)
and setting limits.
Effective supervision
adapts the roles needed by each student at a
given time in their development.

8. Review ofCore
Supervision
Domains…
1. Supervisor Competence
2. Diversity & Cultural Humility/ResponsiveCare
3. Supervisory Relationship
4. Professionalism
5. Assessment/ Evaluation/ Feedback
6. Developing ProfessionalCompetence
7. Ethical, Legal, and Regulatory Considerations
SevenCore Domains of
Health PsychologySupervision

9. Group
Discussion
Supervision
andClinical
Charting
1. Question 1: What is ‘good charting’ - Lets consider what our
personal values are related to charting and what we think
makes good clinical charting.
2. Question 2: What are some of the common challenges people
face when learning to chart?
3. Question 3: How could we help a student grow who is
struggling with an aspect of learning to chart? Let’s pick one of
those challenges and discuss how to help a student with that
challenge.

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

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

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

13. Applying
Competency
Based
Supervision to
ClinicalSkill
Growth
 Competency Based Supervision: Is a trans-theoretical approach
that uses core competencies that are vital for effective clinical
work as an anchor for training in supervision.
It starts with a behaviorally anchored identified competency and
develops learning experiences that develop those competency.
 Behavioral Anchor: Is a clearly described, operationalized
description of a competency. If you can’t describe it in a way that
some one could see it, you need to clarify it further.

14. SmallGroups
BrakeOut
Discussion and
Problem
Solving
Group Exercise Outline
 Brake in to four groups of 2
 All groups need to work on a different skill to develop
 Work with one of these clinical skills
 Rapport Building
 Treatment Planning
 Working with an InterdisciplinaryTeam
 Assessment Planning and Diagnosis
 Pick some one in your pair to be the note taker
 Use the form you have to discuss and identify three levels of
competency for this skill and create a behaviorally anchored
description of each level in approx. one sentence.

15. GrowingTogether
Exploring places where we are pulled into roles…

16. Places we get
stuck in
supervision
relationships…
Dynamics that
can impact
growth.

18. Moving out of
destructive
dynamics into
dynamics of
connection
and growth
fostering
relationships.

20. How strong is your depressive position?
What are some of the things that help
you stay in both and thinking and
dialectical thinking rather then falling
into reaction?

21. Clinical
Supervision
Discussion
 You are thrilled to be asked to undertake supervision of your first
trainee. You find, in your first meeting, that the trainee is angry at
being assigned to a younger supervisor who she believes, because
of less experience, is less competent than she is. The trainee asks
for a change of supervisors. You feel rejected and frustrated.
 How do you manage this situation in a respectful way?

22. DevelopingGrowth
Fostering Relationships
Towards Liberatory Learning and Decolonializing Supervision

25. Creating
Growth
Fostering
Relationships
& Recognizing
Moments of
Disconnection

26. Intersectionality,
Power, and
RelationalSafety in
Context:
KeyConcepts in
ClinicalSupervision
 “Cultural knowledge and life experiences of clients and supervisees is
centered alongside developing field knowledge, supporting cultural
democracy within the microsystems of therapy, and supervision with the
goal of encouraging equity in the broader society.”
 “This requires supervisors and supervisees to acknowledge histories of
oppression and be accountable for legacies of privilege within local and
global contexts.”
 “Supervisors must prepare themselves to engage in critical analysis of
dynamics of power and intersectionality as these relate to the
performance of supervision and therapy.”
 “The importance of a specific, contextual, and hierarchical analysis is
emphasized because oppressions are not equivalent across contexts.”
 “Demonstrating critical social awareness and cultural humility allows
supervisors and clinicians to build the trust and safety necessary to
encourage growth across cultural and social differences.”
 “This approach is based in a pedagogy of emancipation and
empowerment that offers a metaperspective for addressing issues of
power, the legacy of colonialism, and the development of anticolonial
practices.”
Hernández, P., & McDowell, T. (2010). Intersectionality, power, and relational safety in context: Key concepts in clinical
supervision. Training and Education in Professional Psychology, 4(1), 29.
How can supervision be a liberatory process?

29. Critical
Exercise
Cultural
Connection in
Early
Supervision
 ExerciseOverview
 Brake into small groups of 4
 In those small groups reflect on these questions
 Question 1 –What has made me feel safe to bring more of me, my
experiences and my authenticy into supervision?
 Question 2– How can I support my supervisees to feel safe?
 Question 3 – Looking at the ADDRESSING Model handout how
could I use this in early supervision to promote connection,
understanding and communication?

30. FacilitatingGrowth and
Learning

31. Practice, Intention andTalent
Most often what people see as a ‘talent’ is the
outcome of long-term intentional practice. Intentional
practice is taking the time to regularly learn from what
you do.The myth of the 10,000 hours of practice
makes it seem that simply doing 10,000 hours leads to
expertise and excellence. However, practice with out
reflection and the intention to learn often does not
lead to improved skill.
MOST IMPORTANT QUESTION
What Can I learn FromThis?

32. Discussion
types of
clinical work
and areas of
growth.
 Individual ClinicalWork
 Group ClinicalWork
 Consultation
 Testing

33. How to
support the
growth of
clinical
competence…

34. Giving
feedback…
Having difficult
conversations.
 No Sandbagging: Feedback should be given regularly and be
clear and focused towards improvement – ‘No Sandbagging’
 Competency Driven Supervisors “promote openness and
transparency in feedback and assessment, by anchoring such in
the competency development of the supervisee.”
 When Providing Feedback Supervisors Need to Be Sensitive to
 “The power differential as a function of the supervisory evaluative
and gatekeeping roles
 Culture, diversity dimensions (e.g., gender, race, sexual orientation,
socio-economic status) and other sources of privilege and
oppression.
 Supervisee developmental level
 The possibilities of the supervisee experiencing demoralization or
shame in response to the feedback
 Timing and the amount of feedback that a supervisee can assimilate
at any given moment"
American Psychological Association. (2015). Guidelines for clinical supervision in health service
psychology. The American Psychologist, 70(1), 33.

35. Learning to
Grow
Reflecting on
ClinicalWork
Clinical Exercise
 Part 1 – Individual reflection
 Take some time and think back to a recent clinical interaction.
 Choose either a group interaction, a consult or an individual session
 Ask yourself these three questions and make some short notes for
your self.
 Question 1 –What is one thing I did well?
 Question 2 –What is one thing I learned?
 Question 3 –What is one thing that did n0t work out how I had
hoped.
 Part 2 – Small Groups
 One person be the supervisor and one the supervisee
 Supervisee is in a safe supported place with supervisor and is open to
growth.
 The supervisor facilitates a discussion around those three questions
about a real or imagined clinical interaction.