This is part 1 of 5 in a 30 hour lecture series on Clinical Supervision for Mental Health Professionals. This was made for the Approved Clinical Supervisor Certificate through the NBCC. This interactive workshop focuses on the major elements of being an effective Clinical Supervisor. In this workshop, participants will learn about the different roles and pertinent issues in Clinical Supervisor. Participants will learn the different roles that encompass clinical supervision, and learn the structural differences (and similarities) between consultation and clinical supervision. Participants will discuss the working alliance necessary in clinical supervision, and also discuss the roles that conflict and trust play in the supervisory relationship. Other issues discussed include covering types of feedback given to staff members and coworkers, and how best to give feedback, and the role that the experiential level of the supervisee plays in the structure of clinical supervision. Teaching methods include lecture, interactive exercises and group participation/discussion.
2. Definition of Clinical Supervision
1. To nurture the counselor’s professional (and, as appropriate, personal)
development.
2. To promote the development of specified skills and competencies, so as
to bring about measurable outcomes.
3. To raise the level of accountability in counseling services and programs.
Clinical supervision is a disciplined, tutorial process wherein principles
are transformed into practical skills, with four overlapping foci:
administrative, evaluative, clinical and supportive.
3. The Role of Clinical Supervision
Studies have found that training can be more critical than
experience in the development of both supervisees and
supervisors.
Supervisees and supervisors have been found not to develop
with unsupervised experience.
Experience obtained under supervision seems to be enough to
stimulate development. The scrutiny of supervision, despite the
interventions used, causes the kind of self-scrutiny that allows the
supervisee to improve.
4. Supervision Focus: Administrative
The following are some examples of Administrative duties of the
clinical supervisor:
1. Structure the counselor’s work schedule.
2. Ensure a comprehensive orientation to agency, client population,
mission and vision statements, policies and procedures, long
range strategic planning.
3. Develop, evaluate and monitor policies and procedures using
DCA and DAS standards as a guideline to ensure compliance (or
any other regulatory body the agency answers to such as JCAHO
and CARF).
4. Organizational planning and structuring, coordinating, delegating
tasks.
5. Supervision Focus: Administrative
The following are some examples of Administrative duties of the
clinical supervisor:
5. Involving staff in the designing and scheduling of activities
(including clinical programming, administrative activities such as
when paperwork can/will be completed) to maintain clinically
effective service delivery.
6. Participate in the hiring/termination, performance recognition,
disciplinary action, and other personnel decisions to maintain
high standards of clinical care.
7. Ensure workforce development and training to meet service
delivery needs.
6. Supervision Focus: Clinical
Clinical: the focus of the supervisory interaction is on the
supervisee as a counselor. The goal of supervision is to
instruct.
- Evaluates observed clinical interactions.
- Identifies and reinforces appropriate actions by the
supervisee.
- Teaches and demonstrates counseling techniques.
- Explains rationale behind specific strategies and/or
interventions.
- Confronts the supervisee constructively.
To facilitate modeling for the supervisee, a clinical supervisor
should always have clinical responsibility in one form or
another (through private practice, a small caseload, co-
facilitating groups, etc…).
7. Supervision Focus: Supportive
Supportive functions of clinical supervision include handholding,
cheerleading, coaching, morale building, burnout prevention, and
encouragement of personal growth.
This may be considered befriending a supervisee, but close,
personal relationships are inappropriate.
The role here is to help facilitate the personal and professional
growth of the supervisee.
8. Supervision Focus: Evaluative
Addressing counselor skills, clarifying performance standards, negotiating
objectives for learning, and utilizing appropriate sanctions for job
performance impairment and skill deficits.
Two Stages of Evaluation:
Stage 1 - Goal setting (assessing supervisee professional development
level and needs, formulating realistic, measurable objectives that make
performance review possible).
Stage 2 - Feedback (providing clear, constructive, humane
communication concerning the degree to which goals have been
attained).
Evaluation is essential if clinical work is to be held accountable.
9. 3 Roadblocks to Effective
Evaluation
1. Lack of skills in evaluating counselor performance.
2. Confusion about the compatibility of evaluation and supervision.
3. The anxiety-evoking aspects of evaluation. (evaluations should
create positive motivation for growth rather than get in the way of
improved performance by reducing energy and inhibiting risk
taking.
10. Consultation Defined
Consultation is a process whereby an expert enables a consultee
to deliver services more effectively to a client.
A consultant does this by increasing, developing, modifying, or
freeing the consultee’s knowledge, skills, attitudes, or behavior
with respect to the problem at hand.
Counselors assume the consultee role when in need of expert
knowledge from doctors, nurses, psychiatrists, psychologists, and
other counselors who possess high levels of expertise related to
certain types of problems (e.g., sexual abuse, child abuse, and
other problems that require advanced knowledge).
11. Consultant Role
Counselors serve as consultants to members of other
professions and to other counselors in need of their special
expertise.
Examples of Consultation Roles
1. Providing consultation to principles and teachers who need
assistance in understanding and coping with problem students.
2. To physicians who need assistance in the early identification of
symptoms related to substance abuse disorders.
3. To lawyers who need a legal opinion as to whether your client
exhibits enough good judgment in order to regain joint custody
of his children.
12. Consultation vs. Supervision
There are several distinctions between supervision and
consultation.
1. The parties in the consultation relationship are often not of the
same professional discipline.
2. Consultation is likely to be a one-time only event, whereas
supervision is an ongoing process.
3. Supervision is often imposed, whereas consultation is often
freely sought.
4. There may be no evaluative role for the consultant, whereas
supervision always has an evaluative component.
13. Organizational Consultation
When a practitioner is asked to enter an organization and
"consult" the request being made has different meanings to the
various requestors.
1. Sometimes an organization wants a specific problem "fixed”.
2. Other times information and expertise is needed.
3. At times it is a personel problem.
4. Perhaps an educational process for a level of staff is required.
Often an organization will ask you in, without giving thought to
what type of an organization they have and what it needs.
Regardless of how the organization sees their request, the
consultant needs a full compendium of skills.
14. Consultation Exercise
You have been asked to come in and consult in an organization
which has been going through some structural and interpersonal
crises. This organization was almost torn apart by a previous
management team that was very destructive and divisive. This top
management team has since left the organization, but the rifts and
clicks still exist within the organization. A new management team has
come into the organization and has attempted to deal with problems
that they have “inherited”. One of the most divisive (former)
employees was that of the middle management (clinical) director.
Even though a new director has entered the team, this role is still one
in which other “remaining” staff are still having problems with. In
other words, the new middle manager director finds herself caught up
with the fact that existing employees are having problems with her
(some of the same employees that had problems with her
predecessor).
15. Consultation Exercise
An employee (Frank) that previously quit under the old “regime” (due to
legitimate charges of racism of that old regime and perceived abuse by the
old clinical director) has now approached the new management with a
request to be hired (his old position has reopened, and the new management
team is considering this request). This event has rekindled an old fire that
seemed to not be totally put out, but just smoldering under the surface. Some
staff members have reacted negatively to this proposition of rehiring the old
staff member (one staff felt this old staff member was part of the past
problems the organization was having, and the new middle manager also
fears that her position will be further under fire if this old staff member were to
be rehired). The executive director feels this would be an excellent
opportunity to fully address these issues and try to put all of this “political”
unrest and divisiveness to rest.
The executive director (E.D.) feels strongly about hiring this old staff member
(as he has impeccable credentials and would bring to the staff a missing area
of expertise). Seeing the problems that lie ahead, the E.D. brings you in as
the organizational consultant.
16. Consultation Exercise
1. What are the basic organization issues that exist, which need to
be dealt with by you as the consultant?
2. Given the divisiveness and fears that exist currently, what are your
recommendations to the executive director regarding the hiring of
this old staff person?
3. What kind of interventions would you suggest for this organization
so that these old patterns can be dealt with and the staff can move
on from being stuck at their current level of functioning?
17. Working Alliance
The working alliance, or “collaboration to change” is common in to
all models of therapy, and common to the supervisory
relationship.
It is composed of 3 elements:
1. The bond between therapist and client (supervisor and
supervisee).
2. The extent to which they agree on goals.
3. The extent to which they agree on tasks to obtain the goals.
The real change in supervision occurs during the process of
weakening of the relationship and then repair of the relationship.
18. Working Alliance Main Features
There are 4 main features in viewing the working alliance:
1. The (supervisor) must possess certain facilitating human
qualities, the qualities of a good parent.
2. These qualities permit the potential establishment of a power
base for the (supervisor), in which the (supervisor) uses the
(supervisee’s) desire to please as leverage.
3. Within the context of the therapeutic relationship,
experiential learning occurs through the normal
developmental processes of imitation and identification.
4. The success of this relationship-based learning experience
depends on preexisting (supervisee) qualities that permit at
least a beginning level of trust and openness.
19. Working Alliance Goals
Goals in the working alliance model are defined (in part) as the
expectations to the nature and quality of the supervisory relationship.
For example one such goal would be to ensure a constructive supervisory
learning environment, that foster’s an awareness of others, of oneself in terms
of motivation, self-efficacy. Foster two-way feedback with supervisee.
Expectations can be defined as “a person’s anticipatory beliefs about the
nature (i.e., roles, behaviors, interactions, and tasks) or outcome of a
particular event.”
For example one such goal would be teaching the purpose of clinical
supervision to the supervisee, and having the supervisee understand the
boundaries that exist within that supervision relationship.
The congruence of expectations (i.e., shared goals) between or among
people in a relationship is at least as important, and likely more important,
than the expectations of any one individual.
20. Role Induction
To maximize the likelihood of supervisor-supervisee congruence
in expectations for supervision, an initial negotiation or contracting
should occur between them.
When the supervisee does not know the role options, it is
possible to educate him/her about expected behaviors and roles.
This is called role induction.
Another supervisory strategy is to assess participants’
expectations.
21. The Role of Conflict
Role Conflict occurs:
1. When the supervisees are required to engage in two or more
roles that may require inconsistent behavior (e.g., needing to
reveal personal and professional weaknesses while also needing
to present themselves as competent to the supervisor).
2. When the supervisees are required to engage in behavior that is
incongruent with their personal judgment (e.g., supervisor giving
directives that are inconsistent with the supervisees theoretical or
ethical beliefs).
22. The Role of Conflict
In any relationship, whether personal or professional, conflict will
inevitably occur between the supervisor and supervisee.
The conflict often stems from a “mistake” that one party has
made. The manner in which the parties resolve or fail to resolve
that conflict will dictate whether the relationship continues to grow
and develop, or continues to stagnate.
The “weakening and repair” of the working alliance between two
people constitutes the basis of therapeutic change.
23. The Role of Trust
Mutual trust between supervisee and supervisor is essential to
effective supervision, and effects the behavior of all parties
involved in this process.
The supervisee and supervisor must overcome their feelings of
vulnerability.
- For supervisees, the vulnerability concerns their personal
feelings, professional development and abilities, and even
their career paths.
- For supervisors, there is some personal vulnerability, but
there is also professional vulnerability that stems from the
responsibility to the welfare of the client.
24. The Role of Trust
An atmosphere of safety is a necessary condition to counteract
the vulnerability that exists in the supervisory relationship.
One characteristic of trust is that it always exists in some degree:
it is not an all or nothing phenomenon. It also occurs over many
interactions and interpersonal risks taken together.
For supervisees, the level of trust will influence the degree to
which they will disclose what is occurring in interactions with the
client.
For supervisors, trust can help avoid too much intrusion into and
control over the supervisee’s work.
25. Working Alliance & Conflict Exercise
Elena is a Licensed Social Worker working in a mental health agency.
This is her first job post masters, and she has been working there for over
2 years. During the first year of her job, she was horribly mistreated by
her clinical supervisor. This supervisor demeaned her work, and did all
that she could to point out Elena’s professional weaknesses. This old
clinical supervisor (Goofus) leaves and they hire a new clinical supervisor
(Gallant). “Gallant” was told of Elena’s past woes and did her best to
develop a strong therapeutic working alliance with Elena. This work was
slow as Elena had been traumatized and was very slow to trust this new
supervisor. During clinical supervision, mistakes were made in that Elena
had taken issue with a comment the supervisor made about possible
transference issues with a client. The supervisor attempted to repair any
issues that Elena had, however, other problems would pop up (which
included the need to give Elena a written warning for excessive lateness).
26. Working Alliance & Conflict Exercise
The conflict within this relationship came to a boil when, during group
supervision, Elena decided to show a tape of her work with a client.
Elena made the statement “I’m feeling very vulnerable” before showing
the tape. As the tape progressed, the supervisor interjected a point of the
tape where Elena was leading the client to answer in a certain way. The
supervisor pointed this out to Elena. Towards the end of Elena’s
presentation, the supervisor praised Elena for the work she did with this
client. Elena was distraught after this and went to the supervisor’s boss,
with a plea that she could not work with her clinical supervisor due to her
misinterpretations of transference and her inconsiderate comments
regarding her work with a client. Elena felt that past history was
repeating itself and asked this (upper management) person to intervene
in some way.
27. Working Alliance and Trust Exercise
1. What did the clinical supervisor do wrong, if anything, during the
group supervision when Elena showed the tape?
2. Are there any issues of trust that have occurred?
3. If you found a problem with the clinical supervisor in the group
setting, what different course of action could she have taken to avoid
this problem?
4. What actions, if any, should the upper management person take to
help rectify this situation?
5. What would be a good intervention for Elena and the Clinical
Supervisor, in order to help restore the damaged working alliance,
28. The Role of Power within Supervision
Social or interpersonal power is a critical factor in supervision.
Power is defined as the capacity to influence the behavior of
another person. Power has been categorized as:
1. Referent – derived from interpersonal attraction and based on
trainees perceiving that they hold in common with supervisors
relevant values, attitudes, opinions, and experiences.
2. Expert – the display of such resources as specialized knowledge
and skills, confidence, and rationality.
3. Legitimate – a consequence of perceived trustworthiness
because the supervisor is a socially sanctioned provider of
services who is not motivated by personal gains.
29. Supervisee Experiential Level
With experience, the supervisee should develop more:
1. Self-awareness of behavior and motivation within counseling
sessions.
2. Consistency in the execution of counseling interventions.
3. Autonomy (in decision making without need of immediate
supervisory feedback).
4. Sophisticated ways to conceptualize the counseling process and
the issues their clients present.
Novice supervisees should have supervision focus on
conceptualization issues with clients. Focusing on personal
issues may be inappropriate unless these issues are blocking the
supervisee from grasping conceptual information.
30. Supervisee Experiential Level
Novice supervisees will be more rigid and less discriminating in
their delivery of therapeutic interventions.
More advanced supervisees are more flexible and less dominant
when delivering interventions such as confrontation.
- A lack of flexibility or introduction of dominance may indicate
that a particular case is either personally threatening for the
supervisee, or they experience the case as beyond his/her
level of competence.
31. Supervisee Experiential Level
Role ambiguity is a hallmark of the novice supervisor. Role
ambiguity occurs when the supervisee is uncertain about role
expectations the supervisor and/or agency has for him/her.
Role induction should include both what the expectations are as a
supervisee and what the expectations and implications are of the
supervisee as helper (counselor).
Role conflict emerges as an issue with more experienced.
- 2 or more roles that require inconsistent behavior.
- When they are required to engage in behavior that is
incongruent with their personal judgment
32. Supervisee Experience and
Conflict Exercise
Alex is an experienced clinician who has been in the field for over
7 years. He has his LCADC, and a masters in counseling. He
comes into supervision with you and discusses a particularly
difficult case that he has been working with for the past 4 months.
The case involves a family, in which the parents are leading
causes of the dysfunction within the only son (who is the identified
client). Recently Alex shifted work from individual work with the
adolescent, to family work. In the context of this work, Alex has
become stuck in the treatment of the family. The family does not
appear to want to change, despite stating they need therapy.
Father espouses racist terms in therapy sessions, and mother
states that she has never really loved or bonded with her son.
33. Supervisee Experience and
Conflict Exercise
Alex feels that if he continues to just work with the adolescent, the
family is too destructive and devise (yet not enough to have the
child removed from the home), and any positive work that is done
in therapy will be erased at home. At the same time, he states
that when in family sessions he has “urges to reach over and
smack the shit out father” due to father’s racism and general
negativity towards his son. Alex also feels negatively towards the
mother. The end of this discussion, Alex states that this family
goes against all that he stands for as a professional and as a
Christian. Alex then questions you as to how he should proceed
with family.
34. Supervisee Exercise Questions
Given the extreme nature of the role conflict that is occurring in
Alex, how do you feel he should proceed with this family?
Does Alex level of experience play into the decision you have
made about the future direction of this case? How would your
decision and feedback have been different if Alex just came out of
college and this was his first job experience?
Does the decision you just made cause more of a role conflict for
Alex, and if so, how should this be dealt with in the supervisory
process?
35. Feedback
An important process of feedback is that supervisees compare
the feedback they have been given to their own self-assessment.
Thus supervisees are much more open to feedback if it
corresponds to their own ideas as to how they are functioning.
If it’s highly disparate from anything we’ve thought about, then it is
harder to accept and integrate.
36. Feedback
Factors that make feedback easier to accept are:
1. If it does coincide with the supervisee’s impression of his or her own
behavior;
2. If it’s presented as a developmental goal, or part of a supervision
plan, that it’s part of development;
3. If it’s behaviorally-linked and specific, and close in time to when the
actual behavior was observed;
4. If the supervisor models a reflective process regarding the feedback.
And this is, when the supervisor receives feedback, reflects upon it
and integrates it into their on-going behavior or at least tries to
contextualize it and understand it, and then integrate it (and models
how that can be done for the supervisee).
37. Feedback
Feedback that’s viewed as negative can be hard to accept and
integrate, and can be de-motivational.
That’s why it’s so important that even if one is giving what is
deemed negative feedback that it be framed constructively, in
terms of plans, action plans for improvement.
Improvement is most likely if recipients are positive about
receiving feedback, believe change is possible and desirable –
that is, motivated to change – and use it to develop performance
goals and to take action for improvement.
38. Types of Feedback
Facilitative: Facilitate discussion by asking non-directive
questions (e.g., “what did you see happening at that moment” …
“how did you feel when the client responded in that manner”).
Confrontive: Addressing specific behaviors or interventions on the
part of the counselor (e.g., “why did you say that, it didn’t seem to
have the effect you wanted?”).
Catalytic: Asking what-if questions. The supervisor provokes the
counselor to take a different perspective on the situation.
39. Types of Feedback
Conceptual: A conceptual response contributes new information and a
different way of visualizing the case. Examples include:
1. “There seems to be some transference going on, lets talk
about how this transference affects the session”
2. “If you recall from Yalom, this group appears to be at an
early stage of development. Let’s review early stage issues and
see how you can get past this.”
Prescriptive: Skills oriented supervisory style. Directing the counselor to
respond in a particular manner the next time a certain set of
circumstances occurs. This is usually done with new counselors, or
counselors with limited knowledge in a particular area.
40. Guidelines for Giving Corrective
Feedback
Deciding whether to give corrective feedback:
1. Assess your standing as a credible, trustworthy source before giving
corrective feedback.
2. Give corrective feedback only if your underlying motive is to help by
providing information.
3. Do not give attempt to disguise your feedback as corrective if your true
intent is to control, to expression aggression, or to justify your actions.
4. Give corrective feedback only if the receiver is likely to be able and
willing to take appropriate action.
5. Consider whether the organizational system is likely to reward the
desired behavior before you give corrective feedback.
41. Guidelines for Giving Corrective
Feedback
Deciding what to say:
1. Describe the problem behavior and avoid personal attributions.
2. Explain the consequences of the behavior and your feelings
about it.
3. Provide sufficient specific information so the receiver may
become self-correcting, but not so much information as to be
redundant.
4. Emphasize desired, not undesired, behaviors.
42. Guidelines for Giving Corrective
Feedback
Descriptive rather than judgmental (evaluative): “You interrupted
Ann three times” rather than “You sure are impatient.” “You spoke
clearly and your points were well organized” rather than “Great
session.”
Specific rather than general: “Your hands were in constant motion
and your foot was tapping” rather than “Your non-verbals were
distracting.” It should be specific to the behavior being learned.
Timely: Feedback is most effective when given closely after the
incident to be reported. However, you should be sensitive to whether
the person is able to receive the feedback at that time and place.
43. Guidelines for Giving Corrective
Feedback
Focused: Feedback should be addressed to the subject at hand—
the behavior being worked on. Don't overload the person with
extraneous information.
- "Gunny-sacking" is an example of a violation of timeliness and
focus where a person suddenly unloads every complaint they've
ever had about your behavior for the last months.
Checked for Accuracy: If there is any doubt that the receiver
understands your message, ask the person to rephrase so you can be
sure they heard you correctly. In group situations, either sender or
receiver can ask other group members whether or not their
perceptions matched the sender's.
44. Guidelines for Giving Corrective
Feedback
Deciding how and when to give feedback: C = Clear:
1. Give corrective feedback in a considerate tone using “I” rather
than “you” messages.
2. Give corrective feedback privately and immediately, rather than
publicly and belatedly.
Deciding how to handle the receiver’s response:
1. Ask for reactions; be willing to be influenced.
2. Seek agreement that a problem exists.
45. Feedback Summary: C.O.R.B.S.
C = Clear: Be clear about any feedback you deliver. Vague feedback causes
confusion, anxiety and frustration in supervisees.
O = Owned: The feedback you give is your own perception and not the ultimate
truth.
R = Regular: Regular feedback is more useful to supervisees. Try to give feedback
as close to the event as possible and early enough for the person to do something
about it.
B = Balanced: Balance the negative with the positive feedback, depending on the
supervisee sandwiching of feedback may be necessary.
S = Specific: Generalized feedback is hard to learn from. Phrases such as “You
are a frustrating counselor” can lead to hurt and anger. “I feel frustrated when you
don’t follow the recommendations the team made regarding this case” is more to
the point and attached to specific behaviors.
46. Feedback and Fragility Exercise
Bob O. is a relatively new therapist (less than 2 years of
experience), and a particularly fragile soul. He clearly wears his
heart on sleeve in that his reactions to constructive criticism is
visceral in nature (he become flush, facial expressions and
mannerism change). You are quite aware of his reactions to your
feedback and this has even been openly discussed between the
two of you. Bob O. denies the reactions and denies any
defensiveness on his part … in fact he becomes quite defensive
in his denial yet given his fragility of feedback you question
whether you should use this great opportunity to point out the
process of the supervision relationship. Curiosity (and your
insatiable appetite for human drama) gets the best of you and you
decide to point out that he is becoming very defensive about his
defensiveness.
47. Feedback and Fragility Exercise
Bob O. appears to be more open to this feedback and thanks you
for pointing out this behavior in him. Supervision ends, and life
goes on. Next week Bob O. calls out sick on his next regularly
scheduled supervision appointment. You decide not to make an
issue out of this in fear that this may cause a total breakdown of
his immune system, causing further employee rolling blackouts.
However, the next week passes and Bob O. calls out sick again.
You decide to tempt fate and address the issue with Bob O. his
next day back.
48. Feedback, Fragility Exercise Questions
How do you handle this situation of talking with Bob O. about his
latest behavior?
Which type of corrective feedback (i.e., facilitative, confrontive,
catalytic, conceptual, and prescriptive) should be used? Why?
Give an example of a question you would use (either facilitative,
confrontive, catalytic, conceptual, or prescriptive).
Bob O. continues to deny that there is a problem that exists,
where do you go from there?
49. The Future - Role of Clinical
Supervision
Supervisor and Supervisee competence can always be
enhanced.
Institutions and individuals have a responsibility for continuous
quality improvement.
State agencies and training institutions can initiate programs,
tailored to institutions or individuals unique local situations (e.g.,
clinical supervision as it would appear in a Therapeutic
Community may have different characteristics than that of an
Outpatient Clinic).
50. The Future - Role of Clinical
Supervision
Methods for improving clinical practice
Training workshops
Clinical supervision
Clinical and supervision guidelines
Evidence-based clinical methods
Practice-based clinical methods
Clinical audit
Outcomes monitoring and management
Outcomes benchmarking
Continuous quality improvement
51. The Future - Role of Clinical
Supervision
Useful strategies for improving clinical practice
Training workshops
Supervision of clinical supervision
Supervision guidelines
Practice-based methods
Outcomes monitoring and management
Practice-based methods are focused directly on the practices of the clinician
and/or supervisor.
In improving supervisor performance the following criteria can be used: 1)
implementation of supervisor self-report measure; 2) supervisor guidelines; and 3)
objective analysis of supervisor behavior.
Supervisee measure of satisfaction with supervision does NOT serve as an
outcomes measure of: 1) client progress; or 2) the development of clinical
competencies.
52. Bibliography
• Bernard, J. M. & Goodyear, R. K. (2003). Fundamentals of Clinical
Supervision, 3rd
Ed. Allyn and Bacon, Boston, MA.
Bordin, E. S. (1979). The Generalizability of the Psychodynamic Concept
of the Working Alliance. Psychotherapy: Theory, Research and Practice,
16, pp. 252-260.
Cape, J. & Barkham, M. (2002). Practice improvement methods:
Conceptual base, evidence-based research, and practice-based
recommendations. British Journal of Clinical Psychology, 41, pp. 285-
307.
Center for Substance Abuse Prevention Training Library. (2002). Training
of the trainers for the community and migrant health center course
(Giving Feedback).
53. Bibliography
Daniels, J., & Larson, L. (2001). The impact of performance feedback on
counseling self-efficacy and counselor anxiety. Counselor Education and
Supervision, 41, 120-130.
Falender, C. A. & Shafranske, E. P. (2004). Clinical Supervision: A Competency-
Based Approach. American Psychological Association, Washington, DC.
Falender, C. A. (2011). Online Transcript of Competency Based Supervision
Overview. http://www.mirecc.va.gov/visn19/images/videos/falender.pdf
Horvath, A. O. & Greenberg, L. S. (1994). The Working Alliance: Theory,
Research, and Practice. John Wiley and Sons, New York, NY.
Itzhaky, H. & Sztern, L. (1999). The take over of parent-child dynamics in a
supervisory relationship: Identifying the role transformation. Clinical Social Work
Journal, 27(3), Fall, 247-258.
54. Bibliography
Itzhaky, H. (2000). The secret in supervision: An integral part of the social
workers professional development. Families in Society, 81(5), 529-537.
Latting, J. K. (1992). Giving Corrective Feedback: A Decisional Analysis.
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• Powell, D. J. & Brodsky, A. (2004). Clinical Supervision in Alcohol and
Drug Abuse Counseling. Jossey-Bass Publishers, San Francisco, CA.
Robyak, J. E., Goodyear, R. K., & Prange, M. (1987). Effects of
supervisor’s sex, focus, and experience on preferences for interpersonal
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