Theory And Practice Of Supervision

Supervision theories and practices began emerging as soon as counsellors started to train other counsellors (Bernard & Goodyear, 2009). Several different theoretical models have developed to clarify and support counselling supervision. The focus of early models of supervision had generally been based on counselling theories (such as Cognitive Behavioural Therapy, Adlerian or client-centred), but these orientation-specific models have begun to be challenged as supervision has many characteristics that are different to counselling. Competency as a counsellor does not automatically translate into competency as a supervisor, and when supervisee/supervisor orientations differ, conflicts may arise (Falender & Safranske, 2004).

More recent models of supervision have integrated theories from psychology and other disciplines, for one-to-one, peer and group supervision. As supervision has become more focused, different types of models emerged, such as developmental models, integrated models, and agency models. As a result, these models have to some extent replaced the original counselling theory models of supervision, and supervisors may utilise several different models to qualify and simplify the complexities of supervision (Powell, 1993). This paper will briefly look at a definition of supervision, and an outline of two different models – agency and developmental.

What is Supervision?

Supervision is the process where by a counsellor can speak to someone who is trained to identify any psychological or behavioural changes in the counsellor that could be due to an inability to cope with issues of one or more clients. A supervisor is also responsible for challenging practices and procedures, developing improved or different techniques, and informing clients of alternative theories and/or new practices, as well as industry changes. The supportive and educative process of supervision is aimed toward assisting supervisees in the application of counselling theory and techniques to client concerns (Bernard & Goodyear, 2009).

The supervisor is responsible for monitoring the mental health of their supervisee, in turn protecting the public from unhealthy counsellors. Counsellors can face issues such as transference and burn out without any recognition of the symptoms. A supervisor should notice the symptoms before the counsellor (Australian Counsellors Association, 2009).

Supervision is a formal arrangement for counsellors to discuss their work regularly with someone who is experienced in counselling and supervision. The task is to work together to ensure and develop the efficiency of the counsellor/client relationship, maintain adequate standards of counselling and a method of consultancy to widen the horizons of an experienced practitioner (ACA, 2009).

The supervisor’s primary role is to ensure that their clients are receiving appropriate therapeutic counselling. By ensuring the counsellor continually develops their professional practice in all areas, the supervisor ensures a counsellor remains psychologically healthy. The supervisor is also responsible for detecting any symptoms of burn out, transference or hidden agendas in the supervisee. The Australian Counsellors Association (2009) recommends that supervisors cover the following as a matter of course:

Evaluation

• Supervisee’s counselling;
• Developing process of self-review;
• Quality assurance;
• Best practice;
• Service outcomes of service delivery;
• Identifying risk for supervisee and clients;
• Referrals;
• Follow up on client progress;
• Helping the counsellor assess strengths and weaknesses.

Education

• Establishing clear goals for further sessions;
• Providing resources;
• Modelling;
• Explaining the rationale behind a suggested intervention and visa versa;
• Professional development;
• Interpreting significant events in the therapy session;
• Convergent and divergent thinking;
• Use of self;
• Topping up;
• Facilitating peer connection;
• Duty of care;
• Legal responsibilities.

Administration

• Procedures;
• Paperwork;
• Links;
• Accounting;
• Case planning;
• Record keeping;
• Insurance.

Support

• Advocate;
• Challenge;
• Confront;
• Empower;
• Affirm;
• Availability;
• Empowering;
• Use of self.

A range of different models have evolved to provide a framework for these topics within which supervisors of can organize their approaches to supervision, and act as an aid to understanding reality (Powell, 1993).

Agency Model of Supervision – Kadushin

Kadushin describes a supervisor as someone “to whom authority is delegated to direct, coordinate, enhance, and evaluate on-the-job performance of the supervisees for whose work he/she is held accountable. In implementing this responsibility, the supervisor performs administrative, educational, and supportive functions in interaction with the supervisee in the context of a positive relationship” (Powell, 1993).

In educational supervision the primary issue for Kadushin is the counsellor knowing how to perform their job well and to be accountable for work performed, and developing skills through learning and feedback. The object is to increase understanding and improve skill levels by encouraging reflection on, and exploration of the work (Tsui, 2005).

In supportive supervision the primary issue is counsellor morale and job satisfaction, as well as dealing with stress. The stresses and pressures of the coaching role can affect work performance and take its toll psychologically and physically. In extreme and prolonged situations these may ultimately lead to burnout. The supervisor’s role is to help the counsellor manage that stress more effectively and provide re-assurance and emotional support (Tsui, 2005).

The administrative function is the promotion and maintenance of good standards of work and adherence to organisational policies and good practice. This includes reviews and assessments. The interpretation here is that the supervisor inducts the counsellor into the norms, values and best practices. It is the ‘community of practice’ dimension ensuring that standards are maintained (Tsui, 2005.

Not every supervision session will involve all three areas or functions, and at different times there may be more of a focus on one area rather than another.

The supervisor cannot avoid the pressure that arises from their responsibility to the workplace, other staff, and to clients. No simple model of supervision is to be expected to be practical in every situation. Supervisors are expected to adapt approaches to the developmental level of supervisees, and both must adapt to the varying demands of any professional situation (Powell, 1993).

For this model, the focus of supervision is as a prompt for behavioural change and skill acquisition. The emphasis is on persuading staff to learn “how to use oneself in counselling to promote behavioural change in the client” (Powell, 1993).

The supervisor’s attention should be on the activities of the supervisee rather than on study of the supervisee themselves. With a focus on the activity, rather than the worker, it allows the supervisee to listen to constructive criticism rather than feeling compelled to defend themselves from a personal attack (Tsui, 2005).

This model has several strengths in that it is very flexible, and open to exploration and experimentation. It is also more challenging for both the supervisor and supervisee. This style of supervision can be tailored to meet different needs and variables. This model may prove unsatisfactory when the supervisor has insufficient experience to be able to provide proper direction and support, and where supervisor skills do not allow for appropriate evaluation of the supervisee (Powell, 1993).

Developmental Models of Supervision – Erskine

Underlying developmental models of supervision is the notion that as people and counsellors we are continuously growing and maturing; like all people we develop over time, and this development and is a process with stages or phases that are predictable. In general, developmental models of supervision define progressive stages of supervisee development from novice to expert, each stage consisting of discrete characteristics and skills (Bradley & Ladany, 2000).

For example, supervisees at the beginning or novice stage would be expected to have limited skills and lack confidence as counsellors, while middle stage supervisees might have more skill and confidence and have conflicting feelings about perceived independence/dependence on the supervisor. A supervisee in a later developmental stage is expected to employ good problem-solving skills and be reflective about the counselling and supervisory process (Haynes, Corey, & Moulton, 2003).

Erskine (1982) identifies three stages in the development of the skills of a therapist, each of which represents specific characteristics and responds to specific training needs. In the beginning stage of training, therapists have operational needs as they are developing professional skills, a sound theoretical reference system, and intervention techniques. They also have emotional needs: to feel comfortable in their professional role, to be reassured of their ability to do the work, and to feel adequate to act in this new undertaking.

This is the stage at which trainees most need positive motivations centred on their skills so that they can know their strengths and on which they can build their skills. Erskine (1982) suggests temporarily ignoring what the trainee does not do well so as to reduce any feelings of inadequacy and to support self esteem, provided this does not cause harm to the trainee or clients.

During the intermediate stage of training, Erskine proposes that trainees need to reinforce their personal identity as therapists, learn to define the direction of treatment, and draw up a treatment plan. At the personal level, their goal is to integrate their sense of self and to work on their emotions in order to understand and solve any personal difficulties that might create obstacles to their contact with clients. According to Erskine, in this second phase, trainees’ personal therapy is of highest importance (Bradley & Ladany, 2000).

During the advanced stage of training, trainees need to learn various approaches and to integrate theoretical frameworks, to recognise alternative interventions, and to choose among them so as to encourage flexibility. Trainees must also practise self-supervision and learn to differentiate between observations of behaviour, and theorising about observations (Stoltenberg & Delworth, 1987).

One of the potential drawbacks of developmental models is that not only do people learn in different ways but they also develop at diverse speeds, in varied areas. The development model does not show how the supervisee develops and moves from one stage to the next, and how this progress is connected to the supervision process (Bradley & Ladany, 2000).

For this model, it is necessary to modify the relationship to meet the supervisee’s needs based on their current developmental level. Supervisors employing a development approach to supervision need to be able to accurately identify the supervisee’s current stage of development and provide feedback and support appropriate to that developmental stage, while at the same time assisting the supervisee’s advancement to the next stage (Stoltenberg & Delworth, 1987)

Commonalities

Regardless of the model used or theoretical background, any model or theory of supervision should cover some common fundamental principles. Supervisors are responsible for the professional developmental of those under supervision. These responsibilities involve issues such as informed consent, confidentiality, and dual relationships (ACA, 2009).

Ethical and legal concerns are central to supervision. The balance between a supervisory relationship and a therapeutic one only becomes a problem when the supervisor discovers that personal problems hold back the supervisee. The supervisory relationship becomes a dual relationship if the supervisor tries to become the student’s therapist. A dual relationship is considered unethical (Powell, 1993).

Dual relationships can occur in different ways. A supervisory relationship can develop into a close, emotional relationship between supervisor and supervisee. The supervisory relationship will in this situation be less effective and supervision should not continue. In consensual relationships the emotional relationship can continue; however, the professional relationship has to end. The supervisory relationship needs to be governed by the same ethical principle as is the therapeutic process (Powell, 1993).

Different ways of evaluating the supervisory process are important both for the supervisor and the supervisee. Establishing a contract for the supervisory relationship makes evaluation easier. The contract should include the student’s developmental needs, the supervisor’s competencies, and supervisory goals and methods (Stoltenberg & Delworth, 1987).

Throughout the supervision process, the supervisor is responsible for evaluating the quality of the supervisory relationship (Powell, 1993). This responsibility especially comes to bear when a conflict arises or an impasse develops. Investigating problems and challenges often begins with asking questions about various aspects of the supervisory relationship. When asking these questions, it is important to consider not only how the counsellor may be contributing to a problem but also how the supervisor may be contributing.

The supervisor has a responsibility to ensure that confidentiality is maintained, and any information obtained in a clinical or consulting relationship is discussed only for professional purposes and only with persons clearly concerned with the case (ACA, 2009).

Conclusion

Supervision is not a senior counsellor watching over the shoulder of a new or junior counsellor. Nor is it a conversation between two practitioners, or a dialogue of personal matters with a counsellor. It is a distinct intervention, to enhance professional functioning and monitor the quality of counselling services being provided (Bernard & Goodyear, 2009).

Clinical supervision is a complex activity; it can be education or support, assists with confidence or doubts, it can process through different levels or stages. “The competent clinical supervisor must embrace not only the domain of psychological science, but also the domains of client service and trainee development. The competent supervisor must not only comprehend how these various knowledge bases are connected, but also apply them to the individual case” (Bradley & Ladany, 2000). The purpose is to help identify obstacles that prevent the supervisee from learning, growing and ultimately helping their client.

No matter what theoretical framework is used, supervision can be used as a means to develop professionally. Like any other relationship in life it is not perfect, nor is it an answer to every problem. Like any other relationship, it is necessary to be honest, consistent, and dependable, and work hard to build trust. Supervisors and supervisees have to work together to make it successful.

Powell (1993) theorised that the emphasis should not be on why a counsellor feels a certain way, but on being able to put a end to behaviours that inhibit change. Powell advises professionals to develop their own model of supervision in order to understand what one is doing and why.

Whatever model of supervision if employed, a supervisor should seek to encourage ongoing professional education, challenge the supervisee to improve their skills and techniques

A supervisor should intervene where client welfare is at risk, and ensure that ethical guidelines and professional standards are maintained.

A supervisee should endeavour to uphold ethical guidelines and professional standards, be open to change and alternative methods of practice, maintain a commitment to continuing education and consult the supervisor in cases of emergency.

Supervision, regardless of any model used, should enable counsellors to acquire new professional and personal insights through their own experiences.

REFERENCES

Australian Counsellors Association (2009). Professional Supervision. Accessed 2nd February 2010.

http://www.theaca.net.au/docs/Supervision_Complete.pdf

Bernard, J. M., & Goodyear, R. K. (2009). Fundamentals of clinical supervision (4th ed.). Needham Heights, MA: Allyn & Bacon.

Bradley, L.J., & Ladany, N. (2000). Counsellor Supervision: Principles, Process and Practice. Philadelphia, PA: Brunner-Routlege.

Erskine, R. G. (1982). Supervision for psychotherapy: Models for professional development. Transactional Analysis Journal, 12, 314-321.

Falender, C. A., & Shafranske, E. P. (2004). Clinical supervision: A competency-based approach. Washington, DC: American Psychological Association.

Haynes, R., Corey, G., & Moulton, P. (2003). Clinical supervision in the helping professions: A practical guide. Pacific Grove, CA: Brooks/Cole.

Powell, D. (1993). A developmental approach to supervision. In Clinical supervision in alcohol and drug abuse counselling. (p. 58-84). New York, NY: Lexington Books.

Stoltenberg, C. D., & Delworth, U. (1987). Supervising counsellors and therapists. San Francisco, CA: Jossey-Bass.

Tsui, Ming-Sum (2005). Social work supervision: contexts and concepts. Thousand Oaks, CA: Sage Publications.