Research Paper on Training for Clinical Supervisors

Introduction

In the mental health field, clinical supervision has become an interprofessional competency in ensuring the safety of patients and practitioners. Clinical supervision has a significant impact on counselors since it is a prerequisite for the maintenance of quality care (Warner, 2015). Counselor educators have for long held the belief that supervision is necessary for counseling as it encourages systematic supervision in both public and private sector counseling contexts. Milne et al. (2011) assert that some of the main benefits of clinical supervision include improved service to the clients, high satisfaction of the practitioners, decreased staff turnover, and low training as well as administrative costs. Training clinical supervisors is a source of complex clinical supervision skills which lead to general support for the supervisee and maintenance of high-quality practice (Stoltenberg & McNeill, 2011). Due to the increasing cultural diversity among clinical supervisors and their supervisees, one of the vital areas for training is on cultural competence as well as the dynamics arising from the relationship between the supervisor and the supervisee. This paper provides a training which can be used for clinical supervisors to ensure that they are effective in their supervisory role.

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Cultural Competence

Cultural competence is a multidimensional concept which encompasses four aspects- cultural knowledge, cultural sensitivity, cultural awareness, and skillful actions. Additionally, according to Warner (2015), cultural competence can be seen as the process by which supervisors respond respectfully as well as effectively to the different races, languages, classes, races, ethical backgrounds, and other diverse factors of their supervisees. Clinical supervisors should have various beliefs and attitudes which will ensure that they are culturally competent in their supervision relationship. One of those is that they should move from being culturally unaware to being aware and sensitive to their own cultural heritage and valuing as well as respecting the differences in their culture to those of others. Additionally, they should be aware of their personal values and biases and the manner in which such values affect minority supervisees. Clinical supervisors should be comfortable with any differences which may arise between them and their supervisees in terms of their races and beliefs. It is vital for the clinical supervisors to become sensitive to the circumstances such as personal biases and sociopolitical influences which may influence their reference to supervisees from minority groups (Warner, 2015). Having such skills for the clinical supervisors will make sure that they understand the manner in which they can help their supervisees and thus provide them with the necessary support to provide quality services to their clients.

Since clinical supervision can happen in face-to-face settings, small groups, dyads, and even triads, it is vital for the clinical supervisors to adopt supervision strategies which are full of cultural competence (Milne et al., 2011). In specific, they should discuss their own cultural development with their supervisees which would display the transparency of their cultural development. Additionally, they should possess knowledge of cultural identity development models as well as the intersectionality of the multiple identities of human development. Clinical supervisors should incorporate various activities in their supervision which encourage dialogue and awareness about culture. Moreover, Warner (2015) states that they should assess the characteristics of their supervisees especially those to do with self-awareness, openness, cognitive processes, and cultural empathy. Clinical supervisors should encourage their supervisees to practice not only verbalizing but also writing down their case conceptualizations. In the supervision relationship, clinical supervisors should understand the culture as well as power dynamics and discuss them openly with their supervisees. Establishing a working alliance which seeks to establish a collaborative agreement on the expectations and goals of supervision is key for the clinical supervisors. They should also attend to the emotional responses to cultural contexts as well as the dynamics of their supervisees.

Dynamics of Supervisor/Supervisee Relationship

Although ethical standards in the mental health field discourage and even caution practitioners from engaging in multiple relationships with their clients, in a supervisor-supervisee relationship, the issue tends to be more complex. Milne et al. (2011) note that many supervisors tend to have more than one relationship with their supervisees and the situation sometimes become unavoidable. One of the relationships which exist is the circumstantial/coincidental relationship. In specific, multiple relationships can be inevitable due to coincidence or expected circumstances. Other relationships can be structural due to multiple professional roles. For instance, a clinical supervisor may take advantage of a supervisee with the knowledge that the supervisee will agree just because of the power difference (Stoltenberg & McNeill, 2011). Shifts in professional roles especially where a former student now becomes a coworker can result in a shift in power dynamics because of the new relationship created. Personal and professional role conflicts can also arise where blurred personal and professional roles are established. Moreover, predatory professional relationships present various dynamics where clinical supervisors concerns themselves with their needs and seduce/exploit their supervisees through various means (Milne et al., 2011). Clinical supervisors should understand those dynamics in a supervisor-supervisee relationship and adopt mechanisms for addressing them.

Addressing the dynamics of the supervisor-supervisee relationship requires the adoption of various strategies and techniques. One of those is discussing the dynamics with their supervisees and referring the supervisees to therapy if such relationships become a bother. Clinical supervisors should never take the therapist role for their supervisees. Additionally, the supervisors should be guided by the ACA Code of Ethics especially Standard F.3.a. which requires the counseling supervisors to clearly define and even maintain an ethical, professional, personal, and social relationship with their supervisees (Milne et al., 2011). Additionally, Standard F.3.b. prohibits any form of sexual or romantic interactions and relationships with their supervisees as they compromise the effectiveness of the supervision. Since the Code prohibits supervisors from condoning or even subjecting any of their supervisees to sexual harassment, it is key that they ensure that they avoid such types of behaviors. Stoltenberg & McNeill (2011) hold that clinical supervisors should always be aware of the power differential between them and their supervisees and thus take actions which would ensure that the difference does not become a hindrance to effective supervision. A need exists for supervisors to be self-aware of the multiple relationships and evaluate ways that such relationships might impact the performance of their supervisory roles.

Evaluation Process

One of the vital roles of a clinical supervisor it to evaluate the supervisee. In specific, the supervisors are tasked with assessing the skills of the supervisees, their observance of clinical performance standards, and their general job performance. Evaluating can occur either during goal setting or as feedback offered on the degree to which the goals set have been attained. Supervisors should thus receive training about the evaluation process (Stoltenberg & McNeill, 2011). One of the keys to successful evaluation is focusing on the strategies which would deliver feedback and create motivation for the growth for the supervisees. The focus of the clinical supervisors should be on the positive aspects of the supervisees' performance as opposed to just giving negative feedback about what the supervisees can change to become better and more effective practitioners. Clinical supervisors should place an emphasis on the strengths of the supervisees unless there is evidence to show that the supervisees engage in activities which contravene the professional standards. The purpose of evaluation should be threefold- to both evaluate and enhance supervisee competence, monitor the quality of professional performance, and assess the readiness of the supervisee to practice independently. Clinical supervisors should only be concerned about ways in which they can facilitate the supervisees development.

In the evaluation process, clinical supervisors should always have specific criteria defining what is being evaluated and the various benchmarks to be used as the basis for evaluation. Evaluation can be formative or summative. In specific, a formative evaluation will be done on different levels of the supervisory relationship and will seek to asses whether the supervisee has attained the different goals of the diverse roles (Stoltenberg & McNeill, 2011). However, summative evaluation occurs at the end of the supervisory relationship and provides an overall assessment of the manner in which the supervisee has performed throughout the period of the supervision. Some of the areas where evaluation should be done include the possession of technical skills, interpersonal skills, as well as personal characteristics, and the presence of conceptual skills. Technical skills evaluation will determine whether supervisees have improved their skills in terms of their awareness to relationship dynamics and the resolution of the client's problems. However, according to Milne et al. (2011), interpersonal skills will be assessed on aspects such as the capacity of the supervisees to connect, respond with sensitivity, and contain strong emotions when dealing with their clients. Finally, conceptual skills assessment is pegged on the theoretical understanding of the needs of the clients and the integration of various aspects of the client into their overall understanding. Understanding the evaluation process in terms of what to be evaluated and how is vital for the clinical supervisors effectively undertaking their supervisory roles.

Different Models of Supervision

Clinical supervision can either be done through one-to-one between the supervisor and supervisee or in groups where the supervisor discusses the work of two or more practitioners. Additionally, peer/co-supervision exists where the practitioner discusses their work with one another and the role of the clinical supervision is then shared (Stoltenberg & McNeill, 2011). However, in conducting those different types of supervision, clinical supervisors can either deploy the psychotherapy-based supervision models or the developmental models of supervision. The psychotherapy-based models focus on the frameworks as well as the techniques of the specific therapeutic model which has been practiced by the supervisee. Some of the examples of the model include person-centered supervision and cognitive behavioral supervision. In the person-centered supervision, the clinical supervisor will focus on assessing the attitudes and personal characteristics of the supervisee as well as the quality of the client-therapist relationship (Warner, 2015). However, in the cognitive behavioral supervision, the prime focus of the supervisor is the observable cognition and behaviors of the supervisees with regard to their professional identity and reaction to their clients.

The developmental models of supervision; on the other hand, focus on the progressive stages of the supervisee right from their development from novice to experts. In each of the sta...