Self awareness of the supervisor in supervision

Teaching self awareness is an important and sensitive task in the supervision of the clinical casework student. However, lack of self awareness on the part of the supervisor may lead to a serious impaction of this learning process, and unfortunately, there is no institutionalized process for reviewing lack of supervisory self awareness as there is for students. Some occasions in which problems in supervisory self awareness are likely to occur are: the supervisor who has difficulty in responding appropriately to the student's dependency demands in supervision, responding either by withdrawing from the student or being overprotective of him; the supervisor who is threatened by students whose character styles are very different from his own; and the supervisor who views client behavior from the perspective of a value system very different from the student's.     

Supervision of trainees: Tending the professional self

This article seeks to demonstrage how self psychological concepts can be applied to the process of training psychotherapists in a variety of clinical and community settings. The author examines the role of clinical supervision in the development, consolidation, and maintenance of a cohesive professional self. The role of selfobject experience, needs, transference, and countertransference as manifested in the supervisory relationship is elaborated. Supervisor and supervisee form a self-selfobject unit, through which the trainee's anxieties and vulnerabilities can be managed. This selfobject matrix enables maintenance of self-esteem, expansion of cognitive understanding, and structure building in the arena of the professional self. To achieve these ends, the supervisor forms an empathic alliance with the internal, subjective experience of the therapist. The importance of focusing on the self experience and selfobject needs of the therapist in training via an empathic mode of observation is illustrated by several examples and vignettes. The application of theory to practice is emphasized, with examples chosen from a variety of clinical settings and modalities.     

A typology of supervision in child welfare: Multilevel latent class and confirmatory analyses of caseworker–supervisor relationship type

Based on survey data collected from 1460 public- and private-agency child welfare caseworkers in Illinois, this study examines the nature of child welfare supervisory relationships by empirically identifying a discrete set of modal caseworker–supervisor relationship types as defined by a combination of positive and negative supervisory support. This study also examines the degree to which differences in the nature of caseworker–supervisor relationships are attributable, respectively, to supervisors, supervisor–caseworker dyads, and agency settings. Results suggest the existence of qualitatively distinct caseworker–supervisor relationship types that coalesce into discrete mixtures of relationship types at the supervisory team level. In contrast, results suggest that little, if any, of the overall variability in supervisory relationship type is attributable to the agency level. Findings concerning the interrelationships among relationship type and caseworkers' job satisfaction and perceptions of their work environment underscore the salience of individual caseworker–supervisor dyads, and suggest the importance of relationship building as means to improve the effectiveness of supervision.     

An exploration of the use of power in social work supervisory relationships in Hong Kong

Supervision is considered to be a determining factor in the quality of service to clients, the job satisfaction of social workers, and the level of professional development they achieve. How supervisors use their authority affects their relationships with subordinates, which in turn influences service outcomes. This case study reveals the micro-process of the interplay of power in the supervisor–supervisee dyad, the influence of cultural factors on attitudes toward hierarchical relationships, and subordination to authority in the supervisory dyad. Respondents who considered supervision to be counterproductive or disempowering employed tactics to hide their negative attitude, and concealed important cases and project materials, which hindered the disclosure of mistakes. Redistributing power in the current hierarchical supervisor–supervisee relationship could lead to fewer instances of game playing in the supervisory dyad and facilitate disclosure, which is important in ethical practice.     

Borderline Personality Disorder: Foundations of Treatment

The move from social work practitioner to supervisor can cause a crisis in identity for some social workers, a point at which professional values, roles and commitment are questioned and re-analysed. Yet it is an area in which there appears to be little written to assist the worker to normalise their fears and anxieties, or to assist with making the process smoother for both supervisor and supervisee. Drawing on practice experience in a range of health and community service settings, the present study will examine some of the feelings, issues, challenges and dilemmas faced by new social work supervisors. It will also explore the preparation of supervisors, the use of power in the supervisory relationship and the need for training. It will then discuss tips and conditions for improving the supervisory relationship.     

The role of empathy in supervision

Empathy plays an important role in clinical supervision. It is the link between the client whose treatment is being supervised, the clinician/supervisee, and the supervisor. The supervisor uses an empathic capacity as well as theoretical knowledge to understand the clinical work and build the supervisory relationship. Often the progress of a case can be traced through the development of empathic understanding in the supervision. The transmission of empathy requires creativity and openness and is one of the major challenges in supervision. By analyzing the different uses of empathy in clinical supervision we can increase our understanding of the supervisory process.     

Resolving Therapeutic Impasses by Using the Supervisor's Countertransference

The traditional role-set of the clinical social work supervisor has grown to be much more complex. From the exclusive position of teacher, administrator, and overseer she is now an integral part of a system wherein she is influenced not only by the therapist, client, and her own promptings but is a prime source of feedback to the client through the supervisee.As clinical social workers have shifted their conceptualization of therapy to a two-person psychology, this perspective has emerged as part of the supervisory process. Now the supervisor's countertransference responses to the supervisee, to his client, and to their interaction have assumed importance in supervisory work. This article is an attempt to demonstrate through case illustrations how the supervisor's disclosure of countertransference responses to the supervisee can strengthen the supervisory alliance which then enables the client and therapist to resolve therapeutic impasses.     

Supervisor multicultural competence and its relation to supervisory process and outcome

This study investigated the direct and indirect effects of marriage and family therapy trainees' perceptions of their supervisors' multicultural competence in supervision on the supervisory working alliance, trainees' multicultural competence (case conceptualization abilities in etiology and treatment), and perceived supervision satisfaction. Path analyses revealed supervisor multicultural competence to be positively associated with supervisory working alliance and perceived supervision satisfaction. In addition, supervisor multicultural competence seemed to have a negative effect on trainee etiology conceptualization abilities. Finally, results suggested supervisory working alliance to be a significant mediator in the relationship between supervisor multicultural competence and supervision satisfaction. Findings are discussed within the context of theoretical, empirical, and practical implications for multicultural supervision.     

Supervising Mental Health Clinicians in The Context of Complex Organisational Dynamics

This article discusses the complex dynamics and challenges of providing supervision to mental health clinicians working within an organisational context when the supervisor is not part of the organisation and has no formal managerial or accountability responsibility. It considers two models of supervision and their application to three supervisory relationships in an organisational context. It concludes that for supervision to be effective there needs to be a consideration of the social defences in operation within the organisation and how they are met by the anxieties and defences of the supervisor and supervisee. This requires a mixed approach by the supervisor of the technical with the inter-subjective as a reliance on one model of supervision risks limiting the effectiveness of the intervention. The role of the supervisor can enable the supervisee to establish a clinical framework and the necessary environment essentials for their practice.     

A study of live supervisory phone-ins in collaborative family therapy: correlates of client cooperation

The behavior of five supervisors, 19 trainee family therapists, and 20 clients before, during, and after 88 live supervisory phone-in events was examined in this study to determine the correlates of client cooperation. Following supervisory phone-in conversations, client cooperation was associated exclusively with the presence and quality of the collaborative behavior shown by the therapist. Isomorphism between the behavior of the supervisor and therapist was not associated with subsequent client cooperation, nor was any particular category of supervisor behavior. Surprisingly, isomorphism between the quality of supervisor and therapist behavior preceded those events where client resistance occurred.     

Developing a Working Model of Cross-Cultural Supervision: A Competence- and Alliance-Based Framework

Despite numerous suggestions to integrate culture, diversity and social justice issues in clinical supervision, empirical studies on cross-cultural supervision indicate limited uptake of such recommendations. We suggest that a comprehensive model of cross-cultural supervision could benefit the field by guiding supervisors in this task. A working model is proposed based on a foundation of the supervisory alliance and a focus on social work practice competence, integrating strategies to promote self- and relational-reflexivity within the supervisory relationship. The model is comprised of four components: component 1: goal setting to contract on cross-cultural integration in supervision; component 2: active listening for cross-cultural markers; component 3: bonding through the supervisor’s self-reflexivity to foster the supervisee’s self-reflexivity; and component 4: working through tasks for cultural integration in supervision by modelling the supervisor’s relational reflexivity in case formulation and treatment to foster the supervisee’s relational-reflexivity.     

USE OF SELF: A PRIMER REVISITED

Use of self is a concept that is universally accepted yet equally ambiguous. Melding the professional self of what one knows (training, knowledge, techniques) with the personal self of who one is (personality traits, belief systems, and life experience) is a hallmark of skilled practice. This paper synthesizes seminal works regarding the concept of use of self and suggests a five-category typology for defining and describing use of self in social work practice. Drawing from the literature and practice wisdom gleaned from the author’s clinical, teaching, and supervisory observations, the article proposes that use of self can be operationally defined as: use of personality; use of belief system; use of relational dynamics; use of anxiety; and use of self-disclosure.     

Family therapy trainees' evaluations of their best and worst supervision experiences

Supervisees in Commission on Accreditation for Marriage and Family Therapy Education-(COAMFTE) accredited and candidacy training programs were asked to describe their best and worst supervision experiences in terms of the context of training and supervision, the perceived personal attributes of the supervisor, and specific behaviors perceived to be enacted by the supervisor during supervision. Contextual factors such as supervision modality, frequency and duration of supervisory contacts, and sources of supervisory data appeared to distinguish between supervisees' perceptions of their best and worst experiences. These experiences were further distinguished by the supervisees' perceptions regarding the supervisor's level of interpersonal attractiveness, trustworthiness, and expertise. Key behaviors perceived to be enacted by supervisors during best and worst experiences clustered into several dimensions that included creating an open supervisory environment, communication and encouragement, attending to personal growth, and providing conceptual and technical guidance and direction.     

Crisis management during "live" supervision: clinical and instructional matters

In this article, we illustrate two examples of "live" supervision with marriage and family therapy trainees whose clients presented in the therapy room in immediate crisis. The case examples, one a client with suicidal thoughts and the other a parent who had struck her child, demonstrate how the university-based therapy team managed the recursive clinical and supervision processes that unfolded during the sessions. We present the case examples from the perspective of both supervisees and supervisor, discussing how our different experiences of the supervision unfolded in real time. Case discussion and reflections later in the article illustrate the need for an open, transparent, dialogical process throughout supervision. A case is made for supervisory participants to create alternative formats in which multiple supervisory voices can be heard.     

Clinical supervision for psychiatric nurses

Supervision does not represent merely the acquisition of facts. It is an emotionally charged process that touches on therapists' affective problems, interpersonal conflicts, problems in being helped, and problems in helping (Ekstein). As such, it is a process similar to, but not the same as, psychotherapy. Supervision is necessary for continued professional growth, no matter how skilled the nurse may be. Other mental health disciplines have long accepted supervision as an essential component of professional work. A number of methods can be used to review the therapist's work, including case material discussion, conjoint interviewing, direct observation, and review of mechanical recordings. This can be done individually, in groups, or among peers. A supervisor can be a senior clinician from any of the mental health disciplines. The nurse should not be limited to receiving supervision only from other nurses. Periodic evaluations of the supervisory relationship as well as the therapist's skills are recommended. Supervision is a valuable tool that the nurse therapist should use fully to develop the professional self.     

The therapy-supervision dialectic

It is widely agreed that supervision has an emotional load which should be dealt with in the supervisory relationship as means of increasing effectiveness in the learning process. This situation makes it difficult for the supervisor to keep adequate distance between supervision and therapy. Current literature on this subject offers no tools for this matter. This paper suggests a model that uses some basic ideas derived from Winnicott's thinking. Our model integrates the dynamic forces operating in the supervisory space and can be used as a compass to help the supervisor in his or her movements while preventing crossing the boundary between supervision and therapy.     

Intervening in a Rigid Supervisory System: A Bowen/Structural View of Neutrality

This paper expands on an earlier publication (1984), by the author. The earlier paper hypothesized that there were three levels of ‘pathological triangles’ in a stuck supervisory system. These triangles constituted a ‘defence’ against issues of attachment-detachment from the family of origin for both supervisor and therapist. The current paper discusses the ideas which led to the development of the earlier theory and if utilises a case discussion format to illustrate the application of the theory in a stuck supervisory system. It is argued that this is a useful model for teaching neutrality.     

The Role of Supervisory Referral in Employee Assistance Programs

Abstract

A growing number of organizations offer Employee Assistance Programs (EAPs) to help employees with their personal problems. Many organizations rely on their supervisors to help identify and refer troubled employees to the EAP for assistance, yet very little conclusive evidence exists regarding the factors that influence whether or not supervisors identify and intervene with troubled employees. A previous review of the literature (Nord & Littrell, 1989) found that the following variables were consistently related to referral: (a) degree of management support for the EAP, (b) gender of supervisor, (c) gender of subordinate, (d) existence of a supervisor network, (e) occupational category of the employees supervised, (f) social distance between supervisor and troubled employee, (g) supervisors' attitude toward their role in referral, and (h) supervisor knowledge of the EAP. However, results of some of the studies reviewed for the current paper were inconsistent with Nord and Littrell's (1989) findings. Additional research is needed in this area, including research on the effectiveness of EAP supervisory training, in order to provide guidelines for the administration of effective EAP programs.     

The Supervision of Two Isolated Practitioners: It's supervision,Jim, but not as you know it

A supervisory format used over a four year period for two isolated family therapists is discussed. After an initial face to face meeting, in-person supervision took place quarterly. Between these meetings, supervision was by a combination of audiotapes and letters. Supervisees recorded their questions, comments and news on cassette tapes, often sending as well the tape of a client session, and the supervisor responded by letter. The particular difficulties and advantages of this format are discussed, and some attention is given to the special needs of isolated practitioners.