ECS3399 - SECTION 4: METHODS AND TECHNIQUES FOR PROFESSIONAL DEVELOPMENT
Section 4: Methods and Techniques for Professional Development
Within any model of supervision, there will be a number of choices about the methods and techniques utilized to generate professional growth and development in clinical work. Below is an overview the most common approaches to learning used in clinical supervision, with discussion to follow.
Case analysis and review
- Supervisor discusses and/or demonstrates a case presentation; invites supervisee to agency staffing and to present when appropriate.
- Supervisee: identifies client information, problems, and possible solutions or interventions
- Supervisor:Uses reflective listening and guides supervisee to propose an intervention plan
Session Record/Detailed Notes
- Supervisee writes detailed record of client and supervisee communications from session
- Session record is reviewed in supervision
- Use an actual case for relevance and realism
- Don’t go for shock value by using extreme cases
- Supervisee and supervisor need to switch roles being the client and counselor
- Debrief and give feedback
- Ensures roles are shed before moving on
- Reduces anxiety as a result of role play
- Enhances benefits of role play
- Summarize and review what took place in the role play
- Optimizes and clarifies the lessons learned from the role play
Joint facilitation of clinical sessions
- Good technique for learning a new skill
- Helps to build the supervisory relationship
- Best when done early in relationship
- Client selection should be carefully done
Direct Observation of Clinical Sessions
- Choice of client is very important
- Trust must be high between supervisor and supervisee, as well as between client and clinicians
- Number of contacts using this format should be considered carefully
- Steps for Direct Observation
- Gain client permission for observation before session
- Share with client the reason for the observation
- Stress confidentiality
- Ask permission to take notes
- Do NOT observe without client agreement
- Sit where you can see supervisee and client’s non-verbal communication
- Content of session
- Applied skills
- Give feedback
- Directly after session, in private
- Adhere to confidentiality
- Give positive feedback first
- Share ways to improve challenging areas
- End on a positive note
- Two-Way feedback
- Ask supervisee how the session went
- Ask what specifically went well and what he/she would do differently
- After the supervisee has shared his/her evaluation, share your specific positive comments giving examples.
- Comment on areas in need of improvement and ways to accomplish same.
Indirect Observation of Supervisee’s Sessions
- Audio or video equipment used to record session
- Parameters and goals established before session
- Supervisee explains process and gets permission from client
- Supervisee selects segments for review
- Tape discarded after review to protect privacy
- Books, articles, and other reading or audio material
- Videotapes and video clips of lectures, techniques
- Scenario analysis leading to elucidation of problems presented, case conceptualization, and intervention options
There are a number of considerations related to why supervisors should and should not utilize these different methods and techniques at different points in the supervisee’s developmental process. As a starting point, choices of learning experiences should be made in line with the emerging capabilities and confidence of the supervisee. Supervisors should aim to have their supervisees experience some successes in learning in order to support the ongoing development of confidence. This will help them remain motivated to learn.
Putting a very inexperienced, underconfident clinician in a direct observation situation behind a two-way mirror may be a step too far if it occurs too early in the development process. The sharp-eyed reader will notice that this method has the greatest degree of expansion in its explanation. There is a reason for this. Direct observation may cause supervisees to feel extremely exposed as their work is scrutinized by other with all its flaws and missteps. It is to be undertaken with great care.
As Falender and Shafranske’s three-stage model notes, in Stage 1 - early in the developmental process - there is a high degree of anxiety present in most supervisees about possessing the clinical skill necessary for successful work with clients. A direct observation early on – before trust in their own skills and in the safety of the supervisory process - may cause them to feel tooexposed and too anxious within the process, and may not lead to the development of a sense of mastery for what is being taught.
To be sure, there are clinicians who seem to possess enough confidence that they can be thrown into the fire and emerge unscathed. However, they are the exception rather than the rule. Mastery in the complexities of clinical work is achieved much more successfully – and less painfully – by operating within the supervisee’s zone of tolerance. This requires ongoing communication and collaboration in determining when more challenging learning processes, such as direct observation or videotaping, are to be undertaken.
However, there is a converse point to be made in the use of observational methods of learning. These methods may be implicitly called for in situations where there are serious concerns about the current and future competence of the supervisee, and where the supervisee is defensive and secretive about his/her work. There is no more accurate way to ascertain the actual capabilities of the supervisee than to view sessions in real time, or to have a video record of what actually occurred in the session.
In the absence of these two considerations, observational methods of learning should be utilized when possible and when the clinician is ready for them, as they will offer the clearest picture of the level of clinical skills of which the supervisee is capable at any point in time. Obviously, if an organization does not have the resources to incorporate an observational method into their overall development plan, then other methods and techniques will have to compensate as best as possible.
Another important consideration is concerned with the supervisee’s learning style and interactive comfort level. There will be a population of clinicians who will bring into their work a more introverted temperament, and who may have developed a clear preference for and comfort level with more solitary and less interactive modes of learning. They may prefer to learn by reading books or studying videotapes of other clinicians, and may be somewhat hesitant to learn by more experiential and interactive means.
Conversely, clinicians who present with the opposite temperament and who only want to learn from direct interactive experiences may be less willing to engage in the lonely act of doing the basic study, research, and reflection necessary to build their foundational clinical vocabulary rapidly.
Temperament is generally considered to be a trait present from birth that may be consistent and durable over time. However, temperament is a predisposition - and not a destiny set in stone. Learning approaches for supervisees must not only be based on their preferred learning style – that which is easiest and most comfortable for them – it also must be oriented towards what methods will build the necessary skills and capabilities in an effective and efficient manner.
The conscientious supervisor will not only have a clear sense of the temperament and preferred learning style of his/her supervisees, he/she will be judicious in striking a good balance: both using methods that are easy and comfortable for the supervisee but not as effective in developing areas of weakness andusing methods that are much less comfortable for the supervisee because they find and challenge their areas of weakness and need for improvement.
As an example, let’s examine a new supervisee who is very sociable and does very well in direct interaction with clients but is less than exacting and detail oriented in remembering what occurred in the session. This inhibits the capacity to reflect on the session so that a more extensive case conceptualization and treatment planning process can be implemented over time.
In order to strengthen an area of weakness and balance his/her skill set, it may be fruitful to have that clinician take very detailed notes and attempt to generate a complete and full record of everything that both client and supervisee said during the session. The supervisee will find this extremely tedious and uncomfortable – and it will be exactly the right exercise for him/her to undertake in order to firm up an important area of clinical need, the one that is opposite and complimentary to his/her intrinsic strengths and capabilities.
This is choice based upon purpose: the Who-How-Whom factor brought down to the level of the specific activities incorporated into the learning plan. The same process of deciding what methods and techniques to use is also relevant to the selection of a model or models of supervision. This is what will be addressed in the next section.