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welcome to the training on models of supervision this training presents various models including theoretical models developmental models and integrative models a recovery-oriented model is also presented there are a couple of attachments in the lesson media there is a book from Samsa that I highly recommend regarding supervision and although it says it's for substance abuse counselors I have found it to be useful for any professional in the field the next is a very useful article about supervision and finally there is a copy of the PowerPoint slides provided for your convenience you can download and print them and then you can take notes as we proceed through the lesson the lesson is completed by watching the attached video and then downloading and reviewing the handouts after completion of those tasks you'll be required to take the attached quiz with a passing score of at least 70% to successfully complete this lesson clinical supervision for mental health and substance abuse professionals started out much like apprenticeships in other fields that is a student apprentice with minimal skill or knowledge would learn the work by observing assisting and receiving feedback from an accomplished member of the same field it was believed that because the master was quite good at the work he or she would be equally good at teaching or supervising in fact this is not the case today we realized that though clinical supervision and mental health services have much in common the ability to gauge in an interpersonal relationship for example the two tasks also utilize separate and distinct skills this means that a master clinician may not always be a master supervisor without the addition of training and competency and supervisory knowledge and skills furthermore the concept of master apprentice supervision evokes a hierarchy of power that favors the master as the authority a dynamic that is not supported in today's literature on supervision it is also documented that clinical knowledge and skills are not as easily transferable as the master apprenticeship model implies observing experienced clinicians at work is without question a useful training tool but it is it is not sufficient to help students develop the skills necessary to become skilled clinicians themselves development is facilitated when the supervisee engages in reflection on their work and relationship as well as on the supervision itself thus clinical supervision is now recognised as a complex exchange between supervisor and supervising with supervisory models and theories developed to provide a frame for it there are five basic functions of a supervisor in their relationship with the supervisee those functions are as teacher consultant coach mentor and in most supervisory relationships also evaluator in the teacher role the supervisor assists in the development of the staff person's knowledge and skills by identifying their learning needs by determining their strengths promoting self-awareness and giving that individual a body of knowledge that is for practical use and personal and professional growth in the role as consultant the supervisor provides case consultation which helps the staff person understand both how they are working with the individual that's receiving services and what the needs of that individual receiving services are additionally the supervisor monitors the performance of the staff person and assesses that staff person's performance in the role of coach it is very similar to an athletic model where the supervisor is supportive building the staff morale while being constructive and challenging the staff to produce their best efforts and skills the supervisor often becomes a cheerleader for the staff people while alleviating burnout and mitigating the often unpleasant effects of the administrative burdens and issues that are in all positions in the role of mentor the supervisor mentors and teaches the supervisee through role modeling by facilitating the supervisors professional development and identifying and training the next generation of Supervisors and finally briefly the evaluator role in most supervisor relationships the supervisor is not just functioning as a clinical supervisor but is also functioning as the person's employment supervisor and that role is the person's employment supervisor means that that supervisor at some point in time will have to evaluate the supervisors performance and if the performance needs improvement to develop the appropriate improvement plans for strengthening the performance of that supervisee clinical supervision is about the professional development of the supervisee the systematic manner in which supervision is applied is called a model or a model of supervision supervision routines beliefs and practices began emerging as soon as mental health professionals decided that they wanted to train others in what they do the focus of early training was on the efficiency of a particular theory supervision norms were typically conveyed indirectly during the rituals of those kind of apprenticeships as supervision became more purposeful three different types of models emerged orientation specific models developmental models and integrated models we're going to go on to talk specifically about each of these types of models clinical supervision started as the practice of observing assisting and receiving feedback in this way supervision follows the framework and techniques of the specific theoretical model being practiced by the supervisor and supervising as the need for specific supervisory interventions became evident supervisory models developed within each of these theoretical orientations to address this need theoretical based models of supervision often feel like a natural extension of the treatment itself theoretical orientation informs the observation and selection of clinical data for discussion and supervision as well as the meanings and relevance of that data thus there is an uninterrupted flow of terminology focus and technique from the counseling session to the supervision session and back several examples of theoretical models are described below and those include psychodynamic model feminist model cognitive behavioral model and the person centered model psychodynamic supervision draws on the clinical data inherent to that theoretical orientation such as affective reactions defense mechanisms transference and countertransference psychodynamic supervision is can be categorized in three categories patient-centered supervisee centered and supervisory matrix centered patient-centered supervision began with Freud and focus the supervisor supervision session on the patient's presentation and behavior the supervisors role was didactic with the goal of helping the supervisee understand and treat the patient material the supervisor is seen as the uninvolved expert who has knowledge and skills to assist the supervisee thus giving the supervisor considerable authority because the focus is on the patient and not on the supervisee or the supervisory process very little conflict occurs between the supervisor and supervisor as long as they both interpret the theoretical orientation in the same way this lack of conflict or stress in the supervision sessions often reduces the supervisees anxiety making learning easier conversely if conflict were to develop using this model supervision could be impeded by not having a way to deal directly with it supervisee centered psychodynamic supervision came into popularity in the 1950s 50s focusing on the content and process of the supervisors experience as a counselor process focused on the supervisors resistance anxieties and learning difficulties the supervisors role in this approach is still that of the authoritative uninvolved expert but because the attention is shifted to the psychology of the supervisee supervision utilizing this approach is more experiential than didactic supervisees centered supervision was adapted to fit several psychodynamic theories including ego psychology self psychology and object relations supervisees centered supervision can stimulate growth for the supervisee as a result of gaining and understanding of his or her own psychological process but this same advantage can also be a limitation and that it makes the Supervisory highly susceptible to stress under scrutiny the Supervisory matrix centred approach opens up more material in supervision as it not only attends to material of the client and the supervisee but also introduces examination of the relationship between the supervisor and supervising the supervisors role is no longer one of the uninvolved expert supervision within this approach is relational and the supervisors role is to participate in reflect reflect upon and process enactments and to interpret relational themes that arise within either the therapeutic or supervisory dyads this includes an examination of parallel process which is defined as the supervised supervisees interaction with the supervisor that parallels the client's behavior with the supervisee the next model is the feminist model of supervision feminist theory affirms that the personal is political that is an individual's experience are reflective of society's institutional attitudes and values feminist therapists then contextualize contextualize the clients and their own experience within the world in which they live often redefining mental illness as a consequence of oppressive beliefs and behaviors feminist therapy is also described as gender fair flexible interactional and lifespan oriented the ethical guidelines for feminist therapists emphasizes the need for mental health workers to acknowledge power differentials in the client council counselor relationship and to work to model effective use of personal structural and institutional power through the though the guidelines do not specifically address the supervisee supervisor relationship it can be assumed that the same tenets apply to this latter relationship that is the supervisor supervisee relationship should strive to be egalitarian to the extent possible without the supervisor maintaining focus on the impoundment with the supervisor maintaining focus on the empowerment of the supervisee next is cognitive behavioral supervision as with other theoretical based approaches to supervision an important task for the cognitive behavioral supervisor is to teach the techniques of the theoretical orientation cognitive behavioral supervision makes use of observable thoughts and behaviors particularly of the supervisors professional identity and his or her reaction to the client cognitive behavioral techniques used in supervision including setting an agenda for supervision sessions bridging from previous sessions assigning homework to the supervisee and summaries by the supervisor and finally we have person-centered models Carl Carl Rogers develop person center theory around the belief that the client has the capacity to effectively resolve life problems without interpretation and direction from the counselor in the same vein person-centered supervised supervision assumes that the Supervisory has the resources to effectively develop as a counselor the supervisor is not seen as an expert in the model but rather serves as a collaborator with the supervisee the supervisors role is to provide an environment in which the supervisee can be open to his or her experience and to be fully engaged with their clients in person-centered Theory the attitudes and personal characteristics of the therapist and the quality of the client therapist relationship our prime determinants of the outcomes of the theory person-centered supervision adopts this tenant as well relying heavily on the supervisee supervisor relationship to facilitate effective learning and growth supervision in general developmental models of supervision defying progressive stages of supervisee development from novice to expert each states consisting of discrete characteristics and skills for example supervisees at the beginning or novice stage would be expected to have limited skills and lack confidence as professionals while middle stage supervisees might have more skill and confidence and have conflicting feelings about the perceived independence or dependence on the supervisor a supervisor at the expert end of the developmental scale is likely to utilize good problem-solving skills and be reflective about their services and the supervisory process for supervisors employing a developmental approach to supervision the key is to accurately identify the supervisors current stage and provide feedback and support appropriate to that developmental stage while at the same time facilitating the supervisors progression to the next stage to this end a supervisor uses an interactive process often referred to as scaffolding which encourages the supervisee to use prior knowledge and skills to produce new learning as the supervisee approaches mastery at each stage the supervisor gradually moves the scaffold to incorporate knowledge and skills from the next advanced stage through this process not only is the supervisee exposed to new information and skills but the interaction between the supervisor and supervising also fosters the development of advanced critical thinking skills while the process appears linear it is not a supervisee may be in different stages at the same time that is the supervisee may be at mid-level development overall but experienced high anxiety when faced with a new client situation one of the most researched develop mental models of supervision is the integrated developmental model developed by Stoltenberg in the integrated developmental model it describes three levels of counselor development level one supervisees are generally entry level students who are high in motivation yet also high in anxiety and fearful of evaluation level two supervisees are often at mid level and experience fluctuating confidence and motivation often linking their own mood to success with clients and finally level three supervisees are essentially secure stable and motivation and have accurate empathy tempered by objectivity and use the therapeutic self in their interventions the integrated developmental model stresses the need for the supervisor to utilize skills and approaches that correspond to the level of the supervisee so for example when working with a level one supervisee the supervisor needs to balance the supervisees high anxiety and dependence by being supportive and prescriptive the same supervisor when supervising a level three supervise II would emphasize supervisee autonomy and engage in collegial challenging if a supervisor was to consistently mismatch his or her responses to the developmental level of the supervisee it likely result in significant difficulty for the supervisor to satisfactorily master the current developmental stage for example a supervisor who demands autonomous behavior from a level one supervisee is likely to intensify that individuals anxiety and finally the rawness Todd and Scoville model is based on a longitudinal qualitative conducted by interviewing 100 mental health professionals ranging and experienced from graduate students to professionals with up to 25 years experience Rana Stodden Scoville analyzed the resulting data in three ways coming up with a stage model a theme formulation and a professional model of development and stagnation in the most recent revision the model is composed of six phases of development the first three phases called the lay helper the beginning student phase and the advance student phase roughly correspond with the levels of the integrated developmental model the remaining three phases known as the novice professional phase the experienced professional phase and the senior professional phase are self-explanatory in terms of the relative occurrence of this phase in relation to the counselors career in addition to the phase model rawness Todd and skov volt also developed several themes regarding counselor development first they proposed that professional development involves an increasingly higher order integration of the professional self and the personal self second there is continuous reflection which is a prerequisite for optimal learning and professional development at all levels of experience third there is an intense commitment to learn which propels the developmental process fourth professional development is a long slow continuous process that at times can be erratic fifth clients serve as the major source of influence and serve as the primary teachers and finally for the practitioner there is a realignment from the practitioner as hero to the client as hero as the name implies integrative models of supervision rely on more than one theory or technique given the large number of theories and methods that exist within respect to supervision an infinite number of integrations are possible in fact because most practitioners today practice what they describe as in a grade of services integrative models of supervision are also widely practiced there are two approaches to integration technical eclecticism and theoretical integration technical eclecticism tends to focuses focus on differences chooses from many approaches and is a collection of techniques this path calls for using techniques from different schools without necessarily subscribing to the theoretical position that spawned them in contrast theoretical integration refers to a conceptual or theoretical creation beyond a mere blending of techniques this path has the goal of producing a conceptual framework that synthesizes the best of two or more theoretical approaches to produce an outcome that is richer than that of a single theory one of the most commonly used and researched integrative models of supervision is the discrimination model originally published by Janine Barnard in 1979 this model is comprised of three separate foci for supervision those are intervention conceptualization and personalization and three possible supervisor roles teacher counselor and consultant the supervisor could in any given moment respond from one of nine ways three roles for the supervisor and three foci for example the supervisor may take on the role of teacher while focusing on a specific intervention used by the supervisee in a client session or the role of counselor while focusing on the supervisees conceptualization of the work because the response is always specific to the supervisees needs it changes within and across supervisory sessions the supervisor first evaluates the supervisees ability within the focus area and then selects the appropriate role from which to respond this model cautions supervisors not to respond from the same focus a role out of personal preference comfort or habit but instead ensure the focus and role meet the needs of the supervisee in that moment in the system's approach to supervision the heart of supervision is the relationship between supervisor and supervising which is mutually involving and aimed at bestowing power to both members there are seven dimensions of supervision that are listed under this model all connected by the central supervisory relationships these dimensions are the functions of supervision the tasks of supervision the client the supervisee the supervisor and the institution the function and tasks of supervision are at the foreground of the interaction while the latter four dimensions represent unique contextual factors that are covert influences in the supervisory process supervision in in any particular instance is seen to be reflective of a unique combination of these seven dimensions given the emphasis on recovery oriented systems of care in the state of Florida I wanted to add another model of supervision known as the recovery oriented model of supervision recovery oriented supervision involves applying key principles of the recovery model to the process of supervision so that the supervisee can internalize the recovery oriented approach by experiencing it themselves it is grounded in a firm belief that recovery orient oriented practice is profoundly different from mental health practices informed by the medical or clinical models early influences on the recovery perspective were first-person accounts of lived experience that proliferated in the 1980s and 1990s and empirical findings that challenged more pessimistic beliefs about prognosis especially for schizophrenia the recovery perspective or paradigm has become a guiding philosophy promoted by many national mental health authorities and must be deeply understood and taken up in order for the individual to become a recovery oriented practitioner in this model practitioners see themselves as recovery guides and deliver care that is strengths-based is community focused is culturally responsive is grounded in the person's life context is relationally mediated is oriented to promoting recovery allows for reciprocity and relationships addresses the socio-economic context of the person's life and optimizes natural supports given the challenges of helping professionals to internalize the recovery approach a recovery approach to supervision has been developed as a means by wish this can be accomplished one of the important ways to supervise professionals interested in internalizing the recovery approach in psychiatric rehabilitation is to implement its major principles in the supervision of the work itself there are three key tenants to shape this sort of supervision all involved the supervisor engaging with the supervisee in a way similar to how the supervisee would engage with consumers if they were embodying a recovery perspective specifically developing and discovering the selves of the person in recovery second attaining mutuality and negotiating authority and third promoting positive and empowering narratives and self perceptions with the tenets of developing and discovering the selves of consumers there is an emphasis that supports consumers to rediscover their sense of self because this rediscovery can then guide them to develop a sense of agency enabling them to make choices about their lives they emphasize that consumers must have their own story and although it has to be something that others can grasp there is not one right story that they should find recovery of agency has been identified as a key aspect of the recovery process given the major disruption in the sense of self often experienced by persons labeled with a mental illness supporting choice requires practitioners to challenge notions of readiness awareness of their illness and managing risks risk which have has historically been a part of community-based mental health practice in Pat deagan's recovery workforce development initiatives she argues that we practice within a recovery zone between two opposing perspectives neglect and coercion as we consider supporting self-determination and choice neglect us when we take a position to support the individual and whatever they want to do regardless of our concerns and coercion is when we get the person to do what we want regardless of their viewpoint in using this tenant to guide supervision the supervisor helps the supervisee better understand their professional self and strengthen their own sense of agency so that the supervisee can in turn support the consumer to rediscover their sense of self and take actions that develop a sense of agency such as making informed choices about their lives with the tenant regarding attaining mutuality and negotiating authority it is informed by the stance of reciprocity that recovery-oriented practitioners need to take in their work with persons labeled with a mental illness or substance use disorder a stance of reciprocity means that practitioners treat the individuals they serve as equals using this tenant the supervisor strives to attain a mutual relationship with the supervisee that balances the power differential between them allowing for estate exchanging knowledge and experience the supervisor may have more power and authority in their particular role however for a true dialogue to occur the expertise and knowledge of the supervisee also needs to be recognized although the supervisor may have more theoretical or clinical knowledge only the supervisee has the expertise of actually doing the practice work the supervisor must negotiate a mutual exchange so that both can share their expertise as they dialogue and make decisions this then translates to the supervisee engaging in the same negotiation with the consumers they work with the process for the supervisee and the consumer is parallel the supervisee has authority granted by academic and social institution and bears more responsibility in maintaining the relationship but the consumer remains the expert of their own experience if the expertise of both can be recognized and shared a stronger dialogue can be created and finally the recovery tenant of promoting positive and empowering narratives and self perceptions is informed by the stories and the narrative in shaping our meaning making in everyday life especially for the development of self and identity it's been argued that for persons labelled with a mental illness the illness is often in the foreground and takes over the general personal narrative that the conceptualization of the illness is often shaped by others especially health providers instead of themselves and finally that the person's sense of the illness may be shaped more by fatalism passivity helplessness and despair rendering them unable to determine their own fate recovery oriented care then is partially intended to create a space or a personal narrative about the illness can be developed one that may change the meanings attributed to the illness and in turn the consumers manner of coping and supervision the supervisor supports a shift in the supervisees narrative to support a more complex and empowered professional self for example supervisees narratives may constantly focus on areas of weakness that are particularly distressing to them mediate these narratives of weakness the supervisor might remind the supervisee of times when they acted in a way that contradicted those weaknesses for instance if a supervisor thinks they constant we struggle to set boundaries with the consumers they work with resulting in distress the supervisor might use strategic questioning to help the supervisor you remember times when they set reasonable boundaries with someone else that completes our training on models of supervision I appreciate your attention to this presentation at the completion of the video I encourage you to download the handouts that are included in the lesson media and spend some time reviewing those when you are comfortable with all the material you may take the attached quiz and again you must earn a passing score of 70% in order to successfully complete this lesson you