1 using supervision a presentation by bruce d. hartsell, lcsw lecturer california state university,...
Post on 15-Jan-2016
219 views
TRANSCRIPT
1
USING SUPERVISION
A Presentation by
Bruce D. Hartsell, LCSW
Lecturer
California State University, Bakersfield
2
Why study supervision?
a. To become better supervisees. b. To facilitate better service. c. To produce better client outcomes. d. To reduce risk.
3
Purposes of Supervision
a. Protect the public b. Develop professionals c. Support professionals d. Manage the work e. Promote accountability
4
Functions of supervision (Kadushin)
a. administration b. education c. supportive leadership
5
Definition of Supervision
? ? ?
6
Policy Bases of Supervision
a. Ethical b. Legal c. Professional d. Institutional
7
Ethical Requirements – NASW
a. 1.04 Competence. . . within the boundaries of . . . supervised experience . . .
b. 3.07 Administration . . . resources . . . to provide appropriate staff supervision .
8
Ethical Requirements - Kohlberg
Stage 4 – societal norms Stage 5 – universal principles Stage 6 – claims of all individuals Not Stage 1 – what one can get away with
9
Legal Requirements
a. Business and Professions Code, Chapter 14, Article 4
- “. . . supervised course of study . . .”
- “responsibility for, and control of”
b. CCR Title 16, Division 18
Unprofessional conduct -
- aid or abet unlicensed practice
- permits one under “supervision or control”
10
Professional Requirements
a. Based in ethics b. Based in history
11
Institutional Requirements
a. Based in ethics b. Based in professional norms c. Based in law - work must be supervised by MSW - must meet at least 1.5 hours per week FOR SUPERVISION
12
Recommendations
Decide on your own purposes for supervision.
Decide what ethical principles will guide your supervision.
Evaluate the fit between your purposes and your ethics.
13
What distinguishes supervision, consultation, and collaboration?
a. Supervision includes responsibility for the quality of the work and authority over the work.
b. Supervision involves a fiduciary duty to the supervisee and to the client.
14
Distinctions -
c. Supervision requires monitoring and evaluation of the work.
d. Consultation does not involve authority although it implies expertise and therefore responsibility.
e. Collaboration involves parallel work without authority or responsibility for the work of the other.
15
Contexts of Supervision (Kadushin)
a. community b. profession c. organization d. department e. supervisor-supervisee
16
Significance (Kadushin)
a. The work of an organization must be organized.
b. Financial accountability to the community must be maintained.
c. Policy accountability to the community must be maintained.
17
Significance --
d. Management needs information from staff.
e. Because what we do is not directly observable, supervision allows oversight.
f. The results of what we do are often not easily evident.
18
Significance --
g. The agency provides the clients, and the clients have little choice.
h. Supervision is part of professional socialization.
i. Professional activity is not controlled by professional organizations.
19
Significance --
j. Supervision shares responsibility for decisions.
k. The demands of the job require supportive supervision.
l. Social worker personalities and values do not strongly oppose supervision.
20
Three Types of Supervision
Administrative Educational Supportive
21
Tasks of Administrative Supervision
recruiting and selecting staff inducting and placing the worker planning work delegating work monitoring, reviewing, and evaluating work
22
Administrative Tasks -
coordinating work sharing information upwards, downwards,
and laterally advocating change buffering change
23
Six Functions of Leadership (Adair)
planning initiating controlling supporting informing evaluating
24
Management Tasks (Drucker)
set objectives organize motivate and communicate measure develop people
25
Educational Supervision
Facilitates learning– Knowledge– Skills– Values
Applies learning theory– Connects new to known– Connects theory to practice
26
Supportive Supervision
Instrumental issues – – information– skills– structures– facilities
27
Supportive Supervision --
Personal issues – emotional support– recognition– reassurance– encouragement– approval– commendation– catharsis– desensitization
28
Focuses of Supervision - I
People Problem Place Process Personnel
29
Focuses of Supervision - II
theory content interpersonal process intrapersonal process
30
Focuses of Supervision - III
Philosophy Theory Technique
31
Roles and Models
Supervisor as manager, teacher, counselor Developmental models Discrimination model Integrated (eclectic) model Interactional model Theory-specific models Reflection
32
Developmental Model
1. relationship building, goal setting, and contracting the conditions of supervision
2. fluctuation between roles as counselor and teacher as skill deficits and stresses arise
3. collegial role in response to growing expertise and confidence
4. consultant role as the supervisee becomes self-directed and independent
33
Another Developmental Model (Loganbill)
stagnation confusion integration
34
Some dimensions of development
need for structure need for direct feedback need for didactic instruction need for supervisor support
35
36
Discrimination Model(Bernard & Goodyear)
three foci – – process skills – conceptualization skills– personalization skills
three supervisor roles – – teacher– counselor– consultant
37
Integrated (Eclectic) Model
Variously conceived in the literature Intensional inclusion of more than one
psychological theory May include one orientation to supervision
and another to treatment
38
Interactional Model (Shulman)
Preliminary Phase – Tuning In Beginning Phase
– Contracting– Clarifying Purposes– Specifying Roles– Establishing Authority
39
Interactional --
Middle Phase – Work Phase– Session tuning in– Session Contracting– Elaboration– Empathy– Sharing Feelings
40
Interactional --
Middle Phase – Continued– Showing Vulnerability– Demanding Work– Pointing Out Obstacles– Sharing Data– Session Ending
Ending and Transition Phase
41
Theory-specific Models
psychodynamic behavioral cognitive technical eclecticism
42
Reflection
guided questioning assumes that increased awareness leads to
increased skill
43
Recommendations
Choose models Discuss models with your supervisor Agree on one or more models Use the agreed-on models Evaluate use of the models
44
Steps in the Supervision Process
determine what the supervisee needs to learn
determine how the supervisee learns determine which case will best facilitate
that learning prepare to apply the learning
45
Supervision Steps --
apply the learning review the experience provide feedback reevaluate learning needs repeat the process
46
Characteristics of a Good Supervision Meeting
involves preparation and planning by both parties
has a shared objective focuses on the work of the supervisee gives priority to the critical self-analysis of
the supervisee
47
Meeting Characteristics --
provides helpful feedback occurs in the context of a facilitative
learning process is consistent with good teaching-learning
theory and practice provides follow through and connection to
the next meeting
48
Recommendation
Develop an agenda for a typical
supervision meeting.
49
Content of a Supervision Session
Follow up on previous assignments Identification of learning needs Review of cases Interventions within supervision session Recommendations for action outside of
supervision
50
Diversity Issues
Diversity influences . . . a. the experience of problems b. the description of problems c. approaches to solving problems d. perception of helpers
51
The Diversity Triangle
Client
Supervisor Supervisee
52
Supervisor Duties to Clients(Falvey)
a. Assure client welfare b. Assure informed consent for treatment c. Assure informed consent for
supervision d. Manage confidentiality and its limits e. Manage availability to clients
53
Supervisor Duties to Supervisee (after Falvey)
a. Select supervisee b. Assess supervisee competence c. Orient supervisee d. Develop individualized supervision plan e. Obtain informed consent for supervision
54
Duties --
f. Assign cases g. Monitor cases h. Document monitoring i. Schedule and meet regularly for
supervision j. Document supervision
55
Recommendation
Consider what duties you have to your client.
Consider what duties you have to your supervisor.
Does your client have duties to you?
56
The Duty – Negligence Issue
A supervisor has a fiduciary duty to the supervisee and to the client.
The duty involves meeting the standard of care – what a reasonably prudent professional would do in the same situation.
Failure to meet the duty may constitute negligence, which is actionable in court.
57
Negligence involves
a. Duty b. Breach c. Cause d. Damage . . . as shown by preponderance of evidence
58
Examples of Supervisor Negligence (Falvey)
a. failing to adequately plan the supervisee’s work
b. giving inappropriate advice to the supervisee
c. failing to get adequate information about a client
d. assigning tasks that the supervisor knew or should have known the trainee was not qualified to perform
59
Vicarious Liability
Others may be legally liable for your acts or omissions.– Your supervisor– Your agency administrator– Your seminar instructor– Other school officials
60
Supervisor - Supervisee Relationship Problems
unmatched expectations fear of disclosure supervision outside expertise boundary issues with clients boundary issues in supervisory relationship
61
Supervisor - Supervisee Relationship Problems --
games supervisee discomfort with power
differential supervisor discomfort with power
differential organizational/structural barriers
62
Problems in Client-Helper Relationships
inadequate understanding inadequate rapport unclear contract unrealistic expectations lack of progress boundary problems
63
Boundary Problems
Strong feelings Extended sessions Inappropriate communication Off-hours phone calls Inappropriate gift giving
64
Boundary Problems --
Inappropriate home visits Overidentifying Loans, barter, and sale of goods or services Inappropriate self disclosure Touching
65
Responses to Client-Helper Relationship Problems
Identify the problem. Define the problem. Define appropriate behavior. Develop strategies to implement
appropriate behavior. Implement strategies. Evaluate strategies.
66
Levels of Informed Consent (Falvey)
a. client consent to treatment by the supervisee
b. client consent to supervision c. supervisor consent to assume
responsibility d. supervisee consent to supervision e. institutional consent to comply with
supervision standards
67
Special issues with students (Falvey)
a. Those involved in selection must exercise due diligence.
b. The training institution must warn field agencies of known risks. (Altamonte v New York Medical College)
c. Responsible people must share known risks.
68
Issues with Students --
d. Faculty members supervising academic seminars have a duty to exercise authority and control over students.
e. The school may have vicarious liability. f. Status as a trainee does not provide an
exemption from the duty to meet the standard of care.
69
Considerations in assigning clients (Falvey)
a. competencies and limitations of the supervisee
b. complexity of the case c. supervisee caseload numbers and
complexity d. supervisor competencies and limitations e. supervisor time for supervision
70
Documents to Demonstrate Proper Supervision (after Falvey)
a. emergency contact information b. supervisee profile c. plan for supervision d. supervision agreement e. caseload supervision log sheet f. supervision progress notes g. initial clinical summary h. termination summary
71
Recommendations to Reduce Risk (after Falvey)
a. Meet with each client during the screening and assignment process.
b. Orient supervisees to informed consent, dual relationship, and other ethical issues.
c. Require audio recordings on a structured basis.
72
To Reduce Risk --
d. Review recordings. e. Regularly ask about personal reactions
to clients. f. Document and follow up
recommendations. g. Do not allow client contact or
supervision after hours.
73
Recommendations to Avoid Dual Relationships (Falvey)
a. Do not supervise current or former clients.
b. Do not supervise current or former family members, friends, sexual partners, or business associates.
c. Avoid social activities with supervisees that may blur roles or impair objectivity.
74
To Avoid Dual Relationships --
d. Limit self-disclosure to that necessary for supervision.
e. Avoid behavior or comments that could be interpreted as romantic or sexual.
f. Identify personal feelings and obtain consultation.
75
Two more hints for self protection
a. If most people wouldn’t understand, you probably shouldn’t do it.
b. If you can’t make yourself look good when you explain your actions on the evening news, don’t do it.
76
Responses to Client-Helper Relationship Problems
Identify the problem. Define the problem. Define appropriate behavior. Develop strategies to implement
appropriate behavior. Implement strategies. Evaluate strategies.
77
May a supervisor supervise outside of expertise?
What is expertise?
78
Elements of Expertise (after Oliver)
a. acceptable training in the field b. appropriate licensure c. substantial relevant experience d. sound use of knowledge, skills, and
principles e. familiarity with and rational basis for
rejecting alternative views
79
Expertise --
f. opinions based on evidence g. opinions consider contradictory and
absent data h. logical reasoning process i. adherence to professional values and
ethics
80
A Basic Evaluation Scheme
1. Does not recognize or ignores relevant information.
2. Minimally recognizes relevant information.
3. With coaching, can begin to apply relevant information to situations.
4. Can identify and apply relevant information in simple situations.
81
Evaluation Scheme --
5. Can identify and apply relevant information in complex situations.
6. Can identify and apply relevant information from more than one perspective to complex situations.
7. Can identify and apply relevant information from several perspectives to complex situations.
82
Evaluation Scheme --
8. Can identify and apply relevant information from several perspectives to complex situations, and can clearly explain the merits of each perspective in relation to the field of knowledge.
83
Recommendation
Complete a needs assessment. Prioritize learning needs. Incorporate those priorities in the learning
agreement.