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PRINCIPLES & RESOURCES FOR CLINICAL SOCIAL WORK SUPERVISION

Introductions

Bonnie Rinks, LCSW, ACSWDirector of Social Work Field Educationberinks@usi.edu

Summer Wilderman, LCSWAssistant Director of Social Work Field EducationClinical Assistant Professorsnwilderma@usi.edu

John Paulson, LCSW, ACSW, LCACAssistant Professor of Social Workajpaulson@usi.edu

Today’s Objectives■ Identify strategies for promoting success in

clinical supervision

■ Specify key aspects of deliberate practice

■ Locate resources for clinical supervision

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Why Talk about Supervision? Have you been in the role of a supervisor, currently

or in the past?

Have you received formal training on how to become a supervisor?

How many years after receiving your degree were you put into the role of supervisor?

Did you receive what you would consider quality supervision in your early social work career?

Why Talk about Supervision?

As you saw from our conversation, not many of us received formal supervisory

training, we were put into these positions very early, and did not always receive good,

effective examples of supervision.

Our Interest■ “We have provided clinical supervision in the past, with little to no

initial training.”

■ “We also know those we are training today will likely be tapped as supervisors in the near future.”

■ “This has made us explore information, training, continuing education, and credentialing for clinical supervision.”

The trend of early career social workers being promoted into supervisory roles with little or no supervision training was

happening when we graduated 20 years ago. Unfortunately, we are seeing this trend continue, and it is frightening!

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Traditional Approach■ So, those of you that did not receive training, what did

you do?– Most of us use our own experiences (Good or Bad)

as the foundation for supervising others.

■ Most social work supervisors become “supervisors” because of promotion, time, and experience in the field.– Sadly, we assume that because they are

experienced clinicians that they know how to “supervise.”

So, Why is this Happening?■ Clinical supervision is not something that we just “do”

– It is a distinct approach and activity with its own practice models.– It is a field with its own theories and techniques.

■ Social workers generally receive little exposure to education and training on clinical supervision theories and techniques, either during undergraduate or graduate education or once they have entered the field.

■ Many other fields (counseling, addiction counseling, psychology) have more formal, established processes for supervision training.

We need to be more intentionalwith our approach to the practice of Supervision.

Strategies for Promoting Success in Clinical Supervision

Foundations of Supervision Back to Basics Supervisor Roles Approach

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■ Clinical supervision has three general domains1. Administrative - management, productivity, etc.2. Educational - development of supervisee3. Supportive - guidance, encouragement, etc.

(For entry-level counselors, the supportive function is critical!)

Supervisors often have to balance and individualize each domain to focus on the unique professional

and developmental needs of the supervisee.

BACK TO BASICS

https://www.ncbi.nlm.nih.gov/books/NBK64848/

Teacher - development, professional growth

Consultant - monitor, counsel, assess, professional gatekeeper

Coach - support, model, cheerlead

Mentor - role model, train the next generation of supervisors

Supervisor Roles

APPROACH■ Clinical supervision theories and models tend to fall into

three general categories

1. Based on Specific Psychotherapy Model – i.e. CBT, Psychodynamic

2. Developmental - focus on supervisee professional development, developmental stages, tasks and roles

3. Process-Oriented - focus on the process, interaction, and relationship that forms through supervision

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Supervision Techniques

■ Most Commonly Used ■ Most Effective ■ Discussion

SELF-REPORT

■ Supervisee comes in, meets with supervisor, provides

their description, account, memory, recollection, etc. of

what happened with particular individuals

■ Due to time constraints this tends to be the most

common form of supervision

Most Commonly Used

HOWEVER . . . . . ■ It is seen as the least accurate, least desirable, and least

productive approach in supervision literature

■ And is seen as not very valid due to its reliance on the accuracy of

the supervisee’s recall and description

– Supervisees are already overwhelmed with clinically-latent

information and might not yet be able to identify what is most

clinically important or relevant in interactions.

■ At best Self-Reporting may play a tutorial or conceptualization role

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■ Live Observation– Little to no supervisor participation – Can be done through one-way mirror, in person, or as a team

Most Effective

■ Audio/Video Recording– Great for review of and focus on specific techniques, process and

content, tone/pace– Can be done through supervisee transcripts– Best to:

■ Have a plan for what to look for ■ Target specific portions of noteworthy or targeted interaction■ Have supervisee watch video once before watching with supervisor

Most Effective (continued)

■ Live Supervision– Supervisor interacts during the session (i.e. coach or co-therapist)– Can also be done through an ear piece, phone-in consultations, or walk-in

Most Effective (continued)

Client

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DiscussionHow many of you are routinely engaging in live observation, live supervision or consistently, routinely, reviewing video recordings of your supervisees?

– “Sadly, we don’t either.”

So, if we know these are the most effective techniques, why are we not using them?

– Time – Resources– Agency Policies and Practices– Clinician Comfort

Interestingly, recent research shows that clients are usually OK with this and much more open to and comfortable with recording than we are.

Refocusing Our Approach

■Research shows that it takes 10 years (10,000 hours!) to become a good supervisor.

From Malcolm Gladwell, Outliers

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Key Aspects of Deliberate Practice■ Emerging field of study in Psychology

– Studies how people develop expertise and what it takes for them to improve

– Focuses on helping clinicians improve their practice and quality of services

– Targets practices outside of what clinicians are typically doing■ This includes what is done before (planning/preparation) and

after (reflection) services

■ Has been most adapted and applied to psychotherapy by Dr. Scott Miller, Dr. Tony Rousmaniere, and others

Spend most of your time working on what you are not yet good at as opposed to spending the most time

continuing to practice what you already do well

1. Identify skills that are on the “edge” of one’s competency through direct observation and feedback from a trainer or supervisor

2. Target these skills for development, improvement, and refinement

3. Develop a plan for practicing these specific skills4. Receive feedback from trainers/experts on skill

performance

Deliberate Practice (continued)

“In supervision, I get to do many of the same things I get to do in therapy, but with people who

are healthy and enthusiastic and want to hear what I have to say. It's meaningful and very

exciting, especially when you consider you're shaping a new generation of wonderful

therapists.”

Dr. Edrick Dorian, Assistant Clinical Professor at UCLA

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■ Develop a strong working relationship with supervisee -avoid casual relationships

■ Provide frequent feedback

■ Lay out a remediation process

■ Have your own supervision

■ Develop goals with supervisee and delineate expectations up front (contract)

Learning to Supervise Effectively

■ Think “Treatment Plan” or “Learning Plan”

■ Things to Address in Contract

– Logistics: who, what, when, why, how, length of time– Cost

■ DO NOT cheat yourself! Know the going rates in your community.

– Expectations

■ Goal Setting

– Think S.M.A.R.T. – Suggestion: Have Supervisee Provide their Official Job

Description - This will assist in setting appropriate goals

The Supervision Contract

Challenges■ Agency Issues

– Differentiating Between Evaluation Types■ Formative (growth and development) and ■ Summative (job performance/Annual review)

– These can be competing– Buy In

■ Speak to your agency about making an organizational commitment to providing good supervision as well as continuing professional development opportunities throughout workers' careers

■ Making Time– Advocate for supervision and it’s importance

■ i.e. reducing supervisor case loads, increasing pay and title, etc.

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Final Thoughts■ Anticipate some level of conflict ■ Feedback should be regular and ongoing ■ Implement tools to document hours, contracts, and goals■ Use an array of skills

– i.e. Case Conceptualizations, Self-Awareness■ Advocate for yourself!

– Speak up for what you need (supervisors and supervisees)■ Evaluate the effectiveness of supervision, just like you would in

practice■ Ethics, Ethics, Ethics

– Just as in practice – Consult and Document, Regardless of the Outcome, Justify your Actions.

Supervision Resources

Widely used supervision textbook by

Bernard & Goodyear

Free!!! Supervision Resources

SAMHSAhttps://store.samhsa.gov/system/files/sma14-4435.pdf

NASW https://www.socialworkers.org/LinkClick.aspx?fileticket=GBrLbl4BuwI%3D&portalid=0

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Deliberate Practice Resources Rousmaniere, Goodyear, Miller, &

Wampold discuss principles of Deliberate Practice and how to include it in training and supervision

■ Recent edited volume by Rousmaniere, on Deliberate Practice

Video Resources: Deliberate Practice Shrink Rap Radio: https://www.youtube.com/watch?v=tUL0KzXlgK0

Dr. Rousmaniere discusses his early struggles as a clinician, how that led him to deliberate practice, and information about deliberate practice.

Video Resources: Deliberate Practice

https://www.youtube.com/watch?v=pI8Hww1xjK4

The 2013 Evolution of Psychotherapy Conference

Dr. Scott Miller discusses the evolution and

development of therapists, feedback informed

treatment, and deliberate practice

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Thank You for Your Time and Attention!

References■ Bodenheimer, D. Real World Clinical Blog: On Social Work Supervision

– https://www.socialworker.com/feature-articles/real-world-clinical-sw/on-social-work-supervision

■ Borders, D. (2014). Best Practice in Clinical Supervision: Another Step in Delineating Effective Supervision Practice. – America Journal of Psychology. New York, Vol 68, Iss 2, p. 151-162

– https://psychotherapy.psychiatryonline.org/doi/full/10.1176/appi.psychotherapy.2014.68.2.151

■ Hughes, J. (2010). The Role of Supervision in Social Work: A critical analysis – Critical Social Thinking: Policy and Practice, Vol. 2

– https://www.ucc.ie/en/media/academic/appliedsocialstudies/docs/JeanneHughes.pdf

■ Kaas, F. (2017) An Examination of the Relationship Between Supervision and Self-Efficacy in Early Career School Psychologists, School Psychology Interns, and Practicum Students

– https://knowledge.library.iup.edu/etd/1502

■ Kersting, K. (2005). Learning to Supervise: Taking your first crack at supervision? View the job as a special kind of counseling that takes unique skills and preparation.– gradPSYCH Magazine– https://www.apa.org/gradpsych/2005/11/supervise

■ Kettle, M. (2015) Achieving Effective Supervision– https://www.iriss.org.uk/resources/insights/achieving-effective-supervision

■ NASW. (2013). Best Practice Standards in Social Work Supervision

– https://www.socialworkers.org/LinkClick.aspx?fileticket=GBrLbl4BuwI%3D&portalid=0

■ Substance Abuse and Mental Health Services Administration. (2009). Part 1, Chapter 1, Clinical Supervision and Professional Development of the Substance Abuse Counselor: Information You Need to Know

– Clinical Supervision and Professional Development of the Substance Abuse Counselor

– https://www.ncbi.nlm.nih.gov/books/NBK64848/

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