clinical supervision in an educational settingclinical supervision in an educational setting: dr...
TRANSCRIPT
![Page 1: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/1.jpg)
AN UNAVOIDABLE TENSION BETWEEN HOLDING AND ASSESSING
Clinical Supervision in an Educational Setting:
Dr Pól Dominic McCann
![Page 2: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/2.jpg)
navitas.comacap.edu.au
Background
After 2.5 years working in supervision at ACAP, the main tension noted is that of mentor vs monitor
Presentation is based on conversations with supervisors and supervisees
Elisabeth Shaw’s 2013 paper Mentoring or Monitoring which indicates that this is widespread across the workforce
![Page 3: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/3.jpg)
navitas.comacap.edu.au
What is supervision?
Milne (2007) says is in neither therapy nor mentoring – but he takes a very positivist approach and how do you categorise such subjective interactions?
It’s not counselling – but some students will merge the two
Gilbert (2001, p. 200) claims it is naive to believe ‘the proposition that the practices of reflection and clinical supervision are separate and different from processes of surveillance’
Some supervisors say it never happens; others say it does but they contain and redirect; others say they are distinct but there is a need to acknowledge POTT which cannot come about without the student being aware of how their history intersects with their practice
![Page 4: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/4.jpg)
navitas.comacap.edu.au
ACAP Supervision: Overarching Aims Support the supervisee development: personally and
professionally
Challenge blindspots, skill deficiencies
Evaluate competence, empathy, self-awareness
Gatekeeping: ensuring graduates are ready to practice competently and ethically (McCann 2015)
![Page 5: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/5.jpg)
navitas.comacap.edu.au
The tension is not confined to ACAP
Gilbert (2001, p. 201) Workplace supervision can be managerial rather than reflective
The added impost for training supervisors is that we must assess. And we have the third hat of pedagogy
So setting up a contract early in the term: bracket off expectations for each section
Developing the steps along the way: first assessment needs to focus on skills, less on formulation and conceptualisation
![Page 6: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/6.jpg)
navitas.comacap.edu.au
The tension is not confined to ACAP Larger US psych colleges report boundary issues in
supervision which create issues and influences in grading supervisees
APA Ethics Code (APA, 2010) Beneficence and nonmaleficence; fidelity and responsibility; integrity; justice; and respect for people’s rights and dignity
PACFA (2015) 3.1Ethical principles of Counselling and Psychotherapy 3.2.1 Fidelity 3.2.2 Autonomy 3.2.3 Beneficence 3.2.4 Non-maleficence 3.2.5 Justice 3.2.6 Self-respect
These all impact on education and training (Erickson Cornish 2014).
![Page 7: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/7.jpg)
navitas.comacap.edu.au
What we see at ACAP
An academically strong student
A student with good skills
A student who seems to be aware….
…can all fall apart in supervision, despite gatekeeping at several stages
![Page 8: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/8.jpg)
navitas.comacap.edu.au
Impression management
The tension of grading
How to deliver feedback
Power imbalances
Boundaries
Gatekeeping
Themes to consider
![Page 9: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/9.jpg)
navitas.comacap.edu.au
Impression management and political suicide
Are supervisees going to withhold scenarios in which they may appear less competent? (Shaw 2015)
Supervisor comment: ‘I feel like I’m getting a really watered down version of what's going on for them.’ She tells them ‘if your skills aren't there I have to do something about that but I try and build as much safety as I can’, within a fraught set-up, for someone to bring their innermost inadequacies’
![Page 10: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/10.jpg)
navitas.comacap.edu.au
The tension of being graded: Students many not present their weaker moments as they
want to show their best side
Students are assessed by pass/fail in relation to their skills
And yet it is actually a strength to show vulnerabilities
‘It’s about balancing opposites’
![Page 11: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/11.jpg)
navitas.comacap.edu.au
The uses of feedback Supervision should use ‘corrective feedback on the
supervisee’s performance, teaching, collaborative goal setting’ (Milne 2007, p. 439)
Sometimes in group: Can be directed at all, or to one – but it is really directed (indirectly) at the most vulnerable. ‘It’s crucial to work with group dynamics…. I try to catch those teachable moments’
![Page 12: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/12.jpg)
navitas.comacap.edu.au
If too directive… …does supervision risk losing the ability to foster
collaborative knowledge? (Shaw) Is collaboration only viable when there is a graduate-level degree of experience?
Supervisors note that these dynamics occur (generally less frequently) with their private clients: ‘yes but, there’s a reason…’ And there is a need to ask them to look at themselves first so even outside the educational setting, counselling is in the periphery
Students, need to demonstrate skills; private supervision is more about a fluid set of criteria. POTT is critical aspect to both.
![Page 13: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/13.jpg)
navitas.comacap.edu.au
Delivering feedback ‘How does one carry out a monitoring function that
generates anxiety, when trying to maintain a respectful, collaborative arrangement?’ (Shaw 2013, p.302)
Supervisor asks how it felt to get feedback. Then puts it to one side – does not want to keep repeating. About professionalism, being able to move on. So she will have a private conversation if they are upset
The difficulty of this: ‘it’s a very subjective thing, how counsellors need to be, rather than what counsellors to be doing. An educational institute can only assess the doing. It can’t assess the being, because this is so subjective’
![Page 14: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/14.jpg)
navitas.comacap.edu.au
Where to give feedback? ‘I try and keep feedback in the group, because if the group
miss some of the feedback you have given outside of it, they’re not quite on track with what transpired’
Must be aware of not shaming, especially for directive feedback. This may be delivered privately: Or a combination of both
‘[the marking criteria] brings structure to the subjectivity of supervision’
So while grading is seen as a negative in some contexts, the structure of grids assists by removing personality influences
![Page 15: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/15.jpg)
navitas.comacap.edu.au
Boundaries Supervision should not blur into providing counselling of
supervisees. Asking for personal insight into a client case is not about asking for self-analysis (McCann 2015)
Brown, Murdoch and Abels (2014, p. 274) note that ”departure from commonly accepted clinical practice that may, at times, be beneficial to the client, and at other times, neutral or even harmful
Shaw (2014, p. 302) notes that ‘primitive feelings’ emerge and create reactions for supervisors and supervisee – and self-censoring follows
![Page 16: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/16.jpg)
navitas.comacap.edu.au
Gatekeeping Is this the right time for you to do this degree?
Students note that it is harder in the field compared to role plays – so we don’t know how they will react until they get onto placement
Supervisors can identify students of concern about from year one: how do we ethically manage students at risk?
![Page 17: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/17.jpg)
navitas.comacap.edu.au
Gatekeeping: Do they need counselling? Some said it never comes up; others said it will but they
contain and redirect quickly
How do you not assess POTT without examining the supervisee's back story – one noted that she not get drawn in: errs on these side of boundary but ‘I would be derelict of my duty not to address this’
Cites example of student who did placement where she had been volunteering for 2 years – fearful of going outside her boundary. So this was brought to the student’s attention
![Page 18: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/18.jpg)
navitas.comacap.edu.au
Integrative Development Model: Level 1 Motivation and anxiety are high
Seeking structure and guidance in regards to the ‘best’ approach
High-self-focus but limited self-awareness
Apprehensive about being evaluated/judged
Limited autonomy – they need structure and warm guidance from supervisor: some direct challenge is required (Stoltenberg, McNeill & Delworth 1998)
![Page 19: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/19.jpg)
navitas.comacap.edu.au
References American Psychological Association. (2010, June). Ethical principles of psychologists and code
of conduct. Retrieved from http://www.apa.org/ethics/code/ accessed 29 August 2016
Brown, C., Murdock, N. L., & Abels, A. (2014). Ethical issues associated with training in university counseling centres. Training and education in professional psychology, 8(4), 269-276.
Erickson Cornish, J. A. (2014). Ethical issues in education and training. Training And Education In Professional Psychology, 8(4), 197-200
Gilbert, T. (2001). Reflective practice and clinical supervision: meticulous rituals of the confessional. Journal Of Advanced Nursing, 36(2), 199-205. 2648.2001.01960.x
McCann, P.D. (2015). Professional Development Presentation for clinical supervisors, ACAP
Milne, D. (2007). An empirical definition of clinical supervision British Journal of Clinical Psychology, 2007, Vol.46(4), pp.437-447
PACFA Code of Ethics retried from: http://www.pacfa.org.au/wp-content/uploads/2014/04/Interim-Code-of-Ethics-2015.pdf accessed 11 August 2016
Stoltenberg, C.D., McNeill, B. and Delworth, U. (1998) IDM Supervision: An Integrated Developmental Model of Supervising Counselors and Therapists. San Francisco: Jossey-Bass
![Page 20: Clinical Supervision in an Educational SettingClinical Supervision in an Educational Setting: Dr Pól Dominic McCann. acap.edu.au. navitas.com ... (1998) IDM Supervision: An Integrated](https://reader030.vdocument.in/reader030/viewer/2022011900/5f0551a97e708231d4125fbc/html5/thumbnails/20.jpg)
navitas.comacap.edu.au
Questions and feedback