taces presents: development, evaluation, and (when … · taces presents: development, evaluation,...
TRANSCRIPT
TACES Presents: Development, Evaluation, and (When Needed) Remediation of LPC Interns
Marcella Stark, Ph.D., LPC-S
Texas Christian University
Kate Walker, Ph.D., LPC-S, LMFT-S
Agenda
Morning (8:30-12:00)
Introductions and Overview
Learning Objectives
Developing a Supervision Plan
Evaluation
Lunch (12-1:30)
Afternoon (1:30-4:45)
Remediation
Documentation
Practice
Learning Objectives
Understand elements of a supervision plan and be able to develop appropriate goals and objectives.
Describe time requirements and appropriate methods for supervision.
Identify evaluation methods to assess both counselor development and effectiveness of supervision methods and techniques.
Understand administrative tasks required of LPC Supervisors.
Your Views of Supervision
How do you establish rapport?
What areas are important for counselor trainee growth?
How do you facilitate that growth?
What was your experience with LPC supervision? What would you want to do differently?
What is good supervision?
Overholser (2004) suggested that good supervision includes the following:
a positive working alliance
direct feedback to supervisees
Socratic questioning to help supervisees reach their own conclusions
assessing the needs of the supervisee and tailoring supervision accordingly
If you fail to plan, you are planning to fail.
--Benjamin Franklin
Trainees equate supervisor effectiveness with a comprehensive supervisory plan (Leddick & Dye, 1987).
“The antithesis of planning occurs when a supervisor accepts a supervisee, sets weekly appointments with the supervisee, and lets things just happen “ (Bernard & Goodyear, 2004, p. 186).
Elements of a Supervision Plan
1. Teaching, training, and consultation
2. Monitoring and accountability
3. Work design and coordination
4. Communication and linkage within agency and with external resources
--adapted from Hardcastle (1991), cited in Bernard & Goodyear’s Fundamentals of Clinical Supervision
Teaching
Case presentations (typically include video)
o Simple discussion and feedback
o Steps of particular model (e.g., Egan’s skilled helper model, stages of change)
o IPR (Kagan, 1980)
o Experiential (e.g., sandtray)
Didactic
Roleplay
Monitoring
Reported behaviors by intern
Co-counseling
Live supervision
Review of progress/case notes
Review of recorded sessions (audio)
Review of recorded sessions (video)
Work Design
Logistics – When and where will you meet? Communication with site? Triadic or group? Fee arrangements?
How will you conduct the following?
• Review of counseling competencies
• Evaluation
• Goal setting
• Monitoring
Communication with Other Entities
Develop referral resources
Share these with supervisees
Help supervisee develop skills in creating his/her own list
Activity
Describe the last time you received critical feedback or an evaluation of your clinical work.
How was the feedback delivered?
What were your reactions?
Importance of Evaluation
Determines your approach to supervision
Supervisee growth and skill building
Supervisee integration of theory into practice
Supervisee self exploration
Supervisee work satisfaction and professional identity
Difficulties with Evaluation
Sometimes viewed as a necessary evil
Supervisors are trained as counselors
Accept clients’ limitations
Respect clients’ goals
Facilitator of another’s change, not a decision maker about what change is necessary
Working conditions of supervision reflect those in therapy
How do you define clinical competence anyway?
Defining Clinical Competence
Knowledge and skill standards
Accrediting body
Regulatory bodies
Training institutions
Program values
Research
Nonspecific factors such as personal characteristics
Evaluation Criteria
Factual Knowledge
Generic clinical skills
Orientation-specific skills
Clinical judgment
Interpersonal attributes
Multicultural competence
Supervisee theory of choice
Focusing on one aspect of clinical expertise
Initial interview
Evaluation Criteria
Regardless of what criteria are chosen, the Formative and Summative evaluations
Should relate directly to these same criteria
Should be introduced early in the relationship
Should serve as teaching-learning objectives
Should be used as the basis for feedback throughout supervision
Formative Evaluation
Represents the bulk of evaluation
Stresses process and progress rather than outcome
Ongoing
All behavior is communication
Constant coding and decoding
Summative evaluation
Moment of truth – how does the trainee measure up?
Must be clear criteria
Supervisee must be aware of criteria
Summative evaluations may become stressful if there is a disconnect
What have you used?
By what standards have you been evaluated?
So what are the counseling competencies?
One example taken from F. Thomas’s (2012) Solution-Focused Supervision
Case Management: Writing consistent case notes, complying with ISD/agency policies
Therapeutic Relationships: Conveying warmth, respect; use of self
Perceptual Competencies: Ability to observe patterns, see nonverbal behavior, distinguish content/process, self-awareness
Conceptual Competencies: Ability to think within the assumptions of your model, ability to base clinical work (goals, interventions, termination) on model/theory, ability to incorporate idiosyncratic, gender, and cultural aspects
Participatory Competencies: Changing your approach when stuck, controlling when exchanges are nonproductive or chaotic, terminating sessions, follow through with homework
Domains of Stoltenberg & McNeill’s (2009) IDM
Intervention skills
Assessment techniques
Interpersonal assessment
Client conceptualization
Individual differences (both cultural and personality)
Theoretical orientation
Treatment plans and goals
Professional ethics
Others?
Those endorsed by ACA and other professional organizations
o Advocacy Competencies
o ALGBTIC Competencies
oCareer Counseling Competencies
oMultcultural Competencies
See http://counseling.org/knowledge-center/competencies
Favorable Evaluation Conditions (Bernard & Goodyear, 2014, p. 226-229)
Respect power differential in relationship
Clarity in role (expectations) & structure by both parties
Evaluation specifics discussed in advance
Address, attend to, and explore defensiveness & individual differences
Mutual & continuous process
Need a competent and reliable administrative structure
Avoid prejudging
Continue to vicariously mentor through your own professional development
Honor & monitor the relationship
Unfavorable Conditions for Supervision
Dismissal and lack of awareness of the trainees’ thoughts and feelings
Lack of empathy and support
Not providing comfort and/or safety in supervision
All support or all challenge
Expression of anger toward supervisee
Moody
Unwilling to share responsibility for supervision
Inappropriate self-disclosure
Supervisors Must…
Remember supervision is an unequal relationship
Provide clarity if a dual role exists
Will supervisor be making decisions regarding supervisee’s job or academic progress?
Who will be privy to supervisee’s progress?
Clarify supervisee roles and expectations
Address supervisee resistance openly
Teach supervisee how to receive corrective feedback
Supervisors Must
Address individual differences openly
Involve the supervisee in determining what is to be learned
Supervise in a supportive administrative structure
Be organized!
Avoid making quick evaluations
Foster an atmosphere of competence rather than recognizing stars and focusing on initial impressions
Supervisors Must
Invite feedback and model continuing education
Always keep an eye to the relationship
Keep a plan in place in case of personality incompatibility
It is the supervisee’s right to trust the supervisor
Enjoy Supervising!!!
Remember
Supervision is voluntary!
Your supervisees have a real life!
Confusion is normal and “not knowing” is a prerequisite for arriving at new insights
Supervision is a safe place
You give your supervisees permission to challenge = Growth
The Evaluation Process (Bernard & Goodyear, 2014, pp. 230-241)
Supervision Contract – negotiate
Methods of evaluation – choose multiple methods
Choosing evaluation instruments
Attend to developmental process
Feedback messages are seen in terms of both clarity and context
Encourage self-assessment
Subjective – intuition (similar, familiar, priorities)
Evaluation Instruments
See examples in Dropbox folder
Most commonly used: Likert scale or anchored rubric and some open-ended questions
SPAI
Evaluation criteria based on five categories
1. Skill development (interventions)
2. Case conceptualization
3. Personalization (as defined by Bernard’s (1979) Discrimination Model)
4. Professional issues
5. Supervision skills (for the supervisee)
(Fall & Sutton, 2004)
SPAI
Evaluation scale example
A. I have not been trained in using this skill
B. I seldom use this skill
C. I use this skill often
D. This is a skill that does not fit my model/style
E. I am comfortable using this skill
F. I am uncomfortable using this skill
G. I would like additional information and training on this skill
(Fall & Sutton, 2004)
Consequences of Evaluation
Job choice or promotion
Anxiety
Stress on the supervisory relationship
Negative evaluation
Require more documentation
Possibility of an appeal
Legal issues
Chronic Issues with Evaluation
Dual roles
Peer evaluation as administrative evaluation?
What percentage of development is due to supervision? Does this affect evaluation?
Did the supervisor teach the skills they are trying to evaluate?
Are evaluations based on skill development or the relationship between the supervisor and supervisee?
To what extent is supervision reflecting licensure requirements and client needs?
Chronic Issues with Evaluation
Subjective obstacles
Similarity and dissimilarity
Age, appearance, life cycle stage, stressors
Liking and not liking
Familiarity and first impressions
Egocentric bias – what is important to you?
Rater inconsistencies (superior, average, inferior)
Communicating Formative Feedback
Clear
Owned
Regular
Balanced
Specific
Communicating Summative Evaluations
Should contain no surprises
Provide material for the next period of time until the next summative evaluation
Problems occur when:
Supervisor’s style of communication is clouded
Process is ambiguous
Criteria is ambiguous
Supervisor is uncomfortable with the responsibility of the evaluation
Inadequate amount of formative evaluation
Relationship issues
Special Evaluation Issues
Impairment
Incompetence
Remediation
Note: Remediation will be covered in more detail in our course ‘Gatekeeping and Remediation’
Evaluation of Supervision
See examples in Dropbox folder
These types of evaluations can be done periodically to get feedback from supervisees
Helpful to gauge effectiveness
Great discussion starters
Gatekeeping
When Remediation is Needed
Nope, you can’t just fire your supervisee.
Impairment v. incompetence
§681.93. Supervisor Requirements (e)(4)
If a supervisor determines that the LPC Intern may not have the counseling skills or competence to practice professional counseling under a regular license, the supervisor shall develop and implement a written plan for remediation of the LPC Intern.
Problematic Behavior (Lamb et al., 1991)
Supervisee does not acknowledge or understand
Not a simple skill deficit
Has potential ethical or legal consequences
Negatively affects services and spans several areas of professional functioning
Does not improve with feedback, remediation, or time
Supervisor spends a disproportionate amount of time addressing the issue/supervisee
Professional Development Plans
See examples in Dropbox folder
Time Requirements
§681.92. Experience Requirements (Internship) (g) requires
A minimum of four hours per month (averaging once per week)
of face-to-face or live Internet webcam supervision
in individual (up to two Interns) or group (three or more) settings
for each week the intern is engaged in counseling
Don’t get carried away!
No more than 50% of the total hours of supervision can be live Internet webcam supervision
No more than 50% of the total hours of supervision may be received in group supervision.
No more than 50% of the total hours of group supervision may be live Internet webcam supervision.
Info for Supervised Experience Documentation Form
the inclusive dates of the supervised experience and the total number of hours of practice;
the number of hours of weekly face-to-face supervision given to the applicant, the total number of supervisory hours received by the applicant in the experience, and the types of supervision used
the types of clients seen and counseling methods used;
the supervisor's evaluation of the applicant's counseling skills and competence for independent or private practice
Administrative Tasks of LPC-Ss
Initial and final paperwork
Supervisory Agreement w/ copy of supervisor’s renewal card attached
Supervised Experience Documentation Form
Ongoing Supervision Log
Maintain and sign a record(s) to document the date of each supervision conference and document the LPC Intern's total number of hours of supervised experience accumulated up to the date of the conference.
The record shall reflect the site where the hours were accrued and the content of the session.
And the scary part . . .
§681.93(e) The full professional responsibility for the counseling activities of an LPC Intern shall rest with the intern's board approved supervisor(s). If the LPC Intern receives disciplinary action by the board the supervisor may also be subject to disciplinary action.
(1) The supervisor shall ensure that the LPC Intern is aware of and adheres to Subchapter C of this chapter (relating to Code of Ethics).
So what do I do first?
Expectations that need to be discussed in the initial supervisory session:
1. Identify the supervisee’s supervision goals. Collaborate to determine areas for professional growth
2. Discuss supervisee contribution—how might supervisee prepare for supervision?
3. Formal and informal evaluation; provide copy of evaluation instrument.
4. Structure and nature of supervision sessions.
Roleplay
an initial supervisory session
Don’t forget to document!
Enter the mock supervisory session you just had into your
supervision log.
Questions?
Assessment
????