NEO-PI-R - University of Toledo

Report
Developmental Supervision Using
the IDM
John Laux, Ph.D., PCC-s, LICDC
School Psychology, Legal Specialties, &
Counselor Education
The University of Toledo
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Discriminate between Clinical
Supervision & Developmental
Supervision
Understand the First Two
Stages of Integrated
Developmental Model of
Supervision IDM
What is Supervision?
Supervision
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over-seeing, looking over someone’s
shoulder to check on them;
and also ‘super’ in the sense of
outstanding or special, helping
someone to extend their professional
skills and understanding.
http://www.faculty.londondeanery.ac.uk/e-learning/supervision/what-is-supervision
Clinical & Developmental
Supervision
Clinical & Developmental
Supervision
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Development ongoing professional
learning
Clinical/performance clinical
governance and standard setting.
Clinical & Developmental
Supervision
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Who does what?
• Clinical/performance supervision is the
sole domain of the site supervisor
• Developmental supervision is done by
both the university supervisor and
the site supervisor.
Clinical & Developmental
Supervision
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How to tell them apart:
• Who is the focus?
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Answer the question, “Are we talking about
the client/student or the supervisee?”
• Example 1.
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I have a high no-show rate after the initial
session. How do I increase my productivity?
Susan keeps missing appointments. How
can I work to increase her motivation for
counseling?
Clinical & Developmental
Supervision
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Client/student or supervisee?
• Example 2.
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Richard’s parents want to know how they
can improve his study skills both at home
and at school. What interventions do you
suggest I recommend for these parents?
I am not a parent. I feel comfortable
working with students, but I am scared
about meeting with parents and guardians.
Clinical & Developmental
Supervision

Faculty and graduate assistants do
not provide Clinical Supervision.
• Why not?

So, what do faculty do during
practicum and internship?
IDM Supervision
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An Integrated Developmental Model
of Supervision
-Stoltenberg, McNeil & Delworth
3 Levels of Development
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Level 1 Therapist (Practicum)
Level 2 Therapist (Internship-Newly
LicensedIndependence)
Level 3 Therapist (Independence on)
Overarching Structures
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Self & Other Awareness
Motivation
Autonomy
Specific Domains
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Intervention Skills
Assessment
Interpersonal Assessment
Client Conceptualization
Individual Differences
Theoretical Orientation
Treatment Plans & Goals
Professional Ethics
So You’ve Agreed to Be A Site
Supervisor
What Does the Typical
Practicum Student Know?
Overarching Structures—Level 1
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Self & Other Awareness
• About whom is the student thinking
upon entering the counseling room?
Overarching Structures—Level 1
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Self & Other Awareness
• Focus is on personal effectiveness, skills
Overarching Structures—Level 1
Anxiety/fear
Overarching Structures—Level 1
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Concerned about supervisor’s evaluation.
Overarching Structures—Level 1
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Motivation
Overarching Structures—Level 1
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Motivation
• Usually high.
• Focused on going from beginner to
expert.
• Want to move from anxiety to comfort.
• Want to learn the “best” theory,
techniques or approaches.
Overarching Structures—Level 1
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Autonomy
• Heavily dependent on supervisor
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What to do/say in session
Overarching Structures—Level 1
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Autonomy
• Heavily dependent on supervisor
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How to use supervision
Level 1 Intervention Skills
Competence
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Want understandable set of skills in a
structured framework they can
imitate.
Latch on to an orientation & become
a devotee (usually 1st one they read
or CBT)
Every issue becomes a nail.
Level 1 Assessment
Techniques
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Tend to prefer
interview methods
or standardized
methods.
Have little critical
skills. I.e., fail to
consider client
response set or
motivation.
Level 1 Interpersonal Assessment
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Use personal reactions as
assessment tool & barometer of data
received.
Level 1 Client Conceptualization
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Focus is on specific aspects of clients’
story & exclude other relevant data.
Tend to over- or under-pathologize.
Level 1 Individual Differences
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to interpret clients’ MC via own cultural
lenses.
Assume that if they have common traits
then the client’s worldview is the same as
their own.
OR
Assume that if they have dissimilar traits
then the client’s worldview is the vastly
different from their own.
Level 1 Theoretical Orientation
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Seeking the one-truth. When found,
become disciples.
Level 1 Treatment Planning
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Difficult to
conceptualize
treatment from
intake to discharge.
Focus is on keeping
clients.
Tx planning may be
general or cookie
cutter/manualized.
Level 1 Treatment Planning
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Focus is
on
keeping
clients.
Tx planning may
be general or
cookie-cutter or
manualized
Level 1 Professional Ethics
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Rigid application & rote
memorization.
Need guidance in interpreting and
applying.
Supervising the Level 1 Therapist
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Structure!!!!
• Both supervision & their clinical work.
Supervising the Level 1 Therapist
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Break feedback down into
manageable/observable chunks.
Supervising the Level 1 Therapist
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Simplicity & slow speed.
Supervising the Level 1 Therapist
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Encourage self-examination
Supervising the Level 1 Therapist
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How?
• Observation
• Skills training
• Role plays
• Readings
• Group sup
• Balance ambiguity
• Create conflict
• Cont. education
Supervising the Level 1 Therapist
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Be supportive
Be prescriptive
Tie theory to diagnosis to treatment
Initiate growth
Transitioning to Level 2
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Practicum to Internship
100 hours (minimum) under their
belt.
Transitioning to Level 2
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Motivation:
• may decrease for new
approaches/techniques
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Autonomy:
• may desire more than is warranted.
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Awareness:
• Begins to move toward client, away
from self.
Overarching Structures—Level 2
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Self & Other Awareness
• Less on self, more on client via empathy
• Potential for over-identification
Overarching Structures—Level 2
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Vacillation between autonomy &
dependency.
Overarching Structures—Level 2
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Dependency/autonomy struggle
affects motivation.
• Want independence but question self
when in tough/new situations.
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Evidence of struggle in supervision
Level 2 Intervention Skills
Competence
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More comfort w/wide range of
intervention skills, but…
Skills aren’t integrated w/theory.
Level 2 Assessment
Techniques
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Improvement in diagnostic criteria &
assessment instruments, but…
Level 2 Interpersonal Assessment
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Ability to be self-aware & monitor
own cognitive/affective reactions is
compromised due to over
identification.
Level 2 Client Conceptualization
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Case conceptualization is more
complex but subject to over
identification with client.
Level 2 Individual Differences
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More willing to acknowledge
influence of socio/cultural &
environmental influences on
behavior.
Vacillate between global one size fits
all approaches and the idea that
every client is unique.
Level 2 Theoretical Orientation
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Less rigidly aligned with one theory
willing to explore other theories.
Level 2 Treatment Planning
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May lose sight of need for jointly
formulating treatment plans with
clients.
http://www.youtube.com/watch?v=B
YLMTvxOaeE
Level 2 Professional Ethics
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Ethics better understood
• May view as imposition or limitation on
practice that could be violated &
justified by exceptions.
Supervising the Level 2 Therapist
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“Therapeutic Adolescence.”
• Seek balance
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between guidance and support.
between autonomy and challenge.
Supervising the Level 2 Therapist
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Client Assignment:
• Usually get more pathological clients
who are less open to trying out newer
sets of skills.
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Case assignment should be
presenting problems in and out of
trainee comfort zone.
Supervising the Level 2 Therapist
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Interventions
• Ongoing support & concern for
supervisee development.
• Talk about own past difficulties.
• Prescriptive: provide multiple options &
get supervisee input. Encourage
autonomous choices.
• Explain your rationale for your
decisions.
Supervising the Level 2 Therapist
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Interventions
• Encourage alternate client case
conceptualizations.
• Encourage increased self-awareness of
counter-transference & manipulations.

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