Clinical Supervision

A Systems Approach

Elizabeth L. Holloway

• Publisher: SAGE Publications, Inc
• Year: 1995
• Print ISBN: 9780803942240, 9780803942233
• eBook ISBN: 9781506332680
• Edition: 1
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

In her systems approach to supervision, the author presents a unique system of clinical supervision developed with her colleagues over years of experience as supervisors of psychologists in training. . . . The book is written in a ?reader-friendly? manner and is both theoretical and practical. The prose is clear; the charts are easily decipherable. Research findings are separated onto single pages interspersed throughout pertinent sections and printed in darker shades to draw the eye. The various levels of the supervisory session (transcript, recall, interview, analysis) are placed in columns side by side for easy comparison. The author has succeeded in dissecting the complex instructional strategy of modeling counseling task, function, and skill within the supervisory relationship. Her work is a valuable complement to the existing body of literature. --Susan B. DeVaney in Counseling Today "The book uses a range of interesting transcipts to illustrate points together with providing up-to-date research information on subjects such as trainee learning needs, supervisor and trainee gender, institutional factors and supervisor experience, to mention but a few. A thought-provoking book and one which I would recommend as profitable reading for those engaged in or considering becoming engaged in the field of supervision." --Gladeana McMahon in BPS Counselling

1

The Essence of Supervision

Describing Supervision

To supervise is to “oversee,” to view another’s work with the eyes of the experienced clinician, the sensitive teacher, the discriminating professional. Supervision provides an opportunity for a student to capture the essence of the psychotherapeutic process as articulated and modeled by the supervisor and, subsequently, to recreate this process in an actual counseling relationship.

Ideally, the supervisee does not indiscriminately adopt the supervisor’s methods and views. What takes place, rather, is at best a unique improvisation of the principles and means inherent in the professional knowledge provided by the supervisor. A supervisee is called on to reconstruct each session in a way that is appropriate for a particular client at a specific point in the counseling process.

By exploring the supervisory relationship, this book emphasizes the supervisor’s challenge to create a learning context that will enhance the supervisee’s skill in constructing relevant frames of reference from which to devise effective strategies in working with clients. Although the supervisee will operate primarily from research-based techniques and principles, there remains the untold area of “artistry” in practice. By encouraging this latter kind of knowledge, “artistry as an exercise of intelligence” (Schon, 1983, p. 12), supervisors play a most critical role.

Learning all forms of professional artistry depends, at least in part, on . . . freedom to learn by doing in a setting relatively low in risk, with access to coaches who initiate students into the “traditions of the calling” and help them, by “the right kind of telling” to see on their own behalf and in their own way what they need most to see. (Schon, 1983, p. 17)

The highest calling for teachers of supervision is to articulate the components of instruction. In the helping professions, a number of approaches have been used to unravel the complexity of supervisory instructional methodology. Psychology, psychiatry, social work, and education have all made substantial contributions to this task.

Furthermore, Schon’s (1983) concepts of the “reflective practitioner” describe supervisory or apprenticeship processes in several fields of professional education, including architecture, music, and business. The analogy to the master craftsperson-apprenticeship model common to education, however, does not capture the elements of the supervisory process in fields of applied science where the delivery of effective service is the goal. When there is a service demand, human interaction consequently becomes the dominant construct of educating.

The act of applying knowledge requires certain elements that are unknown until a service need is apparent. During supervision, the professional must be taught to treat each case uniquely, to understand and conceptualize the situation, and then selectively adapt known methods. The professional must be capable of strategically adapting to the unfolding needs of the client, delivering interventions through discourse on a moment-to-moment basis. Most important, as the supervisor identifies and describes the covert processes of this dynamic context, the learner is also assisted in the articulation of his or her own process.

Articulating the layers of thinking, understanding, conceptualizing, and applying is the task of the supervisor; the supervisor is the translator of theory and research to practice. Holloway and Wolleat (1994) maintain that

because the goal of clinical supervision is to connect science and practice, supervision is among the most complex of all activities associated with the practice of psychology. The competent clinical supervisor must embrace not only the domain of psychological science, but also the domains of client service and trainee development. The competent supervisor must not only comprehend how these various knowledge bases are connected, but also apply them to the individual case.” (p. 30)

In understanding the purpose and structure of supervision, it must first be asked whether the primary context of a supervisory situation is administrative or clinical. Administrative or managerial supervisors have the task of overseeing, directing, and evaluating the work of clinicians, students, and staff members in a bureaucratic organization. Their objective is to assist the organization in running smoothly and effectively. Clearly defined responsibilities of administrative supervisors might include recruiting, delegating, and monitoring work; being a managerial buffer; and acting as a change agent within the organization (Kadushin, 1985).

In contrast, clinical supervisors focus on the professional development of the supervisee’s skills within the organization. Clinical supervision emphasizes the educational and supportive functions of the supervisory role.

It is the primary purpose of the supervising role that differentiates these two approaches. Is it the organization that must first be served or the professional development of the supervisee? The supervisor who understands his or her priorities can then devise a suitable structure in which supervision is to take place.

Administrative supervision often takes place on an as-needed basis or as a result of a pressing need, change in policy, or scheduled evaluation period (Kadushin, 1985). In both social work and education, the administrative supervisor is not expected to form ongoing, collaborative relationships. The hierarchical structure of the organization and the organizational role of the supervisor dictate the transitory nature of the supervisory relationship.

Professional psychology has focused almost entirely on clinical supervision. Because of the emphasis on supervision as an instructional method in the early training of psychologists (for example, interviewing, practica, and internship), the educative and supportive functions of supervision have been researched extensively (Holloway, 1992b; Holloway & Poulin, in press; Russell, Crimmings, & Lent, 1984). The role of evaluation is closely tied to this study. Although early on it was felt that the function of evaluation and education should be separated, contemporary theorists have been clear that evaluation is an important component of the educational function (Bernard & Goodyear, 1992). Clinical supervisors are in the best position to evaluate the performance of the supervisee because they have direct knowledge of work performance and professional competence. In fact, the supervisor is continually evaluating the supervisee as a function of the instructional role (Mueller & Kell, 1972); thus, evaluation is one of the most critical issues in establishing the supervisory relationship.

In this book, the term supervision refers to clinical supervision. Clinical supervision takes place between two individuals, one of them designated as the supervisor and the other as the supervisee or trainee. During supervision, the two individuals meet on a regular basis and discuss clinical and professional issues as they relate to the professional growth of the supervisee. Although the organizational context and administrative policies of every work site will affect the supervisory relationship, it is not the utmost purpose of clinical supervision to carry out managerial or administrative functions.

Models in Supervision

Supervision has been the focus of considerable speculation in the helping professions since the 1950s. Ekstein and Wallerstein (1958) distinguished between the practice of psychotherapy and the problem of teaching and learning psychotherapy. In their seminal text, they focused on “how to transmit these skills (of psychotherapy) to another, how to supervise rather than how to do psychotherapy” (p. xii). At first, supervision models mirrored theories of counseling. Not surprisingly, the names of these models imitate counseling theories, for example, client-centered supervision (Patterson, 1983), social learning approach to supervision (Hosford & Barmann, 1983), and supervision in rational-emotive therapy (Wessler & Ellis, 1983). Although models are intended to aid in interpreting complex phenomena and help in learning complex skills, the “counseling-bound” models of supervision provided few directions for either research or practice (Russell et al., 1984). Because of this parochialism, important knowledge from relevant disciplines, such as developmental, educational, and social psychology, has been precluded. Research on the process of supervision has revealed that supervisors do not practice supervision and counseling alike; a supervision interview has features different from the counseling interview (Russell et al., 1984). Thus challenged, the counseling-bound models are being replaced by others that incorporate knowledge from related psychological subdisciplines and that provide frameworks for empirical inquiry. Recognition that the teaching of psychotherapy is different from doing supervision is reflected in cross-theoretical models of supervision that incorporate aspects of individual difference, social role theory, and instructional psychology. Two major cross-theoretical approaches have appeared since 1979—developmental models and social role models.

Developmental models draw from developmental psychology, including theories of Loevinger (1976), Perry (1970), Chickering (1969), and Hunt and Sullivan’s (1974) person-environment matching model in education. Although approximately 18 different developmental models have been described, the ones receiving the majority of research attention (Worthington, 1987) are Stoltenberg (1981) and Loganbill, Hardy, and Delworth (1982) and, more recently, Stoltenberg and Delworth (1988). Reviews of developmental models appeared in Holloway (1987, 1988), Stoltenberg and Delworth (1988), Worthington (1987), and Bernard and Goodyear (1992). Basically, these models advocate that supervisors match the structure and style of supervision to the trainee’s level of development as a counselor.

A similar approach advocating person-environment matching is Abbey, Hunt, and Weiser’s (1985) experiential learning model. They relied on Kolb’s (1984) learning styles theory but did not include a developmental perspective in their model. They did, however, refer to individual differences in trainees’ cognitive or learning styles as a basis for structuring supervisory environments (Sugarman, 1985).

Social role models have been described by Boyd (1978); Bernard (1979); Hess (1980); Littrell, Lee-Borden, and Lorenz (1979); and Bartlett (1983). In these models, the position of supervisor includes a set of roles that, when performed, establish certain expectations, beliefs, and attitudes. As a result, the supervisor, engaging in this set of recurring actions consistent with the expected role, promotes an experience of behavioral consistency and certainty for the trainee. Although role model approaches have focused almost exclusively on the supervisor as role sender, the trainee is also expected to play certain roles (Holloway, 1984). Typically, counseling psychologists familiar with the roles prescribed for the supervisor use these models as a heuristic tool in guiding practice (Hess, 1980). There is little research, however, that directly tests social role models (Holloway, 1992b). Nonetheless, cross-theoretical and empirical investigations of supervision have established the groundwork for translating theory and research into practice. The Systems Approach to Supervision (SAS), a theory of practice modeled in the following chapters, has been built on this beginning.

Theory and Research Into Practice

Sergiovanni (1983) states that a theory of practice should be concerned with four questions:

1. What is reality in a given context?
2. What ought to be reality?
3. What do events that constitute this reality mean to individuals and groups?
4. Given these three dimensions, what should supervisors do? (p. 177)

Educators and practitioners of supervision thus need four components of support: (a) a descriptive base, (b) guidelines stating common goals and imperatives, (c) a way to discover meaning as it relates to participants and the profession, and (d) a systematic mode of inquiry to determine objectives and strategies for interaction during supervision.

The purpose of this book is to provide a model that meets these four needs. Herein is a systems approach to understanding supervision that comes from a synthesis of the existing conceptual and empirical literature in combination with the professional reflective knowledge of my colleagues, my students, and myself through years of teaching and practicing supervision. I have designed a heuristic tool to incorporate three sources of knowledge—theory, research, and practice. These bases of knowledge are presented in different forms, including text, transcripts, and graphics. The format of the book attempts to weave the different sources together while keeping their specific identities intact.

Principles of a Systems Approach

To access differing knowledge bases, experience has shown the value of a systems approach grounded in principles that emphasize a learning alliance between the supervisor and supervisee based on multiple interlinking factors in the relationship of supervision. The goal of supervision is the enhancement of the student’s effective professional functioning, and the interpersonal nature of supervision provides an opportunity for the supervisee to be fully involved toward that end. In this way, the supervisee is empowered in the process of acquiring attitudes, skills, and knowledge for independent, effective professional practice. Being aware of “the big picture,” the supervisor is able to access strategies and attitudes during supervision that will enhance the learning environment for a particular supervisee. With knowledge of the whole system, deliberate choices can be made by both supervisor and supervisee within the context of specific relevant supervisory factors.

The assumptions of empowerment and relationship are related to the SAS:

• The goal of supervision is to provide an opportunity for the supervisee to learn a broad spectrum of professional attitudes, skills, and knowledge, in an effective and supportive manner.
• Successful supervision occurs within the context of a complex professional relationship that is ongoing and mutually involving.
• The supervisory relationship is the primary context for facilitating the involvement of the learner in reaching the goals of supervision. The essential nature of this interpersonal process bestows power to both members as they form the relationship.
• For the supervisor, both the content and process of supervision become integral parts of the design of instructional approaches within the relationship.
• As the supervisor teaches, the trainee is further empowered by (a) acquiring the skills and knowledge of the professional work and (b) gaining knowledge through experiencing and articulating interpersonal situations.

Therefore, the primary goal of supervision is the establishment of an ongoing relationship in which the supervisor designs specific learning tasks and teaching strategies related to the supervisee’s development as a professional. In addition, the supervisor empowers the supervisee to enter the profession by understanding the attitudes, skills, and knowledge demanded of the professional and by guiding the relationship strategically to facilitate the trainee’s achievement of a professional standard.

Clinical supervision is the training of a professional and thus adheres to a model that supports the use of professional knowledge and skills. This model, however, does not entertain the notion that individuals are dependent and reliant on experts as a source of power and self-learning. Supervision provides an opportunity for the recognition of a professional’s own resources in combination with the information and skills available. If the learner remains dependent solely on the supervisor, then successful supervision has not taken place. Clearly, the development of such independence is a process of learning about oneself, the consumer one serves, and the profession. As Rappaport (1986) defines e...

Table of contents

• Cover page
• Title
• Copyright
• Contents
• List of Tables
• List of Figures
• List of Research Boxes
• List of Transcripts
• Preface: A Scientist-Practitioner’s Journey
• Acknowledgments
• 1. The Essence of Supervision
• 2. Tasks and Functions of Supervision
• 3. The Relationship of Supervision
• 4. Contextual Factors of Supervision
• 5. Uncovering the Words of Supervision
• 6. Supervising the Consultation Group
• Appendix: The Association for Counselor Education and Supervision Standards for Counselor Supervision
• References
• Author Index
• Subject Index
• Epilogue: Words of Supervison
• About the Author
• The SAS Model: A Systems Approach to Clinical Supervision