Developing Clinicians of Character

A Christian Integrative Approach to Clinical Supervision

Terri S. Watson

• Publisher: IVP Academic
• Year: 2018
• ISBN:
  9780830885282
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

ECPA Top Shelf Book Cover AwardIs there more to clinical supervision than our current theories and methods can provide? Whether we intend them to be or not, our mentoring practices are personally formative for supervisees and supervisors alike. Developing Clinicians of Character grounds our thinking in the historic and contemporary wisdom of virtue ethics and grows out of a love for the practice of clinical supervision. It aims to identify and strengthen supervision's important role for character formation in the classroom, in continuing education for practitioners, and in clinical settings.After an overview of the role of character formation in clinical supervision, Developing Clinicians of Character examines each classical Christian virtue in turn, its corresponding professional ethical aspiration, and how we can use the practices of clinical supervision and spiritual formation together to foster character formation for Christian maturity and Christlikeness.Dr. Terri S. Watson welcomes and equips you to excel in "the helping profession within a helping profession" as you provide clinical supervision for other mental health workers in counseling, psychology, and marriage and family therapy. This book will shape your own character through spiritual disciplines in the classical virtues—and outward in expanding circles of encouragement, formation, and healing.Christian Association for Psychological Studies (CAPS) Books explore how Christianity relates to mental health and behavioral sciences including psychology, counseling, social work, and marriage and family therapy in order to equip Christian clinicians to support the well-being of their clients.

CHAPTER 1

Contemporary
Clinical Supervision

An Overview

THIS BOOK GROWS OUT of a professional journey of over thirty years as a clinical supervisor that has left me with a lingering question, and perhaps an existential crisis. The quest to become an effective supervisor has been a joyful and meaningful journey, and I remain passionate about the practice of clinical supervision. My sweet spot as a clinician is that place where psychological theory and clinical practice meet, and where as a person of Christian faith I can integrate theological understandings and spiritual practices into the work of therapy. I especially enjoy the moments in clinical supervision when theory comes alive for supervisees and we discern just the right intervention to facilitate growth and healing for a hurting family. Also deeply satisfying are those Spirit-led moments in group supervision (for example, where we veer from the agenda and practice a meditative prayer together that leads to a much-needed experience of connection with God, each other, and our deepest selves). I am convinced that the most important responsibility in the career of a mental health professional is the joy and honor of mentoring clinicians in training through this intensive, interpersonally mediated process we call supervision.

Over the years, however, a lingering question has remained. At the end of each academic year when these individual and group supervision experiences are drawing to a close, I have a moment of existential crisis and doubt. I find myself asking: “Was it enough? Did I do the best job of utilizing those valuable hours of clinical supervision to prepare supervisees for the challenges of life as a mental health professional? Have I done everything in my power to help them become their best professional selves?” I am fairly confident that students are prepared to be competent and ethical clinicians who will serve their clients well, so in that sense supervision has been successful in meeting its educational outcome. However, I fear that as a supervisor I have not adequately prepared my supervisees to navigate the inevitable challenges of mental health work such as vicarious trauma, moral and ethical failure, staying committed to lifelong learning in an ever-changing field, and remaining hopeful and compassionate when dealing with human suffering day after day. Have I done my best to encourage long-term faithfulness to God and meaningful service to Christ’s kingdom as mental health professionals? I am afraid the conclusion for me is often “I have not done enough—there has to be more!” I am left with the lingering question: Is there more to clinical supervision than our current theories and methods can provide?

While it may be inescapable that each supervision experience feels somewhat incomplete, I do think that we often fail to help our students develop the personal and professional character and habits that will lead to long-term flourishing. We miss out on key moments in supervision because we do not know where we are going. We have lost a vision for the role of clinical supervision in forming professional character that will lead to long-term competence and effectiveness. Because our goals and aspirations for supervision are too low, I fear we are sending our students out into the professional world without the most essential tools and lessons they need for survival. We are not making the most of supervision as an opportunity for personal, professional, and spiritual formation.

Clinical supervision is inevitably formative. Students learn lessons from supervisors about thinking, living, and working as a mental health professional during the most influential stages of development. They are looking to supervisors to model how to live a vibrant and effective professional life. Our work has a long-term impact as students will internalize both our strengths and weaknesses.

If you are a supervisor or educator reading this book, take a moment to think about the clinical supervisors who have been formative in your own professional life, your professional “family of origin,” if you will. No doubt you have carried your relational experience and their words of advice, challenge, and support with you throughout your own professional journey. Their influence has contributed to the formation of your professional character and fostered the development of your habits, practices, and values. Likely, you can remember pivotal moments when the supervision experience had a deep impact on your emerging sense of personal and professional identity. Reflecting on our own supervision experience can help us be purposeful about the type of supervisor we want to become, or we run the risk of simply supervising the way we were supervised and passing along the good with the bad experiences. Many of us may have been thrust into the role of clinical supervisor before we felt we were adequately prepared and with very little in the way of supervision education and experience. My hope is that this book provides an opportunity for you to consider and enhance your supervision philosophy and practices.

If you are reading this book as a student or supervisee, you are most likely experiencing the joys and challenges of clinical supervision right now. As one of the most important training experiences of your graduate experience, you may have already experienced meaningful and formative moments in supervision where you felt affirmed in your choice of profession, as well as discouraging moments where you wondered if you had made a mistake in pursuing a mental health degree. I would encourage you to use this book to reflect on your supervision experience with the hope that it may inform the kind of supervisor you will become.

Clinical supervision is the capstone educational experience for mental health professionals and has become a discipline in its own right with a growing body of research, theory, and innovative methods. However, our current models fall short of providing trainees with the formative experiences they need to prepare them to face the personal and professional challenges for long-term flourishing in mental health practice. I propose that clinical supervision at its best can be understood as an educational experience that forms the character of supervisees to help them withstand the challenges of contemporary clinical practice. By integrating the interdisciplinary literature on virtue and character strengths with clinical supervision methods and spiritual formation practices, a Christian integrative approach to clinical supervision aims to develop clinicians of faith, hope, and love who serve Christ’s kingdom with wisdom, justice, temperance, and courage.

The interdisciplinary study of virtue and character formation is a virtually untapped resource for the development of clinicians through the clinical supervision process. Recent advances in positive psychology have highlighted human character strengths as an important area of empirical research, and the contribution of virtue to personal and professional flourishing has been well supported. Integrating the contemporary study of virtue in psychology with foundational theological and biblical teaching on character formation provides a rich soil from which a Christian framework for supervision can be developed.

Specifically, this book will integrate scholarship from the best of contemporary supervision literature with the interdisciplinary scholarship on virtue—including theological, philosophical, and psychological perspectives—to provide a Christian integrative framework to guide the practice of clinical supervision. Chapter one provides an introduction to clinical supervision in counseling, psychology, and marriage and family therapy (MFT) and offers a rationale for a virtue-oriented approach to clinical supervision. Chapter two introduces a Christian integrative supervision framework through describing four integrated areas: core virtues, ethical principles, supervision models and methods, and spiritual formation practices. Chapters three through nine will each focus on a core character virtue and corresponding professional ethical aspiration and will provide character-forming supervision methods and spiritual disciplines. Finally, chapter ten will examine the characteristics and practices of institutions and training programs that effectively facilitate the character development of clinicians in training.

A core premise of the proposed framework is that supervision at its best is an integrative endeavor on many levels. Effective supervision integrates wisdom and best practices across the mental health disciplines from diverse models and methods of supervision. Holistic supervision integrates theory and research with experiential learning and self-reflection to promote formative experiences for the heart, mind, and soul of the supervisee. A Christian integrative approach considers clinical supervision from a Christian worldview and incorporates biblical teaching and spiritual practices into the supervision process.

We begin in this first chapter by examining the three distinct but related bodies of literature that provide the foundation for a Christian framework for clinical supervision. First, we review the contemporary theory and practice of clinical supervision in counseling, psychology, and marriage and family therapy. Second, we look at the literature on religious and spiritual issues in clinical supervision. Third, we explore the interdisciplinary study of virtue ethics to identify philosophical, psychological, and theological resources that will guide the character-formative aspect of clinical supervision.

OVERVIEW OF CLINICAL SUPERVISION BY DISCIPLINE: COMMONALITIES AND DISTINCT CONTRIBUTIONS

Clinical supervision is at the heart of the development, education, and training of mental health professionals. Across countries, disciplines, and contexts, clinical supervision facilitates the application of theory to practice, teaches ethical decision making, and protects the public by ensuring the continuity of professional values, standards, and best practices. According to experts, clinical supervision is described as the “signature pedagogy” (Bernard & Goodyear, 2014, p. 2) and the “cornerstone in education and training” (Falender & Shafranske, 2004, p. 3) for mental health professionals. It is a significant component of all clinically oriented graduate programs in mental health as most graduate students in counseling, psychology, and marriage and family therapy (MFT) will spend at least 100 hours per year in individual or group clinical supervision. It is highly likely that all mental health professionals will assume the role of clinical supervisor at some point during their careers. Ideally, mental health professionals will continue to be both consumers and providers of clinical supervision throughout their lives. Tremendous resources are devoted to clinical supervision in graduate education, during post-graduation toward professional licensure, and throughout the career of a mental health professional. Clinical supervision has become a respected discipline with a growing body of literature, theoretical models, and research support.

Clinical supervision is the intensive interpersonal and educational process that facilitates the application of knowledge learned in the classroom to competent intervention in the real lives of suffering individuals, couples, families, and communities. It aims to form trainees into mental health professionals who demonstrate lifelong competence, effectiveness, ethical integrity, and professional vibrancy through facilitating effective and healthy professional habits of thinking, decision making, and action. This is no small task, indeed!

A recent survey of the international literature on clinical supervision concluded that clinical supervision is “truly international and interdisciplinary” with important research and theory development occurring across the globe and across mental health disciplines (Inman et al., 2014, p. 87). Most professionals would agree that approaches to clinical supervision are more alike than different. For example, two of the most popular clinical supervision textbooks are widely used by both counselors and psychologists (Falender & Shafranske, 2004; Bernard & Goodyear, 2014). However, each mental health discipline also relies on its own models, methods, ethical guidelines, and credentialing processes. There is tremendous benefit to utilizing supervision theory and practices across mental health disciplines, as each makes a unique contribution to the best practice of clinical supervision. This section reviews the contemporary landscape of clinical supervision in counseling, psychology, and MFT and suggests the unique contributions of each discipline to the theory and practice of supervision. Building on contemporary theory and practice of supervision across disciplines, we begin to consider the question “What is missing?”

Supervision in Professional Counseling and Counselor Education

Definition and goals. Bernard and Goodyear (2014) offer a definition of supervision applicable to counselors and psychologists: “an intervention provided by a more senior member of a profession to a more junior colleague or colleagues who typically (but not always) are members of that same profession” (here). The purposes of supervision are threefold: professional development of the supervisee toward competency, monitoring the quality of services provided by the supervisee to protect the welfare of the clients, and finally, gatekeeping for the profession. Professional competency includes the development of three kinds of knowledge: theoretical and research knowledge, principles and techniques of practices, and finally, supervisee self-knowledge. Supervision is the process where these various types of knowledge are integrated and applied. As articulated by Borders et al. (2014), “supervision is a proactive, planned, purposeful, goal-oriented, and intentional activity” (here).

Models and methods. The counseling supervision literature emphasizes a number of models of supervision. Developmental models of supervision (Stoltenberg, McNeill, & Delworth, 1998; Stoltenberg & McNeill, 2010) consider developmental needs and training level of supervisees and then match supervisor goals and tasks with each level. For example, a beginning supervisee will likely need a more supportive, structured supervision approach focusing on skill development, while a more experienced trainee will benefit from a supervision style that facilitates autonomy and self-awareness and encourages exploration and experimentation. Psychotherapy models of supervision utilize the theory and techniques from a particular theoretical orientation to facilitate the didactic and experiential learning of the model and the application to clinical work. For example, a systemically minded supervisor teaches relationally oriented change strategies to supervisees for the benefit of clients and implements these strategies in the supervision relationship by focusing on isomorphic processes. Process-oriented models of supervision focus on the goals, dynamics, and relational processes of the supervision experience. One widely used process model is Bernard’s Discrimination Model (1997), which proposes that the supervision process involves supervisor activities around three areas of focus (intervention, conceptualization, personalization) and three roles (teacher, counselor, consultant) for any given supervision session, with the goal of balancing time and attention to each. Integrative approaches to supervision are contemporary models of supervision that include a combination of developmental, psychotherapy, and process models (Bernard & Goodyear, 2014). For example, the common factors approach to supervision uses psychotherapy outcome research to identify the therapist (and supervisor) qualities that are most effective in establishing rapport and promoting change (Hill, 2014b).

Methods of delivery in counseling supervision include individual and group sessions utilizing self-report, review of video or a...