Supervision and Consultation

1. Supervision and Consultation Roles, Values, and Techniques

2. Supervision • “an intervention that is provided by a senior member of a profession to a junior member of that same profession.” • May involve multiple roles • Teacher • Mentor • Coach • Evaluator • Adviser • Consultant

3. Bad Supervision (Borders 1994) • Micro-manage supervision • Hands off supervision • Little personal investment in supervisee • Mismatch in theoretical orientation or personality styles • Lacks rapport • Doesn’t instill a sense of trust or doesn’t encourage taking healthy risks

4. Good Supervision (Borders 1994) • Balance between support and challenge • Perceived faith in and respect for Supervisee • Adjusts role to meet Supervisees particular needs • Empathic, genuine, and open • Effectively teach and share necessary information • Flexible and accurate in supervision interventions (i.e. teacher, counselor, consultant)

5. Good Supervision (Borders 1994) • Clear, accurate, and frequent evaluation • Enjoys supervision • Committed to supervisee’s growth • Adequate preparation and structure • Professionally competent and experienced • Sense of humor

6. Relationship, Relationship… • As with most counseling, consulting, and virtually any interaction within the human service field, the RELATIONSHIP between supervisor and supervisee is the most important characteristic of the dyad!

7. Supervision Contract • Informed Consent for Supervision is Important, just as it is in Counseling • Keep in a Supervision file on each applicant that will include: • Informed consent • When supervisor and supervisee met • Who was involved: individual or triadic? • What was discussed (progress notes) • Any evaluations, assessments or correspondence • Payment record (when applicable)

8. Supervisor • May be responsible • For welfare of supervisees • For welfare to clients served by their supervisees • To their agency for the quality or services • May have gatekeeper responsibilities • Consultation is essentially a peer relationship where supervision involves evaluation and a power differential

9. Supervision • Administrative Supervision: • direct-line administrators give direction or supervision to counselors who are their employees • Purpose: to ensure that counselors who are employed are performing their jobs appropriately

10. Supervision • Clinical Supervision: • the work of counselors is reviewed by other mental health professionals, usually with the goal of increasing the counselor’s effectiveness. • Purpose- to help counselors increase their skills • The degree of control/authority that the supervisor has is an important distinction

11. Supervision • Within Counselor Education programs, supervision has the dual purpose of monitoring the services provided by counselors-in-training and monitoring the welfare of clients who are receiving the services (ACA Code of Ethics)

12. Supervision • Supervisees who work in public institutions and those in private organizations that have policies stipulating due process rights can expect to be protected from unfair or arbitrary decisions that affect them negatively • Legal due process rights derive from the Fourteenth Amendment to the US Constitution

13. Supervision • The most blatant violations of supervisees fair evaluation rights occur when a supervisee is given a negative final evaluation or is dismissed from an internship or job without having been given warning that performance was inadequate. • Supervisors should provide ongoing feedback, periodic evaluations, and reasonable opportunities to improve

14. Supervision • Feedback should be both formative and summative • Feedback should be both written and oral • (ACA Standard F.5.a)

15. Supervision • Informed consent should be obtained from both the client and from the supervisee (ACA Code of Ethics) • Clients have the right to be aware that their counselors are working under supervision, and they have the right to know the supervisee’s qualifications • Written agreements are recommended for supervisory relationships– can avoid later misunderstandings

16. Supervisor Competence • Some states boards require approval of supervisors • NBCC offers a national supervisory credential • ACA Code of Ethics (Standard F.2.a) requires that prior to offering supervision services, supervisors must be trained in supervision methods and techniques. • Supervisors must continually seek continuing education • It is recommended for supervisors to seek consultation themselves.

17. Supervisor Registry • Many states, including Idaho, have a supervisory registry • Do I need to register as a supervisor? • This training was designed to meet the requirements for supervision of the Idaho State Board of Counselors. • Board is reportedly tightening its definition of supervision • Supervision can be a marketable commodity • Counselor Education Departments encourage you to register as a supervisor

18. Confidentiality For the Client • The supervisee will need to provide their clients with disclosure information that informs them of how the supervision process influences the limits of confidentiality and who will have access to their records. • The supervisor should be clearly identified within the supervisee’s informed consent along with contact information. • As a general rule, sharing confidential and privileged information with professionals who have a need to know for professional purposes is acceptable and does not destroy legal privilege

19. Confidentiality for the Supervisee • Information regarding supervisees is not confidential– with the exception of the information shared about clients • This is in marked contrast to confidentiality in Counseling • Be clear with your supervisees about this issue, but it is also best to be respectful of the supervisees and to avoid sharing information– especially negative information, with persons who do not have a need to know.

20. Confidentiality • When working for a community agency, follow the policy and procedures regarding release of client information

21. Supervisory Relationships • Must be carefully managed because of the potential for conflict created by multiple roles: • Teacher • Counselor • Consultant • Sexual relationships are inappropriate • Business relationships are discouraged • Professional distance is encouraged • Counseling and supervision are not the same thing, and counseling relationships are inappropriate with supervisees • Beware of transference and counter transference issues

22. Vicarious Liability • Generally, an employer will be held accountable for the negligence of an employee who is acting within the scope of employment • Respondeat superior: legal term for above • Tarasoff case not only set a precedent for duty to warn, but also liability for harm done was extended to the professional’s supervisor • Lack of awareness of supervisee’s actions is not an adequate defense

23. Vicarious Liability • The degree to which a supervisor is held responsible for a supervisee’s actions is to some degree a function of the authority of the supervisor for the supervisee • Both supervisors and supervisees should carry liability insurance

24. Accountability • Generally, a consultant does not have power and control over the person who is the recipient of the consultant’s advice. • Exceptions: when a consultant is a counselor’s administrative or clinical supervisor • Consultants give advice. • Individuals can choose to take the advice—or not. • Even if consultants give bad advice they generally are not held liable. • Reason: they have no control over the person who made the final decision

25. Ethics in Supervision:Assessment and Evaluation of ClientsReport WritingEvaluation of Supervisees Susan N. Perkins, PhD Counselor Education Program Northwest Nazarene University

26. Competency in assessment and evaluation of clients

27. ASCA F.3 Supervision of School Counselor Candidates Pursuing Practicum and Internship Experiences: Professional school counselors: b. Ensure school counselor candidates have experience in developing, implementing and evaluating a data-driven school counseling program model, such as the ASCA National Model.

28. IAMFC Section VII: Supervision A. … Members provide supervision only within the limits of their professional competence. Additionally, they accept supervisory responsibilities only for counselors they can appropriately and adequately oversee.

29. IAMFC Section VII: Supervision • Supervisors assure that supervisees are knowledgeable about professional ethics and standards, and that they practice within those parameters. • (One of which is knowing limits of one’s competency.)

30. Small Group Brainstorming In your setting, what types of client assessment do you conduct?

31. Client Assessments Some assessments may include: • DSM-IV-TR Diagnoses • Testing • Mental health • Intelligence • Personality • Social skills • Safety issues • Suspicion of abuse • Progress in counseling • Impact of culture on the situation

32. Small Group Brainstorming What decisions are made based on your evaluation of clients?

33. Decisions based on Assessments: Some decisions may include: • Custody *Referral for medication • Assignment of special services *Removal from the home • Placement in classes/grade level • Involuntary admittance to treatment

34. Small Group—Reflection • What did you do to become competent to assess each of these areas? • What did you do to gain expertise in each of these areas?

35. Small Group—Link to Supervision • How can you assess your supervisees’ level of competence in each of these areas? • How can you help your supervisees grow in competence in each of these areas? Report ideas to the workshop attendees.

36. Limits of Competency • Supervisees are rightly concerned about this. However, when they begin, everything is beyond their competency. • How do you address this with supervisees?

37. Limits of Competency How do you know if an area of client assessment or evaluation is beyond your competency? How can you help supervisees recognize their own limits of competency?

38. Competency in oral and written report writing

39. ACA Section F: Supervision, Training, and Teaching: F.1.a: Client welfare: “A primary obligation of counseling supervisors is to monitor the services provided by other counselors or counselors-in-training. Counseling supervisors monitor client welfare and supervisee clinical performance and professional development. To fulfill these obligations, supervisors meet regularly with supervisees to review case notes, samples of clinical work, or live observations.” [emphasis added]

40. ASCA F.3 Supervision of School Counselor Candidates Pursuing Practicum and Internship Experiences: Professional school counselors: b. Ensure school counselor candidates have experience in developing, implementing and evaluating a data-driven school counseling program model, such as the ASCA National Model.

41. Small Group Brainstorming What reports do you CREATE? Verbally Written What reports do you RECEIVE? Verbally Written

42. Reports Verbal or written reports might include: • Grades • Progress reports • Testing reports • Documentation of previous medical treatment • Documentation of previous mental health treatment • Diagnoses • Assessments and intakes • Treatment plans and progress notes Note that some of these reports may be VERY different based on the person to whom they are provided.

43. Consider the Context Your job is to train your supervisee to be competent in these tasks. If the supervisee may practice in a different setting, you need to train the supervisee to be competent at creating and understanding reports in that setting, as well (within reason).

44. Discussion What two strategies might work for training your supervisees to be competent in creating reports? Receiving reports?

45. … A little help Handout: Guidelines for Professional Writing

46. POOR Poor vs. Excellent EXCELLENT 1. What impresses you in excellent reports? 2. What common mistakes do you notice in (lousy) reports? 3. What makes a report pretty terrible?

47. THE BALANCING ACT Client care Supervisee care Clinical Administrative

48. Supervisee evaluation

49. ACA Section F: Supervision, Training, and Teaching: “Counselors have theoretical and pedagogical foundations for their work and aim to be fair, accurate, and honest in their assessments of counselors-in-training.” F.5. Counseling Supervision Evaluation, Remediation, and Endorsement: F.5.a. Evaluation: “Supervisors document and provide supervisees with ongoing performance appraisal and evaluation feedback and schedule periodic formal evaluative sessions throughout the supervisory relationship.”

50. ACA F.5.b. Limitations Through ongoing evaluation and appraisal, supervisors are aware of the limitations of supervisees that might impede performance. Supervisors assist supervisees in securing remedial assistance when needed. They recommend dismissal from training programs, applied counseling settings, or state or voluntary professional credentialing processes when those supervisees are unable to provide competent professional services. Supervisors seek consultation and document their decisions to dismiss or refer supervisees for assistance. They ensure that supervisees are aware of options available to them to address such decisions. (See C.2.g.)