Supervision in play therapy: are there different models of supervision?

Supervision in play therapy: are there different models of supervision? By Amanda Gurock, LCSW

AGENDA FOR THE WEBINAR • Explain the different models of Clinical Supervision • Discuss types of Orientation Models of Supervision • Learn developmental models of supervision • Discuss Integrated Models of Supervision • Learn Supervisory Alliance Model • Learn Interactional Supervision • Learn Merry Conceptualized Supervision Model

Three types of MODELS for clinical supervision • Developmental Model: The idea is that therapists are continuously growing • Integrated Model: therapists view themselves as “eclectic,” integrating several theories into a consistent practice, some models of supervision were designed to be employed with multiple therapeutic orientations. • Orientation Model: use the same theoretical models used to treat clients to work with supervisees

Integrated development model • Developed by Stoltenberg (1981) and Stoltenberg and Delworth (1987) and, finally, by Stoltenberg, McNeill, and Delworth (1998) (Falender & Shafranske, 2004; Haynes, Corey, & Moulton, 2003). • The IDM describes three levels of counselor development: • Level 1 supervisees are generally entry-level students who are high in motivation, yet high in anxiety and fearful of evaluation

Integrated development model • Level 2 supervisees are at mid-level and experience fluctuating confidence and motivation, often linking their own mood to success with clients • Level 3 supervisees are essentially secure, stable in motivation, have accurate empathy tempered by objectivity, and use therapeutic self in intervention

Ronnestad and Skovholtmodel Six Phases are involved: • The Lay Helper • The Beginning Student Phase • The Advanced Student Phase • The Novice Professional Phase • The Experienced Professional Phase • The Senior Professional Phase

Ronnestad and Skovholtmodel 14 themes of counselor development: 1. Professional development involves an increasing higher-order integration of the professional self and the personal self 2. The focus of functioning shifts dramatically over time from internal to external to internal. 3. Continuous reflection is a prerequisite for optimal learning and professional development at all levels of experience. 4. An intense commitment to learn propels the developmental process. 5. The cognitive map changes: Beginning practitioners rely on external expertise, seasoned practitioners rely on internal expertise. 6. Professional development is long, slow, continuous process that can also be erratic.

Ronnestad and Skovholtmodel 14 themes of counselor development: 7. Professional development is a life-long process. 8. Many beginning practitioners experience much anxiety in their professional work. Over time, anxiety is mastered by most. 9. Clients serve as a major source of influence and serve as primary teachers. 10. Personal life influences professional functioning and development throughout the professional life span. 11. Interpersonal sources of influence propel professional development more than ‘impersonal’ sources of influence. 12. New members of the field view professional elders and graduate training with strong affective reactions. 13. Extensive experience with suffering contributes to heightened recognition, acceptance and appreciation of human variability. 14. For the practitioner there is a realignment from self as hero to client as hero.

Littrell, Lee-Borden, and Lorenz Model • Littrell, Lee-Borden, & Lorenz Model: This model attempts to match supervisor behavior to the developmental needs of the supervisees. • Stage 1 : This stage involves the relationship building between the supervisor and supervisee. In this initial stage the supervisor and supervisee set goals and write a working contract. • Stage 2: The supervisor is both a teacher and plays the role of counselor. The supervisee explores the feeling that arise during the therapy sessions. The supervisee is cognizantly aware of their deficient in skills, technique and theory.

Littrell, Lee-Borden, and Lorenz Model • Stage 3: The supervisor moves away from damage control. The supervisee is progressing and feeling more confident. • Stage 4: The supervisor moves further away from the supervisee and takes on more of a consulting role. The supervisee becomes responsible for their own development.

Orientation basedsupervision models • Psychotherapy-based models of supervision often feel like a natural extension of the therapy itself. “Theoretical orientation informs the observation and selection of clinical data for discussion in supervision as well as the meanings and relevance of those data (Falender & Shafaanske, 2008, p. 9). Thus, there is an uninterrupted flow of terminology, focus, and technique from the counseling session to the supervision session, and back again.

Orientation basedsupervision models • Psychodynamic Approach to Supervision: As noted above, psychodynamic supervision draws on the clinical data inherent to that theoretical orientation (e.g., affective reactions, defense mechanisms, transference and countertransferece, etc.). Frawley-O’Dea and Sarnat (2001) classify psychodynamic supervision into three categories: patient-centered, supervisee-centered, and supervisory-matrixcentered.

Orientation based approachto supervision Patient-centered began with Freud and, as the name implies, focuses the supervision session on the patient’s presentation and behaviors. The supervisor’s role is didactic, with the goal of helping the supervisee understand and treat the patient’s material.

Orientation based approachto supervision Supervisee-centered psychodynamic supervision came into popularity in the 1950s, focusing on the content and process of the supervisee’s experience as a counselor (Frawley-O’Dea & Sarnat, 2001; Falender & Shafranske, 2008). Process focuses on the supervisee’s resistances, anxieties, and learning problems (Falender & Shafranske). The supervisor’s role in this approach is still that of the authoritative, uninvolved expert (Frawley-O’Dea & Sarnat), but because the attention is shifted to the psychology of the supervisee, supervision utilizing this approach is more experiential than didactic (Falender & Shafranske).

Orientation based approachto supervision The supervisory-matrix-centered approach opens up more material in supervision as it not only attends to material of the client and the supervisee, but also introduces examination of the relationship between supervisor and supervisee. The supervisor’s role is no longer one of uninvolved expert. Supervision within this approach is relational and the supervisor’s role is to “participate in, reflect upon, and process enactments, and to interpret relational themes that arise within either the therapeutic or supervisory dyads” (Frawley-O’Dea & Sarnat, 2001, p. 41). This includes an examination of parallel process, which is defined as “the supervisee’s interaction with the supervisor that parallels the client’s behavior with the supervisee as the therapist” (Haynes, Corey, & Moulton, 2003).

Orientation based approachto supervision (continued) Cognitive-Behavioral Supervision: As with other psychotherapy-based approaches to supervision, an important task for the cognitive-behavioral supervisor is to teach the techniques of the theoretical orientation. Cognitive-behavioral supervision makes use of observable cognitions and behaviors—particularly of the supervisee’s professional identity and his/her reaction to the client (Hayes, Corey, & Moulton, 2003). Cognitive-behavioral techniques used in supervision include setting an agenda for supervision sessions, bridging from previous sessions, assigning homework to the supervisee, and capsule summaries by the supervisor (Liese & Beck, 1997).

Orientation based approachto supervision (continued) Play Therapy Supervision (Borders and Leddick ): It serves as an opportunity to increase the supervisee's repertoire of play therapy techniques, flexibility in thinking, and playfulness and creativity as both a clinician and an individual. These benefits tend not to be afforded the supervisee through more traditional clinical supervision. The exclusive use of verbal expression within the supervision of play therapists is quite simply not "practicing what you preach."

Orientation based approachto supervision (continued) Play Therapy Supervision (Borders and Leddick): Supervisors who rely solely on verbal expression are at risk of socializing supervisees into a professional worldview that is inconsistent from the notion of play therapy itself, where play is the language (Ginott, 1959). The relationship that is created through an experiential and activity-based supervision allows for a reciprocal experience between supervisor and supervisee.

Orientation based approachto supervision (continued) Play Therapy Supervision: GOALS: • Inclusion of play therapy techniques can assist the supervisory dyad in accomplishing many of the tasks (instructing, modeling, and sharing) and functions (counseling skill, case conceptualization, professional role, emotional awareness, and self-evaluation) of supervision. • It also familiarizes them with the use of play and expressive mediums as a legitimate and valuable means of communication and integral component of the relationship

Orientation based approachto supervision (continued) Play Therapy Supervision: GOALS: 3. As self-evaluation of therapeutic competency is an identified outcome of supervision – play therapists will work independently as the only play therapist in their setting. Therefore, professional play therapists will often have to rely on self-evaluation once they are working professionally in the mental health field. Supervision of play therapists should then include interventions that address the supervisee's personal and professional self. It is important to address the fears of play therapy supervisees about the legitimacy of play therapy, as well as questions about the supervisee's own effectiveness and professional impact.

Integrative Models • Models of supervision relies on more than one theory and technique • Haynes, Corey, and Moulton describe two approaches to integration: technical eclecticism and theoretical integration. • Technical eclecticism tends to focus on differences, chooses from many approaches, and is a collection of techniques. This path calls for using techniques from different schools without necessarily subscribing to the theoretical positions that spawned them. • Theoretical integration refers to a conceptual or theoretical creation beyond a mere blending of techniques. This path has the goal of producing a conceptual framework that synthesizes the best of two or more theoretical approaches to produce an outcome richer than that of a single theory.

Bernard's Discrimination Model • Developed by Bernard and Goodyear • Described as a Social Role Model • It is used as a Training Model • It has the supervisor play three different roles • It focuses on three different areas of supervision • It is an “eclectic” model

Bernard's Discrimination Model • Supervisor Uses Three Approaches: • Teacher: When you are teaching, lecturing, instruct • Consultant: relate to the supervisee and provide feedback (i.e. doing co-therapy) • Counselor: Help supervisee notice their “blind spots.”

Bernard's Discrimination Model • The supervisor first evaluates the supervisee’s ability within the focus area, and then selects the appropriate role from which to respond. Bernard and Goodyear (2009) caution supervisors not to respond from the same focus or role out of personal preference, comfort, or habit, but instead to ensure the focus and role meet the most salient needs of the supervisee in that moment.

Bernard's Discrimination Model • Three Focuses of Supervision: • Intervention/ Process (focuses on learning/ teaching simple or complex skills (all level of behaviors that distinguish a therapeutic interaction from a regular business one (active listening, set boundaries) • Conceptualization make sure that the supervisee’s work makes sense and has a purpose, and a goal • Personalization (makes sure the supervisee can tap internal and personal resources to accommodate the client )

System Approach • Developed by Elizabeth Halloway • Goal: to provide a common language that facilitates among supervisors and their supervisees. • Her book was to help bridge the gap between researchers and practitioners (p. 211)

System Approach • Seven Dimension of the System Approach Model: • The supervision relationship: this is the pillar and is formed by the contract, phase, and structure • the functions of supervision: behaviors and roles of the supervisor (monitor, teach, support, share) • the tasks of supervision: learning goals • Interferences and influences on the supervision relationship: The client, the supervisee, the supervisor, and the institution)

System Approach • In the systems approach to supervision, the heart of supervision is the relationship between supervisor and supervisee, which is mutually involving and aimed at bestowing power to both members (Holloway, 1995). Holloway describes seven dimensions of supervision, all connected by the central supervisory relationship.

System Approach • The function and tasks of supervision are at the foreground of interaction, while the latter four dimensions represent unique contextual factors that are, according to Holloway, covert influences in the supervisory process. • Supervision in any particular instance is seen to be reflective of a unique combination of these seven dimensions.

Supervisory Alliance Model • The model focus on three ROLES of the supervisor • Normative or managerial – Administrative tasks like adherence to policies and ethical codes. • Formative or educative – Teaching by determining supervisee’s strengths and weaknesses and then forming lesson plans • Restorative or supportive – reviews and explores client cases and the supervisee’s response.

Interactional Supervision • Developed by Schulman • Has FIVE core assumptions: • Interaction process between supervisor and supervisee is a medium for influencing outcomes with clients: has potential because of new skills and understanding of client. 2. There are common elements to all supervision: goal is to help the supervisee develop their skills to better help clients and to help them develop professionally.

Interactional Supervision • Has FIVE core assumptions 3. There are universal dynamics and skills that apply to Different Models of Interaction: Supervisors are responsible for supervisee’s client's welfare, looking at client charts, organizing work 4. There are parallels between supervision and other helping relationships: effective communication, problem solving, empathy 5. Supervision is an interactional Process: Each effect each other and they can’t take responsibility for each other. Need to work together to help each other.

Merry Conceptualized Supervision2001 • Person-Centered Approach • Supervisors who provide the conditions of empathy, genuineness, and unconditional positive regard create an environment that facilitate counselors’ under-standing and portrayal of empathy, genuineness, and acceptance. • When supervisors operate from person-centered conditions, they can accept and value supervisees as individuals and produce deeper levels of trust, acceptance, and internal modes of evaluation within supervisees (Lambers, 2007; Ray, 2011; Worrall, 2001). • The purpose of supervision from a person-centered perspective is to develop the supervisee’s self-concept, resulting in an ability to be fully present in the therapeutic relationship characterized by the conditions (Lambers, 2007; Merry, 2001; Ray, 2011; Worrall, 2001).

Merry Conceptualized Supervision2001 Five principles of the model: • Humans are self directing and capable responsible, self-enhancing behavior when operating when operating from a self –actualizing tendency 2. Supervision and supervisee contribute equally to discovering meaning when a democratic relationship is established

Merry Conceptualized Supervision2001 3. A collaborative inquiry encourages a deeper level of engagement with therapy issues because all forms knowledge are respected and considered meaningful 4. Supervisee’s defensiveness is lessened due to lack of evaluation of worth 5. Supervisor and supervisee see each other as collaborators in a cooperative experience: this creates a partnership between the supervisor and supervisee

SUMMARYFOR THE WEBINAR • Explain the different models of Clinical Supervision • Discuss types of Orientation Models of Supervision • Learn developmental models of supervision • Discuss Integrated Models of Supervision • Learn Supervisory Alliance Model • Learn Interactional Supervision • Learn Merry Conceptualized Supervision Model

Supervision in play therapy: are there different models of supervision?