Jeff Chang, Ph.D., R.Psych. Athabasca University & Calgary Family Therapy Centre

Fundamentals of MFT SupervisionOntario Association for Marriage and Family TherapyToronto, ON June 13, 2019 (Day 2) Jeff Chang, Ph.D., R.Psych. Athabasca University & Calgary Family Therapy Centre jeffc@athabascau.ca

Culture Infused Supervisory Working Alliance Orienting question: “Does the supervisory relationship support what I am doing?” • Conceptualizing the working alliance: • SFT’s ideas of “visiting,” “complainant,” and “customer” relationships… working alliance is the manifestation of an interactional pattern • Prochaska and di Clemente’s Transtheoretical Model of Change (stages of change) • Obtain feedback on the working alliance How do you track the supervisory alliance? How do you read the feedback?

Vignette Lawrence, a clinical social worker, was supervising several licensure interns in a family service agency, using a combination of live supervision from behind a one-way mirror, and case consultation. He noticed that one of his supervisees, Anna, seemed to be simply nodding and agreeing with him a great deal, but did not seem to be engaged in the content of his feedback. Wondering if he was fitting his supervision practice with her needs, he asked her directly how she experienced their supervisory alliance ….

Vignette …. She replied, “It’s funny you should mention that. I’ve been a little frustrated with supervision lately – you are always so positive, and I need some concrete ideas about what to do a lot of the time.” Lawrence and Anna went on to renegotiate their supervision contract, based on specific skill development needs, including when she would find a call-in during live supervision helpful.

Culture Infused Supervisory Working Alliance A couple of issues to be aware of… Supervisee non-disclosure: • In order to protect themselves, trainees may selectively decide what to present in supervision to reduce negative evaluation and to promote positive appraisal of their competencies and professional practice, • Upwards of 84% of psychotherapy trainees report they withhold information from their supervisors • Supervisees are more likely to refrain from disclosing concerns related to the supervisory relationship than clinical concerns – phew! • But this does not help us become better supervisors…

Culture Infused Supervisory Working Alliance Informal Supervision • Seeking the support of others in the trainee’s life: fellow students, friends, and significant others… Can be problematic if: • Trainees break confidentiality • Trainees don’t tell supervisors about it • “This whole other world of supervision that exists outside… of “formal”… supervision is not only virtually unrecognized in the professional literature but also unacknowledged by training programs—essentially, a “don’t ask, don’t tell” policy” (Farber & Valery Hazanov, 2014)

Culture Infused Supervisory Working Alliance • “Culture-Infused Counselling” approach (Arthur & Collins, 2010) urges counsellors to: • Be culturally self-aware. • Appreciate the cultural identity of supervisees • Develop a culturally competent working alliance • In this model, culture is not a theoretical abstraction; the rubber meets the road in the supervisory relationship

Vignette Dr. Khalil is a Jordanian-Canadian Muslim MFT supervising Kelly, a master’s practicum student. At their initial meeting, Dr. Khalil stood up, placed his hand over his heart, and graciously bowed toward Kelly. He explained that it is contrary to his religious convictions to shake hands with women, and that his gesture is a way for him to express his respect for women. This opened a conversation about how they each position themselves culturally, and conceptualize gender in their respective approaches to therapy.

Culture Infused Supervisory Working Alliance How do you conceptualize your cultural identity? How does your cultural self-awareness affect how you connect with supervisees? How do you open conversations about culture?

Relational Positions Orienting question: “When should I do what?” • Some functions will not be used with some supervisees: determined by context. • Morgan & Sprenkle’s (2007) three key distinctions: • Clinical competence vs. professional competence (emphasis) • Idiosyncratic vs. general (needs of supervisee or profession) • Collaborative vs. directive (relationship) • Not a bad way to think about things, but finer distinctions are required to ensure that supervisors are clear as to where their primary allegiance lies

Relational Positions Clinical educator: • Teaching concepts and theories (conceptual skills; Tomm & Wright, 1979) • Assisting supervisees to clarify their theories of counselling and them to make their practice consistent with their theory • Challenging supervisees’ assumptions, deconstructing supervisees’ theories • Teaching supervisees to “know what to look for” (perceptual skills; Tomm & Wright, 1979) • Utilizing ideas outside of “therapy” – art, literature, philosophy Discussion question: What are some of your best practices to encourage theoretical clarity in your supervisees?

Vignette Leo, a student in Dr. Jessup’s internship seminar, was a risk of failing because he could not articulate his theory. An addictions counsellor for 25 years before entering a Master’s program, he denigrated the need to identify a theory, proclaiming that he “just wanted to help people.” Rather than “just buying into an established theory,” Leo marched to the beat of his own drum. He seemed unable to connect his clinical work, which seemed to be quite effective when he showed his videos in class, to any coherent way of thinking….

Vignette … Dr. Jessup saw Leo’s promise and thought he was a sensitive, effective, and intuitive counselor, but could not pass him in the internship seminar unless Leo articulated a coherent approach to counselling. He challenged Leo to develop the “Leo Smith model.” Dr. Jessup supported Leo to figure out, inductively, “why he was doing what, when” in his sessions via videotape review and live supervision. He was able to articulate a coherent approach to counseling, and even sheepishly admitted that he was “a cross between CBT and reality therapy, with a little bit of inner child work thrown in” by the end of the internship.

Relational Positions Ethics/Risk Management Consultant • Supporting the application of ethical principles in practice • Moving beginning supervisees from “ethics as a theoretical abstraction” to applied practice outcomes. • Supporting novice supervisees from a fear-based perspective to a realistic outlook. • Warning supervisees of risky situations • Moving supervisees from a risk management, defensive practice outlook to an aspirational outlook Discussion question: How do ethical the dilemmas your supervisees face change as they develop?

Jeff Chang, Ph.D., R.Psych. Athabasca University & Calgary Family Therapy Centre