Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 Clinical Supervision I: Developing Counselors’ Skills Jennifer Wyatt, LMHC, MT-BC, CDP Email: wyattj@ohsu.edu Paul Hunziker, MA, LMFT, CDP Email: paul.hunziker@gmail.com Janis Crawford, MA, LPC, ACS Email: spiritlifewisdom@hotmail.com The ATTC Network Ten Regional Centers Four National Focus Centers • SBIRT • Hispanic and Latino • Native American-Alaska Native • Rural and Frontier Two Centers of Excellence • YMSM + LGBT • PPW Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 1
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 • Sign in sheet WELCOME! • Folders • Credit hours • Bathrooms • Breaks/lunch • Mobile phones • Questions • Confidentiality • Freedom of Movement • ATTC Forms OBJECTIVES • To understand the research supporting effective supervision methods • To identify the roles in the supervisory relationship • To increase awareness of culture in supervision • To practice skills that structure clinical supervision (e.g., Feedback Model, Professional Development Plan, Supervisory Interview) • To gain familiarity with available resources for clinical supervision When people feel like their doing a good job, they do COURSE OVERVIEW Content Process • Didactic • TAP 21: Counselor • Demonstrations Competencies • Small group tasks • TIP 52 • Skill Practice • Skills Assessment using • Personal Action Plan the Rubrics • Feedback Model Everything we do in this • Professional model translates to Development Plan teaching skills to counselors • Supervisory Interview Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 2
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 • Name, Specialty, Job • Experience, training, or interest in clinical supervision • Your favorite thing to do outside of work (self-care) Setting boundaries SUPERVISOR SELF-ASSESSMENT 1 2 3 4 5 6 7 8 9 10 1. How confident are you in your skills as a clinical supervisor right now? 2. What might help you get up to a higher number? MODEL OF SUPERVISION • It is common for Clinical Supervisors to have no formal training. • Motivational Interviewing skills help • How might having a model be helpful to supervisors and counselors alike.? Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 3
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 KEY COMPONENTS Direct Structure Efficiency observation Research- Collaboration Feedback based Skillbuilding OUR GOALS AS SUPERVISORS Assure quality treatment for clients Create a positive work environment Characteristics of a strong team Develop effective clinical skills in counselors Clinical Supervision is defined as observing, Teacher Coach monitoring, and evaluating the work of counselors. Mentor Consultant Support, encouragement, & education… Source: TIP 52, 2014, p. 3-4. Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 4
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 A CLINICAL SUPERVISOR WEARS MANY HATS… EIGHT TRUTHS EVERY SUPERVISOR SHOULD KNOW 1. The reason for supervision is to ensure quality client care; integrity. 2. Supervision is all about the relationship. 3. Culture and ethics influence all supervisory interactions — relationships. 4. Be human and have a sense of humor. Source: TIP 52, 2014, pp. 7-8. EIGHT TRUTHS EVERY SUPERVISOR SHOULD KNOW 5. Rely on direct observation of your counselors and provide specific, objective, and balanced feedback; input from clients. 6. Have and practice a model of counseling and of supervision; have a sense of purpose. 7. Make time to care for yourself spiritually, emotionally, mentally, and physically. 8. You have a unique position as an advocate for the agency, the counselor, and the client. Source: TIP 52, 2014, pp. 7-8. Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 5
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 Often, a parallel process exists between clinical supervision and treatment. In other words, counselors tend to interact with clients consistent with how they are treated in supervision. All activities are education. DEVELOPING YOUR INDIVIDUAL CULTURE OF SUPERVISION Handout, p. 2 TIP 52, pp. 11-13 GOALS OF SUPERVISION • Now that you have identified what you’d like to avoid and emulate, take a look at Tool 3 in TIP 52 on p. 105. • The intent of this tool is to help you reach agreement with staff on the goals of supervision. Which sections might be useful in your agency? Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 6
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 SUPERVISOR ETHICS 1. Uphold the highest professional standards of the field. 2. Seek professional help (outside the work setting) when personal issues interfere with clinical and/or supervisory functioning. 3. Conduct themselves in a manner that models and sets an example for the agency mission, vision, philosophy, wellness, recovery, and consumer satisfaction. Source: TIP 52: 2014, pp. 17. SUPERVISOR ETHICS 4. Reinforce zero tolerance for interactions that are not professional, courteous, and compassionate. 5. Treat supervisees, colleagues, peers, and clients with dignity, respect, and honesty. 6. Adhere to the standards and regulations of confidentiality as directed by the field in both supervisory and counseling relationships. Source: TIP 52, 2014, pp. 17. LEGAL ISSUES IN SUPERVISION Direct • TIP 52, p. 13 Liability Vicarious • TIP 52, p. 14 Liability Supervisory • TIP 52, p. 14 Vulnerability Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 7
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 “Documentation is unquestionably a crucial risk-management tool for clinical supervisors and is no longer optional in supervision. Legal precedents suggest that organizations are both ethically and legally responsible for quality control of their work, and the supervision evaluation, documentation, and record-keeping systems are a useful and necessary part of that professional accountability” ( TIP 52 , p. 113). TOOLS TO DOCUMENT SUPERVISION • Initial Supervision Sessions Tool 9 Checklist • TIP 52, pp. 114 – 115 • Supervision Note Sample Tool 10 • TIP 52, p. 115 Initial Supervisory Sessions on pp. 113 – 117 How might these forms be useful to you? Carefully consider where, and for how long, you will store supervision records. TIP 52, p 113: APA recommends… Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 8
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 SUPERVISION & COUNSELING • Clinical Supervision is different from Administrative Supervision and Counseling. • Clinical Supervision emphasizes improving counselor skills and performance. • Administrative Supervision focuses on agency rules and procedures. • Counseling addresses personal growth outside the work environment. Let’s take a closer look on p. 24 of TIP 52. DIRECT & INDIRECT OBSERVATION • Commonly used • Includes verbal reports and reviewing Indirect written documentation Observation • Information is filtered through the counselor’s perspective • Increasingly common with EBPs • Includes live observation of groups Direct and audio/video recording services Observation • Results in thorough understanding of treatment and counselor’s abilities METHODS & TECHNIQUES OF CLINICAL SUPERVISION TIP 52, PP. 30-32 Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 9
Clinical Supervision I: Developing Counselors’ Skills 11/28/2016 AUDIO OR VISUAL RECORDING Permission is needed from clients and counselors. See TIP 52 pp. 124-126 for ideas. This step likely requires legal counsel to ensure compliance with HIPAA, 42 CFR Part 2, and applicable state laws. GROUP EVALUATION STEMS for clients to provide feedback 1. One specific skill I learned in this group that will support my recovery is… 2. The thing I liked best about this group was… 3. This group would be better for me if… 4. The current needs I have that were not addressed in this group are… PREPARING COUNSELORS FOR DIRECT OBSERVATION ( TIP 52 , P. 38) 1. Acknowledge and understand the clients’ and/or counselors’ anxiety. 2. Listen reflectively to concerns without being dismissive or ignoring the anxiety; noting that these feelings are common may help normalize the counselor’s concerns. 3. Clearly state the value of direct observation and reinforce the idea that such methods are “part of how we do business at this agency”. Jennifer Wyatt, LMHC, MT-BC, CDP & Paul Hunziker, MA, LMFT, CDP Northwest Addiction Technology Transfer Center 10
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