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Consultation and Supervision

Terms in this set (43)

CONSULTATION
- voluntary relationship between professional helper & indv. or group that needs help
- consultant provides assistance by helping to define and resolve a problem or potential problem of client/system
- brief encounters
- once or ongoing
REQUIRED CONSULTATION
Multidisciplinary team:
- Emergency Services
- Inpatient
- PHP
Multiple Providers:
- Home based
- Residential
SUPERVISION
- intensive, interpersonally focused, individual or group relationship in which a more experienced professional is designated to help less experienced professional
SIMILARITIES B/W CONSULT AND SUPERVISOR
Ethical Obligations:
- no dual relationships
- respect confidentiality
- refrain from practicing outside limits of training
Able to create constructive change in supervisee/client
TRIPARTITE RELATIONSHIP
Triadic:
client is the 3rd variable
DIFFERENCES B/W CONSULT AND SUPERVISOR
CONSULTATION: collaborative
SUPERVISION: authoritative
CONSULTATION: voluntary and not evaluative
SUPERVISION: imposed by education and evaluative
CONSULTATION: temporary
SUPERVISION: ongoing
CONSULTATION: may or not be within field
SUPERVISION: always within field
MODELS OF CONSULTATION
1. Expert of provisional model
2. Doctor-patient or prescription model
3. Mediation model
4. Process consultation model
EXPERT OF PROVISIONAL MODEL
- functions as who has the the knowledge and skill to resolve problems
Ex: provide training on process for filling with DYS
DOCTOR-PATIENT OR PRESCRIPTION MODEL
- functions by diagnosing the problem
- responsibly of action lies with consultee
- consultant provides options
Ex: CMHC having challenges retaining clinicians
MEDIATION MODEL
- consultant unifies the activities and processes of diff people.
Ex: Emergency Services Team
PROCESS CONSULTATION/COLLABORATION MODEL
- consultant facilitats problem-solving process rather than providing the actual solution
Ex: team building
ANOTHER MODEL
Consultant-Centered vs. System-Centered
CONSULTANT CENTERED CONSULTATION
- Expert consultation model - the consultant is asked to help an organization solve specific problems based upon her or his expertise
- Prescriptive consultation model - requires the consultant to collect information, correctly identify the nature of the problem, and provide recommendations for its resolution
- Trainer/educator consultation model - the consultant is contracted to provide educational and training opportunities for staff members
SYSTEM-CENTERED CONSULTATION
- focused on the organizational dynamics of the working team or agency. It has three major approaches:
- Collaborative consultation - relies on the shared expertise of consultant and consultee, who work as partners to identify problems, consider solutions, and implement joint decisions
- Facilitative consultation - the consultant helps persons who work within a given system to communicate more effectively with each other and to understand each other
- Process-oriented consultation - believes that the most effective resolution of systemic conflict is that which emerges from among the system members themselves.
CONSULTANT ROLES
- Expert
- Advisor
- Researcher
- Program Evaluator
- Teacher/Trainer/Educator
- Advocate
- Process Specialist
- Collaborator
CONSULTANT SKILLS
- Strong Interpersonal Skills
- Effective Communication
- Positive and Accepting Attitude
- Willingness and Ability to Listen
- Oral and Written Skills
- Ability to speak in public
- Problem solving skills
- Knowledge of organizational development
- Cultural Sensitivity
- Ethical Behavior/Profess. Competency
- Objectivity
- Team Building/Group Process
CONSULTATION SETTINGS
1. Human service agencies
2. Schools
3. A broad category of business, government, and other organizations.
CASE CONSULTATION
- consultant activity among practitioners
- about a specific client, staff training for an agency, or organizational problem solving such as team building and conflict resolution.
EXTERNAL CONSULTATION
- Consultation activities are often focused on the consultee's clients, staff training, resolution of interpersonal dynamics, the nature of the consultee's organizational system, and facilitating systemic change in the organization.
- Consultants often assist those outside their own agency
CONSULTATION IN EDUCATIONAL SETTINGS
- considered an internal consultant who functions as advocate, collaborator, expert and leaders.
- a key factor in the success of this collaboration between school counselors and mental health counselors is the establishment and maintenance of strong working relationships across professional disciplines.
SUPERVISION DEFINITION
- process by which a helping professional with appropriate training mentors and teaches another individual.
- process of professional and personal development in which the supervisor challenges, stimulates, and encourages a professional counselor to reach higher levels of competence.
- experienced counselors may meet informally with other professionals to discuss ideas about how to work with specific clients or to gain different perspectives, a practice often called peer supervision.
- The main purposes of supervision are:
1. Protecting the client's welfare
2. Teaching clinical conceptualization and counseling skills
3. Fostering supervisee self-awareness
4. Evaluating the supervisee
GOALS OF SUPERVISION
- to accomplish purposes of supervision, the supervisor:
- assumes several different roles including mentor, advocate, teacher, case consultant, and collaborator in exploring supervisee counter-transference issues.
- Supervisors should assist supervisees to explore the diversity issues of the clients being served and the communities in which they live and work.
- Appropriate topics for consideration include differences in belief systems; communication and learning styles; and cultural, racial, and gender issues.
MODELS OF SUPERVISION
- include theory-based models, developmental approaches, and models developed specifically for supervision.
- theory or model allows a supervisor to organize, conceptualize, and integrate into practice various pieces of information relevant to the supervision process
THEORY BASED MODEL
- engage with supervisees in a manner that is consistent with their counseling philosophy.
- Person-Centered
- Psychodynamic
- Cognitive-Behavioral
- Systemic Supervision
PERSON-CENTERED SUPERVISION
- Genuineness, Empathy, Warmth
- Supervisor has trust that the supervisee has the ability and motivation to grow and explore the therapeutic situation
- Major goal is to help the counselor grow in self-confidence, self-understanding, and understanding the therapeutic process.
PSYCHODYNAMIC MODEL
- Processing of the relationship counselor/client/supervisor
- Transference/Countertransference
- Trainees dynamic understanding of causality, process, and the role of self-reflection
CBT MODEL
- Goal: teach appropriate counselor behaviors and to extinguish inappropriate behaviors.
- Counseling skils are behaviorally defined
- supervision employs the principles of learning theory within its procedures
- Skill and Intervention oriented
- Specifications of interventions in cognitive-behavioral terms
- Trainees provide data documenting their assessment and intervention efforts, Empirical evaluation
- Provide measurable outcomes for tx
SYSTEMS APPROACH
- Supervisees seen within the context of a larger system
- Constant change, development, and growth are underlying assumptions
- Contextual System: Academic Unit, Clinical System, Supervisor, Supervisee, Client, Supervisor Functions and tasks, Supervisor/Supervisee Relationship
- This model highlights the social influence of the supervisor's assumptive world and how it affects role, focus, format and techniques.
DEVELOPMENTAL SUPERVISION
- Focus on how supervisees change as they gain training and supervised experience.
- Address students based on their developmental level (practicum v. internship)
- Provide student with what they need at their various points in development
INTEGRATED DEVELOPMENTAL MODEL (IDM)
- best known developmental approaches to supervision
- focuses on issues supervisees face throughout their development.
- supervisees pass through three levels of development during their training in three main areas:
--> awareness of self and others
--> motivation
--> autonomy.
- supervisor's role: assess each supervisee for each issue and help the supervisee move to the next stage of development.
INTEGRATED DEVELOPMENTAL MODEL (IDM) 2
- Growth in "skills"
- Intervention skills
- Assessment techniques
- Interpersonal assessment
- Client conceptualization
- Individual differences
- Theoretical orientation
- Tx goals and plans
- Ethics
ISSUES IN DEVELOPMENTAL MODEL
- Competence
- Emotional Awareness
- Autonomy
- Identity
- Respect for Individual Differences
- Purpose and Direction
- Personal Motivation
- Professional Ethics
LEVELS OF IDM
Level 1: Orientation Stage
--> focus on their own behavior, thoughts (what to do next?, trying to understand the client, and emotions).
--> "I have no idea what I'm supposed to be doing here"
Level 2: Working Stage
--> Increased skill level and increased comfort with the process
--> focus shifts to client.
--> Allows greater understanding of the clients world cognitively and affectively.
--> This augments intervention process (increased confidence decreased competence).
--> "The real scary part... I'm responsible for what?!"
Level 3: Transition Stage
--> Change in Self-Other awareness.
--> Awareness of self actions in relation to others - emotions, behaviors.
--> Greater confidence.
--> Reflection. "I can do this! No really I think I can do this...and I might not be that bad at it!"
Level 4:
--> Able to be autonomous and provide consultation.
--> Closer to becoming a peer. "I'm really going to miss this place...I don't want it to end"
DISCRIMINATION MODEL (INTEGRATIVE MODELS)
attends to three separate areas of focus in supervision:
1. Intervention skills- what the supervisee is doing in session that is observable by the supervisor
2. Conceptualization skills - how the supervisee understands what is occurring in the session, identifies patterns, or chooses interventions
3. Personalization skills - the supervisee's personal style
Supervisor assume one of these roles:
1. Teacher - the supervisor teaches specific concepts and techniques and may assign reading to assist the supervisee
2. Counselor - the supervisor may help the supervisee focus on personal issues and help them confront personal issues that may affect the counseling sessions
3. Consultant - the supervisor may work with the supervisee to identify different interventions, discuss model approaches, or address issues related to specific client populations
ROLE AND FUNCTION OF SUPERVISOR ACROSS DEVELOPMENTAL STAGES
1. Disorientation Phase: Supervisor as teacher, concrete feedback, skill assessment, set goals, provide orientation.
2. Working Stage: Supervisor as guide, less teaching, help supervisee see patterns in clinical relationships, parallel process
3. Transition Stage: Supervisee: Doesn't know what she doesn't know, thinks she/he "knows it all", may start to push boundaries, most dangerous of stages, supervisee is blind to own limits
--> Supervisor as Gatekeeper: could experience power struggle, address the illusion of "know it all", positively reinforce increasing skills and independence, yet monitor them, set and enforce clear boundaries
4. Colleague Stage: Supervisee: closer to becoming peer greater self-awareness, autonomous.
--> Supervisor: Role of Consultant. Supervisory sessions more case consultation. At this stage both supervisor and supervisee need to work on developing new personal and professional goals.
FORMATS OF SUPERVISION
INDIVIDUAL: usually start with a check-in which leads to session goals, then the work of the session, and a final check-out.
--> The respective roles of supervisor and supervisee
--> The learning objectives, responsibilities, and criteria for success agreed to in the supervisory contract
--> Assessments
--> Evaluations
--> Areas for growth
--> Interventions or techniques.
GROUP: Staff meetings, Didactic Training, Clinical Supervision
--> Advantages of group supervision include
--> minimized supervisee dependence
--> exposure to a broader range of clients --> economies of time, money, and expertise
TRIADIC SUPERVISION
PEER SUPERVISION
SUPERVISION INTERVENTIONS
- Self-report
- Video/Audiotape Review
- Process Recordings
- Live Supervision
--> Cotherapy/Direct Observation
--> Telephone
--> BITE (Bug-in-the-ear)/Bug-in-the-eye
- Supervisory Consultation Breaks
- In Vivo
LIVE SUPERVISION
- presession/postsession planning/debriefing are important
Pre- session planning:
--> prepare the supervisee for the upcoming counseling session and focus on specific learning goals.
Post-session Debriefing:
--> allows the supervisor and the supervisee to discuss what transpired in the counseling session.
ADV. & DISADV. OF LIVE SUPERVISION
ADVANTAGES:
- Greater likelihood that therapy will go well
- supervisee will learn more efficiently and profoundly
- Provides safety for client welfare
- Allows supervisees to work with more challenging cases
- The supervisee's view of the process of counseling is positively affected
DISADVANTAGES:
- Demands time from supervisors
- Cost of facilities
- Scheduling cases to accommodate all the individuals involved
- Potential negative reactions from clients
SUPERVISEE ROLE IN SUPERVISION
- Active Participant
- Self-Assessment
- Discuss previous experiences with supervision
- How do you learn best
- Identify and express your goals for training
- Set professional and personal goals
Flexibility
- Open and honest about conflict
- Self Awareness
- Willingness to accept and admit mistakes
- Personal growth
- Openness to change
- Provide and integrate feedback
SUPERVISORY DISCLOSURE AND CONTRACT
- The Association for Counselor Education and Supervision (2011):
--> supervisors develop and use informed consent and develop a written contract that outlines expectations, goals, and methods for evaluation.
--> Contact Info.
--> Education/Credentials/Licensure
--> Experience
--> Limits of Confidentiality
--> Process of Supervision/Interventions & Evaluations
--> Fee Schedule
HOW TO FAIL AS A SUPERVISOR
- failing to inspect the trainee's previous experience with supervision
- failing to address the trainee's expectations about the therapeutic and supervisory processes
- failing to prepare trainee for emotions that conducting therapy can evoke
- failing to understand and enhance the trainee's expectations of success
- failing to understand how the supervisor's assumptions about the trainee can affect the supervisory relationship
- failing to address the impact of personal value systems and worldviews on therapeutic and supervisory relationships
ESSENCE OF SUPERVISION
- alliance is key
- optimal level of challenge and support
- foster reflective and questioning approach
- maintain cultural competence
- catalyst for clinical skill building and self discovery
- assist them in identifying intuitions and insights
- promote self-awareness and ability to recognize personal characteristics
- be open to feedback and flexible with theoretical approaches
- positive reinforcement
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