Providing Clinical Supervision for Home-Based Family Therapists Module

Module Sections:

Forming a Unified Framework

Myths about Clinical Supervision

Myths about Clinical Supervision

  • Supervisees are already anxious so monitoring/recording sessions overwhelms therapists and their clients and is counter therapeutic.
    • Some supervision theories portray supervisees as so anxious that it is detrimental to them and hinders their performance in sessions. The corollary that goes with this myth is that monitoring and recording therapy sessions is debilitating to the supervisee therapist as well as the client. Most supervisees are not overly anxious. Recording is not an issue as long as they understand the purpose of the confidential recordings. If clients understand that the purpose of recording is to train the counselor and to improve the quality of treatment, they usually want it.
  • Supervisors (or supervisees) do not need to monitor sessions.
    • Myth is that as supervisors we get a sufficient understanding of what is happening with supervisees, that we do not need to monitor directly what goes on in their sessions. Unfortunately the data suggest otherwise. Supervisees often miss or are unaware, misinterpret, or inaccurately recall that which transpires in the therapy session.
    • Parallel process (isomorphism) is another factor to consider. Parallel process occurs in supervision when supervisees are not aware that they are interpersonally engaging the supervisor in the same process that their clients engaged them in in therapy. It is unclear how supervisors can monitor potential racial microaggressions without observing what takes place during sessions.
    • Supervisees can benefit from reviewing recordings of the session from self-supervision. From a more behavioral learning perspective, supervisees need to not only monitor their own in-session behaviors, but also receive detailed feedback from a supervisor to learn and refine the specific interventions and skills of being a practitioner.
    • Supervisees need to record their sessions and both the supervisee and supervisor review those recordings. As a supervisor, we need to observe, monitor, or oversee and provide feedback on in-session behaviors and interactions.
  • Supervision is all about the using the right theory and techniques.
    • Good supervision is about the relationship not the theory or techniques. The majority of supervision models attend minimally to the supervisory relationship. The most well-known of the theories of the supervisory relationship is Bordin’s (1983) model of the supervisory working alliance which consists of three dimensions: agreements on tasks, agreements on goals, and the emotional bond. Supervisory relationship is directly related to supervisee outcome such as therapist’s skills, the supervision process may be more complex than previously postulated, the supervisory working alliance mediates burnout and enhances vigor and mediates vicarious traumatization, the supervisory alliance is a major predicator of satisfaction in both the US and south Korea Supervision.
  • Clinical supervisors are doing a good job protecting clients and supervisees from harm.
    • Evidence suggest that many supervisors are providing inadequate supervision, some of which is harming clients, and that far too many supervisors are harming their supervisees. “Inadequate clinical supervision subsumes harmful clinical supervision. All harmful supervision is by definition inadequate supervision. Inadequate and harmful supervision are established using 2 criteria – self-identified and de facto. Self-identified inadequate or harmful supervision occurs when a supervisee declares that he or she has received such supervision. De facto harmful or inadequate supervision is defined more objectively, and pertains to the supervisor’s actions, inactions, and effects thereof.
    • Inadequate clinical supervision occurs when the supervisor is unable or unwilling to enhance the professional functioning of the supervisee, monitor the quality of the professional services offered to the supervisee’s clients, or serve as a gatekeeper to the profession. Inadequate supervision is the supervisor’s failure to adhere to the minimal standards of supervisory practice. De facto inadequate supervision is defined as the supervisor’s failure to provide the minimal level of supervisory care as established by his or her discipline or profession or law or when the supervisor clearly violates accepted ethical standards.
    • Harmful supervision is supervisory practices that result in psychological, emotional, and or physical harm or trauma to the supervisee. 2 essential components of harmful supervision are the supervisee was genuinely harmed in some way by the supervisor’s behaviors or the supervisor’s behavior is known to cause harm, even though the supervisee may not identify the actions as harmful.