Supervision 2017 -10 Creative Methods of Observation in Clinical Supervision

10 Creative Methods of

SupervisionInstructor: Dr. Dawn-Elise Snipes, PhD

Executive Director: AllCEUs.com, Counselor Education and Training

Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery

Objectives

Describe 10 methods of observation

Explore the benefits and ways to use group supervision to

enhance learning

CEUs available at All CEUs.com

Drawbacks to Indirect Methods

A counselor will recall a session as he or she experienced it. If a counselor experiences a session positively or negatively, the report to the supervisor will reflect that.

The report is affected by the counselor’s level of skill and experience.

The counselor’s report is affected by his or her biases and distortions (both conscious and unconscious).

The report does not provide a thorough sense of what really happened in the session because it relies too heavily on the counselor’s recall.

The supervisee may withhold clinical information due to evaluation anxiety or naiveté.

There is a time delay


Guidelines that apply to all methods of direct

observation Simply by observing a counseling session, the dynamics will change, but if

you observe the counselor frequently, you will get a fairly accurate picture

of the counselor’s competencies.

You and your supervisee must agree on procedures for observation to

determine why, when, and how direct methods of observation will be

used.

The counselor should provide a context for the session.

The client should give written consent for observation and/or taping at

intake, before beginning counseling.

Clients need to be notified of an upcoming observation by a supervisor

before the observation occurs.

Observations should be selected for review (including a variety of sessions

and clients, challenges, and successes) because they provide teaching

moments


Guidelines that apply to all methods of direct

observation When observing a session, you gain a wealth of information

about the counselor. “What is the most important issue here for

us to address in supervision?”

A supervisee might claim client resistance to direct observation,

however, “client resistance” is more likely counselor anxiety.

The supervisee should know at the outset of employment that

observation and/or taping will be required as part of informed

consent to supervision.


Methods of Observation Include

Videotapes (3 ways)

Audiotapes

Co-facilitation

Live observation (present)

Live observation via closed-circuit video

One-way mirror supervision

Role playing

Hypotheticals

Process recording

Case Presentations


Working with Video and Audio Tapes

Clear goals must be set to determine why, when, and how

videotaped sessions will be conducted

Interactive processes recorded on tape should be related

to the actual counseling session, its goals, and the

memories of the session and the rationale for the

intervention should be explored

Tape segments should be selected for review because they

provide teaching moments not pretexts for scoring critical

points


Videos cont…

The supervisor should provide gradual feedback, not a

litany of judgments, and allow time between segments

discuss and assimilate feedback

It is vital to have signed releases from patients prior to

taping

Risk-management considerations in today’s litigious

climate necessitate that tapes be erased after the

supervision session. Tapes can be admissible as evidence in

court as part of the clinical record. Since all tapes should

be erased after supervision, this must be stated in agency

policies.


Creative ways to use video and audio tapes

Videos

Running the video in fast-forward to convey a heightened image of the counselors and clients body movements

Turn down the audio to try to fill in what is being said on the basis of nonverbals

Cover the counselor and observe the client to guess what the counselor is doing and vice versa.

Focus on the counselor’s nonverbals

Audio and Video

While reviewing the tape prior to supervision, the supervisor might do voiceover dubbing questions for the supervisee onto the tape

Review the tape and stop after a client statement. Ask the counselor to respond. (can be useful in group supervision too)


Co-facilitation and Live Observation

Considerations

It is time-consuming

It is obtrusive and alters the dynamics of counseling

It can be anxiety provoking for both counselor and client

If the session is not also videotaped, there is no record of

the session to review later


Guidelines for cofacilitation & live in-person

observation

The supervisor should begin the session with a pledge of

confidentiality

Prior to the session the supervisor and supervisee should

briefly discuss the background of the session, salient issues

and plans for the session

The supervisor should take notes during the session as a

means of recalling key issues to be discussed later


Cont…

The supervisors interventions during the session should be

limited to no more than three or four comments

Feedback should be given to the counselors as soon as

possible after the session

If a group session is led by two counselors to supervisor

should meet with the to supervisees jointly

Cofacilitation should be used in conjunction with

videotaping whenever possible


Other Methods

Live observation via closed-circuit video and one-way

mirror supervision

Time consuming, but less obtrusive

Opportunity to intervene

Hypotheticals (Dr. Phil, Intervention…)

Requires additional time

No ability to follow up


Case Presentations

Are useful in groups and individual supervision

Should be built around problems and solution-

oriented questions to be answered

Should move from client information to dynamics,

prognosis, and treatment plan

Allow the supervisor to

Observe the counselor's actions

Determine their impact on the client

Assess the counselor's clinical reasoning process

Help the counselor improve treatment delivery


Case Presentation Problems

Too many presentations into short of a time

Focusing on a specific problem instead of giving a case

overview

Material is not contextualized

Supervisee dynamics interfere with free and open

discussion of the case

There are expectations for interventions beyond the

capabilities of the counselor


Role Playing

An alternative to observing the clinician and an actual

counseling session

Ideal for practicing skills

An opportunity to learn-by-doing in a safe environment and

receive helpful feedback


Other Methods

Process recording

Written account of everything that was said and done in session

Only from supervisee point of view

Intentional and unintentional errors and omissions

Can be used with video to compare salient points


Group Supervision Benefits

It provides a cost-effective way of supervising more people

in the same time

It offers each counselor a reality testing of her perceptions

through peer validation

Learning is enhanced by diversity of people in the group

Groups create a working alliance among counselors that

engenders a sense of psychological safety

Groups provide the opportunity for multiple people to

review and “see” things on the tapes


Cont…

The group process facilitates learning by setting up a microcosm of the larger social environment

Group disclosure enhances the potential for self-disclosure, confrontation, and opportunities for growth

Empathy and sharing of interests are available to a greater extent than in individual supervision

When the group works together over time personal growth on the part of the individual members can be reinforced possibly by the group

Alternative clinical approaches and methods are available to a far greater extent than a single supervisor can offer

The potential for constructive feedback is greatly expanded


Processes in Group Supervision

Cohesiveness

A sense of we-ness

A shared frame of reference

Tolerance of diverse opinions

Movement toward common goals

Like any group leader, the task of the supervisor is to help

the group identify its norms, and to model appropriate

qualities, behaviors, and skills


Summary

Methods for Observation

1. Videotapes

2. Audiotapes

3. Co-facilitation

4. Live observation (present)

5. Live observation via closed-circuit video

6. One-way mirror supervision

7. Role playing

8. Hypotheticals

9. Process recording

10. Case Presentations


Supervision 2017 -10 Creative Methods of Observation in Clinical Supervision

Healthcare