Circle of Development

Note: The original version of this article first appeared in Psychotherapy.net, June 2019.

Today we are going to use the concept of Circle of Development (COD) to elaborate on how clinical supervisors can help you get to your their growth edge.

As a clinical supervisor, it is vital to help our supervisees move into their zones of proximal development, or that learning/experiential space just beyond their comfort zone (CZ).[1] But in order to do so, the supervisee’s current realm of abilities and limitations needs to be well defined. This entails figuring out when they are at their best, how they conduct a typical session, what parts of them shines through, and how effective they are on aggregate.

In other words, supervisors need to first help their supervisees figure out the bounds of their CZ so they can begin to push beyond it.

Comfort Zone

Supervisees must regularly pose questions to themselves such as, “What am I doing in sessions?” or “What did I do well” or even ”Was there something I did or said that stands out which might have contributed to the development of my client’s progress?” 

We get comfortable with what we do well. Naturally so. The only problem is, if we fail to take the steps, our comfort zone can become our hell zone. What was once helpful with a particular client or type of client can become  problematic or ineffectual.

Think about your parents. If you were blessed with good enough parents when you were little, imagine if they used the same cuddly warmth and nurturing tendencies with you when you were a teenager. That wouldn’t have worked. You would have rebelled with angst. Past attempted and seemingly successful solutions can become today’s problems.

Here’s one of the axioms I have come to rely upon which defines the bounds of my current comfort zone (CZ): Provide clear and playful strategies to clients at the end of each session.

Over the last few years, I found myself drawn to being more playful and improvisational. This wasn’t how I used to be. I was constantly plagued with the question, “Am I doing this right?” Then I begin to realise that once I freed myself up to be more playful, I felt more flexible and less certain. This mindset shook things up. 

Other practitioners’ CZs that I’ve come across include the following axioms: 

“Be attentive and follow a clear treatment protocol.” 

“Explore a person’s strengths and resources.”

“Develop clear treatment goals from the beginning.”

“Able to attune and empathise with my clients.”

First, and as noted above, it is critical that as supervisors, we help our supervisees to regularly ask themselves, “What did I do well?” “What stands out that I contributed to the development of my client’s progress?” This shall be your comfort zone.

Learning Zone

Second, we need to help our supervisees to stretch out of their comfort zone, and move into a less comfortable terrain that I call the learning zone (LZ). Our field has become obsessed with figuring out the how to improve, and less on taking the time to help individual practitioners figure out the what to improve. We need to get the sequence right. Figure out the what before the how. Especially in the realm of what we call clinical supervision, the supervisor plays a critical guiding role in helping to shape and identify learning objectives that are not only personalised, but ever evolving through the professional’s development over time. 

It’s important to base your supervisee’s  LZ on two critical pieces of information: 

1. The supervisee’s clinical outcome data, and 

2. Feedback from a coach/supervisor who knows their work. 

By looking at the supervisee’s aggregated outcome data, you can begin to spot any glaring patterns. For example, early in my profession, I was shocked to find out that my own clinical outcomes for clients presenting with relational issues were the poorest compared to other presenting concerns, even though I was steeped in the systemic perspectives. Your role as a supervisor is to point out what the supervisee can’t see, and lead them in the right direction.

There is a subtle but critical caveat to note on point #2. For a coach/supervisor to “know the work” of a supervisee, it’s not enough to obtain a thick clinical description about the client and of what happened in-sesison. You’d need to know the way they work, much like an athlete’s coach who knows how they play ball on the court. (More on this in the future).
The coach/supervisor needs know how to marry clinical data and intuition, and, help their supervisees develop focused and targeted learning objectives in their deliberate practice efforts.

Here’s my own recent LZ as a therapist: I would like to learn to help clients face the feelings that they avoid. It’s so easy to continue validating and, as a result, getting lost in the interaction with my clients, while missing the opportunity to go deeper and help them with their difficult and painful emotions.

Other common LZs that I’ve come across in clinicians include: 

“I would like to learn to improve the way I start my sessions.”

“I would like to learn to improve the way I close my first sessions.”

“I would like to learn to improve the way I elicit feedback at the close of a session.”

An excellent way to think about developing your supervisee’s LZ statements is to do this sentence completion exercise with them: “As a therapist, I would like to learn to…” Take it as a given that they will be struggling with this for a while. Give them time for this. Avoid non-specific definitions like, “I want to improve my engagement skills.” Narrow down to something more concrete and workable.[2]

For instance, if your supervisee’s data suggests that many of their clients come only for one session and drop out after that, you may be tempted to state that their  LZ is “…to improve my return rates after the first session.” I see this more as an outcome goal. That is, you want X to influence Y, and “Y”  is your outcome goal. In this case, you need to specify X and work on this. 

Typically, when practitioners try to identify their own learning objectives, they tend to identify theoretically specific areas to work on (e.g., how to better conduct two-chair work on the inner-critic; how to employ a solution-focused approach when working with exceptions). Meanwhile, after examining their aggregated baseline performance metrics and watching samples of their sessions, what I often end up proposing that supervisees work on is more fundamental and maybe even less revolutionary (e.g., how they begin a session, how they  develop an effective focus, how they deepen the client’s emotional experience and how they end a session).  

Most therapists and supervisors I know are life-giving and affirming. However, instead of simply bolstering their esteem with praise and consolation (A common refrain that you must have heard before, “Well, your clients came back to see you, didn’t they?”) without actually helping them identify their learning zones, we are doing our therapists and clients a disservice. 

Panic Zone

Finally, once we are able to identify our supervisee’s comfort zones and help them to move into their learning zones, we need to be able to guide them in articulating their panic zones (PZ). Panic zones tend to trigger overwhelm or cause re-traumatization, which is not ideal for adaptive learning and personal growth. Panic zone materials are usually either too far a stretch in terms of the content to be learned, or the topic at hand might have triggered personal and/or professional ghosts of the past that have not been addressed.

Here are some common Panic Zones self-statements that I’ve encountered: 

“Trying to learn what my supervisor says I should be focusing on, when I do not fully agree.”

“I know I should be working on difficult emotions like anger, but I do not feel ready at this point.”

“I tend to take critical feedback personally.”

“I just do not have the time and energy for this.”

It is important not to skip this step of helping your supervisee to identify their PZ. Doing so can help to remind them remind them what not to do, or what not to focus on at various phases of their professional development.

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Our circle of development is not static; it’s dynamic. If there is movement and directionality in the supervisee’s development, what used to be learning zone material might evolve to into the domain of the comfort zone. Likewise, what was previously panic zone materials can shapeshift into the realm of their  learning zone.

The aim of helping our supervisees in figuring out their boundaries of their  comfort, learning and panic zones is to clarify, magnify, and guide your supervisee’s messy and non-linear of  professional development.[2]  

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If you are a clinical supervisor who wants to take your supervisees to the leading edge of their learning zone and help them experience real development, sign up now to the 8th batch of Reigniting Clinical Supervision web-based workshop.

RCS is in-depth content, combined with a guided community, designed with cutting edge learning sciences in mind. Plus, it’s a LIFE-TIME ACCESS (not subscription-based).

The 8th batch kicks off on 20th of Jan 2020 (MON). Closing date is 17th of Jan 2020 (FRI).
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Take Me to Reigniting Clinical Supervision

P/s: My collaborators and I know how hard it is to figure out the key learning domains that therapists can spend their time and effort to deliberately practice. This is why we turned to what cutting edge research has to tell us, and by deconstructing the therapy hour, we developed a comprehensive guide called the Taxonomy for Deliberate Practice Activities (TDPA) (Therapist’s and Supervisor’s version 5.1) (Chow & Miller, 2015, 2019). This is expanded upon in our forthcoming book, Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness (Miller, Hubble, Chow, 2020). Pre-order now!

Footnotes:
[1] Chow, D. (2017). The practice and the practical: Pushing your clinical performance to the next level. In D. S. Prescott, C. L. Maeschalck, & S. D. Miller (Eds.), Feedback-informed treatment in clinical practice: Reaching for excellence (pp. 323-355). Washington, DC, USA: American Psychological Association.

[2] Chow, D. (2018). The first kiss: Undoing the intake model and igniting first sessions in psychotherapy. Australia: Correlate Press.

Header Photo by Luís Eusébio