{"id":4820,"date":"2021-03-26T20:51:00","date_gmt":"2021-03-26T12:51:00","guid":{"rendered":"http:\/\/darylchow.com\/frontiers\/?p=4820"},"modified":"2024-05-28T20:29:49","modified_gmt":"2024-05-28T12:29:49","slug":"supervision","status":"publish","type":"post","link":"https:\/\/darylchow.com\/frontiers\/supervision\/","title":{"rendered":"Clinical Supervision Series"},"content":{"rendered":"\n

Note: This is a compilation of Frontier Friday<\/a><\/strong>, a weekly Substack published, originally released on 26 Mar. 2021<\/em><\/p>\n\n\n\n

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PART I<\/h2>\n\n\n\n
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  1. Interview: Supervision at the Crossroads<\/a><\/strong>
    Here’s an interview that was featured in     psychotherapy.net<\/a><\/strong> about the current issues in our default ways in clinical supervision, and how we can tweak things to move the needle for therapists and their clients. 
    (Big thanks to Lawrence Rubin and Victor Yalom)
     <\/li>\n\n\n\n
  2. Research:  Supervisor variance on Client Outcome<\/a> <\/strong>
    Recently, Whipple et al. (2020) conducted a replication study examining the amount of variance in client outcome that is attributable to clinical supervision. This study was based on a longitudinal dataset of 3030 clients, 80 therapists and 39 supervisors.
    Findings: <\/strong>Like the first study, they found that supervisors accounted for 0.00% of the variance in client outcome.<\/strong><\/em> Mine you, the previous study which was set in a different context, also had a similar finding. 

    Both studies have about 1 to 2hrs \/week of individual supervision. <\/strong>The original study even had 2hr\/week of group supervision, on top of individual supervision.

    (Big appreciation that this     study<\/a><\/strong> is not behind a paywall.)
     <\/li>\n\n\n\n
  3. Research: What do clinical supervision research reviews tell us? Surveying the last 25<\/a><\/strong>
    Edward Watkins Jr is one of my favorite researchers in clinical supervision. In this recent 2020 publication, he reviews the evidence since 1995 to 2019. He doesn’t mince his words:

    Key grafs: 
    (a) \u2018proof\u2019 for supervision appears to be more \u2018proof by asso- ciation\u2019 than otherwise…;
    (b) evidence supporting supervision impact of any type is weak<\/strong> at best, especially so for worker and client outcomes;
    (c) supervision models generally lack empirical foundation;
    (d) evidence-based supervision appears to be more a hope and dream than supervision-based reality at present; 

    More… <\/em>

    p. 13 <\/em>

    “Supervision, found to be positively associated with job satisfaction, job retention and ability to manage workload (Carpenter et al., 2013; O\u2019Donoghue & Tsui, 2015), appears to be seen as helpful by supervisees (K\u00fchne et al., 2019) and may even benefit their therapeutic competence (e.g. enhanced self-awareness, enhanced sense of self-efficacy; Alfonsson et al., 2018; K\u00fchne et al., 2019; Wheeler & Richards, 2007). But supervision’s favourable impact on worker outcomes is weak at best, yet to be proven <\/strong>(Bogo & McKnight, 2006; Carpenter et al., 2013). Furthermore, the client has been, and continues to be, summarily neglected in supervision research<\/strong>: supervision’s impact on client outcome has yet to be proven<\/strong> (emphasis mine) <\/strong>(Alfonsson et al., 2018; Bogo & McKnight, 2006; Buus & Gonge, 2009; Carpenter et al., 2013; Ellis & Ladany, 1997; Ellis et al., 1996; O\u2019Donoghue & Tsui, 2015; Simpson-Southward et al., 2017; Tsui, 1997; Watkins, 2011; Wheeler & Richards, 2007).”<\/em>

    p. 16 <\/em>

    Practising supervisors and supervisees tend to believe in, and have conviction about, the benefits, power and potential of supervision (Rast, Herman, Rousmaniere, Whipple, & Swift, 2017). But belief and conviction do not necessarily translate into empirical reality.<\/em>

    <\/li>\n\n\n\n
  4. Research: An Exceptional Study<\/a><\/strong>
    This particular study by Matt Bambling and colleagues (2006) stands as perhaps the exception to the overall findings in the clinical supervision literature. (This study was conducted in Queensland, Australia. Wink*).

    Compared to a no-supervision cohort of therapists, the supervision group when taught to focus on alliance process and monitor client feedback, resulted in the supervision group fairing better than the control group in working alliance, symptom reduction and treatment retention. 

    (Paywall to access to the full study. You can request from the author the text on     ResearchGate<\/a><\/strong>).
     <\/li>\n\n\n\n
  5. Words Worth Contemplating:<\/strong>

    \u201cIf we cannot show that supervision affects patient outcome, then how can we continue to justify supervision?\u201d
    ~ Edward Watkins Jr (2011)<\/em><\/li>\n<\/ol>\n\n\n\n

    Reflection:<\/strong><\/h3>\n\n\n\n

    What is clinical supervision for?
    (No, really. What’s the point of clinical supervision?)<\/em><\/p>\n\n\n\n

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    PART II<\/h2>\n\n\n\n
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    1. From My Desk: Brevity<\/a><\/strong>
      Many of us stumble on our own words, trying to explain a formulation, express an idea or even make an emphatic conjecture. 
      We can benefit from not diluting our questions, reflections or feedback by learning not only to say less, but to think clearly and give voice to them in a manner that promotes not only clarity for the other person, but also to touch, move and inspire. 
      This is important because brevity creates impact<\/strong>.

      Brevity = Clarity + Concise<\/strong>

      (Click       here<\/a><\/strong> to read this brief blog)
       <\/li>\n\n\n\n
    2. Listen: Against the Rules by Michael Lewis<\/a><\/strong>
      Michael Lewis is a living legend in the world of storytelling. You probably know his world from movies like The Big Short, Moneyball, etc.
      I bring up this particular podcast because he did this wonderful series on the role of coaches. 

      Here’s one of them:       The Data Coach<\/a><\/strong>
       <\/li>\n\n\n\n
    3. Research Read: Conflictual<\/a> and Counterproductive<\/a> Clinical Supervision<\/strong>
      Here’s 2 research by Nielson and Friedlander (2001) and Evans et al. (2001) that highlights some of the problematic issues that can arise in clinical supervision.

      Key Grafs:
      – Supervisors were described as not being invested in the relationship and as being unwilling to own their role in conflicts.
      – Some felt expected to support their supervisors, and many underwent extreme stress and self-doubt.
      – Supervisors dismissing their thoughts and feelings.
      – Most did not believe their supervisors were aware of the event’s counterproductive nature.

      <\/li>\n\n\n\n
    4. Web Read: Tips on Reigniting Clinical Supervision<\/a><\/strong>
      Here’s a series of articles I wrote for       Psychotherapy.net<\/a><\/strong> 
       <\/li>\n\n\n\n
    5. Words Worth Contemplating: <\/strong>

      “…You win by becoming a better player of the game at large, not by adapting your technique to every new team you face. Your opponent will always be changing; it’s a losing race.
      But if you master the game, you will have skills and knowledge you need to defeat whoever you face.”<\/em>
      ~ John Wooden<\/strong>, A Game Plan for Life, 2009, p.41.<\/li>\n<\/ol>\n\n\n\n

      Reflections:<\/strong><\/h3>\n\n\n\n

      When was the last time you heard a recording of your sessions?

      Were that parts where you can be clearer and more concise?<\/em><\/p>\n\n\n\n

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      PART III<\/h2>\n\n\n\n
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      1. From My Desk: Frontiers on Clinical Supervision<\/a><\/strong>
        There’s an archive of stuff that I’ve written on this topic. Click         here<\/a><\/strong> to go through themes related to clinical supervision.

        Here are some samples: 
        Do Not Seek Out A Supervisor<\/a><\/strong>
        Beyond \u201cCase-By-Case\u201d Clinical Supervision<\/a><\/strong>
        Which Way to Go?<\/a><\/strong>
        How Do You Grow as a Clinical Supervisor?<\/a><\/strong>
        The Skills of a Supervisor Is Not the Same as a Therapist<\/a><\/strong>
         <\/li>\n\n\n\n
      2. Listen: Interview with John Wooden<\/a><\/strong>
        Listen to the legendary John Wooden in person. This         two-part interview<\/a><\/strong> series that Tony Robbins did with Coach Wooden<\/a><\/strong> more than 20 years ago.

        Key Grafs: 
        – A good coach is someone we can give guidance without causing resentment.
        – You’re not defined by a moment but by your consistency.
        – Progress goes up very slowly, but do get worse goes very quickly downwards.
        – The leader must be concerned with finding the best way, not his own way.
        – Real success comes from the things that can\u2019t be taken away from you.
         <\/li>\n\n\n\n
      3. Research: John Wooden’s Coaching Practices<\/a><\/strong>
        Based on a paper of titled What a Coach Can Teach a Teacher, 1975-2004: Reflections and Reanalysis of John Wooden\u2019s Teaching Practices<\/em> by Ronald Gallimore and Roland Tharp 2004, the authors found that slightly less than 7% of his time<\/strong> was spent dispensing compliments or disapproval.
        Meanwhile, 75% percent was comprised of \u201cdiscrete acts of teaching . . . pure information: what to do, how to do it, [and] when to intensify an activity.<\/strong>

        Based on my read of Wooden’s teaching practices, one of his most under-rated skills is his dedication towards keeping organised and structure for helping each of the team players move towards their growth edge. In one interview I heard, Wooden took notes of practice drill for each player on 3 x 5 cards, and would review  them each year and plan how time is spent in training. 

        Interestingly, one of the things I’ve noted from therapists around the world is many report feeling a lack of individualised learning objectives<\/strong> being developed for them in clinical supervision. In part, it’s because we generally stick to a “case-by-base” level (mostly “stuck” cases), and fail to develop the clear growth edges that can help yield better outcomes in the therapist caseload. 
         <\/li>\n\n\n\n
      4. Read: You Haven’t Taught Until They Have Learned<\/a><\/strong>
        It’s no secret by now that I’m a huge fan of John Wooden. That’s because there’s so much wisdom to graft from someone like him.
         <\/li>\n\n\n\n
      5.  Words Worth Contemplating:<\/strong>
        “They won’t care how much you know until they know how much you care.”<\/strong><\/em>
        ~John Wooden, You Haven’t Taught Until They Have Learned, p. 9
        <\/li>\n<\/ol>\n\n\n\n

        Reflection:<\/strong><\/h3>\n\n\n\n

        Take a moment and consider the proportion of compliments vs discrete acts of teaching and guidance in your clinical supervision experience (as a supervisee and as a supervisor if you are one).<\/em><\/p>\n\n\n\n

        Is your experience like Wooden’s pedagogical approach (see point #3), or the opposite?<\/em><\/p>\n\n\n\n

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        If you would like to learn more topics that can help your professional development, subscribe to the Frontiers of Psychotherapist Development (FPD). On Frontiers Friday (FPD), we serve you directly to your Inbox highly curated recommendations each week.<\/em>
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