|Type of paper:||Essay|
|Categories:||Health and Social Care Medicine Internship|
Clinical supervision forms
Various research studies on the topic of clinical supervision have revealed that clinical supervision of new or trainee clinical employees that utilized reflective practice was considered useful. Reflection in clinical supervision is paramount for examining and identifying any experience received and its features. However, according to Carroll (2011), a reflective practice should not be solely used in supervising new or trainee counsellors because they are beginners n the field and need directions on what to do. Reflective practice can be used after the trainees acquire some experience, especially if the supervisor is using the developmental models of supervision.
Research has shown that the level of clinical supervision in the UK is inadequate. Counselling trainees do not receive the stipulated minimal supervision. Surveys have found out that counselling trainees are not always satisfied with the level of supervision and training they receive before they can start operating unsupervised. A case study research by Townend, Iannetta and Freeston (2012) revealed that there exists a significant disparity between supervisors' and trainees' view regarding the amount of time spent on clinical supervision. In this case study, the authors collected data from various clinical settings where new or trainee clinicians were working under supervision. The data was collected from both trainees and supervisors. The results from the case study revealed that trainees were not entirely satisfied with the structure of supervision. For instance, they thought that too much time was being spent on supervision process at the expense of career training and development. Therefore, for the effectiveness of clinical supervision, the supervisor and trainees should begin their supervision relationship by discussing and agreeing on the amount of time to be spent on various aspects. They should also discuss and agree on the structure, time plan, how and when supervision review process will be implemented, all areas to be covered and the responsibilities of each party.
Clinical supervision counseling
Clinical supervision in the counselling field initially started as apprenticeship where a new or trainee counsellor with minimal skills and knowledge would learn by observing, assisting and receiving feedback from a highly accomplished counsellor (Smith, 2009). This concept was based on the assumption that an accomplished counsellor would make an excellent supervisor. Over the time, this has proved not to be the case. Some accomplished counsellors may not be great supervisors without additional training to acquire supervisory skills and knowledge. Research has shown that apprenticeship model of clinical supervision may not be a perfect training tool for new or trainee clinicians. This is because it evokes a hierarchy of power where the new or trainee counsellor views the accomplished counsellor as a higher authority rather than a mentor (Ward and House, 2008). As a result, it hinders the processes of transferring knowledge from the master clinician to the apprentice. Observing experienced clinician as they work is essential to new or trainee counsellors but may not be sufficient in helping them become highly skilled and experienced.
Models of clinical supervision
New clinical supervisory models have been developed to facilitate complex exchange between the supervisor and supervisee. Adequate clinical supervision is perceived as one in which the supervisee engages in reflection on the counselling work, counsellor-client relationship as well as the supervision itself (Smith, 2009). There are many supervision models in counselling, and most of them support instrumental rather than questioning approach (Ward and House, 2008). The choice of supervision model is paramount because it affects the content and style of supervisions and this consequently impacts on the learning of the new or trainee counsellor. According to Smith (2009), supervision process and the model selected should depend on the level of trainees’ experience and training. The following are some of the clinical supervisory models that have been proposed by various researchers and scholars.
Psychotherapy-based supervision model. This model is based on observing, assisting and receiving feedback from the supervisor (Ward and House, 2008). The clinical supervision process follows the framework and techniques of theory or model that is followed and practised by the supervisor. The supervisor’s theoretical orientation determines what the trainee will observe, interact with and the clinical data that the supervisor and trainee will find relevant throughout the supervision process. In psychotherapy-based supervision there is a free, uninterrupted flow of counselling techniques, terminology and focus between the counselling and the supervision sessions (Smith, 2009).
A developmental model of supervision. This model was first researched and proposed by Glickman where he suggested that supervision approach should be in line with the trainees’ conceptual level (Glickman, 2010). This model was tested in a research study that aimed at improving the teaching skills of teachers in physics, mechanics, and electronics. The participating teachers were given personalized supervision according to the researcher’s assessment of their conceptual level. The conceptual level was measured by determining the participants’ ability to define and solve problems related to their field of study and practice. According to the author, directive approach, collaborative approach and non-directive approach should be used where the conceptual level is low, medium and high respectively. The developmental model of supervision has also been applied in counselling and psychotherapy trainees where the trainees are categorized into three progressive stages (Stoltenberg and McNeill, 2011). Trainees at the beginning stage are expected to have limited skills of counselling practice and also lack confidence. Supervisees at the middle stage are supposed to have developed more skills, confidence and may exhibit differing perceptions on independence and depended on the supervisor. The third or last progressive stage supervisee or trainees will show great problem-solving skills, will be more independent on the supervisor and be reflective of the counselling and supervision process. Stoltenberg and McNeill (2011), point out that a supervisor using developmental model should provide support, training, and feedback that is relevant to the trainees' current stage and also facilitate trainees' progression to the next level.
An integrative model of supervision. This model subscribes to more than one theory and technique of supervision. Most counsellor today practice integrative counselling whereby they use different theories and models to treat, assess, diagnose and support their patients. As a result, integrative supervision models are also commonly practised in counselling. The two primary approaches to integrative supervision include technical eclecticism and theoretical integration. Technical eclecticism calls for using techniques from different schools of thought without necessary subscribing to their theoretical positions (Smith, 2009). Theoretical integration, on the other hand, calls for blending theoretical and conceptual framework rather than just merely blending the techniques. Therefore the former deals with blending techniques while the later deals with blending the conceptual framework while offering clinical supervision to new or trainee counsellors.
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