Supervision... Enhancing Supervises Clinical Services (Abbreviated)

In the last section, we discussed three common perspectives in multi-cultural counseling. We also discussed techniques by which to encourage the growth of multicultural counseling skills within supervisees.

In this section, we will discuss teaching self-appraisal to clinical supervisees. We will also discuss the seven point supervisee self-assessment that I use regarding working and evaluating skills. The seven points in this assessment are action steps, focusing, reframing, confronting, evaluating, responding with immediacy, and pointing out endings.

I find that using the following exercise in self-assessment helps my clinical supervisees develop proficiency in their working and evaluating skills, and also in their ability to perform a self-assessment outside of the supervisory setting. For each topic, I have my supervisees rate their ability to perform in this area by ranking their performance in the area from 1 to 4, 4 being complete confidence in their ability.

7 Steps in Supervisee Self-Appraisal

♦ Step 1 - Rehearsing and Reviewing Action Steps
The first item in this supervisee self-appraisal is the ability to effectively use the skill of rehearsing and reviewing action steps with clients. As part of the self-assessment process, I review the principle of action steps with my supervisees. I ask my supervisees to consider their skills in rehearsing an action step with a client, for example, role playing a confrontation with the client’s boss concerning the client’s need for a consistent schedule. I also ask them to consider their skills regarding reviewing the client’s progress concerning the action step in subsequent sessions.

♦ Step 2 - Focusing
The second item in this supervisee self-appraisal concerns focusing. I ask my supervisees, "How proficient are you in redirecting client focus onto the subject of your work together?" For example, in family therapy, one member may interrupt just as plans for an action plan are being finalized. I ask my supervisees to assess how they would redirect the focus of the clients onto the task at hand, while also recognizing the concern brought up by the interruption.

♦ Step 3 - Reframing
In addition to rehearsing and reviewing action steps, and focusing, the third item in this supervisee self-appraisal concerns reframing. I ask my supervisees, "If your client embraces a point of view so determinedly that this perspective is an obstacle to goal achievement, how skillful are you at offering a new perspective? How skillful are you at personalizing meaning for a client by encouraging them to shift the attention of responsibility onto themselves?"

♦ Step 4 - Confronting
The fourth item in this supervisee self-appraisal concerns confronting. I state to my supervisees, "Suppose you have a client in marital counseling who has committed to the action step of making two dates with his wife during your session. He has stated that he wants to do whatever is necessary to heal his relationship with his wife. During the next session, you learn that he voluntarily worked overtime and arrived home too late for the date he had set up. How skillfully could you point out, without disapproval, the inconsistency between this client’s words and actions?"

I also encourage my supervisees to think about their ability level regarding gauging a client’s psychological and social resources in order to determine the impact confronting the client will have. Clearly, not every client possesses the coping skills necessary to make confrontation a successful therapy technique.

♦ Step 5 - Evaluating
In addition to action steps, focusing, reframing, and confronting, the fifth item in this supervisee self-appraisal concerns evaluating. I ask my supervisees to assess how well they can engage a client in reviewing his or her progress towards goal attainment. I ask, "When engaging a client in a discussion of his or her progress, are you able to frame the discussion to help the client feel a sense of self-esteem and accomplishment?"

I also ask my supervisees to consider their abilities regarding a client who has made little or no progress towards his or her goals. I ask, "How comfortable are you concerning reconsidering with the client his or her assessment, the contract, and the action steps you have planned? When progress is not forthcoming, or is negative, how well can you reexamine the approach to change?"

♦ Step 6 - Responding with Immediacy
The sixth item in this supervisee self-appraisal concerns responding with immediacy. I ask my clinical supervisees to consider their skill at exploring a client’s experiences and feelings about the supervisee, his or her relationship to the supervisee, or about the work they are engaged in as they occur. I ask, "By responding with immediacy, can you encourage the client to explore relationship concerns as they occur? How well do you model an open communication style? Can you make effective use of the statement, ‘right here and now with me you seem to be thinking/doing/experiencing….’?"

♦ Step 7 - Pointing out Endings
In addition to action steps, focusing, reframing, confronting, evaluating, and responding with immediacy, the seventh item in this supervisee self-appraisal concerns pointing out endings. In this part of the assessment, I ask my supervisees to evaluate their skill regarding preparing a client psychologically for the conclusion of the therapy relationship.

I state to my supervisees, "Suppose you have a client with whom you have agreed to a three-month relationship to improve their communication with their family. It is now the second month of your working together. Consider your ability to point out how much time is remaining, and how you would prepare this client."

I ask my supervisees to evaluate their skills regarding discussing progression towards goals with their client. I also ask them to evaluate their skills regarding encouraging their clients to discuss what they feel will have changed after the conclusion of the therapeutic relationship.

In this section, we have discussed teaching self-appraisal to clinical supervisees. We  also discussed the seven point supervisee self-assessment that I use regarding working and evaluating skills. The seven points in this assessment are action steps, focusing, reframing, confronting, evaluating, responding with immediacy and pointing out endings.

In the next section, we will discuss training supervisees in ten steps that can help a therapist cope with a client who might be at risk for suicide.
Reviewed 2023

Peer-Reviewed Journal Article References:
Danzi, B. A., Tawfik, S. H., Mora Ringle, V. A., & Saez-Flores, E. (2020). Enhancing profession-wide competencies in supervision and assessment: An evaluation of a peer mentorship approach. Training and Education in Professional Psychology, 14(3), 176–184. 

Johnson, E. A. (2019). Recommendations to enhance psychotherapy supervision in psychology. Canadian Psychology/Psychologie canadienne, 60(4), 290–301.

Mitchell, S. M., Taylor, N. J., Jahn, D. R., Roush, J. F., Brown, S. L., Ries, R., & Quinnett, P. (2020). Suicide-related training, self-efficacy, and mental health care providers’ reactions toward suicidal individuals. Crisis: The Journal of Crisis Intervention and Suicide Prevention. Advance online publication. 

Reiser, R. P., & Milne, D. L. (2014). A systematic review and reformulation of outcome evaluation in clinical supervision: Applying the fidelity framework. Training and Education in Professional Psychology, 8(3), 149–157. 

Stanhope, D. S., Pond, S. B. III, & Surface, E. A. (2013). Core self-evaluations and training effectiveness: Prediction through motivational intervening mechanisms. Journal of Applied Psychology, 98(5), 820–831.

Online Continuing Education QUESTION 5
What are the seven points in the Working and Evaluating Skills supervisee self-assessment? To select and enter your answer go to CEU Test.