Competent Supervision Research Articles

Genetic Counseling Supervisors' Self-Efficacy for Select Clinical Supervision Competencies.

Supervision is a primary instructional vehicle for genetic counseling student clinical training. Approximately two-thirds of genetic counselors report teaching and education roles, which include supervisory roles. Recently, Eubanks Higgins and colleagues published the first comprehensive list of empirically-derived genetic counseling supervisor competencies. Studies have yet to evaluate whether supervisors possess these competencies and whether their competencies differ as a function of experience. This study investigated three research questions: (1) What are genetic counselor supervisors' perceptions of their capabilities (self-efficacy) for a select group of supervisor competencies?, (2) Are there differences in self-efficacy as a function of their supervision experience or their genetic counseling experience, and 3) What training methods do they use and prefer to develop supervision skills? One-hundred thirty-one genetic counselor supervisors completed an anonymous online survey assessing demographics, self-efficacy (self-perceived capability) for 12 goal setting and 16 feedback competencies (Scale: 0-100), competencies that are personally challenging, and supervision training experiences and preferences (open-ended). A MANOVA revealed significant positive effects of supervision experience but not genetic counseling experience on participants' self-efficacy. Although mean self-efficacy ratings were high (>83.7), participant comments revealed several challenging competencies (e.g., incorporating student's report of feedback from previous supervisors into goal setting, and providing feedback about student behavior rather than personal traits). Commonly preferred supervision training methods included consultation with colleagues, peer discussion, and workshops/seminars.

Exploring the Role of Communication Competence in Abusive Supervision

In this article, we propose and test a model of downward abusive communication. According to the model, a superior’s display of abusive communication toward his or her subordinates is caused by a lack of downward communicative adaptability. Superiors from various organizations completed an online survey, which measured their downward communicative adaptability and downward abusive communication. The results of a regression analysis provided support for the model. We conclude the article with a discussion of the practical and theoretical implications of our findings.

Experiential exposure to the supervision competency in graduate education.

Experiential exposure to the supervision competency in graduate education.

On Structure and Leadership in Mentalization-based Group Therapy and Group Analysis

Mentalization-based group therapy (MBT-G) has its roots in group analytic psychotherapy. Modifications were made in order to suit the needs of more disturbed personality disordered patients, and to avoid the chaotic and destructive processes often encountered in groups dominated by these patients. In this article I outline the kind of leadership, structure and authority that MBT proscribes and discuss these principles in comparison with group analysis. I also comment upon a study of a MBT group that failed to establish a good mentalizing culture, with reference to Bion’s concept of ‘attack on linking’. This study reminds us that strong professional support and competent supervision is necessary in order to achieve sound communicational ideals, when the group is composed of members who easily resort to prementalistic modes of thinking.

Apprenticeship Model of Psychotherapy Training and Supervision: Utilizing Six Tools of Experiential Learning.

Apprenticeship experiences have existed for centuries asways to gradually introduce individuals to professionaltrades, skills, and roles. Cobblers, blacksmiths, attorneys,artists, healers, and surgeons have all learned as appren-tices. Traditional apprenticeships focus on specificmethods for carrying out physical skills instrumental toaccomplishing meaningful practical tasks (e.g., buildinga house). Apprenticeship learning occurs through a com-bination of observing, coaching, and practice. The cogni-tive apprenticeship model, initially described by Collins[1] and elaborated by Stalmeijer et al. [2, 3], shares thetraditional apprenticeship’s focus on learning complextasks from experts, but further emphasizes cognitive skillsof the teachers and learners, not as readily observable [1,2]. Cognitive psychotherapy skills refer to clinical reason-ing, the development of a differential diagnosis, and caseformulation. Cognitive skills also include the ability touse emotions, behaviors, precise therapeutic language,and the strategies, tactics, and interventions needed toconduct psychotherapy. Developing psychotherapeuticcognitive skills requires that both supervisor and residentexternalize or think out loud, sharing their thoughts, emo-tional process, and the rationales for their therapeuticchoices. The problems and tasks that supervisors addressare chosen to illustrate the effectiveness of a psychother-apeutic task, discuss mistakes, or demonstrate psychother-apeutic interventions so that psychiatric residents canpractice and improve their reflective psychological andemotion-focused skills.MethodsThe “Apprenticeship Model” is utilized as part of ourPsychotherapy Scholar’s Track (PST) described elsewhere indetail [4]. This track emphasizes use of the common factorsinfluencing psychotherapy outcomes. Residents learn a mini-mum of five psychotherapeutic modalities, including our brieftreatment model [5], psychodynamic, cognitive and behavioraltherapies, family, and group psychotherapies. We consistentlyuse symptom and functional rating scales at the beginning andendofthetreatmentstohelpresidentsquantifypatientoutcomes.Supervisors are a broadly trained scholarly group of psy-chiatrists and psychologists, having 8–45 years of experienceaspsychotherapists.Weareallsalariedpreceptors,workinginour university outpatient department, conducting apprentice-ship cases carved out of our preceptor time.Since no objective measures of psychotherapy supervi-sion competency have ever been consistently validated,we rely on faculty who by virtue of experience, tempera-ment, and reputation are thought to have the necessary“wisdom” and capabilities to teach the skills required toconduct several different forms of psychotherapy.“Wisdom” as used here, is defined by Sternberg [6, 7]as a clinician who has“a deeper understanding of reality,used toward a common good, encompassing the definingcharacteristics of concern for others, psychological under-standing of others, capacity for self-knowledge, the abilityto reframe information, the ability to take the long view ofproblems, readily admitting to and learning from mis-takes, maturity, intuition, and the ability to“see through”situations and circumstances. Our “wise” [6, 7] supervi-sors emphasize common factors affecting psychotherapyoutcomes and psychotherapeutic principles derived from avariety of theoretical perspectives.

Psychotherapy supervision: Ethical considerations and resources

Competent supervision of psychotherapy requires that the supervisor possess a capacity to: (a) identify the ethical issues that emerge in the course of conducting supervision; (b) recognise the presence of one or more ethical conflicts in a given supervision situation; and (c) summon the appropriate principles and standards that inform competent, ethically responsible supervision. The supervisor must also have a capability to proceed through the steps of an ethical decision-making process to identify a course of action that will honor maximally universal ethical principles. The supervisor’s ability to perform the aforementioned tasks rests upon knowledge of what effective psychotherapy supervision is, and how supervision differs from consultation and psychotherapy. It also entails the ability to access the resources that have been developed and collected internationally over the past decade that usefully inform the supervisor’s efforts to grapple with ethical dilemmas. Three vignettes illustrate how the supervisor can benefit from employing these resources.

The significance of minimally invasive surgery in the treatment of inguinal hernia and hypertrophic pyloric stenosis

Inguinal hernia repair and pyloromyotomy are among the most common operations performed on children. In the last two decades minimally invasive surgery has been employed for an increasing number of these procedures. This review describes the development of the techniques involved, and their current role in therapy. A systematic review of the paediatric surgical literature since 1990 was performed on laparoscopic inguinal hernia repair and pyloromyotomy. Relevant publications were summarised. The first laparoscopic pyloromyotomy was described in 1991, the first laparoscopic inguinal hernia repair in children was published in 1998. The learning curve for both procedures is initially steep and reaches a plateau only after about 20 to 30 cases. Both randomised controlled trials and meta-analyses are available comparing the laparoscopic and open techniques for both procedures. The advantages of laparoscopic versus open pyloromyotomy include faster recovery and shorter hospital stay, at similar complication rates. The operation times of laparoscopic inguinal hernia repair are shorter in bilateral cases, while the complication rate again is similar. However, the incidence of metachronous contralateral inguinal hernia is lower after laparoscopic repair. Laparoscopic pyloromyotomy and paediatric inguinal hernia repair require special skills. As a minimum, a surgeon's first 20 cases should therefore be performed under competent supervision. Besides resulting in smaller scars, both procedures have concrete advantages and the same complication rates compared to the open techniques. Therefore, both operations can be regarded as the current gold standard.

ANALISIS NORMATIF UNDANG-UNDANG NO. 1 TAHUN 2013 TENTANG LEMBAGA KEUANGAN MIKRO (LKM) ATAS STATUS BADAN HUKUM DAN PENGAWASAN BAITUL MAAL WAT TAMWIL (BMT)

Baitul Maal Wat Tamwil (BMT) has been growing rapidly in Indonesia from year to year. However, its development has still not been followed by the legal rules. Some of them follow the legal system of Cooperatives, that are Act No. 25 of 1992 and Decree of the Minister of Cooperatives and SMEs, No. 91 /KEP/M.KUKM/IX/2004 about the Implementation Guidelines for Cooperative Operations of Islamic Financial Services (KJKS). However, after Act No. 1 of 2013 about Micro-finance Institutions had been issued, the legal institutional status of BMT and its supervision has become a problem for the existence of BMT. Therefore, this study met the issues of how the legal status and supervision of BMT before and after the issued Act No. 1 of 2013 about micro-finance institutions.This study was an empirical law rechtdogmatik against Act No. 1 of 2013 about Micro-finance Institutions. It used primary legal materials, namely the Micro-finance Institutions Act; the result of interviews; and documentation that were analyzed qualitatively.The result analysis showed that before the Law of Microfinance Institutions was issued, there were 3 groups of BMT, namely: BMT with the Cooperative legal entity and being supervised by the State Ministry of Cooperatives and SMEs; BMT that were formed under the foundations legal entity; and BMT that were formed under Non Governmental Organisation. However, after Act No. 1 of 2013 had been issued, Microfinance Institutions should only have legal status, either as a cooperative or an incorporated company (PT). In addition, the supervision should be conducted by the Financial Services Authority of Indonesia (OJK) coordinated with both the Ministry of Cooperatives and SMEs, and the Ministry of Home Affairs. Nevertheless, the competence of supervision has still not been clearly regulated in the Microfinance Institutions Act, because the new law might effectively run two years after being enacted while the implemention is also still not regulated yet.Thus, it should be recommended to make clear implementation rules in the legal status of Microfinance Institutions, especially for those not have legal entities as well as those should transform. Similarly, in terms of supervision, there should be a clear competence of supervision performed by the FSA and the two mentioned Ministry above. So, there might not be either overlapping or loose supervision.

Embrace the Complexity: Ensuring Multicultural Competence in Supervision

Embrace the Complexity: Ensuring Multicultural Competence in Supervision

Multicultural supervision: supervisees’ reflections on culturally competent supervision

This study examined supervisees’ perceived experiences of supervisor multicultural competence in supervision and its impact on supervisees’ clinical work. Specific attention was given to the cultural content discussed and the supervisory multicultural interventions used in supervision. Data from 102 supervisees was analyzed through a discovery-oriented qualitative approach. With regard to content, the most common focus was on race followed by gender, ethnicity, and religion/spirituality. An examination of the multiculturally competent supervisor interventions revealed that supervisors’ frequently educated and facilitated exploration of specific cultural issues, discussed culturally appropriate therapeutic interventions and skills, facilitated supervisee self-awareness within the supervision session, and challenged and encouraged cultural openness of supervisee’s understanding of client and cultural issues. The most frequent manner by which the supervisory experience affected client work involved the supervisee modifying the treatment approach, recognizing personal limitations and experiencing improved self-awareness as a counselor in their work with clients, and developing an enhanced understanding of and empathy towards their clients. Implications for these findings are discussed.

Clinical supervision: the state of the art.

Since the recognition of clinical supervision as a distinct professional competence and a core competence, attention has turned to ensuring supervisor competence and effective supervision practice. In this article, we highlight recent developments and the state of the art in supervision, with particular emphasis on the competency-based approach. We present effective clinical supervision strategies, providing an integrated snapshot of the current status. We close with consideration of current training practices in supervision and challenges.

Supervision in Neuropsychological Assessment: A Survey of Training, Practices, and Perspectives of Supervisors

Within the psychology supervision literature, most theoretical models and practices pertain to general clinical or counseling psychology. Supervision specific to clinical neuropsychology has garnered little attention. This survey study explores supervision training, practices, and perspectives of neuropsychology supervisors. Practicing neuropsychologists were invited to participate in an online survey via listservs and email lists. Of 451 respondents, 382 provided supervision to students, interns, and/or fellows in settings such as VA medical centers (37%), university medical centers (35%), and private practice (15%). Most supervisors (84%) reported supervision was discussed in graduate school “minimally” or “not at all.” Although 67% completed informal didactics or received continuing education in supervision, only 27% reported receiving training specific to neuropsychology supervision. Notably, only 39% were satisfied with their training in providing supervision and 77% indicated they would likely participate in training in providing supervision, if available at professional conferences. Results indicate that clinical neuropsychology as a specialty has paid scant attention to developing supervision models and explicit training in supervision skills. We recommend that the specialty develop models of supervision for neuropsychological practice, supervision standards and competencies, training methods in provision of supervision, and benchmark measures for supervision competencies.

Competent clinical supervision: Emerging effective practices

With the recognition that clinical supervision is a distinct professional practice comes the necessity for identification of effective practices. In this competency-based era, a meta-theoretical, interpersonal framework is provided in competency-based clinical supervision in which specific attention is paid to the strengths and emerging competencies of the supervisee and to the clinical and supervision competencies of the supervisor. In this article, the authors address the state of the literature on effective clinical supervision and the specific knowledge, skills, and attitudes that comprise competent supervision. A brief summary of research on several particular pivotal areas (e.g. alliance, multicultural competence, legal, and ethical issues) is included. A self-assessment device is provided for both current supervisors and supervisors-in-preparation to assess readiness, competence, and areas in which additional training and experience are desirable. Finally, a vignette illustrating the implementation of effective supervision practices is provided.

Precursors to measuring outcomes in clinical supervision: A thematic analysis.

Outcome studies in clinical supervision will be useful and meaningful if they are soundly based on such precursor fundamentals as an agreed definition of what supervision is, a shared understanding of how the concept of supervision is operationalized, and a consensus approach to identifying the important competencies in supervision. Similarly, the better quality outcome studies are those in which fidelity has been closely attended to. Significant progress has been made toward the goal of operationalizing clinical supervision competencies (Fouad et al., 2009; Rings, Genuchi, Hall, Angelo, & Cornish, 2009; Rodolfa et al., 2013; Roth & Pilling, 2009; Watkins, 2013), but the task is incomplete and the profession is still at a stage in which the specific knowledge, skills, and attitudes of clinical supervisors are yet to be well operationalized (Falender & Shafranske, 2012). By consolidating and aggregating existing competency frameworks, the best available evidence can be utilized to inform the development of a framework of competency that operationalizes the knowledge, skills, and attitudes required to provide clinical supervision. An inductive thematic analysis of international clinical supervision competency frameworks was used to examine the strength of evidence that exists for specific competencies and to identify competencies that require additional conceptualization and consensus. Nine broad themes emerged from the analysis.

Building Bridges: A Pilot Program for Training and Support of Rural Supervisors

The challenges faced by rural mental health supervisors are myriad and highlight the need to make specific training and support available in rural areas. This study was designed to determine the effectiveness of such a program. Forty rural supervisors attended a one-day training program and six supervisors participated in a six-month follow-up peer group supervision program. Pre- and post-test results revealed a significant improvement in overall self-reported supervision competencies and a drop in feelings of burnout. This structured program provided a convenient, effective, and affordable means to enhance supervision in rural areas. Implications for mental health providers, educators, supervisors, and future research are considered.

Towards a Consensus of a Competency Framework for Clinical Supervision in Nursing: Knowledge, Attitudes, and Skills

AimIn the absence of a consensus on what competences are necessary for Clinical Supervision in nursing, this paper presents such a framework on the Knowledge, Attitudes and Skills approach.Data SourcesClinical Supervision literature published from 1996 to 2012 was searched using CINAHL, Medline, Psychlit and British Nursing Index followed by a manual scrutiny of relevant text books.FindingsOur review identified a variety of knowledge, attitudes and skills that have been identified as parts, potentially of a competency ‘framework’.Discussion1) The absence of consensus of Clinical Supervision competencies in nursing can be addressed by embracing the Knowledge, Attitude and Skills approach and undertaking an international Delphi study based on this framework; 2) competency models must include attention to the acquisition and/or development of required qualities, 3) it appears that competencies are being advanced for radically different degrees of Clinical Supervisor (and supervisee) preparation/practice.

An exploration of EFL teachers’ attributions

The present study investigated English as a foreign language (EFL) teachers’ attributions of success and failure. It also set out to investigate whether these attributions vary by teachers’ age, teaching experience, gender and educational level. To do so, 200 EFL teachers were selected according to convenience sampling among EFL teachers teaching English in Language Institutes in Mashhad and Tehran, two cities in Iran. The participants completed the language teacher attribution scale measuring four attributions: teaching competency (TC), teacher effort (TE), student effort (SE) and institution supervision (IS). The present study yielded mixed results regarding English language teachers’ attributions of success and failure events. It was also found that these attributions vary by their age, teaching experience and educational level, but not by gender. The discussion and implications of the research are further presented with reference to the earlier findings.

Evaluation of psychology practitioner competence in clinical supervision.

There is a growing consensus favouring the development, advancement, and implementation of a competency-based approach for psychology training and supervision. There is wide recognition that skills, attitude-values, and relationship competencies are as critical to a psychologist's competence as are knowledge capabilities, and that these key competencies are best measured during placements, leaving the clinical supervisor in an unparalleled position of advantage to provide formative and summative evaluations on the supervisee's progression towards competence. Paradoxically, a compelling body of literature from across disciplines indicates that supervisor ratings of broad domains of competence are systematically compromised by biases, including leniency error and halo effect. The current paper highlights key issues affecting summative competency evaluations by supervisors: what competencies should be evaluated, who should conduct the evaluation, how (tools) and when evaluations should be conducted, and process variables that affect evaluation. The article concludes by providing research recommendations to underpin and promote future progress and by offering practice recommendations to facilitate a more credible and meaningful evaluation of competence and competencies.

Best Practices in Clinical Supervision: another step in delineating effective supervision practice.

Across the helping professions, we have arrived at a point where it is possible to create statements of best practices in supervision that are based on available empirical research; credentialing, ethical, and legal guidelines; and consensus opinion. Best practices are different from, but certainly complementary to, statements of supervision competencies. In this paper, I highlight the differences between competencies and best practices, and then describe the development and content of one comprehensive statement, the Best Practices in Clinical Supervision created for the field of counseling and counselor education. I then illustrate the applicability of the Best Practices across disciplines and countries through a comparison and contrast with several other existing documents. I conclude with a brief look at the development of supervisor expertise, which requires not only declarative knowledge (competencies) and procedural knowledge (statements of best practices), but also reflective knowledge. The latter is composed of insights built over years of supervision education, experience, and self-reflection regarding necessary adaptions and improvisations that inform an individualized approach to supervision practice.

A Framework for Supervision for Mindfulness-Based Teachers: a Space for Embodied Mutual Inquiry.

Over recent decades, there has been an exponential growth in mindfulness-based interventions (MBIs). To disseminate MBIs with fidelity, care needs to be taken with the training and supervision of MBI teachers. A wealth of literature exists describing the process and practice of supervision in a range of clinical approaches, but, as of yet, little consideration has been given to how this can best be applied to the supervision of MBI teachers. This paper articulates a framework for supervision of MBI teachers. It was informed by the following: the experience of eight experienced mindfulness-based supervisors, the literature and understandings from MBIs, and by the authors’ experience of training and supervision. It sets out the nature and distinctive features of mindfulness-based supervision (MBS), representing this complex, multilayered process through a series of circles that denote its essence, form, content and process. This paper aims to be a basis for further dialogue on MBS, providing a foundation to increase the availability of competent supervision so that MBIs can expand without compromising integrity and efficacy.