A transtheoretical model of clinical supervision.

The purpose of this article is to introduce a transtheoretical model of clinical supervision for professional psychology. The various stages and processes of change inherent in the transtheoretical psychotherapy model (Prochaska & DiClemente, 1982, 1984, 1986; Prochaska & Norcross, 2007) are assessed and applied to clinical supervision. Specifically, relevant literature is examined; supervisee stages of change (SSC) and supervisor processes of change (SPC) are introduced and discussed; and existent models of supervision are contextually compared to the proposed transtheoretical model. Strategies and recommendations for implementing and researching a transtheoretical approach to clinical supervision are also provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training graduate students to be clinical supervisors: A survey of Canadian professional psychology programmes.

Recognising the need for training in clinical supervision, the Canadian Psychological Association (CPA) requires that accredited professional psychology programmes offer graduate students training in supervision. To fill a gap in the existing supervision literature, we surveyed training directors (or designates) of CPA accredited clinical and counselling programmes to understand how this training standard is currently being met in the area of clinical supervision. Responses were obtained from 20 of 28 programmes (71.4% response rate). Approximately 50% of respondents indicated that their programmes required some coursework related to clinical supervision, with wide variability, however, in the number of hours of coursework provided to students (range 3 to 39). Most courses included lectures and group discussion, but also often provided students with practical experience in clinical supervision provision. Only 25% of programmes required a practicum in which students gained experience in clinically supervising other students, although an additional 40% of programmes offered an elective practicum in which students gained some training in clinical supervision. Most programmes (~71%) identified strategies for improving training in clinical supervision (e.g., improving course work, requiring practical experience), but also identified challenges to offering clinical supervision training (e.g., availability of skilled supervisors, insufficient time to devote to supervision, student competency). Based on the findings, we offer some recommendations for how training in clinical supervision could be improved in Canadian professional psychology programmes as well as describe some important directions for future research in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The process of becoming a supervisor for students in a doctoral supervision training course.

This qualitative, longitudinal study explored the experiences of 6 counseling psychology doctoral students engaged in an 8-month supervision training course. In-depth, tape-recorded face-to-face interviews were conducted at the beginning, middle, and end of the course to assess how these supervisors-in-training experienced the process of becoming clinical supervisors. Themes that were common to participants were identified through phenomenological data analysis and described for each of the 3 interview sets. The perceived importance of participants’ relationships with the supervisees and their senior supervisor throughout the course, as well as the common themes, are discussed in terms of implications for supervisor training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On supervision: Reflections of a Latino psychologist.

The clinical supervisory relationship can be used to help psychotherapy trainees develop a more integrated sense of a multicultural and professional self. In this paper, the author shares some of his own training experiences in supervision and their influence on his supervision style. Examples from supervisory sessions are given to demonstrate how issues of race, gender, class, and sexual orientation can be used to advance both the supervision and the treatment. Candid discussions around the transferential and countertransferential issues in the supervision and the treatment can improve the supervisee’s capacity to integrate cultural identity into the developing sense of professional self as a therapist. This process also contributes to the clinical understanding of the person being treated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Practicum Experience: A Survey of Practicum Site Coordinators.

It has recently been acknowledged that more needs to be known about predoctoral practicum experience in professional psychology from the perspective of those who do the practicum training. This article reports the results of a survey completed by 263 predoctoral practicum sites in the United States and Canada. Information presented includes the distribution of sites where practicum training is currently taking place and the wide range of training opportunities occurring at diverse sites. Results indicate problems in communication between practicum sites and graduate programs, evidenced in a lack of awareness of graduate program expectations by practicum site coordinators. Recommendations to improve communication are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What we know about predoctoral internship training: A 10-year update.

Ten years ago (Stedman, 1997), I published a review of the extensive body of work related to all facets of the internship enterprise. The current review highlights many positive accomplishments of the last 10 years, including establishing the match, the uniform internship application format, the quantification of selection variables, and a deeper understanding of the training pathway. However, serious problems have surfaced, including the shortfall of internship slots and the impact of economic forces leading some to question the continuing relevance of internship as it currently exists. These issues call for deliberation and decision making by the profession, guided by research, both current and yet to be conducted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The supervisee experience of group supervision: Implications for research and practice.

Group supervision is commonly employed in graduate psychology training but has received insufficient attention in research. Supervisees' own perceptions and experiences in group supervision can provide valuable information in guiding our understanding and exploration of the benefits and uses of this form of training. This paper reviews 11 empirical studies exploring supervisee perceptions of group supervision experiences. Research, to date, appears to be largely in line with conceptual hypotheses regarding the benefits of group supervision experiences, and implications are discussed with regard to current practice. However, this review also points to the need for more in-depth and advanced research efforts in the area that can further explore supervisee experiences and identify means of optimizing this experience as a component of clinical training. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Historically grounding the practice of psychology: Implications for professional training.

The author explores 3 ways the history of psychology can be made relevant to professional training in clinical psychology. Focusing on the practitioner-scholar model of clinical professional training, he argues that 3 central facets of historical understanding can be wedded to existing goals of professional training: (a) providing an interdisciplinary context for psychology, (b) addressing concerns about humans in the field, and (c) mediating theory-practice tensions that often exist in professional training. Suggestions are also made for encouraging historical understanding as essential to fostering critical self-reflection among students preparing for careers in professional psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing supervisee reflectivity in clinical supervision: A case study illustration.

Reflectivity has been described as the cyclical process whereby individuals engage in a critical evaluation of their affective, cognitive, and behavioral experiences to produce insight and fundamental shifts in their original beliefs. Developing reflectivity in supervisees is one of the most challenging, yet important, responsibilities of clinical supervisors, given its link to such skills as critical thinking, ethical decision making, and problem solving. This paper advances the literature by presenting a case example that demonstrates how reflectivity can be emphasized in clinical supervision, highlighting the barriers to reflectivity, and providing strategies that supervisors can utilize to encourage reflectivity within clinical supervision. The strategies and information discussed may be flexibly applied to supervisees of all developmental levels within the context of individual supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A brief feedback intervention for diagnostic overshadowing.

Clinical decision-making errors are well-documented among both experienced clinicians and students. One robust clinical decision-making error is called diagnostic overshadowing (DO), which occurs when the presence of one diagnosis interferes with the detection of other diagnoses. This study tested whether two types of instruction and brief feedback interventions reduced the likelihood of DO. Specifically, content-based feedback and principle-based feedback significantly reduced the likelihood of DO among doctoral students in clinical and counseling psychology (N = 220). An intervention effect was found when the training task and the target task were highly similar. Recommendations for improving diagnostic decision-making among trainees in professional psychology are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Casebook for clinical supervision: A competency-based approach.

Reviews the book, Casebook for clinical supervision: A competency-based approach by Carol A. Falender and Edward P. Shafranske (see record 2008-06295-000). Falender and Shafranske's previous book, Clinical Supervision: A Competency-Based Approach, examined the practise of supervision in the language and framework of competencies. Although this comprehensive book makes a valuable contribution, the writing is decidedly conceptual and abstract, leaving the reader to wonder just how these principles might operate in practise. As if to answer this very question, Falender and Shafranske’s (2008) edited Casebook for Clinical Supervision: A Competency-Based Approach has appeared. The title and editors’ opening chapter promise that the model of supervision described in the earlier text will be illustrated through case material derived from the supervision sessions of the assembled experts and that the chapters of the two books correspond to and complement one another. After finishing the book, I found that although the Casebook did not fully deliver on its promises, I learned a great deal that will be of use in my teaching and practise of supervision. Most of the topics addressed in the Casebook chapters reflect focal concerns in the earlier text, including best practises of supervision, competency-based clinical supervision, alliance issues in treatment and supervision, ethics and legal issues, issues of culture and context, and evaluation. However, it must be said that many of the authors do little to explicitly tie their material to the editors’ model, leaving the reader with the task of determining just how the chapters explicate the earlier model. Overall, although it has some surprising weaknesses, the Casebook’s strengths outweigh them by a wide margin. The book may be read profitably on its own or in conjunction with the earlier companion volume. Graduate students learning how to conduct supervision as well as seasoned supervisors will find a great deal they can learn from in these chapters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical Psychologists Revisited: Comment.

In 1946 the VA, beginning its training program in clinical psychology, sponsored a program of research designed to increase the effectiveness of the procedures used to select trainees. The primary purpose of this five-year research project, which was directed and coordinated through the University of Michigan, was the evaluation of a variety of procedures as predictors of later success in graduate training and professional functioning in clinical psychology. In 1947 and 1948, several hundred college graduates seeking admission to or just entering the four-year VA training program in some 40 universities were evaluated by a wide variety of techniques, and predictions were made concerning their probable success in training and future professional competence. One of the most frequent comments after publication of this work was the concern that our criterion measures were obtained too early in the professional lives of the assessed trainees. In a sense this mirrors our own concern when we stated at that time that, "It is, of course, entirely possible that predictors which look unpromising at this time may have greater validity for predicting later criteria of professional accomplishment and vice versa." In an effort to extend our knowledge we are beginning a follow-up study of the approximately 1,200 persons who participated in some way in the original research. In addition to the original prediction problem, this follow-up stage will also be concerned with attempting to tease out the kinds of variables (personality or situational) which determine whether a clinical psychologist will devote himself primarily to therapy, research, diagnosis, teaching, or administration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An exploratory survey on empirically supported treatments: Implications for internship training.

Is training in empirically supported treatments (ESTs) necessary for internship? Are all internship sites embracing EST training equally? An exploratory survey reports training practices and attitudes toward use of ESTs in internship sites accredited by the American Psychological Association. Training practices during an internship year varied across type of setting, but only 28% reported offering more than 15 hr of training. Lack of managed care demands, flexibility in session limits, and perceived mismatch between client needs and treatment options were reasons endorsed for not doing more training and supervision with ESTs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determining the Optimal Number of Psychologists and Psychology Training Programs: A Cautionary Note.

Marwit (1982, see record 1982-28952-001) argues persuasively for the benefits of university affiliation for schools of professional psychology. However, as part of his discussion, he draws on questionable data in citing the need for additional training programs of this kind. His argument depends on the juxtaposition of epidemiological data, which summarize the prevalence of psychological disorder, and service-availability data. Because there are insufficient practitioners to serve the psychologically disturbed population, Marwit concludes that more practitioners are needed. Marwit's analysis fails to attend to several important considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-critiques of audiotaped therapy sessions: A motivational procedure for facilitating feedback during supervision.

Although supervision is an important mechanism for developing clinical competencies, trainees sometimes find it difficult to accept critical feedback. The procedure of using written self-critiques of audiotaped therapy sessions, based on motivational interviewing (MI) principles, was used to facilitate acceptance of feedback for doctoral clinical psychology students. MI techniques have been shown to decrease resistance and enhance motivation to change. The self-critiques were evaluated very positively by trainees as helping them accept critical feedback and allowing them to provide suggestions for their own clinical skill development. The use of self-critiques based on MI techniques is a promising adjunctive supervisory procedure that warrants additional evaluation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A practicum training program.

"It is the purpose of this paper to describe the development of a state hospital practicum program." "The Southeast Louisiana Hospital from its inception was planned as a facility which would offer unique opportunities in training and research for its professional personnel… . The present census of the hospital is about 360 patients." Fellows in clinical psychology have opportunities for training in diagnostic services, in psychotherapy, and in research. The nature of opportunities for experience in each of these areas is briefly outlined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical and counseling supervision references: Trends and needs.

W. N. Robiner and W. Schofield (1990) presented an article compiling the then current literature on supervision in clinical and counseling psychology. As the arena of health-care delivery has changed, so have training and supervision practices. Supervision had been one of the top 5 activities of psychologists (W. N. Robiner & W. Schofield, 1990), and an important change occurred when the American Psychological Association's Committee on Accreditation (APA, 1996, 2000) included supervision as one of the central domains of training. In this article, the authors address updated issues in supervision such as the call for empirically supported treatments, brief therapy models, and changing ethics in an environment influenced by cost containment. The references listed in the Appendix are from the literature between 1990 and 2000. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contracting for supervision.

The changing job market has increased the demand for psychologists to serve as clinical supervisors of other mental health service provides; however, such supervisory arrangements inevitably increase legal exposure and pose unique ethical challenges for the supervising psychologist. A detailed sample supervision contract incorporating ethical and practice standards of psychology is offered. Although such contracts may not be legally binding, these agreements help facilitate (a) an adherence to these professional and ethical standards, (b) effective supervisory practices, and (c) the quality of care for the persons receiving psychological services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On Setting for Clinical Training.

Comments on "A postdoctoral residency program in clinical psychology" by J. Matarazzo (see record 1965-13326-001). Matarazzo describes an interesting postdoctoral training program in clinical psychology in a medical school setting. A major feature of this program is the intent to train young psychologists to assume "full professional responsibility for patients and clients." The assumption of "full professional responsibility" is incompatible with an extension of the professional's formal training period into the postdoctoral years. The multiple-consultant and highly institutionalized approach characteristic of the medical setting actually attenuates the degree of responsibility that any one professional is required and able to assume, rather than to intensify it. A final objection could be directed at the basic concept of the desirability of one person's assuming "full responsibility" for another. It would seem to me that the use of this concept in Matarazzo's report may in itself be an indication of how a medically based idea can inadvertently infiltrate the thinking of those who had been exposed for years to such a setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trainees with professional competency problems: Preparing trainers for difficult but necessary conversations.

Trainees with professional competency problems, also called problems of professional competence (PPC), are frequently encountered by faculty and supervisors and often are challenging for trainers and educational/training systems. This article underscores the importance of trainers addressing graduate students and interns with PPC for whom regular summative and formative feedback has not been effective by engaging in the often difficult, but necessary, conversations as a first step in many remediation processes. These conversations are framed as an ethical responsibility and suggested as a core competency for trainers. Attention is paid to the myriad barriers that trainers often encounter in engaging in difficult conversations, including personal factors, training setting and systems issues, and the relationship between personal and contextual factors. Strategies are offered with regard to overcoming these barriers. In addition, recommended steps and tools for effective difficult conversations are provided. Implications of this work for trainers and training programs are noted. (PsycINFO Database Record (c) 2011 APA, all rights reserved)