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In Supervision: Ethics and Professional Standards- Our Commitment to our clients (part 3)

In Supervision


Welcome to this week’s instalment of In Supervision, where I will wrap up our commitments to clients’ mini-series.

Next week I’ll continue with the values and principles as stated in the Ethical framework, focusing on the ones I find the most important for my practice.


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Maintaining integrity, accountability and candour are major aspects of the counsellor’s commitment to their clients, to themselves and to the profession.

Counsellors should be as transparent about the work they do as possible.

This starts with a clear contract – and website – that lists all the boundaries and terms of the therapeutic relationship, such as:

  • Fees and how to pay them
  • Cancellation policies
  • Contact outside sessions
  • How the counsellor works
  • What to expect
  • And more…

You can have a look at my contract here

(Note: I’m currently updating it to meet the new GDPR legislation due in May 2018).


If the therapist doesn’t feel they can work with a particular client, they should be clear about this within themselves and with their supervisor, and find the best way to communicate this to the client and refer them on to someone that can help them better.

It is then the therapist’s responsibility to update their knowledge so next time they can see clients with similar issues.


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If a client is doing well in therapy and the counsellor doesn’t feel they need it anymore, it is their responsibility to explore this with the client – keeping someone in therapy because they are paying and not saying they want to end is not being ethical.

Some clients don’t realise that it’s their right to end therapy at any point – even when it’s stated in the contract and discussed in the first session – or some of their presenting issues might mean they are not able to voice the need to end.

They might be anxious about it or fear of letting the therapist down, for example.

It is the counsellor’s duty of care to explore all these issues and more with the client, to ensure that therapy is doing what it’s meant to do – to help and not to make hurt or worse.


I find that my blog, which I started last August (2017) really helps with being honest and presenting myself to clients and potential clients as transparently as possible.

They can read about how I work and what therapy will be and feel like with me.

Blogging opens so many doors for therapists, and as good as it is, we have to be aware of who is reading it and how they will be affected. Too much self-disclosure might be bad for our practice – there are places for us to work through our own issues.


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That leads me to the next point – being honest with ourselves about our need to dip back into therapy is important, because it allows us to “top up” our emotional and psychological needs through our own therapy.


*** I have written a blog post about what to do when your therapist tells you they are also in therapy *** 


Clients are sometimes surprised that I tell them I have my own therapist, but they soon realise that apart from it benefiting me, it benefits them too, and it models that there is no shame in saying you’re attending therapy.

I also let them know about supervision and how that is also for the benefit of their therapy and therapist.


Being human has been something clients have benefited from.

I am not your stereotypical psychodynamic counsellor with a blank screen posture.

I talk a lot, I ask questions, I interact and challenge my clients in a gentle way so they can work through their issues.

I acknowledge to them I’m a bit tired or getting better from a cold, I might get a tear in my eye from listening to their story or get really angry on their behalf.

All of this helps the therapeutic process, and if it doesn’t help then clients are good at telling me.


Honesty goes both ways in therapy!


Being accountable means a lot of things.

The first thing that comes to my mind is supervision.

 

Supervision is a space where we can be accountable for the work we do with clients. Where we keep in check whether we are being objective or being drawn in by the client’s issues and maybe colluding a bit with them. It is where we regroup and find ways to be different with our clients so they get what they came for – support and positive change over time.


part 3 in supervision our commitment to clients


Discussing risk is another important aspect, and one that trainee and those starting off in private practice might find more difficult to address. More experienced counsellors might still struggle with it but find that it comes more naturally for them to ask the questions because of their duty of care and knowledge of how important it has been for past clients. It also safeguards the therapeutic relationship and the therapist’s practice, to say the least.

Asking about potential risks includes asking the client if they’re suicidal, have had any suicidal thoughts or made any plans to end their lives. The answer to this question will lead the therapist to make some ethical and moral choices – do I contact someone for this client so they are not left on their own? Can I keep the client in my office a bit longer if I don’t have another client and will that help or hinder the process? Do I just suggest Samaritans and A&E services if they find themselves struggling between sessions? Do I offer more sessions? What to do next?

These questions can all be asked in supervision and also directly with the client. What do they want to do about their predicament? This can be about suicide risk or other risk – domestic abuse, for example.


Have you got anything to add in regards to being honest and keeping accountable as a therapist and supervisee?

Leave a comment below!


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In Supervision: Ethics and Professional Standards- Our Commitment to our clients (part 2)

In Supervision


Welcome to this week’s In supervision post, where I will continue to discuss our commitment to clients in light of the BACP Ethical Framework and how I work in the therapy and supervision space.


Let’s start with respect.

Respect is a basic quality to have in all relationships. It is particularly important in the therapeutic and supervisory profession for a variety of reasons.

Respect for clients will allow me to value the client’s individuality and autonomy, and therefore work towards the main goal of helping them regain the autonomy and self-worth that they might have lost and which might be one reason for them coming to us for therapy.

Respect also means that I will endeavour to keep their data and information they share confidential and private. I make sure my clients know that the only other person I will discuss them with is my supervisor and that this is for their benefit. Unless there are issues that require disclosing such as child protection issues, terrorism related disclosures by the client, amongst others – you can find these in my contract terms.


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In the therapeutic relationship, the therapist is the expert – in their field, in the counselling skills they’ve trained for – but the expert in themselves can only ever be the client. Therapy is a partnership and the therapist respects the client’s knowledge and expertise of themselves during the process, by asking questions and helping the client gain a different perspective on their story, feelings and thoughts. – of course there is more to it than that, but that’s the starting point.

Respecting the supervisee is also an important aspect – does the supervisee need more help as a trainee or have they moved from trainee to more competent practitioner and therefore need a more collegiate and collaborative type of supervision?

Being treated as a trainee after years of practice will hurt the supervisory relationship and the therapist might feel patronised. The supervisor airing their personal problems with the supervisee or supervisees is unethical and disrespectful at least.

Both supervisors and therapists/supervisees need to keep these things in check so the therapeutic or supervisory relationship doesn’t get contaminated with stuff that has nothing to do with either.

There needs to be an opportunity to discuss this in supervision, and sometimes maybe even with the client if the therapist feels it is plausible and therapeutic to clear the air and move therapy forward.

Respect, Trust and Partnership are very important for a good therapeutic and supervisory relationship to develop and for therapy to be effective.


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This leads to the next point, which relates to building appropriate relationships with our clients.

The ethical framework brings up the following points:

  • Communicating clearly what clients have a right to expect from us

Clear contracting is important to achieve this, as well as reviewing every so often.

Clients might come in more aware of their issues than thinking about contract terms or what the counsellor told them about cancellation policies and what therapy is and how it works.

Clients come looking for a solution to their distress.

It is our job to keep the work on track in regards to boundaries and our way of working (chosen modality, interventions, regular supervision, pacing to the client’s rhythm, being compassionate and empathetic…).

It is also our job to remind our clients of what they can expect from us and also what they can’t – contact outside of the sessions to be limited to rescheduling, for example.

A tutor of mine said that disappointing our clients early on is a good thing and it will happen at any point whether we like it or not.

Like the mother disappoints their baby when baby realises “mum is busy with other things and I’m not her only concern”, the therapist must do something similar. This is something that will happen unconsciously and without any planning or attempt by the therapist.

Therapists are human – we might say the wrong thing or yawn or forget a session or something else…

This might be a massive blow to the client and need repairing in the session, or this might help the client realise that making mistakes is actually OK.

Either way, communicating clearly will allow for growth, change and healing to happen for the client.


  • Communicating any benefits, costs and commitments that clients may reasonably expect

This links well with what I’ve already said above. Adding to this, some benefits will be the client will be able to speak up to meet their needs and set clear boundaries, the client can ask for letters of support but the therapist will charge for this additional service.

There are so many benefits that clients get from therapy that are only visible once the therapist points them out or after the therapy has progressed and we look back at previous achievements in therapy, or when therapy is over – the therapist might never know how they have impacted the client’s life.


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  • Respecting the boundaries between our work with clients and what lies outside that work

Boundaries are vital, and we are models for our clients and supervisees in how to keep these in order to safeguard both the therapist, the client and the therapeutic space.

Modelling good boundaries allows our clients to start testing these out in their personal and work relationships.

Contact outside the therapy room should be limited or non-existent. Sometimes this might be impossible – a client might go to a party you are also attending and you find out on the moment that you meet.

Discussing how to address this is important. – If I see you on the street or in town, do I nod at you or pretend you are a stranger and I don’t know you. If we met at a party, would you want me to leave or would you leave or do we just try to not cross each other’s paths. Or is it ok to talk and say hello and carry on like normal.


  • Not exploiting or abusing clients

Telling a client that you think they’re doing OK enough to stop therapy but that they can come back at any point in the future – life changes, things change and creep back up – is much better than keeping a client in therapy because they can’t manage to tell you they want to stop even though they know they can go it alone for now or for good.

This point is a huge topic and I won’t have space to talk about it fully in this post. But there are people out there, counsellors, that are unfortunately unethical and breaching the boundaries of the profession and the ethics of it all.

I do hope that it is a small number.

This is a reality in many businesses and services unfortunately, and all we can do is supervise and work to the best of our abilities, within the boundaries of our profession and to the best interest of our clients.

Whistleblowing is also an option.


  • Listening out for how clients experience our working together

As therapists and supervisors our first aim is to listen and to provide support in a way that our clients feel heard and safe to work through their distress and issues in the best way possible.

We need to be ready to ask whether something we said might have come out wrong and what does the client need from us to repair and move forward.

We also need to be brave enough to challenge and remind of the contract terms when necessary and be flexible also when necessary.


Questions or comments? Leave me a message and I’ll get back to you!


Next week I’m going to talk about these points:

  • How the therapist maintains integrity in their practice
  • And how the therapist can demonstrate accountability and candour.

    I hold a Certificate in Clinical Supervision from the University of Derby.I offer Clinical Supervision to qualified counsellors, and support during the course for trainee counsellors. (1


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In Supervision: Ethics and Professional Standards- Our Commitment to our clients

In Supervision


Welcome to my new series of In Supervision, where I will spend the next few weeks evaluating the BACP ethical framework and its valuable insights, reviewing it from my individual point of view, gained through my years as a supervisor, supervisee, therapist and client.


(For ease, when I refer to clients, I am referring to both my clients and the clients that my supervisees see, as well as my supervisees).


I will be writing about how I work with supervisees and clients in order to keep my commitments to them and to help clients to regain control of their lives by working through their individual issues and situations.

For more on how I work with specific issues and situations, you might want to check out my In Therapy series.

¡versión en Español también disponible!


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Trust.

Such a short word but in therapy it means so much.

Without trust, there is no way my clients will disclose everything – or anything – that might help them move on and get to where they want to be.

Trust allows our clients to open up, to want to share, and to know that what they share is safe with us. This in turn allows us to work through the more difficult aspects of their current – and past – situation, which is the main purpose of therapy.


The first way in which we can achieve our clients goals, and develop a trusting relationship that allows for change to happen, is to put our clients first.


From the start of our counselling careers, we know that we are doing the course, going to the required therapy and supervision, getting our practice hours in, because we want to make a difference in people’s lives – in our client’s lives.

So, from the beginning of our careers we are focused on the wellbeing of those people we will meet in our counselling rooms, and we work towards getting the training, experience and knowledge necessary to meet our clients’ needs and see effective and long-lasting change in them.


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One way we achieve this goal as therapists and supervisors is by having regular supervision and keeping to our profession’s standards.

These standards include:

  • Working within our competence ­

    • Refer clients we are unsure of being able to help

    • Refer clients who’s situation we don’t know enough about

    • Go to further training to increase our ability to work with particular groups of clients

    • Picking a niche might help to know our boundaries and narrow the type of clients we might want to work with

  • Updating skills and knowledge

    • Continuous professional development is important, for the reasons stated above, but also for keeping up to date with the latest developments and to keep your knowledge fresh and top of mind, which will help choose the best interventions for each individual client at each point in their therapy.

  • Collaborate with colleagues to improve the quality of service to clients

    • I love the time we live in! I have a network of people and groups on social media that I can go to for support – not specific client related stuff, as that would be breaching confidentiality – but more for allowing the lone working to not be so “lonely”.

    • What others are doing to develop their practice and bring the profession to light in society is helpful, and if we all join up together we can help battle issues such as mental health stigma, and support each other at each step of our careers.

  • Self-care – if we look after ourselves, we can then look after others

    • Have a look at my blog series on self-care for some tips, and some ways you can practice self-care without breaking the bank or taking too much time.

  • Keep records in a confidential and accurate manner

    • This is very important and keeping records that keep our clients’ data confidential and safe is going to add to that trust we have discussed above.


I hope you have enjoyed reading this first installlment of the ethics and professional standards series.

I have covered the first two points on the BACP commitment to clients page. I will let you ponder on these and if you have any questions or comments, or anything else you’d like me to discuss in this series, do let me know via the form below.

Click here to read the BACP ethical framework. *** page 1 is covered in this post and in next week’s post *** 


Next week I will be talking about the following topics that relate to our commitments to clients:

  • Showing respect to each individual client
  • How to build appropriate relationships with clients
  • How the therapist maintains integrity in their practice
  • And how the therapist can demonstrate accountability and candour.

I look forward to seeing your comments and feedback.

Feel free to share on social media and with your friends and family.


I hold a Certificate in Clinical Supervision from the University of Derby.I offer Clinical Supervision to qualified counsellors, and support during the course for trainee counsellors. (1


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In Supervision: Model series round-up

NEW BLOG POST (1)


click to enlarge.

click to enlarge.

In this week’s post, I would like to round-up and close the series on the Supervision Model I’ve chosen to follow, which as you can see includes many of the current models of supervision.

I hope you have enjoyed reading up on how I work with each of these models and the value each adds to the supervisory relationship, and in turn to the therapeutic relationship and finally how it benefits the clients discussed.


You can catch up on each model by clicking each of the titles:

Introduction to the Supervision Model

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Hawkins and Shohet – The seven-eyed model of supervision

 

 

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Stoltenberg and Delworth – A developmental model

 

 

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Inskipp and Proctor – a functional model

 

 

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Page and Wosket – The Cyclical Model

 

 

 

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Scaife’s theory of supervision

 

 

 

 

 

 

 

 


As a new series in the In Supervision posts, I would like to discuss ethical issues and practice standards, as presented by a variety of ethical frameworks, starting with the one presented by my professional body – BACP (British Association for Counselling and Psychotherapy).

You can have a look at the BACP ethical framework by clicking here. I shall be discussing each part in detail starting next week.


I hold a Certificate in Clinical Supervision from the University of Derby.I offer Clinical Supervision to qualified counsellors, and support during the course for trainee counsellors. (1


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In Supervision: Scaife’s theory of supervision

In Supervision


Welcome to this week’s In Supervision post. This post will look at Scaife’s theory of supervision, specifically focusing on the responsibilities of each of the parties involved.

Scaife considers the client’s responsibilities as well as the supervisee/therapist and the supervisor. We will now look at each one individually.


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The client’s responsibilities, when they come to see me or another therapist, are to be motivated to change and to work hard to get to a better place in life. The decision to change is with the client. There might need to be an ongoing assessment of this motivation and whether the client is stuck in the process or what is going on for them in the therapeutic relationship.

Both supervisee and supervisor must be aware of this in order to figure out how to best help each client, and how to help the supervisee develop and work successfully in light of arising difficulties.


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The therapist/supervisee’s responsibilities are both towards the clients and the supervisory relationship itself.

Regarding his/her clients, the supervisee must make the therapeutic space one that facilitates trust, honesty and openness on the part of the client, in order to effect change. The therapist must also ensure they are acting within ethical and professional boundaries, which includes attending regular supervision and continuous professional development activities (seminars, conferences, reading books, doing research, amongst others).

Regarding his/her supervision process and supervisor, the supervisee must remember that they are just as responsible for this process as is their supervisor. They must also identify what their learning outcomes are and be prepared for supervision so time is used effectively.

The supervisee learns as they develop as a therapist, about differences between themselves and others, especially their clients – cultural, religious, ethnic, gender, disability and sexuality differences. An awareness of how the employer – if in an organisation – affects their practice is also relevant, as policies and procedures might affect the freedom with which the counsellor works, and influences the supervisory relationship.

Another responsibility of the supervisee is to be open in communicating their arising feelings and thoughts about their practice, their clients and their supervisor, including the reactions to a variety of arising situations with the client and the supervisor, and how they usually deal with them.

Challenging the supervisor in regards to boundaries and contract issues is also important. Assessing whether the supervisee is still at trainee level or has moved up to a more consultative relationship with their supervisor is also important – otherwise the supervisee might feel undermined and this might affect the supervisory relationship and possibly their motivation and their relationship with clients.

Discuss what is helpful and what is unhelpful about supervision, be humble enough to accept errors and learn from them, as well as be able to transfer what’s learned in supervision into practice with clients.


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All of these are the responsibilities of the supervisee, which will be worked on as a team with the supervisor. But added to these, the supervisor’s responsibilities also include a duty of care towards the client, the supervisee and the profession by promoting and teaching the standards and ethical framework of their professional body and the policies and procedures if working for and organisation.

The supervisor’s role is to safeguard both the supervisee and the supervisor, and part of this might be to question the supervisee’s capacity to work with clients or with a particular client, at a particular point in time. Supervisors, according to Scaife, have a gatekeeping function.

Depending on the level of development of the supervisee, the supervisor will help them determine what the best way to act is with a particular client or situation. The supervisor will also facilitate the supervisee’s ability to use the space as a learning environment and also as a space to develop their practice.

Finally, contracting and keeping track of the relationship and any problems or positive things that might arise and need discussing with the supervisee.

Scaife’s theory reinforces what has been discussed in previous models, but looks at it from a completely different perspective – that of responsibility. I find it very interesting but also very important that the client is given responsibility for their therapeutic process, as it is up to them how much they disclose to their therapist and how fast or slow the work is, and it is up to the therapist to know how much they can challenge or pull back a bit, depending on where the client is in their process. And finally it is up to the supervisor to determine whether that particular therapeutic relationship is being good for both supervisee and client, or whether something needs to be changed in the way the supervisee interacts with their client.


Reference:

Scaife, J. (2013). Supervision in Clinical Practice: A Practitioner’s Guide. Routledge. 19 Dec 2013. Psychology.


I hold a Certificate in Clinical Supervision from the University of Derby.I offer Clinical Supervision to qualified counsellors, and support during the course for trainee counsellors. (1


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In Supervision: The Cyclical Model

In Supervision


Hi, and welcome to this week’s In Supervision post!

This week, I’d like to talk about Page and Wosket’s Cyclical model of supervision.

In doing research for this week’s post, I came across the original model and two further updates of the model by the authors. I will write this post from the point of view of my own practice and what I find useful about this model, whilst keeping true to the model as described by Page and Wosket.


An important aspect of this model is that it’s used not only for clinical supervision of counsellors, but also opens the supervision arena to coaches, group facilitators, social workers, managers, nurses, educators, trainee supervisors.

 


So, if you are in any of these other professions, I encourage you enquire for supervision with me!

 


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In regards to the past models I’ve discussed, this model gives them a well-rounded structure and complements them well. The seven-eyed model works well within the focus, bridge and space aspects of the cyclical model, the developmental model encompasses the focus and space, and the functional model links well mainly with the contracting, focus and review aspects of the cyclical model.


page and wosket 1This model pays attention to five areas that are closely linked with each other. These are:

  1. Contract – terms agreed between the supervisor and the supervisee/therapist
  2. Focus – what the work is going to be about and how
    each session is going to look
  3. Space – reflective, exploratory and developmental work that takes place throughout the process of supervision
  4. Bridge – the way the supervision session allows the supervisee to bring what has been worked on back to the sessions with his/her clients
  5. Review – an opportunity to re-contract and talk about how the supervisory relationship is going, what is working well and what is lacking and needs re-formulating and work.

page and wosket 2In the 2000 update of the model, Page and Wosket pair these even further, to make reference to two specific aspects in supervision:

  • Supervisory Relationship – Contract and Review
  • Supervisee – Client Relationships (context/environment) – Focus and Bridge
  • Awareness and Intent of Supervision – The space that develops between these two pairs allows for deeper exploratory work.

Awareness and intent  are important in supervision, especially at the start. These will allow the other areas – contracting, bridge – to develop and work well.

Having an aim, a goal, and a way of working helps develop the supervisee’s awareness of the various aspects of working as a counsellor (or as a social worker, nurse, etc.) and develop the skills required to work to a high standard and best help his/her clients move forward in their lives.

 Awareness also allows space to review the supervisory relationship and adjust or change where things are not working as well as they did at the start or at other stages of the relationship.


page and wosket 3The latest, 2015, update sets the various aspects of the model in a pyramid, but this doesn’t mean for the authors that one is more important than the other. They are all inter-dependent on one another for the supervision process to take place effectively, successfully and ethically. Personally, I prefer the cyclical rather than the pyramid for this model. It seems to make more sense and encompass so much more.


What do you think? Let me know in the comments below.


Vital for a good supervisory relationship are trust, openness and space to grow by asking, questioning, working through mistakes…


I hold a Certificate in Clinical Supervision from the University of Derby.I offer Clinical Supervision to qualified counsellors, and support during the course for trainee counsellors. (1


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In Supervision: A Functional Model of Supervision

In Supervision


Hi, and welcome to this week’s In Supervision post!

This week, I’d like to talk about Inskipp and Proctor’s functional model of supervision.  I find that this model links well to the other two models previously discussed.

First, I want to make a reference to the previous two models discussed in my supervision posts about my diagram (see first post here), and how Inskipp and Proctor’s model relates to them.


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This model links well to Stoltenberg and Delworth’s model in that it assesses the supervisee’s work and development of knowledge and skills; and to Hawkins and Shohet’s model in that it deals with the more relational and personal aspects of the supervisee’s practice.

 

 

 

 

 


Let’s look at the three functions of supervision as theorised by Inskipp and Proctor.


The restorative function is the supportive aspect of supervision. It focuses on the supervisee’s health and wellbeing. As counsellors, we tend to work on a regular basis with strong emotions and distress that might leave us feeling emotionally, mentally and sometimes even physically drained.

Supervision is a space where the supervisee can be looked after, by talking about the feelings that they might be carrying over from a session or sessions, and the supervisor’s role is to help the therapist process these emotions and figure out how to best help themselves first, and then their client in the next session.

Reflecting on their emotions, being aware of what’s going on within themselves and in the relationship with the client are important to help the therapist work through difficult feelings and to be able to provide the client with robust support and interventions to help them get their lives back on track.  I see this very closely linked to what Hawkins and Shohet describe in their seven areas of supervision.


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The normative or managerial function links well with the ethical frameworks that we follow – like the BACP ethical framework for the counselling professions – in that it is a quality control function. The therapist is assessed on their practice and whether they are practicing the principle of beneficience and being helpful rather than harmful to their clients. Other aspects mentioned in the framework that relate to this function are:

 

 

 

 

  • putting the client first

  • working to professional standards, which is what this function assesses

  • show respect

  • maintain integrity

  • build appropriate relationships with clients

  • demonstrate accountability

  • respect the client’s autonomy and help them work towards independence from the therapist through working through the client’s issues

  • justice

  • self-respect, meaning that the therapist is responsible for their self-care as well as their personal development


The last point brings us to the formative and educational function of supervision. Here we focus on the therapist’s development of their knowledge and skills. It is a more practical aspect of supervision, whereas the restorative function is more relational and emotionally developmental, and the normative is more a quality control measure.

The relationship between the client and the therapist, and the therapist and their supervisor, is more obvious in the restorative function, but even so it doesn’t feel like it’s enough.


This is why I am adamant that the three models discussed so far work much better together than in isolation. In the sessions themselves, I believe that these happen naturally, but in theory there isn’t one theory that encompasses all of the qualities, nuances and interactions that make up the supervisory relationship.

 


I hold a Certificate in Clinical Supervision from the University of Derby.I offer Clinical Supervision to qualified counsellors, and support during the course for trainee counsellors. (1

What do you think?

Leave me a message below!


 

Until next week…


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In Supervision: A Developmental Model

In Supervision


Welcome to this week’s In Supervision Post!

This week, I will be discussing another one of the parts of my diagram (see image below) – in particular the developmental model as presented by Stoltenberg and Delworth.


This model focuses on the trainee’s stages of development and how the supervisor can support the trainee at each stage.

This model of supervision is useful when assessing the supervisee’s pace and style of learning, and particularly when the supervisee’s level of development needs to be ascertained.

I feel it only works well if considered on side of other models, such as the Hawkins and Shohet model discussed last week, which goes deeper into supervisory methods.


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The aim of supervision, according to Stoltenberg and Delworth is for the supervisee to develop and monitor their:

  • Awareness of self and others
    • The supervisee works on their personal and professional development, learning how to read their own and their clients’ verbal and nonverbal communications and feelings in order to make adequate and helpful interventions, as well as develop the ability to think and reflect on what goes on in the sessions and within the supervisee themselves.
  • Motivational levels
    • With successes and feelings of “not quite getting it right” in sessions, motivation might go up and down, especially at the beginner and intermediate levels. As the supervisee’s practice develops, he/she will be more consistent in their confidence and motivation.
  • Ability to work towards autonomy
    • The supervisee’s relationship will change, starting off with a dependency on the supervisor’s guidance, suggestions, experience and knowledge, moving towards a more autonomous way of working which will allow reflective practice and the ability to use the supervision space as a space more of consultation between colleagues.

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The authors developed nine areas for the supervisee to work on and master in supervision. The supervisee is in charge of assessing growth and need for development in these areas:

  1. Intervention
    • The supervisee will move from using the interventions the supervisor suggests, to being more confident in trusting their gut and their own interventions during sessions. Also knowing why they said or did a particular thing with this or that client.
  2. Skill competence
    • As supervision and the supervisee’s development progresses, more skill competence will be achieved, and more independence and autonomy will be noticeable from both the way the supervisee sees supervision, but also the way the supervisor supports the supervisee.
  3. Assessment techniques
  4. Interpersonal assessment
    • The supervisee will be more confident in their work and therefore have more space to look at what goes on between him/her and their client, as well as with the supervisor.
  5. Client conceptualisation
    • As above, it will become more natural, as time passes, to think about what the client is doing, why he/she is doing it and how to work with the client through their issues.
  6. Individual differences
    • The supervisee will be able to notice and work through differences between them and their clients, be it sex, age, religion, culture, and how to enhance their knowledge and practice to best help clients that are very different or very similar to them without colluding or doing harm.
  7. Theoretical orientation
    • Development from the supervisor simplifying the theories to help the supervisee, to the supervisee mentioning theories they find useful when working with clients and justifying their interventions.
  8. Treatment goals and plans
  9. Professional ethics
    • Ethical issues will come up in sessions, more with some clients than others, and it is important to discuss these in supervision and work through them, with more or less support depending on the level the supervisee might be in.

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Stoltenberg and Delworth describe what goes on for both supervisee and supervisor at the different levels as follows (you can follow this in the diagram below):

Beginner Level

Role of the supervisee – imitate, little experience, dependent on the supervisor; anxiety, insecurity, highly motivated, self-focussed awareness, performance anxiety, difficult to listen to and process information from the session

Role of the supervisor – demonstrate or model needed skills and behaviours, teacher role; safety, containment, support, structure, attentive listening, memory aid, unscheduled/emergency supervision contact, positive feedback, simplify concepts/theory, graded approach to client complexity

Intermediate Level

Role of the supervisee – less imitative; strives for independence; dependence/autonomy conflicts, overconfident, overwhelmed, fluctuating motivation, self-doubt and abilities

Role of the supervisor – provides some structure but encourages exploration; note development process, use examples, work with confidence issues, provide a firm base and clear boundaries/contracts

Advanced Level

Role of the supervisee – more insightful and motivated; more autonomous sharing; conditional dependency, self-confident, consistent with clients, good insight and awareness of process issues

Role of the supervisor – listens and offers suggestions when asked; guided discovery, reflective practice

Master Counsellor

Role of the supervisee – skilled interpersonally, cognitively and professionally; personal autonomy, insightful, awareness, able to confront personal/professional issues, process in context of client work, collegial approach to supervision

Role of the supervisor – provides collegial and consultative functions; acknowledge that development is an ongoing process.


If we now bring in Hawkins and Shohet’s integrative supervision model, we can see how the relationship discussions that go on in supervision can be graded in a way that the beginner supervisee isn’t overwhelmed with aspects that he/she might still be new to, such as reflective practice and linking theory to practice. These will develop along the supervisee’s development, which is why it is important to assess the developmental level of a supervisee and provide the support required at each level.


References: Russell-Chapin L.A. and Chapin, T. (2011). Clinical supervision: theory and practice. Cengage Learning

Stoltenberg, C.D. and Delworth, U. (1987). Supervising counsellors and Therapists: A developmental approach. Wiley


I hold a Certificate in Clinical Supervision from the University of Derby.I offer Clinical Supervision to qualified counsellors, and support during the course for trainee counsellors. (1


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In Supervision: The seven-eyed model of supervision

 

In Supervision


Welcome to this week’s In Supervision Post.

This week, I will be discussing one of the parts of my diagram (see image below) – an integrative theoretical model of supervision, in particular, Hawkins and Shohet’s theoretical model.

Hawkins and Shohet (2012) developed the seven-eyed supervisor model, which looks at the interactions between client, therapist, and supervisor in its various – direct or indirect -combinations. This theoretical supervision model will be the focus of this post.


Supervision is a space to discuss, analyse and process the dynamics between

See full model below.

See full model below.

  • client and therapist

  • client and supervisor – through the way the therapist communicates (consciously or unconsciously), and what he/she communicates about the client to the supervisor

  • therapist and supervisor

Supervision is also a space to explore the above relationships in the context of  the client’s life as well as how the therapist’s organisational or practice context influences their relationship with both the client and the supervisor.

These interactions give way to two matrices, as mentioned previously and as presented in the diagram below:

See full model below.

See full model below.

 

  • the client-therapist/supervisee matrix

  • the therapist/supervisee- supervisor (or supervisory) matrix

 

 

 


click to enlarge.

click to enlarge.

 


What are each of the seven parts of the seven-eyed model of supervision?


1


  1. Focus on the dynamics of the session in direct relation to the client

The therapist/supervisee will talk about the client’s presentation in this particular session – were they crying as soon as they walked in; did they seem distant or distracted; did they talk a lot or a little; what topics did they want to talk about or not talk about in this particular session; how did this session relate to previous sessions.

When focusing on the dynamics of the session and on what the client did and said, the therapist/supervisee, the therapist is learning to make connections between everything the client has said, and between all the areas of their lives.

  1. Focus on the strategies and interventions used by the supervisee

In this part of supervision, which might happen as part of the general conversation about the client (each of these parts isn’t dealt with in a particular order or individually, supervision is a fluid and dynamic process), the aim is to review the interventions the therapist/supervisee used -what, when, why -, and provide an opportunity to increase the range of interventions in the therapist/supervisee’s arsenal.

  1. Focus on the client-therapist relationship

Here, the therapist/supervisee will relate in words or through parallel process (unconscious body language, attitude or words, that might be similar to what the client did or how they presented during the session) what happened – consciously or unconsciously – between them and the client during the session.

The supervisor will aim to help the therapist/supervisee have “super vision”, vision from above or outside of the relationship with the client, in order to develop greater insight and understanding of what might be happening for the client, as well as what might be happening in the therapeutic relationship.

  1. Focus on the supervisee

An important aspect of supervision is to help the therapist/supervisee process the emotions and thoughts that he/she might be holding for their clients or due to their interaction with their clients.

Therapists/supervisees are human too, and as humans we are affected by the people we encounter and listen to.  The effects of an interaction with a client might be conscious or unconscious, and the goal of the supervisor is to help the therapist/supervisee hone in on these reactions in order to process them and find a way to use them to help their clients, and not get stuck with overwhelming or unprocessed feelings.


2


  1. Focus on the supervisory relationship

Every relationship has its ups and downs. The supervisory relationship doesn’t escape this.

A review to check that the therapist/supervisee is making the most of the supervisory relationship, without censoring or feeling upset with the supervisor is important. This allows a space to reflect on the relationship and also to repair any lose ends that might be hindering the relationship -which could in turn hinder the relationship with the client to a greater or lesser extent.

Working with clients and bringing them to supervision might bring in parallel processes that we might not be conscious off, but might be playing out in the supervisee-supervisor relationship. The supervisor’s responsibility here is to keep this in check and challenge the supervisee when things come up that clearly relate to a particular client, but might be intruding in the supervisory relationship, and help the supervisee work through them. This in turn will help the development of the supervisee but also help in the therapeutic relationship with the client.

  1. The supervisor focusing on their own process

The supervisor is also human, and will experience the client and the supervisee in different ways, which will help both him/her and the therapist/supervisee in making sense of what is going on in the client’s life and mind, as well as making sense of what might be going on in the therapeutic relationship. It could also shed some light as to what might be happening in the supervisory relationship.

  1. Focus on the wider contexts in which the work happens

The therapy and supervision sessions happen in an office, a room where the space created is safe to discuss difficult topics and emotions. But the client’s life doesn’t happen in this vacuum. They come in for 50-60 minutes per week to talk about what ails them, and each time they leave a little better (sometimes a little worse as happens in many therapeutic processes at different points of the therapy).

The point is, they leave and go back to their life contexts – the reality of life might hit them as they leave the door, or it might be what they have come in to talk about. Economic pressures, work pressures, social rules that they don’t want to adhere to, family responsibilities and stresses. Supervision helps put all of these into context for the therapist, and therefore widens the scope to which they intervene and understand their client.

The therapist also doesn’t work in a vacuum – they follow professional codes of ethics, organisational policies and procedures, and other time and procedural limitations. All of these will impact on the relationships the therapist encounters with their clients and supervisor. All of these need to be worked through in supervision.


 

click to enlarge.

click to enlarge.

The model presented by Hawkins and Shohet provide a glimpse into the emotional, supportive and developmental side of the supervision process. I find this model resonates with me the best out of all of them, it is very caring and pays attention to the most relevant areas of the therapeutic and supervisory relationships, in my opinion.  The other models I will be talking about in the next few weeks focus on other aspects such as more administrative or functional aspects of supervision.


Reference: Hawkins and Shohet. Supervision in the helping professions (2012) McGraw-Hill Education (UK)


I am a qualified Clinical Supervisor, and offer this service for other qualified counsellors. If you are interested in supervising with me either online or in person (if in the Brighton and Hove area), do send me a message to arrange an initial meeting.


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In Supervision: A model

In Supervision


Welcome to this week’s In Supervision post.

When I was studying my Postgraduate Certificate in Clinical Supervision, I really enjoyed the module where we were asked to create a model of supervision that worked for us. We were reviewing a variety of theories, all which focused on different aspects of the supervisory process.

I then created a model in which I integrated many of the theoretical models of supervision that made sense to me as a supervisor and supervisee. I still believe in this model and use it in supervision at present.

This is what I want to discuss in the next few weeks.

I will be “disecting” each part of the model and theories it’s based on, in an attempt of creating an image of what supervision looks like when going through each of the areas covered.

These areas include the following:

  • Client-Therapist and Supervisor-Therapist Matrix and what happens in each relationship (Hawkins and Shohet, 2006)

  • Trainee stages of development and how the supervisor can support the trainee at each stage (Stoltenberg and Delworth

  • Functions of supervision (Inskipp and Proctor)

  • Practical aspects of supervision – the supervisory relationship at each stage of relationship, contracting, creating a safe space for the supervisee, reviewing progress and issues in the supervisory relationship (Page and Wosket, 1994)

  • Ethical and other responsibilities of the Supervisor – issues that impact on the emotional state and development of the supervisee; looking after the client by looking after the supervisee (Scaife, 2001)

  • Developmental stages of both supervisee and supervisor (Watkins, 1993)

 

Have a look at the diagram below and let me know if you have any questions or comments before the next post.


diagram for counselling website


I am a quailfied Clinical Supervisor, and offer this service for other qualified counsellors. If you are interested in supervising with me either online or in person (if in the Brighton and Hove area), do send me a message to arrange an initial meeting.


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In Supervision

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