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Feedback in Feedback in Clinical Clinical

SupervisionSupervisionLois A. Ehrmann MA, LPC/ACS, CAC/CCS- DiplomateLois A. Ehrmann MA, LPC/ACS, CAC/CCS- Diplomate

Counseling Alternatives GroupCounseling Alternatives Group444 East College Avenue, Suite 460444 East College Avenue, Suite 460

State College, PA 16801State College, PA 16801(814) 231-0940(814) 231-0940

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In In TWOTWO hours or less, we will hours or less, we will discuss……discuss……

► Assumptions about counselor development Assumptions about counselor development and clinical supervisionand clinical supervision

► IDM of Clinical Supervision IDM of Clinical Supervision ► Feedback Matching to Counselor DevelopmentFeedback Matching to Counselor Development► Formative versus Summative FeedbackFormative versus Summative Feedback► Feedback within a Positive Supervisory Feedback within a Positive Supervisory

EnvironmentEnvironment► Formative FeedbackFormative Feedback► Small Group Exercises and ClosureSmall Group Exercises and Closure

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Assumptions

Counselors are….

The self as a therapeutic tool

Personal and professional development

Clinical Supervision should be life long

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Important Issues for SupervisionImportant Issues for Supervision

1. Personal issues

2. When should they be discussed?

3. Changing nature of supervision based on developmental stage

4. Structure and methods of feedback may need to change over time too.

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The Integrated Developmental Model of The Integrated Developmental Model of Supervision Supervision

(Stoltenberg, Mc Neill & Delworth, 1998(Stoltenberg, Mc Neill & Delworth, 1998

Three movements across development:Three movements across development:

motivation, autonomy and motivation, autonomy and awarenessawareness

Domains of counseling: assessment, diagnostics, Domains of counseling: assessment, diagnostics, conceptualization, treatment goals and conceptualization, treatment goals and implementation of interventionsimplementation of interventions

Review the chartReview the chart

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Feedback for the Level 1 Counselor

Establishing structure

Clear communication of expectations

Encouragement and affirmation

Specific recommendations of strategies

Encouragement to link theory to strategies selected

Late Level 1 challenges or confrontations

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Feedback for the Level 2 Counselor

Supervisors must be very flexible Balance between direct guidance and

counselor autonomy Expressions of care and support Disclosure of past failures or difficult times Rationales and conceptualizations Increase catalytic interventions

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Feedback for the Level 3 Counselor

Affirmation and support are needed but are less crucial

Challenges to the counselors thinking and affective responses to clients

Catalytic responses if counselor gets stuck in a client counselor situation

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Different types of Feedback

Formative Feedback Summative Feedback or Evaluation

•Skill acquisition•Professional growth•Direct feedback

•Formal evaluation•How does the person

measure up

•Stresses progress and

process

•Concerned with the

final outcome •Is the candidate qualified

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Summative Feedback or Evaluation

Clear Criteria are ImportantBernard and Goodyear (1998) Frame and Stevens-Smith (1995)

Factual knowledgeGeneric clinical skillsOrientation specific skillsClinical judgment skills Interpersonal attributes Multicultural competencies

OpennessFlexibilityPositive attitudeLevel of cooperationWillingness to accept and use

feedbackAwareness of one’s impact on

othersThe ability to deal with conflictAcceptance of personal

responsibilityExpression of feelings effectively

and appropriately

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Make Feedback a Positive Make Feedback a Positive Experience- Some TipsExperience- Some Tips

1.1. Acknowledge that supervision is unequalAcknowledge that supervision is unequal

2.2. Be clear about administrative versus clinical supervisionBe clear about administrative versus clinical supervision

3.3. Address supervisee defensivenessAddress supervisee defensiveness

4.4. Individual differencesIndividual differences

5.5. Make feedback mutual and continuousMake feedback mutual and continuous

6.6. Flexibility Flexibility

7.7. Strong administrative structureStrong administrative structure

8.8. Avoid premature evaluationsAvoid premature evaluations

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Tips Continued

9. Practice what you preach

10. Attend to the health of the supervisory

relationship

11. Balance ‘seriousness’ with ‘play’

12. Only do it if you enjoy it

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Always Remember

“Whenever a trainee (or counseling professional) is denied appropriate supervision and evaluation, the professional community is diminished.” (Bernard and Goodyear, 1998)

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Formative Feedback

It’s an ongoing interactional process

You cannot NOT communicate because even when you say nothing you are communicating something!

Any communication to another person contains both (A) a message about the relationship and (B) a message about some particular content.

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Interactional Process ExampleInteractional Process Example

Cn: “I had a difficult silent moment with this client we have been talking Cn: “I had a difficult silent moment with this client we have been talking about. He was really angry at me and I had trouble figuring out what about. He was really angry at me and I had trouble figuring out what to do. I thought….”to do. I thought….”

Sp: (interrupting the CN): Excuse me for interrupting but I need to get Sp: (interrupting the CN): Excuse me for interrupting but I need to get some clarity here first. The client was angry at you or someone else some clarity here first. The client was angry at you or someone else or….or….

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What are the possible relationship messages of the Cn to the SP and the What are the possible relationship messages of the Cn to the SP and the SP to the CN?SP to the CN?

What are the content messages?What are the content messages?

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Tips for Formative Feedback

Focus on changeable behaviors

Offer criticism as an opinion

Separate personal feelings out

Steer away from accusatory comments or ultimatums

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Good Formative Feedback is CORBS

C= Clear

O= Owned

R= Regular

B= Balance

S= Specific

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Small Group WorkSmall Group Work

Use the time to share with your colleagues a Use the time to share with your colleagues a difficult encounter you experienced with a difficult encounter you experienced with a supervisee where you felt you needed to give supervisee where you felt you needed to give some appropriate direction or feedback.some appropriate direction or feedback.

Then do the following:Then do the following:

1.1. Try to figure out the stage of development the Try to figure out the stage of development the counselor fits into andcounselor fits into and

2.2. Discuss the type of feedback appropriate to the Discuss the type of feedback appropriate to the situation. Use COMBS to devise a feedback situation. Use COMBS to devise a feedback statement.statement.

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ClosureClosure

• How did it go?How did it go?

• Anything new learned that could help Anything new learned that could help in future supervision sessions?in future supervision sessions?

• ReferencesReferences

• Thanks for joining me today for this Thanks for joining me today for this workshop!workshop!

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References

• Bernard, J., & Goodyear, R. (1998). Fundamentals of Clinical Supervision (2nd Edition).Boston, MA: Allyn and Bacon.

• Daniels, J., & Larson, L. (2001). The impact of performance feedback on counseling self-efficacy and counselor anxiety. Counselor Education and Supervision, 41, 120-130.

• Delworth, U., Vespia, K, Stone, C. (1999). Counselor supervision: A model for on-site supervisors. Counseling and Human Development, 32, 1-12.

• Frame, M., & Stevens-Smith, P. (1995). Out of harm’s way: Enhancing monitoring and dismissal processes in counselor education programs. Counselor Education

and Supervision, 35, 118-129.

• Fitch, T, & Marshall, J. (2002). Using cognitive interventions with counseling practicum students during group supervision. Counselor Education and Supervision, 41, 335-342.

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References continued• Hensley, L., Smith, S., & Waller-Thompson, R. (2003). Assessing competencies of

counselors in training: Complexities in evaluating personal and professional development. Counselor Education and Supervision, 42, 219-230.

• Pearson, Q. (2000). Opportunities and challenges in the supervisory relationship: Implications for counselor supervision. Journal of Mental Health Counseling, 22(4), 283-294.

• Stoltenberg, C., Mc Neil, B., & Delworth, U. (1998). IDM Supervision: An integrated developmental model for supervising counselors and therapists. San

Francisco: Jossey-Bass Publishers.