Supervision Competency:
Current Status and Future Trends
Presented at APPIC Membership Meeting,
2014
Carol Falender, Ph.D.
www.cfalender.com
Current Status: Supervisors
• Competence of the supervisor has been a “given”
• Assumption that all supervisors ARE competent
• Purely hierarchical supervision attenuates power differential
with additive privilege of the supervisor
• Feminist, humanist, psychodynamic, and and competencybased theorists have deconstructed the power differential
and described a supervisory interpersonal, collaborative
dialectic
– Falender & Shafranske, 2004; Farber, 2010; Frawley-O’Dea & Sarnat,
2001; Porter & Vasquez, 1997)
Current Status: Supervisees
– Competency-based replaces the implicit assumption of
competence with explicit demonstration of competence
– Since EPPP was never defined as a measure of
competence (Schaffer, 2011), the task of ascertaining
implicitly falls to the supervisor
– Major focus has been on competence of the
supervisee—tracking developmentally or at a fixed point
– Supervisees receive no training or “role invocation” to be
effective supervisees (Vespia et al., 2002; Falender &
Shafranske, 2012)
Realities: Supervisor Competence
• Emerging data on harmful supervision (e.g., Ellis et
al., 2014)
• Multiculturally incompetent supervision (e.g.,
Falender, Shafranske, & Falicov, 2014; Green &
Dekkers, 2010; Jernigan et al., 2010; Singh & Chun
2010)
• Power differential, privilege, oppression, and
context diminish supervisee power
Momentum towards Competency-based
Supervision
• Supervisee Competence:
– Benchmarks - Supervision
• Fouad et al., 2009; Hatcher et al., 2013
– NCSPP Competencies –Management and Supervision
• http://www.ncspp.info/DALof%20NCSPP%209-21-07.pdf
• Training Trajectory
– Health Service Psychology Blueprint (2013)
• The Role of the Psychology Internship (D’Angelo, 2013)
• Supervision
– Board of Educational Affairs Supervision Guidelines
• (In review, 2014)
Competency-based Supervision (2)
• Across theories
– (special issue edited by Farber & Kaslow, 2010
Psychotherapy: Theory, Research, Practice, Training
– e.g., Psychodynamic, Cognitive, Humanistic, Family
Systems
• Internationally
– e.g., Australia, U.K., New Zealand
• (see Falender & Shafranske, 2014)
• Process
– Active and Experiential
• (e.g., Bearman et al. 2013; Reiser & Milne, 2012)
Era of Competency-based Supervision and
Training
• Supervision as a distinct professional competency
– What other aspect of psychology is practiced without specific
training?
• Consequence of lack of consensus on supervision as a
distinct professional competency is a lack of
supervision training and agreement on when training
should occur
• Ultimate result—no training until post-licensure if at all
• When SHOULD training in supervision occur?
• Accreditation standards—result in wide range of what
comprises competence in supervision
Status of Supervision Training
• Only about 40% of supervisees have received
formal training in clinical supervision –content highly
variable (electives,
– >60 % among U.S. counseling grad students
• About half of grad students report they received no
coursework or no supervision training at all
• About 60% of supervisors report they have had little
or no supervision training
Most Pervasive Influence
• When asked what is the major influence
on your supervision experience—still the
majority say their own personal
experience of being supervised
» Supervisees—Crook-Lyon et al., 2011
• This premise undermines the reality of supervision
as a distinct professional competency
Competency-based Supervision
• Systematic, meta-theoretical approach addressing alliance,
strains, diversity, personal factors, legal and ethical
• Adoption of competencies frame and establishment of
reliability among supervisors
• Active, experiential process in supervision
• Supervisee self-assesses and supervisor provides
transparent ongoing assessment and feedback
• Specific attention to strengths and areas in improvement—
support and difficult discussions
• Ongoing evaluation so it is never a surprise
Specific Goals and New Developments
• Introduce (Draft) Guidelines for Supervision developed by
the APA Board of Educational Affairs Task Force
• Assist you in identifying specific steps and plans to take
back to your setting regarding clinical supervision
Guidelines for Clinical Supervision in Health
Service Psychology
BEA Task Force of APA
Members of the Task Force
Carol Falender, Chair; Beth Doll; Michael Ellis, Rodney K.
Goodyear; Nadine Kaslow (liaison from the APA Board of
Directors); Stephen McCutcheon; Marie Miville and; Celiane
Rey-Casserly (liaison from BEA); APA Staff: Catherine Grus
and Jan-Sheri Morris
Guidelines for Clinical Supervision in
Health Service Psychology
aka Guidelines on Supervision (DRAFT)
Health Service Psychology refers to:
– “Psychologists are recognized as Health Service Providers if
they are duly trained and experienced in the delivery of
preventive, assessment, diagnostic and therapeutic
intervention services relative to the psychological and
physical health of consumers based on: 1) having completed
scientific and professional training resulting in a doctoral
degree in psychology; 2) having completed an internship and
supervised experience in health care settings; and 3) having
been licensed as psychologists at the independent practice
level” (APA, 1996).
Health service psychology is inclusive of the
specialties of clinical, counseling, and school
psychology.
BEA Task Force Goal
To capture optimal performance expectations for
psychologists who supervise. It is based on the premise
that supervisors
a) strive to achieve competence in the provision of
supervision and
b) employ a competency-based, meta-theoretical
approach to the supervision process.
Competency-based and meta-theoretical refers to
working within any theoretical or practice modality,
systematically considering the growth of specific
competencies in the development of competence.
Purpose
• For supervisors, the Guidelines on Supervision provide a
framework to inform the development of supervisors and to
guide self-assessment regarding professional development
needs.
• For supervisees, the Guidelines on Supervision promote the
delivery of competency-based supervision with the goal of
supervisee competency development.
• A goal of the Guidelines on Supervision is to provide
assurance to regulators that supervision of students in
education and training programs in health service psychology
is provided with and places value on quality.
Guidelines Development: 2012-2014
• Task force convened March 2012
• Meetings via conference call late summer 2013 early
spring 2013
– Reviewed relevant literature including guidelines from
other organizations
– Agreed on domains, prepared drafts
• Face to face meeting May 2013
– Revised draft
• Request for comments fall 2013
• Revised early 2014
Assumptions
about Supervision
• A distinct professional competency that requires formal education and
training
• Prioritizes the care of the client and the protection of the public
• Focuses on the acquisition of competence by and the professional
development of the supervisee
• Requires supervisor competence in services being supervised
• Is anchored in the evidence base related to supervision and the services
being supervised
• Occurs within a respectful and collaborative supervisory relationship
• Entails responsibilities on the part of the supervisor and supervisee
Assumptions (2)
• Intentionally infuses and integrates diversity in all aspects of professional
practice
• Is influenced by both professional and personal factors
• Is conducted in adherence to ethical and legal standards
• Uses a developmental and strengths based approach
• Requires reflective practice and self assessment by the supervisor and
supervisee
• Incorporates bidirectional feedback
• Includes evaluation of the supervisee’s acquisition of competencies
• Serves a gatekeeping function for the profession
• Is distinct from consultation, personal psychotherapy, and mentoring
Domains of the Supervision
Guidelines
Domain A: Supervisor Competence
Domain B: Diversity
Domain C: Supervisory Relationship
Domain D: Professionalism
Domain E: Assessment/ Evaluation/ Feedback
Domain F: Problems of Professional Competence
Domain G: Ethical, Legal, and Regulatory
Considerations
The Guidelines (DRAFT, 2014)
Supervisor Competence
• Supervisors strive to be competent in the psychological services provided to
clients/patients by supervisees under their supervision and when supervising in areas
in which they are less familiar they take reasonable steps to ensure the competence of
their work and to protect others from harm.
• Supervisors seek to attain and maintain competence in the practice of supervision
through formal education and training.
• Supervisors endeavors to coordinate with other professionals responsible for the
supervisee’s education and training to ensure communication and coordination of goals
and expecatations.
• Supervisors strive for diversity competence across populations and settings (as
defined in APA, 2003).
• Supervisors using technology in supervision (including distance supervision), or when
supervising care that incorporates technology, strive to be competent regarding its use.
Diversity
• Supervisors strive to develop and maintain self-awareness regarding their
diversity competence, which includes attitudes, knowledge, and skills.
• Supervisors planfully strive to enhance their diversity competence to establish
a respectful supervisory relationship and to facilitate the diversity competence
of their supervisees.
• Supervisors recognize the value of and pursue ongoing training in diversity
competence as part of their professional development and life-long learning.
• Supervisors aim to be knowledgeable about the effects of bias, prejudice,
and stereotyping. When possible, supervisors model client/patient advocacy
and model promoting change in organizations and communities in the best
interest of their clients/patients.
• Supervisors aspire to be familiar with the scholarly literature concerning
diversity competence in supervision and training. Supervisors strive to be
familiar with promising practices for navigating conflicts among personal and
professional values in the interest of protecting the public.
Supervisory Relationship
• Supervisors value and seek to create and maintain a
collaborative relationship that promotes the supervisees’
competence.
• Supervisors seek to specify the responsibilities and
expectations of both parties in the supervisory
relationship. Supervisors identify expected program
competencies and performance standards, and assist
the supervisee to formulate individual learning goals.
• Supervisors aspire to review regularly the progress of the
supervisee and the effectiveness of the supervisory
relationship and address issues that arise.
Professionalism
• Supervisors strive to model professionalism in their own
comportment and interactions with others, and teach
knowledge, skills, and attitudes associated with
professionalism.
• Supervisors are encouraged to provide ongoing
formative and summative evaluation of supervisees’
progress toward meeting expectations for
professionalism appropriate for each level of education
and training.
Assessment/Evaluation/
Feedback
• Ideally, assessment, evaluation, and feedback occur within a collaborative
supervisory relationship. Supervisors promote openness and
transparency in feedback and assessment, by anchoring such in the
competency development of the supervisee.
• A major supervisory responsibility is monitoring and providing feedback on
supervisee performance. Live observation or review of recorded sessions
is the preferred procedure.
• Supervisors aspire to provide feedback that is direct, clear, and timely,
behaviorally anchored, responsive to supervisees’ reactions, and mindful
of the impact on the supervisory relationship.
• Supervisors recognize the value of and support supervisee skill in selfassessment of competence and incorporate supervisee self-assessment
into the evaluation process.
• Supervisors seek feedback from their supervisees and others about the
quality of the supervision they offer, and incorporate that feedback to
improve their supervisory competence.
Professional Competence
Problems
• Supervisors understand and adhere both to the supervisory
contract and to program, institutional, and legal policies and
procedures related to performance evaluations. Supervisors
strive to address performance problems directly.
• Supervisors strive to identify potential performance problems
promptly, communicate these to the supervisee, and take
steps to address these in a timely manner allowing for
opportunities to effect change.
• Supervisors are competent in developing and implementing
plans to remediate performance problems.
• Supervisors are mindful of their role as gatekeeper and take
appropriate and ethical action in response to supervisee
performance problems.
Ethics, Legal, and Regulatory
Considerations
• Supervisors model ethical practice and decision making and conduct themselves in accord
with the APA ethical guidelines, guidelines of any other applicable professional organizations,
and relevant federal, state, provincial, and other jurisdictional laws and regulations.
• Supervisors uphold their primary ethical and legal obligation to protect the welfare of the
client/patient.
• Supervisors serve as gatekeepers to the profession. Gatekeeping entails assessing
supervisees’ suitability to enter and remain in the field.
• Supervisors provide informed clear information about the expectations for and parameters of
supervision to supervisees preferable in the form of a written supervisory contract.
• Supervisors to maintain accurate and timely documentation of supervisee performance
related to expectations for competency and professional development.
Association of State and Provincial
Psychology Boards Supervision Guidelines
• Regulatory guidelines to inform thinking and regulation
regarding supervision by State and Provincial
Psychology Boards
• Personal communication, Steve DeMers, 2014
APPLICATIONS OF
BEA SUPERVISION GUIDELINES
Clarita began supervision with Dr. Tullson in September. She was delighted that he
described his high level of competence in areas of substance abuse, theoretical
approaches, and the diagnoses of many of the clients in the setting , and outlined his
various areas of specialty. After that they launched right into discussing cases, and after
a month or so Clarita reflected that she was not clear about his expectations for her for
supervision. She was unsure why he addresses her as “Clara”. Typically, each week
she would plan the hour to ensure each of her five cases was addressed systematically,
but she was finding he tended to prefer to stay on one case for the entire hour…and
often asked that they continue on that case for several weeks. She had inquired
whether there was a way to address other cases, but he said, “all in time” and urged her
not to be impatient. The intensive case discussions were highly theoretical and
abstract. At the beginning of the third month, Clarita told Dr. Tullson they must focus on
the child case she was seeing as she was worried about whether criteria were met for
child abuse reporting. Dr Tullson responded that Clara was very perseverative and he
was wondering about her own diagnosis.
How Could the Guidelines
be Useful?
• What are strengths of Dr. Tullson’s supervision?
• What areas appear neglected? What legal issues
are raised?
• How could the guidelines lead him to strengthen his
supervision?
• Be specific
Aaron is a very technically competent supervisee and wants
to use monitoring devices with his depressed client and
have them be sent to his iPhone App from the client—he
also wants to use a professional Facebook page to interact
with that client through a social network.—and he is
exploring other internet features and Apps to treat
depression. The supervisor uses a flip cellphone.
Reactions?
Jin is a practicum student at a Counseling Center. When he
began he had an elaborate orientation and the director outlined
the extremely large number of students waiting for services, the
high suicide risk, and the balance of serving more students and
meeting the needs of those seen through the limited number of
sessions available—4 to 6. Jin has been at the setting for six
weeks, receiving mostly crisis cases and this week he told his
supervisor that he feels the setting is presenting him an ethical
challenge akin to unethical behavior—that he feels to see clients
for such a brief time is highly unethical and he cannot bring
himself to do that. His supervisor is stymied.
Implementation In Your Setting?
• Please consider specific steps you would like to
take to move towards implementation of the
Supervision Guidelines?
– Focus on one or two of the Guidelines sections
– Or
– Focus on implementation of the Entire Guidelines
How Could The BEA Guidelines
Be Useful In Your Setting?
• Identify strengths and “bright spots” in supervision
practice in your setting
• Consider issues that are difficult relating to
A. Supervisor competence and lack of such
B. Potential harm inflicted on clients and supervisees
C. Issues across domains
Questions
• How will these guidelines be useful to you?
• How would you encourage dissemination?
• What additional resources would be helpful for
implementation?
• Additional issues/ comments?
Information For This
Presentation Is Based Upon:
• Guidelines for Clinical Supervision in Health Service
Psychology
• A competency-based framework for supervision
• Written by the Task Force on Supervision Guidelines
• Convened by the Board of Education Affairs
• Public comment period has closed, and it is scheduled
to come before Council in August for approval as policy