Reflective Essay on Clinical Supervision and Debriefing

Assessment 3

COU303 Supervision and Debriefing

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Reflective Essay

In reflection on the learnings of this subject Attending the classes in this tri-semester using the process of Journaling made me learn a diverse set of knowledge. This knowledge has included the introduction to clinical supervision, different supervision models based on psychotherapy, and developed models (Forshaw, Sabin-Farrell & Schröder, 2019). I also learned the general approaches to supervision. This tri-semester also led me towards the knowledge of second-generation models of supervision and the process models. Involvement in the different class activities throughout the whole tri-semester also developed different skills of the supervision that will help me in my long-term career objective as well as my professional development. In the context of the competencies developed during this diverse learning, I would like to include that I have developed the competency of thinking like the supervisor already. Now I can balance the responsibility between the client and supervisor (Kadushin, 1985).

The learnings got from chapter one of the introduction to the clinical supervision updated my knowledge of the supervision as I previously considered the supervision as the work of a higher level of the authorities or the doctors (Sahebi, 2020). This chapter made me learn that in the context of clinical supervision it is also associated with the visit of the student or the physicians to the patients for the discussion on the treatment and the diagnostics. Supervision is the major instructional strategy that every mental health professional needed to add to their characteristics (Cartwright et al., 2021). It is needed as the professionals who will have good supervision competencies will be the ones who will survive in this virtual world. The first chapter also made me learn that supervision also develops a strong bond between the teacher and the trainee. Supervision is not only essential for the development of supervisors’ competencies but it is also necessary for the development of the supervisee’s competencies. Before attending this chapter, I was also confused between teaching and supervision but I got to learn that teaching is more central to supervision (Borders, 2019). In following the process of journaling, I followed the several ways that led me towards successful learning. These steps involved finding the most relevant media to learn things apart from the classroom that enhanced by research skills. Using the research skills, I became able to search for the most relevant and appropriate data for my learning. The anther step was the self-assessment which made me aware of where I was standing in terms of knowledge and experience related to the clinical supervision (Beavis, Davis & McKenzie, 2021). I started writing every piece of knowledge I gained from the classroom activities and teaching. This step was very important in the whole process of journaling as it helped me to remember the things for the long term. With the step-by-step involvement in the subject, I also started writing the small success or achievement of the short terms goals I had achieved.

To make the journaling process more effective I also used the method of a monthly review of the whole process so that I can found out the drawbacks and the positive aspects of the journaling process I was following. Chapter two was based on the psychotherapy-based or the development-based models. The study of the different supervision models made me aware of the importance of following a specific model. The use of these models also helped me to follow a conceptual framework in the process of supervision and I felt more engaged with the process. I have learned that focusing on the personal needs is the major factor that may lead the supervision process toward the ethical issues so in the process of supervision it is also needed to consider the needs of the supervisee also to make the process free from the ethical issues (Cleak and Wilson, 2007). In the process of journaling, I wrote down the different models of the supervision so I can easily use them in category vise. I divided these models into the three major categories that first involved the models that were grounded on the psychotherapy theory. These models were the cognitive behavior, feminist, humanistic relationship, and psychodynamic model (Ranasinghe et al., 2019). The second category was based on the developmental models that involved the models like IDM, Loganbill, Hardy & Delworth, reflective development models, etc. The third category was based on the process models that involved the discrimination model, Hawkins & Shohet, etc. (Knight, 2018).

Among all models, I found the solution-based supervision model as the best supervision model which was suitable for my characteristics and also found suitable to stop me from moving towards the ethical issues in supervision. I liked this model because it focuses on the needs of the client like what they prefer and what they like. Using this model, I also preferred to see things from different perspectives as this model works on the assumption of there is not a single way to see things correctly. Another major advantage I felt in this model was its assumption of focusing first on the things that are possible in the supervision or focusing on the things that can be changed easily. I also got to know that the history of the supervision models is majorly linked with the psychotherapy supervision models. These models are considered the early models also. With the involvement in the supervision practices, I got to know another ethical issue in the clinical supervision that can impact the quality and authenticity of the supervision. I had realized that the very first ethical issue in clinical supervision can be related to the rights of patients that may lead the patient towards disagreement on the decision of the treatment (Augusto et al., 2021). The rights of the patients are related to the access to good treatment services, the right they provide the consent for the medical interventions and the very important right to the confidentiality of the medical information provided by the patient. The second ethical issue is related to not providing equity to access the medical resources by the supervisor. For example, A past criminal is not able to make the right medical treatment from the government hospital of the same city in which he committed the crime. The third potential ethical issue in clinical supervision is related to the patient safety issue that made the patients not share their confidential information (Saarikoski et al., 2006). This also stops them from complaining against the supervisor even if they are facing issues with the supervisor. Another most important potential ethical issues come from informed consent (Glaser et al., 2020). Most patients tend to sign these documents without carefully reading this document and in addition, the difference between the language of the patient and the document also becomes an ethical issue. This issue may misguide the patient or may lead them towards the false promise of treatment. When I was involved in the supervision practice in the class activities, I realized one more important ethical issue which was related to the ways of dealing with patients of the opposite sex. This situation arises when the supervisor needed to supervise a patient of the opposite sex. This issue comes majorly when the supervisor or the supervisee comes from a different cultural background which makes the supervision process challenging with the issues in language and the way of presenting or asking for the information.

Further, the semester moved towards the process models or the models of the second generation for the supervision. This was the final major category of the supervision model I got to know in this learning process. I got to know that development of the process models was the result of interest in the supervision process as the relationship or the educational process. the very first model that captured my attention was the discrimination model. This model was introduced by Bernard in 1979. This was one of the most easily accessible models of the clinical supervision I learned during the Tri-semester (Denise, Moroney & Wilson, 2022). I got to know that this model was created in the mid-1970s to help the supervisors in the supervision process. I added the steps or the recommendations of this model to my skill set as a supervisor because these were the most relevant recommendations for the supervisor. These included considering the different skills of the supervisee in the process of supervision like the skill of intervention. The supervisor must consider what type of intervention level is showcased by the client and also needed to consider the success rate of the counseling intervention to identify the further needs of the clinical supervision (O'Neill, Edvardsson & Hooker, 2022). Another skill of the supervisee that needed to be evaluated is a conception which discloses how the supervisee understands the information conveyed or asked during the sessions. This evaluation helps in developing the right meanings for the client’s statement and also helps in finding the right cultural identity of the client. The last important skill of the client that needed to be evaluated is personalization. This evaluation is based on the way the supervisee uses the personal style for the counseling that helps them to keep the counseling sessions uncontaminated from the cultural biases, counter the transference of information, or the personal issues also.

With the whole learning, the most important learning which I can consider most relevant to my career growth was the learning of different roles the supervisor needed to play as per the need and skills of the client. These are the three major roles, the very first role was the role of teacher which I should use when the supervisee needs clear instructions, modeling, or direct feedback for their situation. The second role I learned was the role of a counselor which needed to use when the supervisor wants to increase the reflectivity of the supervisee so the right information can be abstracted. The final role I learned was the role of a consultant in which the supervisor wants the supervisee to trust their insights and the actual feelings related to their work. This is also important in the situation when I will feel to challenge the supervisee to make them work or act on their own. With the study of the expertise development model, I gained the knowledge and also use the steps to become an effective supervisor. These steps involved learning or starting to think like the supervisor, developing of the own ability to become oneself, developing the confidence while providing the judgment for someone, developing the courage to do the things in the right way, and the very important learning to manage the power.

With the subject learnings, I have also developed a 6 months development plan to develop my supervision competencies. This plan has included the activities like getting an internship in the clinics or working in the role of supervisor and another activity also includes getting training from the external experts for the development of supervisor competencies. This training will provide me feedback for my current clinical supervision competencies helping me to fill the gaps in the areas of clinical supervision (O'Donnell et al., 2022).

References

Augusto, M. C. B., Oliveira, K. S. D., Carvalho, A. L., Carvalho Pinto, C., Teixeira, A. I. C., & Teixeira, L. O. L. S. M. (2021). Impact of a model of clinical supervision over the emotional intelligence capacities of nurses. Rev Rene, 22, e60279. https://comum.rcaap.pt/bitstream/10400.26/36105/1/A.L.Carvalho-01.pdf

Beavis, J., Davis, L., & McKenzie, S. (2021). Clinical supervision for support workers in paediatric palliative care: a literature review. Clinical Child Psychology and Psychiatry, 26(1), 191-206. https://journals.sagepub.com/doi/pdf/10.1177/1359104520961431

Borders, L. D. (2019). Science of learning: Evidence?based teaching in the clinical supervision classroom. Counselor Education and Supervision, 58(1), 64-79. https://libres.uncg.edu/ir/uncg/f/L_Borders_Science_2019.pdf

Cartwright, A. D., Carey, C. D., Chen, H., Hammonds, D., Reyes, A. G., & White, M. E. (2021). Multi-tiered intensive supervision: A culturally-informed method of clinical supervision. Teaching and Supervision in Counseling, 3(2), 8. https://trace.tennessee.edu/cgi/viewcontent.cgi?article=1178&context=tsc

Cleak, H and Wilson, J (2007). Making the Most of Field Placement. (2nd ed.), Australia, Thomson. https://books.google.co.in/books?hl=en&lr=&id=LtxiDwAAQBAJ&oi=fnd&pg=PR1&dq=Cleak,+H+and+Wilson,+J+(2007).+Making+the+Most+of+Field+Placement.+(2nd+ed.),+Australia,+Thomson+&ots=0f-0diSARS&sig=1wN2ux621SZng0eO7I9mgRzQHIE&redir_esc=y#v=onepage&q&f=false

Denise, E., Moroney, T., & Wilson, V. (2022). Clinical supervision: A mechanism to support person?centred practice? An integrative review of the literature. Journal of Clinical Nursing. https://onlinelibrary.wiley.com/doi/pdf/10.1111/jocn.16232

Forshaw, G., Sabin-Farrell, R., & Schröder, T. (2019). Supervisors’ experience of delivering individual clinical supervision to qualified therapists: a meta-ethnographic synthesis. Mental Health Review Journal. https://nottingham-repository.worktribe.com/index.php/preview/1606858/Manuscript%20Supervisors%20Experience%20Meta%20Ethnographic%20Synthesis.pdf

Glaser, J., Nouri, S., Fernandez, A., Sudore, R. L., Schillinger, D., Klein-Fedyshin, M., & Schenker, Y. (2020). Interventions to improve patient comprehension in informed consent for medical and surgical procedures: an updated systematic review. Medical Decision Making, 40(2), 119-143. https://journals.sagepub.com/doi/pdf/10.1177/0272989X19896348

Kadushin, A. (1985). Supervision in Social Work (2nd ed.). New York, Columbia University Press. https://www.degruyter.com/document/doi/10.7312/kadu15176/pdf

Knight, C. (2018). Trauma-informed supervision: Historical antecedents, current practice, and future directions. The Clinical Supervisor, 37(1), 7-37. https://supervisiontraining.ca/wp-content/uploads/2019/01/2018_Carolyn-Knight_TraumainformedsupervisionHistoricalantecedentscurr5bretrieved_2018-09-105d.pdf

O'Donnell, C., Popovich, S., Lee, N., & Hides, L. (2022). Barriers and facilitators to accessing effective clinical supervision and the implementation of a clinical supervision exchange model in the Australian alcohol and other drugs sector. Drug and Alcohol Review. https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/dar.13450

O'Neill, A., Edvardsson, K., & Hooker, L. (2022). Clinical supervision practice by community?based child and family health nurses: A mixed?method systematic review. Journal of Advanced Nursing. https://onlinelibrary.wiley.com/doi/pdf/10.1111/jan.15191

Ranasinghe, C., King, N. A., Arena, R., & Hills, A. P. (2019). FITTSBALL–a dynamic tool for supervision of clinical exercise prescription. Disability and Rehabilitation, 41(26), 3216-3226. https://www.researchgate.net/profile/Chathuranga-Ranasinghe/publication/326669648_FITTSBALL_-_a_dynamic_tool_for_supervision_of_clinical_exercise_prescription/links/5b62c9c2458515c4b259695d/FITTSBALL-a-dynamic-tool-for-supervision-of-clinical-exercise-prescription.pdf

Saarikoski, M., Warne, T., Aunio, R., & Leino-Kilpi, H. (2006). Group supervision in facilitating learning and teaching in mental health clinical placements: a case example of one student group. Issues in Mental Health Nursing, 27(3), 273-285.. https://www.tandfonline.com/doi/abs/10.1080/01612840500502791

Sahebi, B. (2020). Clinical supervision of couple and family therapy during COVID?19. Family Process, 59(3), 989-996. https://www.researchgate.net/profile/Bahareh-Sahebi/publication/343398080_Clinical_Supervision_of_Couple_and_Family_Therapy_during_COVID-19/links/608225d62fb9097c0c01e247/Clinical-Supervision-of-Couple-and-Family-Therapy-during-COVID-19.pdf