A Practical Guide to Clinical Supervision in Genetic Counseling

Cover
Series
A Practical Guide to Clinical Supervision in Genetic Counseling
Copyright
Contents
Preface
About the Authors
Contributors
1. Introduction to Supervision Theory and Practice
	Objectives
	What Is Clinical Supervision?
	Who Does Supervision Serve?
	Reciprocal Engagement Model of Supervision
		REM-​S Tenets and Goals
		REM-​S Supervisor Strategies
	Supervisor Competencies
	Supervision Is Hierarchical
	Why Serve as a Supervisor?
	Closing Thoughts
	Learning Activities
		Activity 1.1 Supervisor Self-​Assessment
		Activity 1.2 Reflecting on Supervision
		Activity 1.3 Wearing Different Supervisor Hats
		Activity 1.4 Genetic Counseling Supervisor Competencies
		Activity 1.5 REM-​S Goals
	Appendix 1A: Genetic Counseling Supervisor Competencies
	Appendix 1B: The Psychotherapy Supervisor Development Scale
2. Supervisory Styles
	Objectives
	Stylistic Differences
		Consultation Style
		Teaching Style
		Counseling Style
		Evaluation Style
		Style Limitations
		Additional Comments About Supervisory Styles
	Behaviors Common to Supervisory Styles
	Closing Thoughts
	Learning Activities
		Activity 2.1 Identifying Supervisory Styles
		Activity 2.2 Using Supervisory Styles
		Activity 2.3 Supervisory Focus and Style
		Activity 2.4 Supervision Metaphors
		Activity 2.5 The Counselor Supervisory Style
		Activity 2.6 Supervisory Styles: Triad Role Plays
	Appendix 2A: Learning Activities Answer Key
3. Setting the Stage for Supervision
	Objectives
	Initiating the Supervisory Relationship
		Building a Supervision Working Alliance
	Prepping for Supervision: Anticipatory Guidance Strategies
		Student and Supervisor Questions
		Supervision Information Statements and Agreements
		Additional Strategies to Set the Stage for Supervision
	Closing Thoughts
	Learning Activities
		Activity 3.1 Working Alliance Factors
		Activity 3.2 Prepping for Supervision—​Getting Started
		Activity 3.3 Prepping for Supervision—​Anticipating Student Questions
		Activity 3.4 Challenging Student Questions
		Activity 3.5 Supervision Information Statement/​Agreement
	Appendix 3A: Genetic Counseling Student Questions About Supervision
	Appendix 3B: Genetic Counselor Supervisor Questions About Students
	Appendix 3C: Sample Information Sheet
	Appendix 3D: Sample Information Agreement
4. Culturally Engaged Supervision
	Objectives
	Introduction
	Important Terminology
		Culture
		Cultural Competence
		Cultural Humility
		Cultural Engagement
		Additional Terms
	Foundations in Theory and Research
	Culturally Engaged Supervision: Applications and Strategies
		Starting Point: Cultural Self-​Awareness
		Entry Points: Communication
	Challenging Issues: Microaggression/​Racism
	Continuing the Work
	Closing Thoughts
	Learning Activities
		Activity 4.1 Cultural Self-​Awareness
		Activity 4.2 Communication Style Dimensions
		Activity 4.3 Culture Sharing in Supervision: Dyad Role Plays
		Activity 4.4 Challenging Situations: Dyad Role Plays
		Activity 4.5 Culturally Engaged Supervision
	Appendix 4A: Cultural Identities and Their Intersection
	Appendix 4B: Communication Style Dimensions
	Appendix 4C: Culture Sharing Worksheet
5. Models of Supervisor and Student Development
	Objectives
	Supervisor and Supervisee Developmental Models
		Supervisor Models
		Common Themes in Supervisor Models
		Supervisee Developmental Models
	Supervisor and Supervisee Developmental Challenges: Parallel Processes
	Developmentally Based Interventions for Supervisors
	Developmentally Based Interventions for Students
		Engage in Assessment
		Match Interventions to Developmental Level
		Use Examples
		Assign Scaffolding Tasks/​Experiences
	Counseling Independently
		Assess Student Readiness
		Prepare Students to Counsel Independently
		Prepare Yourself for Students to Counsel Independently
	Closing Thoughts
	Learning Activities
		Activity 5.1 Supervisor Development Self-​Reflection
		Activity 5.2 Supervisor Development Self-​Assessment
		Activity 5.3 Experiential Evolutionary Scaffolding
		Activity 5.4 Addressing Student Developmental Issues: Triad Role Plays
		Activity 5.5 Supervisor and Student Developmental Stages
6. Setting Goals in Supervision
	Objectives
	What Are Goals and Why Are They Useful?
		Types of Performance Goals
	Characteristics of Viable Goals
	Goal-​Setting Processes
		Determining Goal Content
		Establishing Goal Levels: Bloom’s Taxonomy
	Goal-​Setting Strategies
		Establish Long-​ and Short-​Term Goals
		Regularly Review Long-​ and Short-​Term Goals
		Make Goal Setting a Collaborative and Focused Process
		Modify Goals as Appropriate
		Recognize and Manage Common Goal-​Setting Pitfalls
		Evaluate Your Goal-​Setting Skills
	Strategies for Promoting Goal Accomplishment
		Mind Mapping
	Closing Thoughts
	Learning Activities
		Activity 6.1 Writing Viable Goals
		Activity 6.2 Connecting Goals to Behaviors and Goal Measurement
		Activity 6.3 Writing Goals Using the Discrimination Model and Bloom’s Taxonomy
		Activity 6.4 Mind Mapping to Promote Goal/​Strategy Accomplishment
		Activity 6.5 Setting and Prioritizing Short-​Term Goals
7. Giving and Receiving Feedback
	Objectives
	Types of Feedback
		Positive Feedback
		Corrective Feedback
	Characteristics of Helpful Feedback
	Strategies for Promoting Helpful Feedback  Interactions
		Create a Framework for Feedback
		Use Evocative Feedback Strategies When Feasible
		Shape Students’ Self-​Critique Skills
		Provide Timely Feedback
		Be Honest and Direct
		Provide Sufficient, Balanced Feedback
		Be Strategic, Selective, and Sensitive to Student Reactions
		Provide Specific Feedback and Place It in  a Context
		Recognize Corrective Feedback May Take Time to “Land”
		Provide Oral and Written Feedback
	Feedback Regarding the Supervisor and Supervision Relationship
		Supervisor Self-​Feedback
		Student Feedback
	Closing Thoughts
	Learning Activities
		Activity 7.1 Reflecting on Feedback
		Activity 7.2 Feedback Challenges and Strategies
		Activity 7.3 Challenging Student Responses to Feedback
		Activity 7.4 Challenging Supervisor Feedback Statements
		Activity 7.5 Giving Feedback: Triad Role Plays
8. Evaluation in Supervision
	Objectives
	Evaluation Functions and Criteria
		Formative Versus Summative Evaluation
		Evaluation Criteria
	Approaches to Student Evaluation
		Likert-​Style Evaluations
		Anchored Rubrics
		Qualitative Feedback
		Client Feedback
		Student Self-​Evaluation
	Evaluation Challenges
		Subjectivity
		Power Dynamics
	Strategies for Promoting an Effective Evaluation Process
	Evaluating the Supervisor
	Closing Thoughts
	Learning Activities
		Activity 8.1 Summative Versus Formative Evaluation
		Activity 8.2 Skill-​Specific Anchored Rubrics
		Activity 8.3 Evaluating Student Goals
		Activity 8.4 Qualitative Final Evaluation: Triad Role Plays
		Activity 8.5 Client Feedback Forms
	Appendix 8A: Genetic Counseling Self-​Efficacy Scale
9. Supervision for Self-​Reflective Practice
	Objectives
	What Is Self-​Reflective Practice?
	Self-​Reflection in Supervision
	Strategies for Promoting Student Self-​Reflective Practice
		Cultivate and Model Your Own Self-​Reflection Skills
		Set the Stage with Directed Self-​Reflection Protocols
		Work on Minimizing Barriers to Student Reflective Practice
		Use Evocative Strategies
		Give Students Self-​Reflection Assignments to Complete Outside of Supervision Meetings
		Debrief Role Plays and Counseling Sessions Using Interpersonal Process Recall
		Use Processes from Socratic Dialogue During Supervision
	Closing Thoughts
	Learning Activities
		Activity 9.1 Creating a Self-​Directed Protocol
		Activity 9.2 Engaging in Socratic Dialogue
		Activity 9.3 Supervision Self-​Reflection
		Activity 9.4 Interpersonal Process Recall Debriefing: Role Plays
		Activity 9.5 Using Evocative Strategies in Supervision: Triad Role Plays
10. Fostering Psychosocial Skill Development
	Objectives
	What Are Psychosocial Skills and Why Are They Important?
		Types of Psychosocial Skills
	Strategies for Building Students’ Psychosocial Skills
		Discuss Definitions and Perspectives
		Recognize and Address Barriers to Using Psychosocial Skills
		Assess Student Psychosocial Skills
		Set Developmentally Appropriate Goals
		Model Psychosocial Skills
		Use Directed Self-​Reflection Protocols
		Assign Psychosocial Case Preparations
		Engage in Role Playing
		Debrief with Interpersonal Process Recall Methods
		Use Mind Mapping Methods
		Connect Psychosocial Skills to Their Effects
	Closing Thoughts
	Learning Activities
		Activity 10.1 Addressing Student Misperceptions About Psychosocial Skills
		Activity 10.2 Psychosocial Case Preparations
		Activity 10.3 Directed Self-​Reflection Protocol
		Activity 10.4 Mind Mapping
		Activity 10.5 Addressing Students’ Use of Psychosocial Skills: Triad Role Plays
11. Ethics and Professionalism in Supervision
	Objectives
	Supervisor Responsibilities
	Ethical Considerations in Clinical Supervision
		Supervision Agreement
		Modeling
		Multiple Relationships
		Boundary Crossings and Boundary Violations
		Additional Issues
	Strategies to Promote Ethical and Professional Supervision Practice
		Make a Lifelong Commitment to Ethical Awareness, Sensitivity, and Behavior
		Set and Maintain Clear Boundaries Around the Supervision Relationship
		Manage Multiple Relationships in an Ethical  Manner
		Delineate and Enforce Your Expectations  of Students
		Develop a Strong Supervisory Working Alliance
	Closing Thoughts
	Learning Activities
		Activity 11.1 Addressing Student Questions About Ethical and Legal Aspects of Supervision
		Activity 11.2 Boundaries in Supervision  Discussion
		Activity 11.3 Strategies for Addressing Boundary Issues in Supervision
		Activity 11.4 Addressing Ethical Situations: Triad Role Plays
		Activity 11.5 Ethical Decision-​Making
12. Promoting Student Wellness
	Objectives
	What Is Wellness?
		Resilience
		Self-​Care
	The Role of Supervision in Promoting Student Wellness and Self-​Care
		Stress and Distress
		Supervisor Responsibilities
	Wellness and Self-​Care Strategies
		General Strategies
		Genetic Counselor Wellness Strategies
		Specific Strategies
		Tips for Promoting Student Self-​Care Practices
	Closing Thoughts
	Learning Activities
		Activity 12.1 Self-​Care Practices
		Activity 12.2 Assessing Student Wellness
		Activity 12.3 Setting Wellness Goals
		Activity 12.4 Sources of Stress and Stress Management
		Activity 12.5 Self-​Care Behavior
	Appendix 12A: Self-​Care Behavior Inventory
13. Recognizing and Addressing Student Problematic Performance
	Objectives
	What Is Problematic Performance?
		Problematic Performance Indicators
		Types of Problematic Performance
	Addressing Problematic Performance
		Identify Barriers to Addressing Student Behaviors
		Follow a Deliberate Process
		Prepare Yourself for Initial Conversations
		Be Planful and Deliberate During Conversations
		Additional Strategies to Support Remediation Efforts
	Closing Thoughts
	Learning Activities
		Activity 13.1 Remediation Conversations
		Activity 13.2 Problematic Performance
		Activity 13.3 Barriers to Supervision
		Activity 13.4 Addressing Student Problematic Performance
		Activity 13.5 Developing an Intervention to Improve Student Problematic Performance
14. Common Clinical Supervision Challenges
	Objectives
	Supervisor–​Student Conflict
		Types of Supervision Conflicts
		Conflict Management Strategies
		Example of Addressing a Conflict: Student Autonomy Versus Imitation
	Supervisor Countertransference
		Sources of Supervisor Countertransference
		Types of Countertransference
		Behaviors That Suggest Countertransference
		Strategies to Manage Countertransference
		Example of Addressing Countertransference: Disliking a Student
	Student Anxiety
		Types and Sources of Anxiety
		Behaviors Suggestive of Anxiety
		Anxiety Management Strategies
		Example of Addressing One Source of Student Anxiety: Multiple Supervisors
	Closing Thoughts
	Learning Activities
		Activity 14.1 Conflict in Supervision
		Activity 14.2 Countertransference Self-​Reflection
		Activity 14.3 Addressing Countertransference
		Activity 14.4 Student Anxiety
		Activity 14.5 Addressing Student Anxiety
15. Supervision Delivery Methods
	Objectives
	Live Supervision
		Live Supervision Advantages
		Live Supervision Challenges
		Other Considerations Regarding Live Supervision
	Self-​Report
		Self-​Report Advantages
		Self-​Report Challenges
		Integrating Self-​Report into Genetic Counseling Supervision
	Standardized Patients
		Standardized Patient Advantages
		Integrating Standardized Patients into Genetic Counseling Supervision
	Peer Group Supervision
		Peer Groups for Professionals
		Peer Groups for Students
		Peer Observation and Feedback
	Remote Supervision
	Closing Thoughts
	Learning Activities
		Activity 15.1 Reflections on Supervision Delivery Methods
		Activity 15.2 Challenges in Live Supervision
		Activity 15.3 Client Reactions to Student Involvement
		Activity 15.4 Generating Questions for Self-​Report
		Activity 15.5 Creating Guidelines for Peer Supervision Groups
Appendix: Instructional Tips for Building Supervision  Training Opportunities
References
Index