Training Public Sector Clinicians in Competency-Based Clinical Supervision: Methods, Curriculum, and Lessons Learned.

This article describes an initiative to train public sector clinicians in competency-based clinical supervision. It was delivered as an 18-session course taught online to clinicians employed in departments of behavioral health in nine Southern California counties. The curriculum was co-constructed by a team of clinical supervision scholars and leaders who then served as instructors. Each two-hour meeting addressed a specific topic for which a training video had been prepared, usually featuring a member of the training team who had expertise in that topic. The second part of each meeting focused on a class member's supervision case presentation. Those presentations revealed 35 themes; the four most frequently occurring were: developing supervisees' clinical competencies, addressing countertransference and parallel process, balancing clinical and administrative supervisory roles, and addressing record keeping/paperwork. Participants' pre-to-post supervisory self-efficacy changes demonstrated a moderate effect size (Cohen's d = .46) for the training, with the greatest pre- to post-training changes being in the use of technology, multicultural competencies (awareness of oppression, bias, and stereotyping in clinical work and in clinical supervision), and contracting. They reported that the strengths of the course included an inclusive learning environment and opportunities to reflect on and apply new knowledge and skills, though they also reported struggling with the assignments and the course platform software. Lessons learned reflected the use of technology in this online program, the importance of obtaining buy-in from agency decision makers and being prepared to address challenges related to the use of direct observation in supervision, gatekeeping, and enacting the simultaneous roles of administrative and clinical supervisor.

Telesupervision-of-supervision across national boundaries: United States and China.

This article describes technology-assisted telesupervision-of-supervision, which is a component of a 2-year U.S.-China collaborative program designed to systematically train clinical supervisors in China. Using Zoom conferencing platform, several U.S.-based supervisors facilitated telesupervision-of-supervision groups, with six to ten participants in each group, from different geographic locations in China. This article employs the perspectives of both U.S.-based supervisors and group participants who are themselves supervision scholars in China, describing their experiences and insights about the rewards and challenges of this telesupervision-of-supervision project.

Using accountability mechanisms more intentionally: A framework and its implications for training professional psychologists.

Accountability plays an essential though underexplored role in ensuring quality psychology training. This article considers the accountability of not only training programs but also the people who are involved as faculty, supervisors, and trainees. It discusses the essential processes and purposes of accountability and then suggests a framework that might guide more intentional use of accountability mechanisms. The article then gives examples of how that knowledge might be used to improve psychology training. For example, it makes the distinction between process and outcome accountability and suggests ways in which the latter might be given more prominence.

Ten changes psychotherapists typically make as they mature into the role of supervisor.

Stage models have largely informed scholarship on supervisor developmental processes. We argue that understanding this development as occurring along dimensions is more useful for both supervision practitioners and educators as well as for those engaged in research on supervisor development. Building on the work of Heid () and working with a panel of 7 supervision experts, we identify 10 themes and validate their salience to supervisor development using a sample of 22 clinical supervisors. We describe and elaborate on each theme, and then present and discuss a case vignette that illustrates many of the supervisor developmental themes.

Expertise in psychotherapy: an elusive goal?

It has been argued that psychotherapy is a profession without any expertise (Shanteau, 1992). We examine the validity of this claim, reviewing the literature on expertise, clinical decision making, and psychotherapeutic outcome assessment, and find it a reasonable assessment. There is no demonstration of accuracy and skill that is associated with experience as a therapist. We posit that this absence of an expertise-experience relation is attributable to therapists' lack of access to quality outcome information regarding their interventions and an overreliance on fallible information-processing strategies even when such outcome information is available. The research on providing outcome feedback is reviewed, and although it does relate to client improvement, it has not been shown to be associated with any gains in therapist skill or expertise. We propose a model of outcome information usage and specific a priori hypothesis testing as a means of developing expertise. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Childhood adversity, poly-substance use, and disordered eating in adolescent Latinas: mediated and indirect paths in a community sample.

OBJECTIVE: Although many studies have identified associations between childhood maltreatment and later substance use and disordered eating, few have examined causal or explanatory pathways, and whether victim characteristics predict the development of one versus the other of these outcomes remains uninvestigated. Furthermore, relatively little childhood maltreatment research has examined Latino samples. To address these gaps, this study examined among Latina adolescents the effects of sexual abuse, physical/emotional abuse, neglect, disconnection from family, and parental alcohol problems on poly-substance use and disordered eating, and whether five individual characteristics explain or differentiate these outcomes. METHOD: Data from a community sample of 361 Latina adolescents were analyzed using structural equation modeling. RESULTS: Physical/emotional abuse predicted poly-substance use and weight concerns, and these associations were mediated by impaired current attachment. Disconnection from family predicted bulimic behaviors, and this association was mediated by dysphoria. One indirect path also emerged: Disconnection from family predicted low social conformity, and low social conformity predicted poly-substance use. Childhood sexual abuse did not uniquely predict any adverse outcome or individual characteristic examined. CONCLUSIONS: Dysphoria and impaired current attachment appear to play important roles in the development of substance use and disordered eating in Latina adolescents when physical/emotional abuse or disconnection from family predicts these outcomes. Dysphoria and low social conformity may differentiate the development of bulimic behaviors and poly-substance use, respectively, when family disconnection predicts these outcomes.

Feedback in psychotherapy.

Feedback is defined as a response to an action that shapes or adjusts that action in subsequent performance. Though its pervasiveness in human behavior is noted, feedback in clinical practice is a deliberate psychological intervention that has two essential functions, information and influence. Feedback can be descriptive, evaluative, emotional, and interpretive. The role of feedback in promoting change through interpersonal influence and the role of resistance in the feedback process are discussed. We present practical examples and suggestions for maximizing the effectiveness of feedback and responding therapeutically to resistance. Current outcome research on feedback as a major component of treatment is reviewed and discussed. Implications of the feedback literature for practice are provided.

Voices of the five doctoral training councils in psychology: seeking common ground on Combined-Integrated doctoral training in psychology.

Doctoral training programs in psychology are accredited by the American Psychological Association in four areas: Clinical, Counseling, School, and Combined-Integrated (C-I) psychology. Each area of doctoral preparation in psychology has its own council, which represents its interests within the field and to external constituents. Despite the fact that Combined-Integrated training programs have existed since the mid-1970s, the Consortium representing this area's interests only formed in the past two years. The purpose of this article was to obtain input from representatives of all five training councils regarding the role of the newly formed council in relation to the other councils and the role of Combined-Integrated training. We begin with a brief description of each of the five councils. We then summarize the representatives' responses to narrative questions regarding advantages and disadvantages associated with meeting to discuss the combined model. Finally, common and divergent themes across the councils in training psychologists are presented, and the future role for Combined-Integrated programs is discussed.

Defining competencies in psychology supervision: a consensus statement.

Supervision is a domain of professional practice conducted by many psychologists but for which formal training and standards have been largely neglected. In this article, supervision is proposed as a core competency area in psychology for which a number of elements reflecting specific knowledge, skills, and values must be addressed to ensure adequate training and professional development of the trainee. Supra-ordinate factors of supervision viewed as permeating all aspects of professional development are proposed. These include the perspective that professional development is a lifelong, cumulative process requiring attention to diversity in all its forms, as well as legal and ethical issues, personal and professional factors, and self- and peer-assessment. A competencies framework is presented with particular elements representing knowledge (e.g., about psychotherapy, research, etc.), skills (including supervising modalities, relationship skills, etc.), values (e.g., responsibility for the clients and supervisee rests with supervisor, etc.), and meta-knowledge. Social contextual factors and issues of education and training, assessment, and future directions also are addressed, with specific elements listed. Suggestions for future work in this area are addressed, including the need to refine further and operationalize competences, develop clear expectations for accreditation and licensure regarding supervision competencies, and expand the description of developmental levels of supervisors from minimal to optimal competence. This is one of a series of articles published together in this issue of the Journal of Clinical Psychology. Several other articles that resulted from the Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology will appear in Professional Psychology: Research and Practice and The Counseling Psychologist.

Childhood experiences and psychosocial influences on HIV risk among adolescent Latinas in southern California.

This study determined how adverse childhood experiences influenced risky sexual behavior in a community sample of Latina adolescents in Los Angeles (N = 904) within a modified ecodevelopmental perspective. Psychosocial, sociocultural, and environmental mediators of the relations between childhood experiences and risky sexual behavior were tested. Many direct and mediated paths were revealed using structural equation modeling. Childhood maltreatment was associated with risk sexual practices, including more partners, less condom use, more frequent intercourse, and less HIV testing. Drug use and general self-efficacy mediated several relationships. Reducing childhood maltreatment reduced HIV risk and improved psychosocial functioning. Many factors tested did not influence HIV risk. Much of what is known about HIV risk among other populations may not apply to young Latina women.