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.

A comparative study of clinical supervision in the Republic of Ireland and the United States.

We replicated Son, Ellis, and Yoo (2013) and extended Ellis et al.'s (2014) taxonomy of harmful and inadequate supervision by providing and testing cross-national comparative descriptive data about clinical supervision practices in the Republic of Ireland versus the United States. Participants were 149 Republic of Ireland and 151 U.S. mental health supervisees currently receiving clinical supervision. The results suggested that characteristics of supervision in the Republic of Ireland and United States evidenced both similarities and differences. The dissimilar credentialing systems appeared to account for the observed differences, suggesting that Ellis et al.'s (2014) criteria for inadequate supervision need to be modified to account for country-specific standards for supervision. Unexpectedly, no significant differences were observed between the Republic of Ireland and United States in the high occurrence of inadequate, harmful, or exceptional supervision. The results suggested that 79.2% (Republic of Ireland) and 69.5% (United States) of the supervisees were categorized as currently receiving inadequate supervision, and 40.3% (Republic of Ireland) and 25.2% (United States) of the supervisees as receiving harmful supervision. At some point in their careers, 92.4% (Republic of Ireland) and 86.4% (United States) of the supervisees received inadequate supervision--51.7% (Republic of Ireland) and 39.7% (United States) received harmful supervision. On the positive side, 51.0% (Republic of Ireland) and 55.0% (United States) of the supervisees reported receiving exceptional supervision from their current supervisors. Substantial discrepancies were observed between supervisees' perceptions versus more objective criteria of the inadequate or harmful supervision they received. Implications for cross-national supervision research and training are discussed.

Reducing supervisee anxiety: Effects of a role induction intervention for clinical supervision.

We investigated the effectiveness of a theoretically based role induction (RI) intervention that aimed to clarify supervisee and supervisor role expectations and reduce supervisee anxiety, compared to standard supervision (no-RI). Initially, a feasibility study investigated whether a RI for beginning supervisees would work in the context of a replicated single-subject experimental design; specifically, it assessed whether the RI condition (n = 2) would result in decreased anxiety compared to baseline and a no-RI condition (n = 2). Results suggested that the RI appeared viable and mitigated supervisee anxiety. To address the deficiencies of the feasibility study, for the main study, a more rigorous experimental multiple-baseline research design with randomization procedures was employed to test the effectiveness of the RI intervention for reducing supervisee anxiety in 2 developmentally different groups: beginning supervisees (n = 4) and predoctoral interns (n = 5). Specifically, this study investigated whether supervisee anxiety would be lower following the RI intervention for both groups and whether beginning supervisees would experience larger decreases in anxiety relative to interns. The 3 most salient findings were (a) the efficacy of a RI procedure for reducing the anxiety of novice counselor trainees was tentatively supported, (b) anxiety varied, sometimes markedly, from session to session, but nevertheless was not as pervasive as theorized, and (c) supervisee developmental level appeared to moderate the effects of the RI on supervisee anxiety, such that the RI decreased anxiety for most beginning supervisees and initially increased anxiety for interns. Implications for theory, research, and training are discussed.