“It Works for Me”
Advice and Tips for Teaching/Supervision of the Practicum Trainee
Steve Lisman, Ph.D.
To Supervise or to Teach? --- How about Both?
Do your non-clinical colleagues convey the impression that clinical supervision is easy?...does not involve preparation?... takes less time than classroom teaching?....is not scholarly?.... should not receive teaching credit? Well, then today’s advice column is for you!
Faculty involved in practicum supervision of graduate students in clinical and counseling programs frequently report such complaints by their non-clinical colleagues. What to do? Some of my clinical peers suggest, “Ignore complaining colleagues and continue to do what we do”. But I found that it is more productive to consider that many non-clinical colleagues are simply uninformed about clinical supervision. While examining how to better inform my non-clinical colleagues, I found that I could do so and also improve my supervision by taking into account the kinds of activities that my colleagues readily recognize as “teaching”. After all, clinical supervision is a teaching endeavor.
The problem for my non clinical colleagues was that supervision sounded more like an avuncular chat than teaching as they knew it. It seemed that most of my clinical peers conduct their supervision, whether individually or in a group, by some traditional combination of listening to or watching a recorded session, and discussion of that session with the trainee. And that was it. I thought that it might be useful to develop some guidelines that would parallel the teaching activities of my non-clinical colleagues, and that might also enhance supervision.
First, I learned how much time each week the university administration expects faculty to spend teaching a typical course – comprising prep time and class time, for a course that is not being developed for the first time. That should serve as an upper limit on the amount of time the clinical faculty should be spending in supervision activities, as well as a commitment of time comparable to that of teaching a typical classroom course.
Second, I developed a syllabus. That is, I considered recent texts in psychotherapy and articles that fall into the gaps between formal coursework, articles that affected my training and that may even be in journals that are less familiar to the students. These articles might be strictly clinical (comprising case studies or perspectives on clinical issues), “pre-clinical” (comprising articles in social or cognitive psychology that have direct bearing on how to think about clinical issues), or “translational” (articles that integrate or apply laboratory research with or to clinical domains). The syllabus also contained my own expectations for the supervisees, and was often supplemented by various handouts throughout the year. Of course, supplementary material based on timely readings about the problems of current clients was also frequent.
Third, I structured weekly supervision to include a “seminar” format. Our group would rotate leaders in highlighting the paper or chapter, and developing reactions and questions to foment discussion. This would be followed by the more familiar review of cases, during which issues for supervision would be addressed, both by the initiative of the trainee and the reactions of the supervisor and the rest of the group. How long would this take? – the group supervision meeting and the review/revision of reports and notes between meetings, the addition of individual meetings, and the review of audio/videotape would equal the total teaching time expected by the university for a typical course.
The reaction?
Our faculty consensus was that the format I developed neatly addresses the question of how our clinical supervision can best foster our program model of clinical science. That is, site visitors or accreditation groups can examine selected syllabi and speak to faculty and students about how this strategy works. When faculty are asked each semester to submit their syllabi, some clinical faculty have these detailed, customized descriptions of their supervision course. They are filed with the syllabi of the entire department faculty.
The students are pleased. Students often complain that they do not receive reading suggestions to supplement coursework and their own sometime haphazard searches for materials. They like access to articles that convey their supervisor’s philosophy of therapy and supervision, especially reading that addresses their client issues or their own developing expertise. They express their satisfaction with timelines, contracts (written into the syllabus and then customized for each supervisee), and reading assignments, while concurrently still working with the chaos and uncertainty that clinical work and patients often entails.
When clients do not show up for their session, the supervision meeting is not cancelled; we have plenty to talk about in the form of the readings and the material that spins off from them, typically related to the cases being treated or those that were seen in the recent past, by trainees or by the supervisor.
Problems? Of course. And they are just what you might suspect. While the clinical faculty consensus was that it is a great idea to address the problems described at the outset and to undertake the steps described above, not all have overcome their inertia to take these steps, or fully engage the time commitment (which may even include taking on another supervisee to meet the time commitment that a classroom course entails). Sometimes faculty members do not complete their evaluation of their trainee – whether responding to structured forms or writing a narrative – despite pleading and threats.
But the point of this column is to disseminate what works for some supervisors. And this works for me. I am looking forward to disseminating what you tell me works for you. Send me your advice and tips, and I’ll put them into the next newsletter.
