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The History and Traditions of Clinical Supervision

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The History and Traditions of Clinical Supervision 1 THE HISTORY AND TRADITIONS OF CLINICAL SUPERVISION The traditional literature of counselling supervision seems to lack uncertainty and timidity. It is mostly written from the supervisor’s, or supervisor trainer’s perspective and seems to be full of models, structures, checklists and frameworks. It is not a humble or exploratory literature. —Jane Speedy (2000, p. 3) rom the early medical models of supervi- my own second opinions with regard to how they sion, such as the psychoanalytic models of fit with strengths-based supervision. Along the F learning while being analyzed, to the way, I offer that other component—the super- “study one, watch one, do one, teach one” visee’s point of view—as a vehicle to fill Jane method that medical schools have used, our early Speedy’s (2000) critique for a more holistic point models are still embedded in the supervision and of view. training models of our sisters and brothers in Long-time author and a leader in the field of medicine. Even our educational models that supervision, Janine Bernard (see, e.g., Bernard, teach concepts and then spend time pointing out 1981, 1989, 1992, 1997, 2004, 2005), retrospec- mistakes for remediation more than praising tively reviewed one of her earlier works with strengths are solidly in this camp. Linked to a George Leddick and noted that it was easy to hierarchical arrangement and aimed at problem- review the literature of professional supervision focused evaluation and change, our roots have back then, when compared to today (Leddick & mirrored those early modernist days. Miller, Bernard, 1980). Clinical supervision has become Hubble, and Duncan (2007) stated that the usual a large and expanding field, as we have seen focus on what a clinician did wrong, rather than already. In reviewing the field, however, I have looking for what might be more effective, is a noticed that there is little specific literature about terrible fault of our more traditional thinking clinical supervision per se, and as with many (Miller et al., 2007). This chapter looks at what specific fields, the new branches off the base are history has provided us as a base for our practice, growing strong and varied, with offshoots that as well as an assembly of the nuts and bolts of parallel the growth of our field of clinical work. how the field of clinical supervisor practices in Today, we have models, methods, and points to its various forms, styles, and models. I also offer remember about clinical supervision, and they 3 4 • PART I. IN THE BEGINNING all have a synergy to them that keep them in us for clinical work, consultation, or supervision. flow. Leddick (1994) addressed the issue of Of course there are differences, but they are still models of supervision, indicating that one could clients of ours, regardless. We are about protect- categorize them in three general models: devel- ing and providing a profession service to both opmental, integrated, and orientation specific. clients who come for clinical work, as well as “The systematic manner in which supervision is our supervisees. The term supervisor, as we shall applied is called a ‘model,’ ” (Leddick, 1994, p. 1) come to see, entails many conflicting as well as and this indicates that specific knowledge of a complimentary behaviors and social constructs. model, such as practices, routines, and beliefs What a clinically trained cognitive behavioral (social constructions), are critical to understand- psychologist may believe about supervision will ing clinical supervision. I want to remind the be different in many ways from what a Narrative reader again that from my point of view, the Therapy social worker or even psychiatrist may decision to use either a strengths-based meta- act and think, and a brand new doctoral level model or a problem-focused model is the most counselor educator may have even a different important “practice” a supervisor and clinician view. These beliefs about how to supervise can make up front. There is a lot to know about someone are socially constructed and learned before practicing clinical supervision, but I don’t both from their own experience, as well as in think it is daunting. I will take care to walk you their education. What follows is some of the his- through it all. tory of clinical supervision and the methods and Methods of supervision include the nuts and beliefs attached, followed by, in Chapters 4 and 5, bolts of providing supervision, from the initial a strengths-based perspective that varies by supervisory contracting, to methods of observa- degrees and also by kilometers. tion or data gathering such as live, audio, or Finally, points of interest that include adher- video tape and interpersonal process recall, uti- ing to a multicultural context, philosophy of lized in one-on-one, group, cotherapy, or triadic training (pedagogical vs. andragogical and mod- supervision formats, as well as case presentation, ernist vs. postmodernist), and all the currently modeling, feedback, intervention, and evalua- applied and researched adjoining components tion. These are the day-to-day or session-to- that inform us of what connects with good clini- session mechanics that frame supervisory work, cal supervision, are covered. and they allow for a smooth process. There is a fine line, I believe, between what we do with our clients and what we do with our HISTORY: SOMEWHAT BRIEFLY supervisees. This book’s manuscript has been sent out to a gaggle of other professionals—all Predating many of the deep tomes on supervision from academia I must add—and many have had are an edited book called Social Work Supervision difficulty with my grouping clients and supervi- by Munson (1979) and another called Supervision sors under the term “client.” It is my contention in Social Work by Kadushin and Harkness (1976). that anyone we see in a professional capacity, be Kadushin and Harkness point out that, prior to the they coming for clinical work, supervision, or 1920s, the literature that cited supervision meant consultation, are clients. According to Merriam- something completely different than what we Webster, a client is “1) one that is under the now associate with the noun. The first text about protection of another, 2) a person who engages social work supervision was published in 1904. It the professional advice or services of another” was called Supervision and Education in Charity (see http://www.merriam-webster.com/dictionary/ and was authored by Jeffrey Brackett (as cited by client). So I hope that clears up any faulty per- Kadushin & Harkness, 2002). Brackett’s book ceptions. Again, I call anyone we are working was about the supervision of institutions of wel- with a client, be they a person who comes to see fare organizations and Kadushin and Harkness Chapter 1. The History and Traditions of Clinical Supervision • 5 stated the following: “Supervision referred to Allen Hess wrote his “seminal” book, the control and coordination function of a State Psychotherapy Supervision, in 1980, 1 year after Board of Supervisors, a State Board of Charities, Munson (1979) and 4 years after Kadushin and or a State Board of Control” (2002, p. 1). Inter- Harkness (1976) published their works on super- estingly, social work apparently had a hand in vision in social work. To those of us outside the administrative supervision long before the texts field of social work, Hess’s volume was a gift on it were published by the American Counseling that put some sense to what we were doing; some Association (Henderson, 2009). Of even more of us went for years without any solid thought, interest to me is the statement that as supervi- other than the commonsense. Heath and Storm sion moved from that of administrative focus to (1985) later pointed out, that most supervisors, at direct supervision, it took on the meaning and some level, use their own favorite clinical model action of “helping the social worker develop to inform their clinical supervision practice. practice knowledge and skills, and providing Hess (2008) suggested that the very first emotional support to the person in the social clinical supervision occurred after the first ther- work role” (Kadushin & Harkness, 2002, p. 2). apy session, with a lone clinician observing the Nowhere is it mentioned that supervision also feedback, either positive or negative, from the required or focused on the evaluation of deficits interventions he provided, and correcting his that can be associated with the field today. These work so that it was more effective—a self- days, those who have been gatekeeping the pro- reflective personal supervision, if you will. He fession have morphed this view to one where also pointed to Breuer and Freud, as they “hierarchy and evaluation are so intertwined worked on their ideas of hysteria and how it led with supervision that to remove them makes the to breakthroughs in their work as the first docu- intervention [emphasis added] something other mented peer supervision, as well as the than supervision” (Bernard & Goodyear, 2004, Wednesday evening group meetings in Freud’s p. 12) and “supervision plays a critical role in home, where theories as well as case consulta- maintaining the standards of the profession” tions were held (Breuer & Freud, as cited by (Holloway & Neufeldt, as cited in Bernard and Hess, 2008, pp. 3–4). Goodyear, 2004, p. 2). I wonder how it is that According to Goodyear and Bernard (1998), supervision became an intervention rather than the literature on the practice of mental health “providing emotional support” (Kadushin & supervision places its beginnings over 120 years Harkness, 2002, p. 2). ago, when social work was involved early on Social work has a long and proud tradition of with supervision (Harkness & Poertner, as cited providing supervision to those in the trenches by Goodyear & Bernard, 1998, p.
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