Mutual Admiration

Fortifying Your Competency-Based Supervision Experience

Frank N. Thomas[1]
(published in Ratkes 2/2000) 

MUTUAL ADMIRATION:

Susan[2] was frustrated. We were discussing the last semester’s practicum class, as she was assigned to be one of my therapists[3] for the next four months. “He didn’t teach me anything!” she exclaimed. “I mean, it was my first semester of practicum, and I had never seen a client before. I would ask and ask and ask, but he would never tell me what I should do!

Tom was also frustrated. Gaining momentum from Susan’s statement, he said, “My last supervisor tried to tell me what to do all the time! I’ve been doing counseling for 5 years, but that didn’t seem to matter to her. She treated me like I was an idiot!”

I am certain supervision conversations like this happen over and over again. I am just as certain that most supervisors and therapists have few ways to dialogue around these issues for several reasons. First, I believe many supervisors have not articulated their assumptions regarding supervision and, therefore, have not clearly defined their theory of supervision. If supervisors were aware of their biases, they could communicate their intentions more clearly to therapists and make more headway in supervision. Second, most therapists have no way to make sense of, or to communicate, their understandings of their level of competence or their styles of learning. Because therapists rarely formally study supervision or education, they lack explicit ideas pertaining to how they learn, what they know about their styles of learning, and how to have input into the learning process. Finally, I believe it is rare to find a supervisor who practices a learner-centered style of supervision. That is, most supervisors believe they know what therapists need and what a particular therapist must do to become competent.

I propose that we think about supervision as a consumer issue. If supervision was a learner-centered endeavor, shaped by the needs, styles, and expertise of each therapist, I believe the process would result in greater competency, increased openness in the supervision relationship, less hierarchy, and greater therapy effectiveness.

Research Ideas Informing My Changes

Tony Heath and Lisa Tharp (1991) interviewed therapists about their supervision experiences. The Research on Training and Supervision Project at Texas Woman’s University[4] has adopted their research concept, and conversations with the ROTS group have continued to lead me to focus on both therapist views of supervision and supervisor/therapist collaboration in my attempts to gain useful alternative perspectives.

Heath and Tharp categorized the therapist responses from their qualitative research into seven major themes:

1. "We want relationships based on mutual respect. We want mentors."
2. "You don't have to be a guru."
3. "Supervise us or evaluate us. Not both (at the same time)."
4. "Assume that we are competent. We are hard enough on ourselves already."
5. "Tell us what we're doing right. Affirm us. Empower us."
6. "Listen to us. Make supervision a human experience."
7. "We want different things and sometimes what we want changes."

These themes do not reflect my experiences as a young therapist being supervised, and I am certain that most therapists would not find their experiences matching all of these themes. Nevertheless, I can say that they are very useful to me as a supervisor and have led me to utilize different concepts and intentions.

Guiding Metaphors: Guru, Gatekeeper, Guide

Recently, I ran across a newsletter article that has made a significant difference in my teaching and supervision. Norton’s (2000) “Of gurus, gatekeepers, and guides: Metaphors of college teaching” has provided me with both a mirror and a window as I move toward new ways of acting and thinking in supervision.

Norton points out that in the past, teachers have often seen themselves as “gurus.” Learners who are fulfilling their roles sit at the feet of these experts and are filled with knowledge and wisdom as it falls from the mouth of the Learned One. Some supervisors view themselves as repositories of knowledge, dispensing wisdom to the ignorant and correcting the hapless. I certainly experienced this type of supervision as a therapist ... and I probably have been guilty of it as a supervisor as well!

Norton’s second category of teacher is the “gatekeeper.” These professionals view their role as one who regulates entry into a field, keeping those deemed less-than-acceptable outside the gates and admitting only those who have met certain rigorous standards (as well as some frivolous requirements). An example that may make sense to us is the trade union – if one meets certain standards, submits to a lengthy apprenticeship, and receives the endorsement of a “master,” then one might be allowed to join the guild and practice as a master.

But education in the U.S. has changed. Learners are no longer content to be mere commodities. They come to the learning context with rights and privileges. They have resources, expectations, and goals of their own. And most importantly, they have some sense of what they must know and accomplish before they are ready to move to positions independent of the teacher. As a result, these learners respond to someone other than a guru or a gatekeeper. As an example of such a teacher, Norton uses the metaphor of a guide, and, more specifically, a sherpa.

Sherpa refers to people of Tibetan descent living on the southern side of the Himalaya Mountains in Nepal. These brave people have first-hand knowledge of the terrain, weather, and hazards of their habitat, and they often serve as informants, load-bearers, and companions to those seeking to climb unfamiliar mountains in that region. Guides rarely receive the attention they deserve, but that is changing as beneficiaries of their assistance publically recognize the climbers’ dependence on those who have (literally) gone before them. Applying this metaphor to learning, Norton writes the following: “Sherpas go part of the distance with their students; they help them to assemble the tools they will need to climb on alone; they allow them to explore their own tracks; and they help set up the climbs that may well result in being surpassed” (p. 3).

I believe the image of sherpa, or guide, is a metaphor today’s supervisor and teacher of therapists should aspire to. Those seeking our assistance do not appear tabula rasa, awaiting our chiseling on blank stone; nor do they come seeking training as indentured servants. Instead, I believe this Zen saying best summarizes our current supervisory climate: When you are ready to climb the mountain, the sherpa will appear.

Assumptions of My “Competency-Based” Approach to Supervision

Everyone has beliefs about supervision, none of which can be established as true or factual for all circumstances or contexts. I attempt to be deliberate in outlining my assumptions because I believe dialogue is enhanced by making one’s presuppositions available for all to examine. Here are a few ideas that guide my work (some of which can be found in Thomas [1996]):
 

Notes:

1. The supervisor’s job is to focus on what is possible and changeable while identifying and amplifying desired change. This idea is clearly in line with the Heath and Tharp research themes 4 and 5. Rather than extinguishing undesirable behavior or demanding change, I believe it is best to cooperate with directions therapists are already pursuing. Paying attention to what therapists are already doing well encourages learning, reinforces habits, and invites cooperation. By building momentum in directions the supervisor and the therapist can agree to travel together, rapid change is both expected and probable. I relentlessly seek to both identify what I believe are therapist competencies as well as consider what they perceive to be strengths and resources.

2. There are many “right” ways to view and understand the world -- and some are less informed than others. I believe this principle fits well with Heath and Tharp’s numbers 2 and 7. In addition, it simply fits well with my theoretical alignment with social constructionism (Gergen, 1999). Because I see most useful knowledge as locally created and applied, supervision becomes a co-construction of action and meaning. The idea of “correct” is not only contextual, it is also subject to limitations dependent on one’s ability to influence meaning and activity (Fine & Turner, 1997). I am a licensed marriage and family therapist in the state of Texas (USA); therefore, I am subject to laws regulating certain actions. Part of my responsibility to therapists is to offer more than my own personal views – I must also offer (my ideas of) the views of clients, the public, and the legislative bodies regulating the practice of psychotherapy. This expands hierarchy, including not only the obvious position of authority (and corresponding responsibility) of the supervisor but also those persons and organizations that have authority in therapists’ practices (Gardner, Bobele, & Biever, 1997). I have found making this assumption overt in supervision results in less hubris, more open sharing of legitimate perspectives, and an appreciation for the ethical. I have responsibilities I cannot shirk ... but I also know I do not have the view – I only have a view of any situation (von Foerster, 1984).

3. Curiosity and respect should guide (nearly) all I do, think, and say. I see this final supervision assumption to be directly related to Heath and Tharp’s research themes 1, 3, and 6. I strive to gain some understanding of the therapists’ views and experiences, and I attempt to behave in ways that foster mutual respect. Part of achieving this goal of respect involves clarifying roles and contexts with the therapist. There are times when my position as “professor” requires evaluation, and informing therapists when I am marking their progress for grading purposes is an ethical imperative for me. I believe most good therapists listen carefully; therefore, I also strive to listen to therapists’ concerns, feedback, and understandings.

Although I did not intend to include all of Heath and Tharp’s research themes within my brief list of assumptions, it seems I have! But after examining my own presuppositions, what is it that I believe I can offer a therapist in supervision?

Know-How as Knowledge in Supervision

I believe everyone has ideas and practices guiding his or her practice of supervision. As Barbara Held (2000) has clearly stated, all psychotherapy (and therefore supervision) is guided by theory – even those claiming to be antitheoretical. I have found a clinical nursing model of expertise by Benner (1984) to be compelling and useful. For her research, Benner used a model developed by Dreyfus and Dreyfus (1979; see also Dreyfus, 1982) to study airplane pilots. She concluded that “nursing is relational and therefore cannot be adequately described by strategies that leave out content, context, and function” (Benner, 1984, p. 42). She goes on to say:

It is possible to describe expert practice (Kuhn, 1970, p. 192), but it is not possible to recapture from the experts in explicit, formal steps, the mental processes, or all of the elements that go into their expert recognitional capacity to make rapid assessments ... (Experts) do not build up their conclusions, element by element; rather, they grasp the whole. Even when they try to give detailed accounts of the elements that went into their decisions, essential elements are left out” (Benner, 1984, pp. 42f)

Therapy, especially solution-focused brief therapy, has much in common with Benner’s (1984) view: the contextual nature of knowledge; expertise developed through experience; both therapists and “nurses typically try to develop a sense of ‘possibility’ for their patients...” (p. 6); the development of perceptual “sets” or ways of viewing situations; and the idea that “the proficient clinician compares past whole situations with current whole situations” (p. 9). Because of these commonalities, I have adapted Brenner’s work for the “goaling” process I use in supervision.

Benner believes professionals move from novices to experts in three areas: perception, organization (conceptual), and participation. She has found that expertise development is best understood in terms of qualitative shifts rather than cumulative, progressive growth. To accommodate this idea, I have developed a goaling process that combines these three areas with ethics, case management, and skill development to include most areas I believe are central to professional development.

Applying Competency Assumptions to Supervision

To illustrate my “goaling” process, I’d like to offer my views of supervision with three clinicians. Because I have learned a great deal from each of these therapists, they are fair examples of what I try to do in competency-focused supervision.

I do counseling training in two contexts: a university family therapy program for master’s and doctoral students, and a pastoral counseling training center. At the beginning of each semester, I ask all therapists to complete a “goaling” exercise. This written exercise invites therapists’ views of what they desire from supervision over the next four to five months as well as provides an opportunity for each person to inform me of his or her perspective on personal strengths and needs. I refer to this document regularly, as it sets goals for supervision and (may) provide an evaluative basis for grading. Therapists are told that they may alter goals throughout the semester, as they may find a goal to be beyond their reach or they may achieve their target early. Because I want goal setting to be continuous and meaningful, I usually go over goals once a month during individual supervision time to provide a forum for discussing progress. At the end of the semester, both the therapist and I write up an evaluation based on agreed-upon goals that serves as a mile (or, kilometer!) marker for future goal-setting.

The “goaling” document is reproduced below, with three therapists’ responses to selected points. But first, a beginning sketch of each therapist:

Doug, age 35, is an experienced therapist who is masterful at applying both solution-focused (see de Shazer, 1994; DeJong & Berg, 1998) and narrative therapy (see White & Epston, 199) ideas. He has ventured into other social constructionist (Gergen, 1999) models of therapy, including solution-oriented (O’Hanlon & Weiner-Davis, 1989; Furman & Ahola, 1992) and competency-based (Durrant, 1993; Durrant & Kowalski, 1994; Thomas & Cockburn, 1998). Doug has lived in several cultures, is currently married with one child, and speaks 3 languages. He fits well with what Benner (1984) might call a proficient therapist.

Mary, age 45, describes herself as a pastoral counselor who excels at joining with people but lacks specific skills to create change-oriented contexts. She wants to learn competency-based ways of being with clients while at the same time honing her skills as an empathic listener. Mary says she is a “typical middle-class Anglo (white) woman,” is married with no children, and is monolingual. Benner (1984) might call Mary an advanced beginner.

Finally, Karen, age 25, is a diamond-in-the-rough. She is a new master’s student, conducting therapy for the first time in her life. She is nervous about learning therapy because she wants to do well for the sake of those coming to her for help. Karen is a lesbian, a member of a minority culture in the U.S., and single. Karen would fall into the novice category created by Benner (1984).

This is the introduction I have written for the “goaling” exercise:

I will set some goals for you this semester . . . and you need to set goals for your learning as well. These are to be completed in one week and returned to me. Retain a copy, as we will use this throughout the semester and as a part of your evaluation at semester’s end. Feel free to discuss altering your goals at any time -- I want this to be useful for you!

Whenever possible, please make your goals MEASURABLE, ATTAINABLE, and OBSERVABLE. This will aid the supervision/learning process because others – including your instructor -- will be able to witness your progress. Some of these goal areas include my personal bias; that is, I believe you need to set goals in all areas, but Areas #1 and #6 are areas I believe have standards that must be upheld. Feel free to raise this with me at any time. Let’s proceed!

Goal Area #1: Case Management: writing consistent case notes, writing treatment plans, complying with Clinic policies (example: “I will attain consistency in my case notes with the SFBT model by the end of the semester in 90% of my cases”).

DOUG: I will strengthen my ability to remain on-track with client goals by developing a specific, observable goal (or goals) for every (100%) client and intentionally renegotiating goals during the course of therapy. Of course, my case notes will be completed in 24 hours.

MARY: I will manage my client paperwork efficiently by completing the case summary within 48 hours of the session 90% of the time. (I tried 24 hours in the past and failed pitifully. I will go for 48 hours and make a concerted effort.)

KAREN: I will attain consistency in my case notes with Solution Focused Therapy by the end of the semester in 2/3 of my cases, which will be assessed by my use of a Solution Focused Format I will develop to write them on. I will write case reports for the (practice site name) the same week as the session 90% of the time.

Goal Area #2: Therapeutic Relationships: conveying warmth, respect; use of self (example: “I will convey ‘respect’ to my clients in 50% of my cases, depending on peer, supervisory, and client feedback for evaluation”).

Goal Area #3: Perceptual Competencies: ability to observe pattern, see nonverbal behavior, distinguish content/process, self-awareness (example: “I will be able to identify relevant nonverbal behavior in each session, to be evaluated through the Client Session Summary’s ‘client nonverbal behavior’ section and feedback from clients and supervisor”).

DOUG: I will increase my ability to choose intentionally between a “not knowing” and an “appropriate knowing” position once in each session.

MARY: I will be able to identify theological themes related to the clients’ presenting problem(s) in each session. I will seek to clarify with each client how the spiritual aspect fits into his or her understanding of the difficulty whenever appropriate.

KAREN: I will be able to observe patterns of behavior in 50% of my couple and family sessions, which will be assessed by including these observations in my case notes. I will be able to distinguish content from process in 90% of my sessions, to be assessed by comparing my notes with my supervisor’s observations in this area.

Goal Area #4: Conceptual Competencies: ability to think within the assumptions of your model; ability to base clinical work (goals, interventions, termination) on model/theory; systemic thinking skills; ability to incorporate idiosyncratic, gender, and cultural aspects (example: “I will assess cultural factors in 75% of my first sessions and report these factors in supervision the next supervisory session”).

Goal Area #5: Participatory Competencies: changing your approach when stuck; controlling when exchanges are nonproductive or chaotic; terminating sessions; follow through with homework (example: “I will check on homework assignments on 90% of my cases in which homework is assigned”).

DOUG: I will increase my ability to change my approach when stuck to 100% of the time. I will assess this with my supervisor on a random basis.

MARY: I will ask each client, in 90% of our sessions, “How can I help you today?” and tying that response to the agreed-upon goals for therapy. The purpose of this is to develop new ways of beginning sessions with clients, which will set a therapeutic direction for the session. Evaluation: show 2 examples of this to my supervisor each week for feedback.

KAREN: I will end sessions with positive comments 90% of the time. I will also control chaotic or nonproductive exchanges by bringing the focus back to therapy goals in 80% of such situations. This will be evaluated by showing videotaped examples to my supervisor at least twice per month.

Goal Area #6: Client Feedback: Decide and outline how you will gain client feedback on your cases. I expect direct client responses to your work in writing (i.e., client feedback sheets), through third-party interviewing, on tape, and/or in your notes on 50% of your cases, starting immediately.

Information Area #1: How can I best help you meet your goals? How can others in the practicum help you?

DOUG: You can best help me meet my goals by holding me accountable for those I neglect to “check in” on and by commenting on my progress in supervision. I also hope you will point out other areas for growth or other issues that I may want/need to address. Others at the (training site) can help me by addressing feedback to goals I identify in specific case conferences and role plays.

MARY: You can best help me meet my goals by holding me accountable, asking questions, and giving me feedback.

KAREN: You can best help me meet my goals by giving me specific examples of how I could have handled difficult situations better; by helping me develop the ability to assess things in the framework of my model, even in the midst of confusing sessions; by giving me the opportunity to practice skills in class; by giving me direction as to where to go or how to handle difficult cases/situations; by helping me develop the ability to write appropriate treatment plans; and by helping me become more confident as a therapist.

Information Area #2: How do you best learn?

DOUG: I lean by observation, seeing someone model behavior I would like to learn, and through a personal mentoring relationship. Secondary learning styles include reading and critical reflection on specific issues.

MARY: I learn best by action, followed by reflection.

KAREN: I best learn by visual demonstration and experiential participation. Role plays working on different techniques and ways to handle difficult situations would be very helpful. I also find it helpful to watch video tape of you or some other experienced therapist doing therapy.

Information Area #3: What is your best therapeutic model, at this point in your career? Why?

Information Area #4: What is your top interpersonal strength?

Information Area #5: What is your greatest systemic strength?

Information Area #6: What do you need to get from supervision with me this semester to call it a “success”?

DOUG: In order for our supervision to be a success, I need you to consistently push my learning edges; to compliment me when it is warranted(I am my own worst critic and tend to discount my success); and to model an orientation toward expectation of change and solutions.

MARY: From supervision, I need to get fresh ideas for approaching client problems and honest feedback regarding my clinical abilities and skills.

KAREN: the opportunity to get constructive feedback and positive reinforcement for my work. I need the opportunity to try to identify positive and negative aspects of different people’s therapy. I need the opportunity to practice new skills in a supportive environment where I can get immediate feedback and then try to modify my behavior accordingly.

One can discern clear differences between the goals and learning styles of each therapist. In order to better grasp the distinctions each draws, I frequently refer to the goaling form and attempt to fit with each person’s motivation and style.

Concluding Thoughts

I aspire to join with therapists I supervise in such a way that they can take on this challenge called therapy with confidence in me, their “sherpa.” My admiration grows with each step they take, and I strive to earn their respect as I guide them toward goals we agree are worthy of their efforts. It truly can become a society of mutual admiration!

REFERENCES

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison Wesley.

DeJong, P. & Berg, I.K. (1998). Interviewing for solutions. Pacific Grove, CA: Brooks/Cole.

de Shazer, S. (1994). Putting difference to work.. New York: Norton.

Dreyfus, S.E. (1982). Formal models vs. human situational understanding: Inherent limitations on the modeling of business expertise. Office: Technology and People, 1, 133-155.

Dreyfus, S.E. & Dreyfus, H.L. (February 1979). The scope, limits, and training implications of three models of aircraft pilot emergency response behavior. Unpublished report supported by the Air Force Office of Scientific Research (AFSC), USAF (Grant AFOSR-78-3594), University of California at Berkeley.

Durrant, M. (1993). Residential treatment. New York: Norton.

Durrant, M. & Kowalski, K. (1994). Enhancing views of competence. In S. Friedman (Ed.), The new language of change: Constructive collaboration in psychotherapy. New York: Guilford.

Fine, M. & Turner, J. (1997). Collaborative supervision: Minding the power. In T.C. Todd & C.L. Storm (Eds.), The complete systemic supervisor: Context, philosophy, and pragmatics (pp. 229-240). Boston: Allyn and Bacon.

Foerster, H. von (1984). On constructing a reality. In P. Watzlawick (Ed.), The invented reality (pp. 41‑62). New York: Norton.

Furman, B. & Ahola, T. (1992). Solution talk: Hosting therapeutic conversations. New York:Norton.

Gardner, G.T., Bobele, M., & Biever, J.L. (1997). Postmodern models of family therapy supervision. In T.C. Todd & C.L. Storm (Eds.), The complete systemic supervisor: Context, philosophy, and pragmatics (pp. 217-228). Boston: Allyn and Bacon.

Gergen, K.J. (1999). An invitation to social construction. Thousand Oaks, CA: Sage.

Heath, A. and Tharp, L. (November, 1991). What therapists say about supervision. AAMFT, Dallas.

Held, B. (2000). To be or not be theoretical: That is the question. Journal of Systemic Therapies, 19(1), 35-49.

Kuhn, T.S. (1970). The structure of scientific revolution. Chicago, IL: University of Chicago Press.

Norton, M.K. (April 21, 2000). Of gurus, gatekeepers, and guides: Metaphors of college teaching. First printed September 1999, Vol. 1, Num 1, “Teaching at TWU” Newsletter.

O'Hanlon, W.H. & Weiner‑Davis, M. (1989). In search of solutions. New York: Norton.

Thomas, F.N. (1996). Solution‑focused supervision: The coaxing of expertise in training. In S.D. Miller, M.A. Hubble, & Duncan, B. (Eds.), Handbook of solution‑focused brief therapy: Foundations, applications, and research (pp. 128-151). San Francisco: Jossey‑Bass.

Thomas, F.N. & Cockburn, J. (1998). Competency-based counseling. Minneapolis: Fortress Press.

White, M. & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.

[1] Frank N. Thomas, PhD, is Associate Professor and Clinical Graduate Faculty, Family Therapy Program, Texas Woman's University, Denton, Texas (USA) and Occasional (adjunct) Faculty, Brite Divinity School, Texas Christian University, Fort Worth, Texas. He is a licensed marriage and family therapist (Texas) as well as a Clinical Member and Approved Supervisor with AAMFT. His website is and his email is .

[2]Names of all therapists have been changed to protect their confidentiality.

[3] I refer to “supervisees” and “student therapists” as “therapists,” as I have found they experience that term as more respectful.

[4] The R.O.T.S Project includes Brenda Brunner, Terry Bysom, Chip Chilton, Adam Coffey, Shari Scott, and Kristi Shappee. Their energy, curiosity, and experience drives my desire to understand therapist viewpoints and advocate for more collaborative supervision.