Document 1 - Supervisor Training Workshop - A Competency-Based Approach to Supervision

8/12/2019 Document 1 - Supervisor Training Workshop - A Competency-Based Approach to Supervision

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Presenter

Assoc ProfCraigGonsalvez

ACompetencyBased

ApproachtoSupervision:

BasicSkills

TrainingMaterial


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A competency-based approach to

supervision: Basic skills

Craig Gonsalvez

Wollongong, May 2013

1

2

Overview Day

Session 1: 9.00 am to 10.30 am

Coffee break

Session 2: 11.00 am to 12.30 pm

LUNCH break

Session 3: 1.30 pm to 3.00 pm

Tea break

Session 4: 3.30 to 4.30 pm

Assoc Prof C GonsalvezSchool of Psychology, University of Wollongong


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3

Overview Day

Session 1: Competency-based approaches to clinical supervision

Small group activity: Establishing supervision plans

Session 2: Video review techniques to conduct supervision

Small group activity focusing on skills training

Session 3 The emotion graph video review technique

Session 4

Attitude-value competencies in peer supervision

Objective for Workshop

Enhance understanding of competency models of

supervision

Principles

Implications for practice

Demonstrate two important competencies

Designing a competency bases supervision plan

Use of videotapes to facilitate skills competencies

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1.2 Psychotherapy-based

models: CT vs CT SupervisionCognitive Therapy Cognitive Therapy Supervision

Mood check Check in

Agenda setting Agenda setting

Bridge from previous therapy session Bridge from previous supervision sess.

Inquiry about primary problems Inquiry regarding previous cases

Review of homework Review of homework

Prioritisation and coverage of agenda Prioritisation and coverage of agenda

Assignment of new homework Assignment of new homework

Use of capsule summaries Capsule summaries by supervisor

Client feedback on Ts

conceptualisation

Supervisee feedback on Sr

conceptualisation

7Liese & Beck, 1997

1.3 Developmental models

Dominated supervision theory and practice

Therapists progress through distinct stages

Need for developmentally appropriate strategies

Implications for therapists and supervisors Criticisms: Lack of consensus, overly general

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1.4 Competency Models:

Characteristics Start with the end in mind

Output rather than an input model

Atomistic in its conceptualisation of

competence; task-analytic approach

Criterion based: notionally absolute

Emphasis on demonstration/measurement

Desirable: evidence-based, transparent

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2.1 Competence: Definition

Sufficiency of a broad spectrum of personal and

professional abilities relative to a given requirement

(Falender & Shafranske, 2004)

Unique assemblages of discrete clinical abilities that

incorporate the specific knowledge, skills, values,

emotions, etc., required to perform the specific

professional activity (Falender & Schafranske, 2007)

May be easier to identify in its absence (Kitchener, 2000*)

Not the absolute or ideal standard of performance.

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2.1 Competeny: Definition

Competence: Overall/global capability of an individuals

professional performance

Competency: Discrete component or aspect of competence

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2.1 Competency-based models:

An approach that explicitly identifies the skills,

knowledge and values that form a clinical competency and

develops learning strategies and evaluation procedures to

meet criterion referenced competence standards in keeping

with evidence based practice (Falender et al., 2007)

Include clear specification of competencies for each

developmental level and behavioural anchors to make clear

what this means in practice (E.g. Falender et al., 2004;

The Objectives Approach to Supervision (Gonsalvez et al.,

2002)

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2.1 Stages of competence

Stage Descriptions

1 Unskilled, incompetent

2 Novice, beginner

3 Advanced beginner, intermediate

4 COMPETENT

5 Proficient

6 Expert, master

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Most approaches adopt a developmental approach involving

5-6 stages (e.g., Dreyfus, 1982 (1989?); James et al., 2007*)

2.2 Competency approaches:

Whats new?

What is old:

The notions of competence and competency

Objectives-based approaches to curriculum development

The use of final exit examinations to assess professional

competence

What is new:

Taxonomies of competencies

Stronger theoretical frameworks and paradigms Applying implications to training

Methods for ecologically valid, routine assessment of

competencies

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2.2 Competency movement: History

2002: Competencies Conference: Future

Directions in Education and Credentialing.

(Sponsored by Association of Psychology

Postdoctoral and Internship Centers, and APA)

Aim: to address core competencies expected of

graduates of professional education and training

programs in psychology.

Identification, education and training, and assessment

of competencies within professional psychology 2005: Cube model, an outcome of the conference


2003: Taskforce convened by APA Board ofEducational Affairs

Report on needs for, models of, and challenges incompetency assessment

Report on guiding principles of competency assessment

2005/2006: Creation of the Competency BenchmarksWork Group by APA

Drafts, Consultation with workgroups, public comment,

revisions 2007: Practicum competencies outline (Hatcher &

Lassiter, 2007) by Directors of psychology trainingclinics



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2009: Outcome from the 2006 working group --

Competency Benchmarks paper (Fouad et al.,)

Rodolfas cube model adopted but restructured to

yield

3 new competencies: professionalism, teaching, and

advocacy

15 core competencies defined

7 foundational competencies

8 functional competencies


For each of 15 core competency At 3

developmental levels of education and training

Readiness for practicum

Readiness for internship

Readiness for entry to practice

Identifies essential components and behavioural

indicators for each of these levels



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2.3 Competency Models

The Competency cube (Rodolfa, 1995)

3-D model

Foundational competencies

Functional competencies

Developmental stages

The Objectives-based approach (OBAS)

3-D model (Gonsalvez et al., 2002)

Competency domains

Competency types


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2.3: Classification: The 3D model



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2.3: Classification: Foundational

Competencies1. Professionalism

2. Reflective Practice/Self-Assessment/Self-Care

3. Scientific Knowledge and Methods

4. Relationships

5. Individual and Cultural Diversity

6. Ethical Legal Standards and Policy

7. Interdisciplinary systems

2.3: Classification: FunctionalCompetencies

1. Assessment

2. Intervention

3. Consultation

4. Research and evaluation

5. Supervision

6. Teaching

7. Administration

8. Advocacy



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2.3 The OBAS Grids

Competency domains

Assessment

Intervention

Professional Issues

Competency types


See supervisor toolkit, page..

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2.3 Competency types

Topographical structure: Competencies and

metacompetencies

Competencies

KNOWLEDGE

Demonstrate knowledge of empirical literature governing

cognitive therapy

SKILLS

ability to fluently conduct a diagnostic assessment

ATTITUDE-VALUES

Openness to formative feedback

RELATIONSHIP

Establish and maintain a working alliance

Gonsalvez et al., 2002 29



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2.3 Metacompetencies

Topographically at a deeper level,

underpin higher order competencies

Knowledge, skills, attitudes and

relationship capabilities to advance

KSAR competencies

reflective practice capabilities

the scientist-practitioner mind set

unconditional positive regard30

3. Implications

Training and Supervision

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3. Implications

More new developments! Why bother?

Major impact

Wide implications for psychology and other professions

Within psychology : Training & Supervision

Potential and promise

Options:

Get on the wagon

Get run over/left behind

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3.1 Implications for training

Identification, definitions, and ordering of

competencies into taxonomies for

professions

Implications could be a restructuring of

boundaries, roles and functions among

professions and within a profession (e.g.,

specialisations PBA take on number ofendorsements; IAPT implications for practice

of CBT)

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34

Specialisation A

Specialisation B

Specialisation X

Specialisation Y


Change from input-based criteria to Professional qualifications (e.g., 4 years)

Course content (e.g., assessment, psychopathology..)

Supervision requirements (e.g., 180 hours)

To output-based criteria Demonstration of evidence-based therapy for anxiety disorders

Examination to demonstrate professional competence

Current models Combination of input and output criteria

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Dynamic rather than a static standard

One could attain it and lose competence

The maintenance of competence is a career-

long pursuit

(e.g., PsyBA requirement for 5-year refresher

courses in supervision)

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3.1 Implications: Assessment

Greatest impact in the area of assessment

Emphasis on demonstration (rather than inferred,

implied or expected attainment) of competencies

Ecologically valid (e.g., fewer knowledge-based

examination formats, more integrative tasks)

Final clinical examinations (e.g., OSCE)

Redefines meaning of pass/fail grades

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Introduction of lists/matrices of competencies

Proliferation of domains & competencies

More comprehensive accreditation processes

Emphases on transparency, due-process,

objectivity of assessments

More systematic monitoring to satisfy auditing

requirements

Consequences:

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What are the implications for

supervision?

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3.2 Implications for supervision

Implications for all aspects of supervision:

Planning, conducting, assessment, and evaluation

For supervision and supervisor

Changes to the dynamic within the supervisory

dyad

Focus on measurement and benchmarking

Discrimination among supervision programs

Standards to evaluate satisfactory and unsatisfactory

supervisory practices

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3.2 Implications: Assessment

Greatest impact in the area of assessment

Emphasis on demonstration (rather than inferred,

implied or expected attainment) of competencies

for supervisor

Experience does not beget expertise (Sr training)

Emphasis on summative assessments for trainees

Focus on ecologically valid supervision methods (e.g., fewer knowledge-based examination formats,

more integrative tasks)

Redefines meaning of pass/fail grades41



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Intrusion of a third entity in the supervision room!

Prescription of competency frameworks for

supervisees and supervisors

Emphasis on summative assessments change the

supervisor-supervisee dynamic

Emphasis on evaluation often includes evaluation

of supervisor and supervision

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Lack of consensus in terms of whether changes

would deliver better outcomes

Unease about a new paradigm of thinking,

teaching, assessing

Increased caution and leniency regarding assessments?

Exasperation about new demands and pace of

change When you are about to get used to a process, it

changes!

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4. Practice applications

Is there a simple, workable competency-

based model for supervision?

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Need for a simple model to help

transition

Focus on 2 key supervisor competencies

Designing CDPs for supervision

Using videotapes in supervision

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3 STEPS

Swap the counsellors hat for a teachers/coachs

hat (role)

Design a teaching-plan for the supervision

placement

Follow best-practice pedagogic guidelines for

executing, monitoring and evaluating the

supervision plan

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4. Practice applicationsGonsalvez et al., 2002

In prosecuting steps 2 and 3, make 3 simple

adjustments

Content is not restricted to information, facts and data,

but includes perception and emotion

Important learning outcomes are not knowledge but

skills, attitude-values and relationship attributes

Supervision methods and tools will need to change tofit processing of new content (not for cognitive

processing)

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4. CDP for Supervision: Implementation

Content and Learning Activities

Methods and Techniques

Formative Feedback

Summative Assessments and Reports

Evaluation of Supervision

1. Overarching Considerations and Processes

Influence of Professional Stakeholders

Effects of Developmental Stage

Individual Resources and Constraints

Cross-cultural Effects

Contextual Resources and Constraints

2. Helping Supervisees

Formulate Competencies

3. CDP for Supervision: Finalising Competencies

Formulating SMART Competencies

Foundational and Functional Competencies

Knowledge, Skills, Attitude-value, Relationship Competencies

Metacompetencies

Competency-

based

developmentalplan (CDP) for

supervision

Gonsalvez,C.J.(2013).Establishing

SupervisionGoalsandFormalisinga

SupervisionAgreement:ACompetency

basedApproach.

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4.1 Supervision plans

In supervision, it is helpful to think of competencies

as SMART learning outcomes

Specific, rather than general

Measurable

Appropriate (developmentally), tailored to the individual

Recommended (e.g., consistent with recommendations of

accrediting/professional bodies)

Time-wise: achievable given constraints of time, personnel

and placement context



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4.1 Diagnostic assessment

competency Knowledge: Ability to articulate diagnostic

and differential diagnostic criteria for the

subtypes of mood disorders

Skills: Trainee able to conduct a diagnostic

interview in a fluent and time-efficient

manner

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4.1 Diagnostic assessmentcompetency

Relationship: Ability to conduct the

diagnostic interview in an

interpersonally sensitive manner

Attitude: to diagnostic labels and DSM

classification, to persons with

diagnostic labels and so forth

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4.1 Socratic dialogue

competencyKnowledge: Can describe and define

the technique. Can make relevant

distinctions between Socratic vs. open-

ended and rhetorical questions, .....

Skill: Ability to demonstrate how to

use Socratic dialogue in a given

situation

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4.1 Socratic dialoguecompetency

Relationship: Able to tailor Socratic

dialogue to a variety of interpersonal

situations

Attitude-value: Appreciative and

respectful vs. sceptical and cynical

about the technique

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4.2 Designing a competency-

based developmental plan (CDP)

for supervision

Small group activity

See handout 1

55

Small group activity

Supervision Plan 1

Get all to read activity

Address questions; then break into groups

Activity takes about 30 mins including clarifications

with Sarah the trainee

Options for group: assign knowledge, skills, attitude-

values to different groups

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Small Group Activity

Consider the agenda of supervision objectives for

a typical trainee seeking a placement in your

agency under your supervision. Draw a pie-chart

with the slices of the pie representing percentage

of supervision time you think should be allocated

to the 4 types of supervision objectives.

For each objective type, identify two or three key

methods that you would prefer to use.

57

Reflective analysis

Formulation of the supervision plan as important

as

The most important competency within the competency

framework

Blueprint, master plan,

Formulation for therapy

Key messages about supervision in general

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4.3 Reflective analysis

What are some important benefits of designing

competency based plans (CDP) for supervision?

What are some of the common problems and

barriers of designing CDPs?

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Supervision plans

Best practice criteria

See handout

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Documents

Document 1 - Supervisor Training Workshop - A Competency-Based Approach to Supervision