Academic journal article Journal of Cognitive Psychotherapy

Microskills of Clinical Supervision: Scaffolding Skills

Academic journal article Journal of Cognitive Psychotherapy

Microskills of Clinical Supervision: Scaffolding Skills

Article excerpt

This article examines some of the microskills associated with the moment-to-moment decisions and actions of supervisors within cognitive-behavioral supervision. Through a theoretical review and practice illustration, the article outlines the role of supervisors' dialogue and questioning styles in promoting effective learning. The article also provides a potential guide to the training of supervisors and thereby attempts to benefit clinical practices in general.

Keywords: cognitive-behavior therapy; process; questioning; training

The growing importance of clinical supervision is reflected in national policy developments and professional practice frameworks in the United Kingdom. For example, the British Association of Behaviour and Cognitive Psychotherapists (BABCP) now offers accreditation as a cognitive-behavior therapy (CBT) supervisor or trainer. A multidisciplinary panel scrutinizes applications, and the applicants are required to fulfill a set of seven criteria (e.g., be a dedicated CBT practitioner, with a minimum of 3 years recognized practice, eligible for accreditation with BABCP as a CBT practitioner). The increasing attention to supervision is also reflected in a renewed interest in models and supervision guidelines (James, Milne, Blackburn, & Armstrong, 2007). However, these guidelines are dominated by general statements about the macro issues in supervision (e.g., consistency and length of supervision, appropriateness of contents, use of supervision contracts; see Falender & Shafranske, 2004). We believe that this general level of guidance and analysis needs to be complemented by focusing at a more specific or microskills level (Tharenou, 2001). Within the supervisory setting, microskills are the moment-to-moment activities that supervisors use within supervision sessions to promote learning and supervisee competence. Microskills may be verbal or nonverbal in character, involving the imparting of facts, the promoting of reflection (Bennett-Levy, 2006), action planning, and the use of experiential exercises (Kolb, 1984; Milne, James, Keegan, & Dudley, 2002). In many respects, the exchanges occurring within supervision are more complex than those occurring within therapy, because the supervisor is attempting to influence clinical outcomes indirectly through the work of the supervisee.

In any discussion of microskills in either supervision or therapy, one must address the important role that questions play (James & Morse, 2007). Indeed, one of the main purposes of the current article is to examine the role of questions in supervision, particularly their function and sequencing. "Sequencing" as a concept is concerned with the ability to articulate a logical order for structuring dialogue (e.g., when setting an agenda, it is logical to ask the supervisee what items she wants to discuss prior to summarizing the items). We will also look at the relationship of questions to other aspects of supervisor dialogue, and indicate how we can develop a better understanding of the microskills necessary for conducting effective supervision. Therefore, in this article we start by outlining the rationale for microskills, then provide an illustrative dialogue and comment on the key aspects (the functions and sequences of questioning within supervision). We conclude with some ideas about future research projects.

KEY FEATURES OF SUPERVISION

In a series of empirical studies, Milne et al. (2002) developed a useful list of activities engaged in by supervisors. This list has been packaged into a tool called "Teachers PETS" (Process Evaluation of Training and Supervision; Milne et al., 2002; Milne, Pilkington, Gracie, & James, 2003). PETS is an observational instrument that provides a system for coding the speech of supervisors and their supervisees. It identifies 14 activities typically engaged in by a CBT supervisor. The activities are: listening, gathering information, managing, supporting, summarizing, giving feedback, checking theoretical knowledge, challenging, educating, using experiential learning (e. …

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