Ethical Supervision Skills Workshop

Handout Package

Table of Contents Ethical Decision-Making Model ................................................................................................. 1 Supervision Contract................................................................................................................. 2

Supervision Contract Terms ..................................................................................................... 3 Sample Supervision Questions ................................................................................................. 4 Clinical Supervision Record ...................................................................................................... 5 Case Consultation Template ..................................................................................................... 6 Creating a “Safe Space” for Supervision................................................................................... 7

Intersectional Privilege Worksheet ............................................................................................ 8

Phases of Supervision .............................................................................................................. 9 Difficult Conversations: Supporting emotionally charged situations ........................................ 10 Top 12 Self-Care Tips to Mitigate Compassion Fatigue.......................................................... 11

Scenarios for Workshop Activity ............................................................................................. 12 Practical Resources ................................................................................................................ 13 Further Resources to Promote Reflexivity .............................................................................. 14

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Ethical Decision-Making Model 1. What is the ethical dilemma? Clearly articulate the professional values that are in conflict.

What sections of the Code of Ethics apply to this situation?

2. What is my immediate reaction or instinct for the best way to address the ethical dilemma?

3. Who are the individuals, groups, and organizations that are potentially affected by your decision? Are there any legal implications? What are some of the cultural implications? For whom do you have the greatest responsibility?

4. How might personal biases, stresses, or self-interest influence your choices? Consider power differentials, intersectionality of privilege and oppression as it relates to the parties involved.

5. Consider whether any external or systemic issues have contributed to the problem and consider whether they can be addressed in a positive way.

6. What are the available options or choices for resolving this dilemma? For each option, analyze the short-term, ongoing, and long-term risks and benefits of each course of action. Consultation with a peer, supervisor or manager can be helpful. Go over options with client if appropriate.

7. Based on relevant ethical principles, values, and standards, choose and act on what appears to be the best decision. Document the ethical decision-making process.

8. Monitor and evaluate the impact of the decision and modify if necessary.

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Supervision Contract This contract was drawn up on (date): Between Supervisee: and Supervisor: Frequency / Length (circle appropriate choice) Supervision sessions will be held every ____weeks/months on ______________.

A minimum of one hour will be available. If a supervision session is missed, the

Supervisor/Supervisee takes responsibility to rearrange an alternative date.

Theory/Framework

Goals of Supervision

1.

2.

3.

Skills/Competencies you would like to build

1.

2.

3.

Follow-up Notes

Signed by: ............................................................. Date: ......................................... (Supervisee) Signed by: .............................................................. Date: ......................................... (Supervisor)

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Supervision Contract Terms Confidentiality The supervisory process will be kept confidential in accordance with agency policy,

professional practice standards and legal requirements. Supervisee accepts that case consultations may be discussed, when appropriate, with

other managers or clinical consultants. Supervisee accepts that their supervision record will be kept in their personnel file.

Joint Responsibilities Be fully present, proactive and give and accept feedback positively and respectfully. Keep each other up to date and provide relevant information. Prepare for supervision, including ethical issues, concerns and problems. Uphold ethical guidelines and professional standards. Create a two-way mutual learning and collaboration process.

Hold a safe space through mutual respect, genuineness and non-judgmental attitude.

Acknowledging diversity and alternative ways to practice.

Being prepared to be honest and transparent.

Engage in continual self-reflection including personal biases, judgments, tone of voice or

body language.

Openness to giving and receiving feedback and challenging firmly held ideas and

assumptions in a respectful manner

Holding the client at the center of intention

Being prepared to walk alongside your colleagues not as an ‘expert’ but as someone who

is also imperfect and struggling with complexities of practice

Conflict Every effort should be made to resolve any conflict, within supervision. In exceptional circumstances, where this cannot be achieved, either party may consult

with : ________________________ Initials

Supervisor Supervisee

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Sample Supervision Questions

1. Developing the Supervisory Relationship

What at are your expectations/needs from a supervisor?

What is your theoretical approach?

What are the most important qualities you should demonstrate with a client?

How do you take care of yourself? How do you handle stress?

How do you approach conflict? Give a specific example.

What concerns do you have about your own safety or the safety of clients?

Can you describe a specific accomplishment or a proud moment?

2. Identifying Development Goals

What skills/techniques would you like to further develop?

What is your biggest concern right now and how are you addressing it?

Are there any concerns about your interactions with other team members?

How do you see my supervisory style working with your learning style?

Professionally, where do you see yourself in five years?

3. In response to specific issues or concerns…

How did you experience the situation/person/group?

What skills and experiences do you have related to the current situation?

What strengths do you bring to the relationship?

What personal limitations do you bring to your work?

How do all of these impact your role in facilitating change?

What concerns do you have about your own safety or the safety of clients?

What do you see as the areas of focus to resolve the crisis?

What are your limitations as a helper?

What barriers are you facing? Do you have any ideas about how to overcome them?

4. Check-in and Progress update

Describe your workload. Is it too much, too little, just right?

Is there a recent situation/experience that stands out?

Did you encounter any situations that still don’t sit right to you?

Tell me about an ethical dilemma you recently encountered, and how you worked through it.

If you had the opportunity to do things differently, what would you do?

What feedback has been most helpful to you? What did you learn about yourself?

What areas are a priority for your ongoing professional development?

5. Encouraging reflexive practice

How do your personal values and biases impact the therapeutic relationships?

How do your personal values and biases intersect with professional ethics?

What preconceived ideas do you have about your client’s situation (ie poverty, issues of privilege, race, religion)? How are these influencing your practice?

How do you identify and respond to power differentials in your relationship with clients (or related to a specific experience)?

How do culture and issues of difference impact your client’s experience and the therapeutic relationship?

How can you use your understanding of differences as an opportunity to facilitate change for clients and for yourself?

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Clinical Supervision Record

Supervisee: Supervisor: Date:

Topics discussed:

Duties & expectations

Case planning/ consultation

Skills Development/ Growing Edge

Ethical Decision-making

Problem solving Crisis intervention Risk Management Theory/Practice Framework

Community engagement

Team development Inclusion/Diversity Other

Discussion Summary/Comments:

Strengths:

Challenges:

Tasks to be completed by the next supervision session or date specified:

Student Signature: ________________________________ Field Instructor Signature: __________________________

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Case Consultation Template

Client/Family Name:_____________________________ Date:___________ Date began:________ Date ended: _______ Number of sessions to date: ____________ Presenting Problem(s): ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Parties involved & relationship to client(s): ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Case Formulation/hypothesis: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Recent Interventions and Effectiveness: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Client Goal(s): 1. ________________________________________________________ progress made 2. ________________________________________________________ progress made 3. ________________________________________________________ progress made Issues for supervision (include considerations of own biases/power differentials): ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Summary Recommendations from Supervisor: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Action Plan

Task: __________________________________________ Date due: ___________________ Task: __________________________________________ Date due: ___________________ Task: __________________________________________ Date due: ___________________

Supervisee signature: _______________________ Date: __________ Supervisor Initials: ______

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Creating a “Safe Space” for Supervision

Questions to promote physical, cultural and emotional safety

1. How is "safety" defined in the context of the supervisory relationship?

2. Who is responsible for creating safety?

3. Are there specific threats to the safety of this space?

4. List as many factors that you can think of that affect the safety of this space (ex. power imbalance, philosophical/cultural differences, agency culture, historical trauma, communication style, regulations/legal/reporting requirements)

5. What is my personal/role power in relation to my supervisee? What do I need to do in order to reduce power differentials and create safety?

6. What strategies are in place to encourage positive, respectful communication?

7. What would be your response if a supervisee feels unsafe?

8. What options/opportunities exist outside of the space for support?

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Intersectional Privilege Worksheet for Social Workers

Advantageous Categories Disadvantageous

Positional Power

Seniority/credentials

Supervisor-supervisee

Worker-client

Professional connections

Well-connected parents/friends

Groups/committees

professional connections

Ex/middle class, educated, FT employment, 10+yr experience

Socio-economic status

Social class

Education/knowledge/experience

Employment status (ft/pt/casual)

Ex/financially struggling, expensive childcare

Ex/married, confident, middle-age

Context/Experience

Ex/mother, caregiving duties, grief, no relatives in town

Age

Life stage (marital status/parent)

Mental health/trauma

Resilience/confidence

Ex/white, straight, able-bodied

Personal Characteristics

How close are you to “mainstream” - ethnicity, skin colour, gender identity, size, facial features, ability, sexual orientation, etc.

Ex/female, not fit, poor eyesight

More Power/Privilege Less Power/Privilege

Activity: Brainstorm words that describe who you are in each category and write it down in the left or right column based on your perception of what gives you more advantages or disadvantages as a professional and member of society in general. Circle the words that you feel is particularly relevant to the supervisor-supervisee relationship or clinician-client relationship.

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Phases of Supervision

I. Preliminary Phase: Tuning In

Personal preparation for sessions (feelings, issues, concerns)

Flexibility necessary to reassess needs every time;

Responding to direct and indirect cues of self and others;

Prioritizing needs, setting agendas.

II. Beginning Phase: Contracting

Purpose and role of supervision; supervisor’s and supervisee responsibilities;

Learning about organizational mission, priorities, procedures, populations;

Authority and how power is utilized; consequences of breach of protocols;

Questions of limits and boundaries, wiggle room/flexibility vs. clear borders;

Perceptions of obligations, expectations, esp. re help needed and offered;

Job descriptions, staging and sequencing of learning; others to be involved;

Use of language: avoiding stereotypes, jargon but professional terminologies;

Discovering and building on strengths; agreeing on areas for growth;

Learning new skills, unlearning unhelpful old behavior or ways of working.

III. Middle Phase: Working

Building empathic skills and relationships;

Learning how to articulate and elaborate re client, organization, system, self;

Improving skills in self-awareness and self-disclosure re deeper learning;

Identifying obstacles to successful completion of tasks and processes;

Learning how data is used to evaluate practice and inform organization;

Reviewing theoretical knowledge as it informs practice;

Moving from the general to the specific, and the specific to the general;

Containment of anxiety and negative feelings in service of the client;

Understanding the change process and the parallel process (mirroring clients);

Challenging illusions, issues with authority, deepening the work;

Evaluating, summarizing, identifying next steps.

IV. End Phase: Termination

Reviewing assumptions and realities about teaching and learning;

Reviewing progress and performance;

Clarifying skills development and abilities;

Clarifying processes for transitioning clients;

Saying goodbyes and modeling healthy exits/transitions;

Evaluations, future learning goals, and positive reinforcement; Celebrations and rituals to mark milestones.

From Lawrence Shulman. 1993. Interactional Supervision (WA. D.C.: NASW Press).

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Difficult Conversations: Supporting emotionally charged situations

1. If the supervisee is very worked up, use calming strategies

Walk and talk, model relaxed breathing, offer water/tea, etc.

2. Identify and validate the emotion

Help supervisee describe what they are experiencing. What are you feeling in your body? In your gut? What persistent messages are repeating in your mind?

Validate the emotion/behavior – given past & present circumstances

3. Get supervisee to describe only the facts

Describe the facts that you observed through your senses.

Challenge judgments, absolutes, and black-and-white descriptions.

4. Help supervisee examine different angles

What are other possible interpretations?

Help examine all sides of a situation and different points of view.

Test supervisee interpretations and assumptions to see if they fit the facts.

5. Identify goal in solving the problem

Help supervisee identify what needs to happen. Record goal(s) on paper

6. If applicable, explore threats, consequences, liability issues

What are possible consequences? What is the worst case scenario?

Brainstorm possible outcomes

7. Help develop strategies

Choose a solution/action plan that fits the goal(s) and is likely to work.

If the supervisee is unsure, do pros and cons to compare the solutions.

If the supervisee has no control over the situation, brainstorm grounding/coping strategies

Walk through/role play what the supervisee will do if the worst case happens

8. Follow-up, evaluate effectiveness of strategies used

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Top 12 Self-Care Tips to Mitigate Compassion Fatigue

1.Take Stock-What’s on your plate?

Taking a nonjudgmental inventory of where things are at in your life

Make a list of all the demands on your time and energy (Work, Family, Home,

Health, Volunteering, other). What stands out? What factors are contributing to making your plate too full? What would you like to change most?

2. Start a Self-Care Idea Collection

Pick three ideas that jump out at you and make a commitment to implement them.

Include “5 minutes of self-care” at each staff meeting

3. Find time for yourself every day – Rebalance your workload

Take self-care time when you can, and make the most of it.

Even small changes can make a difference in a busy helper’s life.

4. Delegate - learn to ask for help at home and at work

Are there things that you are willing to let go of and let others do their own way?

Don’t expect others to read your mind: consider holding a regular team meeting to review the workload and discuss new options.

5. Have a transition from work to home

Do you have a transition ritual? Ex/ 20 minute walk home through a beautiful park,10 minute quiet period to shift gears, stay outside for an extra 10 minutes

6. Learn to say no (or yes) more often

Do you think you are good at setting limits? If not, this is something that needs exploring.

7. Assess your Trauma Inputs

There is a lot of extra trauma input outside of client work that we do not necessarily need to absorb or to hear about.

We can create a “trauma filter” to protect ourselves from this extraneous material.

8. Learn more about Compassion Fatigue and Vicarious Trauma

Learn ways to recognize the signs and symptoms of Compassion Fatigue (CF) and Vicarious Trauma (VT) and strategies to address the problem.

9. Consider Joining a Supervision/Peer Support Group

Organize a peer support group who meet once a month or once a week to debrief and offer support to one another.

10. Attend Workshops/Professional Training Regularly

Attending regular professional training is one of the best ways for helpers to stay renewed and healthy. Benefits include: connecting with peers, taking time off work, and building on your clinical skills. Identify an area of expertise that you want to hone.

11. Consider working part time (at this type of job)

Studies have shown that one of the best protective factors against Compassion Fatigue is to work part time or at least, to see clients on a part time basis and to have other duties the rest of the time.

12. Exercise

Can you think of three small ways to increase your physical activity?

Adapted from: www.compassionfatigue.ca

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Scenarios for Workshop Activity

1. A client that you have known for some time is “graduating” from you service, and asks you to remain friends. Before you can give an answer, she proceeds to invite you to a family cultural celebration next weekend. Caught in the moment, you politely refuse using a prior engagement as an excuse, but the client seems to think that you are open to future invitations.

2. You witness a colleague of yours talking about a client to another worker in a very disrespectful way, making negative references to her lifestyle choices and cultural background. This upsets you tremendously, but you don’t have a direct working relationship with this colleague so you are not comfortable approaching her directly and confronting her.

3. Over the past several weeks, your supervisee Linda has had several stressful events in her personal life, and has not been handling her professional responsibilities very well. She often seems to be quite preoccupied, erratic and irritable. She was failing to answer phone calls and follow up in a timely manner, and you have received a couple of client complaints. (in this scenario, one person plays Linda, the other the supervisor)

4. While you are working with a 16 year old male client, he discloses that he is worried about his drug use (alcohol, ecstasy and crystal meth). You offer to help refer him to an adolescent day treatment program and the boy agrees to participate, but refused to let you tell his parents about his drug problem. You have the parent’s informed consent to provide your services to this client, but this does not extend to external services.

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Practical Resources

Best Practice Resources

NLASW. (2011). Standards for Supervision of Social Works Practice. Retrieved from Newfoundland and Labrador Association of Social Workers: http://www.nlasw.ca/pdf/Standards_For_Supervision.pdf

NASW. (2012). Best Practice Standards in Social Work Supervision. Retrieved from The National Association of Social Workers: www.naswdc.org/practice/naswstandards/supervisionstandards2013.pdf

Victorian Dual Diagnosis Initiative. (2012). Our Healing Ways: A Culturally Appropriate Supervision Model for Aboriginal Workers. Victoria: Victorian Dual Diagnosis Initiative. http://www.dualdiagnosis.org.au/home/index.php?option=com_docman&task=doc_download&gid=74&Itemid=27

Ethics in Supervision

NLASW. (2015). Ethical Decision-Making in Social Work Practice. Retrieved from Newfoundland and Labrador Association of Social Workers: http://www.nlasw.ca/pdf/Practice_Standards/Ethical_Decision_Making_Framework.pdf

Canadian Psychological Association. (2009). Ethical guidelines for supervision in psychology: Teaching, research, practice, and administration. Retrieved from Canadian Psychological Association: http://www.cpa.ca/docs/File/Ethics/EthicalGuidelinesSupervisionPsychologyMar2012.pdf

Cross-Cultural Supervision

NLASW. (2016). Standards for cultural competence in social work practice. Retrieved from Newfoundland and Labrador Association of Social Workers: www.nlasw.ca/pdf/Practice_Standards/Cultural_Competency_Standards.pdf

Eklund, K., Aros-O’Malley, M., & Murrieta, I. (2014). Multicultural Supervision: What Difference Does Difference Make? Contemporary School Psychology, 18(3), 195-204.

Wong, L. C., Wong, P. T., & Ishiyama, F. I. (2013). What Helps and What Hinders in Cross-Cultural Clinical Supervision A Critical Incident Study. The Counseling Psychologist, 41(1), 66-85.

Reflexivity in Supervision

Hair, H. (2014). Power Relations in Supervision: Preferred Practices According to Social Workers. Families in Society: The Journal of Contemporary Social Services, 95(2), 107-114.

Fiona L. Calvert, Trevor P. Crowe & Brin F. S. Grenyer (2016). Dialogical reflexivity in supervision: An experiential learning process for enhancing reflective and relational competencies, The Clinical Supervisor, 35:1, 1-21

Supervision in Remote Settings

Moran, A. M., Coyle, J., Pope, R., Boxall, D., Nancarrow, S. A., & Young, J. (2014). Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes. Human Resources for Health, 12(1), 1.

Addressing Compassion Fatigue

Stamm, B.H. (2012). Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). www.proqol.org.

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Further Resources to Promote Reflexivity Anderson, J. M., Rodney, P., Reimer-Kirkham, S., Browne, A. J., Khan, K. B., & Lynam, M. J. (2009).

Inequities in health and healthcare viewed through the ethical lens of critical social justice: Contextual knowledge for the global priorities ahead. Advances in Nursing Science, 32(4), 282-294.

Anderson-Nathe, B., Gringeri, C., & Wahab, S. (2013). Nurturing “critical hope” in teaching feminist social work research. Journal of Social Work Education, 49(2), 277-291.

Baldwin, M. (2016). Social work, critical reflection and the learning organization. Routledge.

Beddoe, L. (2012). External supervision in social work: Power, space, risk, and the search for safety, Australian Social Work, 65(2), 197-213.

Browne, A. J., Varcoe, C., Smye, V., Reimer‐Kirkham, S., Lynam, M. J., & Wong, S. (2009). Cultural safety and the challenges of translating critically oriented knowledge in practice. Nursing Philosophy, 10(3), 167-179.

Butler, A., Ford, D., & Tregaskis, C. (2007). Who do we think we are? Self and reflexivity in social work practice. Qualitative Social Work, 6(3), 281-299.

Clark, N., Handlovsky, I., & Sinclair, D. (2015). Using reflexivity to achieve transdisciplinarity in nursing and social work. Transforming Addiction: Gender, Trauma, Transdisciplinarity, 120.

Gilbert, T. (2001). Reflective practice and clinical supervision: meticulous rituals of the confessional. Journal of advanced nursing, 36(2), 199-205.

Hair, H. J., & O'Donoghue, K. (2009). Culturally relevant, socially just social work supervision: Becoming visible through a social constructionist lens. Journal of Ethnic & Cultural Diversity in Social Work, 18(1-2), 70-88.

Harvey, A., & Henderson, F. (2014). Reflective supervision for child protection practice–Reaching beneath the surface. Journal of Social Work Practice, 28(3), 343-356.

Ingram, R. (2013). Emotions, social work practice and supervision: an uneasy alliance?. Journal of social work practice, 27(1), 5-19.

Ling, J., Hunter, S. V., & Maple, M. (2014). Navigating the challenges of trauma counselling: How counsellors thrive and sustain their engagement. Australian Social Work, 67(2), 297-310.

McPherson, L., Frederico, M., & McNamara, P. (2016). Safety as a Fifth Dimension in Supervision: Stories from the Frontline. Australian Social Work, 69(1), 67-79.

Shim, J. K. (2010). Cultural health capital: A theoretical approach to understanding health care interactions and the dynamics of unequal treatment. Journal of Health and Social Behavior, 51(1), 1-15.

Tsui, M. S., O'Donoghue, K., & Ng, A. K. (2014). Culturally competent and diversity‐sensitive clinical supervision. The Wiley International Handbook of Clinical Supervision, 238-254.