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Resistance to Clinical Supervisor

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Who would you collaborate and consult with if you were the clinical supervisor for a resistant supervisee? Why?

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According to Stoltenberg and Delworth (1987),
and Logenbill, Hardy, and Delworth (1982), there are three stages of counselor
development: the first stage is one of reliance, the second stage is one of trial and error,
and the third stage is one of maturity.

Stage 1 - Reliance
Stage 1 supervisees are highly motivated. They lack basic counseling skills but
have a strong desire to perform effectively. Their focus is on how to perform a skill. The
emphasis on skill mastery evokes performance anxiety or apprehension in performing
interventions. This apprehension is indicative of cognitive self-focus. Autonomy at this stage is absent and reliance on the supervisor is acute. For example, supervisees in
this stage have a propensity to have an over-dependency on textbook theory; this
requires supervisors to provide more assistance to facilitate the trainees' growth and to
help them critically accommodate the use of theory in practice.
Ronnestad and Skovholt (1993) stated that stage 1 supervisees enter counseling
sessions reliant on the assistance of their supervisors, and that this need is as a result
of the hierarchy of skill development. Stage 1 requires that supervisors teach the
fundamentals of counseling to enhance the trainees' skill competency (Bernard, 1979).
To that end, supervisors must be aware of their didactic role of teaching counseling
skills and techniques (Neufedt, Iverson, & Juntunen, 1995; Worthington, 1987). For
example, in this stage supervisors often explain the rationale for counseling strategies
and interventions used in counseling, assist with case conceptualization, evaluate
counseling sessions, and model intervention techniques (Neufedt, Iverson, & Juntunen,
1995; Stoltenberg & Delworth, 1987).
In addition, supervisees in the reliance stage may over-assimilate and/or over accommodate.
Over-assimilation is fitting information received from students into
preconceived notions about the student's concerns. Over-accommodation is ...

Solution Summary

This solution discusses options on options for collaboration and consultation when a clinical supervisee shows resistance to a supervisor.

See Also This Related BrainMass Solution

Dimensions and Competencies for Supervision and Consultation

Case Study

Phyllis is a 25 year-old single woman who was accepted into a PhD program in counselor education immediately after she completed her master's degree in clinical counseling in the same department at a large urban university. During her first semester of enrollment in the doctoral program, she completed a course in supervision. Because the program has a supervisory emphasis, after completing the supervision course, all doctoral students are required to provide supervision to at least on master's level student every semester. Doctoral students receive supervision of their supervision through weekly group meetings with a faculty member.
Phyllis has been assigned her first master's intern, Jena (age 38), who is just beginning her internship experience. Phyllis and Jena began the master's program at the same time several years ago and became good friends. However, Phyllis matriculated at a faster rate, and they grew apart when Jena was forced to take a leave of absence due to personal issues concerning her family ( she is divorced with 2-year-old twin girls) Jena is overjoyed when she discovers that Phyllis will be her campus-based supervisor. Phyllis is also pleased and anticipates a rewarding supervisory relationship with Jena, much like their previous friendship and camaraderie.
During their initial supervisory meeting, Phyllis and Jena review the requirements for successful completion of Jena 600-hour internship. Master's-level interns are expected to produce weekly audiotapes and monthly videotapes and to maintain reflective journal. Doctoral supervisors are required to meet with their intern's on-site supervisor at least once during every semester.

Over the initial 5-week period of the supervisory relationship, things go smoothly, Jena brings both audio and videotapes for review and seem receptive to Phyllis's feedback. Phyllis does note that Jena's counseling style is quite instinctive, and that she seems to have difficulty articulating a theoretical rationale for her interventions. However, Phyllis decides not to press this issue because most of the clients Jena has been assigned to counsel have career exploration or short-term counseling issues, and her clients seem to be doing well. Phyllis thinks Jena's case conceptualization skills probably will develop as she progresses through her internship experience.
When Phyllis and Jena meet during the 6th week of the semester, Jena announces that her sites is so impressed with her skills that they are now referring more challenging cases to her, including clients with issues of clinical depression and substance abuse. When Phyllis asks whether Jena feels ready for the added responsibility, Jena replies rather sharply that she has as much clinical experience as Phyllis, Jena adds that she has relevant life experiences that Phyllis, being much younger, has yet to encounter. Phyllis is feeling somewhat uncomfortable, but does not pursue the matter.

Jena begins counseling a female client who is experiencing severe depression and suicidal ideations. This client is a single female in her early 40s, with three small children, who is struggling with financial problems. After listening to several audiotapes, Phyllis has begun to feel that Jena is becoming somewhat enmeshed with the client. On the most recent tape, Phyllis heard Jena lead her client and give her advice several times. When they meet for supervision, Phyllis asks Jena if she might be over identifying with this client. Jena does not seem open to considering this possibility, and as they continue to review the taped session, Jena again states her belief that life experiences are at least as important, if not more important, than formal preparation for being an effective counselor. Phyllis makes a mental not to herself to ask her doctoral student supervision group for assistance on how to deal with the supervisory session, Phyllis reminds Jena about the requirement that they meet with Jena's on-site supervisor during the semester and ask Jena to set up the meeting. Jena says that she will schedule the meeting.

Over the next three weeks, Phyllis's concerns about Jena's lack of case conceptualization skills begin to grow. She is also troubled because Jena has not arranged the meeting with the on-site supervisor; Jena could not remember the supervisor's phone number. The next week, Jena reported that the site supervisor was switching offices and her phone number was being changed.
At this point Phyllis discussed strategies for dealing with supervisee resistance with her doctoral supervision group, without mentioning Jena's name, and she has done additional reading. Yet nothing she has tried seems to be working. She considers consulting with Dr. Walsh, the faculty member in charge of internships, but was afraid that if Jena were flagged as having difficulties Jena's chances of being accepted into the doctoral program would be ruined. Jena had let her know that she intended to pursue her doctorate and, given her current home situation, she would not be able to apply to any other doctoral programs due to her lack of mobility. Also, Jena had once been her friend, for more than 2 years. Jena had juggled work, home, and school commitments in a way that has impressed Phyllis. In fact, Phyllis doubts that she could have done well. If she gives Jena a little more time, Phyllis thinks Jena may become more accepting of her feedback.

After reviewing "Case Study 18: A Resistant Supervisee," provide an analysis revealing with whom you would collaborate and consult if you were the supervisor in this case.

Briefly describe a situation in an employment setting where there are some ethical issues that existed in this setting. Explain what you would do as an ethical counselor to address these issues. Include what type of consultation and/or supervision you would seek and from whom, as well as the qualifications the supervisor/consultant should have. Finally, evaluate your role as an ethical counselor, seeking and/or providing supervision or consultation.

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