Getting to the Heart of Clinical Supervision: A Theoretical Review of the Role of Emotions in Professional Development

Abstract

Background:The importance of supervision is increasingly recognized, yet it remains little understood, impairing research and practice. Specifically, the CBT supervision model provides a relatively "heartless" account of professional development, which may undermine its effectiveness. Method: A theoretical review of emotions in supervision and learning is provided, to summarize relevant theoretical and empirical literature. The objectives are to clarify the role of emotions in CBT supervision, and to use this understanding to outline an emotionally-attuned model, illustrating its application to two critical aspects of CBT supervision (the development of a learning alliance and enhancing professional competence). Conclusion:The reviewed literature (theory and research evidence) supports the explicit and systematic incorporation of emotions into CBT supervision. Conceptually, this can be achieved by integrating Lazarus's (1991) general theory of emotion with the CBT model. The illustrations of this augmented model indicate its value in understanding and managing both the "rupture-repair" cycle that can affect the supervisory alliance, and the "deskillingdevelopment" pattern that appears to be necessary for the acquisition of competence. We propose that CBT supervision might usefully be guided by our expanded model, as this affords greater internal consistency and may be more effective educationally.

Providing objective feedback in supervision in motivational interviewing: results from a randomized controlled trial

“…The supervisors perceived the behaviour frequency counts as being more objective and less judgemental, and argued that especially supervisees with longer work experience had difficulties handling the global scores on the lower side. This viewpoint is consistent with earlier research which suggests that supervisees may fear negative feedback (Abernethy and Cook, 2011;Bernard and Goodyear, 2014;Clarke and Giordano, 2013;Ellis et al, 2015;Friedberg et al, 2009;Lombardo et al, 2009), and that supervisors often feel critical and worry that their feedback may harm the supervisory working alliance (Chur-Hansen and McLean, 2006). Self-reported data even suggests that supervisors sometimes withhold corrective feedback and/or give higher ratings to avoid negative reactions or harming the supervisory relationship (Turner et al, 2016).…”

Role Transition from Mental Health Nurse to IAPT High Intensity Psychological Therapist

“…Effective CBP role transitions have been previously shown to be delayed and restricted when trainees cling to former roles and cursorily attempt to "bolt on" newly acquired CB skills (Grant et al, 2008). The experience of comfortably demonstrating competence in old roles is suddenly traded with the challenge and uncertainty of the new role, particularly as trainees undergo assessment of clinical competence (Bennet-Levy and Beedie, 2007;Lombardo, Milne and Proctor, 2009). Nicholson (1984) discriminated between positive and negative occupational role transition.…”

PROTECT: Relational safety based suicide prevention training frameworks

“…AWARE, a reflective framework for ongoing development of professionals, protects against undue influences in the act of clinical decision‐making. Intended to make practice safer, its use in clinical supervision (Lombardo et al , ) or multidisciplinary case reviews should bolster practice by making individuals and/or teams who assess people in suicidal crisis, mindful of the implicit effect of the AWARE factors (Table ). It is based on our qualitative study, in which we conducted semistructured interviews with clinicians postassessment.…”