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Supervision: Effective Clinical Relationships with your Supervisees3 CEUs Supervision: Effective Clinical Relationships with your Supervisees

Section 3
Track #3 - Effective Ways of Dealing with Resistant Supervisees

Question 3 | Answer Booklet | Table of Contents | Supervision CEU Courses

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On the last track, we proposed a five-step method of resolving conflict: observation; thoughts; feedback; desires; and next time

On this track, we will examine the various types of supervisees that are resistant to improvement: the "Yeah, but" supervisee; the silent supervisee; the "I'll try" supervisee; and the irrelevant supervisee.

4 Types of Supervisees that are Resistant to Improvement

Share on Facebook Type # 1 - The "Yeah, but" Supervisee
I have found one of the most challenging supervisee is known as the "yeah, but" supervisee. You may have encountered him or her in your own work as a supervisor. These are the supervisees who give the answer, "yeah but" to most pieces of advice you give to them.

You might say, "Cheryl, you have to complete your client progress notes by the end of the week" and Cheryl might say, "Yeah, but, it's just so difficult for me to grasp the key points of what happened during the session." After we review a couple sessions, Cheryl would state something like, "Yeah, but, it's just hard for me to find the time to do them." As you can see, this type of supervisee can easily turn a conversation into a never ending cycle of "yeah, buts."

Share on Facebook Solution for "Yeah, but" Supervisees, 2 Parts
Here's a two part solution to your "yeah, but" supervisee.
Part 1:
To address this problem, acknowledge the problem that the supervisee faces and
Part 2: place the responsibility of solving that conflict back onto the supervisee.

For example, you might say, "You're right, Cheryl, that is a problem. When I first started out, it was difficult for me to get the hang of writing progress notes as well. So how are you planning to handle that situation so that you can meet your responsibility of completing your work?"Should Cheryl respond with, "I have no idea", you might consider saying, "Well, you need to think about that carefully."

As you can see, the key here with your "yeah, but" supervisee is placing the responsibility back on to the supervisee, you leave no opportunity open for a "yeah, but" to sneak in. How? You ask for their solution. If they come back with a "yeah, but," you tell them to think about it, it's their responsibility. Sound like this will work for you and your "yeah-butter"? In summary, the key with your "yeah, but" supervisee is to place responsibility back on them by asking them to think of a solution.

Share on Facebook Type # 2 - The Silent Supervisee
The second type of difficult supervisee is the silent supervisee. First of all, you have to divide your silent supervisee into one of two different categories. Ask yousrself, is he or she silent because they are timid? Or are they using intimidation?

Obviously, the silent supervisee is one who either cannot or will not respond to questions regarding their performance. Sometimes, more timid supervisees, when confronted with inadequacy, might feel anxious about discussing their competency and understandably freeze. This type of silent treatment can be easily rectified by asking gently after a silence, "Are you feeling OK?" or, "Do you need a minute?" This will let your supervisee know that you're not trying to be intimidating and that you do care about his or her wellbeing.

On the other hand, some supervisees fall into the second category and might use silence as an intimidation tactic. The supervisee deliberately remains silent as a visible act of defiance. I feel such passive-aggressive behavior must be addressed and, if necessary, reprimanded, in order to facilitate a productive working relationship. Marilyn, a supervisee, was not convinced of the importance of the family systems model used by the out-patient facility. Marilyn continually needed to be coached about the use of the genogram and continually had to be reminded to add a genogram to her clients' records.

As you know, a genogram is a diagram used in family therapy to depict family relationships extended over at least three generations. Here's what would happen. Marylin continually needed to be reminded regarding simple facts such as the diagram used circles to represent females and squares to represent males with horizontal and vertical lines connecting accordingly. When her supervisor, Carl addressed Marilyn about this problem, Marilyn refused to answer.

After several questions regarding her behavior negligence in either completing a genogram or completing it incorrectly without a response, Carl asked, "Is there a problem? I need your agreement that you will remedy this behavior."

When Marilyn still refused to answer, Carl said, "If you are refusing to discuss this situation with me, it is a very serious matter." Finally, as a last resort, Carl asked one more time, "Are you refusing to respond to my question?" After Marilyn still refused to respond, Carl explained that within twenty-four hours, he was going to have to note Marilyn's behavior in her upcoming supervisee assessment and that any chance Marilyn had of remaining at the facility would probably be slim.

He ended by saying, "I hope we can resolve whatever it is that is causing you lack of response and I hear from you within twenty-four hours." So with the silent passive-aggressive supervisee, a time limited ultimatum seems to be an effective strategy. In summary with your silent type, if timid, provide support; if passive-aggressive, end with an ultimatum.

Share on Facebook Type # 3 - The "I'll Try" Supervisee
In addition to "yeah, but" and silent supervisees, the third type of difficult supervisee is the "I'll try" supervisee. Know the difference between "I'll try" and "I will." The "I'll try" type of supervisee might enthusiastically agree to your request, however, when the time comes to actually change, the same behavior is repeated. But "they state that they tried!" Here's what I do when a supervisee who has not followed through in the past replies "I'll try" to a request for action.

Technique to Address the "I'll Try" Supervisee, 2 Steps
Step 1: I acknowledge his or her willingness but the important thing here is don't stop here.
Step 2: Follow-up with a question about their specific method of correction.

A good example is found in Katie. Katie was an "I'll try" type of supervisee. However, her supervisor, Mitchell, noticed that Katie promised she would try to be more positive during her co-leading of a Twelve-Step meeting. However, her behavior seemed to not improve. You might look into your "I'll Try-er's" rational. Katie confided with Mitchell that her husband had an alcohol problem. However, she felt that her husband was not an alcoholic. Since she was in denial about her husband's addiction, she was extremely negative about some of the cornerstones of the twelve step philosophy.

Mitchell congratulated Katie on her self awareness but stated, "Therapists need to put the clients well-being in the forefront beyond their own need to express their feelings." During the meeting, she showed negative body language by folding her arms across her chest, rolling her eyes, and verbalizing a "tsk" sound of disapproval.

Therefore, when Mitchell told Katie that her body language needed to be more open by unfolding her arms, Katie stated as she had several times in the past with no change, "I'll try." Except this time, Mitchell responded with, "That's great, Katie. I'm glad to hear that, and I'm sure you will try. But what will you actually do to make sure that you'll be successful in controlling your body language, facial expressions, and verbalizations during the meeting?"

Katie thought for a moment and said, "I could lean forward a little when a client is relating something that is obviously important to them. Also, I could make more eye contact with them." The next session Katie had with her group she visibly improved. As you can see, by directly asking them how, you can be better assure that your "I'll try" supervisee will consider the situation and a change of behavior more carefully. Thus in summary, the key with your "I'll try" supervisee is to get specifics by asking "how"

Share on Facebook Type #4 - The Irrelevant Supervisee
In addition to "yeah, but", silent, and "I'll try" supervisees, the fourth and last type of difficult supervisee I have found is the irrelevant supervisee. This type of supervisee will try to divert attention away from their own performance and try and place the blame on an extraneous person or situation. Strangely enough, I have found that the worst thing to do when dealing with an irrelevant supervisee is to call their attention to this behavior. Here's why. In the situations I have experienced, this almost always leads to a non-productive disagreement.

Share on Facebook Technique: "Separately and First"
In your work as a supervisor, have you ever gone through this cycle of confront, defend, confront, defend yourself? Have you, also like I, found it unproductive? To move the process forward, I believe the use of the phrases "Separately and First" are like magic and work well. This technique involves dismissing their initial attempt to digress and then redirecting the conversation back to its primary purpose.

Dan was a supervisee who would divert the topic away from the conversation. Lawrence, his supervisor, noticed this and employed the use of the phrases "Separately and First" to cope with Dan's digressions. Here's how it worked. Dan stated, "Preparatory reviewing? They never taught me that in school. They were too focused on assessments." In response, Lawrence said, "As far as your college education goes, I'd like to talk about that separately. However, first, I need for you to agree to begin to take your own preliminary preparation more seriously."

The important words here of course are "separately" and "first", hence. Avoid using the word "later", because, if the topic truly is irrelevant, there should really be no need to talk about it later. Also, be aware that you don't dismiss their topic as unimportant or unconnected, as, again, this will only lead to conflict.

On this track, we have examined various types of supervisees that are resistant to improvement: the yeahbut supervisee; the silent supervisee; the "I'll try" supervisee; and the irrelevant supervisee. Also, we presented various techniques for overcoming difficult conversations with these supervisees.

On the next track, we will present three main ethical issues involved in the supervision of a therapist: proper knowledge and skill; avoiding dual relationships; and fair and balanced assessment evaluations.

QUESTION 3
What are the four types of supervisees that are resistant to improvement? To select and enter your answer go to Answer Booklet

 
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