CCS EXAM/213 COMPLETE QUESTIONS & ANSWERS
- -One of the most common impairment issues that is dealt with supervisees
is impairment due to substance abuse.
What should the agency and supervisor do if a clinician is thought to be
abusing substances?
First, the agency should have a substance abuse policy in place. This policy,
developed in consultation with legal counsel, should specify what substances
it covers, what the policy is on substance use, and what the progressive
disciplinary response will be to substance abuse on the job.
The policy must not discriminate against the practitioner in recovery by
imposing a stricter standard on those who have disclosed their recovery
history.
If abuse is found, as soon as the problem is identified, the practitioner should
be taken out of counseling functions immediately. However, how long should
they stay out of counseling functions?
-Addressing Supervisee Countertransference - -Addressing
countertransference is an accepted task in many of the supervisory theories
(Powell being a notable exception).
Inquiry into a supervisee's subjective reactions is often initiated following a
supervisees' reports of being frustrated, bored, distracted, confused, or
irritated. Other identifying factors that countertransference could be
occurring are:
When departures from supervisee's usual clinical conduct and disruptions of
therapeutic frame have occurred.
When treatment appears to be going nowhere.
Supervisee factors essential to the successful management of
countertransference:
Self insight
Self integration
Empathy
Conceptualizing abilities
The ability to manage anxiety
-Addressing Supervisee Countertransference - -Well established supervisory
alliance is necessary in the exploration of countertransference.
,Supervisor self-disclosure may be used to model and encourage transference
reactions.
The use of video observation can be used to identify particular sequences of
interaction in which unusual shifts in the supervisee's demeanor, behavior,
and affects occur.
Of utmost importance in addressing countertransference is the maintenance
of the boundary between supervision and psychotherapy. Appropriate to
supervision, inquiry directs attention to the interactions and processes
specific to the supervised case, and, although personal issues of the
supervisee may surface, such material is considered in light of the case.
-Arguments Against Code of Ethics - -These arguments have included the
decontextualized nature of codes and their consequent irrelevance to many
problems of practice.
The privileging of elites who usually hold positions of power that enable them
to develop and enforce codes.
The impossibility of developing a meaningful code that is broadly acceptable,
relevant, and enforceable given the diversity of a given field.
-Assessment Model and Action Plan (Reamer, 1992) - -Identify and collect
data on the professional's impairment.
Speculate about possible causes of the impairment.
Constructively confront the professional with evidence of the impairment.
Urge the professional to seek help and review the available options.
Emphasize the consequences of the professional's failure to address the
problem or problems.
If necessary, notify a regulatory body or governing committee on inquiry.
Formulate a rehabilitation plan or impose sanctions, as appropriate, following
standard due process proceedings.
Monitor and evaluate the professional's progress.
Review the practitioner's standing in the profession, such as licensure or
employment status, and modify it as appropriate.
-Audio Tape Format - -While many formats can be used, a typical format
consists of letting a supervisee choose a part of a session in which they felt
confused, lost, overwhelmed, or frustrated.
Have supervisee state the reason for selecting this part of the session for
discussion in supervision.
Briefly state what transpired up to that point.
,Explain what he or she was trying to accomplish at that point in the
supervision.
Clearly state the specific help desired from the supervisor.
-Audio Taping - -It is the supervisor's responsibility to outline the plan as to
how audio taped supervision will take place.
With beginning supervisees, you may listen to a whole audio tape before
supervision in order to get an overview of the supervisee's ability, and you'll
have control over what part of the tape you'll want to focus on in supervision.
With more advanced supervisees, pre-selected segments can be chosen for a
variety of reasons:
To highlight the most productive part of the session.
To highlight the most important part of the session.
-Audio Taping (cont.) - -To highlight the part of the session where the
supervisee is struggling the most.
To underscore any number of content issues, including metaphors and
recurring themes.
To ask about confusing part of the session.
To focus attention on the point in the session where interpersonal or cross-
cultural dynamics were either very therapeutic or very strained.
-Blended Model - Expanded Supervisor Dimensions (Powell, 2004) - -
Expanded Supervisor Dimensions
The Journey Dimension - Does the supervisor concentrate on the process of
deepening supervisees (Level 3's who are going downward and inward for
reflection and introspection). Or do supervisors concentrate on developing
(Level 1's growing upward and outward in their professional development).
The Internalization Dimension - Does the supervisor seek to aid the
supervisee in developing wisdom and integrating therapeutic behaviors and
attitudes (Level 3). Or do supervisors help to isolate external philosophies of
the supervisee and help them understand the compartmentalization of these
external philosophies as they affect their practice (Level 1).
-Blended Model - Expanded Supervisor Dimensions (Powell, 2004) - -
Expanded Supervisor Dimensions
, The Listening Dimension - Does the supervisor listen with the heart (Level 3)
or with the head (Level 1)
The Questioning Dimension - Does the supervisor pose questions (Level 3) or
answers (Level 1).
-Blended Model - Influential and Symbolic Dimensions - -Influential
Dimension
This dimension has the premise that supervisee's are influenced both
affectively and behaviorally, depending on the individual's stage of
development, needs, and cognitive abilities.
Beginning clinicians will look for basic helping skills, and advanced clinicians
will address more theoretical, and interpersonal issues.
Symbolic Dimension
The blended model emphasizes primarily manifest content, viewing the
unconscious (or latent) symbolic material as interesting but nonessential to
bringing about desired changes.
-Blended Model - Information Gathering Dimension - -Information Gathering
Dimension
This is the belief that the supervisor must gain as much information as
possible on the counseling style of early (level 1 and 2) clinicians. Direct
observation is essential for this process.
As the clinician grows in three developmental structures (motivation, self and
other awareness, and autonomy-independence), the supervisor can utilize
more insight-oriented issues and thus utilize more indirect information
gathering techniques.
-Blended Model - Jurisdictional and Relationship Dimensions - -Jurisdictional
Dimension
The blended model sees jurisdiction over the client and supervisee as resting
ultimately with the supervisor, who cannot escape the ethical and legal
implications of every supervisee and every client.
Relationship Dimension