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Application of the Discrimination Model of Supervision for Residency Education

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Abstract

The advantages of a biopsychosocial emphasis in family medicine have been established. Such an emphasis requires behavioral science specialists who are prepared to instruct and supervise resident physicians regarding non-medical aspects of their treatment of patients. Most behavioral science faculty hail from one of the mental health professions and may not have received clinical supervision training in how to apply their knowledge and skills in a medical setting. The discrimination model of clinical supervision is widely used in psychology and counseling and is described here. A detailed explanation of how it can be applied to residency education is offered and examples are supplied, thus offering assistance to behavioral science faculty in their cross-disciplinary pursuits.
... According to the DM, it is possible to apply for these roles and focuses in 12 distinct ways in a 3x4 matrix, based on the supervision needs (Borders & Brown, 2009). The DM is remarkable as the most known and commonly used model among supervision models (Arthur & Bernard, 2012;Bernard & Goodyear, 2014). The fact that it provides flexibility to switch between roles, focuses based on the need for supervision, and is based on empirical data (Timm, 2015), and its suitability for both individual and group supervision processes (Bernard & Goodyear, 2014) make the DM preferable. ...
... Nevertheless, this study focused on the DM as a supervision model. Although the DM is the most well-known and empirically supported supervision model (Arthur & Bernard, 2012;Bernard & Goodyear, 2014;Timm, 2015), many studies highlighted the uncertainty of the role of consultant emphasized by this model (e.g., Bernard & Goodyear, 2014;Crunk & Barden, 2017;Ülker Tümlü, 2019). I can consider this situation a limitation of the DM. ...
Article
This study examined the effect of Discrimination Model (DM)-based group supervision on novice supervisees' counseling self-efficacy and insight levels. The study used a pretest-posttest model with 3X2 quasi-experimental, comparison, and control groups. Eighteen novice supervisees (6 participates in each group) constituted the participants. Two-factor ANOVA for mixed designs/split-plot tests was performed to analyze the data. The results revealed that DM-based group supervision significantly increased the levels of Helping Skill Self-efficacy (HSS), Session Management Self-efficacy (SMS), Counseling Challenges Self-efficacy (CCS), and Insight of novice supervisees. The comparison group showed significant changes only in their HSS and SMS levels, but not in their CCS and Insight levels. The results revealed that DM-based group supervision led to a significant difference in novice supervisees' SMS, CCS, and Insight levels compared to the comparison group. However, there was no significant difference between the two groups in terms of their HSS levels. Moreover, the control group did not score differently regarding the research variables. DM-based group supervision is an effective way for novice supervisees to develop counseling self-efficacy and insight. Findings provide an empirically-based clinical map for those aiming to provide effective supervision.
... The DM requires the supervisor to switch between supervision roles and supervision focuses (Borders & Brown, 2009) and to be flexible and sensitive to the need for supervision while doing so (Bernard & Goodyear, 2014;Borders & Brown, 2009). The DM is considered a useful model, since it is based on eclecticism rather than on a single theory (Bernard & Goodyear, 2014), is easily applied along with various developmental and theoretical approaches (Arthur & Bernard, 2012;Timm, 2015), focuses on increasing the counseling competence of counselors and reducing their anxiety (Bernard, 1979) and, in particular, provides a systematic roadmap for supervisors at the beginning stage (Bernard, 1979) (Borders & Brown, 2009). On the other hand, it can be said that conducting this process based on the group supervision method, as well as individual supervision, may enrich the supervision process. ...
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This study aims to structure individual counseling practicum (ICP) supervision, including the counseling and guidance of graduate students. In line with this aim, the supervision process is structured within the context of the Discrimination Model (DM), based on the action research method, and in accordance with group supervision stages. In the structuring of the process, a cycle of defining the focus area, collecting data, analyzing and interpreting the data, and developing an action plan is followed, based on the action research method. The data used is obtained from observations, interviews, validation committee meetings' reports, and the researcher's diaries. According to the study results, a supervision agreement, including the goals of supervision, the roles and responsibilities of supervisees, the activities to be considered in this process, and the evaluation process is established to structure the supervision process of the ICP. Furthermore, a 14-session group supervision process, including the beginning, transition, working, and termination stages in which the relevant agreement was put into practice, is designed. The study results indicate that the ICP supervision process could be structured in accordance with the DM and the stages of group supervision.
... (e.g Bernard, 1979;Hess, 1980;Williams, 1995;Wood and Rayle, 2006). The discrimination model of Bernard, (1979Bernard, ( , 1997 besides having been the first developed model, and mostly researched on (Arthur and Bernard, 2012;Carnes-Holt, Meany-Walen and Felton, 2014;Ellis, Ladany, Krengel and Schult, 1996;Glidden and Tracey, 1992;Stenack and Dye, 1982), has provided a theoretical basis for the following models (Koltz, 2008;Luke and Bernard, 2006;Rubel and Atieno Okech, 2006). The model suggests three general roles of supervisors which are teacher, counselor and consultant (Bernard, 1979). ...
... (e.g Bernard, 1979;Hess, 1980;Williams, 1995;Wood and Rayle, 2006). The discrimination model of Bernard, (1979Bernard, ( , 1997 besides having been the first developed model, and mostly researched on (Arthur and Bernard, 2012;Carnes-Holt, Meany-Walen and Felton, 2014;Ellis, Ladany, Krengel and Schult, 1996;Glidden and Tracey, 1992;Stenack and Dye, 1982), has provided a theoretical basis for the following models (Koltz, 2008;Luke and Bernard, 2006;Rubel and Atieno Okech, 2006). The model suggests three general roles of supervisors which are teacher, counselor and consultant (Bernard, 1979). ...
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ZET Bu araştırmanın amacı süpervizyon alan psikolojik danışman adaylarının bakış açısına dayalı, süpervizör rollerini ölçmeye yönelik bir araç geliştirmektir. Çalışma, beş üniversitenin psikolojik danışma ve rehberlik lisans programlarında eğitim gören dördüncü sınıf öğrencileri ile yüksek lisans öğrencilerinden oluşan üç farklı araştırma grubu üzerinde yürütülmüştür. Süpervizyon Rolleri Ölçeğinin yapı geçerliği açımlayıcı ve doğrulayıcı faktör analizleri ile incelenmiştir. Güvenirlik analizi için iç tutarlık ve test-tekrar test yöntemleri kullanılmıştır. Açımlayıcı faktör analizi sonucunda 24 maddeli ve 'öğretmen', 'rehber', 'psikolojik danışman' olarak adlandırılan, üç faktörlü bir yapı elde edilmiştir. Bu üç faktör, ölçeğin toplam varyansının % 73'ünü açıklamıştır. Doğrulayıcı faktör analizi sonuçları ölçeğin iyi uyum gösterdiğini ortaya koymuştur. Ölçeğin güvenirliği Cronbach alfa iç tutarlık katsayısı ile incelenmiş ve öğretmen, psikolojik danışman ve rehber faktörleri için sırasıyla .95, .96 ve .91 olarak bulunmuştur. Dört hafta ara ile yapılan test-tekrar test güvenirlik katsayısı ise sırasıyla .91, .92 ve .87 olarak bulunmuştur. Gerçekleştirilen analizler sonucunda Süpervizör Rolleri Ölçeği'nin süpervizyon uygulamalarında süpervizörler rollerini ölçmeye yönelik geçerli ve güvenilir bir ölçme aracı olduğu sonucuna varılmıştır. ABSTRACT The purpose of this study was to develop an instrument to measure supervisor roles based on perspectives of counselor candidates. This study was carried out among three different samples of psychological counseling and guidance senior and graduate students from five state universities. Structural validity of Supervisor Roles Scale was analyzed by exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability methods were used for reliability investigation. Exploratory factor analysis revealed that the 24 items of the scale contained three factors which labeled as 'teacher', 'adviser' and 'counselor'. These three factors explained 73 % of the total variability. Confirmatory factor analysis indicated that the scale has good fit. Cronbach alpha internal consistencies were found .95 for teacher, .96 for counselor and .91 for adviser factor. Four weeks interval test-retest reliability coefficient was found .91, .92 and .87, respectively. Findings showed that Supervisor Roles Scale is a valid and reliable instrument to measure supervisor roles in supervision practices.
Article
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