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Application of the Discrimination Model of Supervision for Residency Education
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. ...
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. ...
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). ...
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.
... (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). ...
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.
هدفت هذه الدراسة التعرف إلى فاعلية برنامج إشراف إرشادي يستند الى النموذج التمايزي في تحسين مهارات إرشاد الأزمات والكفاءة الذاتية المدركة لدى المرشدين المتدربين في الجامعة الأردنية. تكونت عينة الدراسة من (28) مرشداً متدرباً من طلبة البكالوريوس في الإرشاد والصحة النفسية في الجامعة الأردنية في الفصل الدراسي الأول من العام الجامعي 2016/ 2017، والذين وافقوا على المشاركة في الدراسة، وأظهروا درجات منخفضة على مقياس مهارات إرشاد الأزمات. وتم توزيع أفراد عينة الدراسة بالطريقة العشوائية إلى مجموعتين: مجموعة تجريبية وعدد أفرادها (14) مرشداً متدرباً، تلقوا برنامجاً إشرافياً، مكون من (16) جلسة، ومجموعة ضابطة وعدد أفرادها (14) مرشداً متدرباً لم يتلقوا البرنامج الإشرافي. وقد تم قياس أداء أفراد المجموعتين التجريبية والضابطة على مقياسي مهارات إرشاد الأزمات والكفاءة الذاتية المدركة قبل البرنامج الإشرافي وبعده، في حين تم أخذ قياس المتابعة للمجموعة التجريببة بعد أربعة أسابيع من انتهاء البرنامج. أظهرت نتائج الدراسة وجود فروق ذات دلالة إحصائية بين المجموعتين التجريبية والضابطة في مهارات إرشاد الأزمات والكفاءة الذاتية المدركة لصالح المجموعة التجريبية التي تلقى أفرادها البرنامج الإشرافي.
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The purpose of this study was to investigate the efficacy of a counseling supervision program based on discrimination model in improving crises counseling skills and perceived self-efficacy among counseling trainees at the University of Jordan. The sample of this study consisted of (28) trainees from mental health and counseling students at the University of Jordan in the first semester 2016-2017, who agreed to participate in the study and showed the lowest scores on crises counseling skills scale. The participants were randomly assigned into two groups: experimental group included (14) trainees, who received a supervision program consisted of (16) sessions; and a control group included (14) trainees, who did not receive a supervision program. The scale of crises counseling skills and the scale of perceived self-efficacy were administered to both groups as pre-test and post- test. Follow up measure was taken after four weeks for only the experimental group. The results of the study showed significant differences between the two groups regarding the level of crises counseling skills and perceived self-efficacy in favor of experimental group.
Bernard's discrimination model is frequently used in the supervision of counseling practice. The advantages of this model include its simplicity, flexibility, and research support across a variety of interdisciplinary domains. When working from the foundation of Bernard's discrimination model in counseling supervision, use of narrative techniques can be helpful in reducing supervisee anxiety, promoting creativity, and exploring and solidifying personal and vocational values.
It is well documented that clinical supervision in school settings is underutilized. One hypothesis for this situation is the lack of fit between current supervision models that emphasize the supervision of individual counseling and the multiple roles of school counselors within comprehensive school counseling programs (CSCPs). The authors propose the School Counseling Supervision Model (SCSM) as an extension of J. M. Bernard's (1979, 1997) Discrimination Model. The SCSM uses a 3 (focus of supervision) × 3 (supervisor role) × 4 (CSCP domain) matrix. Examples are provided for potential supervision interventions using the SCSM. Implications for training, practice, and research are discussed.
The delivery of supervision skills to those who direct counselors through practicum is not well defined in the counseling literature. This article addresses that issue by presenting a model for identification and training of those skills, the roles in which the skills are demonstrated, and the types of choices or discriminations that are necessary to make in tutoring trainees through the counseling practicum. This model attempts to pair the training of supervisors with the training of counselors in a systematic fashion.
The second edition of this ground-breaking book continues the mission of its predecessor: to provide a “best principles” and “best practices” overview of the counseling supervision process, one that is firmly rooted in the recent explosion of empirical research in this field. Sponsored by the Association for Counselor Education and Supervision (ACES), the presentation is targeted primarily at master’s-level practitioners who want “how-to” applications of the research literature (with examples) rather than a comprehensive review of the supervision literature. Like the first edition, this revised book is also a useful supplement for more academic texts used for doctoral-level instruction in counseling supervision. Key changes in this new edition include greater attention to multicultural and diversity issues and new chapters on group supervision and on technology. Also new are discussion questions and vignettes meant to enhance application of key concepts in each chapter as well as more sample materials and forms for practice.
In IDM Supervision, the authors expand on their original version of the widely praised Integrated Developmental Model (IDM) of supervision. Useful with any therapeutic orientation, this model offers clear guidelines for applying developmental theories to every step of the supervision process. Based on the most current research, this book provides a thorough understanding of how learning, cognition, emotion, and professional development affct therapists through the training process and in their professional lives.
The Level of Supervision Scale (LSS; R. D. Miars et al, 1983) was administered to 69 supervisors with experience supervising 1st-semester practicum and intern-level trainees. The structure of their responses to 28 LSS items assessing perceptions of supervision as they varied across these 2 trainee experience levels was examined using 3-way multidimensional scaling. A 4-dimensional solution was yielded, which accounted for 63% of the variance. The 4-dimensions are (1) enhancing dynamic understanding, (2) didactic instruction, (3) counseling vs supportive supervisory functions, and (4) authoritative vs collaborative style. The study demonstrated clear differences in the salience of the dimensions across supervisors' perceptions of the 2 trainee experience groups. Supervisors perceived the enhancing dynamic understanding dimension as most important in their supervision of interns, whereas didactic instruction was most salient in perceptions of supervising beginning trainees. No differences were found across experience level for the other 2 dimensions.
It is likely that counselor trainees will be exposed to suicidal clients and subsequently face personal dilemmas, stress, and feelings of incompetence. Ethical guidelines mandate that supervisors have procedures to assist supervisees in such times. Currently, the literature does not provide a framework for providing such supervision. This article presents a theory-grounded model to assist the supervision of supervisees working with suicidal clients.
This study examined the role of the ideal on-site mentor and the actual mentor's role performance, as perceived by 158 mentor counselors and 171 school counseling interns. Results indicated that the ideal mentor's professional traits were given priority by both groups and that the teacher role was the most salient among role domains. In the actual role performance, the 2 groups differed regarding the perceived contribution of the mentor-specific behaviors in each examined role domain. © 2007 by the American Counseling Association. All rights reserved.
Counselor stamina is deemed essential in the midst of a consistently challenging, complex, and changing mental health care environment. Rather than perpetuating conversations about “burnout” and “burnout prevention,” this article provides a salutary or health‐promoting perspective. Seven suggestions for counselor stamina are presented and discussed, based on a review of the literature and the author's reflections on clinical practice today. Each suggestion corresponds to 1 of the 7 letters in the word stamina.