Supervision in couple and family psychology training and practice

Supervision is a core competency that encompasses the foundational concepts and theories offered in the context of supervision (Stanton & Welsh, 2011). When working with the lens of core competencies, the supervisor enables the supervisee to conceptualize and implement a treatment plan that will prove the most effective for the specific client. The supervisor is seen as a mentor and specialist who understands theory, research, and methods that empowers the supervisee to enter the profession by (a) understanding the attitudes, skills, and knowledge demanded of the profession and (b) guiding the supervisory relationship strategically to facilitate the trainee’s achievement of a professional standard (Holloway, 1995).

Supervision in couple and family psychology (CFP) should be consistent with the American Psychological Association’s (APA) Guidelines for Clinical Supervision in Health Service Psychology (HSP; APA, 2014). CFP supervision is distinguished by an emphasis on systemic principles and attention to CFP competencies needed for specialty practice.  The APA Division 43 CFP Training and Education Guidelines under review by the Couple and Family Psychology Specialty Council will offer guidance for training across doctoral, internship/post-doctoral, and professional stages.

During the development of CFP training guidelines, the qualities of competent CFP supervision have been a consistent discussion topic, highlighting the need for clarification regarding adequate levels of training for CFP supervisors.  We hope the following information and resources will be helpful in this discussion and stimulate an interest in sharing your thoughts on CFP supervision with division leaders, or perhaps inspire a research project investigating CFP supervisory competencies that can shed light on the questions raised in conversations regarding guidelines for CFT supervision.

What makes a psychologist competent to provide supervision in CFP-related activities? According to Stanton and Welsh (2011), CFP Supervisors will demonstrate:

• Knowledge about supervision approaches and modalities in CFP training
• CFP supervision uses an integration of diverse theoretical approaches.
• Supervisor utilizes process-based approaches to supervision, including case report, direct supervision, and co-therapy models.
• Knowledge and skills to guide the supervisee in the development of functional competencies in case conceptualization, assessment, and interventions.
• Knowledge about foundational systemic concepts and theories that facilitate supervisee’s growth as a professional and the ability to apply a systemic paradigm in the process of supervision that can be demonstrated by checklist for supervisees and supervisors.
• Foundational competencies include: reflective practice and self-assessment, scientific knowledge and methods, relationships, adherence to ethical and legal standards of practice, individual and multi-cultural diversity, and appreciation of interdisciplinary systems.
• Familiarity with the recent literature on the supervisory alliance that supports the growth of the supervising therapist and fosters supervisory climates that are supportive to the growth of the supervisee.  The supervisor remains aware of the isomorphic effect of the relationship between the supervisor and the supervisee and how it affects the relationship between the therapist and client.

For an overview of foundational and functional CFP competencies, we believe it is essential for supervisors read Stanton and Welsh (2011), which provides a comprehensive overview of the skills and competencies expected of couple and family psychologists. Another critical document written by Celano (2019) clearly ties the general HSP competencies to specific competencies in CFP. The division’s CFP Training and Education Guidelines will also be useful in providing specific recommendations for trainers working with supervisees at the various educational stages.

In addition to the references provided here, an extended reference list of training and supervision resourcesopens in new window can be found under Resources for Educators on the division’s research and education webpage.  For example, several training models offer clear recommendations for CFP supervisors.

• Core competencies (Sperry, 2010) are identified for supervisees that include: conceptual foundation, relationship building and maintenance, intervention planning, implementation, evaluation, and termination.
• Gehart (2014) identified core competencies for family therapists that include: conceptualizing the situation with the help of theory, assessing the client’s mental health status, providing case management, developing a treatment plan with therapeutic tasks that include how to build a working therapeutic relationship and measurable client goals; evaluating the client’s response to treatment and documenting what happens. Supervisors are to focus on core competencies to enable future therapists to thoughtfully apply the knowledge and skills in their respective professions (Pitta, 2014).
• Celano, Smith, and Kaslow (2010) proposed an integrative supervisory approach for couple and family therapy (CFT) that attends to and evaluates eight essential components for supervisee development: Systemic formulation, Forging a successful systemic therapeutic alliance, Understanding family of origin issues, Reframing the family’s negative view of the problem in a positive way, Managing negative interactions, Building cohesion/intimacy/ communication, Restructuring/parenting, and Understanding and applying evidence-based CFT models
• In Assimilative Therapy Model, Pitta (2014) identified seven steps to creating a competent CFP/ATM supervisor.
• Encourage trainees to think, plan, and conceptualize the presenting issues through a systemic theoretical framework, to create a “conceptual map” of “how to approach therapy.”
• The supervisor educates and models the building of the therapeutic alliance.
• The context of the supervisee is discussed to enable its influence on his/her ability to work with clients and families.
• The supervisor will assess the supervisee’s family of origin and extended family systems relationships to assess where the supervisee might become “stuck or triggered” in doing treatment. 
• The supervisor evaluates the supervisee’s progress in identifying and helping clients attain goals in treatment. 
• The supervisor will conduct him/herself in a culturally and ethically sensitive manner with integrity, honesty, and diligence”.
• The supervisor will enable the supervisee to create a case conceptualization.

There is further need for the development and validation of a measure to assess CFP competencies that align with the most recent HSP competencies.  We located a few measures that supervisors may find useful in evaluating trainee competences in couple and family therapy, including the Basic Skills Evaluation Device (Nelson & Johnson, 1999) and the Family Therapy Skills Checklist (Briggs, Fournier, & Hendrix, 1999). In addition, to assess the supervisor’s competencies in providing effective supervisions, we found a very promising bidirectional measure called the Dyadic Supervision Evaluation Device, Trainee and Supervisor forms by Avila, Distelberg, Estrada, Foster, Moline, and Yuenergardt (2017).

References

Avila, Distelberg, Estrada, Foster, Moline, Yuenergardt (2017). Dyadic Supervision Evaluation Device, Trainee and Supervisor forms.

Briggs, Fournier, & Hendrix, (1999). Evaluating trainees’ skill development: The family therapy skills checklist. Contemporary Family Therapy. 353-370.

Celano, M. (2019). Competencies in couple and family psychology for health service psychologists. In B.H. Fiese, M. Celano, K. Deater-Deckard, E.N. Jouriles, M.A. Whisman’s (Eds.), APA handbook of contemporary family psychology: Family therapy and training, Vol. 3 (pp. 427-448). Washington D.C.: American Psychological Association.

Gehart. D. (2014). Mastering competencies in family therapy: A practical approach to theory and clinical case documentation. Stamford, CT: Cengage Learning.

Nelson & Johnson (1999). Basic Skills Evaluation Device. Journal of Marital and Family Therapy, 25, 15-30.

Pitta, P. (2014). Solving modern family dilemmas: An assimilative therapy model. New York: Routledge.

Pitta, P., (1995).  An integrated supervisory model. Family Psychologist, Div. 43. Washington DC: American Psychological Association.

Sperry, L. (2010). Core competencies in psychotherapy series. Core competencies in counseling and psychotherapy: Becoming a highly competent and effective therapist. Routledge/Taylor & Francis Group.

Stanton, M & Welsh, R. (2011). Specialty competencies in couple and family psychology. New York: Oxford Universities Press Inc.

Celano, M.; Smith, C.o., Kaslow, N.  (2010). A competency-based approach to couple and family therapy supervision. Psychotherapy Theory, 47 (1), 35-44.

Health Service Psychology Education Collaborative (2013). Professional psychology in health care services: A blueprint for education and training. American Psychologist. 68(6), 411-426.