April 15, 2008 Features

A Look at Supervision in the 21st Century

At some point in their careers, many professionals will be asked to supervise, providing oversight of individuals with varying levels of expertise, such as graduate students, clinical fellows, practicing SLPs and/or support personnel. Initially, the invitation may be welcomed and viewed as an opportunity to expand professional horizons. On reflection, however, these professionals may feel they have been thrust into the role of supervisor without much preparation or understanding for taking on this important responsibility. They may feel uncertain about which strategies and methodologies to use, and find themselves with more questions than answers. None of us would attempt to provide services to a client with an unfamiliar disorder without study and/or consultation—yet often we take on the job of supervisor in this way.

A Growing Interest in Supervision

In the 1970s and 1980s interest in supervision increased with publications, presentations, and even the formation of organizations focused on supervision. Dissertations by students who had studied with Jean Anderson at Indiana University (Anderson, 1988), along with research within communication sciences and disorders (CSD), began to define the knowledge base. This research also helped identify some of the critical factors in supervision methodology and their relationship to the effectiveness of supervision (McCrea & Brasseur, 2003).

Other factors that have stimulated interest in supervision from the 1990s to the present include:

  • Expanded Scope of Practice—The breadth of practice within CSD has expanded due to advances in knowledge,
    understanding, and research in the discipline. This expanded scope of practice has created an even greater need for internships and workplace assignments where supervisors (also called clinical educators) can facilitate the application of information learned either through academic preparation or professional development. Clinical teaching has become a major responsibility of a large percentage of professionals serving as supervisors of individuals with varying levels of preparation in speech-language pathology and audiology.
  • Personnel Shortages—In the 1990s specific regions of the country began to experience persistent vacancies for qualified speech-language pathologists and audiologists. In the last few years critical personnel shortages have been reported in both educational and health care settings across the country (ASHA, 2007). Such shortages have created workplace environments in which professionals receive increased supervisory responsibilities. These supervisors may work with new professionals or those with many years of experience, but the overriding goal is to oversee the supervisee's competence, skills, and ethics and to ensure quality of service provided to the client.
  • Sustained Influx of New Professionals—Speech-language pathology and audiology rely on the influx of new practitioners to ensure the future of the discipline, a process in which the quality of supervision plays an important role in recruitment and retention of future professionals.

A Continuum Model for Supervision

The publication of Jean Anderson's ground-breaking 1988 book, The Supervisory Process in Speech-Language Pathology and Audiology, presented an approach to the supervisory process that influenced many clinicians who had been launched into a supervisory role without preparation. Influenced by experience and the study of the literature from many fields, Anderson proposed a theoretical framework of supervision for the discipline of communication sciences and disorders (CSD). Referred to as the "continuum model," it is predicated on the idea that there is not just one way to supervise. This model is based on the concept that supervision exists on a continuum employing different strategies and styles that are appropriate at different points in time and situations. This "continuum" framework of supervision (see Figure 1 [PDF]) is the most widely recognized model in CSD.

ASHA's new technical report on clinical supervision in speech-language pathology (ASHA, 2008b; see sidebar below) adopts Anderson's model, stating that "the continuum mandates a change over time in the amount and type of involvement of both the supervisor and the supervisee in the supervisory process. As the amount of direction by the supervisor decreases, the amount of participation in the supervisory process by the supervisee increases across the continuum (Anderson, 1988). The stages (evaluation-feedback, transitional, self-supervision) should not be viewed as time-bound, as any individual supervisee may be found at any point on the continuum depending on situational variables as well as the supervisee's knowledge and skill. The model stresses the importance of modifying the supervisor's style in response to the needs, knowledge, and skills of the supervisee at each stage of clinical development. This model also fosters professional growth on the part of both the supervisor and the supervisee."

Defining the Supervisory Process

To facilitate an understanding of the importance of supervision to the professions, it is important to establish a comprehensive definition. Supervision is not a process unique to speech-language pathology and audiology. As Anderson (1988) points out, "supervision exists wherever individuals work together in any type of hierarchical structure where one person has authority, influence, or power over another…" (p. 10). Often the goal of supervision is to transfer knowledge from one person to another and to ensure adequate service to clients. However, the stated purposes of supervision will vary depending on an individual's perceptions or personal concepts.

For example, when giving workshops, I often ask the participants to write their definition of supervision. As might be expected, the responses vary widely and are based on individual perceptions about the purposes of supervision or the role of the supervisor. Frequent examples include "to monitor the work of others," "to assure quality of service to clients," and "to teach, support and guide individuals to become better professionals." These statements are all accurate, but they do not fully capture the purposes of the supervisory process. Jean Anderson's definition (1988) seems to capture the primary goals of supervision and is reprinted to promote a common understanding about what is involved in the process:

"Supervision is a process that consists of a variety of patterns of behavior, the appropriateness of which depends on the needs, competencies, expectations and philosophies of the supervisor and the supervisee and the specifics of the situation (tasks, client, setting, and other variables). The goals of the supervisory process are the professional growth and development of the supervisee and the supervisor, which it is assumed will result ultimately in optimal service to clients" (Anderson, 1988, p. 12).

This definition is consistent with the goals of the supervisory process and also emphasizes the need to consider the supervisee's level of knowledge, experience, and competence when assigning tasks and responsibilities. Although 20 years have passed, this definition is still relevant today. The recent ad hoc Committee on Supervision enhanced this definition by adding language that addresses the collaborative nature of the supervisory process and the importance of facilitating the supervisee's critical thinking and problem-solving (Technical Report, ASHA 2008b). Therefore, Anderson's definition is expanded to include the following:

"Professional growth and development of the supervisee and the supervisor are enhanced when supervision or clinical teaching involves self-analysis and self-evaluation. Effective clinical teaching also promotes the use of critical thinking and problem-solving skills on the part of the individual being supervised."

Three Key Supervisory Issues

Although several variables influence the supervisory process, the following three issues are key to effective supervision. The importance of these issues is documented in the literature (e.g., Anderson, 1988; Dowling, 2001; McCrea & Brasseur, 2003). Each of these issues is also briefly discussed in the Technical Report on Clinical Supervision in Speech-Language Pathology (ASHA 2008b); references allow the reader to explore each of these areas in more depth.

1. Training

Data focusing on the importance of training supervisors are becoming more readily available. McCrea and Brasseur (2003) discuss studies (Dowling, 1986, 1995; Hagler, 1986; Hagler, Casey, & DesRochers, 1989; Strike-Roussos, 1988; Dowling, Sbaschnig, & Williams, 1991) that demonstrate that supervisors who have been trained are more effective than those who have not. It seems imperative, then, to acknowledge that some type of formal education is necessary for engaging in the supervisory process.

Preparation can be obtained in many ways, but one of the most accessible methods is through continuing education. Formats range from independent study to teleconferences and Web-based instruction. Presentations and workshops on supervision are common at conferences, conventions and special-topic seminars. Books and articles are readily available (see references), including articles in the Perspectives newsletter published by Special Interest Division 11, Administration and Supervision. Membership in this division provides access to a wealth of resources through conferences, publications, and the division Web site.

2. Communication Skills

A supervisee's development may ultimately rest on the supervisor's skill in communicating effectively about the supervisee's clinical and professional behaviors. Research demonstrates that effective communication is essential in a variety of everyday settings (e.g., Adler, Rosenfeld, & Proctor, 2001). For example, Winsor, Curtis, and Stephens (1997) asked human resources managers to describe the top skills of the ideal manager. The top six skills listed by the surveyed managers all related to communication: the ability to listen effectively, work well with others, operate effectively in small groups, gather information from others before making a decision, write effective reports, and give effective feedback. All of these skills are relevant to supervisors as well.

Research in the profession of speech-language pathology also has focused on the interpersonal aspects of the supervisory process. Anderson (1988), Dowling (2001), and McCrea and Brasseur (2003) all discuss studies that demonstrate the important role of communication in the supervisory experience. Examples include research by Pickering, who focused on interpersonal communication throughout her career (e.g. 1979, 1984, 1987a, 1987b, 1990). Ghitter (1987, as cited in McCrea & Brasseur, 2003) explored the relationship between the interpersonal skills of supervisors and the impact on supervisees' clinical effectiveness. Her results affirmed what has been demonstrated in other studies: when supervisees perceive high levels of unconditional positive regard, genuineness, empathic understanding, and concreteness, their clinical behaviors change in positive directions.

Being an effective communicator is frequently assumed to be an aptitude or an innate skill people possess without any training. However, many professionals operate at a level of effectiveness far below their potential (Adler et al., 2001). Although individuals can learn through their successes and failures, they can benefit from observing others and by evaluating their own skills. Training in interpersonal communication is an important component of supervisory training. Growth in the interpersonal domain will enhance supervisors' proficiencies in interacting with supervisees in a helpful manner.

3. Evidence-Based Practices

Objective data about the supervisee's performance adds credibility and facilitates the supervisory process (Anderson, 1988; Shapiro, 1994). Results from the analysis of this data can be applied both to the supervisee's clinical interactions with clients as well as to behaviors of the supervisor and supervisee during supervisory conferences. The supervisory process should be a collaborative activity with shared responsibility for many of the activities involved.

Supervisors must be concerned about their own learning and development if they are to be effective in their role as clinical educators. This process is best accomplished when supervisors become active researchers. Collecting and scientifically analyzing data is an excellent way to answer questions and draw conclusions about whether supervisory goals are being met, and/or whether the supervisor's behavior during supervisory conferences is effective in facilitating the supervisee's independent thinking. As stated by McCrea and Brasseur (2003), "analysis counteracts the superior role of supervisors solely as evaluators or overseers and highlights their role as scientific co-investigator" (p. 191).

Studying the supervisory process in one's own behavior not only facilitates accountability in clinical teaching, but also provides an opportunity for supervisors to examine their own behavior to identify strengths and areas that need improvement. Tools to accomplish this task are not readily available, so supervisors must draw on other resources to obtain results of their own behavior (McCrea & Brasseur, 2003). As Anderson (1988) points out, "When the clinical supervision process proceeds as inquiry, personal discoveries have the potential for becoming collective discoveries" (p. 298). The most informative research concerns supervisory practices and their effects. Such research provides an opportunity for the supervisor/researcher to learn by experiment. For example, if a supervisor is concerned about talking too much during supervisory conferences, a tape may be made of the conference. A transcript of the text might be optimal, but listening to the tape can also increase awareness of the supervisor's verbal behavior. This awareness will help the supervisor become conscious of that behavior in subsequent interactions, increasing the ability to change.

Whether clinicians are already supervisors or hoping to become one, they can prepare for the role by developing familiarity with the literature on the supervisory process, including the new ASHA documents on supervision. Because of the importance and complexity involved in the supervisory process, increased focus should be given to the issues and skills in providing supervision across the spectrum of a professional career in speech-language pathology. We should be proud of the growth and development of supervision in our discipline, avail ourselves of the information available to apply best practices in supervision, and recognize the need to facilitate its future evolution.

Lisa O'Connor, chair of the committee facilitating the development of ASHA's new policy documents, spent 20 years at California State University, Los Angeles, where she supervised student practica. She was the recipient of a federal grant to train bilingual paraprofessionals to work with monolingual SLPs. Contact her at lisa4asha@hotmail.com.

cite as: O'Connor, L. (2008, April 15). A Look at Supervision in the 21st Century. The ASHA Leader.

ASHA Documents on Supervision

Supervision was recognized as a distinct area of practice with ASHA's adoption of a 1985 position statement, Clinical Supervision in Speech-Language Pathology and Audiology. This position statement provided a detailed list of tasks and competencies for supervisors; although the competencies have not been validated, this list offered a base for future exploration into the intricacies of supervision (McCrea & Brasseur, 2003).

New Position Statement

Due to the increasing data from studies on supervision, advances in technology, and a greater understanding of the interpersonal factors in the supervisory process, an ad hoc Committee on Supervision was formed in 2007 to review the 1985 position statement and develop new documents on supervision in speech-language pathology.

The new position statement, Clinical Supervision in Speech-Language Pathology (ASHA, 2008a), affirms the role of supervision within the profession and reaffirms that supervision is a distinct area of practice in the profession. The companion document, Knowledge and Skills Needed by Speech-Language Pathologists Providing Clinical Supervision (ASHA, 2008c), delineates areas of competence necessary to provide quality supervision.

Technical Report

The technical report (ASHA, 2008b) that accompanies both of these documents highlights key principles and issues that reflect the importance and the highly skilled nature of providing exemplary supervision. This report addresses supervision across the spectrum of supervisees; supervision of support personnel is covered in a separate position statement, guidelines, and knowledge and skills document on this topic (ASHA, 2002, 2004a, 2004b).

Although the principles of supervision are common to both speech-language pathology and audiology, the updated documents address only speech-language pathology because of differences in pre-service education and practice between the two professions. All of these supervision documents are available at ASHA's Practice Policy.  



Then and Now: Supervision Dialogues

My first experience with supervision came three years after completing my graduate program in speech-language pathology, when I was asked by a former professor if I would supervise graduate students in the campus clinic. When I think of the experience today, it reminds me how little I knew at the time. I took my supervisory responsibilities seriously and focused on solving all problems encountered by the clinician. Compare this previous dialogue with one I might have now:

Previous Dialogue

Supervisee: I've tried everything you suggested, but nothing is helping the client to produce the sound.

Supervisor: I noticed that he made several errors. Did you tally correct and incorrect responses?

Supervisee: Well, I kept track of the few correct responses.

Supervisor: You need to keep track of all the responses, but let me give this further thought. I will develop some ideas and we can meet again before you see the client.

Current Dialogue

Supervisee: I've tried everything you suggested and nothing is helping the client to produce the sound.

Supervisor: I noticed that he made several errors. Did you tally correct and incorrect responses?

Supervisee: I kept track of the few correct responses.

Supervisor: Would it help if you kept track of all responses so accuracy can be computed?

Supervisee: That would help. I do need to know how accurate he is.

Supervisor: What techniques are you using to elicit correct productions?

Supervisee: I have tried everything you suggested, and it's not working.

Supervisor: Describe what you have tried.

Our goal is to be helpful without taking all the responsibility for supervisees' growth as clinicians. The latter scenario shifts the responsibility for problem-solving and provides the supervisee with an opportunity to examine what is happening and identify potential solutions. Developing communication skills that facilitate supervisees' critical thinking and problem-solving may be one of the most important things we do.

Feedback as a Reciprocal Dialogue

Good communication skills are critical during clinical supervision conferences. In my early years of supervision, I saw supervisory conferences as a time to discuss perceived problems the supervisee had in clinical work. During one conference, I apparently had just shared a litany of perceived problems with the clinician when she said to me, "Professor O'Connor, I don't mean to be rude, but is there anything I did right?"

I began to realize the need for well-timed, practical suggestions on effective supervision. The initial "aha" moments came from reading Jean Anderson's article (1981) on training supervisors in speech-language pathology and audiology. I gained more information from Pickering's article (1984) on interpersonal communication during supervisory conferences. Traditionally, conferences were viewed as a time for supervisors to provide supervisees with feedback, and I was doing an excellent job in that arena. However, feedback must be a two-way street, allowing supervisees to share feelings and perceptions about the supervisory experience.

When planning clinical conferences, I now routinely involve the supervisee by jointly establishing the agenda and facilitating a discussion of previously identified clinical or supervisory data or issues. During conferences, we collect data to allow for ongoing analysis of supervisory interactions. McCrea and Brasseur (2003, p.206) noted that "the supervisor's ability to encourage supervisee participation in self-exploration and problem-solving is essential to movement along the continuum." I listen carefully to the supervisee's ability to brainstorm and develop solutions to clinical issues and problems, and in doing so, I know when it is time to move along the supervision continuum. 



ASHA Supervision Resources

Student Supervision
Links to teaching tools, ASHA certification standards, policy documents, articles on supervision, tips for first-time supervisors, and more

Curriculum Resources
Topic-related resource packets

Quality Indicators for Integration of Clinical Practice and Research: Program Self-Assessment
Quality indicators to assist academic and clinical educators in assessing how well clinical practice and research are integrated

Special Interest Division 11, Administration and Supervision
Membership in Division 11 provides quarterly issues of a peer-reviewed publication, Perspectives, continuing education opportunities, access to their affiliates' Web pages, an e-mail list, Web forums, and reduced registration fees for division-sponsored professional development activities.  



Top 10 Reasons to Supervise a Student

  1. Develop and recruit future employees 
  2. Stay current—learn what students are learning 
  3. Share your expertise with future SLPs 
  4. Establish a relationship with university programs 
  5. Teach future SLPs to advocate for SLP services
  6. Introduce students to interdisciplinary teaming 
  7. Feel good about giving back to the profession 
  8. Develop your mentoring and supervisory skills 
  9. Enhance your clinical skills by teaching someone else 
  10. Leave a legacy  


References

Adler, S., Rosenfeld, L. B., & Proctor, R. F., II. (2001). Interplay: The process of interpersonal communication. New York: Harcourt.

American Speech and Hearing Association. (1978). Current status of supervision of speech-language pathology and audiology [Special report]. Asha, 20, 478–486.

American Speech-Language-Hearing Association. (1985). Clinical supervision in speech-language pathology and audiology [Position statement]. Available from www.asha.org/policy.  

American Speech-Language-Hearing Association. (2002). Knowledge and skills for supervisors of speech-language pathology assistants. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2004a). Guidelines for the training, use, and supervision of speech-language pathology assistants. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2007). Supply and Demand for Speech-Language Pathologists Resource List. Retrieved on March 11, 2008, from  http://www.asha.org/NR/rdonlyres/4FFFD528-72F4-489B-8963-49101523AD8A/0/WorkforceUpdateSLP2007.pdf.

American Speech-Language-Hearing Association. (2004b). Training, use, and supervision of support personnel in speech-language pathology [Position statement]. Available from www.asha.org/policy.

American Speech-Language-Hearing Association. (2008a). Clinical supervision in speech-language pathology [Position Statement]. Available from www.asha.org/policy (pending approval).  

American Speech-Language Hearing Association. (2008b). Technical Report. Clinical supervision in speech language pathology. Available from www.asha.org/policy (pending approval).  

American Speech-Language-Hearing Association. (2008c). Knowledge and skills needed by speech-language pathologists providing clinical supervision. Available from www.asha.org/policy (pending approval).

Anderson, J. L. (1988). The supervisory process in speech language pathology and audiology. Austin, TX: Pro-Ed.

Dowling, S. (2001). Supervision: Strategies for successful outcomes and productivity. Needham Heights, MA: Allyn & Bacon.

McCrea, E. S., & Brasseur, J. A. (2003). The supervisory process in speech-language pathology and audiology. Boston: Allyn & Bacon.

Shapiro, D. A. (1994). Interaction analysis and self-study: A single-case comparison of four methods of analyzing supervisory conferences. Language, Speech, and Hearing Services in Schools, 25, 67–75.

Winsor, J. L., Curtis, D. B., & Stephens, R. D. (1997). National preferences in business and communication education: An update. Journal of the Association for Communication Administration, 3, 170–179.



  

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