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.
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.