Handbook of Strengths-Based Clinical Practices

Finding Common Factors

Jeffrey K Edwards, Andy Young, Holly Nikels

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317484233
• Edition: 1
• Topic: Psychologie
• Subtopic: Psychothérapie

An interdisciplinary handbook about strengths-based clinical practices, this book finds the common factors in specific models from social work, psychology, and counseling. The book ends with a grounded theory informed method that pulls together what each of the chapters report, and posits a theory based on that work. Comprised of 23 chapters and written by leaders in the human services fields, Handbook of Strengths-Based Clinical Practices shows how professionals and students can facilitate change and resiliency in those with whom they work.

Section IV

Training and Education

17

Strengths-Based Clinical Supervision

An Examination of How it Works

Jeffrey K. Edwards

We all blossom in the presence of one who sees the good in us and who can coax the best out of us.

Desmond Tutu (p.143)

A Circuitous Orientation to Strengths-Based Clinical Supervision

I have been excited by news from the Harvard Business Review (HBR) for years. My wife is a wonderful high-level manager of operations at a very large company, and she reads it on line all the time. Me, when I am wandering through grocery stores or the lonely bookstores that are still around, I grab the HBR when it looks like there is information I might adapt to the clinical world. I have quoted information from it over the years, both in chapters and in lectures. Somehow, some of those folks in mental health, and there are only a few, do not like the crossover references, whereas others do not seem to mind. Many of their articles are about leadership, and I think of those of us who have attained the status of a supervisor as being a leader. There are many kinds of leadership ideas but the ones I have gravitated to are those that are either about servant leadership (i.e., Greenleaf & Spears, 2002) or strengths-based (Rath & Conchie, 2008). Several days ago while checking out at the local Whole Foods, I spied my old friend, the HBR’s OnPoint, with a front title that said “Be a Better Boss: How to Bring Out the Best in Your People” (OnPoint, 2015). It sounded like something I would really like, so when I opened it up while waiting in line, I was thrilled to see that there were two articles right up my alley, and that would fit the chapter I was writing for our book. The first was about the simple but powerful word together that I will discuss briefly, and the other was about an old friend I have researched and written about before, the Pygmalion effect. I write about that later in this chapter under the heading “Supervising with Compassion Rather than for Compliance.”

Together

I look for motivators all the time. There was a big one right there in the current HBR titled, “Managers Can Motivate Employees with One Word,” by Heidi Grant Halvorson (2015). I have cited this author before, and I have one of her books, so she has tremendous referent power for me. The word is together and there is solid research that Grant Halvorson quotes which mystifies me because I’m thinking that we do not use it enough in our field of supervision. I have my own ideas about why this powerful word is left out, but the information shows that

… the word “together” is a powerful social cue to the brain. In and of itself, it seems to serve as a kind of relatedness reward, signaling that you belong, that you are connected, and that people you can trust are working with you toward the same goal. (Grant Halvorson, 2015, p. 15)

The word together can be a wonderful tool for helping our supervisees trust the process and us during a time that is potentially worrisome. Talking about cases that are problematic can leave the supervisee feeling vulnerable as they talk it out with us. When we invoke this magical word, we are both in the discourse jointly. We share in our discussion of what to do, without one of us being in charge and all-knowing. It even may lower that anxiety that normally comes about with a flood of responses from the hypothalamus to activate the sympathetic nervous system, and the adrenal-cortical system, beginning the fight or flight response.

Throughout this chapter I give you other researched information that, when used congruently and genuinely, can make your supervision not only strengths-based, but also even more effective than it might be already.

Situating My Beginnings

I first became aware of strengths-based supervision over 25 years ago, when I was contracting for my supervision of supervision in order to receive the American Association for Marriage and Family Therapy’s (AAMFT’s) Approved Supervision Designation. AAMFT had the supervisory training and credentialing long before any of the other associations, and during my doctoral training I realized I might need this credential to supervise students wherever I might land a job. My search stopped at Northern Illinois University’s Family Therapy Studies program where Dr. Tony Heath directed the program. As it turned out, Dr. Heath was the AAMFT national organization’s chair of supervisory training at that time—lucky me. During our first time together, as I nervously began my interview, I shared my story of having crossed eyes at a young age, finally learning to read in the fourth grade, failing eighth grade, being told by my guidance counselor (now called school counselor) that I should follow a course of vocational studies because college was not on the cards for me; I was marginalizing by “experts.” Yet, amazingly, I did go to college, and after that, got into graduate school for a masters in science in counseling psychology. Call it grace or perseverance, but finally I ended up a new doc student wanting to be an approved supervisor. Tony listened patiently as I laid out my woeful problem-saturated story and then said oh so slowly, “So, I’m curious; how would any of that stop you from being a great supervisor?”

Now, in one short sentence Dr. Heath had dispelled my fears and set the bar higher for me than I had ever expected. I would gain my doctorate in counseling, and become an AAMFT approved supervisor. Perhaps I could even teach graduate-level classes. A short strengths-based conversation gave me confidence in my quest to become someone who others (and myself) had said I could never be. Language really does construct reality. I wanted to be like Tony, and help those who like me had what he called an imposter syndrome. He assured me that most everyone who reached for the starry heavens felt that way at one time or another. He normalized it for me saying that those who had the imposter syndrome and admitted it were probably better off than those who pretended, or who fooled themselves into thinking that they know it all. Supervision is about a relationship I was told—a trusting relationship. Making relationships work is not about being one-up on those with whom you want to relate. So, humility and the willingness to show my imperfect side, to be a real human being that makes mistakes and who does not claim to know it all, would make me a far better mentor/supervisor and guide for our field. If I played to my own strengths, and not work to hide my weaknesses—my faults and problems—I could be on a better road to transparency and genuineness. It made good sense to me.

I had been trained early on in my career with the psychodynamic therapy model, and later person-centered, and finally family systems therapy. I learned solution-focused (de Shazer & Berg, 1997) and narrative therapies (White & Epston, 1990), all of which seemed to bypass looking for problems, and went straight to encouraging and building strengths. I was amazed at how quickly someone could change their position or point of view regarding what they saw as problematic. All of these changes without digging in the dirt of “causation,” that according to Bertrand Russell (1953) does not exist.

The usual mental health model we all had learned, of assessing a problem and forming a treatment that the client was to work on, are deeply embedded in our training. The early clinicians, psychiatrists with medical training, simply began to use the medical models, to work with what they assumed were pure psychological or psychiatric problems. Now, we know that our clients come to us with bio-psycho-socio-cultural-familial-spiritual and dare I add political constructs. There is most often more than one factor negatively influencing our being that brings us to a place where we seek outside help. Clinicians and people in general think of these issues as pathology, or maladaptation. They can, however, be seen as a grouping of perceptual sets that influence thinking and thus behavior. Rather than brain chemistry or conditions, they are mindsets influenced by the part of the brain called the narrative, or more technically the thalamocortical network (Siegel, 2007). It is this part of the mind that processes all of the information within our brains about the correct way to think, our beliefs, and our perceptual sets. Siegel goes on to say that our narrative brain actually enslaves us to think and believe all that we have encoded in the thalamocortical network. This network has the purpose of making decisions about life easier to act upon. The information is encoded through life events and learning, no matter if it is factual or old outdated data, or even old wives’ tales. Our beliefs about religion, politics, courtesies, and social behavior have been encoded, and it takes a lot of informational input to counter some of these sets. Sets can be helpful, and the set can be wrong. Sets can become what is called “confirmational data or bias” (opinions), as the set confirm and conform to our beliefs without our checking to make sure the belief is correct. They can also block out new, more correct information.

What I am beginning to see in training and studies is that the effects of working with a person’s strengths, rather than their construed problems (sets), can be a quicker, less problem-focused way of working with clients, be they clinical or supervisory. In addition to the quickness of these models of change is the interesting information about what are called iatrogenic problems, which are problems that arise from being in some sort of treatment. I know that there is a great risk of patients in the doctor’s office, or a hospital clinic, “catching” a disease or virus just from being in proximity of someone else who has that virus. The same has been found to be true of psychological issues, especially the use of problem-focused language, diagnosis for instance (Boisvert & Faust, 2002). I suggest that the strengths-based language is less apt to provide a negative consequence, or as I now know, a negative set. This is not to say that there aren’t some drastic problems out there, but the majority of those coming to us for help are usually not pure biological problems. They are mind constructs—mind perceptual sets that cause difficulties. This is also accurate when I talk about what can happen during supervision. The nature of our usual medically modeled system is for supervisees to come in and talk about the problems they are having with their clients. Strengths-based supervision changes this clinical supervision set. I might begin a supervision session by asking what they think they did well in their recent clinical work, or what they liked about it. Questions such as these can be followed up by asking what they wish they had done differently, or more of, rather than pursuing the problems they perceive they had in a particular session.

As a new assistant professor in a counseling program, I was charged with clinical supervision of sections of both mental health and couple and family counseling students, and it was during this time I became keenly aware of the potential of working with students’ strengths, rather than dwelling on what they might be doing wrong in their work. When working in a supervision class for masters students, I spend time demonstrating different techniques using the students as clients, with either real or made-up scenarios, and then have them practice those skills so that they will become more proficient. I remember working with a woman who, during a role play, talked about being childless. She said she felt as if she was missing something, even though she rattled off many reasons why it wasn’t a problem. But family and friends had “socially constructed” this problem for her by asking about it, and insisting that it must cause her great pain. I suggested that perhaps being childfree was something that might have many benefits. I could tell I had connected with her with this reframe, as her eyes got brighter, and she sat up taller in her chair as she mulled over what I had just said. “Yes, I think that is a far better way to think about it,” she said, and I too began to think I had done our most serious work, all with one sentence … just as had Tony Heath. How is this strengths-based? Well, I did not have to go working with what some might see as problematic issues that this woman “had.” My supervisee had a second-order change.¹ She had a change in cognition that shifted the way she perceived her situation, and all of her perceptions and thoughts moved on in life with little or no regrets regardless of what her family and friends might think. The socially constructed view or set that family and friends had subtly implanted in her head during their discussions, even though they thought they were helpful comments, would no longer work to cause her pain, regret, or anguish.

The constructivist movement in family therapy and counseling programs where these ideas were spreading began to change how some professors as well as our protégé students began to understand and think differently. Two of my more fun published works as an assistant and associate professor were articles I wrote with two of my masters students, Julie Milne and Jill Murchie (Milne, Edwards, & Murchie, 2001), and another with my colleague Mei Whei Chen (Edwards & Chen, 1999). In both articles I invoked the strengths-based models of postmodernity and social constructivism relative to the times. Both articles used ideas I had learned from my two mentors. So, from early on in my academic career, I have been interested in, and practice, a form of strengths-based work. And I must say that this early work, although it was not done purposely, began to change me as a clinician and as a person. I began to believe in myself more … a kind of “future pull” was apparent to me.

Side Effects

Back in June of 2014, I was asked to present a workshop on strengths-based clinical supervision to the site supervisors of a rather large Illinois university. They invited site supervisors from their clinical programs, PsyDs, masters in marriage and family therapy, and their counselor education program. About 60 or more site supervisors of every ilk came to hear me talk about something I have taught for 15 years, both locally and nationally. I have also published on this topic (Edwards & Chen, 1999; Edwards, 2012). The site supervisors engaged with me around the various ideas I presented and watched a video of me supervising a woman who was really stuck clinically and personally on a case she presented. At the end of the not-nearly-enough 2.5 hours of training, there were a few differing opinions on what I had presented. I expected that. It gave us concepts to discuss and unpack. Afterward there were many supervisors who approached me offering compliments for my ideas. Several weeks later, when I received the aggregate of feedback, I was pleased to see mostly positive comments regarding the presentation. There were also two very mean-spirited comments stating that my presentation was the worst they had ever seen and that the video of supervision was useless and not a good example of supervision of any kind. Interestingly enough, the same video has always received great feedback from scores of other professionals, and the supervisee whose work I showed in the video said it was extremely helpful to her. What all of this proved to me is that the same old song about who knows what works best in both clinical work as well as clinical supervision is alive and well. Also, that the guilds that are competing for space and supremacy hav...

Table of contents

• Cover
• Title
• Copyright
• Contents
• List of Contributors
• Acknowledgments
• Section I Introduction to Strengths-Based Practice
• Section II Strengths-Based Clinical Practices with Varying Populations
• Section III Strengths-Based Work in Different Counseling Contexts
• Section IV Training and Education
• Index