https://orcid.org/0000-0003-3278-7023
ABSTRACT
Objectives
There is strong endorsement of competency-based frameworks for practitioner training and widespread use of group supervision in practitioner training. However, there has been little effort made to understand the components and anatomy of group supervision, or efforts made to evaluate its efficacy. The current study investigates the nature and extent to which abilities and skills within individual and group supervision are similar or distinct from each other.
Method
A total of 98 supervisees, across 21 groups, evaluated individual and group supervisor competence of their supervisors (N = 11) using the Supervision Evaluation and Supervisor Competence Scale.
Results
Hierarchical cluster analysis revealed that group supervision emerged as a distinct and independent cluster to individual supervision competencies. Additionally, supervisors were rated higher on individual than group supervision competencies.
Conclusion
Group supervision should be considered a distinct competency requiring specific skills and therefore would likely benefit from specialised training to deliver competent group supervision. These preliminary results have implications for supervisor training, as well as clinical training programs in Australia and abroad who use group supervision as a form of clinical training.
Key Points
What is already known about this topic:
Competency-based supervisory approaches are supported by regulatory authorities.
The evaluation of competent group supervision has received inadequate research attention.
There are no available measures of group supervision to evaluate supervisor competence.
What this paper adds:
First experimental exploration that establishes group supervision as a distinct competency in clinical supervision.
Compared to individual supervision, supervisors were rated lower on group supervision competence and may require specialised training.
A scale is included in the appendix for evaluation of both individual and group supervision competencies.
As a discipline both within Australia and internationally, Psychology has committed to a competency-based approach to practitioner training and clinical supervision. There has been major progress in the development of competency frameworks and regulatory bodies specifications of core competencies for practitioners (Watkins & Milne, Citation2014). Competent psychology practice is conceptualised as a range of skills and knowledge areas for competency psychology practice, which include areas such as intervention, assessment, professionalism, knowledge, attitudes, and are acquired across a developmental trajectory in training (Fouad et al., Citation2009; Rodolfa et al., Citation2005). Although the anatomy of practitioner competence is becoming increasingly explicated, the structure and nature of supervisor competence is yet to receive adequate attention.
Admittedly, there has also been recent progression explaining the structure and nature of supervisor competence: (i) Roth and Pilling (Citation2008) proposed an extensive framework guided by National Health Service (NHS) requirements in the United Kingdom (UK); (ii) Competency guidelines for supervision of health providers have been produced by the American Psychological Association (APA) (Citation2014); and (iii) the Psychology Board of Australia produced a set of supervisor competencies for supervisor training (PsyBA, Citation2018). There is good consensus between these frameworks regarding some competencies, but differences about others. For example, group supervision is identified as a distinct competency by some (Roth & Pilling, Citation2008) but not by other frameworks (PsyBA, Citation2018).
In practice, group supervisors are required to manage additional processes to individual supervision requirements including relationships between peer supervisees and multiple supervisor-supervisee relationships. Further, group supervisors may have to manage differing learning styles, developmental stages, interpersonal sensitivities and cultural differences within the group. Consequently, it is possible that some supervisors are competent in independent (dyadic) supervision but lack competence in group supervision (Falender & Shafranske, Citation2004; Mastoras & Andrews, Citation2011).
It is important to acknowledge that the frameworks proposed for supervisor competence are based on theoretical conceptualisations or expert consensus. Empirical validation of these frameworks has received inadequate research attention and is essential. The Supervision Evaluation and Supervision Competency Scale (SE-SC) (Gonsalvez et al., Citation2017) is a notable exception. Using a competency-based framework, and based on cluster analyses, the SE-SC proposes a set of six generic supervisor competencies (Gonsalvez et al., Citation2017). However, group competencies were omitted as the data were derived from evaluations from individual supervision. Essentially, little is known about how these competencies perform, interact, or represent competencies within group supervision. This lack of research is concerning because current Australian Psychology Accreditation Council (APAC) requirements (APAC, Citation2019) allow for up to 50% of supervision to be delivered in groups.
The current study
Important theoretical, pedagogic and practice-based reasons call for a closer examination of group supervision processes and outcomes. Whilst most trainees, supervisors and practitioners can assume that facilitating group supervision requires distinct skills from individual supervision, this has not been empirically established. From a competency perspective, it is a fundamental issue whether group supervision is an independent and distinct competency for two primary reasons. Firstly, the competency movement requires that supervision be evaluated, and so an empirical distinction between group and individual supervision must be made, if indeed it exists. Secondly, if group supervision is a skillset, and not just requiring skills inherent to individual supervision, then specific training would be required. In the absence of research, the current study seeks (i) to determine if group supervision is an distinct competency within supervisory competencies and (ii) to determine if supervisors who provide individual and group supervision demonstrate differing proficiency levels for individual and group supervision competencies.
Methods
Trainees and supervisors
Trainees (N = 98; 17 males, 79 females) were provisionally registered psychologists enrolled in an accredited Master of Clinical Psychology course at an Australian university. Most trainees were inexperienced, with 81% having completed less than 100 hours of the 1,000 hours of the placement experience required. Eighty percent of respondents reported their preferred theoretical orientation as Cognitive-Behavioural Therapy (CBT), with 7% as eclectic, 2% Acceptance Commitment Therapy (ACT) and Dialectical Behaviour Therapy (DBT) respectively and 1% Family Systems Therapy. Participants were required to have completed one clinical psychology placement involving individual and group supervision. All supervisors of participant trainees were registered clinical psychologists, held recognised postgraduate qualifications in clinical psychology and were board-accredited supervisors. The supervisors (n = 11) supervised 21 groups (4–6 trainees per group; some with multiple groups). Only groups who had responses from all group participants were analysed. Each trainee was enrolled in their placement on a specific weekday for a six-month period and received weekly individual and group supervision from the same supervisor.
Materials
Supervision Evaluation and Supervisor Competence (SE-SC) Scale. The validated version of the SE-SC Scale (Gonsalvez et al., Citation2017) included six A-items that measured overall effectiveness and satisfaction with supervision, and 24 B-items covering the six established supervisor competency clusters which include 1) Openness, Caring and Support, 2) Supervisor’s Expertise and Knowledge as a Therapist, 3) Supervision Planning & Management, 4) Goal-Directed Supervision, 5) Restorative Competencies, 6) Insight Into and Management of Therapist-Client Dynamics and Reflective Practitioner Competencies. Each item is rated on a 7-point Likert scale from 1 (Not at all/strongly disagree) to 7 (Very much so/Strongly Agree) with higher scores indicating higher levels of competency. Six core competencies are assessed as detailed above. Items include “In day-to-day dealings, I got along well with the supervisor” and “Supervision has enhanced my self-awareness as a person”. The scale has good internal reliability (α = 0.75 to 0.92 for subscales), test-retest reliability (r = 0.81 to 0.93), and adequate predictive and concurrent validity (Gonsalvez et al., Citation2017). For the current study, four C-items were added to evaluate group supervisory competence: C1 “the supervisor facilitated engagement of and enhanced the contributions by all group members”,, C2, “learning activities within group supervision were planned and coordinated well”,, C3, “the supervisor was insightful in their analyses of client-practitioner and group processes to enhance group supervision outcomes”, and C4, “the supervisor ensured that group supervision was a safe place for appropriate disclosure and professional growth”.
Procedure
At placement completion, trainees completed the SE-SC evaluation. Evaluations were voluntary, trainees received no payment and were anonymous. Specific instructions were provided to trainees to consider their experiences in individual and group supervision separately. Ethics approval was obtained through the Institutions Ethics Committee (Approval H14367).
Analyses & results
The critical question was whether the four new items purporting to measure group supervision competence would cluster with the established individual supervision competencies, or whether they would cluster together, indicating a separate competency. The data were subjected to a hierarchical cluster analysis, replicating Gonsalvez et al. (Citation2017) original study. The results are displayed in in a dendrogram plot, graphically depicting how individual items on the scale congregate in proximal clusters, and how these clusters meld into larger clusters as the degree of proximity is progressively relaxed to include distant associations (Gonsalvez et al., Citation2017; Nielsen, Citation2016). Proximity is mathematically represented as rescaled distance (RD) ranging from 1 (highest degree of closeness) to 25 (cut-off threshold when all items merge into a single cluster).
Figure 1. Dendrogram representing the hierarchical clustering of items on the Supervisor Evaluation and Supervisory Competence (SE-SC) scale into clusters and super-clusters. B1 to B18 are items from the SE-SC version 2 that represent the six clusters in the original study (Gonsalvez et al., Citation2017). Items C5, C6, C7, and C8 are new items designed to measure the group supervision competency.
The clustering of items B1-B23 has been examined in an already published study (Gonsalvez et al., Citation2017) using data from individual supervision and will not be re-examined. The results indicated that the group supervision competency, represented by items C5 to C8, were closely associated and formed an independent kinship group early in the clustering process (RD = 3, or Step-3 of algorithm) and retained integrity as a cluster through increasing relaxation of the RD. Further, group supervision remained a distinct cluster, and merged with other clusters only at the last step of the clustering process (RD = 25).
Secondly, given the cluster analysis results, it was of interest to map the profile of competencies displayed by supervisors. We conducted a mixed, repeated-measures analysis of variance (ANOVA) with nested factors, where supervision group was nested within the supervisor variable. The within-groups “Competency” factor comprised seven levels: six previously established individual supervision competencies (core subscales of the SE-SC) and the new group supervision competency. The dependent measure was the mean scores of the seven competencies. A-items were omitted from the cluster analysis as they are overall impression items, not specific competency items or subscales.
Descriptive and internal reliability statistics for each subscale are depicted in . The main effect of Competency was significant, F(7, 532) = 60.53, p < 0.001, ηp2 = 0.44. Seven planned deviation contrasts were conducted whereby each competency was compared to the grand mean (mean of all seven competencies). Compared to the grand mean, supervisors received higher ratings on three competencies: Openness, Caring and Support, Supervisor’s Expertise and Knowledge as a Therapist and Supervision Planning and Management, and lower ratings on Group Supervision (see ).
Table 1. Subscale descriptive statistics, internal reliability and mixed ANOVA results.
The effects of the nested factors, Supervision Groups, F(11, 76) = 0.42, p = 0.99, ηp2 = 0.02 and Supervisor, F(1, 76) = 0.26, p = 0.612, ηp2 = 0.01 were non-significant. Some subscales had non-normal skew distributions (2.30; SE =.25), so non-parametric statistics were also obtained. Non-parametric results using Freidman’s ANOVA also indicate a significant effect of Competency χ2(6) = 246.50, p < 0.001. Pairwise comparisons with Bonferroni adjustments indicate Group Supervision as significantly different to all six competencies (p < 0.001) as well as Openness, Caring and Support, Supervisor’s Expertise and Knowledge as a Therapist and Supervision Planning and Management each individually different to Goal-Directed Supervision and Insight and Management of Therapist Client Dynamics and Reflective Practitioner Competencies (p < 0.009). No other pairwise comparisons were significant and full statistics are available as supplementary material.
Discussion
As far as we are aware, this study represents the first experimental exploration into group supervision within a competency framework (Falender & Shafranske, Citation2014). The study makes an important contribution to the conceptual understanding of the anatomy of supervisory competence and has implications for supervisor training and practice. The cluster-analysis results offer compelling preliminary support for group supervision to be considered an independent competency distinct from individual supervision competencies. Secondly, although participants received both individual and group supervision from their supervisor, supervisors were rated significantly lower on group supervision competencies. These results support the assertion that specific skills distinct from individual supervision skills are required for group supervision. (Skjerve et al., Citation2013; Ögren & Sundin, Citation2007). These empirical results support the competency frameworks proposed by the APA in the US (APA, Citation2014) and Pilling and Roth (Citation2014) in the UK, but not the current version by the Psychology Board in Australia (PsyBA, Citation2018).
There are salient implications of the findings. Competency-based pedagogies highlight the importance of a holistic conceptualisation that includes knowledge, skills, and attitude-value aspects (Falender & Shafranske, Citation2004). Feedback from supervisors and peers is an essential component of holistic competency-based programmes. Group supervision is also cost-effective, and current accreditation guidelines (APAC, Citation2019) allow for 50% of supervision to be undertaken within a group format. These merits are likely to promote increased uptake of group supervision, so specialised training in and research on group supervision is warranted. Concurrently, there is a need for systematic research and evaluation of group supervision including the design of relevant instruments.
The current study presents with some limitations. Trainee evaluation of supervisors is an essential but insufficient measure of supervisor competence. It is important that these evaluations are supplemented by objective, ecologically valid assessments such as videotapes conducted by credible assessors. As previously indicated, there is a lack of valid instruments, so a revised SE-SC with an additional subscale that measures group supervision is offered in Appendix A until more comprehensive instruments are designed and validated. A further concern is the possibility that the nested nature of the data may have amplified the similarity of ratings within groups and reduced the similarity between groups, thereby making the results obtained from the cluster analysis unreliable. Whilst it may be ideal to have data that is completely independent (not-nested), there are several factors that mitigate this concern in this specific instance. First, the analysis used in this study examined the clustering of items on the scale and not the clustering of individuals into homogenous versus heterogeneous groups. Second, any such nesting effect would be expected to also affect the rating of other competencies, and our ANOVA results indicate that the group supervision competency was rated different from the other competencies despite any compromising nested-effect. Finally, because the purpose of the study is to examine ratings within and across groups the nesting-problem would continue to be inherent to and difficult to resolve including by alternative analyses such as factor analyses. Therefore, the pattern of results from these preliminary data support the notion of a distinct group supervision competency. Broader sampling from a large number of sites together with concurrent competency data (e.g., evaluation of individual and group supervision competencies by peers and experts), as well as sampling of all groups from each site are required to confirm and extend these results into the future.
In conclusion, this paper provides evidence that group supervision should be considered a distinct competency from individual supervision, and thus requires supervisors possess specific skills to supervise groups competently. This paper also proposes a preliminary measure for the evaluation of competent group supervision. As a distinct competency, it is likely that supervisors would benefit from specialised training in this area, which has implications for supervisor training and clinical training programs who use group supervision as part of clinical training for psychologists.
Supplemental Material
Download MS Word (23 KB)Disclosure statement
No potential conflict of interest was reported by the author(s).
Data availability statement
The data that support the findings of this study are available from the corresponding author, C. Gonsalvez, upon reasonable request.
Supplemental material
Supplemental data for this article can be accessed at https://doi.org/10.1080/00050067.2022.2107890
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Appendix A
Supervision Evaluation and Competency Scale (SE-SC) Individual and Group Supervision version
(Gonsalvez C.J., Hamid, G., Savage, N.M., Livni, D., & Grassby S., Citation2021)
Use the following Likert scale to evaluate the supervision you received by your primary supervisor (individual) at the placement you just completed. Use NA for items that were definitely not applicable, or for information you don’t know.