SENTIO SUPERVISION MODEL (SSM) |
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Steps |
Brief description |
Example |
Step 1. Check trainee’s outcome data |
If outcome data is available,
focus the supervision on the client whose outcomes signal that they are
the most distressed or at risk of clinical deterioration. |
Mary and her
supervisor notice that her client “Joe” is flagged by an outcome
measure as being particularly at risk of deterioration. Because of this,
they choose to focus on this client for supervision. |
Step 2. Review Supervision Preparation Form |
Trainees complete a
Preparation Form prior to each supervision that elicits preliminary
ideas from the trainee on what the focus of supervision could be. |
Mary
wrote in her preparation form that her client Joe tends to get angry at
her when she asks about his feelings. She says she doesn’t know how to
address this. |
Step 3. Identify a Client Challenge |
At this stage, supervisor and
supervisee collaborate to agree on a challenging and observable client
behavior that needs to be more effectively addressed in session. |
As
Mary and her supervisor look at her therapy recording, they indeed
notice that Joe is getting angry after being asked about his feelings.
They agree to focus supervision, at least for now, on addressing this
challenge. |
Step 4. Identify a Therapist Deficit |
After identifying a client
challenge, the supervisor helps the trainee see what they are doing in
session that is not working or keeping therapy stuck. |
The supervisor
noticed and reflected back to Mary that when her client Joe gets angry
in session, she looks anxious and quickly changes the subject. The
supervisor points out that this therapist behavior in session is part of
what might be keeping therapy stuck. |
Step 5. Identify a Learning Goal |
The supervisor and trainee
collaborate to identify a concrete clinical skill to more effectively
address the identified client challenge. |
Mary’s supervisor proposes to
address the identified client challenge by doing an alliance repair
intervention. Especifically, Mary could point out that she notices her
client’s frustration and, instead of quickly changing the subject, she
could nonjudgmentally invite the client to elaborate on his
frustration. |
Step 6. Behavioral Rehearsal |
The supervisor guides the trainee to
repeatedly practice the identified skill in vivo. For each round
of rehearsal, the supervisor provides brief, actionable feedback to
refine the trainee’s intervention. |
The supervisor asks Mary to imagine
she is in front of her angry client right now, and invites her to try
intervening with the proposed alliance repair skill. With each of her
attempts, the supervisor provides feedback on how to better her
intervention. |
Step 7. Assign Deliberate Practice Homework |
The supervisor proposes a
solitary practice homework, if possible using a video recording of the
client challenge to repeatedly keep practicing the same skill that was
practiced during supervision |
Mary’s supervisor ends the supervision
session saying: “Use the therapy recording with Joe to repeat the same
exercise we just did for at least 10-minutes until your next session
with this client or our next supervisor.” |