Mindful Continuing Education

Clinical Supervision in Substance Abuse Counseling

Chapter One-Introduction

1. Supervision is necessary in the substance abuse treatment field to improve client care, develop the professionalism of clinical personnel, and impart and maintain ethical standards in the field.

A. True B. False

Definitions

2. Supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, and, according to the authors, it includes each of the following characteristics EXCEPT:

A. It is a social influence process that occurs over time, in which the supervisor participates with supervisees to ensure quality of clinical care B. Supervisors build teams, create cohesion, resolve conflict, and shape agency culture, while attending to ethical and diversity issues in all aspects of the process C. Competent supervision is key to both quality improvement and the successful implementation of consensus and evidence-based practices D. Effective supervisors create an atmosphere that promotes communication, commitment, and accountability

Rationale

3. Supervision is the mechanism by which clinical skills can be acquired through practice, observation, feedback, and implementation of the recommendations derived from the supervision.

A. True B. False

Central Principles of Clinical Supervision

4. While every clinician needs and has a right to clinical supervision, the frequency and intensity of the oversight and training will depend on the individual's level of education, years of experience, and overall knowledge.

A. True B. False

Guidelines for New Supervisors

5. Experts recommend that new supervisors quickly learn an organization's policies and human resources procedures and that they ask for a period of six months to learn about their new role.

A. True B. False

Working With Staff Who Are Resistant to Supervision

6. At times when supervisees resist supervision, self-disclosure by the supervisor about experiences as a supervisee, if appropriately used, may be helpful in dealing with defensive, anxious, fearful, or resistant staff.

A. True B. False

Models of Clinical Supervision

7. Which of the following is NOT one of the characteristics of competency-based models of clinical supervision?

A. They focus primarily on the skills and learning needs of the supervisee B. Strategies of competency-based models include applying social learning principles, using demonstrations, and using various supervisory functions C. They used a SMART model to set goals that are specialized, manageable, authentic, reasonable, and tangible D. They construct and implement strategies to accomplish these goals

Cultural and Contextual Factors

8. Cultural and contextual factors that should be given care during supervisorial interactions include:

A. Identifying the competencies necessary for substance abuse counselors to work with diverse individuals and navigate intercultural communities B. Identifying methods for supervisors to assist counselors in developing these competencies C. Providing evaluation criteria for supervisors to determine whether their supervisees have met minimal competency standards for effective and relevant practice D. All of the above

Figure 4. Continuum of Cultural Competence

9. On the continuum of cultural competence, cultural openness or sensitivity refers to a heightened capacity for work with minority populations which includes a commitment to excellence and proactive effort.

A. True B. False

Ethical and Legal Issues

10. Underlying assumptions of incorporating ethical issues into clinical supervision include the notion that ethical decision-making is a continuous, active process and that the most complex ethical issues arise in the context of two ethical behaviors that conflict.

A. True B. False

Dual Relationships and Boundary Issues

11. Factors that make a dual relationship unethical in supervision are the abusive use of power by either party, the likelihood that the relationship will impair or injure the supervisor's or supervisee's judgment, and:

A. The risk of exploitation B. The violation of boundaries C. The imbalance of accoutability D. The increased likelihood of transference

Confidentiality

12. In the supervisorial relationship, there is an implied consent and commitment to confidentiality by supervisors to assume their supervisory responsibilities and institutional consent to comply with legal and ethical parameters of supervision.

A. True B. False

Evaluation of Counselors

13. Formative evaluation, a systemic rating of the counselor's overall job performance, fitness for the job, and job rating, is typically done annually and focuses on the counselor's overall strengths, limitations, and areas for future improvement.

A. True B. False

Addressing Burnout and Compassion Fatigue

14. One way to address compassion fatigue and burnout among supervisees is to support them and serve as liaison as they advocate for appropriate and feasible organizational change.

A. True B. False

Methods of Observation

15. Guidelines that apply to all methods of direct observation in supervision include each of the following EXCEPT:

A. The supervisor and supervisee must agree on procedures for observation to determine why, when, and how direct methods of observation will be used B. The counselor should provide session context and the client should give written consent for observation and/or taping at intake, before beginning counseling C. Supervisees are more likely to report that clients are resistant to live observation when they themselves are anxious about the process D. The supervisor should select which cases to observe and explain to the supervisee why these cases have been chosen

Live Observation

16. To maximize the effectiveness of live observation, supervisors must stay primarily in an observer role so as to not usurp the leadership or undercut the credibility and authority of the counselor.

A. True B. False

Practical Issues in Clinical Supervision

17. In order to better understand transference and countertransference issues that may occur in the relationship between supervisee and supervisor, supervisors should learn to recognize clues, participate in personal counseling, and be willing to complete careful self-examination.

A. True B. False

Balancing Clinical and Administrative Functions

18. When a clinical supervisor also serves as an agency or program administer, supervisees may be cautious about expressing difficulties they may face in counseling because they fear it may affect their performance evaluation or salary increases.

A. True B. False

Finding the Time to Do Clinical Supervision

19. When selecting a specific supervision modality, supervisors must first pinpoint:

A. The appropriate theoretical orientation B. The immediate function of supervision C. The experience and developmental level of the supervisee D. The supervisee's learning goals

20. Intensive supervision for all counselors for a pre-selected period of time is considered the cornerstone of professional skill development.

A. True B. False

21. Practice guidelines indicate that all substance abuse counselors, regardless of their experience or academic training, should receive one hour of supervision for every 10-20 hours of clinical practice.

A. True B. False

Documenting Clinical Supervision

22. Mechanisms must be in place to demonstrate the accountability of the supervisorial role, including the means to document:

A. Frequency of supervision, issues discussed, and the content and outcome of sessions B. Informal and formal evaluation procedures C. Due process rights of supervisees and risk management issues D. All of the above

Methods and Techniques of Clinical Supervision-Figure 8

23. While case management in clinical supervision can be an efficient way to organize information and examine issues, it does not allow for observation and reflection of clinical skills.

A. True B. False

24. Co-facilitation and modeling, a technique where supervisors and counselors jointly run a counseling session, enables the supervisor to incrementally shape the counselor's skill acquisition and monitor skill mastery.

A. True B. False

Administrative Supervision

25. One of the most important administrative tasks of a supervisor is that of documenting and recordkeeping, which includes documenting sensitive supervisee information that may impact work performance.

A. True B. False

Chapter Two-Vignette 1

26. One way clinical supervisors can promote the benefits of supervision is to avoid approaching the process with a mechanical or authoritative posture, and instead use a style that is:

A. Authentic B. Consultative C. Dogmatic D. Instinctual

27. Peer group supervision can be very effective in decreasing professional isolation, increasing professional support and networking, normalizing the stress of clinical work, and offering multiple perspectives on any concern.

A. True B. False

Vignette 2

28. Level 3 supervisors are often driven by alternating anxiety and self-confidence and may feel a significant need to be self-reliant, even though they might not yet be prepared to act independently.

A. True B. False


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