iSupe : Leading by (synchronous) example

1. iSupe:Leading by (synchronous) example Angelita Yu, Ph.D. ayu@loyola.edu La Keita Carter, Psy. D. Loyola University Maryland Loyola Clinical Centers Baltimore, MD

2. Overview to Live Supe • Origins: • Live observation of group therapy • [I prefer live supervision over traditional supervision due to the] ability to use feedback right there in the moment, rather than having to wait for a future opportunity to use it. (Note: this was my goal, too!) • Teaching • Practice with corrective element without going public with it • Fun!

3. Live supe • Comparison to • B.I.T.E. (ear) – less imposition • B.I.T.E. (eye) – more covert • Consultation break – less intrusive (hides training a bit) • Other “interruption” methods (knock in, phone in, walk in) Most live supe is supervisor driven (iSupe too) but increase flexibility decrease obtrusiveness increase ongoing feedback

4. “iSupe” • www.iSupe.net • Note: Currently 20% discount until March 15. code: APTC • Contact ayu@loyola.edu with questions or for assistance • Could also use Google doc (watch security)

5. Live supe as an intervention Set intention Conduct preparation Activate intervention Follow up with reflection

6. Effective use of iSupe/live supe • Intention • Informed consent to usage • for both supervisee and client • Preparation • Technology • connection, iPad location, observation vantage point • Note: Seek technology grants to fund the purchase of iPads and iSupeat your clinic • Expectations • feedback parameters (approx. every 5”, must vs. can messages, supervisee responses) • Goal setting • for supervisee and supervisor, about training and client welfare

7. Effective use of iSupe/live supe • Intervention • Requires supervisor self awareness (note: get 360° feedback on your style in advance) • Requires supervisee self awareness (note: know how they take direct feedback) • Effective usage • establish shortcuts • iSupe:use quotation marks, high priority and invisible • Reflection/debriefing • Discuss feedback together • Send transcript • Guide supervisee’s continued learning

8. Leading by example • Focus on training/teaching • I love traditional supe, but live supe was so awesome. I think it helped my professional development more. (iSupe on therapy) • It really helped me see what a ‘real’ therapist would say. (iSupe on therapy) • I feel like I received more specific feedback with live supervision, more feedback on what I can specifically do differently and what I specifically did well. (iSupe on therapy) • Focus on client welfare • I found it to be very, very helpful as I found that it benefited both the group members and myself (in terms of my growth as a clinician). (iSupe on group therapy) As Dawes (1991) states, experiential learning requires “one, a clear understanding of what constitutes an incorrect response....and two, immediate, unambiguous and consistent feedback when such errors are made.” (p.111) iSupe (and B.I.T.E. ) offers both!

9. iSupeLive.com • Sample sessions • SSG: https://www.isupelive.com/isupe/web/lobby.php?sid=145 • Intake: https://www.isupelive.com/isupe/web/lobby.php?sid=139 • Your turn on the iPads

10. When to use iSupe • Intake • Or anytime you are using live observation anyway • New skills or new modality • Therapy (couples, group; advanced empathy, confrontation, relaxation techniques…) • Testing • When requested/able Note: not for regular, ongoing usage! too time intensive and scheduling dependent

11. Using iSupe for teaching Group class Supe class Clinical skills class

12. When to skip iSupe Too much technology already (laptops, testing materials) High anxiety supervisee (may create resistance, heightened vulnerability) Supervisee unable to multi-task Supervisee credibility doubted (unless skill level so low that it’s necessary) When supervisory alliance is not yet established or experiencing rupture

13. Survey says… Note: Research findings by Yu and Coiro in bold. Quotes in italics. Comparison of iSupe vs no iSupe from supervisee perspective: Bond with supervisor, risk-taking, perceived support, perceived challenge all increased; confidence decreased Comparing live supe vs traditional supe (on supe and therapy) Preferred live over traditional average of 4.05, mode of 5! (on 5 point scale, with 3 being same/no pref) Exact same breakdown for both types of live All 5 when iSupe PRN!

14. Drawbacks to live supe • Disruptive to the session • It was distracting for both me and my supervisee to some extent. (consultation break on supe of supe) • Ability to attend to session and supe challenging • …it may have led me to appear a little disengaged or distracted which was a little difficult in regard to both rapport and my ability to attend to my supervisee, my own thoughts, and live supe. (iSupe on supervision) But in study with group therapy, nearly all initially thought it would be distracting yet no members or leaders indicated this after iSupe was applied • Incorporating feedback into own words • Sometimes uncertain of meaning of message As Bernard and Goodyear (2014) summarize, “clients are satisfied with live supervision as long as its perceived helpfulness outweighs its perceived intrusiveness. Therefore, a conservative approach to within session consultations is warranted.” (p. 206) (supervisees concur)

15. Advantages of iSupe • In the moment feedback (nearly all recipients of live supe report this) • Opportunity to implement right away (nearly half report this) • (the above 2 constitute Dawes comment – incorrect response, correction) • It wasn’t intrusive and I was in control of what to use and when to apply it. • It was very nice and reassuring when my supervisor used positive reinforcement (e.g. nice interpretation) …It was like a “confidence booster.” However, other data suggests confidence went down with iSupe • Can offer logistical reminders/serve functional purpose (i.e., record your session, remind about holiday next week, what room are you in?)

16. Suggestions from live supe recipients (supervisees) Don’t give too much feedback – only what can realistically be used Keep suggestions brief Be clear/direct/specific Give positive reinforcement Supervisees implore you, so P.L.S. remember Praise Limit quantity Stay specific