Supervision

Supervision for Interns

Supervision is an essential component to interns’ experiences and is the glue which connects all of the other learning experiences. The program is committed to ensuring that the internship year is clearly a training experience for interns and that the focus is not on productivity. That said, in order for interns to develop the breadth of experience needed to practice independently following Internship, there must be sufficient clinical experience built into the program to support interns’ ability to perform at a reasonable pace. The focus of supervision initially is on assessing Interns’ skill level and structuring experiences to match to developmentally appropriate tasks and activities. Activities are built on throughout the internship year, increasing expectations as interns’ skill and comfort level increases, and as they are able to effectively manage their clinical practices in a competent, safe and ethical manner.

Supervision is an interactive process, although has a hierarchical structure. Supervision includes the process of evaluation of Interns, both formally and informally. The supervision process is designed to support the APA Profession-Wide Competencies and to be a transparent process. Supervision is documented on the Intern Supervision Documentation Form (see Appendix C) by the supervisors each week, with both the supervisor and Intern “signing off” on the form electronically. These forms are kept in an electronic file and are used to inform the Interns’ formal evaluations.

A minimum of four hours of supervision is scheduled with interns each week. It is understood that Interns have access to more supervision and consultation on an informal basis throughout the course of the week. It is further understood that Interns may be required to participate in supervision in excess of that required if they are undergoing remediation or are on probation. Cases are divided between primary supervisors in each location, and primary supervisors are responsible for the provision of supervision of the interns by other appropriately licensed professionals.

1. Individual supervision with a Licensed Psychologist is scheduled twice per week for one hour at times that are convenient for both the psychologist and intern. Supervision is regularly provided for each client that interns see for therapy. Supervision is a learning experience coupled with feedback and focused on enhancing and developing clinical skills that help interns become competent professionals. The interns and the supervisor discuss goals, training, and expectations. During supervisor absences, an alternative Licensed Psychologist is available for supervision. When working with clients, interns inform their clients that they are working under supervision. Interns provide the information of the supervisor to the clients.

Drs. Hinant and Siyaguna are the primary supervisors for all clinical activities in the Moorhead offices, while Drs. Blake and Saxton are the primary supervisor for those activities occurring in Detroit Lakes clinic. While interns work with other professionals during the course of the year, such as while on rotations, the primary supervisors are responsible for all of the clinical activities performed by Interns.

2. Two hours of supervision is provided weekly through a group format. This gives interns an opportunity to discuss clinical and administrative processes as well as provide support to one another. There are several group supervision meetings scheduled for interns.

a. Outpatient Group Supervision. Group supervision is provided one hour per week. The first week of the month is dedicated to supervision of assessments and is run by Dr. Blake. The second week is for general topics and is run by Dr.Paulson. The third week is for supervision of therapy cases and is led by Dr. Paulson. The fourth week is dedicated to the supervision of professional topics and is run by Dr. Witte. Post-doctoral trainees and practicum students also attend these group supervision meetings.

b. DBT Group Supervision. Dr. Siyaguna and Dr. Saxton lead a one-hour group supervision meeting for the interns and other staff who are also learning about and part of the DBT team. The intern on the DBT rotation attends this group supervision on a weekly basis.

c. ABA Group Supervision. Jarrod Erdman, BCBA, runs an ABA group supervision each week for interns and BCBA trainees. The intern on the ABA rotation attends this supervision group.

d. MAP Group Supervision. Denette Narum provides MAP group supervision on designated mornings from November to April for interns and a small group of other MAP trainees in the organization (newly hired therapists). Interns attend these supervision groups as scheduled and are, therefore, afforded additional supervision those weeks. MAP supervision is scheduled for the same time period as the Outpatient case consultation in Moorhead; interns will not attend case consultation on those weeks.

3. Supervision generally occurs in-person, although Solutions has secure videoconferencing capabilities should the supervisor need to be off site during a scheduled supervision session. In light of the COVID-19 pandemic, telesupervision has been utilized to a much greater extent than in the past. Methods of supervision may include the following:

a. Direct observation of clinical activity (assessment, intervention, testing, consultation)

b. Video and/or audio review of sessions

c. Observation and feedback via bug-in-the-ear technology

d. Review of written works (i.e. assessment reports, letters)

e. Review of notes (i.e., progress notes, consultation notes, contact notes)

f. Review of the client chart

g. Review of outcome measures

Supervision training
In addition to the supervision provided to interns, they will also receive training in providing supervision to others under supervision. Supervision training is delivered in a developmental fashion. Supervision training is a topic covered in the didactic sequence. Interns are provided supervision opportunities within their rotations. Supervision is first modeled for them. Following the interns developing a comfort level in providing direct ABA services on the ABA rotation, supervision to behavior intervention staff will be modeled for Interns, and they will then have the opportunity to provide supervision to behavior intervention staff while under supervision. This training of supervision (referred to as “direction and observation” within the ABA program) is provided by Jarrod Erdman, BCBA, under the supervision of Dr. Siyaguna in the Moorhead office, and by Seth Sorum, BCBA, under the supervision of Dr. Blake, in the Detroit Lakes office. Interns on the DBT rotation attend group treatment supervision meetings twice per month for mental health rehabilitation services. Clinical supervision will first be modeled. As Interns develop a level of comfort with the programming and philosophy, they will begin to provide supervision while under supervision.

The second half of the year, assuming readiness, interns may be able to provide supervision to master’s level trainees or psychology practicum students. Opportunity will depend upon the availability of master’s level trainees and the skillset and readiness of the intern. Supervision training activities fall under the responsibility of the primary supervisors but may include assignment of tasks to additional supervisors as appropriate. Activities may include reviewing of diagnostic assessments and providing feedback, reviewing audio or videotapes of sessions, and discussion of cases with the trainee.