Dr. Jeremy Sharp (00:34)
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Dr. Jeremy Sharp (01:19)
Hey everyone, welcome back to the testing psychologist. Happy to be here with you. And today’s topic is a fascinating topic that we have talked a bit about on the podcast before. It’s supervision, supervision of assessment. And the angle today is a little bit different. So in the past, we have talked generally about assessment supervision and some of the ethics and legal considerations of super.
But today we are tackling it in a little bit more I think structured and practical manner So my guests today are both return guests. I have dr. Allison Wilkinson Smith and dr. Stephanie Nelson They are back. They are hosting an upcoming workshop around the content of this episode. So all about practical values driven supervision so just putting in a plug for them if you
like the content of the episode, absolutely go and check out that, that workshop. We’ll have the link in the show notes to sign up. And as you’ll hear in the episode, they’ve extended early bird pricing till I think may the eighth for anyone who wants to register. So about my guests, Alison Wilkinson Smith is a board certified, clinical neuropsychologist with sub specialty in pediatric neuropsychology by the ABP.
She’s also certified in therapeutic assessment of kids by the TA Institute. She’s a professor of psychiatry and practices clinical neuropsychology in an academic medical setting and in private practice. She also offers professional consultation on pediatric, psychological, and neuropsychological assessment. And she specializes in therapeutic and collaborative assessment techniques, pediatric functional neurological disorders, and assessment of kids living with medical and psychosocial complexity.
Dr. Stephanie Nelson is a pediatric neuropsychologist who specializes in complex differential diagnosis. She is board certified in both clinical neuropsychology and pediatric neuropsychology. And she’s a past president of the American Board of Pediatric Neuropsychology. She has a private practice in Seattle and she primarily engages in consultation through the peer consult.
where she provides consultation to psychologists and neuropsychologists who specialize in pediatric assessment. So both of these women are complete powerhouse clinicians and it is a real gift to have them here on the podcast together talking about how they marry their head-driven and heart-driven approaches to supervision. So we talk about lots of different things here, but primarily work through their model for supervision.
We talked about the history of supervision and how we’ve conceptually approached it in our field. We talked about what’s missing at this point. We talked about the different layers of supervision and how we as practitioners can implement the skills based or practical approach to tackling these layers of supervision. And there are lots of acronyms and models and structure.
for you to take away and fall back on if you are supervising folks in assessment. lots of great discussion here, lots to take away. Without further ado, here is my conversation on supervision with Allison Wilkinson-Smith and Stephanie Nelson.
Dr. Jeremy Sharp (04:48)
Stephanie Allison, welcome back to the podcast.
Stephanie (04:52)
Thanks for having us.
Dr. Jeremy Sharp (04:54)
Really glad to have you. Yeah. So let’s do a quick intro just so people can like orient to your voices a little bit. Let me see, Allison, do you want to go first and you can, you can just tell us a little bit about yourself. I know I just did the intro and everything in the beginning, but tell us anything that you would like to.
Alison Wilkinson-Smith (04:55)
Thank you.
Sure. I’m Alison Wilkinson-Smith. I’m a pediatric neuropsychologist. I’m currently practicing at a children’s hospital within an academic medical center. I’ve been here for about 20 years. And relative to our conversation today, I have been doing supervision at multiple levels of training for pretty much all of that 20 years.
Dr. Jeremy Sharp (05:37)
Right, Stephanie?
Stephanie (05:39)
I’m Stephanie. I’m also a pediatric neuropsychologist, and I’ve been doing this for the same amount of time that Alison has, as you’ll probably discover during this podcast. And I spend a lot of my time right now doing consultation mostly to individuals who are already licensed.
Dr. Jeremy Sharp (05:56)
Fantastic. Yeah. So y’all alluded to this, but let’s just, uh, flow into the origin story a little bit here. Y’all met on internship postdoc postdoc. Okay. Yeah. Tell us how y’all connected and how this, uh, you know, the supervision workshop came to be.
Stephanie (06:05)
postdoc.
Alison Wilkinson-Smith (06:10)
postdoc.
So we met on postdoc, so two year postdoc in pediatric neuropsychology. And kind of going into postdoc, we had had very different experiences in our training. I was very fortunate to have some, to work with some amazing people and have some great training. And so when I came to our postdoc, kind of had
you know, I guess an idea in mind for what supervision could be. And then Stephanie had not the same experience in her training up until then. And so during our time there, you know, we, would say our supervision was maybe a mixed bag at best. Some probably that was
actively harmful. And so we kind of struggled through that together. And throughout that time, and then really since then, we have done a lot of reflecting on, you know, what makes a good supervisor? You know, how do we not repeat the bad things that happened to us? And how do we kind of deliberately structure supervision?
so that we can kind of bring out the best in our trainees.
Stephanie (07:33)
Right. So we’d had those really different experiences, but we both ended up with sort of the same problem, which is how do you go on to design supervision once you start doing it? A lot of us just repeat what the supervision we received was, and we pass on both stuff that was great, but also maybe some stuff that was not so great or even actively harmful. And because of our different experiences, we
really solved this problem in two very different ways. Alison was able to take the great training that she had and take the pieces from it and weave it into the wonderful style that she uses now. And because I had supervision that what I would call more, it’s called professional neglect. I didn’t really have that model to.
weave that from. So I solve the problem the way that I solve every problem, which is I just go read all the books and all the literature that’s out there and all the research that’s available. And then the two of us started having these conversations where I would be saying, what are you doing in supervision? And she would talk about it and I would then be linking it to the research or to these other concepts or to gaps in the research. And we were really having these fascinating discussions about how to
build out supervision. And once we’d been doing this for about 20 years, we realized we had something now that we wish that our younger selves had had. And anytime I do, I get interested in something or I go down a rabbit hole, I always try and put together something that’s sort of like a love letter to my past self, like something that I wish that I had had three, five, 10, 15 years ago that might have guided me.
through that place and we realized we were ready to write another love letter. So that’s sort of how we became really interested in this topic.
Dr. Jeremy Sharp (09:24)
Hmm. Yeah, I really love that conceptualization. Yeah as a as a love letter I think that’s how how we do a lot of things, you know trying to you know, provide ourselves or others with corrective emotional experiences that We’re really just addressing things that that happened to us. It’s not lost to me. There’s some parallels with parenting here for sure And just trying to do better than maybe our parents did right?
Stephanie (09:31)
Mm-hmm.
Yeah.
Mm-hmm.
Alison Wilkinson-Smith (09:47)
sure.
Stephanie (09:48)
Right? They
sometimes call that like the osmosis model of parent transmission or supervision transmission where you just get exposed to something and you pass it along as best you can. Right? Mm-hmm. You overcorrect in the other direction.
Dr. Jeremy Sharp (09:59)
Mm-hmm. Mm-hmm. Or you do the opposite, right? Like that, I feel like that’s the other side. Like, you know what
you don’t want to do, or you know exactly what you want to do, but the middle, middle ground is a little sticky. Yeah. Yeah. Well, I think it’s interesting too, because y’all come at this from different perspectives that are like equally exciting and challenging. You know, like from Allison’s side, you have what sounds like a very positive experience, but then you’re tasked with like,
Stephanie (10:08)
Right.
Mm-hmm.
Mm-hmm.
Dr. Jeremy Sharp (10:27)
Okay, how do I translate this sort of like.
you know, generally like vaguely positive experience into like a not manualized approach, but like something I can teach other people, you know. Then Stephanie, you know, you’re like, I didn’t have this great experience. Let me go dig in research and then somehow like translate everything we know into a like rigorous approach, you know.
Stephanie (10:49)
Right, but that
translation problem, you’re really pointing to a gap both in how we’re trained in supervision and a gap in the literature. We can look back at the training that we ourselves received, positive or negative, and maybe identify pieces of it that we may want to keep or pass on or don’t want to keep. Or we can look in the literature and see like, there’s this stuff that sounds maybe good, but then you get in the room.
Dr. Jeremy Sharp (10:56)
Mm-hmm.
Stephanie (11:16)
with a trainee or you start doing consultation and you realize, wait, the actual how-to, it seems to be a gap from whether you come at this from either direction.
Dr. Jeremy Sharp (11:18)
Mm-hmm.
exactly well yeah
Alison Wilkinson-Smith (11:30)
And I think that was one of the things that I struggled with early on as well, because I felt like I had had good supervisors, but they were all different. So how do I, you know, take these different pieces and put them together and kind of have some sort of system? And so that’s what we’ve kind of tried to do is kind of, you know, make a structure around the things that we want supervision to be able to do.
Stephanie (11:38)
Mm-hmm.
Dr. Jeremy Sharp (11:53)
Yes, yes, yes. And I’m excited to talk through all these components and see how the two of you bring your different styles together. I think that it’s a really nice compliment just from talking about it up to this point. So you mentioned research. Let’s do a little bit of that just to set the stage. What do we know at this point about supervision and teaching supervision?
Stephanie (11:53)
Exactly.
Mm-hmm.
Mm-hmm.
Dr. Jeremy Sharp (12:18)
and transmitting knowledge from one person to another in our field.
Stephanie (12:24)
Absolutely. If you are wondering yourself where the great articles or training on assessment supervision that you feel like as a listener you might have missed, you really haven’t missed it. There is not any such thing yet as evidence-based assessment supervision. There are a few books written
Dr. Jeremy Sharp (12:43)
Mm-hmm.
Stephanie (12:46)
sort of on that topic. There’s one by Jordan Wright that has been edited by him, and then there’s one specific to neuropsychology supervision that’s Bowdoin, Stuckey, and Bush. But they’re more edited volumes where people are sort of talking a little bit about some of these ideas. There’s not a lot specifically on exactly what to do, and to find that sort of literature, you can start looking little wider, which is where I started at kind of supervision in general, like supervision for therapists or supervision for social workers, that sort of thing. But then even that starts, you can get some great ideas, but in terms of what to actually do in the room, you may have to look even further afield.
So where I went was to fields like medical education or the wisdom knowledge or coaching in elite areas like music and sports or even some of the parenting literature was helpful in trying to put this all together in terms of what we actually do. But that’s sort of what’s missing. I could, if you like, kind of talk about where the supervision literature has kind of lately that maybe listeners have missed a little bit if they haven’t gone there. Would that be helpful? Yeah.
Dr. Jeremy Sharp (13:42)
Hmm.
Mm-hmm.
Yeah, I think that
would be helpful. Yeah, because there has been a little bit of a shift or a push. Yeah, yeah.
Stephanie (14:08)
A little bit of shift, exactly. That’s correct.
So more and more people are getting a little bit of introduction to supervision earlier in their career. It used to be that nobody was getting it. Now about a quarter to a third of people are at least getting some training in supervision at some point during their training or an internship in postdoc. So there is a little bit more move to try and introduce people to theories.
And then the bigger shift has been this move to a framework that is competency-based, developmental, and focuses on teaching trainees the knowledge, skills, and attitudes that they need to be successful in the field. So the content that sometimes what’s called the know what, the procedures, the skills, which is sometimes called the know how, and then the
Alison Wilkinson-Smith (14:40)
you
Stephanie (15:00)
attitudes that you need to be successful in the field, the work ethic, the values, the mindset, which is sometimes called the know why. And so there’s been this move to make supervision really focus on those three areas that trainees build within a competency based framework that is developmentally guided.
And by competency-based, I mean that you may have different domains in the areas of assessment versus intervention versus research, those types of things. And then that’s developmentally guided. And that has been really embraced by psychology. And so if you read any articles right now about supervision or assessment supervision, you’ll see that mentioned. What you will not see mentioned is exactly how we’re supposed to do that.
Dr. Jeremy Sharp (15:45)
Mm-hmm. Yes. And maybe that’s a time just to comment a little bit on this phenomenon. I know there’s a name for it, but I can’t remember it. Maybe one of y’all know the difficulty that we have even like teaching what we know. So even if, you know, we’re the best clinician in the world, like there is something that has to happen to like get that knowledge and those skills and those attitudes out of our brains and to into the supervisees brain. And that’s hard. Can you describe that at all? Why that’s hard.
Stephanie (16:10)
Mm-hmm. It really, absolutely.
I can absolutely describe that. So when we learn how to do something, when we are learning how to do it, gradually we become more effective at it and we become more or less aware of how good we are at it. And when we first
Dr. Jeremy Sharp (16:31)
Mm-hmm.
Stephanie (16:33)
are introduced to something, we are unconsciously ineffective. We are not great at the task and we don’t know it. So that’s the Denning-Kruger effect, for example, right? Like we all think we’re great at things. We have no idea what we’re doing. That’s often how we go into starting out with assessment, right? Your trainees may have a lot of confidence and not necessarily know what they’re doing. And then we reach this stage where we are consciously ineffective.
We no longer think that what we’re doing is working, we’re aware of that, but we don’t yet know how to become more effective. And then you get to the stage where you are effective and you’re conscious of it. And a lot of us spend a lot of time in this stage because we’re producing great work. It’s also very effortful. We’re very aware of how much time it’s taking. And then by the time you start supervising, you usually have reached the stage where you’re effective, but you’re not conscious of it.
You are unconsciously effective. You no longer know how you’re doing it. You have all this expertise and then trying to externalize it and explain it. All of a sudden you’re like, well, it just is ADHD, like, right? Right? And it’s very hard to translate, which makes it very hard to teach, which is where we’re hoping to come in, that we’re going to help people externalize the stuff that they’re already doing well.
Dr. Jeremy Sharp (17:35)
Mm-hmm.
Ha ha ha ha ha
Stephanie (17:59)
so that they can see what that is, do more of that, and if there’s anything that they don’t need to be doing or that’s less effective, they can kind of take a look at that as well.
Dr. Jeremy Sharp (18:08)
Yeah, yeah, I love that. So to that end, I would love to transition into this model, if you want to call it that. Or do you all call it a model? What do you call this?
Stephanie (18:19)
It’s… We’re trying to make it into a series of moves, a series of approaches, a series of things to do. There are definitely models as part of it. I can’t do anything without making a model. And I’m going to like set Alison up by kind of introducing a model of supervision so that we can get to the next part and kind of answer your question that way, which is I’m going to. I’m going to talk about how when we think about supervision, I picture this three layer cake with the knowledge, the skills, and the attitudes as the three layers. I kind of think of them as like thinking, behaving, and emotions or values sort of stuff. And then if you picture a three layer cake, you picture it with icing on top.
Dr. Jeremy Sharp (19:02)
Mm-hmm.
Stephanie (19:09)
which is like this commitment to growth, this commitment to getting better, this commitment to improving in what we do, but most importantly, contained inside a plate of emotional safety that allows us to practice, be vulnerable, like develop new skills. And I’m going to take that plate and hand it to Alison and have her talk a little bit about that emotional safety piece.
Dr. Jeremy Sharp (19:21)
Mm-hmm.
Yes.
Alison Wilkinson-Smith (19:34)
Okay,
I’m gonna take the plate and try not to break it. So, you know, I think many people are aware or just sort of have this sense that many of the skills that are helpful in supervision are many of the skills that are helpful in practicing as a psychologist. And I think that that’s a lot of where I started. And obviously, when we’re
Dr. Jeremy Sharp (19:38)
Hahaha.
Alison Wilkinson-Smith (19:58)
when we’re practicing as psychologists, we have to kind of create this emotional safety for the people that we’re working with in order to get them to open up to us and things like that. I was trained very early on in therapeutic assessment. My previous episode with you was talking about that and I know you’ve had some other guests come on and talk about that.
Therapeutic assessment has the core values of compassion, humility, openness, respect and collaboration. And for me, I try to ground everything I do as a psychologist in those values. And that includes supervision. And so I’ve tried to think a lot about, you know, how do I use those values, certainly in my practice, but then also how do they look in the supervision setting because there are some things that are similar to what we do. And then there are some things that are that are different about the supervision relationship, right?
So how do we how do we create a safe environment that that is compassionate and feels respectful with someone who we are training, we’re teaching, we’re trying to help them lose skill, develop skills. But, you know, it’s also somebody that you want to approach, you know, as a junior colleague, right? You want to approach ⁓ them as coming in, knowing some things, having some skills. I mean, even our beginning trainees, like they come in with their own life experiences and things like that. So how do we
Stephanie (21:13)
Mm-hmm.
Dr. Jeremy Sharp (21:27)
Of course.
Alison Wilkinson-Smith (21:27)
⁓
How do we fix that collaboration? How do we approach that collaboration in kind of this more professional setting versus how we do it when we’re working with our patients and families?
Stephanie (21:40)
Right, the technical term for that is isomorphism, which is that idea that what you want your trainees to eventually be able to do with their clients is what you’re doing with your trainee in your supervision session. You’re treating them the way you want them to eventually be able to treat their clients.
Dr. Jeremy Sharp (21:41)
Sure.
Stephanie (22:04)
And so that’s where Allison and I would have these great conversations where I would be saying like, okay, you learned how to treat clients. I didn’t really learn any of that. So tell me what when you’re doing that, like when you’re working with a trainee and you’re thinking about that value, Allison, of like openness and collaboration, like how are you actually doing that with a trainee? What does that actually look like? Give me a concrete example of what you might do.
Dr. Jeremy Sharp (22:34)
Ooh, could I jump in real quick and clarify it? Could I clarify something real? I’ll give you like a very specific example if you don’t have and then we can take it whatever direction you can be like, that’s dumb, Jeremy. I’m going to do my own thing. But so, you know, full disclosure, I went into internship completely terrified and with a lot of
Alison Wilkinson-Smith (22:35)
So if, yeah.
Stephanie (22:35)
Yeah.
Dr. Jeremy Sharp (22:56)
performance anxiety and like shame. So I was coming out of grad school. I don’t know if I’ve ever said this on the podcast, but I, my last year of grad school, no, not my last year. I was okay in the last year. The next to last year, I was on like a formal remediation plan for my therapy skills. And it like really shook my confidence. I think it was the first real time in my life where I like, wasn’t good at something that I was really trying to be good at.
Stephanie (22:59)
Mm-hmm.
Mmm. Mm-hmm.
Dr. Jeremy Sharp (23:24)
And you know, so I went into internship like terrified that you know imposter syndrome Everybody’s gonna find out like I’m terrible at this and whatever. Okay, so here we are I come in to you know, the first couple supervision sessions share this with you Allison How might you like navigate something like that with a trainee? I have to imagine you have run into something like this, you know in the past
Alison Wilkinson-Smith (23:49)
mean, my first inclination is to say something like, I’m so sorry that you kind of had to go through that experience. Because in grad school especially, you are learning a new skill. It’s not like other types of learning where, okay, if I just spend enough time with this book or with these flashcards or something like that, then I can get better at it. This is truly learning a skill and
Dr. Jeremy Sharp (23:57)
Hmm.
Alison Wilkinson-Smith (24:17)
you know, it’s hard to simulate, it’s hard to practice unless you’re in the situation. like, I would start by saying like, I wish that you hadn’t had the experience of feeling bad about yourself, because you were struggling to gain a new skill, because we all gain new skills at different rates. And it’s not a reflection of your intelligence or
how much you’re working or even a reflection of how good you may eventually become. It’s just a reflection of where your learning is at that point. And so I think that like my hope is that by approaching, am I maybe writing a love letter to young Jeremy? ⁓ I would hope that by kind of approaching with that level of, with that
Stephanie (24:50)
Mm-hmm.
Dr. Jeremy Sharp (25:00)
Hmm. I’ll take it.
Alison Wilkinson-Smith (25:06)
compassion and respect for you as a person, that that puts you in a state where you can start to grow that confidence, right? It’s really hard to be open, to be collaborative with your client if you’re just in your head thinking about, no, I’m gonna be found out and I don’t know what to do and I don’t know what to say next.
Like I think we all have the experience as early therapists or early assessors of being in our heads a lot, but we wanna leave enough room for the client. And so, as a supervisor, let’s turn the plate into a bowl. So I have to have the bigger bowl, right? To contain the…
Dr. Jeremy Sharp (25:33)
for sure.
Alison Wilkinson-Smith (25:52)
the emotional distress that you might be having, whether that’s from your own struggles in the field or whether you’re maybe experiencing some distress from like secondary trauma. Maybe you’re working with a client who’s been through some things that are really difficult to hear about. So if I can act as the emotional container, right? So we have like nesting bowls here where you can sort of approach
the client with compassion because I’ve given you enough containment for you to kind get out of your own head a little bit.
Stephanie (26:26)
Right. And so this is how our collaboration works. As you can see that Alison is the heart of it. And then I go in there and say, okay. So what I’m hearing in terms of the actual thing that you do is you normalize struggle and then you acknowledge growth to make sure that we’re letting you know that as the trainee, this is exactly where you should be.
Dr. Jeremy Sharp (26:27)
Yes.
Hmm.
Stephanie (26:52)
we’re neutralizing the shame about this that people can feel when things are harder for them to learn. We’re saying that’s normal, natural, acceptable. We’re holding you in positive regard no matter what pace you’re learning at. So we’re normalizing that struggle and then acknowledging the growth that you do. And then I’m going to work normalizing struggle and acknowledging growth into some sort of framework or model.
But this is how we do it is I just ask Allison what she does and then turn it into a specific move of how we might be able to repeat that for a different scenario that comes up in supervision so that it’s generalizable.
Dr. Jeremy Sharp (27:34)
Right, right, right, right. Yeah. And for the record, that response would have been great. know, I’m like, man, it was, I mean, it was, it was similar. It was similar. Yeah. Yeah. And I, know, I do a fair amount of supervision these days. Probably not super well based on the literature, but you know, we’re going to talk about all that. But you know, part of it is in the first session or two, you know,
Stephanie (27:40)
Hopefully you got something like that.
Dr. Jeremy Sharp (27:59)
like explicitly ask if you know folks are bringing in any anything like that like trauma, shame, know, bad experiences in grad school, that kind of thing just to get a sense of what what what safety might need to be created.
Stephanie (28:09)
Right. Right. And you’re normalizing not only that they may have had encounters and struggles, but you’re also normalizing and taking maybe some of the sting out of the fact that if you ask people about their previous training, everybody says, I got a lot of value about it. The supervision that I’ve gotten is the number one part of my training experience. It’s been so helpful. And they also say
Dr. Jeremy Sharp (28:35)
Mm-hmm.
Stephanie (28:37)
that they have received inadequate and harmful supervision at the same time. So when researchers have looked at it, about a third of people are receiving harmful supervision right now, and 50 % have received harmful supervision at some point, and 93 % of trainees across disciplines have received inadequate supervision at some point during their training.
So it’s an almost universal experience that most of us think we encountered on our own because there’s some secret bad part of us. So you’re also sort of doing some with your, the move of some judicious disclosure, you’re normalizing that experience and making the person feel less alone.
Dr. Jeremy Sharp (29:21)
Yes, yes. And, go ahead.
Alison Wilkinson-Smith (29:23)
And I think that’s true for becoming a supervisor as well, right? So, you know, I’m sure some of my former trainees are listening to this and thinking, well, she wouldn’t all that great for me. You know, it’s not really like you’re a good supervisor or a bad supervisor. Your, you know, supervision is another skill that we develop, right? And so,
Stephanie (29:26)
Mm-hmm.
Dr. Jeremy Sharp (29:35)
Ha ha ha!
Hmm.
Alison Wilkinson-Smith (29:47)
We have times when we are probably being neglectful. We have times when we’re probably being harmful. But our hope is that by putting some systems to this and making it sort of more deliberate, people can sort of be mindful of what are the things that I need to do in order to be most effective.
Stephanie (30:09)
Mm hmm. That’s such an important point, Allison, and really brings up that link to parenting again. There are all times as parents when we are not perfect. There’s there’s our goal is to be good enough. Right. And we’re not suggesting that the people during supervision right now are good supervisors or bad supervisors. We’re trying to say that there are always these moments and always will be where you reflect back on a problem that came up or a situation that happened, and you’ll be like, that didn’t go the way that I wanted, or I want to do something different next time. And then sometimes that’s where your brain kind of stops, because you don’t know what you would do to fix the problem or to prevent it from happening next time or how you would address it again in the next session.
You get sort of stuck. And then while over 90 % of us turn to our peers, sometimes they don’t necessarily know either because we’re all practicing in the dark. Very few of us actually see each other do supervision or even talk about what we do in supervision. It’s this kind of, almost this like secret practice that we do that we are out there talking about. And so our hope is really to just kind of start the conversation about some of these things and give people some ideas.
when they get stuck or when they think, I want to do this or this better. Hopefully we’ll have some things that will be helpful in terms of moving that forward.
Dr. Jeremy Sharp (31:37)
Yeah, definitely. Well, I think a good framework goes a long way there. I mean, even to have something to fall back on where we have, you know, a bit of a recipe or a roadmap of some sort, right? I mean, that’s way better than just, you know, like I’m doing my best. think this might be a thing to say or not say.
Stephanie (31:43)
Mm-hmm.
Dr. Jeremy Sharp (31:57)
I’m poor trained, poorly trained. okay, let me orient us a little bit. So we’ve got our plate ⁓ that is containing, we’ve created a container of safety for these three layers of supervision to sit on. me understand the difference. Maybe, I don’t know, this may be an Alison question, but help me understand the difference between like the safety and, you know, those core values and like that layer of
Stephanie (31:57)
Mm-hmm.
Mm-hmm.
Mm-hmm.
Dr. Jeremy Sharp (32:24)
attitude. What’s how do we move from like the plate to that first layer and is there overlap or not so much? How does that work?
Stephanie (32:25)
Mm-hmm.
Alison Wilkinson-Smith (32:31)
I’m not sure I totally understand the question. This is my humility.
Stephanie (32:33)
I think we are trying to…
Dr. Jeremy Sharp (32:37)
⁓ You’re embodying the value of.
Stephanie (32:37)
Perfect. This is a really interesting question. I actually, as I’ve been trying to think about these layers of supervision in the literature, it’s knowledge, skills and attitudes. And then in other models like the integrated developmental model, it’s things like motivation, awareness and something else.
There’s often three levels and they get called various things, but the emotional piece and the values piece all gets kind of squished together along with work ethics and along with like professionalism. And that last category sort of ends up being a bit of a grab bag. But I think one of the things that Alison brings is helping me. I almost have made it into two layers, like a layer of emotional safety, which I made into that plate.
Dr. Jeremy Sharp (33:11)
Mm-hmm. Mm-hmm.
Stephanie (33:25)
And then also that layer of those TA values that she brings in, those therapeutic assessment informed values. And maybe this is a good time, Allison, to talk about like one of the other of those values that you bring into supervision and how you might do that.
Dr. Jeremy Sharp (33:25)
Mm-hmm.
Alison Wilkinson-Smith (33:43)
Sure. I think, kind of maybe piggybacking off of the example that we just talked about, collaboration in supervision can look like you start with your sort of base of safety, right? You have to make it so that your trainee feels comfortable with you. And then you sort of introduce the idea that like,
Stephanie (33:51)
Mm-hmm.
Alison Wilkinson-Smith (34:03)
you as the supervisor know some things about how to do assessment, how to interpret tests, how to diagnose certain things, right? And your trainee, of course, they bring their life experience and their previous training experiences, but they also bring what it’s like to be in the room with the client, right? I wasn’t in the room with them. And so I can’t know that experience.
And so, you know, by presenting it sort of openly as a collaboration, right, I’m going to help model for you how to think through these things. I’m going to help you, you know, this is where all of Stephanie’s like operationalized steps and moves come into play. like, I have a approach that I kind of bring to.
the supervisee and their experience of being in the room and collecting the data.
Stephanie (35:00)
Right. And that’s so important to me. I mean, you can tell from like that we have different personalities and different approaches to this. And Alison focuses really on like how to be in the room with a supervisee, whereas I am constantly focused on like what to do. And without her to remind me, I will overload people with information.
with procedures, with techniques. And then I need her to pull me back and say like, right, but what’s our value here? We want the supervisee, the trainee to feel like they have some ownership over this, to feel like they contributed to this, to develop their autonomy. And then I remember like, right, this is not just about filling a trainee with some knowledge, right? It’s not just teaching them all the rules of how to play tennis.
You can teach someone all the rules, and they’re not going to get to the US Open unless you’re also practicing with them, modeling for them, making it safe for them to feel like they can make mistakes, things like that. So that’s so helpful to me every time you bring in those that values piece.
Dr. Jeremy Sharp (36:09)
Hmm. Yeah, yeah. Y’all are such a good team. No, I just keep coming back to that. Yeah, it’s a real compliment. So OK, I’m going to orient myself again just being super concrete. The plate is our safety. It is, of course, anchored in these values that you’re talking about, the five values that you mentioned. But then that first layer of attitudes maybe is where we’re like, teaching those values or imbuing those values, hopefully, as part of the supervision process and letting the trainee embrace some of those. So maybe we move to the next layer, thinking. Let’s tackle thinking in this whole equation. So help me understand the thinking layer.
Stephanie (36:37)
Embodying,
Mm-hmm.
Right.
Absolutely. So I’m going to back up and give you one more, I think, model, which is if listeners are thinking, OK, this is all great. I want to be grounded in values. Fantastic. But if they’re like me and they’re like, OK, but what do I actually do? I’m to give you just sort of a basic structure of how a supervision session might work. Obviously, you can move these pieces around, but I’m going to use the acronym SCOOP.
which is we’re gonna start by selecting a format for how we’re gonna do our supervision. There’s lots of different ways that you can do it. You’re gonna select it based on your trainee, your setting, your professional style, whether you’re gonna do role play or live supervision or a transcript or something like that. Once you’ve selected your format, you’re going to then cover the three layers, the sort of emotional layer that we’ve talked about, but also the thinking layer, and the doing layer, the behavioral layer.
So we’re going to make sure that we work through the case talking about the thinking part of it, the case conceptualization, but also the doing part of it. Who are we being? What are we doing in that session, in this evaluation, in writing the report, whatever it is. And then for our two O’s in Scoop, we’re going to orient it to the trainees developmental level.
Dr. Jeremy Sharp (37:55)
Mm-hmm.
Stephanie (38:18)
where they are in their path, which will shape whether we’re more directive or not, whether we’re more intellectual in our heads, or whether we’re really doing like role play, like let’s really learn this skill, that sort of thing. And then our other O is going to be to pick, to opt for one skill target, where we’re just picking one thing that we’re really working on in this session that we’re trying to make a little bit better.
then we’ll end with P which I’m going to stick a bunch of P’s in there all under the same letter which sounds really weird to say out loud that sounds fine in my head which I am just going to abbreviate as praise progress and plan. So to make sure you’re giving positive feedback about what’s going well that the trainee can really hear where they’re growing and they can hear what they’re shifting on or what they’re working on or where their growth edge is.
And then that there’s a plan that we’re actually going to do something in our next supervision session or what they’re going to do outside of the room or what we’re going to work on together for how to get them to that next level in the skill that we’re working on. So that’s our sort of like orienting framework. And Allison has kind of already talked a little bit about working through that emotional piece. And then we can transition into how do we shape thinking if you feel like that would be a
good next place to go. Maybe that would be a good place to kind of talk about the, like another value that you might bring in when you’re thinking about helping trainees feel safe enough to learn in this really ambiguous environment of trying to make assessment decisions.
Dr. Jeremy Sharp (39:41)
Yeah, yeah, let’s…
Dr. Jeremy Sharp (41:20)
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Alison Wilkinson-Smith (42:30)
Yeah, I think the model that you’ve laid out here, this scoop model, just the idea of using this type of framework really makes me think of the value of respect because we are, I wanna be respectful for the trainees’ time, so I want to make sure we’re using our time wisely. I want to,
Stephanie (42:44)
Mm-hmm.
Alison Wilkinson-Smith (42:59)
continue to maintain that safe environment. I want to be respectful for not overwhelming them and be respectful for making sure that what we’re working on is at the right level for them. And I want to make sure that I’m giving them feedback, right? That I’m giving them feedback about whatever the specific thing is that we’re talking about. But also maybe feedback on the bigger picture of their development and then kind of how to move forward with that into the next supervision session, right? Setting us up for next time. ⁓ And so, I think this is sort of where that idea of approaching your trainee is, is doing your colleague, right? I’m being respectful of your time, your abilities, your goals for us working together.
Stephanie (43:35)
Right?
Mm-hmm.
You know, one of the ways, Alison, that you’ve told me that you, one of the things you do in supervision that always makes me feel, I feel like vicarious respect, if that’s a thing, is you tell me you always give your trainees the first crack at something. Like you always make sure that they have, like when, and I was thinking about that when you’re trying to help them gain new knowledge, gain new content. One of the ways that you can be respectful is,
by putting it in front of them. Can you talk a little bit about that choice that you make and how you do that?
Alison Wilkinson-Smith (44:23)
Sure. And I would say, and this is something that I also say to my trainees, that I try to give them first crack at it. There are many times when I get overwhelmed by enthusiasm for the clinical work that we’re doing that I will just start sharing my thoughts. But I try really hard to give the trainee the first crack at each step of the assessment process. you know, let’s say after we’ve done the initial interview with the parent,
Stephanie (44:34)
Mm-hmm.
Alison Wilkinson-Smith (44:50)
I want the trainee to have the first crack at developing hypotheses at that point, and then what tests might we want to give. And so I will say to them, maybe as we’re kind of processing right after the session, OK, what are we thinking? And then if they don’t know, then I will say, OK, we’ve got a week till our next session. Go think about it. And then come back to me. Because I realize that you know,
I can do those things in the moment. But the trainee who is just developing that skill, maybe they can’t do it as fast as I can, but they would still be able to do it or do some of it. And so, I will say, you take a crack at it. so, it’s my way of communicating respect that like, is your client, right?
I’m just your support but of also saying like, believe that you can do this or you can get close. And then I always tell them, you know, if you go and think about it and you really have no idea, like that’s fine, just come back to me and then we’ll talk it through. But I want you to try first. And the same thing for like when the testing is done and we’re going to interpret it, right? I will say, okay, you go take these results and sit with them and see what you think is going on and think about how we’re gonna explain that to the parent.
Stephanie (45:51)
Mm-hmm. And then.
Alison Wilkinson-Smith (46:04)
and then kind of come back to me with your ideas. And again, if they just have no idea, then I say, great, come back and we’ll talk through it. I see some complicated cases and sometimes trainees will just be like, I have no idea. And maybe they’ve kind of come up with a conclusion that I don’t necessarily agree with. And so then like, okay, how can we respectfully talk that through? ⁓
Stephanie (46:27)
Mm-hmm.
Alison Wilkinson-Smith (46:27)
but giving them the first chance to do that thinking, realizing that it’s going to take them more time than it is me.
Stephanie (46:35)
Right. And then when I operationalize that, when I listen to that, I realize like, what she’s doing is getting material from the trainee and then listening for material that’s in their zone of proximal development. Meaning it’s material that they’re close to. You they might not be close, but a lot of times you can find something in there that is pretty close and then you can start shaping that. You can expand it or
deepen it or complexify it or make the trainee start thinking through the differences between other concepts that they’re kind of getting it muddied up in. And you take that material that they’re almost there at, you expand it and see if they get there on their own. And then if they don’t, you can figure out what it is that they need that you then go in and fill in. And that’s so much different than what my normal technique would have
been, is to just try and cram content into someone’s brain, whether they were willing or not or needed it or not. It’s instead this respectful like, wait, let me see what you almost know. Let me see if I can get you there on your own. And then you have ownership of it and feel that growth and see it in yourself. And then if we can’t
Then we’ll put in content in manageable bite-sized chunks that you’re actually excited to receive rather than maybe closed off to or overwhelmed by.
Dr. Jeremy Sharp (48:08)
Mm-hmm. Yeah, and it just I mean for me it just gets back to that value of respect that you started with Allison You know like this is like respecting. Hey our trainees are bringing a wealth of knowledge whether they necessarily know how to organize it or access it or you know Articulate it or not. It’s there and it’s we’re gonna like
Stephanie (48:12)
Mm-hmm.
Right?
Dr. Jeremy Sharp (48:27)
draw it out. And, you know, for me, it helps sometimes to think about, we’re kind of in the ballpark of like a Socratic method sort of approach, where, you know, you’re like, I find that it’s very rare for trainees to be like, so far off base. And I’m like, that’s ridiculous. Like that rarely happens for me. So, you know, to be able to ask questions and help guide them, like you are saying to their own conclusions and
Stephanie (48:34)
Mm-hmm.
Right. Mm-hmm.
Right. Socratic questions are one of the best ways to stretch material in that zone of proximal development. So we talk a lot about that in our model. There’s also a good chapter on that by Jacques Danders in the book on supervision of neuropsychology. He writes about using those Socratic questions as well. But it’s a really great way to take material that people are almost have and help them
Dr. Jeremy Sharp (48:59)
Mmm.
Mm-hmm.
Stephanie (49:19)
think it through on their own, which is a completely different process than someone thinking it through for you and then giving it to you completely to, you know, how they are thinking about it.
Dr. Jeremy Sharp (49:30)
Yes, yes, absolutely.
Alison Wilkinson-Smith (49:31)
Because ultimately, we want them to develop the skill, right? We’re teaching a skill. So if I just tell you the answer, that doesn’t help you develop the skill of thinking through it on your own. You got to try thinking through it on your own. And maybe for trainees who are earlier in their kind of training journey, that’ll be more of me thinking out loud, kind of going through it with them. ⁓
Stephanie (49:34)
Right.
Mm-hmm.
Alison Wilkinson-Smith (49:56)
And, you know, maybe somebody who’s further along in the training, kind of get close and then we talk it together. And then maybe somebody who’s, I work with a lot of fellows who are kind of in the last stages of their training. And oftentimes all they need is that little extra time to kind of sit with the information and then they can get the same place that I was. So.
Dr. Jeremy Sharp (49:57)
Mm-hmm.
Stephanie (50:17)
Do you have that experience, Allison, where you’ll be doing this session, I have this sometimes and the person will, like they’ll say a bunch of stuff and I will repeat it back for them and they’ll be like, that sounds so great. And I’m like, those are your words. Like you said that. I’m reflecting it back to you. Do you have that too?
Dr. Jeremy Sharp (50:31)
No.
Alison Wilkinson-Smith (50:36)
Yeah, and I also have the experience of, again, because the trainee is the one in the room, they’re the ones who are doing the work, sometimes they’ll say things that I didn’t think of. And then once I kind of conceptualize it from their perspective, I’m like, huh, that’s a good point. Right now I’m working with a fellow who has a lot of experience with adults. And so she’s learning more about how to work with kids. And so she…
Stephanie (50:46)
Mmm.
Alison Wilkinson-Smith (51:02)
frequently after we do the parent interview will mention one thing or another that like, I didn’t notice that or that didn’t occur to me just because she has more experience working with adults than I do. And then when we’re working on conceptualization, one of the things that I do to kind of help her in that zone of proximal development is I will say like, what if we had these same symptoms in an adult? What would you be thinking? And then that helps her kind of think about like the
Stephanie (51:27)
Mm-hmm.
Dr. Jeremy Sharp (51:28)
Mm.
Alison Wilkinson-Smith (51:30)
developmental trajectory of certain disorders or certain symptoms and things like that.
Dr. Jeremy Sharp (51:35)
Yeah, it’s lovely. Well, let’s transition to the behavior or the skills layer and talk about that. maybe we enter into this the same way we did the last one, is anchored in values, I suppose. So are there?
Particular values, Allison, that you see coming up specifically when you’re talking about behavior or teaching behaviors or skills that might be worth talking about.
Alison Wilkinson-Smith (52:06)
a tough one to answer because I think it probably depends on what specific behavior it is that that we’re working on, right? So if we are working on conceptualization, for example, then collaboration might come into play. And so, you know, this is where they bring their experience of being in the room of administering the tests of, you know,
A really good example of this is that I supervise often in the ADOS and I cannot judge the child’s eye contact from watching the video. The best video in the whole world is not going to tell me whether they’re directly looking in the person’s eyes. And so I’ve got to defer that. I can give them the information of like, here’s how I think about judging eye contact.
Right? Think about the difference between looking in your eyes versus looking orienting towards your face, but not looking directly in your eyes. Think about the difference between someone who is just not meeting your gaze much at all versus somebody who is actively avoiding your So I can give them like these specific touch points, but they still have to bring the experience of, okay, what was this actually like?
Stephanie (53:19)
Mm-hmm. It, yeah.
Dr. Jeremy Sharp (53:20)
Right. think about, maybe this y’all tell me if I’m off base, I’m just sort of like an interloper in y’all’s model here. But I think about openness too, at least for me, you if I’m thinking about that value the right way, especially with skills and behavior, that is where I have to be flexible essentially and say like, okay, like here’s how I think. This could be done, or, you know, like a way you could ask that, but there’s always going to be variation, and the trainee is going to put their own spin on it. And that’s a good thing, but it kind of requires like an openness, you know, from my perspective to acknowledge like, Hey, there’s a different, but similar way we could do this. And it will still be effective.
Stephanie (53:59)
Mm, yeah. It’s so one of the pitfalls of becoming a supervisor is that we do have this ethical mandate to provide really good client care and make sure that the client care we are our trainees are providing is also top notch. And we also are trying to teach evidence based best practices, you know, standardization, you.
Dr. Jeremy Sharp (54:14)
Mm-hmm.
Stephanie (54:27)
have to make sure that you’re scoring correctly. So there are these pieces where, great, the person should make mistakes, do it their own way, grow, etc. But also, I need the WISC scored correctly and we don’t necessarily have a do-over if we get the diagnosis wrong. So that tension that you’re talking about of how do you shape behavior and allow the person to grow and make mistakes and try new things and put their spin on things while
Also trying to be accurate and deliver good quality care is probably one of the tensions of supervision and people often solve it by micromanaging or by sort of being like, well, everything you’re doing is must be great and being sort of more warm and affirming, neither of which necessarily hits that sweet spot, which Allison and I call sort of like being an attuned supervisor where you’re trying to
balance those tensions that are inherent in supervision.
Dr. Jeremy Sharp (55:27)
right? Are there other aspects of, of this layer that we could, that we could talk about, maybe examples of, you know, skills or behaviors?
Stephanie (55:35)
Well, I was thinking
you have told us, Jeremy, about a conversation you were having with your wife about passing on behavior. And I wondered if maybe you could tee that up again, because I thought that was an interesting thing that you were discussing. I think you were talking about passing on group therapy techniques, maybe.
Dr. Jeremy Sharp (55:53)
Yeah, yeah, yeah. Yeah, so my wife does a lot of teaching and training and supervising and group therapy. So we talk about this a lot. This came up like two weeks ago where she was, I don’t know if lamenting is the right word, but we were talking about how it’s really challenging to transmit skills. She was like, I just.
intuitively do what I do. And I’m not sure how to tell people how to do that because it involves 47 different points of analysis of the situation going on and like the emotions and the, members in the group and my, you know, clinical experience. And then it all kind of synthesizes somehow into this intervention. So, yes, it’s a real challenge. And we talked about that quite a bit.
Stephanie (56:17)
Mm-hmm.
Mm-hmm.
Absolutely, and that’s a beautiful illustration of the master trying to pass on to her apprentices what it is that she does. That’s often called the master apprentice model where you’re trying to pass on what you do, but you just are unconsciously effective and you don’t necessarily know what you’re doing. So of course we have a whole framework for this.
I’ll just talk about like kind of two points from it for this. One is making sure that you’re not just telling the person how to do it, but that you’re actually showing them how to do it through modeling, through role play, through talking it through what you would do, making sure that you’re not just telling the person like, do this, do that, do that, and here’s how you do it, but that you’re actually showing them because novices do not see the problem the same way that you do.
Dr. Jeremy Sharp (57:13)
Mm-hmm.
Stephanie (57:36)
And so if you just tell them, you are going to include a lot of extra information or a lot of irrelevant information that you don’t even realize that you’re doing, and they will focus on those pieces and not necessarily what it is that you might have wanted them to focus on. So one of the best things that you can do is make sure that in addition to talking them through it, that you’re also showing them how to do it or having them experience it themselves or having them do it and getting
getting some of that deliberate practice in. Now, of course, you’re also going to use words. We’re not conducting supervision entirely in mime, but instead of focusing so much on talking through what you’re doing and how to do it, you want to instead focus on the when and the where and the why. So like, when would you do this? Why are you trying to do it? And where does your attention as the expert go?
What patterns or pieces are you seeing that a novice wouldn’t necessarily see? So you’re explaining to them instead of here’s exactly how you administer the WISC, you’re saying standardization is important for this reason. Here is when I might deviate from standard administration in a very unusual circumstance and why I might do that. And when I do standard or
non-standard administration, here’s where my attention is going, here’s what I am looking at. So operationalizing that knowledge transfer, that behavioral shaping transfer through two of those methods is something that we’re really interested in helping people understand.
Alison Wilkinson-Smith (59:18)
It’s really a metacognitive activity, right? And I think that’s, Stephanie’s metacognitive skills are really second to none. So that’s one of the reasons why we work so well together is because she kind of supplements my metacognition to be like, okay, what are you doing and why? And then how do we translate that? How do we link that back to what we know from science? So. ⁓
Stephanie (59:20)
Mm-hmm.
Right, and then to bring that isomorphism back in, when we do that, we’re modeling for trainees how to do that, how to do that metacognitive reflection, which is one of the key aspects of getting better at something, is being able to ask yourself those questions or being able to ask someone else those questions to get that information that you need.
Dr. Jeremy Sharp (1:00:02)
Yes. This sounds great. I love a model. I love a nice visual. I love structure. You’ve given us a lot of examples and, I think, practical illustrations of how this might come to life. So theoretically, everything goes great all the time, right? But in reality, that is not what happens. And so I would love to.
Stephanie (1:00:20)
Mmm.
Dr. Jeremy Sharp (1:00:25)
maybe as we start to wrap up, know, talking about situations where supervision becomes a little more challenging or maybe you just get stuck. don’t even, maybe we don’t even have to say challenging because that makes it sound like hard or like a personality problem or something. like for an example, I’ll lead with an example and then we can take it wherever. But like just the other day, I was talking with one of our trainees about an adult autism.
diagnosis, right? And long story short, was, I landed on, yeah, I think there’s enough here. This is, this is an autism diagnosis and you know, here’s why. And the trainee was saying, I don’t see that. Here’s how I would explain all of the symptoms from a different perspective. And ultimately we just got to the point where I kind of had to be like, well, I think this is what it is and that’s what we’re going to go with. And I don’t know that I navigated that really well. So that’s just one example of how, you know,
Stephanie (1:01:16)
Mm.
Dr. Jeremy Sharp (1:01:22)
a little bit, you know, little bit of like friction can come up. So anyway, all that to say, how do you all approach it or how can we implement some of these things in like stuck situations or places where supervision gets a little bogged down?
Stephanie (1:01:37)
I will jump in here with, of course we have a model for this, and I will lay out the steps and kind of how I might think about it in terms of that model. And then I hope this model also translates more widely to not just the supervision ruptures that can happen in session, but also to those ruptures that can happen when you’re really feeling like.
the trainee is not making the kind of progress that you expected or is getting stuck in some area or you as a supervisor getting stuck, it’s going to be the same set of steps, whether it’s individual session or whether it’s wider. And so I’ll lay out the model and kind of apply it a little bit. And then, I’ll give it to you to maybe make even wider than that if something comes up. I don’t mean to give you homework here, but so my model, the acronym is going to be Swirl.
Dr. Jeremy Sharp (1:02:01)
Hmm
Mm-hmm.
Thank
Stephanie (1:02:27)
which is you’re going to stop and spot the pattern. You’re going to really describe in what’s happening. A lot of times we can get in those friction points or we can realize three quarters of the way through a trainee’s experience that we maybe should have addressed something early. So our first step is really to stop and making sure that we are spotting what that pattern is, making sure that it is a pattern and not just a one time thing necessarily that maybe it was just
somebody had a bad day ⁓ and we can recover from that, but we’re seeing a pattern. And then the W in swirl is wondering about it, speaking about it, naming it in neutral terms, describing what’s happening, saying, I’m noticing we’re getting stuck in this, or I’m noticing we’re having this moment of friction where I’m the supervisor and I ultimately have the license and so I have to make sure that I’m making the correct diagnostic decision here and you’re the trainee and
Dr. Jeremy Sharp (1:02:58)
Mm-hmm.
Stephanie (1:03:24)
I’m wondering how this feels for you, what you’re bringing to this, what I’m not understanding, like we’re stuck in this situation. And then the I is the invitation, getting the trainees perspectives, their experiences, where they’re frustrated. You also are being invited to give your experiences and what’s going on with you and where that tension is.
Through that invitation process, it does take a lot of time, but the point of that step is to remind you that this is probably a point where you have to spend more time. This can’t just be one of your quick supervisions or one of your quick, I’m just going to give you all twos on your rating form and we’ll move on and we’ll figure this out later, right? You really do have to stop and everybody’s ideas and perspectives and feelings all need to be laid out on the table. And then the R is to respond differently.
Dr. Jeremy Sharp (1:04:06)
No.
Stephanie (1:04:19)
in real time, like right now, doing something different in supervision. So for example, if you eventually get to a point where you’re like, well, I just have to make this diagnostic call, you can say, I meant to say, I feel this pressure to make a decision. And so I’m leaning in this way. But I think it might have landed like I’m saying you’re wrong or you didn’t do it right. is, you know, and hopefully through the invitation process, you’ve
you’ve heard their perspective of what that felt like for them. And so then you do it, you do it over. You say, what I meant to say was, I see exactly what you’re saying. And I also see it from this slightly different angle and we need to make a decision. And so one of the ways that I’m thinking that will resolve those like this is like this. Or we could do it this other way. How would that feel for you? But you’re trying something new.
literally in real time. And then the L is for linking it to some sort of real world thing moving forward, linking it to action or accountability. What are we going to do differently when we disagree? Or what are, what am I going to have you read and come back next session so that you feel like you can better articulate your viewpoint because I feel like I was missing some piece of it? Or
What am I going to say it differently when I just feel like, gosh, it is 58 minutes after the hour and we got to make a decision. What am I going to do in those moments? You’re linking it to some sort of real world change to get you out of that stuck point.
Dr. Jeremy Sharp (1:05:57)
Nice. Yeah, it’s not lost on me that this could also apply to couples therapy and probably many other just general disagreements or, you know, times of friction. Yeah. Allison, anything to add there in these like stuck situations from kind of that values sort of heart driven perspective?
Stephanie (1:06:05)
rate.
Alison Wilkinson-Smith (1:06:15)
I think this is really where you got to reach for your humility. I think the example that you gave, of humility is working on two different levels, right? The first piece is like the, what diagnosis are we gonna get, right? The actual like clinical answer. And so, you know, I can be really confident in my judgment, but
Again, I wasn’t the one in the room, but also there are always going to be other clinicians out there and maybe other supervisors that this person has had before that are going to decide that differently. So I have to approach this with like, here’s how I’m thinking of it. Other people might see it differently. So I have to like approach my conclusion with some humility. Now that doesn’t mean that I’m necessarily going to just
go with whatever the person says, but it does mean I have to kind of check myself and I have to really go through that reasoning process, right? Then there’s also the humility on the level of the interaction between you and the trainee, right? Because regardless of what you’re, you know, it’s not just what you’re talking about, it’s also how you’re talking about it, right? So,
you and your trainee had a difficult interaction over this disagreement, right? Something about it was not, you know, you had stuck feelings. So something about that interaction wasn’t working. And, you know, you have to have humility about that part to be like, you contributed to that interaction. There’s something that you did in the way that you either communicated to them or set them up to conceptualize this initially or
something that you did that didn’t work, right? And so this is where the swirl method is helpful because you can say, like, you can question and say, has this dynamic happened before? Have I had this feeling before with this trainee? Is there a pattern here? And then that’s the pattern that you can name, right? ⁓ You don’t just have to talk about, I
Stephanie (1:08:20)
Mm-hmm.
Alison Wilkinson-Smith (1:08:22)
I don’t agree with your diagnosis. You also can say like, gosh, we are really seeing this from different perspectives. you know, we’re having trouble kind of figuring out what’s the best thing to do here. And then that’s where you invite their perspective and then shift your response, right? And so like, you realize that you are one half of that dynamic.
and that you can look at your piece and you have to know what their piece is and how they experienced you. And then you change that, right? You respond in a different way or try to respond in a different way. I am really lucky in my academic medical setting to work with a lot of other supervisors. And so most of the time when I’m supervising a trainee, I’m not the only person supervising them.
And so one of the things that we often do is we’ll get together and say, I’m having this problem with this trainee. Is anybody else having this problem? And, you know, sometimes I find out, okay, it’s just me, right? Nobody else is experiencing this difficulty in their interaction with the trainee. So then I have to say, okay, what can I do differently? And sometimes, okay, we’re all having the same problem. And then we kind of all have to get together and think about how are we going to
Dr. Jeremy Sharp (1:09:12)
Hmm.
Mm-hmm.
Alison Wilkinson-Smith (1:09:39)
approach this with our trainees so that we can help them grow in the way that we feel that they need to grow.
Stephanie (1:09:48)
Right. And luckily, because we are assessment psychologists, this ability to integrate multiple sources of information about behavior that changes across context and across dyads, that’s what we do. So hopefully we can bring a lot of those same skills to our supervision if we’re have a little bit more support in making that.
translation of how to use those skills that we’ve honed so well and bring them to our supervision.
Dr. Jeremy Sharp (1:10:19)
Hmm, yeah, yeah, well said, well said. Well, y’all shared a ton of valuable info. And the best part is that this is essentially just the tip of the iceberg for everything that you’ve put together. So I’m guessing folks might want to learn more and there’s a way to do that. So tell us about this workshop that’s coming up and how folks might be able to find it.
Alison Wilkinson-Smith (1:10:45)
Yeah, so we are offering a workshop on May 15th on supervision and consultation for assessment. And if people are interested in learning more and potentially signing up, they can go to level2siteconsult.com. That’s the number two. So level2siteconsult.com. If you click on workshops and continuing education, they’re at the top of the page. It’ll bring you to the information for this particular workshop.
Stephanie (1:11:18)
And it’s three hours and they get CE credits and it will be recorded and there will be dessert metaphors and some bonus content and all kinds of things. we also, the early bird pricing was set to end, but because this got delayed a little bit, we’re going to offer the early bird pricing for a couple extra days for people to the, who just to give them a chance to hear about this and if they’re interested. So we’ll extend that for a couple more days.
Dr. Jeremy Sharp (1:11:18)
Fantastic.
fantastic. OK, that’s really good to hear. Yeah, I appreciate it. All right. So you heard it, folks. Come for the dessert. Stay for the knowledge. right. All right. Now, it was really good to chat with both of you. ⁓
Stephanie (1:11:56)
Yeah.
Alison Wilkinson-Smith (1:11:58)
There are so many more dessert metaphors to come for people who sign up. She has so many. It’s amazing.
Dr. Jeremy Sharp (1:12:01)
I can’t even imagine. Yes, yes, yes. Well, get them all. They’re all out there. All you have to do is register. So good to see both of you. Thank you again for coming back and having this conversation.
Stephanie (1:12:11)
Mm-hmm.
Thanks for having us.
Alison Wilkinson-Smith (1:12:19)
Thank you.
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