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Change Talk
a blog about compassion, motivational interviewing, learning and growing
by Jesse Jonesberg (Berg)

Supervisors Helping Staff Thrive: The Self Discovery Conversation

9/20/2015

 
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One of the most important and most rewarding roles of a supervisor is supporting staff in their development by facilitating a staff's self reflection. In a clinical setting, this often means supporting staff in looking inward to identify both strengths and areas of growth. A good supervisor is able to guide a staff member in this reflective process and ultimately support a staff member in developing a plan to change their approach or actions in some way that improves their performance, self efficacy or outcomes. While supporting a staff in this self exploration can seem simple, it is one of the most challenging tasks that supervisors face.

A powerful way that I have found to help staff develop insight is through what I refer to as a "self discovery conversation" (SDC). The SDC is one in which the staff focuses on their clinical approach and interventions and explores alternatives. This conversation ideally allows the staff to "step outside themselves" or "remove their blinders" in an effort to gain new insights and perspective in their actions. A helpful outcome from this conversation may be one or two new ideas regarding how or what services they are providing. To this end "self discovery" or "reflection" may be the general aim of the conversation suggested by the supervisor, and the staff may identify a specific change goal for the conversation such as "I want to get better at setting boundaries with clients on the phone."
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Clarifying the role of supervision & discovering the change goal 
It is important the supervisor make explicit the role of the SDC. Knowing that the conversation is about the clinician (and not the client) can often help the staff member adopt a new perspective that focuses on self exploration. The supervisor can then help the staff to identify a goal for the conversation by asking questions and using reflections. The goal may be as specific as "how can I engage this specific client," or as general as "what have I been doing with clients that is leading to me feeling overwhelmed and burnt out." Once the change goal is identified, the supervisor is tasked with helping the staff stay focused on their circle of influence and on looking inward in the process of self discovery. To do this, the supervisor will often need to guide the staff back to this path of self exploration and help the staff member avoid traps and tangents along the way. 

Traps
There are a few important traps that commonly get in the way of the SDC, both supervisor and supervisee can fall for these traps so it is important to be vigilant during the conversation. I have described the traps that I or my staff typically fall into when having this type of conversation below, but there are most likely many more.

Blaming Trap
The blaming trap is a very common obstacle that gets in the way during these conversations. Staff will often blame clients, the environment and others during the conversation. This blaming is unproductive as it takes the focus away form things that the staff can control. The blaming trap shifts the focus from the internal exploration of "how can I do better" and shifts it towards the outward looking "what is going on with others." 

Venting Trap
I have had many negative experiences with staff venting and hope to write a future article that compiles much of the research that shows its uselessness as a workplace tool. Staff and supervisors can be seduced by quasi-productive allure of venting built up emotions, I have even heard the tern "positive venting" used. My experience with venting is that it is anything but positive. Venting in it's least benign form can sound like complaining and at its worst can end up solidifying frustration, anger or distain for clients. Venting can take the form of talking negatively about clients while they are not in the room, it can vilify and demonize those very people whom we serve. Ultimately, venting takes the focus of the conversation away from self discovery and towards the external. Similar to the blaming trap, staff and supervisors who fall into the venting trap end up leaving the path of self reflection.

Pseudo Therapy Trap
This trap comes up a lot for me. Being a natural "helper type" person who values compassion and empathy, I sometimes find myself down a rabbit hole with staff during these conversations. There is a gray area between the SDC that realtes to work and client care on one hand and personal struggles and issues on the other. Sometimes it can be useful and appropriate to link a personal experience to a workplace experience (for example when the supervisor is attempting to help the staff member build empathy towards a client experience), but when the conversation is overly focusing on the staff's personal experiences it needs to be guided back on track. While good supervisors have genuine compassion and empathy towards their staff, It is not the supervisor's role to provide any type of therapy. All of us have personal struggles and at times we all need help; when a supervisor notices a need for a staff to get help for their personal issues they must refer the staff to the company's EAP or another support. 

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Self Discovery Conversation Change Talk
In a SDC, it is important the the supervisor identify and reflect the change talk. Change talk in this conversation is talk about the desire, ability, reasons or needs for the staff to re-evaluate or change their own actions, approach or perspective regarding their goal. These words should lead up to the final goal of identifying one or two powerful insights that resonate with the staff. I have included some examples below.
  • "I really wish I could figure out how to help her" [desire]
  • "I have been able to work with other clients in similar situations" [ability]
  • "I keep getting frustrated and nothing seems to be working" [reason]
  • "The current approach is just not working, something needs to change" [need]

Staff often present with one or more of the above types of change talk. Often these statements are framed as a problem that exists with the client, the environment or another external factor. It then may be the role of the supervisor to guide the focus of the conversation towards the clinician and away from the client using OARS skills and role clarification. Below is an example of guiding a staff member back on track during the SDC:
Supervisee (EE): LaQuan doesn't have any options left, we have tried everything and he just can't find housing [other focused].
Supervisor (OR): It has been hard for you to figure out what your role is in his life [reflection - self focused].
EE: Yea, I just don't know what to do. I mean he has made a lot of bad decisions and these are his consequences [self focused, then other focused].
OR: Right, you didn't agree with his choices. Now you are feeling frustrated by the situation and it is a lot more work for you [Amplified reflection, self focused].
EE: Well, it's not that I don't want to work hard, I really want to help him. I am just not sure what to do here, I need to figure that out [self focused articulation of the change goal].
OR: Ah, I see. You are looking to figure out how to best help [reflection of self focused change goal].

When helping staff deepen and broaden change talk, I find it most helpful to give reflections. In the SDC it is vital that all ideas and suggestions come from the staff themselves. It would be impossible for a supervisor to do the self discovery work for the staff. Acting as a nonjudgemental mirror can help the staff person to try things out and judge for themselves how they want to proceed. Redirecting reflections can be used to keep the conversation on the topic of self exploration, reflections of patterns can be helpful in linking experiences, double sided reflections can help in validating sustain talk while focusing on change talk and reflecting feelings can sometimes help to identify staff feelings that are getting in the way of their work with clients.

I have also had success using some of the strategies for eliciting change talk with supervisees during this conversation. Envisioning the future is one strategy that seems to work very well with my staff. I may ask them "where do you see your relationship with the client in 6 months from now?" and then follow up with a discussion of ways to get to that point. Looking back is also a helpful way to help a staff member who is stuck in their path of self exploration: "how have you worked with other clients with similar issues?" Coming alongside of a frustrated staff can be effective if you have a strong relationship with that staff member. A supervisor may use the amplified reflection of "you are not able to work with people who have personality disorders," in order to attempt to get an argument against that statement.

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Closing the Conversation
Hopefully by the end of this conversation, the staff member will have brought up many different ways that they could approach their self development such as "be more mindful with clients," "take breaks more often between tasks," "check in with my supervisor more," etc. On the other hand, the staff member may be stumped and unable to identify many tangible ways to change and may say things like "I am not sure what to do," "I have already tried everything." 

In the first situation (the ideal case), the supervisor would provide a summary of the conversation and end the summary with an evocative question that invites the staff member to think in terms of actions. Then the supervisor can support the staff member in developing one or two things to "try out" over the next week:

Supervisor: So we have talked a lot about your work with LaQuan today. You know that he made decisions that have led him to where he is with his housing, but then you said your role is not to tell him about how bad his decisions are [laugh]. You said that the most important thing to do is to be there for him and keep your strong relationship. While you could be better at adopting a more guiding style with him, overall your relationship is great and he is appreciative of your service. He even says you are one of the most helpful people he has worked with. You noted that in your zeal to help, sometimes you forget that your role is not to save the day and that role confusion causes frustration for you. What do you think?
Supervisee: Right, I know I am helping him. I am just worried about him. I think you are right. Role confusion. I need to remind myself of my role in his life. I can't just jump in and make every thing better in one week. But that is hard.
OR: Well, we only have five minutes left today, but what is one or two small things you could do try out this week to try to remind yourself of that role?
EE: I think it would help to have the conversation with LaQuan directly, that would help to be sure we are on the same page, that would be a good place to start.
OR: Great. I really look forward ot hearing about how that conversation goes, I think that you are on to something!

In the case that a staff member has not been able to identify many options in terms of self development, it is important that the supervisor not argue with the staff or impose ideas onto the staff. The goal should be to plant a seed and check back in next week to see if any new ideas grew over that week.

Supervisor: So we talked a lot about Liz. You are not sure where to go with her and feel like you have tried a lot already and are out of ideas. I had a couple of ideas and I know that your colleagues mentioned some ideas as well - but you are not sure that those will work either. I know that sometimes it takes some extra thinking and research to solve problems. What do you think you will do?
Supervisee: I guess the same as I always do, just try to tell her the risks of her behaviors again.
OR: OK, so continuing to remind her the risks that she is taking [simple reflection]. Would it be OK if I gave you a request for the next week [asking permission]?
EE: Sure, I am open to anything that would help [giving permission].
OR: OK, great, well next time you meet with Liz I would like you to take 3 minutes before meeting her to center yourself so that you can have a clear mind going into the situation. When we approach a situation calmly and without judgement (as you know) sometimes this can help us to notice new things about how we are interacting with others. We can talk about your experience with that next week [homework assignment].
EE: I will give it a try.

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Often the SDC is just the beginning. The plan that you come up with in collaboration with the staff may or may not come to fruition. In my experience, it is often the week after this conversation that the staff really engages in complete self discovery. The SDC merely plants the seed and fertilizes the ground so that it is primed for self discovery and reflection. Just as a plant's initial growth is underground, much of a staff's self development may not initially be visible to the supervisor, but the supervisor must trust in the process and trust in the staff's ability to self develop given quality guidance. Simply by making this conversation a priority in supervision, the supervisor is showing the importance of professional development. By not solving problems for the staff, the supervisor is showing that the owness is on the staff to self correct and develop their own skills and approach. 





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    About the Author

    Jesse Jonesberg (Berg) is a mental health professional, field instructor, trainer, and MINT member. He is passionate about issues of mental health, cultural humility, compassion,  and motivational interviewing. 

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