Modelos contemporáneos de supervisión clínica: nuevas direcciones

Ana Lilia Villafuerte Montiel

doi:10.19136/mhr.a5n1.4210

Autores/as

Ana Lilia Villafuerte Montiel Universidad Iberoamericana

DOI:

https://doi.org/10.19136/mhr.a5n1.4210

Palabras clave:

modelos de supervisión, supervisión clínica, psicoterapia, supervisión del desarrollo, modelos de proceso, basados en evidencia, factores comunes

Resumen

La supervisión clínica es una actividad profesional diseñada para formar psicoterapeutas competentes y éticos, cuyas intervenciones sean eficaces para brindar un servicio de alta calidad a los pacientes. Cumple con funciones formativas, restaurativas y normativas, las cuales dependen en buena medida del modelo de supervisión que se emplee. En este artículo se presenta una revisión de la literatura para dar cuenta de las categorías de modelos existentes y se proporciona una síntesis de algunos modelos comúnmente empleados en la supervisión. Se consultaron bases académicas pertenecientes a EBSCO, específicamente Psychology & Behavioral Sciences Collection, así como ERIC, PsycArticles y Google Scholar, y se seleccionaron artículos que comprendidos entre 1995 y 2020 para llevar a cabo este análisis. La consulta empleó palabras clave en inglés: “clinical supervision”, “supervision”, “competence”, “competency-based”, “evidence-based supervision” y “psychotherapy-based supervision”. Se presentan cuatro categorías de modelos, tres de las cuales son globalmente aceptadas y la cuarta se ofrece como una propuesta a integrar porque cuenta con características específicas y representa la evolución que ha tenido el área y está sustentada por la investigación.

Citas

American Psychological Association. (2014). Guidelines for Clinical Supervision in Health Service Psychology. http://apa.org./about/policy/guidelines-supervision.pdf

Andersen, T. (1994). El equipo reflexivo: diálogos y diálogos sobre los diálogos. México: Gedisa.

Anderson, H & Swim, S. (1995). Supervision as a Collaborative Conversation: Connecting the voices of a supervisor and supervisee. Journal of Systemic Therapies, Vol.14, pp 1-13. https://doi.org/10.1521/jsyt.1995.14.2.1

Bernard, J. & Goodyear, R. (2014). Fundamentals of clinical supervision (5th. Ed.). Estados Unidos: Pearson Education.

Borders, L.D., Glosoff, H.L., Welfare, L.E., Hays, D.G., DeKruyf, L., Fernando, D.M. & Page, B. (2014). Best Practices in Clinical Supervision: Evolution of a Counseling Specialty. Faculty Publications - Graduate School of Counseling- Paper 7.

https://digitalcommons.georgefox.edu/cgi/viewcontent.cgi?article=1007&context=gsc

Bradley, L. J., & Gould, L. J. (2001). Psychotherapy-based models of counselor supervision. In L. J. Bradley & N. Ladany (Eds.), Counselor supervision: Principles, process, and practice (3rd ed., pp. 147–180). Filadelfia: Brunner-Routledge.

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17–31. https://doi.org/10.1016/j.cpr.2005.07.003

Corey, G., Haynes, R., Moulton, P. & Muratori, M. (2010). Clinical supervision in the helping professions: a practical guide (2nd ed.). Estados Unidos: American Psychological Association.

David, D., Lynn, S.J. & Montgomery, G.H. (2018). Evidence-based psychotherapy: The state of the science and practice. Hoboken, NJ: John Wiley & Sons, Inc.

Eagle, G. & Long, C. (2014). Supervision of the Psychoanalytic/Psychodynamic Psychotherapy. En Watkins, E., & Milne, D. (Eds.). The Wiley International handbook of clinical supervision (pp. 471-492). Reino Unido: John Wiley & Sons, Ltd.

Ekstein, R., & Wallerstein, R. (1972). The teaching and learning of psychotherapy (2da. Ed.). Nueva York: International Universities Press, Inc. https://psycnet.apa.org/record/1973-26882-000

Falender, C. & Shafranske, E. (2004). Clinical supervision: a competency-based approach. Estados Unidos: American Psychological Association.

Falender, C. A., & Shafranske, E. P. (2010). Psychotherapy-based supervision models in an emerging competency-based era: a commentary. Psychotherapy (Chicago, Ill.), 47(1), 45–50. https://doi.org/10.1037/a0018873

Falender, C.A., Shafranske, E.P. & Ofek, A. (2014). Competent clinical supervision: Emerging effective practices. Counselling Psychology Quarterly, 27 (4), 393-408. https://doi.org/10.1080/09515070.2014.934785

Farber, E. W. (2010). Humanistic-existential psychotherapy competencies and the supervisory process. Psychotherapy Theory, Research, Practice, Training, 47, 28–34. https://psycnet.apa.org/doi/10.1037/a0018847

Frawley-O’Dea, M. G., & Sarnat, J. E. (2001). The supervisory relationship: A contemporary psychodynamic approach. New York: Guilford Press.

Friedlander, M. L. (2015). Use of relational strategies to repair alliance ruptures: How responsive supervisors train responsive psychotherapists. Psychotherapy, 52, 174–179. http://dx.doi.org/10.1037/a0037044

Gergen, K. (1997). El Surgimiento de la Cultura Posmoderna. En K.Gergen (Editor). El Yo Saturado (pp. 150-182). Barcelona: Paidós.

Grant, J., Schofield, M. J., & Crawford, S. (2012). Managing difficulties in supervision: Supervisors’ perspectives. Journal of Counseling Psychology, 59, 528–541. http://dx.doi.org/10.1037/a0030000

Hawkins, P. (1985). Humanistic psychotherapy supervision: A conceptual framework. Self and Society: Journal of Humanistic Psychology, 13 (2): 69–79. https://doi.org/10.1080/03060497.1985.11084674

Hawkins, P. & McMahon, A. (2020). Supervision in the Helping Professions (5th Edition). Londres: McGraw-Hill Education (Open University Press).

Hawkins, P., & Shohet, R. (2006). Supervision in the helping professions: An individual, group and organization approach (3rd ed.). Philadelphia, PA: Open University Press.

Hoffman, L. (1996). Una Postura Reflexiva para la Terapia Familiar. En S. McNamee y K. Gergen (Editores). La terapia como construcción social (pp.25-43). Barcelona: Paidós.

Holloway, E. & Neufeldt, S. (1995). Supervision: Its contributions to treatment efficacy. Journal of Consulting and Clinical Psychology, 63, 207-213. https://psycnet.apa.org/doi/10.1037/0022-006X.63.2.207

Jones-Smith, E. (2016). Theories of counseling and psychotherapy: An integrative approach (2da.Ed.). California: Sage.

Kaslow, N. J., Rubin, N. J., Forrest, L., Elman, N. S., Van Horne, B. A., Jacobs, S. C., Huprich, S. K., Benton, S. A., Pantesco, V. F., Dollinger, S. J., Grus, C. L., Behnke, S. H., Miller, D. S. S., Shealy, C. N., Mintz, L. B., Schwartz-Mette, R., Van Sickle, K., & Thorn, B. E. (2007). Recognizing, assessing, and intervening with problems of professional competence. Professional Psychology: Research and Practice, 38(5), 479–492. https://doi.org/10.1037/0735-7028.38.5.479

Ladany, N., Friedlander, M. L., & Nelson, M. L. (2005). Critical events in psychotherapy supervision: An interpersonal approach. Washington, D.C: American Psychological Association.

Ladany, N., Friedlander, M. L., & Nelson, M. L. (2016). Supervision Essentials for the Critical Events in Psychotherapy Supervision Model. Washington, D.C: American Psychological Association. (Edición Kindle) http://dx.doi.org/10.1037/14916-000

Ladany, N., Mori, Y. & Mehr, K. (2013). Effective and ineffective supervision. The Counseling Psychologist, 41 (1), 28–47. https://doi.org/10.1177%2F0011000012442648

Liese, B. S., & Beck, J. S. (1997). Cognitive therapy supervision. En C. E. Watkins (Ed.), Handbook of psychotherapy supervision (pp. 114–133). Nueva York: Wiley.

Loganbill, C., Hardy, E., & Delworth, U. (1982). Supervision: A Conceptual Model. The Counseling Psychologist, 10(1), 3–42. https://doi.org/10.1177/0011000082101002

McNamee, S. & Gergen, J.K. (1999). Relational Responsibility: Resources for Sustainable Dialogue. California: Sage Publications.

McNeill, B. & Stoltenberg, C. (2016). Supervision Essentials for the Integrative Developmental Model. Estados Unidos: American Psychological Association.

Miller, S., Duncan, B. & Hubble, M. (2004). Beyond Integration: The Triumph of Outcome Over Process in Clinical Practice. Psychotherapy in Australia, 10, 2, 2-19. https://scottdmiller.com/wp-content/uploads/documents/BeyondIntegration.pdf

Milne, D. (2007). An empirical definition of clinical supervision. British Journal of Clinical Psychology, 46, 437-447. https://doi.org/10.1348/014466507X197415

Milne, D., Aylott, H., Fitzpatrick, H., & Ellis, M. V. (2008). How does clinical supervision work? Using a “best evidence synthesis” approach to construct a basic model of supervision. The Clinical Supervisor, 27(2), 170–190. https://psycnet.apa.org/doi/10.1080/07325220802487915

Milne, D., & Reiser, R. P. (2012). A rationale for evidence-based clinical supervision. Journal of Contemporary Psychotherapy: On the Cutting Edge of Modern Developments in Psychotherapy, 42(3), 139–149. https://doi.org/10.1007/s10879-011-9199-8

Monk, G., & Gehart, D. R. (2003). Sociopolitical activist or conversational partner? Distinguishing the position of the therapist in narrative and collaborative therapies. Family process, 42(1), 19–30. https://doi.org/10.1111/j.1545-5300.2003.00019.x

Morgan, M. M., & Sprenkle, D. H. (2007). Toward a common-factors approach to supervision. Journal of Marital & Family Therapy, 33, 1–17. https://doi.org/10.1111/j.1752-0606.2007.00001.x

Newman, C. F. (2010). Competency in conducting cognitive–behavioral therapy: Foundational, functional, and supervisory aspects. Professional Psychology, Research and Practice, 47(1), 12–19. https://psycnet.apa.org/doi/10.1037/a0018849

Norcross, J. & Popple, L. (2017). Supervision Essentials for Integrative Psychotherapy. Estados Unidos: American Psychological Association.

Norcross, J.C. & Wampold, B.E. (2018). A new therapy for each patient: Evidence‐based relationships and responsiveness. Journal of Clinical Psychology, 1–18. https://doi.org/10.1002/jclp.22678

O'Donovan, A., Halford, W.K. & Walters, B. (2011), Towards Best Practice Supervision of Clinical Psychology Trainees. Australian Psychologist, 46: 101-112. https://doi.org/10.1111/j.1742-9544.2011.00033.x

Pack, M. (2009). Supervision as a liminal space: Towards a dialogic relationship. Gestalt Journal of Australia and New Zealand, 5, 60–78. https://core.ac.uk/download/pdf/41336304.pdf

Pearson, Q.M. (2006). Psychotherapy-driven supervision: Integrating counseling theories into role-based supervision. Journal of Mental Health Counseling, 28 (3), p241-252. https://psycnet.apa.org/doi/10.17744/mehc.28.3.be1106w7yg3wvt1w

Pretorius, W. M. (2006). Cognitive–behavioural therapy supervision: Recommended practice. Behavioural & Cognitive Psychotherapy, 34, 413–420. https://psycnet.apa.org/doi/10.1017/S1352465806002876

Reiser, R. P., & Milne, D. (2012). Supervising cognitive-behavioral psychotherapy: Pressing needs, impressing possibilities. Journal of Contemporary Psychotherapy, 42, 161-171. https://psycnet.apa.org/doi/10.1007/s10879-011-9200-6

Rigazio-DiGilio, S. (2014). Supervising Couple and Family Therapy practitioners. En Watkins, C.E. Jr. and Milne, D. (Eds). The Wiley international handbook of clinical supervision (pp. 204-237). Reino Unido: John Wiley & Sons, Ltd.

Roth, A.D. & Pilling, S. (2015). A competence framework for the supervision of psychological therapies. Research Department of Clinical, Educational and Health Psychology. https://www.ucl.ac.uk/pals/sites/pals/files/background_document_supervision_competences_july_2015.pdf

Salvador, J. T. (2016). Integrated Development Model (IMD): A Systematic Review and Reflection. European Scientific Journal, ESJ, 12(19), 244. https://doi.org/10.19044/esj.2016.v12n19p244

Sarnat, J. E. (2010). Key competencies of the psychodynamic psychotherapist and how to teach them in supervision. Psychotherapy: Theory, Research, Practice, Training, 47, 20–27. https://psycnet.apa.org/doi/10.1037/a0018846

Schwartz, H. (2015). International Psychoanalytical Association: Variations on the Eitingon Training Model. https://www.ipa.world/IPA/iParts/Common/ContentBlock/PostDefault.aspx?iUniformKey=44e29c57-5eb0-4c26-8345-6382aa2bbb3a&ReplyOptions=fa238730-e491-477c-a6e8-d52f298aa9dc&TagKeys=44936ae9-ad33-49d6-8384-25e7e19a90e4&DefaultHtmlSessionKey=910b11e8-f825-472f-a4da-9b7b6f5d8f50&WebsiteKey=

Simon, G. (2010). Self-supervision, surveillance and transgression. Journal of Family Therapy, 32, pp. 308–325. https://doi.org/10.1111/j.1467-6427.2010.00505.x

Skovholt, T.M, & Rønnestad, M.H. (2003). Struggles of the novice counselor and therapist. Journal of Career Development, 30(1), 45-58. https://doi.org/10.1177%2F089484530303000103

Stoltenberg, C., Bailey, K. C., Cruzan, C.B., Hart, J. T. & Ukuku, U. (2014). The Integrative Developmental Model of Supervision. En Watkins, C.E. Jr. and Milne, D. (Eds). The Wiley international handbook of clinical supervision (pp. 576-597). Reino Unido: John Wiley & Sons, Ltd.

Tarragona, M. (1999). La Supervisión desde una Postura Posmoderna. Psicología Iberoamericana, Vol,7, pp. 68-76.

Todd, T. & Storm, C. (2014). The Complete Systemic Supervisor: Context, philosophy and pragmatics (2a. Ed). Estados Unidos: Wiley- Blackwell.

Vethencourt D’Escrivan, V. (2018). Cómo vivencian los psicoterapeutas en formación el inicio de su entrenamiento y la supervisión. Psicología Iberoamericana, 26(1), 64-72. https://psicologiaiberoamericana.ibero.mx/index.php/psicologia/article/view/34

Villafuerte, A.L.(2016). La Práctica de la Supervisión Clínica en México: Una Actividad Profesional en Desarrollo. Multidisciplinary Health Research, 1(2), 43-46. https://doi.org/10.19136/mhr.a1n2.1560

Watkins, C. E. (1995). Psychotherapy supervision in the 1990s: Some observations and reflections. American Journal of Psychotherapy, 49, 568–581.

Watkins, C.E. (2020). Psychotherapy supervision: an ever-evolving signature pedagogy. World Psychyatry, 19-2 (Junio), 244-245. https://doi.org/10.1002/wps.20747

Watkins, E., & Milne, D. (2014). The Wiley International handbook of clinical supervision. Reino Unido: John Wiley & Sons, Ltd.

Wheeler, S. & Richards, K. (2007). The impact of clinical supervision on counsellors and therapists, their practice and their clients. A systematic review of the literature. Counselling and Psychotherapy Research, 7, 54-65. https://doi.org/10.1080/14733140601185274

White, M. (1997). Supervision as Re-authoring Conversation. En M. White (Editor). Narratives of Therapists´ Lives (pp.148-241). Adelaide: Dulwich Center Publications.