Motivational interviewing is defined as a “client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence” (Miller & Rollnick, 2002). In supervision of staff, the ultimate goal is to improve an organization’s efficiency by increasing productivity, decreasing employee stress, vicarious trauma and burnout, and reducing clinical negligence and malpractice. In supervision of interns, the major focus is on meeting the intern’s learning needs and on developing competent practitioners. Motivational interviewing in supervision maximizes focus and positive change by developing action plans and addressing ambivalence toward change. Motivational interviewing uses a guide toward change called FRAMES; the acronym stands for Feedback, Responsibility, Advice, Menu Options, Empathy and Self-Efficacy.
Field instructors solicit and offer regular feedback. They use active and reflective listening and open-ended questions to elicit information about interns’ interests and concerns. They provide a clear statement about the purpose of supervision; for example, they might say, “We are meeting today to talk about your roles and responsibilities as an intern in this agency.” Field instructors emphasize the collaborative aspect of supervision while acknowledging the power differential in supervision. They are careful to provide a safe space for interns to talk about concerns and areas of ambivalence, and to surface the meaning of resistance.
Field instructors make it clear that responsibility for an intern’s growth is shared by both the field instructor and the intern; they might say, “What you and I can decide together is what you want to invest in this learning process.” As Green, Shilts and Bacigalupe (2001) explain, “All voices should share equal partnership in the process, to the extent that this is possible.” Field instructors lay out clear expectations and point out any incongruity between an intern’s behavior and learning goals. At the same time, their own responsibilities to provide appropriate cases and supervision are spelled out in the agreement with the social work school.
Field instructors are repositories of knowledge and skill, who are responsible for providing helpful advice to interns. They offer a vision of possible change and suggest methods by which that change can be realized. For example, supervisors may share with students a technique such as open-ended questioning, a theory such as Cognitive Behavioral Theory, or help with bio-psycho-social assessment. Field instructors should be available for regular consultation, even during a session (Prouty et al, 2001).
Menu of Options
Field instructors present a menu of options to interns about the process of supervision and about possible interventions with clients. They might open a supervisory session by saying, “We could talk about how your work is going, how you feel about the latest challenge with your client, or something else. What might you suggest?” They present various possibilities and choices with regard to interventions, and encourage the value of multiple perspectives on every problem.
One of the most important foundations for the supervisory relationship is empathy. Empathy is especially important in difficult conversations when field instructors are naming challenges and surfacing interns’ ambivalence towards change. Field instructors need to preface these conversations by saying something like, “That was a hard job for you; I can’t imagine what it must have taken for you. The [client, system] is so frustrating. There are so many competing demands.” It is particularly important for field instructors to balance their concerns for clients with their concerns for interns.
The aim of field instruction is to build confidence as well as competence in interns. Field instructors need to focus not only on ambivalence but also on the self-efficacy of interns – the positive sense of self, and belief in one’s ability to grow and achieve. Field instructors might say, “You have shown some strength and courage that really makes me think you can do this. What do you think has helped so far? From where do you draw your strength and abilities?”
The Evaluation Process
FRAMES can be helpful not only in daily supervision but also in the process of evaluating interns. Field instructors and students begin honest collaborative discussions and feedback regarding students’ levels of knowledge and skills. They identify learning needs and define clear areas for growth. They take joint responsibility for conducting the evaluation, and acknowledge joint responsibility for interns’ progress and challenges. Both field instructors and interns clarify their commitment and dedication to the task of intern growth. Field instructors offer advice regarding goals for the next semester or the next year, and a menu of options for fulfilling those goals. Most important, in the evaluation process field instructors demonstrate empathy for interns’ experiences and faith in interns’ abilities to succeed. In these ways, motivational interviewing can contribute to a collaborative supervisory relationship based on honest admission of challenges, clear goals for growth, mutual responsibility, encouragement and respect.
Green, S., Shilts, L., & Bacigalupe, G. (2001). When approved is not enough: Development of a supervision consultation model. Journal of Marital and Family Therapy, 27, 515-525.
Miller, W., & Rollnick, S. (2002). Motivational Interviewing: Preparing people for change. New York: Guilford.
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Prouty, A. M., Thomas, V., Johnson, S., & Long, J. K. (2001). Methods of feminist family therapy supervision. Journal of Marital and Family Therapy, 27, 85-97.
Rudes, J., Shilts, L., & Berg, I. K. (1997). Focused supervision seen through a recursive frame analysis. Journal of Marital and Family Therapy, 23, 203-215.