Neste trabalho, configura-se uma pesquisa para a apresentação de uma leitura fenomenológica existencial da prática profissional em saúde e educação. Parte-se de um questionamento que, dirigindo-se à compreensão da dimensão de ser clínico, atravessou tanto a vida quanto a profissão do pesquisador. Tal empreitada requer que se atenha em temáticas básicas pertinentes a essa prática. Tendo o horizonte delineado pela ontologia fundamental de Martin Heidegger, contida em sua obra \"Ser e Tempo\", o desenvolvimento dos temas recorre a situações da própria prática, sobretudo, em referência ao Plantão Psicológico, uma modalidade de Aconselhamento Psicológico, por ser constituinte da experiência profissional do pesquisador em instituição de ensino em Psicologia. Na exploração desses temas, buscam-se subsídios à prática profissional especificada na antropologia filosófica proposta nessa obra. Para isso, recobram-se explicitações elucidativas dentro de cada capítulo e nos capítulos, que se constituem em ensaios. Inicialmente, apresenta-se a hermenêutica interpretativa, metodologia norteadora desse trabalho, pontuando seus pressupostos e questões peculiares cruciais. No ensaio seguinte, abordando-se a situação como manifestação da existência, discorre-se sobre questões relevantes, tais como poder-ser, facticidade, realidade, mundanidade, linguagem, interpretação. A seguir, explicitam-se as facetas da pluralidade e singularidade do eu, reportando-se à impropriedade, propriedade, solicitude, angústia, cuidado, sentido, finitude e consciência. Após, fala-se do eu como tempo e história, acontecendo em destinação. Num último ensaio, traz-se em cena a dimensão de ser clínico como educador, a qual se sustenta na determinação ontológica de ser-em do eu, expondo sua condição de ser afetado, compreender e falar; novamente, são retomados, entre outros, os assuntos da angústia, interpretação, sentido e linguagem. Espera-se que o principal resultado a ser realçado haja sido a consecução de uma nova perspectiva que integra clínica e educação. / In this work one presents a research and a particular reading of an existential and phenomenological view of the practicing professionals in the health and education activities. One departed from a questioning that, aimed at the comprehension of what is to be a clinical professional, broke through both, the personal life and the profession of the researcher. This undertaking required sticking to the basic thematic related to this particular professional practice. With the surrounding horizon delineated by Martin Heidegger´s fundamental ontology, out of his work \"Being and Time\", the development of the themes goes after situations of the practice itself, moreover related to the Psychological Emergency Attendance, a form of Psychological Counseling, a part of the professional experience of the researcher in a teaching institution of Psychology. In the exploration of these themes, relevant elements are sought for the professional practicing as specified in the philosophical anthropology proposed at his work. For this, explanations are requested, again and again, within each chapter and at each of the chapters which are themselves essays. In the beginning, the interpretative hermeneutics is presented, to be the guidance of the work, pointing to the assumptions underlying it, and to crucial decurrently questioning as well. In the essay that follows, focusing the situation under the point of view of a manifestation of the existence, one speaks on relevant topics, such as potentiality-for-being, facticity, realness, worldliness, language and interpretation. Following suit are made explicit the facets of the plurality and of the singularity of the \"I\", in respect to the impropriety, propriety, solicitude, anxiety, care, meaning, finiteness and consciousness. Afterward one speaks on the \"I\" as time and history, happening in its destination. In a last essay, the dimensions of the clinical being as an educator is brought into the stage, which are supported by the ontological determination of being-in of the \"I\", exposing its condition as subject to be affected, of understanding and discourse, again retaking the topics of anxiety, interpretation, meaning and language, among others. Perhaps, the major result to emphasize is a new integrated comprehension of clinic and education.

The present study examined the relationship between the occurrence of reported supervision and the professional practices of school psychologists. Information provided by more than 1,700 school psychologists in response to the National Association of School Psychologists: Demographic and Professional Practices Survey 1999-2000 School Year - NASP-DPPS 2000 survey were used to create the 1999-2000 national database (Curtis, et al., 2000) and served as the basis for secondary analyses in the current study. The NASPDPPS 2000 collected information regarding the demographic characteristics, employment conditions and professional practices of school psychologists the United States. Correlational and multiple regression analyses were completed to examine the relationship between professional practices and the reported receipt of supervision, background of the supervisor, and ratio of school psychologists to supervisor. Professional practices did not appear to be significantly related to vary as a function of the occurrence of reported supervision. School psychologists reporting receiving supervision completed significantly more initial psychoeducational assessment and reevaluations than school psychologists who reported not receiving supervision. Initial pyshcoeducational assessment and reevaluations are professional practices that can be categorized as special education and direct service delivery model. The subsample of school psychologists who reported the occurrence of supervision was examined for the remaining analyses. In addition, supervised school psychologists' professional practices did not vary as a function the supervisor's type of educational background (i.e., school psychology or non-school psychology), and level of educational preparation (i.e., doctoral or nondoctoral). Finally, the school psychologists-to-supervisor ratio and nature of the school psychologists' professional practices was examined. The remaining correlations were considered non-significant. It was noted that the questions included in the NASP-DPPS 2000 survey did not allow for specific information about the type, topography, or quality of supervision. This limitation precluded drawing specific conclusions regarding the research questions addressed.

Substance abuse counseling has many counselors and supervisors who are in recovery from a personal history of substance abuse. Approximately 37% of supervisors in the substance abuse field reported being in personal recovery (Eby, Burke, & Birkelbach, 2009). Little is known about how a clinical supervisor’s personal recovery influences his or her clinical supervision. The purpose of this phenomenological research study was to investigate the perceived lived experiences of clinical supervisors’ in recovery during the clinical supervision of substance abuse counselors working towards a license or credential in Louisiana. A qualitative phenomenological methodology, Interpretative Phenomenological Analysis (IPA) was used to analyze data from six clinical supervisors in recovery using semi-structured interviews. Themes emerged from the data, which resulted in 13 categories: 1) functions of supervision; 2) factors influencing the supervision relationship; 3) insight into addiction; 4) factors pertaining to self-disclosure; 5) managing dual relationships; 6) recovery isn’t enough; 7) relapse potential and management; 8) stigma of addiction; 9) structure of supervision; 10) countertransference; 11) feelings about self-disclosure; 12) importance of self-care; and 13) supervisors need supervision and consultation The categories provide increased understanding and insight into how recovery influences and were used in supervision by supervisors in recovery. Implications for supervisors in recovery, supervisees of supervisors in recovery, and clinical supervisor educators are also addressed.

Clinical supervision is an essential component in a social work student’s education and development in the field. Social work students should feel comfortable with their clinical supervisors in order to appropriately self-disclose during supervision and gain the ability to recognize countertransference when working with clients. The significance of this is that students should be aware of their feelings and learn how to process these reactions during supervision. A mixed methods approach was utilized, surveying and interviewing students and clinical supervisors affiliated with California State University, San Bernardino. A Pearson correlation coefficient was conducted to determine the relationship between the strength of the supervisory relationship and the ability of social work students to recognize countertransference. The findings of this study suggested that there are significant relationships between the supervisory relationship and perceptions of self-disclosure and countertransference. Based on the qualitative analyses, eight central themes emerged regarding supervision practices and the relationships between students and supervisors. The implications of this study should impact how clinical supervisors foster the development of strong relationships with student interns. This should allow students to gain skills to succeed and provide better services to clients.

As school counseling interns graduate and transition to a professional school counseling work world, there are issues which may affect their personal and professional development, such as ongoing skill acquisition, keeping current in the field, and reflective awareness of professional counselor growth. Counselor educators continually seek approaches and methods of training school counseling interns with potential for transference to the world of practicing school counselors. However, translating ongoing supervision of school counselors to the real world setting can prove problematic. First, there is a lack of clinical supervision after graduation, and then any supervision received tends to be provided by school administrators. This exploratory study sought to explore the potential of one model of group supervision, which could potentially translate into the real work world of practicing school counselors. The purpose of the study was to explore the experiences of school counseling interns' with a reflecting team model of group supervision, Structured Reflecting Team Supervision (SRTS), during the final, internship semester. A qualitative method was used for this exploratory study due to the scant research in the areas of clinical group supervision and the SRTS model with the school counseling intern population. This study was designed to answer the following research question: What are the experiences of school counseling interns exposed to the reflecting team model of group supervision throughout their internship semester? Data consisting of structured open-ended interview guides (SOIG) were gathered three times throughout the semester. Data was also gathered one time through a separate SOIG at the end of the semester from the academic supervisors to ensure consistency of the use of the model. Study participants found hearing multiple perspectives on the same case to be the most important aspect of their time together. Several participants suggested an earlier start to the SRTS model might provide an opportunity to follow the cycle of new idea implementation and reporting back progress from those ideas. A number of participants looked forward to trying the model in the field through peer consultations to meet the needs for further clinical supervision.

The overall aim of the thesis was to describe caregivers’ experiences of caring for women with breast cancer on a surgical ward. The study was based on interviews with narrative parts and tape-recorded clinical supervision sessions. The interviews and clinical supervision sessions were transcribed verbatim, and analysed by content analysis. Nurses (n=10) described life for women with breast cancer as either having freedom or not having freedom, with both physical and existential suffering. Dying occurred either naturally in patients’ own home or unnaturally in hospital. The nurses felt that it is possible to alleviate suffering during dying through providing adequate pain relief but also, through listening, providing information and changing the caring atmosphere (I). Breast cancer as an illness was described from a dark point of view by caregivers (n=37). The descriptions focused on loss of breasts and control, progression of the illness and annihilation. The illness seemed, in the caregivers’ mind, to often end with a painful death. Caregivers who had the opportunity to follow the total care process described a lighter viewpoint (II). According to nurses (=31) the most important needs among women, their relatives and nurses themselves were the needs to talk and receive information. There was a discrepancy between what was described as important needs and the descriptions of how these needs were provided for. Nurses, whose own needs for support were sometimes unsatisfactorily met (III), seemed almost to be unaware of the needs among women and their relatives. In the clinical supervision sessions caregivers reflected on difficult care situations related to women’s, relatives’, and most often caregivers’ feelings (n=38). The care situations were described as evoking feelings of discomfort, powerlessness and reduced self-esteem. These feelings were described by caregivers as arising in connection with caring for especially women with advanced breast cancer in a changing organisation (IV). Caregivers’ descriptions of caring for women with breast cancer show a lot of negative experiences of powerlessness and frustration. They met women and their relatives who suffered in various ways and had considerable need for support. Caregivers often found themselves unable to meet these needs due to organisational obstacles e.g. lack of time and lack of knowledge about other caregivers’ responsibility in the care.

Moralisk stress påverkar sjuksköterskan och kan ses som ett resultat av yttre faktorer. Det finns ett ökat krav på att sjuksköterskan ska klara av att hantera moraliskt, stressade situationer. Genom handledning kan sjuksköterskan få hjälp att verbalisera sina upplevelser. Syftet  är att belysa på vilket sätt omvårdnadshandledning kan bidra till att sjuksköterskan kan hantera den moraliska stressen med fokus på omvårdnadshandledningens struktur och innehåll. En litteraturstudie har genomförts där tio artiklar granskats och analyserats. För att få en förståelse för omvårdnadshandledning har en teoretisk referensram om omvårdnadshandledningens uppbyggnad, struktur och innehåll används. Resultatet visar att handledning kan påverka sjuksköterskans och övrig vårdpersonals moraliska stress i både positiv och negativ riktning då den etiska kompetensen hos deltagarna ökar. Vidare framkommer det att personalen ibland väljer kamratstöd istället för organiserad handledning. Etisk kompetens kan stärkas genom handledning och öka deltagarens förmåga till eftertanke och reflektion. Detta kan dock leda till att sjuksköterskan hämmas att hantera situationer som innefattar etiska problem, då hon eller han blir allt för kritisk i sitt förhållningssätt. Det finns dock anledning att anta att handledning stärker sjuksköterskans beslutskapacitet och självförtoende att handla i etiskt svåra situationer. / Moral stress affects the nurse and can be seen as a result of external factors. There is a growing demand that the nurse should be able to handle moral stressful situations. Through clinical supervision the nurse may be helped to verbalize her experiences. The aim of this study is to illustrate the way in which clinical supervision can help the nurse to deal with moral stress, focusing on the structure and content of clinical supervision. A literature study has been conducted. Ten articles have been reviewed and analyzed. To create an understanding for clinical supervision a theoretical framework has been used focusing on the structure and content of clinical supervision. The results show that the clinical supervision may affect the nursing staff’s moral stress, in both a positive and negative way, when the ethical competence of participants increases. Furthermore, it appears that staff sometimes chooses to turn to colleagues for support instead of organized clinical supervision. Ethical competence may increase through clinical supervision when increasing the participant's ability to reflect upon an ethical situation. However, this can harm the nurses’ ability to deal with future situations involving ethical issues when seeing a situation from a critical approach. Supervision, however, strengthens the nurses’ decision-making capacity and strengthens her confidence to act in ethically difficult situations.

Pediatric mental health nurses, working in an agency in the midst of introducing Trauma Informed Care, were interviewed to examine the factors influencing perceptions of aggression. Relational Inquiry (Hartrick Doane & Varcoe, 2005; 2007) framed the research and Kvale’s (1996) Interpretive Methodology informed the interview and analysis. The complexity of relationships impacted the participants’ perceptions. Two constructs interwoven throughout the findings: time to develop relationships and knowledge about the individuals with whom the relationships were to be formed. Five themes were identified however the Participant-Colleague relationship was critical to perceptions of aggression. The Participant-Child relationship and the functioning of the system of care were important. The participants recognized reflexivity as critical to the understanding of their perceptions. The participant’s created a common understanding of aggression. Recommendations include: 1) clinical supervision to explore issues of moral distress and burnout 2) create capacity for nursing research 3) expand research exploring ‘safety’, ‘support’ and observational studies. / Graduate

abstract: Multicultural counseling competencies (MCCs) are fundamental to the ethical practice of providing services to clients. One such competency is the aspect of self-awareness of one's own worldview. As such, it is incumbent that attention to counselor's self-awareness be a part of clinical training. While research has begun to examine multicultural supervision, much of the research holds assumptions about the types of multicultural discussions that take place, as well as what may actually occur within these sessions. Little is known about what is discussed and how. This exploratory, qualitative study examined what actually occurs within clinical supervision sessions with regard to having discussion of multicultural perspectives, as well as how supervisors and supervisees experience these discussions. Five supervisory dyads from university counseling centers in the southwest were recruited to engage in a guided discussion of multicultural perspectives (DMP) in a supplemental supervision session. In these DMPs, dyads were asked to discuss issues related to personal identity, as well as to discuss the relevance of having such discussions in clinical supervision. Both the supervisors and supervisees then engaged in follow-up telephone interviews with the researcher to discuss their experience in having this discussion. All supervision sessions and follow-up interviews were recorded and transcribed. Grounded theory was used to analyze the transcribed sessions and the follow-up interviews for emergent themes. Four domains emerged from the data: dynamics in the relationship, cultural lens, characteristics of the discussion, and impact of the discussion. Further, several areas of congruence between supervisors' and interns' accounts of what occurred during the DMP, as well as congruence between supervisors' and interns' accounts of what occurred and what actually happened during the DMPs were discovered. These areas of congruence that emerged included power, similarities, differences, comfort level, enjoyment, intentionality for future work and increased awareness. The one distinct pattern of incongruence that emerged from the data was in the category of increased connection in supervisory relationship. A theoretical model of supervisors' and interns' experiences in discussions of multicultural perspectives is included. Implications, limitations and suggestions for future research are explored. / Dissertation/Thesis / Ph.D. Counseling Psychology 2010

This study preliminarily identified clinical supervision competencies needed for alcohol and other drug abuse (AODA) clinical supervisors for integration into rehabilitation counselor training (RCT) curriculum. The Delphi method via LimeSurvey® was utilized to identify competencies specific to AODA clinical supervision. A panel of six experts in RCT and AODA clinical supervision completed five rounds of data collection beginning with an open-ended question. Consensus and stability of responses were calculated following Rounds 2-5 of data collection. Panelist fatigue resulted in data collection being discontinued after Round 5, prior to a consensus or stability of responses being reached. A total of 115 competencies and 51 competency sub-items were administered in Round 5. Results suggested that a consensus was not reached on items as one panelist represented a minority view on many items during multiple rounds of data collection. This panelist discontinued responding during the fifth round of data collection. Rank analysis of items based upon mean response was inconclusive due to limited sample size and response options. Sub-item analysis revealed mixed results regarding original competencies versus sub-items. At times a competency was rated higher, at times a sub-item was rated higher, and in other examples a second sub-item was rated higher. A clear pattern of responses for sub-items was not evident upon visual inspection of mean responses. Content analysis with two reliability raters in addition to the primary investigator suggested competencies fell into seven content areas: Legal and Ethical Concerns; Organizational Management, Administration, and Program Development; Personal Characteristics and Skills of Leadership; Supervisee Performance Evaluation and Feedback; Supervisory Relationship; Theory, Roles, and Interventions of Clinical Supervision; and Treatment Related Knowledge and Skills. Implications for the field, supervisors, supervisees, and rehabilitation educators; limitations including panel and data collection, technology, and reliability and validity; and future research were discussed.