Obsessive-compulsive is a mental disorder that is characterized by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviors.OCD often centers on themes such as a fear of germs or the need to arrange objects in a specific manner. Symptoms usually begin gradually and vary throughout life.
A client came in for counseling and presented with the
issue of OCD, which was diagnosed while the client was in primary school. However,
the presenting problem is that the client now feels that due to the onset of
the COVID- 19, the intensity of handwashing is psychologically affecting him
in that any time he touches anything not belonging to him, he feels
uncomfortable and feels he needs to keep washing his hand.
During the counseling session, the first thing will be
exploration with the client on the consequences
he imagines might take place in the absence of hand washing and construct
exposures to those consequences.
The treatment plan will be exposure therapy.
Psychotherapy of choice for the treatment of OCD is exposure and response
prevention (ERP), which is a form of Cognitive Behavioral Therapy. In ERP
therapy, the client will be gradually exposed to his obsession, which is
touching other people’s belonging and asked not to perform the compulsion of
hand washing that will
Ease his anxiety and distress. This will be done at
the client’s pace.
Supervision is defined as a formal, systematic, and a
a continuous process of professional support and learning for health care
providers and anyone who is in essential services. They are assisted in
developing their practice through being engaged in regular discussions with
experienced colleagues and the major aim is to promote improved decision making
skills, learning how to practice self-care and valuing oneself protection
through the reflective process and clinical practice analysis.
The sessions provide an opportunity for the caregivers to
examine and work through job-related vicarious trauma deal with disruptions in
schemas about self and others and symptoms of post-traumatic stress disorders.
Health workers encounter difficulties or discomfort in dealing with clients’
fearful or angry emotions about the incidences encountered and may avoid
discussing the clients’ traumatic experiences with peers or loved ones.
However, supervision is not about being given advice on
what to do or what not to do. It’s also not in black and white that there is a
clear cut on what is expected of the supervisee when it comes to handling
clients.
It is posited that as health care providers increasingly
draw near to vicarious trauma, and they can become distracted in services
production and question abilities to deal with certain cases. They may struggle
to deal with their own emotional reactions to clients’ issues and as a result end
up having feelings of sadness, helplessness, powerlessness, or fear. There can
be a heightened sense of fear in repeatedly hearing about clients’ health
issues and As a result, they begin to consider all of the risks to their own
safety when it comes to matters of health as well as their own children. A good
example is a case handled recently of a patient who had Obsessive-compulsive
disorder and in the process of treating her it was later found out that she
also had autism which poised even a greater challenge to the health care
provider was not used to handling patients with psychological disorders. As a
result it hindered effective production of health care services to the patient
and in return, the health care provider was equally affected psychologically
resulting in seeking clinical supervision.
Supervision has a number of functions, which help the
professionals in their daily practice among them being, helping them improve
clinical practice and reduce the emotional burden of clinical care as it helps to
identify solutions to problems thus improving practice as well as increasing
the understanding of professional issues. However in the recent supervision,
this function was equally met and it has helped in patient care and the health
care provider as well both individually and as a professional group. This has
helped in reduction of burn out among the health care providers as well as the
the self-doubt that mostly accompanies burn out at the workplace.
Supervision enables in improving clients’ morale at the workplace as they feel cared for and their employer is concerned with their
welfare. As an outcome of clinical supervision, the health care providers will
definitely input all their energy at work since they feel that both their
personal and professional needs are well catered for and, therefore, will have no
hindrance to the provision of the services. In return to these, the clients will be
happy and hence gain confidence in the service providers.
Supervision helps gain feedback and guidance in handling
cases.
They get insight on particular cases in that if a health
care provider handled a case, sharing it with colleagues and supervisor during
supervision process, some clients may appear straightforward, but it is always
possible to miss something that supervision
Might appropriately address. One approach is to ensure
that every client psychological
The formulation is reviewed and discussed within supervision.
Supervision also addresses issues therapeutic
competencies. Among them are the professional, ethical standards when it comes
to handling clients among them Clients’ confidentiality which is a factor that
ought to be put into consideration even as the health care provider shares the
a case for insight with colleagues, clients confidentiality ought to be upheld.
This factor was well achieved in the recent supervision since was able to share
about the case that was recently handled of a client who had autism and OCD.
Some of the insights included using alternative therapeutic methods in
handling such a client, such as using drawing or writing for communication with
the client, allowing the client to use the skill that they enjoy using such as
some autistic children prefer hands-on as their mode of communication, they
also prefer being more artistic for the expression other than verbal.
Supervision helps the service provider become organized
in terms of once they are supervised,
Supervision helps improve the health care provider’s
performance, as well as professional development. In that, the supervisee learns
how to handle work in a more professional manner, is reminded by others what
may have skipped their minds matters handling clients, they get more input on
handling clients, they as well learn new skills from colleagues. Which in
return helps improve their work?
One of the major challenges hindering the development of
clinical supervision has been poor conceptualization in both theory and
empirical studies: Clarifying what supervision is and how it works. Supervision
theories have historically been derived from applying models of therapy, from
extrapolating models from other fields, and from clinical experience.
However, there is evidence base for supervision
(Bradshaw et al. 2007)There is limited evidence of improved quality of care
provided by professionals to individual clients. This is as a result of the use of
the same old techniques in the field of psychology; hence there is a need for new
research to be done and implemented when it comes to matters handling clients.
- (Watkins 2011) Studies are unable to demonstrate direct
and significant benefits to patients. This is so because, the supervision
processes are mostly based on assumptions that the feedback and guidance given
to the supervisee during supervision is assumed that it will work for the
client without putting into consideration the client’s perspective of the
inputs as well. This then makes supervision not client-oriented.
(Evan & Marcroft, 2015) there is a Widespread
consensus over the merits of Clinical Supervision, despite the lack of clarity
over what Clinical Supervision is and little agreement about what constitutes a
‘good’ model of Clinical Supervision. This is as a result of the psychology
researchers not having come to a consensus on the best model for supervision.
Hence it’s difficult to even for the supervisor to decide on the best model and in
most cases, end up combining a number of models and as a result, some sort of
confusion crops up.
(Pollock et al., 2017) a Systematic review was done
in 2017 and found that the evidence relating to clinical supervision is of poor
quality, confounded by the absence of definitions and descriptions of Clinical
Supervision. Thus making it difficult or rather making the supervision less
effective, bearing in mind that there is absolutely no one conclusive
description of supervision.
When it comes to supervision, there are a number of
theories that are applicable inclusive but not limited to Kold’s experiential
learning theory, which will be expounded a bit in this essay. There is also
Erik Ericson psychosocial theory of development which explains about various
psychosocial developmental stages and what a person terms from each particular stage
right from birth to adulthood. There are also Honey and Mumford styles/stages
and the corresponding Kolb learning styles which they defined as, Activist,
reflector, theorist and pragmatist which all corresponds to Kolb’s stages of
learning.
According to Kolb, different people naturally prefer a
certain single different learning style. Of which various factors influence a
person’s preferred style. In his experiential learning theory model (ELT) he
defined three stages of a person’s development and suggested that our
propensity to reconcile and successfully integrate the four different learning
styles improves as we mature through our development stages. He states that the
developmental stages included, Acquisition which is the earning that happens
from birth to adolescence and it’s basically the development of basic abilities
and ‘cognitive structures’. The second developmental stage he defined as
Specialization which is the schooling age it’s inclusive of early work and
personal experiences of adulthood the development of a particular ‘specialized
learning style’ shaped by ‘social, educational, and organizational
socialization’. The final learning stage he termed it as Integration which
onset from mid-career through to later life it’s an expression of non-dominant
learning style in work and personal life.
These people are able to look at things from different perspectives
that are Divergent points. They are sensitive. They prefer to watch rather than
do, they to gather information and use imagination to solve problems. They are
best at viewing concrete situations in several different viewpoints. Kolb called
this style ‘Diverging’ because these people perform better in situations that
require ideas-generation, for example, brainstorming. People with a Diverging learning
style have broad cultural interests and like to gather information. They are
interested in people, tend to be imaginative and emotional, and tend to be
strong in the arts. People with the Diverging style prefer to work in groups,
to listen with an open mind and to receive personal feedback.
The Assimilating learning preference is for a
concise, logical approach. Ideas and concepts are more important than people.
These people require a good clear explanation rather than a practical opportunity.
They excel at understanding wide-ranging information and organizing it in a clear,
logical format. People with an Assimilating learning style are less focused on
people and more interested in ideas and abstract concepts. People with this
style are more attracted to logically sound theories than approaches based on
practical value. This learning style of people is important for effectiveness
in information and science careers. In formal learning situations, people with
this style prefer readings, lectures, exploring analytical models, and having
time to think things through.
People with a Converging learning style can solve
problems and will use their learning to find solutions to practical issues.
They prefer technical tasks and are less concerned with people and interpersonal
aspects. People with a Converging learning style are best at finding practical
uses for ideas and theories. They can solve problems and make decisions by
finding solutions to questions and problems. People with a Converging learning
style are more attracted to technical tasks and problems than social or
interpersonal issues. A Converging learning style enables specialist and
technology abilities. People with a Converging style like to experiment with
new ideas, to simulate, and to work with practical applications.
The Accommodating learning style is ‘hands-on’ and
relies on intuition rather than logic. These people use other people’s
analysis and prefer to take a practical, experiential approach. They are
attracted to new challenges and experiences, and to carrying out plans. They
commonly act on ‘gut’ instinct rather than logical analysis. People with an
Accommodating learning style will tend to rely on others for information than
carry out their own analysis. This learning style is prevalent and useful in
roles requiring action and initiative. People with an Accommodating learning
style prefer to work in teams to complete tasks. They set targets and actively
work in the field, trying different ways to achieve an objective.
He however argues that whatever influences the choice of
style, the learning style preference itself is actually the product of two
pairs of variables, or two separate ‘choices’ that we make, which Kolb
presented as lines of the axis, each with ‘conflicting’ modes at either end:
Knowing owns
Learning style enables learning to be orientated
according to the preferred method. This means that everyone responds to and
needs the stimulus of all types of learning styles to one extent or another.
Therefore it’s a matter of using emphasis that fits best with the given
situation and a person’s learning style preferences.
When it comes to clinical supervision, people’s learning
styles are, in most cases, determined by their mode and speed of adaptation. For instance, those who prefer to learn through converging will definitely find it
difficult to adapt to assimilation. Assimilation works best for a counselor
when it comes to supervision as the health care provider is able to get ideas
and concepts that will be highly effective when it comes to the implementation of
the skills to the clients. However, just as Kolb puts it that some people may combine
more than one learning style at a go, it’s possible to find one person learning
with two or more methods during supervision. Even though there is definitely the
more dominant one than the other.
As for my case, when it comes to learning am good at
assimilation more than any other style. In that, it’s easy for me to sit, listen
and get insight from others and implementation is very easy for me hence it’s
my most preferred mode of learning.
In conclusion, it is not advisable to apply any
methodology blindly and unquestioningly. Therefore one should review and assess
the effectiveness of methods used. However, one should also not ban or denigrate
ideas simply because the evidence does not exist for their effectiveness, or
because in certain applications, the methods are found to be ineffective.
Supervision should engage the supervisees in Sharing and
being expressive about their stress levels, which
Are normally high due to work-related pressure. They
ought also to be taken through quick debriefing sessions, learning new ways of
coping such as watching videos on stress management, art and music therapy to
help the supervisees relax and express where their stress points are. Meditation
sessions are also encouraged to discuss self-care, explore their levels of
self-awareness on how they care for themselves.
During the sessions, the supervisees ought also to share
Their experiences particularly with recent traumatic
events in the world that is the covid-19 menace which has made it
Difficult in handling cases encountered. Hence, as a
result, more support ought to be given and ways of coping discussed by the
supervisor and supervisees. A mediation session ought also to be incorporated.