Active Ingredients for an Effective Supervisory Alliance

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Kate Grandbois: Hello, 

everyone. Welcome to SLP Nerdcast. We are very excited for today's episode. My co host, Amy, is not joining us today, but I am not alone. I am here with another SLP Nerdcast teammate, Ana Paula [00:02:00] Souza Mumi. Hello, Ana Paula. 

Ana Paula Mumy: Hello. I'm so happy to be here. 

Kate Grandbois: We're really excited to share your wisdom you are here to talk to us a little bit about supervision and what you very eloquently called the supervisory alliance.

Before we get into all that, can you tell us a little bit about yourself? 

Announcer: Sure. 

Ana Paula Mumy: I am a program director and associate professor at a small private university, but really prior to this position, which is what, um, or the experience of the clinical supervisory experience that I have that I'm going to be talking about, um, today, uh, comes from my work, uh, prior to this position where I was a clinical assistant.

I'm a professor, um, and was the, um, supervisor for a preschool program, um, at the University of Kansas. So that's 

Announcer: where 

Ana Paula Mumy: I was before and, um, I'm excited to just talk about my experience there. 

Kate Grandbois: I have learned so much from [00:03:00] you in the time that you've been on our team. I'm very excited to. As I said, share everything that you know.

Before we get into it, we do need to read aloud our learning objectives and disclosures. Uh, so here we go before we get into the good stuff. Learning objective number one, identify key components of the supervisory alliance. Learning objective number two, explain attitudes, behaviors, and practices that contribute to an effective supervisory alliance.

And learning objective number three, describe the impact of a positive supervisory alliance. Disclosures, Annapala's financial disclosures. Annapala is employed at East Texas Baptist University and serves as the ASHA administrator for SLP Nerdcast. Annapala's non financial disclosures. Ana Paula is the president of Spiro Stuttering Incorporated, which is a non profit organization.

Um, my financial disclosures, I am the owner and founder of Grand Bois Therapy and Consulting LLC and co founder of SLP Nerdcast. My non [00:04:00] financial disclosures, I'm a member of ASHA SIG 12 and I serve on the AAC advisory group for Massachusetts Advocates for Children. I'm also a member of the Berkshire Association for Behavior Analysis and Therapy.

Alright, now that the boring stuff is behind us, I would love to hear a little bit more about the Therapeutic Alliance. I've used the term, I've heard the word alliance before, obviously, but never in the context of supervisors and supervisees or even really in therapy.

So what can you tell us about that to kind of set the tone for the conversation? 

Ana Paula Mumy: The Therapeutic Alliance is really, uh, A way to think about three different areas that are important in the, um, therapeutic, uh, relationship. And so the first being that client clinician bond. So thinking about, um, your belief in that, um, client, their ability to make changes, whatever changes are important to them.

Um, and then also, [00:05:00] That positive regard which includes, uh, supporting them, um, their, their values, their beliefs and, um, and really just, you know, walking alongside them, uh, in whatever, uh, goals that they have for themselves, which kind of leads to the next one, which is really agreement on goals. So thinking about, are we dictating what goals they want, right, or are we listening to our clients in what is it that they want to see different, right?

How is. What is their communication disorder or difference impacting them negatively and what are some goals that would help them achieve greater quality of life, right? The third aspect being agreement on what are the tasks or what are the processes, um, to accomplish or reach the goals, right? That are set.

And so, uh, having the, uh, ability to experiment, exploring ideas or [00:06:00] techniques or strategies or whatever that might be, but. Um, so that's in a nutshell just what that Therapeutic Alliance, um, consists of. And I don't know if you want me to go ahead and go into like how I have now framed it into the supervisory, um, or, or thinking about the supervisory role that I was in for a really long time.

Um, and I will say that I, I started supervising students from the moment I became eligible after getting my C's. I just, I loved working. With students, I, uh, I was at, I was in Wichita and there was a university there that was looking for, um, um, individuals that, you know, wanted to work with students. And I'm like, yeah, I'd love to.

And so I started right away, um, as soon as I could. And then I've, I've done a lot of. Um, both as a, at that time, I was an external supervisor taking in students and then also CFs at times, um, supervising clinical fellows, [00:07:00] um, but then, of course, within my role, um, at my previous university, I, that's, that was my primary, um, role was to do clinical supervision, and so I, I just began thinking, you know, how There were parallels, right, between, like, how we function as clinicians and thinking about, oh, yeah, I, I have to keep these things in mind, how does this translate, right, to the, uh, supervisor, supervisee, or, um, the clinical supervisor, clinician, um, relationship.

And so. That's where I just began, uh, thinking about this, you know, paradigm, if you will, and so, uh, and then realizing really, you know, they're, they're essentially the same, right, just having that supervisor student clinician bond, how, you know, my belief in that person, right, my belief in them as a student and their ability to, uh, grow and learn, um, in this profession, and then, you Um, also, [00:08:00] what are their learning goals?

So, of course, I have learning goals or things that I want them to achieve, but at the same time thinking about how they also, um, have goals for themselves, you know, things that they want to achieve, uh, and, and how they want to grow. And then what are the tasks and the processes to reach those goals? So. I, again, as the supervisor, have some ideas of what those tasks might be, right, and what that process might look like, but at the same time, getting their buy in, um, into, you know, this is what we're doing in order to help you, um, move to that next level.

Kate Grandbois: What I love about this parallel that you've made, so first in thinking about the therapeutic alliance with our clients, this is very much our patient centered care model, right? So the third of our evidence based practice triangle, um, client perspectives and values, um, you know, walking with the patient, letting them have, you know, making sure that our goals and objectives are aligned with their values, what's meaningful to [00:09:00] them, um, What I love about this in, in mapping this on to the supervisor and supervisee relationship is it puts the supervisee in a position of empowerment to be a contributing partner in their learning journey.

And as many of us have had, as many of us have experienced in the past, when you have a supervisor that is just, as I say, shitting all over you, like, well, you should do this and you should do that and you should do this and you're not given space to be who you want to be, or to, to challenge your own thinking, or to work towards your own goals.

It can feel really, maybe I'm speaking from my own experience, but it can create a lot of tension. And I love that you've put the supervisor, and I love that you've put the supervisee In a position of empowerment through this alliance because at the end of the day, if you're in a learning environment, you have to feel safe to be vulnerable [00:10:00] to make the mistakes and do all of those things.

I, I, I love that parallel. I think it's awesome. 

Ana Paula Mumy: And if you think about in the same way with a therapeutic alliance, um, it's all about the relationship, right? It's building rapport and having this relationship where, um, you are, listening and you are, you know, open. And I think in the same way, um, with clinicians or students, it's about the relationship.

It's about building, um, that rapport with them as well, where they feel like, yes, you're on my team, right? Like you, um, are going to be giving me Feedback that maybe will be hard to implement or maybe that will be hard to take at times or whatever, but when they, I think, believe that you believe in them, right, and that there is that relationship, um, that's, uh, reciprocal in a sense that, um, then it's easier to navigate, you know, especially when they are maybe having challenges or when there are struggles [00:11:00] or, you know, they're overwhelmed or, um, I think the relationship is really at the center in both situations, right?

Kate Grandbois: You also, in a lot of your talking points here, use the word bonding, which I think is a great word. What do you, what can you, how can you elaborate on that for us? 

Ana Paula Mumy: You know, I think within this concept of bonding is, um, I think the, the first thing that comes to my mind is We're both humans, right? We're both living this human experience.

So yes, maybe I'm in a position of power because I'm the supervisor, right? But I'm also a human being. I'm a mother. I'm a wife. I'm a friend. I'm a colleague. I'm all these things. And I also have Experiences where I struggle or experiences where I maybe doubt myself or feel inadequate or, you know, there's all these things that I think.

Um, [00:12:00] so bonding in the sense that, you know, I try to be a person first, right, to them, to say, I am here to, to listen, I'm, I do care about you, I want to get to know you, so it's not just about this clinical relationship, but it's also, I want to invest in getting to know who is this person in front of me, right, and, um, what are their interests, and what are the things that they're excited about, or, you know, do they have a family, do they have, you know, Most of our students generally aren't married, but the ones that are, you know, are they married?

Do they have kids? You know, so just really kind of getting to know the person and then allowing them to get to know me as well Of course, you know, there's still boundaries within that relationship, but I think just seeing each other as humans, right? 

Kate Grandbois: I, I have to imagine that Many people who are listening to this episode are in either in a position of of power so you're a super you're [00:13:00] listening and you're a supervisor and or maybe you want to be a supervisor or Maybe you're listening and you're a supervisee and you feel grouchy feelings about your suit or or you know, you already have a supervisor and you're reflecting on your supervisor supervisee relationship One of the things that you just said that we've talked about on this podcast before, and I promised not to get on my own personal soapbox about it because it's a passion topic for me.

But one of the things that you brought up that I love so, so, so much is that if you are in a position of power, if you are in a position where there's a power differential and you, one of the most important things that you can do is embrace, this is my favorite term, Embrace professional humility. So understanding that no one knows everything.

There are things that even you need to still learn checking, checking your ego at the door, being comfortable in your discomfort, right? Those things [00:14:00] can create such examples of strength, um, and, and create a lot of much more comfortable feelings for others around you. And I think it is such a, um, a sign of strength and a sign of leadership and such a wonderful quality to have when you are in those positions.

So tiny little soapbox. I just wanted to say, here, here, I completely agree. And I love that you brought that up because it's so important. And thinking about that in the context of bonding is awesome because how are you going to develop one of those, you know, wonderful relationships if you don't approach it with, Curiosity and humility.

Right? 

Ana Paula Mumy: Right. And I think that goes hand in hand also with, um, vulnerability. So just being willing to be vulnerable. And, uh, I know for me, um, for example, in team meetings or in, in different situations where I may share, you know, my own mistakes, um, in my clinical development as a therapist, right? Where, [00:15:00] This happened or that happened and being able to, uh, just share, you know, here's how I learned something the hard way, right?

Or, or even, you know, talking about my emotional responses to, um, client situations that maybe I wasn't prepared for or, um, Ways that, you know, I grew in that sense or, um, and I guess bringing it back to like the human piece of, you know, difficulties with work and home balance and, you know, other challenges that, you know, I have faced, you know, as a professional, as a, an SLP.

And so I think just that openness, that vulnerability just to be a person in front of them and say, you know, yeah, I've, um, and, and. Like you said, I'm always learning like that lifelong learner. That's not just a cute term. Like I'm literally a lifelong learner. I have much to learn yet. And so [00:16:00] just, I think modeling that for them is really important.

Kate Grandbois: I totally agree. And I'm wondering how all of these things, all of these wonderful philosophical guide posts that we've mentioned, I wonder how that contributes to the experience of someone. What can you tell us about. Different variables like this and different elements that can contribute to a positive supervisory experience.

Ana Paula Mumy: I would say, um, again, central relationship, right? That's key. Um, and in a practical sense, I would say that, um, there are some things that I think about. So, for example, um, For, for the student to be successful, you know, clear expectations have to be present. So they have to know what it is that they're expected to do.

And it's our job, right, to make sure that we're communicating that in a very clear way. Um, and then [00:17:00] also thinking about, you know, what are the students. Um, or that's particular students. What's their level like they're coming in at a certain developmental level or, or experiential level, right? So just thinking about, um, our expectations are matching in a sense, you know, their level.

So where are they at? Because of course, students come to us with different, um, experiences and at different levels. So you just have to be really aware of that. Um, and I would say just being able to Scaffold. You know, they're learning and, um, giving them constructive feedback, um, at different, um, points, you know, within their journey and, but making sure that they're also frequent, right?

So making sure that we're being really mindful that students, even though sometimes feedback is hard to receive. They [00:18:00] want that feedback. They need that feedback. And so, uh, just being able to, you know, provide that with frequency, um, and, and then creating a safe space for them to make mistakes. Right? So knowing that mistakes are opportunities to grow, right?

We learn when we make mistakes. Actually, somebody was asking me the other day about, um, how have I learned in my new role as a program director to, Um, you know, such and such or whatever. And I said, honestly, from the mistakes that I made, and that's how I've learned, you know, the most. And so just really being able to view those as a positive thing and just those learning opportunities that come with it.

Kate Grandbois: And I, something that you said just then resonated with me about how every student comes to you with a unique set of skills, a unique learning level, um, unique needs of support. And I think that's so true. And you have a quote in your talking points that really resonated with me and I'm going to read it.

The [00:19:00] quote is, we must teach the students we have and not the ones we wish we had. And that is a quote by Tony Holland from the book Establishing Leadership Mindset, a guide, a guide to using the power of the human brain to motivate learning. And one of the reasons I love this quote is that You know, as clinicians, we are trained to meet our learners where they are, right?

So you do an evaluation, I'm in pediatrics, so that's the example I'm going to use. You do an evaluation on a child, you have a good understanding of where they are in their language learning, and you write goals and objectives to meet them where they are. Adults are learners too, and we often forget that we need to meet all learners where they are, including our students.

And I have had this experience myself just as a supervisor feeling, oh, you know, this, this person I'm supervising is, I'm feeling frustrated because they really don't know X, Y, or Z. And this really [00:20:00] seems to be a concept that they're having a difficult time grasping. And that is. Not a great reaction because I need to adjust my expectations to meet them where they are, as opposed to having expectations that they fall short of.

Would you say that that's a fair, that's a fair statement? 

Ana Paula Mumy: Yes, and I think, um, I love that quote as well, and it's one that I, repeat to myself often, right? Because of course, you know, when students struggle, then there is more work, right? That's involved in whether it be like you said, you having to realize like, oh, I need to adjust here, or I need to do more of this, or, you know, it does take more effort and intentional, um, Changes, right, that you have to make to the environment.

And, um, but at the same time, you know, it's like honoring who's the student in front of me, right? So realizing [00:21:00] they're going to come with different, you know, personal factors, personalities, cultural experiences, um, even experiences, um, clinical experiences, right? Because some grad students have had, um, clinical experiences at the undergraduate level.

Some have not, right? So some of them come with maybe a little bit more preparation than another. Um, they also come with different insecurities and different, um, questions or doubts, right? About themselves. And so there's just so many variables that are at play that you really just have to almost like.

Just be willing to say yes, I'm going to accept you as you are. You come to me, right? It's the students I have not the ones that I wish I had in the sense that you know Of course like when we get those You know, the, the type A, like go getters, you know, who, who are just, you know, independent and, you know, all this, of course, that's easier, right?

It's, [00:22:00] um, I think about, you know, raising kids, you know, it's easier when you have the, the perfectly compliant and never questioning whatever child, right? And yet that's not reality. And, and it's, so just being able to look at them and say, okay, this is, this is what you come to me with. And. We're going to figure out how to walk this, you know, together and, um, and being willing to go the extra mile to, um, brainstorm, you know, when, especially, of course, this comes up when they're struggling.

Right? So when they are struggling, why are they struggling? And why are they having a hard time? Responding to the feedback or what is it that is creating, you know, those barriers or do I need to be more explicit, which I'm going to say the answer is always yes. Yes. I need to be more explicit, right? Which we'll talk about a little bit later.

And how do we make things explicit, um, in terms of expectations and what we're asking them to [00:23:00] do, giving them examples. Um, so just, I think that answers your question, but, you know, I, I just think that we have to. Um, just leave our expectations at the door in the sense of like, oh, I, I want you to be this and just really be willing to, um, grow with them.

Right? 

Kate Grandbois: I also think that, you know, I can see the role of the relationship there. Right? So if you are in a position where you're getting to know the student, you're realizing that they're having a harder time, you're concerned that their, the feedback isn't given, being given in a way that's well received, or you need to be more explicit.

If you have a good relationship, or if you have spent the time investing in that relationship as a human with kindness, I have to imagine that those other points of conflict are going to be. You know, improved upon or those points of conflict are going to become [00:24:00] less contentious and less negative because you have this great foundation, 

Ana Paula Mumy: right?

Absolutely. Yeah, I agree. Um, I think that usually, you know, when there's resistance. in any way due to whatever, you know, factors might be present. Um, there, there's usually, um, an explanation, right? Like there's something there and just being willing to, you know, uncover what that might be. And, um, and in the context of that relationship, it's certainly easier.

Kate Grandbois: So what are some of the Challenges that we face in terms of adult learners and, you know, aside from probably the obvious, like restrictions on time in the workplace and, you know, some of the infrastructure barriers that we all inevitably, but up against, what are some of the general challenges in your experience that you see in a supervisory [00:25:00] role?

Ana Paula Mumy: I would say that the two, um, if, if I was to put students into two categories, um, um, When there is conflict that's present, usually it's either because, um, there's under dependence on the supervisor where they think they have it.

They've figured it out, right? I don't need supervision. I've got this, um, or over dependence where, um, they lack confidence, you know, they're afraid to, uh, jump in and do what you have equipped them to do, you know, and there's again, self doubt or, um, Insecurities for whatever reason. And so dealing with, you know, underdependence, uh, where maybe they, they feel like they know more than they know.

Um, that's probably harder, um, because there's maybe ego involved or some, you know, a pride factor, maybe, you know, and it's just, I think, [00:26:00] gently being able to, Um, for them, like, here's what I am wanting you to learn from this experience, or maybe just explaining the why behind something. Like I'm asking you to do it this way, even though I know that you might want to do it this way, but I'm asking you to try this in order to X, Y, Z, right?

So like giving that the reason behind something, um, and, and then on the other side when there's maybe lack of confidence or. If they're afraid or whatever is getting down to like, why is that right? And what is it that you need? So, for example, sometimes, um, so in the preschool program that I was, um. In where I supervise students, they had gradual, um, expectations in terms of like how they moved along, um, in how much they were leading.

So, um, they had one on one interaction with their [00:27:00] clients that they were assigned to, but then they also were leading things like story time or opening circle because, you know, we were in a preschool setting. And for some of those students, even though, you know, your, your audience is three, four and five year olds, you know, they still were terrified, right, because they had to essentially run, you know, that segment of the day.

And that can be scary, you know, and there I remember being terrified. I remember being absolutely terrified. And you think, hey, it's a forgiving audience, right. They're three year olds. They're not going to mind. They're not going to notice, right? And, um, but I would say that to them. I would remind them and say, Hey, um, these are, you know, you have a forgiving audience.

They're going to love you regardless of what you do. They're never going to notice that you made a mistake, right? So just, I think sometimes affirming those things and saying them out loud and being able to tell them and always reminding them, like this is a safe space for you to make mistakes, especially when.

You're talking about [00:28:00] a preschool classroom. It's a very safe space to make mistakes, even though they don't feel. And pick 

Kate Grandbois: your nose. I'm just kidding. 

Ana Paula Mumy: Yes. It's a preschool classroom. Right? In a preschool classroom. Right. Um, but just reminding them, like, you know, there is no expectation of perfection. There is no expectation that you're gonna get it, you know, the very first time that you try or that it's going to go beautifully.

Um, because even the most well planned, well thought out, um, Whatever activity that you come up with, you're talking about engaging with, you know, 3 year olds, 4 year olds that are going to do what they want to do. Right. And so just reminding them, like, even though you may be prepared, things are going to go different a different way, or they may not respond, you know, and.

It always happens that, you know, the things sometimes that you plan that you think, oh, they're going to love it. And then it just kind of like falls flat. And then the things that you were like, not so sure that they just adore, right? So like, just having that tolerance for, um, not [00:29:00] knowing, you know, and, and, but I think the more we talk openly about those things that they can expect, like, It's going to happen, right?

And, or you're going to have to deal with behavior issues, or you're going to have to deal with the child who maybe occasionally wants to bite somebody, or the child who wants to, um, you know, run around the room or whatever, you know, so just talking about like, here, here's what to expect, like, it's organized chaos, you know, in many ways, of course, I'm talking about the preschool setting, but in whatever setting that you're in, you know, preparing them for work.

Transcribed The variables that are, are there and helping them realize like, okay, I, it's not going to go perfectly. And that's okay. I don't have that expectation. And I tell my students all the time, I would tell them, you know, I just want to see that you're growing. I just want to see that from day to day that you're here from week to week, from month to month, that I'm seeing progress.

And as long as that's happening, I'm happy, right? And I want, [00:30:00] um, and I'm just going to continue to support you, but I just, I want to see that you're, you know, building rapport yourself with your clients and building rapport with the other students and, you know, um, being just a part of this, um, you know, therapeutic environment that, of course, in a preschool setting is very naturalistic, you know, which makes it a little bit challenging too.

Kate Grandbois: Sure. So in turn, going back to those two general categories where, you know, you may have a student who is overly confident in their skills and feels that they need less support or is under, you know, and has a lack of confidence and is feeling like they need more support than they actually need. It's just, it's, it's making me, I feel like I've met other professionals who are non students who have the same profile.

So I feel like this, you know, how to approach a learner based on these two general categories is probably very helpful for anyone listening who is supervising [00:31:00] even, you know, not even necessarily grad students, but newer grads or CFs or, you know, people who are earlier in their careers. And I'm wondering if you have suggestions for what support strategies are more or less helpful across those two categories.

Ana Paula Mumy: Gosh, I don't know that I, um, would necessarily divide them based on the two categories because it Um, I don't know, because I think it applies maybe to all, but just at different levels. So if I was to say, you know, what are like the three things that I think are just essential, you know, when it comes to supervision, um, I would say, um, macro affirmations is one.

So thinking about, um, which I'm just going to read the definition because I, I feel like I'm going to butcher if I just try to talk through it. Um, it's defined as tiny acts of opening doors to opportunity, gestures of inclusion and caring, and graceful acts of listening. So, [00:32:00] in that sense, it's, you know, asking for student input.

You know, being willing and curious about what do they think and what ideas do they bring, right? And then recognizing their achievements. So, um, Naming the things that you notice, right, being a good observer about the positive things that you see, um, which is also good parenting, right? I'm thinking about my kids as I'm saying this.

I'm like, oh, noticing the positive and, you know, stating it out loud. Right, right, right. Um, but, uh, and, you know, taking an interest in their lives and, um, just affirming them, you know, in different ways, giving credit to their ideas. Um, I think all these things contribute to just them feeling affirmed, right, as an individual and as a clinician.

So I think either, either student, you know, in either category are going to respond to that. Right. And [00:33:00] then clear expectations. I cannot state this enough, you know, just clear, explicit, explicitly clear, yeah, assignments. Having, you know, cleared deadlines and, um, giving them examples of, you know, like, for example, and I'm going to tie it back to the preschool 1 component of what we did during opening circle was, um, we would.

Make a word come to life. So we had these, you know, words, target words that we were teaching that tied to the story time that were tier two words that, um, we were trying to help them learn, um, but also infuse into our natural interactions and infuse in different opportunities. And so anyway, there was just a very specific way that we would instruct them to kind of make these words come to life.

They could use different things. They could use video or. Tangible things or audio, they could really present the word in any way, but [00:34:00] it had to be very, um, interactive, right? And of course, you know, students would, um, struggle sometimes because one, you have to, if you're defining a word, you know, for a preschooler, it has to be very child friendly.

It has to be very, um, uh, you can't use unknown words to describe an unknown word, right? Like there's things, the factors that you have to think through. And, um, And I would, you know, model for them what that might look like, um, but then I realized, like, they need a script. They need a script that they can look at so that when they're coming up with their own way, they realize, like, oh, this is what she means.

Right. And I would show them, like. You're going to introduce the word, you're going to give the child friendly definition, you're going to repeat it several times, you're going to model it or demonstrate it in some way, you're going to do it, you know, and by giving them that script of, um, that would [00:35:00] Show them like here's what it's supposed to look like, you know, then when it's their time to do it, they can do it right.

And they know exactly what's expected. Um, and I literally began doing that for every single segment that they had to lead. Um, so we did it for story time. We had very clear. Guides and, um, scripts when necessary of like, okay, here's what we want it to look like, um, music time, even, you know, it's like music time, especially in a, uh, a language rich environment.

It's, we're not just singing, you know, twinkle, twinkle, little star, like there's, We want clear targets for the songs that are chosen. We want it to be age appropriate because these are little ones. We want it to be repetitive. We want it to be this. So then again, like I gave them this framework for what's music time supposed to look like, you know, and sometimes you feel like it's overkill, like, Oh my gosh, like, do they really need all this?

But they really do [00:36:00] like, and that just helps with giving them those clear expectations. Um, and even, you know, in practical, Other practical ways of, um, meeting schedules that are clear. Like, when are we meeting? When are we not meeting? Like, not being, you know, like, all over the place with deadlines or, um, you know, all of that.

And then, so, like, I'm big on, you know, cheat sheets or. Guides, you know, whatever, just, I'm, I probably go overboard when it comes to, you know, making sure that they have a model or if it's, let's say a report that they're supposed to write, that they have a model of like, here's one that has been written.

This is what we're looking for, right? So that's the second component. And then I would say the third would be feedback. So fair, specific, timely feedback, making sure that we are being consistent with that. Um, and for me, I felt like written feedback, even [00:37:00] though I would sometimes give them verbal feedback to that written feedback that they can go back.

To and look at and reread and ponder. And so just, I would sit sometimes in the classroom and have my little, you know, I had my iPad and I would just be writing, writing, writing, writing, and then I would clean it up and just making sure that, you know, it was clear, but it was very time intensive. However, um, my students.

Really, um, benefited from that. And they would say, because sometimes like in our, our team discussions, I'd say, you know, what resonated with you the most, you know, um, from the feedback or what did you learn and say, Oh, my gosh, that was so, you know, it just helped me see this or, you know, just, um, One, I wanted to make sure that they were reading my feedback, but also, you know, right, making sure that it was, um, helpful to them.

And then I would ask them, like, is there [00:38:00] a way that you would prefer? Or would you prefer feedback in a different way? Or is this helpful to you? Is there more that you need or less that you need? You know, so just. Seeking their feedback, um, on, you know, is there something I need to add, um, to and, um, and then of course, you know, just helping them build on their strengths and then grow in their areas.

That they're struggling. So I always always always start with I love that you did such and such or I really like seeing such and such and so just starting with the positive and then for anything where areas of struggle I would say you might try this or I noticed that you did such and such Maybe you know, it didn't go so well.

I wonder if you know, so Even though I'm saying you really should try this. I'm also suggesting like And bringing their attention to this didn't go so well, what can we do to make it better? You know, so that I'm not [00:39:00] saying like, no, that's wrong. You're horrible. That's terrible. You know, but I'm saying, I noticed this.

So just having, um, that observing language, if you will, of, Here's what I saw. Let's try something different and see if they might respond better. You know, so I think feedback is crucial. And then the feedback component also, I think, ties to, you know, just what are the necessary tasks and the processes. So where do I go from here?

Right? Because we have, um, I also talk about, um, the cycle, right? Of feedback and practice. And what does that look like? And I don't know if you want me to go into that now, Um, Yeah. 

Kate Grandbois: Yeah. I would love to hear about that. I also, I think the only comment I wanted to make was as you were talking, I had this kind of moment putting two and two together, going back to what you said earlier, making parallels between us as clinicians and our clients.

Because when [00:40:00] we are working as clinicians, we are taught explicitly to set our clients up for success, right? To provide lots and lots of support because it is very easy to peel away the support once it's there. But if you don't want to set up, you know, create any alliance or any therapeutic situation where you're setting someone up to fail, letting them fail and then intervening with the supports.

And I can see this parallel here where It was when you said you don't think that they need that much support, but they do even if you don't think they do providing it as part of your regular modus operandus, you know of supervision and then removing it more slowly or as they need it just sets us sets a supervisee up for so much more success, um, than just kind of Waiting and seeing, you know, you don't, I can't imagine that you'd want to wait and see.

I just wanted to make that comment because those light bulbs went off for me, um, while you were talking, but I would [00:41:00] love to hear about the cycle of practice and feedback. 

Ana Paula Mumy: So I'm again, very explicit about, you know, what is the purpose of what we're doing? Um, so. With practice, of course, you know, anytime that they're with a client, um, whether it's one on one or within the preschool setting, um, they're getting to practice, right, their clinical skills.

So we talk about how, you know, practice leads to that observed performance. So I'm going to be observing their, and I hate to use the word performance because it's not like they're performing, but essentially we're evaluating them, right? We're, we're observing and we're giving them. Um, feedback. Um, and so that observed or observing of their skills leads to or allows for that targeted feedback.

So you're giving them that feedback, which then, of course, the hope is that it's going to guide their further practice. So there's this cycle of, you know, practice to being observed to that feedback [00:42:00] back to practice, right? And of course, the goal in the end is that one, Maybe they're needing less and less of that targeted feedback because they're getting it.

They're, um, they're learning, they're making changes, they're growing in their skills as clinicians, um, but still, so of course, your, your feedback is going to change over time, but, um, it's just crucial that that cycle just be continuous, that there's just always, you know, and of course, at the beginning of the semester, you're Uh, I'm going to be doing it way more often than, you know, towards the end of the semester, or if not, there's a problem, right?

Like, if I, if I'm giving the same level of feedback at the end as I was at the beginning, then we know something did not go well. Um, but for most students, of course, you know, you, you are. changing the way that you provide that feedback. Maybe they don't need it as often, [00:43:00] um, or you don't have to be as detailed, or it can be that you're giving a lot more of just those positive notice, the positive noticing, like, I love that you did this, or yes, you got it, like, you know, this went super well, and you are really attuned to the students in that moment, or, you know, you really, um, Infused or, you know, incorporated such and such that we talked about in our discussion the other day, you know, because at least for, um, the preschool each week, we would have, um, these 2 hour team meetings where we would discuss, you know, what's going well, what's not going so well, um, brainstorming about clients, um, but then also, um, we would read, we would have readings that we would cover, um, that would relate to different aspects of what we're doing.

So. Literacy type, you know, like readings related to literacy or vocabulary growth or, um, language [00:44:00] facilitation strategies, um, within a naturalistic environment, right? So we were, um, all of our discussions related to things that they needed to know and learn and utilize, right, in their day to day, um, as clinicians within this particular, um, setting.

And so when. You see them putting into practice, right? Some of the things that we've discussed. It's like, yes, you know, you're getting it. Um, and then, you know, and you can affirm that. But then, of course, if you don't see it, then it's. Pointing them back to remember when we talked about, you know, such and such, you know, this is what I want to see, or, um, we did a lot with dramatic play, um, so that was huge, you know, within a naturalistic setting of how do we, um, uh, help children, preschoolers grow within the context of these dramatic play experiences, you know, that are very much, um, free and, you know, there, there's, Not necessarily a [00:45:00] script there, but you know, you can be very attuned to what's happening and how can you facilitate language in that context?

And so, um, 1 thing that I would do sometimes. Related to language facilitation is I would take, like, a 10 minute block of time where I would observe them and I would jot down, like, how many times they either, like, recast it or expanded or, um, use, you know, 1 of the strategies that we've talked about narrated or whatever.

And of course, towards the beginning of the semester. It's like, you know, zero, one, maybe two, or, you know, whatever, and then they're like, oh my gosh, and they also generally use a ton of closed ended questions where it's just, you know, prompting for these yes, no, or one word answers. And of course, we know that that's not really good for language facilitation.

And so it's, it's a very eye opening exercise where they're like, Oh, wow, I didn't know this. [00:46:00] Like, I really. need to, you know, beef up some of the other things that we're doing. And so then we talk about, okay, so what is a language facilitation strategy that you want to focus on and increase, right, for this week?

And then maybe, you know, two weeks down the road, I would do it again. And then inevitably, you know, most of the students, they're much more self aware and they're using more of those strategies, right? So, but, The, the exercise of, you know, sitting down and logging it, it's not to shame them. It's not to say, oh, you're not doing enough.

It's to say, here, you know, become aware of what you're doing currently. And then what do you want to do more of? What can you do more of? What can you learn to naturally do more of within this context, right? To facilitate language. And then obviously they're always proud of the fact that within a couple of weeks to three weeks, they're doing more of it.

And they're like, yes, I'm, you know, I'm learning. And so it's not, it's never meant to be a negative [00:47:00] of noticing like the bad. It's just like, okay, here's where you are. And here's where we want to get. 

Kate Grandbois: And not again to make that analog, but we take data on our clients learning. Right. I mean, this is your data collection strategy to measure progress.

Um, you know, and that. I think that, you know, it's science has proven that measurement is an effective strategy for behavior change across everything, across smoking cessation, across fitness, across, you know, you name it, there is some measurement strategy and a quote that I love actually, I think it's from like the business realm, but, uh, what gets measured And I think that this is a very, very good example of that.

I'm wondering, I mean, you've, you've reviewed feedback strategies. You've talked about the cycle of practice and feedback loop. Um, you've talked about, All of the key components of a supportive environment, investing in the [00:48:00] relationship, professional humility. Um, I'm wondering if you have any words of wisdom for when things are not going well.

If there is conflict, you know, you have, you've spent the time investing in the relationship, you've Approached a problem with professional humility, but there is still a sense of your feedback is not being received well, or there are clear points of friction or the therapist, the student or, um, or supervisee doesn't think they deserve your feedback or is affronted by it or insulted.

You know, there is some point of friction. What do you do in that situation? That's a 

Ana Paula Mumy: hard 

Kate Grandbois: question to 

Ana Paula Mumy: answer, 

Kate Grandbois: but 

Ana Paula Mumy: I didn't mean for it to be a trick question. No, it's just that, you know, there's just so many variables that create sometimes that conflict. Right. And so I think the first, um, thing that would come to my mind is communication is approaching that [00:49:00] student to say, Hey, We're struggling, right?

You know, or there seems to be, um, conflict or that, you know, we're, we're not communicating very well or whatever, you know, just to be able to say, let's. Have a discussion, right? So just to, um, give them a chance to, um, maybe communicate what it is, you know, are, are there, um, external challenges that you're not aware of?

Or is there, um, are there insecurities that they're dealing with? You know, and I, I think if you start with. I just want to hear, you know, what do you feel is going well? Okay, so what do you feel is not going well? Um, do you feel that you have a sense of why? Or, you know, just really being curious, you know, but not, um, judgmental in that curiosity of, like, what's going on, right?

So just to, um, [00:50:00] give them room to express. Um, I also think of, like, motivational interviewing in the sense of, like, you know, Figuring out like where they are. So like, where do they rate themselves in X, you know, whatever, maybe area where there's struggle and then, okay. So what do you think you could do?

Let's say that, um, they're really struggling with giving feedback to the client, right? So just say, okay, on a scale of one to 10, you know, where do you find yourself? Oh, I think I'm, I'm at a five, you know, of in terms of like, I'm giving really great feedback is, you know, one end and it's horrible feedback on the other end.

Right? So like, okay, I think I'm at a five. So what do you think you would be doing? To be at a six right to get to a six, or maybe it's even a half step, you know, to get to a five and a half, like, what would you do differently in helping them kind of find their own solutions, you know, to what it is that.[00:51:00] 

They could do differently or that they could try so that it's not you saying you need to do blah blah blah right but where they can say, Oh, yeah, you know, I could probably try such and such, or I could maybe change this, you know, or Yeah, I think my preparation or maybe my planning, that's where I'm faltering, you know, because I'm not giving that planning component enough time or, you know, so then it's, it's more you listening to them work it out in front of you, right?

Um, and then you're like, yeah, that's great. Great plan. Let's do it. You know, um, that's maybe how I would approach it. 

Kate Grandbois: Um, I also what's coming to mind is something. That we also that we learned on the podcast, I think last season, uh, we welcomed to have, I think it was three or four guests who talked about mental health in speech pathology graduate students, because there was some research showing that, um, speech pathology [00:52:00] graduate students have some of the highest stress rates, uh, than, uh, compared to like I can't remember what the research says, and someone can write in and remind me.

It's also in our show notes for that episode, uh, but we have some of the highest, um, stress related, um, issues, you know, some of the most struggling mental health compared to all grad students across allied, allied health. Um, and I, I think just based on. Some of your previous advice about being a human first, just taking a second to consider, hey, is this, if there is this like true conflict where they're upset or they, they, they're, you know, there is, you know, they're, your conversations are contentious, just taking a second to be curious about them as a person.

In case there are additional things going on with them or the stress of graduate school is, you know, really wearing on them and this is the last straw, you know, we've all been there like where you telling me not to give [00:53:00] feedback for the client is the last straw and now I'm crying and yelling at you because So because this is so undeserved, you know, um, not that it, things get that dramatic necessarily, but, um, I think it's just worth holding space for that and, and all of your suggestions as well, because sometimes things are challenging.

And again, just another vote for your original advice, which is investing in that relationship and being a human first, because that's going to facilitate a much better outcome. And I have to also assume. I assume prevents some unwanted discomfort and conflict because if you do have that great foundational relationship, then they may come to you before they get overly stressed or you know, they, there's that safe space for vulnerability and asking for help, um, which is so important.

Ana Paula Mumy: You, when you were talking about mental health and just really any condition that, that student is facing, one [00:54:00] thing that came from sometimes, um, instances where students were struggling, um, again and again with something and you're like, okay, why are you not getting it? Um, it's. Leading them to other resources that would allow them to figure out.

So, like, for example, 1 student, um, did not have an autism diagnosis and she. Eventually through some conversations and just reflection and, um, she ended up going through like a, uh, an evaluation and, um, and then she realized, like, oh, my gosh, like, this is why I've been struggling my whole life because I have this undiagnosed, you know, condition that I never knew.

Right. And she always thought why can't I get it? So helping them identify, like, are there other things going on? Do you need support in another way? Whether it's ADHD or whether it's, um, autism or whether it's, you know, just something [00:55:00] else, right? Like, sometimes there are other.

Um, co occurring things that they have not identified, right, for themselves. And so, um, helping them along. I remember, um, and this doesn't have to do with a condition, but it had to do with a bilingual student who, even though she grew up in a bilingual home, because she had lost her expressive language in that language, she did not see herself as bilingual.

But she wasn't processing her challenges or difficulties that she was having with language To that, and it was like me walking alongside her and we even like ended up doing some testing and talking through different things to realize like, Oh my gosh, like, yes, you are an English language learner. You may not feel that because you don't speak that language anymore.

She still had receptive, um, skills in, in that home language, but she felt so far removed from it that she wasn't viewing herself [00:56:00] with that lens. And so it was almost like. Cause she was experiencing all kinds of like communication apprehension and rehearsing things that she needed to say because she was afraid that it was going to come out wrong.

Like there was just like all this mental, like cognitive load. Yeah. Happening, um, in meetings and whatever. And then as we talked about it and as we like probed and I helped her identify some things, it was like, Oh my gosh, like she was a new person because she felt. Understood, and she felt like here's the explanation for why I have struggled, where she before she actually said this to me, she's like, I just thought I was dumb.

I just thought that I just, you know, was, she always felt inferior. Right. And so just helping her just open this. You know, lens of like, Oh, this is why this is so difficult, you know, so our 

Kate Grandbois: grad students are people to the moral of the story, learning about themselves [00:57:00] in a very stressful time, speech pathology graduate school is so difficult.

A lot of individuals in graduate school are in an earlier phase of life. So, you know, where a lot of things can be in flux, everything from finances to family to housing to all the things. So I, I really appreciate that reframe, um, and in supporting them through their learning journey as three dimensional people who have lives outside of the clients that they're seeing.

And I think that that's a great practice to start. early, early in their career. Um, before we wrap up, I wonder if you could just give us a few pointers. And in your, in your talking points here, I see that you've got some suggestions for feedback as it relates to report writing. And I'd love to hear a little bit about that before we wrap up today.

What can you tell us about feedback for report writing? 

Ana Paula Mumy: Report writing is like what makes us pull our hair out, right? Because [00:58:00] again, students come with different skills when it comes to their writing skills. And so one aspect or something that I did was I developed a little, uh, rubric that would allow them to go through their writing and think about three different areas.

So we talk about content, we talk about clarity, and we talk about conciseness. So I, I have, These, um, phrases essentially that, so, for example, um, where they would, you know, write a report or a progress note or whatever it was, and then they would filter it through this rubric essentially, right? Where they're asking themselves, like, have I described my subjective observations and objective data, right?

Have I, um. Or it says, like, the information I have provided is specific and accurate, or I have used positive language to describe challenges, right? So, like, just helping them think about the [00:59:00] content. Then for, um, clarity is really helping them, um, cover the content in a way that's coherent, in a way that's clear.

So, for example, you know, using, um, uh, family friendly language, right? So Avoiding maybe a lot of jargon or, um, but also thinking about the audience, you know, if, of course, you're writing a report to, uh, an insurance company, that's going to look different than it does for a parent, you know, so thinking about your audience, um, but also are you giving tangible examples?

So again, it says, It's a declarative, so it'll say, I have made it clear who my reference is in each paragraph, or I have used, I 

Kate Grandbois: feel like I need this rubric, 

Ana Paula Mumy: blah, blah, blah. Yeah, 

Kate Grandbois: this sounds very helpful. 

Ana Paula Mumy: But they're doing like a self check right like I have I have I have done this or, you know, and then with conciseness is really just about, you know, Not writing the novel, right?

Like, give me enough information, but [01:00:00] not so much information that, you know, you are, um, going to lose me as the reader. So just what's the most relevant data, um, being concise, you know, within the sentences, but also descriptive across your paragraphs. And so just thinking about that. And then the last one being just mechanics, right?

So making sure that they're checking their spelling and their grammar and their punctuation. And, you know, just, I always, I'll tell. And not using chat GPT to write the report somehow. But I'll say to them, I'll say. Read it out loud to yourself because if you read it out loud and it makes no sense, it's not going to make sense.

You're a reader, right? So sometimes walking away from it, then reading it again. And so just walking them through that process to really help them improve as writers. Um, and Clinical writing so that they know again, this is the expectation, you know, and then I mean, still, you have to give gobs of feedback on writing, but at least it gives them that structure to think about.

[01:01:00] Okay, content, clarity and conciseness. So what does that mean? You know, and just helping them along in that process, which is really hard. 

Kate Grandbois: That's really wonderful. Um, I love, I love, we love a good rubric here. That's really, really helpful. And I, I also feel like having things written down and having a clear sense of direction again, back to your explicit, explicit instruction is really, really helpful.

Um, and I know you also have some handouts that you are going to put on our website that are to accompany. This episode. So thank you for those. We will link to those in the show notes. Um, do you have any parting words for wisdom for us, for anyone listening who is wanting to be a supervisor, who still is a super or who is a supervisor now?

What are your, what are your parting wisdom, words of wisdom for us? 

Ana Paula Mumy: No, I would just say, um, look this. [01:02:00] As an opportunity for you to grow to, um, and if you're wanting to do it, do it. You know, working with students is wonderful. It's very rewarding. I love it. Um, but then also self reflect, you know, what are you doing to ensure that, you know, your students.

Are not going to leave grad school, um, you know, hating the experience, like, am I going to, you know, encourage them in their love of learning? Am I going to foster that rather than kill it? Right? With that, those two years of, of grad school and, and just thinking about, you know, how can I contribute to their wellbeing and their enjoyment of learning?

How can I do that? You know, just on a regular basis and, and just helping with just it. Yeah. You know, avoiding the burnout and avoiding the exhaustion of, you know, being a student. Of course, that's a part of grad school and that's just inherent in the experience. But at the same time, we don't have to add to it, right?

We don't have to add to that burnout or to the exhaustion or to even their satisfaction with [01:03:00] grad school. You know, we can make a positive impact in the other direction. So I would just encourage supervisors in that sense and just keep doing what you're doing. It's, you know, we, we can't. Do this without clinical supervisors.

That's just obviously that's goes without saying, you know, and so, um, I just I'm grateful for everybody who's willing to do that because it's not for everyone. It's not something that necessarily is, you know, everybody's cup of tea. But for those who are willing to work with students, just keep doing it.

Your work means something that matters and is impactful. So. 

Kate Grandbois: Thank you so much for everything today, Ana Paula. This was really so wonderful. Uh, for anyone listening who would like to earn this, um, use this episode to earn ASHA CEUs or Certificates of Completion, the link is in the show notes along with links to the handouts that Ana Paula has, uh, included, um, and offered as accompaniments to today's episode.

There is also a list of all of our [01:04:00] references and resources. Thank you again so much for being here. We really appreciate it. 

Ana Paula Mumy: I've loved it. 

Kate Grandbois: Thank you.

Ana Paula Mumy: Thank you so much for joining us in today's episode, as always, you can use this episode for ASHA CEUs. You can also potentially use this episode for other credits, depending on the regulations of your governing body. To determine if this episode will count towards professional development in your area of study.

Please check in with your governing bodies or you can go to our website, www.slpnerdcast.com all of the references and information listed throughout the course of the episode will be listed in the show notes. And as always, if you have any questions, please email us at info@slpnerdcast.com

thank you so much for joining us and we hope to welcome you back here again soon.

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