區辨模式沙盤督導對受督焦慮與督導效能之影響：十二次沙盤督導之研究

Effect of Sandtray in the Discrimination Model of Supervision on Supervisee Anxiety and Supervisory Effectiveness: A Study of a 12-Session Sandtray Supervision

10.6251/BEP.202203_53(3).0008

蔡美香(Mei-Hsiang Tsai)

區辨模式 ； 沙盤督導 ； 受督焦慮 ； 督導效能 ； discrimination model ； sandtray supervision ； supervisee anxiety ； supervisory effectiveness

教育心理學報

53卷3期（2022 / 03 / 01）

687 - 716

繁體中文

本研究探究區辨模式沙盤督導對受督焦慮與督導效能之影響，共招募5對大學場域之全職實習諮商心理師及其督導者，配對督導者──受督導者，進行每週一次、共12次沙盤督導，督導單元依據本模式六個步驟進行。本研究以質性為主、量性為輔，研究參與者在沙盤督導第四、八、十二次後，接受個別訪談，共三次。受督導者接受沙盤督導前，填寫「預期受督導者焦慮量表」；督導者進行沙盤督導後，填寫「沙盤督導自我評估表」，共12次。訪談資料以內容分析法進行分析，量表資料以Wilcoxon等級檢定加以分析，以了解受督導者在督導歷程的焦慮情形及依循區辨模式督導者運用沙盤督導的效能及其轉變。結果顯示受督焦慮主題為：擺盤克服挑戰、展露安心；沙盤承載情緒、安放焦慮；沙圖具象故事、顯現脈絡；沙盤照映內在、滋長力量。督導效能主題為：跨越擔憂、喚發信心；隨心駕馭、斟酌平衡的督導焦點；水能載舟、亦能覆舟的督導者角色；穩固同盟、豐厚理解；共同觀盤、效能提升。結果亦顯示受督焦慮達統計顯著下降、督導效能無統計差異。研究者依據結果提出討論與對未來研究與實務的建議。

In Taiwan, the Psychologists Act was passed almost 20 years ago. According to the regulations, counseling psychology education must consist of core professional courses and 1-year full-time internship (Psychologist Act, 2020). This internship is a necessary component in which counselors-in-training integrate the knowledge acquired in their professional courses into counseling practice. As part of practical learning during the full-time internship, gaining supervision experience is essential. During the past decade, creative supervision of expressive arts such as puppet play, sandtray activities, and drawing has gradually developed and received increased attention. The creative activities in creative supervision involve interactive relationships among the supervisor, supervisee, and client. The symbolic and metaphoric communication in these relationships can be presented through creative works and can deepen the discussions between supervisor and supervisee. Creative works can assist the supervisee in expanding the vision of a client's inner world and in expressing their personal emotions. Creative approaches also support the supervisor in enhancing their supervisory working alliance and supervisory effectiveness. Sandtray therapy, developed by Lowenfeld (1979), creates a safe and protective space in which individuals can exercise control, lower their defenses, overcome resistance, set boundaries and limits, address interpersonal and intrapersonal problems, and express non-verbalized emotional concerns. With its nonverbal characteristics, sandtray therapy is beneficial in terms of both counseling and clinical supervision. The discrimination model of clinical supervision contains two dimensions that cover the foci of supervision and roles of the supervisor, all of which unite in a three-by-three matrix to form nine supervisory strategies. The foci of supervision comprise intervention, conceptualization, and personalization skills, and the roles of the supervisor comprise teacher, counselor, and consultant (Bernard, 1979; Bernard & Goodyear, 2019). This study explored the impact of sandtray in a discrimination model of supervision on supervisee anxiety and supervisory effectiveness. Five pairs of full-time counseling interns and their clinical supervisors were recruited from three university student counseling centers as research participants. The five supervisors all had master's degrees in counseling psychology and 5 to 10 years of practical experience. The five supervisees were enrolled in master's counseling programs and were participating in full-time internships. Before conducting sandtray supervision, the supervisors received 2 days of professional training in sandtray therapy, discrimination supervision modeling, and applying sandtray in a discrimination model of supervision, with a total of 6 days of training. This research focused on qualitative data that were supplemented with quantitative data. The supervisors conducted weekly individual sandtray sessions with discrimination supervision with their paired supervisees for a total of 12 sessions. The supervision process was based on the six sandtray steps in the discrimination model of supervision used in this study. All supervisors and supervisees participated in individual interviews after the fourth, eighth, and twelfth supervision sessions for a total of three interviews. Additionally, the supervisees completed the Anticipatory Supervisee Anxiety Scale prior to their sandtray supervision, and the supervisors completed the Sandtray Supervision Self-Evaluation Form after conducting sandtray supervision; each scale and form were thus completed 12 times. The interview data were analyzed using the content analysis method to understand the supervisees' anticipatory supervision anxiety and to assess the supervisory effectiveness of the supervisor from the framework of the discrimination model of supervision. Scale data were analyzed using a non-parametric Wilcoxon signed-rank test. Based on the qualitative results, the themes of supervisees' supervision anxiety included the following: the sandtray layout assisted in overcoming challenges and enhanced peace of mind; the sandtray carried emotions and situated anxiety; the sandtray picture represented a concrete story and its context; and the sandtray reflected the inner and developed strength. The following themes of supervisory effectiveness were observed: worries were overcome and confidence increased; control was maintained and the balance of the focus of supervision was considered; the role of the supervisor can be positive at times but it can also be negative; the working alliance was stabilized and understanding enhanced; and views were shared and effectiveness improved. The findings from the Anticipatory Supervisee Anxiety Scale demonstrated a statistically significant decrease in supervisee anxiety (Z = -2.02, p = .043) following the 12-week sandtray program with discrimination supervision. The results from the Sandtray Supervision Self-Evaluation Form revealed no statistical difference in supervisory effectiveness (Z = -1.22, p ＞ .05). Based on the results of the study, the researcher offered four recommendations for future researchers. First, sandtray with the discrimination model of supervision can be conducted with supervisees at different stages of professional development, such as practicum interns and novice supervisors who have received supervisory training to explore the effectiveness of this supervision model. Second, the effect of sandtray, combined with other supervision models (e.g., integrated development, system-oriented, or self-awareness supervision models), on supervisory effectiveness must be investigated. Third, multiple interventions (e.g., once every other week or once a month) can be conducted to enrich the application of this model. Measurement of the retained effects on supervisory anxiety and supervisory effectiveness can also performed. Fourth, an effectiveness assessment tool for sandtray supervision could be introduced. Finally, according to the process and results of this study, the researcher proposed six practical suggestions for future sandtray supervision. First, the creative supervision model can be integrated into supervision training courses to enhance supervisors' supervisory ability and diversify supervision approaches to increase supervisory effectiveness. Second, a sandtray therapy course can be offered as part of the counseling program. Learning about sandtray therapy can strength counseling students' ability to apply symbolic and metaphoric concepts during their internships to enhance their counseling effectiveness. Third, sandtray supervisors are recommended to acquire knowledge and practical experience in play or sandtray therapy to ensure they are familiar with the expressive medium and the use of symbolic and metaphoric response skills. These trained sandtray supervisors could then provide clear and specific supervision direction during the sandtray supervision process. Fourth, sandtray supervisors must also be supervised after conducting sandtray supervision. Sandtray in the discrimination model of supervision combines two professional fields. At the beginning of a sandtray supervision session, sandtray supervisors can choose a supervision intervention strategy from the nine specified supervision strategies but may dynamically switch supervision strategies according to the supervision context and supervisees' responses. Because the evaluation of the transition of the supervision strategy is related to the supervisors' professional ability, supervisors can deepen their understanding and mastery of sandtray in the discrimination model of supervision when they receive individual or group supervision after performing supervision. Fifth, supervisees must have experimental experience in sandtray creation before being subjected to sandtray supervision. Because of the highly emotive and expressive characteristics of the sandtray medium, supervisees may feel surprised or panicked through their disclosure of their thoughts or emotions in the early stages of supervision. If supervisees have no sandtray experience, supervisors can offer experimental sandtray sessions to assess how supervisees react to the sandtay medium. Thus, supervisees can increase their familiarity with sandtray materials, which can strengthen their sense of security in sandtray creation. Sixth, to provide sufficient time for sandtray creation and discussion, each sandtray supervision session must be allotted at least 1.5 h. Therefore, supervisors and supervisees can deepen their discussion and exploration of the supervision content.

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