Cultivation of the Therapist
Clinical supervision requires more than the oversight of cases. Clinical supervision requires the cultivation of the therapist. Beginning therapists often hope that at some point they will learn everything that they need to know about being a therapist. They believe that there is a place they will arrive and that once there, they will obtain all of the knowledge that they need.
The truth is…it is common to feel uncertain. Experienced therapists feel uncertain. We all need support and guidance from time to time.
Clinical supervisors need to facilitate dialogue with their supervisees that reveals their values and beliefs. What therapists truly believe guides every aspect of therapy. For example, do they believe that their client can be helped? Do they believe it is a hopeless case? Do they believe that they are capable of being effective?
Clinical supervision can be provided by someone in the supervisee’s work setting or by an off-site supervisor. The challenge of onsite supervision (beyond the internship stage) is that supervisors have a vested interest in helping the supervisee to function in that setting. They can become de facto administrative supervisors whether that is the role or not.
Clinical supervision should engage on a “meta” level. The meta level is observational. I imagine it like a perch upon which an aspect of my consciousness sits above the supervision meeting I am facilitating. From that perch I am observing myself and the other (supervisee).
- Supervisors need to be “thinking” about their own thinking.
- Supervisors also need to be “thinking” about their supervisee’s thinking.
- The meta level involves an awareness of what is happening and what it means.
- Supervisory interventions need to be informed by meta-analysis.
Don’t: Focus only on the Therapy Client
An important function of clinical supervision is looking out for the welfare and protection of the therapy client. However it is not the only function. Additionally, the best way to look out for clients is to support the overall competency of the therapist treating them.
Many supervisors are more comfortable in their role as therapist. They have developed their therapeutic skills for a number of years. Clinical supervisors will revert back to their therapist role naturally and as needed during supervision. However, if the supervisor is only thinking about what they would do if they were treating the client when providing clinical supervision, then they lose track of the supervisee. The supervisee becomes a surrogate for the supervisor as therapist in the room with the client.
Administrative supervision is a function of employment. It is the role of the director or someone the director assigns such as a clinical director, team leader or manager/supervisor. Treatment team meetings and staff meetings are administrative in function.
Administrative supervisors oversee the therapist’s work on behalf of an organization and that organization’s goals to serve clients. Administrative supervision can have an impact on their employment and job related performance reviews. Clinical supervisors provide evaluation primarily for the purpose of the supervisee’s professional/personal development.
Administrative supervisors are concerned with role, duty, and function, as well as the execution of tasks related to billing and payment. Administrative supervisors are fulfilling their duty to the clients served and they employ or oversee therapists to perform those tasks.
Do: Attend to Boundaries
Effective administrative supervisors attend to healthy boundaries. They support the value of clinical supervision. They try to perform their managerial tasks while honoring the growth and development needs of the therapists they employ.
They are aware that the role of Director/Administrative Supervisor involves a certain amount of power over the supervisee/employee/contractor. Clinical supervisors have to be aware of healthy boundaries as well. Safety is paramount for budding therapists. They are depending upon their administrative and clinical supervisors to endorse them for licensure.
Don’t: Abuse Power
Abuse of power can occur when supervisors – whether clinical or administrative – put therapists in a position to suppress their ideas or aspects of self in order to appear agreeable and continue in their employment or supervision. This is not to say that supervisors should never provide directives or instruction. Instead, supervisees should always have a seat at the table. They need opportunities to share their views and to ideally come to a shared rationale for decisions that are made.
A relationship of mutual respect is the foundation. Further, supervisors must be able, willing and aware that ego can and does get in the way of our work. It is our ability to catch our selves, repair the damage, and take responsibility that demonstrates the highest standards of our profession.
ACES- The Association of Counselor Education and Supervision
I highly recommend that supervisors review Best Practices in Clinical Supervision Adopted by the ACES Executive Council April 22, 2011. ACES is a division of the American Counseling Association.
It outlines 12 areas of competency and best practices for supervisors. It serves as an effective outline of what supervisors should do as we create the structure and foundation for counselors to become themselves as therapists.
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