In the past, good counseling skills and years of experience as a therapist were considered to be sufficient credentials for becoming a supervisor. But the role and the requirements for doing it have changed markedly over the last 15 to 20 years.
Supervisors have always been expected to help their supervisees broaden their therapeutic skills, develop their ability to work with a number of modalities (individual, group, family therapy, etc.), manage collateral work, and deal with their own stress with effective coping strategies.
Those tasks continue to be important. What has changed is a heightened emphasis on legal and ethical accountability.
In response, clinical supervision has become recognized as a distinct specialization, not just another assignment. The best way to protect yourself, the supervisees under your direction, and ultimately the clients, is to get adequate training in a model of supervision as well as in the legal and ethical responsibilities that come with the job.
This article is intended only to provide an overview of the issues involved in becoming a clinical supervisor. To fully understand the responsibilities of supervisors within your profession, see the standards for supervision that have been set by your professional organization.
Get adequate training: It is important, both for structuring your supervision and for taking care of yourself legally, that you choose a supervision model and develop expertise in using it. If you are ever brought into a court proceeding, your position as a supervisor is seen as far more legitimate if you can certify your training and document your on-going commitment to excellence as a supervisor.
Your credibility is enhanced when you couch your comments within a recognized supervisory model.
- Choose a model: Training and support are available for psychodynamic, patient-centered, behavioral, and cognitive-behavioral models, to name only a few. As with therapeutic models, none have been shown to be demonstrably superior.
If you are unfamiliar with the options, you can find helpful descriptions and demonstrations of different models for counseling supervision on Youtube and online. Look into training opportunities through continuing education programs, workshops, and graduate school programs. Join the related professional organization.
- Get supervision of your supervision: For very much the same reason as therapists need supervision, supervisors deserve the support, additional training, and legal protection that comes with being supervised within the model in which they were trained. Good supervision notes provide important documentation of your activity and your integrity as a supervisor.
Liability issues: We live in an increasingly litigious environment. To be officially named (or to name yourself) a “supervisor” has legal and ethical meaning. Be clear with your employer and with yourself about your qualifications and what you are and are not agreeing to do in a supervisory role. To protect yourself, your supervisees, and your agency, consider including the following tasks in your job description:
- Review of all clients: Be aware of all of your supervisees’ clients, not just the ones that are of most concern to the therapist or only the cases the therapist chooses to bring to you. Periodic review of each therapist’s entire caseload ensures that you are not caught off guard if a case becomes difficult, threatening, or litigious.
- Live supervision: Periodically sit in on your supervisees’ cases, both to be helpful with the cases and to monitor therapist competence and client care.
- Personnel issues: Be clear about your involvement in personnel issues. If you will be involved in disciplinary actions or firing decisions, it’s important to get comfortable with the fact that ensuring compliance with agency policy is the priority.
This is often a challenge for supervisors who are more comfortable advocating for a supervisee who is struggling due to issues in their private life or for a therapist who does excellent therapeutic work but doesn’t do well with the necessary collateral tasks.
- Time for documentation: Documentation is part of taking care of yourself legally. It’s a good idea to formalize your supervision agreement with the therapists under you by developing a written supervision contract that spells out your respective roles and your relationship.
Keep process notes for all supervision sessions. It’s essential to discuss and document any corrective directives to supervisees when they occur so they aren’t surprised by a negative personnel review.
Ethical Issues: Responding to ethical issues is a constant balancing act. Supervisors are responsible for managing the rights and responsibilities of their supervisees, the rights of clients, and their own responsibilities to both groups.
- As with therapy, it’s essential to only supervise within your own area of competence. It is ethical to refuse to supervise clinicians who are doing work for which you have little or no training.
- Your supervisees have a right to informed consent. That should include a mutual agreement about the frequency, purpose and expectations of the supervisory relationship and how they will be evaluated. as well as how your will document progress. Further, it’s very important that supervisees understand your agency’s limits to confidentiality about the content of supervision sessions.
- Dual relationships: This is especially difficult if you have been promoted from within the agency and have been a peer with the very people you must now supervise. Do consider this issue before accepting the assignment. If you do accept such a promotion, clarify boundary issues with your superiors and your staff.
- If a supervisee violates ethics of his or her profession: Supervisors are generally expected to ascertain that the client is safe and supported, to suspend the therapy and provide a transfer, to inform superiors, and to decide if the situation is egregious enough to report the therapist to their licensing board.
Insurance: It’s imperative that you carry professional liability insurance in an amount sufficient for worst-case scenarios. Be aware of the limits of agency protection for your work and fill in with an additional policy if need be. Many professional organizations offer insurance at reasonable rates. Many also have a legal team that can be helpful when needed.
Clinical supervision of other therapists’ work is a huge responsibility but it is also a very rewarding role for senior clinicians. It is an opportunity to develop other therapists, to apply years of experience to a wide variety of cases, and to ensure excellence in client treatment. Done well, the demands for accountability are more than compensated for by the opportunity to “pass the torch” of excellence in therapeutic work to supervisees.