Everywhere I go I run into conversations with new therapists about clinical supervision. The underlying theme in those conversations is “How do I get the most of out clinical supervision?” That question is exactly what Lauren Ostrowski agreed to write about today.
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A Guest Post by Lauren Ostrowski, MA, LPC, NCC, DCC
As mental health professionals, supervision is always going to be a mainstay in our routines. In general, I hesitate to 
use the term “requirement” when discussing supervision because I believe that case consultation with colleagues and supervisors can provide valuable and important learning opportunities. Of course, this must be discussed in informed consent documentation. It’s also imperative for supervisee and supervisor to be a good fit for one another.
For the purpose of this blog post, however, I am referring to required, formal, clinical supervision where there is a contract or agreement in place. Depending on education or licensing requirements, clinical supervision likely plays a major role at one time or another.
Think back to your supervision experiences. What comes to mind? After asking a range of counselors that question over the course of several years, the responses varied from supervision being “just a requirement” to “a wonderful experience that I learned a lot from.”
Now, here’s another question: What made it a great experience or would have made it better? Chances are that most of those answers will be related to preparation – whether on the part of the supervisor or the supervisee – before, during, or after the supervision session.
For the Supervisee
When I was receiving supervision for my license, I found that some preparation was helpful. Some elements related to professional development took some time (preparing for presentations or researching different ethical components, for example). The majority of my preparation was very easy to do, but also very crucial for making the most of my supervision experience.Here are some things that I found helpful as a supervisee:
- Take notes during the week so that you don’t forget what you want to cover at the next meeting (these can be 2 to 3 reminders).
- Be prepared to take just a few minutes with a concept that you think may take the whole session and vice versa.
- Be mindful of what is going well and what you would like to improve upon; chances are discussions of those positive occurrences can lead to learning something new.
- Don’t forget to discuss things that may not be directly client-related, such as an interaction with a colleague or a relevant news item.
- Remember that supervision is often focused on what we can do better, but it doesn’t mean that what you are already doing is necessarily wrong; it may help to think of it as different
For the Clinical Supervisor
Preparing for supervision as a supervisor can also vary widely, depending on needs and desires of both supervisee and supervisor. While I do not hold a credential specific to supervision, I have taken several different continuing education courses on supervision. I have worked with interns in two capacities: informally, as a colleague discussing cases that they had observed, and formally, where the intern’s cases and professional development are paramount to discussion of observed cases.Here are some things that I find helpful as a supervisor:
- Remember where the supervisee is in their professional development – There will be different questions brought to the table by a master’s level intern as compared to a seasoned professional who is seeking licensure in a third state and needs additional supervision hours.
- Find a balance in the pace of supervision sessions that is right for both supervisee and supervisor.
- Discuss at least one concept that is not directly related to client care in each supervision session – this can really help to divide discussions between cases and it offers the chance to answer questions or provide information about professional development or current events.
- Provide information about counselor self-care – anecdotal evidence has shown that supervisees seem more likely to take this concept seriously when it is discussed often in connecting with certain difficult sessions.
For Your Consideration
I find these questions to be helpful when there is time remaining and all of the other goals for that session has been accomplished – it may even be useful for both supervisor and supervisee to answer them:
- What is a memorable statement or event from a session?
- What has one or more of your clients taught you that changed the way you look at something or approached it in future sessions with others?
- What occurrence in session has made you happy, nervous, rattled, or surprised?
- If_____ [something that happened] in session, I feel that I would be able to handle it at the time, but I definitely know I would need supervision afterwards.
- What do you find easiest about counseling? Most difficult?
What kind of preparation did you do as a supervisee?
What do you do to prepare as a supervisor?
If you haven’t yet been a supervisor, what do you think you would do to prepare?
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About the Author: Lauren C. Ostrowski, MA, LPC, NCC, DCC is a counselor in a community mental health agency in Pennsylvania. She is also a Distance Credentialed Counselor and is excited about beginning a limited private practice using distance (online) counseling.
Thank you, for some sound advise! I too have been a supervisee as well as a supervisor. This can be delicate when you have to supervise your co workers when your boss is away. I have had to do this on several occasions. When I have had to tell my co worker to go back and do a suicide assessment, or report a situation to child protection, I have had to be careful not to do this from a one up position. For me, I have stressed the point that we want the best for the client or family, as well as protecting ourselves. I just thought I would share this because some maybe put in this very same position. Thanks!
Hi, Nancy! You make a great point about that whole balancing act! It can be really tricky, can’t it?! And, of course, then there’s the whole administrative supervision thing vs. the clinical supervision thing, too!
Nancy, you mention an entirely different element of supervision when you’re talking about stepping in on behalf of someone else as a supervisor. You also emphasized a really good point about the main focus being on the welfare of the client.
I have been lucky to date in that I have been able to stress certain things (such as suicide assessment, child abuse/protection, or important questions for clients who are experiencing hallucinations) prior to when the events have actually occurred. I have also set up some guidelines for when it would be advantageous to speak to me or another clinician prior to the end of the session. This can even be necessary in non-crisis situations at times.
Thanks for the insight into what it’s like to try to work with a situation after the fact or when you’re not the primary supervisor.
Does anybody have anything special that helped them prepare for supervision?
Is there anything you wish you or the other person in the supervisee/supervisor relationship would have done differently?
Lauren, I was clueless when I was under supervision. I thought I was supposed to ask my supervisor about “problem cases” but beyond that I had no idea how to maximize the benefits of my supervision. (That’s why I love your guest post here!)
Thankfully, I had a really great licensed social worker, Jane Oderberg, for a clinical supervisor. She took the initiative to bring useful information to me, prompt me to look beyond my client load for growth, and was incredibly supportive.
The whole trend in clinical supervision now is to see it as your first post graduate steps in professional development. That’s why supervisees should be expected to have supervision plan that provides some type of path for professional growth.
I would also add that the trend in clinical supervision is to require clinical supervisors to have actual training in supervision (because, of course, clinical work with clients requires different skills than supervisory skills). I know in Texas they initially require 40 hours of such training. I would recommend that any supervisee seek out potential supervisors who have invested the time and resources to learn supervision in addition to the clinical work of counseling, social work, or psychology.
Tamara, I was lucky enough to have several supervisors who had strengths in different parts of supervision. My last clinical supervisor prior to licensure (as part of licensure hours) was really a wonderful counselor, mentor, and I must admit, confidence builder. While most of the case discussion was focused on cases with which I was looking for other strategies or guidance, sometimes I would report back on something that had worked really well (whether or not the idea came from supervision) and most of the time, even these discussions would lead to more learning other opportunities for growth and change. I remember being anxious to work with this particular supervisor in the beginning, but halfway through the first session, I realized that most of my concerns were not valid and I knew it was going to be the best experience of my professional career.
Before this last supervisor that I’m speaking of, I had absolutely no direction in terms of involvement in the counseling profession. Not only did I learn about licensing and certification processes, I have come to really understand the requirements enough that I can explain them to others (with the caveat that they are continually changing, of course).
I also learned about the value of joining professional organizations and becoming involved in them through working with this supervisor. I would not have gone to the Pennsylvania Counseling Association conferences had it not been suggested by him. I was amazed by how much I felt more connected to the counseling profession after joining ACA and becoming more involved in PCA and conferences.
Oh, my gosh, yes! Getting connected to your particular discipline makes a qualitative difference, doesn’t it? Which reminds me . . . I would definitely recommend that if possible you get your initial clinical supervision under someone in your own discipline. There is plenty of time to work with colleagues across discipline but it’s so very helpful to start out with a really clear understanding of your own discipline’s strengths and weaknesses! For all of the many way’s that Jane was a ROCK STAR of a supervisor, I do see the advantage of staying in discipline . . . especially for newer professionals.
It’s so hard sometimes for new professionals to find the courage and direction needed to engage with their professional associations at the state and national levels. However, for so many reasons that is exactly what help your career grow exponentially. Glad you and PCA found each other!
There has been recent mention on the CESNET-L listserv about a sort of rating scale or assessment used to help supervisees consider different theoretical orientation. Does anybody here use written instruments for that?
The American Counseling Association has links here about counselor wellness and impairment, which may also be useful when providing supervision: http://www.counseling.org/wellness_taskforce/tf_resources.htm
Thanks, Lauren! I’ll share whatever I suggestions I receive from CESNET-L here soon!
I think this is a really great topic. I have had 3 – 4 supervisees at a time over the last few years and I really enjoy the work a lot. I sometimes struggle with striking a balance between encouraging them to come prepared, and allowing some space for meandering conversations which can lead to meaty clinical or professional development conversations. When organizational issues are at the fore for clinicians, it really is important to help them manage this in terms of navigating the system, setting boundaries around work, and feeling steady and riding the “waves” even when your institution feels unsteady. At the same time, though, I don’t think that we should sacrifice clinical discussion and learning. I try to talk collaboratively with supervisees to find an ongoing balance here, but I would appreciate others’ perspectives on this issue as well. Thanks again!
Hey, Amy, it really is a balancing act, isn’t it?! And with so many of our agencies these days being under-funded and under-staffed, a lot of our work as clinical supervisors really is about teaching self-advocacy, isn’t it? I absolutely know what you mean!
Hey, I’m noticing that this blog post is one of my older ones and so will not get a lot of traffic – at least not as much as this topic deserves. I don’t know if you would be interested but . . . I would love to have a guest post written on some aspect of this topic so that we can get more dialogue going about this. Would you have an interest in writing that? Here’s a link to my guest posting guidelines. If you decide to write it, I’ll be happy to link it back to your website so that you can get some traffic and boost your SEO. What do you think?
Hey Tamara:
I think this is a great idea! I will get to work.
Amy
Great! Looking forward to it!
Has anyone ever written an informed consent for supervisions?
Hi Wendy,
I do have a consultation agreement. Is this the kind of thing you’re looking for:
NAME is a counselor for OFFICE NAME and is seeking clinical supervision to become licensed as a Professional Counselor. The purpose of clinical supervision is to provide guidance and support to your counselor as they pursue licensure. Part of clinical supervision includes a review of counseling skills and record keeping.
As a client, you are being asked to sign a consent form allowing me to have access to your clinical records and to monitor your case while you are receiving counseling services at OFFICE NAME. Normally, there is no need for a special consent since clinical supervision is part of the operating procedures of counseling agencies and is generally accomplished using supervisors who are employees of these agencies. What makes this situation different is that I am providing supervision outside of my typical role as a counselor at OFFICE NAME. Therefore a special consent form is required. As a licensed professional counselor and a national certified counselor, I am ethically and legally bound to protect any information I obtain regarding you or your situation.
From time to time, direct observation of counseling sessions will occur as part of the supervision process. These observations are necessary to evaluate the clinical skills of the therapist and are not related to the issues presented by any particular client. Due to the sensitivity of certain issues, clients may feel uncomfortable with an observer in a particular session and can verbally refuse to allow direct observation without recourse.
Just as with any other consent, you have the right to rescind this consent at any time following the procedures established by OFFICE NAME and explained to you during intake. If you decide to rescind your consent, there will be no negative actions taken against you and my access to information about you will cease immediately. Your consent is being given voluntarily.
The following is my contact information and professional credentials:
If you have any questions regarding the clinical services provided by your counselor, you have the option to speak to the administration of OFFICE NAME or me to discuss your concerns. Your signature below indicates you have read this form or have had this form read to you and that you received a copy.
Hi, Lauren!
It’s good to have you back here!
Thank you for your generosity.
I have not yet heard back from Wendy but I think that she is actually wanting examples of a disclosure statement for clinical supervision (rather than consultation).
I think she may be thinking about starting to offer clinical supervision.
Hi, Wendy. You can find what goes into an informed consent for supervisors right here – http://www.cce-global.org/ACS. And, if you google “Informed consent for clinical supervision” or “disclosure statement for supervision,” you can find lots of examples. And, finally, any decent training on how to do clinical supervision will likely have feedback and samples for you.
HI Lauren,
I was doing a google search in order to try to structure the supervision that I provide to be more beneficial and to have direction and this article came up in the search. Fantastic advice! I saw your face at the bottom and said, hey I know her 😉 It looks like you are doing very well! Nice to “see” you 🙂
Hi, Amber! I’m so glad you found it helpful!
Don’t laugh but I know 3 different Amber Giffiths!
Which one are you?
Didn’t see a website listed so can’t go find you!
Hi Tamara,
I’m not sure we’ve ever met. I met Lauren in undergrad. Lauren, I will get in contact with you! I’m super excited to reconnect.
Amber! Hi! I’m glad you found the info to be helpful.
Feel free to email me if you’d like: Ostrowski.Lauren@Gmail.com. I would love to catch up if you are interested in doing that. A lot has changed in the decade or more since we have seen each other. Was that all the way back in undergrad? My goodness! Hope you’re well.
I appreciate this blog article! I’m curious if you (or anyone else who has commented) know of any consultation groups for clinical supervisors? I’d love to get involved in a once a month event to discuss everyones’ experiences, as well as new models and interventions of clinical supervision.
Karen Kerschmann, LCSW
Hi, Karen! Thanks for dropping in to chat this week! I’m so glad you find this article useful! Where are you located geographically?
Hi Tamara!
I’m in San Diego- sorry, thought I had put my website in! https://therapyinsd.com
Karen