A soon-to-be fully licensed clinician sat across from me for one of our last supervision sessions. I told him the same thing I say to everyone when they get to this point. After today, you will have your license in your hand, and depending on the nature of your practice, you never have to talk to another mental health professional again for the rest of your career.
Although it is improbable that any clinician will literally never speak to another person in the field, it is not at all improbable that they may not have any “supervision” for the rest of their career. That should make us all shudder. I regularly present trainings — often on supervision, ethics or both — at conferences. I can tell who is there to learn and who is there just to get a piece of paper that says they sat in a room for five hours. I wouldn’t want my counselor to be in the latter group.
I want the newly trained clinicians I supervise to see the ethical responsibility they have for their own self- assessment, competence and professional growth. Those who isolate themselves in their own practices and see clients day in and day out, are at risk of being the same counselor a year from now that they are today. They won’t have someone sitting across from them each month asking them “What are your strengths and what are your weaknesses?” like I do with my supervisees.
Using a 10-point scale, I evaluate my supervisees using nine areas of competence: ethics, theory, diagnostics, case presentation, clinical skills, documentation, diversity, self-care and remediation. I ask my supervisees to rank where they are in these nine areas during the final weeks of supervision, and they almost always rate themselves higher that I rate them.
I know why. They are very good at the things they know and the issues they face regularly. But what they lack sometimes is a recognition of what they don’t know — questions they don’t even stop to ask.
For example, when I asked one clinician, “On a scale of one to ten, where are you in your understanding of the Diagnostic and Statistical Manual of Mental Disorders (DSM)?” she gave herself a nine. But when I probed a bit, she admitted she hadn’t even looked at the latest edition, DSM-5-TR, and didn’t know what changes had been made. She is a competent clinician who knows what she needs to know with the clients she sees every day. But she didn’t know what she didn’t know. That is why supervision, consultation and training are critical.
Some clinicians are just lazy and unethical. They won’t grow because they don’t want to. I can’t do much about them.
But others fail to pursue professional growth because they don’t know any better. Evidence of weak professional growth might look like the following: You see your continuing education requirements as “hours you have to get” as opposed to opportunities for growth. If this is the case, I have concerns about your professionalism.
Some clinicians wait until the month their license renewal is due and then scramble to get any continuing education credits that meet their state requirements. Hmmm, that doesn’t scream “professional” to me.
If a counselor doesn’t see the need to regularly meet with other professionals in the field, discuss cases or ask for someone to look over and evaluate their work, then it sounds like someone who thinks they have “arrived” and have nothing else to learn.
When it comes professional growth, I practice what I preach. A few years ago, a married couple came to me in an attempt to repair their seriously broken relationship. It was an incredibly complex and challenging case for me. Even though I’ve been in practice for decades and started my general practice in the 80s as a family therapist, I’m not a licensed marriage and family therapist (LMFT), so I wasn’t fully confident I was seeing everything I needed to see with this couple.
I sought supervision from a LMFT I trusted. He was humbled at my request because he was my former student and former supervisee. But he had far more experience in the marriage and family arena than I did. I consulted with him for months about this case, and happily the marriage survived.
In addition to seeking supervision when needed, I also evaluate myself using the nine areas of competence that I use to evaluate my supervisees (i.e., ethics, theory, diagnostics, case presentation, clinical skills, documentation, diversity, self-care and remediation).
My challenge to you is to rate yourself on these nine areas and, even more important, have a colleague rate you as well. If you don’t have a colleague who knows you well enough to evaluate you, then that tells you that you have some work to do.
Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.
Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.