Tag Archives: counselor supervision

Developing trust in your effectiveness as a helper

By Peter Scheer September 12, 2017

As a newly minted counselor, I sometimes remember back to my early days in the program when my classmates and I shared some deep concerns about “doing it right.” Our heads were full of theories and dos and don’ts, and we really struggled to understand how we could possibly help anyone as we stumbled around during our practice sessions with other students during the prepracticum course.

While reviewing tapes of our sessions in class, we questioned ourselves: Were we doing anything to help this client? Were we just wasting their time? What the heck were we doing as counselors?

Many months later, after completing our required internship hours under the supervision of a licensed practitioner, we then had to supervise students in their early stages of counseling during prepracticum. I was actually very glad for this experience and quite surprised at how much it reminded me of where I had been at the beginning of the program. I observed my supervisee and recognized many characteristics that I had at that stage: self-doubt, setting high standards for myself, wanting to control the session.

It made me realize how far I had come. I was surprised at my ability to empathize with my supervisee and to find words to ease their concerns while providing some guidance and hope that they too could make it one day. I saw how much my internship hours had changed me and helped me develop some degree of confidence.

While reviewing tapes one week with my supervisee, I noticed that they were struggling significantly with self-doubt and wanting to see improvements quickly. The supervisee felt that because they had not managed the counseling session well enough, the client had not been well served. The supervisee took on a lot of pressure to get an outcome and ended up feeling very inadequate.

A few days after the session was over, I thought of a personal experience that had been significant in helping me to see how therapy works. It was a single session that was so helpful, although neither I nor my therapist knew it at the time. Over the course of about 20 years, I went to 12-step meetings to work on my codependency, went to therapy off and on, read many books and discussed mental health with others who were also in emotional recovery. I explored spiritualty and many forms of alternative healing modalities. Many times I encountered the concept and benefits of forgiveness and would remember my therapist’s story. Like water dripping on a rock, over time, my stubborn anger softened and yielded.

I want to share my journey to wholeness and how that first encounter with forgiveness was foundational in my eventual release of anger, even if that therapist is unaware of how she helped me. I share that with you now using an excerpt from an email to my supervisee.

 

Email to supervisee

I did have something else that I wanted to share with you to support you with this new skill that you are developing.

I recall your desire to steer and to control the session and hope to see some results, or at least some change in the client fairly quickly. Also, your desire to rate and assess your personal helping skills during a session. This mental health therapy is quite different than other professions, as we have discussed. I too came from a problem-solving profession where we assess, diagnose, make a plan, implement it and reassess … and try something new if that does not work. It is quite action-oriented and “managed” by us. We rely on feedback of some sort to assess progress.

However, mental health therapy is quite different. It has some similarities in that we may try different approaches until we see progress. However, the feedback we get from the client can range from direct and clear to none at all. Many times it is vague and sometimes even evasive. It is really hard to work with this kind of self-reporting as feedback.

Also, a reminder that counseling is a collaborative activity. We may forget that desired change in the client requires action and effort by both counselor and client. It is not realistic to think that we as counselors are solely responsible for client outcomes.

Finally, you may recall I mentioned that a client may actually be helped even if they do not show it in session. We may say something that triggers an awareness that proves helpful, but we, as the therapist, do not know of it. I want to share a personal experience I had to illustrate this point.

Many years ago, I saw a therapist. This was my first experience with counseling. It was possibly our third or fourth session, and I was struggling with unresolved anger at my father. She sensed that I needed help to forgive him and release the emotional burden I was carrying. She told me her personal story of forgiveness. How she managed to forgive the DUI driver who killed her only child, and how she found emotional peace after that. I was both stunned and impressed by her ability to forgive and her calm and peaceful demeanor while recounting it. Clearly, she walked the talk of emotional wellness.

While I found it impossible to forgive, I was deeply affected by her story and thought of it many, many times over the years. I returned to that story many times as I worked through my anger with my father and as I learned how to forgive.

Her story did not “fix” my problem with my father, but it certainly did give me a new awareness about forgiveness, what it means and the benefits of forgiveness for me. It has taken 20 or more years to forgive my father. However, I worked on it and am now at peace with that relationship.

To illustrate how a therapist may help a client but not know at the time, and how the collaborative nature of counseling should work, I offer the following questions and answers for you to consider:

Did that therapist “cure” me in that session? No.

Was that session helpful to me? Yes.

Did I tell the therapist at that time this was helpful? No (because I was just processing this information).

Did that therapist lay a foundation for a positive change in me? Yes.

Does she know today how that one session helped me? No.

Who had the choice to work on changing me? I did.

Who did the actual work to change me? I did.

I think what I carry with me because of this experience is the awareness that I may be helping this client in front of me, but I may never know it. I may be adding one brick to this client’s efforts to rebuild his/her house of emotional health. I may never see the finished house. It may never be finished. But I know I tried to help the client in the moment. I am not sure I can do more than give it my best effort and keep learning and stay focused on the client.

This all feeds into the notion of “letting go” of the outcome of a session. To accept that we just do not know in many cases what effect, if any, we may have on a client. Sometimes, it may be enough to just sit there and be present and caring as they tell us painful and personal stories.

This can be quite difficult to accept; to allow ourselves to believe that if we make an honest effort to help each client, that this may actually be enough. Improvements in mental health require a collaboration and involve a client being both willing and trying to change, along with a supportive therapist to help them change. It is complex and time consuming. It is vague and uncertain most times. This is what we are getting into.

I offer all this and ask you to reconsider your definition of what a “successful” session looks like. I offer this to allow you to reconsider how you judge your performance in this profession. Your heart is in the right place. I believe that you will help people by just having patience and persistence (with the client and with yourself), along with caring and empathy, ongoing practice and continual learning.

My best wishes to you!

Peter

 

 

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Peter Scheer conducts a private practice, Heartbeats to Wellness, offering private counseling with a focus on adolescents, major life transitions, and grief and loss in Harrisburg, Pennsylvania. He is a national certified counselor (NCC) and Health Rhythms facilitator offering drum-based group therapy. Contact him at peter.heartbeats@gmail.com.

 

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Related reading on practitioner self-doubt, from the Counseling Today archives: “Facing the fear of incompetence”

 

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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.

Document like a clinician: The ins and outs of documenting your training supervision

By Brian Carnahan and Margaret-Ann Adorjan January 17, 2017

Supervision is critical to the career development and advancement of many mental health professionals, including counselors, marriage and family therapists, and social workers. The boards responsible for licensure set standards regarding the number of hours, frequency and nature of the supervision necessary for licensure as an independent professional. Various professional organizations also set standards for other credentials and certifications. For example, the National Board for Certified Counselors requires national certified counselors to earn 100 hours of supervision and work as a counselor a minimum of 3,000 hours.

Given the centrality of supervision to the mental health professions, it is surprising how often it is treated casually. Clinicians who must document client files are often lax in how they treat the supervision they receive. One can understand why. Supervision can feel like a break from work, even though work is discussed. Unfortunately, supervision is not the time to relax.

It helps to understand the supervision requirements in the jurisdiction in which you are receiving supervision. Some jurisdictions have limited requirements for documentation, but most jurisdictions require some tracking of supervision. Although it should go without saying, it bears repeating: It is your responsibility as the professional receiving supervision to know what is required. Too often, the professional in supervision relies on more seasoned professionals for guidance. But rules and requirements can change, making it important for the professional seeking independent licensure to remain up to date, including verifying with the appropriate board what must be done to earn supervision hours.

Think about treating supervision sessions as you might a session with clients. In this situation, you are the person receiving a service — namely, supervision. Take notes, and follow up after the session with additional notes and thoughts. The notes and comments you retain will help to make clear that appropriate training supervision occurred. This can be particularly important if any questions arise regarding the type of supervision provided. Occasionally, the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board has to consider whether supervision should be classified as work supervision or training supervision. The details in the training log, along with the applicant’s explanations, can help answer those questions.

If a supervision form is required, use the form prescribed by the licensing board. If one is not available, create one that covers, at a minimum, the supervision date, the length of the session, name of the supervisor, topics discussed, required follow-up and similar entries. Consult your jurisdiction rules regarding supervision to make sure nothing is missed.

It can help to seek templates from supervisors or colleagues, but beware. Just because someone else is using a template does not mean that it is sufficient. Too many professionals have found themselves in trouble because they relied on the work of others instead of seeking guidance from their respective licensing board. Where supervision is concerned, it pays to confirm with the appropriate board what format, if any, is required.

Consider tracking work hours, particularly client contact hours. Also, be sure to confirm whether there are requirements to log separate direct client contact hours or “relational” hours. This distinction can be important depending on the license type or certification being sought, particularly if the supervision is earned by a marriage and family therapist. Documenting and retaining these hours can make a difference in obtaining a license in another state. Even if your jurisdiction does not have specific requirements for documenting supervision, you may wish to maintain it anyway, because other jurisdictions may require evidence of supervision when you apply for a license.

Some jurisdictions require persons seeking a supervision designation (such as Ohio for its licensed professional clinical counselor with training supervision designation) to complete supervision of supervision. Supervision of supervision is when a professional is supervised while providing training supervision. These sessions should also be carefully documented. Check with your licensing board to determine how (or whether) these hours can be used by each of the professionals involved because some jurisdictions limit who can claim the hours as supervision.

Retain an electronic version of all your supervision documentation. This log could be in a Word or Excel file, or you could regularly scan and save the written log to a file sharing service. A number of free and low-cost cloud storage solutions can help with this task. Your ability to use the supervision hours is only as good as your ability to document the fact that you completed the supervision.

Turn in supervision logs or evaluations as required. In Ohio, we recommend turning in evaluations at the end of the first year of supervision and the end of the second year, when the independent license is sought. We also recommend submitting evaluations whenever supervisors change. This helps to ensure that the supervision is documented fully. Although Ohio does not require submission of the logs, they must be available and up to date in case there are any questions about the supervision and the logs are requested to confirm any details.

Completing supervision requirements does not have to be stressful. By knowing the requirements, retaining good records and completing required documentation in a timely manner, a licensed professional can secure his or her independent license.

 

 

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Brian Carnahan is executive director of the state of Ohio Counselor, Social Worker, and Marriage and Family Therapist Board. Contact him at brian.carnahan@cswb.ohio.gov.

 

Margaret-Ann Adorjan is the marriage and family therapist licensure coordinator and investigative compliance officer for the Ohio Counselor, Social Worker, and Marriage and Family Therapist Board. Contact her at margaretann.adorjan@cswb.ohio.gov.

 

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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.