Tag Archives: counselor supervision

The beauty of client and supervisee resistance

By Michelle Backlund and Veronica Johnson August 8, 2018

In the counseling profession, resistance is essentially considered a four-letter word. Actually, many counselors probably feel more comfortable using a four-letter word than they do talking about a client’s or supervisee’s resistance. There are good reasons for this aversion.

Traditionally, resistance shown by clients or during supervision was considered a type of pathology. It was akin to victim blaming. As a profession, we have come to understand that resistance to change or to feedback is often a normal reaction to anxiety, stress, evaluation, trauma or even the learning process. Counselors have substituted many names, including ambivalence and self-protection, in place of resistance to avoid pathologizing normal behavior. As counselors and supervisors, we must choose our words wisely, understanding that every word has unspoken meaning.

History is full of negative references to resistance. Most of these denote the effect of some form of rejection — an idea is discarded, a form of government is found offensive, love has bloomed unrequited in someone’s heart, advice is unwanted, and on and on. However, resistance also has a beautiful aspect: the formation of diamonds as they respond to the pressure of the earth, muscles gaining tone and strength under the resistance of weight, the violinist’s fingers sturdily pressing the strings of her instrument as she then presses her bow to produce the sound.

Taking it a step further, here is an object lesson: I (Michelle Backlund) was visiting with a colleague who previously taught ballroom dance for 30 years, and he recognized how physical resistance could create connection, spontaneity and fun within a dance partnership. I was sharing with this colleague the many negative effects of resistance on relationships.

He asked me, “Did you know that resistance is really a great tool to make relationships strong?”

I said, “How?”

He said, “Put your hand up, with your palm facing me.”

I did, and he placed his hand against mine, then gently pressed. I automatically pressed back. He showed me how the pressure in the form of resistance connected our hands and held us together. The resistance allowed him to move his hand from place to place; it allowed me to feel that movement and follow him. Then he said, “With no resistance, there is no connection — you cannot move together.”

This simple object lesson created a paradigm shift for me as a counselor and as a supervisor. I began wondering how to harness client and supervisee resistance to create stronger, more collaborative, nonpathologizing relationships. This is the beauty of resistance.

Most humans use resistance to assure their physical and emotional safety. The reality is that the world can be truly threatening, and resistance is a means of reducing that threat. Whether we are discussing resistance as it relates to a client who has taken the risk to attend counseling or a supervisee who understands that supervisors serve as gatekeepers to the counseling profession, their anxiety and protection of identity should be regarded as normal reactions to a perceived threat.

An obvious question then arises: How do we recognize resistance that is showing up in our counseling or supervision sessions? You might laugh at this question, feeling that you know all too well how to recognize resistance. Resistance can be difficult to identify, however, especially for new counselors and new supervisors. Responding to the many threatening experiences that humans face from childhood through adulthood, people may unknowingly develop very artful and socially acceptable methods of manifesting their resistance. Of course, some methods are less artful.

Recognizing forms of resistance

Some forms of resistance are easier to detect than others. My interest in this subject came from my experiences as a counselor and as a supervisor. I noticed that sometimes I would come out of a session feeling what I called “yucky,” but I didn’t really know why. Things seemed fine, but for some obscure reason, I did not feel good about the session.

Then I came across some old literature about how resistance manifests in supervision, written by Cheryl Glickauf-Hughes, that changed my world. First, I started saying things like, “I do that to my supervisor,” and “I feel like that.” Then, when I was counseling or supervising others, I suddenly heard what I had not been able to hear previously: resistance. In my new exuberance, however, I quickly picked up on an attitude from other professionals of “We don’t use that word.”

The conclusion I finally reached after an extensive literature review on the different linguistic substitutes for the word resistance is that no word stands alone without using resistance to help define it. To me, this says that turning away from use of the word resistance is not really feasible. However, it is feasible to harness the constructive power of resistance by using it to create relationship. But to use this tool, we need to be able to identify resistance in its various forms.

Game playing

Game playing may be used as a form of resistance either consciously or unconsciously. Either way, it is deployed as an attempt to maintain control. I think of it as a type of shell game in which attention is drawn elsewhere to get the player (i.e., the counselor or supervisor) to lose his or her place. Esteemed social worker Alfred Kadushin wrote about game playing; what follows in this section is a synthesis of some of his ideas combined with some of my own.

One game-playing technique is flattery, which is used to deflect counselors or supervisors either from confrontation or their evaluative agenda. Flatterers are the clients or supervisees who can talk for 20 minutes about the counselor’s or supervisor’s outfit, the office décor or even the “game” the other night, secretly hoping that the counselor will run out of time to address some important aspect of the prior session or the supervisor will run out of time to look at their session recording.

Other types of game playing may include:

  • Redefining the relationship, in which the client or supervisee creates ambiguity.
  • Self-disclosure, in which the client or supervisee talks about himself or herself through telling stories. Clients might do this by skipping from one story to another, giving no time for reflection or comment. Supervisees might use storytelling about self or clients, engaging the supervisor so there is no time for skill correction.
  • Trying to reduce the counselor’s or supervisor’s power, in which clients or supervisees attempt to show that they are more intelligent than the counselor or supervisor.
  • Working to control the situation with the direct use of questions that can steer conversation away from the client’s or supervisee’s areas of anxiety.
  • Focusing on failure and seeking reassurance.
  • Allowing helplessness to feed into dependency by working to implement every single word that the counselor or supervisor shares in session.
  • Practicing self-protection by externalizing blame for their lack of growth on the counselor or supervisor.

It is important to remember that playing games is designed to create safety and protect the self.

One simple way to work with game playing is role induction. Clients and supervisees have constructed coping strategies (resistance) that have served them well. Typically, these strategies have evolved in an organic way and are outside of the client’s or supervisee’s awareness. We can help these individuals understand that counseling or supervision can be stressful and that clients or supervisees may develop certain behaviors as a way of dealing with their anxiety or stress. In normalizing this process, it becomes less threatening.

You could provide your clients or supervisees with a list of behaviors, thoughts and feelings that they might experience during your work together, then invite them to freely point out these behaviors, thoughts and feelings to you as they notice them. This broaching process becomes a step toward creating a collaborative relationship. As they point out their own resistance, you can be appropriately curious about it and then thank them for bringing it to your attention. Often, clients and supervisees will not call attention to their own resistance. However, as they grow more aware of it, they may choose to lay these behaviors down in an effort to use their time more wisely.

Developmental causes of resistance

Another way to look at resistance is through a developmental lens. It has been proposed that manifestations of resistance can have roots in the unsuccessful completion of Erik Erikson’s developmental stages. What would we listen for if we used this framework in our counseling or supervision sessions?

Trust versus mistrust: When clients or supervisees have not fully learned to trust others, the anxiety produced in an ambiguous setting such as counseling or supervision may create enormous tension. In many instances, those who have not successfully navigated this stage have experienced parents, guardians or other authority figures as harsh, critical or unaccepting of them. Often, they expect to be rejected by their counselor or supervisor.

This lack of trust can be recognized by clients’ or supervisees’ maintenance of distance in the relationship; they may seem closed, guarded, defensive and extremely self-sufficient. Identifying these traits is essential to using this information to strengthen the relationship and create collaboration. Glickauf-Hughes suggests that when working with those who are distrustful, taking a person-centered, nondirective approach can help them to feel safe and may provide a corrective experience. Consider letting them know that you can tell they are a bit guarded; ask them whether they have been hurt in the past and whether they are concerned that you might also hurt them.

Autonomy versus shame and doubt: Clients or supervisees who struggle with issues surrounding the need for autonomy can be confusing for counselors and supervisors. Erikson warned that controlling others helps those without a sense of autonomy to feel in control of their own lives.

Often, those who struggle with autonomy cannot quite put a name to what they want, but they can clearly identify what they do not want. They often vacillate between seeking direction and then dismissing the very information they sought. An exchange with someone who struggles with autonomy might sound something like this:

Counselor: “Mary, I hear you saying that this situation is irritating you.”

Mary: “I’m not irritated, I’m frustrated.” 

To protect their personal freedom, these individuals may mince words or say things like “yes, but …” — anything not to accept influence from others.

Glickauf-Hughes and Linda Campbell suggested three ideas for working with those who struggle with autonomy: Socratic questioning, homework, and healing stories or puzzles. These strategies put power directly into the hands of clients or supervisees, allowing them to arrive at the answers they seek without things being laid out for them explicitly. Interestingly, this is helpful even when resistance is not present. Most people enjoy finding their own answers; it increases their self-efficacy and helps them to feel autonomous. This is exactly why it works so well for those with issues of autonomy.

Those who have not successfully navigated the aspect of shame versus doubt are particularly sensitive to any confrontation or feedback, even when it is done with extreme care and sensitivity. Issues of shame originate within relationships and indicate to the individuals being shamed that, somehow, they themselves are unworthy or defective. Unfortunately, shame can be so internalized that it becomes self-activated and no longer attached to an interpersonal event. This may present as clients or supervisees being so hard on themselves that it preempts any possible feedback from others.

This ultra-vulnerable type of person is, in some ways, reminiscent of a sensitive child. This makes sand tray therapy or sand tray supervision an excellent tool for working with clients or supervisees who have internalized shame. For those who believe intrinsically that they are somehow unworthy or defective, the sand tray is a wonderful avenue for them to look at issues and dynamics in a nonthreatening way. The figures become a buffer between these individuals and the counselor or supervisor, protecting the ego from further damage. This is less threatening for supervisees because they can work out the dynamics they are witnessing with their clients. Sand tray therapy or sand tray supervision can also create self-awareness. When incorporated with Carl Rogers’ core conditions, this can cause confidence to grow and doubts to recede among clients and supervisees.

The use of positive reframes can also be used to reduce anxiety and increase receptivity to change. Mark A. Masters suggests that positive reframes should be designed to emphasize the client’s or supervisee’s experience of personal power and self-esteem. The use of positive reframes is most useful when three different components are present.

First, the reframe empowers clients and supervisees by improving their self-reliance and motivation. Second, most behaviors can be asserted in a positive connotation. This can increase clients’ and supervisees’ sense of safety within the counseling or supervisory relationship, thereby promoting reflectivity and growth. Finally, the positive reframe is most useful when it models more effective ways of dealing with the person’s thoughts, feelings and behaviors. When all three of these components are applied together, they can create a powerful alliance that furthers clinical development. Glickauf-Hughes emphasizes that when reframing, the counselor’s or supervisor’s word choice needs to be mild and should evoke curiosity in the client or supervisee.

Identity versus role confusion: What about the client or supervisee whose fundamental issues with others involves the developmental stage of identity versus role confusion? This fragile sense of self can come into play as clients and supervisees strive to find their confidence or shift their already-fragile identity. In this case, learning from the counselor or supervisor would mean merging with him or her, so clients and supervisees in this developmental stage steadfastly hold to their current identity. Signs of this resistance can come through expressions of contempt (such as eye rolling and other demeaning behaviors and statements), often appearing argumentative or expressing directly or indirectly that all other modes of being (for the client) or all other theories (for the supervisee), other than their own, are without value.

Metaphors can provide a means to use what a person already knows and relate it to even more complicated information in a way that transfers the learner’s original understanding to the new situation. The use of metaphors, or the process of transferring information from the known to the unknown, can enhance the learning process and create an atmosphere in which resistance improves emotional connection. For those who feel their identity threatened, the use of metaphors, jokes or Socratic questioning can help them find their own answers. This maintains their identity and prevents them from rejecting the information.

Externalizing issues can also reduce stress in the client or supervisee, again allowing both learning and a better relationship. For example, let’s say your client with a talent for writing music has a goal to develop relationship skills to create a more satisfying social life. Relating the client’s goal to something with which the client is familiar may transfer his or her understanding of one skill to another. In this case, you might first create a theme for the type of song or type of social life the client wants. Let’s imagine it will be a ballad because the client is looking for an intimate relationship. Next, a basic melody is plotted out (what type of person is the client looking for?). Then the lyrics are sketched in (does the client believe this type of person already exists in the client’s current social circle?). Add some harmonies (how can the client enlarge his or her social group?). Once the basic song is set, the addition of instrumentation, percussion and orchestration develops the song into a masterpiece, with all of the different pieces adding to the complexity and beauty of the finished product (how might the client expand the types of activities that he or she enjoys — sports, theater, reading, dancing, outdoor recreation and so on?).

Metaphors, in the form of stories or drawing activities, allow clients and supervisees to depict themes, issues and relationships in their lives or their clients’ lives. At the same time, the use of metaphors leaves the identity or newly emerging identity of the client or supervisee intact.

Motivational interviewing

Motivational interviewing can broaden our view of resistance in a way that can be applied to the supervisory relationship. William R. Miller and Stephen Rollnick, the primary developers of motivational interviewing, explore using resistance to increase connection. Rolling with resistance — which simply means being curious about it — can strengthen relationships and depathologize resistance as normal. Supervisors can easily detect resistance in supervision and can choose to employ some basic motivational interviewing responses to join with the supervisee and open the door to exploration.

Developing the discrepancy: Imagine a supervisee who presents as needing assistance and guidance in working with a difficult client, but when provided with that guidance, responds with, “I don’t think that will work because I already tried ________” or “I don’t think the client will respond well to that because of ________.” 

Developing the discrepancy involves acknowledging what the supervisee wants and then also acknowledging the difficulty the supervisee has in accepting this help or guidance when it is offered. The supervisor’s response might be along these lines: “This sounds like a really challenging client. I hear that you really want help moving forward with the client, and I notice that it’s hard to hear some of the suggestions that I have.”

The specific use of and instead of but in this example is important. And creates the possibility that the supervisee can exist in both worlds — one of wanting help and another of rejecting it. Embracing the ambivalence that a supervisee might feel in supervision can open the possibility for the supervisee to explore what it feels like to be needing connection and resisting it at the same time. And it’s also possible that the supervisee’s client feels the same way — an example of parallel process.

Agreeing with a twist: Being a supervisee is hard work. The courage it takes to present clinical work that is mediocre and the vulnerability required to sit with a supervisor and watch the “magic” unfold can be unnerving. “Agreeing with a twist” refers to reflecting on the risk that a supervisee takes when sharing difficult sessions with a supervisor (especially when the supervisee is not yet in a place to be vulnerable and courageous) and then providing a reframe that opens discussion.

Imagine a supervisee who seems to select sessions or cases to discuss in supervision that aren’t of substance or that don’t allow many opportunities for constructive feedback. This behavior could indicate that the supervisee is protecting his or her already-fragile ego from potentially critical or damaging feedback. Addressing this in supervision is tricky. Agreeing with a twist might sound something like, “It can be so hard to watch sessions that you don’t think are great. I remember what that felt like when I was in training. What are some of your concerns about showing me your not-so-great sessions?”

This example is a three-part equation:

1) Acknowledging and validating the supervisee’s experience.

2) Offering a simple self-disclosure that deepens the reflection.

3) Asking an open-ended question that gets at the heart of what is happening, apart from the actual case the supervisee has brought to discuss.

This method of “caring confrontation” serves to invite the supervisee to share his or her fears of negative evaluation. It also allows the supervisor to assuage those fears and build the kind of relationship in which a supervisee can share “not so great” work without sacrificing a piece of his or her ego.

Using OARS as a basic model for resistance-free supervision: At its core, motivational interviewing is person-centered. Simple strategies for supporting, inviting and engaging supervisees early in the supervisory relationship are often overlooked. OARS is an acronym that can serve as a reminder to supervisors (and counselors) that the basic skills of open-ended questions, affirmation (support, appreciation and understanding), reflective listening and summarizing are absolutely essential and can foster connection, openness and curiosity in both supervisees and supervisors (and clients and counselors).

 

Conclusion

The usefulness of any tool involves its accessibility and effectiveness. The beautiful aspect of resistance as a tool is that it is consistently present in some form. It is always available to strengthen the counseling or supervisory relationship. Try using the tools we have suggested in this article and working to identify strategies that can reframe resistance in positive, collaborative and nonpathologizing ways. Resistance provides opportunities to connect, engage, be curious and, ultimately, foster the kind of counseling and supervisory relationships that create growth and change.

 

****

Special thanks to Ray Backlund, coordinator of the New Mexico State University dance program, who holds a doctorate in counselor education and supervision, for sharing his connection between ballroom dance and positive uses of resistance with supervisees.

 

****

 

Michelle Backlund is an assistant professor and clinical director of the master’s program in the Counseling and Educational Psychology Department at New Mexico State University. Identifying positive uses of resistance to enhance all types of relationships is a major part of her research agenda. Contact her at micback@nmsu.edu.

Veronica Johnson is an associate professor and chair of the Department of Counselor Education at the University of Montana. Her research interests are intimate relationship development and maintenance, forgiveness in intimate relationships and clinical supervision. Contact her at veronica.johnson@mso.umt.edu.

Letters to the editor: ct@counseling.org

Counseling Today reviews unsolicited articles written by American Counseling Association members. To access writing guidelines and tips for having an article accepted for publication, go to ct.counseling.org/feedback.

 

****

 

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.

Guiding lights

By Bethany Bray May 30, 2018

Counselor supervision is a rite of passage for professional counselors. Although supervision requirements vary from state to state, the crux of the experience — learning that is based in a relationship between a beginning counselor and an experienced practitioner — is universal. As is the case for any relationship to remain healthy and beneficial, the supervisor–supervisee pairing requires care, hard work, respect and trust from both parties.

Supervision is meant to be “the other half” of counselor education, bridging classroom learning and in-session counseling skills, says Summer Reiner, a licensed mental health counselor (LMHC), clinical supervisor and associate professor and school counseling coordinator at the College of Brockport, State University of New York. “There’s no way you can fully prepare the student in a classroom. Supervision is to fill out your education,” says Reiner, president of the Association for Counselor Education and Supervision, a division of the American Counseling Association.

Supervision begins “a lifelong process of always stepping back and looking at what went well and what didn’t,” she adds. “Supervision is training to be able to do that throughout your career, a constant of thinking what went well and what do I need to do differently? It’s a supervisor’s role to get that internal dialogue moving, by demonstrating it first and letting [supervisees] know that they will self-evaluate, in a healthy way, throughout their career.”

Balancing act

The supervisor–supervisee relationship is different from the therapeutic bond forged between counselor and client. However, many counseling skills come into play as supervisors support and foster growth in their supervisees. Although supervisors never shed their identity as counselors, they must learn to shift gears between working with clients and working with counselors-in-training or beginning professionals.

Supervisors must also achieve a balance between two primary roles that can, at times, feel like they are at odds with each other: fostering an open and honest dynamic with supervisees and evaluating supervisees. The best learning opportunities often arise when supervisees feel comfortable with and have enough trust in their supervisors to ask questions and admit when they are struggling.

“It’s a delicate balance,” says Kevin Doyle, a licensed professional counselor (LPC), clinical supervisor and adjunct instructor of counselor education at Virginia Tech. “The supervisor has the power, but it still needs to be an open relationship. … A supervisor should focus on creating a connection that is similar to counseling, with focus on the supervisee’s professional growth and development. Transparency is paramount, even though there’s a grade or evaluation piece to the situation.”

“It’s one of the biggest fissures in supervision: There’s this evaluative piece. It’s similar to a counseling relationship, but you also have the responsibility to assign grades or to be a reference for a future employer,” says Doyle, a member of ACA. “It’s not a counselor–client relationship, but it also shouldn’t be an inverted relationship” with a power imbalance.

Supervisors are a unique blend of teacher, counselor, evaluator and role model, and they need to be able to nimbly weave in and out of those roles as the moment demands, Reiner says. Throughout the process, counselor supervisors should remain very supportive of their supervisees while also offering honest feedback.

“Help them understand that we’re not evaluating them as a person, or as a counselor, but with each intervention they use with a client,” says Reiner, whose experience is with graduate student supervision as a counselor educator. “This isn’t me judging you; it’s me helping you see what was your intent in this process? What was the intended outcome? If that didn’t happen, what would you have changed?’”

“At the same time,” she continues, “it’s important not to be a cheerleader. Don’t let them feel like everything’s OK when it’s not. It’s this balancing act of having students hear critical feedback without personalizing it and [then] using it constructively.”

Stacey Brown, an LMHC and clinical supervisor in Fort Myers, Florida, stresses that the best supervision happens when the relationship is central to the experience, which transcends simply going through the motions of clocking the needed hours and ticking items off of a to-do list. “For me, it’s about becoming a counselor — beyond the techniques they learn in grad school,” says Brown, an ACA member. “It’s very easy to forget the human part of the equation, and our role as nurturer and encourager, as there are so many boxes to tick. Don’t make it so structured that [supervision] sessions are repetitive or predictable. Be open and allow flow to happen, like you would in a counseling session. You can still cover everything you need to cover, but be creative and open to what comes. Otherwise, you may lose out on [teaching] opportunities that pop up.”

For example, a supervisor might have a stack of case studies ready for review with a supervisee, but the beginning counselor walks into the room with tears in her eyes because of professional stress or something going on in her personal life. In that case, “You shouldn’t push forward with your case reviews,” Brown says. “You should take a step back, ask what’s going on and how can you [the supervisee] manage it? But if I have some kind of checklist to get through, I will miss out on opportunities to help her become a counselor. Teach [supervisees] flexibility, intuition, being present and learning that they have to deal with their own stuff and take care of themselves to be able to help other people. What better way to teach that than by doing it?”

Modeling and forging a bond

Doyle says the skills that supervisees gain through counselor supervision can be divided into two realms: everything that happens in the room with clients, and everything that happens outside of the counseling room.

The first part of the equation, the “nuts and bolts” of counseling, as Doyle calls it, is developed through case review and the one-on-one guidance that a supervisor provides. It involves real-time application of the knowledge base that counseling students were introduced to in graduate school.

The second part encompasses learning that can’t truly be acquired from textbooks. It involves preparation for the entirety of the job of being a professional counselor, Doyle says. Much of the knowledge acquired in this sphere is based on how supervisors model their own professional skills, both inside and outside of client sessions, in the presence of their supervisees. Supervisees watch and absorb not only their supervisors’ interactions with clients, but also the professional boundaries that supervisors set, how much they focus on self-care and how they manage time, professional ethics and other aspects of the job.

Supervisees “absorb so much from how we carry ourselves and what we do in supervision,” says Doyle, who wrote his doctoral dissertation on how supervisors can model wellness and how that influences supervisees’ wellness.

A little self-disclosure, when appropriate, on the part of supervisors can help keep the supervisor–supervisee relationship open and honest, says Kathryn Henderson, an LPC and an assistant professor at the University of Saint Joseph in West Hartford, Connecticut. When supervisors disclose, for example, that they sometimes struggle to prioritize self-care, it demonstrates not only that even supervisors are imperfect but also that wellness will need to be a career-long goal.

“I stress that we’re in this together,” says Henderson, an ACA member. Supervisors share “our knowledge and experience, but we’re learning from [our supervisees] and growing ourselves. We’re learning just as much from them as they are from us. It’s mutually enriching.”

Brown says she is upfront with her supervisees that counselors are no different from the general population in that they sometimes have trauma in their past, struggle with an inner critic or anxiety, or face other challenges. “Part of being a good counselor is being comfortable with yourself and coming to terms with your own issues. I can’t be [my supervisees’] therapist, but as a supervisor, [I] can recommend they see a therapist,” Brown says. “I tell people right off the bat, there’s no reason to hide who you are.”

Brown also thinks that supervisor self-disclosure, within ethical boundaries, can strengthen the relationship with supervisees and help them realize that being honest about their struggles won’t sabotage their evaluation. Brown recalls one supervisee who had an infant at home. When Brown would check in with her about her stress level and self-care routine, the supervisee would insist she was fine. In truth, she was struggling with breastfeeding and a severe lack of sleep. The supervisee opened up only after being shown photos of Brown’s children and having Brown share a few of her own struggles during motherhood.

“My job, as I see it, is not to be rigid or pretentious at all, but to be real,” Brown says. “Being a real person who can share my experiences, my missteps, my learning, my boundary conflicts, my wellness efforts, etc., helps supervisees to be willing to be real with me. Then I
can see who they are and can offer suggestions that can help them personally and professionally.”

“The relationship is the most important part of the supervision,” she continues. “Elements of trust, mentoring, nurturing, directing, humor, compassion and tutoring are all there, just as in the counseling relationship. The difference is that in supervision, the supervisee will one day be completely equal or surpass me in credentials and expertise. I treat them as colleagues while still offering the nurturing and guidance and respect they need and deserve.”

Henderson agrees that trust is paramount in creating a good supervision experience. For supervisors, this includes trusting their supervisees enough to give them room to find their own way professionally. For supervisees, this means trusting the relationship enough to be able to share — and, in turn, work on — their weaknesses and areas of struggle.

“You can’t give someone insight; [a supervisee] needs to find that on their own. But we can create that opportunity in supervision,” says Henderson, co-editor with Alicia M. Homrich of Gatekeeping in the Mental Health Professions, published by ACA in May. “Supervision is their first time working with real clients in a real-world setting and applying what they’ve spent so many hours learning. That can be scary and overwhelming — there’s a fear of inadequacy. … The crux of supervision is that you’re not alone in that. This is exactly where you go to talk about those concerns and get the support and help that you need to grow in your own self-awareness and confidence in your skills.

“Supervisors are the ones to build that support [by offering] encouragement and validation. All of that helps create an environment where I [the supervisee] can come and bring my greatest concerns and failures, be vulnerable and not be afraid of being judged or of negative outcomes or consequences. Trust is so needed to create that environment.”

It takes two

What does it take to establish a healthy and beneficial supervision experience? In part, both parties must contribute by being flexible and practicing open and honest communication.

Suggestions for supervisees

Shop around to find the best fit. Look for a supervisor with whom you click, both professionally and personally. Alicia Simmons, a counselor intern working toward counselor licensure in Florida, found her supervisor, Stacey Brown (quoted in this article), by searching online and talking with friends from graduate school. She called and spoke with Brown before meeting her in person to test the waters of what would become a very positive supervision relationship. Simmons and Brown co-presented a session, “Intuitive Clinical Supervision: Creative Solutions for Helping New Counselors,” at the ACA 2018 Conference & Expo in Atlanta this past April.

“Look for someone who is going to walk beside you for … however long it takes,” says Simmons, a clinician and play therapist at an agency that serves children removed from their homes due to trauma or neglect. “Don’t be afraid to ask questions before you begin. You want to know you’re in the right fit. Don’t be afraid to try more than one supervisor. … Look for someone who is going to be flexible and work with you in the way you need to work. If you don’t know what that is, work with someone who will help you figure that out.”

Speak up. If you have a need that is not being met through the supervision experience, talk to your supervisor in a tactful but honest way. Doyle acknowledges that this can be a tall order because supervisors are seen as authority figures. At the same time, identifying any area where you might be struggling in the relationship will actually help your supervisor, he says. Counselors who provide supervision have so much to focus on — including client needs, scheduling, paperwork and so on — that they may not notice everything going on with their supervisees.

“Advocate for your needs [even though] that’s a lot to ask at the outset,” says Doyle, who will be starting a new job as assistant professor of mental health counseling at the University of Tennessee at Chattanooga this fall. “Speak up when you need support. Realize that the supervisor will rely on that. … When you come to see your supervisor as a safe person, you will really connect with them and [that will] make it easy to disclose your struggles.”

Respect the process. Keep in mind that your supervisor likely took on this extra responsibility because he or she wanted to “pay it forward” to the profession, Reiner says. Yes, supervisees have needs that should be met through the supervision experience, but at the same time, they must remember that a counselor’s first priority will always be client care.

“Step one is being appreciative that someone was willing to take you on as a supervisee and has trust in you that you will be able to serve clients well,” says Reiner, an ACA member. “Keep in mind that you are practicing under the license of someone else. If the [supervisee] does something really inappropriate, it can open the supervisor up to a lawsuit. They are taking on a personal risk as well as an additional workload. … Recognize that the supervisor is investing in the future of the profession and has no obligation to do that. Realize that they care about your future and the clients you are going to work with.”

Be authentic and drop preconceived expectations. Bring your true self into supervision. Don’t act one way with clients and another way with your supervisor. There should be “a thread of authenticity” throughout your work in supervision, Simmons says. “Counseling is basically holding up a mirror and showing somebody what’s there. Supervision I think ideally would be the same way.” Authenticity, both on the part of the supervisee and the supervisor, builds trust, she asserts.

In addition, it might be best for supervisees to leave behind their ideas of what supervision should look like. The important thing is for the supervisor and supervisee to be working toward the same goals. “What I had heard about clinical supervision was mostly [about] case review and going over the work with clients — very textbook and academic,” says Simmons, an ACA member. “What I’ve learned is that it can be much more fluid than that. All the in-between stuff is what has stuck with me and helped me develop my own style and confidence in my abilities. It’s about more than just the logistics of what’s going on in each [client] case.”

Remain open to feedback. Having a relationship built on trust makes it easier for supervisees to remember that any critical feedback they receive from their supervisor is meant to help them and that they are both working toward the same goal: the supervisee’s growth and development as a counselor. “It’s the same as the counseling relationship — you have to have that rapport,” Simmons says.

Regardless, being critiqued can prove challenging. “As a supervisee, it’s our responsibility to be able to receive feedback,” Simmons says. “If there’s something that’s getting in the way, perhaps that’s something [we] need to work through. We may need to seek therapy ourselves to work on it. Check yourself: Is it something related to the supervisor, or is it something unrelated that you need to work on?”

Think for yourself. At the same time, do not accept feedback blindly. Think it through and talk through any areas you have questions about with your supervisor, Reiner advises. But first, take a step back and consider whether you have received similar feedback from others in the past.

“Critically examine any feedback that you are receiving and be open to being the one who needs to grow and change. Or simply say ‘thank you for that feedback’ and ‘I’ll be mindful of that in the future,’” Reiner says. “I don’t think that supervisees know that supervisors are sometimes uncomfortable sharing critical feedback. They have probably thought it through [before telling supervisees] and were anxious about it themselves.”

Suggestions for supervisors

Temper criticism. Set realistic expectations and frame criticism in a way that lets supervisees know you’re focused on their growth, Doyle says.

In Reiner’s work supervising graduate students, she assures them that she won’t start evaluating them for a grade until halfway through the semester, once they have settled into the experience. It is important to stress that feedback is never personal but rather focused on supervisees’ development, Reiner says.

“There’s also an element of modeling for your supervisees — ‘This is how you have hard conversations with people.’ [They] will need to do that as a counselor,” Reiner says.

Debunk myths of perfection and the existence of one right way. Henderson shares an important lesson with her supervisees that she learned through her own supervision: There is no such thing as a perfect counseling session. Supervisees often put enormous pressure on themselves to find the “right” way to do something, she says. The truth is, clinicians can work with the same client in multiple ways and take different therapeutic directions and still arrive at a positive outcome, Henderson says.

Prioritize fostering growth. Might your supervisees end up working for a local competitor or leave your agency and move on once they’re licensed? Be supportive and invested in their growth, even if it won’t benefit you in the long run, Doyle urges. “Don’t think of [supervision] as just one more thing to get through. Don’t think of it as a task but as a relationship to foster,” he says.

One mark of a good supervision relationship is when a supervisor is comfortable enough to allow — or even to encourage — a supervisee to seek additional skills elsewhere, Simmons says. For example, if supervisees use different therapeutic modalities than their supervisors do, they might want to look for workshops or online training while
in supervision.

Help supervisees embrace their counselor identity. Supervisors can help prepare supervisees for work environments in which they may be the only counselor. “Once people get into a work environment, there becomes a lot of pressure to do things not in the way a counselor is trained to do. Part of a supervisor’s job is to train a supervisee not to lose their identity as a counselor,” Reiner says. “Sometimes you might get the message, ‘We know that’s what you learned in college, but that’s not how we do it.’ Be mindful of teaching them to be a team player yet [also] an advocate for counselors and counseling.”

For example, a counselor in a school setting may be the only person in the building with a counseling background, and he or she may repeatedly be asked to spend time as a test proctor or hall monitor or to perform other noncounseling duties. “How do you politely tell your principal that counselors are not lunch monitors?” Reiner asks. “Instead, explain that your approach will be different. ‘I will do it, but I’ll do it within my counselor identity. Instead of being a disciplinarian, I will use it as an opportunity to talk to students.’”

Lift supervisees up. Supervisees should leave the supervision experience even more energized about the counseling profession than when they began, Brown says. “The way I see it, our job is to lift them up. To help them see that they are more capable than they think they are. To teach, to offer guidance and education, and to model how we do what we do. … Yes, there are techniques and ethics and strategies, but there is also joy in the giving. Graduate students don’t often pick up on that part in grad school. I believe that is the key element we, as supervisors, need to be offering to new counselors. This will help keep integrity in the profession and prevent burnout [by] shining a light on the ability to truly offer healing to clients.”

Navigating the ups and downs

Because supervision is an experience that involves two human beings, it is only natural that not every experience will be positive. Frustration, awkwardness and other negative feelings may surface.

Conflict can arise easily in supervision relationships in which expectations are unclear, Henderson notes. To decrease the likelihood of that happening, she recommends that supervisors document their expectations thoroughly before supervision begins, regardless of whether that process is mandated by the state in which the supervisor practices.

Among the details that should be included:

  • How the supervisee will be evaluated
  • How often the supervisor plans to meet with the supervisee
  • The cancellation policy should a supervisee need to miss a meeting
  • The length of the supervision or how many hours are expected
  • How much the supervisee will pay the supervisor (if applicable)

These details should be talked through with supervisees before they agree to sign the document.

This is also a good time to map out wellness goals, says Doyle, who has supervisees include self-care in the learning contract they create at the beginning of supervision.

“In many ways, it’s on the supervisor to try and develop a welcoming, supportive, yet honest and challenging relationship with their supervisee,” Reiner says. “That starts out with being very direct and forward with your supervisee about what is expected and how they will be evaluated.”

The importance of being direct also extends to addressing any differences between supervisors and supervisees, from level of expertise to gender identity to spirituality, Reiner says. She recommends asking supervisees upfront, “How are you feeling about these elements of who you are and who I am and how that comes together in our space together?” In addition, she says, supervisors can offer assurances to ease supervisees’ concerns about those differences: “If there’s ever a time when I’m not hearing you or not understanding you, please tell me. I want to hear it because it will only help our relationship.”

When tough conversations arise or when things aren’t going well in supervision, it is helpful to keep the discussions focused on growth opportunities. In her role as a counselor educator, Reiner sometimes has to mediate meetings between supervisors and supervisees who aren’t seeing eye to eye. She begins by asking both, individually, what is going well, what can be improved on and what they would like to do or see in supervision that hasn’t happened yet. Reiner tries to frame the conversation so that both parties are able to take personal ownership of what has transpired without placing blame. That way, they are able to share and focus on what they want from the experience that they haven’t yet received.

Clear and open communication is essential when the supervision relationship is having its ups and downs, agrees Henderson, and that is when a supervisor’s counseling skills especially come into play. Supervisors should focus on concrete expectations that aren’t being met rather than vague or arbitrary attributes that they may not like, such as a supervisee’s personality or professional style. If necessary, supervisors can also refer to the contract put in writing at the beginning of the relationship, she adds.

“Many times, we talk around things without talking about the process that’s going on in the room, that here-and-now experience,” says Henderson, who presented on supervision and ethics at the ACA 2018 Conference & Expo in Atlanta. “Oftentimes we need to go to that level of metacommunication, to use counselor lingo, to address the dynamics that are happening between us and what’s contributing to it. That can be a very difficult conversation to have, especially considering the power differential. I like to make it as concrete as possible. Having clear expectations and a contract helps focus on competencies and what’s not being met.”

“[Sometimes] it’s these unexpected lessons that find us, that we’re not looking for, that can be the most difficult but that lead to the most growth,” she adds. “When we are having these conversations, keep in mind our mutual goals. What’s our purpose? The supervisee’s growth as well as client welfare. Monitor both.”

Keep it going

Peer support and feedback, mentorship and case review with colleagues can play a vital role throughout a counselor’s career, long after formal supervision leading up to licensure has ended. Doyle recommends that counselors engage in lifelong supervision, whether in an informal or formal capacity, to continue learning and to find support.

“It’s extremely rewarding work that we do, but it’s extremely taxing too. Peer support becomes that much more important after formal supervision ends,” he says. “It’s hard to describe the grind you go through daily as a counselor and the emotional toll it takes. Connect with people who can understand that. Connect with peers across the profession, whether that’s within a professional organization or the practitioner in the office next to you. Make sure you have a support network, wherever you are.”

Henderson says one of the things that stuck with her most from Irvin Yalom’s keynote at the ACA 2017 Conference & Expo in San Francisco was that he — a noted psychiatrist, author and scholar — had sought support from peer groups throughout his storied career. “Even though he’s a giant in the field, he continues to work on his own development,” she says.

“The message that we want to send is that the journey doesn’t end when you get that license or degree,” Henderson adds. “The journey is ongoing, and we don’t want to be alone in that journey.”

 

****

Related reading: Counselor supervision: Reflections and lessons learned,” an online-exclusive companion piece to this article: wp.me/p2BxKN-58U

 

Additional resources:

From the Counseling Today archives:

 

****

 

Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

Letters to the editor: ct@counseling.org

 

****

 

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.

Counselor supervision: Reflections and lessons learned

Compiled by Bethany Bray May 25, 2018

[EDITOR’s NOTE: This is an online-only companion article to “Guiding lights,” a feature on the ins and outs of the counselor supervision process appearing in the June issue of Counseling Today.]

 

Counselor supervision can have quite a steep learning curve — one that often comes with several ups and downs for beginning counselors.

Counseling Today recently asked several American Counseling Association members about their experience navigating the supervision learning curve. They share their thoughts here so that others can learn from their journeys along the sometimes-bumpy road into professional practice.

 

Fill in the blank: I wish I had known ________ when I was in my supervision.

 

“I wish I had known that it was OK to think outside of the box. I am a naturally creative and intuitive person, but I tried to reel all of that in during supervision. My supervisor was very structured. I still learned a lot, but it took me many years of practicing as a counselor before integrating who I am into my work as a counselor.

Be open to your supervisees interests — you can miss out on opportunities for them to grow, otherwise.”

Stacey Brown, a licensed mental health counselor (LMHC) and clinical supervisor in Fort Myers, Florida

 

” [In supervision,] I felt that I couldn’t make a mistake because it would be evidence that I’m not a good counselor. I felt scared, instead of realizing that my supervisor was interested in knowing me as a person and interested in my development. [My supervisor] wasn’t looking for me to be a fully-formed counselor, they were expecting me to be a novice, and expecting to provide modeling and encouragement for improvement.

Now, I remind my students: If you’re scared and hiding [things from your supervisor], those are the students who don’t do as well, as opposed to those who are open and seeking growth. Be honest about your weaknesses instead of not acknowledging them.”

Summer Reiner, LMHC, clinical supervisor and associate professor and school counseling coordinator at the College of Brockport, State University of New York and president of the Association for Counselor Education and Supervision

 

“One of the hardest lessons for me in supervision was [learning] the boundary of my own responsibility with my client. I was always wanting more [for them], feeling like I was responsible for more of their change and their experience. [Feeling that] it was somehow my fault or responsibility that they weren’t making progress in a way we wanted to see.

It took some very strong and honest supervisors [for me to learn not to feel that way]. That’s a level of insight, something you can’t give anybody. They helped me find my way.

One supervisor challenged me with ‘where does Kathryn end and where does your client begin?’ At first, I didn’t know that that meant. But it has really stuck with me.

It’s a very common, normal part of development as clinician [feeling responsible for client change]. We can have a parallel process of that, as supervisors — feeling responsible for the growth of supervisees: Where do they begin and we end?

It’s really about being the best that we can for our clients, and supervisees, and acknowledging that we don’t have all the answers.”

Kathryn Henderson, a licensed professional counselor (LPC) and assistant professor at the University of Saint Joseph in West Hartford, Connecticut

 

“I wish I knew how to advocate for myself within supervision. A lot of times, I didn’t speak up when I was in situations I didn’t feel comfortable in. I wish I had known how to advocate within supervision and how to broach [tough] conversations. But more importantly, knowing how to spot a supervisor who would be willing to broach [those conversations] and model wellness.

I wish I knew [then] how to spot a strong supervision relationship from a weak relationship because ultimately that’s how we benefit.”

Kevin Doyle, an LPC and counselor educator who begins a position as assistant professor of mental health counseling at the University of Tennessee at Chattanooga this fall

 

I wish I had known:

  • How to navigate cultural barriers in the supervisee/supervisor process
  • How to advocate for quality over quantity for clients (providing quality clinical services to the client while meeting the agencies financial demands)
  • How to obtain clarity of expectations for my role in practicum/internship
  • That the process would be arduous at times

Kerri Legette McCullough, an LPC, licensed clinical professional counselor (LCPC), doctoral candidate at Argosy University and a mental health therapist at Hillcrest Children and Family Center in Washington, D.C.

 

 

“I had learned that in clinical supervision, I would learn how to function in the role of a counselor. Here’s what I didn’t know: I did not know that it was okay to not know things — that actually, it was pretty much expected that I wouldn’t.

I was unaware that clinical supervision could be an intuitive process — or that I would learn so much just within the context of the supervisory relationship. I was unaware of the full potential and was not expecting it to be as transformative as it has been for me, in both professional and personal ways.  I think that if I had known this in the beginning, I definitely would have had a lot less anxiety about the process. But experiencing it in real time has been a valuable part of becoming a counselor.  I wouldn’t change it.”

Alicia Simmons, a counselor intern working toward counselor licensure in Florida and a clinician and play therapist at an agency that serves children removed from their homes due to trauma or neglect

 

 

 

 

 

*****

 

 

Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

 

Letters to the editor: ct@counseling.org

 

****

 

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.

 

 

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

 

 

****

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.

 

****

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

 

****

 

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.

 

 

****

 

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.

 

****

 

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.