WELCOME TO WELCOME TO THE GEORGIA SCHOOL : THE GEORGIA SCHOOL :

20152015

©CLINICAL SUPERVISION CLINICAL SUPERVISION TRAINING TRAINING

SHELDON L. ROSENZWEIG, SHELDON L. ROSENZWEIG, M.A., LPC, CCS M.A., LPC, CCS & &

CARL SHANTZIS, Ed.D.CARL SHANTZIS, Ed.D.

PURPOSE of today* is to:PURPOSE of today* is to:

ADVOCATEADVOCATE for current & future supervisorsfor current & future supervisors

ENGAGEENGAGE in the ‘supervisory conversation ’

ENHANCE ENHANCE knowledge & skill of Clinical Supervisors knowledge & skill of Clinical Supervisors

PARTICIPATEPARTICIPATE in learning activities in learning activities

* (* (As developed by D. Powell & endorsed by IC&RC, AODA, Inc.)As developed by D. Powell & endorsed by IC&RC, AODA, Inc.)

DISCLAIMERDISCLAIMER

CompletionCompletion of this training of this training does notdoes not implyimply that you have obtained mastery that you have obtained mastery of competencies needed for the of competencies needed for the position of Clinical Supervisor.position of Clinical Supervisor.

CompletionCompletion of this training of this training does notdoes not implyimply that you are ready to that you are ready to successfully sit for the IC&RC,AODA, successfully sit for the IC&RC,AODA, Inc. Clinical Supervisor written Inc. Clinical Supervisor written examination.examination.

CLINICAL SUPERVISION: ___________ We work in a profession faced with challenges: Meeting financial; ethical;

legal & credentialing requirements and demands of management. Sound business practices help ‘insure’ quality TX.

Clinical _________________ is shared.

Supervision provides an effective way to _____________ staff performance, behavior & professional growth.

Supervisors have an ________ & ________responsibility to supervise.

Supervision is an avenue of communicating/monitoring the ongoing changes in our work.

Clinical supervision provides a rich opportunity to develop professionally & personally.

Clinical supervision improves morale, care & ______________.

SUPERVISION is…• An intervention…

• Provided… by a senior/experienced/credentialed member of the profession

• A _________________… that extends over time

• Tasks… of evaluating/monitoring/consulting

• Serving… as ‘gate keeper’

• Guided… by ‘ethical practices’

Bernard & Goodyear, 1998 / Rosenzweig & Shantzis 2014

SHARED CLINICAL SUPERVISION ASSUMPTIONS

The number one task of supervision is

to ______________ well being.

The supervisor is more ___________ than the supervisee.

Counselor performance is _____________ through indirect &/or direct observations.

GUIDING PRINCIPLESThe goal of supervision is to help a person be

a better worker … not necessarily a better person.

A Clinical Supervisor’s most important task(s) are

protecting the consumer & ensuring the highest quality of service delivery.

Remember: You are not their therapist.

_________ __________…

…is a legal principle that holds that individuals who have control & authority over others will be held ___________ for the _____________ of those under their control.

…The degree that the supervisor will be held responsible is directly proportional to the amount of _______ the supervisor has over the supervisee.

“Do the right thing. It will gratify some people and astonish the rest.” Mark Twain

V_______ L__________ occurs when:

…damage to a client results from a dereliction in carrying out one’s supervisory responsibility for the supervisee’s work

…from giving inappropriate ___________ to the supervisee to the detriment of the client

…from failing to ____________ carefully to the supervisee’s report about a client

…or… from _______________ tasks to a counselor who was not up the demands of the task!

The professional code:

DO NO HARM!

THERE ARE REAL DIFFERENCES…

• Unethical

• Illegal

• Immoral

Black Grey White

It is It is not

Right Wrong

Always Never

All None

CONFLICTS of INTEREST

$ PeopleService

Test: The Rule of Arms Length… Who benefits?

______ is the non-abuse of power

• You may ________power… when there is none.

• Those you “are helping” may ______ power to you … that you may not really have.

• The more intimate the situation… the more _______ that may be assigned.

HERE COME…

5 BAD BELIEFS

Rationalizations: That Allow For Unethical Behavior*

• The belief that what I’m doing is really not unethical, illegal or immoral.

• The belief that there are times when the end justifies the means.

• The belief that what I’m doing is important to the welfare of the organization and the organization would support it.

• The belief that I’m expected (by my organization, peers, colleagues) to do this; or …it’s the norm.

• The belief that no one will ever know or find out. *Based upon Management Values In Perspective,Warren Schmidt & Barry Posner, 1999

GUIDANCE BY GUT

When in doubt… Be human.

2003: OUR FIELD LOOKED LIKE

75% of workforce was over 40 years of age

Only 50 - 55% of direct service staff were CD credentialed The average reported case load was: 29

20% of all work-time was reported as dedicated to paper work

Annual turnover in management was almost 50%

Counselors turned over jobs every 2 years…

WHY? …& ? Now ?

WHAT DO YOU THINK?*

What/how are the aforementioned…

impacted by technology?

“With technological advancement comes an array of ethical and legal questions.” T. Powell

XRCIZ 4UR MNTL MSCLS

Fld ur paper n qrtrs…

3 qualities of your least liked supervisor ?

3 qualities of your most liked supervisor ?

One of my supervisory ‘weaknesses’ is…

One of my supervisory ‘strengths’ is…

Traits of an Effective Supervisor Powell’s Prerequisite traits:

• Clinical skills & competencies: Your clinical experience is the single most important qualification to be a supervisor.Powell’s advice: Always keep a caseload, it keeps you connected to staff & reminds them why you became a supervisor in the first place..

• Passion: Supervisors must remain passionate about what they do.

• Stay involved & committed: It will be inspirational for those you serve & supervise.

• Balance: Have fun, have friends, spend time with your family, exercise, eat well, nurture your spiritual life. Have things that you believe in & do these things with fire & urgency.

Take ‘reasonable risks’ in the pursuit of a fulfilled life.

OUR Traits of an Effective Supervisor Clinical knowledge, skills & experience

Has been supervised & is currently supervised

Professional education & training

Good teaching, motivational & communication skills

A desire to “pass the torch” of knowledge & skills

A sense of humor, humility & balance in ones life

Good helping skills, observation skills & affective qualities

Good time-management, executive & delegation skills

OUR Traits of an Effective Supervisor

The strongest traits of a Supervisor ought to be:

• A willingness & ability to teach (& learn)• Good communication & listening skills• A sense of fairness• Well organized• Clinical skills

? Conversant in technology?

More: Traits of an Effective Supervisor

Ability to create an open, trusting atmosphere Respect among peers, colleagues & supervisees Familiarity with legal & ethical issues, policies &

procedures Cognitive & conceptual abilities Concern for the welfare of the client, the agency & ones

community A non-threatening, non-authoritarian, diplomatic manner Decision making & problem solving skills

Crisis management skills_

SUMMARY QUIZKY

What are the 5A’s of being a quality supervisor?

• A ble• A ble• A ble• A ble• A ble

THE 5 A’s of Supervision…

Available: open, receptive, trusting,

non-threatening

Accessible: easy to approach &

speak with freely, there for you

Able: knowledgeable & skilled

Affable: pleasant, friendly, reassuring

Accountable: to self, clients, organization…

Traits of an ineffective Supervisor The most common supervisory weaknesses:

Difficulty in exercising management authority Poor decision making Not giving constructive feedback Unable to advocate on behalf of staff Insufficient time allocated for staff needs (-) Personal qualities (rigid, loud, insensitive,

overwhelmed, impatient, unrealistic) Lack of supervisory knowledge, skills & experience Inability to manage crisis

DON’T EXPECT IF YOU DON’T INSPECT

Poor Supervisors:

Leave notes & expect change…

Send e-mails & expect problems to be resolved…

Use staff meetings to target one worker

DIFFERENCES BETWEEN ADMINISTRATIVE SUPERVISION & CLINICAL SUPERVISION

Administrative supervisors aim to maintain healthy functioning of the organization and to accomplish the organization’s mission.

Administrative supervisors are responsible for firing, promoting, scheduling, raising salaries & other personnel duties.

Administrative supervisors focus on productivity, workload management, & accountability.

Administrative supervisors make decisions in terms of benefit or harm to the organization/system, not individuals (clients/staff?).

• Clinical Supervisors target helping supervisees to develop skills, overcome obstacles, increase competency, & to practice ethically.

• Clinical supervisors focus on the supervisee’s activities with clients.

• Clinical supervisors make suggestions and provides corrective feedback concerning cases.

• Clinical supervisors provide ongoing evaluation as to the fitness of the supervisee to continue preparation or to practice independently.

DIFFERENCES BETWEEN ADMINISTRATIVE SUPERVISION & CLINICAL SUPERVISION (continued)

CLINICAL SUPERVISION MODELS ________________ Model

Reflects the Supervisors Therapeutic approach

__________ or competency-based models

A counselor … is a counselor … is a counselor

_____________-specific Models

Defines the tasks & issues of supervision based upon the requirements of the clinician's discipline

… Can an LPC supervise an MSW … etc.?

__________________ Model

Defines the stages through which a counselor develops skills Impacts the supervisory expectations & time spent supervising

The _______-Model Model

Assumes that an outstanding counselor will be an outstanding supervisor.

Represents a reactive, retrospective approach to supervision. They focus on what the supervisee identifies as ‘a problem’…

and…

Relies on the supervisee’s awareness of ‘needing help’.

THE _____________ _____________MODEL

A disciplined process with a regular schedule & stated goals.

A tutorial process … teaching the Supervisee … what they need to know.

Has aspects of a therapeutic alliance between the Supervisor & the Supervisee …

without the Supervisor becoming the Supervisee’s therapist.

Recognizes… Supervisee strengths & weaknesses.

Provides… the Supervisee with realistic support & the expectancy of eventual competency.

The philosophical foundations of the are:

1. People can get better with the help of a guide…

2. People do not always know what is best for them …

3. The key to growth is a blending of insight/attitudinal & behavioral change in the right amounts … at the right time

4. ____________ is constant & inevitable

5. In counseling & supervision, the guide focuses on what is changeable, solutions vs. problems.

6. It is not necessary to know a great deal about the cause or function of an issue to resolve it.

hold on…there’s more

Philosophical foundations (continued):

7. There is more than one way to see the world & more than one way to do counseling

8. The aim of counseling & supervision must always be on whether it brings about desired change.

9. We’re talking about you … not the client or the supervisee.

10. People inherently know what is right for them, although they might be blinded to that by their current ‘false self’.

SUPERVISION• There is need to learn/grow as a professional

• There is a need/must for there to be someone to whom you can bring any question, any concern, any issue, or any confidence, related to professional practice.

• There is need to ___________ your competence/actions

• There is need for accountability

• There is need for/to…???

JUSTIFICATION for CLINICAL SUPERVISION Without proper supervision there is _________ that

any/all the following can/will happen:

Supervisors can become a counselors therapist… blurring tasks & expectations

Excessive familiarity can lead to boundary violations

Judgementalism & authoritarianism by the supervisor

Poor supervision as a counselor, begets poor supervision as a promoted counselor

Supervisor & counselor burnout

High levels of staff turnover

Confusion between clinical supervision & case management

• Unrealistic expectations• Unrealistic case loads• Becoming an “enabler”• Serving the need of the organization

rather than the consumer/client

• Lack of written service agreements• Preaching not teaching

What To Expect In Supervision

A Supervisor obtains information on what a supervisee is doing through…

_______________ METHODS

• Written & verbal records

• Forms, files

• Observe how the counselor interacts with staff & clients

• Most good treatment systems have some type

of feedback/evaluation forms

What To Expect In Supervision

___________ Supervision Methods• One-Way Mirror• Audio or Video Recordings• Joint Sessions, co-facilitation of sessions

• Bug In The Ear• Bug In The Eye*

When a clinical supervisor observes a session, especially “live”, there is a natural

tendency to want to INTERVENE.

Powell’s rule for intervention is clear:

INTERVENE _______WHEN IT IS AN OBVIOUS TEACHING MOMENT …or…

______ THE WELFARE OF THE CONSUMER IS AT RISK. ___________ INTERVENING ASK THESE QUESTIONS:

• Urgency? Consequences of now vs later• Probability of unprompted action? Will the counselor do the right thing?• Will the counselor know why the intervention is taking place & how will they use the data provided?• Will the intervention create undue dependence? (Level of Counselor 1,2 or 3?)

What questions to ask (continued):

• Will the intervention skew the therapeutic event?

• Interventions should be limited to important moments.

• Interventions should not minimize or undermine the credibility of the counselor being observed... Use positive language.

• The counselor should always be given ‘veto power’ over the intervention from the supervisor… unless…

THE BEST (?) METHODS OF SUPERVISION

Munson (1999) ranked the most useful to the least useful methods of supervision, as practiced among social work supervisors.

1. Co-facilitation (this goes for group work also)2. ‘Bug In The Ear’(some agencies must have time & $) 3. One-Way Mirror4. Video Tapes5. Audio Tapes6. Process Recordings7. Case Discussion

What about caseloads & time management?

Does your work setting support quality supervision?

ADVANTAGES/DISADVATAGES of ______________ SUPERVISION

Advantages:• Confidentiality is less likely to be compromised• The counselor often feels safer & more comfortable• There is more time to focus on the individual counselor• The supervisory relationship is more likely to grow into one that is

trusting, more honest & deeper.

• Disadvantages:• Expensive & time consuming• Increased chance of collusion between counselor & supervisor• More chance that supervisor will overlook an issue or a problem• Supervisor may only care about ‘their special agenda’• Relationship can become too cozy, self-promoting• Greater pressure on the supervisor when dealing with difficult

counselors

ADVANTAGES/DISADVANTAGES of _________ CLINICAL SUPERVISION

Advantages:• Economic use of time, money, expertise• Decreases isolation among staff, learning others have difficult cases• The group learns from each other• Provides a wider range of experiences…mixes gender, age, race• Provides opportunities for role playing, simulations & trying

different strategies

Disadvantages:• Each counselor receives less individual time• For new &/or intimidated counselors, group supervision can be scary• Exposes shortcomings to a larger group, thus it can be very

threatening• Confidentiality can become a matter of concern• Group supervision could look/sound like ‘a dysfunctional family’

CONTENT of CLINICAL SUPERVISION

Supervision begins with basic ‘___________ skills’:

• Attending, paraphrasing, summarizing, reflection of feelings & especially probing, confrontation & use of self disclosure in therapy

• Affective qualities such as: empathy; genuineness; concreteness; & respect for clients

• Differential diagnosis skills…particularly regarding assessing co-occurring disorders

• Transference, counter-transference & counter resistance… • Counter-transference is not harmful• Key is to address counselor’s unresolved issues• Understand what is a healthy/unhealthy response to a situation• The key to counter transference is counselor self-understanding

TOP REASONS FOR BEING SUED

• Sexual impropriety

• Incorrect Tx

• Breach of confidentiality

• Incorrect diagnosis

• Assorted others

_____________ IN COUNSELING Do nothing in private that you wouldn’t do in public.

• Supervisor over sight: Self-Disclosure Rules: Counselor to Client.

• Does the counselor’s self-disclosure help the client?

• Has the client’s profile been considered when self-disclosing?

• Are there any current, unresolved issues for the counselor?

• Has the counselor received informed consent from the client for this disclosure? (…Isn’t Self-Disclosure most often spontaneous?)

• • What are the possible consequences of this self-disclosure?

• How often does the counselor self-disclose to clients?

__________ TOUCH IN COUNSELINGThe SA field, with it’s roots in ‘chummy, joyful anonymous groups’ features lots of touching/hugging. As the SA field attracts more ‘non-recovering professionals’ this issue has been/will be discussed & debated.

The BOTTOM LINE:

If … It Feels The Least Bit Uncomfortable… DON’T DO IT! If … It Feels Comfortable… MAKE SURE YOU KNOW WHY!

• 59% of the CD counselors studied: hugged, kissed or affectionately touched their clients. Powell considers this a “startling & disturbing figure.”

• Lee Silverstein once said, “When we touch all of our patients the same, then we know it is therapeutically supportive.”

Powell says this is a good rule to follow.

______ regarding touching by counselors should be clear.

– To achieve safety– Touching should only be used sparingly & carefully– As a form of greeting/parting– With the client’s permission– As a therapeutic intervention, with clearly intended purposes– When it meets client’s needs– To establish trust– It should be avoided if it raises difficult transference issues, if the

client has a history of unresolved boundary issues (what about the counselors history?), or it creates either discomfort for the counselors &/or the client

“ To feel attraction is not unethical. Rather it is unethical not to address the attraction in supervision.” Pope & Bajt (1988)

Studies of boundary & sexual violations in counseling have demonstrated a progressive pattern of behavior on the part of the

counselor, from contact to eventual violation & sexual misconduct.

It is the clinical supervisors obligation to watch for this pattern as it develops, & to intervene before a boundary violation occurs:

– Counselor ‘neutrality’ decreases…– Sessions become more ‘social’…– The client is treated as ‘special’…– The counselor’s self disclosure increases…– Gentle touch begins & leads to embrace…

• The counselor manipulates __________________ to build a strong bond with the client. The counselor may make statements such as……

““Oh your spouse sounds like they are unresponsive Oh your spouse sounds like they are unresponsive to you. I am sure there are those who would be to you. I am sure there are those who would be more responsive to you, especially someone as more responsive to you, especially someone as good looking as you are.good looking as you are.””

…OR…

““ WasnWasn’’t it a lucky break that we got to sit together at t it a lucky break that we got to sit together at the AA meeting last night? Sitting with you made the AA meeting last night? Sitting with you made that meeting special for me.that meeting special for me.””

• Extra Sessions Begin

• Sessions are scheduled at the end of the day & run longer… or a client’s “schedule” is accommodated & the counselor stays late & alone

• The counselor stops billing the client & the size of the notes shrink

• The counselor & client have social time together, begin openly dating

• It must be clearly understood that it is expected & required that counselors seek self understanding, insight & counseling for themselves as needed.

• Supervisors, armed with facts, are expected to talk about these issues.

Problems & Concerns In Supervision

The goal of supervision is to help a person be a _________________ not necessarily a better person. A Clinical Supervisor’s most important tasks are __________________________________________ &… to ensure the highest quality of service delivery. You are__________________________________________. If therapy &/or treatment is called for… it should be received at another agency.

Problems & Concerns In Supervision

• What a counselor does in their private life is none of your business unless it interferes in some way with client care or service delivery

• Supervising often looks & sounds like therapy.

• Policy is your protection.

• Under what circumstances might supervision look like therapy?

• When harm may be done to a client, it is important for the Supervisor to assess the Counselor’s limits/blind spots in order to protect the client’s welfare & care…

Problems & Concerns in Supervision

• Supervision can look like therapy when a supervisee has transitory issues, impacting on the delivery of services.

• When the Supervisor teaches the Counselor emotional awareness & parallel processes. This according to Holloway.

• When events are so intense that it is impossible for the supervisor not to respond.

If you think you are ‘drifting into therapy’… always ask the following question:

ORGANIZATIONAL RESPONSE

Competent, well thought of CLINICANS don’t necessarily make competent well thought of SUPERVISORS.

____ clinicians well because they are worth it.

______ assume that good clinicians will be good supervisors.

DOCUMENTATION

Document No Less Than…

WHEN you meet (date, time, amount of time) WHAT was discussed ( client issue, strategy, etc.) WHAT the supervisee is to do as next steps REMEDIES to problems WHEN you will meet again (follow up/follow thru)

DOCUMENTATION

What you learned/should know about client _________notes… applies to ____________ notes.

“SOAP” NOTES: A BRIEF• S__________: Quotes from the counselor.

• O__________: Data collected by you.

• A__________: Include any indications of progress or lack of progress on the IDP.

• P____________: Recommendations for follow up…next steps

CASE NOTES: REMINDERS

• Case notes & charts are public records & ____________________________.

• Do not write anything down that you do not want read aloud in court.

• Good case notes are a part of ethical & professional development.

• Case notes document the quality of services & can/will be used to determine ___________________________________.

• Do not leave out important information or change diagnosis to help client receive insurance…

this is fraud.

• Use behavioral descriptors and avoid emotions or subjective impressions.

• Write clearly, accurately, and succinctly, in ink (Some sites use blue ink to sign and black typed notes).

• Initial & draw a single line through a mistake. On a computer you do a strike over and put your initials in parenthesis.

• Inform the supervisee as to what the policy is and expectations are.

• Be concise/brief. Do not give extended quotes or detailed descriptions.

• Do not write disparaging statements about the clients, their lifestyle, parentage, cultural or racial origin, or diagnosis.

• Try to complete notes immediately after seeing the client.

• Always keep client files in locked places.

If you must take files from one site to another, you need a locked box or briefcase.

• Computers and other electronic devices must be determined to be secure by the site or agency.

• Do not discuss clients on cell phones, as these

can be monitored by an unknown third party.

If you must say something make it coded to the party you are discussing it with…

• Be up to date on record keeping requirements and procedures, laws, and regulations.

• Follow HIPPA rules and regulations when applicable.

• As supervisor… an unscheduled random check of supervisee’s progress notes, intakes, charting, or other client documentation is recommended.

DO THE RIGHT THING

IF YOU ARE IN COURT… (EEOC, Civil, Non-

Agency Review Board, etc.)

ALWAYS…

Legal & Ethical Issues Earlier we discussed ‘physical touch’. That is one aspect of the legal & ethical issues that we face as Clinical Supervisors. Remember unethical … isn’t necessarily illegal.

A Clinical Supervisor has legal liability for the actions of a Counselor under their supervision if … the Supervisor has the ability to

initiate, change or terminate the treatment of the client.

The supervisor therefore has a legal responsibility to make a ‘reasonable effort to supervise’, generally seen as 1 hour of _______________________________for every 20 hours of client contact .

The key ethical legal issue faced in supervision is… ________________________________________________

Legal & Ethical Issues At every supervisory session… do you ask your counselor:

…has anything happened that might put you in a different light with any clients/patients?

…are there concerns you have about any of your clients/patients?

…are any clients/patients dangerous or suicidal?

…have you failed to maintain client/patient confidentiality in any way?

…is there anything a client/patient shared with you that gives you ‘a duty to warn’?

Legal & Ethical Issues

A Supervisor __________:

• Have a clearly defined frequency of supervision, especially regarding high-risk cases

(Are You Available for Hallway Consultations?)

• Have a consistent format for supervisees to describe & conceptualize problems

• Carefully review treatment plans, especially crisis management contingencies

• Document their feedback/directives & maintain a written summary of recommendations

• Directly observe the supervisee’s clinical & administrative work

Supervisory CompetenceCourts in particular have defined a ‘standard of care & practice in supervision’ as a result of malpractice cases by accepting the testimony of experts in the field.

Does the supervisor…

• have ___________ to perform the requisite supervisory functions?

• make ‘____________________________’ to supervise?

…&… does the agency have a formalized process for providing feedback & (ongoing) evaluations to counselors?

…teach the tenets & legal and ethical standards of the profession?

…maintain adequate documentation of the supervision of the supervision process?

Court rulings have pointed to several common legal & ethical errors that occur in supervision.

Confusing supervision with ‘case management’…

Focusing on client’s needs rather than the Supervisee’s development…

Relying on the Supervisor’s clinical skills in supervision, thereby turning supervision into therapy with a Supervisee…

Adopting a laissez-faire attitude with supervision, hence it occurring on a sporadic basis…

Conducting quasi-casual case conferences & crisis-management supervision…

Using one’s supervisory power inappropriately.

Supervisory Accountability

The legal criterion for malpractice is a breach of duty, that is, of one’s fiduciary responsibility to protect the welfare of another…

Although only two percent (02%) of psychotherapeutic malpractice claims in 1998 were due to a failure to supervise a counselor…

There is growing concern that supervisors are to be held accountable for the actions of their supervisees.

Supervisory Accountability

Confidentiality & Its Limits:

Breaches of confidentiality are one of the top ___ charges in successful lawsuits against psychotherapists.

In Roe vs. the State Board of Psychology (1995) the court ruled that it was the Supervisor’s responsibility… to train the Supervisee in the limits of confidentiality.

Tarasoff vs. Regents of the University of California has been used as the standard for duty to warn. Pesce vs. J.Sterling Morton High School (1987) lays out guidelines for mandatory child abuse reporting.

The 2003 implementation of the HIPPA standards established new guidelines that limit confidentiality.

Clinical Oversight: Dangerous Liaisons

Court rulings have emphasized that

____________________ must know :

The qualifications of _______________________.

Critical patient information related to

performance of their clinical duties.

The logistics of treatment… Insurance reimbursement procedures. Required record keeping. The risks & benefits of alternatives to treatment.

Clinical Oversight:Many courts have ruled that the Supervisor has the responsibility to oversee the counseling relationship between a Supervisee & a client.

Ignorance of the nature of that relationship is no longer an acceptable excuse for a Supervisor. Monitor Supervisee’s cases.

The courts expect the Supervisor to confront the Supervisee about any allegations of impropriety.

Document recommendations & actions taken.

Supervisors must question client whenever feasible & clinically viable. Place a critical incident report in the Supervisee’s file pending resolve.

Supervisors are expected to consult with colleagues.

Supervisors are expected to report the allegation to investigative services, state boards, & relevant ethics committees.

Clinical Oversight:

Supervisors should meet the Supervisee’s clients whenever possible.

Supervisors should have Supervisees review & sign the code of ethics of the counseling profession.

Supervisors should regularly audiotape or videotape counseling sessions conducted by Supervisees & document all recommended actions.

Direct observation of counselors in action is no longer a luxury.

Supervisory ContractingA contract between a Supervisor & a Counselor is strongly suggested. Indeed, as a guide to expectations, contracting may help set the path of supervision.

ITEMS FOR INCLUSION:

An individualized development/training plan (IDP) for the Supervisee

The schedule, format, duration, roles, responsibilities, goals & objectives of supervision

Information on the Supervisor's training & model of supervision

Emergency & crisis-management procedures, including the availability of 24/7 coverage in the event of a clinical emergency

Clarification of roles of an academic supervisor (if any)

A ratio of the number of clients to the number of supervision hours (see the 20 :1ratio)

Formative, summary evaluations, disciplinary procedures, due process, rights of the supervisee & sanctions

Supervisee Selection, Assignments & Documentation

It is imperative that the Supervisor protect the clients welfare by:

• Knowing the clinical competencies & limitations of their supervisees…

• Assessing the complexity of client issues prior to assigning cases to a supervisee… • Determining whether the supervisee is adequately trained to assume the case… • Ensuring that the supervisee does not have too many cases to be able to provide proper services to clients…

• Protecting the supervisee from having too many difficult-to-treat cases in their caseload…

• Identifying & resolving learning & personal problems that may compromise the supervisee’s effectiveness…

• Ensuring that there is sufficient supervision time for the cases assigned…

• Having deep knowledge of the skills & history of the counselors hired.

The professional code:

SOME STUDY RESOURCES

Powell, D. and Brodsky A., Clinical Supervision in Alcohol & Drug Abuse Counseling: Principles, Models & Methods. Josey-Bass, 2004.

Clinical Supervisor of Alcohol & Other Drug Abuse Counselors Role Delineation Study

www.ICRCAODA.com

Addiction Counseling Competencies: the Knowledge, Skills & Attitudes of Professional Practice. Technical Assistance Pub (TAP) Series 21. DHHS Publication No. (SMA) 07-4243). 2006.

Competencies for Substance Abuse Treatment Clinical Supervisors. TAP 21-A. DHHS Publication No. (SMA) 07-4243). 2007.

CSAT Treatment Improvement Protocols (TIPS) (see TIP 52: Clinical Supervision and the Development of the Substance Abuse Counselor) also (Quick Guide for Administrators)

http://store.samhsa.gov. Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727)

Best Practices in Clinical Supervision: Adopted by the ACES’ Executive Council. 4/22/2011

Campbell, J. M. (2006). Essentials of Clinical Supervision. Hoboken, NJ: John Wiley & Sons ISBN 0-471-23304-8

DISCLAIMERCompletion of this training does not imply

that you have obtained mastery of the competencies needed for the position of Clinical Supervisor.

Completion of this training does not imply that you are ready to successfully sit for the IC&RC,AODA, Inc. Clinical Supervisor written examination.