Julie A. Jacobs, Psy.D., J.D.
Supervising trainees can be a meaningful and fulfilling part of clinical practice. However, we don’t always consider the fact that supervision requires different skills and experience than therapy or assessment. It is sometimes presumed that good clinicians are good supervisors, but this is not always the case. This article will explore some specific skills and considerations for becoming a good supervisor and can help you manage the risks that come along with taking on this important role. You can learn more about supervision (and earn CE credit) by viewing our On Demand Webinar called “Ethical and Risk Management Issues in Supervision” – presented by Carol Falender, Ph.D., Edward Shafranske, Ph.D. – follow this link for more information: https://beacon360.content.online/xbcs/S1537/catalog/product.xhtml?eid=7178
In order to be a good supervisor, it is vital to be competent not only in the clinical areas in which you will be supervising trainees, but also in the “distinct professional competency of clinical supervision.” (American Psychological Association (2014) Guidelines for Clinical Supervision in Health Service Psychology. Retrieved from http://apa.org/about/policy/guidelines-supervision.pdf). It is not enough to supervise others based solely on your own experience as a supervisee; you should instead seek specific training in providing supervision. Even after gaining the necessary knowledge and skills to provide supervision, you should constantly monitor and reflect on your performance as a supervisor and seek feedback from your colleagues and supervisees regarding your performance.
Competence includes more than being competent as a clinician and a supervisor. If you use technology in providing supervision, you must have an appropriate level of competence in the use of such technology. You must also be culturally competent and maintain awareness of diversity issues. Consider how your cultural identity and that of your supervisee and client interact and impact your work as a supervisor and attempt to infuse awareness of diversity into all aspects of supervision and training.
As a supervisor, you should be aware of guidelines and best practices, as well as relevant laws, rules, or policies of your specific state. Two good sources of guidance for psychology supervisors are:
Additionally, you should check your state laws, regulations, and board policies for state-specific guidance on supervision in your state.
You also need to be aware of what your supervisee is doing by monitoring his/her work regularly and directly. It is not enough to rely solely on verbal reports from your supervisee; you should regularly view or listen to recordings of sessions or directly observe the work in which your supervisee is engaged. Feedback that is based on direct observation will be more effective, useful, and accurate than feedback based solely on the supervisee’s self-report. In addition, don’t always allow your supervisee to choose what work you observe. Select work samples yourself to remain fully aware of how the supervisee is performing and seek input about your supervisee’s performance from a variety of sources when possible.
Awareness includes being aware of your own limitations in providing supervision. If you are struggling with a supervisee, don’t ignore your own reactions. Instead, seek consultation and guidance from colleagues to help determine the source of the struggle and possible solutions.
Finally, always remain aware of your ultimate responsibility for the care and welfare of clients who are working with your supervisee. Although someone else is providing the direct clinical work, you are the one who is responsible for ensuring that each client’s needs are being appropriately addressed, and it is your license that will be on the line if any inappropriate or problematic actions are taken by your supervisee.
It is extremely important to be intentional and clear from the outset about the supervisory relationship. You should have an explicit written agreement with your supervisee that, at a minimum, addresses the following:
- Structure of supervision
- Supervisor’s duties and responsibilities
- Supervisee’s duties and responsibilities
- Goals of supervision and individual learning goals
- Criteria for evaluating supervisee competence and process for evaluation
- Processes when supervisee does not meet criteria for performance
- Procedures for supervisee to clarify or contest a negative evaluation
- Expectations for preparation for supervision sessions
- Process for communication with training program regarding supervisee’s performance
- Legal and ethical compliance, including disclosing supervisee status to clients, limits of confidentiality, duties to warn and protect, and multiple relationships
- How supervisees will deal with emergency situations
It is also important to be intentional about creating a collaborative relationship with your supervisees. You should take responsibility for initiating conversations about expectations, goals, and tasks on a regular basis. Be intentional about addressing issues such as differences in beliefs, culture, values, or interpersonal styles that may impact the supervisory relationship. Intentionally address the inherent power differential in a supervisory relationship and do your best to proactively manage this dynamic. Being thoughtful and intentional as a supervisor will model this behavior for your supervisees and lead to more open, collaborative relationships.
Being a trainee can be a challenging, confusing, and stressful role, and your supervisees need to know that you are available to them on a regular and predictable basis. Your supervision agreement should include a schedule for regular face-to-face interactions with your supervisees, which can be supplemented by secured phone calls, emails, or video chats. Honor the schedule you agree upon with your supervisees; supervision should be a priority just like any other client care matter, and your supervisees need to know that you will make time to meet with them and discuss their work. In addition to regularly scheduled interactions, there must be some way for your supervisees to reach you in the event of a crisis or emergency situation after hours. Finally, if you will be unavailable for a period of time, you will need to ensure that there is adequate back-up coverage available to provide supervision and consultation to your supervisees during your absence.
Being physically available to your supervisees is important, but it is not enough. You must also create a collaborative relationship with your supervisees in which they will feel comfortable sharing information with you – the good, the bad, and the ugly. Work to create a safe space for your supervisees to explore their professional development. Don’t be punitive, dismissive, or judgmental with your supervisees; this will only encourage them to limit what they share with you and can lead to disastrous consequences in some situations. Using a strengths-based approach to supervision may help supervisees feel more comfortable approaching you with challenging situations.
It is also important for you to seek feedback from your supervisees, including whether they feel comfortable with your interactions and supervision style. Incorporate this feedback into supervision in a way that makes your supervisees feel heard and respected. Similarly, it is important to recognize and manage conflict effectively rather than avoiding it. Show a willingness to acknowledge and address conflict proactively, and your supervisees may feel more comfortable coming to you with problems or conflicts they are experiencing with their clients.
Face-to-face supervision is a vital aspect of the supervisory relationship, but it is not the complete picture. You need to ensure that you are taking a comprehensive and thorough approach to supervision. As noted above, be sure to review progress notes and observe clinical work, either live or recorded, on a regular basis. Supervisee self-reports will not be adequate to fully evaluate the performance of your supervisees since they may tend to self-select records or recordings that they feel are the “best” work they do. You will learn a lot more about your supervisees by seeing their “worst” work and helping them work through whatever challenges they are facing.
It is also important to maintain consistent contact with off-site supervisors and other professionals who are responsible for your supervisees’ training and education. Talk with these other professionals to identify their goals and expectations for supervision and be sure they are consistent with your goals and expectations. You should work as a team to help your supervisees gain the knowledge and experience they need during their training experiences.
Finally, be thorough in documenting your supervision sessions as well as any identified problems with performance and the steps you are taking to address these problems. This way, you will be able to demonstrate that you were aware of what your supervisees were doing throughout their training and you were taking appropriate steps to help your supervisees improve their performance when issues arose.
This should go without saying, but we are saying it anyway – model ethical behavior for your supervisees throughout their supervision experience. This applies not only to clinical practice, but also to how you conduct supervision and interact with supervisees, colleagues, clients, and others. Be sure you are conducting yourself in accordance with the ethics code of your profession and other relevant guidelines, laws, and regulations. Show your supervisees how to access this guidance so they can refer to important guidelines on their own. Be sure that your supervisees are appropriately disclosing their status as trainees to clients and that they are providing your contact information on paperwork and disclosures given to clients in accordance with relevant ethics codes and applicable state laws.
It is your ethical duty to put the well-being and safety of clients first. Any issues related to competence of your supervisees must be addressed immediately and directly. At the first sign of an issue, develop a plan with your supervisee on how to address any deficiencies, then monitor his/her performance closely and modify the plan as needed. You must be willing to dismiss a supervisee who is unable to perform competently, remembering that your first duty is to the clients. You are the one who is ultimately responsible for client care, and while you may want to help your supervisee improve, this can’t happen at the expense of the client.
You must also be sure to document supervision appropriately and maintain records of supervision in accordance with relevant guidelines. Per the ASPPB Guidelines referenced above, supervision records should be maintained until the supervisee acquires a license or for at least 7 years after supervision terminates, whichever is longer.
Finally, be cognizant of the need to maintain appropriate boundaries and avoid dual relationships with supervisees. Don’t ask your supervisee to do tasks for you such as picking up your dry cleaning or babysitting your kids, even if you are offering to pay for those services. The power differential in a supervisory relationship can be more potent than that of a therapy relationship, and supervisees may not feel able to turn down a request for help from you. Further, remember your role is that of a supervisor, not a therapist or a friend, and respect that boundary throughout the supervisory relationship.
Supervision can be an extremely rewarding experience, and trainees depend upon supervisors to help them achieve competence and confidence as clinicians. Although it can be challenging and difficult at times, knowing that you are contributing to the next generation of psychologists can make all of the work well worth the effort. The guidance above provides important ways to manage the risks associated with supervision, and following this guidance may be protective of both you and your supervisee as you navigate these risks. Strive to be competent, aware, intentional, approachable, thorough, and ethical in your work as a supervisor; hopefully, this will lead to better outcomes for supervisees and clients alike.