#17 What to look for in Selecting a Clinical Consultant or Supervisor.
This time we should start with whatever lenses you have, your therapy model of choice, your client population and the issues you work with. There are 3 basic things to watch for when thinking about what kind of supervisor you want: 1/ the overlap with your areas of practice and their's; 2/ the trust level that exists and how it could grow through the on-going relationship to follow; 3/ your comfort level with their supervision model and contract. All of these identifyers will help you to narrow down the significant aspects of a consultant/supervisor's goodness of fit on at least some of these issues. Another very important element to consider is what you know of this perspective consultant or supervisor's professional reputation, or if they have a good reference from someone else who knows them and their supervisory work. This is about the trust you are going to be investing in them to have your back when you will need it the most, eg. when you are not sure yourself of what to do. You should consider this to become an on-going relationship and an important member of your backup professional development team, along with your own therapist, your peer group and your accountant.
Seeking a Clinical Supervisor: Let's get more specific, if you have the luxury of selecting your Clinical Supervisor, that probably means you are an intern working within an internship setting that most often already have designated who will do the supervision of their interns. What this usually means is you are assigned to that supervisor and you probably don't get to select an alternate one. The good news is they are an important part of the internal culture of the agency, they are already well informed about the agency's mandate, current policies and procedures. This makes for an easier learning about the agency and improves your orientation to the client population and issues they bring. Typically they will stay as your supervisor for your entire internship at that agency.
In your initial interviews with this supervisor, listen carefully for details about how the supervision sessions will be structured up front. If there is little detail, after they finish presenting their approach and plan, ask about it: will it be individual supervision only, or also group supervision? What is the format of how they prefer the cases to be presented? How often will they meet with you? When will you start to see clients, will that be in-person sessions or via a video platform, will they need to be recorded? You want to be especially clear about what skills you will be evaluated on, how often and using what criteria. Here you are looking for a well organized supervisor who will offer you clarity and transparency in the way they will work with you. There is a power differential that can not be avoided but the relationship can also be significantly collaborative if they are comfortable with that. Listen for evidence of that in what they describe, or the way they describe the process. You may also inquire into which supervision model they prefer, if they favour one.
Seeking Clinical Consultation: This would generally apply to all clinicians after they graduate and become registered with a professional association as their governing body. This is where you can absolutely select your consultant, and sometimes, more than one depending on the areas of practice you work in. This consultant is who you would turn to with: questions about ethics, clinical problems with a client, or even issues with colleagues that may be difficult. You would be potentially seeking their advice, their recommendation about clinical strategies, the training options aligned with their growing clinical interests, or how to manage any counter-transference issues when they emerge. They would not however, also offer you personal therapy, as that would cross an important professional boundary. The better they know how you want to approach this work, the more useful they can be when things get uncomfortable, which is why the trust issue is so important to keep in view about the relationship. There can be some dual relationship boundary issues that develop over the course of building this trusting supervisory relationship. Navigating these boundaries can become unexpectedly complex at times. Remembering the purpose and the contract is very useful at these times, because it can focus the professional contract aspect over the more personal emotional context that often accompanies some of the vulnerability which frequently occurs within the consultation processes. It is important to see this supervisory relationship as an on-going professional one, not just an occaisional one.
Seeking Supervision of your Supervision: The letters SoS are a universal indicator of NEED HELP, for supervisors there are times when we too need help to understand and manage what we do in our supervision practices. We should, as part of best practices in supervision, also have a trusted supervisor colleague or mentor that we bring our clinical supervisory work to for another perspective, feedback or just another pair of eyes and ears to help us to notice when we too may be distorting some of the process without knowing it, or noticing it and not knowing what to do with it. Supervising supervisors, as I see it, is not simply being a supervisor, it is holding space, back another notch, to consider what the plans are for how to deal with the things we engage about and also the things that we have not yet engaged about because we didn't notice that aspect of it. Helping a supervisor to learn how to plan is the work of the SoS in my view. Just as a supervisor is not generally offering a supervisee the way they would do something if it was their client, their job is to influence the supervisee while helping their style and skills to emerge. It is a different relationship than just taking over the client as if it were theirs. This is how supervisors stay sharp and get support for the sometimes lonely work of a supervisor. It is also how we grow, even when we have a great deal of clinical experience, we still need to continue to develop as supervisors and be accountable as a professional.
Seeking Supervision Coaching: This would be when you as a supervisor have a specific issue that you want some specific advice or recommendations for how to proceed. This may be within a specific therapy model for example or a thematic question that can be saught as and when needed but may not be within an on-going supervisory relationship. This is sometimes referred to as 'Just-in-time' supervision or consultation and would most often be using a specic area of expertise that a given supervisor may have that would be useful to another supervisor at that time. Let me give an example, if you work with mandated clients, or mandated supervision, which does happen within our profession when a clinician is found to have been unethical in some way. This mandated clinical supervision will have the power differential even though this clinician has already graduated, what would be at steak would be the clinician remaiing in good standing with their professional association as long as they engage with the requirements the Inquiry Committee have determine as needed. Typically they would have to undergo a period of focused clinical supervision until the ethical concern has been sufficiently addressed to return a clinician to competant ethical decision making in their practice. This is a niche area of supervieory practice where this coaching service may be sought for a specific question.
Supervision as Insurance: Clinical supervision and consultation is the best insurance any clinician can have by having someone who is knowlegeable and experienced enough to be able to help them through any of the many times when they need to reach out to a known and trusted source to have their back into and through a rough time in clinical practice. These times do occur for all of us, and not because someone is not trained well enough or imperfect in some other way. This is always going to occur within the predictably unpredictable circumstances that we all work in as counsellors and professional helpers. It is not a question of IF, it is a question of WHEN it happens to you. The bigger question for me is, do you have your team already assembled? This backup can be very supportive should a client register a complaint against you with your professional association. This is something I think all professionals worry about. By having consulted with a supervisor regarding a case, that goes a long way to demonstrate your best practice by seeking help when needed. Having your supervisor's support throughout an ethical complaints investigation can be a very re-assuring presence during what can be very difficult times.
It is the hallmark of every profession that they have a code of ethics that they are goverened by and there is credable oversight of the clinicians meeting those professional standards on an on-going basis. They both gate keep entry into the profession and continue to support and oversee the continuing professional standards they set are met by those within that profession. Clinical supervision for interns learning the ropes and on-going clinical consultation is the way, in combination with the regulatory function of the Inquiry Committee, that we can protect the public by ensuring that standards are met. It is the best practice standard for all counselling professionals.
So that's it for now about selecting a supervisor, next month I will be looking at how to pivot when you find yourself in session experiencing counter-transference. I hope this month's blog was useful to you, and that you join me again next month too, Ciao, David