Making the Most of Clinical Supervision
As my social media newsfeeds have been filling up with pictures of proud graduates in their caps and gowns and newly minted clinical licenses over the past few weeks, I have been reflecting upon my own experience in graduate school and during my early days of clinical practice. There were so many things to be excited about ... and a lot of things to be completely freaking out about, too! As an "older" student completing my Masters in Social Work degree at 31 years old, I already had nearly a decade of experience in the field under my belt, yet I still felt unsure of myself stepping into a strictly clinical role. I managed to land my dream job, a part-time job working in a locked inpatient psychiatric facility at the local hospital, which allowed me the flexibility to keep my existing job as a Houseparent at a children's home. I was thrilled to take on new my new clinical role and I had a badass private Clinical Supervisor lined up to start as soon as my license arrived in the mail. What I learned over the next two years, split between multiple jobs and a total of three Clinical Supervisors, is that being a therapist is seriously hard work. It's cognitively and emotionally draining, there are potential ethical pitfalls around every corner, and there is no amount of "book learning" that can aptly prepare you for the intensely raw and real scenarios that you encounter in this line of work. It's just hard work, period. Having an awesome Clinical Supervisor is really an imperative and effectively utilizing your time in supervision is extraordinarily important for both you as a budding clinician, as well as for the clients depending on you. As I have transitioned over the years from a new clinician to a seasoned Clinical Supervisor myself, I have found that there are lots of ways to maximize the impact of your time spent in supervision. First and foremost, you'll want to find a Clinical Supervisor that is a great fit for your needs, which you can read about in a separate blog post here. Once you have an awesome supervisor, here are a few recommendations to make Clinical Supervision work best for you and your clients:
1) Get started on time and wrap up on time. Your time is valuable and you deserve to use that time fully. If you are scheduled for one hour of supervision each week, prioritize spending that entire hour with your Clinical Supervisor and make it clear that you expect the same courtesy in return. We all know how insanely easy it is to get caught up in the daily grind, especially in a community mental health or agency setting, knocking 5-15 minutes off of supervision very quickly. While it does't seem like much, 5-15 minutes can really add up over time. Also please keep in mind that, ethically, those lost few minutes here and there really shouldn't be counted as supervision hours towards full licensure. If you are consistently starting late or wrapping up early, you're losing out on HOURS of Clinical Supervision over the course of your Associate licensure period.
2) Recognize that Clinical Supervision is YOUR time, not your agency's time and not your supervisor's time. Things can get a bit confusing when your Clinical Supervisor is also your administrative supervisor in an agency setting. I have personally received both agency-based and private Clinical Supervision, and I have also provided both agency-based and private Clinical Supervision. In the best case scenario, you'll have access to high quality Clinical Supervision with a provider of your choice, someone able to focus completely on your needs and goals, free from the external pressures of an employing agency's agenda. In the worst case scenario, you might spend your Clinical Supervision meetings focused on things like productivity expectations and agency policy updates while your own questions and issues for staffing are quickly glazed over. If this is happening in your supervision sessions, it's okay to appropriately assert yourself and redirect the conversation back to your own needs. If necessary, offer to schedule a different time to discuss agency-related issues. Simply say something like, "I know it's really important that we discuss my job performance and I'd like to do that at a separate time. I'd really like to use my Clinical Supervision session today to staff a couple of clients and discuss interventions related to Generalized Anxiety Disorder. When can we meet to talk about administrative issues separately?"
3) Be prepared. Walk into your Clinical Supervision meeting armed with a pen and paper for taking notes, as well as a list of topics that you would like to discuss. It's helpful to keep a notebook handy on your desk (or in your work bag, if you're providing services out and about in the community) to jot down notes throughout the week. There is no question that you'll have lots of random issues arise between supervision sessions and it's easy to forget details if you don't write them down immediately. In the rare event that nothing exciting has happened since your last Clinical Supervision session and there aren't any client-related issues to discuss (like that one time you went on vacation or were out with the flu!), there are lots of other ways to use your time in Clinical Supervision. Exploring the DSM-5, reviewing standardized assessment tools, discussing theoretical orientations, learning about a specific Evidence-Based Practice, preparing for your licensing exam, discussing ethical conundrums, working through your own "stuff" that seems to pop up after sessions with clients, and talking about professional development are some good topics that you can always count on to easily take up an hour or more.
4) Be vulnerable and acknowledge when you don't know what you don't know. Regardless of how long you have been in the field, it's highly unlikely that you know absolutely everything there is to know about being a clinician. I personally learn something new on a near-daily basis and frequently say to my colleagues, "Well, I thought I had seen it all until now!" There is strength in knowing your limits. Highly competent and skilled clinicians will actively seek, even relish, the opportunity for feedback and collaboration on a regular basis. It is widely accepted that we are doing difficult work and none of us is the ultimate expert on every topic, so please feel confident that seeking guidance is a valued necessity in this line of work.
5) Talk about your own "stuff" and how it's impacting your clinical work. We all have "stuff," that's not even an issue of debate. While it can be uncomfortable to talk openly about things going on in your own life, whether it be current stressors or issues stemming from your childhood, it's imperative that you acknowledge how your own "stuff" may be impacting your work with clients. Clinical Supervision is a wonderful space to process through issues like countertransference, vicarious trauma, and compassion fatigue. While Clinical Supervision isn't a substitute for therapy, it should be a safe space to process through some of the pitfalls that are typically experienced by clinicians. If it seems like you consistently have a lot of "stuff" that takes up a great deal of your Clinical Supervision time, you might also want to consider working with your own therapist on addressing underlying issues in as well.
6) Think about your long-term goals and start your career journey now! It is often so easy to get caught up in learning the ropes of the day-to-day life of a clinician that you lose focus on what you really want for yourself and your career in the long-run. While it is undoubtedly important to focus on what is immediately in front of you, like staffing cases and learning interventions, it's also valuable to spend some of your time in supervision developing your long-term career plan. Ask your supervisor for assistance in learning more about what types of careers are available in your area, bounce around ideas and seek feedback, and openly talk about what you're currently loving and loathing about your job. This can get tricky in an agency setting as your supervisor may have a personal (or employer-based) agenda to keep you right where you are, so acknowledge this early in the supervision process and assert yourself to create to safe and productive space to explore your long-term goals.
In the end, please remember that Clinical Supervision is about YOU and your development as a clinician. This is your opportunity to learn new interventions, hone your skills, explore career options, and develop your own personality as a clinician. Clinical Supervision can truly make a huge difference in how your career as a clinician shapes up in the long-run, so use that time wisely now.
Jill Williams is a Licensed Clinical Social Worker providing therapy and Clinical Supervision in Asheville, NC. Jill works with children and adults of all ages and specializes in treating anxiety disorders, mood disorders, and issues stemming from past traumatic experiences. Jill has a special passion for providing support to clinicians and others individuals in "helping" roles. You can learn more about Jill and her practice at www.flourishasheville.com or by calling 828-407-0243.