Supervision - Aligning For Growth

Expectations for Quality Supervision: It Takes Two Hands to Clap

Despite coursework and training on how to do clinical work, for many there is one subject lacking: how to “do supervision (Falender, 2018).” The APA has published Guidelines on Supervision, meant to “inform the practice of clinical supervision…(2015, p. 34)” which delineate an array of important skills and competencies. Over the last 35 years I (JS) have had quite a few supervisors, have supervised many students, and have attended continuing education workshops about supervision. As internship coordinator for a master’s program I hear about the supervision experience of many students. Based on those experiences, what follows is not meant to teach the competency of supervision but rather to suggest the basic and concrete elements that should be present in order for supervision to be successful.

In individual supervision,consider expectations for behavior on both sides. Baird and Mollen (2019, Chapter 5) explore factors that lead to successful supervision and include supporting research. Having known trainees who were not meeting expectations and supervisors not providing appropriate guidance, I have clarified my own thoughts and expectations for each of those roles in two brief lists.

Expectations for the trainee

Perhaps more straightforward than those of the supervisor are the expectations of the trainee.

Recognize that supervision is for learning.
Be on time.
Take care of your duties, including timely paperwork. While not the most fun aspects of the clinical experience, they are useful, visible, and important. If you struggle with these responsibilities, reviewing how to get them done might happen during supervision but it is not the best use of supervision time.
Come prepared to talk about what happened in sessions. This includes not only interventions you provided but how, what words you used, and how they were received. Bring up what you think went well and what did not. Note what went fine but could be tweaked.
Be open to critiques without becoming defensive. Plan to learn from your experiences.
Have high expectations for yourself. You are in the position you are in because you are qualified. Do right by yourself and clients.
Ask questions and let your supervisor know what you are hoping to get out of the experience.
Use the time. Do not think about flying through the meeting to complete other tasks. Supervision is for both your clients’ benefit and yours.
If you are not getting what you need, address it with your supervisor. You may need to be concrete. For example, you may tell them that you are looking for specific suggestions around how to handle certain situations, rather than simply validation that you did OK. Tell them that you are seeing this as a learning experience. Even if what you report to them is fine, you still would like ideas and critiques.
If you still are not getting what you need, think about who can help you get that. Talk with that person and make a plan.
Recognize that your supervisor has clinical responsibility for you and your work. If you disagree with what they say, respectfully talk with them about it but do not “go rogue” and decide that you are not doing what they told you. That is a risk to you and to them, as well as your client.

Think about what you want to get out of this experience and use that to guide your use of supervision. Get as much out of it as you can. You will be a better clinician for it. Remember that your supervisors are human. They may frustrate you. They may have to reschedule supervision. They may disagree with you. Think about what you can learn from them and keep your eye on that prize, that being growing as a clinician.

Expectations for the clinical supervisor

The supervisor may not think expectations for themselves but expectations are very much present. This list is not comprehensive but serves as a baseline.

Be reliable. Trainees should have their designated supervision time and know that they can count on you being there for it. When an urgent issue interferes, offer to meet another time.
Model therapeutic curiosity and a professional demeanor.
Recognize that this is a learning experience for your supervisee. Even if they are doing well, think about what you can teach them to bring them to the next level. What can you say to them, beyond “that’s good” to further improve their skills or encourage them to consider another standpoint?
Create a space that is comfortable. By this I mean not the physical space (although attend to that as well) but the emotional space. You do not need to be their best friend. In fact, that would not be appropriate. However, they do need to feel that they can bring uncomfortable topics to you, including when things went wrong,when things were uncomfortable, and when they feel they messed up.
Have high expectations for your supervisee. They earned the position that they are in because they are qualified. Expect them to do a good job and work to figure out why if they are not.
Be responsive. When your trainee reaches out, respond to them in a timely manner.
Let your supervisee know what the plan is when something urgent or upsetting comes up and you do not have scheduled supervision coming up within the next day. Think about the unneeded discomfort of them sitting with the question of whether they handled something correctly or the concern over a very challenging clinical situation and stewing on it for days to a week.
Admit when you do not know something and figure out where to get an answer.
Know who you and your supervisee can consult with if you need other opinions. You are not expected to know everything.
Recognize supervision as important and not just something to get through as quickly as possible in order to move on to other tasks. It is a commitment to trainees and to their clients.
Remember that you can learn from your trainee as well.

Reflect on what you want your trainee to get out of supervision and what you can do to facilitate that. Think back on your experiences. What did you value in your supervision when you were a trainee? What did not work for you? How can you create a positive learning experience for your supervisees?

Quality supervision is transformative

The supervisory relationship can be joyful and formative for both members. Supervision can make the difference – the difference between frustration and burnout versus learning and excitement, between strong clinical skills and just good enough. These differences matter for the clinician, the clients, and the professions.

References:

APA (2015). Guidelines for clinical supervision in health service psychology. American Psychologist, 70(1), 33–46.

Baird, B. N. & Mollen, D. (2019). The internship, practicum, and field placement handbook: A guide for the helping professions. Routledge.

Falender, C. A., (2018). Clinical supervision—the missing ingredient. American Psychologist, 73(9), 1240-1250.