Clinical Supervision
Within the four walls of my office, on the phone or in a group treatment room, I have listened to – and witnessed the re-telling of molestation, bullying, physical violence, heartbreak, loneliness, grief, conflict, death, murder, attempted murder, bankruptcy, harassment, doubt, illness, miracles, neglect, and abandonment. The impact of hearing these stories in the privacy of my office, isolated from the rest of the world, has transformed me, and I am no longer the person I was before starting my social work training in September 1997.
Since most of our wounds occur in the context of relationships, issues of trust, safety, power, and control can find their way into the therapy relationship, which can become both complicated and compelling for both the client and the social workers. Clinical supervision facilitates an examination of the process of therapy, allowing new and experienced therapists to share thoughts, feelings, struggles, and fantasies with the expressed purpose of creating optimal healing environments for clients.
Despite its potential benefits, the reality is that most clinicians do not receive regular clinical supervision. If employed by a social work organization, supervision can tend to focus on case management and staff evaluation. Within the profession itself, supervision is perceived as something only beginning therapists need to engage in and that competent social workers would never allow themselves to be impacted by their work, because the notion that he/she is always aware of what is occurring within the therapy relationship.
Clinical supervision is offered to new and experienced clinicians. The process allows clinicians to share thoughts, feelings, experiences, therapeutic impasses and ethical dilemmas with the purpose of enhancing skills, developing tools to address or prevent vicarious trauma while also ensuring effective therapeutic interventions for clients.
The Nature and Purpose of Supervision
Thankfully my first experience with clinical supervision was a positive one. It began in the second semester of my master of social work internship at a local women’s shelter. Like most shelters there was little funding to provide residents with “on-the-spot” immediate and/or long-term therapy. To help meet the needs of the residents, the university I attended agreed to provide a clinical social work intern (me), and a faculty member who would provide me with 1.5 hours of weekly clinical supervision.
I was worried and confused, and had no idea what clinical supervision entailed until my supervisor provided me with an article explaining the process. I was relieved to discover that rather then a weekly evaluation of my work, the relationship was intended as more of a mentorship. Throughout the duration of our meetings, my supervisor showed increasing curiosity about my interest in working with women; my beliefs about power and control; how I planned to take care of myself; how I felt before, during and after each meeting with a client; and how my view of the world might be changing as I listened to the women’s stories of abuse, poverty, and racism.
My clinical supervisor was respectful and encouraging of my choice to pursue my own personal therapy. When I felt I had made a “mistake” with a client, she helped me to process it and to see how I might use this new learning in my next therapy session. She created an interpersonal container where it was safe for me to discuss transference, counter-transference, and vicarious trauma (see appendix A for definitions). The relationship that emerged was based on mutual respect and empowerment, curiosity, education, personal growth, support and confrontation. We were both willing to be challenged and transformed. Through this first supervisory relationship, my love for learning and reading evolved into a passion for therapy.
Unfortunately this type of growth fostering supervisory relationship is not the norm. I myself have worked in environments that have ranged from no supervision at all or worse yet, bad supervision, to environments where training, education and quality supervision were embraced and encouraged. The inconsistencies with how support, education, and training are viewed in the field of trauma work seem to point to a general lack of understanding of clinical supervision by both supervisees and supervisors (Mathews, 1995; Richardson, 2001).
To begin with, clinical supervision is not, nor should it ever be, linked to performance management, whereby the supervisee might fear the content of supervision making its way into a performance review (Richardson, 2001). The purpose of clinical supervision is to provide a safe space for supervisees to debrief, share difficult experiences, relax, promote self-care, be affirmed, and have energy restored (Richardson, 2001). More like an apprenticeship then counseling, the supervisor must still use therapy skills to create the trust and safety necessary for the supervisee to feel free enough to explore difficult feelings and experiences, while creating a process that is both “stretching and fluid” (Hewson, 2001).
Since most of our wounds occur in the context of relationships, issues of trust, safety, power, and control can find their way into the therapy relationship, which can become both complicated and compelling for both the client and the social workers. Clinical supervision facilitates an examination of the process of therapy, allowing new and experienced therapists to share thoughts, feelings, struggles, and fantasies with the expressed purpose of creating optimal healing environments for clients.
Despite its potential benefits, the reality is that most clinicians do not receive regular clinical supervision. If employed by a social work organization, supervision can tend to focus on case management and staff evaluation. Within the profession itself, supervision is perceived as something only beginning therapists need to engage in and that competent social workers would never allow themselves to be impacted by their work, because the notion that he/she is always aware of what is occurring within the therapy relationship.
Clinical supervision is offered to new and experienced clinicians. The process allows clinicians to share thoughts, feelings, experiences, therapeutic impasses and ethical dilemmas with the purpose of enhancing skills, developing tools to address or prevent vicarious trauma while also ensuring effective therapeutic interventions for clients.
The Nature and Purpose of Supervision
Thankfully my first experience with clinical supervision was a positive one. It began in the second semester of my master of social work internship at a local women’s shelter. Like most shelters there was little funding to provide residents with “on-the-spot” immediate and/or long-term therapy. To help meet the needs of the residents, the university I attended agreed to provide a clinical social work intern (me), and a faculty member who would provide me with 1.5 hours of weekly clinical supervision.
I was worried and confused, and had no idea what clinical supervision entailed until my supervisor provided me with an article explaining the process. I was relieved to discover that rather then a weekly evaluation of my work, the relationship was intended as more of a mentorship. Throughout the duration of our meetings, my supervisor showed increasing curiosity about my interest in working with women; my beliefs about power and control; how I planned to take care of myself; how I felt before, during and after each meeting with a client; and how my view of the world might be changing as I listened to the women’s stories of abuse, poverty, and racism.
My clinical supervisor was respectful and encouraging of my choice to pursue my own personal therapy. When I felt I had made a “mistake” with a client, she helped me to process it and to see how I might use this new learning in my next therapy session. She created an interpersonal container where it was safe for me to discuss transference, counter-transference, and vicarious trauma (see appendix A for definitions). The relationship that emerged was based on mutual respect and empowerment, curiosity, education, personal growth, support and confrontation. We were both willing to be challenged and transformed. Through this first supervisory relationship, my love for learning and reading evolved into a passion for therapy.
Unfortunately this type of growth fostering supervisory relationship is not the norm. I myself have worked in environments that have ranged from no supervision at all or worse yet, bad supervision, to environments where training, education and quality supervision were embraced and encouraged. The inconsistencies with how support, education, and training are viewed in the field of trauma work seem to point to a general lack of understanding of clinical supervision by both supervisees and supervisors (Mathews, 1995; Richardson, 2001).
To begin with, clinical supervision is not, nor should it ever be, linked to performance management, whereby the supervisee might fear the content of supervision making its way into a performance review (Richardson, 2001). The purpose of clinical supervision is to provide a safe space for supervisees to debrief, share difficult experiences, relax, promote self-care, be affirmed, and have energy restored (Richardson, 2001). More like an apprenticeship then counseling, the supervisor must still use therapy skills to create the trust and safety necessary for the supervisee to feel free enough to explore difficult feelings and experiences, while creating a process that is both “stretching and fluid” (Hewson, 2001).
Click here to upload a chapter I wrote for "The Use of the Creative Therapies with Sexual Abuse Survivors" edited by Dr. Stephanie L. Brooke
| clinical_supervision_and_the_trauma_therapist.pdf |