Clinical Supervision CEUS - Chapter 3 - THE SUPERVISOR

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Chapter 3: THE SUPERVISOR Role of the Clinical Supervisor Clinical supervision has become the means by which practitioners obtain practical knowledge and proficiency for counseling and social work professions, creating a bridge from the classroom to the job. Over the last few years, clinical supervision has been considered the foundation of excellent care and treatment. It is NOT "pulling the strings" as the illustration suggests! Supervision is critical to effectively strengthen client care, increase the professionalism and reliability of clinical staff, and provide and sustain ethical standards within the profession. Supervision has a distinctive role in aiding supervisees to progress from basic types of counseling skills to a more seasoned and perceptive type of counseling proficiency. The experience of the supervisee should be positive and enabling rather than demanding and negative. Supervision gives a dependable background to aid supervisees in adapting their learning experiences and developing professionalism (Rawson, 2003). Excellent clinical supervision is established on a solid supervisor-supervisee partnership which advances client wellbeing as well as professional growth and development of the supervisee. You might be a teacher, trainer, advisor, mentor, evaluator, and manager; you give encouragement, support, and training to supervisees who are dealing with a range of physical, interpersonal, emotional, and perhaps even spiritual issues of clients. Essentially, successful clinical supervision helps to ensure that clients are suitably served; supervision also helps to ensure that counselors and other social workers continuously grow their skills, which then improves effectiveness of treatment, keeps clients, and satisfies staff. The clinical supervisor also may also function as a link between clinical and administrative staff (Center for Substance Abuse Treatment, 2009). To sum it up so far, a supervisor: Realizes that people don't wish or need to be bossed, but they need to be guided. Displays integrity, honesty, wisdom, and strength of character (Malone). Keeps track of client welfare while keeping focused on the work of and the growth of the supervisee. Oversees her own relationship with the supervisee, along with the supervisee's relationships with clients. Aids in enhancing the professional growth and functioning of the supervisee, promoting transition from one stage to another. Monitors and evaluates the quality of service given by the supervisee (Cole, 2001, and Padel, 1985) [QN.No.#4: The clinical supervisor's role does NOT include:] Legally, you'll find there are two kinds of supervisees--trainee and intern. An intern is usually getting college credit for his work with you and will likely pay the agency rather than be paid by the agency. A trainee is an employee. In California, supervisees are monitored through the Board of Behavioral Sciences (BBS). Be aware that typically you, being the supervisor, are required to follow the rules and regulations pertinent to the professional status of your supervisee.For instance, a social worker supervising a marriage and family therapist (MFT) trainee is required to follow the regulations associated with the supervision of MFT trainees. An MFT who is an assigned supervisor for a social worker intern is required to follow the regulations associated with social work interns (Sultanoff, 2008). A portion of California's requirements, October 20, 2005, for associate clinical social work supervisors reads: ARTICLE 6. LICENSED CLINICAL SOCIAL WORKERS 1870. REQUIREMENTS FOR ASSOCIATE CLINICAL SOCIAL WORKER SUPERVISORS (a) (4) The supervisor has had sufficient experience, training and education in the area of clinical supervision to competently supervise associates. Effective January 1, 2001, supervisors who are licensed by the board shall have: (A) A minimum of fifteen (15) contact hours in supervision training obtained from a state agency or approved continuing education provider. This training may apply towards the approved continuing education requirements set forth in Sections 4980.54 and 4996.22 of the Code. … (5) The supervisor knows and understands the laws and regulations pertaining to both supervision of associates and the experience required for licensure as a clinical social worker. (6) The supervisor shall ensure that the extent, kind and quality of clinical social work performed is consistent with the training and experience of the person being supervised and shall review client/patient records, monitor and evaluate assessment and treatment decisions of the associate clinical social worker, and monitor and evaluate the ability of the associate to provide services at the site(s) where she will be practicing and to the particular clientele being served, and ensure compliance with all laws and regulations governing the practice of clinical social work. The BBS expects supervisors of MFT interns or social work associates to continue to provide a minimum of 1 unit (1 hour individual or 2 hours of group) once a supervisee has accrued all his/her hours. The supervisor does not need to meet the 1-10 supervision to client contact hours ratio (Sultanoff, 2008). The Importance of Clinical Supervision Although the important of clinical supervision has already been mentioned, it's worth stressing further. The Task Force that developed the guidelines for clinical supervisors in the area of substance abuse expressed the belief that further study is needed for clinical supervision in general and for the framework of supervisor competency. They believed that the implementation of experience-based and supported treatment interventions, the connection between the quantity and quality of supervision to clinical outcomes are dependent on better understanding of the relationship between effective delivery of clinical services and supervision. The Task Force believed that research specific to the competence of supervision should focus on: Validating the relationship between improved quality of service and this competence; Developing more tools for assessing the proficiency of supervisors in the competencies; Determining the best ways to train supervisors and teach the competencies Pinning down the best ways to prepare future clinical supervisors (Center for Substance Abuse Treatment, 2007). You, as clinical supervisor, wear several important and vital “hats.” You assist the process of integrating counselor self-insight, theoretical foundations, and continuing growth and development of clinical knowledge and skills. At the same time you aid in improvement of functional skills and professional procedures. Your roles include: Teacher: You must identify the learning needs of the supervisee, determine her strengths as a counselor, promote self-awareness, and pass on practical knowledge and professional expertise. You'll teach, train, and model. Consultant: You'll play the role of case consultant and reviewer, as well as monitor performance, counsel, assess the therapist concerning job performance, and counsel how performance may be improved. Additionally, you'll present alternative conceptions of management of specific cases, aid the counselor in achieving goals you have mutually agreed upon, and do whatever else seems necessary to aid the supervisee in crossing the bridge from student to professional (Bernard and Goodyear, 2004). Coach: You've probably seen movies of sports coaches that harass their players to make certain improvements. That may be acceptable (although questionably) in sports, but seldom works with therapists and social workers. You'll need to find supportive ways to build morale, suggest a variety of clinical approaches, and prevent burnout. You'll model good professional techniques and behaviors and be a cheerleader for your supervisees. This supportive approach is critical for most entry-level professionals. Mentor: One of the overlapping areas of coaching and mentoring is being a role model. As mentor you'll also do whatever you can to facilitate the supervisee's sense of professional identity and his general professional development. The manner in which you train and mentor your supervisees, is the manner in which many of the next generation of supervisors may be trained. These roles often overlap and are fluid in the framework of the supervisory partnership. For this reason, the supervisor is in an exceptional placement as an advocate for the agency and the counselor, as well as the client. You're the main connection between management and front-line staff, interpreting and overseeing compliance with agency goals and objectives, regulations and procedures, in addition to presenting staff and client needs to administrators. Key to your supervisor’s performance is the alliance between the supervisor and supervisee (Rigazio-DiGilio, 1997). Until somewhere in the first years of the 21st century, there were many who advocated for the importance of clinical supervision, but there was little written about it, especially in the U.S. Journal articles often show how trainees believe in the importance of clinical supervision, but less often how experienced professionals believe in it. Although it's changing, in the past, interest in supervision has quickly declined once "basic training" has been completed (McLean, Duncan, 1996). "New" forces that have enforced a change in this attitude are: Third-party insurance reimbursements usually require clinical social workers to be receiving formal supervision. Professional organizations for social workers require a specific number of minimum hours of supervision for membership and or professional certificates. Most state boards of social work, including California, require a minimal number of clinical supervision hours in order to obtain different levels of licenses in clinical social work. Because of the above requirements, many agencies have additional external accreditation or internal administrative requirements for supervisors (Berman, n.d.) [QN.No.#5. Forces that have encouraged the importance of supervision include:] Distinction between Supervision and Consultation Supervision and consultation are not the same. Consultation is considered a distinct area of practice that is separate from supervision (Munson, 2002). A consultant is a professional clinician who offers advice to another professional and who has no authority over the services that professional provides (Cole, 2001). If a supervisee directly hires a supervisor, the relationship becomes one of consultation and not supervision (American Board of Examiners in Clinical Social Work, 2004). It's important that you function as a supervisor, not a consultant. Clinical supervision concentrates on four domains: Direct practice Treatment-team collaboration Treatment-team collaboration Job management [QN.No.#6. Four domains on which clinical supervision concentrate are:] Within each of these domains, supervisors practice either in the employment setting or under contract to an agency, never under contract to the supervisee. According to the American Board of Examiners in Clinical Social Work (2004) the definitions of the four domains are: Clinical Supervision of Direct Practices: Activities in which the supervisor educates and guides the supervisee in assessment, treatment/intervention, evaluation of interventions done with the client, and identification ad resolutions of ethical issues. Clinical Supervision of Treatment-Team Collaboration: Client-oriented activities in which the supervisor educates and guides the supervisee in interacting with other professionals in the service environment, influencing policies and procedures in the professional environment, and affecting political systems whose policies have an impact on client treatment/ interventions. Clinical Supervision of Continued Learning: Activities in which the supervisor educates and guides the supervisee in developing skills necessary for life-long continued professional learning. Clinical Supervision of Job Management:Activities in which the supervisor educated and guides the supervisee in work-related issues that are adjuncts to the clinical work: record-keeping, report-writing, handling of phone calls and missed sessions, fees, caseload management, timeliness, and resolution of ethical issues. Competencies of a Clinical Supervisor There have been numerous attempts and articles to define the competencies of a good clinical supervisor. Martin and Cannon (2010) have given perhaps the largest list of these competencies, based on their experience as supervisors "in the field" and in a university. Because of its wide range, it's quoted here for your thought. Then you'll find a checklist of competencies for you to use to help you understand what your competencies are and where you need further work. Martin and Canon state that, "Good clinical supervisors: Understand and practice good therapy. Understand and affirm the power differential between themselves and their supervisees. Unambiguously support their supervisees in forming clear goals for their supervision so that they gain self-awareness and skill in progress toward being effective practitioners. Should be willing and able to demonstrate their clinical skill for their supervisees. Know that their supervision exists in the real world where human lives are seriously impacted by their supervision, instead of only as an academic or intellectual exercise. Ask good questions of those whom they supervise and help the supervisee to experience the worth of the struggle to serve clients in a positive fashion, and to discover that therapy is more a way of being than a way of doing. Empower supervisees to confidently conduct clinical work, by confronting supervisee’s inadequacies, but, moreover, by affirming their struggle to succeed and their consequent successes. They stay alert to opportunities for helping supervisees to improve their clinical judgment. Respect the boundary between clinical supervision and the supervisee’s possible need for personal therapy. Understand that their way of responding to clinical situations is one among many clinically appropriate ways of responding. Seek to nurture counseling identity in their supervisees. Know that clients’ needs take precedence over supervisors’ and supervisees’ needs. Remain cognizant of advancing the profession of counseling, along with nurturing supervisees’ development. Understand that supervision is a process, not an event or a technique. The process involves a perpetual quest for meaning, satisfaction, and personal fulfillment as a supervisor, ever dependent on the need of supervisors and supervisees to improve the delivery of clinical services. Commit to spontaneity, experimentation, inventiveness, and other existential necessities, knowing that their self-discipline is indeed disciplined and well-informed. This means they're accountable for the process of growth for themselves and their supervisees and, paradoxically, subordinate to it. Know that their conjoint and occasional incapacity to help clients provides opportunities for growth. Further, a great deal may be learned from the experience failure. Understand that a professional working alliance with supervisees is necessary and mutual. Increase supervisees’ awareness of transference and counter-transference issues in therapy, but also in supervision. Establish plans for their own professional development. Remain cognizant of the potential threats that sometime attend growth towards healthy and effective therapeutic functioning by their supervisees. This is to say that good therapy sometimes upsets individuals and the institutional political systems in which they function. Know that confrontation—along with its consequent stress—is necessary in the conduct of clinical supervision, but that tenderness and support are necessary, too. Appreciate empirical research in counseling and psychotherapy and self-consciously integrate findings into the process of supervision. In 2002, Epstein and Hundert gave the following basic definition of competency: "Habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served." The definition is applicable to any area, but has become foundational to competency-based supervision. A Competencies Conference was held in 2002 by the Association of Psychology Postdoctoral and Internship Centers. An outline was made for psychology supervisor competencies, with the four basic areas being: Knowledge Skills Values associated with supervision Social context [QN.No.#7. Four basic areas of supervisor competencies include:] These are also apropos to supervision of social work and clinical therapy. Using the following self-assessment given by Falender (2010) and based on Falender, et al. (2004), your competencies as a supervisor. This assessment adds several other areas to consider: Training of Supervision Competencies Assessment of Supervision Competencies Other to be defined by supervisor/setting Check List: For both your present practice and the practice you hope to attain, mark the range from 1 (which indicates you have no knowledge, values or skills in that area) to 7 (which indicates that you have superior knowledge, values or skills)--you'll have two marks for each competency (present and hopeful) You can then use the results to plan the steps you need and want to take to improve. [QN.No.#8. True or False: You should have a supervisor checklist on which you keep track of your current competencies and those you want to improve.] KNOWLEDGE Of area being supervised Of models, theories, modalities, and research on supervision Of professional/supervisee development Of evaluation, process/ outcome Awareness of diversity in all forms SKILLS Supervision modalities Relationship skills Sensitivity to multiple roles: Perform and balance Provide effective formative and summative feedback Promote growth and self-assessment in trainee Conduct own self-assessment Assess learning needs and developmental level of supervisee Encourage and use evaluative feedback from trainee Teaching and didactic skills Set appropriate boundaries and seek consultation when supervisory issues are outside domain of supervisor competence Flexibility Scientific thinking and translation of scientific finding to practice throughout professional development VALUES Responsibility for client and supervisee Respectful Responsibility for sensitivity to diversity in all forms Balance between support and challenging Empowering Commitment to lifelong learning and professional growth Balance between clinical and training needs Value ethical principles Commitment to knowing and utilizing available psychological science related to supervision Commitment to knowing one’s own limitations SOCIAL CONTEXT OVERARCHING ISSUES Diversity Ethical and legal issues Developmental process Knowledge of immediate system and expectations within which the supervision is conducted Creation of climate in which honest feedback is the norm (supportive and challenging) TRAINING OF SUPERVISION COMPETENCIES Coursework in supervision including knowledge and skill areas listed Has received supervision of supervision including some form of observation (video or audiotape) with critical feedback ASSESSMENT OF SUPERVISION COMPETENCIES Successful completion of course on supervision Verification of previous supervision of supervision document readiness to supervise independently Evidence of direct observation (e.g., audio or videotape) Documentation of supervisory experience reflecting diversity Documented supervisee feedback Self-assessment and awareness of need for consultation when necessary Assessment of supervision outcomes – both individual and group OTHER TO BE DEFINED BY SUPERVISOR/SETTING Best Practices of Supervision Falender and Shafranske (2007) characterized supervision best practices and detailed the steps to be taken to become successful and competent as a supervisor. The supervisor must: Examine her own competence and expertise as a clinician and as a supervisor. Describe expectations as a supervisor, including general practice, rules and standards. Recognize competencies that are setting-specific that the supervisee must achieve for a successful close to the supervision experience. Work with the supervisee to develop a supervisory contract or agreement (to be covered in detail later in the course). Model self-assessment and development of self-awareness of competencies throughout supervision, and engage the supervisee in doing the same. Fouad, et al., (2009) reported that more and more evidence is appearing to show that reflection and self-assessment make it easier for supervisees to accept and integrate supervisory feedback--positive, corrective or negative--which is an essential part of supervision. This finding stresses the need for both supervisee and supervisor to do the reflection and self-assessments that are part of supervision best practices. "Side Effects" of Being a Clinical Supervisor Although there are many benefits of being a supervisor, there are "side effects" that may deter some folks from taking such a position. These are not mentioned here for that reason, but that you would be prepared to handle them successfully. Increased Liability Once you become a supervisor, you're not only legally liable for yourself, but also for your supervisee(s). You take responsibility for supervisee work; the agency for which you work shares that responsibility and liability. But the legal issues are largely on your shoulders. Areas of risk assessment and risk management for which you need to give continual attentiveness are civil-law issues such as: Domestic violence Duty-to-report Duty-to-warn Perceived threat to your supervisee Other areas under state mandates relate to malpractice and related topics. For instance: Fraudulent practice Abusive practice HIPPA rules Record keeping Relationship between supervisor and supervisee (Munson, 2002) [QN.No.#9. Which of the following legal issues do you NOT need to worry about:] Because of this need for exceptional alertness, and because of a supervisor's accountability for the safety and well-being of the client--based on the governing control you've been given, some state licensing boards have gone to great measures to oversee clinical licensure. They have made guidelines for requirements of clinical supervision, and have issued the names of social workers qualified to supervise licensure candidates. They do this to protect the public from illegal and unethical treatment. Some states even require supervisor hopefuls to demonstrate a defined competence level in their practice and awareness of what the legal and ethical issues are before they can become supervisors (ABECSW, 2004). Legal and ethical issues and practices will be discussed in more detail throughout this course. Liability Insurance The fact that you assume these legal and ethical responsibilities requires you to have professional liability insurance. There are several facts you should be aware of regarding malpractice insurance: ALWAYS assume you could easily be sued in the current suit-happy culture. If a client perceives, imagines or perhaps even finds it convenient to lie that your services or lack thereof caused him harm, you could be sued. Any gaps in the plan your employer provides--a not uncommon occurrence--may cause you to rejoice that you have your own insurance. Even if your employer provides malpractice insurance for you, you should purchase your own individual policy. This policy protects only you, not also your employer. The policy the employer provides for you will focus more on its own interests should there be a lawsuit. Having your own policy will not increase the likelihood of you being sued. No one needs to know you have such a policy unless you're sued. Then it would be revealed and your insurance stands ready to help you. Having your own policy will not affect whether or not the plaintiff's attorney(s) will keep your name on a lawsuit's defendant list. If those attorneys believe or imagine that you're even remotely involved with the case in a way that could help its the strength, they will keep you on the list whether or not you have an individual policy. [QN.No.#10. True or False: If you are covered by your agency's liability insurance, you do not need to purchase your own liability insurance.] Gerson (2003) recommends listing all supervisees--interns, assistants, trainees--on your liability policy. This is an absolute must if you employ the supervisee. Even if the supervisee is not in your employ, it's extra assurance for you if you list them as co-insured or "addition insured." The supervisee should also have his own liability policy for self-protection supposing there could be litigation. Cole (2001) suggests having back-up supervision coverage for your supervisee if you're on an extended vacation or illness or are unavailable for some other reason. Due Process If you hear someone talk about "due process," they generally are taking about "their due," or something they feel entitled to (Stevens, 2003). Due process includes written policies and procedures to be adhered to if a complaint or grievance has been made about the counselor, the supervisor or the administration. It makes certain that all sides are given opportunity to voice their point of view and that both the statement of disagreement and the response to it are given the consideration due to them. When all parties are appraised of the process for making a complaint, they're considered to have informed consent (Center for Substance Abuse Treatment, 2009a). It's your responsibility to ensure that both your supervisees and their clients know their rights and the procedures of due process (North Carolina Center for Credentialing and Education, 2008). [QN.No.#11. Due process is:] The policies and procedures also generally outline what to do for conflict resolution and for any decisions to be made concerning corrections to be made, as well as probation, suspension or termination of the individuals involved (Comish, 2011). The Ethics Committee of the American Association for Marriage and Family Therapy (AAMFT) considers as "innocent until proven guilty" those who have been accused (AAMFT, 2001). If an individual is found guilty of charges or even a lesser problem, the agency usually has several possible ways to deal with that, depending on the severity of the issue. These generally include verbal warning, developmental/remedial plan, probation, extended or second period of training, suspension, temporary reduction or removal of case privileges, or termination. Verbal Warning The first level of dealing with a grievance that has been made is only for low level problems of inappropriate behavior and is a verbal warning to change the behavior. Of an educative nature, this consequence is usually handled in supervision times. The nature of the problem will dictate whether or not there is a need to increase supervision time, focus or format, or whether a change in case responsibilities is called for. (Comish, 2011) Developmental/Remedial Plan The developmental plan is to remediate a problem more serious nature than that which receives only a verbal warning. Competencies that are being looked at are listed with the date or dates they were discussed with the supervisee and by whom. Also listed are steps that have been taken to correct the problems--by the supervisee, supervisor or other staff. Required expectations are listed, as are the supervisee's responsibilities, the supervisor's or other staff's responsibilities, the time frame in which satisfactory performance is expected, assessment methods used, and evaluation dates. If remediation has been unsuccessful, the consequences of that are listed (Comish, 2011). Probation Plan If the grievance is too serious for the previous plans, or if the developmental plan didn't bring about the desired results, a probation plan will be written (Comish, 2011). In some places there are four possible reasons to place a supervisee on probation: Inadequate response to supervision The nature of a specific incident or incidents Unacceptably low formal evaluations Noncompliance with paperwork requirements Probation is also designed for remediation and gives the supervisee a chance to improve or change her behavior or performance. Probation is time limited; during the time of probation the supervisee is carefully monitored by the supervisor, or even a site clinical supervisor, who will regularly consult with other training staff. The supervisee is also given timely and regular feedback about her improvement or lack therefore, and is also given a date for the next written, formal review (Internship Consortium, 2011). Extension of the Supervision Time When the supervisee's skills or behavior need improved, and when he has made some improvement but not sufficient improvement by the end of the period of required intense supervision, the supervisee may be required to extend the time. Sometimes this may include remaining longer at a clinical site in order to finish the requirements. If the supervisee does not show a willingness and aptitude for complete remediation, he may be suspended or dismissed (Comish, 2011 and Internship Consortium, 2011). Suspension Suspension is a means of putting the supervisee's job "on hold" while the related problem is worked out or while a training committee reviews the problem. Examples of situations that could cause suspension are: A client or staff person is viewed as being endangered. Probation has not resulted in the problem being solved. The supervisee has not kept a required level of malpractice insurance Supervisees are notified immediately of an impending suspension. They're given a copy of any related documentation and reminded of the procedures for grievance and appeal (Comish, 2011). The nature of the problem and its resolution determine the length of the suspension. However, everyone involved is expected to do all in their power to hasten the resolution of the problem in such a way that all who are involved will have their best interested served. Supervisees who are suspended will need to make up the hours lost by extending the time of required supervision (Internship Consortium, 2011). Termination Termination is obviously the most severe consequence of problematic behavior of a supervisee. Because of the need to protect the rights of the supervisee and to secure the rights and standards of the agency and the profession, guidelines and policies for termination are set forth. Generally you, the supervisor, and the site clinical supervisor if your agency has one, would recommend termination in extreme instances in which the supervisee's performance has put a client at risk. Other reasons for termination may include the fact that the supervisee: Has a problem with appropriate and effective interaction with clients. Is unable to distinguish between social and professional relationships. Does not maintain a sufficient caseload. Does not properly respond to supervision. Does not follow policies of the agency. Shows unprofessional and inappropriate appearance and overall behavior. Does not adhere consistently and adequately to remediation plans in lesser stages of correction. Demonstrates little awareness of his improper or negative impact on clients, supervisors, colleagues and other staff. Does not take care of herself, such as not getting help for medical or emotional problems. Shows disregard for ethical and legal guidelines for the profession. Does not follow evaluative and other principles of the agency. The supervisee is given notice in advance of a hearing, usually five days. If she does not attend the hearing, it's common for it to still take place. Also, the supervisee is generally notified in person and in writing of termination. If, as sometimes happens, termination occurs because of something such as agency downsizing and no fault of the supervisee, many agencies will do their best to suggest alternative work places and will give recommendations (Internship Consortium, 2011). Temporary Reduction or Removal of Case Privileges If, at any time during this process, it's concluded that the supervisee's or client's welfare has been put at risk, the supervisee's case privileges may be either considerably reduced or taken away for a designated period of time. When the time is up, the supervisor will consult with other training staff to evaluate the supervisee's ability to function effectively, and to decide whether or not to return the case privileges (Comish, 2011; Internship Consortium, 2011). Appeal Procedure Although most conflicts will be concluded jointly between the supervisee and the supervisor, there are times when the supervisee will wish to appeal a decision. Each agency has its own procedure for this. An example of this procedure is: The supervisee appeals in writing to whoever the supervisor is responsible to, perhaps the site administrator. A committee comprised of the supervisor, her superior and other staff that may be involved in supervising will meet as soon as possible after the appeal is received. Sometimes the supervisee making the appeal is invited to attend. This committee reviews the appeal and makes a decision concerning the supervisee's appeal and notifies the supervisee in writing. During this process, primary importance must be given to the safety of the supervisee's clients. Consequently, the supervisee is expected to abide by the conditions of his case privileges set forth by the agency while the appeal is being deliberated (Internship Consortium, 2011). Extra Work Load Clinical supervision might be a much easier undertaking if the only task the clinical supervisor was required to do was to provide supervision. The requirements agencies and providers are under usually demand that the clinical supervisor wear many hats in addition to being the clinical supervisor. According to Malone (2009), additional positions the clinical supervisor might also need to perform are: Therapist--All too often clinical supervisors must maintain their own caseloads; that includes giving clinical services to clients. However, having their own clients provides the clinical supervisors a chance to continually develop their own skills, and stay mindful of the daily challenges of clinical practice. Additionally, it's through this position that the clinical supervisor is able to demonstrate effectual procedures that the clinical supervisee can watch and emulate. Nevertheless, this isn't the spot in which the clinical supervisor can say, "do what I say, not what I actually do." That would be an invitation for failure that would end up in distrust and lack of believability. Administrator--Sometimes clinical supervisors are also given administrative tasks that may include financial demands for the agency, hiring (and dismissing) staff, implementing and overseeing the goals of the agency, and/or being involved in legal and ethical issues of the agency.The clinical supervisor must balance the tasks of these two demanding areas. Should the supervisor spend too much time being an administrator, rather than the necessary time for being a clinical supervisor, the supervisees may believe they're on their own and act accordingly. The wise clinical supervisors will keep in mind that their main responsibility is to the supervisee. The business needs are second. Employee--Being the clinical supervisor ought not afford the supervisor exceptional status. The supervisor is required to follow the agency's procedures and polices just like any other person in the agency. The supervisor is simply not exempt from sticking to the basics of the agency's procedures and practices--in fact, they should likely be even more particular about following them. Moreover, the supervisor needs to ensure that supervisees are well informed of all the policies and procedures that regulate the agency and the profession. Overseer of professional advancement--The clinical supervisor might be a resource for professional growth for the people in the agency, regardless of their job. This can be successfully done by by developing and maintaining a learning atmosphere that is both secure and encouraging. To phrase it differently, the clinical supervisor is a team player who's happy to share his know-how and experience with any staff member who asks. Professional advancement can be provided by the clinical supervisor participating in exercises that improve understanding, knowledge, proficiency, attitudes, and principles. Identifying the objectives and plan for the supervisor/supervisee alliance is an area the supervisor should practice. However, your role and set of skills as a clinical supervisor are distinctive from those of other professionals and employees in the agency. ------------------------------------------------------------------------------------------------------------- Objective 1a: Define the role of clinical supervisor. Question 4: The clinical supervisor's role does NOT include: a) Keep track of client welfare b) Enhance the supervisee's functioning c) Being the boss of the relationship d) Monitor supervisee's quality of service e) All of the above f) None of the above Question 5: Forces that have encouraged the importance of supervision include: a) State boards requiring supervision for licensure b) Insurance companies requiring supervision of therapist c) Professional organizations requiring supervision for membership d) Agencies having special requirements for supervisors e) All of the above f) None of the above Question 6: Four domains on which clinical supervision concentrate are: a) Direct practice, therapist individuality, continued learning, project management b) Direct practice, treatment-team collaboration, annual CEU courses, job management c) Direct practice, treatment-team collaboration, continual learning, job management d) Direct practice, treatment-team collaboration, continual learning, project management e) All of the above f) None of the above Question 7. Four basic areas of supervisor competencies include: a) Values associated with supervision b) Knowledge c) Social context d) a and b e) All of the above f) None of the above Objective 1b: List at least four competencies that a supervisor needs. Question 8. True or False: You should have a supervisor checklist on which you keep track of your current competencies and those you want to improve. Question 9. Which of the following legal issues do you NOT need to worry about: a) Duty-to-warn b) Perceived threat to supervisee c) Supervisee noncompliant with paperwork d) Domestic violence e) All of the above f) None of the above Question 10. True or False: If you are covered by your agency's liability insurance, you do not need to purchase your own liability insurance. Question 11. Due process is: a) Policies and procedures to be followed if a grievance has been made about the supervisee. b) A rule to ensure a grievance is heard. c) A rule to allow the one accused to give his side of the story. d) a and b e) b and c f) a, b, and c

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