An editorial by Romey Peavler, PhD, LCAS, CCS
North Carolina addiction credentials require clinical supervision by a LCAS, CSI or CCS, depending on one’s level in the credentialing process. Agencies who are fortunate to have a CCS on staff can provide their employees with all the required supervision. However, there are situations where the agency or the individual must contract with a person outside the agency for the necessary clinical supervision. These contract supervisors charge for these services, with fees that run the gamut of costs. The supervision might be done individually or with a group and varies in length of time (i.e., one hour per week, 2 hours twice a month, and so forth).
In my experience as a clinical supervisor, I have found that for me to be most effective I limit group supervision to 6 members for sufficient communication (there are, of course, other opinions). I find that supervision on a weekly basis offers the opportunity to address any issues as soon as possible. One possible method is to utilize Stoltenbery and Delworth’s Developmental Approach to Supervision that includes the following domains (Powell & Brodsky, 2004):
- Intervention Skills
- Assessment Techniques
- Interpersonal Assessment
- Client Conceptualization
- Individual Differences
- Theoretical Orientation
- Treatment Goals and Plans
- Professional Ethics
The following is from the Blended model of Clinical Supervision for the Alcohol and Drug Abuse Field (Ready to Test, 2008)
In recent years the number of professional organizations credentialing clinical supervisors has grown. The Professional organizations that regulate the ethical and legal practices of supervisors are the National Board of Certified Counselors (NBCC), the National Association of Social Workers (NASW), the American Association of Marriage and Family Therapy (AAMFT), and in the alcohol and drug abuse field, the International Certification and Reciprocity Consortium (ICRC).
These organizations and the courts have posed critical questions in assessing supervisory competence and in defining the range and scope of clinical supervision. Courts in particular have defined a standard of care and practice in supervision as a result of malpractice cases by accepting the testimony of experts in the field.
- Does the supervisor have the skills to perform the requisite supervisory functions?
- Does the supervisor make an adequate effort to supervise? “Adequate” is defined by the profession in which the person practices. Most professions define adequate as one hour of supervision for every twenty hours of client contact or approximately one hour of supervision per week for a full-time therapist.
- Do the supervisor and the agency have a formalized process for providing feedback and evaluations to counselors?
- Does the supervisor teach the tenets and legal and ethical standards of the profession?
- Does the supervisor maintain adequate documentation of the supervision process?
Count rulings (e.g., Gilmore vs. Board of Psychological Examiners, 1986) have pointed to several common legal and ethical errors that occur in supervision.
- Confusing supervision with case management
- Focusing on the client’s needs rather than the supervisee’s development
- Relying on the supervisor’s clinical skills in supervision, thereby turning supervision into therapy with a supervisee.
- Adopting a laissez-faire attitude with supervision occurring on a sporadic basis
- Conducting quasi-casual case conferences and crisis-management supervision
- Using one’s supervisory power inappropriately.
Court rulings have affirmed the importance of clarifying the roles and expectations of clinical supervision, correcting these common legal and ethical errors. The two most important legal issues have been: Did the supervisor make a reasonable effort to supervise? And is the supervisor competent (as demonstrated by credentialing, training and experience) to perform the tasks of a supervisor?
I would encourage everyone to review one’s expectations of supervision while taking note of the supervision received. I suggest, if you are not satisfied with the process , that you discuss this with your supervisor. Supervision can build your skills and knowledge – and it can be a guide for you in your career.References:
Powell, D. and Brodsky, A. Clinical Supervision in Alcohol & Drug Abuse Counseling: Principles, Models & Methods. Jossey-Bass, 2004 Getting Ready to Test: A Supplemental Review/Preparation Manual for the Advanced Alcohol and Other Drug Abuse Credentialing Examination. Prepared by ReadyToTest.com, A Division of the Distance Learning Center, LLC, 2008 Editorials are both welcomed and encouraged from all APNC Members, however, member submitted articles do not necessarily represent the official views of APNC, its affiliates or partners.