Common Issues & Topics Explored In Supervision
Many supervisees are nervous, anxious, and stressed about supervision.
This makes sense because supervision can be vulnerable and uncomfortable to discuss parts of you and your practice that you find challenging and difficult.
You might talk about:
Legal issues and liability
Countertransference issues (feelings you have about your clients)
Documentation and note taking
Clinical skills and interventions
Theoretical orientations and frameworks for change
Measuring outcome and asking for feedback (evaluation)
Fees and finances
Endings and terminations
Receiving support and guidance
Receiving education about possible professional trainings, development, and seminars
Receiving education on possible career routes as a clinical social worker or therapist
Receiving education on marketing and advertising if you are in private or group practice
Becoming more confident as a therapist
Managing impostor syndrome
Self care
Managing compassion fatigue and secondary trauma
Noticing signs toward burn out
How to bounce back from burn out
And more
Sample Topics You Might Discuss In Supervision
Client Caseload Management
Protection and monitoring of client welfare
Reviewing clients (treatment, goals, risks, etc.)
Assessing to see how your caseload feels (e.g. reducing or increasing client hours)
Taking Time Off
How to take time off, when to notify clients, and how to notify clients
Unexpected time off due to illness, accident, or unforeseen circumstances
Backup coverage for clients when you are on extended leave
Marketing & Advertising
If you are working for a group practice or operate your own private practice, you may be unsure how to run a small business
School taught us the basics of clinical skills and therapy, but did not teach us the business aspects of running a small business
Your supervisor can help you find authentic and congruent ways for you to market and advertise to your ideal client and areas of niche(s)
Strengthening Clinical Skills
Perhaps you want to specialize in a therapeutic approach such as CBT, CPT, PE, EMDR, IFS, SE, etc.
Your supervisor may have advanced clinical training and consultation in such approaches and can help you learn and refine your clinical skills with clients
Deliberate practice is a great way to strengthen your clinical skills through the use of practical and applicable clinical exercises and practices
Reviewing videos and audio clips are another way to strengthen clinical skills
Lastly, writing up a process recording is another way to strengthen your clinical skills
Specialities & Areas of Focus
How and if you want to develop an area of focus (generalist vs. specialist)
The benefits and limits to certifications post-grad
Lifelong learning and continuing education
Professional development opportunities
Ethics
Dual relationships
Boundary crossings and boundary violations
Informed consent
Confidentiality and its limits
Client welfare and “do no harm” principle
Therapist violations and unprofessional conduct
Self Care
How do we hold a wide range of human experiences like suffering, pain, hurt, joy, and love without personalizing and taking on the client’s “stuff”?
How do we continue to do this work in a sustainable, long-term way honoring our boundaries and limits?
Understanding the reality of compassion fatigue and ways toward personal joy, liberation, and resilience.
Defenses & Anxiety
How do we work with resistance and psychological defenses and avoiding crashing into them?
The difference between defense and anxiety
Ways to bypass defenses
Ways to regulate anxiety
Building client capacity to reflect, tolerate, and relate to their emotions and thoughts in a manageable way
Trauma
How do we avoid re-traumatizing clients with a history of complex and developmental trauma?
How do we avoid re-traumatizing ourselves as a therapist with a history of trauma?
Culturally Attuned Care
How do we build and increase our awareness, knowledge, understanding, and skills working with different dimensions of difference?
How do we manage our own cultural countertransference so it doesn’t interfere with our client’s cultural “stuff”?
How do we continually practice culturally responsibility and reflective practice so we can open up difficult conversations around trauma, oppression, micro/macroaggressions, and difference?
Congruence
How do we learn to listen to our authentic selves/intuiton in addition to using evidenced based practices?
How do we develop our own therapeutic style unique to our identities and experiences?
Boundaries
What is the therapeutic frame and how can we hold strong therapeutic boundaries in service of both our clients and ourselves?
How do we flexibly use the therapeutic frame toward healing for our clients?
Therapeutic Relationship
How do we repair ruptures, conflicts, and misalliances?
How do we ensure that we are building consistent therapeutic progress?
How do we become more comfortable with endings and saying goodbye (termination)?
Conversations and explorations around transference and countertransference
Pacing
How do we become more comfortable with imperfection, tension, patience, uncertainty, and not knowing?
How do we incorporate collaborative client-centered care into our practice?
Suicidality
Suicide assessments
Safety plans
Assessing for self harm
Assessing for non-suicidal self injurious behaviors
Limits to confidentiality
Endings & Terminations
How to say goodbye to clients
Reviewing and summarizing treatment
Anticipating future client obstacles and challenges
Letting the client matter to you
Gifts and rituals
Referrals
When to refer out for a higher level of care than outpatient care (IOP, PHP, IP)
When to refer out due to client need for specialized therapy training and skill
How to start the conversation around referring out
Read My Other Blog Posts On Clinical Supervision