CLINICAL SUPERVISION IN

ALCOHOL AND DRUG ABUSE COUNSELING:

PART ONE Presented by: Nick Lessa, LCSW,

MA, CASAC

Nlessa@inter-care.com

INTRODUCTION Based on the highly acclaimed book by

David J. Powell Originally printed in 1993 and revised in

2004 Makes the case for substance abuse

counseling as a unique discipline with its own model of supervision

Disputes the notion that a good counselor automatically makes a good supervisor

COMMON ERRORS OF AN UNTRAINED SUPERVISOR Confusing clinical supervision with case

management, focusing on the client’s rather than the counselor’s needs

Counseling the counselors giving rise to role confusion

Taking a laissez-faire attitude Becoming judgmental, authoritarian,

and overly demanding

INTRODUCTION Most counselors need a mentoring and

support system, which translates into a coach, cheerleader, handholder, and wise advisor

According to studies, better clinical supervision led to greater job satisfaction and better retention rates

Good clinical supervision improves client outcomes

INTRODUCTION

A good supervisory relationship is one of the most satisfying aspects of the counselor’s work

KEY FEATURES OF A GOOD RELATIONSHIP Openness to feedback (supv. &

counselor) Supv.’s helping the counselor feel

relaxed & open to criticism Supv’s ability to listen to the counselor

& respect the counselor’s therapeutic style

Consistency of therapeutic orientations Emotional support provided by

supervisor Sharing clinical responsibilities

RECOMMENDATIONS CONCERNING CLINICAL SUPERVISION Managers of tx facilities need to be

trained in the value of good clinical supervision

Clinical supervisors need more thorough training in how to supervise

More sophisticated mechanisms are needed for supervising counselors

PART ONE: PRINCIPLES

Towards a Working Definition of Supervision

ADMINISTRATIVE SUPERVISION Firstly, understanding the difference

between administrative and clinical supervision.

The administrative supervisor helps the supervisee function more effectively within the organization, with the overall intent of helping the organization run smoothly

Addresses areas such as case records, referral procedures, continuity of care, accountability, hiring/firing, and performance evaluations.

CLINICAL SUPERVISION Clinical supervision focuses on the

development of the supervisee specifically as an interpersonally effective clinician (Hart, 1982)

Clinical supervision attends to the supervisee’s professional and personal needs as they directly affect the welfare of the client.

DIFFERENT CLINICAL DEFINITIONS Supervision as a Therapeutic

Process – becoming aware of one’s personal issues and its impact on clients

Supervision as Education – learning skills and developing professional competence

DEFINITION OF SUPERVISION

“Clinical supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical, and supportive.”

EXAMINING THE DEFINITION Disciplined – regularly scheduled, time

limited, specific agenda & expectations Tutorial – instruction and guidance with

an individualized training plan A Process – supervisor as coach,

cheerleader, mentor, friend, handholder, educator, and colleague

Principles into practice – help counselor identify what they did and why they did it

EXAMINING THE DEFINITION: THE FOUR FOCI Administrative – involves

organizational management issues Evaluative – assess counselor’s skills,

clarify performance standards, negotiate objectives for learning, utilize sanctions for poor performance. Involves goal setting & feedback

EXAMINING THE DEFINITION: THE FOUR FOCIClinical – the clinical, educational, and training functions of supervision include: Developing counseling knowledge &

skills, Identifying learning issues & problems, Determining counselor strengths &

weaknesses, Promoting self-awareness & professional

& personal growth and, Transmitting knowledge for practical

use.

The best supervisor teaches by example – not just instructing but modeling clinical competencies

The most effective way to teach: to let the student watch you work

FOUR FOCI - CONTINUED Supportive – the supportive functions

of clinical supervision include handholding, cheerleading, coaching, morale building, burnout prevention, and encouragement of personal growth

When a counselor reveals a personal issue that is impeding the clinical process, the supervisor must see that he/she gets the support needed to resolve the impasse

LEADERSHIP PRINCIPLES FOR SUPERVISORS Leadership is not the same as

management, and management is not the same as supervision

Leadership transforms people by raising their sights & aspirations to a higher level, thereby engendering a greater sense of purpose

LEADERSHIP ABILITIES To establish trust with co-workers &

subordinates To serve as a team leader To define & set dept. & organizational goals

& communicate these goals companywide To inspire staff by encouragement &

motivation To communicate enthusiasm & capability To keep up staff morale, including one’s

own To take appropriate risks & be decisive in

action

LEADERSHIP ABILITIES - CONTINUED To possess the ability to change in

response to needs To have vision, drive, clear judgment,

initiative, poise, and maturity of character

To command enthusiasm, loyalty, sincerity, courtesy, and confidence

To exercise control through inspiration rather than command

MANAGEMENT ABILITIES get work done through staff make effective use of dept. resources get results in achieving goals & objectives control through command identify, analyze, and solve problems adapt to change & growing needs of org. organize work as needed to get the job

done Intervene to bring about positive results See all aspects of operations

SUPERVISION ABILITIES Know the responsibilities of staff Clearly communicate these

responsibilities Effectively utilize the performance

appraisal system to get max. productivity of staff

Write clear job descriptions & quarterly & annual goal & work statements for all staff

Delegate responsibilities to all staff Promote staff’s professional

development

LEADERSHIP QUALITIES IN THE NEW ORGANIZATIONAL CONTEXT Take full responsibility for decisions you

make Always put the well-being of those

reporting to you above your personal well-being

Give subordinates full credit for successes

Don’t be afraid to take risks when they’re in the best interest of the company or client

Protect your supervisees to superiors when they’re being unfairly attacked or punished

LEADERSHIP QUALITIES IN THE NEW ORGANIZATIONAL CONTEXT

6. Take a personal interest in the welfare of your staff7. Make decisions promptly even if, at times, you don’t have full information8. Be a teacher9. Do not play favorites10. Don’t give orders just to prove you’re the boss

SUPERVISION & LEADERSHIP Good supervision is largely a matter of

caring for staff Supervision is not about structures, but

about people: their needs, concerns & growth

The ultimate goal of leadership is to create a sense of community at work

SERVANT LEADERSHIP The leader is a servant first. That’s the

key to the leader’s influence The power to lead comes from giving up

personal need for power in order to serve the group

“Leaders bear pain. They do not inflict it.”

The servant leader cares for people The goal is to motivate people; tap into

it

THE 6 STAKEHOLDERS OF AN AGENCY Owners Employees Customers – most critical element of

agency Vendors Competitors The Community at Large

THE NEW WORK ENVIRONMENT

“When organizations empower employees to be part of the decision-making process, establish a bottom-up management structure, practice servant leadership, and balance the needs of all stake-holders, they become great places to work.”

COMMON THEMES OF SUCCESSFUL COMPANIES Camaraderie De-emphasis on Politics (through

trust, openness, & fairness throughout company)

Growth Values (employee empowerment)

Family and Community (give a sense of being part of a family)

TRAITS OF AN EFFECTIVE CLINICAL SUPERVISORThe Four A’s of supervision1. Available: open, receptive, trusting,

non threatening2. Accessible: easy to approach and

speak freely with3. Able: having real knowledge & skills

to give4. Affable: pleasant, friendly, reassuring

TRAITS OF AN EFFECTIVE CLINICAL SUPERVISOR Two Essential Qualities1. Sound Clinical Experience – must be

a good clinician

2. A Passion for Counseling – the source being a desire to help others

PART TWO:Models of Supervision