What Is The Clinical Supervisor Doing? Part II, Mental Health

Hopefully you’ve taken a look at Part I of this series. It was easy to call Part I “Substance Abuse,” because, well, it is!  In this bIog I know that it is arbitrary to identify the Clinical Social Worker and Professional Counselor as “mental health,” as individuals with either license can provide treatment for substance abuse problems, in addition to other issues.  Bear with me a few minutes…

When I look at the competencies for a supervisor as defined by the North Carolina Social Work Certification and Licensure Board (NCSWCLB) or the North Carolina Board of Licensed Professional Counselors (NCBLPC), there are many conditions similar to the Certified Clinical Supervisor (Substance Abuse).

With one difference: That the supervisor be competent in the population / treatment.  Why this one  difference?

I take it this way: The bulk of the work in substance abuse occurs after the problem has taken a turn for the worse. The pathology of drinking and drugging almost always takes time to develop, and the client base is predominantly composed of adults.  True, there are youth, and the youth population has expanded in numbers.  Still, the substance abuse counselor and supervisor can now that the prevention component of substance abuse and, perhaps, the novice drinker’s driving while intoxicated ticket and the resulting mandated treatment are exceptions in a population made up mostly of adults.

The substance abuse field doesn’t deal with normal adjustment problems that are not pathological. The substance abuse field doesn’t deal with purely mental health problems. The substance abuse field doesn’t deal with the behavioral problems of very young children.  And the substance abuse field doesn’t deal with the behavioral problems of geriatric populations except substance use.

So supervisors (and clinicians) in clinical social work and clinical counseling are working with a variety of age ranges, normal and pathological developments, and other complexities, making it difficult for those Boards to construct a list of content expectations equivalent to those outlined by the NCSAPPB

The NCBLPC sets a high bar to supervise: 45 hours of supervision specific training or academic course work. The NCSAPPB requires 15 hours of clinical supervision specific training to obtain the Certified Supervisor Intern (CSI) credential and an additional 15 hours of clinical supervision specific training, a total of 30 hours.  Plus the two years practical experience as a CSI and passing the examination to obtain the Certified Clinical Supervisor credential. The NCSWCLB has the lowest standard to supervise.  No supervision course requirements, no examination.

Supervisees: Take care of yourselves, ask your supervisor about their supervision training and what they offer, what specialized training in the either the treatment(s) or the populations or the mental health problems you’ll encounter.

What Is The Clinical Supervisor Doing? Part I, Substance Abuse

When I look at the competencies for the substance abuse supervisor (CSI and CCS) posted on the North Carolina Substance Abuse Professional Practice Board (NCSAPPB) website, I read a high standard of knowledge and practice which is daunting even after 20+ years in the field.   [Go to the url below, see pp. 50-53.]

Since most clinical supervisors are conducting “other business” as their main focus at any one time – they are either in their own private practice, they are conducting clients’ individual and group treatment in an agency setting, or they are administrators – their own development as clinical supervisors is uneven.   The administrative components – “Program Development” & “Administration – could take several years of concentrated effort before one achieved competence in that area alone.

Keep in mind: the NCSAPPB only requires 15 hours of clinical supervision specific training to obtain the Certified Supervisor Intern (CSI) credential and an additional 15 hours of clinical supervision specific training (plus the two years experience and passing the examination) to obtain the Certified Clinical Supervisor credential.   And those two years of experience could be limited to the CSI supervising one CSAS – Intern or one LCAS-Associate.

Supervisees may not detect the range of supervisor competence (or lack of) until they’ve met their second (or third of fourth…) supervisor.

Unless the supervisor takes the time to explain their limits and lacks as well as their competencies and proficiencies.  Which behavior on part of the supervisor itself would indicate some supervisory competence (!), and should be a relief to the supervisee, even if there are gaps in the supervisor’s “resume.”

I have found myself studying hard to stay a few steps ahead of some supervisees. Either their beginning personal interest in some therapy or practice or their employing agency’s embracing a new service definition or evidence-based practice has me researching on-line or driving to Chapel Hill to the graduate or health sciences libraries.   And there is, at least on my part, not just for the clients I see, but for the supervisee’s benefit, ‘going back to the well,’ revisiting topics.  The other week I picked up an anthology of Motivational Interviewing, applied to various problems I hadn’t tackled, but that might come up in supervision, and what to do you know, one week later I had a patient who may have benefited. Who knows: maybe a supervisee next?

http://www.ncsappb.org/wp-content/uploads/2016/05/NCSAPPB_Cred_Manual_5_18_2016PDF.pdf