Clinical Supervision

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

August 28, 2016September 1, 2016 Frank Heitmann

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

July 30, 2016 Frank Heitmann

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

What Do You Want From Clinical Supervision?

July 11, 2016 Frank Heitmann

Supervising the past fifteen years has been exciting and humbling. Each new contact and its potential for productive work both on my part as well as the supervisee’s is a tale of its own. What comes next? What does this person want and need from me to achieve their goal(s)?

The possibilities are so varied. I’ll cover two of the points today:

Time. Just recently a supervisee finished their latest (last?) license. Our journey started in 2008! No, it did not take them eight years (this post being written in 2016) to get a license. But their initial and later academic clinical education, their first paraprofessional work, their first license….stacked up as the years went by.

What was my role? Roles!

Educator, work supervisor, clinical supervisor for credentialing; advisor; then clinical supervisor for licensure.

A few months ago another, now former supervisee, now licensed for a year, called up for consultation. A thorny problem, one that could affect their career. Our call lasted an hour and set things aright. Today he has more satisfaction in the new work and left the old work behind with dignity.

Effort. When I became interested in clinical supervision – which was almost from the very beginning of my career in this field – I knew it would take effort. What I didn’t know was how much effort it would take. Or how it would evolve over the period when – seemingly all at the same time, though it actually took more than five years – clinical social work, substance abuse counseling and professional counseling created their licenses and established their conditions for supervision.

And though I had help stacking them up, it took just under ten years to put it all together. Fortunately, humbly, that about matches the time needed to develop a broad base of clinical supervision skills.

The other day I sat with a field instructor and her new academic intern, embarking on their relationship for the next year. The intern, determined, was outlining their plan for the academic year – and beyond. The subject of dual licensure came up, and the conversation turned to how long it would take, and what would be required. As they sketched out how much effort would be called for, adding up the requirements, then adding some more, I asked if I could advise them and perhaps shorten the way.

Then I took at least 40% of the effort off the table, pointing out how the intern’s previous experience and course work and other training already met certain requirements. You could see the relief.

That’s a sample of the exciting part of knowledgeable clinical supervision. It seemed effortless, but it was the result of many hours of guiding people not only in their clinical work, but their careers.

I hope that you find what you need when you need it, it will certainly help with achieving what you want.

Conference Delights June 7, 2016

June 27, 2016June 27, 2016 Frank Heitmann

One hundred and fifty people attended this year’s twelfth clinical supervision conference sponsored by the National Association of Social Workers – North Carolina chapter. A full house for this opportunity to acquire specific knowledge about supervising licensed clinical social worker associates. A sold out house, with every seat available filled.

By a show of hands, a few in attendance – maybe five – had been to one of these conferences in the past. Since the conference started twelve years ago – and was at bigger venues is the past with perhaps two hundred in attendance – that means it is possible that up to two thousand licensed clinical social workers have a base of knowledge about clinical supervision to apply.

What would you have gotten had you attended? An entire day spent with Rob Van Meir learning the history of the practice of supervision; a condensed tutorial on the role of the North Carolina Social Work Certification and Licensure Board by one of the staff and one of the Board members of the NCSWCLB; a half day session on the supervision of dually licensed associates (in the social work and the substance abuse fields); a half day of cultural competency and ethics. And a condensed tutorial on supervising to promote adherence to evidence based therapy by this author. The enthusiastic attendees had multiple opportunities to ask probing questions of the presenters during the presentations and throughout the day.

Next year’s conference will be at the same location in Winston-Salem, and while a date hasn’t been set yet, mark your calendars, and post an email to:

[email protected]

And please remember: If you are seeking the North Carolina Substance Abuse Professional Practice Board’s Certified Clinical Supervisor credential, you can use these hours towards the thirty hours of continuing education units for that credential.