Finding the Ideal Clinical Supervisor

Feb 21, 2022

Well, it looks like your life just got really real!

You wrapped up grad school, you just got your first official clinical license in the mail, and you are ready to rock the therapy world with your energy, optimism, and newly acquired expertise! Whether you are an old pro with more than a decade of experience in the field working in non-clinical roles or you're a fresh-faced novice thrilled to be part of something bigger than yourself, one thing is certain: You're going to spend the next couple of years practicing with the support and guidance of a Clinical Supervisor.

As you're fantasizing about landing your "dream job," which you can read more about here, I encourage you to expend that same amount of energy in locating and locking down a Perfect-for-You Clinical Supervisor. Knowing that this will be your go-to person for the next 2-3 years of your professional life, it's important to planfully and intentionally select a Clinical Supervisor that is a great fit for your unique needs. Since things are already a bit overwhelming right now as you are sifting through job options and launching your career, it might be helpful to have some guidance regarding the questions to ask and things to consider when selecting a Clinical Supervisor.

Let's start with the basics!

Ideally, your Clinical Supervisor will be someone that you are able to select on your own, someone who is completely focused on your needs as a new clinician, someone who has experience in your specific area of interest, someone who understands your philosophical and theoretical approaches, and someone who has established his or her own relatively successful career in the field. Most licensing boards do not allow you to use a spouse or significant other for Clinical Supervision, for obvious reasons, and I additionally recommend that you select a person who isn't already a close friend as it may impact their objectivity and ability to provide direct feedback. Mixing business and pleasure simply isn't a great idea when seeking a Clinical Supervisor, even if you have a friend willing to provide it at a bargain price.

Another fairly basic piece of information to consider is whether you would like to have an agency-based Clinical Supervisor or a private Clinical Supervisor. Some employers will hand you a ready-made Clinical Supervisor that often doubles as an administrative supervisor, some employers will provide you with a monthly stipend to put towards private supervision, and still other employers will leave you completely on your own to obtain and bankroll Clinical Supervision. There are also some employers who will offer to provide you with agency-based Clinical Supervision for free while also allowing you the option of obtaining a private Clinical Supervisor and paying for it on your own. Let's talk a little more about this issue, as it can get confusing or even create an ethical conundrum over time if it's not handled well. I have been both a recipient of and provider of Clinical Supervision in each of those capacities (agency-based and private), and I've learned quite a bit from my own experiences as well as the experiences of my supervisees. There are some pros and cons of each option, which we should talk a little more about.

Agency-based Clinical Supervision: The Pros
 
1) It's typically free. That's an obvious YAY!!
 
2) It's typically scheduled into your workday, which means less commuting time to and from someone else's office.
 
3) Your Clinical Supervisor is typically available on-site and you can pop in with questions as needed.
 
4) Your Clinical Supervisor is typically keeping notes for the agency, which means lots of oversight that he or she is providing adequate hours of supervision. The paperwork is also typically kept in your HR file as a double protection in the event you are audited by your licensing board in the future.
 
5) Your Clinical Supervisor has likely provided a very similar service to what you are doing in your new clinical role.
 
6) If your long-term career goals lie within that specific agency, it's great to bolster your relationship with colleagues and learn the ropes there.
 
 
Agency-based Clinical Supervision: The Cons
 
1) There are often a limited number of Clinical Supervisors available within an agency, which automatically limits your ability to select who you would like to work with.
 
2) It is shockingly easy to have your supervision time trumped by agency-related crises, cutting into your meetings by 5-15 minutes on a fairly consistent basis.
 
3) While they are YOUR Clinical Supervisors, they are also acting on behalf of the agency, which means that external pressures from their own supervisors will undoubtedly carry into your sessions. Here are examples of things that have come up in agency-based Clinical Supervision sessions for myself and for many of my colleagues:
  * Discussing productivity expectations and why you aren't meeting them every week and what could happen if you don't meet them consistently. (Let's be real. It's annoying.)
  * Discussing agency policies and procedures
  * Reviewing paperwork, excessive documentation requirements, etc
  * Feedback from "administration" regarding issues that aren't related directly to clinical practice
 
4) Your Clinical Supervisor may be so entrenched in the agency's agenda that they defend all of the agency's policies, procedures, and practices to the point that they unintentionally shut down your ideas and valuable feedback.
 
5) You may not feel comfortable venting about the difficult aspects of your work or acknowledging your faults to someone in a role of power within the agency. It is very difficult to be vulnerable in front of your employer, especially when you are new and trying to demonstrate your value.
 
6) Your Clinical Supervisor may be invested in keeping you in the role that you are already filling within the agency, possibly to the point that he or she unintentionally steers you away from exploring your long-term career goals that are not a clear benefit to the agency.
 

Private Clinical Supervision: The Pros

1) You can select your own Clinical Supervisor based solely on YOUR needs. You have lots of options.

2) Your Clinical Supervision will likely be more respectful of your time and needs, as you are paying them to provide you with a service and customer service is important in this field.

3) You Clinical Supervisor will not be wearing multiple hats (i.e.: administrative supervisor, program director, etc). They are just your Clinical Supervisor and that's it.

4) You have a safe and confidential place to vent, acknowledge areas where growth is needed, and be vulnerable without fear of it reflecting on the services you are providing within your agency.

5) Your Clinical Supervision sessions can focus completely on YOUR needs and the issues that you yourself would like to discuss, not agency-related topics, as your Clinical Supervisor has no other agenda based on allegiance to an outside party.

6) You may feel more empowered and able to discuss your long-term career goals in a setting that is outside of your current pace of employment. Your Clinical Supervisor most likely has no personal desire to keep you working in the role that you are currently in, unless that's where you truly want to be.

7) Your Clinical Supervisor will likely be more willing to assist you in advocating for yourself in terms of salary and benefit negotiations, asserting yourself with your agency, etc.

Private Clinical Supervision: The Cons

1) A private Clinical Supervisor is going to cost you money. Thankfully, the cost of Clinical Supervision is tax-deductible as a work expense, so you'll see a little bit of that back when tax season rolls around.
 
2) Your Clinical Supervisor will be off-site, meaning they aren't readily available for pop-in, face-to-face consultation throughout the work week and you'll have to commute to and from supervision sessions.

3) Your Clinical Supervisor may or may not be intimately familiar with your specific agency, which could mean that he or she may not fully understand your job role, paperwork, policies, etc. It will fall on you to educate your Clinical Supervisor on those specific issues.  

4) Some Clinical Supervisors may not be the best at formalized record keeping, so you'll want to have a clear understanding of how your records will be maintained.

With both agency-based and private Clinical Supervision, there is definitely a range of competence that you'll come across, both in terms of clinical skills as well as knowledge about the actual process of Clinical Supervision. There are lots of questions that you should keep in mind while interviewing a potential Clinical Supervisor, which I highly recommend is done in-person, to give you a good feel of whether he or she will be a good fit for you. Immediate red flags that someone may not be a good fit as a Clinical Supervisor include a lack of willingness to provide a free consultation session and an inability to provide thorough response to basic questions below:
 
1) What is your licensure and how long have you been a practicing clinician? Has your license ever been suspended in the past and are you currently in good standing with your licensing board? (Confirm this last part online!)

2) Have you yourself ever been terminated from employment or had a complaint made against your license? Have you ever had any ethics-based issues arise with clients that were not appropriately resolved?

3) Are you contracted with any specific agencies to provide supervision?

4) How many people have your provided Clinical Supervision to? What percentage of your supervisees have passed their licensing exams and met the requirements for full licensure? Have you ever been 'fired' by a supervisee?

5) Can you explain to me the full, start-to-finish process for licensure? What are the requirements for paperwork? What about continuing education? What are the work and supervision hour requirements? What are the minimum and maximum time-frames for licensure?

6) What is your area of expertise and what additional trainings have you had in that area?

7) What types of theoretical orientations do you practice from? What types of modalities do you find yourself typically using with clients and why?

8) How do you view your role as my Clinical Supervisor? What expectations do you have of me as a supervisee?

9) Have you ever personally worked in my specific job role? If not, can you explain to me your understanding of what my role is?

10) What does your availability look like, both for standing weekly supervision sessions as well as for support during crises?
 
Once you have those answers in hand, you'll be able to make a more informed decision regarding who will be the right fit for you. Remember, while agency-based supervision is free, it can come at a price. If you meet your agency-based Clinical Supervisor and find that it's a perfect fit, that's completely awesome and you are one lucky supervisee! In the event that your agency-based Clinical Supervisor isn't the best fit for your needs, it's okay to advocate for yourself and request either a stipend to reimburse the cost of outside supervision or a salary bump that allows you to offset the cost on your own.
 
Think not only about the "here and now" of your current clinical practice, but also take into consideration your long-term career goals, while hunting down your ideal Clinical Supervisor!