Clinical Supervision: A Supervisor's Journal

“ As above, so below. As inside, so outside.”

A Supervisor's Journal
Clinical Supervision, Law and Ethics

15 CEs

Fulfills the CA BBS requirement for supervising LCSW Associates
Fulfills CA BBS & BOP Supervision Training Requirements

by Anonymous, LMFT

(Note: This journal appeared anonymously in our e-mail box)

A continuing education course for 15 ces

APA, APT, BRN, CA BBS, FL, NAADAC, NASW, NBCC, OH, TX

meeting the CA BBS & BOP requirements for Supervision and Law & Ethics

Faster than a speeding bullet
More powerful than a locomotive!
Able to leap tall buildings at a single bound!
Look! Up in the sky!
It's a bird! It's a plane!
It's Super...visor!

(You are kidding, right? No one can live up to that!)

In this course, we will cover aspects of supervision, including:

Legal and ethical issues in clinical supervision

Current laws and regulations pertaining to supervision

Supervisor's responsibilities

Records to keep

Roles and functions of Clinical Supervisor

Models of clinical supervision

Mental health related professional development

Methods and techniques in clinical supervision

Supervisory relationship issues

Cultural issues in clinical supervision

Evaluation of supervisee competence and the supervision process

Reverberations in the 3-dimensional Interpersonal Field between supervisor and supervisee as it parallels the field between supervisee and his or her patient

Contains a discussion of “As above, so below. As inside, so outside.”

And, in blue, the Journal of an anonymous supervisor, including raw and unedited countertransference material, as well as examples of Parallel Process in action

Featuring excerpts from DSM-S - The DSM-Supervisors, with a special examination of DSM-S 004.78 -Engaging in an Act of Desperation by Desperate Supervisor

Contains an extensive Supervision Bibliography

In this course, the term 'intern' = trainee = supervisee = social work associate = psych assistant = someone who is being supervised by any other name (or, to quote Shakespeare: "What's in a name? That which we call a rose by any other word would smell as sweet.")

Fulfills the CA BBS requirement for supervising LCSW Associates:
Effective January 1, 2001, you will need to have completed fifteen (15) contact hours in supervision training obtained from a state agency or approved continuing education provider. This training may apply towards the continuing education requirements.
(source:http://www.bbs.ca.gov/licstat7.htm)

Please note that many of the legal and ethical considerations and the clinical material presented here are repeated in Parts I & II (the 6 unit sections) of the Clinical Supervision series.

In purple are places for YOU to think about the issues that supervision raises in your psyche. These are solely for you; we won't be asking you to share them. The hope is that this introspection will prove helpful to you as a supervisor. Some of these are marked with a cup of "cyber-coffee" (or tea, if you prefer) expressing my wish that we could sit down and discuss these issues over a cup of coffee. I hope that you will slow down when you see these areas, and really think about the issues. The danger of self-study is that people can just skim the material, in order to pass the post-test.

is approved by the:

American Psychological Association to sponsor continuing education for psychologists - www.psychceu.com maintains responsibility for this program and its content.
The Association for Play Therapy (#02-117)
Board of Registered Nursing (#13620)
California Board of Behavioral Science (#1540)
Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling (BAP #753)
NAADAC - The Association for Addiction Professionals (#478)
National Association of Social Workers (#886382116)
National Board for Certified Counselors (#6055)
Ohio Counselor, Social Work and Marriage and Family CPE (#RCST090402)
The Texas State Board of Examiners of Professional Counselors (#52526)
The Texas Board of Social Work Examiners (#CS3473)

www.psychceu.com
maintains responsibility for the program.

Note: This journal appeared anonymously in our e-mail box. With it was this note:

"Please use this as a supervision course. I am staying anonymous, because it contains very raw and honest countertransference material, and I am afraid that it will ruin my reputation when therapists see how my shadow emerged when I was supervising. I am particularly embarrassed about the times when I had an urge to 'throttle my intern'. I do hope that you will publish this as a course, however. I think it will help supervisors to hear about a truthful account of supervision. I also included the law and ethics stuff, but the journal is mostly about my experience as a supervisor. Thank you."

A Supervisor's Journal: As Above, So Below:
Clinical Supervision, Law and Ethics

Learning Objectives
In this 15 unit course, Clinical Supervisors will:
1. Be aware of the specific laws and ethics in regard to supervision.
2. Be cognizant of the clinical issues involved in the supervision relationship.
3. Be able to identify components of ethical professional conduct in the supervision of both beginning and advanced interns/trainees/social work associates/psych assistants.
4. Become more familiar with the legal issues regarding child abuse, patient/therapist privilege, Tarasoff Issues and the mandated responsibilities of the supervisor.
5. Be able to identify issues that may be associated with confidentiality, including client welfare, competence/scope of practice and informed consent, as they apply to supervision.
6. Be cognizant of the role of countertransference in the supervisory relationship, with regard to multiculturalism.
7. Be able to identify scope of practice and have resources for outside consultation in supervision.
8. Be aware of the use of Self and the concept of parallel process in the supervision.

Excerpted from the course:

When Daniel came for supervision, I replayed this part of the tape for him. He said he was very concerned that Maria was being neglected, in light of the comments her mother had made on Maria's developmental survey.

I was a bit confused about what Daniel meant. "Well," he said, "She is obviously neglected if her parents can't take the time to fill out the answers, or give her breakfast."

My reaction was the DSM-S 126.90348558: "What planet is this intern from? Doesn't he know that having a newborn in the house, and no sleep, is incredibly stressful? And don't all parents yell at their kids in the morning?" Then I went into my own self doubt, thinking that maybe I was a bad mother, for yelling at my son in the morning! Oh dear! Maybe it was not normal to yell at your child, especially when he wouldn't get ready for school. I pulled myself back from my crisis of self-doubt, and struggled to find a neutral place inside myself, and asked Daniel what he meant.

"Obviously, the child is neglected. I am thinking that I need to make a Child Protective Services report. That's why I asked her what else her parents did to her. I know that we are charged with reporting child abuse. Her mentioning that bruise was quite suspicious, I think. And the fact that she is not fed breakfast is significant. "

I knew that I had to pull back my countertransference, and not blast Daniel. I didn't want to recreate in the supervision what Daniel had done in the session, when he yelled at Maria for spilling the water and throwing the sand.

As Daniel's task with Maria was delicate, so was mine with Daniel. How much of this parallel process should I discuss with Daniel?

“As above, so below. As inside, so outside.” This refers to the fact that whatever is going on in the patient’s or supervisee's life or psyche will be replicated in the session. This is how people heal; we keep repeating the same patterns in an attempt to find a different solution.

How did this happen, that I was as frustrated with Daniel as he was with Maria; that I was as judgmental of him as he was of Maria's mother?? To understand, I started researching “Somatic Consciousness”. I read in “A General Theory of Love” that:

“ Every person broadcasts information about his inner world. As a collection of dense matter betrays its presence through electromagnetic transmissions, a person’s emotional Attractors manifest themselves in a radiant aura of limbic tones. If a listener quiets his neocortical chatter and allows limbic sensing to range free, melodies begin to penetrate the static of anonymity….As the listener’s resonance grows, he will catch sight of what the other sees inside that personal world, start to sense what it feels like to live there.”(p. 169)

In the midst of movement and chaos,
keep stillness inside of you.
Deepak Chopra

"A gathering cloud looms over the patchwork landscape of psychotherapy: the growing certainty that, despite decades of divergent rectification and elaboration, therapeutic techniques per se have nothing to do with results….Strip away a therapist’s orientation, the journals he reads, the books on his shelves, the meetings he attends – the cognitive framework his rational mind demands – and what is left to define the psychotherapy he conducts?

Himself. The person of the therapist is the converting catalyst, not his order or credo, not his spatial location in the room, not his exquisitely chosen words nor denominational silences...(p. 186)

I decided not to go into the parallel process at that moment, but inside to focus on Daniel's content. Like in therapy, the supervisor often has to choose between making a PROCESS intervention, versus a CONTENT comment. It seemed to me where Daniel was going was potentially explosive, so I asked him what other signs of abuse or neglect he was sensing....

Supervising Social Work Associates

Please remember, when supervising social work associates, that you must develop a supervisory plan that defines the goals and objectives of the supervision. This must be submitted by the Associate Clinical Social Worker to the BBS within thirty days of starting supervision. Additionally, assessments of the social work associate are required both annually and at termination.

Mandatory Continuing Education

Before supervising a social work associate you must complete 15 hours of coursework specific to supervision, including: familiarity with supervision literature, facilitation of therapist-client and supervisor-therapist relationships, evaluation and identification of problems, structuring to maximize supervision, knowledge of contextual variables, and the practice of social work including legal and ethical issues.

Cost for the 15 unit course is $165
The optional text is $40 + shipping and tax
The e-book (course material only; without post-test or credits) is $20