Introduction

The BHEC indicates that the Supervisor status isn’t a type of license. Rather, it designates an LPC who is approved by the board to supervisor LPC-Associates.

Texas Licensed Professional Counselors with Supervisor status (LPC-S) are authorized to provide the supervision LPC-Associates need to fulfill the 3,000 hours of supervised experience required for full licensure as Texas Licensed Professional Counselors (LPC). According to Texas Administrative Code Rule 681.92, LPC Associates must complete supervised experience acceptable to the Texas Behavioral Health Executive Council of 3,000 clock-hours under a Council-approved supervisor (LPC-S).

According to TAC Rule 681.141, licensed professional counselors holding the supervisor status (LPC-S) must complete six hours of continuing education in supervision and that count towards the 24 hours required each renewal period of all Texas Licensed Professional Counselors. The purpose of this course is to provide the six additional hours of supervision required for license renewal for Texas Licensed Professional Counselors holding the supervisor status (LPC-S).

There are currently 6,000 LPCs with supervisor status and approximately 5,000 LPC Associates in Texas. This ratio implies there are probably many LPC Supervisors not currently supervising any Associates, but who see the value in having the Supervisor status for many reasons including an employer, or future employer, requiring it to accommodate supervision needs of other employees working on full licensure. Even when supervisors do not supervise Associates, the status is an indication the licensee has been licensed for at least five years.

Statutes and Rules for LPC-Supervisors

The Texas Administrative Code, Chapter 681 (Professional Counselors), Subchapter C (Application and Licensing), Rules 681.91, 681.92 and 681.93, provide the bulk of guidelines for LPC Supervisors and the Associates they supervise.

LPC Supervisors should be aware that the rules found in the TAC change periodically, so these requirements should be verified with the most recently published guidelines found at the Texas Secretary of State website.

Many licensees may choose to use the Consolidated Rulebook for Professional Counseling as a reference for rules. It is found at the Texas Behavioral Health Executive Council (“Council”) website. When using the Rulebook, the Council advises:

As a courtesy to the public, BHEC agency staff have consolidated the various rules applicable to each profession into an easy-to-use rulebook available for download as a portable document format (PDF) file.

The BHEC indicates that, while the Council makes every reasonable effort to update and maintain the accuracy of these rulebooks, due to the evolving nature of the law and limited time and resources, the rulebooks may not reflect the current state of the law.

You are cautioned against relying solely upon these rulebooks and urged to review the current rules which are available through the links below. Moreover, if a conflict exists between a rulebook and the rules published on the Secretary of State’s website, the version on the Secretary of State’s website shall control. Compliance with the law cannot be excused due to an outdated, mistaken, or erroneous reference in a rulebook.

Notification of Rulemaking and Texas Register

The Council publishes all of its proposed, adopted, withdrawn and emergency rules in the Texas Register in accordance with the Administrative Procedure Act. Any proposed, adopted, withdrawn or emergency rule action taken by the Council can be viewed online via the Texas Register.

REQUIREMENTS of TAC RULES 681.91, 681.92, and 681.93:

One of the most important responsibilities of being a Licensed Professional Counselor with Supervisor status is staying informed of the statutes and rules applicable to licensees, Supervisors, and Associates.

Although some of the statutory requirements for LPC Supervisors are separate and distinct from those of LPC Associates, there is substantial overlap in many duties as codified in TAC RULES 681.91,681.92, and 681.93.

LPC Supervisors should be aware of all requirements specific to both them and supervisees since questions relevant to these statutes and rules will inevitably arise in the supervision process. The Supervisor carries responsibility for ensuring the Associate has received instruction on the statutory requirements the Associate must fulfill.

According to Rule 681.93; 1) Supervisors must review all provisions of the Act and Council rules in this chapter during supervision, and (2) The supervisor must ensure the LPC Associate is aware of and adheres to all provisions of the Act and Council rules.

The following highlights many of the required tasks and documents mentioned in Rules 681.91, 681.92, and 681.93:

RULE 681.91

►The LPC Associate enters into a supervisory agreement with a Licensed Professional Counselor Supervisor (LPC-S); and has not completed the supervised experience described in §681.92 of this title (relating to Experience Requirements or Internship). Comments: This reiterates the idea that LPC Associates cannot complete any supervised experience in Texas unless it is through an approved supervisor and the approved supervisor cannot sign-off on any hours completed before the supervision agreement began and was approved by the Board. The Supervisory Agreement form can be found at the BHEC website under Forms and Publications. The top of the first page looks like this:

►An LPC Associate must comply with all provisions of the Act and Council rules. Comments: LPC Associates are bound to the same ethical standards of fully licensed professional counselors when applicable.

►To practice counseling in Texas, a person must obtain an LPC Associate license before the person begins an internship or continues an internship. Hours obtained by an unlicensed person in any setting will not count toward the supervised experience requirements. Comments: The Supervisor Agreement Form is sent in with the application for LPC Associate licensure. Issuance of the LPC Associate license indicates the Supervisory Agreement and Supervisor have been approved. A separate notification of approval is not sent to the supervisor.

►An LPC Associate may practice counseling only as part of his or her internship and only under the supervision of a Licensed Professional Counselor Supervisor (LPC-S). The LPC Associate shall not engage in independent practice. Comments: TAC 681.2 defines independent practice as the practice of providing professional counseling services to a client without the supervision of an LPC-S. All Associates have to be under supervision by a LPC-S.

►An LPC Associate may have no more than two (2) Council-approved LPC supervisors at any given time. Comments: The limitation of having no more than two supervisors was implemented in the TAC in 2013. Apparently, there was no limit prior to this time. However, Associates who have even two supervisors could potentially encounter some of the same issues of clients seeing two therapists concurrently; there could be disagreement between the supervisors. This potential conflict or difference of opinion might especially be relevant in regard to the theoretical approach used by a supervisor.

►An LPC Associate must maintain their LPC Associate license during his or her supervised experience.

►An LPC Associate license will expire 60 months from the date of issuance.

►An LPC Associate who does not complete the required supervised experience hours during the 60-month time period must reapply for licensure.

►An LPC Associate must continue to be supervised after completion of the 3,000 hours of supervised experience and until the LPC Associate receives his or her LPC license. Supervision is complete upon the LPC Associate receiving the LPC license.

►The possession, access, retention, control, maintenance, and destruction of client records is the responsibility of the person or entity that employs or contracts with the LPC Associate, or in those cases where the LPC Associate is self-employed, the responsibility of the LPC-Associate. Comment: Some have argued that self-employed LPC Associates who have control of client records may limit a supervisor’s access to them. Also, allowing Associates to be self-employed may require the supervisor to be responsible for issues beyond their expertise such as aspects of running a business, and generally create a greater workload for supervisors. Others have supported this rule believing it to open up new opportunities for rural residents to receive quality counseling services by attracting more licensees to those communities, provide potential financial benefit to Associates, and create greater parity with other licensed mental health professions. Please refer to the Texas Register Preamble for a more detailed explanation for the reasoning behind the adoption of this rule.

►An LPC Associate must not employ a supervisor but may compensate the supervisor for time spent in supervision if the supervision is not a part of the supervisor’s responsibilities as a paid employee of an agency, institution, clinic, or other business entity.

►All billing documents for services provided by an LPC Associate must reflect the LPC Associate holds an LPC Associate license and is under supervision.

►The LPC Associate must not represent himself or herself as an independent practitioner. The LPC Associate’s name must be followed by a statement such as “supervised by (name of supervisor)” or a statement of similar effect, together with the name of the supervisor. This disclosure must appear on all marketing materials, billing documents, and practice related forms and documents where the LPC Associate’s name appears, including websites and intake documents.

RULE 681.92

►All applicants for LPC licensure must complete supervised experience acceptable to the Council of 3,000 clock-hours under a Council-approved supervisor. Comment: The BHEC has been asked about decreasing the 3,000-hour requirement. In essence, the BHEC does not adopt rules that conflict with the Texas Occupations Code. The specific BHEC response is found in the Texas Register, Preamble, as follows: The 3,000 hours of supervised experience needed for licensure is required by statute, see §503.302(a)(4) of the Occupations Code, therefore this agency declines to reconsider this requirement or shorten it. The Council declines to amend the licensing requirements for an LPC or LPC-Associate, the Texas State Board of Examiners of Professional Counselors has not articulated a need to amend the licensure requirements because of these rule amendments.

►All internships physically occurring in Texas must be completed under the supervision of a Council-approved supervisor.

►For all internships physically completed in a jurisdiction other than Texas, the supervisor must be a person licensed or certified by that jurisdiction in a profession that provides counseling and who has the academic training and experience to supervise the counseling services offered by the Associate. The applicant must provide documentation acceptable to the Council regarding the supervisor’s qualifications.

►The supervised experience must include at least 1,500 clock-hours of direct client counseling contact. Only actual time spent counseling may be counted. Comments: The BHEC Rules define “direct hours” as “time spent counseling clients.” Indirect hours are defined as time spent in management, administration, or other aspects of counseling service ancillary to direct client contact.

►An LPC Associate may not complete the required 3,000 clock-hours of supervised experience in less than 18 months.

►The experience must consist primarily of the provision of direct counseling services within a professional relationship to clients by using a combination of mental health and human development principles, methods, and techniques to achieve the mental, emotional, physical, social, moral, educational, spiritual, or career-related development and adjustment of the client throughout the client’s life.

►The LPC Associate must receive direct supervision consisting of a minimum of four (4) hours per month of supervision in individual (up to two Associates) or a group (three or more) setting while the Associate is engaged in counseling unless an extended leave of one month or more is approved in writing by the Council approved supervisor. No more than 50% of the total hours of supervision may be received in group supervision.

►An LPC Associate may have up to two (2) supervisors at one time.

RULE 681.93

► A supervisor must keep a written record of each supervisory session in the file for the LPC Associate. The supervisory written record must contain:

• a signed and dated copy of the Council’s supervisory agreement form for each of the LPC Associate’s supervisors;

• a copy of the LPC Associate’s online license verification noting the dates of issuance and expiration;

• fees and record of payment;

• the date of each supervisory session;

• a record of an LPC Associate’s leave of one month or more, documenting the supervisor’s approval and signed by both the LPC Associate and the supervisor;

• a record of any concerns the supervisor discussed with the LPC Associate, including a written remediation plan as prescribed in subsection (e) of this section; and

• a record of acknowledgement that the supervisee is self-employed, if applicable.

• The supervisor must provide a copy of all records to the LPC Associate upon request.

Comment: This is an example of the Supervision Hours Log found at the BHEC website under Forms and Publications that documents some of the requirements mentioned above:

► Both the LPC-Associate and the supervising LPC-S are fully responsible for the professional counseling activities of the LPC-Associate. The LPC- S may be subject to disciplinary action for violations that relate only to the professional practice of counseling committed by the LPC-Associate which the LPC-S knew about or due to the oversight nature of the supervisory relationship should have known about. Comments: The BHEC explanation found in Texas Register, Preamble: LPC-Supervisors are required to provide supervision as it relates to the practice of professional counseling by the LPC-Associate, if a matter is outside of this scope a supervisor would not be subject to a disciplinary action by the Council. For example, if an LPC-Associate decides to create a legal entity, such as a limited liability company, in Texas but fails to timely or properly file a required form or fee with Texas Comptroller of Public Accounts, the Texas Workforce Commission, or any other applicable government agency, then the LPC-Supervisor would not be subject to disciplinary action by the Council for this failure by the LPC-Associate. Rule 681.92(e) requires a minimum of four hours of supervision per month for an LPC-Associate, but this is only the minimum standard supervisors can provide or require more than this minimum standard if a supervisor finds more supervision is necessary for a particular LPC-Associate.

► Supervisors must review all provisions of the Act and Council rules in this chapter during supervision. Comment: This task alone, along with much repetition and application to Associate work experience, will comprise much of what goes on in supervision.

► The supervisor must ensure the LPC Associate is aware of and adheres to all provisions of the Act and Council rules.

► The supervisor must avoid any relationship that impairs the supervisor's objective, professional judgment. Comment: this Rule (681.93 (c)) is more broad than Rule 681.42 that restricts supervisors from having sexual contact with the Associate within five years of cessation of the supervision, or of ever committing sexual exploitation or therapeutic deception of an Associate supervised by the licensee. Even after five years, supervisors can be held in violation unless certain factors are met described in 681.42.

► The supervisor may not be related to the LPC Associate within the second degree of affinity or within the third degree of consanguinity. Comments: Affinity is related by marriage. Consanguinity is related by blood. The second degree of affinity would include the supervisor’s step-children, stepmother/stepfather, mother-in-law, father-in-law (first degree) and stepbrothers/stepsisters, brothers-in-law, sisters-in-law, step grandchildren, and step grandparents (second degree). Third degree of consanguinity would include the supervisor’s spouse, children, parents (first degree), brother/sisters, half-brother and sisters, grandchildren, and grandparents (second degree).

► The supervisor may not be an employee of his or her LPC Associate. Comment: LPC-Associates are prohibited from employing their supervisor, but the LPC-Associate may compensate the supervisor (e.g. contract for supervision) if the supervision is not part of the supervisor’s responsibilities as a paid employee of an agency, institution, clinic, or other business entity.

► The supervisor must submit to the Council accurate documentation of the LPC Associate's supervised experience within 30 days of the end of supervision or the completion of the LPC Associate's required hours, whichever comes first.

► If a supervisor determines the LPC Associate may not have the counseling skills or competence to practice professional counseling under an LPC license, the supervisor will develop and implement a written plan for remediation of the LPC Associate, which must be reviewed and signed by the LPC Associate and maintained as part of the LPC Associate's file.

► The supervisor must ensure the supervised counseling experience of the LPC Associate were earned: after the LPC Associate license was issued; and in not less than 18 months of supervised counseling experience.

Comment: Once the Associate has completed the 3,000 hours of experience the Supervised Experience Documentation/Upgrade Form found at the BHEC website is filled in by the Associate and Supervisor and sent in by the Associate.

► A supervisor whose license has expired is no longer an approved supervisor and: must immediately inform all LPC Associates under his or her supervision and assist the LPC Associates in finding alternate supervisors; and must refund all supervisory fees for supervision after the expiration of the supervisor status. Hours accumulated under the person's supervision after the date of license expiration may not count as acceptable hours.

► Upon execution of a Council order for probated suspension, suspension, or revocation of the LPC license with supervisor status, the supervisor status is revoked. A licensee whose supervisor status is revoked: must immediately inform all LPC Associates under his or her supervision and assist the LPC Associates in finding alternate supervisors; and must refund all supervisory fees for supervision after the date the supervisor status is revoked; and hours accumulated under the person's supervision after the date of license expiration may not count as acceptable hours.

► Supervision of an LPC Associate without having Council approved supervisor status is grounds for disciplinary action.

The Nature of Supervision

Clinical supervision by Licensed Professional Counselors with Supervisor status (LPC-S) provides one of the key ways LPC Associates acquire knowledge and skills for the counseling profession, providing a bridge between theory and practice.

Supervision is necessary in the counseling field to improve client care, develop professionalism, and impart and maintain ethical standards. In recent years, clinical supervision has become the cornerstone of quality improvement and assurance.

The role of an LPC Supervisor is distinct from those of counselor and administrator. Quality clinical supervision is founded on a positive supervisor–supervisee relationship that promotes client welfare and the professional development of the supervisee. You are a teacher, coach, consultant, mentor, evaluator, and administrator; you provide support, encouragement, and education to staff while addressing an array of psychological, interpersonal, physical, psychosocial and spiritual issues of clients. Ultimately, effective clinical supervision ensures that clients are competently served. Supervision ensures that counselors continue to increase their skills, which in turn increases treatment effectiveness, client retention, and staff satisfaction. The clinical supervisor also serves as liaison between administrative and clinical staff.

This course focuses primarily on the teaching, coaching, consulting, and mentoring functions of Texas LPC approved Supervisors. Supervision, like counseling, is a profession in its own right, with its own theories, practices, and standards. The profession requires knowledgeable, competent, and skillful individuals who are appropriately credentialed both as counselors and supervisors.

The perspective of this course is informed by the following definitions of supervision:

• “Supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical, and supportive” (Powell & Brodsky, 2004, p. 11). “Supervision is an intervention provided by a senior member of a profession to a more junior member or members. This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s); monitoring the quality of professional services offered to the clients that she, he, or they see; and serving as a gatekeeper of those who are to enter the particular profession” (Bernard & Goodyear, 2004, p. 8).

• Supervision is “a social influence process that occurs over time, in which the supervisor participates with supervisees to ensure quality of clinical care. Effective supervisors observe, mentor, coach, evaluate, inspire, and create an atmosphere that promotes self-motivation, learning, and professional development. They build teams, create cohesion, resolve conflict, and shape agency culture, while attending to ethical and diversity issues in all aspects of the process. Such supervision is key to both quality improvement and the successful implementation of consensus­ and evidence-based practices” (CSAT, 2007, p. 3).

Rationale

For hundreds of years, many professions have relied on more senior colleagues to guide less experienced individuals in their crafts. This is a relatively new development in the counseling field, as clinical supervision was acknowledged as a discrete process with its own concepts and approaches only within the last twenty or thirty years.

As a supervisor to the client, Associate, and possibly the organization, the significance of Licensed Professional Counselors with Supervisor status is apparent in the following statements:

• Organizations have an obligation to ensure quality care and quality improvement of all personnel. The first aim of clinical supervision is to ensure quality services and to protect the welfare of clients.

• Supervision is the right and obligation of all LPC Associates and has a direct impact on their development and the services they provide the public.

• Supervisors oversee the clinical functions of Associates and have a legal and ethical responsibility to ensure quality care to clients, the professional development of counselors, and maintenance of program policies and procedures.

• Clinical supervision is how Associates in the field learn. In concert with classroom education, clinical skills are acquired through practice, observation, feedback, and implementation of the recommendations derived from clinical supervision.

Functions of a Clinical Supervisor

The clinical supervisor wears several important “hats.” They facilitate the integration of counselor self-awareness, theoretical grounding, and development of clinical knowledge and skills; and assist in improving functional skills and professional practices. These roles often overlap and are fluid within the context of the supervisory relationship. Hence, the supervisor is in a unique position as an advocate for the agency, the counselor, and the client. You are the primary link between administration and front-line staff, interpreting and monitoring compliance with agency goals, policies, and procedures and communicating staff and client needs to administrators. Central to the supervisor’s function is the alliance between the supervisor and supervisee. Teacher, Consultant, Coach and Mentor are some of the roles a supervisor fulfills.

Your roles as a supervisor in the context of the supervisory relationship include:

• Teacher: Assist in the development of counseling knowledge and skills by identifying learning needs, determining counselor strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth. Supervisors are teachers, trainers, and professional role models.

• Consultant: Bernard and Goodyear (2004) incorporate the supervisory consulting role of case consultation and review, monitoring performance, counseling the counselor regarding job performance, and assessing counselors. In this role, supervisors also provide alternative case conceptualizations, oversight of counselor work to achieve mutually agreed upon goals, and professional gatekeeping for the organization and discipline (e.g., recognizing and addressing counselor impairment).

• Coach: In this supportive role, supervisors provide morale building, assess strengths and needs, suggest varying clinical approaches, model, cheer­ lead, and prevent burnout. For entry level counselors, the supportive function is critical.

• Mentor/Role Model: The experienced supervisor mentors and teaches the supervisee through role modeling, facilitates the counselor’s overall professional development and sense of professional identity, and trains the next generation of supervisors.

Roles of the Clinical Supervisor

Central Principles of Clinical Supervision

Although clinical supervision can initially be a costly undertaking for many financially strapped programs, ultimately clinical supervision can be a cost saving process. Clinical supervision enhances the quality of client care; improves efficiency of counselors in direct and indirect services; increases workforce satisfaction, professionalization, and retention; and ensures that services provided to the public uphold legal mandates and ethical standards of the profession. Central principles include:

1. Clinical supervision is an essential part of all clinical programs. Clinical supervision is a central organizing activity that integrates the program mission, goals, and treatment philosophy with clinical theory and evidence based practices (EBPs). The primary reasons for clinical supervision are to ensure (1) quality client care, and (2) clinical staff continue professional development in a systematic and planned manner. Clinical supervision is the primary means of determining the quality of care provided.

2. Clinical supervision enhances staff retention and morale. Staff turnover and workforce development are concerns for any agency, especially in recent years. Clinical supervision is a primary means of improving workforce retention and job satisfaction (see, for example, Roche, Todd, & O’Connor, 2007).

3. Every clinician, regardless of level of skill and experience, needs and has a right to clinical

supervision. In addition, supervisors need and have a right to supervision of their supervision. Supervision needs to be tailored to the knowledge base, skills, experience, and assignment of each counselor. All staff need supervision, but the frequency and intensity of the oversight and training will depend on the role, skill level, and competence of the individual. The benefits that come with years of experience are enhanced by quality clinical supervision.

4. Clinical supervision needs the full support of agency administrators. Just as treatment programs want clients to be in an atmosphere of growth and openness to new ideas, counselors should be in an environment where learning and professional development and opportunities are valued and provided for all staff.

5. The supervisory relationship is the crucible in which ethical practice is developed and reinforced. The supervisor needs to model sound ethical and legal practice in the supervisory relationship. This is where issues of ethical practice arise and can be addressed. This is where ethical practice is translated from a concept to a set of behaviors. Through supervision, clinicians can develop a process of ethical decision making and use this process as they encounter new situations.

6. Clinical supervision is a skill in and of itself that has to be developed. Good counselors tend to be promoted into supervisory positions with the assumption that they have the requisite skills to provide professional clinical supervision. However, clinical supervisors need a different role orientation toward both program and client goals and a knowledge base to complement a new set of skills. Programs need to increase their capacity to develop good supervisors.

7. Clinical supervision of Associates most often requires balancing administrative and clinical supervision tasks. Sometimes these roles are complementary and sometimes they conflict. Often the supervisor feels caught between the two roles. Administrators need to support the integration and differentiation of the roles to promote the efficacy of the clinical supervisor.

8. Culture and other contextual variables influence the supervision process; supervisors need to continually strive for cultural competence. Supervisors require cultural competence at several levels. Cultural competence involves the counselor’s response to clients, the supervisor’s response to counselors, and the pro­ gram’s response to the cultural needs of the diverse community it serves. Since supervisors are in a position to serve as catalysts for change, they need to develop proficiency in addressing the needs of diverse clients and personnel.

9. Successful implementation of EBPs requires ongoing supervision. Supervisors have a role in determining which specific EBPs are relevant for an organization’s clients (Lindbloom, Ten Eyck, & Gallon, 2005). Supervisors ensure that EBPs are successfully integrated into ongoing programmatic activities by training, encouraging, and monitoring counselors. Excellence in clinical supervision should provide greater adherence to the EBP model. Because State funding agencies now often require substance abuse treatment organizations to provide EBPs, supervision becomes even more important.

10. Supervisors have the responsibility to be gatekeepers for the profession. Supervisors are responsible for maintaining professional standards, recognizing and addressing impairment, and safeguarding the welfare of clients. More than anyone else in an agency, supervisors can observe counselor behavior and respond promptly to potential problems, including counseling some individuals out of the field because they are ill­ suited to the profession. This “gatekeeping” function is especially important for supervisors who act as field evaluators for practicum students prior to their entering the profession. Finally, supervisors also fulfill a gatekeeper role in performance evaluation and in providing formal recommendations to training institutions and credentialing bodies.

11. Clinical supervision should involve direct observation methods. Direct observation should be the standard in the field because it is one of the most effective ways of building skills, monitoring counselor performance, and ensuring quality care. Supervisors require training in methods of direct observation, and administrators need to provide resources for implementing direct observation. Although small substance abuse agencies might not have the resources for one­ way mirrors or videotaping equipment, other direct observation methods can be employed (see the section on methods of observation, pp. 20–24).

New LPC Supervisors

There are many challenges to be expected for LPC Supervisors, especially those without any prior supervisory experience. Many new LPC Supervisors have been clinical supervisors to employees in work settings before becoming LPC Supervisors to LPC Associates. The general supervisory experience attained prior to the role of LPC Supervisor may make the transition to supervising LPC Associates a little easier. However, the role of LPC Supervisor may bring on unique dynamics and duties that create a greater sense of uncertainty about your ability to be effective. You might feel that you knew what to do as a counselor, but feel totally lost with your new responsibilities as a supervisor.

Before you became a LPC Supervisor, you might have felt confidence in your clinical skills. Now you might feel unprepared and wonder if you need more training for your new role. Although you are a good counselor, you do not necessarily possess all the skills needed to be a good supervisor. Your new role requires a new body of knowledge and different skills, along with the ability to use your clinical skills in a different way. Be confident that you will acquire these skills over time.

Suggestions for LPC supervisors:

• Become very familiar with all the Rules and Statutes applicable to Texas LPCs and Associates found in various documents including the Texas Administrative Code and the Consolidated Rulebook for Professional Counseling found at the TSBEPC site.

• Become familiar with the Forms and Publications provided at the TSBEPC site including the forms under Supervised Experience Forms.

• Become familiar with the BHEC and TSEBPC sites and the information provided including: Board News; Meet the Board; Meeting Dates, Agendas, and Minutes; Statues and Rules; Jurisprudence Examination; Find A Supervisor; Fingerprint Information; FAQs; Human Trafficking Awareness, and other issues relevant to licensees.

• If your LPC Supervision of Associates is to occur through an employer, learn the employer’s policies and procedures and human resources procedures (e.g., hiring and firing, affirmative action requirements, format for conducting meetings, giving feedback, and making evaluations). Seek out this information as soon as possible through the human resources department or other resources within the organization.

• Take time to learn about your supervisees, their career goals, interests, developmental objectives, and perceived strengths.

• Establish a contractual relationship with supervisees, with clear goals and methods of supervision.

• Learn methods to help staff reduce stress, address competing priorities, resolve staff conflict, and other interpersonal issues in the workplace.

• Obtain 0n-going training in supervisory procedures and methods beyond the required 40 hour course required for Supervisory status.

• Find a mentor, either internal or external to the organization or private practice.

• Shadow a supervisor you respect who can help you learn the ropes of your new job.

• Ask Associates often, “How am I doing?” and “How can I improve my performance as a supervisor?”

• Seek supervision of your supervision from another LPC-Supervisor.

Problems and Resources

As a supervisor, you may encounter a broad array of issues and concerns, ranging from working within an employer’s system that does not fully support clinical supervision to working with resistant LPC Associates. Some of your supervisees may have been in the field longer than you have and see no need for supervision. Other counselors, having completed their graduate training, do not believe they need further supervision, especially not from a supervisor who might have less formal academic education or work experience than they have. A particularly important issue is when Associates believe their approach is the best one and are resistant to other models or techniques.

In addressing resistance, you must be clear regarding what your supervision program entails and must consistently communicate your goals and expectations to staff. To resolve defensiveness and engage your supervisees, you must also honor the resistance and acknowledge their concerns. Abandon trying to push the supervisee too far, too fast. Resistance is an expression of ambivalence about change and not a personality defect of the counselor. Instead of arguing with or exhorting supervisees, sympathize with their concerns, saying, “I understand this is difficult. How are we going to resolve these issues?”

When counselors respond defensively or reject directions from you, try to understand the origins of their defensiveness and to address their resistance. Self-disclosure by the supervisor about experiences as a supervisee, when appropriately used, may be helpful in dealing with defensive, anxious, fearful, or resistant staff. Work to establish a healthy, positive supervisory alliance with LPC Associates. Because many counselors have not been exposed to clinical supervision, it is important to clearly explain expectations and the rationale for those expectations, at the beginning of, and throughout, supervision. Discussing how differences of opinion or conflicts between supervisor and supervisee will be handled in advance is important.

Things Supervisors Should Know

There are several general truths that often apply to supervision. Some, if not all, of should be committed to memory:

1. The reason for supervision is to ensure quality client care. The primary goal of clinical supervision is to protect the welfare of the client and ensure the integrity of clinical services.

2. Supervision is all about the relationship. As in counseling, developing the alliance between the counselor and the supervisor is the key to good supervision.

3. Be human and have a sense of humor. As role models, you need to show that everyone makes mistakes and can admit to and learn from these mistakes.

4. Rely first on direct observation of your counselors and give specific feedback. The best way to determine a counselor’s skills is to observe him or her and to receive input from the clients about their perceptions of the counseling relationship.

5. Have and practice a model of counseling and of supervision; have a sense of purpose. Before you can teach a supervisee knowledge and skills, you must first know the philosophical and theoretical foundations on which you, as a supervisor, stand. Counselors need to know what they are going to learn from you, based on your model of counseling and supervision.

6. Make time to take care of yourself spiritually, emotionally, mentally, and physically. Again, as role models, counselors are watching your behavior. Do you “walk the talk” of self­care?

7. As a supervisor, you have a wonderful opportunity to assist in the skill and professional development of Associates, advocating for the best interests of the supervisee, the client, and your organization.

Models of Clinical Supervision

It is important to work from a defined model of supervision and have a sense of purpose in your oversight role. Four supervisory orientations seem particularly relevant. They include:

• Competency­based models.

• Treatment­based models.

• Developmental approaches.

• Integrated models.

Competency ­based models (e.g., microtraining, the Discrimination Model [Bernard & Goodyear, 2004], and the Task­Oriented Model [Mead, 1990], focus primarily on the skills and learning needs of the supervisee and on setting goals that are specific, measurable, attainable, realistic, and timely (SMART). They construct and implement strategies to accomplish these goals. The key strategies of competency­based models include applying social learning principles (e.g., modeling role reversal, role playing, and practice), using demonstrations, and using various supervisory functions (teaching, consulting, and counseling).

Treatment­based supervision models train to a particular theoretical approach to counseling, incorporating EBPs into supervision and seeking fidelity and adaptation to the theoretical model. Motivational interviewing, cognitive–behavioral therapy, and psychodynamic psychotherapy are three examples. These models emphasize the counselor’s strengths, seek the supervisee’s understanding of the theory and model taught, and incorporate the approaches and techniques of the model. The majority of these models begin with articulating their treatment approach and describing their supervision model, based upon that approach.

Developmental models, such as Stoltenberg and Delworth (1987), understand that each counselor goes through different stages of development and recognize that movement through these stages is not always linear and can be affected by changes in assignment, setting, and population served.

Integrated models, including the Blended Model, begin with the style of leadership and articulate a model of treatment, incorporate descriptive dimensions of supervision, and address contextual and developmental dimensions into supervision. They address both skill and competency development and affective issues, based on the unique needs of the supervisee and supervisor. Finally, integrated models seek to incorporate EBPs into counseling and supervision.

It is important to identify your model of counseling and your beliefs about change, and to articulate a workable approach to supervision that fits the model of counseling you use. Theories are conceptual frame­ works that enable you to make sense of and organize your counseling and supervision and to focus on the most salient aspects of a counselor’s practice. You may find some of the questions below to be relevant to both supervision and counseling. The answers to these questions influence both how you supervise and how the counselors you supervise work:

• What are your beliefs about how people change in both treatment and clinical supervision?

• What factors are important in treatment and clinical supervision?

• What universal principles apply in supervision and counseling and which are unique to clinical supervision?

• What conceptual frameworks of counseling do you use (for instance, cognitive–behavioral therapy, 12­Step facilitation, psychodynamic, behavioral)?

• What are the key variables that affect outcomes? (Campbell, 2000)

According to Bernard and Goodyear (2004) and Powell and Brodsky (2004),the qualities of a good model of clinical supervision are:

• Rooted in the individual, beginning with the supervisor’s self, style, and approach to leadership.

• Precise, clear, and consistent.

• Comprehensive, using current scientific and evidence­based practices.

• Operational and practical, providing specific concepts and practices in clear, useful, and measurable terms.

• Outcome­oriented to improve counselor competence; make work manageable; create a sense of mastery and growth for the counselor; and address the needs of the organization, the supervisor, the supervisee, and the client.

Finally, it is imperative to recognize that, whatever model you adopt, it needs to be rooted in the learning and developmental needs of the supervisee, the specific needs of the clients they serve, the goals of the agency in which you work, and in the ethical and legal boundaries of practice. These four variables define the context in which effective supervision can take place.

Developmental Stages of Counselors

Counselors are at different stages of professional development. Thus, regardless of the model of supervision you choose, you must take into account the supervisee’s level of training, experience, and proficiency. Different supervisory approaches are appropriate for counselors at different stages of development. An understanding of the supervisee’s (and supervisor’s) developmental needs is an essential ingredient for any model of supervision.

Various paradigms or classifications of developmental stages of clinicians have been developed. This course specifically examines the Integrated Developmental Model (IDM) of Stoltenberg, McNeill, and Delworth (1998). This schema uses a three­stage approach. The three stages of development have different characteristics and appropriate supervisory methods.

Further application of the IDM to the substance abuse field is needed. (For additional information, see Anderson, 2001.)

It is important to keep in mind several general cautions and principles about counselor development, including:

• There is a beginning but not an end point for learning clinical skills; be careful of counselors who think they “know it all.”

• Take into account the individual learning styles and personalities of your supervisees and fit the supervisory approach to the developmental stage of each counselor.

• There is a logical sequence to development, although it is not always predictable or rigid; some counselors may have been in the field for years but remain at an early stage of professional development, whereas others may progress quickly through the stages.

• Counselors at an advanced developmental level have different learning needs and require different supervisory approaches from those at Level 1; and

• The developmental level can be applied for different aspects of a counselor’s overall competence (e.g., Level 2 mastery for individual counseling and Level 1 for couples counseling).

Developmental Stages of Supervisors

Just as counselors go through stages of development, so do supervisors. The developmental model presented in figure 3 provides a framework to explain why supervisors act as they do, depending on their developmental stage. It would be expected that someone new to supervision would be at a Level 1 as a supervisor. However, supervisors should be at least at the second or third stage of counselor development. If a newly appointed supervisor is still at Level 1 as a counselor, he or she may have little to offer to more seasoned supervisees.

Cultural and Contextual Factors

Culture is one of the major contextual factors that influence supervisory interactions. Other contextual variables include race, ethnicity, age, gender, discipline, academic background, religious and spiritual practices, disability, and recovery versus non­recovery status. The relevant variables in the supervisory relationship occur in the context of the supervisor, supervisee, client, and the setting in which supervision occurs. More care should be taken to:

• Identify the competencies necessary for counselors to work with diverse individuals and navigate intercultural communities.

• Identify methods for supervisors to assist counselors in developing these competencies.

• Provide evaluation criteria for supervisors to determine whether their supervisees have met minimal competency standards for effective and relevant practice.

Models of supervision have been strongly influenced by contextual variables and their influence on the supervisory relationship and process, such as Holloway’s Systems Model (1995) and Constantine’s Multicultural Model (2003).

The competencies listed in SAMHSA’s TAP 21­A publication reflect the importance of culture in supervision (CSAT, 2007). Supervisors are encouraged to conduct self­ examination of attitudes toward culture and other contextual variables.

Cultural competence “refers to the ability to honor and respect the beliefs, language, interpersonal styles, and behaviors of individuals and families receiving services, as well as staff who are providing such services. Cultural competence is a dynamic, ongoing, developmental process that requires a commitment and is achieved over time” (U.S. Department of Health and Human Services, 2003, p. 12). Culture shapes belief systems, particularly concerning issues related to mental health and substance abuse, as well as the manifestation of symptoms, relational styles, and coping patterns.

There are three levels of cultural consideration for the supervisory process: the issue of the culture of the client being served and the culture of the counselor in supervision. Holloway (1995) emphasizes the cultural issues of the agency, the geographic environment of the organization, and many other contextual factors. Specifically, there are three important areas in which cultural and contextual factors play a key role in supervision: in building the supervisory relationship or working alliance, in addressing the specific needs of the client, and in building supervisee competence and ability. It is your responsibility to address your supervisees’ beliefs, attitudes, and biases about cultural and contextual variables to advance their professional development and promote quality client care.

Becoming culturally competent and able to integrate other contextual variables into supervision is a complex, long term process. Although you may never have had specialized training in multicultural counseling, some of your supervisees may have (see Constantine, 2003). Regardless, it is your responsibility to help supervisees build on the cultural competence skills they possess as well as to focus on their cultural competence deficits. It is important to initiate discussion of issues of culture, race, gender, sexual orientation, and the like in supervision to model the kinds of discussion you would like counselors to have with their clients. If these issues are not addressed in supervision, counselors may come to believe that it is inappropriate to discuss them with clients and have no idea how such dialog might proceed. These discussions prevent mis­ understandings with supervisees based on cultural or other factors. Another benefit from these discussions is that counselors will eventually achieve some level of comfort in talking about culture, race, ethnicity, and diversity issues.

If you haven’t done it as a counselor, early in your tenure as a supervisor you will want to examine your culturally influenced values, attitudes, experiences, and practices and to consider what effects they have on your dealings with supervisees and clients.

Counselors should undergo a similar review as preparation for when they have clients of a culture different from their own. Some questions to keep in mind are:

• What did you think when you saw the supervisee’s last name?

• What did you think when the supervisee said his or her culture is X, when yours is Y?

• How did you feel about this difference?

• What did you do in response to this difference?

Constantine (2003) suggests that supervisors can use the following questions with supervisees:

• What demographic variables do you use to identify yourself?

• What worldviews (e.g., values, assumptions, and biases) do you bring to supervision based on your cultural identities?

• What struggles and challenges have you faced working with clients who were from different cultures than your own?

Beyond self-examination, supervisor will want continuing education classes, workshops, and conferences that address cultural competence and other contextual factors. Community resources, such as community leaders, ministers, elders, and healers can contribute to your understanding of the culture your organization serves. Finally, supervisors (and counselors) should participate in multicultural activities, such as com­ munity events, discussion groups, religious festivals, and other ceremonies.

The supervisory relationship includes an inherent power differential, and it is important to pay attention to this disparity, particularly when the supervisee and the supervisor are from different cultural groups. A potential for the misuse of that power exists at all times but especially when working with supervisees and clients within multicultural contexts. When the supervisee is from a minority population and the supervisor is from a majority population, the differential can be exaggerated. You will want to prevent institutional discrimination from affecting the quality of supervision.

Ethical and Legal Issues

The supervisor is responsible for ethical and legal issues involving the Associate. First, you are responsible for upholding the highest standards of ethical, legal, and moral practices and for serving as a model of practice to supervisees. Further, you should be aware of and respond to ethical concerns. Part of your job is to help integrate solutions to everyday legal and ethical issues into clinical practice.

Some of the underlying assumptions of incorporating ethical issues into clinical supervision include:

• Ethical decision-making is a continuous, active process.

• Ethical standards are not a cookbook. They tell you what to do, not always how.

• Each situation is unique. Therefore, it is imperative that all personnel learn how to “think ethically” and how to make sound legal and ethical decisions.

• The most complex ethical issues arise in the context of two ethical behaviors that conflict; for instance, when a counselor wants to respect the privacy and confidentiality of a client, but it is in the client’s best interest for the counselor to contact someone else about his or her care.

• Therapy is conducted by fallible beings; people make mistakes—hopefully, minor ones.

• Sometimes the answers to ethical and legal questions are elusive. Ask a dozen people, and you’ll likely get twelve different points of view.

Supervisees should acquire resources on legal and ethical issues. Legal and ethical issues that are critical to clinical supervisors are many, but include (1) vicarious liability, (2) dual relationships and boundary concerns, (4) informed consent, (5) confidentiality, and (6) supervisor ethics.

Direct Versus Vicarious Liability

An important distinction needs to be made between direct and vicarious liability. Direct liability of the supervisor might include dereliction of supervisory responsibility, such as “not making a reasonable effort to supervise.”

In vicarious liability, a supervisor can be held liable for damages incurred as a result of negligence in the supervision process. Examples of negligence include providing inappropriate advice to a counselor about a client (for instance, discouraging a counselor from conducting a suicide screen on a depressed client), failure to listen carefully to a supervisee’s comments about a client, and the assignment of clinical tasks to inadequately trained counselors. The key legal question is: “Did the supervisor conduct herself in a way that would be reasonable for someone in her position?” or “Did the supervisor make a reasonable effort to supervise?” A generally accepted time standard for a “reasonable effort to supervise” in the behavioral health field is 1 hour of supervision for every 20–40 hours of clinical services. Of course, other variables (such as the quality and content of clinical supervision sessions) also play a role in a rea­ sonable effort to supervise.

Supervisory vulnerability increases when the counselor has been assigned too many clients, when there is no direct observation of a counselor’s clinical work, when staff are inexperienced or poorly trained for assigned tasks, and when a supervisor is not involved or not available to aid the clinical staff. In legal texts, vicarious liability is referred to as “respondeat superior.”

Dual Relationships and Boundary Issues

Dual relationships can occur at two levels: between supervisors and Associates and between Associates and clients. You have a mandate to maintain boundaries with the Associates you supervise, and help your supervisees recognize and manage boundary issues with clients. A dual relationship occurs in supervision when a supervisor has a primary professional role with a supervisee and, at an earlier time, simultaneously or later, engages in another relationship with the supervisee that transcends the professional relationship.

Examples of dual relationships in supervision include providing therapy for a current or former supervisee, developing an emotional relationship with a supervisee or former supervisee, or becoming sexually involved with a current Associate or within five years after supervision has terminated. Even after five years of cessation of supervision, the Supervisor must make sure the conduct is consensual, not the result of sexual exploitation, and not detrimental to the client. The licensee must demonstrate there has been no exploitation in light of all relevant factors, including, but not limited to:

(A) the amount of time that has passed since therapy terminated;

(B) the nature and duration of the therapy;

(C) the circumstances of termination;

(D) the client's, LPC Associate's, or student's personal history;

(E) the client's, LPC Associate's, or student's current mental status;

(F) the likelihood of adverse impact on the client, LPC Associate, or student and others; and

(G) any statements or actions made by the licensee during the course of therapy, supervision, or educational services suggesting or inviting the possibility of a post-termination sexual or romantic relationship with the client, LPC Associate, or student. There are many other Rules in the TAC applicable to sexual contact between supervisors and Associates. Supervisors should carefully consider and commit to upholding all of the Rules in the TAC before contemplating such contact with any Associate regardless of how much time has elapsed after supervision has ended. Also, keep in mind that According to Rule 681.93, LPC Supervisors; “must avoid any relationship that impairs the supervisor’s objective, professional judgment.”

Obviously, there are varying degrees of harm or potential harm that might occur as a result of dual relationships, and some negative effects of dual relationships might not be apparent until later.

You have the responsibility of weighing with the counselor the anticipated and unanticipated effects of dual relationships, helping the supervisee’s self-reflective awareness when boundaries become blurred, when he or she is getting close to a dual relationship, or when he or she is crossing the line in the clinical relationship.

Exploring dual relationship issues with counselors in clinical supervision can raise its own professional dilemmas. For instance, clinical supervision involves unequal status, power, and expertise between a supervisor and supervisee. Being the evaluator of a counselor’s performance and gatekeeper for training programs or credentialing bodies also might involve a dual relationship. Further, supervision can have therapy­like qualities as you explore countertransference issues with supervisees, and there is an expectation of professional growth and self-exploration. What makes a dual relationship unethical in supervision is the abusive use of power by either party, the likelihood that the relationship will impair or injure the supervisor’s or supervisee’s judgment, and the risk of exploitation.

One of the most common basis for legal action against counselors and the most frequently heard complaint by certification boards against counselors is some form of boundary violation or sexual impropriety.

Codes of ethics for most professions clearly advise that dual relationships between counselors and clients should be avoided. This topic must be stressed with Associates. Some, but not all, of the relevant Texas Administrative Code come from Rule 681.41:

►A licensee must not engage in activities for the licensee's personal gain at the expense of a client.

►A licensee must set and maintain professional boundaries.

►Except as provided by this subchapter, non-therapeutic relationships with clients are prohibited.

• A non-therapeutic relationship is any non-counseling activity initiated by either the licensee or client that results in a relationship unrelated to therapy.

• A licensee may not engage in a non-therapeutic relationship with a client if the relationship begins less than two (2) years after the end of the counseling relationship; the non-therapeutic relationship must be consensual, not the result of exploitation by the licensee, and is not detrimental to the client.

• A licensee may not engage in sexual contact with a client if the contact begins less than five (5) years after the end of the counseling relationship; the non-therapeutic relationship must be consensual, not the result of exploitation by the licensee, and is not detrimental to the client.

Dual relationships between counselors and supervisors are also a concern and are addressed in the counselors’ codes and those of other professions as well. Problematic dual relationships between supervisees and supervisors might include intimate relationships (sexual and non­sexual) and therapeutic relationships, wherein the supervisor becomes the counselor’s therapist. Sexual involvement, referred to as sexual contact, sexual exploitation and therapeutic deception in the TAC, between the supervisor and supervisee can include sexual attraction, harassment, consensual (but hidden) sexual relationships, or intimate romantic relationships. Other common boundary issues include asking the supervisee to do favors, providing preferential treatment, socializing outside the work setting, and using emotional abuse to enforce power.

It is imperative that all parties understand what constitutes a dual relationship between supervisor and supervisee and avoid these dual relationships. Sexual relationships between supervisors and supervisees and counselors and clients occur far more frequently than one might realize (Falvey, 2002b). In many States, they constitute a legal transgression as well as an ethical violation.

The decision tree presented in figure 5 indicates how a supervisor might manage a situation where he or she is concerned about a possible ethical or legal violation by a counselor.

Informed Consent

Informed consent is key to protecting the counselor and/or supervisor from legal concerns, requiring the recipient of any service or intervention to be sufficiently aware of what is to happen, and of the potential risks and alternative approaches, so that the person can make an informed and intelligent decision about participating in that service. The supervisor must inform the supervisee about the process of supervision, the feedback and evaluation criteria, and other expectations of supervision. The supervision contract should clearly spell out these issues.

Supervisors must ensure that the supervisee has informed the client about the parameters of counseling and supervision (such as the use of live observation, video­ or audiotaping).

Confidentiality

In supervision, regardless of whether there is a written or verbal contract between the supervisor and supervisee, there is an implied contract and duty of care because of the supervisor’s vicarious liability. Informed consent and concerns for confidentiality should occur at three levels: client consent to treatment, client consent to supervision of the case, and supervisee consent to supervision (Bernard & Goodyear, 2004). In addition, there is an implied consent and commitment to confidentiality by supervisors to assume their supervisory responsibilities and institutional consent to comply with legal and ethical parameters of supervision.

With informed consent and confidentiality comes a duty not to disclose certain relational communication. Limits of confidentiality of supervision session content should be stated in all organizational contracts with training institutions and credentialing bodies.

Criteria for waiving client and supervisee privilege should be stated in institutional policies and discipline-specific codes of ethics and clarified by advice of legal counsel and the courts. Because standards of confidentiality are determined by State legal and legislative systems, it is prudent for supervisors to consult with an attorney to determine the State codes of confidentiality and clinical privileging.

Supervisors need to train counselors in confidentiality regulations and to adequately document their supervision, including discussions and directives, and inform clients of the limits of confidentiality as part of the agency’s informed consent procedures.

Organizations should have a policy stating how clinical crises will be handled. What mechanisms are in place for responding to crises? In what timeframe will a supervisor be notified of a crisis situation? Supervisors must document all discussions with counselors concerning crises and limits on confidentiality.

New technology brings new confidentiality concerns. Websites now dispense information about substance abuse treatment and provide counseling services.

With the growth in online counseling and supervision, the following concerns emerge: (a) how

to maintain confidentiality of information, (b) how to ensure the competence and qualifications of counselors pro­ viding online services, and (c) how to establish reporting requirements and duty to warn when services are conducted across State and international boundaries. New standards will need to be written to address these issues.

Supervisor Ethics

In general, supervisors adhere to the same standards and ethics as counselors with regard to dual relationship and other boundary violations.

Supervisors will:

• Uphold the highest professional standards of the field.

• Seek professional help (outside the work setting) when personal issues interfere with their clinical and/or supervisory functioning.

• Conduct themselves in a manner that models and sets an example for agency mission, vision, philosophy, wellness, recovery, and consumer satisfaction.

• Reinforce zero tolerance for interactions that are not professional, courteous, and compassionate.

• Treat supervisees, colleagues, peers, and clients with dignity, respect, and honesty.

• Adhere to the standards and regulations of confidentiality as dictated by the field. This applies to the supervisory as well as the counseling relationship.

Monitoring Performance

The goal of supervision is to ensure quality care for the client, which entails monitoring the clinical performance of staff. Your first step is to educate supervisees in what to expect from clinical supervision.

Once the functions of supervision are clear, you should regularly evaluate the counselor’s progress in meeting organizational and clinical goals as set forth in an Individual Development Plan (IDP) (see the section on IDPs below). As clients have an individual treatment plan, counselors also need a plan to promote skill development.

Behavioral Contracting in Supervision

Among the first tasks in supervision is to establish a contract for supervision that outlines realistic accountability for both yourself and your supervisee. The contract should be in writing and should include the purpose, goals, and objectives of supervision; the context in which supervision is provided; ethical and institutional policies that guide supervision and clinical practices; the criteria and methods of evaluation and outcome measures; the duties and responsibilities of the supervisor and supervisee; procedural considerations (including the format for taping and opportunities for live observation); and the supervisee’s scope of practice and competence. The contract for supervision should state the length of supervision sessions, and sanctions for noncompliance by either the supervisee or supervisor. The agreement should be compatible with the developmental needs of the supervisee and address the obstacles to progress (lack of time, performance anxiety, resource limitations). An example of a contract that incorporates areas to consider:

Once a behavioral contract has been established, the next step is to develop an IDP.

Individual Development Plan

The IDP is a detailed plan for supervision that includes the goals that you and the Associate wish to address over a certain time period. Each of you should sign and keep a copy of the IDP for your records. The goals are normally stated in terms of skills the counselor wishes to build or professional resources the counselor wishes to develop. These skills and resources are generally oriented to the counselor’s job in the program or activities that would help the counselor develop professionally. The IDP should specify the timelines for change, the observation methods that will be employed, expectations for the supervisee and the supervisor, the evaluation procedures that will be employed, and the activities that will be expected to improve knowledge and skills.

As a supervisor, you should have your own IDP, based on the supervisory competencies that addresses your training goals. This IDP can be developed in cooperation with your supervisor, or in external supervision, peer input, academic advisement, or mentorship.

Evaluation of LPC Associates

Supervision inherently involves evaluation, building on a collaborative relationship between you and the Associate. Evaluation may not be easy for some supervisors. Although everyone wants to know how they are doing, counselors are not always comfortable asking for feedback. And, as most supervisors prefer to be liked, you may have difficulty giving clear, concise, and accurate evaluations to staff.

The two types of evaluation are formative and summative. A formative evaluation is an ongoing status report of the counselor’s skill development, exploring the questions “Are we addressing the skills or competencies you want to focus on?” and “How do we assess your current knowledge and skills and areas for growth and development?”

Summative evaluation is a more formal rating of the counselor’s overall performance, fitness for the full licensure, and job rating. It answers the question, “How does the counselor measure up?” Typically, summative evaluations are done annually and focus on the counselor’s overall strengths, limitations, and areas for future improvement.

It should be acknowledged that supervision is inherently an unequal relationship. In most cases, the supervisor has positional power over the counselor. Therefore, it is important to establish clarity of purpose and a positive context for evaluation. Procedures should be spelled out in advance, and the evaluation process should be mutual, flexible, and continuous.

The evaluation process inevitably brings up supervisee anxiety and defensiveness that need to be addressed openly. It is also important to note that each individual counselor will react differently to feedback; some will be more open to the process than others.

There has been considerable research on supervisory evaluation, with these findings:

• The supervisee’s confidence and efficacy are correlated with the quality and quantity of feedback the supervisor gives to the supervisee (Bernard & Goodyear, 2004).

• Ratings of skills are highly variable between supervisors, and often the supervisor’s and supervisee’s ratings differ or conflict (Eby, 2007).

• Good feedback is provided frequently, clearly, and consistently and is SMART (specific, measurable, attainable, realistic, and timely) (Powell & Brodsky, 2004).

Direct observation of the counselor’s work is the desired form of input for the supervisor. Although direct observation is not always possible, ethical and legal considerations and evidence support that direct observation as preferable. One of the least desirable feedback is unannounced observation by supervisors followed by vague, perfunctory, indirect, or hurtful delivery.

Clients are often the best assessors of the skills of the counselor. Supervisors should routinely seek input from the clients as to the outcome of treatment. The method of seeking input should be discussed in the initial supervisory sessions and be part of the supervision contract. In an inpatient setting, you might regularly meet with clients after sessions to discuss how they are doing, how effective the counseling is, and the quality of the therapeutic alliance with the counselor.

Before formative evaluations begin, methods of evaluating performance should be discussed, clarified in the initial sessions, and included in the initial contract so that there will be no surprises. Formative evaluations should focus on changeable behavior and, whenever possible, be separate from the overall annual performance appraisal process. To determine the counselor’s skill development, you should use written competency tools, direct observation, counselor self-assessments, client evaluations, work samples (files and charts), and peer assessments. It is important to acknowledge that counselor evaluation is essentially a subjective process involving supervisors’ opinions of the counselors’ competence.

Addressing Burnout and Compassion Fatigue

Did you ever hear a counselor say, “I came into counseling for the right reasons. At first I loved seeing clients. But the longer I stay in the field, the harder it is to care. The joy seems to have gone out of my job. Should I get out of counseling as many of my colleagues are doing?” Most counselors come into the field with a strong sense of calling and the desire to be of service to others, with a strong pull to use their gifts and make themselves instruments of service and healing. The counseling field risks losing many skilled and compassionate licensees when the life goes out of their work. Some counselors simply withdraw, care less, or get out of the field entirely. Many just complain or suffer in silence. Given the caring and dedication that brings counselors into the field, it is important for you to help them address their questions and doubts.

You can help counselors with self­care; help them look within; become resilient again; and rediscover what gives them joy, meaning, and hope in their work. Counselors need time for reflection, to listen again deeply and authentically. You can help them redevelop their innate capacity for compassion, to be an openhearted presence for others.

You can help counselors develop a life that does not revolve around work. This has to be supported by the organization’s culture and policies that allow for appropriate use of time off and self­care without punishment. Aid them by encouraging them to take earned leave and to take “mental health” days when they are feeling tired and burned out. Remind staff to spend time with family and friends, exercise, relax, read, or pursue other life­giving interests.

It is important for the clinical supervisor to normalize the counselor’s reactions to stress and compassion fatigue in the workplace as a natural part of being an empathic and compassionate person and not an individual failing or pathology. (See Burke, Carruth, & Prichard, 2006.)

Rest is good; self­care is important. Everyone needs times of relaxation and recreation. Often, a month after a refreshing vacation you lose whatever gain you made. Instead, longer term gain comes from finding what brings you peace and joy. It is not enough for you to help counselors understand “how” to coun­ sel, you can also help them with the “why.” Why are they in this field? What gives them meaning and pur­ pose at work? When all is said and done, when coun­ selors have seen their last client, how do they want to be remembered? What do they want said about them as counselors? Usually, counselors’ responses to this question are fairly simple: “I want to be thought of as a caring, compassionate person, a skilled helper.” These are important spiritual questions that you can discuss with your supervisees.

Other suggestions include:

• Help staff identify what is happening within their organization or place of employment that might be contributing to their stress and learn how to address the situation in a way that is productive to the client, the counselor, and the organization.

• Get training in identifying the signs of primary stress reactions, secondary trauma, compassion fatigue, vicarious traumatization, and burnout. Help staff match up self­care tools to specifically address each of these experiences.

• Support staff in advocating for organizational change when appropriate and feasible as part of your role as liaison between administration and clinical staff.

• Assist staff in adopting lifestyle changes to increase their emotional resilience by reconnecting to their world (family, friends, sponsors, mentors), spending time alone for self­reflection, and forming habits that re­energize them.

• Help them eliminate the “what ifs” and negative self­talk. Help them let go of their idealism that they can save the world.

• If possible in the current work environment, set parameters on their work by helping them adhere to scheduled time off, keep lunch time personal, set reasonable deadlines for work completion, and keep work away from personal time.

• Teach and support generally positive work habits. Some counselors lack basic organizational, team­ work, phone, and time management skills (ending sessions on time and scheduling to allow for docu­ mentation). The development of these skills helps to reduce the daily wear that erodes well­being and contributes to burnout.

• Ask them “When was the last time you had fun?” “When was the last time you felt fully alive?” Suggest they write a list of things about their job about which they are grateful. List five people they care about and love. List five accomplish­ ments in their professional life. Ask “Where do you want to be in your professional life in 5 years?”

You have a fiduciary responsibility given you by clients to ensure counselors are healthy and whole. It is your responsibility to aid counselors in addressing their fatigue and burnout.

Gatekeeping Functions

In monitoring counselor performance, an important and often difficult supervisory task is managing problem Associates who should not be counselors. This is the gatekeeping function. Part of the dilemma is that most likely you were first trained as a counselor, and your values lie within that domain. You were taught to acknowledge and work with individual limitations, always respecting the individual’s goals and needs. However, you also carry a responsibility to maintain the quality of the profession and to protect the welfare of clients. Thus, you are charged with the task of assessing the counselor for fitness for duty and have an obligation to uphold the standards of the profession.

Experience, credentials, and academic performance are not the same as clinical competence. In addition to technical counseling skills, many important therapeutic qualities affect the outcome of counseling, including insight, respect, genuineness, concreteness, and empathy. Research consistently demonstrates that personal characteristics of counselors are highly predictive of client outcome (Herman, 1993, Hubble, Duncan & Miller, 1999). The essential questions are: Who should or should not be a counselor? What behaviors or attitudes are unacceptable? How would a clinical supervisor address these issues in supervision?

Unacceptable behavior might include actions hurtful to the client, boundary violations with clients or program standards, illegal behavior, significant psychiatric impairment, consistent lack of self­awareness, inability to adhere to professional codes of ethics, or consistent demonstration of attitudes that are not conducive to work with clients in certain populations. You will want to have a model and policies and procedures in place when disciplinary action is undertaken with an impaired counselor. For example, progressive disciplinary policies clearly state the procedures to follow when impairment is identified. Consultation with the organization’s attorney and familiarity with State case law are important. It is advisable for the agency to be familiar with and have contact with your State impaired counselor organization, if it exists.

How impaired must a counselor be before disciplinary action is needed? Clear job descriptions and statements of scope of practice and competence are important when facing an impaired counselor. How tired or distressed can a counselor be before a supervisor takes the counselor off­line for these or similar reasons? You need administrative support with such interventions and to identify approaches to managing worn-out counselors. It is recommended that your organization have an employee assistance program (EAP) in place so you can refer staff outside the agency. It is also important for you to learn the distinction between a supervisory referral and a self-referral. Self-referral may include a recommendation by the supervisor, whereas a supervisory referral usually occurs with a job performance problem.

You will need to provide verbal and written evaluations of the counselor’s performance and actions to ensure that the staff member is aware of the behaviors that need to be addressed. Treat all supervisees the same, following agency procedures and timelines. Follow the organization’s progressive disciplinary steps and document carefully what is said, how the person responds, and what actions are recommended. You can discuss organizational issues or barriers to action with the supervisee (such as personnel policies that might be exacerbating the employee’s issues).

Finally, it may be necessary for you to take the action that is in the best interest of the clients and the profession, which might involve counseling your supervisee out of the field.

Remember that the number one goal of a clinical supervisor is to protect the welfare of the client, which, at times, can mean enforcing the gatekeeping function of supervision.

Methods of Observation

It is important to observe counselors frequently over an extended period of time. Supervisors often rely on indirect methods of supervision (process recordings, case notes, verbal reports by the supervisees, and verbatims). However, it is recommended that supervisors use direct observation of counselors, or live webcams. Make sure beforehand that the devices (phone, desktop, laptop, etc) you may use for recording sessions are secure and confidential and allowed by your employer and the State Board. Also, make sure the client has understood and signed the informed consent for video recordings. Indirect methods have significant drawbacks, including:

• A counselor will recall a session as he or she experienced it. If a counselor experiences a session positively or negatively, the report to the supervisor will reflect that. The report is also affected by the counselor’s level of skill and experience.

• The counselor’s report is affected by his or her biases and distortions (both conscious and unconscious). The report does not provide a thorough sense of what really happened in the session because it relies too heavily on the counselor’s recall.

• Indirect methods include a time delay in reporting.

• The supervisee may withhold clinical information due to evaluation anxiety or naiveté.

Your understanding of the session will be improved by direct observation of the counselor.

Guidelines that apply to methods of direct observation in supervision include:

• Simply by observing a counseling session, the dynamics will change. You may change how both the client and counselor act. You get a snapshot of the sessions. Counselors will say, “it was not a representative session.” Typically, if you observe the counselor frequently, you will get a fairly accurate picture of the counselor’s competencies.

• You and your supervisee must agree on procedures for observation to determine why, when, and how direct methods of observation will be used.

• The counselor should provide a context for the session.

• The client should give written consent for observation and/or video and/or audio taping at intake, before beginning counseling. Clients must know all the conditions of their treatment before they consent to counseling. Additionally, clients need to be notified of an upcoming observation by a supervisor before the observation occurs.

• Observations should be selected for review (including a variety of sessions and clients, challenges, and successes) because they provide teaching moments. You should ask the supervisee to select what cases he or she wishes you to observe and explain why those cases were chosen. Direct observation should not be a weapon for criticism but a constructive tool for learning: an opportunity for the counselor to do things right and well, so that positive feedback follows.

• When observing a session, you gain a wealth of information about the counselor. Use this information wisely, and provide gradual feedback, not a litany of judgments and directives. Ask the salient question, “What is the most important issue here for us to address in supervision?”

• A supervisee might claim client resistance to direct observation, saying, “It will make the client nervous. The client does not want to be taped.” However, “client resistance” is more likely to be reported when the counselor is anxious about being recorded. It is important for you to gently and respectfully address the supervisee’s resistance while maintaining the position that direct observation is an integral component of his or her supervision.

• The supervisee should know at the outset that observation and/or taping will be required as part of informed consent to supervision.

It is critical to note that even if permission is initially given by the client, this permission can be withdrawn. You cannot force compliance. The use and rationale for taping needs to be clearly explained to clients. This will forestall a client’s questioning as to why a particular session is being taped.

Too often, supervisors watch long, uninterrupted segments of tape with little direction or purpose. To avoid this, you may want to ask your supervisee to cue the tape to the segment he or she wishes to address in supervision, focusing on the goals established in the IDP. Having said this, listening only to segments selected by the counselor can create some of the same disadvantages as self-report: the counselor chooses selectively, even if not consciously. The supervisor may occasionally choose to watch entire sessions. You need to evaluate session flow, pacing, and how counselors begin and end sessions.

Live Observation

With live observation you actually sit in on a counseling session with the supervisee and observe the session first hand. The client will need to provide informed consent before being observed. Although one-way mirrors are not readily available at most agencies, they are an alternative to actually sitting in on the session. A videotape may also be used either from behind the one-way mirror (with someone else operating the videotaping equipment) or physically located in the counseling room, with the supervisor sitting in the session. This combination of mirror, videotaping, and live observation may be the best of all worlds, allowing for unobtrusive observation of a session, immediate feedback to the supervisee, modeling by the supervisor (if appropriate), and a record of the session for subsequent review in supervision. Live supervision may involve some intervention by the supervisor during the session.

Live observation is effective for the following reasons:

• It allows you to get a true picture of the counselor in action.

• It gives you an opportunity to model techniques during an actual session, thus serving as a role model for both the counselor and the client.

• Should a session become countertherapeutic, you can intervene for the well­being of the client.

• Counselors often say they feel supported when a supervisor joins the session, and clients may also appreciate the added staff.

• It allows for specific and focused feedback.

• It is more efficient for understanding the counseling process.

• It helps connect the IDP to supervision.

To maximize the effectiveness of live observation, supervisors must stay primarily in an observer role so as to not usurp the leadership or undercut the credibility and authority of the counselor.

Live observation has some disadvantages:

• It is time consuming.

• It can be intrusive and alter the dynamics of the counseling session.

• It can be anxiety-provoking for all involved.

Some mandated clients may be particularly sensitive to live observation. This becomes essentially a clinical issue to be addressed by the counselor with the client. Where is this anxiety coming from, how does it relate to other anxieties and concerns, and how can it best be addressed in counseling?

Supervisors differ on where they should sit in a live observation session. Some suggest that the supervisor sit so as to not interrupt or be involved in the session. Others suggest that the supervisor sit in a position that allows for inclusion in the counseling process.

Here are some guidelines for conducting live observation:

• The counselor should always begin with informed consent to remind the client about confidentiality. Periodically, the counselor should begin the session with a statement of confidentiality, reiterating the limits of confidentiality and the duty to warn, to ensure that the client is reminded of what is reportable by the supervisor and/or counselor.

• While sitting outside the group (or an individual session between counselor and client) may undermine the group process, it is a method selected by some. Position yourself in a way that doesn’t interrupt the counseling process. Sitting outside the group undermines the human connection between you, the counselor, and the client(s) and makes it more awkward for you to make a comment, if you have not been part of the process until then. For individual or family sessions, it is also recommended that the supervisor sit beside the counselor to fully observe what is occurring in the counseling session.

• The client should be informed about the process of supervision and the supervisor’s role and goals, essentially that the supervisor is there to observe the counselor’s skills and not necessarily the client.

• As preparation, the supervisor and supervisee should briefly discuss the background of the session, the salient issues the supervisee wishes to focus on, and the plans for the session. The role of the supervisor should be clearly stated and agreed on before the session.

• You and the counselor may create criteria for observation, so that specific feedback is provided for specific areas of the session.

• Your comments during the session should be limit­ ed to lessen the risk of disrupting the flow or taking control of the session. Intervene only to protect the welfare of the client (should something adverse occur in the session) or if a moment critical to client welfare arises. In deciding to intervene or not, consider these questions: What are the consequences if I don’t intervene? What is the probability that the supervisee will make the intervention on his or her own or that my comments will be successful? Will I create an undue dependence on the part of clients or supervisee?

• Provide feedback to the counselor as soon as possible after the session. Ideally, the supervisor and supervisee(s) should meet privately immediately afterward, outlining the key points for discussion and the agenda for the next supervision session, based on the observation. Specific feedback is essential; “You did a fine job” is not sufficient. Instead, the supervisor might respond by saying, “I particularly liked your comment about . . .” or “What I observed about your behavior was . . .” or “Keep doing more of ”

Practical Issues in Clinical Supervision

Distinguishing Between Supervision and Therapy

In facilitating professional development, one of the critical issues is understanding and differentiating between counseling the counselor and providing supervision. In ensuring quality client care and facilitating professional counselor development, the process of clinical supervision sometimes encroaches on personal issues. The dividing line between therapy and supervision is how the supervisee’s personal issues and problems affect their work. The goal of clinical supervision must always be to assist counselors in becoming better clinicians, not seeking to resolve their personal issues. Some of the major differences between supervision and counseling are summarized in this figure:

The boundary between counseling and clinical supervision may not always be clearly marked, for it is necessary, at times, to explore supervisees’ limitations as they deliver services to their clients. Address counselors’ personal issues only in so far as they create barriers or affect their performance. When personal issues emerge, the key question you should ask the supervisee is how does this affect the delivery of quality client care? What is the impact of this issue on the client? What resources are you using to resolve this issue outside of the counseling dyad? When personal issues emerge that might interfere with quality care, your role may be to transfer the case to a different counselor. Most important, you should make a strong case that the supervisee should seek outside counseling or therapy.

Problems related to countertransference (projecting unresolved personal issues onto a client or supervisee) often make for difficult therapeutic relationships. The following are signs of countertransference to look for:

• A feeling of loathing, anxiety, or dread at the prospect of seeing a specific client or supervisee.

• Unexplained anger or rage at a particular client.

• Distaste for a particular client.

• Mistakes in scheduling clients, missed appointments.

• Forgetting client’s name, history.

• Drowsiness during a session or sessions ending abruptly.

• Billing mistakes.

• Excessive socializing.

When countertransferential issues between counselor and client arise, some of the important questions you, as a supervisor, might explore with the counselor include:

• How is this client affecting you? What feelings does this client bring out in you? What is your behavior toward the client in response to these feelings? What is it about the substance abuse behavior of this client that brings out a response in you?

• What is happening now in your life, but more particularly between you and the client that might be contributing to these feelings, and how does this affect your counseling?

• In what ways can you address these issues in your counseling?

• What strategies and coping skills can assist you in your work with this client?

Transference and countertransference also occur in the relationship between supervisee and supervisor. Examples of supervisee transference include:

• The supervisee’s idealization of the supervisor.

• Distorted reactions to the supervisor based on the supervisee’s reaction to the power dynamics of the relationship.

• The supervisee’s need for acceptance by or approval from an authority figure.

• The supervisee’s reaction to the supervisor’s establishing professional and social boundaries with the supervisee.

Supervisor countertransference with supervisees is another issue that needs to be considered. Categories of supervisor countertransference include:

• The need for approval and acceptance as a knowledgeable and competent supervisor.

• Unresolved personal conflicts of the supervisor activated by the supervisory relationship.

• Reactions to individual supervisees, such as dislike or even disdain, whether the negative response is “legitimate” or not. In a similar vein, aggrandizing and idealizing some supervisees (again, whether or not warranted) in comparison to other supervisees.

• Sexual or romantic attraction to certain supervisees.

• Cultural countertransference, such as catering to or withdrawing from individuals of a specific cultural background in a way that hinders the professional development of the counselor.

To understand these countertransference reactions means recognizing clues (such as dislike of a supervisee or romantic attraction), doing careful self­examination, personal counseling, and receiving supervision of your supervision. In some cases, it may be necessary for you to request a transfer of supervisees with whom you are experiencing countertransference, if that countertransference hinders the counselor’s professional development.

Finally, counselors will be more open to addressing difficulties such as countertransference and compassion fatigue with you if you communicate understand­ ing and awareness that these experiences are a nor­ mal part of being a counselor. Counselors should be rewarded in performance evaluations for raising these issues in supervision and demonstrating a will­ ingness to work on them as part of their professional development.

Balancing Clinical and Administrative Functions

In some agencies that provide counseling, the clinical supervisor may also be the administrative supervisor, responsible for overseeing managerial functions of the organization. Many organizations cannot afford to hire two individuals for these tasks. Hence, it is essential that you are aware of what role you are playing and how to exercise the authority given you by the administration. Texts on supervision sometimes overlook the supervisor’s administrative tasks, but supervisors structure staff work; evaluate personnel for pay and promotions; define the scope of clinical competence; perform tasks involving planning, organizing, coordinating, and delegating work; select, hire, and fire personnel; and manage the organization. Clinical supervisors are often responsible for overseeing the quality assurance and improvement aspects of the agency and may also carry a case­ load. For most of you, juggling administrative and clinical functions is a significant balancing act. Tips for juggling these functions include:

• Try to be clear about the “hat you are wearing.” Are you speaking from an administrative or clinical perspective?

• Be aware of your own biases and values that may be affecting your administrative opinions.

• Delegate the administrative functions that you need not necessarily perform, such as human resources, financial, or legal functions.

• Get input from others to be sure of your objectivity and your perspective.

There may be some inherent problems with performing both functions, such as dual relationships. Counselors may be cautious about acknowledging difficulties they face in counseling because these may affect their performance evaluation or salary raises.

On the other hand, having separate clinical and administrative supervisors can lead to inconsistent messages about priorities, and the clinical supervisor is not in the chain of command for disciplinary purposes.

Finding the Time To Do Clinical Supervision

Having read this far, you may be wondering, “Where do I find the time to conduct clinical supervision as described here and in the Rules of the Texas Administrative Code?” If you are already supervising Associates, you know that the responsibility is vast and requires significant organization skills. The documentation requirements of Rule 681.93 alone confirm this fact. How can LPC Supervisors comply? LPC Associates must receive at least four hours of direct supervision per month according to TAC 681.92. Some individuals with the Supervisor status may recognize their inability to provide quality supervision that meets the many demands and opt not to supervise Associates until they have the time to do so.

One suggestion to save time is to take advantage of the parameters set forth for supervision in Rule 681.92 where individual supervision can include up to two LPC Associates. At least 50% of supervision hours must consist of individual supervision. The other 50% can be in group supervision involving three or more Associates. In group supervision, time can be maximized by teaching and training counselors who have common skill development needs.

As you develop a positive relationship with supervisees based on cooperation and collaboration, the anxiety associated with observation will decrease. Counselors frequently enjoy the feedback and support so much that they request observation of their work. Observation can be brief. Rather than sitting in on a full hour of group, spend 20 minutes in the observation and an additional 20 providing feedback to the counselor.

Group clinical supervision is a frequently used and efficient format for supervision. The recommended group size is four to six persons to allow for frequent case presentations by each group member. With this number of Associates, each person can present a case every other month—an ideal situation, especially when combined with individual supervision. The benefits of group supervision are that it is cost effective, members can test their perceptions through peer validation, learning is enhanced by the diversity of the group, it creates a working alliance and improves teamwork if the Associates are co-workers, and it provides a microcosm of group process for participants.

The plan described below may be a useful structure for supervision. It is based on a scenario where a supervisor oversees one to five counselors. This plan is based on several principles:

• Supervisees will receive at least 1 hour of supervision for every 20 to 40 hours of clinical practice.

• Direct observation is the backbone of a solid clinical supervision model.

• Group supervision is a viable means of engaging all staff in dialog, sharing ideas, and promoting team cohesion.

Documenting Clinical Supervision

TAC Rule 681.93 requires that LPC Supervisors review with Associates all provisions of the Act and Council rules in TAC, Chapter 681, during supervision. The “Act” refers to Texas Occupations Code, Chapter 503, also known as the Licensed Professional Counselor Act. This requirement alone will dictate many of the issues discussed during supervision. It is recommended that Supervisors document that each section is covered. It should be noted that Rules found in TAC, Title 22, Part 41, pertaining to the Texas Behavioral Health Executive Council, should also be covered. These rules can be found in the Consolidated Rulebook for Professional Counseling found at the BHEC website. The Rules found in Part 41 are not always included in Part 30 specific to Professional Counselors. For instance, the rule pertaining to display of license, as well as the human trafficking course required for license renewal, are mentioned in Rules 882.30 and 883.1 respectively, but not mentioned in Chapter 681. The Supervision Hours Log form mentioned earlier in this text and found at the BHEC website, may provide an example form for documenting the many required topics to be covered. However, this form does not prescribe specific, required topics that must be included in supervision. A few of many topics should include:

• Instruction on TAC Chapters 681 and 881

• Informal and formal evaluation procedures.

• Frequency of supervision, issues discussed, and the content and outcome of sessions.

• Due process rights of supervisees (such as the right to confidentiality and privacy, to informed consent).

• Risk management issues (how to handle crises situations, breaches of confidentiality, etc).

• Evidence Based Practices and its application to specific clients seen by Associates.

Structuring the Initial Supervision Sessions

As discussed earlier, your first tasks in clinical supervision are to establish a behavioral contract, get to know your supervisees, and outline the requirements of supervision. Before the initial session, you should send a supportive communication to the supervisee expressing your desire to provide him or her with a quality clinical supervision experience. You might request that the counselor give some thought to what he or she would like to accomplish in supervision, what skills to work on, and which core functions used in the addiction counselor certification process he or she feels most comfortable performing.

In the first few sessions, helpful practices include:

• Briefly describe your role as both administrative and clinical supervisor (if appropriate) and discuss these distinctions with the counselor.

• Briefly describe your model of counseling and learn about the counselor’s frameworks and models for her or his counseling practice.

• Describe your model of supervision.

• State that disclosure of one’s supervisory training, experience, and model is an ethical duty of clinical supervisors.

• Discuss methods of supervision, the techniques to be used, and the resources available to the supervisee (e.g., agency in-service seminar, community workshops, professional association memberships, and professional development funds or training opportunities).

• Explore the counselor’s goals for supervision and his or her particular interests (and perhaps some fears) in clinical supervision.

• Explain the differences between supervision and therapy, establishing clear boundaries in this relationship.

• Work to establish a climate of cooperation, collaboration, trust, and safety.

• Create an opportunity for rating the counselor’s knowledge and skills.

• Explain the methods by which formative and summative evaluations will occur.

• Discuss the legal and ethical expectations and responsibilities of supervision.

• Take time to decrease the anxiety associated with being supervised and build a positive working relationship.

It is important to determine the knowledge and skills, learning style, and conceptual skills of your supervisees, along with their suitability for the work setting, motivation, self-awareness, and ability to function autonomously. A basic IDP for each supervisee should emerge from the initial supervision sessions. You and your supervisee need to assess the learning environment of supervision by determining:

• Is there sufficient challenge to keep the supervisee motivated?

• Are the theoretical differences between you and the supervisee manageable?

• Are there limitations in the supervisee’s knowledge and skills, personal development, self-efficacy, self-esteem, and investment in the job that would limit the gains from supervision?

• Does the supervisee possess the affective qualities (empathy, respect, genuineness, concreteness, warmth) needed for the counseling profession?

• Are the goals, means of supervision, evaluation criteria, and feedback process clearly understood by the supervisee?

• Does the supervisory environment encourage and allow risk taking?

Methods and Techniques of Clinical Supervision

A number of methods and techniques are available for clinical supervision, regardless of the modality used. Methods include (as discussed previously) case consultation, written activities such as verbatims and process recordings, audio and videotaping, and live observation. Techniques include modeling, skill demonstrations, and role playing. Figure 8 outlines some of the methods and techniques of supervision, as well as the advantages and disadvantages of each method.

The context in which supervision is provided affects how it is carried out. A critical issue is how to manage your supervisory workload and make a reasonable effort to supervise. The contextual issues that shape the techniques and methods of supervision include:

• The allocation of time for supervision. If the 20:1 rule of client hours to supervision time is followed, you will want to allocate sufficient time for supervision each week so that it is a high priority, regularly scheduled activity.

• The unique conditions, limitations, and requirements of the agency. Some organizations may lack the physical facilities or hardware to use videotaping or to observe sessions. Some organizations may be limited by confidentiality requirements, such as working within a criminal justice system where taping may be prohibited.

• The number of supervisees reporting to a supervisor. It is often difficult to provide the scope of supervision needed if a supervisor has more than ten supervisees.

• Clinical and management responsibilities of a supervisor. Supervisors have varied responsibilities, including administrative tasks, limiting the amount of time available for clinical supervision.

Figure 8 Continued:

Figure 8 Continued

Administrative Supervision

As noted above, clinical and administrative supervision overlap in the real world. Most clinical supervisors also have administrative responsibilities, including team building, time management, addressing agency policies and procedures, recordkeeping, human resources management (hiring, firing, disciplining), performance appraisal, meeting management, oversight of accreditation, maintenance of legal and ethical standards, compliance with State and Federal regulations, communications, overseeing staff cultural competence issues, quality control and improvement, budgetary and financial issues, problem solving, and documentation. Keeping up with these duties is not an easy task!

Documentation for Administrative Purposes

One of the most important administrative tasks of a supervisor is that of documentation and recordkeeping, especially of clinical supervision sessions. Obviously, there are certain documentation requirements of LPC Supervisors as indicated in the Texas Administrative Code already discussed. If your supervisee(s) work at the same facility, you will probably have additional requirements required by your employer.

Unquestionably, documentation is a crucial risk-management tool. Supervisory documentation can help promote the growth and professional development of the counselor. However, adequate documentation is not a high priority in some organizations. For example, when disciplinary action is needed with an employee, your organization’s attorney or human resources department will ask for the paper trail, or documentation of prior performance issues. If appropriate documentation to justify disciplinary action is missing from the employee’s record, it may prove more difficult to conduct the appropriate disciplinary action.

Documentation is no longer an option for supervisors. It is a critical link between work performance and service delivery. You have a legal and ethical requirement to evaluate and document counselor performance. A complete record is a useful and necessary part of supervision. Records of supervision sessions should include:

• The supervisor–supervisee contract, signed by both parties.

• A brief summary of the supervisee’s experience, training, and learning needs.

• The current IDP.

• A summary of all performance evaluations.

• Notations of all supervision sessions, including cases discussed and significant decisions made.

• Notation of cancelled or missed supervision sessions.

• Progressive discipline steps taken.

• Significant problems encountered in supervision and how they were resolved.

• Supervisor’s clinical recommendations provided to supervisees.

• Relevant case notes and impressions.

The following should not be included in a supervision record:

• Disparaging remarks about staff or clients.

• Extraneous or sensitive supervisee information.

• Alterations in the record after the fact or prema­ ture destruction of supervision records.

• Illegible information and nonstandard abbreviations.

Time Management

By some estimates, people waste about two hours every day doing tasks that are not of high priority. In your busy job, you may find yourself at the end of the week with unfinished tasks or matters that have not been tended to. Your choices? Stop performing some tasks (often training or supervision) or take work home and work longer days. In the long run, neither of these choices is healthy or effective for your organi­ zation. Yet, being successful does not make you man­ age your time well. Managing your time well makes you successful. Ask yourself these questions about your priorities:

• Why am I doing this? What is the goal of this activity?

• How can I best accomplish this task in the least amount of time?

• What will happen if I choose not to do this?

It is wise to develop systems for managing time wasters such as endless meetings held without notes or minutes, playing telephone or email tag, junk mail, and so on. Effective supervisors find their times in the day when they are most productive. Time management is essential if you are to set time aside and dedicate it to supervisory tasks.

Addressing Resistance

At times it is necessary for a supervisor to openly address staff resistance. The skill is in knowing when to address and when to deflect the resistance. Sometimes, it is useful to talk about staff resistance, to soothe people’s discomfort before launching into the specifics of how supervision will be accomplished. Motivational Interviewing suggests that it is most helpful to “roll with resistance” by reflecting back to counselors both sides of their ambivalence about the new supervision format. Often it is best to return to the issue at a later time.

Group Supervision

LPC Associates may receive up to half of their required supervised work experience hours through group supervision. Peer feedback is an effective tool of group supervision. Supervisees confer in the group, discuss key topics of their counseling, and suggest solutions for difficult situations. The participants learn better ways to manage clinical issues, thus increasing their professionalism.

The strengths and success of group supervision depend on the composition of the group, the individual members’ strengths, and the clarity of the group contract. Members must agree on the time, location, and frequency of meetings, as well as the organizational structure and goals of the meetings and limits of confidentiality.

Group supervision decreases professional isolation, increases professional support and networking, normalizes the stress of clinical work, and offers multiple perspectives on any concern. Group supervision has the added benefits of being of lower cost than individual supervision, intellectually stimulating, and fun for supervisees. Vague, ambiguous, or ambivalent goals and structure often lead to difficulties in group supervision. As with individual or clinical supervision, an interpersonal atmosphere of reasonable safety (including respect, warmth, honesty, and a collaborative openness) are critical.

The effectiveness and supervisee enjoyment diminish when competitiveness, criticism, inconsistency of members, and absence of support are prevalent. The success of peer group supervision is affected by supervisees’ varying commitment and irregular attendance.

Defining and Building the Supervisory Alliance

Overview

The following vignette illustrates the tasks of defining and building a supervisory alliance, particularly when working with an entry level counselor. Perhaps you remember when you first started in the counseling field. You may have formulated and planned an eclectic approach with clients, or perhaps you felt strongly about using one particular approach, such as CBT. Perhaps you were unsure what you would do and relied heavily on a supervisor or experienced co-workers you admired. Most counselors will continue to broaden and adjust their approaches as they gain more experience and research validates new approaches in the field. There may be some well established approaches that all counselor should use, such as effective listening skills, but there is often more than one effective approach.

The model of counseling a new counselor uses, and the way she views the genesis and treatment of various mental health disorders, will be one of many issues that will be discussed in supervision. Navigating these differences, or even potential conflicts, takes skill and practice. Skilled supervisors know when to recognize and question supervisees’ techniques or practices that are not evidence based.

There are many possible scenarios involving a variety of modalities and disorders that could be presented, but the one used in the following vignettes pertains to supervision of Associates working in the addictions field.

Background

Bill is a Texas Licensed Professional Counselor with supervisor status (LPC-S) who worked his way up through the ranks with his employer, starting as a substance abuse counselor 20 years ago. He works as a clinician and supervisor in a community-based substance abuse treatment program. In addition to his supervisory duties, he is director of the program’s intensive outpatient program (IOP). He supervises one or two Associates at any given time.

Jan is an LPC Associate and in her first month at the agency. She had limited substance abuse treatment experience in a practicum in an EAP program and sees her current employment as a stepping stone to private practice after she receives full LPC licensure. Her supervision in the field placement assignment through her university focused on counseling skills and integrating field work learning with her academic program.

The agency is a private, nonprofit organization providing comprehensive addiction treatment and education services. Jan has been assigned to the IOP under Bill’s supervision for both employment and to count towards the 3,000 work experience hours required for full licensure.

Learning Goals

1. To illustrate how to initiate supervision with a new counselor.

2. To demonstrate how to establish a supportive supervisory relationship and build rapport.

3. To define goals and boundaries of supervision.

4. To demonstrate how to identify supervision expectations and goals of the supervisee.

5. To illustrate how to address the developmental needs of a new counselor.

6. To show the start of a discussion on an IDP.

[After brief introductions, the discussion begins about what will occur in supervision.]

BILL: We’re excited to have you here, Jan. You may already know that supervision is an essential part of how we help counselors in the agency. Since this is our first session together, perhaps we can explore what you want from supervision and how I can help you. Building on your training and experience, maybe you can give me some ideas about the areas where you wish to grow professionally.

JAN: Well, I haven’t thought about that yet. I had excellent training and experience at the EAP [Employee Assistance Program] in the county health clinic. I’m not sure where to begin or even what I need. I recognize the need for supervision, certainly for orientation to the agency. And, I am working on my 3,000 hours for full LPC licensure. That was one of the reasons I wanted to work here. I’d like to know about how much supervision I’ll get and the focus and style of supervision that will be provided. I do need supervision to meet the requirements for licensure as a counselor.

BILL: I can understand that you’re really excited about starting a new job and career. You had an excellent experience in your placement in the EAP at the health clinic. I’d love to hear more about it, so perhaps you might tell me something about that placement, what you learned, and what treatment models they used there.

JAN: Wow, there is so much to tell you about that. I averaged ten clients on my caseload. Some were just assessments, but I did get to work longer term with several clients. I sat in on several counseling sessions, observed the senior counselor conduct the sessions, and co-led a group and several family sessions. I had weekly clinical supervision with my supervisor and the senior counselors. We used process recordings in school and that was really sufficient because I would write the verbatim, give it to my supervisor, she’d make comments, and we’d talk about it. So I didn’t really need to have her watch me work. I’ve heard from Margaret [another counselor in the agency] that in supervision you do direct observation of counselors here and that idea is new to me. My model for counseling is eclectic, whatever is needed for the client. They used a lot of cognitive–behavioral counseling approaches at the EAP. I try to meet the clients where they are and focus my therapeutic approach to meet their needs.

[Discussion continues about Jan’s experience at her placement and academic training.]

BILL: So, we have a good sense of your background and experience. If it’s OK, I’d like to return to the earlier question about whether you have any thoughts about what you want from our supervision together.

JAN: I’m not sure. Do all counselors here get supervision and are they all observed? I’m not sure I need that observation, especially since the placement didn’t do that.

BILL: I appreciate your concerns about supervision. All our counselors here receive supervision. Some agencies don’t do much direct observation of staff, but we’ve found it very helpful for a number of reasons. Here, we see supervision as an essential aspect of all we do. In addition to the many directives provided in the Texas Administrative Code about the responsibilities of supervisors and the Associates they supervise, we believe you have a right to supervision for your professional development. We have great respect for our counselors and their skills and also understand that we have a legal and ethical obligation to supervise, for the well­being of the clients. There are many things we will cover in supervision; The Texas Administrative Code Rule 681.93 requires that LPC Supervisors must cover with Associates all provisions of the Licensed Professional Counselor Act and Council rules found in Chapter 681 of the TAC, as well as other relevant chapters. This alone will require extensive hours. Keep in mind that, in addition to agency policy and procedures, as your supervisor I must ensure that you are aware of and adhere to all provisions of the Licensed Professional Counselor Act and (BHEC) Council rules. The TAC states that both the LPC-Associate and the supervising LPC-S are fully responsible for the professional counseling activities of the LPC-Associate

Notice how Bill is laying the foundation and rationale for why clinical supervision is essential for full licensure, as well as to the agency. Whereas every agency needs to develop its own, unique clinical supervision approach, there are models and standards of clinical supervision, as discussed earlier which provide direction. Agencies might benefit from adapting aspects of these models.

JAN: So, everyone receives supervision?

BILL: We take our legal and ethical obligations seriously. We want all of our counselors—even the most experienced ones—to grow professionally, to be the best counselors they can be, for their own development and for the welfare of the clients. As you probably learned in your graduate program, vicarious liability is an emerging issue for agencies. Counselors are legally liable for their actions. Vicariously, so are the agency and the supervisor.

JAN: OK, so what do you expect of me?

BILL: I’d like to explore that with you. I’m really interested in both what you expect of yourself and what you expect of us.

JAN: Again, I never really thought about that. I want to grow as a counselor and to develop skills that I can use in my future employment. I understood when I took this position that you do an excellent job of providing training opportunities for staff, something I really liked about the organization.

BILL: In our agency, clinical supervision is part of a larger package of staff development efforts. We try to help counselors improve their skills by offering the opportunity to work with a variety of different clients, using a variety of treatment modalities, such as individual, group, couples therapy, family therapy, and psychoeducation. Also, we want staff to be able to obtain full licensure in the future. We want counselors to develop new skills by attending training both in­house and in workshops around the State. We encourage and support any efforts you might make toward professional development, such as getting your full licensure. Our philosophy is that one of our greatest assets is our clinical staff and as they develop, the agency grows too. We believe clinical supervision is critically important in this mix. We both—you and the agency—benefit as a result.

[A discussion continues about Jan’s course work in school and her training in the field placement, and how she can continue that learning in the agency. She articulates her clinical strengths.]

BILL: That sounds good. Those are the skills we saw in you that we thought would be helpful to our agency. In what ways do you wish to grow professionally?

JAN: I could learn other counseling techniques beyond CBT. What do you think I need?

BILL: That’s what we can explore in supervision. I’ll need to have a sense of what you’ve learned and where you see your skills. In addition to talking about your skills, we find it helpful to learn through observation of our staff in action, by either sitting in with you on a session or by viewing videotapes of counseling sessions. That way, we can explore your specific learning objectives. We all learn from watching each other work, finding new ways of dealing with clinical issues. What do you think of that process?

JAN: As I said, I wasn’t observed in my placement and find it anxiety provoking. I don’t really like the idea of your taping my session. It feels a bit demeaning. After all, I do have my master’s degree. I don’t recall anyone saying anything in my interview about being videotaped. Now, that’s intimidating, to me and the clients.

BILL: Being anxious about being taped is a fairly common experience. Most counselors question how clients will accept it. You might speak with Margaret and some of your other coworkers about their early experiences with taping, what it was like for them, and how they feel about it now.

JAN: How often do we have to meet for supervision?

BILL: Generally, I meet each counselor individually for an hour each week. Then we do weekly group supervision where each counselor, on a regular basis, gets a chance to present a case and videotape, and we, as a group, discuss the case, and talk about what the counselor did well and how other things might have been handled differently. When you present a case, we all grow and benefit.

JAN: I want to be a proficient therapist, ultimately, to work as a private practitioner. If supervision can help me professionally, that’s good.

It is important for Bill to be aware of what feelings are arising within him, particularly concerning Jan’s seeming desire to pass through and use the agency as a route to private practice. This has happened to Bill and the agency before. Bill acknowledges to himself his feelings of being used by these clinicians in the past. Bill’s self-awareness of these feelings is critical and he does not respond out of anger or resentment but makes a conscious effort to remain present to what the issues are with Jan.

BILL: I’m glad you see the value of supervision. And I admire your professional goals of wanting to be in private practice although I must say that I have difficulties with people just “passing through our agency” on the way to something else. But, that’s my issue, and I’ll address those concerns if they come up in our relationship.

In his own supervision, Bill might explore his feelings about people passing through the agency, his anger or resentment, and how he can effectively address those feelings. For example, Bill’s supervisor might wish to explore with Bill the following questions:

1. What feelings does Jan bring out in you? When have you had these similar feelings in the past?

2. How do you deal with negative feelings about a supervisee?

3. How do you keep from being drawn into a defensive posture where you are justifying the agency’s use of direct methods?

As discussed earlier, just as there are levels of counselor development, there are also levels of supervisor development. Level 1 supervisors might have a tendency to be somewhat mechanical in their methods, perhaps needing to assert their leadership and position, and approaching situations somewhat anxiously. This is especially so for supervisors who have been promoted from within the organization. Their peers, with whom they have worked side-by-side before, know they do not know their strengths and limitations, and hence the new Level 1 supervisor may feel that she has to assert her authority. A Level 2 supervisor is much like the Level 2 counselor, who is driven by alternating anxiety and self-confidence and who feels the need to be independent, even though she might not as yet be able to act independently. Finally,

Level 3 supervisors have balanced their levels of self-awareness, motivation, and autonomy.

Addressing Ethical Standards and Boundaries

Overview

This vignette illustrates the role of the supervisor as a monitor of ethical and professional standards for clinicians, with the goal of protecting the welfare of the client. The vignette begins with a discussion about a potential ethical boundary violation and illustrates how to address this issue in clinical supervision.

Background

Stan, a LPC-S, has provided clinical supervision for Eloise, LPC Associate, for 1 year. He’s watched her grow professionally in her skills and in her professional identity. Lately, Stan’s been concerned about Eloise’s relationship with a younger female client, Alicia, who completed the 10­week IOP 2 months ago and participates weekly in a continuing care group. Alicia comes to the agency weekly to visit with her continuing care counselor. She also stops by Eloise’s office to chat. Stan became aware of her visits after noticing her in the waiting room on numerous occasions. Earlier in the day, Stan saw Eloise greet Alicia with a hug in the hall and commented that she will see Alicia “at the barbecue.” Stan is aware that Alicia and Eloise see each other at 12­Step meetings, as both are in recovery. Eloise feels she is offering a role model to Alicia who never had a mother figure in her life. Eloise expresses no reservations about the relationship. Stan sees the relationship between Eloise and Alicia as a potential boundary violation.

Learning Goals

1. To illustrate monitoring professional boundary issues of counselors in clinical supervision.

2. To demonstrate supervisory interventions to help the counselor find appropriate professional boundaries with clients.

3. To help counselors learn and integrate a process of ethical decision making into their clinical practice.

4. To demonstrate skills in addressing transference and countertransference issues as they arise in clinical supervision.

[After brief introductory comments, the discussion begins with how Alicia is progressing in her recovery.] STAN: If it’s OK, I’d like to share some concerns I have about Alicia.

ELOISE: Sure, I’m always ready for feedback.

STAN: When I walked through the lobby a few minutes ago I heard you say something to Alicia about seeing her at a barbecue.

ELOISE: Right. Sarah is one of my sponsees in AA, and we’re having a barbeque at her house for some people in recovery. She and Alicia have gotten really close, so Alicia will probably go, too.

STAN: And that’s a barbecue you might be attending?

ELOISE: Yeah. I’m fairly active with all my 12­Step friends and sponsees.

STAN: I would like to raise a concern I have about your relationship with Alicia. You take great pride in working with recovering people, helping them, and doing everything you possibly can to ensure their recovery.

ELOISE: Yes, it means the world to me. Alicia reminds me of myself when I was in early recovery. When I see her and how hard she’s working, it inspires me because I know that struggle.

STAN: I’m pleased that you care so much about your clients and that you can identify with their struggles. I do have concerns though, when I hear you are going to see her at a barbeque. It seems like a possible dual relationship issue for you, and I would like to know what you think about this?

ELOISE: Well, I certainly know not to sleep with my clients, or borrow money from them, or hire them to mow my lawn, or take them on trips. But seeing Alicia at a barbecue? Come on, Stan.

At this point Stan might be feeling somewhat defensive and may need to restrain his urge to begin disciplinary action against Eloise for her attitude. A Level 1 supervisor might react angrily to Eloise’s tone of voice, seeing this as a clear disciplinary issue. A Level 2 supervisor might get caught up in an argument with Eloise about the extent of the violation. The skill of a Level 3 supervisor is to be clear with Eloise about what a dual relationship is without responding out of anger. As shown below, Stan needs to help her identify what a boundary violation is, how to make ethical decisions, and how to have this discussion in the context of a supportive supervisory relationship. It is important for Stan to help her be more aware in future situations with similar clients and dynamics.

STAN: I’m glad we agree on those kinds of extremes because dual relationships are a big concern for licensees and of our agency and staff. A dual relationship occurs when a counselor has two relationships with a client, one personal, one professional. As an LPC, our mission is to provide professional clinical services to clients. Within those services there is a scope of practice. When a personal relationship with a client or former client intrudes on that professional clinical service, then we may have a relationship that is considered outside the parameters of what’s considered solely professional.

ELOISE: What I understand about dual relationships is that it . . . well, help me here. For example, I know I’m not supposed to hire anybody for any personal services or any form of exchange of money or buy anything from a client. If they’ve been a client here, I can’t contract with them for private practice or anything like that.

STAN: Let’s talk about your relationship with Alicia and what the intent is now. You want to do everything you can to build a safety net for her recovery. I appreciate your concern for her recovery. One goal of recovery is for the client to achieve a sense of autonomy and make decisions on her own, to take care of herself. You play a role. So, if we can, let’s discuss what that professional role is, and what it isn’t. When I walked through the lobby and heard you say “I’ll see you at the barbecue,” I had some concerns.

ELOISE: You mean I shouldn’t say that in a public place?

STAN: My concern is whether going to a barbecue with a client is appropriate behavior, to have a relationship with her outside your professional relationship as defined by our agency and LPC ethics. When I heard your remark, I thought, “I wonder what Eloise’s intent was and where that’s going or what might that lead to? Let me check it out to see if I am being clear.”

ELOISE: Are you saying I shouldn’t see clients in other contexts? How reasonable is that? We live in a small town here and run into clients all the time in the supermarket and at 12­Step meetings. So, what are you saying?

There is a difference between a dual quality to a relationship and a dual professional and personal relationship. Dual qualities are inevitable in certain communities. A dual relationship has the potential for the abusive use of power, where harm might be done to the client through manipulation or inappropriate self-disclosure. Actions in one context might be acceptable, whereas in another they might be harmful. A skillful supervisor would help Eloise see this distinction and help her be better able to make sound ethical decisions concerning the line between dual qualities and dual relationships.

STAN: Great observation. Yes, we find ourselves in situations that potentially have a dual quality to them. The difference between running into clients in the supermarket and going to social activities together involves the potential impact that action might have on the client and our use of the power we have in the relationship. You were her counselor.

ELOISE: Yes, but I’m not her counselor anymore. She’s in continuing care now.

STAN: Okay, but she’s still a client of the agency. The ethical question is how long is a client a client? I refer you to Texas Administrative Code and Rule 681.41 concerning Rules of Practice:

(m) Except as provided by this subchapter, non-therapeutic relationships with clients are prohibited. (1) A non-therapeutic relationship is any non-counseling activity initiated by either the licensee or client that results in a relationship unrelated to therapy. (2) A licensee may not engage in a non-therapeutic relationship with a client if the relationship begins less than two (2) years after the end of the counseling relationship; the non-therapeutic relationship must be consensual, not the result of exploitation by the licensee, and is not detrimental to the client.

Also, our agency policy is that we should avoid all dual relationships with former clients no matter the length of time since the therapeutic relationship ended.

ELOISE: Yes, but she just stops by when she’s here. She pops in just to say hi, for not more than 5 minutes. I don’t counsel her anymore.

STAN: Okay, that might be reasonable. Perhaps we can discuss that relationship and the impact of seeing her outside the agency at functions.

ELOISE: Well, she goes to the women’s AA meeting that I go to. And she knows some of my sponsees. What should we do, leave our home group because clients attend the meetings also?

STAN: It is inevitable that we will run into clients at meetings. When does that cross over the ethical boundary and become a dual relationship? I’d like to hear your ideas about where you see that line for you.

ELOISE: I don’t want to do the wrong thing, Stan, to hurt her. My intent is to be helpful.

STAN: Again, I know you don’t want to hurt her, and I know you’re trying to help her in her recovery. We have to be mindful of not being drawn into relationships that hurt the client or that could be perceived as dual relationships.

ELOISE: She doesn’t call me or come see me. I want you to know I’m not sponsoring her. But I didn’t know that going to the barbecue was wrong. So, I won’t go.

Stan really wants to keep the focus on the larger issue of dual relationships. Once Stan and Eloise have clarified this larger perspective, then it might be more appropriate to come back to the specific issue of the barbecue. A more inexperienced supervisor might be tempted to just establish the boundary about socializing with clients with a comment like “That would be a wise decision (not to attend the barbecue)” but would possibly lose the potential of helping Eloise develop more effective ethical decision making skills in the process. It would, in effect, run the risk of making the decision for Eloise, rather than helping her come to an ethical decision on her own.

STAN: With your permission, perhaps we can talk about how we make ethical decisions about the nature of a relationship with a client or a former client, and what’s not professionally appropriate. If it’s okay, let’s use the conversation with Alicia in the agency lobby. How do you think that conversation might be perceived by anyone who is walking by who hears you say you’ll meet at the barbecue?

ELOISE: I’ve never really thought about it. Well, I guess if it was someone who didn’t know me, they might think that I was personal friends with her. That’s not a perception I want others to have.

STAN: So, you want others to see you as a professional, upholding boundaries and your code of ethics?

ELOISE: Yes, of course.

STAN: I reread some of the pertinent Rules relevant to counselor ethics, as well as our agency’s policies and procedures, to help evaluate whether or not there might be an issue. I was reminded of the power differential in all counseling relationships and that as professionals in our field we need to be careful to not engage in social relationships (or relationships that might be seen by others as social relationships) with clients or former clients. You may recall we recently had a lawsuit over dual relationships that put the agency in jeopardy. It got resolved in our favor but we’re particularly sensitive about our liability. It was a wake­up call to all of us. So how can we clarify this boundary issue with your relationship with Alicia?

ELOISE: Wow, I never saw going to the barbecue as pursuing a friendship, and I certainly would not want to jeopardize our agency’s relationship with her. I certainly don’t seek any personal gain from our time together. Although I must admit, she does remind me of myself when I was in early recovery. Besides, she has never had a strong, positive, maternal figure in her life. That’s something I think I can help her with. What do you think?

STAN: I admire your concern for her and it sounds like you are becoming aware of some maternal feelings for her that might be coming close to stepping over that professional boundary. When our relationships with others, and particularly with clients or former clients, begin to even have the possibility of affecting their recovery in a potentially negative way, then we might be edging close to an ethical boundary violation.

ELOISE: I understand, but part of my recovery program is being in touch with other people in recovery, other people from meetings, like Alicia.

STAN: I agree. It’s important for your own recovery that you stay connected to other people in recovery. So, the question is: What’s the difference between seeing people in recovery at meetings, such as the people you sponsor or your sponsor, and relating to clients active in treatment at our agency whom you encounter at a meeting?

ELOISE: Do I have to cut off all my recovery relationships and not go for coffee after meetings?

It is important for supervisors to take into account cultural variables that might affect clinical relationships, such as differences in ethnic, religious, and geographic factors and their impact on the counselor–client relationship. This is not to condone unethical behavior but to be mindful of cultural issues as they affect the context of counseling.

STAN: I understand the dilemma we find ourselves in as counselors. We have to go on living our lives in our small rural community. So, how do we reconcile our daily lives with the Federal laws, agency policies, and our code of ethics? We need to be mindful of those boundaries just because of the closeness of our community. The interesting thing is that the clients are not bound by the same rules as we are. So, they might not see it as a boundary violation. In fact, as often as not, clients and former clients are flattered by contact with their current or former counselor and invite such relationships. How will we reconcile these differences? How do we know what the ethical wall looks like before we hit it?

ELOISE: Well, I guess we need to be careful about what contexts we see clients in, whether they are actively being counseled by us or not. Is that what you’re saying?

STAN: Yes, we do need to be mindful of the various relationships we develop with clients. I’d like to use the barbeque as an example to discuss. Okay?

ELOISE: Sure. First, I sponsor six individuals. They’ve all been in recovery for different lengths of time, and they like to get together every 3 months, all six of them, and do some kind of activity. And they invite over a bunch of people from the 12­Step group. Sarah was having this barbecue and asked me because we go to the same home group. She also invited Alicia. I’m not sponsoring Alicia. Does that mean I can’t go?

How To Perform Ethical Decision-making

Stan’s task here is to help Eloise identify potential boundary issues in a broader context and aid her in her ethical decision making. The following are steps to ethical decision making:

1. Recognize the ethical issues by asking whether there is potentially something harmful personally, professionally, or clinically. In what way might this go beyond a personal issue to the agency, the profession?

2. Get the facts. What are the relevant facts? What facts are unknown to us at this time? Who has a stake in the decision making? What are the options for action? Have all of the affected parties been consulted?

3. Evaluate alternative actions through an ethics lens. Which options will produce the most good and least harm? What action most respects the rights of all parties? What action treats everyone fairly?

4. Make a decision and test it. If you told someone you respected what you did, how would they react?

5. Act, then reflect again later on the decision. If you had to do it all over again, how would you react differently?

STAN: It might help to ask yourself what happens for you when you find yourself in such a dilemma, to be your own problem solver.

ELOISE: Well, it’s hard to not go to social activities in this small community when I’m invited. But I can see how some might see me in a different light because I’m a counselor. At one party, someone came up to me and started to ask questions about problems in their marriage. I guess she figured that since I’m a counselor, she could get some free assistance. I was really uncomfortable in that situation.

STAN: What did you do?

At this point Stan might:

1. Have Eloise consider her own solution.

2. Use her solution in a dialog to expand the context so she can generalize the solution to other situations she may encounter.

3. Conclude with Eloise’s restatement of what she has learned for the future from this discussion.

ELOISE: I told her I could not be her counselor and was there at the activity in my “civilian” clothes. [Chuckling.] Ah, I see what you’re getting at. It’s hard to be in two relationships, a professional and a personal one, with the same person. And I can see what you mean by how a reasonable uninvolved person might view this situation. At the party, when that person wanted free counseling, it was clear that that was not the context or the relationship for that. That’s unprofessional. But Alicia is different.

STAN: So, you see that it is unprofessional to counsel someone outside of a professionally defined relationship. I’d like to hear how it is different with Alicia.

ELOISE: Well, I really care for her. She reminds me of myself when I was younger. I am the mother she never had. I feel bad for her that she’s never had a positive female, maternal role model in her life.

[Eloise cries as she expresses her concern for Alicia.]

STAN: This is difficult for you. You care very deeply for her. I can understand that in some ways she reminds you of yourself at that point in your recovery.

ELOISE: Yes, she does.

ELOISE: The last thing I want to do is to hurt her or to act in an unprofessional manner.

STAN: I value your concern for Alicia and your desire to be professional. It is difficult when we care so deeply for our clients. We’re asked to show empathy and caring for clients, and sometimes it can be confusing if we care too deeply. It’s like, as caring professionals, we’re always living close to that ethical slippery slope. We can retreat into “professional white coats” and separate ourselves emotionally from clients. But that turns counsel­ ing into a sterile activity, and we’re detached and removed from their pain. But, when we care deeply, we are drawn into the emotional world of our clients. And the boundaries can become fuzzy for us.

ELOISE: I see what you mean. I guess we can rationalize a lot of our behavior when we care so deeply. We call that enabling behavior, don’t we, when family members do that with the person in substance abuse treatment? So, how do we walk close to that ethical slippery slope without falling over the edge?

STAN: That’s an excellent question. Ethical decision making can be difficult at times. Intent is an important part of ethical decision making.

How To Ask Questions in Ethical Decision making

The following are key questions to ask at this point:

1. What would a reasonable person, counselor, or colleague do in a similar situation?

2. What are the relevant issues regarding justice, fairness, self-advocacy, non­ malfeasance?

3. How would a person discern his or her intentions? How do you keep yourself from self-deception about your motives, remembering that the best test for your motives is time?

ELOISE: What do you mean by “intent?” It was my intent with Alicia to be helpful, certainly not to hurt her in any way or to be disrespectful of our agency or of me as a professional.

STAN: When we commit to a professional relationship with a client, there is always a power differential. When someone like Alicia comes with her need for a maternal figure, as you well described, we need to be careful of our role in offering to fulfill that need. The power differential alone can create some opportunities for people to misperceive what’s going on. What do you think?

ELOISE: Can it be that I took advantage of her because of my own need to be a mother figure in someone’s life?

STAN: That is always a risk we have. It could be perceived that way.

ELOISE: I feel bad that I wasn’t being very professional with her and my own needs came out.

It is important to remember the power differential between supervisor and supervisee. How might key audiences (colleagues, the community, board of directors, the press, peers) see or experience the counselor’s behavior? What is the risk? There are many stakeholders involved who each view the situation from their own perspective. For example, stakeholders (such as the board of directors) might be concerned about the risks of legal liability for the agency, the media and community with the public image of the organization, and peers with the clinical implications of a possible boundary violation.

STAN: That’s a key insight. It’s great that you could step back from the situation and see how your caring deeply for her spilled over in other ways.

ELOISE: You think I had power over Alicia?

STAN: As I said, when you’re a counselor to a client, there is always a power differential that we have to be very cautious and very aware of. It may not be something we do so much as the power that the client gives us. Now, if it is okay with you, I’d like to summarize a little.

[Stan and Eloise review what has been discussed and what actions might be appropriate for Eloise to take at this point. They express their concerns about Alicia and how she might be hurt if Eloise abruptly cuts off the relationship with Alicia. They strategize on how to best handle the situation in a way that would be clinically supportive of Alicia.]

STAN: I want to talk a little about ethical decision making and how we can keep within certain guidelines. There are some questions to be asked, such as how that behavior is experienced by someone else. How would your actions be perceived by colleagues, the community, a supervisor, and clients?

ELOISE: I appreciate your saying that; I need to think about it. It makes sense.

STAN: I’d like to review what we’ve discussed and your understanding of the issue.

ELOISE: I have a clearer understanding of how my relationship with clients after they’re discharged is as important as when they are my active clients. I need to think and give more consideration to how that’s perceived, to consider my role with clients from their perspective. In my relationship with Alicia, I’ve thought of myself primarily as a recovering person, but I need to remember that she may perceive me primarily as her counselor. In other words, I am wearing two hats—a counselor and a person in recovery—and I need to be clear which hat I am wearing and when those hats are on.

STAN: So you have a sense of the potential conflict of interest depending on what hat you’re wearing and how that might be perceived.

ELOISE: Yes. I need to think about how that reflects on the agency and how the community sees it.

[The supervision session ends with Eloise making a commitment to rethink the relationship with Alicia and strategies for making ethical decisions in the future.]

Implementing an Evidence­Based Practice

Many mental health agencies encourage or require staff to use specific counseling methods and techniques. Annual trainings in Motivational Interviewing, CBT, and other approaches are often required. This does not suggest that evidence-based practices are perfect. Almost any method of counseling can be misused or ineffective depending on the counselor using it and the individual receiving it. Also, the term “Evidence-Based Practice” is often defined or perceived too narrowly as a set of techniques instead of a wide array of practices encompassing many aspects of counseling. There are far too many variables to determine a particular approach to be the best one in all cases. This is one reason why so many counselors use an ‘eclectic’ approach. Nevertheless, there are certain approaches that have wide application or seem to be more effective than others for certain disorders. Agencies have the right to emphasize or even require their use, especially as payor sources require documented evidence that they are being used. Supervisors may need to help Associates adjust to the requirements of employers that may not always be consistent with the academic training, counseling methods, or preferences familiar to the Associate. The following vignette demonstrates the reality Supervisors may face when an employer requires a particular technique to be used and the resulting reluctance of Associates to use it.

Overview

This vignette portrays supervision of two counselors at different levels of experience and orientation to implement an evidence-based practice (EBP) into their clinical work. Both counselors have reservations about adapting the way they practice and have some resistance to undertaking the new EBP. The clinical supervisor has to address their resistance while achieving the mandate of the agency.

Background

The executive director (ED) of a mid­sized substance abuse treatment program has issued a statement to all staff that, according to State requirements, the agency must incorporate EBPs, now a necessity for State funding. Therefore, the ED has directed the three clinical supervisors to begin the implementation of Motivational Interviewing as a primary treatment method for treatment staff, first on a pilot basis then agency­wide. Gloria, one of the supervisors, is meeting with Larry and Jaime, two LPC Associates, to discuss implementation of MI with their clients. Both Larry and Jaime are aware of the mandate but have not had an opportunity to discuss the change with Gloria until their regularly scheduled supervisory session this morning. Both have, in the last year, expressed some resistance to undertaking a new treatment approach when they were required to attend MI basic training.

Learning Goals

1. To demonstrate leadership by a clinical supervisor toward meeting agency goals and mission.

2. To demonstrate leadership in the face of staff who are resistant and reluctant to incorporate EBPs into their counseling.

3. To model MI in the supervisor/supervisee relationship.

4. To illustrate fostering a spirit of learning and professional development among counselors.

5. To illustrate how a clinical supervisor can help counselors build new clinical skills, especially those that are science­based practices.

6. To understand the resistance and impediments in the field to the implementation of EBPs.

GLORIA: I know you have some reservations about the MI implementation program. Today I want to spend time discussing your reservations and how MI can be good for our clients and for the agency. You have both done a tremendous service for our programs. We want to be responsive to your needs, not just impose some­ thing on you. When you’ve been doing a good job and you know that what you’re doing works, it’s hard to take on something new that you’re uncomfortable with. I know that you’re concerned that taking on something new could, at least initially, potentially interrupt the normal flow you have with clients.

So, there are several things that I think are important for us to consider today. First, let’s review why we are implementing MI for staff as a tool in their counseling. Perhaps we can explore any concerns you might have, then review why it is important to implement MI.

Second, let’s look at your concerns about how those changes might affect client care.

Third, let’s focus on how we can keep the strengths you have with your clients and be sure they don’t get lost in the transition process. One of the beauties of MI is that it integrates well with what good counselors do natural­ ly: active listening, respect for others’ views, an appreciation of the role of resistance, good goal setting practices, and the like. Most important, MI aids in establishing and enhancing the therapeutic alliance between the counselor and the client.

Finally, I want to spend a little time talking about where we go from here and how we are going to make the implementation process as smooth as possible.

How To Introduce Changes in Clinical Practices

Changes in counseling methods are difficult for staff who are attached to their model of counseling and know that it is working for them. When presenting new policies and directions to staff, or simply pointing out a better approach to a client’s problems in private practice where agency guidelines are not an issue, it is important that you follow these guidelines:

1. Be respectful of staff’s resistance. Instead of exhorting, arguing with, or threatening the counselor if they do not “play ball,” seek to understand the counselor’s concerns with words such as “Yes, this is difficult. So how can we resolve the issue?”

2. Show respect for counselors and for the experience each brings.

3. Depending on the individual counselor, you may need to be flexible yet firm in your approach with staff who are expressing resistance to or ambivalence about change, being clear that the change is needed yet allowing time for the person to adjust and providing the resources needed to aid the counselor in making that change.

4. Recall when you were in the counselor’s role and perhaps how you experienced resistance to change in supervision.

5. Consider using self-disclosure to address defensiveness with supervisees. You can either give an example from your own training or experience, such as, “I know it was difficult for me too when I was a supervisee,” or by describing your own ambivalence in the present, such as, “I also have concerns about the change we have to undertake and want to ensure that it works in the best way for clients, now—what can I do?” These self-involving statements can engage supervisees in the discussion and problem solving.

LARRY: Well, Gloria, we’ve had the MI training, and I like its focus on active listening, the attention it gives to the relationship and respect for the client’s perspective. But, you know, I’m basically a 12­Step facilitation guy. That works for me and for my clients. I don’t see changing horses in the middle of the stream to achieve political correctness.

GLORIA: Your 12­Step approach works for you, and we heartily endorse it, too. 12­Step facilitation is an essential part of everything we do at the agency. And I definitely don’t want to see us throw out the baby with the bathwater. As you know, counseling is an ever evolving process, and I think our task is to be able to take what we do well and build on it with new approaches. I think MI can add to your repertoire. I think your concerns are realistic, and we need to consider that as we move into adopting new methods. What about you, Jaime?

At times a supervisor might feel caught in the middle, representing policies and procedures coming down from funding sources, yet posing implementation difficulties. An effective supervisor plays this dual role of advocating for both administrators and leadership and the line worker and client. Whether working on a factory floor or in a clinical setting, it is difficult being in the middle. To aid you in this position, it is helpful to:

1. Understand the rationale of both administrators and line staff.

2. Never lose sight of where you came from. At some point in your career, you were a supervisee. It is useful to remember what it felt like being in that position.

3. In the example of MI, practice reflective and active listening to understand the concerns of those above and below, and to empathize with each group’s concerns.

JAIME: I just want my clients to get good care and for their treatment needs to be respected. My clients need decent jobs and to be accepted as being sober in their community. That’s what’s important to me. I just want to serve my clients. I know that may not be what you want to hear, but that’s how I feel.

A Level 1 supervisor might respond either in a defensive or overly directive fashion here, telling Jaime that this is something he must do. A Level 2 supervisor might get into a struggle over what really matters, defending MI as good for Jaime’s clients, or disrespecting his statement about what matters most to him, his clients. A Level 3 supervisor listens to Jaime’s statement, affirms and supports him in that, and tries to engage Jaime in the discussion. Further, Gloria is working with two counselors at different levels of proficiency, so she has different expectations for their contributions and recognizes that they have different learning needs. An effective supervisor understands the stages of counselor development and varies the approach depending on the stage of each staff member.

GLORIA: Jaime, I respect your commitment to your clients. Larry is clear about one of the things he knows works, 12­Step facilitation. In your experience, what has worked with your clients?

JAIME: I’d agree with Larry, 12­Steps, because I believe they work. But what’s also important is jobs, not feeling discriminated against. What helps is to be with a group of sober people. That’s what helps my clients.

GLORIA: You both seem to be clear on what you see works for you and your clients. That’s a good start for us. As you know from the recent ED’s memo to staff, the State has required all agencies to implement an EBP to continue to receive State funds. There has been a lot of discussion at all levels about this. We’ve talked before about our desire to move from being a good agency to a great one, being one of the best in the State. Over the past year we’ve made incredible progress toward this goal, thanks to all the staff’s efforts. And all through this process, we’ve been able to stay true to our 12­Step philosophy. Honestly, when I first heard about the new State policy, I, too, was skeptical, saying to myself, “Here we go again.” But then I was reminded of the agency’s mission to keep improving our skills for the well­being of the clients. So, discussing this together now is helpful. I’d like to hear more from you about your concerns regarding MI.

LARRY: I don’t really care about MI versus CBT versus 12­Step facilitation versus the next thing to come down the pike. I’ve been in the field for a long time, and I know what works is my relationship with people. I know 12­Step works, and I have to be convinced that this doesn’t interfere with having a strong relationship with my clients. I think that’s the most important thing. I’m not sure I need a new way to do this. I don’t want to have to be worried about whether I have to use a new approach.

GLORIA: Wow, Larry! I really hear that the most important thing to you is building strong relationships with your clients, and it’s not so important what method you use to build strong relationships, but that the method helps you accomplish that goal. Perhaps we can look at how MI’s approach to active listening with clients and reflection enhances that relationship. If it builds the therapeutic alliance with the clients, that’s good. I’m curious how you feel about that.

LARRY: What I want to be sure of is that we’re not moving away from our roots: that this is not taking us away from 12­Step. That’s what this agency is founded on, and that’s what we stood for all these years. I need to hear that from you.

GLORIA: That’s a really excellent point. How do MI and other approaches keep us close to our roots of 12­Step work? What do you think?

LARRY: If an approach builds the relationship with the client, I’m all for it. I know that 12­Step facilitation does that. And I know from the course I took on MI that it also emphasizes the counselor–client relationship. But it is also a new way of thinking and a whole new vocabulary and I don’t want to get so bogged down in catchy phrases that I lose contact with my client.

GLORIA: Larry, I clearly hear your concerns about interfering with your relationship with your clients and about us losing our roots. There are several different ways we can approach the implementation. We may decide that MI works better with some client populations than others. A place to begin would be for us to learn more about how MI can be implemented in the program. I know you’ve been to the MI training. That’s a great start. MI has some good strategies that are congruent with a variety of client populations.

LARRY: What I heard you just say is that it doesn’t matter whether we’re on board or not.

GLORIA: That’s a dilemma. The State’s said, “You have to do it.” What they haven’t said is how you have to do it. They said we have to do “something.” We have something to say about how we’re planning this, how we’ll implement an EBP. I want to be sure that we hear and use your experience.

It is helpful to watch how Gloria handles the polarizing confrontation. A Level 1 supervisor might either come down hard on Larry for his suggestion, saying “No, we’re not doing that.” A Level 2 might argue about it. Note the Level 3 approach, not to confront the statement by Larry but to find a working alternative.

A master supervisor is able to manage staff confrontation and avoid becoming defensive. To do this, it is important for the supervisor to understand that struggle is a sign of staff ambivalence to change. Resistance and ambivalence are normal in any situation involving change. A master supervisor works with the resistance, using its energy to promote change, not taking it “head­on.”

LARRY: I like the idea that we can implement the strategies that work best for our agency because that allows us to stay close to our roots of 12 Steps.

GLORIA: So you see the value of implementing an EBP approach such as MI as long as it stays close to our 12­ Step roots. Moving ahead, I recognize that this is going to change some of our approaches, how we think about treatment, how clients experience us.

LARRY: How are we going to do this implementation anyway? Who’s going to do the implementation, train us in MI?

GLORIA: Perhaps I can show a videotape of a counseling session I conduct when I think I am doing effective MI. What do you think of that idea? Would that help us all feel more comfortable with an EBP? I’m willing to stick my neck out if you’re willing to give me feedback on what you see on the videotape.

A basic rule of supervision is “do not ask an LPC Associate to do something you’re not willing to do first.” A second rule is that “leaders bear pain, they don’t inflict it.” Master supervisors are willing to take a risk by demonstrating their skills first before asking staff to do so. Effective supervisors are able to establish trust by serving as a team leader, inspiring staff by encouragement and motivation, communicating enthusiasm and capability, and taking appropriate risks to initiate change. Leaders also demonstrate vision, drive, poise under pressure, and maturity of character. They inspire rather than command staff. Since leadership entails teaching, mentoring, and coaching, having the title “supervisor” does not necessarily make a person a leader. To earn respect, the supervisor should display qualities of honesty, responsibility, fairness, and understanding. In this vignette, Gloria provides direction and leadership by showing staff how they can implement MI together and how the training will work. She also gives them a say in the process and allows them to keep to their roots, learn new tools, and do so over time.

How To Address Personal Issues That Affect Effectiveness as a Counselor

Consider the following points when you need to confront a supervisee in clinical supervision with problems of effective counseling that are exacerbated by personal difficulties, such as emotional, familial, interpersonal, financial, health, or legal concerns:

1. You can help your supervisees see the relationship between their personal difficulties and work-related problems. The key question you need to return to is “How is this personal issue affecting your counseling abilities?” This prevents you from becoming the counselor’s counselor and turning supervision into therapy.

2. You can clarify the boundaries of what constitutes acceptable job performance, as some counselors may be uncertain where the boundaries lie.

3. You should continually focus on approaches to improve counseling abilities and job performance, providing useful suggestions and recommendations for improvement. It is also helpful to provide measurable benchmarks by which counselors can assess their own improvement.

4. You and your supervisee should develop a written work plan for how the employee will take the necessary steps to improve job performance.

5. You can help the counselor examine how personal stressors might affect interactions with coworkers or clients.

6. Finally, you and your supervisee can explore how you and the agency can support the employee in confronting and resolving personal issues that are affecting job performance, such as a referral to the EAP, use of personal or sick time, rescheduling of the counselor’s time, and the like.

Although the distinction between personal counseling and supervision may be contingent on the supervisor’s theoretical orientation, and both are interpersonal relationships, there are differences between the two, as summarized in the table below.

To help the counselor and the supervisor differentiate between therapy and supervision, the supervisor needs to continually ask him­ or herself, “What does this have to do with your counseling functions? How is this affecting your relationship with clients?”

How To Demonstrate Leadership

It is important for a new supervisor to demonstrate leadership without being controlling or condescending, especially if promoted from within. Perceptions of quality leadership have shifted from the traditional hierarchical, command-and-control model to a networked, team-based approach that values participative leadership and staff empowerment, bottom-up management, team input, and collaboration. Qualities of this leadership style include:

1. Taking responsibility for decisions made, never blaming others for something you’ve done, and giving credit to others when things succeed.

2. Always putting the well­being of supervisees above personal accomplishments.

3. Not being afraid of taking appropriate risks that are in the best interests of the organization, staff, and clients.

4. Protecting and advocating for supervisees, defending them to senior adminis­ trators and buffering them from rapid changes.

5. Not playing favorites. Most importantly, not giving orders just to prove who’s boss.

Conclusion

The goal of clinical supervision of LPC Associates is to continuously improve quality client care. Supervision by trained and qualified supervisors helps Associates understand and respond more effectively to all types of clinical situations and prevent clinical crises from escalating. It specifically addresses many issues including, but not limited to; assessment, case conceptualization, treatment strategies, professional ethics, and discharge planning. Supervision aids in addressing the unique needs of each client. It provides a mechanism to ensure that clinical directives are followed and facilitates the implementation and improvement of evidence-based practices (EBPs). Clinical supervision also enhances the cultural competence of an organization by consistently maintaining a multicultural perspective.

Supervision is a social influence process that occurs over time in which the supervisor participates with supervisees to ensure quality care. Effective supervisors observe, mentor, coach, evaluate, inspire, and create an atmosphere that promotes self-motivation, learning, and professional development. Finally, supervision increases staff members’ sensitivity and responsiveness to diversity issues among staff, with clients, and between staff and clients.