You are on page 1of 38



#7686 Clinical Supervision:EAxpiration
Release Date: 05/01/13
Person-Centered Approach
Date: 04/30/16

Clinical Supervision:
A Person-Centered Approach
HOW TO RECEIVE CREDIT This course is designed for professional clinicians,
• Read the enclosed course.
including counselors, social workers, therapists, psy-
chologists, and pastoral counselors, who supervise
• Complete the questions at the end of the course.
others, clinically and/or administratively.
• Return your completed Answer Sheet/Evaluation
to NetCE by mail or fax, or complete online at Accreditations & Approvals Your postmark or facsimile date NetCE, #1092, is approved as a provider for social
will be used as your completion date. work continuing education by the Association of
• Receive your Certificate(s) of Completion by mail, Social Work Boards (ASWB) through
fax, or email. the Approved Continuing Education (ACE) Program.
NetCE maintains responsibility for the program.
ASWB Approval Period: 3/13/2016 to 3/13/2019.
Social workers should contact their regulatory board
Faculty to determine course approval for continuing education
Jamie Marich, PhD, LPCC-S, LICDC-CS, RMT, credits.
travels internationally speaking on topics related to
This program is approved by the National Association
EMDR, trauma, addiction, and mindfulness while
of Social Workers (Approval #886531582-2005) for
maintaining a private practice in her home base of War-
Social Work continuing education contact hours.
ren, Ohio. She is the developer of the Dancing Mind-
fulness practice. Dr. Marich is the author of EMDR NetCE has been approved by NBCC as an Approved
Made Simple: 4 Approaches for Using EMDR with Every Continuing Education Provider, ACEP No. 6361. Pro-
Client, Trauma and the Twelve Steps: A Complete Guide grams that do not qualify for NBCC credit are clearly
for Recovery Enhancement, and Trauma Made Simple: identified. NetCE is solely responsible for all aspects
Competencies in Assessment, Treatment, and Working of the programs.
with Survivors. Her new book, Dancing Mindfulness: A This course is approved by the Association of Social
Creative Path to Healing and Transformation, is scheduled Work Boards - ASWB NJ CE Course Approval Program
for release in 2015. Provider #14 Course #43. Social workers will receive
Faculty Disclosure the following type and number of credit(s): Clinical
Contributing faculty, Jamie Marich, PhD, LPCC-S, Social Work Practice 9, and Social and Cultural Com-
LICDC-CS, RMT, has disclosed no relevant financial petence 1 for the approval period starting 09/09/2014
relationship with any product manufacturer or service and ending 09/09/2016.
provider mentioned. NetCE SW CPE is recognized by the New York State
Division Planner Education Department’s State Board for Social Work
Alice Yick Flanagan, PhD, MSW as an approved provider of continuing education for
licensed social workers #0033.
Division Planner Disclosure
The division planner has disclosed no relevant financial
relationship with any product manufacturer or service
provider mentioned.

Copyright © 2013 NetCE

A complete Works Cited list begins on page 37. Mention of commercial products does not indicate endorsement.
NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 1
#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
This course is considered self-study, as defined by the Our contributing faculty members have taken care to
New York State Board for Social Work. Materials that ensure that the information and recommendations are
are included in this course may include interventions accurate and compatible with the standards generally
and modalities that are beyond the authorized practice accepted at the time of publication. The publisher dis-
of licensed master social work and licensed clinical claims any liability, loss or damage incurred as a conse-
social work in New York. As a licensed professional, quence, directly or indirectly, of the use and application
you are responsible for reviewing the scope of practice, of any of the contents. Participants are cautioned about
including activities that are defined in law as beyond the potential risk of using limited knowledge when
the boundaries of practice for an LMSW and LCSW. integrating new techniques into practice.
A licensee who practices beyond the authorized scope
Disclosure Statement
of practice could be charged with unprofessional con-
It is the policy of NetCE not to accept commercial sup-
duct under the Education Law and Regents Rules.
port. Furthermore, commercial interests are prohibited
Designations of Credit from distributing or providing access to this activity to
Social Workers participating in this intermediate to learners.
advanced course will receive 10 Clinical continuing
Course Objective
education clock hours, in accordance with the Associa-
The purpose of this course is to help supervisors or
tion of Social Work Boards.
potential supervisors in the human services or helping
This program is approved by the National Association professions to more effectively work with those they
of Social Workers for 10 Social Work continuing edu- are entrusted to supervise.
cation contact hours.
Learning Objectives
NetCE designates this continuing education activity Upon completion of this course, you should be able to:
for 3 NBCC clock hours.
1. Identify and discuss common problems
Individual State Behavioral Health Approvals in supervising counselors/clinicians.
In addition to states that accept ASWB, NetCE is
2. Define the basic components of clinical
approved as a provider of continuing education by the
following state boards: Alabama State Board of Social
Work Examiners, Provider #0515; Florida Board of 3. Discuss the role of consultation in effective
Clinical Social Work, Marriage and Family Therapy work with supervisees.
and Mental Health, Provider #50-2405; Illinois Divi- 4. Describe what the psychotherapeutic
sion of Professional Regulation for Social Workers, professions reveal about the importance of
License #159.001094; Illinois Division of Professional empathy and therapeutic alliance in treatment
Regulation for Licensed Professional and Clinical (regardless of specific method or model).
Counselors, License #197.000185; Illinois Division of 5. Apply these principles of empathy to the
Professional Regulation for Marriage and Family Thera- practice of clinical supervision.
pists, License #168.000190; Texas State Board of Social 6. Articulate and discuss the stages of counselor
Work Examiners, Approval #3011; Texas State Board of development as they relate to the person-
Examiners of Professional Counselors, Approval #1121; centered approach to clinical supervision.
Texas State Board of Examiners of Marriage and Family
Therapists, Approval #425. 7. Utilize motivational interviewing approaches
with resistant supervisees.
About the Sponsor 8. Incorporate empathetic, person-centered
The purpose of NetCE is to provide challenging cur- principles into ethical and legal decision
ricula to assist healthcare professionals to raise their making.
levels of expertise while fulfilling their continuing
education requirements, thereby improving the quality 9. Develop a self-care plan that takes into account
of healthcare. empathetic approaches to self and others.
10. Assist others in developing both work plans
and self-care plans.

2 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
variety of models and theories in the helping pro-
INTRODUCTION fessions to guide the execution of psychotherapy,
there are a variety of models available to guide the
A horrible supervisor has a huge impact on job sat-
supervision process; the developmental model, the
isfaction and performance. Most people can relate
psychodynamic model, the skills-based model, the
to the feeling of dread the seemingly authoritarian
systemic model, and the blended model are among
command of those in power can cause. In an ideal
the most popular. Whatever model is chosen to
sense, a supervisor is supposed to be a mentor, a
guide supervision, person-centered principles of
leader to learn from and hopefully to emulate as
empathy, congruence, and unconditional positive
part of professional formation. Yet for a variety of
regard can be implemented to enhance delivery of
reasons, these relationships, whether they be of a
supervisory services. Thus, the focus of this course
boss-employee, supervisor-supervisee, or mentor-
is more practical, as opposed to academic. As such,
protégé variety, can go horribly wrong. Although
learners are encouraged to view this course as an
incompetence or unwillingness to accept feed-
exercise in their professional development as a
back from those being led can be a factor in these
supervisor. Staying with the person-centered theme
troublesome dynamics, more often the problems
of the course, take time to reflect on your own
seem to arise from unpreparedness on the part of
experiences and be mindful of how you respond (or
the supervisor to work with people in a respectful
in the case of past reflections, responded) as a per-
way that manages dynamics of power, responsibil-
son. Reflection questions are included throughout
ity, and humanity.
the course to facilitate this process; the questions
The purpose of this course is to help supervisors or may also be used as journal prompts or guides for
potential supervisors in the human services or help- meditation. Above all, take from this course what
ing professions to more effectively work with those you most need, personally and professionally. By
they are entrusted to supervise. As will be explored, approaching this course with an open mind to the
the supervisory relationship in the helping profes- personal and the professional, you will be best able
sions in unique because it implies more than just to put person-centered supervision into action.
management, it entails genuine leadership in the
formation of professionals who are typically new to
the professions. Because respecting the personhood FOUNDATIONS: TAKING A
of the professional being supervised is paramount PERSON-CENTERED APPROACH
to a successful supervisory dynamic in the helping TO CLINICAL SUPERVISION
professions, it is important that the same person-
centered principles used with clients (e.g., empa- NEEDS ASSESSMENT
thy, unconditional positive regard, congruence) AND BASIC DEFINITIONS
be incorporated into work with supervisees. This Clinical supervision trainings are notoriously theo-
course will address how to work these principles retical. But even clinical supervision trainings can
into supervision within traditional frameworks for be interesting if they meet the practical needs of
clinical supervision. Although traditional models those taking the course. Most states require some
and approaches will be covered, in addition to form of continuing education specific to supervi-
ancillary issues such as legal/ethical management sion in order to acquire and/or to obtain supervi-
and monitoring self-care of your supervisees, sory endorsements on clinical licenses. Thus, it is
learners are encouraged to think outside of the imperative that operational foundations of various
proverbial box when it comes to incorporating definitions and concepts connected to supervision
these person-centered elements. Just as there are a be discussed.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 3

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
Supervision nature. Rather, the helping professionals adopted
Supervision can have different meanings for dif- the practice of clinical supervision as a measure of
ferent people. The word origin traces back to 17th good common sense, carrying on the tradition of
century Latin, literally meaning “to look over.” In the master working with the apprentice that has
this most basic definition of the word, it is clear existed in many professions for centuries.
it has multiple applications: parents can supervise Historically, Kadushin’s definition of supervision is
their children at play, leaders can supervise vol- often cited as one of the first guiding descriptions
unteers, and employers can supervise those under of what constitutes clinical supervision [2]. He
their employ. In some professions, the supervisory described clinical supervision as, “an administra-
relationship is simply one of a boss overseeing his tive and clinical process designed to facilitate the
or her employees. For instance, a movie theater counselor’s ability to deliver the best possible ser-
manager may be responsible for making sure that vices to clients, both quantitative and qualitative,
his or her employees report to work on time and in accordance with agency policies and procedures,
perform the tasks of their job description, like and the context of a positive relationship between
selling concessions, taking tickets, and sweeping counselor and supervisor” [2]. This foundational
theaters after shows. The manager may also be definition still resonates in the present day, espe-
responsible for conducting quarterly evaluations cially because the duality of the administrative and
and writing up or otherwise punishing an employee clinical functions is acknowledged. Moreover, the
if he or she consistently fails to meet the tasks of imperative of quality supervision as a client care
the job. Ensuring that employees complete these issue is directly stated in this seminal definition. In
tasks with efficiency is vital to ensuring satisfactory the Handbook of Clinical Social Worker Supervision,
customer service, a priority for any person or entity clinical supervision is defined as an interactional
running a business. process in which a supervisor has been assigned or
In consumer-driven businesses, supervisors can designated to assist in and direct the practice of
choose to be authoritarian, simply carrying out supervisees in the areas of teaching, administration,
the function of management, or they can choose and helping [3]. Kadushin’s original thoughts, origi-
to see themselves more as mentors to those they nating in social work, have been long regarded by
supervise, helping supervisees grow in their job the field of social work, with widespread acceptance
or their chosen profession. While taking on this in the field of clinical supervision as an effective
mentorship component is an option in conven- practice [4]. However, the various helping profes-
tional business, it becomes a necessity in the sions have established their own definitions.
helping professions. This combined mentorship In the counseling field, clinical supervision is best
and management component is the essence of defined as a process whereby consistent observa-
clinical supervision. In examining educational tion and evaluation of the counseling process is
trends in the history of the helping professions, provided by a trained and experienced professional
discussion about clinical supervision is a relatively who recognizes and is competent in the unique
newer idea. In fact, there is little direct, empirical body of knowledge and skill required for profes-
evidence within mental health professions to show sional development [5]. In counselor education,
that clinical supervision has an impact on clini- supervision involves facilitating the counselor’s
cian behavior and thus service quality with clients personal and professional development as well as
[1]. This is supported by reviews of the literature, promoting counselor competencies for the welfare
with the majority of peer-reviewed literature of the client [6].
on clinical supervision reading as theoretical in

4 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
The purpose of supervision in substance abuse Formation
counseling is to bring about change in the knowl- Formation is a term often used in seminaries and
edge, skills, and behavior of another individual, monastic life to describe the process by which a
typically one with less training and experience person responding to his or her vocation (or “call-
than the supervisor. Regardless of various models ing”) learns how to live their calling to the fullest.
or definitions, there are five essential components Formation entails receiving mentorship and formal
that constitute supervision in the field of substance instruction and growing through the initial trials
abuse counseling [6]: or tests, often called a novitiate or probationary
• An experienced supervisor period. So much of what new helping professionals
experience during their initial internships and first
• Actual clients in clinical settings
several years in the field parallels the concept of
• “Do no harm”/welfare focus for formation, and by choosing to view supervision as
both the clients and the supervisee a function in assisting formation, supervisors can
• Monitoring performance through truly help new professionals to live their callings
direct or indirect observation to help to the fullest. As British psychotherapists
• The goal of changing the counselor’s Peter Hawkins and Robin Shohet express, “super-
behavior vision can be a place where a living profession
breaths and learns” [8]. This is a beautiful concept,
Finally, in psychology, supervision is a distinct
yet it is up to supervisors to create and foster an
professional activity in which education and
environment that is free of professional suffocation.
training aimed at developing science-informed
This course will explore how adopting person-
practice are facilitated through a collaborative,
centered concepts into the function of supervision
interpersonal process. It involves observation,
is optimal for establishing and maintaining such
evaluation, feedback, the facilitation of supervisee
an environment.
self-assessment, and the acquisition of instruction
and skills by instruction, modeling, and mutual CONSULTATION AND THE
problem solving [7]. Although there are solid mer- PERSON-CENTERED APPROACH
its in each definition, this last description serves Before delving into person-centered concepts and
as the best operational definition for this course. how to apply them to supervision, consider how
Not only does it cover many of the components taking on a consultant’s role within the context of
of clinical supervision and the activities involved, supervision may help a new professional to grow
but it emphasizes two key components that are into the fullness of his or her calling. It is important
essential to person-centered supervision. First, to make an essential distinction, from the stand-
like in person-centered therapy, supervision is a point of responsibility, between a supervisor and a
collaborative process. Second, clinical supervision consultant. With technical, clinical supervision, in
is educational in its nature. Although there may most states and within most organizations, the role
be managerial and legal/ethical implications in of supervisor carries some form of responsibility.
any given supervisory relationship, supervision is In essence, if the work of a counselor or helper is
fundamentally an educational activity, a critical called into question, especially regarding an ethical
part of a helper’s professional formation. breech, the supervisor will be questioned and may
even be subjected to legal or ethical responsibility
if the counseling occurred under the umbrella of
the supervisor’s license or certification. A much
higher degree of responsibility is implied with
supervision compared to consultation, which can
simply be defined as collaborating with a special-

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 5

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
ist who is called upon for his or her expert advice For instance, when supervising those who are older
in the field, for instance, in matters of assessment, chronologically, taking on more of a consultation-
diagnosis, or treatment planning. Sears, Rudisill, based, collaborative mindset may allow for more
and Mason-Sears describe a consultant as a “person effective supervision.
with special knowledge, skills, or talent who makes
needed expertise for clients available for a fee” [9].
When consultation services are provided, the con-
sultant is being compensated for his or her opinion Even though consultation and supervision are
technically different, what do they have in common?
and guidance; there is no sense of responsibility or How might approaching supervision with the spirit
obligation implied in the relationship. of a consultant make you more effective with those
you supervise?
The hierarchical structure of the supervisory rela-
tionship can put a damper on supervision being
a formational experience, and removing this ele-
ment results in more of a consultant position; an
enriching collaboration can result. To use terms DEFINING THE PERSON-
often employed in the addiction recovery field, in CENTERED APPROACH
consultation, the consultant can share his or her TO SUPERVISION
experiences, strengths, and hopes with a consultee.
Many who have achieved an independent status A clinical supervisor is someone who can play
with their licensure and practice and who no lon- four primary roles: a teacher, a coach, a mentor,
ger require formal clinical supervision continue and a consultant. However, a myriad of other roles
to engage in consultation with peers, colleagues, can emerge at any given time: an administrator,
and administrative supervisors. The revised codes a liaison (between upper management and those
of many states encourage this consultation (and being supervised), a champion of the underdog, a
documentation of it) for continued growth in the client care coordinator, and even an emergency
profession [10; 11]. Indeed, learning experiences therapist or helper if the supervisee is encountering
can certainly be experienced by independent an especially rough day on the job due to personal
counselors no longer in need of formal, clinical circumstances. As with juggling many life roles, it
supervision. Valuable lessons are learned through is best for the supervisee to wear one hat at a time,
informal exchange of experience, strength, and but due to circumstances in the fast paced world of
hope with trusted colleagues. human services, this is often impossible. Regardless
Formal, clinical supervision may never be this of what role or roles are being juggled at any given
casual because there is such a responsibility implied time, the most effective clinical supervision takes
with the relationship, but consider how adopting place in the context of a solid relationship between
some of the spirit of peer-to-peer consultation supervisee and supervisor. One could visualize
may help those supervisees to better relate to their these different roles orbiting the sun like planets,
supervisor. Implementing some of the same skills with the relationship as the sun. This is also a
practiced in consultation (e.g., fostering confi- good metaphor for the person-centered approach
dence, supporting self-efficacy) work in supervision to therapy. Just as adopting person-centered prin-
as well. These skills can be especially effective ciples like empathy and unconditional positive
with professionals who may be new to the field regard can work alongside many models, so too
but entered the helping professions as a second can applying person-centered approaches to your
or third career and are not necessarily new to life. specific philosophy or model of supervising others.
An approach is not a model in and of itself; rather,
it is a mindset or attitude that can be applied to a
variety of existent models.

6 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
How could appreciating a supervisee’s motive for
Rogerian Empathy becoming a helper and choosing to work in the
One of the core principles of the person-centered helping professions help you to better supervise
him or her?
approach to psychotherapy is empathy. It may be
valuable to pause and reflect on what empathy
means to you. Perhaps it is more of a feeling or a
For psychotherapeutic professionals, empathy
body-level, visceral reaction to a specific memory
is often associated with the person-centered or
in which someone showed empathy in a difficult
humanistic approach to psychotherapy and its
situation. Empathy is a human quality that can
father, Dr. Carl Rogers. Along with other elements,
manifest in a variety of arenas, not just in psycho-
such as unconditional positive regard for the cli-
therapy, and it is perhaps the inherent compassion
ent and congruence, practicing empathy is vital
of empathy, shown amongst people, that makes it
to adopting a person-centered approach. Rogers
so powerful.
created a metaphor of empathy as a dance between
A colloquial phrase often intoned to explain a client and the helper serving the client in order
empathy is being able to “step into the shoes” of to explain the concept [13]:
another person. German philosopher Rudolf Lotze
Being empathetic reflects an attitude of
coined the term empathy, as a humanistic concept,
profound interest in the client’s world
in 1858. The German word, Einfühlung, literally
of meanings and feelings. The therapist
translates as “in” and “feeling.” The derivation is
receives these communications and con-
from the Greek empatheia, em meaning “in” and
veys appreciation and understanding,
pathos defined as feeling. Interestingly, pathos is
assisting the client to go further or deeper.
also the root of the words “passion” and “pain,” two
The notion that this involves nothing
elements of living that are significant to human
more than a repetition of the client’s last
experience and, of course, to psychotherapy.
words is erroneous. Instead, an inter­action
Although English language dictionaries interpret
occurs in which one person is a warm,
these origins in a variety of ways, useful definition
sensitive, respectful companion in the
of empathy to those in service professions appears
typically difficult exploration of another’s
in Stedman’s Medical Dictionary, which defines the
emotional world. The therapist’s man-
term as the “direct identification with, understand-
ner of responding should be individual,
ing of, and vicarious experience of another person’s
natural, and unaffected. When empathy is
situation, feelings, and motives” [12]. When it
at its best, the two individuals are partici-
comes to having empathy for supervisees, this final
pating in a process comparable to that of
word of the definition (motives) is a significant
a couple dancing, with the client leading
part of the process. Consider that every helper is
and the therapist following.
drawn into the field for a certain reason or a variety
of reasons; these reasons constitute the motive of If you re-read this passage, replacing the word
a developing helper for being in the field in the client with supervisee, and the word therapist with
first place. Motive is a fascinating component of supervisor, one has a good idea of the application
empathy that is not often considered, but it can of the metaphor. Consider whether or not this
help one to appreciate another person’s perspec- metaphor of “the dance” can make sense within
tive. Appreciating an individual’s perspective is a the supervisory relationship.
key factor in being able to mentor, to coach, and
ultimately to work with that individual.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 7

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
On first reading, it may be it concerning to think of of guidance that may be helpful in clinical work,
giving supervisees this much autonomy, especially especially with clients who seem to be labeled as
when one’s license could be at risk if they end up “difficult” cases. This does not mean that supervi-
going in an unforeseen direction. However, in any sors should abandon theories, models, or technical
structured dance, one of the partners is the leader training, but simply that letting humanity take
while the other is led. If one feels that he or she precedence and focusing on building the relation-
is being led erratically, they can halt the dance in ship with supervisees should be a priority.
order to make adjustments to correct the original
problem. On the other hand, if both dancers try
to lead, the overall training ultimately suffers.
As scary as it may seem, the supervisees are the Think about Yalom’s assertion that therapy should be
relationship-driven, not theory driven. Now consider
ones leading; they inform the supervisor of their applying this to supervision: Supervision should be
needs and of where they need to go. One can best relationship-driven, not model-driven. What benefits
supervise by following their lead, knowing you can be derived from taking this approach?
have every right (and responsibility) to intervene
if something is clearly wrong.
Relational Alliance and the Helping Professions
Reflection Although the relationship-based ideals expressed
What other ways can the concept of “the dance” by Rogers and Yalom may sound humanistic but
as an empathetic concept be applied to clinical not exactly scientific, they are supported by the
supervision? How might this metaphor work into your research literature. Several leaders in the field, in
style of clinical supervision? Staying with the “dance” investigating what works in psychotherapy, assert
metaphor, how can embracing other person-centered
principles, like unconditional positive regard and
through use of meta-analytic research and litera-
congruence, impact the supervisory relationship? ture that the relationship is the vital ingredient in
what makes therapy successful [16; 17; 18]. A term
often used to refer to this concept is therapeutic
alliance; however, in the context of clinical super-
Irvin Yalom and The Gift of Therapy
vision, the term relational alliance is a better fit.
Psychiatrist Irvin Yalom is perhaps best known in A relational alliance is when two parties, such as
the context of his seminal text on group therapy a supervisor/supervisee, are engaging in a mutually
[14]. However, one of his later works, The Gift respectful, trusting interaction, working toward a
of Therapy, may have a greater application to goal or benefit.
our professional formation as clinical supervisors
[15]. In this text, published more than 30 years In the text The Heart and Soul of Change: What
after his seminal piece on group therapy, Yalom Works in Psychotherapy, Duncan, Miller, Wampold,
declares that in spite of all his years writing about and Hubbard assert that the collaborative, thera-
techniques, it really is the relationship that mat- peutic alliance between client and clinician (and
ters most [15]. perhaps by extension the supervisee and supervi-
sor) is a primary factor in determining successful
Written in plain English as an “open-letter” to therapy outcomes and is more important than the
young therapists, the book’s thesis is that therapy specific execution of therapeutic protocols [19].
should not be theory driven, but relationship They also stressed that obtaining continuous cli-
driven. Yalom contends that our heightened ent feedback throughout the therapeutic process
sensibility to existential issues deeply influences is critical to enhancing client care. When this
the nature of the therapeutic relationship and the literature is examined as a whole, it is clear that
therapy itself [15]. According to this perspective, little difference exists among the specific factors
a therapist has no place forcing solutions, a piece

8 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
(e.g., technical elements) of researched therapeutic
therapies. Rather, there are a series of four com-
mon factors among these therapies that seem to be If you replace the word client with supervisee and the
word therapist with supervisor in this quote, what do
contributing to change. These common factors are: you notice? How might this apply to your approach
the clients and their extra-therapeutic factors (e.g., to supervision?
what they bring to the table in therapy and situa-
tions out of the control of the clinician); models
and techniques that work to engage and inspire an Norcross, whose work is considered seminal in the
individual client; the therapeutic relationship/alli- field of psychology, arrived at similar conclusions
ance; and therapist factors. Interestingly, these four in Psychotherapy Relationships that Work: Therapist
common factors were first proposed and published Contributions and Responsiveness to Patients [21].
by psychiatrist Saul Rosenzweig in 1936, predating Using a collection of empirical research as part
the work of Rogers and Yalom [20]. Rosenzweig, of an American Psychological Association Task
who grew discouraged with the “therapy wars” Force, Norcross concluded that the therapy rela-
waging around him at the time, asserted the fields tionship, together with discrete method, influences
need to focus on the factors that all good therapies treatment outcomes. Norcross further concluded
have in common instead of fighting over what is that therapists can hone these relational elements
superior about a specific approach or technique. and that it is their responsibility to tailor these
By respecting the common factors and focusing skills to the needs of individual patients. Thus,
on these simple, humanistic elements, therapists the relationship should drive the theory, not the
can best meet people where they are coming in to other way around, which is concomitant to Yalom’s
therapy. contentions.
Respecting the common factors, as a therapist or a APPLYING EMPATHY AND
supervisor, does not give one permission to throw PERSON-CENTERED PRINCIPLES
competence to the wind and abandon theory, tech- TO CLINICAL SUPERVISION
nique, or model altogether. Rather, it is important
to reconceptualize their meanings to the overall The next step is applying these principles to the
helping process. According to Duncan, Miller, practice of clinical supervision. By accepting that
Wampold, and Hubbard [19]: the same person-centered concepts used with
clients can be applied to supervisees, a better con-
…We conclude that what happens (when nection (or relational alliance) may be established.
a client is confronting negative schema, There are so many ways to conduct supervision,
addressing family boundaries, or inter­ just as there are a myriad of ways to conduct psy-
preting transference) is less important chotherapy; the great common thread is to appeal
than the degree to which any particular to the most basic components of personhood.
activity is consistent with the therapist’s Supervisees are, above anything else, humans, and
beliefs and values (allegiances) while embracing this humanity as opposed to their status
concurrently fostering the client’s hope as a supervisee helps them to grow to their fullest
(expectations). Allegiance and expec- potential. Supervision is a process that supervisees
tancy are two sides of the same coin: the can view as a punitive chore, and many who have
faith of both the therapist and the client had negative experiences with supervisors have
in the restorative power and credibil- viewed it as such. So, consider how the field can
ity of the therapy’s rationale and related be changed by taking an institution that is often
rituals. Though rarely viewed this way, dreaded and approaching it as a safe container
models and techniques work best when in which growth can occur and potential can be
they engage and inspire the participants. explored.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 9

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
In addition, there is a potential to achieve tre- who are overly administrative in their mindsets
mendous progress by focusing on commonalities or those who see it as their duty to shape a new
as opposed to divisive differences. This humanistic generation of therapists in their image. Respecting
principle is evident in Roszenweig’s common fac- the individual dignity of a supervisee is not only
tors. Supervisors can teach those they supervise a person-centered concept, it is a way to put non-
and work with them to implement understanding maleficence into action.
into their work. However, it can be beneficial to Putting the person-centered value of empathy into
address this idea of focusing on what the various action as a supervisor is based on remembering
approaches to supervision have in common in what it was like to be supervised. It also entails
order to best meet supervisees where they are in being willing to step into the shoes of a supervisee
the supervisory process. Powell captured the spirit and consider what he or she may be going through
of Roszenweig’s common factors in psychotherapy at any point in professional formation. As will be
with his five common components of supervision discussed in the next session, there are ways to
[6]. Powell noted that there are so many defini- build empathy and cultivate putting it into action.
tions of what constitutes supervision in the various Although some supervisors and counselors may
helping professions, so it is important to look at naturally be more empathetic than others, empathy
the commonalities in these various definitions. To is an action word, and as a person-centered value,
review, these five common elements are: it can be practiced and built.
• An experienced supervisor
• Actual clients in clinical settings Reflection
• “Do no harm”/welfare of both clients What does “doing no harm” mean to you? Can you
and the supervisee think of a time in your career when, either knowingly
• Monitoring performance through direct or unknowingly, you put a supervisee in harm’s way?
What lessons can you draw from this experience?
or indirect observation
• The goal of changing the counselor’s
These common elements show that various models PRACTICING EMPATHY
can work, as long as they meet these criteria. Just
as it is important for therapists to have a variety AND THE ART OF SUPERVISION
of different models or techniques on hand in order Fostering critical thinking and putting the person-
to engage and inspire clients, it is important for centered principles covered thus far into action is
supervisors to have a variety of ways to work with a the next step in building a supervisory practice. To
supervisee. This logic is the ultimate representation best do this, this section will explore case studies
of clinical common sense; just as no two clients of four very different supervisees in the helping
are alike, no two supervisees are alike. Embracing professions and consider the supervisory strate-
this logic is a hallmark of putting person-centered gies for each person, depending on context. The
supervision into action. supervisees are Ms. V, Mr. B, Ms. T, and Mr. N.
Powell writes about the importance of non- Ms. V is a white, heterosexual woman, 26 years of
maleficence, or doing no harm, to both clients age. Assigned to a public mental health agency,
and supervisees [6]. Considering the emotional she is in the internship phase of a Master’s degree
welfare of the supervisee in addition to that of program in clinical counseling at a small, Christian
the client represents a person-centered value that university. Ms. V opted to go to graduate school
clinical supervisors often neglect, especially those immediately after finishing her Bachelor’s degree

10 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
in psychology. Her initial motivation for studying intern at his community’s correctional treatment
psychology was to help people, and she chose to do facility. He has every intention of going on to com-
this despite the protests of her upper middle class plete his Bachelor’s degree and perhaps a Master’s
parents, who believed that there was no “future” degree, but he is not sure if he is “smart” enough
(financially) in the psychotherapeutic professions. to handle the writing component of this advanced
Partially to ease their protests and partially to “get education. The clients at the facility connect with
on” with a career, she entered graduate school. Mr. B’s easy, natural style, partially because it is
Ms. V has found working with clients to be quite very clear that he has been to the dark places that
a struggle. She went into the field with every good they have been.
intention of helping people, and she believed it was Ms. T is an African American woman, 50 years of
part of her spiritual path. However, the first time a age, who completed her Master’s degree in social
client from a background different to hers, a tall, work two years ago. Ms. T was grandfathered into
African American man on welfare, towered over being a licensed social worker in her state before
her and told her that she “didn’t know what she formal licensure laws came into effect; she worked
was talking about,” Ms. V melted down and spent her way up the ranks in the medical social work
the rest of the day in her office crying. She called department at a hospital near her hometown.
off from her site duties for the rest of the week, Around 40 years of age, she became restless in the
citing illness. At this point, Ms. V is wondering if “paper pushing” culture of her hospital and decided
a career in counseling is really the best fit for her it was time to make some changes. She thought
because of her discouraging experiences working about going to school for another profession, like
with clients. Yet the thought of going through a nursing, but ultimately decided to complete a
Master’s degree program and not using it, especially Bachelor’s degree in social work and stay on for
when her parents paid and supported her through her Master’s. She enjoys working with clients in
the program, is a shaming prospect to her. At this an individual manner, conducting therapy; she
point, she is at a juncture and feels trapped. feels that she has a great deal to share because of
Mr. B is a homosexual man, 38 years of age, of her rich life experience. Ms. T is the mother of
multiple ethnicities. (His mother was born to a three, the grandmother of five, and lost one of her
Jamaican father and a white mother, and his father grandchildren in a fatal car accident. Ms. T’s father
was of Dominican origin.) Mr. B is a recovering worked with Medgar Evers during the Civil Rights
heroin addict and alcoholic, having amassed 3 movement, and Ms. T was raised with a strong
years of clean time in his chosen twelve-step pro- commitment to social justice. Despite liking her
gram. A machinist in his first profession, Mr. B clinical job at a company near her hometown, Ms.
was not able to maintain employment because of T experiences frustrations. For instance, she never
unreliability in showing up. After trying rehabilita- thought that there would be as much paperwork
tion programs several times, unsuccessfully, his last in clinical life as there was in medical social work.
attempt seemed to stick, following his diagnosis She finds juggling her schedule, with the mixture
with hepatitis C. Taking an open mind to recov- of clinical and administrative demands, to be a
ery, Mr. B discovered a new life for himself, and challenge. She also finds working with some of the
he especially found that working with others gave younger counselors from a more privileged back-
him a renewed sense of purpose in life. At two years ground to be a struggle, as she sees them as being
sober, he decided to complete an associate’s degree “out of touch” with what their clients go through.
program in chemical dependency counseling at his Moreover, Ms. T’s clinical supervisor is 18 years
community college. Mr. B loves school and loves younger than her, and Ms. T often has resentment
working as a chemical dependency counseling in having to take direction from her.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 11

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
Mr. N is a self-described “family man,” 52 years “STEPPING INTO THE
of age of Polish Jewish descent. His parents were SHOES” OF THE SUPERVISEE
refugees following the Second World War and The idea of “stepping into the shoes” of another
immigrated to the United States in the 1940s. Edu- to better appreciate his or her perspective is the
cation was highly valued in his family growing up, hallmark of putting empathy in to practice. We are
and Mr. N immediately went to college, finishing a encouraged, as professionals, to do it with clients,
Bachelor’s and Master’s degree in social work. Mr. and many do it quite well, but it is important to
N established a career working with Jewish fam- consider this with supervisees as well. Engaging in
ily services in a major American city as a clinical such a practice is an effective way to build com-
social worker, and he genuinely enjoyed his work. petence as a person-centered supervisor. There are
At 45 years of age, Mr. N was compelled to return simple ways to practice this art. For instance, take
to college and complete a PhD. His brother is a one of the four cases introduced at the beginning
medical doctor and his sister is a lawyer, and even of this section. As a supervisor, which case would
though he is successful in his own right, he was you be most likely to struggle supervising? Reread
always made to feel like the underachiever in the that case and then take a moment to reflect and ask
family for not living up to his full potential. At yourself, “What is he or she really going through?
the advice of his agency director, Mr. N decided to If I had to put myself in his or her shoes for a day,
pursue a PhD in psychology, not in social work, as how would I respond?” Often, supervisees indi-
completing the degree would make him eligible for viduals most struggle with are those whose shoes
a psychology license. This new license would make they “resist” stepping in to. This simple exercise,
Mr. N eligible to do forensic and educational evalu- inspired by guided imagery, is one of the best ways
ations that could be quite lucrative in his state; to practice exploring one’s potential for empathy
after all, his agency always “contracted out” such and what blocks exist that keep you from being as
services. However, completing a PhD in psychology effective a person-centered supervisor as possible.
means that Mr. N would have to complete another In some cases, resistance is more than about dis-
internship with a licensed psychologist. He has a similarity to one’s own life or fear-based (e.g., fear
friend who is willing to conduct the supervision, being in a position in life in which more schooling
monitoring his existing hours at Jewish family and more supervision is necessary). However, if
services, in addition to mentoring him through one is able to honor and access this sense of trepi-
other evaluation-based tasks that he must learn. dation, he or she may be able to connect to what
About halfway through the program, Mr. N finds Rothschild and Rand called somatic empathy [22].
he is growing weary of being supervised again and Somatic empathy is about noting and honoring
wishes that he would have chosen to complete a physical reactions to a person or a situation, rec-
PhD in social work instead. ognizing that this response is likely mirroring what
that person is experiencing. A sense of trepidation
and visceral uneasiness at the thought of having to
be in a supervisee’s position gives a supervisor a bet-
What is your gut-level reaction, as a supervisor, after
reading these four cases? Before working further in
ter understanding of the trepidation and uneasiness
the course, what does your common sense tell you he or she is likely experiencing in the work context.
about how each individual person would need to So much of empathy is being attuned to visceral,
be approached in the supervisory context? body-level clues. Instead of ignoring them, these
responses can be used to better work with others.

12 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
SKILLS FOR DEVELOPING Being corrected can be difficult enough, but being
AND BUILDING EMPATHY insulted or shamed during the process can be a
Doing brief guided imagery meditations in order dehumanizing, discouraging experience. Using
to “step into the shoes” of supervisees, as described the cases that opened this section, think about
previously, is one option for developing one’s ability how being called a “novice counselor” might affect
to be empathetic and build on existing capacity for someone like Ms. V or Mr. B. Although they are
empathy and unconditional positive regard that relatively new to the helping professions, such a
may already exist as a therapist. Even if one is a phrase, used pejoratively, might break the spirit
very empathetic therapist who is capable of putting of someone who is new and doubting his or her
person-centered principles into action with clients, skills in the first place. Moreover, the practice of
it is still important to do these exercises to evaluate “keeping people in their place” is not kind, from
capacity for practicing these principles with super- a humanistic perspective, and can do harm to
visees. Even though the principles are similar, the the new supervisee. Promoting a climate of sup-
context differs, which is why it is important to prac- portive growth, as opposed to enforcing perceived
tice building empathetic capacity with supervisees. hierarchical differences or reminding supervisees
For instance, all of the administrative and legal/ of their newness to the field, is a necessary part of
ethical responsibilities associated with supervision practicing person-centered supervision.
may result in a sense of nervousness or pressure Supervisees often feel that their supervisor holds
to “do it right.” In this new context, empathetic their future in their hands whether it be for intern-
capacities can be significantly altered. Thus, doing ships to get a license or while licensed in order
these “step in to their shoes” types of exercises can to become independently licensed. They may be
help to better appreciate the perspective of your scared that sharing personal experiences will be
supervisee, and it may be worthwhile for you to used against them later, or they may be reticent
notice how the context or pressures of “being a to seek additional help, fearing it will damage
supervisor” affect one’s supervisory practice. the relational alliance. Simply appreciating that
supervisees may see you this way and making a
conscious choice not to exploit that dynamic is
putting humanistic empathy into action within
How do the pressures that come with being a
supervisor affect your ability to practice empathy, the supervisory relationship. Although in cases of
unconditional positive regard, and other person- unethical or downright inappropriate behavior it
centered principles? may be necessary to use leverage as a supervisor to
bring about change in the supervisee’s behavior,
these uses of leverage should be implemented only
Constant correction and criticism from a supervi- in exceptional cases. A supervisee, in regular cir-
sor is generally ineffective. However, if you value cumstances, should not be made to fear that you, as
the supervisee and welcome his or her newness as the supervisor, can destroy them over a personality
something “fresh,” as something to be welcomed conflict or power struggle.
as opposed to something to be feared, a supportive
Another potent way to building empathetic capaci-
relationship in which corrective feedback is much
ties, whether for working with clients or supervis-
more likely to be received will be created. Many
ees, is to quite literally remember what it was like.
have experienced success with this logic in work-
Ineffective supervisors may be either so jaded or
ing with clients.
so caught up in being an “expert” that they forget
what it was like to be a developing professional in
need of supervision. It is important to call upon

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 13

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
our past memories of what it was like to be “super- only, and supervisors are encouraged to incorporate
vised,” whether it was in a human services capacity tools into their own unique practices.
or in another job. Even negative experiences will
inform your choices as a supervisor, giving insight Imbuing Fear versus Fostering Confidence
into what not to do. “Imbuing fear” is the notion of being too afraid to
do something, and this often happens with people
trained in a new approach to therapy, especially
Reflection with something that can seem complicated, like
One of the prime skills for building empathy as a eye movement desensitization and reprocessing
supervisor is to remember what it was like to be (EMDR) [23]. If trainers and instructors overload
supervised. Can you recall one or more of your worst
experiences with being supervised, whether in a
people with information, trainees can become
clinical context or in a non-clinical context? One afraid, fearing that if they miss one step, they will
of your most positive? Reflect on how it felt to be somehow mess up the whole therapy or do grave
in these dynamics. Remembering those feelings, harm to a client. Although the desire to “do no
and knowing what you know now, how can you use harm” is noble, by focusing too much on little
these experiences to inform your work with others?
details, people can miss the big picture of therapy,
such as how fostering a safe, therapeutic context
is most likely to promote a healthy environment
Just as there are negatives to learn from, positive for therapy.
experiences can enrich and inspire us. Perhaps in
your experiences as a supervisee, you felt supported The same is true in supervision. Supervisees may
in your continued growth as an independent coun- become overwhelmed if they are bombarded with
selor. As a result of feeling supported, supervisees negative feedback and too many things to work on
actively seek out clinical supervision, even when at once. Letting the supervisee know what is being
they are not technically required to receive it regu- done right and giving him or her no more than two
larly. Being supported and empowered, no matter or three things to work on at a time will result in
one’s age, specialty, or status in life, is the optimal the best outcomes. This can be accomplished in
environment for supervision, both clinical and many ways, but one useful tool is what is referred
administrative. It is a simple matter of “golden rule” to as the “compliment sandwich.” In the “compli-
logic: treat others how you would like to be treated. ment sandwich,” share with supervisees something
that they’re doing right, then insert an area of
PRACTICAL SUGGESTIONS FOR improvement, and then end with a compliment.
PUTTING EMPATHY INTO PRACTICE While this approach may seem too soft to some,
The skills of stepping into the shoes of another and especially those of a more militaristic or direct
remembering one’s own experiences are two critical temperament, it can be successful.
ways to build one’s ability to be empathetic and to People are so used to getting criticized that being
put it into practice in the supervisory relationship. praised and empowered in a genuine way is such
The person-centered principle of meeting people an effective supervisory technique. Shaming and
where they are, which is an art often practiced criticism can make people defensive, especially
with clients, can also be applied in the supervi- if it causes them to doubt their own abilities or
sory relationship, in addition to embracing simple competencies. Recognizing this dynamic is part
elements of kindness, like the golden rule. In this of what fostering confidence is all about. Working
section of the course, we will begin to build upon with new counselors who are very raw and seem
these basics of person-centered logic to develop to need a great deal of work can make the art of
strategies that work in both supervision and clini- fostering confidence difficult, but it can be done.
cal consultation. These are meant to be suggestions

14 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
Even starting with a singular strength and building Ms. V: I don’t know. I just feel in over my head.
upon it will get farther than focusing only on all Supervisor: Okay…Can you help me understand
of the areas that need improvement. When work- a little bit more about what you mean by “over
ing with supervisees, make it a point to tell them your head”?
what they are doing that is positive and beneficial
to those that they serve. A simple “You can do it!” Ms. V: I mean, I have thought about it…I’ve really
can go a long way. been thinking about it for the last several days, and
I think he’s right. I mean, what do I really know
Trouble can arise if a supervisor focuses on the about real life? I’m just a privileged little white girl
specifics of a technique and imbues fear by focus- who has a degree.
ing on everything that can go wrong and being
militant about following the letter of the law. By Supervisor: Wow, that’s heavy…Is that what L
not focusing so much on the technique and what said?
can go wrong, people are in a better place to learn, Ms. V: More or less.
and this is a person-centered idea. As clinicians, we
stress the importance of helping clients find their Supervisor: And you’ve been thinking about this
senses of self-efficacy and empowerment, so why for the last several days since it happened?
would we not impart this same attitude of discov- Ms. V: That’s all I’ve been able to think about.
ery and exploration with supervisees? Of course,
Supervisor: Wow, that’s heavy stuff, V. I’m sorry
correction may also be necessary. Remember the
that you’ve been beating yourself up about this
parallel of the dance: they are leading, you are fol-
issue. I just want to assure you that you are not
lowing, but you have the right at any time to say
alone here. We have all been told off or talked
“halt” if something seems amiss. Staying with the
down to by clients at one point or another during
dance analogy, should a good partner criticize you
our careers.
and constantly make suggestions, cheering you on
for the good job that you are doing? Ms. V: Really?
Let’s apply this idea to the case of Ms. V, the young Supervisor: Absolutely.
counselor who feels overwhelmed as an intern with Ms. V: It just seems to come so easy for so many
agency work. How would she feel if, after criticiz- people.
ing herself already due to frustrating interactions
with clients, her supervisor simply harped on her Supervisor: I hear that it can seem that way. You
for everything that she was doing wrong? Part of may have heard that cliché before that everyone
a supervisor’s job may entail evaluating areas of who’s an expert at something was once a beginner.
further training Ms. V should pursue, or perhaps That applies here, too, V.
it may require suggesting that Ms. V seek out some Ms. V: I just feel like I’m not cut out for this.
of her own therapy in order to work through her
Supervisor: Can you tell me more about that?
blocking issues. However, think of how much more
smoothly broaching these issues will be if Ms. V Ms. V: Well, yeah. I mean, the people that we’re
knows her supervisor cares about her as a person. dealing with here in the city. I’ve just never had
Here is an example of how a person-centered to deal with this kind of pain before. I can’t even
supervisory interaction could play out: imagine what it’s like to be on welfare or to have
parents that ran off on you, or to be addicted to
Supervisor: V, I got your email about the session
drugs. I want to help people, but I just don’t know
you had with L (client in question) and that it took
what to say.
a toll on you. How can I best help you with this?

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 15

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
Supervisor: I hear that. What seemed to bother Textbooks are full of information about what to
you the most about what L said to you? do in theory, but guidance from an experienced
Ms. V: I don’t think it was what he said as much supervisor gives a better understanding of the art
as how he said it. Just that he towered over me and of counseling and how to handle tricky scenarios
I felt paralyzed to say or do anything. I get that I that clinical life entails.
can never really understand what’s going on in his As a supervisor, it is important to give your super-
life, but he was so harsh about it. visees options. An experienced clinician can
Supervisor: Interesting. There is a couple of ways respond to supervisees’ questions regarding com-
we can approach this. We can look at what about plex scenarios by presenting what the textbook says
this interaction with L triggered things for you. Or to do and what he or she would actually do (if they
we might re-examine what you remember saying in differ), providing information on both perspectives
the conversation that seemed to set L off. You tell on the matter. Offering choice is the very essence
me, V, where do you need to go with this? of empowerment.
Some experts argue that the field, as a whole, would
be enriched if practitioners candidly shared what
they actually do, as opposed to what the standards
What are the person-centered approaches that state [23]. Offering supervisees choices on how to
you see at work with Ms. V in this interaction?
If you were in Ms. V’s shoes, how would you react
handle a situation, just like the supervisor gave Ms.
to this approach/the beginning of this supervisory V a choice on where she wanted to go with her
interaction? supervisory session following the difficult encoun-
ter with a client, is paramount, especially if a
person-centered approach to supervision is desired.
Intuition and Following the Rules Here’s an example of how this choice dynamic may
In many cases supervisors face a choice of going play out with a different supervisee, Mr. B:
by the book, or following their intuition. Some Supervisor: So, what would you like to work on
people are “by the book” and more interested in today?
following letter of the law, and others have more of
Mr. B: Well, I’m struggling. When I was in treat-
a free-spirited, intuitive, experiential orientation.
ment all of those times that didn’t work, I used to
Some want to see an empirical research study to
get pretty nasty with counselors when they brought
inform every intervention, while others are content
up the idea of going to AA or NA meetings. Then,
with the feedback that they receive from clients
I got clean in a 12-step program and it all clicked, as
or others. Others approach decision making in
you know from my story. So now when I talk with
the human services with a combination of these
clients about meetings or using 12-step language,
approaches: the letter and the spirit, the logic and
they’re getting smart with me the same way that I
the intuition, the research and the experience.
used to get with counselors. And it’s frustrating me
All vantage points can be helpful in the human
like crazy. I just want to shake them sometimes and
services professions, and this applies to supervision
tell them that they’re going to keep failing until
as well.
they get into a program.
Of course, all supervisees are different, so the
Supervisor: I see. Well, I can relate to some extent.
approaches used with them must differ in order to
It can be a struggle when you feel that, as a person,
be truly person-centered and meet people where
you worked hard and something really clicked for
they are. Although some may request technical
you, and you just don’t see why others won’t get
instruction and specific feedback, many supervis-
it too.
ees are looking for an experience richer than the
technical elements that they can read in a text.

16 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
Mr. B: Yeah, that’s a big part of what’s going on. I consider that reviewing a treatment plan to see
didn’t think it would bother me as much. if something is working to help a client reach his
Supervisor: What do you think you need to do or her goals is a way of measuring and evaluating
to address it? outcomes. Clinicians must be able to demonstrate
which interventions work, not only to the enti-
Mr. B: I mean, meetings are the only way for a ties (like third-party payers) who are supporting
person to get clean. How can I make them see that? treatment, but to clients so that they stay engaged.
Supervisor: Well, let me share this with you. Tech- Some clinicians are advocates of tracking outcomes
nically, if we look at what the studies in the field say on an agency-by-agency and case-by-case level
about getting sober, we know that meetings aren’t to most effectively determine whether or not an
the only way to get and stay clean, although they approach is working [19]. However, the thought
are certainly one of the most popular and effec- of asking a client “How am I doing?” scares many
tive ways. Again, that’s what the field as a whole clinicians, because they fear they might not be
teaches, so we need to respect that. But what this able to handle what the client shares. Although it
treatment center has learned through experience can be frightening, consider how setting an honest
and feedback is that meetings seem to work the best culture of feedback within the therapeutic context
for the most people who come through our doors… can foster a more interactive therapeutic alliance.
if they want to stay sober long-term. Setting the culture of feedback consists of assuring
the supervisee that he or she will not be punished
Mr. B: I don’t know if I buy that. About what “the for sharing honest reactions and following through
field” says. with this commitment.
Supervisor: I’m not saying you have to buy it, B. The same commitment to setting a culture of
I’m just sharing the information with you. What feedback can be practiced within the supervisory
you do with it is up to you. I’m just asking you relationship as well. Because of the precarious
to keep an open mind to it and think about how power dynamic that may exist between supervisee
sharing both sides with a client, like I just shared and supervisor, following through on this commit-
with you, might be helpful. ment to non-retaliation becomes imperative to
achieving and maintaining this healthy feedback
Reflection culture. A supervisor can simply obtain feedback
Think about the dichotomy of rules versus intuition.
by asking at the end of each session or every few
Which best represents your approach to clinical sessions. Some examples include, “How useful was
supervision, or do you embody both? Have you the session for you today?” or “Is there anything I
received feedback from your supervisees about which could have done differently today that might help
they most value? better next time?” The fact that a supervisor asks
these questions can help to forge the professional
The Importance of Outcomes
Supervisors can also elicit this feedback within
and Seeking Feedback
a session, on a micro level. When sharing a sug-
Outcomes, or clear data/evidence to show whether gestion or offering guidance to a supervisee, ask if
or not (or to what extent) a certain intervention is the suggestion feels right or is helpful. If a culture
effective, are an important component of evalua- of feedback has been promoted within a solid
tion in the psychotherapeutic professions. Certain relational alliance, this feedback will be reliable.
agencies and accrediting bodies place more value Consider how a dialogue in this approach might
on outcomes data than others. Regardless of what play out between Ms. T, another case outlined
one’s opinion about tracking formal outcomes, previously, and her supervisor:

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 17

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
Ms. T: I find that J (a client on Ms. T’s case load) Supervisor: I’ve tried it before with some success
is frustrating me more and more. I don’t know if with those chatty types of clients or those who
she’s just rubbing me the wrong way or if I’m doing want to analyze everything.
something wrong. Ms. T: What if she resists?
Supervisor: What seems to be the source of the Supervisor: That’s definitely a possibility. When-
frustration? ever a client puts up a protest, a common line
Ms. T: Well, she comes into session, always with that I use is, “Would you be willing to try it? It’s
a catastrophe, just chattering and chattering away something different than what we’ve been doing
and I can’t get a word in edgewise. and I have a feeling it may work better for you.”
Make her realize that you are interested in trying
Supervisor: Hmm…Did you ever deal with these
every possible option to help her.
chatty types when you were working at the hos-
pital? Ms. T: That’s a good point. I never thought of it
that way.
Ms. T: Sure, but it never seemed to be this bad.
And I never have this sense, like I had with J, Supervisor: How is this suggestion we just dis-
that she’s expecting me to fix things for her. And cussed resting for you?
I mean, how can I fix things for her? She won’t let Ms. T: I like it. It feels good, and it’s certainly
me suggest anything. worth a try.
Supervisor: Well, that is a very good point. Just
to look at it though, did you ever do anything
with your clients at the hospital that seemed to
get them on track? What does feedback mean to you? What frightens
you or concerns you about directly asking for feedback
Ms. T: Well, it’s little, but I usually found that the from a supervisee?
“take a deep breath” line would work, even if I was
interrupting them to suggest they take a breath.
Supervisor: I think that you’re on to something, T. Getting to the Underlying Issue
In my work, I really praise the benefit that breath At one time or another, you have likely asked a
and using the body can have with clients. So let client, “What is this really about?” For instance, a
me share with you something I’ve tried before with client may be having an intense reaction to what
clients like J. seems to be a petty stressor, but it becomes clear
Ms. T: Okay. after observing some deep, visceral level distress
that something else is going on. Perhaps that
Supervisor: Clearly, there is some type of relation- “petty” work stressor is a reminder of a stressful
ship established because J keeps coming back for dynamic with an abusive parent. Within the con-
sessions and seems to trust you. So, the next time text of a working, therapeutic alliance, asking a
that she comes in, after you get the initial hellos client to examine the underlying cause of distress
out of the way, be assertive. Ask if she is willing to can be a powerful intervention, and it can be in
try something different to start this session. Ask her clinical supervision as well. However, one should
if she would be willing to just do some breathing not use this strategy with a supervisee who is new
for the first 5 minutes of the session, before you do or with whom you have not formed a working
any talking. relational alliance yet. This question can backfire
Ms. T: Interesting. You think that would work? if the supervisee ends up resenting it. But, if the
alliance is established, this simply placed question
can open up a world of new discovery. Let’s revisit

18 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
the supervisee case of Ms. V and the dialogue Ms. V: Oh, absolutely. And I think it hit me even
explored in an earlier session about her struggles harder because my parents never really wanted me
with her client, L, and see how the approach of to go into this field in the first place, even though
asking what the distress is really about may work they financially supported my education. It’s like L
with her. Remember that the conversation left off telling me I don’t know what I’m doing is hitting
with the supervisor giving Ms. V an option about me even harder because that sounds like something
what she most needed to address: they would say.
Ms. V: I don’t think it was what he said as much Supervisor: That’s really fascinating, V. Is this
as how he said it. Just that he towered over me and something you’re comfortable continuing to talk
I felt paralyzed to say or do anything. I get that I about with me or do you feel you may want to
can never really understand what’s going on in his address it with someone else?
life, but he was so harsh about it. As a point of clarification, a supervisor, even a
Supervisor: Interesting. There is a couple of ways person-centered one, should never become the
we can approach this. We can look at what about supervisee’s therapist; obvious complications can
this interaction with L triggered things for you. Or arise with a dual relationship. However, it is inevi-
we might re-examine what you remember saying in table that a supervisor will explore some issues of
the conversation that seemed to set L off. You tell emotional significance with a supervisee, especially
me, V, where do you need to go with this? if these issues are triggered by on-the-job issues or
if these issues impact one’s ability to do the job.
Ms. V: I’m not sure.
If it is clear that using the “what’s this about” or
Supervisor: Well, just take a minute then. You other exploratory approaches opens up more than
can close your eyes and get silent if you need. Ask the supervisory relationship is designed to contain,
yourself where you most need to go today. it then becomes the supervisor’s responsibility to
Ms. V: Okay. (She briefly pauses) It’s the way he explore the supervisee’s potential need for clinical
just got up and stood over me. I felt very unsafe. services of his or her own. That exploration is what
the last line of this dialogue leads to. This idea will
Supervisor: Okay, V. That’s very honest. If I can be explored further later in this course.
ask, being towered over like that and not feeling
safe, what is that really about?
Ms. V: Wow, I didn’t think of that parallel. When-
Have you ever used the question “What is this really
ever my parents doubted my opinion on something,
about?” with a supervisee? What type of results did it
especially about my career choice and field of study yield? Is there another way to ask this question in a
in college…whenever I fought them on anything, manner that works better with your style?
they would stand up, even if we were at the dinner
table. It’s like it was their way of making me feel
small. Even if we were all standing during an argu- Repair the Ruptures
ment, it would seem like they became 10-foot-tall
A rupture is a break or a disturbance that causes
giants when they started to argue.
impairment in flow or function. Ruptures can occur
Supervisor: How interesting. Is there a chance in every kind of relational alliance, whether it is
that you interaction with L triggered this dynamic a personal relationship, a romantic relationship,
with you? a therapeutic relationship, or a supervisory rela-
tionship [24]. A rupture occurs when something
goes wrong, for whatever reason, in a relation-
ship. Unless it’s addressed in some manner, it can
permanently alter the relationship and have an

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 19

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
impact on its success or failure. Even if the original Mr. N: Uh, oh. I feel a lecture. What’s the prob-
rupture is significant, if it is addressed effectively, lem?
it can positively impact the relationship overall. Supervisor: Now, don’t jump to conclusions.
Ruptures can happen in supervisory relationships There’s just something I feel I need to address.
for a variety of reasons. What is most important According to the terms of our supervisory agree-
for supervisors to accept is that if they played a ment for your psychology license, I need to meet
role in causing the rupture by offending or other- with you in person at least once a week for our
wise causing friction with a supervisee, they take session. I’ve noticed that you’ve been showing up
responsibility and address it immediately. Just at least 15 minutes late to almost all of our sessions,
like the “golden rule” logic can go a long way, so and you’re skipping a few of our meetings, which
too does the simple act of admitting when one is doesn’t seem to be like you at all.
wrong. Many supervisors or managers are reticent Mr. N: It’s no big deal. I’m just really busy juggling
to do this, feeling that it will make them look weak my work at family services, my course work, com-
or that admitting fault can undermine authority. ing here, and doing some of the new evaluation
However, nothing creates more respect for those tasks I’m being asked to complete. I thought you
in power than when they can admit that they are understood this.
wrong and correct a mistake.
Supervisor: I’m sensitive to the position you’re
Part of a supervisor’s responsibility is being able in. I’m just starting to feel like the time I’m setting
to recognize what his or her part is in a situation aside doesn’t matter to you or that these sessions
and what part the supervisee may play. Of course, are more of a chore for you than anything.
supervisors are not always in the wrong in the case
of the breach and it is not totally their job to fix the Mr. N: Well, to be perfectly honest with you, they
rupture. However, it is their responsibility, if they kind of are. It’s one more thing I have to do.
know that a rupture exists, to bring it to light and Supervisor: I can appreciate that. Is there any part
attempt to elicit a repair with the supervisee, even of you that is resenting being supervised?
if he or she is are clearly in the wrong. Consider
how this dynamic might play out for the supervisor Mr. N: Well, it’s kind of tricky, yes. I know there
working with Mr. N, the PhD psychology student/ are some different tasks as a psychologist that I
social worker introduced earlier: have to learn, but in essence, I’m just doing the
same thing I’ve always done as an independent
Supervisor: N, I need to ask how you feel things social worker.
are going with our supervision sessions.
Supervisor: I understand. But I would be dishon-
Mr. N: Oh, fine. est with you if I kept pretending that everything
Supervisor: Fine? was okay here. Above all, I want to make sure that
you’re alright and to see if there’s anything I can
Mr. N: Yup, no complaints. You’re doing a good reasonably do here to make this situation more
job, if that’s what you want to know. beneficial for you.
Supervisor: Thanks, N. Bringing this up with Mr. N: Is it okay if I think about that and get back
you is a bit tricky, because we’ve had a collegial to you?
relationship, and I’d like to think friendship, for
many years now.

20 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
Supervisor: Absolutely. If I were in your situation in their careers. Consider how approaching Ms.
and needed to go through supervision all over again V about issues might be different than how you
to get a new license, I would probably be a little would approach Mr. N, for instance. To revisit the
salty, too, so know that I can relate. I just hope we common sense logic that resonates throughout this
can figure out a way to move forward that works course, person-centered supervision is all about
for both of us. appreciating where a person is coming from and
meeting that person where he or she is.

Reflection In this section, some accepted stages of counselor

Think about the concept of repairing a rupture.
development used by the helping professions will
When is the last time one of your life relationships be examined in order to have some type of guide,
had a rupture that was able to be repaired? although these stages should be taken as guide
What was helpful in repairing the rupture? only, not an absolute teaching. In the spirit of
flexibility, an alternate construct to conventional
development models, stages of changes theory, and
motivational enhancement will also be provided.
CLINICAL DEVELOPMENT These same approaches for motivational enhance-
AND FORMATION ment used with clients can be as valuable in work-
ing with supervisees, regardless of where they are
The psychotherapeutic professions are greatly on any developmental spectrum.
focused on models. Models are used to explain how
a certain phenomenon is supposed to unfold or how
a certain aspect of behavior should be reshaped.
Although models or technical explanations can be The purpose of this section is not to explain devel-
useful, the tendency to obsess over fully grasping opmental models in general, like those of Erickson
a model or trying to fit clients and supervisees to or Loevinger. However, if existing knowledge of
specific models is not. Models and theories tend to these models helps one’s work with supervisees,
develop independently of each other over time to they can certainly be used. Some of the popularly
explain a particular phenomenon that profession- accepted models of counselor development that
als seek to understand. Skinner once stated that exist in the various human services professions
assigning a level to an individual “does violence to include [26; 27; 28; 29; 30]:
the nature of the development process” [25]. This Hogan’s Four Levels
is true; development is a multidimensional process. of Counselor Development
Appreciating the developing clinician in such a
way is optimal in the person-centered approach • Counselor dependent upon the supervisor
to clinical supervision. • Autonomy-dependence conflicts with
the supervisor
In supervising clinicians, navigating developmen-
tal appropriateness becomes an even more complex • Higher level of counselor self-confidence/
task. Consider the four cases introduced earlier in autonomy in action
this course. According to traditional, Ericksonian • Counselor acts with a high level of
development, Ms. V is at a different stage of devel- personal autonomy, which includes
opment than the other three, and one could argue awareness of a continuing need for
that Ms. T and Mr. N are perhaps transitioning personal and professional development
between two developmental stages at these points

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 21

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
Hess’s Stages of Supervisee through a process. Person-centered supervision
and Supervisor Development acknowledges that each clinical professional’s
• Inception (e.g., insecurity, dependency, process, although one of growth, is unique to that
inadequacy) person.
• Skill development (i.e., move from
dependency to autonomy/adequacy) Reflection
• Consolidation (e.g., self-confidence, Do any of the models described in this section jump
individuation) out at you as effectively describing the clinical growth
of a professional you are entrusted to supervise?
• Mutuality (e.g., creativity, independent
Which of these models seem to best describe how
practice) you developed as a counselor?
Ralph’s Developmental Stages
of the Supervisory Process
• Nondirective expert guidance WORKING WITH THE
• Adoption of client/content-centered
The approach of motivational interviewing can
• Relationship-centered approach
be incorporated into supervisory practice much
• Therapist-centered supervision as it is used in psychotherapy. As the name of this
Rice’s Four Stages of Counselor Development approach suggests, motivational interviewing is
about asking a series of questions to enhance an
• Formation
individual’s overall drive toward change, a shift
• Development from confrontational or directive approaches to
• Stabilization counseling [31]. Motivational interviewing assumes
• Refreshment that all people have within them the abilities and
the skills they need to change. Mental health pro-
D’Andrea’s Person-Process fessionals can help people realize this potential so
Model of Supervision they can manifest change for themselves. Motiva-
• Preconformist stage: One-on-one tional interviewing, as a strategic approach, works
supervision needed well alongside many theories and techniques in
• Conformist stage: Group supervision counseling. It is ultimately very effective because
and continuous feedback needed the conclusions that one draws from oneself that
lead to change are more likely to persist in the
• Self-awareness/post-conformist stage:
long-term than changes that feel forced by outside
Supervisor becomes a colleague and peer
entities. Because motivational interviewing steers
These models are a sampling of available proposed away from specific direction or confrontation, it is
models to explain counselor development. A person-centered in its aims. The substance abuse
common theme in all of these models is perhaps field increasingly regards motivational interview-
captured in a statement from Hogan’s work [25]: ing as the best approach to working with resistant
“The overall aim of supervision is to foster growth clients. So, let’s consider how using an approach
toward independence, moving the clinical trainee that works with clients may also apply to work
from student, to colleague, to expert.” Supervisors with supervisees, especially supervisees who may
are essentially guiding a new professional’s growth be resistant to supervision.

22 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
Many professionals resent being supervised, and • Autonomy: The counselor affirms the
these resentments can take on a variety of shapes. client’s right and capacity for self-direction
The time commitment is often a first barrier for and facilitates informed choice.
busy professionals. Older professionals like Ms. T This is another example in which the word “coun-
and Mr. N who have been working in human ser- seling” can be replaced with the word “supervi-
vices in some capacity for many years but are mov- sion,” the word “counselor” can be replaced with
ing into a new area of service within the professions the word “supervisor,” and the word “client” can
are likely to feel some level of resentment. This be replaced with the word “supervisee.”
resentment can be more significant if they are being
supervised by younger professionals, contingent, Perhaps these principles make sense in terms of
of course, upon personal variables. Professionals working with a supervisee, but the next step is put-
like Mr. B may be more likely to experience this ting them into action in the supervisory relation-
resentment or be resistant if they feel they know ship in working with resistant supervisees. Miller
more about “real recovery,” obtained through and Rollnick suggest for resistant clients [31]:
life experiences, compared to a supervisor who • Express empathy.
has learned only through formal training. Super
• Develop discrepancy.
students like Ms. V may be prone to entering an
internship or work site feeling that she knows it • Roll with resistance.
all and could be sensitive to correction. Inferiority • Support self-efficacy.
fears, which may be present in all four cases for a Clearly, empathy is of massive importance, and
variety of reasons, can also be a major reason for much of this course has been devoted to discussing
resisting supervision and the corrective feedback it. If empathy is present on the part of the supervi-
that comes with it. sor, all of the other skills can flow much more suc-
cessfully. Developing discrepancy is an alternate,
more positive way to look at confrontation. Instead
of directly confronting a behavior that should be
Looking back on your own experiences being
supervised, what were some reasons you may have changed, point out a discrepancy and allow the
resisted being supervised? How can these experiences supervisee to arrive at his or her own conclusion.
help you better empathize with your supervisees or Consider how Ms. V’s supervisor might implement
those entrusted to your management? this skill:
Supervisor: V, help me understand. On one hand,
Consider the three major principles of motivational you believe L when he accused you of knowing
nothing about real life, yet on the other hand you
interviewing described by Miller and Rollnick [31]:
share that you know what it’s like to be towered
• Collaboration: Counseling involves a over and looked down upon by your parents. Isn’t
partnership that honors the client’s expertise that real life?
and perspectives. The counselor provides
Rolling with resistance is perhaps the most well-
an atmosphere that is conductive rather
known component of motivational interviewing.
than coercive to change.
It is commensurate to the age-old parenting advice
• Evocation: The resources and motivation of choose your battles. Supervisors are likely to
for change are presumed to reside within create a defensive climate if they confront every
the client. Intrinsic motivation for change resistance that a supervisee presents or if they
is enhanced by drawing on the client’s inundate a supervisee with an excessive amount
own perceptions, goals, and values. of negative feedback. By accepting that initial

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 23

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
resistance is part of the change process, supervisors A large part of supervisory function is to monitor
can take the first successful step in working with a client welfare and supervisee clinical performance
resistant supervisee. and professional development [11]. This can be
accomplished by meeting regularly with supervisees
Supporting self-efficacy is a strengths-based con-
to review case notes and clinical work or through
cept. This skill can be put into place by taking
live observations. Feedback should be given to
the positive coaching approach to supervision
supervisees on scheduled dates and at appropriate
described previously.
occasions throughout the year [10].
Competency and confidentiality are arguably the
ISSUES IN SUPERVISION two most important ethical principles pertain-
The ethical duties of supervisors are somewhat ing to the helping professions. They are also the
more complex than those of other practitioners. In cornerstone of the Hippocratic Oath, from which
this role, there must be a coexisting consideration all modern ethical codes trace their lineage. The
for the welfare of both supervisees and clients [32]. following is translated from the Oath: “Whatever
Among the many relevant issues, five are central I see or hear in the lives of my patients, whether
to supervisor ethics: competency, confidentiality, in connection with my professional practice or
informed consent, dual relationships, and duty to not, which ought not to be spoken of outside, I
warn. will keep secret, as considering all such things to
be private” [33].
Various professional organizations’ ethical codes
contain information regarding supervisory function Although they are somewhat different concepts,
and will be cited and/or discussed in the follow- confidentiality and the right to privacy are closely
ing sections. Although an organization’s ethical related. The supervisor/supervisee relationship is
code only specifically governs the practice of their unique in that confidential information is shared
members, the ethical principles in each are a good between practitioners. To respect a client’s right
reference for all supervisors (Appendix). to privacy and to maintain confidentiality, it is
recommended that only the most pertinent case
COMPETENCY information (as deemed necessary for the purposes
Competency is the ethical duty to practice in one’s of supervision and/or consultation) be exchanged
areas of knowledge and abilities. This consists of between professionals [10; 32]. For example, only
limiting practice to professional competencies a client’s first name should be shared and other
(including multicultural competency) and improv- identifying information should be remain undis-
ing personal knowledge when a deficit is recognized closed (e.g., demographics). The NBCC Code
in order to better assist clients and supervisees. The of Ethics states that practitioners “shall respect
competencies of supervisees must also be known client’s privacy and shall solicit only information
and managed effectively. The National Board of that contributes to the identified counseling goals”
Certified Counselors (NBCC) Code of Ethics [10]. Remember that this also applies to supervisors.
states that those “who provide clinical supervi-
sion services shall intervene in situations where
supervisees are impaired or incompetent and thus
place client(s) at risk” [10].

24 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
INFORMED CONSENT or educators should not engage in sexual activities
Supervisors have the responsibility of ensuring that or contact with supervisees, students, trainees, or
clients are informed about all aspects of therapy/ other colleagues over whom they exercise profes-
interventions, including the appropriateness of sional authority” [34]. The American Counseling
services, what to expect during and from the Association (ACA) Code of Ethics also prohibits
services, the limitations of confidentiality, and sexual or romantic interactions and relationships
supervision procedures. Supervisors also have the [11].
responsibility of informing supervisees about: the The ACA Code discusses the existence of non-
supervision process, including the potential for dual sexual dual relationships as being potentially ben-
relationships, limitations of confidentiality, and eficial to both parties, but also suggests remaining
performance standards and reviews; procedures for aware of the power imbalance [11]:
responding to emergencies and absences; legal and
ethical standards related to the profession; how to Examples of potentially beneficial inter-
express concerns regarding the supervision process; actions or relationships include attend-
and due process appeals of supervisory actions or ing a formal ceremony; hospital visits;
decisions [10; 11; 32]. providing support during a stressful event;
or mutual membership in a professional
DUAL RELATIONSHIPS association, organization, or community.
The development of nonsexual/nontherapeutic Counseling supervisors engage in open
dual relationships in clinical or educational set- discussions with supervisees when they
tings is often inevitable [32]. Shared professional consider entering into relationships with
experiences naturally draw some individuals closer. them outside of their roles as clinical
However, even a nonsexual relationship contains and/or administrative supervisors. Before
a power imbalance that can lead to preferential engaging in nonprofessional relationships,
treatment or exploitation of a supervisee or super- supervisors discuss with supervisees and
visor. Of course, dual relationships with a sexual document the rationale for such interac-
component (e.g., sexual attraction, consensual tions, potential benefits or drawbacks,
sexual, intimate romantic) also include a power and anticipated consequences for the
imbalance and generally have a greater likelihood supervisee. Supervisors clarify the specific
of producing harm and negative outcomes than nature and limitations of the additional
good or even acceptable outcomes [32]. Supervisors role(s) they will have with the supervisee.
must be aware of this power imbalance. As discussed, it is also important to avoid taking
Professional ethical codes explicitly forbid roman- on the role of a supervisee’s counselor or therapist.
tic or sexual relationships between a supervisor/ Referrals may be helpful in these cases.
supervisee. For example the NBCC Code of Eth-
ics states that “[certified counselors] who act as
counselor educators, field placement or clinical A practitioner has the duty to prevent harm to both
supervisors shall not engage in sexual or romantic clients and to other members of society; this can
intimacy with current students or supervisees. They conflict with the ethical principle of confidential-
shall not engage in any form of sexual or romantic ity. The NBCC Code of Ethics sums up the duty
intimacy with former students or supervisees for very concisely: “[Certified counselors], recognizing
two years from the date of last supervision con- the potential for harm, shall not share information
tact” [10]. Similarly, the National Association of that is obtained through the counseling process
Social Workers (NASW) Code of Ethics states without specific written consent by the client or
that “social workers who function as supervisors legal guardian except to prevent clear, imminent

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 25

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
danger to the client or others or when required One possible option is to divide the supervisory
to do so by a court order” [10]. The “danger” may sessions to allow time for each facet, setting clear
include threats of suicide, violence, or others, such boundaries and expectations. For example, the first
as disclosure of a communicable, life-threatening 30 to 45 minutes of the session could be devoted
disease that the client may spread either with or to clinical case discussion and clinical develop-
without intent to harm [11]. ment/formation issues. The rest of the session can
then be used to address administrative matters like
An ethical decision must be made whether to
productivity, meetings, or paperwork concerns. By
breach confidentiality when an expression of
creating this clear separation, you can promote the
intent to commit harm to an individual or their
idea that what is said during the clinical portion
property has been made by a client, in which case a
of the session will not be used against a supervisee
supervisor may be consulted regarding the validity
administratively. Commitment to keeping issues
of an expressed threat. Supervisors have the duty
as separate as possible so supervisees do not feel
to inform and remind supervisees of their ethical
like any sensitive issues they disclose in their
and legal obligations to warn potential victims
[32]. Supervisors are also legally liable if they have case discussions will be used against them is also
knowledge of imminent, foreseeable danger and
they do not make a reasonable attempt to warn Another dual relationship issue that may manifest,
potential victims or confirm that a warning has causing ethical dilemmas, is if a friend serves as a
been made by the supervisee. supervisor or if a supervisee becomes too close of
a friend. Consider Mr. N’s case, introduced earlier.
EMPATHY AS A “COMMON Out of convenience, he asked a friend to super-
SENSE” ETHICAL PRINCIPLE vise him, and this ended up potentially causing
Seeking to embrace person-centered concepts in problems in the relational alliance. Unless the
one’s work as a supervisor is a good first step to circumstances are truly unique, this is an arrange-
carrying out ethical supervision. So much of ethics ment that is probably best avoided; too many dual
is about embracing common sense principles and relationship issues may become apparent.
knowing when and how to collaborate with oth-
Supervisors often become friendly with supervisees,
ers. There are two issues that are often mentioned
and forging a friendly connection is a normal part
in discussions of the ethics of supervision that are
of the human experience. However, it is advised
worth addressing here, especially to consider how
that supervisors reserve forging a friendship out-
empathetic, common sense principles may help
side of the confines of a work setting until the
when navigating an ethical conundrum.
formal period of clinical supervision ends. If one
In clinical life, supervisors are usually asked to fulfill remains an administrative supervisor to a person
two roles: that of administrative supervisor, con- who is considered as a friend, seek consultation if
cerned with managerial issues of the agency, and necessary about how to negotiate dual relationship
that of clinical supervisor, concerned with issues of issues.
clinical growth and formation. A supervisee may
show great promise as a clinician, but the same
supervisee may be abysmal at administrative tasks
like paperwork and time management. How does
one resolve the conflicts of acting in both capaci-
ties for this supervisee?

26 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
Simply having the opportunity to sit down with
SELF CARE AS A someone more experienced who is in a solid posi-
SUPERVISION ISSUE tion to share experience, strength, hope, and
perspective can be very helpful to supervisees,
As the wording suggests, self care simply involves resulting in clinicians who are better prepared for
taking care of oneself. However, in the helping pro- their jobs. Supervisors and mentors, within the
fessionals, self care carries a more potent meaning. context of a solid, relational alliance, can make
Because those in these professions spend so much small yet powerful suggestions on how a supervisee
time and energy taking care of other people, it is can better take care of his or her self. One such
imperative that they make time and energy to take suggestion is to prioritize self-care time, and some
care of themselves. The psychotherapeutic profes- have recommended that self care be allotted at least
sions are placing increasing importance on the role 3 hours per week. Although seemingly a paradox,
of therapist self care to shield against burnout and the more time we allot to take care of ourselves,
vicarious traumatization, which improves one’s the more time we will inevitably have to complete
ability to better serve clients. Honoring self care is necessary tasks. In addition, taking time for self
an ethical imperative for therapists to embrace [35; care will allow one to be more mentally present
36]. This idea makes a great deal of sense; healthier and thus more efficient.
people make healthier, more effective therapists,
which will have a positive effect on the people they
are entrusted to serve. Thus, it becomes important Reflection
to discuss self care as a supervision issue, especially What does self care mean to you? How have you
if a supervisor identifies that a supervisee’s lack benefitted from engaging in your own self care as
of self care seems to be impacting his or her job a professional? How would you share these benefits
with a supervisee?
An extensive study from the field of nursing sug- The concept of self care can be explored in each of
gests that effective clinical supervision has a posi- the supervisory cases discussed previously. Assum-
tive impact on assuaging reported levels of burnout ing that a solid, relational alliance is in place, these
in supervisees [37]. This finding would make equal cases will explore ways that a supervisor can make
sense if the same phenomenon was investigated suggestions to a supervisee on improving self-care
in the helping professions. If one-on-one, or even measures.
group, supervision time exists as a forum in which
There are many ways to introduce self-care strate-
to vent emotional or technical frustrations con-
gies to a supervisee in a manner that does not cross
nected to the job, it is clear that quality supervision
into the realm of therapy. Appreciating the context
time can be part of a supervisee’s self-care regimen.
of their situation and their life is absolutely vital.
The imperative, as discussed in previous sessions,
If supervisees are resistant, it may help to bring up
is that the supervisee feels safe to engage in such a
that self care for the helper is ultimately a quality-
catharsis without fear of administrative retribution.
of-service issue and an ethical imperative [36].

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 27

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
Ms. V Supervisor: If I can ask, how are you doing with
Supervisor: I can see that this whole situation with getting to your own meetings?
L has brought up a lot of things for you. What do Mr. B: (Laughs) What, are you trying to bust me?
you feel you need to do to best take care of yourself
in the wake of all of this? Supervisor: No, B, and I’m certainly not trying to
play your sponsor. I just know that in working with
Ms. V: I don’t know…Drop out of the counseling professionals in the field who are also in recovery,
program? (Laughs) it becomes so important for you to keep working
Supervisor: Take a moment and ask yourself if your own program, maybe even amping it up a bit.
that’s what you really want. This is a stressful field, as you are learning.
Ms. V: Of course not. I still really want to be a Mr. B: Well, before I started school, I was routinely
counselor. doing 4 to 5 meetings a week. My sponsor told me I
should never slip below 3, and I’ve been pretty good
Supervisor: Okay, if I may be so bold, let me ask with that overall. But since I’ve started working
you this. When’s the last time you went through here, there are weeks where it seems to go down
your own counseling? to 2 plus a phone call to my sponsor.
Ms. V: Well, I saw one of the campus counseling Supervisor: B, recovery is not something you can
center professionals when I was an undergraduate, get by osmosis, which I hope you are learning. It’s a
but since then, nothing. great idea to think that by working around recovery
Supervisor: Would you consider perhaps getting so much we will pick some of it up for ourselves, and
some counseling for yourself again, especially since we can. But I have seen countless people burnout
we’ve concluded that this situation with L triggered or even relapse when they replace working their
a lot of personal stuff for you? own program with working in the field.
Ms. V: Am I allowed? Mr. B: Those are good points.
Supervisor: Well, you couldn’t do it here, but I Supervisor: Are you willing to talk to your sponsor
have a list of some providers. I can refer you to about the matter further?
people that I trust to work with other profession- Mr. B: Absolutely.
als. Rest assured, V, if you are going to work in this
field, there is no shame in getting your own therapy. Ms. T
A mentor of mine told me once that to be a good Ms. T: It’s been a rough week. There must be a full
therapist, you ought to have a good therapist! moon out or something!
Ms. V: That makes me feel better. And you’re Supervisor: I hear you, T. It’s been stressful for me,
right; it’s probably a good idea. too. Anything I can do to help?
Mr. B Ms. T: I don’t think so. It’s just been that every
Mr. B: I’m not going to lie—it’s been a rough client on my case load this week seems to be in
week for me. crisis and I’m behind on paperwork. And to make
matters worse, my husband is sick, my dog is sick,
Supervisor: Yeah, the patients seem to be getting the grandkids are coming to visit next week, and
you down. the church benefit auction that I’m on the com-
Mr. B: For sure. mittee for is happening the week after.
Supervisor: Wow, I’d say that’s a lot on your plate.

28 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
Ms. T: Yeah. Mr. N: So, what are you saying?
Supervisor: T, if I can be frank…when’s the last Supervisor: I’m just putting this out there. What
time you’ve done something nice for yourself? would you tell a client who was on parole or pro-
bation who didn’t want to put in the necessary
Ms. T: (Laughs) Oh, you would have to play shrink
and ask me that.
Mr. N: I would work with them on practicing
Supervisor: T, I’m not asking you to do therapy
with me. I just get concerned sometimes that you
are so many things to so many people. I would hate Supervisor: Yup, that’s what I was getting at. And
to see you burn out. do you have a favorite strategy that you like to use
for practicing acceptance?
Ms. T: Well, point taken.
Mr. N: Well, prayer and meditation. (Laughs)
Supervisor: Let me put it to you this way: If one
Okay, I see what you’re getting at here.
of your clients came in and told you how stressed
they were, if one of your clients told you what you WORKING WITH SUPERVISEES ON
just told me, how would respond to the client? DEVELOPING AND IMPLEMENTING
Ms. T: I’d tell them to go get a massage or some- A SELF-CARE PLAN
thing! Or at least spend some time each night The National Institute for Occupational Safety
chilling out and taking a bath. and Health summarizes the essentials of a self-care
plan as [38]:
Supervisor: Both excellent ideas. Have you done
that lately? • Balance between work and family
or personal life
Ms. T: No.
• A support network of friends and coworkers
Supervisor: Would you consider it?
• A relaxed and positive outlook
Ms. T: (Laughs) Well, you got me there, and you’re
This is a basic framework that can be shared with
probably right. I’ll make it a point to get in the tub
supervisees, consultees, and trainees if they are
tonight after work.
feeling stuck on how to make commitments to
Mr. N self care. When seeing these three components of
Supervisor: N, I know that we’ve talked about the framework, people can usually identify which
some difficult matters with our professional and area needs the most work. Using the case scenarios
personal relationship here. Is there anything else from the previous section, it seems that Ms. V most
I can do to help? needs support, so the second area would be a place
for emphasis. Mr. B may have deficits in all three,
Mr. N: You can tell the state board to cut back on but because of his commitment to 12-step recovery,
the hours for supervision requirements. his supervisor suggests that he amplify the second
Supervisor: I know that’s an issue for you; I hear area as well. For Ms. T, the first area is the main
that clearly. But I also know that you are one of focus, and for Mr. N, it was area three.
the best social workers in this area, and you work
with clients who are in situations like this all the
time—having to tough something out that they
don’t really want to do.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 29

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________


I, __________________ , agree to engage in the following activities on a daily basis:


Examples include: Morning prayer and meditation (at least 5 minutes), listening to favorite music on the car ride into work
instead of talking on the phone, and making sure to take a lunch break outside of the office.

I agree to engage in the following activities on a weekly basis:


Examples include: At least three 12-step meetings per week, at least two phone calls per week to a sponsor, engaging in a physical
exercise activity at least three days per week.

I agree to bring any concerns that I have about my effectiveness in dealing with clients to my clinical supervisor.
I understand that we can work to modify this plan together at any time. We will review this plan in four weeks from
the original date to gauge its effectiveness.

Supervisee’s Signature

Source: Compiled by Author Figure 1

In most cases, formal self-care plans are not nec- Putting the plan down on paper and having both
essary. Typically, self-care discussions can be inte- the supervisee and the supervisor sign it can add
grated into our supervisory sessions. However, if a that heightened degree of accountability. And if a
supervisee continues to struggle with implement- person has an accountability partner for self-care
ing the basics of self care with this more casual plans, he or she is much more likely to follow
approach, working together on a formal plan, even through with them. Active clinical supervisors
putting it into the language of a contract, may be should consider accessing the National Institute for
warranted (Figure 1). Occupational Safety and Health’s online manual
Stress at Work for more ideas on how to create an
environment at the work place that supports self
care [38]. The ideas in this guide are especially
relevant for those in the dual role of being a clini-
cal and administrative supervisor. This manual is
available online at

30 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach

Supervision is the ultimate form of leadership Autonomy: a principle of motivational interview-
within the helping professions. Treating super- ing affirming one’s right and capacity for self-
visees as people, not as things, is the essence of direction and informed choice.
person-centered supervision, a concept extensively Clinical supervision: a relationship in the helping
explored in this course. professions that implies a simultaneous managerial
The course began with the basic foundations of and mentorship component. Per Falander and
defining supervision within the helping profes- Shafranske, clinical supervision is “a distinct pro-
sions, and then advanced to integrating ideas from fessional activity in which education and training
person-centered approaches to helping others to aimed at developing science-informed practice are
fully describe person-centered supervision. Specific facilitated through a collaborative, interpersonal
skills for developing empathy in supervisory work process. It involves observation, evaluation, feed-
with others were explored, using supervisee case back, the facilitation of supervisee self-assessment,
studies to guide the discussion and reflective exer- and the acquisition of instruction and skills by
cises to help integrate and personalize the learning. instruction, modeling, and mutual problem solv-
Other common supervisory issues were examined, ing” [7].
including counselor development, working with Collaboration: a principle of motivational inter-
resistant supervisees, legal and ethical issues, and viewing involving a partnership that honors the
self care as a supervision issue. client’s/supervisee’s expertise and perspectives.
Person-centered supervision is not a new model or “Compliment sandwich:” sharing with students
a radical approach to clinical supervision. Rather, or supervisees something that they are doing right,
person-centered supervision is an approach, a then inserting an area of improvement, and ending
mindset that can be implemented alongside with a compliment.
any other existing models or techniques used in
supervision. This approach embraces the notion Congruence: a Rogerian, person-centered term
that practicing some common sense logic and meaning that the supervisee and supervisor are on
honoring supervisees as people, in the same way the “same page” in terms of goals and direction for
one would honor clients, is the best way to reach the supervisory relationship.
them. Person-centeredness can bring about the Consultation: collaborating with a specialist who is
high-quality formation necessary in the helping called upon for his or her expert advice in the field,
professions. for instance, in matters of assessment, diagnosis, or
treatment planning.
Empathy: derived from Greek roots meaning “in”
and “feeling;” coined as a philosophical concept
in 1858 by a German philosopher. According
to Stedman’s Medical Dictionary, it is defined as
“direct identification with, understanding of, and
vicarious experience of another person’s situation,
feelings, and motives” [12].

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 31

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
Evocation: a principle of motivational interview- Unconditional positive regard: a Rogerian, person-
ing that the resources and motivation for change centered term meaning fundamental, total accep-
are presumed to reside within the client/supervisee. tance of the person, regardless of what he or she
Intrinsic motivation for change is enhanced by does or has done.
drawing on the supervisee’s own perceptions, goals,
and values.
Feedback: commentary about performance, either
positive or negative, delivered with the intention The codes of ethics of various professional asso-
of helping a person to better grow or improve in ciations form the framework for clinical practice
his or her work. Therapists can receive feedback and supervision. The following sections contain
from clients, supervisees can receive feedback from excerpts from various codes of ethics that per-
supervisors, and supervisors can receive feedback tain to supervisors specifically. Professionals are
from their supervisees. encouraged to become familiar with their state and
Formation: a spiritual term often used in seminaries national codes, rules, and regulations.
and monastic life to describe the process by which a NBCC CODE OF ETHICS
person responding to his or her vocation (or “call-
Several sections in the NBCC’s Code of Ethics
ing”) learns how to live their calling to the fullest.
have applicability to supervisors and supervisees
Motivational interviewing: an approach to coun- [10]. According to the Code:
seling/change attributed to Miller and Rollnick
• Nationally certified counselors (NCCs) who
that advocates asking a series of questions to
act as counselor educators, field placement or
enhance a person’s overall drive toward change;
clinical supervisors shall not engage in sexual
represents a shift from confrontational or directive
or romantic intimacy with current students
approaches to counseling [31].
or supervisees. They shall not engage in any
Nonmaleficence: the ethical principle of doing form of sexual or romantic intimacy with
no harm. former students or supervisees for two years
Relational alliance: when two parties, such as a from the date of last supervision contact.
supervisor/supervisee, are engaging in a mutually • NCCs who provide clinical supervision
respectful, trusting interaction, working toward a services shall keep accurate records of
goal or benefit. supervision goals and progress and consider
all information gained in supervision
Rupture: a break or a disturbance that causes
as confidential except to prevent clear,
impairment in flow or function in a relational
imminent danger to the client or others or
when legally required to do so by a court
Self care: in the helping professions, time and or government agency order. In cases in
energy to care for oneself. which the supervisor receives a court or
Somatic empathy: noticing physical responses to a governmental agency order requiring the
person or a situation that is likely mirroring what production of supervision records, the NCC
that person is experiencing. shall make reasonable attempts to promptly
notify the supervisee. In cases in which
Supervision: in a general sense, one party is over- the supervisee is a student of a counselor
seeing another. education program, the supervisor shall
release supervision records consistent with
the terms of the arrangement with the
counselor education program.

32 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
• NCCs who provide clinical supervision • NCCs who provide supervision services
services shall intervene in situations where to supervisee’s who have more than
supervisees are impaired or incompetent one supervisor (e.g., field placement
and thus place client(s) at risk. and university) shall exchange contact
• NCCs who provide clinical supervision information and communicate regularly
services shall not have multiple relationships about the shared supervisee’s performance.
with supervisees that may interfere with • NCCs who provide supervision services
supervisors’ professional judgment or exploit to supervisee’s who have more than
supervisees. Supervisors shall not supervise one supervisor (e.g., field placement
relatives. and university) shall exchange contact
• NCCs who provide supervision services information and communicate regularly
shall present supervisees with feedback about the shared supervisee’s performance.
according to a schedule with identified ACA CODE OF ETHICS
evaluation dates as well as on appropriate
occasions throughout the process. The ACA Code of Ethics contains sections dealing
specifically with supervisor competence, relation-
• NCCs shall promote the welfare of ships, responsibilities, and processes [11]. The fol-
supervisees by discussing ethical practices lowing is an excerpt of these sections:
relating to supervision as well as the legal
standards that regulate the practice of F.2. Counselor Supervision Competence
counseling. F.2.a. Supervisor Preparation
• NCCs who provide supervision services Prior to offering clinical supervision services,
shall establish with their supervisees counselors are trained in supervision methods and
procedures for responding to crisis situations techniques. Counselors who offer clinical supervi-
or expressing concerns regarding the sion services regularly pursue continuing education
supervision process. This information shall activities including both counseling and supervi-
be provided in verbal and written formats. sion topics and skills.
• NCCs who provide supervision services F.2.b. Multicultural Issues/
shall present accurate written information Diversity in Supervision
to supervisees regarding the NCC’s Counseling supervisors are aware of and address the
credentials as well as information regarding role of multiculturalism/diversity in the supervisory
the process of supervision. This information relationship.
shall include any conditions of supervision,
supervision goals, case management pro- F.3. Supervisory Relationships
cedures, confidentiality and its limitations, F.3.a. Relationship Boundaries With Supervisees
appraisal methods and timing of evaluations. Counseling supervisors clearly define and maintain
• NCCs shall include all electronic ethical professional, personal, and social relation-
communications exchanged with clients and ships with their supervisees. Counseling supervisors
supervisees, including those through digital avoid nonprofessional relationships with current
technology and social media methods, as a supervisees. If supervisors must assume other pro-
part of the record, even when strictly related fessional roles (e.g., clinical and administrative
to clerical issues such as change of contact supervisor, instructor) with supervisees, they work
information or scheduling appointments. to minimize potential conflicts and explain to
All electronic therapeutic communication supervisees the expectations and responsibilities
methods shall use encryption and password associated with each role. They do not engage in
security. any form of nonprofessional interaction that may
compromise the supervisory relationship.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 33

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
F.3.b. Sexual Relationships F.4.b. Emergencies and Absences
Sexual or romantic interactions or relationships Supervisors establish and communicate to super-
with current supervisees are prohibited. visees procedures for contacting them or, in their
absence, alternative on-call supervisors to assist in
F.3.c. Sexual Harassment
handling crises.
Counseling supervisors do not condone or subject
supervisees to sexual harassment. F.4.c. Standards for Supervisees
Supervisors make their supervisees aware of profes-
F.3.d. Close Relatives and Friends
sional and ethical standards and legal responsibili-
Counseling supervisors avoid accepting close rela-
ties. Supervisors of post-degree counselors encour-
tives, romantic partners, or friends as supervisees.
age these counselors to adhere to professional
F.3.e. Potentially Beneficial Relationships standards of practice.
Counseling supervisors are aware of the power
F.4.d. Termination of the
differential in their relationships with supervisees.
Supervisory Relationship
If they believe nonprofessional relationships with
Supervisors or supervisees have the right to termi-
a supervisee may be potentially beneficial to the
nate the supervisory relationship with adequate
supervisee, they take precautions similar to those
notice. Reasons for withdrawal are provided to the
taken by counselors when working with clients.
other party. When cultural, clinical, or professional
Examples of potentially beneficial interactions
issues are crucial to the viability of the supervisory
or relationships include attending a formal cer-
relationship, both parties make efforts to resolve
emony; hospital visits; providing support during a
differences. When termination is warranted,
stressful event; or mutual membership in a profes-
supervisors make appropriate referrals to possible
sional association, organization, or community.
alternative supervisors.
Counseling supervisors engage in open discussions
with supervisees when they consider entering into F.5. Counseling Supervision Evaluation,
relationships with them outside of their roles as Remediation, and Endorsement
clinical and/or administrative supervisors. Before F.5.a. Evaluation
engaging in nonprofessional relationships, super- Supervisors document and provide supervisees with
visors discuss with supervisees and document the ongoing performance appraisal and evaluation
rationale for such interactions, potential benefits feedback and schedule periodic formal evaluative
or drawbacks, and anticipated consequences for the sessions throughout the supervisory relationship.
supervisee. Supervisors clarify the specific nature
and limitations of the additional role(s) they will F.5.b. Limitations
have with the supervisee. Through ongoing evaluation and appraisal, super-
visors are aware of the limitations of supervisees
F.4. Supervisor Responsibilities that might impede performance. Supervisors assist
F.4.a. Informed Consent for Supervision supervisees in securing remedial assistance when
Supervisors are responsible for incorporating into needed. They recommend dismissal from training
their supervision the principles of informed con- programs, applied counseling settings, or state
sent and participation. Supervisors inform super- or voluntary professional credentialing processes
visees of the policies and procedures to which they when those supervisees are unable to provide
are to adhere and the mechanisms for due process competent professional services. Supervisors seek
appeal of individual supervisory actions. consultation and document their decisions to dis-
miss or refer supervisees for assistance. They ensure
that supervisees are aware of options available to
them to address such decisions.

34 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
F.5.c. Counseling for Supervisees The following standards are excerpted from the
If supervisees request counseling, supervisors pro- Best Practice Standards in Social Work Supervision
vide them with acceptable referrals. Counselors sections dealing with ethical issues and dilemmas
do not provide counseling services to supervisees. in clinical social work supervision [39]:
Supervisors address interpersonal competencies in
Supervisors have the responsibility to address any
terms of the impact of these issues on clients, the
confusion that supervisees may encounter as a
supervisory relationship, and professional function-
result of ethical demands. A supervisor should be
ing. (See F.3.a.)
aware of the differences between professional eth-
F.5.d. Endorsement ics, core values, and personal moral beliefs and help
Supervisors endorse supervisees for certification, the supervisee to distinguish these elements when
licensure, employment, or completion of an making practice decisions. Supervisors can use the
academic or training program only when they supervisory relationship as a training ground for
believe supervisees are qualified for the endorse- ethical discretion, analysis, and decision-making.
ment. Regardless of qualifications, supervisors do
not endorse supervisees whom they believe to be Ethical Decision-Making
impaired in any way that would interfere with Supervisors help supervisees learn ethical deci-
the performance of the duties associated with the sion-making, a process that is both cognitive and
endorsement. emotional. Supervisors should discuss and model
the process of identifying and exploring problems,
NASW/ASWB BEST looking at issues, values, principles, and regula-
PRACTICES IN SUPERVISION tions. Supervisors and their supervisees should
In 2013, the NASW and the Association of Social discuss possible consequences, as well as costs and
Work Boards (ASWB) jointly developed and benefits, of certain actions. They should explore
published the Best Practice Standards in Social Work what actions best achieve fairness, justice, and
Supervision [39]. This guideline provides informa- respect for others, make a decision about actions to
tion on a wide range of issues that may arise during be taken, and evaluate them after implementation.
social work supervision, and many of the ethical When a supervisee makes an ethical mistake, he or
standards are derived from the NASW’s Code of she, with the assistance of the supervisor, should try
Ethics, specifically the following precepts [34]: to ameliorate any damage and learn how to avoid
3.01(a) Social workers who provide supervision or that mistake in the future. If appropriate or required
consultation should have the necessary knowledge by the jurisdiction, the violation may have to be
and skill to supervise or consult appropriately and reported to the licensing board.
should do so only within their areas of knowledge Boundaries
and competence.
The supervisory relationship is an excellent forum
3.01(b) Social workers who provide supervision for supervisees to learn about boundaries with cli-
or consultation are responsible for setting clear, ents. Ethical issues related directly to supervision
appropriate, and culturally sensitive boundaries. include the nature of the professional responsibil-
3.01(c) Social workers should not engage in any ity to the supervisee, appropriate boundaries, and
dual or multiple relationships with 20 supervisees responsibilities when dealing with incompetent
in which there is a risk of exploitation of or poten- or unethical behavior. Becoming involved in a
tial harm to the supervisee. romantic or familial relationship with a super-
3.01(d) Social workers who provide supervision visee is an ethical violation and should be strictly
should evaluate supervisee’ performance in a man- avoided because it creates marked role conflict that
ner that is fair and respectful. can fatally undermine the supervisory relationship.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 35

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
If the supervisor recognizes a potential boundary Alternative Practice
issue with a supervisee, he or she should acknowl- The social work supervisor should decide whether
edge it, assess how the boundary issue has affected an alternative practice, a non-traditional social
supervision, and resolve the conflict. Although the work intervention, is the best modality of treat-
supervisory relationship is between professionals, ment for a supervisee to use with a client. When
supervisors usually have more power in the rela- a supervisee uses an alternative practice, the
tionship than supervisees. To avoid boundary prob- supervisor should have expertise of that practice
lems and conflicts of interest with a supervisee, the and ensure that the supervisee has the prerequisite
ethical supervisor must accept his or her power and training and knowledge to perform the alternative
be comfortable in using that authority to ensure practice. In situations in which the supervisor
accountability and protect clients. Other ethical does not have the skills to provide the alternative
considerations include the following: practice, it may be necessary to involve a second
• A supervisor should always focus on the supervisor. In such cases, the two supervisors should
goals of supervision and the nature of the work closely together to avoid conflicts and ensure
supervisory relationship and avoid providing effective use of the alternative practice for the
psychotherapy services to the supervisee. client.
• Supervisors working with more than one Social work supervisors share responsibilities for
supervisee should see each supervisee as an the services provided to clients. Liability of supervi-
individual and adapt to that supervisee’s sors has been determined by the courts and includes
needs. At the same time, supervisors must direct liability related to negligent or inadequate
be fair and consistent when providing supervision and vicarious liability related to neg-
supervision to multiple supervisees. ligent conduct by supervisees.
Self-Disclosure Supervisors and supervisees should both have pro-
fessional liability insurance. In an agency setting, a
Supervisors should be discreet in sharing personal
supervisor’s potential liability is affected by his or
information and not allow it to become the focus
her level of responsibility and authority. Supervi-
of supervision. When personal information is
sors should familiarize themselves with the scope
disclosed, it should be brief and support the goals
of their responsibility and authority, which may be
of supervision. Supervisors should explain their
specified in an agency written policy manual, the
comments and rationale to help supervisees gain
supervisor’s job description, or a written contrac-
understanding of appropriate techniques to use in
tual agreement.
the interview process with clients.
The requirements and expectations of a supervisor’s
Attending to Safety position also may affect liability, especially in situa-
Supervisors make supervisees aware of safety issues tions in which the supervisor may have competing
and train them how to respond to workplace con- demands and is unable to adequately perform his
flict, respond to threats and harassment, protect or her supervisory functions. Such situations may
property, and deal with assaults and their emotional present legal challenges.
aftermath. Supervisors help supervisees plan for
safety in the office and in the community by learn-
ing non-violent response strategies and appropriate
ways to respond to crises.

36 NetCE • March 25, 2016

__________________________________________ #7686 Clinical Supervision: A Person-Centered Approach
Works Cited
1. Spence SH, Wilson J, Kavanagh D, Strong J, Worrall L. Clinical supervision in four mental health professions: a review of the
evidence. Behaviour Change. 2001;18(3):135-155.
2. Kadushin A, Harkness D. Supervision in Social Work. 4th ed. New York, NY: Columbia University Press; 2002.
3. Munson CE. Handbook of Clinical Social Worker Supervision. 3rd ed. New York, NY: Routledge; 2001.
4. Pack M. Clinical supervision: an interdisciplinary review of literature with implications for effective practice in social work.
Reflective Practice. 2009;10(5):657-668.
5. Corey G, Haynes R, Moulton P, Muratori M. Clinical Supervision in the Helping Professions: A Practical Guide. 2nd ed. Alexandria,
VA: The American Counseling Association; 2010.
6. Powell DJ. Clinical Supervision in Alcohol and Drug Abuse Counseling. 2nd ed. San Francisco, CA: Jossey-Bass; 2004.
7. Falander CA, Shafranske EP. Clinical Supervision: A Competency-Based Approach. Washington, DC: The American Psychological
Association; 2004.
8. Hawkins P, Shohet R. Supervision in the Helping Professions. 4th ed. New York, NY: Open University Press/The McGraw Hill
Companies; 2012.
9. Sears RW, Rudisill JR, Mason-Sears C. Consultation Skills for Mental Health Professionals. Hoboken, NJ: John Wiley & Sons; 2006.
10. National Board for Certified Counselors. NBCC Code of Ethics. Available at Last accessed March 6,
11. American Counseling Association. ACA Code of Ethics. Available at
Last accessed April 3, 2013.
12. Stedman’s Medical Dictionary. 29th ed. Philadelphia, PA: Lippincot, Williams, and Wilkins; 2013.
13. Weiner IB, Craighead WE (eds). The Corsini Encyclopedia of Psychology. Hoboken, NJ: Wiley; 2009.
14. Yalom I, Lesczc M. The Theory and Practice of Group Therapy. 5th ed. New York, NY: Basic Books; 2005.
15. Yalom I. The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients. London: Piatkus; 2009.
16. Horvath AO, Luborsky L. The role of the therapeutic alliance in psychotherapy. J Consult Clin Psychol. 1993;61(4):561-573.
17. Barber JP, Connolly MB, Crits-Christoph P, Gladis L, Siqueland L. Alliance predicts patients’ outcome beyond in-treatment
change in symptoms. J Consult Clin Psychol. 2000;68(6):1027-1032.
18. Flückiger C, Del Re AC, Wampold BE, Symonds D, Horvath AO. How central is the alliance in psychotherapy? A multilevel
longitudinal meta-analysis. J Couns Psychol. 2012;59(1):10-17.
19. Duncan BL, Miller SD, Wampold BE, Hubble MA (eds). The Heart and Soul of Change: Delivering What Works in Therapy. 2nd ed.
Washington, DC: American Psychological Association; 2009.
20. Rosenzweig S. Some implicit common factors in diverse methods of psychotherapy. Am J Orthopsychiatry. 1936;6(3):412-415.
21. Norcross JC (ed). Psychotherapy Relationships that Work: Evidence-Based Responsiveness. New York, NY: Oxford University Press;
22. Rothschild B, Rand M. Help for the Helper: The Psychology of Compassion Fatigue and Vicarious Trauma. New York, NY: W.W. Norton
& Co.; 2006.
23. Marich J. EMDR Made Simple: 4 Approaches for Using EMDR with Every Client. Eau Claire, WI: Premiere Education and Media;
24. Dworkin M, Errebo N. Rupture and repair in the EMDR client/clinician relationship: now moments and moments of meeting.
Journal of EMDR Practice and Research. 2010;4(3):113-123.
25. Skinner BF. Science and Human Behavior. New York, NY: The Free Press; 1965.
26. Hogan RA. Issues and approaches in supervision. Psychotherapy: Theory, Research, and Practice. 1964;1(3):139-141.
27. Hess AK. Growth in supervision: stages of supervisee and supervisor development. In: Kaslow FW (ed). Supervision and Training:
Models, Dilemmas, and Challenges. New York, NY: Haworth Press; 1986; 51-67.
28. Ralph NB. Learning psychotherapy: a developmental perspective. Psychiatry. 1980;43;243-250.
29. Rice DG. Supervision of cotherapy. In: Kaslow FW (ed). Supervision and Training: Models, Dilemmas, and Challenges. New York, NY:
Haworth Press; 1986; 119-142.
30. D’Andrea M. Person-process model of supervision: a developmental approach. In: Bradley LJ (eds). Counselor Supervision. 4th ed.
Philadelphia, PA: Brunner-Routledge; 2010.
31. Miller WR, Rollnick S. Motivational Interviewing: Helping People Change. 3rd ed. New York, NY: Guilford Press; 2012.
32. Syracuse University. Ethical and Legal Issues in Supervision. Available at
services/modules/Preparing_for_Supervision/ethical_legal_issues_in_supervision.aspx. Last accessed March 6, 2013.
33. National Institutes of Health. Greek Medicine: The Hippocratic Oath. Available at
greek_oath.html. Last accessed March 6, 2013.

NetCE • Sacramento, California Phone: 800 / 232-4238 • FAX: 916 / 783-6067 37

#7686 Clinical Supervision: A Person-Centered Approach __________________________________________
34. National Association of Social Workers. NASW Code of Ethics. Available at
Last accessed March 6, 2013.
35. Barnett JE. Positive ethics, risk management, and defensive practice. The Maryland Psychologist. 2007;53(1):30-31.
36. Norcross JC, Guy JD Jr. Leaving it at the Office: A Guide to Psychotherapist Self-Care. New York, NY: The Guilford Press; 2007.
37. Edwards D, Burnard P, Hannigan B, et al. Clinical supervision and burnout: the influence of clinical supervision for community
mental health nurses. J Clin Nurs. 2006;15(8):1007-1015.
38. National Institute for Occupational Safety and Health. Stress…at Work. Cincinnati, OH: U.S. Department of Health and Human
Services; 2008.
39. National Association of Social Workers, Association of Social Work Boards. Best Practice Standards in Social Work Supervision.
Washington, DC: National Association of Social Workers; 2013.

38 NetCE • March 25, 2016