| This article is
for professionals who train and supervise clinicians that
work with divorced-family and stepfamily clients. It
proposes that effective supervision requires
additional knowledge and skills compared to supervising clinicians with
other client-types. The article offers... |
-
a
definition of effective supervision or case management;
-
a
summary of what's different about
supervising therapists with these complex clients;
-
a
checklist of 11 requisites for effective
supervision with these clients; and...
-
perspective on common supervisory problems with
these clients.
What
is Effective Clinical Supervision?
Because
effective systemic therapy requires
a complex set of skills and
can significantly affect a client's
and relationships, novice and veteran clinicians need empathic, clear, unbiased
feedback and seasoned guidance as they learn their craft.
Premise: effective clinical supervision will clearly satisfy
three to six sets of needs,
as judged by all concerned:
clients'
needs for effective, ethical, cost-effective professional help in (a)
and (b) filling their short and long-term
and...
each
trainee's
needs to...
-
feel respected and
professionally competent,
-
learn
- in general,
and from mistakes,
-
be encouraged and
inspired in difficult situations,
-
satisfy clients'
needs well enough,
-
stay balanced and
stimulated (avoid overload and burnout),
-
resolve individual
case problems,
-
get human and
other resources when needed, and...
-
manifest their
life purpose; and...
the
supervisor
or case manager's needs to...
-
feel competent,
respected, and useful as a professional coach,
-
help trainees
develop their general and case-specific competencies,
-
meet ethical and
legal responsibilities to clients and co-workers,
-
balance their
needs with those of clients, clinicians, and administrators, and...
-
manifest their
unique life purpose/s over time.
supervisors in an organization (vs. independent
consultants) also need to understand, negotiate, and help fill their
organization's human-service
and financial goals and
policies in a cost-effective way, as judged by themselves and the
person/s they work for. Supervisors may also need to demonstrate their
knowledge and competence to state licensing, accreditation, and professional-ethics examiners.
case managers supervising a group of therapists
and/or cross-discipline co-workers need the above plus effective problem-solving,
directing, and harmonizing everyone's goals and efforts to fill their
respective needs well enough, in a way satisfying to all involved.
Individual
clinicians have (a) unique knowledge levels, skills, and traits, and (b)
different styles of learning. Some therapists need more direction and discussion than
others, and some are more reactive (defensive, guilty, anxious)
to critical feedback than others. Typical supervisors have
their own
guidance styles: patient vs. curt; clear vs. vague; empathic vs.
didactic/intellectual; collegial vs. authoritarian; direct vs. indirect;
conflict-avoiding vs. confrontational; goal-directed vs. intuitive and
organic; spiritual vs. practical; pessimistic/cynical to realistic to
idealistic; and so on. Can you describe what your style is, and how trainees
react to it?
Effective
supervisors need to (a) be aware of the interplay of these
variables in their work with individual therapists, and (b) be able to flex
situationally to fill their mix of current needs (above) without losing
their integrity or personal and professional balances.
A classic ethical and practical
question is: who supervises (assesses, supports, guides, confronts) the supervisor?
Recap: here,
"effective supervision" means "filling the current mix of three or more
sets of
(above) 'well enough' according to each person involved." Reflect: do you
need to edit this premise to better express your definition of
"effective clinical supervision"?
What's Different about Supervising Stepfamily Therapists?
Premise: Typical
divorced-family and stepfamily systems are significantly more complex and
needy than other client-family types. They have...
-
four or five
to manage; and...
-
a
multi-home
to stabilize, balance, and coordinate; and...
-
typical stepfamilies have
and...
-
many special
biofamily-merger adjustment needs to fill; and...
-
extra
developmental phases to negotiate;
and...
-
more concurrent
secondary
stressors to resolve, including (a)
identifying and filling kids' special
adjustment needs, and (b) patiently reducing ex-mate
to co-parenting
And these client families usually have...
-
more psychological
and knowledge deficits to identify, accept,
and reduce; and...
-
more major
to grieve, and...
-
generally lower
family
,
and...
-
fewer
informed social supports;...
...than typical intact-biofamily clients. (a)
Assessing clients' needs and resources, (b)
forming an appropriate therapeutic strategy, and then (c)
intervening effectively
requires advanced clinical knowledge, skills,
and resources.
Because of
these interactive factors, typical
clinicians working with these complex client families often need (a) to acquire
seven clinical requisites and (b) informed
supervision in assessing and intervening individual cases. They also
need (c) special empathic
feedback on potential frustration, confusion, overwhelm, and/or
burnout
with these challenging multi-problem,
clients.
This is specially true for therapists, case workers, and
counselors working with many divorcing families and stepfamilies at once,
and/or with many client-families interacting with state welfare,
law-enforcement, family court, and child-protective-service systems. These
professional systems are typically low nurturance;
overloaded and under-supported; must prioritize (triage) their services;
and their workers are generally unaware of stepfamily
basics,
and
Does this match your experience?
Bottom line:
for consistently effective clinical outcomes, counselors and therapists working with
divorced-family and stepfamily clients
need more knowledge + special
attitudes + extra
skills and resources than
clinicians working with other types of family systems.
A vital requisite is that they must
be consistently guided by their
This means that effective
supervisors and case managers must (a) have all these themselves, and (b) be
able to competently assess their trainees for these requisites; and (c)
guide trainees in acquiring the
and using them effectively with
each client case. That
implies that whoever hires, assigns, and/or mentors such supervisors must
know all these special requisites too. Is this true in your setting?
Requisites for Effective
Clinical Supervision with These Client Families
Each case and situation will have basic and unique requisites. Basic
requisites for effective supervision as defined above include...
1) the
supervisor genuinely enjoys and prefers helping co-workers raise their
direct-contact effectiveness, rather than working with clients directly.
2) the
supervisor has the
for direct client service, according to a knowledgeable
observer. An essential among these is
the supervisor (a) being consistently guided by her or his resident
,
or (b) making significant intentional progress at
and
significant false-self
And effective supervisors or case managers need...
3) to be (a)
clear on their definitions of
and effective supervision and/or case management; and (b) clear on
and (c) confident in their version of this therapeutic
and (d) be able to explain it effectively to therapists they guide and
related colleagues, consultants, and administrators; and...
4)
supervisors need to be able to objectively spot clinician (a) requisite
deficits and (b) process errors, and (c) help
clinicians accept these, guide and encourage them to make needed corrections,
and follow up to see that they do. And effective supervisors need...
5) a
high-nurturance, stepfamily-
(a) agency or
organizational administration, (b) Clinical or Program Director, and
(c) Board of
Directors. "Stepfamily-aware"
means being able to spontaneously describe lay
basics + clinical and
agency/organizational requisites + these supervision requisites; and
supervisors need...
6) consistently-
and
with co-workers, superiors, and relevant policy-makers and
service regulators; and they need...
7) clear
authority to
(a) select and assign clinicians to incoming cases, and/or to (b) make
recommendations to the Clinical or Program Director on such assignments, and to
(c)
change or augment clinical case-responsibility if an assigned clinician
isn't able to serve a given client family adequately. And effective
supervisors also need...
8) access to an
effective in-service program to help (a) them
gain needed supervisory skills, and (b) help clinicians gain requisite
knowledge and skills for serving these complex clients; and they need...
9) current
accurate knowledge of local and national (a)
stepfamily-aware consultants, cross-discipline human-service
referrals, and (b) support programs, groups, and organizations; and...
10) an
informed, professional
case-discussion (support) group to help identify and resolve
supervision problems, including situational
transference and burnout stresses; and effective supervisors need...
11) the ability to enhance and
access a local inventory of clinical and
lay divorce and stepfamily-related
educational resources including handouts,
books, videos, games, and current resource
lists like this.
Pause and reflect - do these 11 basic requisites for effective supervision with
these complex client families seem valid? If you need to modify this checklist,
what do you need to change - and why? Note the option of using your version of
this summary as a checklist for discussion and evaluation with co-workers,
employers, and clinicians. Option: for specific cases, use this list with
these client-assessment and
intervention checklists to provide structure
for the supervision process.
Common
Supervisory Problems and Options
Though [ client + clinicians + supervisor + setting ] combinations approach
infinity, common supervisory "problems" (unmet needs) include...
1) Someone decides
the supervisor lacks too many requisites
(above). A major version of this occurs if
the supervisor is denying significant false-self
and/or that s/he's in pseudo
from them.
2) Someone
decides
a clinician lacks too many
to work with these clients effectively. Ditto the above.
3)
The
supervisor (a) denies s/he is ambivalent, or would really rather work
with clients directly, and becomes over-involved in clinicians
work; and/or (b) s/he won't assert his or her needs toward being
reassigned. Both suggest significant
dominance.
4)
The
supervisor is intimidated, overwhelmed, and/or paralyzed by
individual or collective case complexities, and denies this. Another
sign of false-self dominance.
5) The
supervisor
can't (a) identify or (b) resolve significant
therapist
transference and/or
burnout stressors
6)
A
clinician "resists"
acquiring needed knowledge,
skills, and
resources to work well with these clients
7)
A
clinician feels her or his supervisor or case manager isn't qualified
and/or able to provide needed guidance with one or all divorced-family
and stepfamily cases. If the clinician confronts the supervisor on this,
the latter may deny, ignore, excuse, freeze, collapse, or counterattack.
All are symptoms of (a) false-self dominance, (b) lack of effective
communication
and/or (c) a low-nurturance (wounded, ignorant)
organization.
8)
Someone
feels
the supervisor's and clinician's professional styles and
clash "too much," despite both of them being qualified to work
with these clients. Inability to compromise on this suggests one or both
are significantly
and lack process-
and effective communication skills.
9)
The caseload
inhibits a therapist from taking time to acquire needed
knowledge,
guidance, and/or encouragement - and s/he doesn't (a) recognize this, or (b)
assert for needed case-reduction. Another sign of false-self dominance
and/or a low-nurturance workplace.
10)
There
are no
adequate in-service training programs and/or
relevant resources available to the supervisor
and/or clinicians. This is a clear sign of an unaware and/or wounded
(low-nurturance) administration - including the supervisor, if s/he
isn't asserting for an effective educational program and resources
11)
Local family-law judges lack requisite knowledge of
divorced-family and stepfamily client families, and issue orders that
hinder or block effective service to court-referred clients. A corollary
problem occurs if supervisors or organizational administrators tolerate
this, rather than helping judges (and attorneys, mediators, and
psychological evaluators) to learn and apply requisite knowledge for
everyone's sakes.
12)
Funding, licensure
accreditation, professional association (e.g. APA, NASW, etc),
religious, and/or state legal requirements and policies hinder delivery
of effective service - and the supervisor and/or organizational
administration accepts this passively vs. asserting for positive change.
13)
Agency,
clinic, or departmental management lacks
too many requisites to support effective supervision and
clinical outcomes with these
clients - and the supervisor tolerates this and/or working in an unqualified
(ignorant, wounded, low-nurturance) organization.
Each of these generic "supervisory problems" are
surface issues caused by underlying primary needs. For
example, if a clinician is clearly providing ineffective service, the gross
problem is the inability of the professional, supervisor, or agency to
identify and acquire the missing requisites.
A common related problem is one or more of the involved professionals
lacking effective communication (problem-solving)
basics, attitudes and
.
Premise: generally, each person whose
current primary needs
are unmet is responsible to...
Where these don't seem to work (fill needs
permanently), use these communication options,
blocks, and
tips to achieve better outcomes if
each involved person's
true Self usually leads their personality.
If not, (a)
for wounds first, and then (b) adapt these
options to fit your situation.
An important universal option is to apply these
in case some factors are beyond the needy person's ability
to affect them. Another option is to invite a
qualified consultant to advise. Other common options are...
-
the problem/s and/or their impacts,
-
delaying needed confrontations or
changes, and/or...
-
justifying and trying ineffective
(superficial) solutions.
All these suggest significant
false-self dominance.
Recap
This article
exists because of the premises that (a)
effective therapy with stepfamily and divorced-family clients is unusually
complex, and (b) therefore, effective case supervision or management requires special
knowledge, skills, and resources. The article defines "effective clinical supervision,"
and
proposes factors that make supervising these cases more
complex. The article then offers 11 special requisites for effective supervision
of therapists working with these complex multi-home, multi-problem clients. These are in addition to the normal requisites for
supervising other types of family clients well.
The article
outlines 13 common supervisory problems with these client cases, and
offers direction toward effective resolutions. Effective supervision or case management
is one of
for providing effective
clinical service to these
complex, needy client families.
+ + +
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https://sfhelp.org/pro/basics/supervise.htm