**COMPETENCIES FOR**

**SUBSTANCE ABUSE**

**TREATMENT CLINICAL**

**SUPERVISORS**

*Technical Assistance Publication (TAP) Series*

**TAP 21-A**

**U.S. Department of Health and Human Services**

Substance Abuse and Mental Health Services Administration

Center for Substance Abuse Treatment

1 Choke Cherry Road

Rockville, MD 20857

**ACKNOWLEDGMENTS**

Numerous people contributed to this publication. The clinical
supervision competencies were developed by a Task Force of experts (see
below), and the document was reviewed by others in the substance use
disorder treatment field (see Appendix D). Section II: Implementation
Guidelines was written by Steve Gallon, Ph.D., and Pamela Mattel,
LCSW-R, CASAC. This publication was produced by JBS International, Inc.
(JBS), under Knowledge Application Program (KAP) contract number
270-04-7049 with the Substance Abuse and Mental Health Services
Administration (SAMHSA), U.S. Department of Health and Human Services
(DHHS). Christina Currier served as the Center for Substance Abuse
Treatment (CSAT) Government Project Officer, and Karl White, Ed.D.,
served as the CSAT Workforce Development Team expert. Lynne MacArthur,
M.A., A.M.L.S., served as the JBS KAP Executive Project Co-Director, and
Barbara Fink, RN, M.P.H., served as the JBS KAP Managing Project
Co-Director. Other JBS KAP personnel included Dennis Burke, M.S., M.A.,
Deputy Director for Product Development; Candace Baker, M.S.W., CSAC,
MAC, Senior Writer/Publication Manager; Wendy Caron, Editorial Quality
Assurance Manager; Frances Nebesky, M.A., Quality Assurance Editor;
Pamela Frazier, Document Production Specialist; and Claire Macdonald,
Graphic Artist.

**DISCLAIMER**

The opinions expressed herein are the views of Task Force members and do
not necessarily reflect the official position of CSAT, SAMHSA, or DHHS.
No official support of or endorsement by CSAT, SAMHSA, or DHHS for these
opinions or for particular resources described in this document is
intended or should be inferred.

**PUBLIC DOMAIN NOTICE**

All materials appearing in this volume except those taken directly from
copyrighted sources are in the public domain and may be reproduced or
copied without permission from SAMHSA/CSAT or the authors. Do not
reproduce or distribute this publication for a fee without specific,
written authorization from SAMHSA's Office of Communications.

**ELECTRONIC ACCESS AND COPIES OF PUBLICATION**

This publication may be accessed electronically through
**www.kap.samhsa.gov.** Copies may be obtained free of charge from
SAMHSA's National Clearinghouse for Alcohol and Drug Information
(NCADI), (800) 729-6686 or (240) 221-4017; TDD (for hearing impaired),
(800) 487-4889; or electronically through **www.ncadi.samhsa.gov.**

**RECOMMENDED CITATION**

Center for Substance Abuse Treatment. *Competencies for Substance Abuse
Treatment Clinical Supervisors*. Technical Assistance Publication (TAP)
Series 21-A. DHHS Publication No. (SMA) 08-4243. Rockville, MD:
Substance Abuse and Mental Health Services Administration, 2007;
reprinted 2008.

**ORIGINATING OFFICE**

Quality Improvement and Workforce Development Branch, Division of
Services Improvement, Center for Substance Abuse Treatment, Substance
Abuse and Mental Health Services Administration, 1 Choke Cherry Road,
Rockville, MD 20857.

DHHS Publication No. (SMA) 08-4243

Printed 2007

Reprinted 2008

**CONTENTS**

**Clinical Supervision Competencies Task Force**

**Section I: Introduction**

Background

A Changing Profession

A Competency-Based Framework for Clinical Supervision

What This Document Is *Not*

Using This Document

Directions for Future Research

Bibliography

**Section II: Implementation Guidelines**

Why Have Implementation Guidelines?

What Needs To Be Implemented?

Bibliography

**Section III: Foundation Areas**

FA1: Theories, Roles, and Modalities of Clinical Supervision

FA2: Leadership

FA3: Supervisory Alliance

FA4: Critical Thinking

FA5: Organizational Management and Administration

**Section IV: Performance Domains**

PD1: Counselor Development

PD2: Professional and Ethical Standards

PD3: Program Development and Quality Assurance

PD4: Performance Evaluation

PD5: Administration

**Section V: Integrated Bibliography**

**Section VI: Appendices**

Appendix A: Clinical Supervision Certification---National Resources

Appendix B: Professional Codes of Ethics Specific to Clinical
Supervision

Appendix C: Suggested Reading and Other Resources

Appendix D: Field Reviewers

**Other Technical Assistance Publications**

**CLINICAL SUPERVISION COMPETENCIES TASK FORCE**

**Steve Gallon, Ph.D. (Chair)**

Principal Investigator

Northwest Frontier Addiction Technology

Transfer Center

Salem, Oregon

**Charlotte Chapman, M.S., LPC**

Clinical Assistant Professor

Virginia Commonwealth University

Richmond, Virginia

**Thomas Durham, Ph.D., CCS**

Executive Director

The Danya Institute

Silver Spring, Maryland

**Christiane Farentinos, M.D., CADA II**

Director

ChangePoint, Inc.

Portland, Oregon

**Karen Garrett, M.A., CAP, CAPP**

Quality Improvement and Training Director

River Region Human Services, Inc.

Jacksonville, Florida

**Anne Hatcher, Ed.D., CAC III, NCAC II**

Professor, Co-Director

Center for Addiction Studies

Metropolitan State College of Denver

Denver, Colorado

**Jim Knorp, M.S.W., CAP**

Project Manager

Southern Coast Addiction Technology

Transfer Center

Tallahassee, Florida

**Pamela Mattel, LCSW-R, CASAC**

Behavioral Healthcare Consultant/Trainer

13 Hill Drive

Oyster Bay, New York

**Jeanne Obert, MFT, MSM**

Executive Director

Matrix Institute

West Los Angeles, California

**Laura Tonkin**

Partner

The Mackey Group

Issaquah, Washington

**Mike Towey, M.P.A., CDP, CPP**

Instructor

Tacoma Community College

Tacoma, Washington

Section I:

**INTRODUCTION**

**BACKGROUND**

In 1998, the Substance Abuse and Mental Health Services Administration's
Center for Substance Abuse Treatment (CSAT) published Technical
Assistance Publication (TAP) 21, *Addiction Counseling Competencies: The
Knowledge, Skills, and Attitudes of Professional Practice*. TAP 21 has
been widely distributed and is now a benchmark by which curricula are
developed and educational programs and professional standards are
measured in the U.S. substance use disorder treatment field. In 2006,
CSAT produced a reformatted, revised version of TAP 21 (Center for
Substance Abuse Treatment, 2006).

The TAP 21 counselor competencies describe what fully proficient
counselors can do in clinical practice. Those competencies may be
introduced in preemployment education and training settings, but they
are often developed more fully on the job. It is typically the clinical
supervisor's responsibility to mentor counselor development and
facilitate the building of new knowledge and skills, not only during
counselors' early years but throughout their careers. To that end,
clinical supervisors in agencies specializing in the treatment of
substance use disorders are expected to be knowledgeable and proficient
in the addiction counseling competencies.

Clinical supervision itself is much discussed in the professional
literature of several disciplines, including social work, psychology,
and both mental health and substance use disorder counseling. Theories,
process dynamics, and tools abound, but the functional responsibilities
and essential skills of the substance use disorder treatment supervisor
had not been synthesized into one document that could serve as a
standard for the field. To remedy that situation, CSAT convened the
Clinical Supervision Competencies Task Force (the Task Force) in fall
2005. The Task Force, composed of experts in substance abuse treatment
and clinical supervision from across the country, was charged with
developing this document, TAP 21-A, *Competencies for Substance Abuse
Treatment Clinical Supervisors*. TAP 21-A is designed to accompany TAP
21, taking monitoring, assessment, and improvement of addiction
counseling competencies to the next level.

**A CHANGING PROFESSION**

Professional treatment for substance use disorders is a rapidly changing
discipline. Research and evaluation studies are identifying new methods
and tools for facilitating change and recovery. Payers, clients and
their families, and the general public are seeking increased
accountability and effectiveness of services. Licensing and
credentialing bodies are raising their standards and expecting higher
qualifications from applicants for certification or licensure. For
example:

> States and the Federal Government are implementing contracts and
> grants that require treatment organizations to demonstrate specified
> levels of client outcomes rather than just delivery of services.
>
> Licensing and funding sources of all types are expecting programs to
> use evidence-based practices in the delivery of treatment services.

Treatment programs also are seeing clients who have co-occurring
disorders and present with complex life situations and issues. More
complex treatment issues call for more sophisticated and competent
treatment and supervision skills. To meet increasing demands, modern
treatment organizations must be able to---

> Monitor, evaluate, and promote clinical competence, directly and
> objectively;
>
> Ensure fidelity to evidence-based practices; and
>
> Increase treatment efficacy and cost-effectiveness.

Historically, professional substance abuse treatment organizations have
focused resources on providing direct client care but have not provided
sufficient resources for clinical supervision, an activity critical to
ensuring service quality and effectiveness. Supervision time is limited
in most agencies, and supervisory activities are frequently more
administrative than clinical in nature. Supervisors often carry a
clinical caseload and have a variety of program management
responsibilities. It is no wonder that direct clinical supervision of
counselors (including performance observation, feedback, and mentoring)
is rarely a part of an agency's staff development plan.

Counselors often are promoted into supervisory positions on the basis of
seniority, academic training, or their competence as counselors.
Although a high level of counseling proficiency is an important
prerequisite, it is not the only qualification of a competent clinical
supervisor. Clinical supervision requires a new set of knowledge,
skills, and abilities, as well as assumption of a different professional
role. Many new supervisors receive little or no training in clinical
supervision, leading to enormous inconsistency in the quality of
supervision available in the field. As a result, many counselors receive
inadequate clinical training and supervision. New counselors working
toward certification or licensure frequently have to go outside their
agencies, and even outside the field of substance use disorder
treatment, to obtain competent supervision.

In addition, as professional performance expectations increase,
substance use disorder treatment agencies are experiencing an
unprecedented workforce shortage. An aging workforce and the lure of
better paying positions in related settings have contributed to the
shortage of qualified treatment personnel. Clinical staff members can
become overwhelmed or dissatisfied when faced with the high demands of
the job and little supervision. Some even choose to leave the
profession. At the same time, fewer individuals are entering the field
than in the past. Literature suggests that one potential solution is to
provide consistent, high-quality clinical supervision in a way that will
attract new counselors, enhance career satisfaction, mitigate burnout
among veteran providers, and help clinicians become (and feel) more
competent and effective.

**A COMPETENCY-BASED FRAMEWORK FOR CLINICAL SUPERVISION**

Clinical supervision has become an organizational function with its own
conceptual framework and methodology. Key competencies for effective
clinical supervision represent an array of knowledge and skills
pertinent to the clinical, administrative, and evaluative
responsibilities of a clinical supervisor. Before the framework can be
described in more detail, definitions of two key terms are needed:
*clinical supervision* and *competency.*

A number of definitions for *clinical supervision* have appeared in the
published literature. Two of the most popular are the following:

> 1\. Clinical supervision is a disciplined, tutorial process wherein
> principles are transformed into practical skills, with four
> overlapping foci: administrative, evaluative, clinical, and supportive
> (Powell, 2004, p. 11).
>
> 2\. Supervision is an intervention that is provided by a senior member
> of a profession to a more junior member or members of that same
> profession. This relationship is evaluative, extends over time, and
> has the simultaneous purposes of enhancing the professional
> functioning of the more junior person(s), monitoring the quality of
> professional services offered to the clients that she, he, or they
> see, and serving as a gatekeeper of those who are to enter the
> particular profession (Bernard and Goodyear, 2004, p. 8).

After reviewing the available literature, the Task Force synthesized the
following consensus definition of *clinical supervision:*

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

Marrelli and colleagues (2004, p. 4) define *competency* as follows:

> \[A\] measurable human capability that is required for effective
> performance . . . \[composed\] of *knowledge*, a single *skill* or
> *ability*, a *personal characteristic*, or a cluster of two or more of
> these attributes. Competencies are the building blocks of work
> performance. The performance of tasks requires the simultaneous or
> sequenced demonstration of multiple competencies.

A competency-based model, as presented in this document, provides a
framework for understanding, learning, and implementing the multiple
functions and tasks of clinical supervision. Becoming an effective and
fully competent clinical supervisor is a developmental process. As
knowledge and skills are accumulated over time, the supervisor's
proficiency incrementally increases. This document describes
competencies required to reach *mastery* as a clinical supervisor. It
establishes a set of expectations for clinical supervision in substance
use disorder treatment settings, describes the capabilities of a fully
proficient clinical supervisor, and provides a standard toward which
organizations and supervisors are encouraged to strive.

The nature of the relationship between supervisor and supervisee is
unique. It can be characterized as highly charged and intense. When one
person is in a position of power and authority over another, tension,
discomfort, and conflict can arise. It is crucial that clinical
supervisors understand the nature of this relationship and exercise
supervisory responsibilities in a respectful, fair, and objective
manner.

It is important, too, for supervisors to understand the developmental
process of supervisees (e.g., how they learn, how skills are developed
over time) and how to establish a spirit of learning and personal
development in an organization. Service improvement occurs most
effectively when service providers have the freedom to practice new
skills in an environment marked more by support and mentoring than by
critical judgment.

The clinical supervision competencies identified below are presented
under two major headings: foundation areas and performance domains.

Foundation areas identify the broad knowledge and concepts essential to
supervisory proficiency. The competencies representing these foundations
of supervision are grouped into five areas:

> FA1: Theories, Roles, and Modalities of Clinical Supervision;
>
> FA2: Leadership;
>
> FA3: Supervisory Alliance;
>
> FA4: Critical Thinking; and
>
> FA5: Organizational Management and Administration.

Performance domains identify the specific responsibilities and abilities
essential to protecting client welfare, improving clinical services,
developing a competent staff, and fulfilling an organization's mission
and goals. The competencies relating to these specifics of supervisory
practice are grouped into five domains:

> PD1: Counselor Development;
>
> PD2: Professional and Ethical Standards;
>
> PD3: Program Development and Quality Assurance;
>
> PD4: Performance Evaluation; and
>
> PD5: Administration.

Clinical supervision is distinguished from administrative supervision in
some models of supervisory practice, and many believe that
administrative duties take precious time away from the provision of
direct supervision to clinical staff. However, in substance use disorder
treatment settings, the two kinds of supervision significantly overlap
in real-world practice; Powell (2004, p. 11) identified "administrative"
as one of four "overlapping foci" of clinical supervision. The Task
Force members believe strongly that this document would not be complete
if it did not address elements of organizational and administrative
functioning. Unlike the other competencies described in this document,
the extent to which clinical supervisors are expected (or have the
authority) to perform the administrative functions varies greatly from
organization to organization. Few supervisors have responsibility for
performing *all* of the administrative activities included. However, as
supervisors move to other organizations, their administrative activities
may well change. It is important that clinical supervisors understand
the range of administrative competencies that may be expected of them.

This competencies document is both research and consensus based. A
thorough literature search was conducted, and Task Force members
developed competencies based on a review of literature available. The
specific resources the Task Force used to identify particular
competencies are listed in a bibliographic section after each foundation
area and performance domain. In addition, Section V provides an
integrated bibliography. Additional reading suggestions and resources
for further study are in Appendix C.

**WHAT THIS DOCUMENT IS *NOT***

Before discussing ways in which this document can be used, it is
important to clarify what this document is *not* intended to be. It is
not the following:

> A description of the competencies, models, or techniques of
> *counseling*. This document presupposes knowledge and mastery of the
> counseling competencies described in TAP 21, *Addiction Counseling
> Competencies: The Knowledge, Skills, and Attitudes of Professional
> Practice.*
>
> A clinical supervision certification test preparation manual. Each
> certifying body can provide guidance about the best preparation
> material for its test (see Appendix A for a list of national
> certifying bodies).
>
> An in-depth description of specific supervision models, approaches, or
> techniques. The competencies are relevant across treatment settings
> and models of supervision. The references listed throughout the
> document and in Appendix C: Suggested Reading and Other Resources are
> excellent sources of information about models and specific supervision
> techniques.

**USING THIS DOCUMENT**

Basing clinical supervision practices on the competencies described in
this publication may require significant changes in current supervisory
practices. State agencies may choose to alter guidelines for clinical
supervision in their administrative rules. Community agencies may choose
to make changes throughout their organizations in day-to-day clinical
supervision practices. Making such changes requires planning and a
process designed for gradual incremental change. To assist in the
implementation process, Section II contains a discussion of how a set of
guidelines could be useful and presents recommendations for facilitating
successful implementation at both the State and the community agency
levels.

The clinical supervision competencies in the foundation areas (Section
III) and performance domains (Section IV) serve as guides to providing
consistent and comprehensive supervisory training and development. In
general, they promote a common understanding of the clinical
supervisor's roles and responsibilities, foster development of standards
for the delivery of clinical supervision, encourage the development of
clinical supervision credentials, and raise questions for future study.
Specifically, the competencies provide a resource for professional
development to the following individuals and organizations:

> New and experienced supervisors can assess their proficiency and use
> their self-assessment to establish personal professional development
> plans. Aspiring supervisors can develop accurate expectations about
> the nature of being a supervisor and seek education and training that
> will prepare them for the role.
>
> Counselors can become familiar with supervision standards, develop
> accurate expectations about their role in supervision, and identify
> how supervision can contribute to their professional development.
>
> Agency administrators can identify the potential benefits of
> establishing an effective clinical supervision program, improve their
> understanding of the clinical supervisor's tasks and responsibilities,
> and provide clear guidelines for the delivery of clinical supervision
> in their agencies.
>
> Professional and advocacy associations can establish practice
> standards and plan continuing education efforts for clinical
> supervisors.
>
> Educators and training professionals can assess and improve existing
> curricula related to supervision, as well as enhance the quality of
> supervision in academic practica, field training, and internship
> experiences.
>
> Single State Authorities can establish administrative rules related to
> the availability and delivery of clinical supervision and recommend or
> provide technical assistance to State-affiliated or contracted
> agencies that provide treatment services for substance use disorders.
>
> Certification and licensing bodies can establish or update clinical
> supervisor credentialing or licensing standards and prepare
> credentialing examination questions.
>
> Federal agencies can develop contract and grant guidelines to ensure
> the quality of services they support and to promote the highest
> possible standard of care.
>
> Allied health professionals can establish or improve supervision
> guidelines in their clinical settings.
>
> Researchers can develop research agendas.

**DIRECTIONS FOR FUTURE RESEARCH**

The Task Force recognizes that more work is needed and hopes that
clinical supervision in general and this supervisor competency framework
will be the subject of further study. Future research could examine the
importance of clinical supervision in implementing empirically supported
treatment interventions, the relationship between the quality and
quantity of supervision to clinical outcomes, and other important issues
related to an improved understanding of the relationship between
supervision and effective clinical service delivery.

Research specific to the supervisor competencies in this document could
focus on---

> Validating the relationship between these competencies and improved
> service quality;
>
> Developing additional tools to assess supervisor proficiency in the
> competencies;
>
> Determining how best to train supervisors or teach them the
> competencies; and
>
> Determining the best way to prepare aspiring clinical supervisors for
> their future positions.

The Task Force hopes that this document encourages both continued
development of clinical supervision as a discipline and continuous
improvement of clinical services for people with substance use
disorders.

**BIBLIOGRAPHY**

Bernard, J.M., and Goodyear, R.K. Ethical and legal considerations. In:
*Fundamentals of Clinical Supervision* (3d ed.). Boston: Allyn & Bacon,
2004. pp. 49--72.

Center for Substance Abuse Treatment. *Addiction Counseling
Competencies: The Knowledge, Skills, and Attitudes of Professional
Practice.* Technical Assistance Publication (TAP) Series 21. DHHS
Publication No. (SMA) 06-4171. Rockville, MD: Substance Abuse and Mental
Health Services Administration, 2006.

Marrelli, A.F., Tondora, J., and Hoge, M.A. Strategies for developing
competency models. *Competency Conference Proceedings.* The Annapolis
Coalition on the Behavioral Health Workforce, 2004.
**www.annapoliscoalition.org/pdfs/Competency%20Modeling%20Strategies.pdf**
\[accessed December 12, 2006\].

Powell, D.J. *Clinical Supervision in Alcohol and Drug Abuse Counseling:
Principles, Models, Methods.* San Francisco: Jossey-Bass, 2004.

Section II:

**IMPLEMENTATION GUIDELINES**

**WHY HAVE IMPLEMENTATION GUIDELINES?**

*Competencies for Substance Abuse Treatment Clinical Supervisors
(Supervisor Competencies)* succinctly describes the knowledge and skills
essential to the competent practice of clinical supervision in treatment
settings. Within the performance domains (Section IV), responsibilities
are clearly laid out for counselor development, maintaining professional
and ethical standards, program development and quality assurance,
performance evaluation, and administrative functions. When supervisors
have an opportunity to observe and evaluate the work of clinicians, they
become aware of both the strengths and the deficits of the services
being delivered. They can identify issues that need resolution and
services or supervisee skills that need to be enhanced.

Such comprehensive practice, in reality, is relatively rare in clinical
settings today. Most treatment agencies have clinical supervisors.
However, their work typically is limited to administrative and case
management duties such as reviewing case records, facilitating case
staffing conferences, and collaborating on difficult cases. Actual
observation of clinical services, performance feedback, coaching,
teaching, and negotiating professional development plans occur
relatively infrequently.

For most agencies, adopting clinical supervision practices consistent
with the performance domains identified in this document will require a
significant change in operations. In return for their investment in time
and resources, agencies will find themselves engaged in an
improvement-oriented approach to the monitoring and development of
clinical services that likely will lead to improved staff retention,
enhanced counselor skills, and better clinical outcomes.

If agencies are to improve their supervisory practices by adding
activities identified as clinical supervision competencies, a set of
guidelines is needed to support the development of an implementation
plan and to ensure a smooth transition from existing practice to a
different way of supervising clinical staff. Some necessary tasks
include---

> Defining or clarifying the rationale, purpose, and methods for
> delivering clinical supervision;
>
> Ensuring that agency management fully understands and supports the
> changes that need to be made;
>
> Providing training and support in supervisory knowledge and skill
> development; and
>
> Orienting clinicians to the new supervision rationale and procedures.

These tasks require an implementation *process*. Too often, the
assumption is made that systemic changes can be made by administrative
order. However, research indicates that successful change requires a
comprehensive plan, management support, effective leadership, and a
period of effort sufficient for the change to become a normative
practice (Bradley et al., 2004). Agencies should introduce and enact
changes in supervisory practice over a defined period that allows for
procedures to be developed, supervisors to test the new operations, and
clinicians to provide feedback and adjust to a more collaborative,
observational supervisory process. The broad goal is to create a
continuous learning culture in the agency that encourages professional
development, service improvement, and a quality of care that maximizes
benefits to the agency's clients.

**WHAT NEEDS TO BE IMPLEMENTED?**

Agency management needs to study the five performance domains in the
*Supervisor Competencies* and compare them with existing agency practice
to determine the type and extent of change needed. At a minimum,
management needs to examine its current---

> Organizational culture;
>
> Policies and procedures;
>
> Position descriptions;
>
> Direct service expectations; and
>
> Time allocated to the delivery of clinical supervision.

Time is a significant issue. The type of clinical supervision described
in this document takes considerably more time than is typically allotted
in community agencies. Nonetheless, that time should be considered an
investment that will return benefits of improved service delivery, fewer
direct service performance problems, improved risk management, and
better treatment outcomes.

If agency management clarifies expectations for both the delivery and
the outcome of clinical supervision before its implementation, staff is
likely to be more receptive to the time investment necessary to
implement an effective clinical supervision model. Supervisors need to
be trained in the roles and processes of clinical supervision that are
consistent with management expectations. Such training is best delivered
over a period that allows supervisors to apply new knowledge and
practices during the learning process. Making available a consultant or
coach, who can meet regularly with supervisory staff to guide
implementation, enhances the likelihood of a smooth and effective
transition.

While supervisors are being trained, staff clinicians need to be
introduced to the new supervisory paradigm. As clinicians begin to
experience being observed, receiving feedback, and negotiating
individual development plans, it is important that they discuss their
experiences with supervisors and managers. Such discussion likely will
yield suggestions for process improvement and provide opportunities to
clarify misunderstandings and improve communication.

Most agencies can expect to complete the initial change process within 6
months. However, learning and adjustments to the model will continue as
agencies assess the performance and needs of both supervisors and
clinical staff. Agencies may need to be encouraged to "hang in there"
when faced with implementation difficulties. In addition, when a new
practice is introduced and adopted, the ability to monitor, provide
feedback, and coach facilitates continuous quality improvement and
increases fidelity to a new protocol. Without the opportunity to
directly monitor clinical processes, it is unlikely that fidelity to any
treatment intervention or protocol will be maintained.

The following guidelines are suggested, for both State- and agency-level
implementation efforts, to facilitate successful adoption of enhanced
clinical supervision practices in addiction treatment agencies.

***Implementation Guidelines: State Level***

> **1. Appoint a leader for the improvement effort.** Without an
> accountable leader, change initiatives often move slowly, are plagued
> with miscommunication, or founder altogether. The leader---
>
> Assesses readiness to adopt a new model of clinical supervision;
>
> Oversees the change process;
>
> Facilitates the achievement of objectives;
>
> Monitors data being gathered to measure success;
>
> Checks in regularly with key players on the change team; and
>
> Troubleshoots when unanticipated problems arise.
>
> The leader's success often hinges on whether sufficient time has been
> allocated to the project. When a system change is important,
> management must ensure that the leader, whether an employee or a
> contractor, has the time and resources to successfully implement the
> change plan.
>
> **2. Start with agencies that choose to adopt the change.** Change is
> often accompanied by resistance. To be successful, statewide
> initiatives should consider a phase-in process that begins with the
> agencies most interested in adopting the change. Using this strategy
> can accomplish two objectives that enhance the possibility of success
> throughout the system. First, agencies that are most ready are most
> likely to be successful. Word of their success can be spread
> throughout the system, thus reducing resistance among a significant
> number of peer agencies. Second, by starting small, State management
> and the participating "early adopters" can work out problems and
> develop a proven set of guidelines for other agencies to use. The
> selection of agencies for this first phase of the process should be
> done carefully; only those deemed most ready should be selected to
> participate.
>
> **3. Establish clear written standards and agreements with
> participating agencies.** Expectations, timeframes, deliverable
> products, and progress benchmarks should be clarified in the State's
> agreement or contract with a participating agency. Before such
> conditions are established, the State may do several things in
> preparation. First, it may survey agencies to determine the current
> state of clinical supervision activities. This survey can provide a
> baseline for comparison purposes later and can yield information about
> the types of changes needed to bring agencies in line with the State's
> goals. Second, the State may consider establishing a set of minimum
> standards for the delivery of clinical supervision. The minimum
> amount, type, and frequency of clinical supervision activities
> (depending on caseload and number of clinicians) could be established,
> preferably in consultation with selected treatment agency
> representatives. Third, the State may establish minimum clinical
> supervisor qualification standards (e.g., for education, clinical
> licensure, supervisory certification) to provide guidance to agencies
> in revising their clinical supervision protocols.
>
> **4. Establish criteria for annual performance evaluations of clinical
> staff.** Evaluations should be based on multiple, periodic direct
> observations of clinical duties and activities. Performance should be
> assessed in relation to proficiency in the relevant addiction
> counseling competencies. The agency should include other criteria that
> reflect its strategic plan, position descriptions, and individual
> professional development plans implemented during the year.
>
> **5. Recognize that change is incremental.** Although establishing
> statewide goals and objectives is important, so is remembering that
> each agency is different and that success depends on an agency's
> ability to adapt its clinical services system to the new requirements.
> Variations in how the new standards are implemented at the agency
> level are inevitable. It is important to provide clinical supervision
> in a way that facilitates the continuous improvement of clinical
> services and improves treatment outcomes. Creative adaptations are to
> be expected and even encouraged. Agencies, to be successful, need to
> buy into and own the improvements they make and not simply respond to
> a mandate from a regulatory authority.

6.  **Develop a source of technical assistance and statewide
    monitoring.** Not all agencies can successfully enhance their
    supervisory practices without outside assistance. Technical
    assistance can be provided in a number of ways. For example, the
    State could develop a manual that includes---

> Sample supervisory practices;
>
> Performance assessment tools;
>
> Professional development planning forms;
>
> Checklists for required policies and procedures; and
>
> A list of resources and external sources of technical assistance.
>
> Consultants or peer experts could be identified to review a requesting
> agency's clinical supervision program and resolve specific issues.
> Agencies also could be required to submit specific prescribed data to
> allow statewide monitoring of clinical supervision activities,
> changes, and the effect of supervision activities on other measures of
> agency performance. Without some objective measures, it is impossible
> for the State to monitor and assess progress in the delivery of
> clinical supervision.
>
> **7. Ensure the availability of ongoing training in clinical
> supervision methods.** Too often the expectation is that new knowledge
> and skills can be acquired quickly, with brief exposure during a
> class, workshop, or conference. Complex skills and knowledge, however,
> are best acquired over time, interspersed with periods of
> experimentation and practice. Clinical supervision, as described in
> this volume, is a discipline marked by a large body of foundation
> knowledge and many performance domains. A working knowledge of the
> competencies and proficiency in supervisory skills can be acquired
> only through a learning *process*, not one or even several learning
> *events*. Clinical supervisors motivated to master their craft need to
> attend continuing education programs throughout their careers.
>
> **8. Develop a credential that reflects proficiency in the clinical
> supervision competencies.** Most disciplines with an array of unique
> competencies establish a way of verifying basic qualifications and
> practice knowledge. Clinical supervision should not be an exception. A
> State's existing credentials need to be modified to encompass minimal
> State qualifications and an assessment of the supervisor's
> understanding and appreciation of the competencies described in this
> volume, or a new credential needs to be established that does so. Only
> then can employers and State monitors accurately assess an applicant's
> readiness to fill a supervisory position in a clinical setting.

***Implementation Guidelines: Agency Level***

> **1. Base improvement objectives on needs identified within the
> agency.** The best way to identify agency needs is to study existing
> clinical supervision practices, compare them with the competencies in
> the performance domains, and note important issues to management.
> Sometimes a consultant trained in facilitating service improvement,
> who has expertise in clinical supervision, can help management
> prioritize improvements and recommend implementation processes
> tailored to agency needs. Often the consultant works with the agency
> over several months to facilitate the process and provides coaching to
> agency leadership.
>
> **2. Select only changes that management will fully support.** Some
> improvements in clinical supervision require significant changes in
> the amount of time supervisors devote to supervisory activities and
> the nature of those activities. It is important to choose only
> objectives that the highest level of management supports. The
> initiative gains credibility with staff when management announces the
> importance of the change, identifies how the agency expects to
> benefit, and clarifies how progress will be measured. Anything less
> than a serious commitment is likely to limit severely the success of
> an improvement process.
>
> When more than one change is identified as a high priority, it is
> important to limit changes to what can be planned and implemented
> while attending to other key agency functions. Changing too much at
> once can be as detrimental as a lack of management support and can
> overwhelm everyone involved. Overwhelming frequently results in
> returning to the familiar rather than forging ahead to explore the
> unknown.
>
> **3. Create a change plan with objectives that are specific,
> achievable, and measurable.** Management must identify the reasons for
> change and communicate them clearly to agency staff. The objectives or
> outcomes sought should be clearly defined and measurable. The change
> process needs to be initiated by developing, with a small number of
> key staff members, a detailed plan to achieve management's objectives.
> Such a plan typically includes a progression of activities that
> gradually enact the new processes or improvements. As the plan
> unfolds, revisions can be made to accommodate unanticipated situations
> or difficulties encountered by participating supervisors.

4.  **Identify a leader to facilitate the improvement process.**
    Regardless of whether the agency secures outside consultation, it
    should assign a staff member who has the respect of both management
    and supervisory staff to serve as the internal leader of a change
    initiative team. This team leader---

> Collaborates with the consultant and the supervisory team;
>
> Helps present the change plan to the staff;
>
> Clarifies assignments for implementing the plan;
>
> Debriefs and celebrates progress;
>
> Prevents discouragement when problems are encountered;
>
> Keeps both management and line staff apprised of progress; and
>
> Facilitates problem resolution when necessary.
>
> The change leader ensures that data indicating progress are gathered
> and checks in with those implementing change to ensure fidelity with
> the plan. In short, the change leader is responsible for moving the
> project forward, keeping it on track, and identifying both successes
> and problems along the way.
>
> The supervisory team should also facilitate peer supervision and
> support as the implementation process progresses. Collaboratively
> debriefing supervisors about their experiences of directly observing
> clinicians, providing feedback, and developing learning plans generate
> momentum and solidify the importance of the improvement initiative.
> Another value of peer support is that clinical supervisors often are
> isolated and need as much clinical supervision as the people they
> supervise.

**5. Make sure that all staff members are prepared to implement the
plan.** Supervisors often need training in the new skills and practices
they are expected to implement. They typically are promoted based on
their performance as clinicians or because they have advanced
educational degrees and are considered the best-trained staff in the
agency. In either case, supervisors rarely have much training in how to
be effective, so most agencies will need to provide supervisory training
in both the foundation areas and the performance domains that constitute
the *Supervisor Competencies.*

> Just as supervisors need training in the foundation areas and
> performance domains, clinicians must be oriented to new ways of
> receiving clinical supervision. Some clinicians are anxious or even
> resistant to the monitoring, feedback, and coaching that form the
> essence of the *Supervisor Competencies.* They need reassurance that
> the goal is to facilitate service improvements, not to criticize
> individuals. Clinical supervision identifies and acknowledges
> clinicians' strengths and limitations and provides opportunities for
> continued learning and improvement of clinical services. The goal of
> clinical supervision is not to find fault but to identify ways for
> clinicians to grow professionally.
>
> When everyone understands the intent and the mechanics of the new
> procedures, then the agency is ready to begin implementation.
> Management should arrange for staff members to meet with the change
> leader and consultant to provide feedback on the new procedures.
> Modifications can be made to the initial plan as needed.

**6. When success is achieved, implement a sustainability plan.** Once
supervisors have integrated the improvement processes and tools into
their practice, are experiencing success in their alliance with
supervisees, and see improvements in clinical skills and service
delivery, it is time to establish an ongoing process to ensure the
continued development of supervisory practices. The plan can include
periodic (e.g., quarterly) review of quality assurance indicators, the
strengths and limitations of current supervisory practices, and
adjustments to the agency's expectations of supervisors and clinical
staff.

Readers are encouraged to develop a thorough working knowledge of the
competencies described in this volume. The Task Force predicts that
quality supervision will become a major factor in determining the degree
to which evidence-based practices are adopted in community settings;
identifying the professional development needs of agencies, clinical
supervisors, and clinicians; and improving retention rates for both
clients and clinical staff.

**BIBLIOGRAPHY**

Bradley, E.H., Webster, T.R., Baker, D., Schlesinger, M., Inouye, S.K.,
Barth, M.C., Lapane, K.L., Lipson, D., Stone, R., and Koren, M.J.
Translating research into practice: Speeding the adoption of innovative
health care programs. *Issue Brief (Commonwealth Fund)*,
July(724):1--12, 2004.

Section III:

**FOUNDATION AREAS**

Effective clinical supervisors are skilled, experienced clinicians. They
are knowledgeable about substance use disorders and generally accepted,
research-based assessment, intervention, treatment, and recovery
strategies. It is important that supervisees believe that their
supervisors have substantial knowledge and skill to pass along. However,
knowledge and skill as a counselor are not enough to ensure success as a
clinical supervisor.

The specific tasks, responsibilities, and roles of supervisors vary
depending on agency mission, target population, theoretical model,
treatment modality, and general structure. However, some basic
competencies are common to a variety of settings and professional
disciplines. These basic concepts are reflected in the foundation area
competencies in this document. They are common across the variety of
disciplines and interest groups that provide care for clients with
substance use disorders. The competencies identified as *foundation
areas* complement those found in the transdisciplinary foundations
section of TAP 21. Clinical supervisors in substance use disorder
treatment settings are expected to be familiar with the knowledge
described in the transdisciplinary foundations.

The framework used here identifies five foundation areas in clinical
supervision:

> FA1: Theories, Roles, and Modalities of Clinical Supervision;
>
> FA2: Leadership;
>
> FA3: Supervisory Alliance;
>
> FA4: Critical Thinking; and
>
> FA5: Organizational Management and Administration.

Each contains several competencies that, taken together, define the work
of the clinical supervisor.

**FA1: THEORIES, ROLES, AND MODALITIES OF CLINICAL SUPERVISION**

***Introduction***

Although some similarities exist between counseling and supervising,
there are many important differences. Clinical supervision has its own
knowledge base, and supervisors must understand different theoretical
perspectives. They also must understand the roles clinical supervisors
are expected to fill and the various modalities, or ways of implementing
supervision, that are available.

***The Competencies***

> Understand the role of clinical supervision as the principal method
> for monitoring and ensuring the quality of clinical services.
>
> Appreciate the systemic role of the clinical supervisor as a primary
> link between management and direct services.
>
> Understand the multiple roles of the clinical supervisor, including
> consultant, mentor, teacher, team member, evaluator, and
> administrator.
>
> Be able to define the purpose of clinical supervision specific to the
> organization's clinical and administrative contexts, including
> supervisory goals and methods.
>
> Be familiar with a variety of theoretical models of clinical
> supervision, including (but not limited to) psychotherapy-based,
> developmental, multicultural, integrative, and blended models.
>
> Be able to articulate one's model of supervision.
>
> Be familiar with modalities of clinical supervision, including
> individual, group, direct observation, and consultation.
>
> Be familiar with the current research literature related to
> recommended practices in both substance use disorder treatment and
> clinical supervision.
>
> Be familiar with the literature regarding multiple learning strategies
> (e.g., instructions, demonstrations, role plays, critiques).
>
> Recognize the importance of establishing with the supervisee a
> productive, healthy learning alliance focused on improving client
> services and job performance.
>
> Understand and reinforce the complementary roles of members on a
> multidisciplinary team.
>
> Understand the importance of assessing needs and carefully planning
> and systematically implementing individual and group supervisory
> activities that promote clinical and program service improvement.

***Bibliography***

Bernard, J.M., and Goodyear, R.K. Introduction to clinical supervision.
In: *Fundamentals of Clinical Supervision* (3d ed.). Boston: Allyn &
Bacon, 2004. pp. 1--18.

Falender, C.A., and Shafranske, E.P. The practice of supervision. In:
*Clinical Supervision: A Competency-Based Approach.* Washington, DC:
American Psychological Association, 2004. pp. 3--36.

Haynes, R., Corey, G., and Moulton, P. *Clinical Supervision in the
Helping Professions: A Practical Guide.* Belmont, CA: Wadsworth
Publishing Company, 2002.

Orlans, V., and Edwards, D. Focus and process in supervision. *British
Journal of Guidance and Counselling,* 25(3):409--415, 1997.

Pearson, Q.M. Opportunities and challenges in the supervisory
relationship: Implications for counselor supervision. *Journal of Mental
Health Counseling,* 22(4):283--294, 2000.

Powell, D.J. *Clinical Supervision in Alcohol and Drug Abuse Counseling:
Principles, Models, Methods.* San Francisco: Jossey-Bass, 2004.

Stoltenberg, C.D., McNeill, B., and Delworth, U. *IDM Supervision: An
Integrated Developmental Model for Supervising Counselors and
Therapists.* San Francisco: Jossey-Bass, 1998.

**FA2: LEADERSHIP**

***Introduction***

Leadership is an important element of clinical supervision. Leadership
may be defined as a bidirectional social influence process in which
supervisors seek voluntary participation of supervisees to achieve
organizational goals, while providing leadership in the management
structure of the agency. Leaders mentor, coach, inspire, and motivate.
They build teams, provide structure, create cohesion, and resolve
conflict. In addition, leaders build organizational culture, facilitate
individual and organizational growth and change, and foster a culturally
sensitive service delivery system by consistently advocating, at all
levels of the organization, the need for high-quality clinical care for
all patients or clients of the agency.

***The Competencies***

> Use a leadership style that creates and maintains an environment based
> on mutual respect, trust, and teamwork.
>
> Be a role model by taking full responsibility for one's decisions,
> supervisory practices, and personal wellness.
>
> Seek job performance feedback from supervisees, peers, and managers to
> improve supervisory practices.
>
> Create, regularly assess, and revise a personal leadership plan to
> provide direction for one's continuing professional development.
>
> Seek out and use leadership mentors to assist with one's personal
> development, knowledge acquisition, and skill development.
>
> Understand the historical context of treatment for substance use
> disorders and use that understanding to participate in developing the
> agency's guiding vision and its related mission, principles, and sense
> of purpose.
>
> Clarify agency vision, mission, and service goals and objectives for
> the supervisee.
>
> Interpret agency mission, policies, procedures, and critical events.
> Effectively communicate those interpretations to supervisees and
> foster an organizational climate that promotes continuous improvement
> and excellence in client care.
>
> Understand, monitor, and ensure compliance with State and Federal
> regulations and accrediting body (e.g., Commission on Accreditation of
> Rehabilitation Facilities, Joint Commission on Accreditation of
> Healthcare Organizations, Council on Accreditation) standards for the
> delivery of substance use disorder treatment.
>
> Recognize the safety and security issues facing the organization and
> participate in enforcing and enhancing organizational policies that
> ensure the safety and security of clients, personnel, and facilities.
>
> Understand and acknowledge the power differential inherent in the
> supervisor--supervisee relationship, using power fairly and
> purposefully avoiding the abuse of power.
>
> Proactively structure and schedule clinical supervision activities.
>
> Teach, mentor, and coach in the context of the organization's core
> values.
>
> Provide honest feedback---positive, constructive, and corrective.
>
> Guide through motivational empowerment rather than control. Facilitate
> work through team building, training, coaching, and support.
>
> Plan and organize for orderly workflow, controlling details without
> being overbearing.
>
> Empower and delegate key duties to others while maintaining goal
> clarity and commitment. Delegate mindfully, considering both the
> supervisee's professional development and the agency's needs.
>
> Encourage supervisee participation in communicating observations,
> ideas, and suggestions to agency management.

***Bibliography***

Kinicki, A., and Kreitner, R. *Organizational Behavior: Key Concepts,
Skills and Best Practices* (2d ed.). New York: McGraw-Hill, 2006.

Maxwell, J.C. *Failing Forward: How to Make the Most of Your Mistakes.*
Nashville, TN: Nelson Business, 2000.

Maxwell, J.C. *The 360 Degree Leader: Developing Your Influence From
Anywhere in the Organization.* Nashville, TN: Nelson Business, 2006.

Powell, D.J. Leadership principles for supervisors. In: *Clinical
Supervision in Alcohol and Drug Abuse Counseling: Principles, Models,
Methods.* San Francisco: Jossey-Bass, 2004. pp. 20--39.

Washington State Division of Alcohol and Substance Abuse. *Clinical
Supervisor Skill Standards.* Olympia, WA: Washington State Department of
Social and Health Services, 2002.

White, W., and Albright, L. Calling a new generation of leaders.
*Addiction Professional,* 4(1):12--21, 2006.

**FA3: SUPERVISORY ALLIANCE**

***Introduction***

Clinical supervision takes place in the context of the
supervisor--supervisee relationship. A positive supervisory alliance
includes mutual understanding of the goals and tasks of supervision and
a strong professional bond between supervisor and supervisee. To be
effective, a supervisor must have a clear understanding of the nature
and dynamics of this relationship.

***The Competencies***

> Be familiar with the literature about supervisory alliance, including
> key factors that strengthen or compromise the supervisory alliance,
> supervisory contracting, and relational issues (e.g., transference and
> countertransference).
>
> Understand the complex, multilevel, and bidirectional nature of the
> supervisory triad of client, counselor, and supervisor. Maintain an
> awareness of potential dual relationships and boundary violations
> within the triad.
>
> Recognize that the supervisor--supervisee relationship develops over
> time and that the stage of relationship development influences the
> rules, roles, and expectations of the alliance.
>
> Conceptualize the supervisor--supervisee relationship as a learning
> alliance that provides for role induction, includes agreement on goals
> and tasks, and recognizes the bond that develops between the
> supervisor and the supervisee.
>
> Understand the value of mentoring as a dynamic way of forming an
> alliance, teaching counseling skills through encouragement, and giving
> suggestions for accomplishing goals.
>
> Create an explicit supervisory contract that clarifies expectations
> and goals, the relationship's structure and evaluative criteria, and
> the limits of supervisor--supervisee confidentiality.
>
> Present as a credible professional who possesses knowledge and
> expertise relevant to the setting and the population being served.
>
> Model ethical behavior vis-à-vis the supervisee and reinforce ethical
> standards in the relationship between the supervisee and the
> supervisee's clients.
>
> Be continually alert to the effects of one's interpersonal style on
> the supervisee.
>
> Maintain appropriate boundaries in forming and maintaining a safe and
> trusting professional relationship.
>
> Attend to cultural, racial, gender, age, and other diversity variables
> essential to a productive supervisor--supervisee relationship.
>
> Understand, recognize, and know how to ameliorate the effects of
> personal countertransference triggered by the supervisee's
> interpersonal style, the supervisee's developmental issues, or the
> supervisee's unresolved personal issues.
>
> Recognize interpersonal conflict and supervisory impasses, accept
> appropriate responsibility, and actively participate in resolving
> difficulties.

***Bibliography***

Abroms, G.M. Supervision as metatherapy. In: Kaslow, F.W., ed.
*Supervision, Consultation, and Staff Training in the Helping
Professions.* San Francisco: Jossey-Bass, 1977. pp. 81--99.

Bernard, J.M., and Goodyear, R.K. The supervisory relationship: The
influence of individual and developmental differences. In: *Fundamentals
of Clinical Supervision* (3d ed.). Boston: Allyn & Bacon, 2004. pp.
136--157.

Bernard, J.M., and Goodyear, R.K. The supervisory relationship:
Processes and issues of the supervisory triad and dyad. In:
*Fundamentals of Clinical Supervision* (3d ed.). Boston: Allyn & Bacon,
2004. pp. 101--135.

Bordin, E.S. A working alliance based model of supervision. *The
Counseling Psychologist,* 11:35--41, 1983.

Fleming, J., and Benedek, T. *Psychoanalytic Supervision: A Method of
Clinical Teaching.* New York: Grune & Stratton, 1966.

Haynes, R., Corey, G., and Moulton, P. Ethical issues and multiple
relationships. In: *Clinical Supervision in the Helping Professions: A
Practical Guide.* Belmont, CA: Wadsworth Publishing Company, 2002. pp.
151--181.

Holloway, E.L. Structures for the analysis and teaching of supervision.
In: Watkins, C.E., Jr., ed. *Handbook of Psychotherapy Supervision.* New
York: John Wiley & Sons, 1997. pp. 249--276.

Ladany, N., Ellis, M.V., and Friedlander, M.L. The supervisory working
alliance, trainee self-efficacy, and satisfaction. *Journal of
Counseling & Development,* 77(4):447--455, 1999.

Muse-Burke, J.L., Ladany, N., and Deck, M.D. The supervisory
relationship. In: Bradley, L.J., and Ladany, N., eds. *Counselor
Supervision: Principles, Process, and Practice.* New York:
Brunner-Routledge, 2001. pp. 28--57.

**FA4: CRITICAL THINKING**

***Introduction***

Critical thinking refers to the cognitive processes of conceptualizing,
analyzing, applying information, synthesizing, and evaluating.
Supervisors are expected to use critical thinking to make sound
decisions and solve problems on a regular basis; they also must help
supervisees hone critical thinking skills.

***The Competencies***

> Understand the various contexts (e.g., organizational, political,
> societal, cultural) in which supervision is conducted.
>
> Analyze and evaluate agency issues and policies to better understand,
> clarify, and participate in the continuous improvement of agency and
> staff performance and service outcomes.
>
> Evaluate and select written and oral communication strategies
> appropriate to the audience and purpose.
>
> Select, adapt, implement, and evaluate appropriate problemsolving,
> decisionmaking, and conflict resolution techniques.
>
> Apply experience, insight, and lessons learned to new situations.
>
> Apply critical thinking to information gathering by evaluating the
> content of the information and the credibility of its source.
>
> Ask supervisees relevant and clarifying questions and listen
> critically for content and underlying issues in their self-disclosure.
>
> Help supervisees develop skills in case conceptualization and analysis
> of client--counselor interactions.
>
> Negotiate, communicate, and document the resolution of conflicts or
> disagreements and strategies for resolving performance problems.
> Document outcomes.
>
> Develop sound criteria for self-evaluation and clarify personal
> beliefs, values, and biases.
>
> Help supervisees develop sound criteria for self-evaluation and
> clarify their beliefs, values, and biases.

***Bibliography***

Bradley, L.J., and Gould, L.J. Psychotherapy-based models of counselor
supervision. In: Bradley, L.J., and Ladany, N., eds. *Counselor
Supervision: Principles, Process, and Practice* (3d ed.). New York:
Brunner-Routledge, 2001. pp. 147--182.

Culbreth, J.R. The Wisconsin clinical supervision training model.
*Clinical Supervisor,* 20(1): 61--71, 2001.

Estrada, D., Wiggins Frame, M., and Braun Williams, C. Cross-cultural
supervision: Guiding the conversation toward race and ethnicity.
*Journal of Multicultural Counseling & Development,* 32:307--319, 2004.

Fisher, R., and Ury, W.L. *Getting to Yes: Negotiating Agreement Without
Giving In* (2d ed.). New York: Penguin Books, 1991.

Foundation for Critical Thinking. Strategy List: 35 Dimensions of
Critical Thought. Dillon, CA: Foundation for Critical Thinking, 2004.
**www.criticalthinking.org/resources/TRK12-strategy-list.shtml#s22**
\[accessed December 12, 2006\].

Mackey, S., and Tonkin, L. *Living Well, Working Smart: Soft Skills for
Success.* Bothell, WA: Book Publishers Network, 2005.

Robinson, C.R. The role of critical thinking skills in counselor
supervision. *Inquiry: Critical Thinking Across the Disciplines,*
20(3):19--25, 2001.

Washington State Division of Alcohol and Substance Abuse. *Clinical
Supervisor Skill Standards.* Olympia, WA: Washington State Department of
Social and Health Services, 2002.

**FA5: ORGANIZATIONAL MANAGEMENT AND ADMINISTRATION**

***Introduction***

Management can be defined as the process of working with and through
others to achieve organizational objectives in an efficient, legal, and
ethical manner. Administration, in the context of this document, is the
day-to-day implementation of the organization's policies and procedures.

Although clinical supervision is distinguished from administrative
supervision in some models of supervisory practice, the two
significantly overlap in the real world. Virtually all clinical
supervisors have responsibility for some management and administrative
activities, but the scope of these activities can vary widely depending
on the organization.

***The Competencies***

> Recognize that organizational and managerial skills and tasks enhance
> clinical supervision.
>
> Understand and consistently apply agency policies, procedures,
> organizational structure, and communication protocols.
>
> Understand the legal demands and liabilities inherent in supervisory
> and clinical services, including the vicarious liabilities incurred in
> supervising interns and students.
>
> Be familiar with and abide by current principles, laws, ethical
> guidelines, and agency policies regarding personnel management.
>
> Learn to implement effective disciplinary and administrative
> management techniques that enhance clinical supervision and
> accomplishment of the organization's mission.
>
> Understand and ensure supervisee compliance with State program
> licensing requirements and with other State and Federal laws and
> statutes.
>
> Understand and ensure supervisee compliance with the substance use
> disorder treatment standards of the organization's healthcare
> accrediting body (e.g., Commission on Accreditation of Rehabilitation
> Facilities, Joint Commission on Accreditation of Healthcare
> Organizations).
>
> Monitor and maintain the human and technical resources needed to meet
> organizational and program objectives.
>
> Evaluate and contribute to improving the organization's cultural
> proficiency.
>
> Possess and continually improve organizational and time management
> skills.
>
> Understand and work within the organization's budgetary constraints.
>
> Effectively apply technology, within agency and regulatory limits, for
> communication, program monitoring, report writing, problemsolving,
> recordkeeping, case management, and other activities.
>
> Ensure the maintenance, storage, and security of employee records and
> protected health information consistent with the organization's
> policies and procedures, government regulations, and ethical
> principles.

***Bibliography***

Abernethy, A.D. Increasing the cultural proficiency of clinical
managers. *Journal of Multicultural Counseling & Development,*
33(2):81--93, 2005.

Bernard, J.M., and Goodyear, R.K. Organizing the supervision experience.
In: *Fundamentals of Clinical Supervision* (3d ed.). Boston: Allyn &
Bacon, 2004. pp. 180--208.

Falvey, J.E., and Bray, T.E. *Managing Clinical Supervision: Ethical
Practice and Legal Risk Management.* Pacific Grove, CA:
Brooks/Cole-Thomson Learning, 2002.

Falvey, J.E., and Cohen, C.R. The buck stops here: Documenting clinical
supervision. *Clinical Supervisor,* 22(2):63--80, 2003.

Garcia, B. Professional development of AODA practice with Latinos: The
utility of supervision, in-service training and consultation.
*Alcoholism Treatment Quarterly,* 16(1--2):85--108, 1998.

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supervision. *Professional Psychology: Research & Practice,*
32(4):415--420, 2001.

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clinical supervision and practice. *Clinical Supervisor,*
20(2):201--215, 2001.

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role of management in community mental health programs. *Social Work,*
48(4):532--544, 2003.

Washington State Division of Alcohol and Substance Abuse. *Clinical
Supervisor Skill Standards.* Olympia, WA: Washington State Department of
Social and Health Services, 2002.

Section IV:

**PERFORMANCE DOMAINS**

Performance domains identify specific areas of clinical supervision
practice that are essential to protecting client welfare, achieving
agency goals, and improving clinical services. To ensure high-quality
service delivery, supervisors work to develop and maintain competence
among direct service staff while adhering to high professional and
ethical standards. Supervisors provide supervisees with appropriate
feedback while facilitating knowledge and skill development. To
accomplish these tasks, supervisors must gather objective information on
which to base an evaluation of their supervisees' performance.
Supervisors also perform administrative tasks that preserve and build
the organizational culture.

The framework used here identifies five performance domains:

> PD1: Counselor Development;
>
> PD2: Professional and Ethical Standards;
>
> PD3: Program Development and Quality Assurance;
>
> PD4: Performance Evaluation; and
>
> PD5: Administration.

The competencies listed within each performance domain identify the
specific abilities and responsibilities that clinical supervisors must
master to be effective in the essential roles they play in the service
delivery system.

Counselor development and performance evaluation are discussed here as
two separate performance domains because each requires a distinct set of
competencies. It is important to note, however, that each is integral to
the other. Performance evaluation without a counselor development
process would not necessarily lead to improved counselor proficiency.
Similarly, counselor development activities in the absence of
performance evaluation would likely be untargeted, general, and of less
value to the counselor.

**PD1: COUNSELOR DEVELOPMENT**

***Introduction***

The continuous development of staff clinical skills is key to the
delivery of high-quality client care. Counselor development is a complex
process that involves teaching, facilitating, collaborating, and
supporting counselor self-efficacy. Supervisors must facilitate this
process in the context of a collaborative supervisor--supervisee
relationship and within professional, ethical, and legal guidelines.
Supervisors also must consistently maintain a multicultural perspective.

***The Competencies***

> Teach supervisees the purpose of clinical supervision and how to use
> it effectively.
>
> Ensure that comprehensive orientation is provided to new employees,
> including in areas such as the organization's client population,
> mission, vision, policies, and procedures.
>
> Build a supportive and individualized supervisory alliance that
> respects professional boundaries.
>
> Maintain a constructive supervisory learning environment that fosters
> awareness of oneself and others, motivation, self-efficacy,
> enthusiasm, and two-way feedback.
>
> Conceptualize and plan individual and group supervision activities,
> incorporating supervisees' preferred learning styles, cultures,
> genders, ages, and other appropriate variables.
>
> Encourage supervisees to examine their views regarding culture, race,
> values, religion, gender, sexual orientation, and potential biases.
>
> Help supervisees develop skills of empathy and acceptance specific to
> working with culturally diverse clients.
>
> Provide timely and specific feedback to supervisees on their
> conceptualizations of client needs, attitudes toward clients, clinical
> skills, and overall performance of assigned responsibilities.
>
> Create a professional development plan with supervisees that includes
> mutually approved goals and objectives for improving job performance,
> how goals and objectives will be met (including the respective
> responsibilities of the supervisor and the supervisee), a timeline for
> expected accomplishments, and measurements of progress and goal
> attainment.
>
> Implement a variety of direct supervisory activities (e.g., role play,
> live supervision/observation, review of audiotaped and videotaped
> sessions, presentation/discussion of case studies) to teach and
> strengthen supervisees' theoretical orientation, professional ethics,
> clinical skills, and personal wellness.
>
> Help supervisees recognize, understand, and cope with unique problems
> of transference and countertransference when working with clients with
> substance use disorders.
>
> Acknowledge supervisees' development and celebrate accomplishments
> through frequent rewards and recognition.
>
> Encourage and help supervisees develop a personal wellness plan to
> manage their stress and avoid compassion fatigue and burnout.

***Bibliography***

Aten, J.D., and Hernandez, B.C. Addressing religion in clinical
supervision: A model. *Psychotherapy: Theory, Research, Practice,
Training,* 41(2):152--160, 2004.

Barnes, K.L. Applying self-efficacy theory to counselor training and
supervision: A comparison of two approaches. *Counselor Education &
Supervision,* 44(1):56--69, 2004.

Bernard, J.M., and Goodyear, R.K. *Fundamentals of Clinical Supervision*
(3d ed.). Boston: Allyn & Bacon, 2004.

Cashwell, T.H., and Dooley, K. The impact of supervision on counselor
self-efficacy. *The Clinical Supervisor,* 20(1):39--48, 2001.

Haynes, R., Corey, G., and Moulton, P. *Clinical Supervision in the
Helping Professions: A Practical Guide.* Belmont, CA: Wadsworth
Publishing Company, 2002.

Ladany, N., Friedlander, M.L., and Nelson, M.L. Remediating skill
difficulties and deficits: It's more than just teaching. In: *Critical
Events in Psychotherapy Supervision: An Interpersonal Approach.*
Washington, DC: American Psychological Association, 2005. pp. 23--52.

Ladany, N., Friedlander, M.L., and Nelson, M.L. Toward an events-based
understanding of the supervisory process. In: *Critical Events in
Psychotherapy Supervision: An Interpersonal Approach.* Washington, DC:
American Psychological Association, 2005. pp. 3--22.

Ladany, N., Friedlander, M.L., and Nelson, M.L. Working through
countertransference: When super-vision is needed. In: *Critical Events
in Psychotherapy Supervision: An Interpersonal Approach.* Washington,
DC: American Psychological Association, 2005. pp. 99--126.

McMahon, M., and Simons, R. Supervision training for professional
counselors: An exploratory study. *Counselor Education & Supervision,*
43(4):301--309, 2004.

Pearson, Q.M. Getting the most out of clinical supervision: Strategies
for mental health. *Journal of Mental Health Counseling,*
26(4):361--373, 2004.

Powell, D.J. *Clinical Supervision in Alcohol and Drug Abuse Counseling:
Principles, Models, Methods.* San Francisco: Jossey-Bass, 2004.

Stoltenberg, C.D., McNeill, B., and Delworth, U. *IDM Supervision: An
Integrated Developmental Model for Supervising Counselors and
Therapists.* San Francisco: Jossey-Bass, 1998.

Utsey, S.O., Gernat, C.A., and Hammar, L. Examining white counselor
trainees' reactions to racial issues in counseling and supervision
dyads. *Counseling Psychologist,* 33(4):449--478, 2005.

**PD2: PROFESSIONAL AND ETHICAL STANDARDS**

***Introduction***

Supervisors work in a complex environment subject to professional,
statutory, and regulatory guidelines. This domain identifies
competencies related to protecting the public, clients, and staff
members. It also describes the development of supervisors' professional
identity and integrity in the context of professional supervisory
practice.

***The Competencies***

> Be familiar with relevant professional codes of ethics (see Appendix
> B), client's rights documents, and laws and regulations that govern
> both counseling and clinical supervision practices.
>
> Ensure that supervisees are familiar with generally accepted
> professional codes of ethics, State and Federal statutes regarding
> duty to report (e.g., child abuse) and duty to warn (e.g., threat of
> physical violence against a reasonably identifiable victim or
> victims), Federal confidentiality (e.g., 42 Code of Federal
> Regulations, Part 2) and privacy (e.g., Health Insurance Portability
> and Accountability Act) rules and regulations, and other legal
> constraints on the counseling relationship.
>
> Follow due process guidelines when responding to grievances and ensure
> that supervisees know their rights as employees and understand the
> organization's employee grievance procedures.
>
> Ensure that supervisees are familiar with client's rights and
> understand client grievance procedures.
>
> Ensure that supervisees inform clients about the limits of
> confidentiality (e.g., child abuse reporting, specific threats of
> violence).
>
> Ensure that supervisees inform clients about supervision practices
> (e.g., direct observation, session transcripts) and obtain documented
> informed consent from clients as appropriate (e.g., signed releases
> for audio or video recording of sessions).
>
> Learn about supervisees' cultures, lifestyles, beliefs, and other key
> factors that may influence their job performance.
>
> Use and teach supervisees an ethical decisionmaking model, such as
> that described by Corey and colleagues (2002), as a guide for
> supervisory and clinical practice.
>
> Understand the risks of dual relationships and potential conflicts of
> interest in the supervisor--supervisee relationship and maintain
> appropriate relationships at all times.
>
> Help supervisees develop awareness of possible dual relationships in
> the client--counselor relationship.
>
> Monitor supervisees' clinical practice to enhance their competence and
> ensure their ethical treatment of clients.
>
> Provide timely consultation and guidance to supervisees in situations
> that present moral, legal, and/or ethical dilemmas.
>
> Ensure that supervisees maintain complete, accurate, and necessary
> documentation at all times, including detailed descriptions of actions
> taken in critical situations.
>
> Intervene immediately and take action as necessary when a supervisee's
> job performance appears to present problems.
>
> Report supervisees' ethical violations to the appropriate professional
> organizations and State bodies as required.
>
> Maintain familiarity with consensus- and evidence-based best practices
> in the treatment of substance use disorders.
>
> Build supervisory competence by actively participating in professional
> organizations and in a variety of relevant professional and
> educational activities.
>
> Seek supervision and consultation to evaluate one's personal needs for
> training and education, receive and discuss feedback on supervisory
> job performance, and implement a professional development plan.
>
> Practice only within one's areas of clinical and supervisory
> competence.
>
> Develop and maintain a personal wellness plan for physical and mental
> health and encourage supervisees to develop and maintain personal
> wellness plans.

***Bibliography***

Association for Counselor Education and Supervision, Supervision
Interest Network. ACES ethical guidelines for counseling supervisors.
*ACES Spectrum,* 53(4):5--8, 1993.

Bernard, J.M., and Goodyear, R.K. Ethical and legal considerations. In:
*Fundamentals of Clinical Supervision* (3d ed.). Boston: Allyn & Bacon,
2004. pp. 49--72.

Borders, L.D., and Brown, L.L. Ethical issues in supervision. In: *The
New Handbook of Counseling Supervision.* Mahwah, NJ: Lawrence Erlbaum,
2005. pp. 81--87.

Columbia Assessment Services, Inc. *Clinical Supervision of Alcohol and
Other Drug Abuse Counselors Role Delineation Study.* Washington, DC:
International Certification & Reciprocity Consortium/Alcohol and Other
Drug Abuse, Inc., 2000.

Corey, G., Corey, M.S., and Callanan, P. *Issues and Ethics in the
Helping Professions* (6th ed.). Belmont, CA: Wadsworth Publishing
Company, 2002.

Falvey, J.E., and Bray, T.E. *Managing Clinical Supervision: Ethical
Practice and Legal Risk Management.* Pacific Grove, CA:
Brooks/Cole-Thomson Learning, 2002.

International Consortium of Addiction and Prevention Credentialing
Boards. Certified Clinical Supervisor Code of Ethics, n.d.
**www.mcbap.com/ccs_ethics1.htm** \[accessed December 12, 2006\].

Ladany, N., Friedlander, M.L., and Nelson, M.L. Managing sexual
attraction: Talking about sex in supervision. In: *Critical Events in
Psychotherapy Supervision: An Interpersonal Approach.* Washington, DC:
American Psychological Association, 2005. pp. 127--154.

Legal Action Center. *Confidentiality and Communication: A Guide to the
Federal Alcohol & Drug Confidentiality Law and HIPAA* (revised ed.). New
York: Legal Action Center, 2003.

Washington State Division of Alcohol and Substance Abuse. *Clinical
Supervisor Skill Standards.* Olympia, WA: Washington State Department of
Social and Health Services, 2002.

White, W.L., and Popovits, R.M. *Critical Incidents: Ethical Issues in
the Prevention and Treatment of Addiction* (2d ed.). Bloomington, IL:
Chestnut Health Systems, 2001.

**PD3: PROGRAM DEVELOPMENT AND QUALITY ASSURANCE**

***Introduction***

Program development is the process of guiding the natural evolution of a
service delivery organization to maximize the potential of its staff and
resources to meet the needs of the population it serves. Quality
assurance (QA) is the process of designing, implementing, monitoring,
and improving a program's activities to ensure maximum effectiveness and
efficiency of services within the limitations of the agency and its
operating environment.

The extent to which clinical supervisors are responsible for program
development and QA activities varies, depending on the size, structure,
and mission of the organization. However, all clinical supervisors have
*some* responsibility for these activities.

***The Competencies***

> Structure and facilitate staff learning about specific consensus- and
> evidence-based treatment interventions, program service design, and
> recovery models relevant to the organization and the population it
> serves.
>
> Understand the limitations of addiction treatment in general; its
> relationship to sustained, long-term recovery; and the specific
> limitations of the models or design in use by supervisees.
>
> Understand and be able to apply principles of technology transfer to
> assist in the adoption and implementation of new clinical practices.
>
> Identify, develop, and obtain appropriate learning and treatment
> resource materials that meet the needs of the agency, its clients, and
> supervisees.
>
> Plan and facilitate inservice training and other organizational
> activities that support application of empirically based clinical
> interventions that are responsive to needs of the agency, clients, and
> supervisees.
>
> Understand the balance between fidelity and adaptability when
> implementing new clinical practices.
>
> Be familiar with the methods used to analyze the organization's
> developmental needs and clinical outcomes, including regular needs
> assessments.
>
> Advocate within the agency for ongoing quality improvement, including
> strategies for enhancing client access, engagement, and retention in
> treatment.
>
> Understand the organization's QA plan and comply with all monitoring,
> documenting, and reporting requirements.
>
> Develop program goals and objectives and counselor development plans
> that are consistent with the organization's QA plan.
>
> Solicit, document, and use client feedback to improve service
> delivery.
>
> Provide diversity training and other experiences that empower one to
> become an advocate for the organization's target population and an
> agent of organizational change.
>
> Build and maintain relationships with referral sources and other
> community programs to expand, enhance, and expedite service delivery.
>
> Develop skills to advocate for clients throughout the entire continuum
> of care.

***Bibliography***

Abernethy, A.D. Increasing the cultural proficiency of clinical
managers. *Journal of Multicultural Counseling & Development,*
33(2):81--93, 2005.

Addiction Counselor Certification Board of Oregon. Addictions Treatment
Clinical Supervision Competencies. n.d. **www.accbo.com/super.htm**
\[accessed December 12, 2006\].

Hodgson, J.L., Johnson, L.N., Ketring, S.A., Wampler, R.S., and Lamson,
A.L. Integrating research and clinical training in marriage and family
therapy training programs. *Journal of Marital & Family Therapy,*
31(1):75--88, 2005.

Hubble, M.A., Duncan, B.L., and Miller, S.D., eds. *The Heart and Soul
of Change: What Works in Therapy.* Washington, DC: American
Psychological Association, 2000.

Lindbloom, G., Ten Eyck, T.G., and Gallon, S.L. *Clinical Supervision:
Building Chemical Dependency Counselor Skills* (3d ed.). Salem, OR:
Northwest Addiction Technology Transfer Center, 2005.

Washington State Division of Alcohol and Substance Abuse. *Clinical
Supervisor Skill Standards.* Olympia, WA: Washington State Department of
Social and Health Services, 2002.

**PD4: PERFORMANCE EVALUATION**

***Introduction***

Counselor evaluation is central to the assurance of high-quality client
care. It is a professional and ethical responsibility of clinical
supervisors to regularly monitor the quality of supervisees'
performance, to facilitate improvement in supervisees' clinical
competence, and to assess supervisees' readiness to practice with
increasing autonomy. As such, this domain is closely related to
Counselor Development (PD1). The competencies in each are distinct yet
highly complementary and interactive.

***The Competencies***

> Communicate agency expectations about the job duties and competencies,
> performance indicators, and criteria used to evaluate job performance.
>
> Understand the concept of supervision as a two-way evaluative process
> with each party providing feedback to the other, including
> constructive sharing and resolution of disagreements. Actively
> encourage supervisees to provide feedback to the supervisor regarding
> the supervisor's performance.
>
> Assess supervisees' professional development, cultural competence, and
> proficiency in the addiction counseling competencies.
>
> Differentiate between counselor developmental issues and those
> requiring corrective action (e.g., ethical violations, incompetence).
>
> Assess supervisees' preferred learning style, motivation, and
> suitability for the work setting.
>
> Use multiple sources of quantitative and qualitative data, direct and
> indirect observations, and formal and informal methods of assessment
> to ensure substantiated and accurate evaluation.
>
> Institute an ongoing formalized, proactive process that identifies
> supervisees' training needs, actively involves supervisees in
> conjointly reviewing goals and objectives, and reinforces performance
> improvement with positive feedback.
>
> Communicate feedback clearly, including feedback regarding performance
> deficits, weak competencies, or harmful activities. Provide timely
> written notification of all performance problems and ensure that
> supervisees understand the feedback.
>
> Evaluate the competency, including the fidelity, with which
> supervisees implement research-based treatment protocols.
>
> Address and manage relational issues common to evaluation, including
> anxiety, disagreements, and full discussion of performance problems.
>
> Guide and evaluate supervisees' ability to use a range of evaluative
> tools (e.g., process recordings, memory work, audiotapes and
> videotapes, direct observation) and encourage them to use the most
> effective techniques available in the setting.
>
> Skillfully use agency evaluation tools and procedures.
>
> Self-assess for evaluator bias (e.g., leniency, overemphasis on one
> area of performance, favoritism, stereotyping) and conflict with other
> supervisory roles.
>
> Adhere to professional standards of ongoing supervisory documentation,
> including written individual development plans, supervision session
> notes, written documentation of corrective actions, and written
> recognition of good performance.

***Bibliography***

Addiction Counselor Certification Board of Oregon. Addictions Treatment
Clinical Supervision Competencies, n.d. **www.accbo.com/super.htm**
\[accessed December 12, 2006\].

American Board of Examiners in Clinical Social Work, Work Group on
Clinical Social Work Supervision. *Clinical Supervision: A Practice
Specialty of Clinical Social Work.* Salem, MA: American Board of
Examiners in Clinical Social Work, 2004.

Bernard, J.M., and Goodyear, R.K. *Fundamentals of Clinical Supervision*
(3d ed.). Boston: Allyn & Bacon, 2004.

Borders, L.D., and Brown, L.L. Ethical issues in supervision. In: *The
New Handbook of Counseling Supervision.* Mahwah, NJ: Lawrence Erlbaum,
2005. pp. 81--87.

Bradley, L.J., and Whiting, P.P. Supervision training: A model. In:
Bradley, L.J., and Ladany, N., eds. *Counselor Supervision: Principles,
Process, and Practice* (3d ed.). New York: Brunner-Routledge, 2001. pp.
361--387.

Center for Substance Abuse Treatment. *Addiction Counseling
Competencies: The Knowledge, Skills, and Attitudes of Professional
Practice.* Technical Assistance Publication (TAP) Series 21. DHHS
Publication No. (SMA) 06-4171. Rockville, MD: Substance Abuse and Mental
Health Services Administration, 2006.

Columbia Assessment Services, Inc. *Clinical Supervision of Alcohol and
Other Drug Abuse Counselors Role Delineation Study.* Washington, DC:
International Certification & Reciprocity Consortium/Alcohol and Other
Drug Abuse, Inc., 2000.

Falender, C.A., and Shafranske, E.P. Evaluation of the supervisory
process. In: *Clinical Supervision: A Competency-Based Approach.*
Washington, DC: American Psychological Association, 2004. pp. 195--226.

Powell, D.J. Evaluation and feedback. In: *Clinical Supervision in
Alcohol and Drug Abuse Counseling: Principles, Models, Methods.* San
Francisco: Jossey-Bass, 2004. pp. 228--252.

Washington State Division of Alcohol and Substance Abuse. *Clinical
Supervisor Skill Standards.* Olympia, WA: Washington State Department of
Social and Health Services, 2002.

**PD5: ADMINISTRATION**

***Introduction***

Clinical supervisors' administrative responsibilities are the executive
functions of the position, those duties that help the organization run
smoothly and efficiently. Administrative responsibilities include
following the organization's policies and procedures (including those
related to human resource management), ensuring the maintenance of case
records, monitoring case documentation, assisting in financial resource
development (e.g., grant proposal writing), and developing relationships
with referral sources in the community. Administrative responsibilities
also include program development and quality assurance, which are
addressed separately in PD3. Although the competencies described below
are administrative in nature, many overlap significantly with clinical
functions and serve to ensure the quality of services being delivered
within the agency. As noted previously, the range of administrative
functions clinical supervisors are responsible for will vary from agency
to agency.

***The Competencies***

> Participate in developing, maintaining, applying, and revising the
> organization's policies, procedures, and forms.
>
> Monitor, evaluate, and provide feedback regarding supervisees'
> compliance with administrative policies and procedures.
>
> Understand and ensure that supervisees understand the organization's
> chain-of-command and communication protocols.
>
> Monitor, evaluate, and provide guidance regarding the supervisees'
> case recordings, including session notes, treatment plans,
> correspondence, and behavioral contracts.
>
> Establish and maintain an efficient and comprehensive recordkeeping
> system that provides clear, chronological documentation of supervisory
> activities.
>
> Recommend personnel actions to maintain high standards of clinical
> care (e.g., hiring, performance recognition, disciplinary action,
> suspension, termination of clinical staff).
>
> Maintain and regularly update clinical staff job descriptions
> according to agency policies and procedures.
>
> Understand and help supervisees understand and manage the
> relationships among clinical services, fee assessment and collection,
> and overall fiscal responsibility.
>
> Understand and comply with procedures necessary for processing
> third-party payment claims, if applicable.
>
> Participate actively in the organization's resource development
> activities (e.g., grant application or proposal writing).
>
> Develop and rely on schedules, deadlines, and reminders to meet
> service needs and ensure completion of assigned projects and tasks.
>
> Ensure that supervisees have proper training for using information
> technology systems and have access to technical assistance and other
> resources.
>
> Obtain regularly scheduled diversity, crisis management, and safety
> training for oneself and supervisees.
>
> Develop and comply with intraorganizational and interorganizational
> agreements that expand, enhance, and expedite service delivery.
>
> Maintain security of all supervisory notes, assessments, and other
> pertinent documents.
>
> Structure and facilitate effective staff meetings.

***Bibliography***

Bernard, J.M., and Goodyear, R.K. Organizing the supervision experience.
In: *Fundamentals of Clinical Supervision* (3d ed.). Boston: Allyn &
Bacon, 2004. pp. 180--208.

Bradley, L.J., and Kottler, J.A. Overview of counselor supervision. In:
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Process, and Practice* (3d ed.). New York: Brunner-Routledge, 2001. pp.
3--27.

Spencer, P.C., and Munch, S. Client violence toward social workers: The
role of management in community mental health programs. *Social Work,*
48(4):532--544, 2003.

Section V:

**INTEGRATED BIBLIOGRAPHY**

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managers. *Journal of Multicultural Counseling & Development,*
33(2):81--93, 2005.

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Addiction Counselor Certification Board of Oregon. Addictions Treatment
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\[accessed December 12, 2006\].

American Board of Examiners in Clinical Social Work, Work Group on
Clinical Social Work Supervision. *Clinical Supervision: A Practice
Specialty of Clinical Social Work.* Salem, MA: American Board of
Examiners in Clinical Social Work, 2004.

Association for Counselor Education and Supervision, Supervision
Interest Network. ACES ethical guidelines for counseling supervisors.
*ACES Spectrum,* 53(4):5--8, 1993.

Aten, J.D., and Hernandez, B.C. Addressing religion in clinical
supervision: A model. *Psychotherapy: Theory, Research, Practice,
Training,* 41(2):152--160, 2004.

Barnes, K.L. Applying self-efficacy theory to counselor training and
supervision: A comparison of two approaches. *Counselor Education &
Supervision,* 44(1):56--69, 2004.

Bernard, J.M., and Goodyear, R.K. Ethical and legal considerations. In:
*Fundamentals of Clinical Supervision* (3d ed.). Boston: Allyn & Bacon,
2004. pp. 49--72.

Bernard, J.M., and Goodyear, R.K. *Fundamentals of Clinical Supervision*
(3d ed.). Boston: Allyn & Bacon, 2004.

Bernard, J.M., and Goodyear, R.K. Introduction to clinical supervision.
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Bernard, J.M., and Goodyear, R.K. Organizing the supervision experience.
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Bernard, J.M., and Goodyear, R.K. The supervisory relationship: The
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Cashwell, T.H., and Dooley, K. The impact of supervision on counselor
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Center for Substance Abuse Treatment. *Addiction Counseling
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Columbia Assessment Services, Inc. *Clinical Supervision of Alcohol and
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2003.

Hodgson, J.L., Johnson, L.N., Ketring, S.A., Wampler, R.S., and Lamson,
A.L. Integrating research and clinical training in marriage and family
therapy training programs. *Journal of Marital & Family Therapy,*
31(1):75--88, 2005.

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Ladany, N., Friedlander, M.L., and Nelson, M.L. Remediating skill
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Section VI:

**APPENDICES**

**APPENDIX A: CLINICAL SUPERVISION CERTIFICATION---**

**NATIONAL RESOURCES**

**APPENDIX B: PROFESSIONAL CODES OF ETHICS**

**SPECIFIC TO CLINICAL SUPERVISION**

**APPENDIX C: SUGGESTED READING AND OTHER**

**RESOURCES**

**APPENDIX D: FIELD REVIEWERS**

**APPENDIX A: CLINICAL SUPERVISION CERTIFICATION---NATIONAL RESOURCES**

Clinical supervisor credentials are available through many State
addiction counselor certification boards. Check with the local board for
more information about State-level supervisory credentialing.

***Approved Clinical Supervisor***

National Board for Certified Counselors

Center for Credentialing and Education, Inc.

3 Terrace Way

Greensboro, NC 27403

\(336\) 482-2856

\(336\) 482-2852 (fax)

**www.cce-global.org/acs.htm**

***Approved Supervisor Designation***

American Association for Marriage and Family Therapy

112 South Alfred Street

Alexandria, VA 22314

\(703\) 838-9808

\(703\) 838-9805 (fax)

**www.aamft.org/membership/Approved%20Supervisor/AS_Main.asp**

***Certified Clinical Supervisor***

International Consortium of Addiction and Prevention Credentialing
Boards

620 Eye Street, N.W., Suite 210

Washington, DC 20006

\(202\) 785-0683

\(202\) 785-8949 (fax)

**www.icrcaoda.org/credentialing.asp**

***Certified Pastoral Counselor Supervisor***

National Board for Certified Pastoral Counselors

Certification Committee

1331 County Road D

St. Paul, MN 55109

**www.nbcpc.org/Webpage.asp?MID=647147**

**APPENDIX B: PROFESSIONAL CODES OF ETHICS SPECIFIC TO CLINICAL
SUPERVISION**

***The National Board for Certified Counselors/Center for Credentialing
and***

***Education***

***The Approved Clinical Supervisor (ACS) Code of Ethics***[^1]

*Updated September 2005*

In addition to following the Code of Ethics of their mental health
credentialing body, approved clinical supervisors shall:

1.  Ensure that supervisees inform clients of their professional status
    (e.g., intern) and of all conditions of supervision.

> Supervisors need to ensure that supervisees inform their clients of
> any status other than being fully qualified for independent practice
> or licensed. For example, supervisees need to inform their clients if
> they are a student, intern, trainee or, if licensed with restrictions,
> the nature of those restrictions (e.g., associate or conditional). In
> addition, clients must be informed of the requirements of supervision
> (e.g., the audio taping of all clinical sessions for purposes of
> supervision).

2.  Ensure that clients have been informed of their rights to
    confidentiality and privileged communication when applicable.
    Clients also should be informed of the limits of confidentiality and
    privileged communication.

> The general limits of confidentiality are when harm to self or others
> is threatened; when the abuse of children, elders or disabled persons
> is suspected and in cases when the court compels the mental health
> professional to testify and break confidentiality. These are generally
> accepted limits to confidentiality and privileged communication, but
> they may be modified by state or federal statute.

3.  Inform supervisees about the process of supervision, including
    supervision goals, case management procedures, and the supervisor's
    preferred supervision model(s).

4.  Keep and secure supervision records and consider all information
    gained in supervision as confidential.

5.  Avoid all dual relationships with supervisees that may interfere
    with the supervisor's professional judgment or exploit the
    supervisee.

> Any sexual, romantic, or intimate relationship is considered to be a
> violation. Sexual relationship means sexual conduct, sexual
> harassment, or sexual bias toward a supervisee by a supervisor.

6.  Establish procedures with their supervisees for handling crisis
    situations.

7.  Provide supervisees with adequate and timely feedback as part of an
    established evaluation plan.

8.  Render assistance to any supervisee who is unable to provide
    competent counseling services to clients.

9.  Intervene in any situation where the supervisee is impaired and the
    client is at risk.

10. Refrain from endorsing an impaired supervisee when such impairment
    deems it unlikely that the supervisee can provide adequate
    counseling services.

11. Supervisors offer only supervision for professional services for
    which they are trained or have supervised experience.

> Supervision should not include assistance in diagnosis, assessment, or
> treatment without prior training or supervision. Supervisors are
> responsible for correcting any misrepresentations of the
> qualifications of others.

12. Ensure that supervisees are aware of the current ethical standards
    related to their professional practice, as well as legal standards
    that regulate the practice of counseling.

13. Engage supervisees in an examination of cultural issues that might
    affect supervision and/or counseling.

14. Ensure that both supervisees and clients are aware of their rights
    and of due process procedures, and that you as supervisor are
    ultimately responsible for the client.

15. Refrain from supervising a relative or immediate family member.

***Ethical Guidelines for Counseling Supervisors***

***Association for Counselor Education and Supervision***[^2]

*Adopted by ACES Executive Counsel and Delegate Assembly*

*March 1993*

Preamble:

The Association for Counselor Education and Supervision (ACES) is
composed of people engaged in the professional preparation of counselors
and people responsible for the ongoing supervision of counselors. ACES
is a founding division of the American Counseling Association (ACA) and
as such adheres to ACA's current ethical standards and to general codes
of competence adopted throughout the mental health community.

ACES believes that counselor educators and counseling supervisors in
universities and in applied counseling settings, including the range of
education and mental health delivery systems, carry responsibilities
unique to their job roles. Such responsibilities may include
administrative supervision, clinical supervision, or both.
Administrative supervision refers to those supervisory activities which
increase the efficiency of the delivery of counseling services; whereas,
clinical supervision includes the supportive and educative activities of
the supervisor designed to improve the application of counseling theory
and technique directly to clients.

Counselor educators and counseling supervisors encounter situations
which challenge the help given by general ethical standards of the
profession at large. These situations require more specific guidelines
that provide appropriate guidance in everyday practice.

The Ethical Guidelines for Counseling Supervisors are intended to assist
professionals by helping them:

1.  Observe ethical and legal protection of clients' and supervisees'
    rights;

2.  Meet the training and professional development needs of supervisees
    in ways consistent with clients' welfare and programmatic
    requirements; and

3.  Establish policies, procedures, and standards for implementing
    programs.

The specification of ethical guidelines enables ACES members to focus on
and to clarify the ethical nature of responsibilities held in common.
Such guidelines should be reviewed formally every five years, or more
often if needed, to meet the needs of ACES members for guidance.

The Ethical Guidelines for Counselor Educators and Counseling
Supervisors are meant to help ACES members in conducting supervision.
ACES is not currently in a position to hear complaints about alleged
non-compliance with these guidelines. Any complaints about the ethical
behavior of any ACA member should be measured against the ACA Ethical
Standards and a complaint lodged with ACA in accordance with its
procedures for doing so.

One overriding assumption underlying this document is that supervision
should be ongoing throughout a counselor's career and not stop when a
particular level of education, certification, or membership in a
professional organization is attained.

***DEFINITIONS OF TERMS:***

**Applied Counseling Settings** -- Public or private organizations of
counselors such as community mental health centers, hospitals, schools,
and group or individual private practice settings.

**Supervisees** -- Counselors-in-training in university programs at any
level who \[are\] working with clients in applied settings as part of
their university training program, and counselors who have completed
their formal education and are employed in an applied counseling
setting.

**Supervisors** -- Counselors who have been designated within their
university or agency to directly oversee the professional clinical work
of counselors. Supervisors also may be persons who offer supervision to
counselors seeking state licensure and so provide supervision outside of
the administrative aegis of an applied counseling setting.

**1. Client Welfare and Rights**

> 1.01 The primary obligation of supervisors is to train counselors so
> that they respect the integrity and promote the welfare of their
> clients. Supervisors should have supervisees inform clients that they
> are being supervised and that observation and/or recordings of the
> session may be reviewed by the supervisor.
>
> 1.02 Supervisors who are licensed counselors and are conducting
> supervision to aid a supervisee to become licensed should instruct the
> supervisee not to communicate or in any way convey to the supervisee's
> clients or to other parties that the supervisee is himself/herself
> licensed.
>
> 1.03 Supervisors should make supervisees aware of clients' rights,
> including protecting clients' right to privacy and confidentiality in
> the counseling relationship and the information resulting from it.
> Clients also should be informed that their right to privacy and
> confidentiality will not be violated by the supervisory relationship.
>
> 1.04 Records of the counseling relationship, including interview
> notes, test data, correspondence, the electronic storage of these
> documents, and audio and videotape recordings, are considered to be
> confidential professional information. Supervisors should see that
> these materials are used in counseling, research, and training and
> supervision of counselors with the full knowledge of the clients and
> that permission to use these materials is granted by the applied
> counseling setting offering service to the client. This professional
> information is to be used for full protection of the client. Written
> consent from the client (or legal guardian, if a minor) should be
> secured prior to the use of such information for instructional,
> supervisory, and/or research purposes. Policies of the applied
> counseling setting regarding client records also should be followed.
>
> 1.05 Supervisors shall adhere to current professional and legal
> guidelines when conducting research with human participants such as
> Section D-1 of the ACA Ethical Standards.
>
> 1.06 Counseling supervisors are responsible for making every effort to
> monitor both the professional actions and failures to take action of
> their supervisees.

**2. Supervisory Role**

Inherent and integral to the role of supervisor are responsibilities
for:

> a\. Monitoring client welfare;
>
> b\. Encouraging compliance with relevant legal, ethical, and
> professional standards for clinical practice;
>
> c\. Monitoring clinical performance and professional development of
> supervisees; and
>
> d\. Evaluating and certifying current performance and potential of
> supervisees for academic, screening, selection, placement, employment,
> and credentialing purposes.
>
> 2.01 Supervisors should have had training in supervision prior to
> initiating their role as supervisors.
>
> 2.02 Supervisors should pursue professional and personal continuing
> education activities such as advanced courses, seminars, and
> professional conferences on a regular and ongoing basis. These
> activities should include both counseling and supervision topics and
> skills.
>
> 2.03 Supervisors should make their supervisees aware of professional
> and ethical standards and legal responsibilities of the counseling
> profession.
>
> 2.04 Supervisors of post-degree counselors who are seeking state
> licensure should encourage these counselors to adhere to the standards
> for practice established by the state licensure board of the state in
> which they practice.
>
> 2.05 Procedures for contacting the supervisor, or an alternative
> supervisor, to assist in handling crisis situations should be
> established and communicated to supervisees.
>
> 2.06 Actual work samples via audio and/or video tape or live
> observation in addition to case notes should be reviewed by the
> supervisor as a regular part of the ongoing supervisory process.
>
> 2.07 Supervisors of counselors should meet regularly in face-to-face
> sessions with their supervisees.
>
> 2.08 Supervisors should provide supervisees with ongoing feedback on
> their performance. This feedback should take a variety of forms, both
> formal and informal, and should include verbal and written
> evaluations. It should be formative during the supervisory experience
> and summative at the conclusion of the experience.
>
> 2.09 Supervisors who have multiple roles (e.g., teacher, clinical
> supervisor, administrative supervisor) with supervisees should
> minimize potential conflicts. Where possible, the roles should be
> divided among several supervisors. Where this is not possible, careful
> explanation should be conveyed to the supervisee as to the
> expectations and responsibilities associated with each supervisory
> role.
>
> 2.10 Supervisors should not participate in any form of sexual contact
> with supervisees. Supervisors should not engage in any form of social
> contact or interaction which would compromise the
> supervisor-supervisee relationship. Dual relationships with
> supervisees that might impair the supervisor's objectivity and
> professional judgment should be avoided and/or the supervisory
> relationship terminated.
>
> 2.11 Supervisors should not establish a psychotherapeutic relationship
> as a substitute for supervision. Personal issues should be addressed
> in supervision only in terms of the impact of these issues on clients
> and on professional functioning.
>
> 2.12 Supervisors, through ongoing supervisee assessment and
> evaluation, should be aware of any personal or professional
> limitations of supervisees which are likely to impede future
> professional performance. Supervisors have the responsibility of
> recommending remedial assistance to the supervisee and of screening
> from the training program, applied counseling setting, or state
> licensure those supervisees who are unable to provide competent
> professional services. These recommendations should be clearly and
> professionally explained in writing to the supervisees who are so
> evaluated.
>
> 2.13 Supervisors should not endorse a supervisee for certification,
> licensure, completion of an academic training program, or continued
> employment if the supervisor believes the supervisee is impaired in
> any way that would interfere with the performance of counseling
> duties. The presence of any such impairment should begin a process of
> feedback and remediation wherever possible so that the supervisee
> understands the nature of the impairment and has the opportunity to
> remedy the problem and continue with his/her professional development.
>
> 2.14 Supervisors should incorporate the principles of informed consent
> and participation; clarity of requirements, expectations, roles and
> rules; and due process and appeal into the establishment of policies
> and procedures of their institutions, program, courses, and individual
> supervisory relationships. Mechanisms for due process appeal of
> individual supervisory actions should be established and made
> available to all supervisees.

**3. Program Administration Role**

> 3.01 Supervisors should ensure that the programs conducted and
> experiences provided are in keeping with current guidelines and
> standards of ACA and its divisions.
>
> 3.02 Supervisors should teach courses and/or supervise clinical work
> only in areas where they are fully competent and experienced.
>
> 3.03 To achieve the highest quality of training and supervision,
> supervisors should be active participants in peer review and peer
> supervision procedures.
>
> 3.04 Supervisors should provide experiences that integrate theoretical
> knowledge and practical application. Supervisors also should provide
> opportunities in which supervisees are able to apply the knowledge
> they have learned and understand the rationale for the skills they
> have acquired. The knowledge and skills conveyed should reflect
> current practice, research findings, and available resources.
>
> 3.05 Professional competencies, specific courses, and/or required
> experiences expected of supervisees should be communicated to them in
> writing prior to admission to the training program or
> placement/employment by the applied counseling setting, and, in case
> of continued employment, in a timely manner.
>
> 3.06 Supervisors should accept only those persons as supervisees who
> meet identified entry level requirements for admission to a program of
> counselor training or for placement in an applied counseling setting.
> In the case of private supervision in search of state licensure,
> supervisees should have completed all necessary prerequisites as
> determined by the state licensure board.
>
> 3.07 Supervisors should inform supervisees of the goals, policies,
> theoretical orientations toward counseling, training, and supervision
> model or approach on which the supervision is based.
>
> 3.08 Supervisees should be encouraged and assisted to define their own
> theoretical orientation toward counseling, to establish supervision
> goals for themselves, and to monitor and evaluate their progress
> toward meeting these goals.
>
> 3.09 Supervisors should assess supervisees' skills and experience in
> order to establish standards for competent professional behavior.
> Supervisors should restrict supervisees' activities to those that are
> commensurate with their current level of skills and experiences.
>
> 3.10 Supervisors should obtain practicum and fieldwork sites that meet
> minimum standards for preparing student to become effective
> counselors. No practicum or fieldwork setting should be approved
> unless it truly replicates a counseling work setting.
>
> 3.11 Practicum and fieldwork classes would be limited in size
> according to established professional standards to ensure that each
> student has ample opportunity for individual supervision and feedback.
> Supervisors in applied counseling settings should have a limited
> number of supervisees.
>
> 3.12 Supervisors in university settings should establish and
> communicate specific policies and procedures regarding field placement
> of students. The respective roles of the student counselor, the
> university supervisor, and the field supervisor should be clearly
> differentiated in areas such as evaluation, requirements, and
> confidentiality.
>
> 3.13 Supervisors in training programs should communicate regularly
> with supervisors in agencies used as practicum and/or fieldwork sites
> regarding current professional practices, expectations of students,
> and preferred models and modalities of supervision.
>
> 3.14 Supervisors at the university should establish clear lines of
> communication among themselves, the field supervisors, and the
> students/supervisees.
>
> 3.15 Supervisors should establish and communicate to supervisees and
> to field supervisors specific procedures regarding consultation,
> performance review, and evaluation of supervisees.
>
> 3.16 Evaluations of supervisee performance in universities and in
> applied counseling settings should be available to supervisees in ways
> consistent with the Family Rights and Privacy Act and the Buckley
> Amendment.
>
> 3.17 Forms of training that focus primarily on self understanding and
> problem resolution (e.g., personal growth groups or individual
> counseling) should be voluntary. Those who conduct these forms of
> training should not serve simultaneously as supervisors of the
> supervisees involved in the training.
>
> 3.18 A supervisor may recommend participation in activities such as
> personal growth groups or personal counseling when it has been
> determined that a supervisee has deficits in the areas of self
> understanding and problem resolution which impede his/her professional
> functioning. The supervisors should not be the direct provider of
> these activities for the supervisee.
>
> 3.19 When a training program conducts a personal growth or counseling
> experience involving relatively intimate self disclosure, care should
> be taken to eliminate or minimize potential role conflicts for faculty
> and/or agency supervisors who may conduct these experiences and who
> also serve as teachers, group leaders, and clinical directors.
>
> 3.20 Supervisors should use the following prioritized sequence in
> resolving conflicts among the needs of the client, the needs of the
> supervisee, and the needs of the program or agency. Insofar as the
> client must be protected, it should be understood that client welfare
> is usually subsumed in federal and state laws such that these statutes
> should be the first point of reference. Where laws and ethical
> standards are not present or are unclear, the good judgment of the
> supervisor should be guided by the following list:
>
> a\. Relevant legal and ethical standards (e.g., duty to warn, state
> child abuse laws);
>
> b\. Client welfare;
>
> c\. Supervisee welfare;
>
> d\. Supervisor welfare; and
>
> e\. Program and/or agency service and administrative needs.

**APPENDIX C: SUGGESTED READING AND OTHER RESOURCES**

These books, journals, Web sites, and training resources were
recommended by the Clinical Supervision Competencies Task Force or field
reviewers.

***Books***

Addiction Technology Transfer Center Network. *The Change Book: A
Blueprint for Technology Transfer* (2d ed.). Kansas City, MO: Addiction
Technology Transfer Center Network, 2004.

Addiction Technology Transfer Center Network. *The Change Book Workbook:
A Companion to The Change Book.* Kansas City, MO: Addiction Technology
Transfer Center Network, 2004.

American Association for Marriage and Family Therapy. *Readings in
Family Therapy: Selected Articles from the AAMFT Supervisor Bulletin.*
Washington, DC: American Association for Marriage and Family, 2000.

Anderson, B.S., and Hopkins, B.R. *The Counselor and the Law* (4th ed.).
Alexandria, VA: American Counseling Association, 1996.

Bernard, J.M., and Goodyear, R.K. *Fundamentals of Clinical Supervision*
(3d ed.). Boston: Allyn & Bacon, 2004.

Boylan, J.C., Malley, P.B., and Reilly, E.P. *Practicum and Internship,
Textbook and Resource Guide for Counseling and Psychotherapy* (3d ed.).
London: Taylor & Francis Group, 2001.

Campbell, J.M. *Becoming an Effective Supervisor: A Workbook for
Counselors and Psychotherapists.* Philadelphia: Accelerated
Development/Taylor & Francis Group, 2000.

Campbell, J.M. *Essentials of Clinical Supervision.* New York: John
Wiley & Sons, 2006.

Holloway, E., and Carroll, M., eds. *Training Counselling Supervisors:
Strategies, Methods and Techniques.* London: Sage Publishers, 1999.

Hubble, M.A., Duncan, B.L., and Miller, S.D., eds. *The Heart and Soul
of Change: What Works in Therapy.* Washington, DC: American
Psychological Association, 2000.

Kinney, J. *Clinical Manual of Substance Abuse.* St. Louis, MO: Mosby,
1996.

Legal Action Center. *Confidentiality and Communication: A Guide to the
Federal Alcohol & Drug Confidentiality Law and HIPAA* (revised ed.). New
York: Legal Action Center, 2003.

Maxwell, J.C. *Failing Forward: How to Make the Most of Your Mistakes.*
Nashville, TN: Nelson Business, 2000.

Maxwell, J.C. *The 360 Degree Leader: Developing Your Influence From
Anywhere in the Organization.* Nashville, TN: Nelson Business, 2006.

Maxwell, J.C. *The 360 Degree Leader Workbook: Developing Your Influence
From Anywhere in the Organization.* Nashville, TN: Nelson Business,
2006.

Morrissette, P.J. *Self-Supervision: A Primer for Counselors and Helping
Professionals.* New York: Brunner-Routledge, 2001.

Powell, D.J., and Brodsky, A. *Clinical Supervision in Alcohol and Drug
Abuse Counseling: Principles, Models, Methods* (revised ed.). San
Francisco: Jossey-Bass, 2004.

Shulman, L. *Interactional Supervision.* Washington, DC: NASW Press,
1993.

Simon, R.I. *Concise Guide to Psychiatry and Law for Clinicians* (3d
ed.). Arlington, VA: American Psychiatric Publishing, Inc., 2001.

Skovholt, T.M., & Rønnestad, M.H. *The Evolving Professional Self:
Stages and Themes in Therapist and Counselor Development.* New York:
John Wiley & Sons, 1992.

Storm, C.L., and Todd, T.C. *The Reasonably Complete Systemic Supervisor
Resource Guide.* New York: Authors Choice Press, 2002.

Walker, M., and Jacobs, M. *Supervision Questions and Answers for
Counsellors and Therapists.* London: Whurr Publishers, 2004.

White, W.L. *Slaying the Dragon: The History of Addiction Treatment and
Recovery in America.* Bloomington, IL: Lighthouse Institute, 1998.

White, W.L. *The Incestuous Workplace: Stress and Distress in the
Organizational Family.* Bloomington, IL: Lighthouse Institute, 1997.

***Journals***

*The Clinical Supervisor: The Journal of Supervision in Psychotherapy
and Mental Health.* Binghamton, NY: The Haworth Press.

*Counselor Education and Supervision.* Alexandria, VA: American
Counseling Association. Association for Counselor Education and
Supervision members receive the journal as a member benefit. For
nonmember subscriptions call (800) 633-4931 or write to ACA
Subscriptions, P.O. Box 361, Birmingham, AL 35201-0361.

***Web Sites***

Association for Counselor Education and Supervision

**www.acesonline.net**

Foundation for Critical Thinking

**www.criticalthinking.org**

Institute for Professional Development in the Addictions

**www.ipdany.org**

Legal Action Center

**www.lac.org**

***Training***

*Clinical Supervision of Alcohol and Drug Counselors: An Independent
Study Course.*

Thomas Durham, Ph.D., CCS

> Distance learning; available through NAADAC, the Association for
> Addiction Professionals, **www.naadac.org** or (800) 548-0497.

*Clinical Supervision: Skills for the Future.*

David J. Powell, Ph.D., LADC, CCS, LMFT

> Onsite training; available through the International Center for Health
> Concerns, **www.ichc-us.org/index.htm** or (860) 653-4470.

*Clinical Supervision for Substance Abuse Treatment Practitioners
Series.*

> Distance learning; available through the Mid-Atlantic Addiction
> Technology Transfer Center, **www.mid-attc.org** or (804) 828-9910.

*Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles,
Models, Methods; Advanced Skills in Clinical Supervision: Updates on the
Blended Model of Clinical Supervision; and Expanding the Role of the
Clinical Supervisor in Alcohol and Drug Abuse Counseling.*

David J. Powell, Ph.D., LADC, CCS, LMFT

> Distance learning; available through the Distance Learning Center for
> Addiction Studies, **www.dlcas.com.**

*National Addiction Technology Transfer Centers' Leadership Institute.*

> Live, intensive training offered at regional Addiction Technology
> Transfer Centers. For schedules and other information about this
> training program, go to **www.nattc.org/leaderInst/index.htm** or call
> the regional center.

**APPENDIX D: FIELD REVIEWERS**

**L. Worth Bolton, M.S.W., LCAS, CCS**

Clinical Instructor

University of North Carolina School of Social Work

Chapel Hill, North Carolina

**David C. Bowen, LMSW, CASAC**

Counselor/International Student Advisor

Clarkson University

Potsdam, New York

**Linda J. Bradshaw, M.A., CADC III**

Program Manager

ChangePoint, Inc.

Portland, Oregon

**Jane M. Campbell, Ph.D., NCC, ACS**

Consulting Psychologist

Houston, Texas

**Daniel L. Carzoli, M.A., CAP, NCAC II, ICADC, CPC**

Corrections Program Director

River Region Matrix House

Jacksonville, Florida

**Ann H. Davis, M.Ed., CCS, LCAS**

Director of Administrative Services

Walter B. Jones Alcohol and Drug Abuse

Treatment Center

Greenville, North Carolina

**Michael V. Ellis, Ph.D.**

Professor, Division of Counseling Psychology

University at Albany, State University of New York

Albany, New York

**Arthur Flescher, LCSW, CASAC**

Deputy Director

Suffolk County Division of Community Hygiene

Hauppauge, New York

**Sharon R. Foley, M.A., LPC, ACS, CAC**

Clinical Coordinator, Preceptorship Program

Danya International, Inc.

Silver Spring, Maryland

**Maria del Mar Garcia-Rodriguez, M.S.W., M.H.S.**

Continuing Education Coordinator

Caribbean Basin and Hispanic Addiction Technology Transfer Center

Universidad Central del Caribe

Bayamon, Puerto Rico

**Suzanne Goolden, M.H.A., CTRS, CASAC**

Inpatient Services Director

St. Joseph's Rehabilitation Center, Inc.

Saranac Lake, New York

**Rick Gressard, Ph.D., NCC, LPC, MAC**

Associate Professor

College of William and Mary

Williamsburg, Virginia

**Stephen J. Gumbley, M.A., LCDP**

Education Specialist

Addiction Technology Transfer Center of New England

Providence, Rhode Island

**Charles T. Holt, Ph.D., MFT, LADC**

Personal Development Consultants

Reno, Nevada

**John D. Hughes, M.S.W., CDP**

Coordinator, Safe and Effective Schools

Sunnyside School District

Sunnyside, Washington

**Stephen S. Mason, ACSW, LICSW, CCAC-S**

Director

West Virginia State Division on Alcoholism and Drug Abuse

Charleston, West Virginia

**Leslie D. McCrory, LPC, LCAS, CCS**

McCrory Consulting

Asheville, North Carolina

**Robert L. Neri, M.A., CAP, LMHC**

Chief Clinical Officer

WestCare Foundation

St. Petersburg, Florida

**Michele A. Packard, Ph.D.**

Executive Director

Sage Training

Boulder, California

**David J. Powell, Ph.D., CCS, LADC**

President

International Center for Health Concerns, Inc.

East Granby, Connecticut

**Annie Ramniceanu, M.S., LCMHC, LADC**

Clinical Director

Spectrum Youth and Family Services

Burlington, Vermont

**Scott Reiner, M.S., CAC, CCS**

Program Development Manager

Virginia Department of Juvenile Justice

Richmond, Virginia

**Jeffrey Savoy, LCSW, CASAC**

Vice President, Director of Clinical Support Services

Odyssey House, Inc.

New York, New York

**Donald H. Scherling, Psy.D., ICADC, CCS, LADC, MAC**

Program Director

Berkshire Medical Center, McGee Acute

Addictions Unit

Pittsfield, Massachusetts

**Anne Helene Skinstad, Ph.D.**

Director

Prairielands Addiction Technology Transfer Center

University of Iowa

Iowa City, Iowa

**Robert M. Vincent, M.S.Ed.(c), NCAC II, CPP**

Director

True North Student Assistance and Treatment Services

Olympia, Washington

**Michael J. Wagner, LICSW, MAC**

Owner MJW Consulting

Seattle, Washington

**William L. White, M.S.**

Senior Research Consultant

Chestnut Health Systems

Bloomington, Illinois

HHS Publication No

**Other Technical Assistance Publications (TAPs) include:**

TAP 1 *Approaches in the Treatment of Adolescents with Emotional and
Substance Abuse Problems* **PHD580**

TAP 2 *Medicaid Financing for Mental Health and Substance Abuse Services
for Children and Adolescents* **PHD581**

TAP 3 *Need, Demand, and Problem Assessment for Substance Abuse
Services* **PHD582**

TAP 4 *Coordination of Alcohol, Drug Abuse, and Mental Health Services*
**PHD583**

TAP 5 *Self-Run, Self-Supported Houses for More Effective Recovery from
Alcohol and Drug Addiction* **PHD584**

TAP 6 *Empowering Families, Helping Adolescents: Family-Centered
Treatment of Adolescents with Alcohol, Drug Abuse, and Mental Health
Problems* **BKD81**

TAP 7 *Treatment of Opiate Addiction With Methadone: A Counselor Manual*
**BKD151**

TAP 8 *Relapse Prevention and the Substance-Abusing Criminal Offender*
**BKD121**

TAP 9 *Funding Resource Guide for Substance Abuse Programs* **BKD152**

TAP 10 *Rural Issues in Alcohol and Other Drug Abuse Treatment*
**PHD662**

TAP 11 *Treatment for Alcohol and Other Drug Abuse: Opportunities for
Coordination* **PHD663**

TAP 12 *Approval and Monitoring of Narcotic Treatment Programs: A Guide
on the Roles of Federal and State Agencies* **PHD666**

TAP 13 *Confidentiality of Patient Records for Alcohol and Other Drug
Treatment* **BKD156**

TAP 14 *Siting Drug and Alcohol Treatment Programs: Legal Challenges to
the NIMBY Syndrome* **BKD175**

TAP 15 *Forecasting the Cost of Chemical Dependency Treatment Under
Managed Care: The Washington State Study* **BKD176**

TAP 16 *Purchasing Managed Care Services for Alcohol and Other Drug
Abuse Treatment: Essential Elements and Policy Issues* **BKD167**

TAP 17 *Treating Alcohol and Other Drug Abusers in Rural and Frontier
Area*s **BKD174**

TAP 18 *Checklist for Monitoring Alcohol and Other Drug Confidentiality
Compliance* **PHD722**

TAP 19 *Counselor's Manual for Relapse Prevention With Chemically
Dependent Criminal Offenders* **PHD723**

TAP 20 *Bringing Excellence to Substance Abuse Services in Rural and
Frontier America* **BKD220**

TAP 21 *Addiction Counseling Competencies: The Knowledge, Skills, and
Attitudes of Professional Practice* **(SMA)08-4171**

TAP 21-A *Competencies for Substance Abuse Treatment Clinical
Supervisors* **(SMA)08-4243**

TAP 22 *Contracting for Managed Substance Abuse and Mental Health
Services: A Guide for Public Purchasers* **BKD252**

TAP 23 *Substance Abuse Treatment for Women Offenders: Guide to
Promising Practices* **BKD310**

TAP 24 *Welfare Reform and Substance Abuse Treatment Confidentiality:
General Guidance for Reconciling Need to Know and Privacy* **BKD336**

TAP 25 *The Impact of Substance Abuse Treatment on Employment Outcomes
Among AFDC Clients in Washington State* **BKD367**

TAP 26 *Identifying Substance Abuse Among TANF-Eligible Families*
**BKD410**

TAP 27 *Navigating the Pathways: Lessons and Promising Practices in
Linking Alcohol and Drug Services with Child Welfare* **BKD436**

TAP 28 *The National Rural Alcohol and Drug Abuse Network Awards for
Excellence 2004, Submitted and Award-Winning Papers* **BKD552**

TAP 29 *Integrating State Administrative Records To Manage Substance
Abuse Treatment System Performance* **(SMA)07-4268**

Other TAPs may be ordered by contacting the National Clearinghouse for
Alcohol and Drug

Information (NCADI), (800) 729-6686 or (240) 221-4017, TDD (for hearing
impaired), (800) 487-4889.

[^1]: *Reprinted with permission of the Center for Credentialing and
    Education, Inc., an affiliate of the*

    *National Board for Certified Counselors, 3 Terrace Way, Greensboro,
    NC 27403-3660.*

[^2]: ^\*^*Reprinted with permission of the Association for Counselor
    Education and Supervision.*