CUs CLINICAL 

SUPERVISION 

Clinical Supervision and 

Professional Development of 

the Substance Abuse Counselor 

A Treatment 

Improvement 

Protocol 

TIP 

52 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

Center for Substance Abuse Treatment 

www.samhsa.gov 
Clinical Supervision and 

Professional Development 

of the Substance Abuse 

Counselor 

Treatment Improvement Protocol (TIP) Series 

52 

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

This publication was produced under the Knowledge Application Program, contract number 270-04-7049, a 

Joint Venture of The CDM Group, Inc. and JBS International, Inc., for the Center for Substance Abuse 

Treatment CSAT), Substance Abuse and Mental Health Services Administration SAMHSA), U.S. Department 

of Health and Human Services (HHS). Christina Currier served as the CSAT Government Project Officer. 

Disclaimer 

The views, opinions, and content expressed herein are those of the expert panel and do not necessarily reflect 

the views, opinions, or policies of CSAT, SAMHSA, or HHS. No official support of or endorsement by CSAT, 

SAMHSA, or HHS for these opinions or for particular instruments, software, or resources 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. Citation of 

the source is appreciated. However, this publication may not be reproduced or distributed for a fee without 

the specific, written authorization of the Office of Communications, SAMHSA, HHS. 

Electronic Access and Copies of Publication

This publication may be downloaded or ordered at http://www.samhsa.gov/shin. Or, please call SAMHSA’s 

Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español). 

Recommended Citation 

Center for Substance Abuse Treatment. Clinical Supervision and Professional Development of the Substance 

Abuse Counselor. Treatment Improvement Protocol (TIP) Series 52. DHHS Publication No. (SMA) 09-4435. 

Rockville, MD: Substance Abuse and Mental Health Services Administration, 2009. 

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. 

HHS Publication No. (SMA) 09-4435. 

Printed 2009 

ii 
Contents



Consensus Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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 Supervision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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v



What Is a TIP? vii



Foreword ix



How This TIP Is Organized xi



Part 1 1



Overview of Part 1 1



Chapter 1 3



Introduction 3



Central Principles of Clinical Supervision 5



Guidelines for new Supervisors 6



Models of Clinical Supervision 8



Developmental Stages of Counselors 9



Developmental Stages of Supervisors 10



Cultural and Contextual Factors 11



Ethical and Legal Issues 13



Monitoring Performance 17



Methods of Observation 20



Practical Issues in Clinical 24



Methods and Techniques of Clinical Supervision 30



Administrative Supervision 33



Resources 34



Chapter 2 35



Introduction 35



Vignette 1—Establishing a New Approach for Clinical Supervision 35



Vignette 2—Defining and Building the Supervisory Alliance 44



Vignette 3—Addressing Ethical Standards 51



Vignette 4—Implementing an Evidence-Based Practice 58



Vignette 5—Maintaining Focus on Job Performance 64



Vignette 6—Promoting a Counselor From Within 69



Vignette 7—Mentoring a Successor 73



Vignette 8—Making the Case for Clinical Supervision to Administrators 78



Part 2 85



Chapter 1 87



Benefits and Rationale 87



Key Issues for Administrators in Clinical Supervision 88



Administrative and Clinical Supervision 89



Clinical Supervision and Professional Development iii 
Legal and Ethical Issues for Administrators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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90



Diversity and Cultural Competence 91



Developing a Model for Clinical Supervision 92



Implementing a Clinical Supervision Program 92



Professional Development of Supervisors 99



Chapter 2 101



Introduction 101



Assessing Organizational Readiness 101



Legal and Ethical Issues of Supervision 106



Supervision Guidelines 109



The Supervision Contract 111



The Initial Supervision Sessions 113



Evaluation of Counselors and Supervisors 118



Individual Development Plan 122



Outline for Case Presentations 123



Audio- and Videotaping 124



Appendix A—Bibliography 127



Appendix B—New York State Office of Alcoholism and Substance Abuse



Services Clinical Supervision Vision Statement 135



Appendix C—Advisory Meeting Panel 139



Appendix D—SAMHSA Stakeholders Meeting Attendees 141



Appendix E—Field Reviewers 143



Appendix F—Acknowledgments 145



Index 147



iv 
Consensus Panel 

Chair, Part 1 and Part 2 Consensus Panels 

David J. Powell, Ph.D. (Chair) 

President 

International Center for Health Concerns, Inc. 

East Granby, Connecticut 

Part 1 Consensus Panel Members 

Bruce Carruth, Ph.D. 

KAP Expert Content Director 

The CDM Group, Inc. 

Bethesda, Maryland 

Bettye Harrison 

Opioid Treatment Program Accreditation Director 

CARF International 

Tucson, Arizona 

Sharon Hartman, M.B.A., LSW 

Director of Professional Training and Education 

Caron Treatment Centers 

Wernersville, Pennsylvania 

Pamela Mattel, M.S.W., LCSW-R, ACSW, CASAC 

Executive Deputy Director 

BASICS, Inc. 

New York, New York 

John Porter, M.S. 

Northwest Frontier Addiction Technology Transfer Center 

Wilsonville, Oregon 

Part 2 Consensus Panel Members 

Bruce Carruth, Ph.D. 

KAP Expert Content Director 

The CDM Group, Inc. 

Bethesda, Maryland 

Charles F. Gressard, Ph.D., LPC, NCC 

Associate Professor, School of Education 

College of William & Mary 

Williamsburg,Virginia 

Pamela Mattel, M.S.W., LCSW-R, ACSW, CASAC 

Executive Deputy Director 

BASICS, Inc. 

New York, New York 

Clinical Supervision and Professional Development v 
What Is a TIP? 

Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), 

part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. 

Department of Health and Human Services (HHS), are best-practices guidelines for the treatment of substance 

use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to 

produce the TIPs, which are distributed to facilities and individuals across the country. As alcohol and drug use 

disorders are increasingly recognized as a major problem, the audience for the TIPs is expanding beyond public 

and private treatment facilities to include practitioners in mental health, criminal justice, primary care, and 

other healthcare and social service settings. 

The recommendations contained in each TIP are grounded in scientific research findings and the opinion of the 

TIP consensus panel of experts that a particular practice will produce a specific clinical outcome (measurable 

change in client status). In making recommendations, consensus panelists engage in a process of “evidencebased thinking” in which they consider scientific research, clinical practice theory, practice principles, and practice guidelines, as well as their own individual clinical experiences. Based on this thinking, they arrive at recommendations for optimal clinical approaches for given clinical situations. Relevant citations (to research outcome reports, theoretic formulations, and practice principles and guidelines) are provided. 

TIP Format 

This TIP is organized into three parts: 

•		 Part 1 for substance abuse clinical supervisors focuses on providing appropriate supervision methods and 

frameworks. 

•		 Part 2 for program administrators focuses on providing administrative support to implement adoption of the 

counseling recommendations made in Part 1. 

•		 Part 3 for clinical supervisors, program administrators, and interested counselors is an online literature 

review that provides an in-depth look at relevant published resources. Part 3 will be updated every 6 months 

for 5 years following publication of the TIP. 

Ideally this TIP might be used in a series of six or so meetings in which the materials in the TIP would be 

reviewed, discussed, and in other ways used as an educational and training vehicle for the improvement of clinical supervision skills (with the particulars of how this training would be done determined by the trainer, based 

upon her or his unique situation, needs, and preferences). Thus, after a relatively short period of time and with 

few or no additional resources, this TIP could meet the challenge of fostering improvement in the delivery of 

substance abuse treatment services. 

Development Process 

The topic for this TIP was selected following an advisory meeting of experts in substance use disorders (appendix C). Two Consensus Panels of experts on clinical supervision and substance abuse treatment were convened: 

one for clinical issues, and the other for administrative guidelines (p. v). The TIP then was field reviewed by an 

external group of subject matter experts, who provided suggestions for further refining the document (see 

appendix E). 

Clinical Supervision and Professional Development vii 
TIPs Online 

TIPs can be accessed via the Internet at http://www.kap.samhsa.gov. The online Clinical Supervision and 

Professional Development of the Substance Abuse Counselor: Part 3, A Review of the Literature, which will be 

updated every 6 months for 5 years, is also available at http://www.kap.samhsa.gov. 

Terminology 

Throughout the TIP, the term “substance abuse” has been used to refer to both substance abuse and substance 

dependence (as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision 

[DSM-IV-TR] [American Psychiatric Association 2000]). This term was chosen partly because substance abuse 

treatment professionals commonly use the term “substance abuse” to describe any excessive use of addictive 

substances. In this TIP, the term refers to the use of alcohol as well as other substances of abuse. Readers 

should attend to the context in which the term occurs in order to determine what possible range of meanings 

it covers; in most cases, however, the term will refer to all varieties of substance use disorders described by 

DSM-IV. 

viii 
Foreword
 


The Treatment Improvement Protocol (TIP) series supports SAMHSA’s mission of building resilience and facilitating recovery for people with or at risk for mental or substance use disorders by providing best practices guidance to clinicians, program administrators, and payors to improve the quality and effectiveness of service delivery and, thereby, promote recovery. TIPs are the result of careful consideration of all relevant clinical and 

health services research findings, demonstration experience, and implementation requirements. Clinical 

researchers, clinicians, and program administrators meet to debate and discuss their particular areas of expertise until they reach a consensus on best practices. This panel’s work is then reviewed and critiqued by field 

reviewers. 

The talent, dedication, and hard work that TIP panelists and reviewers bring to this highly participatory 

process have helped bridge the gap between the promise of research and the needs of practicing clinicians and 

administrators to serve, in the most scientifically sound and effective ways, people who abuse substances. We 

are grateful to all who have joined with us to contribute to advances in the substance abuse treatment field. 

Eric Broderick, D.D.S., M.P.H. 

Acting Administrator 

Substance Abuse and Mental Health Services Administration 

H. Westley Clark, M.D., J.D., M.P.H., CAS, FASAM 

Director 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services Administration 

Clinical Supervision and Professional Development ix 
How This TIP Is Organized 

This TIP is divided into three parts: 

•		 Clinical Supervision and Professional Development of the Substance Abuse Counselor, Part 1. 

•		 Clinical Supervision and Professional Development of the Substance Abuse Counselor: An Implementation 

Guide for Administrators, Part 2. 

•		 Clinical Supervision and Professional Development of the Substance Abuse Counselor: A Review of the 

Literature, Part 3. 

Parts 1 and 2 are presented in this publication; Part 3 is available only online at http://www.kap.samhsa.gov. 

Part 1 of the TIP is for clinical supervisors and consists of two chapters. Chapter 1 presents basic information 

about clinical supervision in the substance abuse treatment field. It covers: 

•		 Central principles of clinical supervision and guidelines for new supervisors, including the functions of a 

clinical supervisor. 

•		 The developmental levels of counselors and clinical supervisors. 

•		 Information on cultural competence, ethical and legal issues such as direct and vicarious liability, dual relationships and boundary issues, informed consent, confidentiality, and supervisor ethics. 

•		 Information about monitoring clinical performance of counselors, the various methods commonly used for 

observing counselors, the methods and techniques of supervision and administrative supervision, and practical issues such as balancing one’s clinical and administrative duties, finding the time to do clinical supervision, documentation, and structuring clinical supervision sessions. 

Chapter 2 presents the “how to” of clinical supervision. Chapter 2 contains: 

•		 Representative vignettes of clinical supervision scenarios. 

•		 Master supervisor notes and comments that help you understand the thinking behind the supervisor’s 

approach in each vignette. 

•		 “How-to” descriptions of specific techniques. 

It is strongly recommended that you read chapter 1 before reading chapter 2. 

Part 2 is an implementation guide for program administrators and consists of two chapters. Chapter 1 lays out 

the rationale for the approach taken in chapter 2 and will help administrators understand the benefits and 

rationale behind providing clinical supervision for their program’s substance abuse counselors. Chapter 2 provides tools for making the tasks associated with implementing a clinical supervision system easier. 

The following topics are addressed in Part 2: 

•		 How to develop a model for clinical supervision and implement a clinical supervision program. 

•		 Key issues for administrators to consider, including assessing organizational structure and readiness. 

•		 Legal and ethical issues to consider. 

•		 Cultural competence issues. 

•		 Providing professional development for clinical supervisors. 

Clinical Supervision and Professional Development xi 
Part 3 of this TIP is a literature review on the topic of clinical supervision and is available for use by clinical 

supervisors, interested counselors, and administrators. Part 3 consists of three sections: an analysis of the 

available literature, an annotated bibliography of the literature most central to the topic, and a bibliography of 

other available literature. It includes literature that addresses both clinical and administrative concerns. To 

facilitate ongoing updates (which will be performed every 6 months for up to 5 years from first publication), the 

literature review will be available only online at http://www.kap.samhsa.gov. 

xii 
Clinical Supervision and 

Professional Development of 

the Substance Abuse 

Counselor 

Part 1



Overview of Part 1 

Chapter 1: Information You Need To Know 

This chapter presents the basic information about clinical supervision in the substance abuse treatment field 

and is organized as follows: 

• Introduction (pp. 3–4) 

• Central Principles of Clinical Supervision (pp. 5–6) 

• Guidelines for New Supervisors (pp. 6–8) 

• Models of Clinical Supervision (pp. 8–9) 

• Developmental Stages of Counselors (pp. 9–10) 

• Developmental Stages of Supervisors (pp. 10–11) 

• Cultural and Contextual Factors (pp. 11–13) 

• Ethical and Legal Issues (pp. 13–17) 

• Monitoring Performance (pp. 17–20) 

• Methods of Observation (pp. 20–24) 

• Practical Issues in Clinical Supervision (pp. 24–29) 

• Methods and Techniques of Clinical Supervision (pp. 30–32) 

• Administrative Supervision (pp. 33–34) 

• Resources (p. 34) 

Chapter 2: Clinical Scenarios Showing How To Apply the Information 

This chapter presents several realistic clinical supervision scenarios that could take place in a substance abuse 

treatment agency to demonstrate the material presented in chapter 1. Master Supervisor Notes are provided to 

explain the thinking behind these actions. How-to Notes instruct supervisors on using a specific technique. The 

scenarios should be useful to both counselors and supervisors. 

Clinical Supervision and Professional Development 1 
Chapter 1



Introduction 

Clinical supervision is emerging as the crucible in 

which counselors acquire knowledge and skills for the 

substance abuse treatment profession, providing a 

bridge between the classroom and the clinic. 

Supervision is necessary in the substance abuse 

treatment field to improve client care, develop the 

professionalism of clinical personnel, and impart and 

maintain ethical standards in the field. In recent 

years, especially in the substance abuse field, clinical 

supervision has become the cornerstone of quality 

improvement and assurance. 

Your role and skill set as a clinical supervisor are distinct from those of counselor and administrator. 

Quality clinical supervision is founded on a positive 

supervisor–supervisee relationship that promotes 

client welfare and the professional development of the 

supervisee. You are a teacher, coach, consultant, 

mentor, evaluator, and administrator; you provide 

support, encouragement, and education to staff while 

addressing an array of psychological, interpersonal, 

physical, and spiritual issues of clients. Ultimately, 

effective clinical supervision ensures that clients are 

competently served. Supervision ensures that counselors continue to increase their skills, which in turn 

increases treatment effectiveness, client retention, 

and staff satisfaction. The clinical supervisor also 

serves as liaison between administrative and clinical 

staff. 

This TIP focuses primarily on the teaching, coaching, 

consulting, and mentoring functions of clinical supervisors. Supervision, like substance abuse counseling, 

is a profession in its own right, with its own theories, 

practices, and standards. The profession requires 

knowledgeable, competent, and skillful individuals 

who are appropriately credentialed both as counselors 

and supervisors. 

Definitions 

This document builds on and makes frequent reference to CSAT’s Technical Assistance Publication 

(TAP), Competencies for Substance Abuse Treatment 

Clinical Supervision and Professional Development 

Clinical Supervisors (TAP 21-A; CSAT, 2007). The 

clinical supervision competencies identify those 

responsibilities and activities that define the work of 

the clinical supervisor. This TIP provides guidelines 

and tools for the effective delivery of clinical supervision in substance abuse treatment settings. TAP 21-A 

is a companion volume to TAP 21, Addiction 

Counseling Competencies (CSAT, 2006), which is 

another useful tool in supervision. 

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

•		 “Supervision is a disciplined, tutorial process 

wherein principles are transformed into practical 

skills, with four overlapping foci: administrative, 

evaluative, clinical, and supportive” (Powell & 

Brodsky, 2004, p. 11). “Supervision is an intervention provided by a senior member of a profession 

to a more junior member or members. . . . This 

relationship is evaluative, extends over time, and 

has the simultaneous purposes of enhancing the 

professional functioning of the more junior person(s); monitoring the quality of professional services offered to the clients that she, he, or they see; 

and serving as a gatekeeper of those who are to 

enter the particular profession” (Bernard & 

Goodyear, 2004, p. 8). 

•		 Supervision is “a social influence process that 

occurs over time, in which the supervisor participates with supervisees to ensure quality of clinical 

care. Effective supervisors observe, mentor, coach, 

evaluate, inspire, and create an atmosphere that 

promotes self-motivation, learning, and professional development. They build teams, create cohesion, 

resolve conflict, and shape agency culture, while 

attending to ethical and diversity issues in all 

aspects of the process. Such supervision is key to 

both quality improvement and the successful 

implementation of consensus- and evidence-based 

practices” (CSAT, 2007, p. 3). 

Rationale 

For hundreds of years, many professions have relied 

on more senior colleagues to guide less experienced 

professionals in their crafts. This is a new develop3 
ment in the substance abuse field, as clinical supervision was only recently acknowledged as a discrete 

process with its own concepts and approaches. 

As a supervisor to the client, counselor, and organization, the significance of your position is apparent in 

the following statements: 

•		 Organizations have an obligation to ensure quality 

care and quality improvement of all personnel. 

The first aim of clinical supervision is to ensure 

quality services and to protect the welfare of 

clients. 

•		 Supervision is the right of all employees and has a 

direct impact on workforce development and staff 

and client retention. 

•		 You oversee the clinical functions of staff and have 

a legal and ethical responsibility to ensure quality 

care to clients, the professional development of 

counselors, and maintenance of program policies 

and procedures. 

•		 Clinical supervision is how counselors in the field 

learn. In concert with classroom education, clinical 

skills are acquired through practice, observation, 

feedback, and implementation of the recommendations derived from clinical supervision. 

Functions of a Clinical Supervisor 

You, the clinical supervisor, wear several important 

“hats.” You facilitate the integration of counselor selfawareness, theoretical grounding, and development of 

clinical knowledge and skills; and you improve functional skills and professional practices. These roles 

often overlap and are fluid within the context of the 

supervisory relationship. Hence, the supervisor is in a 

unique position as an advocate for the agency, the 

counselor, and the client. You are the primary link 

between administration and front line staff, interpreting and monitoring compliance with agency goals, 

policies, and procedures and communicating staff and 

client needs to administrators. Central to the supervisor’s function is the alliance between the supervisor 

and supervisee (Rigazio-DiGilio, 1997). 

As shown in Figure 1, your roles as a clinical supervisor in the context of the supervisory relationship 

include: 

•		 Teacher: Assist in the development of counseling 

knowledge and skills by identifying learning 

needs, determining counselor strengths, promoting self-awareness, and transmitting knowledge 

for practical use and professional growth. 

Supervisors are teachers, trainers, and professional role models. 

•		 Consultant: Bernard and Goodyear (2004) incorporate the supervisory consulting role of case consultation and review, monitoring performance, 

counseling the counselor regarding job performance, and assessing counselors. In this role, supervisors also provide alternative case conceptualizations, oversight of counselor work to achieve mutually agreed upon goals, and professional gatekeeping for the organization and discipline (e.g., recognizing and addressing counselor impairment). 

•		 Coach: In this supportive role, supervisors provide morale building, assess strengths and needs, 

suggest varying clinical approaches, model, cheerlead, and prevent burnout. For entry-level counselors, the supportive function is critical. 

•		 Mentor/Role Model: The experienced supervisor 

mentors and teaches the supervisee through role 

modeling, facilitates the counselor’s overall professional development and sense of professional identity, and trains the next generation of supervisors. 

Figure 1. Roles of the Clinical Supervisor 

4 Part 1, Chapter 1 
Central Principles of 

Clinical Supervision 

The Consensus Panel for this TIP has identified central principles of clinical supervision. Although the 

Panel recognizes that clinical supervision can initially be a costly undertaking for many financially 

strapped programs, the Panel believes that ultimately clinical supervision is a cost-saving process. 

Clinical supervision enhances the quality of client 

care; improves efficiency of counselors in direct and 

indirect services; increases workforce satisfaction, 

professionalization, and retention (see vignette 8 in 

chapter 2); and ensures that services provided to the 

public uphold legal mandates and ethical standards 

of the profession. 

The central principles identified by the Consensus 

Panel are: 

1. Clinical supervision is an essential part of 

all clinical programs. Clinical supervision is a 

central organizing activity that integrates the 

program mission, goals, and treatment philosophy 

with clinical theory and evidence-based practices 

(EBPs). The primary reasons for clinical supervision are to ensure (1) quality client care, and (2) 

clinical staff continue professional development in 

a systematic and planned manner. In substance 

abuse treatment, clinical supervision is the primary means of determining the quality of care 

provided. 

2. Clinical supervision enhances staff retention and morale. Staff turnover and workforce 

development are major concerns in the substance 

abuse treatment field. Clinical supervision is a 

primary means of improving workforce retention 

and job satisfaction (see, for example, Roche, 

Todd, & O’Connor, 2007). 

3. Every clinician, regardless of level of skill 

and experience, needs and has a right to 

clinical supervision. In addition, supervisors 

need and have a right to supervision of their 

supervision. Supervision needs to be tailored to 

the knowledge base, skills, experience, and 

assignment of each counselor. All staff need 

supervision, but the frequency and intensity of 

the oversight and training will depend on the 

role, skill level, and competence of the individual. 

Clinical Supervision and Professional Development 

The benefits that come with years of experience 

are enhanced by quality clinical supervision. 

4. Clinical supervision needs the full support 

of agency administrators. Just as treatment 

programs want clients to be in an atmosphere of 

growth and openness to new ideas, counselors 

should be in an environment where learning and 

professional development and opportunities are 

valued and provided for all staff. 

5. The supervisory relationship is the crucible 

in which ethical practice is developed and 

reinforced. The supervisor needs to model sound 

ethical and legal practice in the supervisory relationship. This is where issues of ethical practice 

arise and can be addressed. This is where ethical 

practice is translated from a concept to a set of 

behaviors. Through supervision, clinicians can 

develop a process of ethical decisionmaking and 

use this process as they encounter new situations. 

6. Clinical supervision is a skill in and of itself 

that has to be developed. Good counselors tend 

to be promoted into supervisory positions with the 

assumption that they have the requisite skills to 

provide professional clinical supervision. 

However, clinical supervisors need a different role 

orientation toward both program and client goals 

and a knowledge base to complement a new set of 

skills. Programs need to increase their capacity to 

develop good supervisors. 

7. Clinical supervision in substance abuse 

treatment most often requires balancing 

administrative and clinical supervision 

tasks. Sometimes these roles are complementary 

and sometimes they conflict. Often the supervisor 

feels caught between the two roles. 

Administrators need to support the integration 

and differentiation of the roles to promote the 

efficacy of the clinical supervisor. (See Part 2.) 

8. Culture and other contextual variables 

influence the supervision process; supervisors need to continually strive for cultural 

competence. Supervisors require cultural competence at several levels. Cultural competence 

involves the counselor’s response to clients, the 

supervisor’s response to counselors, and the program’s response to the cultural needs of the 

diverse community it serves. Since supervisors 

are in a position to serve as catalysts for change, 

they need to develop proficiency in addressing the 

needs of diverse clients and personnel. 

5 
9. Successful implementation of EBPs requires 

ongoing supervision. Supervisors have a role in 

determining which specific EBPs are relevant for 

an organization’s clients (Lindbloom, Ten Eyck, & 

Gallon, 2005). Supervisors ensure that EBPs are 

successfully integrated into ongoing programmatic activities by training, encouraging, and monitoring counselors. Excellence in clinical supervision should provide greater adherence to the EBP 

model. Because State funding agencies now often 

require substance abuse treatment organizations 

to provide EBPs, supervision becomes even more 

important. 

10. Supervisors have the responsibility to be 

gatekeepers for the profession. Supervisors 

are responsible for maintaining professional standards, recognizing and addressing impairment, 

and safeguarding the welfare of clients. More 

than anyone else in an agency, supervisors can 

observe counselor behavior and respond promptly 

to potential problems, including counseling some 

individuals out of the field because they are illsuited to the profession. This “gatekeeping” function is especially important for supervisors who 

act as field evaluators for practicum students 

prior to their entering the profession. Finally, 

supervisors also fulfill a gatekeeper role in performance evaluation and in providing formal recommendations to training institutions and credentialing bodies. 

11. Clinical supervision should involve direct 

observation methods. Direct observation 

should be the standard in the field because it is 

one of the most effective ways of building skills, 

monitoring counselor performance, and ensuring 

quality care. Supervisors require training in 

methods of direct observation, and administrators 

need to provide resources for implementing direct 

observation. Although small substance abuse 

agencies might not have the resources for oneway mirrors or videotaping equipment, other 

direct observation methods can be employed (see 

the section on methods of observation, pp. 20–24). 

Guidelines for New 

Supervisors 

Congratulations on your appointment as a supervisor! 

By now you might be asking yourself a few questions: 

What have I done? Was this a good career decision? 

There are many changes ahead. If you have been promoted from within, you’ll encounter even more hurdles and issues. First, it is important to face that 

your life has changed. You might experience the loss 

of friendship of peers. You might feel that you knew 

what to do as a counselor, but feel totally lost with 

your new responsibilities (see vignette 6 in chapter 

2). You might feel less effective in your new role. 

Supervision can be an emotionally draining experience, as you now have to work with more staff-related 

interpersonal and human resources issues. 

Before your promotion to clinical supervisor, you 

might have felt confidence in your clinical skills. Now 

you might feel unprepared and wonder if you need a 

training course for your new role. If you feel this way, 

you’re right. Although you are a good counselor, you 

do not necessarily possess all the skills needed to be a 

good supervisor. Your new role requires a new body of 

knowledge and different skills, along with the ability 

to use your clinical skills in a different way. Be confident that you will acquire these skills over time (see 

the Resources section, p. 34) and that you made the 

right decision to accept your new position. 

Suggestions for new supervisors: 

•		 Quickly learn the organization’s policies and procedures and human resources procedures (e.g., hiring and firing, affirmative action requirements, 

format for conducting meetings, giving feedback, 

and making evaluations). Seek out this information as soon as possible through the human 

resources department or other resources within 

the organization. 

•		 Ask for a period of 3 months to allow you to learn 

about your new role. During this period, do not 

make any changes in policies and procedures but 

use this time to find your managerial voice and 

decisionmaking style. 

•		 Take time to learn about your supervisees, their 

career goals, interests, developmental objectives, 

and perceived strengths. 

•		 Work to establish a contractual relationship with 

supervisees, with clear goals and methods of 

supervision. 

•		 Learn methods to help staff reduce stress, address 

competing priorities, resolve staff conflict, and 

other interpersonal issues in the workplace. 

•		 Obtain training in supervisory procedures and 

methods. 

6 Part 1, Chapter 1 
•		 Find a mentor, either internal or external to the 

organization. 

•		 Shadow a supervisor you respect who can help you 

learn the ropes of your new job. 

•		 Ask often and as many people as possible, “How 

am I doing?” and “How can I improve my performance as a clinical supervisor?” 

•		 Ask for regular, weekly meetings with your 

administrator for training and instruction. 

•		 Seek supervision of your supervision. 

Problems and Resources 

As a supervisor, you may encounter a broad array of 

issues and concerns, ranging from working within a 

system that does not fully support clinical supervision 

to working with resistant staff. A comment often 

heard in supervision training sessions is “My boss 

should be here to learn what is expected in supervision,” or “This will never work in my agency’s bureaucracy. They only support billable activities.” The work 

setting is where you apply the principles and practices of supervision and where organizations are driven by demands, such as financial solvency, profit, 

census, accreditation, and concerns over litigation. 

Therefore, you will need to be practical when beginning your new role as a supervisor: determine how 

you can make this work within your unique work 

environment. 

Working With Staff Who Are 

Resistant to Supervision 

Some of your supervisees may have been in the field 

longer than you have and see no need for supervision. 

Other counselors, having completed their graduate 

training, do not believe they need further supervision, 

especially not from a supervisor who might have less 

formal academic education than they have. Other 

resistance might come from ageism, sexism, racism, 

or classism. Particular to the field of substance abuse 

treatment may be the tension between those who 

believe that recovery from substance abuse is necessary for this counseling work and those who do not 

believe this to be true. 

In addressing resistance, you must be clear regarding 

what your supervision program entails and must consistently communicate your goals and expectations to 

Clinical Supervision and Professional Development 

staff. To resolve defensiveness and engage your 

supervisees, you must also honor the resistance and 

acknowledge their concerns. Abandon trying to push 

the supervisee too far, too fast. Resistance is an 

expression of ambivalence about change and not a 

personality defect of the counselor. Instead of arguing 

with or exhorting staff, sympathize with their concerns, saying, “I understand this is difficult. How are 

we going to resolve these issues?” 

When counselors respond defensively or reject directions from you, try to understand the origins of their 

defensiveness and to address their resistance. Selfdisclosure by the supervisor about experiences as a 

supervisee, when appropriately used, may be helpful 

in dealing with defensive, anxious, fearful, or resistant staff. Work to establish a healthy, positive supervisory alliance with staff. Because many substance 

abuse counselors have not been exposed to clinical 

supervision, you may need to train and orient the 

staff to the concept and why it is important for your 

agency. 

Things a New Supervisor 

Should Know 

Eight truths a beginning supervisor should commit to 

memory are listed below: 

1.		 The reason for supervision is to ensure quality 

client care. As stated throughout this TIP, the 

primary goal of clinical supervision is to protect 

the welfare of the client and ensure the integrity 

of clinical services. 

2.		 Supervision is all about the relationship. As in 

counseling, developing the alliance between the 

counselor and the supervisor is the key to good 

supervision. 

3.	 	Culture and ethics influence all supervisory 

interactions. Contextual factors, culture, race, 

and ethnicity all affect the nature of the supervisory relationship. Some models of supervision 

(e.g., Holloway, 1995) have been built primarily 

around the role of context and culture in shaping 

supervision. 

4.		 Be human and have a sense of humor. As role 

models, you need to show that everyone makes 

mistakes and can admit to and learn from these 

mistakes. 

7 
5.		 Rely first on direct observation of your counselors 

and give specific feedback. The best way to determine a counselor’s skills is to observe him or her 

and to receive input from the clients about their 

perceptions of the counseling relationship. 

6.		 Have and practice a model of counseling and of 

supervision; have a sense of purpose. Before you 

can teach a supervisee knowledge and skills, you 

must first know the philosophical and theoretical 

foundations on which you, as a supervisor, stand. 

Counselors need to know what they are going to 

learn from you, based on your model of counseling 

and supervision. 

7.		 Make time to take care of yourself spiritually, 

emotionally, mentally, and physically. Again, as 

role models, counselors are watching your behavior. Do you “walk the talk” of self-care? 

8.		 You have a unique position as an advocate for the 

agency, the counselor, and the client. As a supervisor, you have a wonderful opportunity to assist 

in the skill and professional development of your 

staff, advocating for the best interests of the 

supervisee, the client, and your organization. 

Models of Clinical 

Supervision 

You may never have thought about your model of 

supervision. However, it is a fundamental premise of 

this TIP that you need to work from a defined model 

of supervision and have a sense of purpose in your 

oversight role. Four supervisory orientations seem 

particularly relevant. They include: 

•		 Competency-based models. 

•		 Treatment-based models. 

•		 Developmental approaches. 

•		 Integrated models. 

Competency-based models (e.g., microtraining, 

the Discrimination Model [Bernard & Goodyear, 

2004], and the Task-Oriented Model [Mead, 1990], 

focus primarily on the skills and learning needs of 

the supervisee and on setting goals that are specific, 

measurable, attainable, realistic, and timely 

(SMART). They construct and implement strategies 

to accomplish these goals. The key strategies of competency-based models include applying social learning principles (e.g., modeling role reversal, role playing, and practice), using demonstrations, and using 

various supervisory functions (teaching, consulting, 

and counseling). 

Treatment-based supervision models train to a 

particular theoretical approach to counseling, incorporating EBPs into supervision and seeking fidelity and 

adaptation to the theoretical model. Motivational 

interviewing, cognitive–behavioral therapy, and psychodynamic psychotherapy are three examples. These 

models emphasize the counselor’s strengths, seek the 

supervisee’s understanding of the theory and model 

taught, and incorporate the approaches and techniques of the model. The majority of these models 

begin with articulating their treatment approach and 

describing their supervision model, based upon that 

approach. 

Developmental models, such as Stoltenberg and 

Delworth (1987), understand that each counselor goes 

through different stages of development and recognize that movement through these stages is not 

always linear and can be affected by changes in 

assignment, setting, and population served. (The 

developmental stages of counselors and supervisors 

are described in detail below). 

Integrated models, including the Blended Model, 

begin with the style of leadership and articulate a 

model of treatment, incorporate descriptive dimensions of supervision (see below), and address contextual and developmental dimensions into supervision. 

They address both skill and competency development 

and affective issues, based on the unique needs of 

the supervisee and supervisor. Finally, integrated 

models seek to incorporate EBPs into counseling and 

supervision. 

In all models of supervision, it is helpful to identify 

culturally or contextually centered models or 

approaches and find ways of tailoring the models to 

specific cultural and diversity factors. Issues to consider are: 

•		 Explicitly addressing diversity of supervisees (e.g., 

race, ethnicity, gender, age, sexual orientation) 

and the specific factors associated with these types 

of diversity; 

•		 Explicitly involving supervisees’ concerns related 

to particular client diversity (e.g., those whose culture, gender, sexual orientation, and other attributes differ from those of the supervisee) and 

addressing specific factors associated with these 

types of diversity; and 

8 Part 1, Chapter 1 
•		 Explicitly addressing supervisees’ issues related to 

effectively navigating services in intercultural 

communities and effectively networking with 

agencies and institutions. 

It is important to identify your model of counseling 

and your beliefs about change, and to articulate a 

workable approach to supervision that fits the model 

of counseling you use. Theories are conceptual frameworks that enable you to make sense of and organize 

your counseling and supervision and to focus on the 

most salient aspects of a counselor’s practice. You 

may find some of the questions below to be relevant 

to both supervision and counseling. The answers to 

these questions influence both how you supervise and 

how the counselors you supervise work: 

•		 What are your beliefs about how people change in 

both treatment and clinical supervision? 

•		 What factors are important in treatment and clinical supervision? 

•		 What universal principles apply in supervision 

and counseling and which are unique to clinical 

supervision? 

•		 What conceptual frameworks of counseling do you 

use (for instance, cognitive–behavioral therapy, 

12-Step facilitation, psychodynamic, behavioral)? 

•		 What are the key variables that affect outcomes? 

(Campbell, 2000) 

According to Bernard and Goodyear (2004) and 

Powell and Brodsky (2004),the qualities of a good 

model of clinical supervision are: 

•		 Rooted in the individual, beginning with the 

supervisor’s self, style, and approach to leadership. 

•		 Precise, clear, and consistent. 

•		 Comprehensive, using current scientific and evidence-based practices. 

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

•		 Outcome-oriented to improve counselor competence; make work manageable; create a sense of 

mastery and growth for the counselor; and address 

the needs of the organization, the supervisor, the 

supervisee, and the client. 

Finally, it is imperative to recognize that, whatever 

model you adopt, it needs to be rooted in the learning 

and developmental needs of the supervisee, the specific needs of the clients they serve, the goals of the 

agency in which you work, and in the ethical and 

legal boundaries of practice. These four variables 

define the context in which effective supervision can 

take place. 

Developmental Stages of 

Counselors 

Counselors are at different stages of professional 

development. Thus, regardless of the model of supervision you choose, you must take into account the 

supervisee’s level of training, experience, and proficiency. Different supervisory approaches are appropriate for counselors at different stages of development. An understanding of the supervisee’s (and 

supervisor’s) developmental needs is an essential 

ingredient for any model of supervision. 

Various paradigms or classifications of developmental 

stages of clinicians have been developed (Ivey, 1997; 

Rigazio-DiGilio, 1997; Skolvolt & Ronnestrand, 1992; 

Todd and Storn, 1997). This TIP has adopted the 

Integrated Developmental Model (IDM) of 

Stoltenberg, McNeill, and Delworth (1998) (see figure 

2, p. 10). This schema uses a three-stage approach. 

The three stages of development have different characteristics and appropriate supervisory methods. 

Further application of the IDM to the substance 

abuse field is needed. (For additional information, see 

Anderson, 2001.) 

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

including: 

•		 There is a beginning but not an end point for 

learning clinical skills; be careful of counselors 

who think they “know it all.” 

•		 Take into account the individual learning styles 

and personalities of your supervisees and fit the 

supervisory approach to the developmental stage 

of each counselor. 

•		 There is a logical sequence to development, 

although it is not always predictable or rigid; some 

counselors may have been in the field for years but 

remain at an early stage of professional development, whereas others may progress quickly 

through the stages. 

Clinical Supervision and Professional Development 9 
•		 Counselors at an advanced developmental level 

have different learning needs and require different 

supervisory approaches from those at Level 1; and 

•		 The developmental level can be applied for different aspects of a counselor’s overall competence 

(e.g., Level 2 mastery for individual counseling 

and Level 1 for couples counseling). 

Figure 2. Counselor Developmental Model 

Developmental Level Characteristics Supervision Skills 

Development Needs Techniques 

Level 1 • Focuses on self 

• Anxious, uncertain 

• Preoccupied with performing the right way 

• Overconfident of skills 

• Overgeneralizes 

• Overuses a skill 

• Gap between conceptualization, goals, and 

interventions 

• Ethics underdeveloped 

• Provide structure and 

minimize anxiety 

• Supportive, address 

strengths first, then 

weaknesses 

• Suggest approaches 

• Start connecting theory 

to treatment 

• Observation 

• Skills training 

• Role playing 

• Readings 

• Group supervision 

• Closely monitor clients 

Level 2 • Focuses less on self and 

more on client 

• Confused, frustrated 

with complexity of counseling 

• Overidentifies with client 

• Challenges authority 

• Lacks integration with 

theoretical base 

• Overburdened 

• Ethics better understood 

• Less structure provided, 

more autonomy encouraged 

• Supportive 

• Periodic suggestion of 

approaches 

• Confront discrepancies 

• Introduce more alternative views 

• Process comments, highlight countertransference 

• Affective reactions to 

client and/or supervisor 

• Observation 

• Role playing 

• Interpret dynamics 

• Group supervision 

• Reading 

Level 3 • Focuses intently on client 

• High degree of empathic 

skill 

• Objective third person 

perspective 

• Integrative thinking and 

approach 

• Highly responsible and 

ethical counselor 

• Supervisee directed 

• Focus on personal-professional integration and 

career 

• Supportive 

• Change agent 

• Peer supervision 

• Group supervision 

• Reading 

Source: Stoltenberg, Delworth, & McNeil, 1998 

Developmental Stages of 

Supervisors 

Just as counselors go through stages of development, 

so do supervisors. The developmental model presented in figure 3 provides a framework to explain why 

supervisors act as they do, depending on their developmental stage. It would be expected that someone 

new to supervision would be at a Level 1 as a supervisor. However, supervisors should be at least at the 

second or third stage of counselor development. If a 

newly appointed supervisor is still at Level 1 as a 

10 Part 1, Chapter 1 
counselor, he or she will have little to offer to more 

seasoned supervisees. 

Figure 3. Supervisor Developmental Model 

Developmental 

Level Characteristics To Increase Supervision Competence 

Level 1 • Is anxious regarding role 

• Is naïve about assuming the role of supervisor 

• Is focused on doing the “right” thing 

• May overly respond as an “expert” 

• Is uncomfortable providing direct feedback 

• Follow structure and formats 

• Design systems to increase organization of 

supervision 

• Assign Level I counselors 

Level 2 • Shows confusion and conflict 

• Sees supervision as complex and multidimensional 

• Needs support to maintain motivation 

• Overfocused on counselor’s deficits and perceived resistance 

• May fall back to being a therapist with the 

counselor 

• Provide active supervision of the supervision 

• Assign Level 1 counselors 

Level 3 • Is highly motivated 

• Can provide an honest self-appraisal of 

strengths and weaknesses as supervisor 

• Is comfortable with evaluation process 

• Provides thorough, objective feedback 

• Comfortable with all levels 

Source: Stoltenberg, Delworth, & McNeil, 1998 

Cultural and Contextual 

Factors 

Culture is one of the major contextual factors that 

influence supervisory interactions. Other contextual 

variables include race, ethnicity, age, gender, discipline, academic background, religious and spiritual 

practices, sexual orientation, disability, and recovery 

versus non-recovery status. The relevant variables 

in the supervisory relationship occur in the context 

of the supervisor, supervisee, client, and the setting 

in which supervision occurs. More care should be 

taken to: 

•		 Identify the competencies necessary for substance 

abuse counselors to work with diverse individuals 

and navigate intercultural communities. 

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

•		 Provide evaluation criteria for supervisors to 

determine whether their supervisees have met 

minimal competency standards for effective and 

relevant practice. 

Models of supervision have been strongly influenced 

by contextual variables and their influence on the 

supervisory relationship and process, such as 

Holloway’s Systems Model (1995) and Constantine’s 

Multicultural Model (2003). 

The competencies listed in TAP 21-A reflect the 

importance of culture in supervision (CSAT, 2007). 

The Counselor Development domain encourages selfexamination of attitudes toward culture and other 

contextual variables. The Supervisory Alliance 

domain promotes attention to these variables in the 

supervisory relationship. (See also the planned TIP, 

Improving Cultural Competence in Substance Abuse 

Counseling [CSAT, in development b].) 

Cultural competence “refers to the ability to honor 

and respect the beliefs, language, interpersonal 

styles, and behaviors of individuals and families 

receiving services, as well as staff who are providing 

such services. Cultural competence is a dynamic, 

ongoing, developmental process that requires a commitment and is achieved over time” (U.S. Department 

Clinical Supervision and Professional Development 11 
of Health and Human Services, 2003, p. 12). Culture 

shapes belief systems, particularly concerning issues 

related to mental health and substance abuse, as well 

as the manifestation of symptoms, relational styles, 

and coping patterns. 

There are three levels of cultural consideration for 

the supervisory process: the issue of the culture of 

the client being served and the culture of the counselor in supervision. Holloway (1995) emphasizes the 

cultural issues of the agency, the geographic environment of the organization, and many other contextual 

factors. Specifically, there are three important areas 

in which cultural and contextual factors play a key 

role in supervision: in building the supervisory relationship or working alliance, in addressing the specific needs of the client, and in building supervisee 

competence and ability. It is your responsibility to 

address your supervisees’ beliefs, attitudes, and biases about cultural and contextual variables to advance 

their professional development and promote quality 

client care. 

Becoming culturally competent and able to integrate 

other contextual variables into supervision is a complex, long-term process. Cross (1989) has identified 

several stages on a continuum of becoming culturally 

competent (see figure 4). 

Figure 4. Continuum of Cultural Competence 

Cultural Destructiveness 

Superiority of dominant culture and inferiority of other cultures; active discrimination 

Cultural Incapacity 

Separate but equal treatment; passive discrimination 

Cultural Blindness 

Sees all cultures and people as alike and equal; discrimination by ignoring culture 

Cultural Openness (Sensitivity) 

Basic understanding and appreciation of importance of sociocultural factors in work with minority populations 

Cultural Competence 

Capacity to work with more complex issues and cultural nuances 

Cultural Proficiency 

Highest capacity for work with minority populations; a commitment to excellence and proactive effort 

Source: Cross, 1989. 

Although you may never have had specialized training in multicultural counseling, some of your supervisees may have (see Constantine, 2003). Regardless, 

it is your responsibility to help supervisees build on 

the cultural competence skills they possess as well as 

to focus on their cultural competence deficits. It is 

important to initiate discussion of issues of culture, 

race, gender, sexual orientation, and the like in 

supervision to model the kinds of discussion you 

would like counselors to have with their clients. If 

these issues are not addressed in supervision, counselors may come to believe that it is inappropriate to 

discuss them with clients and have no idea how such 

dialog might proceed. These discussions prevent misunderstandings with supervisees based on cultural or 

other factors. Another benefit from these discussions 

is that counselors will eventually achieve some level 

of comfort in talking about culture, race, ethnicity, 

and diversity issues. 

If you haven’t done it as a counselor, early in your 

tenure as a supervisor you will want to examine your 

culturally influenced values, attitudes, experiences, 

and practices and to consider what effects they have 

on your dealings with supervisees and clients. 

Counselors should undergo a similar review as 

preparation for when they have clients of a culture 

different from their own. Some questions to keep in 

mind are: 

•		 What did you think when you saw the supervisee’s 

last name? 

12 Part 1, Chapter 1 
•		 What did you think when the supervisee said his 

or her culture is X, when yours is Y? 

•		 How did you feel about this difference? 

•		 What did you do in response to this difference? 

Constantine (2003) suggests that supervisors can use 

the following questions with supervisees: 

•		 What demographic variables do you use to identify 

yourself? 

•		 What worldviews (e.g., values, assumptions, and 

biases) do you bring to supervision based on your 

cultural identities? 

•		 What struggles and challenges have you faced 

working with clients who were from different cultures than your own? 

Beyond self-examination, supervisors will want continuing education classes, workshops, and conferences 

that address cultural competence and other contextual factors. Community resources, such as community 

leaders, elders, and healers can contribute to your 

understanding of the culture your organization 

serves. Finally, supervisors (and counselors) should 

participate in multicultural activities, such as community events, discussion groups, religious festivals, 

and other ceremonies. 

The supervisory relationship includes an inherent 

power differential, and it is important to pay attention to this disparity, particularly when the supervisee and the supervisor are from different cultural 

groups. A potential for the misuse of that power 

exists at all times but especially when working with 

supervisees and clients within multicultural contexts. 

When the supervisee is from a minority population 

and the supervisor is from a majority population, the 

differential can be exaggerated. You will want to prevent institutional discrimination from affecting the 

quality of supervision. The same is true when the 

supervisee is gay and the supervisor is heterosexual, 

or the counselor is non-degreed and the supervisor 

has an advanced degree, or a female supervisee with 

a male supervisor, and so on. In the reverse situations, where the supervisor is from the minority 

group and the supervisee from the majority group, 

the difference should be discussed as well. 

Clinical Supervision and Professional Development 

Ethical and Legal Issues 

You are the organization’s gatekeeper for ethical and 

legal issues. First, you are responsible for upholding 

the highest standards of ethical, legal, and moral 

practices and for serving as a model of practice to 

staff. Further, you should be aware of and respond to 

ethical concerns. Part of your job is to help integrate 

solutions to everyday legal and ethical issues into 

clinical practice. 

Some of the underlying assumptions of incorporating 

ethical issues into clinical supervision include: 

•		 Ethical decisionmaking is a continuous, active 

process. 

•		 Ethical standards are not a cookbook. They tell 

you what to do, not always how. 

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

decisions. 

•		 The most complex ethical issues arise in the context of two ethical behaviors that conflict; for 

instance, when a counselor wants to respect the 

privacy and confidentiality of a client, but it is in 

the client’s best interest for the counselor to contact someone else about his or her care. 

•		 Therapy is conducted by fallible beings; people 

make mistakes—hopefully, minor ones. 

•		 Sometimes the answers to ethical and legal questions are elusive. Ask a dozen people, and you’ll 

likely get twelve different points of view. 

Helpful resources on legal and ethical issues for 

supervisors include Beauchamp and Childress (2001); 

Falvey (2002b); Gutheil and Brodsky (2008); Pope, 

Sonne, and Greene (2006); and Reamer (2006). 

Legal and ethical issues that are critical to clinical 

supervisors include (1) vicarious liability (or respondeat superior), (2) dual relationships and boundary 

concerns, (4) informed consent, (5) confidentiality, 

and (6) supervisor ethics. 

Direct Versus Vicarious Liability 

An important distinction needs to be made between 

direct and vicarious liability. Direct liability of the 

supervisor might include dereliction of supervisory 

responsibility, such as “not making a reasonable 

effort to supervise” (defined below). 

13 
In vicarious liability, a supervisor can be held liable 

for damages incurred as a result of negligence in the 

supervision process. Examples of negligence include 

providing inappropriate advice to a counselor about a 

client (for instance, discouraging a counselor from 

conducting a suicide screen on a depressed client), 

failure to listen carefully to a supervisee’s comments 

about a client, and the assignment of clinical tasks to 

inadequately trained counselors. The key legal question is: “Did the supervisor conduct him- or herself in 

a way that would be reasonable for someone in his 

position?” or “Did the supervisor make a reasonable 

effort to supervise?” A generally accepted time standard for a “reasonable effort to supervise” in the 

behavioral health field is 1 hour of supervision for 

every 20–40 hours of clinical services. Of course, 

other variables (such as the quality and content of 

clinical supervision sessions) also play a role in a reasonable effort to supervise. 

Supervisory vulnerability increases when the counselor has been assigned too many clients, when there 

is no direct observation of a counselor’s clinical work, 

when staff are inexperienced or poorly trained for 

assigned tasks, and when a supervisor is not 

involved or not available to aid the clinical staff. In 

legal texts, vicarious liability is referred to as 

“respondeat superior.” 

Dual Relationships and Boundary 

Issues 

Dual relationships can occur at two levels: between 

supervisors and supervisees and between counselors 

and clients. You have a mandate to help your supervisees recognize and manage boundary issues. A dual 

relationship occurs in supervision when a supervisor 

has a primary professional role with a supervisee 

and, at an earlier time, simultaneously or later, 

engages in another relationship with the supervisee 

that transcends the professional relationship. 

Examples of dual relationships in supervision include 

providing therapy for a current or former supervisee, 

developing an emotional relationship with a supervisee or former supervisee, and becoming an 

Alcoholics Anonymous sponsor for a former supervisee. Obviously, there are varying degrees of harm 

or potential harm that might occur as a result of dual 

relationships, and some negative effects of dual relationships might not be apparent until later. 

Therefore, firm, always-or-never rules aren’t applicable. You have the responsibility of weighing with the 

counselor the anticipated and unanticipated effects of 

dual relationships, helping the supervisee’s selfreflective awareness when boundaries become 

blurred, when he or she is getting close to a dual relationship, or when he or she is crossing the line in the 

clinical relationship. 

Exploring dual relationship issues with counselors in 

clinical supervision can raise its own professional 

dilemmas. For instance, clinical supervision involves 

unequal status, power, and expertise between a 

supervisor and supervisee. Being the evaluator of a 

counselor’s performance and gatekeeper for training 

programs or credentialing bodies also might involve a 

dual relationship. Further, supervision can have therapy-like qualities as you explore countertransferential issues with supervisees, and there is an expectation of professional growth and self-exploration. What 

makes a dual relationship unethical in supervision is 

the abusive use of power by either party, the likelihood that the relationship will impair or injure the 

supervisor’s or supervisee’s judgment, and the risk of 

exploitation (see vignette 3 in chapter 2). 

The most common basis for legal action against counselors (20 percent of claims) and the most frequently 

heard complaint by certification boards against counselors (35 percent) is some form of boundary violation 

or sexual impropriety (Falvey, 2002b). (See the discussion of transference and countertransference on 

pp. 25–26.) 

Codes of ethics for most professions clearly advise 

that dual relationships between counselors and 

clients should be avoided. Dual relationships between 

counselors and supervisors are also a concern and are 

addressed in the substance abuse counselor codes and 

those of other professions as well. Problematic dual 

relationships between supervisees and supervisors 

might include intimate relationships (sexual and nonsexual) and therapeutic relationships, wherein the 

supervisor becomes the counselor’s therapist. Sexual 

involvement between the supervisor and supervisee 

can include sexual attraction, harassment, consensual 

(but hidden) sexual relationships, or intimate romantic relationships. Other common boundary issues 

include asking the supervisee to do favors, providing 

preferential treatment, socializing outside the work 

setting, and using emotional abuse to enforce power. 

14 Part 1, Chapter 1 
It is imperative that all parties understand what constitutes a dual relationship between supervisor and 

supervisee and avoid these dual relationships. Sexual 

relationships between supervisors and supervisees 

and counselors and clients occur far more frequently 

than one might realize (Falvey, 2002b). In many 

States, they constitute a legal transgression as well 

as an ethical violation. 

The decision tree presented in figure 5 (p. 16) indicates how a supervisor might manage a situation 

where he or she is concerned about a possible ethical 

or legal violation by a counselor. 

Informed Consent 

Informed consent is key to protecting the counselor 

and/or supervisor from legal concerns, requiring the 

recipient of any service or intervention to be sufficiently aware of what is to happen, and of the potential risks and alternative approaches, so that the person can make an informed and intelligent decision 

about participating in that service. The supervisor 

must inform the supervisee about the process of 

supervision, the feedback and evaluation criteria, and 

other expectations of supervision. The supervision 

contract should clearly spell out these issues. 

Supervisors must ensure that the supervisee has 

informed the client about the parameters of counseling and supervision (such as the use of live observation, video- or audiotaping). A sample template for 

informed consent is provided in Part 2, chapter 2 

(p. 106). 

Confidentiality 

In supervision, regardless of whether there is a written or verbal contract between the supervisor and 

supervisee, there is an implied contract and duty of 

care because of the supervisor’s vicarious liability. 

Informed consent and concerns for confidentiality 

should occur at three levels: client consent to treatment, client consent to supervision of the case, and 

supervisee consent to supervision (Bernard & 

Goodyear, 2004). In addition, there is an implied consent and commitment to confidentiality by supervisors to assume their supervisory responsibilities and 

institutional consent to comply with legal and ethical 

parameters of supervision. (See also the Code of 

Ethics of the Association for Counselor Education and 

Clinical Supervision and Professional Development 

Supervision [ACES], available online at 

http://www.acesonline.net/ethical_guidelines.asp). 

With informed consent and confidentiality comes a 

duty not to disclose certain relational communication. 

Limits of confidentiality of supervision session content should be stated in all organizational contracts 

with training institutions and credentialing bodies. 

Criteria for waiving client and supervisee privilege 

should be stated in institutional policies and discipline-specific codes of ethics and clarified by advice of 

legal counsel and the courts. Because standards of 

confidentiality are determined by State legal and legislative systems, it is prudent for supervisors to consult with an attorney to determine the State codes of 

confidentiality and clinical privileging. 

In the substance abuse treatment field, confidentiality for clients is clearly defined by Federal law: 42 

CFR, Part 2 and the Health Insurance Portability 

and Accountability Act (HIPAA). Key information is 

available at http://www.hipaa.samhsa.gov. Supervisors need to train counselors in confidentiality regulations and to adequately document their supervision, 

including discussions and directives, especially relating to duty-to-warn situations. Supervisors need to 

ensure that counselors provide clients with appropriate duty-to-warn information early in the counseling 

process and inform clients of the limits of confidentiality as part of the agency’s informed consent procedures. 

Under duty-to-warn requirements (e.g., child abuse, 

suicidal or homicidal ideation), supervisors need to be 

aware of and take action as soon as possible in situations in which confidentiality may need to be waived. 

Organizations should have a policy stating how clinical crises will be handled (Falvey, 2002b). What 

mechanisms are in place for responding to crises? In 

what timeframe will a supervisor be notified of a crisis situation? Supervisors must document all discussions with counselors concerning duty-to-warn and 

crises. At the onset of supervision, supervisors should 

ask counselors if there are any duty-to-warn issues of 

which the supervisor should be informed. 

New technology brings new confidentiality concerns. 

Websites now dispense information about substance 

abuse treatment and provide counseling services. 

With the growth in online counseling and supervision, the following concerns emerge: (a) how to main15 
16 Part 1, Chapter 1

tain confidentiality of information, (b) how to ensure 

the competence and qualifications of counselors providing online services, and (c) how to establish reporting requirements and duty to warn when services are 

conducted across State and international boundaries. 

New standards will need to be written to address 

these issues. (The National Board for Certified 

Counselors has guidelines for counseling by Internet 

at http://www.nbcc.org/AssetManagerFiles/ethics/ 

internetcounseling.pdf.) 

Supervisor Ethics 

In general, supervisors adhere to the same standards 

and ethics as substance abuse counselors with regard 

to dual relationship and other boundary violations. 

Supervisors will: 

•	 Uphold the highest professional standards of the 

field. 

•	 Seek professional help (outside the work setting) 

when personal issues interfere with their clinical 

and/or supervisory functioning. 

•	 Conduct themselves in a manner that models 

and sets an example for agency mission, vision, 

philosophy, wellness, recovery, and consumer 

satisfaction. 

•	 Reinforce zero tolerance for interactions that are 

not professional, courteous, and compassionate. 

•	 Treat supervisees, colleagues, peers, and clients 

with dignity, respect, and honesty. 

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

to the supervisory as well as the counseling 

relationship. 

Monitoring Performance 

The goal of supervision is to ensure quality care for 

the client, which entails monitoring the clinical performance of staff. Your first step is to educate supervisees in what to expect from clinical supervision. 

Once the functions of supervision are clear, you 

should regularly evaluate the counselor’s progress in 

meeting organizational and clinical goals as set 

forth in an Individual Development Plan (IDP) (see 

the section on IDPs below). As clients have an individual treatment plan, counselors also need a plan 

to promote skill development. 

Clinical Supervision and Professional Development 

Behavioral Contracting in 

Supervision 

Among the first tasks in supervision is to establish a 

contract for supervision that outlines realistic 

accountability for both yourself and your supervisee. 

The contract should be in writing and should include 

the purpose, goals, and objectives of supervision; the 

context in which supervision is provided; ethical and 

institutional policies that guide supervision and clinical practices; the criteria and methods of evaluation 

and outcome measures; the duties and responsibilities of the supervisor and supervisee; procedural considerations (including the format for taping and 

opportunities for live observation); and the supervisee’s scope of practice and competence. The contract 

for supervision should state the rewards for fulfillment of the contract (such as clinical privileges or 

increased compensation), the length of supervision 

sessions, and sanctions for noncompliance by either 

the supervisee or supervisor. The agreement should 

be compatible with the developmental needs of the 

supervisee and address the obstacles to progress (lack 

of time, performance anxiety, resource limitations). 

Once a behavioral contract has been established, the 

next step is to develop an IDP. 

Individual Development Plan 

The IDP is a detailed plan for supervision that 

includes the goals that you and the counselor wish to 

address over a certain time period (perhaps 3 

months). Each of you should sign and keep a copy of 

the IDP for your records. The goals are normally stated in terms of skills the counselor wishes to build or 

professional resources the counselor wishes to develop. These skills and resources are generally oriented 

to the counselor’s job in the program or activities that 

would help the counselor develop professionally. The 

IDP should specify the timelines for change, the 

observation methods that will be employed, expectations for the supervisee and the supervisor, the evaluation procedures that will be employed, and the activities that will be expected to improve knowledge and 

skills. An example of an IDP is provided in Part 2, 

chapter 2 (p. 122). 

As a supervisor, you should have your own IDP, 

based on the supervisory competencies listed in TAP 

21-A (CSAT, 2007), that addresses your training 

17 
goals. This IDP can be developed in cooperation with 

your supervisor, or in external supervision, peer 

input, academic advisement, or mentorship. 

Evaluation of Counselors 

Supervision inherently involves evaluation, building 

on a collaborative relationship between you and the 

counselor. Evaluation may not be easy for some 

supervisors. Although everyone wants to know how 

they are doing, counselors are not always comfortable 

asking for feedback. And, as most supervisors prefer 

to be liked, you may have difficulty giving clear, concise, and accurate evaluations to staff. 

The two types of evaluation are formative and summative. A formative evaluation is an ongoing status 

report of the counselor’s skill development, exploring 

the questions “Are we addressing the skills or competencies you want to focus on?” and “How do we assess 

your current knowledge and skills and areas for 

growth and development?” 

Summative evaluation is a more formal rating of the 

counselor’s overall job performance, fitness for the 

job, and job rating. It answers the question, “How 

does the counselor measure up?” Typically, summative evaluations are done annually and focus on the 

counselor’s overall strengths, limitations, and areas 

for future improvement. 

It should be acknowledged that supervision is inherently an unequal relationship. In most cases, the 

supervisor has positional power over the counselor. 

Therefore, it is important to establish clarity of purpose and a positive context for evaluation. Procedures 

should be spelled out in advance, and the evaluation 

process should be mutual, flexible, and continuous. 

The evaluation process inevitably brings up supervisee anxiety and defensiveness that need to be 

addressed openly. It is also important to note that 

each individual counselor will react differently to 

feedback; some will be more open to the process than 

others. 

There has been considerable research on supervisory 

evaluation, with these findings: 

•	 The supervisee’s confidence and efficacy are correlated with the quality and quantity of feedback the 

supervisor gives to the supervisee (Bernard & 

Goodyear, 2004). 

•	 Ratings of skills are highly variable between 

supervisors, and often the supervisor’s and supervisee’s ratings differ or conflict (Eby, 2007). 

•	 Good feedback is provided frequently, clearly, and 

consistently and is SMART (specific, measurable, 

attainable, realistic, and timely) (Powell & 

Brodsky, 2004). 

Direct observation of the counselor’s work is the 

desired form of input for the supervisor. Although 

direct observation has historically been the exception 

in substance abuse counseling, ethical and legal considerations and evidence support that direct observation as preferable. The least desirable feedback is 

unannounced observation by supervisors followed by 

vague, perfunctory, indirect, or hurtful delivery 

(Powell & Brodsky, 2004). 

Clients are often the best assessors of the skills of the 

counselor. Supervisors should routinely seek input 

from the clients as to the outcome of treatment. The 

method of seeking input should be discussed in the 

initial supervisory sessions and be part of the supervision contract. In a residential substance abuse 

treatment program, you might regularly meet with 

clients after sessions to discuss how they are doing, 

how effective the counseling is, and the quality of the 

therapeutic alliance with the counselor. (For examples of client satisfaction or input forms, search for 

Client-Directed Outcome-Informed Treatment and 

Training Materials at http://www.talkingcure.com.) 

Before formative evaluations begin, methods of evaluating performance should be discussed, clarified in 

the initial sessions, and included in the initial contract so that there will be no surprises. Formative 

evaluations should focus on changeable behavior and, 

whenever possible, be separate from the overall annual performance appraisal process. To determine the 

counselor’s skill development, you should use written 

competency tools, direct observation, counselor selfassessments, client evaluations, work samples (files 

and charts), and peer assessments. Examples of work 

samples and peer assessments can be found in 

Bernard and Goodyear (2004), Powell and Brodsky 

(2004), and Campbell (2000). It is important to 

acknowledge that counselor evaluation is essentially 

a subjective process involving supervisors’ opinions of 

the counselors’ competence. 

18 Part 1, Chapter 1 
Addressing Burnout and 

Compassion Fatigue 

Did you ever hear a counselor say, “I came into counseling for the right reasons. At first I loved seeing 

clients. But the longer I stay in the field, the harder 

it is to care. The joy seems to have gone out of my job. 

Should I get out of counseling as many of my colleagues are doing?” Most substance abuse counselors 

come into the field with a strong sense of calling and 

the desire to be of service to others, with a strong pull 

to use their gifts and make themselves instruments of 

service and healing. The substance abuse treatment 

field risks losing many skilled and compassionate 

healers when the life goes out of their work. Some 

counselors simply withdraw, care less, or get out of 

the field entirely. Most just complain or suffer in 

silence. Given the caring and dedication that brings 

counselors into the field, it is important for you to 

help them address their questions and doubts. (See 

Lambie, 2006, and Shoptaw, Stein, & Rawson, 2000.) 

You can help counselors with self-care; help them 

look within; become resilient again; and rediscover 

what gives them joy, meaning, and hope in their 

work. Counselors need time for reflection, to listen 

again deeply and authentically. You can help them 

redevelop their innate capacity for compassion, to be 

an openhearted presence for others. 

You can help counselors develop a life that does not 

revolve around work. This has to be supported by the 

organization’s culture and policies that allow for 

appropriate use of time off and self-care without punishment. Aid them by encouraging them to take 

earned leave and to take “mental health” days when 

they are feeling tired and burned out. Remind staff to 

spend time with family and friends, exercise, relax, 

read, or pursue other life-giving interests. 

It is important for the clinical supervisor to normalize 

the counselor’s reactions to stress and compassion 

fatigue in the workplace as a natural part of being an 

empathic and compassionate person and not an individual failing or pathology. (See Burke, Carruth, & 

Prichard, 2006.) 

Rest is good; self-care is important. Everyone needs 

times of relaxation and recreation. Often, a month 

after a refreshing vacation you lose whatever gain 

you made. Instead, longer term gain comes from finding what brings you peace and joy. It is not enough 

Clinical Supervision and Professional Development 

for you to help counselors understand “how” to counsel, you can also help them with the “why.” Why are 

they in this field? What gives them meaning and purpose at work? When all is said and done, when counselors have seen their last client, how do they want to 

be remembered? What do they want said about them 

as counselors? Usually, counselors’ responses to this 

question are fairly simple: “I want to be thought of as 

a caring, compassionate person, a skilled helper.” 

These are important spiritual questions that you can 

discuss with your supervisees. 

Other suggestions include: 

•		 Help staff identify what is happening within the 

organization that might be contributing to their 

stress and learn how to address the situation in a 

way that is productive to the client, the counselor, 

and the organization. 

•		 Get training in identifying the signs of primary 

stress reactions, secondary trauma, compassion 

fatigue, vicarious traumatization, and burnout. 

Help staff match up self-care tools to specifically 

address each of these experiences. 

•		 Support staff in advocating for organizational 

change when appropriate and feasible as part of 

your role as liaison between administration and 

clinical staff. 

•		 Assist staff in adopting lifestyle changes to 

increase their emotional resilience by reconnecting 

to their world (family, friends, sponsors, mentors), 

spending time alone for self-reflection, and forming habits that re-energize them. 

•		 Help them eliminate the “what ifs” and negative 

self-talk. Help them let go of their idealism that 

they can save the world. 

•		 If possible in the current work environment, set 

parameters on their work by helping them adhere 

to scheduled time off, keep lunch time personal, 

set reasonable deadlines for work completion, and 

keep work away from personal time. 

•		 Teach and support generally positive work habits. 

Some counselors lack basic organizational, teamwork, phone, and time management skills (ending 

sessions on time and scheduling to allow for documentation). The development of these skills helps 

to reduce the daily wear that erodes well-being 

and contributes to burnout. 

•		 Ask them “When was the last time you had fun?” 

“When was the last time you felt fully alive?” 

Suggest they write a list of things about their job 

19 
about which they are grateful. List five people 

they care about and love. List five accomplishments in their professional life. Ask “Where do you 

want to be in your professional life in 5 years?” 

You have a fiduciary responsibility given you by 

clients to ensure counselors are healthy and whole. It 

is your responsibility to aid counselors in addressing 

their fatigue and burnout. 

Gatekeeping Functions 

In monitoring counselor performance, an important 

and often difficult supervisory task is managing problem staff or those individuals who should not be counselors. This is the gatekeeping function. Part of the 

dilemma is that most likely you were first trained as 

a counselor, and your values lie within that domain. 

You were taught to acknowledge and work with individual limitations, always respecting the individual’s 

goals and needs. However, you also carry a responsibility to maintain the quality of the profession and to 

protect the welfare of clients. Thus, you are charged 

with the task of assessing the counselor for fitness for 

duty and have an obligation to uphold the standards 

of the profession. 

Experience, credentials, and academic performance 

are not the same as clinical competence. In addition 

to technical counseling skills, many important therapeutic qualities affect the outcome of counseling, 

including insight, respect, genuineness, concreteness, 

and empathy. Research consistently demonstrates 

that personal characteristics of counselors are highly 

predictive of client outcome (Herman, 1993, Hubble, 

Duncan & Miller, 1999). The essential questions are: 

Who should or should not be a counselor? What 

behaviors or attitudes are unacceptable? How would a 

clinical supervisor address these issues in supervision? 

Unacceptable behavior might include actions hurtful 

to the client, boundary violations with clients or program standards, illegal behavior, significant psychiatric impairment, consistent lack of self-awareness, 

inability to adhere to professional codes of ethics, or 

consistent demonstration of attitudes that are not 

conducive to work with clients in substance abuse 

treatment. You will want to have a model and policies 

and procedures in place when disciplinary action is 

undertaken with an impaired counselor. For example, 

progressive disciplinary policies clearly state the procedures to follow when impairment is identified. 

Consultation with the organization’s attorney and 

familiarity with State case law are important. It is 

advisable for the agency to be familiar with and have 

contact with your State impaired counselor organization, if it exists. 

How impaired must a counselor be before disciplinary 

action is needed? Clear job descriptions and statements of scope of practice and competence are important when facing an impaired counselor. How tired or 

distressed can a counselor be before a supervisor 

takes the counselor off-line for these or similar reasons? You need administrative support with such 

interventions and to identify approaches to managing 

worn-out counselors. The Consensus Panel recommends that your organization have an employee 

assistance program (EAP) in place so you can refer 

staff outside the agency. It is also important for you 

to learn the distinction between a supervisory referral and a self-referral. Self-referral may include a 

recommendation by the supervisor, whereas a supervisory referral usually occurs with a job performance 

problem. 

You will need to provide verbal and written evaluations of the counselor’s performance and actions to 

ensure that the staff member is aware of the behaviors that need to be addressed. Treat all supervisees 

the same, following agency procedures and timelines. 

Follow the organization’s progressive disciplinary 

steps and document carefully what is said, how the 

person responds, and what actions are recommended. 

You can discuss organizational issues or barriers to 

action with the supervisee (such as personnel policies 

that might be exacerbating the employee’s issues). 

Finally, it may be necessary for you to take the action 

that is in the best interest of the clients and the profession, which might involve counseling your supervisee out of the field. 

Remember that the number one goal of a clinical 

supervisor is to protect the welfare of the client, 

which, at times, can mean enforcing the gatekeeping 

function of supervision. 

Methods of Observation 

It is important to observe counselors frequently over 

an extended period of time. Supervisors in the substance abuse treatment field have traditionally relied 

20 Part 1, Chapter 1 
on indirect methods of supervision (process recordings, case notes, verbal reports by the supervisees, 

and verbatims). However, the Consensus Panel recommends that supervisors use direct observation of 

counselors through recording devices (such as video 

and audio taping) and live observation of counseling 

sessions, including one-way mirrors. Indirect methods 

have significant drawbacks, including: 

•		 A counselor will recall a session as he or she experienced it. If a counselor experiences a session positively or negatively, the report to the supervisor 

will reflect that. The report is also affected by the 

counselor’s level of skill and experience. 

•		 The counselor’s report is affected by his or her 

biases and distortions (both conscious and unconscious). The report does not provide a thorough 

sense of what really happened in the session 

because it relies too heavily on the counselor’s 

recall. 

•		 Indirect methods include a time delay in 

reporting. 

•		 The supervisee may withhold clinical information 

due to evaluation anxiety or naiveté. 

Your understanding of the session will be improved 

by direct observation of the counselor. Direct observation is much easier today, as a variety of technological tools are available, including audio and videotaping, remote audio devices, interactive videos, live 

feeds, and even supervision through web-based cameras. 

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

•		 Simply by observing a counseling session, the 

dynamics will change. You may change how both 

the client and counselor act. You get a snapshot of 

the sessions. Counselors will say, “it was not a 

representative session.” Typically, if you observe 

the counselor frequently, you will get a fairly accurate picture of the counselor’s competencies. 

•		 You and your supervisee must agree on procedures 

for observation to determine why, when, and how 

direct methods of observation will be used. 

•		 The counselor should provide a context for the 

session. 

•		 The client should give written consent for observation and/or taping at intake, before beginning 

counseling. Clients must know all the conditions of 

Clinical Supervision and Professional Development 

their treatment before they consent to counseling. 

Additionally, clients need to be notified of an 

upcoming observation by a supervisor before the 

observation occurs. 

•		 Observations should be selected for review (including a variety of sessions and clients, challenges, 

and successes) because they provide teaching 

moments. You should ask the supervisee to select 

what cases he or she wishes you to observe and 

explain why those cases were chosen. Direct observation should not be a weapon for criticism but a 

constructive tool for learning: an opportunity for 

the counselor to do things right and well, so that 

positive feedback follows. 

•		 When observing a session, you gain a wealth of 

information about the counselor. Use this information wisely, and provide gradual feedback, not a 

litany of judgments and directives. Ask the salient 

question, “What is the most important issue here 

for us to address in supervision?” 

•		 A supervisee might claim client resistance to 

direct observation, saying, “It will make the client 

nervous. The client does not want to be taped.” 

However, “client resistance” is more likely to be 

reported when the counselor is anxious about 

being taped. It is important for you to gently and 

respectfully address the supervisee’s resistance 

while maintaining the position that direct observation is an integral component of his or her 

supervision. 

•		 Given the nature of the issues in drug and alcohol counseling, you and your supervisee need to 

be sensitive to increased client anxiety about 

direct observation because of the client’s fears 

about job or legal repercussions, legal actions, 

criminal behaviors, violence and abuse situations, and the like. 

•		 Ideally, the supervisee should know at the outset 

of employment that observation and/or taping 

will be required as part of informed consent to 

supervision. 

In instances where there is overwhelming anxiety 

regarding observation, you should pace the observation to reduce the anxiety, giving the counselor adequate time for preparation. Often enough, counselors 

will feel more comfortable with observation equipment (such as a video camera or recording device) 

rather than direct observation with the supervisor in 

the room. 

21 
The choice of observation methods in a particular situation will depend on the need for an accurate sense 

of counseling, the availability of equipment, the context in which the supervision is provided, and the 

counselor’s and your skill levels. A key factor in the 

choice of methods might be the resistance of the counselor to being observed. For some supervisors, direct 

observation also puts the supervisor’s skills on the 

line too, as they might be required to demonstrate or 

model their clinical competencies. 

Recorded Observation 

Audiotaped supervision has traditionally been a primary medium for supervisors and remains a vital 

resource for therapy models such as motivational 

interviewing. On the other hand, videotape supervision (VTS) is the primary method of direct observation in both the marriage and family therapy and 

social work fields (Munson, 1993; Nichols, Nichols, & 

Hardy, 1990). Video cameras are increasingly commonplace in professional settings. VTS is easy, accessible, and inexpensive. However, it is also a complex, 

powerful and dynamic tool, and one that can be challenging, threatening, anxiety-provoking, and humbling. Several issues related to VTS are unique to the 

substance abuse field: 

•		 Many substance abuse counselors “grew up” in the 

field without taping and may be resistant to the 

medium; 

•		 Many agencies operate on limited budgets and 

administrators may see the expensive equipment 

as prohibitive and unnecessary; and 

•		 Many substance abuse supervisors have not been 

trained in the use of videotape equipment or in VTS. 

Yet, VTS offers nearly unlimited potential for creative 

use in staff development. To that end, you need training in how to use VTS effectively. The following are 

guidelines for VTS: 

•		 Clients must sign releases before taping. Most programs have a release form that the client signs on 

admission (see Tool 19 in Part 2, chapter 2). The 

supervisee informs the client that videotaping will 

occur and reminds the client about the signed 

release form. The release should specify that the 

taping will be done exclusively for training purposes and will be reviewed only by the counselor, the 

supervisor, and other supervisees in group supervision. Permission will most likely be granted if 

the request is made in a sensitive and appropriate 

manner. It is critical to note that even if permission is initially given by the client, this permission 

can be withdrawn. You cannot force compliance. 

•		 The use and rationale for taping needs to be clearly explained to clients. This will forestall a client’s 

questioning as to why a particular session is being 

taped. 

•		 Risk-management considerations in today’s litigious climate necessitate that tapes be erased 

after the supervision session. Tapes can be admissible as evidence in court as part of the clinical 

record. Since all tapes should be erased after 

supervision, this must be stated in agency policies. 

If there are exceptions, those need to be described. 

•		 Too often, supervisors watch long, uninterrupted 

segments of tape with little direction or purpose. 

To avoid this, you may want to ask your supervisee to cue the tape to the segment he or she 

wishes to address in supervision, focusing on the 

goals established in the IDP. Having said this, listening only to segments selected by the counselor 

can create some of the same disadvantages as selfreport: the counselor chooses selectively, even if 

not consciously. The supervisor may occasionally 

choose to watch entire sessions. 

•		 You need to evaluate session flow, pacing, and 

how counselors begin and end sessions. 

Some clients may not be comfortable being videotaped 

but may be more comfortable with audio taping. 

Videotaping is not permitted in most prison settings 

and EAP services. Videotaping may not be advisable 

when treating patients with some diagnoses, such as 

paranoia or some schizophrenic illnesses. In such 

cases, either live observation or less intrusive measures, such as audio taping, may be preferred. 

Live Observation 

With live observation you actually sit in on a counseling session with the supervisee and observe the session first hand. The client will need to provide 

informed consent before being observed. Although 

one-way mirrors are not readily available at most 

agencies, they are an alternative to actually sitting in 

on the session. A videotape may also be used either 

22 Part 1, Chapter 1 
from behind the one-way mirror (with someone else 

operating the videotaping equipment) or physically 

located in the counseling room, with the supervisor 

sitting in the session. This combination of mirror, 

videotaping, and live observation may be the best of 

all worlds, allowing for unobtrusive observation of a 

session, immediate feedback to the supervisee, modeling by the supervisor (if appropriate), and a record of 

the session for subsequent review in supervision. Live 

supervision may involve some intervention by the 

supervisor during the session. 

Live observation is effective for the following reasons: 

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

in action. 

•		 It gives you an opportunity to model techniques 

during an actual session, thus serving as a role 

model for both the counselor and the client. 

•		 Should a session become countertherapeutic, you 

can intervene for the well-being of the client. 

•		 Counselors often say they feel supported when a 

supervisor joins the session, and clients periodically say, “This is great! I got two for the price of 

one.” 

•		 It allows for specific and focused feedback. 

•		 It is more efficient for understanding the counseling process. 

•		 It helps connect the IDP to supervision. 

To maximize the effectiveness of live observation, 

supervisors must stay primarily in an observer role 

so as to not usurp the leadership or undercut the 

credibility and authority of the counselor. 

Live observation has some disadvantages: 

•		 It is time consuming. 

•		 It can be intrusive and alter the dynamics of the 

counseling session. 

•		 It can be anxiety-provoking for all involved. 

Some mandated clients may be particularly sensitive 

to live observation. This becomes essentially a clinical 

issue to be addressed by the counselor with the client. 

Where is this anxiety coming from, how does it relate 

to other anxieties and concerns, and how can it best 

be addressed in counseling? 

Supervisors differ on where they should sit in a live 

Clinical Supervision and Professional Development 

observation session. Some suggest that the supervisor 

sit so as to not interrupt or be involved in the session. 

Others suggest that the supervisor sit in a position 

that allows for inclusion in the counseling process. 

Here are some guidelines for conducting live 

observation: 

•		 The counselor should always begin with informed 

consent to remind the client about confidentiality. 

Periodically, the counselor should begin the session with a statement of confidentiality, reiterating the limits of confidentiality and the duty to 

warn, to ensure that the client is reminded of 

what is reportable by the supervisor and/or 

counselor. 

•		 While sitting outside the group (or an individual 

session between counselor and client) may undermine the group process, it is a method selected by 

some. Position yourself in a way that doesn’t interrupt the counseling process. Sitting outside the 

group undermines the human connection between 

you, the counselor, and the client(s) and makes it 

more awkward for you to make a comment, if you 

have not been part of the process until then. For 

individual or family sessions, it is also recommended that the supervisor sit beside the counselor to fully observe what is occurring in the 

counseling session. 

•		 The client should be informed about the process of 

supervision and the supervisor’s role and goals, 

essentially that the supervisor is there to observe 

the counselor’s skills and not necessarily the 

client. 

•		 As preparation, the supervisor and supervisee 

should briefly discuss the background of the session, the salient issues the supervisee wishes to 

focus on, and the plans for the session. The role of 

the supervisor should be clearly stated and agreed 

on before the session. 

•		 You and the counselor may create criteria for 

observation, so that specific feedback is provided 

for specific areas of the session. 

•		 Your comments during the session should be limited to lessen the risk of disrupting the flow or taking control of the session. Intervene only to protect 

the welfare of the client (should something 

adverse occur in the session) or if a moment critical to client welfare arises. In deciding to inter23 
vene or not, consider these questions: What are 

the consequences if I don’t intervene? What is the 

probability that the supervisee will make the 

intervention on his or her own or that my comments will be successful? Will I create an undue 

dependence on the part of clients or supervisee? 

•		 Provide feedback to the counselor as soon as possible after the session. Ideally, the supervisor and 

supervisee(s) should meet privately immediately 

afterward, outlining the key points for discussion 

and the agenda for the next supervision session, 

based on the observation. Specific feedback is 

essential; “You did a fine job” is not sufficient. 

Instead, the supervisor might respond by saying, 

“I particularly liked your comment about . . .” or 

“What I observed about your behavior was . . .” or 

“Keep doing more of . . . .” 

Practical Issues in Clinical 

Supervision 

Distinguishing Between 

Supervision and Therapy 

In facilitating professional development, one of the 

critical issues is understanding and differentiating 

between counseling the counselor and providing 

supervision. In ensuring quality client care and facilitating professional counselor development, the 

process of clinical supervision sometimes encroaches 

on personal issues. The dividing line between therapy 

and supervision is how the supervisee’s personal 

issues and problems affect their work. The goal of 

clinical supervision must always be to assist counselors in becoming better clinicians, not seeking to 

resolve their personal issues. Some of the major differences between supervision and counseling are 

summarized in figure 6. 

Figure 6. Differences Between Supervision and Counseling 

Clinical Supervision Administrative 

Supervision Counseling 

Purpose • Improved client care 

• Improved job performance 

• Ensure compliance with 

agency and regulatory 

body's policies and procedures 

• Personal growth 

• Behavior changes 

• Better self-understanding 

Outcome • Enhanced proficiency in 

knowledge, skills, and 

attitudes essential to 

effective job performance 

• Consistent use of 

approved formats, policies, and procedures 

• Open-ended, based on 

client needs 

Timeframe • Short-term and ongoing • Short-term and ongoing • Based on client needs 

Agenda • Based on agency mission 

and counselor needs 

• Based on agency needs • Based on client needs 

Basic Process • Teaching/learning specific skills, evaluating job 

performance, negotiating learning objectives 

• Clarifying agency expectations, policies and procedures, ensuring compliance • Behavioral, cognitive, 

and affective process 

including listening, 

exploring, teaching 

Source: Adapted from Dixon, 2004 

24 Part 1, Chapter 1 
The boundary between counseling and clinical supervision may not always be clearly marked, for it is necessary, at times, to explore supervisees’ limitations as 

they deliver services to their clients. Address counselors’ personal issues only in so far as they create 

barriers or affect their performance. When personal 

issues emerge, the key question you should ask the 

supervisee is how does this affect the delivery of quality client care? What is the impact of this issue on the 

client? What resources are you using to resolve this 

issue outside of the counseling dyad? When personal 

issues emerge that might interfere with quality care, 

your role may be to transfer the case to a different 

counselor. Most important, you should make a strong 

case that the supervisee should seek outside counseling or therapy. 

Problems related to countertransference (projecting 

unresolved personal issues onto a client or supervisee) often make for difficult therapeutic relationships. The following are signs of countertransference 

to look for: 

•		 A feeling of loathing, anxiety, or dread at the 

prospect of seeing a specific client or supervisee. 

•		 Unexplained anger or rage at a particular client. 

•		 Distaste for a particular client. 

•		 Mistakes in scheduling clients, missed appointments. 

•		 Forgetting client’s name, history. 

•		 Drowsiness during a session or sessions ending 

abruptly. 

•		 Billing mistakes. 

•		 Excessive socializing. 

When countertransferential issues between counselor 

and client arise, some of the important questions you, 

as a supervisor, might explore with the counselor 

include: 

•		 How is this client affecting you? What feelings 

does this client bring out in you? What is your 

behavior toward the client in response to these 

feelings? What is it about the substance abuse 

behavior of this client that brings out a response 

in you? 

•		 What is happening now in your life, but more particularly between you and the client that might be 

contributing to these feelings, and how does this 

affect your counseling? 

Clinical Supervision and Professional Development 

•		 In what ways can you address these issues in your 

counseling? 

•		 What strategies and coping skills can assist you in 

your work with this client? 

Transference and countertransference also occur in 

the relationship between supervisee and supervisor. 

Examples of supervisee transference include: 

•		 The supervisee’s idealization of the supervisor. 

•		 Distorted reactions to the supervisor based on the 

supervisee’s reaction to the power dynamics of the 

relationship. 

•		 The supervisee’s need for acceptance by or 

approval from an authority figure. 

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

supervisee. 

Supervisor countertransference with supervisees is 

another issue that needs to be considered. Categories 

of supervisor countertransference include: 

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

•		 Unresolved personal conflicts of the supervisor 

activated by the supervisory relationship. 

•		 Reactions to individual supervisees, such as dislike or even disdain, whether the negative 

response is “legitimate” or not. In a similar vein, 

aggrandizing and idealizing some supervisees 

(again, whether or not warranted) in comparison 

to other supervisees. 

•		 Sexual or romantic attraction to certain supervisees. 

•		 Cultural countertransference, such as catering to 

or withdrawing from individuals of a specific cultural background in a way that hinders the professional development of the counselor. 

To understand these countertransference reactions 

means recognizing clues (such as dislike of a supervisee or romantic attraction), doing careful self-examination, personal counseling, and receiving supervision of your supervision. In some cases, it may be necessary for you to request a transfer of supervisees 

with whom you are experiencing countertransference, 

if that countertransference hinders the counselor’s 

professional development. 

25 
Finally, counselors will be more open to addressing 

difficulties such as countertransference and compassion fatigue with you if you communicate understanding and awareness that these experiences are a normal part of being a counselor. Counselors should be 

rewarded in performance evaluations for raising 

these issues in supervision and demonstrating a willingness to work on them as part of their professional 

development. 

Balancing Clinical and 

Administrative Functions 

In the typical substance abuse treatment agency, the 

clinical supervisor may also be the administrative 

supervisor, responsible for overseeing managerial 

functions of the organization. Many organizations 

cannot afford to hire two individuals for these tasks. 

Hence, it is essential that you are aware of what role 

you are playing and how to exercise the authority 

given you by the administration. Texts on supervision 

sometimes overlook the supervisor’s administrative 

tasks, but supervisors structure staff work; evaluate 

personnel for pay and promotions; define the scope of 

clinical competence; perform tasks involving planning, organizing, coordinating, and delegating work; 

select, hire, and fire personnel; and manage the 

organization. Clinical supervisors are often responsible for overseeing the quality assurance and improvement aspects of the agency and may also carry a caseload. For most of you, juggling administrative and 

clinical functions is a significant balancing act. Tips 

for juggling these functions include: 

•		 Try to be clear about the “hat you are wearing.” 

Are you speaking from an administrative or clinical perspective? 

•		 Be aware of your own biases and values that may 

be affecting your administrative opinions. 

•		 Delegate the administrative functions that you 

need not necessarily perform, such as human 

resources, financial, or legal functions. 

•		 Get input from others to be sure of your objectivity 

and your perspective. 

There may be some inherent problems with performing both functions, such as dual relationships. 

Counselors may be cautious about acknowledging difficulties they face in counseling because these may 

affect their performance evaluation or salary raises. 

On the other hand, having separate clinical and 

administrative supervisors can lead to inconsistent 

messages about priorities, and the clinical supervisor is not in the chain of command for disciplinary 

purposes. 

Finding the Time To Do Clinical 

Supervision 

Having read this far, you may be wondering, “Where 

do I find the time to conduct clinical supervision as 

described here? How can I do direct observation of 

counselors within my limited time schedule?” Or, 

“I work in an underfunded program with substance 

abuse clients. I have way too many tasks to also 

observe staff in counseling.” 

One suggestion is to begin an implementation process 

that involves adding components of a supervision 

model one at a time. For example, scheduling supervisory meetings with each counselor is a beginning 

step. It is important to meet with each counselor on a 

regular, scheduled basis to develop learning plans 

and review professional development. Observations of 

counselors in their work might be added next. 

Another component might involve group supervision. 

In group supervision, time can be maximized by 

teaching and training counselors who have common 

skill development needs. 

As you develop a positive relationship with supervisees based on cooperation and collaboration, the 

anxiety associated with observation will decrease. 

Counselors frequently enjoy the feedback and support 

so much that they request observation of their work. 

Observation can be brief. Rather than sitting in on a 

full hour of group, spend 20 minutes in the observation and an additional 20 providing feedback to the 

counselor. 

Your choice of modality (individual, group, peer, etc.) 

is influenced by several factors: supervisees’ learning 

goals, their experience and developmental levels, 

their learning styles, your goals for supervisees, your 

theoretical orientation, and your own learning goals 

for the supervisory process. To select a modality of 

supervision (within your time constraints and those 

of your supervisee), first pinpoint the immediate function of supervision, as different modalities fit different functions. For example, a supervisor might wish 

to conduct group supervision when the team is intact 

and functioning well, and individual supervision 

26 Part 1, Chapter 1 
when specific skill development or countertransferential issues need additional attention. Given the variety of treatment environments in substance abuse 

treatment (e.g., therapeutic communities, intensive 

outpatient services, transitional living settings, correctional facilities) and varying time constraints on 

supervisors, several alternatives to structure supervision are available. 

Peer supervision is not hierarchical and does not 

include a formal evaluation procedure, but offers a 

means of accountability for counselors that they 

might not have in other forms of supervision. Peer 

supervision may be particularly significant among 

well-trained, highly educated, and competent counselors. Peer supervision is a growing medium, given 

the clinical supervisors’ duties. Although peer supervision has received limited attention in literature, the 

Consensus Panel believes it is a particularly effective 

method, especially for small group practices and 

agencies with limited funding for supervision. Peer 

supervision groups can evolve from supervisor-led 

groups or individual sessions to peer groups or can 

begin as peer supervision. For peer supervision 

groups offered within an agency, there may be some 

history to overcome among the group members, such 

as political entanglements, competitiveness, or personality concerns. (Bernard and Goodyear [2004] has 

an extensive review of the process and the advantages and disadvantages of peer supervision.) 

Triadic supervision is a tutorial and mentoring relationship among three counselors. This model of 

supervision involves three counselors who, on a 

rotating basis, assume the roles of the supervisee, 

the commentator, and the supervision session facilitator. Spice and Spice (1976) describe peer supervision with three supervisees getting together. In current counseling literature, triadic supervision 

involves two counselors with one supervisor. There is 

very little empirical or conceptual literature on this 

arrangement. 

Individual supervision, where a supervisor works 

with the supervisee in a one-to-one relationship, is 

considered the cornerstone of professional skill 

development. Individual supervision is the most 

labor-intensive and time-consuming method for 

supervision. Credentialing requirements in a particular discipline or graduate studies may mandate 

individual supervision with a supervisor from the 

same discipline. 

Clinical Supervision and Professional Development 

Intensive supervision with selected counselors is helpful in working with a difficult client (such as one with 

a history of violence), a client using substances unfamiliar to the counselor, or a highly resistant client. 

Because of a variety of factors (credentialing requirements, skill deficits of some counselors, the need for 

close clinical supervision), you may opt to focus, for 

concentrated periods of time, on the needs of one or 

two counselors as others participate in peer supervision. Although this is not necessarily a long-term 

solution to the time constraints of a supervisor, intensive supervision provides an opportunity to address 

specific staffing needs while still providing a “reasonable effort to supervise” all personnel. 

Group clinical supervision is a frequently used and 

efficient format for supervision, team building, and 

staff growth. One supervisor assists counselor development in a group of supervisee peers. The recommended group size is four to six persons to allow for 

frequent case presentations by each group member. 

With this number of counselors, each person can 

present a case every other month—an ideal situation, 

especially when combined with individual and/or peer 

supervision. The benefits of group supervision are 

that it is cost-effective, members can test their perceptions through peer validation, learning is 

enhanced by the diversity of the group, it creates a 

working alliance and improves teamwork, and it provides a microcosm of group process for participants. 

Group supervision gives counselors a sense of commonality with others in the same situation. Because 

the formats and goals differ, it is helpful to think 

through why you are using a particular format. 

(Examples of group formats with different goals can 

be found in Borders and Brown, 2005, and Bernard & 

Goodyear, 2004.) 

Given the realities of the substance abuse treatment 

field (limited funding, priorities competing for time, 

counselors and supervisors without advanced academic training, and clients with pressing needs in a 

brief-treatment environment), the plan described 

below may be a useful structure for supervision. It is 

based on a scenario where a supervisor oversees one 

to five counselors. This plan is based on several 

principles: 

•		 All counselors, regardless of years of experience or 

academic training, will receive at least 1 hour of 

supervision for every 20 to 40 hours of clinical 

practice. 

27 
•		 Direct observation is the backbone of a solid clinical supervision model. 

•		 Group supervision is a viable means of engaging 

all staff in dialog, sharing ideas, and promoting 

team cohesion. 

With the formula diagramed below, each counselor 

receives a minimum of 1 hour of group clinical supervision per week. Each week you will have 1 hour of 

observation, 1 hour of individual supervision with one 

of your supervisees, and 1 hour of group supervision 

with five supervisees. Each week, one counselor will 

be observed in an actual counseling session, followed 

by an individual supervision session with you. If the 

session is videotaped, the supervisee can be asked to 

cue the tape to the segment of the session he or she 

wishes to discuss with you. Afterwards, the observed 

counselor presents this session in group clinical 

supervision. 

When it is a counselor’s week to be observed or taped 

and meet for individual supervision, he or she will 

receive 3 hours of supervision: 1 hour of direct observation, 1 hour of individual/one-on-one supervision, 

and 1 hour of group supervision when he or she presents a case to the group. Over the course of months, 

with vacation, holiday, and sick time, it should average out to approximately 1 hour of supervision per 

counselor per week. Figure 7 shows this schedule. 

Figure 7. Sample Clinical Supervision Schedule 

Counselor Week 1 Week 2 Week 3 Week 4 Week 5 

A 

1 hour direct observation 

1 hour individual supervision 

1 hour group supervision of A’s case 

(3 hours) 

1 hour group 1 hour group 1 hour group 1 hour group 

B 1 hour group 3 hour group 1 hour group 1 hour group 1 hour group 

C 1 hour group 1 hour group 3 hour group 1 hour group 1 hour group 

D 1 hour group 1 hour group 1 hour group 3 hour group 1 hour group 

E 1 hour group 1 hour group 1 hour group 1 hour group 3 hour group 

When you are working with a counselor who needs 

special attention or who is functioning under specific 

requirements for training or credentialing, 1 additional hour per week can be allocated for this counselor, 

increasing the total hours for clinical supervision to 4, 

still a manageable amount of time. 

Documenting Clinical Supervision 

Correct documentation and recordkeeping are essential aspects of supervision. Mechanisms must be in 

place to demonstrate the accountability of your role. 

(See Tools 10–12 in Part 2, chapter 2.) These systems 

should document: 

•		 Informal and formal evaluation procedures. 

•		 Frequency of supervision, issues discussed, and 

the content and outcome of sessions. 

•		 Due process rights of supervisees (such as the 

right to confidentiality and privacy, to informed 

consent). 

•		 Risk management issues (how to handle 

crises, duty-to-warn situations, breaches of 

confidentiality). 

One comprehensive documentation system is Falvey’s 

(2002a) Focused Risk Management Supervision 

System (FoRMSS), which provides templates to 

record emergency contact information, supervisee 

profiles, a logging sheet for supervision, an initial 

case review, supervision records, and a client termination form. 

Supervisory documents and notes are open to management, administration, and human resources (HR) 

personnel for performance appraisal and merit pay 

increases and are admissible in court proceedings. 

Supervision notes, especially those related to work 

28 Part 1, Chapter 1 
with clients, are kept separately and are intended for 

the supervisor’s use in helping the counselor improve 

clinical skills and monitor client care. It is imperative 

to maintain accurate and complete notes on the 

supervision. However, as discussed above, documentation procedures for formative versus summative 

evaluation of staff may vary. Typically, HR accesses 

summative evaluations, and supervisory notes are 

maintained as formative evaluations. 

An example of a formative note by a supervisor might 

be “The counselor responsibly discussed countertransferential issues occurring with a particular client and 

was willing to take supervisory direction,” or “We 

worked out an action plan, and I will follow this 

closely.” This wording avoids concerns by the supervisor and supervisee as to the confidentiality of supervisory notes. From a legal perspective, the supervisor 

needs to be specific about what was agreed on and a 

timeframe for following up. 

Structuring the Initial Supervision 

Sessions 

As discussed earlier, your first tasks in clinical supervision are to establish a behavioral contract, get to 

know your supervisees, and outline the requirements 

of supervision. Before the initial session, you should 

send a supportive letter to the supervisee expressing 

the agency’s desire to provide him or her with a quality clinical supervision experience. You might request 

that the counselor give some thought to what he or 

she would like to accomplish in supervision, what 

skills to work on, and which core functions used in 

the addiction counselor certification process he or she 

feels most comfortable performing. 

In the first few sessions, helpful practices include: 

•		 Briefly describe your role as both administrative 

and clinical supervisor (if appropriate) and discuss 

these distinctions with the counselor. 

•		 Briefly describe your model of counseling and 

learn about the counselor’s frameworks and models for her or his counseling practice. For beginning counselors this may mean helping them 

define their model. 

•		 Describe your model of supervision. 

•		 State that disclosure of one’s supervisory training, 

experience, and model is an ethical duty of clinical 

supervisors. 

Clinical Supervision and Professional Development 

•		 Discuss methods of supervision, the techniques to 

be used, and the resources available to the supervisee (e.g., agency inservice seminar, community 

workshops, professional association memberships, 

and professional development funds or training 

opportunities). 

•		 Explore the counselor’s goals for supervision and 

his or her particular interests (and perhaps some 

fears) in clinical supervision. 

•		 Explain the differences between supervision and 

therapy, establishing clear boundaries in this 

relationship. 

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

•		 Create an opportunity for rating the counselor’s 

knowledge and skills based on the competencies in 

TAP 21 (CSAT, 2007). 

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

•		 Discuss the legal and ethical expectations and 

responsibilities of supervision. 

•		 Take time to decrease the anxiety associated with 

being supervised and build a positive working 

relationship. 

It is important to determine the knowledge and skills, 

learning style, and conceptual skills of your supervisees, along with their suitability for the work setting, motivation, self-awareness, and ability to function autonomously. A basic IDP for each supervisee 

should emerge from the initial supervision sessions. 

You and your supervisee need to assess the learning 

environment of supervision by determining: 

•		 Is there sufficient challenge to keep the supervisee 

motivated? 

•		 Are the theoretical differences between you and 

the supervisee manageable? 

•		 Are there limitations in the supervisee’s knowledge and skills, personal development, self-efficacy, self-esteem, and investment in the job that 

would limit the gains from supervision? 

•		 Does the supervisee possess the affective qualities 

(empathy, respect, genuineness, concreteness, 

warmth) needed for the counseling profession? 

•		 Are the goals, means of supervision, evaluation 

criteria, and feedback process clearly understood 

by the supervisee? 

•		 Does the supervisory environment encourage and 

allow risk taking? 

29 
Methods and Techniques 

of Clinical Supervision 

A number of methods and techniques are available 

for clinical supervision, regardless of the modality 

used. Methods include (as discussed previously) case 

consultation, written activities such as verbatims and 

process recordings, audio and videotaping, and live 

observation. Techniques include modeling, skill 

demonstrations, and role playing. (See descriptions of 

these and other methods and techniques in Bernard 

& Goodyear, 2004; Borders & Brown, 2005; Campbell, 

2000; and Powell & Brodsky, 2004.) Figure 8 outlines 

some of the methods and techniques of supervision, 

as well as the advantages and disadvantages of each 

method. 

Figure 8. Methods and Techniques in Clinical Supervision 

Description Advantages Disadvantages 

Verbal Reports Verbal reports of clinical 

situations 

Group discussion of clinical 

situations 

• Informal 

• Time efficient 

• Often spontaneous in 

response to clinical situation 

• Can hear counselor’s report, 

what he or she includes, thus 

learn of the counselor’s 

awareness and perspective, 

what he or she wishes to 

report, contrasted with supervisory observations 

• Sessions seen through eyes 

of beholder 

• Nonverbal cues missed 

• Can drift into case management, hence it is important 

to focus on the clinical 

nature of chart reviews, 

reports, etc., linking to the 

treatment plan and EBPs 

Verbatim Reports Process recordings 

Verbatim written record of a 

session or part of session 

Declining method in the 

behavioral health field 

• Helps track coordination and 

use of treatment plan with 

ongoing session 

• Enhances conceptualization 

and writing skills 

• Enhances recall and reflection 

skills 

• Provides written documentation of sessions 

• Nonverbal cues missed 

• Self-report bias 

• Can be very tedious to write 

and to read 

Written/File 

Review 

Review of the progress 

notes, charts, documentation 

• An important task of a supervisor to ensure compliance 

with accreditation standards 

for documentation 

• Provides a method of quality 

control 

• Ensures consistency of records 

and files 

• Time consuming 

• Notes often miss the overall 

quality and essence of the 

session 

• Can drift into case management rather than clinical 

skills development 

The context in which supervision is provided affects 

how it is carried out. A critical issue is how to manage your supervisory workload and make a reasonable effort to supervise. The contextual issues that 

shape the techniques and methods of supervision 

include: 

•	 The allocation of time for supervision. If the 20:1 

rule of client hours to supervision time is followed, 

you will want to allocate sufficient time for supervision each week so that it is a high priority, regularly scheduled activity. 

•	 The unique conditions, limitations, and requirements of the agency. Some organizations may lack 

the physical facilities or hardware to use videotaping or to observe sessions. Some organizations 

may be limited by confidentiality requirements, 

30 Part 1, Chapter 1 
Figure 8. Methods and Techniques in Clinical Supervision (continued) 

Description Advantages Disadvantages 

Case 

Consultation/ 

Case 

Management 

Discussion of cases 

Brief case reviews 

• Helps organize information, 

conceptualize problems, and 

decide on clinical interventions 

• Examines issues (e.g., cross-cultural issues), integrates theory 

and technique, and promotes 

greater self-awareness 

• An essential component of 

treatment planning 

• The validity of self-report is 

dependent on counselor 

developmental level and the 

supervisor’s insightfulness 

• Does not reflect broad range 

of clinical skills of the counselor 

Direct 

Observation 

The supervisor watches the 

session and may provide 

periodic but limited comments and/or suggestions 

to the clinician 

• Allows teaching of basic skills 

while protecting quality of care 

• Counselor can see and experience positive change in session 

direction in the moment 

• Allows supervisor to intervene 

when needed to protect the 

welfare of the client, if the session is not effective or is 

destructive to the client 

• May create anxiety 

• Requires supervisor caution in 

intervening so as to not take 

over the session or to create 

undue dependence for the 

counselor or client 

• Can be seen as intrusive to 

the clinical process 

• Time consuming 

Audiotaping Audiotaping and review of 

a counseling session 

• Technically easy and inexpensive 

• Can explore general rapport, 

pace, and interventions 

• Examines important relationship issues 

• Unobtrusive medium 

• Can be listened to in clinical or 

team meetings 

• Counselor may feel anxious 

• Misses nonverbal cues 

• Poor sound quality often 

occurs due to limits of technology 

Videotaping Videotaping and review of 

a counseling session 

• A rich medium to review verbal 

and nonverbal information 

• Provides documentation of clinical skills 

• Can be viewed by the treatment team during group clinical supervision session 

• Uses time efficiently 

• Can be used in conjunction 

with direct observation 

• Can be used to suggest different interventions 

• Allows for review of content, 

affective and cognitive aspects, 

process relationship issues in 

the present 

• Can be seen as intrusive to 

the clinical process 

• Counselor may feel anxious 

and self-conscious, although 

this subsides with experience 

• Technically more complicated 

• Requires training before 

using 

• Can become part of the clinical record and can be subpoenaed (should be 

destroyed after review) 

Clinical Supervision and Professional Development 31 
Figure 8. Methods and Techniques in Clinical Supervision (continued) 

Description Advantages Disadvantages 

Webcam Internet supervision, synchronistic and asynchronistic 

Teleconferencing 

• Can be accessed from any computer 

• Especially useful for remote 

and satellite facilities and locations 

• Uses time efficiently 

• Modest installation and operation costs 

• Can be stored or downloaded 

on a variety of media, watched 

in any office, then erased 

• Concerns about anonymity 

and confidentiality 

• Can be viewed as invasive to 

the clinical process 

• May increase client or counselor anxiety or self-consciousness 

• Technically more complicated 

• Requires assurance that 

downloads will be erased and 

unavailable to unauthorized 

staff 

Cofacilitation 

and Modeling 

Supervisor and counselor 

jointly run a counseling 

session 

Supervisor demonstrates a 

specific technique while 

the counselor observes 

This may be followed by 

roleplay with the counselor practicing the skill 

with time to process learning and application 

• Allows the supervisor to model 

techniques while observing the 

counselor 

• Can be useful to the client 

(“two counselors for the price 

of one”) 

• Supervisor must demonstrate 

proficiency in the skill and help 

the counselor incrementally 

integrate the learning 

• Counselor sees how the supervisor might respond 

• Supervisor incrementally shapes 

the counselor’s skill acquisition 

and monitors skill mastery 

• Allows supervisor to aid counselor with difficult clients 

• Supervisor must demonstrate 

proficiency in the skill and 

help the counselor incrementally integrate the learning 

• The client may perceive counselor as less skilled than the 

supervisor 

• Time consuming 

Role Playing Role play a clinical situation • Enlivens the learning process 

• Provides the supervisor with 

direct observation of skills 

• Helps counselor gain a different perspective 

• Creates a safe environment for 

the counselor to try new skills 

• Counselor can be anxious 

• Supervisor must be mindful 

of not overwhelming the 

counselor with information 

Source: Adapted from Mattel, 2007. 

such as working within a criminal justice system 

where taping may be prohibited. 

• The number of supervisees reporting to a supervisor. It is difficult to provide the scope of supervision discussed in this TIP if a supervisor has more 

than ten supervisees. In such a case, another 

supervisor could be named or peer supervision 

could be used for advanced staff. 

• Clinical and management responsibilities of a 

supervisor. Supervisors have varied responsibilities, including administrative tasks, limiting the 

amount of time available for clinical supervision. 

32 Part 1, Chapter 1 
Administrative 

Supervision 

As noted above, clinical and administrative supervision overlap in the real world. Most clinical supervisors also have administrative responsibilities, including team building, time management, addressing 

agency policies and procedures, recordkeeping, 

human resources management (hiring, firing, disciplining), performance appraisal, meeting management, oversight of accreditation, maintenance of legal 

and ethical standards, compliance with State and 

Federal regulations, communications, overseeing staff 

cultural competence issues, quality control and 

improvement, budgetary and financial issues, problem solving, and documentation. Keeping up with 

these duties is not an easy task! 

This TIP addresses two of the most frequently voiced 

concerns of supervisors: documentation and time 

management. Supervisors say, “We are drowning in 

paperwork. I don’t have the time to adequately document my supervision as well,” and “How do I manage 

my time so I can provide quality clinical supervision?” 

Documentation for Administrative 

Purposes 

One of the most important administrative tasks of a 

supervisor is that of documentation and recordkeeping, especially of clinical supervision sessions. 

Unquestionably, documentation is a crucial risk-management tool. Supervisory documentation can help 

promote the growth and professional development of 

the counselor (Munson, 1993). However, adequate 

documentation is not a high priority in some organizations. For example, when disciplinary action is 

needed with an employee, your organization’s attorney or human resources department will ask for the 

paper trail, or documentation of prior performance 

issues. If appropriate documentation to justify disciplinary action is missing from the employee’s record, 

it may prove more difficult to conduct the appropriate 

disciplinary action (See Falvey, 2002; Powell & 

Brodsky, 2004.) 

Documentation is no longer an option for supervisors. 

It is a critical link between work performance and 

service delivery. You have a legal and ethical requirement to evaluate and document counselor performClinical Supervision and Professional Development 

ance. A complete record is a useful and necessary 

part of supervision. Records of supervision sessions 

should include: 

•		 The supervisor–supervisee contract, signed by 

both parties. 

•		 A brief summary of the supervisee’s experience, 

training, and learning needs. 

•		 The current IDP. 

•		 A summary of all performance evaluations. 

•		 Notations of all supervision sessions, including 

cases discussed and significant decisions made. 

•		 Notation of cancelled or missed supervision 

sessions. 

•		 Progressive discipline steps taken. 

•		 Significant problems encountered in supervision 

and how they were resolved. 

•		 Supervisor’s clinical recommendations provided to 

supervisees. 

•		 Relevant case notes and impressions. 

The following should not be included in a supervision 

record: 

•		 Disparaging remarks about staff or clients. 

•		 Extraneous or sensitive supervisee information. 

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

•		 Illegible information and nonstandard 

abbreviations. 

Several authors have proposed a standardized format 

for documentation of supervision, including Falvey 

(2002b), Glenn and Serovich (1994), and Williams 

(1994). 

Time Management 

By some estimates, people waste about two hours 

every day doing tasks that are not of high priority. In 

your busy job, you may find yourself at the end of the 

week with unfinished tasks or matters that have not 

been tended to. Your choices? Stop performing some 

tasks (often training or supervision) or take work 

home and work longer days. In the long run, neither 

of these choices is healthy or effective for your organization. Yet, being successful does not make you manage your time well. Managing your time well makes 

you successful. Ask yourself these questions about 

your priorities: 

33 
•	 Why am I doing this? What is the goal of this 

activity? 

•	 How can I best accomplish this task in the least 

amount of time? 

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

It is wise to develop systems for managing timewasters such as endless meetings held without notes 

or minutes, playing telephone or email tag, junk mail, 

and so on. Effective supervisors find their times in 

the day when they are most productive. Time management is essential if you are to set time aside and 

dedicate it to supervisory tasks. 

Resources 

The following are resources for supervision: 

•	 Code of Ethics from the Association of Addictions 

Professionals (NAADAC; http://naadac.org). 

•	 International Certification & Reciprocity 

Consortium’s Code of Ethics 

(http://www.icrcaoda.org). 

•	 Codes of ethics from professional groups such as 

the American Association for Marriage and Family 

Therapy (http://www.aamft.org), the American 

Counseling Association 

(http://www.counseling.org), the Association for 

Counselor Education and Supervision 

(http://www.acesonline.net), the American 

Psychological Association (http://www.apa.org), the 

National Association of Social Workers 

(http://www.socialworkers.org), and the National 

Board for Certified Counselors (NBCC; 

http://www.nbcc.org). 

•	 ACES Standards for Counseling Supervisors; 

ACES Ethical Guidelines for Counseling 

Supervisors 

(http://www.acesonline.net/ethical_guidelines.asp); 

and NBCC Standards for the Ethical Practice of 

Clinical Supervision. 

TAP 21-A provides detailed appendices of suggested 

reading and other resources (CSAT, 2007). 

Additionally, Part 3 of this document provides a literature review and bibliographies (available online only 

at http://www.kap.samhsa.gov). The following are 

examples of online classroom training programs in 

clinical supervision in the substance abuse field: 

•	 http://www.attcnetwork.org/midatlantic, Clinical 

Supervision for Substance Abuse Treatment 

Practitioners Series. 

•	 http://www.attcnetwork.org/midatlantic, 

Motivational Interviewing Assessment: Supervisory 

Tools for Enhancing Proficiency. 

•	 http://www.attcnetwork.org/northeast, Clinical 

Supervision to Support the Implementation, 

Fidelity and Sustaining Evidence-Based Practices. 

•	 http://www.attcnetwork.org/northwestfrontier, 

Clinical Supervision, Part 2: What Happens in 

Good Supervision. 

Other training programs are given in professional 

graduate schools, such as New York University 

School of Social Work; Smith College School for Social 

Work; University of Nevada, Reno, Human and 

Community Sciences; and Portland State University 

Graduate School of Education. 

For information about tools to measure counselor 

competencies and supervisor self-assessment tools, 

along with samples, see the following: 

•	 David J. Powell and Archie Brodsky, Clinical 

Supervision in Alcohol and Drug Abuse 

Counseling, 2004. 

•	 L. DiAnne Borders and Lori L. Brown, The New 

Handbook of Counseling Supervision, 2005 

•	 Jane M. Campbell, Becoming an Effective 

Supervisor, 2000. 

•	 Janet Elizabeth Falvey, Managing Clinical 

Supervision: Ethical Practice and Legal Risk 

Management, 2002. 

•	 Carol A. Falender and Edward P. Shafranske, 

Clinical Supervision: A Competency-Based 

Approach, 2004. 

•	 Cal D. Stoltenberg, Brian McNeill, and Ursula 

Delworth, IDM Supervision: An Integrated 

Developmental Model for Supervising Counselors 

and Therapists, 1998. 

34 Clinical Supervision and Professional Development	 Part 1, Chapter 1 
Chapter 2



Introduction
 


In this chapter, through vignettes, you will meet eight clinical supervisors with a variety of skill levels, a number of their supervisees, and an administrator. The supervisors face counselors with a variety of issues. One is 

unfamiliar with supervision, one has ethical issues, one is resistant to change, and another is a problem 

employee. The supervisors also have issues of their own. One grapples with the challenges of a new position, 

and another works to create a legacy. The vignettes, which incorporate these issues along with the principles 

outlined in Part 1, chapter 1, are designed to show how clinical supervisors might manage some fairly typical 

situations. 

Each vignette provides an overview of the agency and of the backgrounds of the supervisor and other individuals in the dialog. A list of the learning objectives for each vignette is also included. Embedded in the dialog are 

additional features: 

Master Supervisor Notes are comments from an experienced clinical supervisor about the strategies used, 

what the supervisor may be thinking, how supervisors with different levels of experience and competence might 

have managed the situation, and information supervisors should have. 

“How-to” Notes contain information on how to implement a specific method or strategy. 

The master supervisor represents the combined experience and wisdom of the TIP Consensus Panel and provides insights into the counselor’s relationships with clients and suggests possible approaches. The notes provide some indication of the breadth of the master supervisor’s clinical skills as well as the extent to which the 

supervisor moves effortlessly among clinical, supportive, evaluative, and administrative roles. 

“How-to” notes reflect the collected experience of the TIP Consensus Panel along with information gleaned from 

a variety of textbooks, manuals, and workbooks on clinical supervision. Not all “how-tos” will apply in every situation, but this information can be adapted to meet the specific needs of your case. 

This format was chosen to assist clinical supervisors at all levels of mastery, including those who are new in 

the position, those who have some experience but need more diversity and depth, and those with years of experience and training who are true master supervisors. The Consensus Panel has made significant efforts to present realistic scenes in supervision using clinical approaches that include motivational interviewing (MI), cognitive–behavioral therapy (CBT), supportive psychotherapy, crisis intervention methods, and a variety of supervisory methodologies including live observation, education, and ethical decisionmaking. In all of these efforts, 

basic dynamics of supervision, such as relationship building, managing rapport in stressful situations, giving 

feedback, assessing, and understanding and responding to the needs expressed by the counselor are demonstrated. The Panel does not intend to imply that the approach used by the supervisor is the “gold standard,” 

although the approach shown does represent competent supervision that can be performed in real settings. 

Vignette 1—Establishing a New Approach for Clinical 

Supervision 

Overview 

This vignette illustrates the tasks of a clinical supervisor in describing a range of supervision methods to clinical staff, including establishing a consistent model of direct observation. The vignette begins with the supervisor describing to staff how he will implement a new method of supervision. 

Clinical Supervision and Professional Development 35 
Background 

Walt has been assigned to redesign the supervision program for a community-based substance abuse treatment 

program, which includes an inpatient program, intensive outpatient program, family therapy, impaired driver 

treatment, drug court program, halfway house, and educational services. The decision was made to establish an 

integrated system of supervision. The agency’s staff, with ten full-time-equivalent counseling positions, has a 

broad range of professional training and experience, from entry-level certified addiction counselors to licensed 

social workers and licensed professional counselors. All staff, regardless of degrees and training, basically have 

the same duties. 

Until now, staff received primarily administrative supervision with an emphasis on meeting job performance 

standards. Walt wants to make the supervision more clinical in nature, using direct methods of observation 

(videotape and live observation). He anticipates program growth in the next few years and wants to mentor key 

staff who can assume supervisory responsibilities in the future. 

Walt has been meeting with clinical staff in small groups organized along work teams into dyads and triads to 

describe the changes and new opportunities. The vignette begins with Walt meeting with two staff members to 

discuss their learning needs and to present the new clinical supervision system. Al is in recovery, with 5 years 

of sobriety and 3 years of experience as a counselor. Carrie has an M.S.W. degree with 6 years of work experience. 

Learning Goals 

1. To demonstrate a range of supervision methods, with an emphasis on direct observation through videotaping 

and live observation. 

2. To illustrate the mentoring, coaching, and educational functions of supervision. 

3. To demonstrate how these functions can be integrated into a consistent model of clinical supervision with 

fidelity to the methods and adaptability to the unique needs of each organization. 

[After greetings, Walt begins the discussion about the new supervision approach.] 

WALT : As you know, our CEO and senior staff have agreed that we need to establish a program of staff training and supervision that will help achieve the goals of the agency and, at the same time, help counselors 

improve their skills. We’ve done a good job developing other administrative systems, and the next step is to 

implement clinical supervision to address both agency goals and your individual goals for professional development. People are moving into new roles, so new skills will be required of us. 

AL: I’m not sure what I need. How will supervision enhance my skills? 

WALT: Al, I think that is a great place to start. We’ve had administrative supervision so far. As we continue to 

grow individually and together, we’ll need new skills. Perhaps a place for us to start is to discuss what will be 

asked of us in the future, what skills we’ll need. How would it be if we had that discussion now? 

AL: That sounds a little frightening. We need to know and do more? How much more blood can they get out of us? 

Part 1, Chapter 2 3636 
[Laughter in the group.] 


Master Supervisor Note: A new supervisor might respond differently to Al’s 

comment, in a more mechanical or authoritarian manner, asserting authority, 

wanting to be the expert, creating an “us vs. them” scenario. Such an approach 

might discourage staff from embracing the new supervision system. An experienced supervisor would be less confrontive and authoritarian and would adopt a 

more consultative posture. He would be direct but not necessarily confrontational. 

CARRIE: I remember the good supervision I had in my M.S.W. program. This sort of reminds me of that—that 

you’re suggesting we have more clinical supervision. Not to sound selfish, but what’s in it for me, to get more 

supervision? 

WALT: That’s a great question, Carrie. We all want to know what’s in it for us. I’d like to hear about your experiences in supervision. How did you learn from that process? What direct observation did you have? 

How To Provide a Rationale for Clinical Supervision 

Clinical supervision has several benefits, which Walt can offer Carrie at this 

point: 

1.	 Administrative benefits: ensuring quality care, providing a tool to evaluate 

the staff’s strengths and learning needs 

2.	 Clinical benefits: improving counselors’ knowledge and skills and offering a 

forum to implement evidence-based practices within an organization 

3.	 Professional and workforce development: enhancing staff retention, improving morale, providing a benefit to enhance staff recruitment, and upgrading 

the qualifications and credentials of personnel 

4.	 Program evaluation and research: providing valuable information to determine program outcome and patient success 

CARRIE: In school I found observation both frightening and helpful. At first I hated being observed and taped. 

Very quickly, though, I really saw the benefits of observation and learned a lot from the experience. 

WALT: It’s been my experience that almost everybody has some initial reservations about direct observation, 

but at the same time nearly everyone finds it beneficial, too. I think one thing to keep in mind is that good 

direct observation doesn’t focus on the negative—on what somebody did wrong. The objective is to help us look 

at what we do well, give us new options, build a bigger tool box of skills, and help us to look at the larger 

process of our counseling, rather than just getting stuck in applying techniques with people. As we look at our 

goals and what we need to learn, I hope we can see how supervision, and particularly direct observation, will 

help all of us. 

CARRIE: I’m told I’ll be doing more group counseling. I certainly need further training and feedback on my 

group skills. This is something we didn’t focus on much in grad school. There are other areas that I’d also like 

to be more proficient in, such as doing marriage and family counseling. 

WALT: Okay. That would be one place for us to begin, Carrie. How about you, Al? 

AL: I’m excited. I’ve wanted to do more counseling, moving out of running DWI groups and doing assessments. I 

Clinical Supervision and Professional Development 37 
need more training but I have concerns about being videotaped or observed. I’m going to make mistakes. I’ll be self-


conscious about that. I think videotaping a session or having a supervisor sit in will make the clients nervous, too. 
 

How To Help Counselors and Clients Become Comfortable 

With Live Observation 

The following steps are recommended: 

1.		 Acknowledge and understand the clients’ and/or counselors’ anxiety about 

observation or taping. 

2.		 Listen reflectively to these concerns without being dismissive or ignoring the 

anxiety; noting that these feelings are common may help normalize the counselor’s concerns. 

3.		 Clearly state the value of direct observation and reinforce the idea that such 

methods are “part of how we do business at this agency. We want to be 

respectful of your concerns. And we believe strongly that it is important for 

us to do so for quality assurance and improved client service.” 

4.		 Keep the door open with the clients and counselors to continue to address 

their concerns and feelings as part of their normal clinical or supervisory 

process. 

5.		 Help the counselor to allay clients’ anxiety or concerns by coaching the counselor through methods for presenting the direct observation methods to the 

client. 

WALT: I can sure understand your sense of feeling self-conscious and your concerns that clients will, too. 

You’ve never been either videotaped or observed before? 

AL: No, I haven’t. In the DWI program, my supervisor sat in a few times when I first started, but it was more a 

question of whether I was following the curriculum. 

WALT: So, although you did have some observation before, this seems like it will be different for you. Perhaps 

we could look at your goals and how supervision with observation can assist us in meeting your goals. 

[A discussion follows where Al and Carrie present their ideas for supervision needs. They then discuss what 

skills they need to develop in the next year.] 

WALT: Perhaps we can discuss what the new supervision system will look like, how it will work, and what’s in 

it for you. First, we’re going to have regular observation of all clinical staff, through either one-way mirror (if 

we can get the audio working in the room), videotaping (my preferred method), or one of the supervisors will sit 

in and observe counselors with clients. We hope to observe each counselor at least once a month. We’ll meet as 

a group for supervision for an hour a week, and we’ll discuss the session that was videotaped or observed that 

week, with one of you leading the discussion. Each person will get a turn at bat over the course of 1 or 2 

months. 

[Walt explains the “how-tos” of live observation and videotaping, including the concept of saliency, bringing to 

supervision the one issue the counselor wishes to address. Walt presents a step-by-step process to begin doing 

direct observation.] 

Part 1, Chapter 2 3838 
How To Implement Direct Observation or Videotaping 

1.		 Obtain written and verbal agreement from the clients and all concerned parties to be videotaped. Clients should be informed on admission that: 

•		 Counselor–client contact may be observed by supervisors, and/or audio or 

videotaped. 

•		 The conditions under which the tape will be used for training. 

•		 How the taped material will be stored and destroyed after use. 

2.		 Counselors should briefly explore client concerns about taping and observation, and respect their right not to be observed. If the client objects after the 

initial exploration, the counselor must respect that choice and ask another 

client. 

3.		 On the visit before the observation occurs, remind the client that on their 

next visit, their session will be taped for quality assurance purposes. Ask 

them if they have any questions about that. If the client strongly objects to 

the taping, discuss those concerns. If the client repeatedly objects to any 

form of observation, the counselor should explore the client’s resistance, and 

attempt to understand the client’s concerns and point of view. Even though a 

client has signed an informed consent that discusses the possibility of direct 

observation by supervisors, a client always has the right to decline any 

aspect of treatment. Remember, no method of observation should ever exceed 

the client’s level of comfort so as to be detrimental to the therapeutic 

process. 

4.		 At the beginning of the taping or observation, restate to the client the limits 

of confidentiality and how the videotape or observation notes will be used by 

the clinical supervisor and/or the counseling team. Clarify whether or how 

the supervisor will observe and/or cofacilitate the session or simply observe 

and intervene only as needed. 

5.		 Be attentive to the counselor’s concerns about direct observation. It may be 

helpful to begin with the idea that “observation gives us a chance to learn 

from each other.” Then you can move into a discussion about the benefits 

and cost-effectiveness of certain observation methods. 

6.		 Ask the counselor to cue the tape to the most salient points of the session 

and bring that section to their next supervisory session. In the beginning, 

counselors might be encouraged to choose the section of a session in which 

they thought they did well. 

CARRIE: I’d like to hear more about why you prefer videotaping. 

WALT: I prefer videotaping for several reasons: First, it is the most cost-effective way for us to observe a session. 

Second, videotaping helps us allocate staff time better; we don’t have to sit in on an entire session but can just look 

at the most salient points in the tape. It gives us all a chance to observe and learn from each other. Sometimes we 

get a tape where a counselor has done something really special, and we can use that tape again before destroying it, 

teaching a particularly powerful and effective technique. We can all learn from each other’s experiences. 

Clinical Supervision and Professional Development 39 
[Walt describes how direct observation works, including the legal requirements such as signed releases by clients, 

preparation and procedures for observation, and procedures for using tapes and observations and maintaining 

confidentiality.] 

Master Supervisor Note: It is important for you to prepare the counselor for 

what will happen during the session. If you are sitting in the session to observe, 

you should explain if and/or when you might intervene in the session, seating 

arrangements for the session, nonverbal ways of communicating during the session, and how other interruptions, should they occur, might be handled. 

AL: As I said before, I’ve never been observed or taped, and that makes me nervous. 

CARRIE: Well Al, I think you’ll get comfortable with it, and you’ll find it to be very helpful when it comes to 

areas that you have concerns about. You said that you were concerned about mistakes, but it really won’t be 

about mistakes. My supervisor in grad school had a motto I liked; she always tried to “catch counselors doing 

something right.” I liked that. So, hopefully this is not about making mistakes but learning from each other. 

When you see yourself on the videotape and you have someone go over it with you, they can give you pointers 

about what worked and how you might have done other things differently. Over time you become comfortable 

with it. Observation was very helpful to me. I think your misgivings will go away after a couple of sessions with 

Walt. You’ll be surprised. 

Master Supervisor Note: It may be helpful for you, as a supervisor, to find a 

“champion”—someone who’s experienced direct observation and found it helpful. 

Hearing positive statements about supervision from a colleague is often more 

acceptable than hearing it from superiors. 

WALT: That’s been my experience, too, with videotaping and direct observation. Al, you said it would make the 

client nervous. Actually, we’re the ones who’re most nervous. We all want to know how we’re doing, but often 

we’re afraid to ask, to get feedback and be observed. 

AL: Maybe it would be better if I saw tapes of others doing counseling first. 

WALT: That’s a great idea. I can present a videotape of a session I conduct. Then we can all sit and discuss 

what I did. How would that work for you if we were to look at a videotape of one of my sessions for our next 

supervisory meeting? I’d benefit from your reflections. It might be a good place for us to start the process. 

Part 1, Chapter 2 4040 
Clinical Supervision and Professional Development 

How To Encourage Acceptance of Direct Observation 

Since you should never ask a staff member to do something you are unwilling to 

do, it might be helpful for you to: 

1.		 Be the first to be taped or observed. 

2.		 Be open to feedback from staff, setting the tone of acceptance and vulnerability to feedback. 

3.		 Solicit comments and suggestions from the counselors concerning what they 

might have done differently and why. 

4.		 Model acceptance by committing to trying out these suggestions in future 

counseling sessions. 

AL: Yeah, I like that idea. 
 

CARRIE: That would be fine with me. I’ll volunteer to be second. It’s been a while since I was observed, but I



don’t have any problem with it. 
 

WALT: Thanks, Carrie. So, since I’m up to bat first, let’s talk about some of the processes of observation. 
 

[A discussion follows about what will happen in supervision when Walt presents his case.] 
 

Master Supervisor Note: You will want to state clearly what is expected from 

counselors in supervision. A supervision contract forms the basis of this statement, and explains the ramifications of missing supervision sessions and what 

they can expect from you and each other. For example, if a supervisee repeatedly 

misses supervision sessions, this might be considered an administrative or disciplinary issue, much as if an employee was repeatedly late filling out paperwork 

or getting to work. Also, if the supervisee does not provide the required videotape of a counseling session for review by the supervisor, the supervisor might 

need to take action, following the organization’s policies for progressive 

discipline. 

WALT: There are different methods that we can use, besides videotaping, that might work better for some 

clients or situations. We want to have an integrated supervision system, one that includes reviewing cases 

together; periodic review of our files, such as client progress notes and treatment plans; training that meets the 

needs of a variety of staff; and review of our client evaluation surveys. While I’m on that topic, we also want to 

receive more input from clients about how we’re doing. There’s a new tool we hope to incorporate that routinely 

asks for input from clients after each counseling session, and at the end of each day for our residential units. 

AL: I have reservations about how useful information from clients might be. After all, for clients in early recovery, their brains are still foggy. 

WALT: Good point Al. If we ask clients regularly, though, we should get useful information about our ability to 

address clients’ needs and the quality of our relationships with them. This is helpful information when we link 

it to our direct observation and supervision. Sort of like watching a TV program and getting the Nielsen 

Ratings about the show at the same time. 

41 
[Laughter.] 

[In the discussion that follows, Walt acknowledges Al’s concerns, and Al, Carrie, and Walt talk about those concerns. Walt asks how they can get past those concerns, how they can work together to have further client input 

into the process.] 

Master Supervisor Note: At times it is necessary for a supervisor to openly 

address staff resistance. The skill is in knowing when to address and when to 

deflect the resistance. Sometimes, it is useful to talk about staff resistance, to 

soothe people’s discomfort before launching into the specifics of how supervision 

will be accomplished. MI suggests that it is most helpful to “roll with resistance” 

by reflecting back to counselors both sides of their ambivalence about the new 

supervision format. Often it is best to return to the issue at a later time. 

WALT: And that’s what we want to see happen with an integrated system of supervision. It will help us identi­


fy what we need to learn, the skills and competencies. To start the process, each of us will bring in a counseling



session that we think is going well, that we feel good about. How does that sound to each of you?



CARRIE: I like that: a chance for each of us to “show off” a bit. 
 

AL: Well, if you go first, Walt, as you said. I’ll go the week after Carrie. I have all kinds of sessions where I’m



doing a good job. 
 

[Laughter.] 
 

CARRIE: I found it helpful in grad school for us to help each other, to avoid throwing anyone into the process



alone. Will that be possible for us? 
 

WALT: That’s a great idea, Carrie. How did peer supervision work in grad school?



[Carrie discusses how peer supervision and team coaching work.]



Master Supervisor Note: Peer supervision is an effective form of group supervision. Supervisees confer in the group, discuss key topics of their counseling, 

and suggest solutions for difficult situations. The participants learn better ways 

to manage clinical issues, thus increasing their professionalism. 

Peer supervision and team coaching have the following advantages and disadvantages: 

1.		 The strengths and success of peer group supervision depend on the composition of the group, the individual members’ strengths, and the clarity of the 

peer group contract. Members must agree on the time, location, and frequency of meetings, as well as the organizational structure and goals of the meetings and limits of confidentiality. In these dimensions, peer supervision differs from occasional and unplanned peer consultation, a more informal 

process. 

2.		 Peer group supervision decreases professional isolation, increases professional support and networking, normalizes the stress of clinical work, and 

offers multiple perspectives on any concern. Peer supervision has the 

added benefits of being of low or no cost, intellectually stimulating, and fun 

for supervisees. 

Part 1, Chapter 2 4242 
3.		 Vague, ambiguous, or ambivalent goals and structure often lead to difficulties in peer supervision. As with individual or clinical supervision, an interpersonal atmosphere of reasonable safety (including respect, warmth, honesty, and a collaborative openness) are critical. 

4.		 Effectiveness and supervisee enjoyment diminish when competitiveness, criticism, inconsistency of members, and absence of support are prevalent. 

5.		 The success of peer group supervision is affected by supervisees’ varying 

commitment and irregular attendance. 

WALT: So, we’ve identified how this works. This is a new role for me, too, so I can use your feedback and suggestions. Supervision involves a different set of skills than being a counselor. 

CARRIE: Right. I took a course in school on clinical supervision and that’s exactly what the professor said. 

Clinical Supervision and Professional Development 

How To Choose a Course on Clinical Supervision 

Look for the following components: 

1.		 The training should be approved by credentialing organizations to fulfill the 

requirements for certification as a clinical supervisor. 

2.		 It should meet the minimum training requirements of 30 hours. 

3.		 The training should be provided by a trainer with the following skills: Level 

3 counselor, Level 3 supervisor, excellent training experience, and ability to 

provide information on both administrative and clinical supervisory issues. 

4.		 The training should teach practical clinical supervisory skills through roleplays and demonstrations, video- and audiotapes of supervision sessions, and 

opportunities to practice clinical supervisory skills. 

5.	 	The training should be provided by a reputable training individual or 

organization. 

6.		 Online courses are also available. However, an organization should first verify if online courses are approved by their State certification board. 

WALT: Let’s summarize what we’ve said. We’re moving into new treatment program strategies. Each of us has 

an Individual Development Plan (IDP) stating our individual learning goals. Mentorship is an important aspect 

of helping us all meet our IDP goals. 

[Walt describes the process of mentorship, that each staff member will have a mentor. Some staff will mentor 

each other. Walt discusses the relationship between the IDPs, clinical supervision, and the mentorship system. 

Walt also discusses the issue of stages of readiness and how that affects the form and extent of mentorship each 

person will receive.] 

Master Supervisor Note: Mentorship is a formalized relationship between a 

skilled professional and a mentee and is established to enhance the mentee’s 

career by building skills and knowledge. In a series of structured sessions, a person of greater experience instructs, guides, advises, provides feedback, and 

coaches someone of lesser experience. 

43 
WALT: One of my tasks is to ensure that all of us get training so that any one of you could take over for me if 

need be. I love to surround myself with people who can take over my job on a given day. 

CARRIE: I’d be happy to both be mentored and serve as a mentor to others, if that’s what you wish. I’m feeling 

a lot better than when we began this discussion today. 

[Walt starts a discussion on clinical issues that might be topics for discussion in supervision, such as caseload 

size and complexity, work with clients with co-occurring disorders, the impact of dual relationships with clients, 

and confidentiality. The session ends with the group establishing the times for their group supervision and the 

procedures for tape review and live observation.] 

Vignette 2—Defining and Building the Supervisory 

Alliance 

Overview 

This vignette illustrates the tasks of defining and building a supervisory alliance, particularly when working with 

an entry-level counselor with an academic background different from that of the supervisor. The dialog is the 

initial supervisory session. It illustrates how to introduce direct observation and the establishment of an IDP. 

Background 

Bill is a certified clinical supervisor who worked his way up through the ranks, starting as a substance abuse 

counselor 20 years ago, 3 years into his own sobriety. Ten years ago he enrolled in a part-time master’s degree 

program in counseling and completed the degree in 5 years. Since receiving his master’s degree, he has worked 

as a clinician and supervisor in a community-based substance abuse treatment program. In addition to his 

supervisory duties, he is director of the program’s intensive outpatient program (IOP). 

Jan is in her first month at the agency, right out of graduate school. She is a Level 1 counselor, her first 

employment since receiving her M.S.W. She had limited substance abuse treatment experience in a field work 

placement and sees her current employment as a stepping stone to private practice after she receives her social 

work license. Her supervision in the field placement assignment focused on social work skills and integrating 

field work learning with her academic program. She averaged ten cases during her second year of field work. 

The agency is a private, nonprofit organization providing comprehensive addiction treatment and education 

services. Jan has been assigned to the IOP and is expected to participate in a structured internship program of 

3 months wherein she will receive training in the substance abuse treatment field. The agency has a well-established system for clinical supervision. 

Learning Goals 

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

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

3. To define goals and boundaries of supervision. 

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

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

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

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

Part 1, Chapter 2 4444 
BILL: We’re excited to have you here, Jan. You may already know that supervision is an essential part of how 

we help counselors in the agency. Since this is our first session together, perhaps we can explore what you want 

from supervision and how I can help you. Building on your training and experience, maybe you can give me 

some ideas about the areas where you wish to grow professionally. 

JAN: Well, I haven’t thought about that yet. I had excellent training and experience at the EAP [Employee 

Assistance Program] in the county health clinic. I’m not sure where to begin or even what I need. I recognize 

the need for supervision, certainly for orientation to the agency. I’d like to know about how much supervision 

I’ll get and the focus and style of supervision here. I also need supervision to meet the requirements for licensure as a social worker. 

BILL: I can understand that you’re really excited about starting a new job and career. You had an excellent 

experience in your placement at the health clinic. I’d love to hear more about it, so perhaps you might tell me 

something about that placement, what you learned, and what treatment models they used there. 

JAN: Wow, there is so much to tell you about that. I averaged ten clients on my caseload. Some were just 

assessments, but I did get to work longer term with several clients. I sat in on several counseling sessions, 

observed the senior counselor conduct the sessions, and co-led a group and several family sessions. I had weekly 

clinical supervision with my supervisor and the senior counselors. We used process recordings in school and 

that was really sufficient because I would write the verbatim, give it to my supervisor, she’d make comments, 

and we’d talk about it. So I didn’t really need to have her watch me work. I’ve heard from Margaret [another 

counselor in the agency] that in supervision you do direct observation of counselors here and that idea is new to 

me. Frankly, I’m not sure if I really need that. My model for counseling is eclectic, whatever is needed for the 

client. They used a lot of cognitive–behavioral counseling approaches at the EAP. I try to meet the clients 

where they are and focus my therapeutic approach to meet their needs. 

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

BILL: So, we have a good sense of your background and experience. If it’s OK, I’d like to return to the earlier 

question about whether you have any thoughts about what you want from our supervision together. 

JAN: I’m not sure. Do all counselors here get supervision and are they all observed? I’m not sure I need that 

observation, especially since the placement didn’t do that. 

BILL: I appreciate your concerns about supervision. All our counselors here receive supervision. Some agencies 

don’t do much direct observation of staff, but we’ve found it very helpful for a number of reasons. Here, we see 

supervision as an essential aspect of all we do. We believe you have a right to supervision for your professional 

development. We have great respect for our counselors and their skills and also understand that we have a 

legal and ethical obligation to supervise, for the well-being of the clients. 

Master Supervisor Note: Notice how Bill is laying the foundation and rationale for why clinical supervision is essential to this agency. Whereas every agency 

needs to develop its own, unique clinical supervision approach, there are models 

and standards of clinical supervision, as discussed in Part 1, chapter 1, which 

seem to be most effective. Agencies might benefit from adapting aspects of these 

models. 

JAN: So, everyone must have supervision and observation? 

BILL: We take our legal and ethical obligations seriously. We want all of our counselors—even the most experienced ones—to grow professionally, to be the best counselors they can be, for their own development and for the 

welfare of the clients. As you probably learned in your M.S.W. program, vicarious liability is an emerging issue 

for agencies. Counselors are legally liable for their actions. Vicariously, so are the agency and the supervisor. 

Clinical Supervision and Professional Development 45 
We need to make a “reasonable effort to supervise.” 

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

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

expect of us. 

JAN: Again, I never really thought about that. I want to grow as a counselor and to develop skills that I can 

use in my future employment. I understood when I took this position that you do an excellent job of providing 

training opportunities for staff, something I really liked about the organization. 

BILL: In our agency, clinical supervision is part of a larger package of staff development efforts. We try to help 

counselors improve their skills by offering the opportunity to work with a variety of different clients, using a 

variety of treatment modalities, such as individual, group, couples therapy, family therapy, and psychoeducation. Also, we want staff to be able to obtain their social work or substance abuse license or certification in the 

future. We want counselors to develop new skills by attending training both in-house and in workshops around 

the State. We encourage and support any efforts you might make toward professional development, such as getting your various levels of social work licensure. Our philosophy is that one of our greatest assets is our clinical 

staff and as they develop, the agency grows too. We believe clinical supervision is critically important in this 

mix. We both—you and the agency—benefit as a result. 

[A discussion continues about Jan’s course work in school and her training in the field placement, and how she 

can continue that learning in the agency. She articulates her clinical strengths.] 

BILL: That sounds good. Those are the skills we saw in you that we thought would be helpful to our agency. In 

what ways do you wish to grow professionally? 

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

BILL: That’s what we can explore in supervision. I’ll need to have a sense of what you’ve learned and where 

you see your skills. In addition to talking about your skills, we find it helpful to learn through observation of 

our staff in action, by either sitting in with you on a session or by viewing videotapes of counseling sessions. 

That way, we can explore your specific learning objectives. We all learn from watching each other work, finding 

new ways of dealing with clinical issues. What do you think of that process? 

JAN: As I said, I wasn’t observed in my placement and find it anxiety provoking. I don’t really like the idea of 

your taping my session. It feels a bit demeaning. After all, I do have my M.S.W. I don’t recall anyone saying 

anything in my interview about being videotaped. Now, that’s intimidating, to me and the clients. 

BILL: Being anxious about being taped is a fairly common experience. Most counselors question how clients 

will accept it. You might speak with Margaret and some of your other coworkers about their early experiences 

with taping, what it was like for them, and how they feel about it now. 

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

BILL: Generally I meet each counselor individually for an hour each week. Then we do weekly group supervision where each counselor, on a regular basis, gets a chance to present a case and videotape, and we, as a 

group, discuss the case, and talk about what the counselor did well and how other things might have been handled differently. When you present a case, we all grow and benefit. 

JAN: I want to be a proficient therapist, ultimately, to work as a private practitioner. If supervision can help 

me professionally, that’s good. 

Part 1, Chapter 2 4646 
Master Supervisor Note: It is important for Bill to be aware of what feelings 

are arising within him, particularly concerning Jan’s seeming desire to pass 

through and use the agency as a route to private practice. This has happened to 

Bill and the agency before. Bill acknowledges to himself his feelings of being 

used by these clinicians in the past. Bill’s self-awareness of these feelings is critical and he does not respond out of anger or resentment but makes a conscious 

effort to remain present to what the issues are with Jan. 

BILL: I’m glad you see the value of supervision. And I admire your professional goals of wanting to be in pri­


vate practice although I must say that I have difficulties with people just “passing through our agency” on the



way to something else. But, that’s my issue, and I’ll address those concerns if they come up in our relationship. 
 

Master Supervisor Note: In his own supervision, Bill might explore his feelings about people passing through the agency, his anger or resentment, and how 

he can effectively address those feelings. For example, Bill’s supervisor might 

wish to explore with Bill the following questions: 

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

feelings in the past? 

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

3.		 How do you keep from being drawn into a defensive posture where you are 

justifying the agency’s use of direct methods? 

JAN: Will I be criticized by others, perhaps those without as much formal training as I have? I understand you 

have several nondegreed counselors here—certified addictions professionals, with lots of life experience but 

without advanced degrees. 

Master Supervisor Note: A Level 1 supervisor might respond angrily here. A 

Level 2 supervisor might get into an argument about the quality of counselors at 

the agency. Bill, as a Level 3 supervisor, does not react to Jan’s seeming criticism 

of the nondegreed counselors. He responds in a supportive but direct manner, as 

you will see. But perhaps Jan is making this comment in response to Bill’s previous statement that he has “difficulties with people just passing through” and this 

is another reason for Bill to address this in his own supervision. 

As discussed in Part 1, chapter 1, just as there are levels of counselor development, there are also levels of supervisor development. Level 1 supervisors might 

have a tendency to be somewhat mechanical in their methods, perhaps needing 

to assert their leadership and position, and approaching situations somewhat 

anxiously. This is especially so for supervisors who have been promoted from 

within the organization. Their peers, with whom they have worked side-by-side 

before, know they do not know their strengths and limitations, and hence the 

new Level 1 supervisor may feel that she has to assert her authority (see 

vignette 6). A Level 2 supervisor is much like the Level 2 counselor, who is driven by alternating anxiety and self-confidence and who feels the need to be independent, even though she might not as yet be able to act independently. Finally, 

Clinical Supervision and Professional Development 47 
Level 3 supervisors have balanced their levels of self-awareness, motivation, and 

autonomy. For further descriptive information on levels of counselors and supervisors, see Part 1, chapter 1, pp. 9–11. 

BILL: Perhaps it would be a good idea if you began by observing in one of my groups. Then, when you’re feeling 

more comfortable with it, we can discuss what times work best for you to be observed, and what cases you’d like 

me to observe. This will give you time to schedule the observation. The first time, maybe I could sit in when 

you’re working on a case that you have confidence about so we can see how you accomplish the session’s goals. 

JAN: OK, that makes sense to me. I like the idea of talking to others and getting their impressions of the 

process and their suggestions on how to best make it work. 

BILL: We also need to develop a learning plan for you, an IDP that all staff have, so that you can continue to 

learn. That’s part of a supervision contract that we work on together. How does that sound? 

Master Supervisor Note: It is important to develop an IDP for each supervisee, and counselors should understand why an IDP is important for the supervisory relationship. Jan’s IDP might focus on: 

1.	 Increasing her understanding of addiction by reading texts on the subject 

and beginning the credentialing process. 

2.	 Discussing this material in supervision, in reference to clients in treatment. 

3.	 Finding a social worker within or outside the agency who can assist her in 

fulfilling the requirements for her social work licensure. 

4.	 Beginning direct observation of her counseling sessions within 2–3 months 

with monthly videotaping and discussion of a session. 

JAN: It will be a new experience for me but it sounds like it might be helpful. I’d appreciate your helping me 

look at my skills and growing as a social worker in substance abuse treatment. 

BILL: I’ll provide you with as much background in substance abuse treatment as I can and also try to help you 

develop as a social worker to meet your career goals. 

Master Supervisor Note: Bill is working with Jan to establish a supervisory 

alliance, through listening, reflection, and mutual goal setting. 

JAN: Good. I hope it will broaden my skills and further my career goals. I can learn more about working with 

clients’ substance abuse. I think I can learn from people in other disciplines. 

BILL: Although each discipline has its unique perspective, we have a multidisciplinary team approach and 

value each staff member’s contributions. We teach one another. For example, Margaret has worked in this unit 

for 10 years and has a lot of experience working with the kinds of clients you’ll be treating. She is a useful 

resource for you to use to improve your skills so that you can be successful here and in your career. How will 

that work for you? 

JAN: I’ve heard about Margaret. People have a high regard for her clinical skills. So I’m sure I can learn something from her. I still would like some more details about how the supervision works, who else is involved, and 

how do we do this together. 

Part 1, Chapter 2 4848 
BILL: We do individual observation and group supervision where we find common issues in our counseling, 

using videotape and case presentation to trigger discussion of related issues. Everyone learns from the presenter’s experience. Each counselor takes a turn presenting a case, including a videotape. We can cue the tape to 

the session segment you want us to discuss. After your brief introduction of the case, we discuss how the session went, what skills were effective, and what areas might be further developed. How does that sound? 

JAN: That sounds great. Can I come to you at other times to review cases, especially while I am learning the 

ropes of how things are done here? 

BILL: Yes. I appreciate your wanting immediate feedback. I have an open-door policy. Although I may look 

busy, I’ll try to find time when we can discuss whatever you want. You can also meet with others if you feel 

comfortable doing so. We encourage teamwork. Does that seem reasonable? 

JAN: Yeah. I’m pretty autonomous at this point. I think it’s great that there are other counselors and social 

workers I can collaborate with. It will be really helpful for me especially since I’m new at the job, and it’s good 

to be able to work together. I’m OK with supervision, and I like the fact that we’re both going to have an agenda, so that’s fine. 

BILL: So, let’s go back to your experience. I’d love to hear more details about your internship and what you 

learned there. 

[Jan explains her work experience in her internship.] 

JAN: In my second year I was at an EAP clinic. I had a great supervisor, Jackie. Several of my clients were 

alcoholics, my first introduction to substance abuse. There was something that attracted me, to understand 

more about the disorder and to contribute what I was learning in social work. Jackie was a social worker and a 

really good role model. I need to understand more about substance abuse treatment, and try to marry the social 

work and substance abuse fields. 

[Bill and Jan continue to discuss her experience with supervision, what worked best, what she found most useful 

and supportive.] 

JAN: I’m a little worried about how I’ll meet my licensure requirements about being supervised by a social 

worker. Will that be a problem for me? 

BILL: Not at all. Margaret is an LCSW and we can ask her to provide the supervision you need for social work 

licensure. This will allow Margaret to develop her supervision skills. I also think that an important part of 

developing a professional identity is receiving coaching from an experienced person, and perhaps Margaret can 

assist in that area too. 

JAN: That sounds fair and helpful. 

BILL: You mentioned that Jackie was a good supervisor. Can you tell me what she was like and what she did 

that made her a good supervisor? 

JAN: She was really smart. I could learn from her. When I went to talk to her she always gave me good advice. 

She trusted that I knew what I was doing and didn’t micromanage me. She was open about her theories and 

made linkages to issues. She trusted me to just go ahead and implement what I learned. She was easy to talk 

to. If I had a problem, I could say so. 

BILL: It sounds like Jackie and I have a similar orientation as supervisors, and that should make the transition easier. I hope you’ll observe from your perspective how the supervision is developing, and give me feedback 

on the relationship, the process, and the outcomes from your point of view. Our first step will be to expand your 

training by introducing you to a broad range of substance abuse issues. Perhaps at our next session we can 

start developing a learning plan to apply your studies to clinical work. What do you think of that? 

Clinical Supervision and Professional Development 49 
Part 1, Chapter 2 

How To Write a Supervision Contract 

The following elements might be included: 

1.		 The purpose, goals, and objectives of supervision. 

2.		 The context of services to be provided. 

3.		 The criteria and methods of evaluation and outcome measures. 

4.		 The duties and responsibilities of the supervisor and supervisee. 

5.		 Procedural considerations. 

6.		 The supervisees’ scope of practice and competence. 

7.		 The rewards for fulfillment of the contract (such as clinical privileging or 

increased compensation). 

8.		 The frequency and method of observation and length of supervision sessions. 

9.		 The legal and ethical contexts of supervision as well as sanctions for noncompliance by either the supervisee or supervisor. 

JAN: That’d be good. I like that you’re interested in my experience, about who I am. I’d like to know a bit about 

you. Jackie would talk about who she was, her model of supervision, and why this work was important to her. I 

felt I could trust her because I knew where she was coming from. Would you tell me more about yourself? 

Bill: I’d be happy to. 

[Bill provides an overview of his work, academic experiences, and primary model of counseling and supervision.] 

JAN: I have a beginning understanding of the type of supervisor you are. I like that you’re direct so I don’t have 

to guess at the agenda. So, we’ll work on a training plan and I’ll suggest times for you to observe a session and 

videotape. Is that correct? 

BILL: That seems fair and clear. Any other concerns we should talk about today? 

[Further discussion follows about Jan’s anxiety about supervision. They discuss how supervision would work to 

help reduce her anxiety about being scrutinized and critiqued.] 

BILL: So, although you’re a bit nervous about the process, you’re ready to begin. We’ll start with your observation of me to give you an opportunity to get your feet wet. Then you can tell me when you’re ready for me to 

come in and observe, maybe in the next 6 or 8 weeks. 

JAN [jokingly] I think sometime in the next 6 months. 

Master Supervisor Note: As a Level 3 supervisor, Bill doesn’t react to this 

comment. A Level 1 supervisor might respond by saying “The timeframe is not 

negotiable. You’ll begin the observation in 6 weeks.” Another response might be 

to avoid the issue without affirming her. When she is noncompliant after 6–8 

weeks, he’d blame her for her lack of follow through. Such responses might negatively affect the relationship. A supervision of supervision issue might be to 

explore what was happening for Bill and his possible ambivalence about Jan. 

5050 
BILL: Thanks for your willingness to begin and try the process. 

JAN: OK. So, I can pick the client? 

BILL: Yes. You can pick the client or group. We’ll meet every week for about an hour. 

[Bill and Jan set the time for the next supervision session and discuss what is expected for the next session and 

end the discussion with both excited about the process.] 

Vignette 3—Addressing Ethical Standards 

Overview 

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

Background 

Stan has provided clinical supervision for Eloise for 2 years. He’s watched her grow professionally in her skills 

and in her professional identity. Lately, Stan’s been concerned about Eloise’s relationship with a younger 

female client, Alicia, who completed the 10-week IOP 2 months ago and participates weekly in a continuing 

care group. Alicia comes to the agency weekly to visit with her continuing care counselor. She also stops by 

Eloise’s office to chat. Stan became aware of her visits after noticing her in the waiting room on numerous occasions. Earlier in the day, Stan saw Eloise greet Alicia with a hug in the hall and commented that she will see 

Alicia “at the barbecue.” Stan is aware that Alicia and Eloise see each other at 12-Step meetings, as both are in 

recovery. Eloise feels she is offering a role model to Alicia who never had a mother figure in her life. Eloise 

expresses no reservations about the relationship. Stan sees the relationship between Eloise and Alicia as a 

potential boundary violation. 

Learning Goals 

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

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

with clients. 

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

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

supervision. 

[After brief introductory comments, the discussion begins with how Alicia is progressing in her recovery.] 

STAN: If it’s OK, I’d like to share some concerns I have about Alicia. 

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

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

her at a barbecue. 

ELOISE: Right. Sarah is one of my sponsees in AA, and we’re having a barbeque at her house for some people 

in recovery. She and Alicia have gotten really close, so Alicia will probably go, too. 

Clinical Supervision and Professional Development 51 
STAN: And that’s a barbecue you might be attending? 

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

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

ELOISE: Yes, it means the world to me. Alicia reminds me of myself when I was in early recovery. When I see 

her and how hard she’s working, it inspires me because I know that struggle. 

STAN: I’m pleased that you care so much about your clients and that you can identify with their struggles. I do 

have concerns though, when I hear you are going to see her at a barbeque. It seems like a possible dual relationship issue for you, and I would like to know what you think about this? 

ELOISE: Well, I certainly know not to sleep with my clients, or borrow money from them, or hire them to mow 

my lawn, or take them on trips. But seeing Alicia at a barbecue? Come on, Stan. 

Part 1, Chapter 2 

Master Supervisor Note: At this point Stan might be feeling somewhat defensive and may need to restrain his urge to begin disciplinary action against Eloise 

for her attitude. A Level 1 supervisor might react angrily to Eloise’s tone of 

voice, seeing this as a clear disciplinary issue. A Level 2 supervisor might get 

caught up in an argument with Eloise about the extent of the violation. The skill 

of a Level 3 supervisor is to be clear with Eloise about what a dual relationship 

is without responding out of anger. As shown below, Stan needs to help her identify what a boundary violation is, how to make ethical decisions, and how to 

have this discussion in the context of a supportive supervisory relationship. It is 

important for Stan to help her be more aware in future situations with similar 

clients and dynamics. 

STAN: I’m glad we agree on those kinds of extremes because dual relationships are a big concern of our agency 

and staff. A dual relationship occurs when a counselor has two relationships with a client, one personal, one 

professional. Our mission is to provide professional clinical services to clients. Within those services there is a 

scope of practice. When a personal relationship with a client or former client intrudes on that professional clinical service, then we may have a relationship that is considered outside the parameters of what’s considered 

solely professional. 

ELOISE: What I understand about dual relationships is that it . . . well, help me here. For example, I know I’m 

not supposed to hire anybody for any personal services or any form of exchange of money or buy anything from 

a client. If they’ve been a client here, I can’t contract with them for private practice or anything like that. 

STAN: Let’s talk about your relationship with Alicia and what the intent is now. You want to do everything you 

can to build a safety net for her recovery. I appreciate your concern for her recovery. One goal of recovery is for 

the client to achieve a sense of autonomy and make decisions on her own, to take care of herself. You play a 

role. So, if we can, let’s discuss what that professional role is, and what it isn’t. When I walked through the 

lobby and heard you say “I’ll see you at the barbecue,” I had some concerns. 

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

STAN: My concern is whether going to a barbecue with a client is appropriate behavior, to have a relationship 

with her outside your professional relationship as defined by our agency. When I heard your remark, I thought, 

“I wonder what Eloise’s intent was and where that’s going or what might that lead to? Let me check it out to 

see if I am being clear.” 

5252 
ELOISE: Are you saying I shouldn’t see clients in other contexts? How reasonable is that? We live in a small 

town here and run into clients all the time in the supermarket and at 12-Step meetings. So what are you saying? 

Clinical Supervision and Professional Development 

Master Supervisor Note: There is a difference between a dual quality to a relationship and a dual professional and personal relationship. Dual qualities are 

inevitable in certain communities. A dual relationship has the potential for the 

abusive use of power, where harm might be done to the client through manipulation or inappropriate self-disclosure. Actions in one context might be acceptable, 

whereas in another they might be harmful. A skillful supervisor would help 

Eloise see this distinction and help her be better able to make sound ethical decisions concerning the line between dual qualities and dual relationships. 

STAN: Great observation. Yes, we find ourselves in situations that potentially have a dual quality to them. The 

difference between running into clients in the supermarket and going to social activities together involves the 

potential impact that action might have on the client and our use of the power we have in the relationship. You 

were her counselor. 

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

STAN: Okay, but she’s still a client of the agency. The ethical question is how long is a client a client? According 

to our substance abuse counselor’s code of ethics, once a client, always a client in terms of our professional 

responsibilities. 

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

don’t counsel her anymore. 

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

outside the agency at functions. 

ELOISE: Well, she goes to the women’s AA meeting that I go to. And she knows some of my sponsees. What 

should we do, leave our home group because clients attend the meetings also? 

STAN: It is inevitable that we will run into clients at meetings. When does that cross over the ethical boundary 

and become a dual relationship? I’d like to hear your ideas about where you see that line for you. 

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

STAN: Again, I know you don’t want to hurt her, and I know you’re trying to help her in her recovery. We have 

to be mindful of not being drawn into relationships that hurt the client or that could be perceived as dual relationships. 

ELOISE: She doesn’t call me or come see me. I want you to know I’m not sponsoring her. But I didn’t know that 

going to the barbecue was wrong. So, I won’t go. 

Master Supervisor Note: Stan really wants to keep the focus on the larger 

issue of dual relationships. Once Stan and Eloise have clarified this larger perspective, then it might be more appropriate to come back to the specific issue of 

the barbecue. A more inexperienced supervisor might be tempted to just establish 

the boundary about socializing with clients with a comment like “That would be a 

wise decision (not to attend the barbecue)” but would possibly lose the potential of 

helping Eloise develop more effective ethical decisionmaking skills in the process. 

53 
It would, in effect, run the risk of making the decision for Eloise, rather than 

helping her come to an ethical decision on her own. 

STAN: With your permission, perhaps we can talk about how we make ethical decisions about the nature of a 

relationship with a client or a former client, and what’s not professionally appropriate. If it’s okay, let’s use the 

conversation with Alicia in the agency lobby. How do you think that conversation might be perceived by anyone 

who is walking by who hears you say you’ll meet at the barbecue? 

ELOISE: I’ve never really thought about it. Well, I guess if it was someone who didn’t know me, they might 

think that I was personal friends with her. That’s not a perception I want others to have. 

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

ELOISE: Yes, of course. 

STAN: I reread the code of ethics to help evaluate whether or not there might be an issue. I was reminded of 

the power differential in all counseling relationships and that as professionals in our field we need to be careful 

to not engage in social relationships (or relationships that might be seen by others as social relationships) with 

clients or former clients. You may recall we recently had a lawsuit over dual relationships that put the agency 

in jeopardy. It got resolved in our favor but we’re particularly sensitive about our liability. It was a wake-up 

call to all of us. So how can we clarify this boundary issue with your relationship with Alicia? 

ELOISE: Wow, I never saw going to the barbecue as pursuing a friendship, and I certainly would not want to 

jeopardize our agency’s relationship with her. I certainly don’t seek any personal gain from our time together. 

Although I must admit, she does remind me of myself when I was in early recovery. Besides, she has never had 

a strong, positive, maternal figure in her life. That’s something I think I can help her with. What do you think? 

STAN: I admire your concern for her and it sounds like you are becoming aware of some maternal feelings for 

her that might be coming close to stepping over that professional boundary. When our relationships with others, and particularly with clients or former clients, begin to even have the possibility of affecting their recovery 

in a potentially negative way, then we might be edging close to an ethical boundary violation. 

ELOISE: I understand, but part of my recovery program is being in touch with other people in recovery, other 

people from meetings, like Alicia. 

STAN: I agree. It’s important for your own recovery that you stay connected to other people in recovery. So, the 

question is: What’s the difference between seeing people in recovery at meetings, such as your sponsees or your 

sponsor, and relating to clients active in treatment at our agency whom you encounter at a meeting? 

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

Part 1, Chapter 2 

Master Supervisor Note: It is important for supervisors to take into account 

cultural variables that might affect clinical relationships, such as differences in 

ethnic, religious, and geographic factors and their impact on the counselor–client 

relationship. This is not to condone unethical behavior but to be mindful of cultural issues as they affect the context of counseling. For example, in some Latino 

cultures some form of socializing may be expected. In Asian cultures, it is not 

uncommon for a client to ask the counselor personal questions as a means of 

establishing trust. Skillful supervisors assist counselors in understanding cultural variables while continuing to make sound ethical decisions. 

5454 
STAN: I understand the dilemma we find ourselves in as counselors. We have to go on living our lives in our 

small rural community. So, how do we reconcile our daily lives with the Federal laws, agency policies, and our 

code of ethics? We need to be mindful of those boundaries just because of the closeness of our community. The 

interesting thing is that the clients are not bound by the same rules as we are. So, they might not see it as a 

boundary violation. In fact, as often as not, clients and former clients are flattered by contact with their current 

or former counselor and invite such relationships. How will we reconcile these differences? How do we know 

what the ethical wall looks like before we hit it? 

ELOISE: Well, I guess we need to be careful about what contexts we see clients in, whether they are actively 

being counseled by us or not. Is that what you’re saying? 

STAN: Yes, we do need to be mindful of the various relationships we develop with clients. I’d like to use the 

barbeque as an example to discuss. Okay? 

ELOISE: Sure. First, I have six sponsees. They’ve all been in recovery for different lengths of time, and they 

like to get together every 3 months, all six of them, and do some kind of activity. And they invite over a bunch 

of people from the 12-Step group. Sarah was having this barbecue and asked me because we go to the same 

home group. She also invited Alicia. I’m not sponsoring Alicia. Does that mean I can’t go? 

Clinical Supervision and Professional Development 

How To Perform Ethical Decisionmaking 

Stan’s task here is to help Eloise identify potential boundary issues in a broader 

context and aid her in her ethical decisionmaking. The following are steps to ethical decisionmaking: 

1.		 Recognize the ethical issues by asking whether there is potentially something harmful personally, professionally, or clinically. In what way might 

this go beyond a personal issue to the agency, the profession? 

2.		 Get the facts. What are the relevant facts? What facts are unknown to us at 

this time? Who has a stake in the decisionmaking? What are the options for 

action? Have all of the affected parties been consulted? 

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

all parties? What action treats everyone fairly? 

4.		 Make a decision and test it. If you told someone you respected what you did, 

how would they react? 

5.		 Act, then reflect again later on the decision. If you had to do it all over again, 

how would you react differently? 

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

own problemsolver. 

ELOISE: Well, it’s hard to not go to social activities in this small community when I’m invited. But I can see 

how some might see me in a different light because I’m a counselor. At one party, someone came up to me and 

started to ask questions about problems in their marriage. I guess she figured that since I’m a counselor, she 

could get some free assistance. I was really uncomfortable in that situation. 

STAN: What did you do? 

55 
Part 1, Chapter 2 

Master Supervisor Note: At this point Stan might: 

1.		 Have Eloise consider her own solution. 

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

solution to other situations she may encounter. 

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

from this discussion. 

ELOISE: I told her I could not be her counselor and was there at the activity in my “civilian” clothes. 

[Chuckling.] Ah, I see what you’re getting at. It’s hard to be in two relationships, a professional and a personal 

one, with the same person. And I can see what you mean by how a reasonable uninvolved person might view 

this situation. At the party, when that woman wanted free counseling, it was clear that that was not the context or the relationship for that. That’s unprofessional. But Alicia is different. 

STAN: So, you see that it is unprofessional to counsel someone outside of a professionally defined relationship. 

I’d like to hear how it is different with Alicia. 

ELOISE: Well, I really care for her. She reminds me of myself when I was younger. I am the mother she never 

had. I feel bad for her that she’s never had a positive female, maternal role model in her life. 

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

STAN: This is difficult for you. You care very deeply for her. I can understand that in some ways she reminds 

you of yourself at that point in your recovery. 

ELOISE: Yes, she does. 

[Her crying continues, and Eloise speaks of her concern for Alicia. After a few minutes, the two sit quietly.] 

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

STAN: I value your concern for Alicia and your desire to be professional. It is difficult when we care so deeply 

for our clients. We’re asked to show empathy and caring for clients, and sometimes it can be confusing if we 

care too deeply. It’s like, as caring professionals, we’re always living close to that ethical slippery slope. We can 

retreat into “professional white coats” and separate ourselves emotionally from clients. But that turns counseling into a sterile activity, and we’re detached and removed from their pain. But, when we care deeply, we are 

drawn into the emotional world of our clients. And the boundaries can become fuzzy for us. 

ELOISE: I see what you mean. I guess we can rationalize a lot of our behavior when we care so deeply. We call 

that enabling behavior, don’t we, when family members do that with the person in substance abuse treatment? 

So, how do we walk close to that ethical slippery slope without falling over the edge? 

STAN: That’s an excellent question. Ethical decisionmaking can be difficult at times. Intent is an important 

part of ethical decisionmaking. 

5656 
How To Ask Questions in Ethical Decisionmaking 

The following are key questions to ask at this point: 

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

situation? 

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

3.	 How would a person discern his or her intentions? How do you keep yourself 

from self-deception about your motives, remembering that the best test for 

your motives is time? 

ELOISE: What do you mean by “intent?” It was my intent with Alicia to be helpful, certainly not to hurt her in 

any way or to be disrespectful of our agency or of me as a professional. 

STAN: When we commit to a professional relationship with a client, there is always a power differential. When 

someone like Alicia comes with her need for a maternal figure, as you well described, we need to be careful of 

our role in offering to fulfill that need. The power differential alone can create some opportunities for people to 

misperceive what’s going on. What do you think? 

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

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

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

Master Supervisor Note: It is important to remember the power differential 

between supervisor and supervisee. How might key audiences (colleagues, the 

community, board of directors, the press, peers) see or experience the counselor’s 

behavior? What is the risk? There are many stakeholders involved who each 

view the situation from their own perspective. For example, stakeholders (such 

as the board of directors) might be concerned about the risks of legal liability for 

the agency, the media and community with the public image of the organization, 

and peers with the clinical implications of a possible boundary violation. 

STAN: That’s a key insight. It’s great that you could step back from the situation and see how your caring 

deeply for her spilled over in other ways. 

ELOISE: You think I had power over Alicia? 

STAN: As I said, when you’re a counselor to a client, there is always a power differential that we have to be 

very cautious and very aware of. It may not be something we do so much as the power that the client gives us. 

Now, if it is okay with you, I’d like to summarize a little. 

[Stan and Eloise review what has been discussed and what actions might be appropriate for Eloise to take at 

this point. They express their concerns about Alicia and how she might be hurt if Eloise abruptly cuts off the 

relationship with Alicia. They strategize on how to best handle the situation in a way that would be clinically 

supportive of Alicia.] 

Clinical Supervision and Professional Development 57 
STAN: I want to talk a little about ethical decisionmaking and how we can keep within certain guidelines. 

There are some questions to be asked, such as how that behavior is experienced by someone else. How would 

your actions be perceived by colleagues, the community, a supervisor, and clients? 

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

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

ELOISE: I have a clearer understanding of how my relationship with clients after they’re discharged is as 

important as when they are my active clients. I need to think and give more consideration to how that’s perceived, to consider my role with clients from their perspective. In my relationship with Alicia, I’ve thought of 

myself primarily as a recovering person, but I need to remember that she may perceive me primarily as her 

counselor. In other words, I am wearing two hats—a counselor and a person in recovery—and I need to be clear 

which hat I am wearing and when those hats are on. 

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

that might be perceived. 

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

[The supervision session ends with Eloise making a commitment to rethink the relationship with Alicia and 

strategies for making ethical decisions in the future.] 

Vignette 4—Implementing an Evidence-Based Practice 

Overview 

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

address their resistance while achieving the mandate of the agency. 

Background 

The executive director (ED) of a mid-sized substance abuse treatment program has issued a statement to all 

staff that, according to State requirements, the agency must incorporate EBPs, now a necessity for State funding. Therefore, the ED has directed the three clinical supervisors to begin the implementation of MI as a primary treatment method for treatment staff, first on a pilot basis then agency-wide. Gloria, one of the supervisiors, is meeting with Larry and Jaime, two program counselors, to discuss implementation of MI with their 

clients. Both Larry and Jaime are aware of the mandate but have not had an opportunity to discuss the change 

with Gloria until their regularly scheduled supervisory session this morning. Both have, in the last year, 

expressed some resistance to undertaking a new treatment approach when they were required to attend MI 

basic training. 

Learning Goals 

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

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

their counseling. 

Part 1, Chapter 2 5858 
3.		 To model MI in the supervisor/supervisee relationship. 

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

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

science-based practices. 

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

GLORIA: I know you have some reservations about the MI implementation program. Today I want to spend 

time discussing your reservations and how MI can be good for our clients and for the agency. You have both 

done a tremendous service for our programs. We want to be responsive to your needs, not just impose something on you. When you’ve been doing a good job and you know that what you’re doing works, it’s hard to take 

on something new that you’re uncomfortable with. I know that you’re concerned that taking on something new 

could, at least initially, potentially interrupt the normal flow you have with clients. 

So, there are several things that I think are important for us to consider today. First, let’s review why we are 

implementing MI for staff as a tool in their counseling. Perhaps we can explore any concerns you might have, 

then review why it is important to implement MI. 

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

Third, let’s focus on how we can keep the strengths you have with your clients and be sure they don’t get lost in 

the transition process. One of the beauties of MI is that it integrates well with what good counselors do naturally: active listening, respect for others’ views, an appreciation of the role of resistance, good goal setting practices, and the like. Most important, MI aids in establishing and enhancing the therapeutic alliance between the 

counselor and the client. 

Finally, I want to spend a little time talking about where we go from here and how we are going to make the 

implementation process as smooth as possible. 

Clinical Supervision and Professional Development 

How To Introduce Changes in Clinical Practices 

Changes in counseling methods are difficult for staff who are attached to their 

model of counseling and know that it is working for them. When presenting new 

policies and directions to staff, it is important that you follow these guidelines: 

1.		 Be respectful of staff’s resistance. Instead of exhorting, arguing with, or 

threatening the counselor if they do not “play ball,” seek to understand the 

counselor’s concerns with words such as “Yes, this is difficult. So how can we 

resolve the issue?” 

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

3.		 Depending on the individual counselor, you may need to be flexible yet firm 

in your approach with staff who are expressing resistance to or ambivalence 

about change, being clear that the change is needed yet allowing time for the 

person to adjust and providing the resources needed to aid the counselor in 

making that change. 

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

59 
5.		 Consider using self-disclosure to address defensiveness with supervisees. 

You can either give an example from your own training or experience, such 

as, “I know it was difficult for me too when I was a supervisee,” or by 

describing your own ambivalence in the present, such as, “I also have concerns about the change we have to undertake and want to ensure that it 

works in the best way for clients, now—what can I do?” These self-involving 

statements can engage supervisees in the discussion and problemsolving. 

LARRY: Well, Gloria, we’ve had the MI training, and I like its focus on active listening, the attention it gives to 

the relationship and respect for the client’s perspective. But, you know, I’m basically a 12-Step facilitation guy. 

That works for me and for my clients. I don’t see changing horses in the middle of the stream to achieve political correctness. 

GLORIA: Your 12-Step approach works for you, and we heartily endorse it, too. 12-Step facilitation is an essential part of everything we do at the agency. And I definitely don’t want to see us throw out the baby with the 

bathwater. As you know, counseling is an ever-evolving process, and I think our task is to be able to take what 

we do well and build on it with new approaches. I think MI can add to your repertoire. I think your concerns 

are realistic, and we need to consider that as we move into adopting new methods. What about you, Jaime? 

Part 1, Chapter 2 

Master Supervisor Note: At times a supervisor might feel caught in the middle, representing policies and procedures coming down from funding sources, yet 

posing implementation difficulties. An effective supervisor plays this dual role of 

advocating for both administrators and leadership and the line worker and 

client. Whether working on a factory floor or in a clinical setting, it is difficult 

being in the middle. To aid you in this position, it is helpful to: 

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

2.		 Never lose sight of where you came from. At some point in your career, you 

were a supervisee. It is useful to remember what it felt like being in that 

position. 

3.		 In the example of MI, practice reflective and active listening to understand 

the concerns of those above and below, and to empathize with each group’s 

concerns. 

JAIME: All of this discussion is really above me. I just want my Latino clients to get good care and for their 

treatment needs to be respected. My clients need decent jobs and to be accepted as Latino men being sober in 

their community. That’s what’s important to me. I just want to serve my clients. I know that may not be what 

you want to hear, but that’s how I feel. 

Master Supervisor Note: A Level 1 supervisor might respond either in a 

defensive or overly directive fashion here, telling Jaime that this is something he 

must do. A Level 2 supervisor might get into a struggle over what really matters, defending MI as good for Jaime’s clients, or disrespecting his statement 

about what matters most to him, his clients. A Level 3 supervisor listens to 

Jaime’s statement, affirms and supports him in that, and tries to engage Jaime 

in the discussion. Further, Gloria is working with two counselors at different lev6060 
els of proficiency, so she has different expectations for their contributions and 

recognizes that they have different learning needs. An effective supervisor 

understands the stages of counselor development and varies the approach 

depending on the stage of each staff member. 

GLORIA: Jaime, I respect your commitment to the Latino clients. Larry is clear about one of the things he 

knows works, 12-Step facilitation. In your experience, what works with Latino men? 

JAIME: I’d agree with Larry, 12-Steps, because I go to AA myself, and I know AA works. But what’s also 

important is jobs, not feeling discriminated against, not being asked for ID papers if you’ve lived here all your 

life. What helps is to be with a group of sober men. That’s what helps my clients. 

GLORIA: You both seem to be clear on what you see works for you and your clients. That’s a good start for us. 

As you know from the recent ED’s memo to staff, the State has required all agencies to implement an EBP to 

continue to receive State funds. There has been a lot of discussion at all levels about this. We’ve talked before 

about our desire to move from being a good agency to a great one, being one of the best in the State. Over the 

past year we’ve made incredible progress toward this goal, thanks to all the staff’s efforts. And all through this 

process, we’ve been able to stay true to our 12-Step philosophy. Honestly, when I first heard about the new 

State policy, I, too, was skeptical, saying to myself, “Here we go again.” But then I was reminded of the agency’s 

mission to keep improving our skills for the well-being of the clients. So, discussing this together now is helpful. 

I’d like to hear more from you about your concerns regarding MI. 

LARRY: I don’t really give a darn about MI versus CBT versus 12-Step facilitation versus the next thing to 

come down the pike. I’ve been in the field for a long time, and I know what works is my relationship with people. I know 12-Step works, and I have to be convinced that this doesn’t interfere with having a strong relationship with my clients. I think that’s the most important thing. I’m not sure I need a new way to do this. I don’t 

want to have to be worried about whether I have to use this science-based thing. 

GLORIA: Wow, Larry! I really hear that the most important thing to you is building strong relationships with 

your clients, and it’s not so important what method you use to build strong relationships, but that the method 

helps you accomplish that goal. Perhaps we can look at how MI’s approach to active listening with clients and 

reflection enhances that relationship. If it builds the therapeutic alliance with the clients, that’s good. I’m curious how you feel about that. 

LARRY: What I want to be sure of is that we’re not moving away from our roots: that this is not taking us away 

from 12-Step. That’s what this agency is founded on, and that’s what we stood for all these years. I need to hear 

that from you. 

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

work? What do you think? 

LARRY: If an approach builds the relationship with the client, I’m all for it. I know that 12-Step facilitation 

does that. And I know from the course I took on MI that it also emphasizes the counselor–client relationship. 

But it is also a new way of thinking and a whole new vocabulary and I don’t want to get so bogged down in 

catchy phrases that I lose contact with my client. 

GLORIA: Larry, I clearly hear your concerns about interfering with your relationship with your clients and 

about us losing our roots. 

LARRY: Maybe Jaime can do the MI stuff and I can do my 12-Step facilitation. 

JAIME: What? 

GLORIA: There are several different ways we can approach the implementation. We may decide that MI works 

better with some client populations than others. A place to begin would be for us to learn more about how MI 

Clinical Supervision and Professional Development 61 
can be implemented in the program. I know you’ve been to the MI training. That’s a great start. MI has some 

good strategies that are congruent with a variety of client populations. 

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

GLORIA: That’s a dilemma. The State’s said, “You have to do it.” What they haven’t said is how you have to do 

it. They said we have to do “something.” We have something to say about how we’re planning this, how we’ll 

implement an EBP. I want to be sure that we hear and use your experience. 

Part 1, Chapter 2 

Master Supervisor Note: It is helpful to watch how Gloria handles the polarizing confrontation. A Level 1 supervisor might either come down hard on Larry 

for his suggestion, saying “No, we’re not doing that.” A Level 2 might argue 

about it. Note the Level 3 approach, not to confront the statement by Larry but 

to find a working alternative. 

A master supervisor is able to manage staff confrontation and avoid becoming 

defensive. To do this, it is important for the supervisor to understand that struggle is a sign of staff ambivalence to change. Resistance and ambivalence are normal in any situation involving change. A master supervisor works with the 

resistance, using its energy to promote change, not taking it “head-on.” 

LARRY: I like the idea that we can implement the strategies that work best for our agency because that allows 

us to stay close to our roots of 12 Steps. 

GLORIA: So you see the value of implementing an EBP approach such as MI as long as it stays close to our 12­

Step roots. Moving ahead, I recognize that this is going to change some of our approaches, how we think about 

treatment, how clients experience us. 

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

in MI? 

GLORIA: Perhaps I can show a videotape of a counseling session I conduct when I think I am doing effective 

MI. What do you think of that idea? Would that help us all feel more comfortable with an EBP? I’m willing to 

stick my neck out if you’re willing to give me feedback on what you see on the videotape. 

Master Supervisor Note: A basic rule of supervision is “do not ask a supervisee to do something you’re not willing to do first.” A second rule is that “leaders bear pain, they don’t inflict it.” Master supervisors are willing to take a risk 

by demonstrating their skills first before asking staff to do so. Effective supervisors are able to establish trust by serving as a team leader, inspiring staff by 

encouragement and motivation, communicating enthusiasm and capability, and 

taking appropriate risks to initiate change. Leaders also demonstrate vision, 

drive, poise under pressure, and maturity of character. They inspire rather than 

command staff. Since leadership entails teaching, mentoring, and coaching, having the title “supervisor” does not necessarily make a person a leader. To earn 

respect, the supervisor should display qualities of honesty, responsibility, fairness, and understanding. In this vignette, Gloria provides direction and leadership by showing staff how they can implement MI together and how the training 

will work. She also gives them a say in the process and allows them to keep to 

their roots, learn new tools, and do so over time. 

6262 
GLORIA: That’s a good question about implementation. Any approach we use needs to be respectful and build 

on the counselor–client relationship. So let’s start there. First, we want to implement MI over time. It’s not 

something that we’ll become instant experts at. I want to make sure that we’re well prepared and understand 

what we’re doing. 

[Larry and Jaime nod in agreement.] 

GLORIA: Again, let’s be clear. We need to implement EBP for State funding. Remember when the agency went 

smoke free: How difficult that was, how much resistance some staff expressed? But, it was something we just 

needed to do, and in the end, being smoke free has had significant health benefits to staff and clients, and has 

reduced the health care premiums for all personnel. I’m interested whether you see the similarity to such 

changes. 

LARRY: Yes, I do. The smoke-free campus has been a real benefit to all. I hope implementing an EBP is also. 

GLORIA: I agree. Maybe we can return to the training issue you raised earlier. Larry and Jaime, with your 

help and support, I’d like to establish a year-long training plan. First, I’d like to have an advanced trainer come 

in and provide several days more of training that particularly addresses the needs and concerns of the staff. 

We’d also like to contract with the trainer to establish an MI coding system that will be part of what we do in 

our clinical supervision. Over the year, we’d continue our direct observation for supervision. Only now we’d look 

at the interactions through the MI lens. The coding system will help us in doing so. 

JAIME: I remember hearing about coding in the basic MI course I attended. Can you tell me more about that? 

GLORIA: Here is a coding sheet that the trainer of that course recommended. I like the form and find it simple 

and easy to use. I also think it’s consistent with what we do as counselors, and it reinforces our efforts to listen 

better to clients. As in 12-Step facilitation, it helps to build an alliance with the client. 

LARRY: So you’re convinced this is a good thing? You’re not just doing this to get State money? 

GLORIA: From what I know about MI and have read about it, I think MI is a very useful tool for us. We’re concerned about our funding, of course. But, client welfare always comes first. No, we would not be doing this simply for money. I believe this will help our clients, and that’s the bottom line, isn’t it? So, perhaps we can discuss 

the skills we have as a team and how to proceed. 

JAIME: I think we work well together and we seem to have good stable funding that allows us to maintain the 

quality of care we offer to our clients. 

LARRY: Yes, we have good teamwork and support each other. Jaime and I work well together. We’ve got a lot 

of respect for each other. We’ve had the basic MI training. That’s a good start. 

GLORIA: Teamwork is important. 

LARRY: We do good treatment. Our clients respect us. We have good credibility out there. That’s a plus. 

GLORIA: I’d also add that we have experience at successfully implementing changes. 

JAIME: Three years ago we had few Latino clients and no Latino program. 

GLORIA: Implementing a Latino program was a major positive step forward. The other thing I like is that we 

have a good supervision system which helps us assess how we’re doing when we implement any new practice or 

program, like the Latino program. It gives us a way of assessing quality. 

LARRY: So, what’s going to change here? 

GLORIA: We do have time for more training. It’s difficult jumping into a new approach if we don’t feel like 

we’re adequately prepared for the change. One solution would be for us to devote more time in our normal clinical supervision sessions (individually and in group) to MI practices, to use videotapes and role plays to continue 

Clinical Supervision and Professional Development 63 
our learning and practice our skills. We can phase in MI over time. I’m committed to supporting you in whatever you need to do your job effectively. More than 150 studies have shown that MI is effective; this will 

enhance our skills and give us better client outcomes. It might be helpful for us to talk to an agency that uses 

MI and ask how they did it. We need to do training, as I said earlier, so we can be consistent with our core 

approach. I want to integrate this in a way that makes sense for all of us. Perhaps between now and our next 

meeting you’d think about two things you can do to help us write the implementation plan that will show how 

we’re going to do this. We have an excellent team and do good work. I value and trust the work that we do. 

Learning a new strategy requires training, mentoring, and coaching. Our relationships with the clients and 

each other are the most important because that’s how we serve the clients. 

[A discussion follows when they discuss the training system, who might serve as a consultant for the advanced 

training, and how the coding system works and can be incorporated into the clinical supervision system. The session ends with a mutual commitment to move to the next stage of implementation.] 

Vignette 5—Maintaining Focus on Job Performance 

Overview 

In this supervisory session, a counselor with marital problems carries this stress into the workplace. She feels 

overwhelmed by the complexity of her caseload, misses work, and cancels patient appointments. Observe how 

the supervisor must address the counselor’s job performance, provide emotional support for the counselor, and, 

at the same time, not get involved in the counselor’s personal life. 

Background 

Juanita has worked as a counselor at the agency for over a year and brings a number of valuable attributes to 

her job. She is bilingual, understands the stresses and cultural dynamics faced by recent Central American 

immigrants living in the United States, works well with female clients, and gets along well with other staff. 

Her husband is a recovering alcoholic, and Juanita has been active in Spanish-speaking Al-Anon. She recently 

received her addiction counselor credential. 

Since receiving her license as a substance abuse counselor, Juanita has been given new job assignments that 

involve working with more complex and difficult clients. She now conducts educational and support groups by 

herself, does intake interviews, provides individual counseling to her caseload, and has recently increased her 

caseload to accommodate the increased number of clients at the agency. She is also seeing several clients with 

co-occurring disorders. 

While she is friendly and outgoing with others, her natural response to stress is to withdraw and isolate herself, rather than ask for help. To Melissa, her supervisor, Juanita seems more tentative and less energetic in 

their supervision sessions. She seems to be meeting most of her work performance goals established in the 

supervision, but the quality of discussion about her cases and her lack of vitality in the meetings concerns 

Melissa. 

In the past month, Juanita has come late to work on a number of occasions and missed several client appointments. She has called in sick three times in the last 3 weeks. In supervision, she seems distracted, which is a 

change from her prior behavior. Melissa, in her concern, asked in supervision “is everything OK?” Juanita 

replied, “No, Jorge has been laid off his construction job, and he has been drinking.” She explains that she is 

quite distressed, having trouble sleeping, and feeling overwhelmed. Though clearly worried, Juanita did not 

elaborate, and Melissa did not pursue the questioning. Juanita did ask if she could talk to Melissa at another 

time to discuss her personal problems and to seek Melissa’s advice on how to handle her current situation at 

Part 1, Chapter 2 6464 
home. Melissa was uncomfortable agreeing to this but also was uncomfortable not responding to Juanita’s distress. She hesitatingly said that they could discuss this at the next supervisory meeting. 

In the upcoming supervisory session, Melissa feels it is important to clarify the differences between providing 

help for personal problems and maintaining supervision goals. Melissa also thinks it is important to address 

Juanita’s job performance issues in the next meeting. 

Learning Goals 

1.		 To illustrate how work-related stresses and personal problems can interact and affect one another. 

2.		 To demonstrate the boundary between clinical supervision and personal counseling. 

3.		 To demonstrate how to help an employee get the help necessary to address personal (non–work-related) life 

problems that affect the work environment. 

4.		 To illustrate how to monitor and maintain adequate clinical performance when an employee is facing difficult personal dilemmas that affect job performance. 

5.		 To demonstrate awareness of and sensitivity to cultural issues that arise in the context of personal issues 

that affect job performance. 

[The vignette picks up with the beginning of the next clinical supervisory session.] 

MELISSA: Juanita, hi! Come on in. Before we start talking cases today, I would really like to go over some of 

what we discussed last week and see where things stand. 

JUANITA: That’s fine, but I think I owe you an apology about our last session. I really want to apologize for 

saying all those things to you about my family and how that is affecting me and all that, and I just want to 

apologize. I know it had nothing to do with anything work related. We were doing supervision and should just 

have talked about cases, and I just want to assure you that that will never happen again. 

MELISSA: Well, Juanita, I’m sorry you have to cope with all that’s going on, but I don’t feel you need to apologize for anything last week. I know that what’s happening is stressful to you. I hope we can work out a plan to 

help you get the help you need and also be sure that the pressures you are experiencing don’t spill over into 

your work with clients. 

Clinical Supervision and Professional Development 

How To Address Personal Issues That Affect Job Performance 

Consider the following points when you need to confront a supervisee in clinical 

supervision with problems of job performance that are exacerbated by personal 

difficulties, such as emotional, familial, interpersonal, financial, health, or legal 

concerns: 

1.		 You can help your supervisees see the relationship between their personal 

difficulties and work-related problems. The key question you need to return 

to is “How is this personal issue affecting your job performance?” This prevents you from becoming the counselor’s counselor and turning supervision 

into therapy. 

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

3.		 You should continually focus on approaches to improve job performance, providing useful suggestions and recommendations for improvement. It is also 

65 
helpful to provide measurable benchmarks by which counselors can assess 

their own improvement. 

4.		 You and your supervisee should develop a written work plan for how the 

employee will take the necessary steps to improve job performance. 

5.		 You can help the counselor examine how personal stressors might affect 

interactions with coworkers or clients. 

6.		 Finally, you and your supervisee can explore how you and the agency can 

support the employee in confronting and resolving personal issues that are 

affecting job performance, such as a referral to the EAP, use of personal or 

sick time, rescheduling of the counselor’s time, and the like. 

JUANITA: I appreciate that. I just want you to know that that’s not me. That’s not me. 

MELISSA: And I appreciate that, and I want you to know that I value your work. You’ve worked hard. You’ve 

really worked hard in learning not only your job, but also as a professional counselor and you’ve made a valuable contribution to working with our clients. 

JUANITA: I love my job. I love it. 

MELISSA: Juanita, I want to be really clear with you that I am concerned about what is going on in your personal life, and I want to work with you to get help for that. I don’t feel that it’s something that we should address 

in supervision though, except to the extent that it affects your job performance. The goal of our supervision time 

is to help you to be the best counselor possible. When personal issues come up, those may keep you from being 

the best person you can be. These are important issues for you to address in your own personal counseling and 

therapy. I hope that distinction is clear for you. But I really want you to hear my concern for you. 

Part 1, Chapter 2 

Master Supervisor Note: Although the distinction between personal counseling and supervision may be contingent on the supervisor’s theoretical orientation, and both are interpersonal relationships, there are differences between the 

two, as summarized in the table below. 

Personal Counseling 

1. The goal is personal growth and development, self-exploration, becoming a better person. 

2. Requires exploration of personal issues. 

3. The focus of exploration is on the origins 

and manifestations of cognitions, affects, 

and behaviors associated with life issues 

and how these issues can be resolved. 

Supervision 

1. The goal is to make the counselor a 

better counselor. 

2. Requires monitoring of client care and 

facilitating professional training. 

3. The focus is on how issues may affect 

client care, the conceptualization of the 

client problems and counseling process, 

and accomplishment of client goals. 

To help the counselor and the supervisor differentiate between therapy and 

supervision, the supervisor needs to continually ask him- or herself, “What does 

this have to do with your counseling functions? How is this affecting your relationship with clients?” 

6666 
JUANITA: I’m still kind of worried that I told you about my personal life, but I do want to be the best counselor 

I can be. 

MELISSA: I’m concerned about the time you have been missing from work and especially the times you have 

had to cancel patient appointments as a result of your situation at home. 

JUANITA: I know I’ve missed a couple of sessions, but I called. The clients were okay with me rescheduling, 

and I’ve continued to meet with them. I don’t think there’s any problem. It was the first time I ever had to 

reschedule those clients, and we caught up on their visits later in the week. 

MELISSA: I hear that you were concerned about missing some sessions so you made a strong effort to reconnect with your clients later. I really appreciate your effort. I had a chance to review a videotape of a session you 

did last week. I’m pleased with the skills you’ve developed in group counseling. In the middle of the session we 

videotaped, there were some issues that came up about men that I thought might be a concern and might illustrate what we’re talking about. Can we view that section of the tape and discuss what was happening for you at 

that point? 

JUANITA: Sure, if you have the tape there. 

[Together, Juanita and Melissa watch the tape, cued to the segment about clients actively drinking while in 

treatment. Juanita appears surprised to see her response to the client on tape and notes the impact she might be 

having on clients. For example, there was an interaction between Juanita and a male client in group where she 

saw herself being judgmental and overly critical. Melissa and Juanita continue to discuss the tape and the 

meaning of counter-transference in the counseling relationship. From the discussion of being angry at clients 

who continue to drink, Juanita becomes aware that the sessions she has cancelled with clients were all with 

drinking men.] 

MELISSA: I’m glad you can stand back objectively and see the relationship between your personal issues and 

your clinical functioning. So, what do you think you need to do now? 

JUANITA: Well, first maybe I shouldn’t see any more male patients? 

MELISSA: That is an option. But I think we can find a better resolution. For right now, let’s focus on what else 

needs to change. 

JUANITA: Well, I just won’t cancel any more appointments. I didn’t realize rescheduling was such a problem. 

But I just won’t do it anymore. And about the missed days, I think that is beyond me now. If I need a day off 

for personal reasons, I’ll schedule them in advance from now on. 

MELISSA: OK. I think I would like you to go through me for the next few months if you need either time off or 

if you have to cancel patient appointments. I know emergencies happen, but just let me know if you need time 

off and we’ll see where we go from there. 

JUANITA: I understand. I am so sorry that my personal life is intruding on my counseling. I never thought 

that would happen. And I’m going to get back to my work. I’m going to make sure I get the paperwork and 

everything done, and I will be on time tomorrow. 

MELISSA: Let’s put the paperwork aside and talk about your work with the clients and what you need to do to 

maintain your high level of work performance. Let’s get back to the countertransference. I’d like to hear more 

about the clients you work with. Let’s go back to the videotape and discuss what else is happening in the session. 

JUANITA: Basically, I’ve moved into working with some of the more difficult clients in the last several months. 

It’s been very challenging developing plans with them and encouraging their attendance and working with 

their treatment plans on a more active level because I’m definitely sensing the resistance. 

Clinical Supervision and Professional Development 67 
MELISSA: So, not only are you working with more complex clients but you also have a higher caseload than 

you had not so long ago. So your job responsibility has increased significantly recently. I think you’ll see some 

different features of supervision as you continue to see clients with more complex problems and as you begin to 

work in other treatment modalities, such as group. Let’s discuss how you’re dealing with the more complex 

clients. 

[A discussion follows, using the videotape, about how Juanita has been working with these clients, some of her 

concerns about working with clients with more difficult co-occurring disorders, some specific points about counseling interventions and her countertransferential reactions to men who are drinking. She acknowledges that her 

reaction to the client who has relapsed is in part a response to her current life situation with her husband. Now 

that Juanita recognizes where her work is being impacted by her personal issues, Melissa returns to the issue of 

the EAP and re-introduces the possibility of a referral.] 

Master Supervisor Note: It is important for the supervisor and counselor to 

understand the impact of countertransference in a counseling relationship, 

including: 

1.		 It can distract from the therapeutic relationship. 

2.		 A counselor’s personal issues may contaminate how he or she sees the 

client’s issues. 

3.		 The counselor may distance him- or herself or avoid discussion when the 

client’s issues come too close to home, or conversely, the counselor may focus 

on client issues that resemble her own. 

4.		 The counselor may have negative reactions to the client, based on the counselor’s current life issues, as Juanita did with the men in her group who 

were actively drinking. 

MELISSA: Juanita, you may remember that, as part of your professional development plan, we talked about a 

personal care plan: knowing when you need support and where you could get it. Your Al-Anon program has 

been a strong support for you, and you’ve used it in a very effective way. I’m wondering if you have used or 

would consider using our EAP to help you address the crisis you are experiencing now. I think it would be helpful if you had the opportunity to sit down with someone and assess how things are going and what could help. I 

hope you’ll use our EAP for that. As you know, using the EAP is optional. I’m not mandating that you go. But if 

you think it would help, I hope you’ll take advantage of it. This booklet has some information about the EAP 

and how to access their services. As you know, the EAP is strictly confidential, and nothing is reported back to 

the agency. I’m also wondering how I can be of support to you. 

JUANITA: Just be there for these sessions. Just be there as the supervisor when I come and have questions. I’ll 

call the EAP this afternoon. Do you think they would also be willing to help Jorge if he is willing to come with me? 

MELISSA: The EAP is for the whole family, and I’m sure they would be available to see Jorge too, either with 

you or separately. I’m glad you are going to follow up on that. 

Part 1, Chapter 2 6868 
Clinical Supervision and Professional Development 

Master Supervisor Note: Note that Melissa doesn’t ask Juanita to report back 

to her about using the EAP. The EAP referral is to address personal life issues 

that are not the concern of her employer. It is Melissa’s role to monitor job performance and to use all of the resources that are available to help Juanita 

improve her job performance. In most organizations, an employee’s use of the 

EAP is not the concern of the supervisor. The focus of the supervisor needs to be 

on improving job performance. Statements such as “Let me know if you use the 

EAP” are not within the supervisor’s scope. Remember, the goal of clinical supervision is not necessarily to make the supervisee a better person, but a better 

worker. It is tempting for clinical supervisors to focus on the personal issues of 

staff—after all that’s what they do for a living. However, personal issues are a 

part of clinical supervision only insofar as they affect the counselor’s interactions 

with clients. 

[Melissa and Juanita continue to discuss some of her cases and her efforts to work with more challenging clients. 

At the end of the supervision session, Melissa and Juanita schedule two sessions in the coming week for Melissa 

to sit in on Juanita’s sessions again. Melissa reaffirmed that she hoped Juanita would consider using the EAP to 

address some of the issues in her personal life.] 

Vignette 6—Promoting a Counselor From Within 

Overview 

In this vignette, a counselor has been promoted from within a work group to a supervisor position over the 

counselors she worked with as a peer. Issues addressed include how the new supervisor handles staff resistance 

and works to build a new relationship with the counselors she will now be supervising. 

Background 

Kate has been a counselor at the agency for 3 years. She, Maggie, and Kevin have worked together as outpatient counselors, supervised by Gene, who left the agency last month to take another position. Kate has a master’s degree in counseling, is licensed as a drug and alcohol counselor and, for the past year, has been taking 

continuing education courses to develop her supervisory skills, hoping that a supervisory position would open 

up in this or another agency. But the courses only gave brief reference as to how to work with and supervise 

counselors who last week were her peers. 

Maggie has worked at the agency 2 years longer than Kate, is a licensed drug and alcohol counselor, recently 

completed her bachelor’s degree and has started working on her master’s degree. She understands that Kate 

got the promotion partly because of her advanced degree but still feels she was treated unfairly in the selection 

process because she has been with the agency longer. 

Kevin, also a counselor, is in process of becoming licensed. He has a bachelor’s degree and has worked in the 

field for about a year. He has concerns that someone who was a counselor and his peer last week can be an 

effective supervisor for him now. He likes Kate and has turned to her numerous times for advice and support, 

but wonders about her competence as a supervisor. 

69 
The agency director announced the promotion yesterday afternoon and suggested to Kate that she meet with 

Maggie and Kevin soon. The director offered to sit in on the meeting, but Kate declined, feeling that she would 

rather discuss the promotion and changes alone with Maggie and Kevin first. Since everyone had appointments 

already scheduled for the morning, lunchtime was the first available opportunity for the meeting. 

Learning goals 

1. To demonstrate how a new supervisor can establish a leadership position and demonstrate a leadership style 

with former peers. 

2. To show how a new supervisor handles the potential conflict of her promotion over others with whom she has 

worked. 

3. To give some guidance to recently promoted supervisors to clarify their roles, develop opportunities to learn 

new supervisory skills, and establish rapport with supervisees. 

[Kate, Maggie, and Kevin meet over lunch to discuss Kate’s new position.] 

KATE: Thanks for being willing to sit down with me and discuss how we are going to proceed in face of the 

changes that were announced yesterday. I’m pleased with the promotion and excited about getting my feet wet 

in this new role. I hope we can work together to continue doing the good job we have been doing. 

[Long pause while Kevin and Maggie wait for Kate to proceed.] 

KATE: I hope you see this as an opportunity for all of us. 

[Another pause while Kate waits expectantly.] 

KEVIN: Well, Kate, it’s going to be strange having you as a supervisor. Gene and I had a good relationship. He 

was my boss the entire time I’ve been here, and I learned a lot from him. I knew there were going to be 

changes. I guess I’d rather see you or Maggie get the promotion rather than having someone new come in from 

the outside. This is quite a shift. Two weeks ago, when Gene announced he was leaving, all three of us were in 

group supervision together. Now you’re our boss. 

[Another pause.] 

KATE: Yes, Kevin, it seems strange for me too, I have to admit. I’ve enjoyed our collegial relationship. I’ve 

learned from you and appreciated your input too. I’ve even enjoyed our “grousing sessions” when we’ve felt 

overworked and underpaid. [Laughter.] And I know there is going to be a shift in our relationship, but I still 

want us to see ourselves, as well as new staff, as a team, focused on the best patient care we can offer. 

Master Supervisor Note: It is important for new supervisors who are 

promoted from inside not to try to be something they’re not. Everyone knows you 

don’t know the job. Don’t try to fake it. Instead, acknowledge to staff that this is 

new, that you have things to learn, and that, with their assistance, you can work 

as a team. The worst mistake you can make as a new supervisor promoted from 

within is to try to take the reins of leadership abruptly and without consideration of staff reaction to your promotion. 

KEVIN: I’d like to hear about any changes you are planning or how things might be different now that you are 

running the show. 

KATE: Great question, Kevin. In the past, we’ve all sat around in the lunchroom and spoken of what needs to 

be different in the agency. Now, together, perhaps we have an opportunity to make some of those changes. For 

Part 1, Chapter 2 7070 
example, we’ve spoken before about how we’d like to streamline the paperwork process. I know we’re all buried 

in forms. How can we reduce the strain of administrative tasks we all face? How do we deal with our burnout? 

So much is asked of us, and that places great strain on us. We’ve spoken about that together, how tired we can 

become. How can we take better care of ourselves and of the team? 

But, I want that process to unfold together. I need your help and input. Also, I want a few weeks or a month of 

breaking in time before any changes are made. So, perhaps we can sit together as a group and think about 

what needs to be different. I will then “run those changes up the flagpole” with the director and do what needs 

to be done to bring about the changes we deem necessary. How does that sound to you? 

How To Demonstrate Leadership 

It is important for a new supervisor to demonstrate leadership without being 

controlling or condescending, especially if promoted from within. Perceptions of 

quality leadership have shifted from the traditional hierarchical, command-andcontrol model to a networked, team-based approach that values participative 

leadership and staff empowerment, bottom-up management, team input, and collaboration. Qualities of this leadership style include: 

1.		 Taking responsibility for decisions made, never blaming others for something 

you’ve done, and giving credit to others when things succeed. 

2.	 	Always putting the well-being of supervisees above personal accomplishments. 

3.		 Not being afraid of taking appropriate risks that are in the best interests of 

the organization, staff, and clients. 

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

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

boss. If you have to prove who is the boss, you are not. 

MAGGIE: I have to say that I’m not very happy about this. I met with Gene and Susan [the agency director] 

about ten days ago and expressed an interest in applying for the position. I didn’t hear a word until I found out 

yesterday that you got the job. I want to be clear that I’m not upset with you. I’m glad for you, but I’m not 

happy about the way this was handled, especially how Susan made the announcement. It makes me wonder 

how decisions are really made around here. 

KATE: I think if I were in your situation I’d be unhappy too. It doesn’t feel very good when there’s no communication. I understand that you were interested in the position. I am sorry about how the communication was 

handled. 

MAGGIE: Like I said, I’m not upset with you, but with Gene and Susan. I felt disrespected after my years of 

service to the agency. That really doesn’t feel very good, like not being valued. 

KATE: Yes, it feels like you should have had some communication at the least, and not have been surprised by 

the decision. 

MAGGIE: Yeah, it feels lousy. I wonder what my future is with the agency: if I’ll be passed over for other promotions. And, quite honestly, I regret that I didn’t go back to school and finish my degree years ago, if that’s 

required for a supervisory job. It makes me angry though, because they never told me that education would be 

a deciding factor. I don’t even know what the criteria were for the decision. 

Clinical Supervision and Professional Development 71 
KATE: Maggie, I can sure understand your feeling that way. And to be honest with you, I think I would have 

felt much the same as you do if the decision had gone the other way. I’m sorry that’s the way this happened. If 

it would be helpful to discuss your concerns with Susan, either together or alone, I’d be willing to help you 

with that. 

Master Supervisor Note: It would be easy for Kate at this point to triangulate 

the communication, making Gene and Susan “the bad guys.” However, Kate 

skillfully identifies Maggie’s feelings, provides self-reflection on how she’d feel if 

in a similar situation, without polarizing the process and the others involved. 

KATE: In the future, perhaps we can make suggestions to administrators on how we’d prefer the process and 

communication to flow. How could this situation have been handled differently? What would have been more 

helpful to you, Maggie? 

[A healthy discussion follows between Kate, Kevin, and Maggie about how to improve the communication process 

in the future. Maggie feels like she has a voice in the process and feels listened to and understood. Kate asks 

Maggie what she needs now.] 

MAGGIE: Thanks for this conversation and for your concern. Let me think about what I want to do now and 

what I need. Can I get back to you on that? 

KATE: Sure, we can discuss it when you’re ready. 

KEVIN: I’d still like to maintain our friendship. I understand it is going to be a little different, for instance, 

calling you “boss.” But the three of us have had a good thing going here. It’s been fun for this last year. I want 

to keep that. 

MAGGIE: Our friendship has been fun: something I’ve treasured, too. As you say, things aren’t going to be the 

same. Kate is the supervisor now. And when we hire a new counselor, you are no longer the new guy on the 

block. More is going to be expected of you. 

KATE: I am going to miss some of what we have had together too. It would be hard to act as if we’re peers and 

then have any objectivity when it comes to management decisions. We’d risk claims by others of favoritism. So, 

as hard as that will be for me, I’ll need to stop doing as much socializing as I did before. I don’t understand 

fully what I mean by that, but I know things will be different. I also will experience a sense of loss of some of 

my clinical duties. I’m giving up some of the real satisfaction that I found in counseling, working with clients. 

And I’m swapping that for new tasks. So I likely will also go through some grieving as well. 

KEVIN: Thanks for your honesty, Kate. This means changes in a number of ways, for all of us. Kate, I have 

confidence you’ll do a good job. Although you’ll have to get a new wardrobe and dress more like a manager. 

[Laughter.] 

KATE: Thank you so much for your patience and understanding. I was nervous coming into this meeting, given 

how this all unfolded. I feel like we’re heading in the right direction. How do you feel we’re doing so far? 

MAGGIE: I appreciate your listening to my venting and I think you understand how I’m feeling. 

KEVIN: I am cautiously optimistic, which, for me, is saying something positive. After all, you know what a 

cynic I am. [Laughter.] 

KATE: You, a cynic, Kevin? No way! [Laughter.] There’s one more thing I would like to address before we stop 

today: how we proceed. Gene had a really good system in place for clinical supervision. I would like to return to 

that system and schedule that includes the efforts Gene was making to improve our supervision process. What 

do you think? 

Part 1, Chapter 2 7272 
[The discussion continues about what to do in clinical supervision, returning to the effective system formerly in 

place.] 

Master Supervisor Note: It is important to move forward, saving what was 

working before, not seeking to make radical, hasty, drastic changes. Also, this is 

an opportunity for Kate to demonstrate leadership by not languishing in the 

present situation, not “badmouthing” administrators for how this decision was 

made, while also acknowledging the emotional and professional concerns of staff. 

[The session ends with a group decision to move forward in their clinical supervision.] 

Vignette 7—Mentoring a Successor 

Overview 

This vignette illustrates the process of mentorship as a supervisor faces retirement and needs to mentor a successor from within the agency. Mentorship is an urgently needed process in the substance abuse field as a significant number of current leaders in the field face retirement in the near future. 

Background 

Margie is a certified clinical supervisor with 25 years’ experience in the field. She is in her early 60s, has 

worked at the agency her entire career, and is, in fact, the longest term employee at the agency. She is 

approaching retirement in the next 2 years. It is agency policy to promote from within whenever possible. 

Betty has been in the field for 10 years and has been employed by this agency for 3 years. She is an excellent 

counselor and is well respected by colleagues in the agency. She has the potential to be promoted to Margie’s 

position as clinical supervisor. However, she has professional development issues that need to be addressed 

before she could be promoted. For example, she would need training in clinical supervision skills and eventually 

will need to get her certification as a supervisor. She also has a managerial style that needs to soften a bit. She 

sometimes comes off as too authoritarian and abrupt. Previous attempts by other supervisors to address this 

style have not been successful in changing the behavior. Margie has worked with Betty for 3 years as her clinical supervisor but without a mentorship training plan. 

The vignette focuses on how Margie can mentor her successor and the next generation of personnel so they 

could be promoted upon her retirement. The vignette addresses the necessary systems of mentorship that can 

be involved, what ought to be in Betty’s IDP, and the coaching Margie will provide to Betty. 

The dialog begins with a discussion about current and future personnel issues and Margie’s pending retirement. Margie’s goals in this session are to begin to define Betty’s learning needs, to establish a mentoring relationship, and to pave the way for Betty to be accepted as a supervisor by others in the agency. Margie’s 

approach is to be a positive, supportive coach and to encourage Betty to begin the professional development and 

training required to be a supervisor. 

Learning Goals 

1. To illustrate how to design a mentorship program for personnel, including the writing of mutually agreed 

upon IDPs for potential successors and all clinical staff. 

Clinical Supervision and Professional Development 73 
2. To illustrate the process of establishing a supervisory alliance that incorporates principles of mentorship 

and training. 

3. To suggest how to develop and maintain a strong collaborative and professional supervisor–supervisee relationship. 

MARGIE: Betty, as you know, I’m beginning to wind down my career and am looking forward to retirement in 2 

years. Our agency strongly believes in the idea of fostering our own leaders and promoting people from within. 

You and I have had a great relationship over these past few years. I’ve seen your skills and feel you have great 

potential to grow professionally and as an important professional in this agency. Your clinical skills are excellent, you always complete your paperwork on time, and you’re a joy to supervise. 

Part 1, Chapter 2 

Master Supervisor Note: It takes a Level 3 supervisor to be able to mentor 

someone else. Level 1 and 2 supervisors might find it difficult to let go of the 

reins, to essentially work themselves out of a job, and might feel threatened by 

helping others develop to their own level of competence. A Level 3 supervisor 

needs superior vision: the ability to look ahead and see what’s needed for the 

sake of the agency and staff. This requires maturity, serenity, and wisdom. 

BETTY: Thanks so much, Margie. That really feels good. I really like my job and would like to continue working here. 

MARGIE: I hope you continue working here. You’re a great asset to the agency. You’ve just implemented some 

innovative ideas, and you’re enthusiastic about the work. Whenever I ask you to take on an assignment, you’re 

always the first to complete it. I like that. You’ve worked hard to become an excellent counselor. So, I’d like to 

have an idea where you want to be in 5 years. Would you be willing to discuss that with me? 

BETTY: Sure. I hope I’m still here. I like the clients, my colleagues, and this agency. I like that I get to try new 

things. You’ve been supportive of that. This is a place where I’m able to make a contribution to my community. 

MARGIE: So this is “home” for you: That is so evident. It’s working really well for you. Perhaps we can discuss 

what’s ahead for you. What would you like to be doing differently here in the future? 

BETTY: I don’t know. I’d like to continue to improve my counseling skills, maybe even advance up the ladder a 

bit. I think I have good individual and group counseling skills, but I also know administration involves another 

whole set of competencies. 

MARGIE: You’re right, there are different skills in administration and that’s important to recognize. And I’m 

excited that you want to move up. 

BETTY: Oh, that scares me a bit. I like seeing clients and wouldn’t want to become a paper-pusher, not that 

that’s all you do. [Laughter.] 

MARGIE: I like that you want to stay anchored in clinical work. I think that is important and I appreciate your 

concern for clients. That’s one reason you’re so good at counseling. You have a real caring and compassionate 

nature for the people you work with. 

[A discussion follows about Margie’s job and what it means to be in a supervisory position at that agency. 

Margie outlines the roles and requirements of being a supervisor.] 

MARGIE: Another way to look at your contribution to clients and legacy in counseling might be in the fancy 

word used by Erik Ericson, who spoke of “generativity”: getting to a stage of life when you want to give something over to the next generation of people to follow you. You’re having a great impact now on your clients. As 

7474 
you progress into a supervisory role, you have the potential of affecting even more clients and staff, as you train



and supervise counselors.



BETTY: What do you mean?



MARGIE: Remember years ago in school? Can you recall any teachers that left their mark on you, people that



helped you become the professional you are today?



BETTY: Yes, there were many. 
 

[A discussion follows about these mentors and how Betty benefited from their teaching.]



MARGIE: As you supervise, you have the opportunity to touch more people’s lives. Yes, there is more dreaded



paperwork. But, at the end of my day, I go home with a rich sense of legacy that I’ve had the chance to touch



even more people’s lives as a result of being a supervisor, even more than I might have as a counselor alone.



BETTY: Yes, I see that in you. You’ve had a profound impact on my life and that of so many counselors here. 
 

Clinical Supervision and Professional Development 

Master Supervisor Note: One of the most effective ways to lead is by example. 

Mentorship should include something of attraction; people should see something 

in you that they want. “Whatever she has, whatever she does, I want to have 

and do that.” People are imitative; they find role models they want to be like. So, 

when mentoring, use personal examples for the potential to grow and impact on 

others. It is important to identify the qualities and characteristics of a positive 

mentor and role model for staff, such as eliciting, rather than imposing, their 

judgment; drawing ideas from the supervisee, and being positive and affirming. 

Mentorship is a special kind of professional growth opportunity, differing from 

other supervisory models. In mentorship, the mentee asks questions, shares concerns, and observes a more experienced professional in a safe learning environment. Through reflection and collaboration, the mentee can become more selfconfident and competent in his or her integration and application of the knowledge and skills gained. Mentorship addresses the unique needs, personality, 

learning styles, expectations, and experiences of each person. Mentorship can be 

defined in numerous ways. One definition is a working alliance offering regular 

opportunities for discussion, training, and learning to occur between less experienced and more experienced people in various settings, addressing practical, 

hands-on work experience to enhance the knowledge, skills, attitudes, and competencies of everyone. 

MARGIE: So, perhaps we can discuss how you can increase your skills, both clinically and in supervision. This 

is the beginning of our developing and updating your IDP. One place to start would be for you to attend clinical 

supervision training. There are online courses, self-study programs, and classroom programs. I have a list of 

upcoming training events. I’d encourage you to take a look at these options and see whether you’d be interested 

in one of them. 

BETTY: Sure, of course. I’m always open to training, especially if it’s held on the beach, in a nice location. 

[Laughter.] Will the agency pay for the training? You know a counselor’s salary will only stretch so far. 

MARGIE: Yes, it would be part of your IDP. We fund professional development as much as possible. 

BETTY: Thanks for the vote of confidence. 

75 
MARGIE: Further, I’d like you to start doing more staff training, using your clinical experience and conducting 

sessions for other staff. 

BETTY: You mean like some of the presentations I do in the community, to staff here? That’s a little intimidating, presenting to my peers. 

MARGIE: It can be intimidating, presenting to people you work with. 

BETTY: I assume you’ll help me with that? 

MARGIE: Yes. I also think you have the potential to present at State and national conferences. This would 

expand your repertoire of material, hone your speaking skills, build your confidence, and help you become better known outside the agency. We know you’re good. It’s time for others outside to see in you what we see. 

BETTY: Really? 

MARGIE: Really. I have a call for papers for a counselors’ conference in Cincinnati this fall. I think you should 

submit a proposal. The conference’s theme is PTSD and substance use disorders. I’ve heard you present here at 

the agency on this topic. The people attending the conference will be your peers. That’s a good place for us to 

take another step in the mentorship process, and you can begin with an area where we know you’re especially 

strong. I’ll attend the conference, too, and we can discuss afterward how it went for you. I’m interested if you’ve 

ever thought of being acknowledged outside of the agency for what we all know you know. 

BETTY: If I’m really honest with you, yes. I’ve gone to conferences and thought “I can talk on that subject.” But 

it’s always seemed immodest to say that out loud. 

MARGIE: Yes, it’s difficult stepping forward, not wanting to seem arrogant, but also acknowledging that you 

might have something others would benefit from hearing. So, how about putting your thoughts together for a 

proposal? It’s due in 3 weeks. You and I can review the proposal together. I’m confident it will be accepted for 

presentation. When it comes to your actual presentation, you can do the outline and slides and we can discuss 

your ideas. 

BETTY: So is this what you meant by mentorship? 

MARGIE: It’s a good place to start. I’ll never forget my mentor, Todd. He saw in me something I couldn’t see in 

myself at the time. He believed in me when I was feeling uncertain and insecure about my abilities, when I 

wasn’t even sure I wanted to stay in counseling for the rest of my life. He got me to do things I didn’t think I 

could do. He made me really stretch and taught me some invaluable lessons I still remember. Perhaps I can 

discuss what I mean by mentorship. Would that be okay with you? 

BETTY: Sure, I want to hear. 

MARGIE: Well, this is my own view and from my own experience, but it seems to me that mentorship is when 

someone with more experience and professional maturity helps someone coming along to want to reach out for 

more and develop new skills. There are lots of new opportunities for mentorship that weren’t available just a 

few years ago. Mentorship is different from our supervision relationship. Together we can identify areas of 

growth for you, and then we’ll meet to discuss what we need to do so you can achieve your goals. 

BETTY: I am honored (and a wee bit embarrassed) that you see that potential in me, and want to invest in my 

professional growth. I’m not sure anyone else has expressed that interest to me before. I’m really flattered. 

MARGIE: It has been an honor for me to work with you these last 3 years. It also gives me great joy to see you 

grow professionally, and perhaps advance into supervisory and administrative positions here in the future. 

Speaking nationally will give you better exposure. We’ll start with that, if that’s okay. Then we’ll move on into 

other areas that we identify together on your IDP. 

BETTY: Okay, if you really think I can do this. 

Part 1, Chapter 2 7676 
Master Supervisor Note: One of the four foci of supervision is supportive, 

which includes at times cheerleading and encouragement. Often counselors may 

lack the confidence in themselves to step forward. Supervision should build on 

strengths, nurture assets, and support and encourage all personnel to grow. 

Identifying staff with high potential for advancement is a key function of a 

supervisor. Through mentorship, personnel can grow professionally, and leadership succession can become a key aspect of the organization and field. 

MARGIE: You can help our agency. We will see the scope and the focus of how you want to shape your career 

as it moves on. 

BETTY: And you would be willing to make that kind of investment in me, Margie? 

MARGIE: I sure am. The agency surely is. 

BETTY: You know how exciting this is? I am fluttering inside. 

MARGIE: It’s exciting for me too. I enjoy seeing staff use their potential to the fullest. It’s something I can 

leave behind when I retire that will last far beyond my years of service. It’s like looking into the eyes of children and seeing the future in them that I will never realize myself. If I can help mentor you and others, that 

will be the icing on the cake of my career. 

BETTY: If I can grow to become a representative of the agency and to work more closely with you and learn 

from your experience and your wisdom, I’d love that. 

MARGIE: Here are some other ideas where you might consider growing professionally: learning about leadership, creating a vision, business and financial management, continuous quality improvement, organizational 

development, conflict resolution, and on and on. I know that might all sound rather intimidating at this point, 

but there are many areas we can address. I’ll be there with you throughout the learning and mentorship 

process. 

[Discussion continues about the next steps for Betty. First, they arrange to begin to revise and update her IDP 

and the strategies to reach her learning goals. The supervision session then turns to the future needs of the 

agency and how Margie and Betty can be part of the evolving future. The session ends with an agreement to 

begin writing an IDP and decide on the next steps for their mentorship.] 

Resources on Mentorship 

ATTC Leadership Institute (http://www.nattc.org/leaderInst/index.htm). After an assessment of leadership and management interests, values, and skills, participants attend a 5-day training session designed to present the necessary body of 

information. With their mentors, participants develop an individualized training plan and individualized project. They 

then return to their organizations for 6 months of mentoring and working on their projects. 

Michael E. Townsend Leadership Academy (http://www.mhmr.ky.gov/mhsas/files/KSAODSCatalog.pdf). A 3-day onsite 

workshop continues in followup sessions throughout the year in this program sponsored by the Kentucky Division of 

Mental Health and Substance Abuse. 

South Carolina Addiction Fellows Program (http://www.addictionrecoveryinstitute.com/Southcarolina/welcome.htm). 

Participants meet in six 3-day sessions during the year. 

North Carolina Addiction Fellows Program (http://www.addictionfellows.com/). Twenty participants meet to create a 

group of leaders for the field in North Carolina. 

Clinical Supervision and Professional Development 77 
Vignette 8—Making the Case for Clinical Supervision 

to Administrators 

Overview 

This vignette illustrates how a clinical supervisor can justify a system of supervision, along with time and 

resource allocations, to agency administrators in the light of recent pressures from the administration to 

increase billable hours. (Clinical supervision is not a billable expense at this agency.) 

Background 

Ella, a Level 2 supervisor, was recently hired to be the clinical supervisor of this agency, overseeing the work of 

six counselors. Jonathan is the agency’s CEO and Ella’s immediate boss. Jonathan has directed Ella to maintain supervisory functions “the way your predecessor did.” Jonathan does not want to introduce any significant 

tasks into the workload, especially those that are not billable or revenue generating. 

Ella, on the other hand, recently attended a 30-hour class on clinical supervision and is seeking her certification as a clinical supervisor. During the class she learned the importance of “making a reasonable effort to 

supervise,” and the legal and ethical obligations of the agency to supervise. She learned about her and the 

agency’s vicarious liability for the actions of the clinical staff. In the class, Ella was given the 20-to-1 guideline: 

for every 20 hours of client contact, staff should receive a minimum of 1 hour of clinical supervision. 

Until now, staff has received primarily consultation and support with case management. To justify more indepth clinical supervision, Ella needs the support and endorsement from Jonathan of the new supervision system. Given his emphasis on billable hours and reducing nonreimbursable activities, Ella knows that introducing these changes in the agency will not be easy, but she comes to Jonathan with her plan for supervision, asking for his endorsement. 

Learning Goals 

1. To describe the benefits and rationale of clinical supervision. 

2. To design a system of supervision that is efficient and effective, without greatly increasing staff and supervisory time and resources. 

3. To explore a system in which the supervisor can balance management and administrative duties, maintain a 

clinical caseload, conduct training, and perform other duties as assigned. 

[The vignette begins with a meeting between Jonathan and Ella to discuss her supervisory tasks and her plan. After 

a short introduction in which Ella discusses her feeling of being overwhelmed by her tasks, the dialog continues.] 

JONATHAN: The last time we met you were to look at how to improve the quality of our counseling and design 

a new plan for supervision. What did you come up with? 

ELLA: Well, first I looked at what makes us a quality agency: our strengths and skills and our weaknesses and 

liabilities. We want to be the best agency possible. There are four issues that came to me. First, after the client 

suicide last year, concerns were raised about our liability as an agency. Even though we took the right action, 

we need to be mindful of our vicarious liability for what our staff does. I think we’re both concerned about that 

issue. 

Second, we’re now required by the State to eventually have all counseling staff be certified addiction counselors. 

Our accrediting body is pushing us to provide better quality assurance systems with more clinical supervision. 

Part 1, Chapter 2 7878 
Third, I know our organizational development plan calls for us to expand services in the near future. We need 

to attract high-quality counselors. That’s difficult in a highly competitive market, with many agencies vying for 

good staff. We’ve had significant staff turnover in recent years for several reasons. I found that the average 

tenure of a counselor in our agency is 2 years, which, by the way, is consistent with the national average. We 

know from the exit interviews that the majority of staff who leave complain that we didn’t provide as many 

good training and supervision opportunities as other agencies do to support their learning and self-care needs. 

It’s costing us a lot of money to have such high staff turnover. 

Finally, we need to increase our billable hours. Research tells us that the better the supervision, the better staff 

morale and in turn, the better the client services. This has a direct impact on our bottom line if we retain 

clients in treatment longer. 

[Ella gives Jonathan copies of various studies she’s compiled from her training on the cost of staff turnover, the 

CSAT Manpower Study (CSAT, 2003), and a synopsis on staff development issues from the agency’s development 

plan.] 

Clinical Supervision and Professional Development 

Master Supervisor Note: Notice how Ella is well prepared for her presentation 

to Jonathan, providing a rationale in language and terms that appeal to administrators: concerns about liability, credentialing of personnel as mandated by the 

State, staffing needs and turnover, and billable hours. When presenting a proposal for a clinical supervision system to senior administrators, it is wise to: 

1.		 Use terms and language that apply and appeal to administrators 

2.		 Be prepared with facts and figures (e.g., the CSAT Manpower Study) 

3.		 Be clear, direct, and succinct; most administrators value clarity, directness, 

and results-oriented presentations 

4.		 State clearly the goals, objectives, timelines, and costs for the system and 

have the data to support them 

JONATHAN: Wow, I’m impressed. You’ve done your homework. So, what is it you’re suggesting? You know 

money is a key issue right now. 

ELLA: Money is an important issue. I’m suggesting that we look at our current supervision system and that we 

design and offer a new system that will help counselors become credentialed, meet the requirements of our 

accreditation body, reduce our high turnover rates, protect our liability concerns, improve morale, and in turn, 

bring more money into the agency. 

JONATHAN: That’s a tall order. And you’re going to do this without spending any money? [Laughing.] Let me 

go back to what you said. I thought after last year’s suicide that we beefed up our oversight. 

ELLA: Yes, we trained staff on how to deal with suicidal ideation and what actions to take. We were really sensitive to suicidal symptoms and documentation of issues. We have done a good job addressing that issue. 

However, I have concerns about our liabilities in general. What is going on right now that we don’t know about? 

What are our counselors actually doing behind closed doors? Is there another legal issue waiting for us that we 

don’t know about? That’s what I mean by our vicarious liability. Without a sound, consistent system of supervision, it will feel like we’re constantly putting our fingers in the dike. 

79 
Part 1, Chapter 2 

Master Supervisor Note: When conceptualizing, justifying, and implementing 

a new comprehensive supervision program each level of staff—agency administration, supervisory staff, counselors providing direct services, and support 

staff—have unique concerns about the needs and effects of clinical supervision. 

Administrative staff are most likely to be concerned about some of the issues 

noted below: 

1.		 Legal and ethical requirements for supervision, such as vicarious liability, 

scope of competence and practice requirements, and recent court rulings 

requiring clinical supervision. It is useful to stress the agency’s fiduciary 

responsibility to ensure the quality of services provided. 

2.		 Relevant Federal, State, and credentialing or accreditation requirements for 

supervision. 

3.		 Staffing costs, such as personnel retention and turnover rates, hiring costs 

and expenses associated with retraining of personnel, and impact on staff 

morale. It is useful to provide any research data available in the field or 

from your agency. 

4.		 Costs associated with implementing a supervision system, such as material 

and time costs and the impact on billable hours. 

5.		 The cost benefit for implementing a supervision system, addressing: “What’s 

in it for the agency? Why should we do this? What are the ramifications and 

costs if we don’t?” 

6.		 A timeline for implementation, with dates and deliverables, including benchmarks to measure success. 

It is important that support in the form of data or relevant resource materials 

supplement these points. 

JONATHAN: I agree. Are you telling me we’re not doing our job? That our supervisors are not supervising? 

ELLA: Our counselors are working very hard. We have fine staff here. Yet, we’ve got to give them more tools to 

do a better job, to continue to enhance their skills, and to ensure they recognize what they don’t know. And, as 

we grow, the skills needed by staff will also grow. 

JONATHAN: We’re not doing that now? We have money in the budget for training. We send people to summer 

institutes every year. We have weekly training sessions. Isn’t that supposed to address those issues? 

ELLA: It does, but only partly. Much of what we do in these sessions is administratively oriented, addressing 

new policies, procedures, and paperwork, compliance issues, and personnel concerns. We’re not doing clinical 

supervision. 

JONATHAN: I’m confused. Maybe I don’t have a good understanding of what clinical supervision is. I thought 

that’s what we were doing. Are we better off than we were a year ago? I need to assure the board of directors 

that we’re doing a better job, that the legal concerns of last year have been addressed. 

[Ella presents a brief and clear description of what clinical supervision is and how it differs from what they have 

been doing, which is primarily case management.] 

8080 
ELLA: We’ve made significant progress. You can assure the board of that. We’ve minimized some of our legal 

risk. We’ve addressed compliance issues. That’s good! When you asked me to look at a quality assurance plan, it 

was clear our weekly staff meetings and training sessions only address some of the needs. We must increase 

our clinical oversight of staff. That’s not just administrative in nature. In the course on clinical supervision you 

sent me to, I found a definition that I think really makes my point. First, clinical supervision is a process where 

counseling principles are transformed into practical skills. Second, there are four focuses in clinical supervision: 

administrative, evaluative, supportive, and clinical/educational. We’ve addressed the administrative aspects of 

supervision well. We now need to increase the amount of evaluation we give staff, support them in their clinical 

duties, and train them by watching them work with our clients more closely. 

Clinical Supervision and Professional Development 

Master Supervisor Note: In many agencies, administrators may not have a 

clinical background and thus may not understand the differences between case 

management and clinical supervision. A skillful supervisor patiently educates 

administrators about the distinction and stresses clinical concerns. 

JONATHAN: I think I understand the difference. I’m not a clinician so I am not always familiar with terminology. So what are you proposing we do? 

ELLA: I need your endorsement and support for a system of supervision involving direct observation of counseling staff, so we shift the balance of our supervision from mostly administrative to include a clinical focus, too. 

The supervision will address each counselor’s skills, what competencies they need to develop further, and how 

each can best address the needs of the clients. 

How To Demonstrate the Importance of Administrative Support for 

Clinical Supervision 

An individual developing a clinical supervision program for an agency clearly 

needs to explain to an administrator what is being asked of the organization. It 

is essential that administrators understand and support the supervision system. 

Without that endorsement, supervision systems will not be successful. Critical 

steps in this process include: 

1.		 The endorsement of supervision to all staff should be both verbal and in 

writing. 

2.		 Clinical supervision systems need the support of staff at all levels of management and in a manner they will understand: how it will benefit them, the 

agency, and the clients. 

3.		 Staff should hear a consistent message about supervision over time, lest they 

see the supervision system as the current “flavor of the month,” and believe 

“this will pass as soon as another priority comes along.” Staff need to hear 

that administrators have a long-term commitment to a consistent program of 

quality assurance in their supervision program. 

4.		 It is essential that administrators understand that systemic change takes 

time. Although some immediate results will be seen, long-term results can 

best be measured over the long term. Many staff have settled into their ways 

of doing counseling and might take time to adjust to receiving clinical supervision and make noticeable improvements in their skills. 

81 
JONATHAN: This is making me nervous. It’s sounding like money. [Laughing.] You know the pressure we’re 

under to increase billable hours and decrease activities that don’t generate revenue. Now you seem to be adding 

more activities and expenses. Where’s the time coming from to do this? 

ELLA: I understand the concern about increasing expenses. There are two answers. Remember the oil commercial years ago, that went something like: “Pay me now or pay me later, but you’re eventually going to pay me.” 

We’re paying a lot for staff turnover and decreased productivity because people are feeling unsupported by 

administrators. Staff morale is lower, too. If we can provide better training and supervision, we can save the 

agency considerable expense. Second, if we can train our staff better, we can perhaps increase both the quality 

of our care and the number of clients we can serve. That goes right to the bottom line. 

JONATHAN: Are you sure you didn’t get an M.B.A. somewhere along the way? You sound like a business person. Are you saying we’re not as productive as we might be? Isn’t that an administrative issue if people are not 

doing their jobs? 

ELLA: If we support them further, they could do an even better job. Our counselors are excellent at what they 

do. They work very hard and for long hours. Often that leads to burnout and eventually staff turnover. If we 

reduced that burnout through supervision, we’d keep them here longer, and their treatment of clients would 

improve. That would help our credibility in the community and eventually lead to more services and revenue. 

“Pay me now or pay me later.” The choice is up to you. 

JONATHAN: Okay. So what are you proposing, and what will it cost? 

ELLA: For an agency our size, with only a few counselors, two clinical supervisors can do the job. At the same 

time, they can attend to some administrative issues too, in addition to their own clinical work. At the training, I 

learned of a system where a supervisor would spend about 3 hours a week supervising her counselors. Some of 

the time is observation, and the rest is individual and group supervision. I can show you the matrix we’d use to 

do this. Each counselor would be observed in action with a client at least once a month. The supervisor would 

meet with the team every week and review the case presented by the counselor of the week. We’d use videotape 

of counseling sessions to demonstrate the counselor’s skills and actions. The group would view sections of the 

videotape, and we’d have an hour-long discussion of the tape. In some cases, instead of videotaping (it may not 

be appropriate to videotape some clients), the supervisor would sit in on the actual session and observe. They’d 

then follow the same individual in small group supervision discussion. To do this, I need you to provide funds to 

purchase video cameras, tripods, and DVDs. We need $1,000 for this purchase. That will ensure we’re making a 

reasonable effort to supervise and will significantly increase our clinical supervision system here. What do you 

think? 

Part 1, Chapter 2 

How To Implement a Clinical Supervision System 

To clarify the above statement by Ella, if a supervisor oversees the work of one 

to five counselors, it typically requires 2–3 hours per week (see Figure 3 on p. 11). 

This entails relying on group clinical supervision and direct observation through 

audio- or videotaping or live supervision. Supervisors might need to provide 

additional time for close supervision of trainees, interns, or counselors needing 

specific attention. The critical aspects in rolling out a clinical supervision system 

include: 

1.		 Administrative support. This should be in the form of both written and oral 

communication to all personnel showing administrators’ support for clinical 

supervision. 

2.		 Training of supervisors. Credentialing organizations require a certain number of hours of training to be certified as clinical supervisors. Simply because 

8282 
a person is a good counselor does not qualify them to be a supervisor. It 

requires another body of knowledge and skills to be a supervisor. 

3.		 Educating staff about what quality supervision is and what to expect in the 

new system. A session for clinical staff should be held (1–2 hours duration), 

explaining the rationale for supervision, the policies, procedures, techniques, 

and expectations of supervision. 

4.		 A system of supervision of supervision, monitoring the progress of supervisors in implementing the system, and providing feedback on how they are 

doing. This is sorely lacking for most supervisors, at least initially. This can 

be done through internal supervisors overseeing other supervisors, peer 

supervision of supervisors, or externally by contracting with a master supervisor to oversee the work of supervisors. 

5.		 Consistency of the message that supervision is here to stay and that clinical 

supervision is a requirement of the agency. 

6.		 Time to implement the system, acknowledging and working through staff 

resistance to change. Attitudes and behaviors about supervision change 

slowly. Thus, administrators need to understand that it takes time to work 

with personnel, to be clear about what’s expected of them, and to overcome 

staff resistance. 

JONATHAN: We can do that. That’s a modest expense we can afford. How do I sell this to the board? 

ELLA: What did the potential law suit cost us last year in legal fees? Surely more than the cost of three cameras. What does it cost us to train a new counselor when someone leaves? Surely more than the time we’re 

investing in their training. Perhaps you could tell that board that if we can retain a staff member for 6–12 

months longer, we’ll save the agency far more than you’ve invested in supervision. By being careful, by providing quality supervision, in the long run, it will in fact save us money by being preventive. 

JONATHAN: What else can I tell the board about this supervision system? 

ELLA: You can tell them that when a counselor leaves, clients react and the quality of their care decreases. The 

board is interested in client satisfaction and treatment outcome. This supervision system will help with that. 

JONATHAN: Okay, I’m sold. What’s next? 

ELLA: First, I want to submit to you this plan I’ve developed for the supervision system. I’d ask that you read 

it and next time we meet, if we concur, I’d like a written statement from you endorsing the plan. I’d also like 

you to introduce the program at our next all-staff meeting. How does that sound so far? 

JONATHAN: That’s fair. Then what? 

ELLA: Second, we need funding for the equipment. Third, we need to identify potential supervisory candidates 

from within the organization. If none can be found, we will have to look outside the agency to recruit a qualified 

supervisor. Fourth, we will begin to train our supervisors in this model of supervision. This can be done 

through a number of low-cost media. Fifth, we will provide an in-service training for all staff on the supervision 

system. We need to be clear with staff that we’re going to be observing them with videotape and/or direct observation. Some won’t like that. Some staff will be quite resistant to the change. This will take time—likely about 

a year for everybody to be on board. You and I have to be consistent over time, reinforcing the message that 

this is how we’re doing clinical supervision here, regardless of staff’s credentials or years of experience. There’s 

going to be a learning curve. 

Clinical Supervision and Professional Development 83 
Part 1, Chapter 2 

Master Supervisor Note: Again, it is important to be prepared for this presentation with a clear statement of funding requirements, training needs, mechanisms of how these needs will be met, and benchmarks for success. Further, it is 

essential to get a firm commitment to the plan from administrators before the 

supervisor proceeds. The supervisor should also stress the barriers and obstacles 

to be overcome and how those will be addressed. 

JONATHAN: Some of the distinction between case management and clinical supervision will hopefully become 

clearer to me and staff as we implement the system. You’re going to have to continue to educate me about it. I’d 

like to meet regularly with you, perhaps once a week during the roll-out, to discuss how we’re doing. Since the 

State now requires our counselors to eventually be certified, will this help in that process? 

ELLA: Absolutely. As you might recall, to be certified as an addiction counselor, the person must be supervised 

by a certified supervisor. This system will meet that requirement. It will help our counselors to be certified. 

[Jonathan and Ella summarize the advantages of a model for clinical supervision that includes workforce development and a means to implement evidence-based practices, address risk-management issues and vicarious liability, create consistency within the agency, minimize reactivity, address accreditation issues, and support counselor wellness.] 

JONATHAN: Can you bring me a budget for what this will cost in person hours and hardware by next week? 

Talk to our accountant if you need costing data. How are we going to train our supervisors? What will that 

cost? What’s the most cost-effective way of conducting the staff and supervisor training? I’d like to see a 3-, 6-, 

and 12-month implementation and financial plan for this. Can you provide projections as to potential cost offsets and savings on the other end? Can you have that for me by next week? 

ELLA: Yes, I can do that by next week. I’ll also give ideas as to how supervisors can balance management and 

administrative duties, maintain a caseload, and perform other duties as assigned. 

8484 
Clinical Supervision and



Professional Development 
 

of the Substance 
 

Abuse Counselor



Part 2: 
 

A Guide for Administrators



PART 2
 


Clinical Supervision and Professional Development 85
Chapter 1



Clinical supervision should be an essential part of all 

substance abuse treatment programs. Every counselor, regardless of skill level and experience, needs 

and has a right to supervision. In addition, supervisors need and have a right to their own clinical supervision. For more on the essential nature of clinical 

supervision, see Appendix B, New York State Office of 

Alcoholism and Substance Abuse Services Clinical 

Supervision Statement. Unfortunately, many agencies 

place a higher priority on administrative tasks (such 

as case recordkeeping and crisis management), than 

on clinical supervision. This guide for administrators 

will assist in developing a rationale for and designing 

a clinical supervision system for your substance abuse 

treatment organization. Part 2 provides strategies and 

tools for implementing effective supervision along 

with advice on allocating resources for best results. 

Benefits and Rationale 

A successful clinical supervision program begins with 

the support of administrators. You communicate the 

value, benefits, and integral role of clinical supervision in quality care, staff morale and retention, and 

overall professional development within the context of 

the organization’s mission, values, philosophy of care, 

and overall goals and objectives. Being able to discuss 

specific benefits of clinical supervision will increase 

the likelihood of internal support, enhance your organization’s ability to deliver quality supervision, and 

add marketability for funding opportunities. 

Administrative Benefits 

Clinical supervision enables organizations to measure 

the quality of services. It ensures that employees follow agency policies and procedures and comply with 

regulatory accreditation standards while promoting 

the mission, values, and goals of the organization. 

Supervision provides administrators with tools to 

evaluate job performance, maintain communication 

between administrators and counselors, facilitate conflict resolution, and hold personnel accountable for 

quality job performance. Clinical supervision is a 

risk-management tool that increases an organizaClinical Supervision and Professional Development 87 

PART 2
 


tion’s ability to respond to risk, thereby reducing 

overall liability. It also addresses human resource 

issues, including staff satisfaction and retention of 

personnel. Finally, supervision provides marketing 

benefits by improving the overall reputation of the 

agency in the community and among other service 

providers. 

Clinical Services Benefits 

The goal of clinical supervision is to continuously 

improve quality client care. Supervision by trained 

and qualified supervisors helps staff understand and 

respond more effectively to all types of clinical situations and prevent clinical crises from escalating. It 

specifically addresses assessment, case conceptualization, treatment strategies, and discharge planning. Supervision aids in addressing the unique 

needs of each client. It provides a mechanism to 

ensure that clinical directives are followed and facilitates the implementation and improvement of evidence-based practices (EBPs). “Quality supervision 

will become a major factor in determining the degree 

to which EBPs are adopted in community settings” 

(CSAT, 2007, p. 12). Clinical supervision also 

enhances the cultural competence of an organization 

by consistently maintaining a multicultural perspective. “Supervision encourages supervisees to examine their views regarding culture, race, values, religion, gender, sexual orientation, and potential biases” (CSAT, 2007, p. 27). 

CSAT’s Technical Assistance Publication (TAP) 21-A, 

Competencies for Substance Abuse Treatment Clinical 

Supervisors, defines supervision as a “social influence 

process that occurs over time in which the supervisor 

participates with supervisees to ensure quality care. 

Effective supervisors observe, mentor, coach, evaluate, inspire, and create an atmosphere that promotes 

self-motivation, learning, and professional development” (CSAT, 2007, p. 3). Also, supervision can 

improve client outcomes (Carroll, Ball, Nich, Martino, 

Frankforter, Farentinos, et al., 2006). Finally, supervision increases staff members’ sensitivity and 

responsiveness to diversity issues among staff, with 

clients, and between staff and clients. 
PART 2
 


Part 2, Chapter 1 

Professional Development 

Benefits 

Quality clinical supervision has been shown to 

increase staff retention through professional skills 

development and increased competency (Bernard & 

Goodyear, 2004). Supervision provides the forum for 

expanding current clinical practices, intellectual stimulation, emotional support, and improvement in critical thinking (see CSAT, 2007). Supervision is part of 

an organization’s career ladder, as it supports staff in 

obtaining and maintaining professional credentials. It 

also provides information and guidance about key 

contextual factors that may influence their work performance such as culture, lifestyles, and beliefs. 

Workforce Development Benefits 

Supervision by trained and qualified supervisors is 

an essential tool in the recruitment and retention of 

personnel, as counselors often rate training and 

development as critical factors in their selection of 

employment. In addition, supervision has been 

shown to improve staff morale and motivation by 

making staff feel valued and appreciated (Bernard 

& Goodyear, 2004). It also assists in promoting 

counselor wellness, and promotes the overall development of the substance abuse treatment field by 

upgrading the credentials, knowledge, skills, and 

attitudes of personnel. 

Program Evaluation and Research 

Benefits 

Implementation of program evaluation and/or 

research is often misunderstood by counselors and 

viewed as more work that is unrelated to quality 

client care. Supervision can mediate in this area by 

providing staff with the rationale for the initiative, 

connecting it to client outcomes, and communicating achievements and challenges to the evaluators. 

Clinical supervision can also provide the mechanism for data gathering and information retrieval 

in support of the new projects and programmatic 

innovations. 

Key Issues for 

Administrators in Clinical 

Supervision 

Administrative and Clinical Tasks 

of Supervisors 

Supervisors wear many hats. In most organizations, 

the administrative and clinical supervisor is the same 

person (see also the section that follows, 

Administrative and Clinical Supervision, p. 89). Most 

clinical supervisors still carry a client caseload (albeit 

reduced somewhat from that of a line counselor), perform administrative duties, write grant proposals, 

serve as project managers, and supervise the clinical 

performance of counselors. Each role involves different expectations and goals. It is important for administrators to be aware of each of these roles and for 

supervisors to be prepared to perform effectively in 

administrative, organizational, and clinical roles. 

Kadushin (1976) outlines multiple administrative 

tasks for a clinical supervisor: staff recruitment and 

selection; orientation and placement of employees; 

work planning and assignments; monitoring, coordinating, reviewing, and evaluating work; staff communication both up and down the chain of command; 

advocating for client and clinician needs; acting as a 

buffer between administrators and counselors; and 

acting as a change agent and community liaison. 

Munson states, “As part of their administrative 

responsibilities, supervisors are often required to 

manage program transitions and modifications. 

Departments and programs can be altered, restructured and merged” (1979, p. 72). 

Assessing Organizational 

Structure and Readiness for 

Clinical Supervision 

In implementing a clinical supervision program, an 

important first step will be to evaluate the agency’s 

preparedness to support the functions of clinical 

supervision by identifying the agency’s culture and 

organizational structure. Organizational readiness 

scales and attitude inventories can be helpful in the 

88 
process of assessing and adopting EBPs. You need to 

assess the following: 

•		 How decisions are made within the organization 

(centralized versus decentralized, vertical or 

horizontal). 

•		 How authority is defined and handled (top down, 

bottom up, through the chain of command, or ad 

hoc). 

•		 How power is defined and handled (reward, coercion, legitimate power through status, prestige, 

titles, expert power through skills and experience, 

or referent power through respect for an individual—or all of the above). 

•		 How information is communicated (structured/formal/informal, on a need-to-know basis, bidirectional feedback and communication). 

•		 How the organizational structure influences supervisory relationships, process, and outcome. 

•		 The overall cultural proficiency of the organization. 

The following organizational issues should be considered by an agency before a clinical supervision system 

is implemented: 

•		 Organizational context. How consistently do staff 

adhere to agency philosophy and culture? To what 

extent will clinical supervisors teach and support 

this philosophy? 

•		 Clinical competence. What specific knowledge, 

skills, and attitudes are expected of substance 

abuse counselors? What is each counselor’s baseline competence and learning style? What is the 

level of cultural competence of staff? 

•		 Motivation. How should the staff’s motivation and 

morale be characterized? 

•		 Supervisory relationships. What is the nature of 

relationships between administrators and frontline workers? How healthy or unhealthy are those 

relationships? 

•		 Environmental variables. To what extent do 

administrators expect supervisors to proactively 

teach ethical and professional values? Do staff 

have a common set of goals? How does the organization promote professional development? How is 

progress toward those goals monitored and supported? What is the cultural, racial, religious, gender, and sexual orientation mix of the clients 

served by the organization? 

Clinical Supervision and Professional Development 89 

PART 2
 


•		 Methods and techniques. How familiar is the 

organization with individual, group, and peer 

supervision? How familiar is the organization with 

case progress note review, case consultation methods, direct observation, live supervision, audio- or 

videotaping, and role playing? 

Assessing an organization’s readiness for a clinical 

supervision system may also include such questions 

as: “What stage of readiness for implementing a clinical supervision system are the board of directors, 

other administrative staff and clinical supervisory 

staff (if any), direct care staff, and support personnel? 

What are some of the organizational, administrative, 

and clinical barriers to implementing a clinical supervision system?” Potential barriers include lack of 

familiarity with supervision methods and techniques, 

the need for further training of supervisors, and lack 

of technical equipment such as video cameras. It is 

helpful to develop a timeframe for addressing the 

most important barriers. What would you as an 

administrator like to see happen and who should be 

part of the process for implementing clinical supervision? (See Tools 1 and 2 in chapter 2.) 

Administrative and 

Clinical Supervision 

This section is a comprehensive look at the issues facing supervisors in their dual roles. In the substance 

abuse treatment field, one of the major challenges 

facing supervision is the reality that most supervisors 

perform both administrative and clinical supervisory 

functions. The numerous conflicts and ambiguity that 

result from these roles can pose serious problems for 

administrators, supervisors, and supervisees. 

Determining the distinction between the roles of clinical and administrative supervision can be difficult 

because there are no uniform definitions of these 

functions. Most writing on administrative supervision 

is in the context of the evaluative and record-keeping 

functions of a supervisor. 

To the extent possible, administrative supervision 

should be distinguished from clinical supervision. 

Bradley and Ladany (2001) state that administrative 

supervisors “help the supervisee function effectively 

as a part of the organization,” with an emphasis on 
PART 2
 


Part 2, Chapter 1 

“organizational accountability, case records, referrals, 

and performance evaluations” (p. 5). In contrast, clinical supervisors focus on the services received by the 

client, including the therapeutic relationship, assessment, interventions, and client welfare. While these 

tasks may be seen as substantially different, many 

are complementary. Therefore, you and the supervisors need to be mindful of the different roles and of 

the inherent ethical, relational, and role conflict 

issues. Best supervision practices will work to keep 

the dual roles as clear as possible. 

Legal and Ethical Issues 

for Administrators 

You play a vital role in clarifying legal and ethical 

issues for your organization, especially for clinical 

supervisors and counseling personnel. You are invaluable in providing information and support for supervisors and staff. 

You and your supervisors need to define and document (in writing) the legal and ethical standards for 

the agency. You can draw from the staff’s professional 

codes of ethics as well as accepted best practices. All 

personnel should be consistently and continually 

trained in the agency’s legal and ethical standards, as 

well as in changing case law and legislation affecting 

clinical practice. You need to reinforce your support 

for supervisors who face situations where legal and 

ethical issues may arise. You should help supervisors 

develop a process for ethical decisionmaking as supervisors as well as a process for teaching ethical decisionmaking to counselors. 

Among the key issues for you and your supervisors 

are the following: 

•		 Direct and vicarious liability. Important factors 

affecting liability include the supervisor’s power of 

control; the counselor’s duty to perform a clinical 

service; the time, place, and purpose of the service; 

the motivation for responding the way the counselor responded; and the supervisor’s expectations 

for action. Critical legal questions for administrators are: Did you make a reasonable effort to 

supervise? Was there any dereliction of duty? Did 

treatment create any harm, wrongdoing, or damage to the client, the organization, or the community? Did you and the supervisor give appropriate 

advice concerning the counselor’s actions? Were 

tasks assigned to staff that were outside their 

scope of competence? 

Confidentiality. Has the organization adhered to all

laws of confidentiality (i.e., the Health Insurance

Privacy and Portability Act [HIPAA], 42 CFR, Part

2)? To what extent has the organization balanced the

counselor’s and client’s right to privacy and performance review? Has the organization adhered to its duty

to warn, to report, and to protect? 

•		 Informed consent and due process. This requires 

that supervisees and clients be fully informed as 

to the approach and procedures of the agency’s 

actions (see Tools 4 and 19). Have the clients and 

counselors been informed about treatment 

parameters and supervision requirements? Have 

all required forms and documents been read and 

signed by all relevant parties? Is there a fair 

process that encourages conflict resolution and 

ensures the person a process of appeals? 

•		 Supervisor and counselor scope of competence. 

Are supervisors and counselors operating within 

their scope of practice and competence? Are 

supervisors and counselors meeting minimal 

standards of competence regarding cultural and 

contextual awareness, knowledge, and skills? Are 

they effectively working within the wider client 

systems and networking appropriately with wider 

community services and institutions? 

•		 Dual relationships. A dual relationship exists 

when a supervisor and supervisee or counselor 

and client have an additional relationship outside 

the primary professional relationship. Guidelines 

for supervisory relationships prohibit supervising 

current or former clients (a difficult issue in the 

substance abuse field where it is not uncommon 

for an agency to hire and supervise former clients 

in recovery). Do any supervisors have current or 

former romantic or sexual partners, business 

associates, family members, or friends among 

their supervisees? Is the distinction clear 

between the teaching and supervisory roles when 

students are being supervised? Are supervisors 

mindful of crossing over from the supervisory 

relationship to social activities with supervisees 

that may impair objectivity? Do supervisors avoid 

excessive self-disclosure in supervision and avoid 

comments or actions that might be interpreted as 

sexual? Do you and your supervisors respect and 

recognize professional boundaries in all aspects of 

90 
your relationships? When in doubt, do you 

consult with colleagues? 

You should provide comprehensive legal and ethical 

orientation to all employees, review codes of ethics at 

the time of hire, and require employees to sign a 

statement that they will abide by these codes. You 

will want to review agency adherence to these codes 

periodically under the umbrella of a quality assurance or compliance program. Clinical supervisors 

should be proactive and provide documentation that 

describe and conceptualize client problems addressing 

potential legal and ethical dilemmas, document all 

clinical directives given, and offer counselors a written summary of recommendations. Finally, you 

should review liability insurance coverage and suggest that supervisors and counselors maintain their 

own personal professional liability and malpractice 

insurance. 

For further legal and ethical issues, the reader is 

referred to the forms in this section. 

Diversity and Cultural 

Competence 

An important responsibility for supervisors is to continually improve their cultural competence in order to 

teach and support staff. Cultural competence is gained 

through education and training, supervised clinical 

work, and ongoing exposure to the population being 

served. All potential supervisors should be required to 

receive training in cultural competence. It is the supervisor’s responsibility to initiate discussions of differences in race, ethnicity, gender, religion, socioeconomic 

status, sexual orientation, or disability regarding both 

clinical work with clients and supervisory and team 

relationships. This promotes the acceptance of diversity and cultural issues as appropriate topics of discussion and allows the supervisor the opportunity to 

model culturally competent behaviors. 

To appreciate the importance of cultural competence, 

counselors must first recognize “the power of their 

own cultural assumptions to influence their thinking 

and their interactions with others” (Bernard & 

Goodyear, 2004, p. 118). From there, supervisors can 

help supervisees understand how their own diversity 

variables affect their interactions with clients. 

Administrators should be watchful for problems that 

can arise in the supervisory relationship when supervisors are of a different race, culture, or ethnicity 

than their supervisees. Fong and Lease (1997) have 

identified four areas that might present challenges: 

1.		 Unintentional racism. Well-intentioned supervisors who are unaware of how their racial identity 

affects their relationships with supervisees may 

avoid talking about race or culture. 

2.		 Power dynamics. The power differential in the 

supervisory relationship may be exaggerated in 

dyads where the supervisor is part of the dominant group and the supervisee is a member of a 

minority group. 

3.		 Trust and vulnerability. Supervisees who are in a 

vulnerable position are, at the same time, encouraged to trust their supervisors, when they may 

have little reason to do so. 

4.		 Communication issues. Differing communication 

styles among cultural groups can result in misunderstandings. 

An excellent exercise for you and your supervisors is 

to evaluate how supervisors measure up to multicultural supervision competencies. Bradley and Ladany 

(2001) list the following in what they term the “supervisor-focused personal development” domain: 

•		 “Supervisors actively explore and challenge their 

own biases, values, and worldview and how these 

relate to conducting supervision; 

•		 Supervisors actively explore and challenge their 

attitudes and biases toward diverse supervisees; 

•		 Supervisors are knowledgeable about their own 

cultural background and its influence on their attitudes, values, and behaviors;. 

•		 Supervisors possess knowledge about the background, experiences, worldview, and history of culturally diverse groups; and 

•		 Supervisors are knowledgeable about alternative 

helping approaches other than those based in a 

North American and Northern European context” 

(pp. 80–81). 

PART 2
 


Clinical Supervision and Professional Development 91
PART 2
 


Part 2, Chapter 1 

Developing a Model for 

Clinical Supervision 

An organization must develop a model for clinical 

supervision that best fits its needs. What are its 

underlying needs, goals, and objectives? What models are available to assist in reaching your organizational goals? The model should be selected in light of 

the organization’s mission, philosophy of treatment, 

and orientation. You need to assess the organization’s readiness for implementing a supervision system and barriers that might impede the process. 

What are the organization’s capacities for implementation? Once implemented, how will the program’s 

quality be evaluated? How will continuous quality 

improvement strategies be incorporated into the 

supervision model? And if the program is successful, 

how will it be sustained? 

An effective model for clinical supervision will keep 

the target clear: ensuring that the client receives better treatment as a result of the clinical supervision 

system. In addition: 

•		 It will begin with the supervisors’ unique management or leadership style, their levels of proficiency 

in supervision, the organization’s philosophy about 

clinical supervision, and the specialized client 

needs for clinical services. 

•		 It will improve counselor competence, make work 

more manageable, encourage staff to stretch 

beyond their current capabilities, build mastery 

and growth, and meet the needs of the client, 

counselor, agency, and credentialing bodies. 

•		 It will encourage supervisees to grow professionally in their understanding of culture, race, religion, 

gender, and sexual orientation as these issues are 

present clinically. 

Implementing a Clinical 

Supervision Program 

TAP 21-A (CSAT, 2007) describes the importance of 

using a clearly articulated process for implementing a 

new model of clinical supervision in both State and 

local agency settings as follows: “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” (p. 7). To ensure a 

smooth transition to the new supervision program, an 

agency will need to perform the following tasks: 

[d]efining or clarifying the rationale, purpose and 

methods for delivering clinical supervision; [e]nsuring 

that agency management fully understands and supports the changes that need to be made; [p]roviding 

training and support in supervisory knowledge and 

skill development; and [o]rienting clinicians to the 

new supervision rationale and procedures” (p. 7). 

These tasks are part of an implementation process 

whereby the changes are introduced over a limited 

period of time that allows for procedures to be developed and tested and clinicians to provide feedback 

and adjust to the supervisory process. “The broad 

goal is to create a continuous learning culture within 

the agency that encourages professional development, 

service improvement, and a quality of care that maximizes benefits to the agency’s clients” (p. 8). 

More detailed guidelines for implementing and phasing a clinical supervision system into existing 

processes include: 

1.		 You need to be clear as to the organization’s goals 

of supervision, viewing supervision as a way of 

supporting and reaching the agency’s mission. 

2.		 You should be familiar with the skills and competencies outlined in TAP 21-A (CSAT, 2007) and 

other experience and/or credentialing requirements. The competence of the designated supervisors is central to the successful design and implementation of the program. In some cases, agencies will need to invest in additional training for 

potential clinical supervisors. Ask yourself the following about your supervisors: 

•		 Has the supervisor had formal training and is 

he or she credentialed in counseling, substance abuse, and clinical supervision? 

•		 At what level of supervision proficiency are 

the clinical supervisors? 

•		 Has the supervisor received supervision of his 

or her clinical skills? 

•		 What is the supervisor’s relationship with 

staff? 

•		 What is his or her level of cultural proficiency 

and ability to work with culturally diverse 

clients? 

3.		 It is essential that a clear statement of support 

from senior administration be provided both verbally and in writing to all levels of administra92 
tion, counselors, and support staff. This statement should provide a rationale (see p. 95) for 

implementing clinical supervision. The importance of this step cannot be overemphasized. 

4.		 The next step in implementing a clinical supervision system is to create a Change Team from 

within your organization to spearhead the effort. 

Selecting the appropriate agency representatives 

to be the link between you and the supervision 

system will ensure internal communication and 

support. The Team should comprise individuals 

committed to quality care and the supervision 

process. They need to be somewhat familiar with 

the process of supervision and have a clinical 

background. Supervisors need to have a thorough 

understanding of the agency’s model and techniques of supervision. The Change Team leader 

will ensure participation and followup with the 

organization’s clinical supervisors. Planning specific steps to ensure sustainability of the system 

is integral to long-term success. 

5.		 You, the Change Team, and clinical supervisors 

should read and understand the importance of 

the standards outlined in TAPs 21 (CSAT, 2006) 

and 21-A (CSAT, 2007). Each counselor should 

have a copy of TAP 21 (Addiction Counseling 

Competencies—The Knowledge, Skills, and 

Attitudes of Professional Practice [CSAT, 2006]). 

It is important for clinical supervisors to meet 

with the Change Team to discuss the skills and 

competencies in TAP 21-A, and to identify both 

the organization’s strengths and areas needing 

improvement. The Team should draft formal policies and procedures to articulate expectations and 

guidelines. 

6.		 An all-staff meeting should feature the organization’s view of clinical supervision and how it will 

implement the supervision system. The formal 

policy and procedure should be distributed and 

discussed. All clinical staff involved in the system 

should attend this briefing, presented by the 

Change Team leader and key clinical supervisors. 

7.		 Provide necessary training, time, and funding for 

supervisors. Because the training requirement for 

credentialing as clinical supervisors is typically 

participation in a 30-hour class on supervision, 

you need to ensure that all supervisors receive 

training before proceeding to comprehensive 

implementation. 

Clinical Supervision and Professional Development 93 

PART 2
 


8.		 If the organization is sizable or the clinical staff is 

large, it is sometimes helpful to initiate a pilot 

supervision system in selected units of the organization. This is an issue that can be addressed by 

the Change Team. If organizational staff are particularly resistant to implementing the supervision program, it may be helpful to demonstrate 

the efficacy of a quality supervision program via a 

pilot program. 

9.		 Supervisors should prioritize discussing the 

supervisory agreement or contract with each 

supervisee and invest time to determine the 

training needs and goals for each counselor. This 

is the beginning of an Individual Development 

Plan (IDP), outlining the counselor’s knowledge, 

skills, attitudes, and cultural competence. It is 

essential that the supervisor observe the counselor in action before rating her or his abilities. 

Rating scales provide the baseline from which to 

begin supervision. Both supervisors and counselors should develop and complete rating scales 

and IDPs. Dialog on areas of agreement and disagreement at the outset form a vital part of the 

supervision process. This discussion also provides 

the supervisor with an opportunity to praise staff 

members for their strengths. 

10. Supervisors should schedule formal, frequent, and 

regular individual supervisory sessions. These 

sessions, similar to individual sessions with 

clients, need to be respected and protected from 

unnecessary interruptions or distractions. The 

supervisory sessions should be documented and 

follow the prescribed focus outlined in the IDP. 

11. To begin direct observation, design an implementation strategy (assuming the organization has 

recognized the value of direct observation; see 

Part 1, chapter 1), and establish a weekly rotation schedule for the observation of each counselor over the next 3 months. Initially, the clinical 

supervisor can provide direct observation feedback to counselors individually and then move 

toward a group supervision model whenever practical and possible to promote team building and 

efficiency. To help with sustainability, the supervisor should discuss supervision at every opportunity. Staff needs to see that supervision will be 

conducted on a regular basis, and that frequency 

will be determined by the agency’s needs and 

those of the individual counselor and team. 
PART 2
 


Part 2, Chapter 1 

12. Provide feedback and review the IDP. Through 

the observation, the supervisor and counselor can 

discuss the strengths and challenges of the counselor’s performance. The developing IDP should 

outline in detail the areas for improvement and 

how these changes will be further observed and 

monitored. Learning goals evolve as continued 

observation leads to further suggestions for 

improving performance. 

13. Supervisors should document their direct observation using various forms that exist for this purpose. The documentation should include times of 

meetings and observation, a brief statement of 

the content of the clinical session observed, 

review procedures (audio or video tape), feedback 

provided, and mentoring and teaching offered. 

14. Incentive plans can be developed to encourage 

counselors to become seriously involved in their 

professional development. 

15. Create a sustainable treatment team. Over time, 

some staff will leave and others will join the 

team. It is important for you and your supervisors 

to work with the team to create an atmosphere of 

learning that supports the agency’s commitment 

to clinical supervision. This means including the 

clinical supervision policy and procedures in the 

orientation of new staff. It definitely means that 

the team will continue to meet for supervision on 

a regular basis. 

16. Develop a system of supervision of clinical supervisors, particularly for those who are new to their 

role. Supervisors need to continually build and 

improve their supervisory skills as well as have a 

forum to discuss staff challenges. Some agencies 

have created supervisory peer groups where the 

supervisors present and receive feedback on their 

supervision, other agencies hire a consultant to 

provide supervision, while some regional coalitions have established monthly forums. 

Some of the primary elements in a supervision of 

supervisors system include: 

•		 Direct observation. This may best be done by 

periodically (e.g., once a calendar quarter) 

videotaping a supervision session and having 

the supervisor’s supervisor review the videotape. They then discuss what occurred during 

the supervision, with the supervisor’s supervisor providing feedback and recommendations. 

•		 Competencies. It is important that the supervisors of supervisors be Level 3 counselors and 

preferably Level 3 supervisors (see Figures 5 

and 6 in Part 1, chapter 1). They need to be 

certified clinical supervisors and to have had 

supervision as supervisors themselves so they 

have experience with this type of supervision. 

Administrators should give them the responsibility and authority to perform this task and 

to require that tapes be provided for review in 

a timely fashion. Supervisors should develop 

the competencies sufficient to attain their credentials as a certified clinical supervisor. 

•		 Record-keeping system. A logging system 

should maintain records on the initial counselor–supervisor sessions and the supervision 

of supervisors sessions. 

•		 Recruiting personnel. If your agency does not 

have an internal person to provide the supervisor’s supervision, it is recommended that 

you contract for such services with external 

sources. Over time, the external supervisor 

should train an internal person to assume 

this role. 

Phasing in a Clinical Supervision 

System 

The steps below have been found to be helpful in 

phasing in clinical supervision systems in an orderly 

manner. Although the list is provided sequentially, 

the needs of an agency will determine the timeframe 

and selection of objectives. 

Phase I: Organization and Creation of a 

Structure 

•		 Assess and describe the agency culture (including 

assets and deficits), selecting assets to build on 

and/or deficits for remediation regarding clinical 

supervision. 

•		 Assess the facility’s policies and procedures to 

determine the feasibility and practicality of a clinical supervision system (i.e., presence of clinical 

supervisory staff, availability of direct observation 

technology, etc.). 

•		 Examine job descriptions to determine staff scope 

of practice and competence. 

94 
•	 Reach consensus among the Change Team about 

the definition of clinical supervision and its key 

components for that agency. 

•	 Publicize this consensus statement to all personnel, introducing staff to the new supervisory model 

and clearly communicating expectations for the 

delivery and outcomes of clinical supervision 

before program implementation. 

•	 With all personnel, discuss and introduce clinical 

supervision policies and procedures. 

•	 Review the organization’s cultural competence as 

it relates to the client populations served. 

•	 Develop documentation and accountability systems. 

Phase II: Implementation 

•	 Implement a supervisory contract, including 

informed consent, with all staff to improve the 

supervisory working alliance. 

•	 Assess the quality of the supervisory relationship 

and devise interventions to strengthen the learning alliance. 

•	 Conduct counselor assessments to establish competency baselines. 

•	 Design initial supervisory goals and measurable 

objectives for each counselor. 

•	 Use strengths-based approaches where appropriate and possible in clinical supervision, supporting 

counselors’ positive actions with clients. 

•	 Develop a system of supervision of supervision. 

Some programs use the same taping and monitoring systems for supervisors that are used between 

counselors and clients, with supervisors expected 

to videotape their supervision sessions at least 

once a month, and receive supervision of their 

supervision by the team of supervisors and/or 

their supervisor. 

Phase III: Establishing a Training Plan and 

Learning Goals 

•	 Complete a written IDP for each counselor. 

•	 Provide focused, on-the-job training. 

•	 Identify clinical supervision quality indicators to 

monitor the quality assurance program for the 

agency. 

•	 Periodically review job descriptions and evaluation 

procedures to ensure that counselor competencies 

Clinical Supervision and Professional Development 95

are sound. Review the counselor’s ability to perform the TAP 21 competencies, the activities and 

functions performed by a substance abuse counselor that form the basis of the standards required 

in many States for credentialing. Also see the 

Northwest Frontier Addiction Technology Transfer 

Center Performance Rubric at 

http://www.nfattc.org. 

Phase IV: Improving Performance 

Proficiency in the Addiction Counseling Competencies 

(CSAT, 2006) and the International Certification and 

Reciprocity Consortiums 12 Core Functions should be 

the subject of continuous assessment and professional 

development during clinical supervision. Additional 

specific performance concerns include: 

•	 Continually align the clinical supervision goals to 

the agency’s mission, values, and approach; 

•	 Create risk management policies and practices 

and monitor adherence; 

•	 Address the cultural competence of personnel in 

supervision; 

•	 Consistently address a deepening of counselor 

knowledge, skills, and attitudes about legal and 

ethical issues; 

•	 Use formative and summative evaluation and 

feedback procedures to inform the clinical supervision process; 

•	 Develop quality improvement plans for the agency, 

including clinical supervisory procedures; 

•	 Overtly address and encourage counselor and staff 

wellness programs; 

•	 Invest in counselor and staff training; and 

•	 Foster your staff from within, continually seeking 

individuals with the potential to become tomorrow’s supervisors. 

Documentation and Record 

Keeping 

Overseeing documentation and record keeping is an 

essential administrative task, as maintaining a 

supervisory record has multiple purposes for administrators, supervisors, and counselors. One of the primary purposes of documentation is to serve as the 

legal record for the delivery of supervision: a reasonable effort was made to supervise. The supervisory 

PART 2
 
PART 2
 


Part 2, Chapter 1 

record is also important in developing a thoughtful 

plan for both quality client care and professional 

development. The supervisory record serves to: 

•		 Improve client care. 

•		 Model good record-keeping procedures for personnel. 

•		 Afford and enhance ethical and legal protection. 

•		 Provide a reliable source of data in evaluating the 

competencies of counselors. 

•		 Provide information concerning staff ability to 

assess and treat clients. 

•		 Reflect staff understanding of the dynamics of 

behavior and the nature and extent of the problems treated. 

•		 Assess staff cultural competence and proficiency. 

•		 Provide information about the clinical supervisor’s 

ability to assess counselor competencies and the 

nature of the clinical supervisory relationship. 

•		 Provide information about the clinical supervisor’s 

clinical and supervisory competence. 

A good clinical supervision record should include the 

following elements: 

•		 Requirements for counselor credentialing (certification/licensure) and the extent to which each 

counselor meets those requirements. 

•		 The counselor’s regularly updated resume and a 

brief summary of his or her background and clinical expertise. 

•		 A copy of the informed consent document, signed 

by the supervisor and the supervisee. 

•		 A copy of the clinical supervision contract, signed 

by the supervisor and the supervisee. 

•		 The IDP, updated minimally twice a year and 

preferably every 3 months. 

•		 A copy of the formative and summative evaluations the supervisor has given to the supervisee 

and all relevant updates to these evaluations. 

•		 A log of clinical supervision sessions, dates, times; 

a brief summary of key issues discussed; recommendations given by the supervisor and actions 

taken by the counselor; documentation of cancelled 

or missed sessions by either the supervisor or 

supervisee; and actions taken by the supervisor 

when supervision sessions are missed. 

•		 A brief summary of each supervision session, 

including specific examples that support learning 

goals and objectives. 

•		 A risk management review summary, including 

concerns about confidentiality, duty to warn situations, crises, and the recommendations of the 

supervisor concerning these situations. 

The entire documentation record can be brief and in 

summary form. (See Tools 10–12 in Part 2, chapter 2, 

including checklists and summary statements to 

reduce the volume of work for the supervisor.) 

Evaluation 

Although training in how to conduct productive and 

constructive evaluations of personnel is rare, evaluation of personnel is a critical administrative task of 

supervisors and administrators. The goals of evaluation include, but are not limited to, reviewing job performance; assessing progress toward professional 

development goals; eliciting future learning goals; 

assessing fitness for duty and scope of competence; 

and providing feedback to staff on adherence to 

agency policies, procedures, and values. 

There are a number of issues that shape the feedback 

process, including: 

•		 How does the agency define a “good” counselor? 

What knowledge, skills, and attitudes are critical? 

What level of cultural competence is needed? 

•		 How does a supervisor measure general affective 

qualities, such as counselor’s empathy, respect, 

genuineness, concreteness for clients? 

•		 What standardized tools will be used to support 

the evaluation? There are few evaluation instruments with psychometric validity or reliability. 

The IDP can be the basis for evaluation. Each counselor should have a development plan that takes into 

consideration her or his counseling developmental 

level (see Stoltenberg, McNeill, & Delworth, 1998), 

learning needs and styles, job requirements, client 

needs, and the agency’s overall goals and objectives. 

A sample IDP is provided in chapter 2 (Tool 15). 

How do administrators and supervisors evaluate personnel and assess job performance? There are two 

forms of evaluation: formative and summative. 

Formative evaluation focuses on progress, is regularly 

provided, and gives feedback to the employee regarding his or her attainment of the knowledge, skills, 

and attitudes necessary to the job. It addresses the 

96 
question, “Are you going in the right direction?” The 

quality of the supervisory relationship determines the 

success of the formative evaluation process. 

Summative evaluation is a formal process that rates 

employees’ overall ability to do their job and their fitness for duty. It answers the question, “Does the 

employee measure up?” In substance abuse counseling, summative evaluation takes into account many 

variables: the range and number of clients seen, the 

issues and problems addressed by the counselor, the 

general themes in training and supervision, skill 

development, self-awareness, how learning goals have 

been translated into practice, and the employee’s 

strengths, expertise, limitations, and areas for future 

development. Summative evaluation also addresses 

the nature of the supervisory relationship and goals 

for future training. 

The best evaluations occur when there is open 

exchange of information and ideas between the 

supervisor and counselor, where specific examples 

are gleaned from the ongoing supervisory documentation, and expectations are again reviewed and 

agreed upon. Some organizations have moved to 

360-degree assessments, with input from many layers of the organization. Tool 13 in chapter 2 is a 

counselor evaluation of a supervisor. The quality 

and quantity of feedback from a supervisor is an 

important part of supervision, according to supervisees (Bernard & Goodyear, 2004). Formalized feedback and evaluation is designed to review the ongoing, frequent feedback provided over time in a 

supervisory system (see Tool 14). 

Conducting an evaluation involves exercising authority and power. When supervisors evaluate counselors, 

they are also evaluating themselves and their effectiveness as supervisors with particular supervisees. 

The evaluation process brings up many emotions for 

both parties. In providing feedback, supervisors 

should: 

Provide positive, as well as constructive, feedback: 

•		 Differentiate between data-based and qualitative 

judgments about job performance. 

•		 State observations clearly and directly. 

•		 Prioritize key areas for review rather than flood 

the counselor with an all-inclusive review. 

Supervisees prefer: 

•		 Clear explanations. 

•		 Written feedback whenever possible. 

•		 Feedback matched to their counseling development level. 

•		 Encouragement, support, and opportunities for 

self-evaluation. 

•		 Specific suggestions for change. 

Feedback should be: 

•		 Frequent. 

•		 As objective as possible. 

•		 Consistent. 

•		 Credible. 

•		 Balanced. 

•		 Specific, measurable, attainable, realistic, and 

timely: SMART. 

•		 Reduced to a few main points. 

Supporting Clinical Supervisors in 

Their Jobs 

Being a supervisor in any setting is a difficult job. 

The supervisor represents the concerns of administrators, counselors, and clients. Supervisors advocate on 

behalf of those above and below them in the organization chart. Hence, it is imperative that you provide 

support for the clinical supervisor in the agency and 

in the job. 

To show support for clinical supervision, review the 

organization’s receptivity to supervision: Is its climate for change, tolerance, and commitment conducive to efficient implementation of a clinical supervision system? Also, assess the magnitude of the proposed supervision system and the critical factors 

needed for success. “The agency structure and the 

supervisory program within it define the parameters 

of the supervisory relationship. Decision-making 

processes, autonomy within units, communication 

norms, and evaluative structures are all relevant to 

the supervisory function” (Holloway, 1995, p. 98). 

To assess the organization’s receptivity to supervision, you should address the following issues: 

1.		 To what degree does the organization value 

accountability and have clear expectations of its 

personnel? 

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Clinical Supervision and Professional Development 97
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Part 2, Chapter 1 

2.		 How is supervision tied to an employee’s ongoing 

performance improvement plan or performance 

incentive program? 

3.		 To what extent does the organization have efficient and effective systems in place to manage 

day-to-day operations? 

4.		 To what extent does the organization view itself 

as a learning environment, encouraging inquisitiveness, creativity, innovation, and professional 

development? 

5.		 To what extent does the organization value 

upward and downward communication and relationships by creating opportunities for staff to be 

heard? Does the organization understand that the 

learning alliance and relationship is key to successful supervision? 

6.	 	In what ways is the organization a dynamic, 

growing organism that values everyone’s 

contribution? 

7.		 To what extent does the organization “provide 

diversity training and other experiences that 

empower [a counselor] to become an advocate for 

the organization’s target population and an agent 

of organizational change” ? (CSAT, 2007, p. 31) 

8.		 How does the organization view teamwork, and 

what structures are in place to support the teambuilding process? 

9.		 How do lines of authority and communication 

operate in the organization? How do formal and 

informal decisionmaking processes that influence 

the supervisors’ functions work? 

10. To what extent do administrators know about and 

understand the process and practices of clinical 

supervision? What training do they need in this 

regard? 

11. What is the common ground in understanding the 

relationship between the administrative and clinical functions of the supervisor? 

12. If the organization does not have trained and 

motivated clinical supervisors, what is your plan 

for recruiting new supervisors and/or training 

current supervisors who will be able to take on 

this new responsibility? 

13. Are the job descriptions and roles clear, current, 

and accurate for all personnel? 

14. How much supervision of their supervision will 

the supervisors receive from administrators or 

other consultants? 

You support clinical supervision when you help 

supervisors build an organizational climate in which 

they can do quality work. This entails the following 

factors: 

1.		 Allocating time for clinical supervision. Since 

supervision is not (in most cases) a revenue-generating activity, administrators may tend to minimize the importance of quality clinical supervision and fail to provide the needed time to “make 

a reasonable effort to supervise.” A matrix presented in Part 1, chapter 1 gives guidelines to 

supervisors for organizing their time and providing quality supervision. 

2.		 Making clinical supervision an agency priority. 

You can support the clinical supervisor with a 

clear statement of the importance of supervision 

and provide the resources needed to perform this 

function. This might include the acquisition of 

taping equipment, provision of one-way mirrors, 

etc. Staff need to hear unequivocally that supervision is a necessity and a requirement for all personnel, regardless of years of experience, academic background, skill and counselor developmental 

levels, and status within the organization. 

Supervisors also need supervision. 

3.		 Supporting creative methods for supervision. As 

this TIP advocates for direct methods of supervision through one-way mirrors, video/audio taping, 

and live observation, you can state clearly that 

“at our agency we observe.” Other methods for 

clinical supervision might include group or peer 

supervision models (see Part 1, chapter 1). 

4.		 Building and supporting a record-keeping process 

for clinical supervision. This entails providing 

time and tools for the documentation related to 

clinical supervisory and administrative functions. 

Supervisory notes need to be integrated with clinical notes and human resource files. One good 

documentation system is the Focused Risk 

Management Supervision System (FoRMSS; 

Falvey, Caldwell, & Cohen, 2002). Assisting in 

organizing the supervisory process by investing in 

activities that will increase productivity over 

time, setting and adhering to priorities, and 

increasing coping skills repertoire to manage multiple tasks through cross-training and team building. You also need to periodically review job 

descriptions, personnel strengths and aptitudes, 

and cultural competence, and reorganize work98 
loads accordingly. You should periodically review 

the purpose and function of every meeting and 

seek to streamline meeting times for economy and 

efficiency. 

5.		 Assisting supervisors in implementing agency priorities, such as the adaptation of EBPs to fit the 

agency’s goals and objectives. Hence, if an organization is implementing an EBP, it is imperative 

that supervisors also be trained in how to supervise that practice, perhaps even before counselors 

are trained. 

6.		 Assisting supervisors in other personnel functions, such as working with impaired professionals and providing an employee assistance program (EAP) as a resource to supervisors and 

supervisees. You and your supervisors need to 

work together when staff are involved in ethical 

or legal issues that might impair the organization’s function and credibility, and the supervisor 

needs to keep the administrator informed of all 

actions taken throughout the process. 

7.		 Supporting supervisors in developing cultural 

competence within the organization. This entails 

hiring culturally competent clinical supervisors 

and staff and providing personnel training on cultural issues. It also requires supporting supervisors in developing and improving cultural competence in counselors. 

Professional Development 

of Supervisors 

You both support clinical supervisors in their function and monitor their professional development and 

performance by: 

•		 Building a system to monitor, evaluate, and provide feedback to clinical supervisors. Supervision 

of one’s supervision is lacking in many organizations. Every clinical supervisor is entitled to and 

needs to have some form of supervision of their 

supervision, either live or online. 

•		 Creating IDPs with all supervisors. Even as every 

client needs a treatment plan and every staff 

member needs an IDP, every clinical supervisor 

also needs an IDP. Supervisors’ IDPs are jointly 

developed and monitored by the clinical supervisor 

and his or her supervisor. 

•		 Helping supervisors develop a professional identity as a supervisor. This entails encouraging the 

supervisor to be credentialed as a clinical supervisor. They should also receive ongoing training 

required for recertification. 

•		 Providing time for them to work with a mentor 

(either someone within the organization or an outside consultant). 

•		 Requiring an annual minimum number of clinical 

supervision training hours. 

•		 Offering time and resources for supervisors to participate in State or local support groups for supervisors. 

•		 Providing job performance evaluations on a regular and timely basis. 

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Clinical Supervision and Professional Development 99
Chapter 2 
 

Introduction
 


Your clinical supervision system needs to match the unique issues and contextual factors of your agency, and 

your agency needs to have a clear vision of what it wishes to accomplish with its clinical supervision system 

and actively determine and understand the processes by which it will get there. The tools presented in this 

chapter are designed to make the tasks associated with implementing a clinical supervision system easier. You 

will want to take advantage of the experience of well-established supervision programs and adapt the tools that 

have worked for them to suit the specific needs of your program. 

The resources presented in this chapter are organized to be parallel to Part 2, chapter 1. These tools should be 

considered as prototypes and, in some cases, might even be used as is, provided they fit the context of your 

organization. These tools can be used by both clinical supervisors and administrators as part of a comprehensive clinical supervision system. 

The Change Book: A Blueprint for Technology Transfer (Addiction Technology Transfer Center [ATTC] National 

Office, 2004) provides the basis for the organizational change process presented here. You may wish to consult 

with colleagues who have implemented a clinical supervision system for their organizations, especially if the 

agency is similar to yours. Managing organizational change is very similar to working with a client in a clinical 

setting. Your understanding of the recovery process and of the counselor’s personal qualities and skills that 

facilitate recovery are invaluable resources as you apply the tools presented in this chapter. 

Assessing Organizational Readiness 

You will need to determine the state of readiness of your organization and its personnel to implement a clinical 

supervision system. This assessment should include agency contextual variables, competence of supervisory 

staff, clinical competence of counseling staff and organizational integrity, motivation of personnel, the nature of 

your relationships with staff, environmental variables (such as current or recent organizational changes, financial issues, accreditation, and legislative mandates), and the best methods and techniques to be used (see Tool 

1). Tool 2 will help in assessing organizational readiness to change and identifying and prioritizing barriers to 

change. Just as a clinician might assess a client’s stage of readiness to change, these principles can be applied 

to implementing a clinical supervision system or other types of organizational change. Tool 3 will help you 

reach agreement with staff on the goals of supervision. 

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Clinical Supervision and Professional Development 101
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102 Part 2, Chapter 2 

Tool 1. Initial Organizational Assessment 

Organizational Context 

Conditions Not at All 

1 

A Little 

2 

Possibly 

3 

Very Likely 

4 

Definitely 

5 

Staff have a common set of goals. A goal of the organization is 

that clinical supervision is valued and should be provided. 

Administrators model a norm of collegiality. Although a supervisee's performance evaluation implies a hierarchy, the organization demonstrates an openness ensuring that each person 

will be respected and treated as a valuable member of the 

team. 

The organization promotes professional development. 

Continuous education and professional growth are promoted 

for supervisors as well as counselors. 

Progress toward goals is monitored actively and does not wait 

for outcome evaluation. Ongoing monitoring is valued. 

Obstacles are identified and handled as an organizational challenge, instead of allowing a situation to deteriorate and be 

judged as demonstrating a lack of competence of particular 

staff members. 

Support for clinical supervision is appropriately generous. 

Allotment of time and resources is critical. 

Priority Focus______________________________________________________________________________________ 

Secondary Focus __________________________________________________________________________________ 

Source: Based on Bernard & Goodyear, 1998; Adapted from Porter & Gallon, 2006. 
Tool 2. Organizational Stage of Readiness To Change 

Implementing a Clinical Supervision Program in Your Agency 

Stages of Change 

Precontemplation 

Contemplation 

Preparation 

Action 

Maintenance 

Unaware of issue 

Considering the issue 

Designing a plan of action 

Implementing the action plan 

Maintaining the change 

Stage of Readiness Incentives to Change Obstacles to Change Resources for Change 

Board of Directors 

Administration 

Supervisors 

Direct Care Staff 

Support Staff 

Primary Group—Focus of Change Expected Outcome and Timeframe 

Secondary Group—Focus of Change Expected Outcome and Timeframe 

______________________________ ______________________________ 

______________________________ ______________________________ 

______________________________ ______________________________ 

______________________________ ______________________________ 

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Clinical Supervision and Professional Development 103
_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

_______________________________________________________________________________________________________ 

This part of Tool 2 is designed for use by administrators and supervisors to identify the current barriers in the 

organization to implementing a comprehensive supervision system. Administrators and supervisors should fill 

this out separately, and then discuss answers in an executive team meeting. 

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104 Part 2, Chapter 2 

Tool 2. Organizational Stage of Readiness To Change 

Implementing a Clinical Supervision Program in Your Agency 

Current Barriers to Change 

Organizational Administrative Clinical Other 

List the most important barriers to address within the next 3 months. 

What would you like to have happen? 

Who do you need to help participate in the change? 

Source: Adapted from Porter & Gallon, 2006. 
Tool 3. Goals for Supervision 

Organizational Context 

How does the organization support counselors and supervisors in achieving the organization’s mission statement? What 

steps are needed to gain consensus between administration and direct service personnel to achieve the mission statement? What are the specific steps we can take as administrators to achieve this goal of consensus regarding the philosophy of the organization and its relationship to clinical work? 

GOAL: 

Cultural Competence 

What cultural and contextual factors are unique to this agency? What factors need to be addressed in clinical supervision? 

GOAL: 

Clinical Competence 

What specific knowledge, skills, and attitudes do we expect from our counselors? How do we acknowledge and address 

the individual counselor’s baseline competence and learning style? 

GOAL: _

Motivation 

How can we ensure that the clinical supervisor will help motivate counselors to participate in clinical supervision and 

perform clinical tasks? 

GOAL: 

Supervisory Relationship 

How can we support and validate the supervisory relationship both informally and formally? 

Do we believe that the supervisory relationship is an important variable in the supervisory process? How can we support 

and validate the supervisory relationship both informally and formally? 

GOAL:

Ethics and Professional Values 

How much do we expect that clinical supervisors will proactively teach ethics and professional values? 

GOAL:

Source: Adapted from Mattel, 2007 

_______________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

_______________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

______________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

_______________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

 _______________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

 _______________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

______________________________________________________________________________________________________ 

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Clinical Supervision and Professional Development 105
PART 2
 

Legal and Ethical Issues of Supervision 

Legal and ethical considerations should be paramount as you implement a supervision system. The goal is to 

know how to operate within the boundaries of legal and ethical codes and regulations for the protection of all 

parties, including the agency, administration, staff, and clients. Legal and ethical issues of supervision include 

direct and vicarious liability, confidentiality, informed consent and due process, supervisor and supervisee scope 

of competence and practice, and dual relationships (see discussion of these issues in Part 2, chapter 1). 

The Association for Counselor Education and Supervision (ACES) has standards for counseling supervisors 

that can serve as guidelines for the substance abuse field (available online at 

http://www.acesonline.net/ethical_guidelines.asp). ACES also has ethical guidelines for supervisors that address 

issues such as protecting client welfare and rights, supervisory roles, and program administration roles. The 

National Board for Certified Counselors, Inc., has a Code of Ethics pertaining to the practice of professional 

counseling and clinical supervision. This code, like the ACES code, is reproduced in TAP 21-A (Competencies for 

Substance Abuse Treatment Clinical Supervisors [CSAT, 2007]). Other professions also have similar guidelines, 

such as the Association of State and Provincial Psychology Boards (reprinted in Falvey, 2002b), the National 

Association of Social Workers (NASW, Guidelines for Clinical Social Work Supervision, 1994), and the 

American Association for Marriage and Family Therapy (AAMFT Supervisor Designation: Standards and 

Responsibilities Handbook, 1999). 

Informed consent is important for several reasons: (1) clients are entitled to know and agree to what processes 

support quality treatment, who will be reviewing information about them, and how this information will be 

used; (2) counselors are entitled to know how their work will be evaluated, the process of the supervision, and 

how this information will be used to support both quality care and their professional development; and (3) the 

administration is entitled to know that supervisory processes are articulated to support quality care and 

address legal and ethical standards. 

Tool 4 is one of a number of sample informed consent for supervision forms that are available. 

Tool 4. Informed Consent Template 

The consent should include: 

The purpose of supervision: the structure and mutual understanding of supervision 

• Goals of supervision 

• How goals will be evaluated and the specific timeframes 

• Specific expectations of the supervisor and the supervisee 

• Integration of theoretical models 

Professional disclosure: information about the supervisor that includes credentials and qualifications and 

approach to supervision 

• Educational background 

• Training experiences 

• Theoretical orientation 

• Clinical competence with various issues, models, techniques, populations 

• Sense of mission or purpose in the field 

• Educational plans and professional goals 

Supervision process: methods and format of supervision 

• Individual, group, peer, dyadic 

• Method of direct observation 

• Permission to record sessions on audio- or videotape 

Due Process: includes written procedures to be followed when a grievance or complaint has been made against the 

administration, the supervisor, or the counselor. It ensures that all sides are heard and that the complaint and response 

to the complaint receive due consideration. In this case, informed consent means that all parties are aware of the 

process for lodging a complaint. 

106 Part 2, Chapter 2 
Tool 4. Informed Consent Template (continued) 

Ethical and legal issues: policies, regulations, and laws regarding supervisory and therapeutic relationships 

• Number of supervisees for which the supervisor will be responsible 

• Emergency and back-up procedures (e.g., supervisor accessibility) 

• Ethical codes of conduct 

• Process for discussing ethical dilemmas 

• Confidentiality regarding information discussed in supervision 

• Confidentiality issues when more than one supervisee is involved 

• Dual roles and relationships 

• Process for addressing supervisee issues (e.g., burnout, countertransference) 

Statement of agreement 

Signed acknowledgement by all parties that they understand and agree to comply with the contract 

Source: Adapted from Falvey, 2007. 

Selection and Competencies of Supervisors 

When hiring or appointing a person as a clinical supervisor, you will need to understand the scope of practice 

and competence of a supervisor. Consult TAP 21-A (CSAT, 2007) and the International Certification and 

Reciprocity Consortium [IC&RC] Role Delineation Study for Clinical Supervisors (2000). 

Administrators can use checklists such as Tool 5 to determine the competencies of a potential clinical supervisor. 

Tool 5. Checklist for Supervisor Competencies 

Competencies Poor Below 

Average Average Above Average 

Excellent 

Knowledge 

Has knowledge of theory and intervention strategies 

Has knowledge of screening, assessment, and diagnostic standards 

Understands cultural and ethnic issues 

Has knowledge of resources in the community 

Has knowledge of current ethical guidelines and legal issues 

Practice 

Demonstrates mastery of intervention techniques 

Is timely and thorough in documentation 

Is able to develop rapport 

Is able to conceptualize problems 

Can respond to multicultural issues 

Is able to formulate treatment goals 

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Clinical Supervision and Professional Development 107
Tool 5. Checklist for Supervisor Competencies (continued) 

Competencies Poor Below 

Average Average Above Average Excellent 

Personal 

Demonstrates ethical behavior 

Demonstrates use of good judgment and counseling skills 

Is interpersonally competent 

Is able to identify own strengths and weaknesses 

Is able to accept and learn from feedback 

Is an asset to the profession 

Source: Adapted from Campbell, 2000. Permission pending. 

Other sources to consult on the same topic include: 

•		 Bernard and Goodyear, 2004: Evaluation Questionnaires and Scales (pp. 316–339). 

•		 Falvey, 2004b: Ethical Mandates for Professional Competence, Standards for Clinical Supervisor 

Competence (pp. 25, 28). 

•		 Powell and Brodsky, 2004: ACES Supervision Interest Network, Competencies of Supervisors (pp. 327–332). 

•		 Campbell, 2000 (pp. 257–285). 

Substance Abuse Policy 

As an administrator, you have ultimate responsibility for enforcing policies and procedures for maintaining a safe 

workplace. Under provisions of the Drug-Free Workplace Act of 1988, all agencies receiving Federal and/or State 

funds are required to have a substance abuse policy. This policy should state how the organization maintains a safe 

workplace so as to provide the highest quality service to its clients. The procedures should address how the agency 

will deal with issues related to alcohol and drugs in the workplace, fitness-for-duty concerns, testing of employees, 

drug-related convictions, searches, and violations of policies. Tool 6 is a sample substance abuse policy. Other 

administrative issues can be addressed, such as gambling and tobacco in the workplace, pornography in the workplace, and abuse of Internet access and use in the workplace. Tool 6 is an example of a substance abuse policy. 

Tool 6. Sample Policy on Substance Abuse 

This organization is committed to maintaining a safe workplace and to providing high-quality service to its clients. 

Successful attainment of these goals depends on the establishment and maintenance of a workplace that is free from 

the adverse effects of drug use and alcohol abuse. 

Alcohol 

1. The use, possession, or being under the influence of alcohol while on duty or on the premises is strictly forbidden. 

This prohibition precludes an employee from consuming alcohol at meal times during work hours, even off premises. 

2. Employees are prohibited from working with the smell of alcohol on their breath, regardless of when or where alcohol was consumed. 

Drugs 

1. The use, possession, being under the influence of, manufacture, sale, dispensation, or distribution of illegal or unauthorized drugs or drug paraphernalia while on duty or on the premises is forbidden. 

2. An employee’s involvement with illegal or unauthorized drugs off duty and/or off premises may result in discipline, 

up to and including discharge, where such involvement may have an adverse effect on the organization’s reputation. 

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108 Part 2, Chapter 2 
Tool 6. Sample Policy on Substance Abuse 

3. Employees who are taking prescribed medications must keep them in a secure location, completely inaccessible to 

anyone but themselves, while on the premises. It is expected that employees will follow all safety precautions associated with consumption of that drug (i.e., regarding operating machinery or driving vehicles). 

Fitness for Duty 

1. Employees are required to be fit for duty. 

2. An employee is unfit for duty if, while on duty or on the premises, he or she is under the influence of or affected by 

illegal or unauthorized alcohol and/or has an impermissible level of illegal or legally prescribed drugs or alcohol in his 

or her system and/or is affected to a degree that the employee cannot perform work because of the legally prescribed drugs. 

3. Unfitness for duty can be determined through a variety of means, separately or in conjunction with each other, 

depending on the circumstances, such as direct observation and/or drug and/or alcohol testing. 

4. An employee will be terminated if he or she is unfit for duty because of drugs and/or alcohol. 

Testing of Employees 

1. Reasonable Suspicion. An employee may be required to submit to drug and/or alcohol testing whenever there is reason to believe because of physical, behavioral, or performance indicators, that the employee is under the influence of 

or is affected by illegal or legally prescribed drugs and/or alcohol while on duty or on the premises. 

2. Post-Accident. An employee may be tested for drugs and/or alcohol after any accident that could have been caused 

by human error or carelessness. An accident is defined as an event resulting in medical treatment by a professional or 

property damage in excess of $500. 

3. Medication Control. If prescribed medication or controlled substances dispensed by the organization disappear or 

cannot otherwise be accounted for, all employees who may have had access to such medication or substances will be 

tested for illegal drugs. 

4. Positive Test Result. An employee who tests positive for an illegal drug or unauthorized or illegally obtained legal 

drug and/or alcohol is unfit for duty and may be disciplined. 

Drug-Related Convictions 

An employee who is convicted of a drug-related offense occurring in or out of the workplace is in violation of this 

policy. A conviction includes a guilty plea, a plea of nolo contendere, or any court-supervised program or courtimposed sentence. 

Searches 

The organization reserves the right to search an employee, his or her possessions, work area, or vehicle while on the 

premises to determine if illegal drugs or alcohol are present. 

Failure to Cooperate 

An employee who refuses to provide a specimen at the date and time requested, who refuses to provide written consent 

to testing, who provides a false or tampered specimen, or refuses to consent to a search of his or her person, possessions, work area, or vehicle may be discharged. 

Supervision Guidelines 

Supervision guidelines describe the organization’s commitment to clinical supervision, working terms, principles of supervision at that organization, and required documentation of clinical sessions and clinical supervision. The guidelines should clearly state the frequency of supervision, ongoing feedback procedures, and commitment to ongoing professional development. Tool 7 is an example of such a document. 

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Tool 7. Clinical Supervision Policy and Procedure 

Underlying Principles 

Clinical supervision is a powerful tool for managing and ensuring continuous improvement in service delivery. Clinical 

supervision is comprised of balancing four distinct functions: administrative, evaluative, supportive, and clinical. 

Fundamental structures include a positive working relationship, client-centered approach, commitment to professional 

development, and accountability. The following principles ensure high-quality clinical supervision: 

• A safe, trusting working relationship that promotes a learning alliance. 

• A counselor-centered program with a culturally and contextually responsive focus. 

• Active promotion of professional growth and development. 

• Shared clinical responsibility ensuring that the client’s treatment goals are addressed. 

• A rigorous process that ensures ethical and legal responsibility. 

• An individualized approach based on the learning needs and style of the supervisee. 

• Congruence with the values and philosophy of the agency. 

Terms 

A healthy working relationship is built on shared vision and goals, clear expectations, and the belief in the good 

intentions of staff members. It demonstrates reciprocal communication where all parties provide comprehensive, timely 

information that is respectful. Each person is responsible for providing relevant information critical to his or her job 

function and the mission of the agency. The working relationship recognizes the importance of the chain of command 

throughout all agency levels. The agency expects that this chain of command supports structure, appropriate boundaries, 

and decisionmaking at all levels. The chain of command is followed to ensure effective and efficient communication. 

Trust is central to the working relationship. This is manifested in several ways: (1) people are accountable to their work 

and job responsibilities, (2) confidentiality is maintained, (3) decisions are respected, and (4) misunderstandings are pursued to clarify miscommunication, seek to understand the other person, air emotions, and reach resolution. 

The learning alliance is based on the belief that the supervisee has specific learning needs and styles that must be 

attended to in supervision. The relationship between supervisor and supervisee is best formulated and maintained when 

this frame of reference is predominant. Supervisees participate in a mutual assessment based on a combination of direct 

and indirect observations. 

Guidelines for Clinical Supervision 

The principles of clinical supervision are made explicit by a clear contract of expectations, ongoing review and feedback, 

and a commitment to professional development. 

Clear contract of expectations 

It is critical that both the supervisor and supervisee share their expectations about the process, method, and content of 

clinical supervision. This can advance the development and maintenance of a trusting, safe relationship. The following 

information should be discussed early in the working relationship: 

• Models of supervision and treatment. 

• Supervision methods and content. 

• Frequency and length of supervisory meetings. 

• Ethical, legal, and regulatory guidelines. 

• Access to supervision in emergencies. 

• Alternative sources of supervision when the primary supervisor is unavailable. 

The supervisee will be provided with a job description that outlines essential duties and performance indicators. 

Additionally, each supervisee will receive an assessment of core counseling skills based on the TAP 21 competencies and 

other appropriate standards. 

Documentation 

Supervisory sessions are recorded as notes that indicate the focus of the session, the issues discussed, solutions suggested, and agreed upon actions. Supervisors will maintain a folder for each of their supervisees. The folder will contain the 

IDP, clinical supervision summaries, and personnel actions (e.g., memos, commendations, other issues). Supervisees are 

allowed full access to the folders. 
Tool 7. Clinical Supervision Policy and Procedure (continued) 

Clinical supervision frequency 

Each supervisee will receive 4 hours of supervision monthly. A combination of individual and group supervision may be 

used. Supervisors are to ensure that a minimum of 50 percent of this time is devoted to clinical, as opposed to administrative, supervision. 

Ongoing review and feedback 

The supervisee will be given an annual performance evaluation that reviews both job expectations and the clinical skills 

learning plan. Written records of the supervisee will be reviewed on a regular basis. Supervisees will be given specific 

written feedback regarding their strengths and areas for improvement. The supervision system operates through direct 

observation of clinical work. This ensures that direct, focused feedback will be provided, increases the degree of trust 

and safety, and provides an accurate evaluation of skills development progress. Observations will be pre-arranged and 

take the form of sitting in on a session, co-facilitating, or videotaping. The supervisee will present a case at a minimum 

of once per month. 

Commitment to ongoing professional development 

The supervisee’s learning plan should document goals, objectives, and methods to promote professional development. 

The plan should be completed within the first 6 months of employment and updated annually. Ongoing supervision 

should focus on achieving the identified goals. The agency supports supervisees’ participation in training to achieve their 

professional development goals. 

Source: Adapted from unpublished Basics, Inc. materials 

The Supervision Contract 

A supervision contract protects the rights of the agency, the supervisor, and supervisee. A written contract 

between supervisor and supervisee, stating the purpose, goals, and objectives of supervision is important. Tool 

8 is a template for supervision contracts. In addition to the contract, for the purposes of informed consent, it is 

useful to have a supervision consent form signed by both the supervisor and supervisee, indicating the supervisee’s awareness and agreement to be supervised (see Tool 4). 

Tool 8. Supervision Contract Template 

This document serves as a description of the supervision provided by (supervisor name, credentials, title) to (supervisee, 

credentials, title). 

Primary Purpose, Goals, and Objectives 

• Monitor and ensure client welfare 

• Facilitate professional development 

• Evaluate job performance 

Provision 

• (Frequency) of individual supervision at (day and time) 

• (Supervision model and case review format) will be used 

• Clients of the counselor will give informed consent for supervision of their case 

• Counselor will have a minimum of (amount) of supervision for every (number) of client contact hours 

• All client cases will be reviewed on a rotating basis based on need 

Documentation 

• (Form name) will be used to document the content and progress of the supervision 

• Informal feedback will be provided at the end of each session 

• Written formal evaluation will be provided (frequency) 

• Supervision notes will be shared (at the supervisor’s discretion or at request of counselor) 

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Tool 8. Supervision Contract Template (continued) 

Duties and Responsibilities 

The supervisor at a minimum will: 

• Review all psychosocial histories, progress notes, treatment plans, and discharge plans. 

• Question the counselor to justify approach and techniques used. 

• Present and model appropriate clinical interventions. 

• Intervene directly if client welfare is at risk. 

• Ensure that ethical guidelines and legal statutes are upheld. 

• Monitor proficiencies in working with community resources and networking with community agencies. 

The counselor at a minimum will: 

• Uphold all ethical guidelines and legal statutes. 

• Be prepared to discuss all client cases. 

• Discuss approaches and techniques used and any boundary issues or violations that occur. 

• Consult supervisor or designee in emergencies. 

• Implement supervisor directives. 

• Adhere to all agency policies and procedures. 

Procedural Consideration 

• The Individual Development Plan’s goals and objectives will be discussed and amended if necessary. 

• The quality of the supervisory relationship will be discussed and conflicts resolved. 

• If conflicts cannot be resolved, (name) will be consulted. 

• In the event of an emergency, the counselor is to contact the supervisor. If unavailable, contact (alternate’s name, 

title, and other relevant back-up information). 

• Crises or emergency consultations will be documented. 

• Due process procedures (as explained in the agency’s policy and procedure handbook) have been reviewed and will 

be discussed as needed. 

Supervisor’s Scope of Competence 

• Title/date of credentials/licensure. 

• Formal supervisory training and credentials. 

• Years providing supervision. 

• Current supervisory responsibilities. 

This agreement is subject to revision at any time on request of either person. Revision will be made only with consent of 

the counselor and approval of the supervisor. We agree to uphold the directives outlined in this agreement to the best 

of our ability and to conduct our professional behavior according to the ethical principles and codes of conduct of our 

professional associations. 

Supervisor Title__________________________ _____ 

Supervisee_____________________________________ Title__________________________ Date___________ 

This agreement is in effect from (current date) to (annual date of review or termination) 

Source: Mattel, 2007 

_____________________________________ Date______

Another sample supervision contract form can be found in Campbell (2000), p. 285.


The Initial Supervision Sessions 

An initial supervision sessions checklist documents the topics to be covered in initial sessions by the supervisor 

and supervisee. The goal is that as part of establishing the supervisory relationship, the supervisor and supervisee should discuss the basic issues in substance abuse counseling and in supervision. For new supervisors 

and for administrators to monitor the implementation of supervision, a checklist, such as Tool 9, can ensure 

that the important issues are discussed. The example below can aid in setting a preliminary structure for 

supervision, clarifying goals and expectations, and incorporating feedback so as to promote a sense of openness, 

trust, and safety. It is understood that not all of these topics can be covered in the first few sessions, but these 

topics are important considerations in initiating clinical supervision. 

Documentation and Recordkeeping 

Documentation is unquestionably a crucial risk-management tool for clinical supervisors and is no longer 

optional in supervision. Legal precedents suggest that organizations are both ethically and legally responsible 

for quality control of their work, and the supervision evaluation, documentation, and record-keeping systems 

are a useful and necessary part of that professional accountability. However, in contrast with the myriad clinical forms and documentation required, there is a paucity of tools for documentation in supervision. Most organizations rely on the personal style and records of individual supervisors, and do not have an organization-wide 

standardized system of record keeping for supervision. Documenting supervision should not be burdensome, but 

it should be systematic and careful. Key components of what should be documented and how it should be documented are provided in the following paragraphs. 

A record of supervision sessions needs to be maintained that documents: when supervision was conducted, what 

was discussed, what recommendations were provided by the supervisor, and what actions resulted. A supervisor should maintain a separate file on each counselor supervised, including: 

•		 Caseloads. 

•		 Notes on particular cases. 

•		 Supervisory recommendations and impressions. 

•		 The supervision contract. 

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

•		 The individual development plan. 

•		 A summary of all performance evaluations. 

•		 Notations of supervision sessions, particularly concerning duty-to-warn situations, cases discussed, and significant decisions made. 

•		 Notations of canceled or missed supervision sessions. 

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

By far, the most comprehensive documentation system for clinical supervisors is Falvey’s FoRMSS system 

(2002a), which includes emergency contact information, supervisee profiles, a log sheet for supervision, an initial case overview, a supervision record, and a termination summary that records the circumstances of client 

termination, client status at termination, and any followup or referrals needed. The FoRMSS system alerts 

supervisors to potential clinical, ethical, or legal risks associated with cases. 

Records of supervision must be retained for the period required by the State and pertinent accreditation bodies. 

The American Psychological Association’s guidelines (2007) recommend retaining clinical and supervisory 

records for at least 7 years after the last services were delivered. Organization policy may differ from this. 

Administrators should check with local and State statutes regarding record-keeping requirements. It is prudent 

for an organization and supervisor to retain supervision records for at least as long as required by the State 

and accreditation bodies. 

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114 Part 2, Chapter 2 

Tool 9. Initial Supervision Sessions Checklist 

Education, Training, and Clinical Experience 

_____ Educational background 

_____ Training experience 

_____ Setting(s), number of years 

_____ Theoretical orientation 

_____ Clinical competence with various issues, models, techniques, populations, presenting problems, treatment 

modalities 

_____ 	 Sense of mission and purpose in the field 

_____ 	 Educational plans and professional goals of the supervisee 

_____ 	 Training and awareness of cultural and contextual issues in counseling 

_____ 	 Training and awareness of community networking in counseling 

Philosophy of Supervision 

_____ Philosophy of therapy and change 

_____ Purpose of supervision 

Previous Supervision Experiences 

_____ Previous supervision experiences (e.g., format, setting) 

_____ Strengths and weaknesses as counselor and as supervisee 

_____ Supervisee’s competence with stages of counseling process 

_____ Supervisee’s level of development in terms of case planning, notes, collateral support, and networking 

_____ Supervisory competence with various issues, models, techniques, populations, therapy groups, and modalities 

_____ Methods for managing supervisor-supervisee differences 

Supervision Goals 

_____ Goals (personal and professional)



_____ Process of goal evaluation and timeframe



_____ Requirements for which supervisee is seeking supervision (e.g., licensure, professional certification)



_____ Requirements to be met by supervision (e.g., total hours, individual or group supervision)



Supervision Style and Techniques 

_____ Specific expectations the supervisee or supervisor has of the parties involved (e.g., roles, hierarchy)



_____ Type of supervision that would facilitate clinical growth of the supervisee
 


_____ Preferred supervision style (didactic, experiential, collegial)



_____ Parallels between therapy and supervision models



_____ Supervision focus (e.g., counselor’s development, cases)
 


_____ Manner of case review (e.g., crisis management, in-depth focus)



_____ Method (e.g., audio- or videotaping, direct observation)



Theoretical Orientation 

_____ 	 Models and specific theories in which supervisee and supervisor have been trained, practice, and or conduct 

supervision 

_____ 	 Extent to which these models have been used clinically 

_____ 	 Populations, presenting problems, and/or family forms with which the models have been most effective 

_____ 	 Interest in learning new approaches 
Tool 9. Initial Supervision Sessions Checklist (continued) 

Legal and Ethical Considerations 

_____ Ultimate responsibility for clients discussed in supervision in different contexts (e.g., licensed vs. unlicensed counselor, private practice vs. public agency) 

_____ Number of cases for which the supervisor will be responsible 

_____ Emergency and back-up procedures 

_____ Awareness of professional ethical codes 

_____ Confidentiality regarding the information discussed in supervision 

_____ Confidentiality issues when more than one supervisee is involved 

_____ Specific issues in situations where dual relationships exist (e.g., former client) 

_____ Process for addressing supervisee issues (e.g., burnout, countertransference) 

Other 

What do we need to know about each other that we have not already discussed? 

Source: Adapted from Falvey, 2002b. Permission pending. 

Tools 10–12 are sample documentation forms. (See also Campbell, 2000.)



Tool 10. Supervision Note Sample 

Professional Development Plan Current Focus 

Goal/TAP Competencies Objective Date of Expected Completion 

Supervision Content 

Issue Discussion Recommendation/ Action Followup 

Progress on Professional Development Plan Objectives 

_________________________________________________________________________________________________________________ 

________________________________________________________________________________________________________________ 

Other___________________________________________________________________________________________________________ 

Supervisor__________________________________ Counselor________________________________ Date______________________ 

Source: Porter and Gallon, 2006. 

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116 Part 2, Chapter 2 

Tool 11. Current Risk-Management Review 

Case:_____________________________________ Date::____________________________________________ 

ISSUES 

~ Informed Consent 

~ Parental Consent 

~ Confidentiality 

~ Recordkeeping 

~ Records Security 

~ Child Abuse/Neglect 

~ Risk of Significant Harm 

~ Duty to Warn 

~ Medical Exam Needed 

~ Supervisee Expertise 

~ Supervisor Expertise 

~ Institutional Conflict 

~ Dual Relationship 

~ Sexual Misconduct 

~ Releases Needed 

~ Voluntary/Involuntary Hospitalization 

~ Utilization Review Discharge/Termination 

Discussion: 

_________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Recommendation: 

_________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Action: 

_________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Signature__________________________________________________Date_________________________________________________ 

Title_______________________________________________________ 

Source: Based on Falvey, 2002b. 
Tool 12. Supervisory Interview Observations 

STATEMENTS/BEHAVIORS STATEMENTS/BEHAVIORS COMMENTS 

Step 1 

SET AGENDA 

Decrease anxiety 

Involve counselor 

Step 2 

GIVE FEEDBACK 

Empower 

Individualize 

Step 3 

TEACH and NEGOTIATE 

Share agenda 

Clarify knowledge, skills, attitude 

Identify learning steps 

Agree upon methods of learning 

Step 4 

SECURE COMMITMENT 

Clarify expectations 

Clarify responsibility 

Create mutual accountability 

LOOK FOR OBSERVATIONS, BEHAVIORS, NOTES 

SUMMARY OBSERVATIONS 

Interview structure followed? 

Time managed effectively? 

Established nurturing and supportive environment? 

Stayed on course? 

Resistance? Power struggle? 

Agreement secured? 

Followup plan created? 

NOTES: 

Source: Based on Porter & Gallon, 2006. 

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118 Part 2, Chapter 2 

Evaluation of Counselors and Supervisors 

Evaluation of counselors and supervisors is both formative (ongoing and evolving over time) and summative 

(periodic and formal). Nowhere else in supervision does the power differential between the supervisor and 

supervisee become more evident than in the evaluation process. Feedback and evaluation are necessary and 

important in an organization’s risk-management procedures. Agencies need a formal procedure and criteria for 

staff evaluation. When supervisors conduct supervisee evaluations, counselors need to understand there is a 

level of subjectivity in the process. There is no psychometrically valid tool to assess counselor competence. An 

element of the supervisor’s judgment is always involved. 

Most evaluation guidelines and tools identify general areas of competence to assess—knowledge, skills, and 

attitudes—but specific criteria for making an evaluation are left to the individual supervisor and the organization. It is important that the evaluation of staff be closely linked to job descriptions, the supervision contract, 

and the specific needs of the agency. Levels of competence and fitness for duty should be established by the 

individual organization, with consideration given to the credentialing and accreditation requirements of the 

agency. Supervisee triads also offer another option to assist in the evaluation process. A grievance and appeals 

process should be defined. Finally, supervisors need to be reminded that they are the gatekeepers for the 

agency, providing feedback, remediation as needed, and dismissal of personnel if indicated. 

Tools 13 and 14 aid the supervisee in evaluating the supervisor and the supervisor in assessing the counselor. 

Tool 13. Counselor Evaluation of the Supervisor 

This evaluation form gives the supervisor valuable feedback while it gives the counselor a sense of responsibility and 

involvement in the design and development of supervision. 

Use a 7-point rating scale where: 

1 = strongly disagree 

4 = neither agree nor disagree 

7 = strongly agree 

Rating 

1. Provides useful feedback regarding counselor behavior 

2. Promotes an easy, relaxed feeling in supervision 

3. Makes supervision a constructive learning process 

4. Provides specific help in areas needing work 

5. Addresses issues relevant to current clinical conditions 

6. Focuses on alternative counseling strategies to be used with clients 

7. Focuses on counseling behavior 

8. Encourages the use of alternative counseling skills 

9. Structures supervision appropriately 

10. Emphasizes the development of strengths and capabilities 

11. Brainstorms solutions, responses, and techniques that would be helpful in future counseling situations 

12. Involves the counselor in the supervision process 

13. Helps the supervisee feel accepted and respected as a person 

14. Appropriately deals with affect and behavior 

15. Motivates the counselor to assess counseling behavior 
Tool 13. Counselor Evaluation of the Supervisor (continued) 

This evaluation form gives the supervisor valuable feedback while it gives the counselor a sense of responsibility and 

involvement in the design and development of supervision. 

Use a 7-point rating scale where: 

1 = strongly disagree 

4 = neither agree nor disagree 

7 = strongly agree 

Rating 

16. Conveys a sense of competence 

17. Helps to use tests constructively in counseling 

18. Appropriately addresses interpersonal dynamics between self and counselor 

19. Can accept feedback from counselor 

20. Helps reduce defensiveness in supervision 

21. Encourages expression of opinions, questions, and concerns about counseling 

22. Prepares the counselor adequately for the next counseling session 

23. Helps clarify counseling objectives 

24. Provides an opportunity to discuss adequately the major difficulties the counselor is facing with clients 

25. Encourages client conceptualization in new ways 

26. Motivates and encourages the counselor 

27. Challenges the counselor to perceive accurately the thoughts, feelings, and goals of the client 

28. Gives the counselor the chance to discuss personal issues as they relate to counseling 

29. Is flexible enough to encourage spontaneity and creativity 

30. Focuses on the implications and consequences of specific counseling behaviors 

31. Provides suggestions for developing counseling skills 

32. Encourages the use of new and different techniques 

33. Helps define and achieve specific, concrete goals 

34. Gives useful feedback 

35. Helps organize relevant case data in planning goals and strategies with clients 

36. Helps develop skills in critiquing and gaining insight from counseling tapes 

37. Allows and encourages self-evaluation 

38. Explains the criteria for evaluation clearly and in behavioral terms 

39. Applies criteria fairly in evaluating counseling performance 

40. Addresses cultural issues of supervisee in a helpful manner. 

41. Discusses cultural and contextual issues of the client, family, and wider systems that open up new 

resources and avenues for support. 

Source: Adapted from Powell and Brodsky, 2004. 

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Tool 14. Counselor Competency Assessment 

Based on TAP 21, Addiction Counseling Competencies: 

The Knowledge, Skills, and Attitudes of Professional Practice (CSAT, 2006) 

Competency Area Needs 

Improvement 

Able to Perform 

Skill Proficient Consistent Mastery 

Understand Substance Use 

Disorders 

• Models and theories 

• Recognize complex context 

of substance abuse 

Treatment Knowledge 

• Philosophies 

• Practices 

• Outcomes 

Application to Practice 

• DSM-IV-TR 

• Repertoire of helping 

strategies 

• Familiar with medical and 

pharmacological resources 

Diversity and Cultural 

Competence 

• Understand diversity 

• Use client resources 

• Select appropriate strategies 

Clinical Evaluation 

• Screening 

• Assessment 

Assess Co-Occurring 

Disorders 

• Symptomatology 

• Course of treatment 

Treatment Planning 

• Based on assessment 

• Individualized 

• Ensure mutuality 

• Reassessment 

• Team participation 

Referral and Followup 

• Evaluate referrals 

• Ongoing contact 

• Evaluate outcome 

Case Management 

120 Part 2, Chapter 2 
Tool 14. Counselor Competency Assessment (continued) 

Based on TAP 21, Addiction Counseling Competencies: 

The Knowledge, Skills, and Attitudes of Professional Practice (CSAT, 2006) 

Competency Area Needs 

Improvement 

Able to Perform 

Skill Proficient Consistent Mastery 

Group Counseling 

• Group theory 

• Describe, select, and use 

appropriate strategies 

• Understand and work with 

process and content 

• Facilitate group growth 

Family, Couples Counseling 

• Theory and models 

• Understand characteristics 

and dynamics 

• Describe, select, and use 

appropriate strategies 

Individual Counseling 

• Theory of individual 

counseling 

• Describe, select, and use 

appropriate strategies 

• Understand functions and 

techniques of individual 

counseling 

Client, Family, and 

Community Education 

• Culturally relevant 

• Provide current information 

• Teach life skills 

Documentation 

• Knowledge of regulations 

• Prepare accurate, concise 

notes 

• Write comprehensive, clear 

psychosocial narrative 

• Record client progress in 

relation to treatment goals 

• Discharge summaries 

Professional and Ethical 

Responsibilities 

• Adhere to code of ethics 

• Apply to practice 

• Participate in supervision 

• Participate in performance 

evaluations 

• Ongoing professional 

education 

Source: Porter & Gallon, 2006. 

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Other useful resources are: 

•	 Bernard and Goodyear, 2004: Supervision Instruments (pp. 317–326). 

•	 Campbell, 2000: Generic Rating Sheet and Evaluation Form, Supervisee’s Basic Skills and Techniques 

(p. 263); Sample Generic Supervisee Evaluation Form (p. 275). 

•	 Powell and Brodsky, 2004: Evaluation of the Counselor, adapted from Stoltenberg and Delworth, 1987 

(p. 351). 

•	 Powell and Brodsky, 2004: Counselor Assessment Forms (p. 373–379). 

•	 Northwest Frontier Addiction Technology Transfer Center Performance Rubric available online at 

http://www.nfattc.org. 

Individual Development Plan 

After the supervisor and counselor have agreed on goals, they should formulate an individual development plan 

(IDP) or professional development plan. It should address the expectations for supervision, the counselor’s experience and readiness for the position, procedures to be used to observe and assess the counselor’s competencies, 

and the counselor’s professional development goals. Some IDP formats follow the 12 Core Functions taking into 

account the stage of development of the counselor. Other formats might use the competencies in TAP 21. Tool 

15 outlines the generic knowledge, skills, and attitudes to be addressed as part of one’s professional development plan. Whatever format is adopted, the IDP should provide the counselor with a road map for learning 

goals. 

Tool 15. Professional Development Plan 

Staff_____________________________________ Position ___________________________________ Date ______________________ 

Practice Dimension: ______________________________________________________________________________________________ 

Competency number and page from TAP 21: _______________________________________________________________________ 

Present level of competence from TAP 21 Rating Form: 

1 

Understands 

2 

Developing 

3 

Competent 

4 

Skilled 

5 

Master 

1 = Understands 

2 = Developing 

3 = Competent 

4 = Skilled 

5 = Master 

Comprehends the tasks and functions of counseling 

Applies knowledge and skills inconsistently 

Consistent performance in routine situations 

Effective counselor in most situations 

Skillful in complex counseling situations 

Describe the counselor’s strengths and challenges for this rating: ____________________________________________________ 

_________________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Expected level of competency to be achieved with this learning plan: 

1 

Understands 

2 

Developing 

3 

Competent 

4 

Skilled 

5 

Master 

Describe the goal for this learning plan in observable terms:_________________________________________________________ 

_________________________________________________________________________________________________________________ 

122 Part 2, Chapter 2 
Tool 15. Professional Development Plan (continued) 

List the Knowledge, Skills, and Attitudes relevant to achieving the target competency. 

Knowledge_______________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Skills ____________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Attitudes ________________________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

State the performance goal in specific behavioral terms: ____________________________________________________________ 

_________________________________________________________________________________________________________________ 

What activities will the counselor complete in order to achieve the stated goal? ______________________________________ 

How will progress be evaluated? How will proficiency be demonstrated? _____________________________________________ 

Supervisor Signature ________________________________________________________ Date ________________________________ 

Counselor Signature ________________________________________________________ Date ________________________________ 

UPDATE 

Date of “re-observation” ______________________________________ 

Demonstration of knowledge and skills successful? _________ Yes _________ No 

If “No,” demonstration needs the following correction and followup demonstration rescheduled: 

Supervisor Signature ________________________________________________________ Date ________________________________ 

Counselor Signature ________________________________________________________ Date ________________________________ 

Source: Adapted from Porter & Gallon, 2006. 

Outline for Case Presentations 

Counselors often need to be taught how to present cases in supervision. The counselor needs to think about the 

goals he or she would like to achieve for the client and his or her particular concerns about the case. It is possible to use the case presentation format for a variety of purposes: to explore the client’s clinical needs, to aid in 

case conceptualization, to process relational issues in counseling (transference and countertransference), to 

identify and plan how to use specific clinical strategies, and to promote self-awareness for the counselor. In the 

beginning, the supervisor should structure the case presentation procedures to ensure consistency and conformity to agency guidelines. Tool 16 can be adapted to the particular theoretical model of the agency and the specific needs of the supervisee and organization. 

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124 Part 2, Chapter 2 

Tool 16. Sample Case Consultation Format 

Name of presenter:_______________________________________________________________________________________________ 

Date:____________________________________________________________________________________________________________ 

Identifying data about the client (age, marital status, number of marriages, number and ages of children, occupation, 

employment status) 

Presenting problem:______________________________________________________________________________________________ 

Short summary of the session:_____________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Important history or environmental factors (especially cultural or diversity issues):_____________________________________ 

_________________________________________________________________________________________________________________ 

Tentative assessment or problem conceptualization (diagnosis):______________________________________________________ 

_________________________________________________________________________________________________________________ 

Plan of action and goals for treatment (treatment plan):____________________________________________________________ 

_________________________________________________________________________________________________________________ 

Intervention strategies:___________________________________________________________________________________________ 

_________________________________________________________________________________________________________________ 

Concerns or problems surrounding this case (e.g., ethical concerns, relationship issues):________________________________ 

_________________________________________________________________________________________________________________ 

Source: Adapted from Campbell, 2000. 

Audio- and Videotaping 

To ensure competence, the agency should provide instruction on audio- and videotaping to all staff. Instruction 

should include the overall purpose of taping, how to inform the client about the taping procedure, how to use 

the recording equipment, the placement of taping devices, how to ensure client confidentiality and obtain 

signed releases, how to begin the actual session while recording, and how to process the tapes after recording. 

Tool 17 provides helpful hints for successful audio- and/or videotaping. 

Tool 17. Instructions for Audio and Videotaping 

1. Use quality equipment. Check the sound quality, volume, and clarity. It is best to use equipment with separate clipon microphones unless you are in a sound studio with a boom microphone. Clip-on microphones are inexpensive and 

easy to obtain. 

2. Buy good quality tapes. It is not necessary to buy top-of-the-line tapes, but avoid the cheapest. Better tapes give 

better sound and picture and can be reused. 

3. Placement of equipment matters. Use a tripod for the video camera. Check the angle of camera, seating, volume, 

and the stability of the picture. 
Tool 17. Instructions for Audio and Videotaping (continued) 

4. Check the background sound and volume. Choose a quiet, private place to do this, both to protect confidentiality 

and to improve recording quality. Do not use an open space, an office with windows facing the street, or a place subject to interruption. Loud air-conditioning fans, ringing phones and pagers, street noise, and office conversations all 

disrupt the quality of taping. 

5. Know how to use the equipment. Conduct a dry run. Be sure to check the placement of chairs, video camera 

angles, and picture quality before you begin. If the supervisee is especially anxious or unfamiliar with the equipment, 

have him or her make a practice tape. Be sure those in the picture are the persons agreed on by the supervisor and 

supervisee. 

6. Protect the confidentiality of the supervisee and the client. Choose a private, controlled space for taping. Keep 

the tapes in a locked cabinet and don’t include identifying data on the outside of the tape. When finished with 

supervision, erase the tape completely before reusing; do not just tape over the previous session. 

7. Process with the supervisee any anxiety or concern generated by taping. Three areas of potential anxiety are 

the technical aspects (equipment and room availability), concern for the client (confidentiality), and the effect of taping on the session (critical evaluation of performance by the supervisor). 

8. Explain taping, its goals, and its purpose to the client at least one session before proceeding. Review with the client 

any concerns about confidentiality. Remember that the more comfortable and enthusiastic the supervisor and the 

supervisee are with the value of taping, the more comfortable the client will be. Sometimes just reassuring the client 

that the tape can be turned off at any point if the client is uncomfortable increases a sense of control and reduces 

anxiety. Usually after the first few minutes of taping, both the client and counselor forget its presence, and this 

option is rarely used. If the client appears resistant, a decision should be made as to the appropriateness of using this 

particular method of supervision in this situation. 

9. Get a written release from the client. Be sure the release includes a description of the purpose of the tape, limits 

of confidentiality, identities of those viewing the tape, and assurance of erasure of the tape afterward. If the tape is 

to be used in group supervision or a staffing seminar, the client should be informed of that fact. 

10. Before beginning the actual session, check the equipment by making a short practice tape covering background 

material on the client. Then, rewind the tape and play it to check sound, volume, camera angle, and picture. When 

satisfied, begin the actual session. 

Source: Adapted from Campbell, 2000. 

PART 2
 


Clinical Supervision and Professional Development 125
Further, it is essential that an organization provide documentation to protect the confidentiality of information 

and to preserve patients’ rights. This is especially important if direct observation of clinical sessions is to occur 

using audio or videotaping. Tool 18 explains the benefits and procedures of taping and can be read by the counselor to the client. The consent form, Tool 19, should be signed and dated prior to taping. 

PART 2
 


126 Part 2, Chapter 2 

Tool 18. Confidentiality and Audio- or Videotaping 

Video recording of clinical processes will be conducted with the client’s written, informed consent for each taping. 

Clients understand that no taping will occur without their consent. A process already in place will ensure the security 

and destruction of DVDs or erasure of VHS tapes. 

The purpose of videotaping is to improve counselors’ clinical skills through supervision and teaching. 

Counselor benefits of videotaping include: 

•		 Improving therapeutic skills. 

•		 Improving treatment team cohesion. 

•		 Improving assessment, treatment planning, and delivery of services. 

•		 Improving clinical supervision. 

Procedure: 

The client’s counselor will explain and fully disclose the reason, policy, and procedure for videotaping the client. Both 

will sign a specific videotaping release form. The counselor should also explain that refusal to be taped will not affect 

the client’s treatment at the agency. 

1.		 The client must be 18 years old to sign the consent. Those under 18 must have a parent’s signature in addition to 

their own. 

2.		 Respecting the client’s concerns is always the priority. Should any client or family member show or verbalize concerns 

about taping, those concerns need to be addressed. 

3.		 All taping devices will be fully visible to clients and staff while in use. 

4.		 A video camera will be set up on a tripod, consistent with safety standards and in full view of each client. Clients will 

be notified when the camcorder is on or off. 

5.		 The tape will be labeled when the session is completed, and no copies will be made. 

6.		 Clinical review for supervision or training: The treatment team will review the tape and assess clinical skills for the 

purpose of improving clinical techniques. 

7.		 The tape will be turned over to the Medical Records Department (if available) for sign out. 

8.		 Tapes and DVDs will be stored in a locked drawer in the Medical Records Department. Within 2 weeks of taping, 

tapes will be erased and DVDs destroyed in the presence of two clinical staff members who attest to this destruction 

on a form to be kept for 3 years. 

9.		 Tapes and DVDs may not be taken off premises. 

Tool 19. Audio or Video Recording Consent 

I , ________________________________, consent to be recorded or filmed for supervision purposes. I also agree to allow 

the clinical staff to review the film as a resource to facilitate staff development for the enhancement of clinical procedures. I understand that any film in which I am a participant will be erased within 2 weeks of the date of filming. I 

understand that no copies will be made of such film. 

Patient Signature __ Date __

Witness Signature _ Date __

__________________________________________________________ ____________________________ 

__________________________________________________________ _____________________________ 
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Appendix B: New York State 

Office of Alcoholism and 

Substance Abuse Services 

Clinical Supervision Vision 

Statement 

To position clinical supervision, within the system of prevention, treatment, and recoveryoriented services, as integral to a continuous learning culture that encourages professional 

development, service improvement, and quality of care, maximizing benefits to the client. 

Clinical supervision is defined as “a social influence process that occurs over time in which the 

supervisor participates with the 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” (TAP 21A). 

Highlights 

•	 Clinical supervision is a valuable and necessary strategy to ensure continuous staff 

and program development. 

•	 The supervisory relationship must be supportive and culturally competent, provide 

direct oversight, and prioritize skill development and counselor wellness. 

•	 Clinical supervision is a formal process that is provided frequently and employs direct 

observation techniques. 

•	 Clinical supervisors are specifically trained and invest in continuing professional 

development. 

•	 Fully integrated clinical supervision is expected to result in improved staff retention, 

counselor skills, and clinical outcomes. 

Clinical Supervision and Professional Development 135 
The integration of clinical supervision is both a short-term and long-term strategy for ongoing quality improvement and increased successful client outcomes. The proficiency and integrity of the 

workforce, and subsequently the caliber of services, are strengthened through gatekeeping functions, direct oversight, teaching, training, infusion of diversity-cultural competence and sensitivity, 

and the morale-boosting benefits inherent in quality clinical supervision. 

Research and expert consensus links clinical supervision with a wide variety of actual and potential outcomes, including improved quality of services to clients, professional development of staff, 

better adherence to codes of ethical conduct, increased staff retention, improved morale and wellness, fidelity to evidenced-based practices, improved regulatory compliance and risk management, 

and enhanced perception of recovery-oriented systems of care by consumers, professionals, and the 

community. Though more empirical work is needed, there is enough reliable evidence to indicate 

that clinical supervision is a highly efficient practice key to the growth and future of the field 

Skilled clinical supervisors help staff gain advanced competency through both formal training and 

education supported by ongoing feedback and guidance throughout their professional career. 

Values inherent in clinical supervision are articulated in the acronym ASPECT: 

Accountability – upholding the promise to deliver quality services. 

Stewardship – mindful use of all available resources. 

Professionalism – consistent and ethical role modeling and application. 

Excellence – the relentless pursuit to provide the best quality care. 

Continuous Learning – steadfast commitment to ongoing development. 

Teamwork – active support of collective wisdom and energy to achieve great results. 

The quality of the relationship between the clinical supervisor and supervisee is critical to a positive learning alliance. Clinical supervisors exercise supervisory responsibilities in a culturally 

responsive, respectful, fair, and objective manner. They invest in a positive supervisory alliance 

and endorse the professional development process of supervisees through well-thought-out, documented, and actively supported learning plans. These more experienced and objective professionals 

also help to mitigate the potentially adverse effects of countertransference, compassion fatigue, and 

burnout. 

Moving the field forward by integrating clinical supervision into all recovery-oriented systems of 

care requires increasing the value of clinical supervision amongst policy makers, administrators, 

supervisors, and direct-line staff; retooling staffing patterns to support the provision of clinical 

supervision as a primary responsibility; and including a clinical supervisor certification. Full integration across the State may require a mechanism to include clinical supervision as a reimbursable service, thereby endorsing the integrity of clinical supervision and staffing needs. 

Effective clinical supervisors have available specialized training in clinical supervision inclusive 

of formal education and direct supervision to supplement their clinical training. Clinical supervisors are recognized through an established credential that certifies their competency. 

Individual and group clinical supervision is offered regularly through acceptable methods including 

direct observation. This can be through live face-to-face supervision, audio/video tapes, and/or other 

electronic resources. Supervisors use this information to target specific skill enhancement to 

improve performance. 

136 Appendix B 
The clinical supervision hour focuses on the clinical content of the work and how the worker performs as a professional helper. Clinical technique and theory are explored and integrated to 

empower the supervisee’s conceptual understanding and application of practical skills. 

Resources are available for supervisors to receive their own clinical supervision that coaches them 

in their own professional development and supports effective clinical care. 

Adopting clinical supervision may require significant change in agency, local, and State operations. 

This system-wide investment will yield invaluable gains, including a quality improvement-oriented 

approach to monitoring and service delivery that is projected to lead to improved staff retention, 

enhanced counselor skills, and better clinical outcomes. 

Clinical Supervision and Professional Development 137 
Appendix C: Advisory Meeting



Panel



H. Westley Clark, M.D., J.D., M.P.H., CAS, 

FASAM 

Director 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Mady Chalk, Ph.D. 

Director 

Division of Services Improvement 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Christina Currier 

Public Health Analyst 

Practice Improvement Branch 

Division of Services Improvement 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Michael T. Flaherty, Ph.D. 

Northeast Addiction Technology Transfer 

Center 

Institute for Research, Education and 

Training in Addictions 

Pittsburgh, Pennsylvania 

Kevin Hennessy, Ph.D. 

Science to Service Coordinator 

Substance Abuse and Mental Health Services 

Administration/OPPB 

Rockville, Maryland 

Constance M. Pechura, Ph.D. 

Senior Program Officer 

Robert Wood Johnson Foundation 

Princeton, New Jersey 

Richard A. Rawson, Ph.D. 

Pacific Southwest Addiction Technology 

Transfer Center 

Los Angeles, California 

Jack B. Stein, Ph.D. 

Acting Deputy Director 

Division of Epidemiology, Services, and 

Prevention Research 

National Institute on Drug Abuse 

National Institutes of Health 

Bethesda, Maryland 

Richard T. Suchinsky, M.D. 

Associate Chief for Addictive Disorders 

Mental Health and Behavioral Sciences 

Service 

U.S. Department of Veteran Affairs 

Washington, D.C. 

Karl D. White, Ed.D. 

Public Health Analyst 

Practice Improvement Branch 

Division of Services Improvement 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health 

Services Administration 

Rockville, Maryland 

Mark Willenbring, M.D. 

Director 

Division of Treatment and Recovery Research 

National Institute on Alcohol Abuse and 

Alcoholism 

National Institutes of Health 

Bethesda, Maryland 

139 
Appendix D: Stakeholders 

Meeting Participants 

H. Westley Clark, M.D., J.D., M.P.H., CAS, 

FASAM 

Director 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Mirean Coleman, M.S.W., LICSW, CT 

Senior Policy Associate 

National Association of Social Workers 

(NASW) 

Washington, DC 

Tom Durham, Ph.D. 

Executive Director 

The Danya Institute 

Silver Spring, Maryland 

Anne M. Herron, M.S.W. 

Director, Division of State and Community

Assistance 

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Ted Judson, M.Ed., ADC2, CCS 

Certification and Contracts Officer 

Navy Drug and Alcohol Counselor School 

San Diego, California 

Linda Kaplan

Special Expert

Division of Services Improvement

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Peter J. Martieau 

Public Health Analyst

Center for Substance Abuse Prevention 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Jack Stein, M.S.W., Ph.D. 

Director, Division of Services Improvement

Center for Substance Abuse Treatment 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

Bill Trefzger

Lead, Communication Services Team 

Office of Communication 

Substance Abuse and Mental Health Services 

Administration 

Rockville, Maryland 

141 
Appendix E: Field Reviewers



L. DiAnne Borders, Ph.D. 

Excellence Professor 

University of North Carolina at Greensboro 

Greensboro, NC 

Donny Brock 

Treatment Director, Outpatient Division Head 

Charleston Center 

Charleston, SC 

Patricia A Burke, M.S.W., LCSW 

Private Practice 

West Baldwin, ME 

Charlotte M. Chapman 

Director of Training 

Mid-Atlantic Addiction Technology Transfer 

Center 

Richmond, VA 

Thomas G. Durham, Ph.D. 

Executive Director, The Danya Institute 

Silver Spring, MD 

Janet E. Falvey, Ph.D., NCC, ACS 

Professor 

University of New Hampshire 

Durham, NH 

Steven L. Gallon, Ph.D. 

Northwest Frontier Addiction Technology 

Transfer Center 

Salem, OR 

John Hamilton LMFT, LADC 

Regional Network of Programs, Inc. 

Fairfield, CT 

Ted Judson, M.Ed., ADC2, CCS 

Assistant Department Head 

Navy Drug and Alcohol Counselor School 

San Diego, CA 

Hunter McQuisition, M.D. 

Director, Division of Integrated Psychiatric 

Services, Department of Psychiatry 

The St. Luke’s–Roosevelt Hospitals 

New York, NY 

Thomas A. Peltz, LMHC, CADAC I, CAS 

Private Practice 

Beverly Farms, MA 

Annie Ramniceanu 

Clinical Director 

Spectrum Youth and Family Services 

Burlington, VT 

Sandra A. Rigazio-DiGilio, Ph.D. 

Professor 

Marriage and Family Therapy Program 

University of Connecticut 

Storrs, CT 

John (Jack) M. Schibik, Ph.D., LPC, 

LCADC, CCS, CPS 

Kairos Counseling, Consulting Coaching 

Services 

Naples, Florida 

Diane Shea, Ph.D. 

Adjunct Professor 

Holy Family University 

Newtown, PA 

Ernestine Winfrey 

Executive Director 

Good News Home for Women 

Flemington, NJ 

143 
Appendix F— 

Acknowledgments 

Numerous people contributed to the development of this TIP, including the TIP Consensus 

Panel (see page v), the Knowledge Application Program (KAP) Advisory Meeting Panel (see 

Appendix C), the SAMHSA Stakeholders Meeting attendees, (see Appendix D), and TIP Field 

Reviewers (see Appendix E). 

This publication was produced under KAP, a Joint Venture of The CDM Group, Inc. (CDM), 

and JBS International, Inc. (JBS), for the Substance Abuse and Mental Health Services 

Administration, Center for Substance Abuse Treatment. 

CDM KAP personnel included Rose M. Urban, M.S.W., J.D., LCSW, LCAS, KAP Executive 

Deputy Project Director; Susan Kimner, Managing Project Co-Director; Bruce Carruth, Ph.D., 

Expert Content Director; Janet Humphrey, M.A., former Editor; Virgie D. Paul, M.L.S., 

Librarian; Lee Ann Knapp, Quality Assurance Editor. 

145 
Index
 

A

AAMFT. See American Association for 

Marriage and Family Therapy 

ACES. See Association for Counselor 

Education and Supervision


Addiction Counseling Competencies, 3


Addiction Technology Transfer Center


The Change Book: A Blueprint for


Technology Transfer, 101


Leadership Institute, 77


Administrative tasks


balancing with supervisory tasks, 5, 26,


33, 78, 88, 89–90


documentation for administrative purposes, 33, 91, 94, 95–96


Administrators


administrative supervision compared with


clinical supervision, 89–90


administrative support for clinical supervision, 81, 92–93


assessing organizational readiness for


clinical supervision, 88–89, 101–105


assessing the competence of supervisors


and counselors, 90, 92


assessing the organization’s receptivity to


supervision, 97–98


Change Teams and, 93


competence of supervisors and counselors


and, 90, 120–121 

confidentiality issues, 90–91 

developing a model for clinical supervision, 92


direct and vicarious liability and, 90


direct observation and, 93, 94


diversity and cultural competence and, 91


documentation and recordkeeping and, 33,


91, 94, 95–96


dual relationships and, 90–91


ethical issues for, 90–91


feedback and, 94, 96, 97
 

implementing a clinical supervision program, 92–99



informed consent and, 90



key issues for, 80, 88–89



legal issues for, 90–91



making the case for clinical supervision to 

(vignette), 78–84 

organizational structure considerations, 

89, 97–98 

phasing in a clinical supervision system, 

94–95


pilot supervision systems and, 93


professional development of supervisors


and, 99


recruiting personnel, 94


scheduling supervisory sessions, 93


substance abuse policy, 108–109


supporting clinical supervisors in their


jobs, 97–99 

understanding the differences between


case management and clinical supervision, 81


Advisory Meeting Panel, members, 139


Al. See Walt vignette


Alicia. See Stan vignette


American Association for Marriage and


Family Therapy


ethical and legal guidelines, 106


American Psychological Association


guidelines for retaining records of supervision, 113


Assessing organizational readiness


administrator’s role, 88–89


elements of, 101


identifying current barriers to implementing a supervision system (Tool 2), 104


initial organizational assessment (Tool 1),


102


organizational stage of readiness to


change (Tool 2), 103–104


Association for Counselor Education and


Supervision


standards and ethical guidelines, 106


Association of State and Provincial Psychology


Boards


ethical and legal guidelines, 106


ATTC. See Addiction Technology Transfer


Center


Audiotaped supervision


confidentiality and (Tool 18), 126


147
description, advantages, and disadvantages of, 22, 31


instructions for (Tool 17), 124–125


recording consent (Tool 19), 126


B

Beauchamp, T.L.


ethical and legal issue resource, 13


Behavioral contracting in supervision


elements of, 17


Benefits of clinical supervision


improvement of client outcome, 87


professional development, 88, 99
 

program evaluation and research, 88


responsiveness to diversity, 87


workplace development, 88


Bernard, J.M.


examples of work samples and peer


assessments, 18


qualities of a good model of clinical supervision, 9


Betty. See Margie vignette


Bibliography, 127–134


Bill vignette


defining and building the supervisorsupervisee alliance, 44–51 

Blended Model. See Integrated models of 

supervision 

Boundary issues 

ethical and legal considerations, 14–15, 

51–58 

Bradley, L.J. 

administrative supervision/clinical supervision comparison, 89–90 

supervisor-focused personal development 

domain, 91 

Brodsky, A.


ethical and legal issue resource, 13


examples of work samples and peer


assessments, 18


qualities of a good model of clinical supervision, 9


Burnout


helping counselors with, 19–20


examples of work samples and peer


assessments, 18


supervision contract, 112


Carrie. See Walt vignette


Case consultation/case management


description, advantages, and disadvantages, 31


understanding the differences between


case management and clinical supervision, 81


Case presentations


outline for, 123–124


sample case consultation format (Tool 16),


124


The Change Book: A Blueprint for Technology


Transfer, 101


Childress, J.F.


ethical and legal issue resource, 13


Clinical supervision. See also Supervision


administrative benefits, 87


administrative supervision comparison,


89–90 

advocating for both administrators and 

workers and clients, 60


benefits of, 87–88


central principles of, 5–6


definitions, 3, 87


demonstrating the importance of administrative support for, 81


differences between supervision and counseling (figure), 24


goals of, 17, 20, 24, 44, 51, 69, 87
 

implementing a clinical supervision system, 82–83 

making the case for clinical supervision to 

administrators (vignette), 78–84


presenting a proposal for, 79, 84


qualities of effective supervisors, 62


rationale for, 3–4, 37, 45, 78, 87
 

time standard for, 14, 27, 28, 30, 50


Clinical supervisors


competence of, 90, 92, 106


functions of, 4


gatekeeper role, 6, 13


guidelines for new supervisors, 6–8


identifying staff with high potential for


advancement, 77



roles of (figure), 4



supervision of, 5



148 Index

C

Caldwell, C.F.


Focused Risk Management Supervision


System, 28, 98


Campbell, J.M.


 

Coach role of clinical supervisors


description, 4


vignette illustrating, 35–44


Codes of ethics 

employees’ signing of statements agreeing 

to abide by, 91



resources, 34, 106



reviewing, 91



Cofacilitation and modeling method of 
 

supervision


description, advantages, and disadvantages of, 32


Cognitive-behavioral therapy. See Treatment-


based supervision models


Cohen, C.R.


Focused Risk Management Supervision


System, 28, 98


Compassion fatigue


communication and, 26


helping counselors with, 19–20


Competence of clinical supervisors


assessing, 90, 92, 106


checklist for supervisor competencies


(Tool 5), 107–108 

Competencies for Substance Abuse Treatment


Clinical Supervisors, 3, 87


Competency-based models of supervision


description and key strategies, 8


Confidentiality


audiotaping, 39, 126


criteria for waiving, 15


direct observation, 39


duty-to-warn requirements and, 15, 90


issues for administrators, 90–91, 106


levels of, 15


online counseling and supervision and,


15, 17


State legal and legislative standards for,


15



training counselors in, 15



videotaping, 39, 126



Consensus Panel 

central principles of clinical supervision, 

5–6


employee assistance program, 20


peer supervision recommendation, 27


Constantine, M.G.


Multicultural Model of supervision, 11


questions supervisors can use with 
 

supervisees, 13


Consultant role of clinical supervisors, 4 

Contextual factors. See Cultural and contextual factors 

Counselors. See also Developmental stages of 

counselors; Evaluation of counselors and 

supervisors 

competency assessment (Tool 14),


120–121


counselor evaluation of the supervisor


(Tool 13), 118–119


outline for case presentations, 123–124


Countertransference


between counselor and client, 25, 51–58,


68


signs of, 25


between supervisors and supervisees, 25


Cross, T.L.


stages of becoming culturally competent,


12


Cultural and contextual factors. See also


Diversity and cultural competence 
 

contextual issues in techniques and methods of supervision, 30, 32, 101
 

Counselor Development domain and, 11


example of, 54


identifying, 11


importance of culture in supervision, 11


levels of cultural consideration, 12


supervisor self-examination, 12–13, 34


Supervisory Alliance domain, 11


D

Delworth, U.


Integrated Developmental Model of supervision, 8, 9


Developmental model of supervision


description and key strategies, 8


Developmental stages of counselors 

cautions and principles, 9–10 

counselor developmental model 

(figure), 10


defining and building the supervisory


alliance (vignette), 44–51


managing staff confrontations, 62


mentoring and, 74


working with counselors at different levels of proficiency, 60–61


Developmental stages of supervisors


description, 10–11, 47–48, 94


Index 149
supervisor developmental model 
 

(figure), 11



Direct liability


administrators and, 90


description, 13


vicarious liability and, 14, 90, 106


Direct observation


administrators and, 93, 94


advantages of, 21, 28, 31


confidentiality and, 39


disadvantages of, 31


effectiveness of, 6


encouraging acceptance of, 41


feedback and, 18, 21, 40


guidelines for, 21


implementing, 39


resistance to, 21, 39, 42


selecting cases for, 21


vignette on implementing, 35–44


Disciplinary actions 

policies and procedures for dealing with


unacceptable behavior by counselors,


20, 41


Discrimination Model. See Competency-based 

models of supervision 

Diversity and cultural competence


addressing personal issues, 65


administrators’ responsibilities, 91, 98


assessing, 89


communication issues, 91


continuum of cultural competence (figure),


12


description, 5, 11–12


importance of cultural competence, 5, 91


responsiveness to diversity, 87


Documentation and recordkeeping


for administrative purposes, 33, 91, 94,


95–96


duty-to-warn situations, 15


evaluations of counselors, 20, 28, 94,


96–97


Focused Risk Management Supervision


System, 28, 98


formative and summative evaluations


and, 29


importance of, 28


individual development plans, 17


initial supervision sessions, 113–117


purpose of, 95–96


records of supervisory sessions, 33


retention period for records of supervision, 113


systems to be documented, 28


Drug-Free Workplace Act


substance abuse policy requirement, 108


Dual relationships


between counselors and clients, 14, 51–58,


106


description and examples of, 14, 53, 106


ethical and legal considerations, 14–15,


51–58, 106


issues for administrators, 90–91, 106


between supervisors and supervisees, 14,


106


Due process


description, 106


documentation of, 28


Duty-to-warn requirements


confidentiality and, 15, 90


E

EAPs. See Employee assistance programs 

EBPs. See Evidence-based practices 

Ella vignette 

making the case for clinical supervision to 

administrators, 78–84 

Eloise. See Stan vignette 

Employee assistance programs 

informing supervisors and, 69



recommendation for, 20



videotaped supervision and, 22



Environmental variables in clinical supervision systems


description, 89


Ethical and legal issues


addressing ethical standards (vignette),


51–58


for administrators, 90–91


codes of ethics, 34, 91
 

competence of supervisors and counselors,


90, 92, 106, 120–121


confidentiality, 15, 17, 90–91, 106


deciding how to address potential legal or


ethical violations (figure), 16


direct versus vicarious liability, 13–14, 90,


106


dual relationships and boundary issues,


14–15, 90–91, 106


150 Index

 

due process and, 28, 106


how to ask questions in ethical decision-


making, 57


informed consent, 15, 90, 106


orientation in for all employees, 91


policies and procedures for dealing with


unacceptable behavior by counselors, 

20, 110–111


resources on, 13, 34


steps to ethical decisionmaking, 55


supervision note admissibility in court


proceedings, 28–29



supervisor ethics, 17



underlying assumptions, 13



Evaluation of counselors and supervisors


client input, 18


counselor competency assessment (Tool


14), 120–121 

counselor evaluation of the supervisor 

(Tool 13), 118–119


documentation and, 28, 29, 96–97


feedback issues, 18, 96, 118


formal procedure for, 118


formative, 18, 96–97, 118


general areas of competence to assess, 118


goals of, 96


summative, 18, 97, 118


timely basis for, 99


Evidence-based practices 

implementing an evidence-based practice 

(vignette), 58–64


integrated models of supervision and, 8


integration with clinical supervision, 5, 6,


87, 88–89 

staff resistance to incorporating, 58–64 

treatment-based supervision models 

and, 8


F

Falvey, J.E.


ethical and legal issue resource, 13


Focused Risk Management Supervision


System, 28, 98, 113
 

standardized format for documentation of


supervision, 33


Feedback


administrators and, 94, 96, 97
 

direct observation and, 18, 21, 40


importance of, 118


live observation and, 24, 40


Field reviewers, 143


Focused Risk Management Supervision


System


description, 28, 98, 113
 

Fong, M.L.


diversity and cultural competence issues,


91


Formative evaluation of counselors


description, 18, 118


documentation of, 29


focus of, 18, 96–97


FoRMSS. See Focused Risk Management 

Supervision System 

G

Gatekeeper role of clinical supervisors


ethical and legal issues and, 13


importance of, 6


managing problem staff, 20


policies and procedures for dealing with


unacceptable behavior by counselors,


20, 41


Glenn, E.


standardized format for documentation of


supervision, 33


Gloria vignette


implementing an evidence-based practice,


58–64


Goals of clinical supervision


description, 17, 20, 24, 44, 51, 69, 87
 

form for identifying (Tool 3), 105


Goodyear, R.K.


examples of work samples and peer


assessments, 18


qualities of a good model of clinical supervision, 9


Greene, B.


ethical and legal issue resource, 13


Group clinical supervision


description, 27


as a means of engaging all staff in dialog,


sharing ideas, and promoting team


cohesion, 28


Gutheil, T.G.


ethical and legal issue resource, 13


Index 151
H

Health Insurance Portability and 

Accountability Act 

confidentiality and, 15, 90–91 

HIPAA. See Health Insurance Portability and 

Accountability Act 

Holloway, E. 

cultural issues in supervision, 12 

Systems Model, 11 

I

IC&RC. See International Certification and 

Reciprocity Consortium 

IDM. See Integrated Developmental Model of 

supervision 

IDPs. See Individual development plans 

Implementing a clinical supervision system 

administrators and, 92–99



barriers to (Tool 2), 104



supervisors and, 82–83



Indirect observation 

drawbacks to, 21 

Individual development plans 

as a basis for evaluation, 96 

beginning discussion of, 44–51 

elements of, 17, 122 

implementing for each supervisee, 48 

initial supervision sessions and, 29 

for potential successors, 73 

professional development plan (Tool 15), 

122–123 

for supervisors, 17–18, 99 

Individual supervision 

description, 27 

Informed consent 

description, 15, 106 

importance of, 106 

issues for administrators, 90 

levels of, 15 

live observation and, 22, 39 

observation and/or taping of 

sessions, 21, 39



supervision contract and, 15



template for, 106–107



Initial supervision sessions 

checklist (Tool 9), 114–115 

current risk management review (Tool 

11), 116 

documentation and recordkeeping, 

113–117 

goal of, 113 

helpful practices, 29 

individual development plans and, 29 

learning environment of supervision and, 

29 

supervision content (Tool 10), 115 

supervision note sample (Tool 10), 115 

supervisory interview observations (Tool 

12), 117 

Integrated Developmental Model of supervision 

description and key strategies, 8, 9 

Integrated models of supervision 

description and key strategies, 8 

Intensive supervision 

description, 27 

International Certification and Reciprocity 

Consortium 

Role Delineation Study for Clinical 

Supervisors, 107 

J

Jaime. See Gloria vignette 

Jan. See Bill vignette 

Juanita vignette 

maintaining focus on job performance, 

64–69 

K

Kadushin, A. 

administrative tasks for clinical supervisors, 88 

Kate vignette 

promoting a counselor from within, 69–73 

Kevin. See Kate vignette 

L

Ladany, N. 

administrative supervision/clinical supervision comparison, 89–90 

supervisor-focused personal development 

domain, 91 

Larry. See Gloria vignette 

Lease, S.H. 

diversity and cultural competence 

issues, 91 

Legal issues. See Ethical and legal issues 

Liability 

direct versus vicarious liability, 13–14, 90 

issues for administrators, 90 

152 Index
Index 153

issues in supervisory vulnerability, 14


“reasonable effort to supervise” and, 14


Live observation


description, 22


disadvantages of, 23


effectiveness of, 23


feedback and, 24, 40


guidelines for conducting, 23–24


helping counselors and clients become


comfortable with, 38


intervening during the session, 23–24, 40


one-way mirrors and, 22–23


videotaping and, 22–23


vignette on implementing, 35–44


M

Maggie. See Kate vignette 

Margie vignette 

mentoring a successor, 73–77 

McNeill, B. 

Integrated Developmental Model of supervision, 8, 9


Melissa. See Juanita vignette


Mentor/role model role of clinical supervisors


description, 4, 43, 75


mentoring a successor (vignette), 73–77


resources on mentorship, 77


vignette illustrating, 35–44


Methods and techniques of clinical supervision


assessing, 89


contextual issues, 30, 32, 101


description, advantages, and disadvantages (figure), 30–32 

implementing a new method of supervision (vignette), 35–44 

introducing changes in clinical practices, 

59–60 

Methods of observation


choice of method, 22


direct, 6, 20–21, 28, 31, 35–44, 93, 94


indirect, 21


live, 22–24, 35–44


recorded, 22, 35–44, 124–125, 126


MI. See Motivational interviewing


Michael E. Townsend Leadership Academy


description and contact information, 77


Microtraining. See Competency-based models


of supervision


Modalities of supervision


group clinical supervision, 27


individual supervision, 27


intensive supervision, 27


peer supervision, 27, 42–43, 94


sample clinical supervision schedule (figure), 28


triadic supervision, 27


Models of clinical supervision. See also


Evidence-based practices


competency-based, 8


cultural and diversity factors and, 8–9


development of, 92


developmental, 8


identifying and selecting your model, 9


integrated, 8


introducing changes in clinical practices,


59–60


qualities of a good model, 9


time management and, 26


treatment-based, 8


Monitoring performance 

addressing personal issues that affect job 

performance, 65–66


behavioral contracting, 17


burnout and compassion fatigue and,


19–20, 26


evaluation of counselors, 18, 96–97


gatekeeping role and, 20


individual development plan, 17–18


maintaining focus on job performance


(vignette), 64–69 

Motivational interviewing. See also 

Treatment-based supervision models


implementing (vignette), 58–64


staff resistance and, 42


Multicultural Model of supervision


description, 11


Munson, C.E.


administrative tasks for clinical supervisors, 88


N

NASW. See National Association of Social


Workers


National Association of Social Workers


ethical and legal guidelines, 106


National Board for Certified Counselors, Inc.


Code of Ethics, 106


New supervisors


building a leadership position, 69–73

guidelines for, 6–8


implementing a new method of supervision and, 37


promoting a counselor from within


(vignette), 69–73


qualities of an effective leadership style,


71


things a new supervisor should know, 7–8


New York State Office of Alcoholism and


Substance Abuse Services


Clinical Supervision Vision Statement,


135–137


North Carolina Addiction Fellows Program


description and contact information, 77


O

Online classroom training programs


list, 34


Online counseling and supervision


confidentiality issues, 15, 17


P

Peer supervision


advantages and disadvantages, 42–43


description, 27


developing a system for, 94


Personal problems. See Stress


Pope, K.S.


ethical and legal issue resource, 13


Powell, D.J.


examples of work samples and peer


assessments, 18


qualities of a good model of clinical supervision, 9


Practical issues


balancing clinical and administrative


functions, 26


countertransference and, 25–26, 51–58,


68


distinguishing between supervision and


therapy, 24–26, 65, 66


documenting and recordkeeping issues,


28–29


finding the time to do clinical supervision,


26–28 

selecting a modality of supervision, 26–27 

structuring the initial supervision 

sessions, 29



transference and, 25, 51–58



Prison settings


videotaped supervision and, 22


Professional development benefits of clinical


supervision, 88, 99
 

Professional development plan (Tool 15),


122–123


Program evaluation and research benefits of


clinical supervision


description, 88


Psychodynamic psychotherapy. See


Treatment-based supervision models


R

Racism. See Diversity and cultural competence 

Rationale for clinical supervision


description, 3–4, 45, 78, 87
 

providing, 37


Reamer, F.G.


ethical and legal issue resource, 13


Reasonable effort to supervise


importance of, 78


liability issues, 14


Recorded observation 

audiotaped, 22, 124–126 

videotaped, 22, 35–44, 124–126 

Recordkeeping. See Documentation and 

recordkeeping 

Resources


bibliography, 127–134


competencies of clinical supervisors, 108


counselor competency assessment, 122


ethical and legal issues, 13, 34, 106


for supervision, 34


Risk management issues 

current risk management review (Tool 

11), 116



documentation, 28, 33



videotaped supervision and, 22



Role playing method of supervision


description, advantages, and disadvantages of, 32


S

Serovick, J.M.


standardized format for documentation of


supervision, 33


Sexual relationships. See Boundary issues;


Dual relationships


154 Index
SMART. See Specific, measurable, attainable, 

realistic, and timely 

Sonne, J.L. 

ethical and legal issue resource, 13 

South Carolina Addiction Fellows Program 

description and contact information, 77 

Specific, measurable, attainable, realistic, and 

timely competency-based models of supervision and, 8 

feedback and, 18 

Spice, C. G., Jr. 

triadic supervision, 27 

Spice, W.H. 

triadic supervision, 27 

Staff resistant to supervision 

working with, 7 

Stakeholders meeting participants, 141 

Stan vignette 

addressing ethical standards, 51–58 

Stoltenberg, C.D. 

Integrated Developmental Model of supervision, 8, 9 

Stress 

addressing personal issues that affect job 

performance, 65–66 

helping counselors with, 19–20, 64–69 

Substance abuse policy 

sample policy (Tool 6), 108 

Summative evaluation of counselors 

description, 18, 97, 118 

documentation of, 29 

Supervision. See also Clinical supervision 

definitions of, 3, 87 

Supervision contracts 

elements of, 50 

informed consent and, 15 

template (Tool 8), 111–112 

uses for, 111 

Supervision guidelines 

clinical supervision policy and procedure 

(Tool 7), 110–111 

Supervisor ethics 

standards for, 17 

Supervisor self-examination 

feelings toward counselors, 47, 50 

questions for, 12–13, 47 

resources, 34 

Supervisor-supervisee alliance 

countertransference issues, 25 

Index

cultural issues, 11, 13 

defining and building the alliance 

(vignette), 44–51 

developing and maintaining a strong and 

professional relationship, 73–77 

dual relationships and boundary issues, 

14–15, 51–58



importance of, 4



mentorship and, 74



power issues, 13, 14, 18, 57, 91



Systems Model of supervision 

description, 11 

T

Task-Oriented Model. See Competency-based 

models of supervision 

Teacher role of clinical supervisors, 4 

Techniques of clinical supervision. See 

Methods and techniques of clinical supervision 

Time management 

adding components of a supervision model 

one at a time, 26–27 

administrative tasks and, 33–34 

plan for scheduling supervision, 27–28 

questions about one’s priorities, 33–34 

Time standard for clinical supervision 

20:1 rule of client hours, 14, 27, 28, 30 

Training programs 

choosing a course on clinical supervision, 

43 

establishing a training plan and learning 

goals, 95 

online, 34, 43 

Transference 

examples of, 25 

vignette, 51–58 

Treatment-based supervision models 

description and key strategies, 8 

Triadic supervision 

description, 27 

V

Verbal reports 

description, advantages, and disadvantages, 30 

Verbatim reports 

description, advantages, and disadvantages, 30 

155
Vicarious liability 

administrators and, 90 

confidentiality and, 15 

description, 14 

direct liability and, 13–14, 106 

examples of negligence, 14 

Videotaped supervision 

confidentiality and, 39, 126 

description, advantages, and disadvantages of, 22, 31 

guidelines for, 22 

implementing, 39 

instructions for (Tool 17), 124–125 

live observation and, 22–23 

recording consent (Tool 19), 126 

resistance to, 22, 42 

risk-management issues, 22 

vignette on implementing, 35–44 

Vignettes 

addressing ethical standards, 51–58 

defining and building the supervisory 

alliance, 44–51 

establishing a new approach for clinical 

supervision, 35–44 

implementing an evidence-based practice, 

58–64 

maintaining focus on job performance, 

64–69 

making the case for clinical supervision to 

administrators, 78–84 

mentoring a successor, 73–77 

promoting a counselor from within, 69–73 

VTS. See Videotaped supervision 

W

Walt vignette 

implementing a new method of supervision, 35–44 

Webcam method of supervision 

description, advantages, and disadvantages of, 32 

Williams, L. 

standardized format for documentation of 

supervision, 33 

Work setting 

benefits of clinical supervision, 88 

problems and resources, 7 

Written/file reviews 

description, advantages, and disadvantages, 30 

156 Index
CSAT TIPs and Publications Based on TIPs 

What Is a TIP? 

Treatment Improvement Protocols (TIPs) are the products of a systematic and innovative process that brings together clinicians, 

researchers, program managers, policymakers, and other Federal and non-Federal experts to reach consensus on state-of-the-art treatment practices. TIPs are developed under CSAT’s Knowledge Application Program to improve the treatment capabilities of the 

Nation’s alcohol and drug abuse treatment service system. 

What Is a Quick Guide? 

A Quick Guide clearly and concisely presents the primary information from a TIP in a pocket-sized booklet. Each Quick Guide is 

divided into sections to help readers quickly locate relevant material. Some contain glossaries of terms or lists of resources. Page numbers from the original TIP are referenced so providers can refer back to the source document for more information. 

What Are KAP Keys? 

Also based on TIPs, KAP Keys are handy, durable tools. Keys may include assessment or screening instruments, checklists, and summaries of treatment phases. Printed on coated paper, each KAP Keys set is fastened together with a key ring and can be kept within a 

treatment provider’s reach and consulted frequently. The Keys allow you—the busy clinician or program administrator—to locate 

information easily and to use this information to enhance treatment services. 

TIP 1 	 State Methadone Treatment Guidelines—Replaced by 

TIP 43 

TIP 2* 	Pregnant, Substance-Using Women— BKD107 

Quick Guide for Clinicians QGCT02 

KAP Keys for Clinicians KAPT02 

TIP 3 Screening and Assessment of Alcohol- and Other 

Drug-Abusing Adolescents—Replaced by TIP 31 

TIP 4 Guidelines for the Treatment of Alcohol- and Other 

Drug-Abusing Adolescents—Replaced by TIP 32 

TIP 5 Improving Treatment for Drug-Exposed Infants— 

BKD110 

TIP 6* 	Screening for Infectious Diseases Among Substance 

Abusers—BKD131 

Quick Guide for Clinicians QGCT06 

KAP Keys for Clinicians KAPT06 

TIP 7 	 Screening and Assessment for Alcohol and Other 

Drug Abuse Among Adults in the Criminal Justice 

System—Replaced by TIP 44 

TIP 8 	 Intensive Outpatient Treatment for Alcohol and Other 

Drug Abuse—Replaced by TIPs 46 and 47 

TIP 9 	 Assessment and Treatment of Patients With Coexisting 

Mental Illness and Alcohol and Other Drug Abuse— 

Replaced by TIP 42 

TIP 10 	Assessment and Treatment of Cocaine-Abusing 

Methadone-Maintained Patients—Replaced by TIP 43 

TIP 11* Simple Screening Instruments for Outreach for 

Alcohol and Other Drug Abuse and Infectious 

Diseases— BKD143 

Quick Guide for Clinicians QGCT11 

KAP Keys for Clinicians KAPT11 

TIP 12 	Combining Substance Abuse Treatment With 

Intermediate Sanctions for Adults in the Criminal 

Justice System—Replaced by TIP 44 

TIP 13 	Role and Current Status of Patient Placement 

Criteria in the Treatment of Substance Use 

Disorders—BKD161 

Quick Guide for Clinicians QGCT13 

Quick Guide for Administrators QGAT13 

KAP Keys for Clinicians KAPT13 

TIP 14 	Developing State Outcomes Monitoring Systems for 

Alcohol and Other Drug Abuse Treatment—BKD162 

TIP 15 	Treatment for HIV-Infected Alcohol and Other Drug 

Abusers—Replaced by TIP 37 

TIP 16 	Alcohol and Other Drug Screening of Hospitalized 

Trauma Patients—BKD164 

Quick Guide for Clinicians QGCT16 

KAP Keys for Clinicians KAPT16 

TIP 17 	Planning for Alcohol and Other Drug Abuse 

Treatment for Adults in the Criminal Justice System— 

Replaced by TIP 44 

TIP 18 	The Tuberculosis Epidemic: Legal and Ethical Issues 

for Alcohol and Other Drug Abuse Treatment 

Providers—BKD173 

Quick Guide for Clinicians QGCT18 


KAP Keys for Clinicians KAPT18 


TIP 19 	Detoxification From Alcohol and Other Drugs— 

Replaced by TIP 45 

TIP 20 	Matching Treatment to Patient Needs in Opioid 

Substitution Therapy—Replaced by TIP 43 

*Under revision 

157 
TIP 21		Combining Alcohol and Other Drug Abuse Treatment 

With Diversion for Juveniles in the Justice System— 

(SMA) 08-4073 

Quick Guide for Clinicians and Administrators 

QGCA21 

TIP 22		LAAM in the Treatment of Opiate Addiction— 

Replaced by TIP 43 

TIP 23		Treatment Drug Courts: Integrating Substance Abuse 

Treatment With Legal Case Processing— 

(SMA) 08-3917 

Quick Guide for Administrators QGAT23 

TIP 24		A Guide to Substance Abuse Services for Primary 

Care Clinicians—(SMA) 08-4075 

Concise Desk Reference Guide BKD123 

Quick Guide for Clinicians QGCT24 

KAP Keys for Clinicians KAPT24 

TIP 25		Substance Abuse Treatment and Domestic Violence— 

(SMA) 08-4076 

Linking Substance Abuse Treatment and 

Domestic Violence Services: A Guide for Treatment 

Providers MS668 

Linking Substance Abuse Treatment and Domestic 

Violence Services: A Guide for Administrators MS667 

Quick Guide for Clinicians QGCT25 

KAP Keys for Clinicians KAPT25 

TIP 26		Substance Abuse Among Older Adults—(SMA) 08-3918 

Substance Abuse Among Older Adults: A Guide 

for Treatment Providers MS669 

Substance Abuse Among Older Adults: A Guide 

for Social Service Providers MS670 

Substance Abuse Among Older Adults: 

Physician’s Guide MS671 

Quick Guide for Clinicians QGCT26 

KAP Keys for Clinicians KAPT26 

TIP 27		Comprehensive Case Management for Substance 

Abuse Treatment—(SMA) 08-4215 

Case Management for Substance Abuse Treatment: A 

Guide for Treatment Providers MS673 

Case Management for Substance Abuse Treatment: A 

Guide for Administrators MS672 

Quick Guide for Clinicians QGCT27 

Quick Guide for Administrators QGAT27 

TIP 28* Naltrexone and Alcoholism Treatment— 

(SMA) 05-4077 

Naltrexone and Alcoholism Treatment: Physician’s 

Guide MS674 

Quick Guide for Clinicians QGCT28 

KAP Keys for Clinicians KAPT28 

TIP 29		Substance Use Disorder Treatment for People With 

Physical and Cognitive Disabilities—(SMA) 08-4078 

Quick Guide for Clinicians QGCT29 

Quick Guide for Administrators (SMA) 08-3592 

KAP Keys for Clinicians KAPT29 

TIP 30		Continuity of Offender Treatment for Substance Use 

Disorders From Institution to Community— 

(SMA) 08-3920 

Quick Guide for Clinicians QGCT30 

KAP Keys for Clinicians KAPT30 

TIP 31		Screening and Assessing Adolescents for Substance 

Use Disorders—(SMA) 08-4079 

See companion products for TIP 32. 

TIP 32		Treatment of Adolescents With Substance Use 

Disorders—(SMA) 08-4080 

Quick Guide for Clinicians QGC312 

KAP Keys for Clinicians KAP312 

TIP 33		Treatment for Stimulant Use Disorders— 

(SMA) 06-4209 

Quick Guide for Clinicians QGCT33 

KAP Keys for Clinicians KAPT33 

TIP 34		Brief Interventions and Brief Therapies for Substance 

Abuse—(SMA) 07-3952 

Quick Guide for Clinicians QGCT34 

KAP Keys for Clinicians KAPT34 

TIP 35		Enhancing Motivation for Change in Substance Abuse 

Treatment—(SMA) 08-4212 

Quick Guide for Clinicians QGCT35 

KAP Keys for Clinicians KAPT35 

TIP 36		Substance Abuse Treatment for Persons With Child 

Abuse and Neglect Issues—(SMA) 08-3923 

Quick Guide for Clinicians QGCT36 

KAP Keys for Clinicians KAPT36 

Helping Yourself Heal: A Recovering Woman’s Guide 

to Coping With Childhood Abuse Issues— 

(SMA) 08-4132 

Available in Spanish: PHD981S 

Helping Yourself Heal: A Recovering Man’s Guide to 

Coping With the Effects of Childhood Abuse— 

(SMA) 08-4134 

Available in Spanish: PHD1059S 

TIP 37		Substance Abuse Treatment for Persons With 

HIV/AIDS—(SMA) 08-4137 

Quick Guide for Clinicians MS678 

KAP Keys for Clinicians KAPT37 

Drugs, Alcohol, and HIV/AIDS: A Consumer Guide— 

(SMA) 08-4127 

Drugs, Alcohol, and HIV/AIDS: A Consumer Guide for 

African Americans—(SMA) 07-4248 

*Under revision 

158 
TIP 38	 Integrating Substance Abuse Treatment and
 

Vocational Services—(SMA) 06-4216
 

Quick Guide for Clinicians QGCT38
 

Quick Guide for Administrators QGAT38
 

KAP Keys for Clinicians KAPT38
 

TIP 39	 Substance Abuse Treatment and Family Therapy—
 

(SMA) 08-4219
 

Quick Guide for Clinicians QGCT39
 

Quick Guide for Administrators QGAT39
 

TIP 40	 Clinical Guidelines for the Use of Buprenorphine in
 

the Treatment of Opioid Addiction—(SMA) 07-3939
 

Quick Guide for Physicians QGPT40
 

KAP Keys for Physicians KAPT40
 

TIP 41	 Substance Abuse Treatment: Group Therapy—
 

(SMA) 05-3991
 

Quick Guide for Clinicians QGCT41
 

TIP 42	 Substance Abuse Treatment for Persons With Co-


Occurring Disorders—(SMA) 08-3992
 

Quick Guide for Clinicians (SMA) 07-4034
 

Quick Guide for Administrators QGAT42
 

KAP Keys for Clinicians (SMA) 08-4036
 

TIP 43	 Medication-Assisted Treatment for Opioid Addiction
 

in Opioid Treatment Programs—(SMA) 08-4214
 

Quick Guide for Clinicians QGCT43
 

KAP Keys for Clinicians (SMA) 07-4108
 

TIP 44	 Substance Abuse Treatment for Adults in the Criminal
 

Justice System—(SMA) 05-4056
 

Quick Guide for Clinicians QGCT44
 

KAP Keys for Clinicians (SMA) 07-4150
 

TIP 45	 Detoxification and Substance Abuse Treatment—
 

(SMA) 08-4131
 

Quick Guide for Clinicians (SMA) 06-4225
 

KAP Keys for Clinicians (SMA) 06-4224
 

Quick Guide for Administrators (SMA) 06-4226
 

TIP 46	 Substance Abuse: Administrative Issues in Outpatient
 

Treatment—(SMA) 06-4157
 

Quick Guide for Administrators—(SMA) 07-4232
 

TIP 47	 Substance Abuse: Clinical Issues in Outpatient
 

Treatment—(SMA) 06-4182
 

Quick Guide for Clinicians—(SMA) 07-4233
 

KAP Keys for Clinicians—(SMA) 07-4251
 

TIP 48	 Managing Depressive Symptoms in Substance Abuse
 

Clients During Early Recovery—(SMA) 08-4353
 

TIP 49	 Incorporating Alcohol Pharmacotherapies Into
 

Medical Practice—(SMA) 09-4380
 

TIP 50	 Addressing Suicidal Thoughts and Behaviors in
 

Substance Abuse Treatment—(SMA) 09-4381
 

TIP 52	 Clinical Supervision and Professional Development of
 

the Substance Abuse Counselor—(SMA) 09-4435
 

159 
Treatment Improvement Protocols (TIPs) from the Substance Abuse and Mental Health Services 

Administration’s (SAMHSA’s) Center for Substance Abuse Treatment (CSAT) 

Place the quantity (up to 5) next to the publications you would like to receive and print your mailing address below. 

___TIP 2* BKD107 

___QG+ for Clinicians QGCT02 

___KK+ for Clinicians KAPT02 

___TIP 5 BKD110 

___TIP 6* BKD131 

___QG for Clinicians QGCT06 

___KK for Clinicians KAPT06 

___TIP 11* BKD143 

___QG for Clinicians QGCT11 

___KK for Clinicians KAPT11 

___TIP 13 BKD161 

___QG for Clinicians QGCT13 

___QG for Administrators QGAT13 

___KK for Clinicians KAPT13 

___TIP 14 BKD162 

___TIP 16 BKD164 

___QG for Clinicians QGCT16 

___KK for Clinicians KAPT16 

___TIP 18 BKD173 

___QG for Clinicians QGCT18 

___KK for Clinicians KAPT18 

___TIP 21 (SMA) 08-4076
 

___QG for Clinicians & Administrators
 

QGCA21
 

___TIP 23 (SMA) 08-3917
 

___QG for Administrators QGAT23
 

___TIP 24 (SMA) 08-4075
 

___Desk Reference BKD123
 

___QG for Clinicians QGCT24
 

___KK for Clinicians KAPT24
 

___TIP 25 (SMA) 08-4076
 

___Guide for Treatment Providers MS668
 

___Guide for Administrators MS667
 

___QG for Clinicians QGCT25
 

___KK for Clinicians KAPT25
 

___TIP 26 (SMA) 08-3918
 

___Guide for Treatment Providers MS669
 

___Guide for Social Service Providers
 

MS670 

___Physician’s Guide MS671 

___QG for Clinicians QGCT26 

___KK for Clinicians KAPT26 

___TIP 27 (SMA) 08-4215
 

___Guide for Treatment Providers MS673
 

___Guide for Administrators MS672
 

___QG for Clinicians QGCT27
 

___QG for Administrators QGAT27
 

___TIP 29 (SMA) 08-4078
 

___QG for Clinicians QGCT29
 

___QG for Administrators (SMA) 08-3592
 

___KK for Clinicians KAPT29
 

___TIP 30 (SMA) 08-3920
 

___QG for Clinicians QGCT30
 

___KK for Clinicians KAPT30
 

___TIP 31 (SMA) 08-4079
 

(see products under TIP 32)
 

___TIP 32 (SMA) 08-4080
 

___QG for Clinicians QGC312
 

___KK for Clinicians KAP312
 

___TIP 33 (SMA) 06-4209
 

___QG for Clinicians QGCT33
 

___KK for Clinicians KAPT33
 

___TIP 34 (SMA) 07-3952
 

___QG for Clinicians QGCT34
 

___KK for Clinicians KAPT34
 

___TIP 35 (SMA) 08-4212
 

___QG for Clinicians QGCT35
 

___KK for Clinicians KAPT35
 

___TIP 36 (SMA) 08-3923
 

___QG for Clinicians QGCT36
 

___KK for Clinicians KAPT36
 

___Brochure for Women (English)
 

(SMA) 08-4132
 

___Brochure for Women (Spanish)
 

PHD981S
 

___Brochure for Men (English) 


(SMA) 08-4134
 

___Brochure for Men (Spanish) 


PHD1059S
 

___TIP 37 (SMA) 08-4137
 

___QG for Clinicians MS678
 

___KK for Clinicians KAPT37
 

___Consumer Guide (SMA) 08-4127
 

___Consumer Guide for African
 

Americans (SMA) 07-4248
 

___TIP 38 (SMA) 06-4216
 

___QG for Clinicians QGCT38
 

___QG for Administrators QGAT38
 

___KK for Clinicians KAPT38
 

___TIP 39 (SMA) 08-4219
 

___QG for Clinicians QGCT39
 

___QG for Administrators QGAT39
 

___TIP 40 (SMA) 07-3939
 

___QG for Physicians QGPT40
 

___KK for Physicians KAPT40
 

___TIP 41 (SMA) 05-3991
 

___QG for Clinicians QGCT41
 

___TIP 42 (SMA) 08-3992
 

___QG for Clinicians (SMA) 07-4034
 

___QG for Administrators QGAT42
 

___KK for Clinicians (SMA) 08-4036
 

___TIP 43 (SMA) 08-4214
 

___QG for Clinicians QGCT43
 

___KK for Physicians (SMA) 07-4108
 

___TIP 44 (SMA) 05-4056
 

___QG for Clinicians QGCT44
 

___KK for Clinicians (SMA) 07-4150
 

___TIP 45 (SMA) 08-4131
 

___QG for Clinicians (SMA) 06-4225
 

___QG for Administrators (SMA) 06-4226
 

___KK for Clinicians (SMA) 06-4224
 

___TIP 46 (SMA) 06-4151
 

___QG for Administrators (SMA) 07-4232
 

___TIP 47 (SMA) 06-4182
 

___QG for Clinicians (SMA) 07-4233
 

___KK for Clinicians (SMA) 07-4251
 

___TIP 48 (SMA) 08-4353
 

___TIP 49 (SMA) 09-4380
 

___TIP 50 (SMA) 09-4381
 

___TIP 52 (SMA) 09-4435
 

*Under revision 

+QG = Quick Guide; KK = KAP Keys 

Name: 

Address: 

City, State, Zip: 

Phone and e-mail: 

You can either mail this form or fax it to (240) 221-4292. Publications also can be ordered by calling SAMHSA’s NCADI at 

1-877-SAMHSA-7 (1-877-726-4727) (English and Español). 

TIPs can also be accessed online at http://www.kap.samhsa.gov. 
FOLD 

FOLD 

STAMP 

SAMHSA’s National Clearinghouse for Alcohol and Drug Information 

P.O. Box 2345 


Rockville, MD 20847-2345 

Clinical Supervision and Professional
 


Development of 
 

the Substance Abuse Counselor



This TIP is divided into three parts that are bound and produced separately. 

Clinical Supervision and Professional Development of the Substance Abuse Counselor, Part 1, is for clinical supervisors. It presents basic information about clinical supervision in the substance abuse treatment field. It covers the central principles of clinical supervision and guidelines for new supervisors, 

including the functions of a clinical supervisor; developmental levels of counselors and clinical supervisors; cultural competence; ethical and legal issues such as direct and vicarious liability, dual relationships and boundary issues, informed consent, confidentiality, and supervisor ethics; monitoring clinical 

performance of counselors; and practical issues such as balancing one’s clinical and administrative 

duties, finding the time to do clinical supervision, documentation, and structuring clinical supervision 

sessions. Chapter 2 of Part 1 presents the “how to” of clinical supervision and contains representative 

vignettes of clinical supervision scenarios, master supervisor notes and comments that help you understand the thinking behind the supervisor’s approach in each vignette, and “how-to” descriptions of specific techniques 

Clinical Supervision and Professional Development of the Substance Abuse Counselor: An 

Implementation Guide for Administrators, Part 2 will help administrators understand the benefits and 

rationale behind providing clinical supervision for their programs’ substance abuse counselors. It provides tools for making the tasks associated with implementing a clinical supervision system easier, 

including how to develop a model for clinical supervision and implement a clinical supervision program; 

key issues for administrators to consider, including assessing organizational structure and readiness; 

legal and ethical issues to consider; cultural competence issues; and providing professional development 

for clinical supervisors. 

Clinical Supervision and Professional Development of the Substance Abuse Counselor: A Review of the 

Literature is for clinical supervisors, interested counselors, and administrators. It consists of three sections: an analysis of the available literature, an annotated bibliography of the literature most central to 

the topic, and a bibliography of other available literature. It includes literature that addresses both clinical and administrative concerns. Part 3 is available only online at http://www.kap.samhsa.gov. 

HHS Publication No. (SMA) 09-4435



Printed 2009



U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
 


Substance Abuse and Mental Health Services Administration
 


Center for Substance Abuse Treatment