Clinical Supervision in Alcohol and Drug Abuse Counseling - Part 1

Presented by: Nick Lessa, LCSW, MA,
CASAC
Nlessa@inter-care.com

 Based

on the highly acclaimed book by David
J. Powell
 Originally printed in 1993 and revised in 2004
 Makes the case for substance abuse
counseling as a unique discipline with its own
model of supervision
 Disputes the notion that a good counselor
automatically makes a good supervisor

 Confusing

clinical supervision with case
management, focusing on the client’s rather
than the counselor’s needs
 Counseling the counselors giving rise to role
confusion
 Taking a laissez-faire attitude
 Becoming judgmental, authoritarian, and
overly demanding

 Most

counselors need a mentoring and
support system, which translates into a
coach, cheerleader, handholder, and wise
advisor
 According to studies, better clinical
supervision led to greater job satisfaction
and better retention rates
 Good clinical supervision improves client
outcomes

A good supervisory relationship is one of the
most satisfying aspects of the counselor’s work

 Openness

to feedback (supv. & counselor)
 Supv.’s helping the counselor feel relaxed &
open to criticism
 Supv’s ability to listen to the counselor &
respect the counselor’s therapeutic style
 Consistency of therapeutic orientations
 Emotional support provided by supervisor
 Sharing clinical responsibilities

 Managers

of tx facilities need to be trained
in the value of good clinical supervision
 Clinical supervisors need more thorough
training in how to supervise
 More sophisticated mechanisms are needed
for supervising counselors

Towards a Working Definition of Supervision

 Firstly,

understanding the difference
between administrative and clinical
supervision.
 The administrative supervisor helps the
supervisee function more effectively within
the organization, with the overall intent of
helping the organization run smoothly
 Addresses areas such as case records,
referral procedures, continuity of care,
accountability, hiring/firing, and
performance evaluations.

 Clinical

supervision focuses on the
development of the supervisee specifically as
an interpersonally effective clinician (Hart,
1982)
 Clinical supervision attends to the
supervisee’s professional and personal needs
as they directly affect the welfare of the
client.

 Supervision

as a Therapeutic Process –
becoming aware of one’s personal issues and
its impact on clients

 Supervision

as Education – learning skills
and developing professional competence

“Clinical supervision is a disciplined, tutorial
process wherein principles are transformed
into practical skills, with four overlapping foci:
administrative, evaluative, clinical, and
supportive.”

 Disciplined

– regularly scheduled, time
limited, specific agenda & expectations
 Tutorial – instruction and guidance with an
individualized training plan
 A Process – supervisor as coach, cheerleader,
mentor, friend, handholder, educator, and
colleague
 Principles into practice – help counselor
identify what they did and why they did it

 Administrative

– involves organizational
management issues
 Evaluative – assess counselor’s skills, clarify
performance standards, negotiate objectives
for learning, utilize sanctions for poor
performance. Involves goal setting &
feedback

Clinical – the clinical, educational, and
training functions of supervision include:
 Developing counseling knowledge & skills,
 Identifying learning issues & problems,
 Determining counselor strengths &
weaknesses,
 Promoting self-awareness & professional &
personal growth and,
 Transmitting knowledge for practical use.

 The

best supervisor teaches by example – not
just instructing but modeling clinical
competencies

 The

most effective way to teach: to let the
student watch you work

 Supportive

– the supportive functions of
clinical supervision include handholding,
cheerleading, coaching, morale building,
burnout prevention, and encouragement of
personal growth
 When a counselor reveals a personal issue
that is impeding the clinical process, the
supervisor must see that he/she gets the
support needed to resolve the impasse

 Leadership

is not the same as management,
and management is not the same as
supervision

 Leadership

transforms people by raising their
sights & aspirations to a higher level, thereby
engendering a greater sense of purpose

 To

establish trust with co-workers &
subordinates
 To serve as a team leader
 To define & set dept. & organizational goals
& communicate these goals companywide
 To inspire staff by encouragement &
motivation
 To communicate enthusiasm & capability
 To keep up staff morale, including one’s own
 To take appropriate risks & be decisive in
action

 To

possess the ability to change in response
to needs
 To have vision, drive, clear judgment,
initiative, poise, and maturity of character
 To command enthusiasm, loyalty, sincerity,
courtesy, and confidence
 To exercise control through inspiration rather
than command

 get

work done through staff
 make effective use of dept. resources
 get results in achieving goals & objectives
 control through command
 identify, analyze, and solve problems
 adapt to change & growing needs of org.
 organize work as needed to get the job done
 Intervene to bring about positive results
 See all aspects of operations

 Know

the responsibilities of staff
 Clearly communicate these responsibilities
 Effectively utilize the performance appraisal
system to get max. productivity of staff
 Write clear job descriptions & quarterly &
annual goal & work statements for all staff
 Delegate responsibilities to all staff
 Promote staff’s professional development

 Take

full responsibility for decisions you
make
 Always put the well-being of those reporting
to you above your personal well-being
 Give subordinates full credit for successes
 Don’t be afraid to take risks when they’re in
the best interest of the company or client
 Protect your supervisees to superiors when
they’re being unfairly attacked or punished

6. Take a personal interest in the welfare of
your staff
7. Make decisions promptly even if, at times,
you don’t have full information
8. Be a teacher
9. Do not play favorites
10. Don’t give orders just to prove you’re the
boss

 Good

supervision is largely a matter of caring
for staff
 Supervision is not about structures, but
about people: their needs, concerns &
growth
 The ultimate goal of leadership is to create a
sense of community at work

 The

leader is a servant first. That’s the key
to the leader’s influence
 The power to lead comes from giving up
personal need for power in order to serve the
group
 “Leaders bear pain. They do not inflict it.”
 The servant leader cares for people
 The goal is to motivate people; tap into it

 Owners
 Employees
 Customers

– most critical element of agency

 Vendors

 Competitors
 The

Community at Large

“When organizations empower employees to
be part of the decision-making process,
establish a bottom-up management structure,
practice servant leadership, and balance the
needs of all stake-holders, they become great
places to work.”

 Camaraderie
 De-emphasis

on Politics (through trust,
openness, & fairness throughout company)
 Growth Values (employee empowerment)
 Family and Community (give a sense of
being part of a family)

The Four A’s of supervision
1. Available: open, receptive, trusting, non
threatening
2. Accessible: easy to approach and speak
freely with
3. Able: having real knowledge & skills to give
4. Affable: pleasant, friendly, reassuring

Two Essential Qualities
1. Sound Clinical Experience – must be a
good clinician
2.

A Passion for Counseling – the source
being a desire to help others

Clinical Supervision in Alcohol and Drug Abuse Counseling - Part 1

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