Thursday, November 17, 2011

Supervision - An Evolving Process

Earlier this year, I got my coveted "independent" license - meaning I am officially qualified to practice clinical social work without a more experienced clinician supervising me. Having this license means that a lot more professional opportunities are open to me...but it does NOT mean that I'm no longer supervised. 

That may not seem very logical (since the whole point is "independent" practice), but this is social work, people! We consider clinical supervision a pillar of professional development, and believe professional development is never "finished" as long as we're still practicing, so.... The only social workers I know who don't have some sort of supervision are either in private practice, or are the highest ranking clinical staff in their agency or department.

I have learned, however (through some uncomfortable trial and error) that supervision does change post-licensure (or did for me, at least). Now, that may  not be as true for people who continue with the same job and supervisor pre- and post-licensure - but these people might experience a similar change when they do ultimately move into a different position. 

To explain what I think changes, it's helpful to first look at how supervision operates in previous stages of professional development. Obviously, that begins as students, and supervision is definitely different for students than for staff. Students are there to learn new skills, and are not expected to know what they're doing the same way staff do. They're expected to make more mistakes, and to have more questions. As a result, supervision is also somewhat more structured because students are asked to provide examples of their clinical work in the form of process recordings. (Did I hear a collective shudder?) Supervisors therefore have a better idea of what students are doing, saying, thinking and feelings while they're with clients, and students come to supervision with some questions and dilemmas already identified. 

Hopefully, students' field placements provide them with some solid, positive experiences of supervision that teach them how to make the most of the supervisory process. However, the process has to change somewhat once the student graduates and becomes an employee. For one thing, every student swears that she will never write another process recording after graduation! As employees, they are also expected to have a foundation of expertise and function with appropriate autonomy and efficacy in their roles. Consequently, in most settings, supervisors can only assess what kind of work staff are doing through their notes, case presentations, and discussions in supervision. However, since most new staff still feel like they're muddling through, they are likely to have a lot of questions and curiosities, and request more feedback, all of which gives some structure to supervision, and makes the process feel beneficial to both supervisor and supervisee.

Now fast forward a few years. With more experience, clinicians are more confident and have fewer questions for their supervisors. However, they've also been trained to make the most of supervision, and are therefore likely to use the time to discuss their most challenging cases and clinical dilemmas, especially those where their own reactions have the potential to get in the way if not addressed. If the supervisor is already familiar with the clinician's work, or has another window into how they're doing with the cases that are going smoothly, this shift may not cause any difficulties. However, if the supervisor doesn't know the clinician well and has limited other exposure to their work, there is a risk that the supervisor may extrapolate, and get the impression that the challenges and reactions raised in supervision are bigger or more global problems than they are.

It's helpful for me to remember two things, in this post-licensure version of supervision: 1) the supervisor has limited other exposure to my work, and doesn't know what is going well unless I tell her; and 2) supervisors also want to feel good about their work, so including some positive feedback and letting my supervisor know what I've taken away from supervision and found helpful makes the whole process more positive for both of us.

Have you noticed any changes in how you use supervision over the course of your career? What suggestions do you have for making it successful, particularly after you've become an experienced clinician?

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