Clinical supervision in counseling

Have you ever looked into the educational requirements for a counseling career and wondered what the terms— supervision, clinical hours, or clinical supervision— actually mean?

What is clinical supervision?

Clinical supervision is part of the internship requirement for CACREP accredited masters programs in counseling, as well as undergraduate alcohol and drug counseling training. Beyond school, supervision is a part of employment. For prospective students, it is common for supervision to provoke some feelings of anxiety. The word supervisor sounds like a boss who checks your work and makes sure that you are not making mistakes. While that is part of it, clinical supervision has a unique meaning in the counseling profession. By learning about what to expect, you can reduce anxiety and get more out of your supervision experience.

Supervision as a student

In the beginning of your counseling career, you are required to complete an internship that takes place just prior to graduation. Finding an internship site is like finding a job. Once you have secured a site, there is paperwork from your university that needs to be completed confirming that your site agrees to meet the requirements of your internship supervision. You are assigned a clinical supervisor at your internship site. You can expect to have a different supervisor that you meets with at your university.

Your supervisor is tasked with monitoring your overall professionalism, just like any other job. This includes being on time, completing the duties of your job, dressing appropriately, and communicating effectively. At your site, your supervisor helps you get started with your caseload. Your clinical caseload includes how many clients you see and what the documentation and paperwork requirements are. This can vary depending on your site and how many hours a week you are working. Your supervisor also signs off on your own documentation to show that you are acquiring the hours needed for your internship, certification, or licensure. Here is a sample log sheet used for master’s students from one university.

Both your university program and the state boards stipulate the frequency of supervision.

In addition to the hours you spend with clients, you are also required to obtain supervision hours. This can occur in a group setting with your supervisor facilitating the group, or as individual meetings. Ideally, you have one-to-one weekly meetings with your supervisor when you are starting out.

There is an expectation that the less experience you have, the greater your supervision needs. Both your university program and the state boards stipulate the frequency of supervision. Similarly, your place of employment has expectations around how often you need to meet for supervision. It is what occurs when you meet for supervision that makes clinical supervision different from having a boss that you report to as part of general employment.

Why supervision as a student is important

The counseling job is unique and involves strict rules around confidentiality. Supervision provides you with a space to discuss your work with clients, ask what you need help with, and share what you think is going well. Your supervisor’s role is to check in with you and the work you are doing with your clients. They are also responsible for the care you provide to your clients. They may have suggestions for new interventions for you to try. They may hear what you are doing and agree that you are doing everything expected. If you meet for group supervision, you can expect the same thing except that it happens with peers. They may also give suggestions for time management and keeping track of the essential paperwork.

Counseling work can bring up subjects that are emotional for you. As a counselor, your job is to be there for your client. A clinical supervisor is not your personal counselor, although they can help identify where your own issues are impacting the therapeutic relationship you have with your client. In rare instances, a supervisor may recommend that a change in counselor is needed to better help the client. If personal issues impact your work, or if your work is causing you distress, your clinical supervisor may advise you to seek your own personal counseling. This is part of their job of checking in with your self-care management since the counseling field can be demanding and anxiety is normal when you are new. You need to be at your best to give your best care to your clients.

» Read: Best MFT programs in the country

Recording client sessions

Depending on your supervisor and program, you can expect to record some of your sessions to be reviewed in supervision. This entails getting written consent to record the session from your clients. Most clients do consent to the recording if you explain that they are not identified that your supervisor’s focus is on you, and that this is an important part of your education. These recordings allow your supervisor to hear your interventions and witness the dynamic between you and your clients.

Some counselors continue to record sessions for their own personal reflection and growth in their work even outside of supervision.

Perhaps you feel vulnerable sharing your counselor-self with your supervisor or peer supervision group. They may want to hear what you think went well or what you think went horribly. There is much variation in individual client needs and counseling styles, so there is not always a completely correct approach. In supervision you can be exposed to different counseling interventions and styles, but that does not mean yours is wrong. The goal is to support you in your professional growth so that you can be the best counselor you can be. Some counselors continue to record sessions for their own personal reflection and growth in their work even outside of supervision.

Other issues to discuss with your supervisor

Outside of scheduled supervision meetings, you may consult your supervisor for issues as they arise. As a new counselor, there are some limitations to what you can do on your own. For instance, your supervisor should ensure that you know what to do if you have a client who is actively suicidal, and the specific circumstances that demand that they are immediately informed. They may need to sign off on client forms, or on diagnoses until you have your independent license. Your supervisor may also meet with one of your clients if they require help and you are not available.

Supervision at college

As an intern counseling student, you can anticipate expect to meet for supervision meetings in the university setting. Your university supervisor will also be checking in about your growth, any issues you are having, and that you are getting the hours you need. If there are issues at your site, such as not having enough clients, they can help you develop a plan to advocate for yourself. Your university supervisor is not the person to contact in an emergency, but they can help you process your thoughts and feelings if difficult situations arise at your site. Your university supervisor and site supervisor remain in regular contact throughout the semester.

The relationship you have with your supervisor greatly impacts your supervision experience. Just like any relationship, there may be personality or philosophical differences that cause you to feel uncomfortable with your supervisor. A change in supervisor is not always possible. Some supervisory relationships are built upon common goals such as counseling style, but often they come from necessity such as availability, qualifications, and your options for employment. You may not stay at the same place as your internship, so in this case your supervision experience is temporary.

A difficult supervision experience does not mean you do not have what it takes to be a counselor. It is all part of the learning experience and sometimes this includes learning what does not work best for you.

» Read: Counselor vs therapist: how they’re different

Supervision beyond school

When the internship is over and you have graduated from your program, supervision continues. If you hold an undergraduate level certification, supervision is legally required because you cannot practice independently. If you obtain a master’s degree and have the goal of getting your independent license, supervision is required as you continue to gain your required clinical hours. This varies between states and how often you work, but on average it takes 2-3 years of supervised practice to get your license.

You may be asked to sign a contract for supervision. This can set clear goals and expectations for supervision including how often you meet, how to contact your supervisor, and who to contact if they are unavailable. In some agency settings this agreement is implied and reviewed as part of your onboarding.

It is an essential part of the counseling profession and when done right, it is something counselors look forward to.

Community agency settings often include supervision as part of your employment. In the private practice setting, you may be charged for supervision. This is because the time spent providing supervision is time not spent with a client and your supervisor also assumes responsibility and liability for your clients. Joining a group of peers that also need supervision can reduce the amount charged.

After you earn your license, your supervision needs will depend on your employer. At this stage, you can open your own practice. Although supervision is no longer legally required, this does not mean that it is not needed or beneficial. Supervision never truly ends: it evolves. It is an essential part of the counseling profession and when done right, it is something counselors look forward to.