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Foundations of Supervision in Social Work Practice

Foundations of Supervision in Social Work Practice
Alison D. Peak, MSW, LCSW, IMH-E
August 31, 2021

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Editor’s note: This text-based course is an edited transcript of the webinar, Foundations of Supervision in Social Work Practice, presented by Alison Peak, MSW, LCSW, IMH-E.

Learning Outcomes

After this course, participants will be able to:

  • Identify supervision as a foundational aspect of social work practice.
  • Examine the various styles of supervision and the purpose of each.
  • Identify the responsibilities of the supervisor and supervisee in establishing a supervision relationship.

Introduction

I am excited to dive into this and to begin to think about foundationally what social work supervision means. I am a social worker through and through, an old school social worker who largely believes in collaborating with communities and families in the context of all the ways that they engage with the world. 

I have spent the majority of my career as a clinician, working primarily with children who have backgrounds in hard places and from trauma. I have worked with children in child welfare, and I have worked with both international and domestic adoption, specifically around building and repairing attachment relationships. As I have gone through my career and lived some years and gained experience, I have had the great pleasure to be able to supervise interns and licensees as they go through their process. I have also had the opportunity to build projects and programs, that have required their own level of supervision and oversight of staff in a variety of ways. I am excited to be able to think about that today and what that means for us in regard to forwarding the future of social work as a profession and a field.

Supervision in Social Work

Supervision for social workers is a really big deal. It is part of how we begin to approach the work from the time that people are undergraduate candidates in BSW programs through the process of their careers. We are required to some extent in BSW and MSW programs to participate in supervision, and to receive supervision for a period of time after graduation if you are going to pursue a license.

We also know that this concept of supervision is best practice regardless of if you are licensed or not, and regardless of whether you are two years into the field or 25 years into the field. This concept of supervision is a hallmark to how social work sets itself apart from other professional disciplines. Supervision is a foundation of how we identify as a culture of being social workers. 

The NASW Code of Ethics mentions this idea of supervision 16 times in its ethical standards, and challenges social workers to practice within their scope, but to seek feedback and to address ethical dilemmas to grow themselves in their own career development through the supervisory relationship.

This concept of supervision takes on a couple of connotations. It may be the supervision that we receive for licensure purposes, it may very well be somebody who is with us for that purpose, and it might also be supervision in the context of overseeing a program or overseeing the function of someone else's job. 

Supervision, generally speaking within social work, also has a connotation given to it of a relationship, of there being space for learning, of there being an idea that something is going to occur together among this group or among this pair; that are meeting for the purposes of discussing cases, timelines, accountability to the position, and quality of documentation in a variety of different positions.

Supervision is a concept that is not necessarily held in other disciplines and can be confusing for people who are coming into social work, or when we are talking about interdisciplinary teams. For example, a social worker in a hospital setting with nurses, physicians, occupational therapists, and physical therapist, work with professionals who are not going to have a concept of supervision, and who may hear and infer “supervision” to mean administrative oversight. 

Understanding supervision as a foundational aspect of social work practice, includes our responsibility to be able to explain why and how the supervision process allows us to be better social workers and better clinicians within the field. 

Supervision is required by a qualified social worker for completion of field placement activities at all educational training levels. Qualified social worker varies based on whether or not this is a BSW placement or an MSW placement. Although, social work as a profession, considers supervision as a foundational training field for our future workforce, and holds that only social workers can supervise social workers. Social workers are experts of our own role, our own ethics, and our own way of being, therefore it is our responsibility as social workers to provide that to future social workers and to develop essentially an intergenerational pattern.

Supervision by qualified social workers is also required for clinical licensure in all 50 states. The amount, type, and frequency of that supervision varies across states, but there is still that requirement, that supervision is a gold standard to moving forward and being able to say, I have done advanced training in the field, and to say that training was done with someone who has walked that journey already, and also holds the same kind of ethics. 

Supervision is from the CSWE through education, from NASW through the code of ethics, and also from the way that each state writes its own expectations around licensure behavior. Supervision is clearly essential to social work as a profession.

Defining Supervision

In 2013, the NASW and the Association of Social Work Boards defined supervision as the relationship between, (relationship being that there is a space, there is an entity, there is a process that occurs) between a supervisor and a supervisee, in which the responsibility and accountability for the development of competence, demeanor, and ethical practice take place.

The supervisor is responsible for providing direction, has to be able to apply social work theory, has to be able to communicate standardized knowledge, skills, competency, and applicable ethical content in the practice setting, and the supervisor assumes the responsibility for setting direction and being able to scaffold experiences for that supervisee's growth and development competency and accountability for the long-term. It is a lot of responsibilities to be charged in one relationship.

3 Roles of Supervision

There are three general roles within supervision:

  • Education/Professional Development
  • Administrative Oversight
  • Emotional Process/Support

Educational/Professional Development

A general role within supervision is educational/professional development. How are we communicating theoretical knowledge? How are we communicating developmental standards, general practice standards, and what evidence-based practice is? What do all of those pieces look like? How are we helping to scaffold the professional development process of the individual in front of us? 

Administrative Oversight

Supervision also holds the role of administrative oversight, of how are people juggling both the person of being the social worker and also the process of being the social worker. Many, many times, I am going to bank it is  close to a 100%, we become social workers out of excitement of working with communities and legislatures and clients and families, and not because we thought it would be really fun to write a court report.

Sometimes in the duality of our role, it can be really easy for that administrative oversight to feel lost in what might really be the thing that catches, again, almost all of our attention, of being with people. 

Supervision absolutely plays a role in administrative oversight, of ensuring that those social workers at all stages of their development really are able to understand how some of those processes connect to ensuring that the services provided continue, and that we are engaged in ethical and transparent practice. 

Emotional Process/Support

The third role of supervision is emotional process and support. There is an aspect of showing up, of being present in places where hard stories are told and hard work is done, that it is important that we have another, someone else to go back to, to be able to recount that story, to be able to think together about what does it mean? What did we see? What did we hear? How do we hold onto that for our own experience, and also make meaning of it for the people that we were there with? 

Those three roles of supervision, to some extent, are going to be found in lots of different places. It may be in licensure supervision, it may be in supervision of a field placement, and it might also be in supervision of a program where the individual in front of you is neither an intern or on licensure track. 

Supervision in Research

Within the research world, recent studies in Australia and Europe both identified this idea of average career life. Thinking about how long does an individual, on average, stay within a career field before they either retire, find a different position, or say, "I quit," and go cut fabric at Joanne's.

How long do they typically say, "I stayed with this identified career trajectory before this concept of burnout just became so big." In that study, what they found was that generally, physicians will hang in on that identified career path for about 25 years post-graduate, so after medical school, so about 25 years before they either retire or say, "I'm going to cut back to part-time," or, "I've decided to take up becoming a bartender."  For pharmacists, the average career life was approximately 28 years, whereas the average career life for a social worker is about eight years. It is considerably less than many other professional programs. In that same study, social workers, when asked, discussed high caseload, paperwork, and the urgency of the work in front of them as far more stressful than being with clients and families and their stories of hard places.

What we know is that at the end of the day most of us come to social work in this place of being prepared to hear hard stories, of having this desire to be with people. We do not generally come to the work prepared to fill out SOAP notes on 50 people. That is a process where we are not as well educated, we are generally not as well prepared on the front end, and it can feel as though the family and the client get lost in the midst of all of the systemic things when we do not have context, and someone to help us gain perspective and scope and to really be able to regulate in those places of feeling mismatch.

That same study, took a look at those social workers who really outpaced and surpassed this eight year career mark. They took that group that were over the eight year point and they said, "Why did you stay?” "Why did you keep doing this?" "What helped you keep going?”

The factors that this group of people pointed to were consistent supervision, the ability to externalize stressors with someone else present, not that somebody else made it go away, not that somebody else made the SOAP notes randomly disappear, but that somebody else could sit and be present and listen to feelings of being overwhelmed by broken systems, by paperwork, by expectations and deadlines; that there was a preserved time set aside for them as an individual.

That means that not only was supervision there and there was someone to listen to the stressors of the moment, but that there was also consistency for the time held; Every Tuesday at two p.m., every Thursday at eight a.m. There was a pattern and a predictability to the level of support. In addition, there was shared experience with another in the stress of the situation, that again, somebody in that supervisory relationship could say, "Yeah when I get behind, it is really hard.” "Yeah, I do not like it when I spend all day in court and then feel like I lost the entire day to do all the other things that are calling on me." 

There is that place of not being alone, of being able to say, “oh, other people have gotten through this.”  Also, being able to name the process in front of them and there was also mentorship. There was somebody that they could look up to, somebody that they felt had some answers, somebody who they felt had their best interest at heart.

When we talk about supervision as an option for the foundation of the field, as an option for preservation of future generations of social workers, part of the preservation of future generations of social workers is to keep them for longer than eight years. It is a lot of training and a lot of learning to just lose so frequently, and to rotate through all of these efforts. Supervision really does point to being one of the leading protective factors for keeping people in positions longer, and for being able to allow them to feel more supported in that process. 

Research has also shown a connection between decreases in burnout and vicarious trauma when there is satisfaction with supervision. Whenever there are individuals who feel as though their supervision has met the needs in front of them, then they are less likely to feel burnt out and to have symptoms of vicarious trauma. On the flip side of that, individuals who feel frustrated and unheard in their supervision are more likely to have symptoms of vicarious trauma and to express feeling burnout. 

What those factors in that place of perceived satisfaction within supervision were about, did they feel like supervision was frequent? Did the individual feel as though supervision provided them with perceived emotional support? And again, NASW describes this as a relationship, was the style of the relationship a fit between the supervisor and the supervisee? 

Research has also shown that dissatisfaction in those areas generally leads to increased senses of burnout and also is really linked to increased turnover, long-term. In places where there are frequent turnover within programs or frequent turnover within agencies, it is a point of evaluation. Not a determining factor, but a point of evaluation of the supervision provided, meeting the needs of the individuals requesting it, and is it allowing for this place to have a style that matches the relationship being requested, is it frequent, and is it emotionally supportive?

Styles of Supervision

The Center of Excellent at Georgetown through partnership with HRSA and SAMHSA defines four styles of supervision:

  • Administrative
  • Clinical
  • Modality
  • Reflective

Administrative

Administrative supervision is the oversight on timeliness, documentation, policies, and procedures. This is supervision that everybody needs. This is supervision to say, "Hey, you forgot to sign this note, can you go do that?" Or, "Hey, remember, we've got this deadline coming up, "this audit is coming through, "it is really important that you make sure you do all your documentation in 72 hours.” "If not, there are these implications long-term." Administrative supervision plays its own very integral role in development of providers, but also in the functioning of agencies and organizations. 

Clinical

Clinical supervision focuses on providing direct feedback on clinical concepts, such as theoretical knowledge, an assessment of the client or family or organization that the social worker is working with, thinking together about developing goals and treatment planning, selecting diagnoses, and thinking about which modality might be the best approach. Clinical supervision sometimes takes on the air of the answer to the question of what do I do now, that the new social worker comes and says, "Okay, I tried this thing, what do I do now?" Sometimes clinical supervision can be that place of setting direction for that next clinical step, kind of paves a path. Like, "we have walked this path five times now, you have a better expectation of what is coming than you did the first time you walked it, so tell me what you think we should do next?" 

Modality

There is also supervision specific to modalities. When we think about specifically evidence-based practices under SAMHSA or evidence-based practices under the National Center for Child Traumatic Stress, there are learning collaboratives specific to those evidence-based practices that require additional supervision on the implementation of that modality. How are we doing it? What do we do next? Did we follow these steps? What was it like for you in that place when the family said, "I do not  want to do that?" And, how do we navigate those places, in an effort to make sure that individuals in programs are meeting fidelity of those research-based, evidence-based practices? 

Reflective

Last is reflective supervision. As it relates to styles supervision, I will acknowledge my own bias of this style of supervision, this is the place where I live most. This is the place that I enjoy. I enjoy being in a reflective stance that really sits with supervision focusing towards the emotional experience of providing services, of slowing down and thinking about, who is this child and who is this family and who is this person in front of me? What is the story of this organization and how they came to be in function, and what does it mean to be a part of them, or not a part of them? How do we, as providers, in whatever our capacity, show up to interface with these people who have asked to be in relationship with us?

Reflective supervision slows down in that place of focusing on details, of increasing awareness to the emotional process of the client. For example, what is it like for the client to be the other half of this clinical relationship? Or if the client is an organization, what is it like for them to seek consultation, for them to seek advisement on these things? What does it mean for them to be the other part of this relationship? What are their relationships around them like? And what is the emotional process of the social worker, of the clinician, who presents in that moment and says, "I will engage in this relationship, and now be with you?"

There are lots of overlap of the styles of supervision. There will be times that even in a really slowed down, reflective place, that I will say, "Oh, timeout. I need to know…" For example, I did reflective supervision with one of my staff a couple of weeks ago and we got into this conversation about this client the staff member is working with, and the staff stated, "he told me he was suicidal." My response was, "Timeout. I need to know if you called your direct supervisor. I need to know if you documented it. I need to know if they are safe and I need to make sure we did assessments." The administrative responsibilities in that moment took over. 

Styles of supervision sometimes are clearly carved. There are different people who are doing different roles, and sometimes it is a Venn diagram of overlapping perspectives of how we show up to provide support to those who are engaged in the work. Within that, supervision styles are also like clinical styles. Some clinicians are trained to be really CBT focused, and others are trained to be really focused on internal family systems or psychodynamic.

There is always that place, goodness of fit, and oftentimes when we look at the research, there is not a ton of discrepancy about whether or not one is vastly more impactful than another. It is about relationship and goodness of fit. The same is true when we look at supervision and supervision styles. Supervisors are going to have different styles of how they show up, of what they are comfortable with, of how they negotiate that relationship, that space between, and yet supervision might often parallel the experience of the clinical space. 

If this is a short-term program, like an intensive outpatient, and we have only got clients for 28 days, and we have these goals that we have to meet, it is likely that supervision will focus on, these are the goals that we have to meet, and we have a very short amount of time to get it done in. There will be parallel between the experience of the work being provided to the client and the experience of the supervision being provided to the staff. And so again, thinking about how those styles match up, thinking about what the organization and the supervisor hope to bring to this relationship for learning are really important beginning points when we start supervision with anyone. 

Role of the Supervisor

As the supervisor, whether or not we are engaged with a new supervisee, or we're taking on a new position, we got a promotion, we switched agencies, whatever it may be, as the supervisor, our number one job is to begin to identify the purpose of the supervision. 

Are we here to provide clinical direction? Are we here as a consultant to set trajectory for a learning cohort? Are we in this moment really supposed to hold space and slow down and think together about what clinical challenges might be in for this program?

What is our role? What is our lane? How do we sit and identify with the purpose of that? 

Identify the Boundaries Inherent to the Relationship

We also want to think about identifying the boundaries of that relationship, because again, we might show up as supervisors in lots of places. We may be the supervisor within the agency, the consultant to the agency at large, or again, a place of that fidelity and implementation model. So, what is our relationship to the person being supervised? What is our relationship to their organization and work context? How is their relationship as an entity also going to impact the relationship between the supervisor and these entities? How is all of this going to work together? 

Establishing Expectations for Supervision

Within that, we see consistently through the research that one of the places where supervision is communicated as most helpful is when it is predictable. We also know that relationships are at their healthiest when they are predictable, predictable in people's responses, predictable in the events that will occur, predictable in how we access someone. And so again, there is a parallel there, and the experience of what we know is good for humans and what we know is good for supervision of social workers. 

Within setting some of that sense of predictability and safety, we really want to set up expectations. Some of those expectations come in routines. Is there an expectation that a supervisee bring a list of questions to supervision? Is there an expectation that supervision will always begin with a grounding activity?  Is there an expectation that supervision will cover quality of documentation? What is the expectation for being together in that place?

What will the routines of your time together be? How will you negotiate them? Who gets to decide what the topic for focus is? Is it the supervisee, or is it the supervisor who reviews documentation and may have concerns? Who goes first? Whose concerns may be priority? How do you discuss that? How do we have the conversation of, "I hear that is really hard for you, but today I have got to talk about this.” "I have to know about this specific situation.” "How do we help you contain this until I can make sure that the priority is safe?" 

We are also in that place of setting up for felt safety, and this is really specific to each individual idea. What does that mean for there to be felt safety around supervision?

There are lots of things that impact that, people's own stories of development, their own histories of early relationships and trauma, our experiences as supervisors, as well as the experience of the supervisee. If we are supervisors, we may be hoping to embody a style and a presence within supervision that either emulates someone that we really appreciated in our career growth, or is in direct contrast of someone we experienced in our career growth. Supervisor have to think through what is it that participants need in order to be able to be present in this moment, to allow themselves to focus on the task at hand, and to really consider themselves within the context of the work. In addition, supervisor want to make sure that supervisees clearly know what are the topics of focus.

Depending on your role as the supervisor, this is going to change. If you are there as a consultant on a learning cohort for a fidelity model, the topic probably is not going to be documentation timeliness. It is probably not going to be frustration with the new healthcare plan. Therefore, being able to say, "Oh, that is an important thing to talk about.  Let us talk about who should hear that. Let us talk about what things should be brought here, and how we best negotiate use of our time together." 

We are also looking in this beginning phase as the supervisor to identify supervisee development. This one I think is hard. I think this one really takes time. It takes time in the same way that it takes time to properly assess clients, and to really think about what that client's strengths are and their areas of growth.

There are lots of parallels when we think about the supervisory relationship. Does this supervisee really think about the work, think reflectively, and take ownership of their own experience? Are there experiences they have had that are getting in their way of being able to take feedback or to see the perspective of multiple people in the room? Is this a supervisee who maybe did not have a great intern experience, and so is coming to us with less hands-on work than somebody who has been in a BSW role for 15 years and decided to go back and get a Masters, and has really been in the field, maybe in a different capacity, but been present and been in the work for quite a while.

Within that, we are looking to really think about development for clinical capacity, but also for a reflective capacity. Can they make sense of another? Do people feel as appropriately complex as they should? Does it feel like a math problem to solve, that a staff quickly figures out, claps their hands and says, "see that was not so hard?" Are there consistent places of frustration or biases, blind spots that need to be addressed, maybe through training and technical assistance, maybe through direct conversation? Just like we talk about development existing across the lifespan, development also exists in a professional domain. There are places where people are really learning to crawl, and other people might be running down the hallway.

Scaffolding Learning and Growth Through Supervision

Within the infant mental health world, we have this adage of do for, do with, stand back, and admire. It is a pocket guide to what it means to scaffold, For example, when we think about children specifically, we start off doing everything for them. Infants do not feed themselves, they do not change themselves, and they do not hold their own heads up. We do everything for them, and as they get older, we begin to help them. "Oh, I will help you pour your juice.” "I will help you cut your sandwich.” "I will help you tie your shoes."  As they (children) continue to develop, we stand back and we say, "Oh, look how good you did.” “Look how proud of you we are, look at all the things you have accomplished." And there is again, parallel to this in staff development. 

As a supervisor, part of our role is to really think about the scaffolding. Is this a skillset that if we do for, do with, stand back, and admire, that a staff can grasp? They need to be shown how to input the form in the EHR, they need to be walked through an example of how we would develop a Trauma Triangle for TF-CBT. We ask them to bring it back to us, "Show me next time you do this, "let me check it with you first. "Let's talk about it before you present it to a family." 

And then again, sit in that place of congratulatory praise around, "See how far you've come. Look at all the things you've learned to do." That is scaffolding, of remembering, we have got to start at that bottom floor and we go to build our way up. It helps us to set expectations both for ourselves as the supervisor, but also for the supervisee in front of us. 

Highlighting Opportunities for Growth and Reflection 

As supervisors we want to highlight opportunities for growth and reflection. We want to be able to think with that supervisee about what it means to be at this point in their career. One of the things that I hear so often from my new staff and by “new,” I mean, not yet licensed; is this idea of, “I should feel more comfortable,” “I should be more confident,” and “I should know what I'm doing.”

I tell them often you are on a developmental trajectory. You cannot know what you do not know. This is a process. People do not learn to speak a foreign language in six months, and people do not learn how to be present and really understand all of the complexities that present in front of us in clinical capacities. 

This really does parallel in macro level work and organizational consultation and work with policymakers and legislators as well. When something new occurs, it takes us time to build a relationship, to understand all the dynamics at play, and to really get a good understanding of what is in front of us. 

As the supervisor, we get this opportunity to highlight options for growth and reflection, and to think about the underlying emotional response to the issues."What was that like for you, when you were in that family session, and Mom and Dad started screaming at each other?" “What did you want to do? Not what you did, but internally, what would you as a human like to have done in that moment?" 

It is also our opportunity to highlight clinical knowledge and gaps within preparation level, The role of the MSW program is to prepare people with sufficient knowledge to engage in introductory practice. MSWs are not given evidence-based treatment models, they are not trained specifically in how to do DBT or what it is like to run a residential treatment unit for kids who are going to be there for eight months.

They (new MSWs) do not have that level of experience. Therefore, our own lived experience as social workers, as the supervisor in the situation, is to say, "here is a place where we can learn." This is a place of saying, "let me give you some information to scaffold you to the next step, because trying to make that leap on your own will not be sufficient." 

Within this, and highlighting those opportunities for growth and reflection, the supervisor is also challenged with highlighting both implicit and overt bias and cultural awareness. There is emphasis within the social work code of ethics on being aware of all of the cultures in which we serve, and again, of seeking supervision in places where we are outside of our scope of practice or when ethical dilemmas are raised. 

So, this place of implicit bias and overt bias, not just the I was unaware blind spots, but the places we knew we had big strong opinions about an individual, about a lived experience, about the thing that is sitting in front of us at that moment. The awareness of cultures, and that may mean racial culture, that may mean of different countries, but it may also mean of organizations, of the culture of this organization. For example, the organizational culture may be one where we do not talk about things until they get really big and they blow up, or this is the point of problem solving, and so everybody goes to this individual to solve problems. 

We are aware of the role that culture and that the worn paths and journeys in front of us play in an interfacing and engaging with others in the work. The supervisor's job is to help scaffold, to set expectations, to help that supervisee to take a step back and think about things from an externalized perspective, and begin to consider all the pieces at play in being the social worker present in that situation.

Social Justice 

Recently, there have also been increased calls among the social work community that supervision is a place to highlight our dedication to social justice. Social work is a social justice field. I feel very strongly in that place and very proud of social work's efforts to say, it is not enough to just show up and say we are professionals. It is our job to be advocates for larger social justice movements outside of the work we do on a daily basis.

Part of that is that our role should filter that call to social justice through our supervision, and through supervision we are highlighting those roles, we are emphasizing what it means for there to be social justice concepts in the work in front of us.

Just this week, I had a conversation with a supervisee about what it would mean if Biden's economic rescue plan goes through, and earned income tax credits are an option for our families with children. What does it mean if their economic status suddenly changes? What does it mean for the problems in front of them? What does it mean for their need for services? Are they going to need us anymore? What will the implications on our work be when there are shifts within the system that are current events, that are moments of social justice that are right in front of us?

It is also the place in that of being in situations of confronting bias, and being able to highlight those. For example, after the murder of George Floyd, being able to sit down with the team and say, what does it mean for us to be a majority white organization serving a majority minority population? What does it mean for our clients? What is our role in dedication to social justice and being able to voice that, own it, push ourselves, recognize the places, and the opportunities for growth and reflection within those space? And again, this is a place that as the supervisor, if we are talking about setting expectations and setting routines, we have to early on in the supervisory relationship set the expectation that these topics of social justice, these concepts of race and equity are very much going to be part of the conversation at hand.

Role of the Supervisee

The supervisee also has a role. D.W. Winnicott in the 1950s described the relationship as a dance. Dancing alone does not get us very far. We are engaged in things like the tango. There is always two, there is always back and forth, and so while the supervisor bears a larger burden based on career trajectory, development, and experience; the supervisee also bears responsibility to what is in front of them.

Attend Consistently 

 The supervisee has to attend consistently. They have to show up, and sometimes, depending on their background, depending on their training field, depending on their internship maybe this got to be optional, maybe it was a sometimes thing or a supervision group, that they could pop by if they needed something. It may be that we have to expressly indicate that the supervisee has got to show up. Sometimes the beginning of the foundation of the relationship is just being present.

Bring Things to Discuss to the Supervisory Time

 The supervisee has to bring things to discuss. Maybe it is in the form of a list, maybe it is concrete questions, maybe it is just a concept or a free-floating idea that they need to come with. But to come to supervision and be like, "Everything's great, "I've got it totally handled. "I need nothing, I'm on top of it" all the time leaves a whole lot of dead space in a relationship. 

Identify Needs and Vulnerabilities

Relationships to be truly authentic must imply that there is some level of vulnerability and that there is some level of acknowledgement of need. This will progress over time. If it is the first supervision you have ever had with the supervisee and they come in and disclose their own personal traumas and how it shows up in a clinical session, most of us would be a little concerned. There should be, just as within the parallel to the clinical world, the parallel to our relationships as humans, there should be progression over time where those needs and vulnerabilities shift. In our scaffolding process that we as supervisors are naming, that process will grow and shift over time. They are also very much in the beginning a need for the supervisor to emphasize that saying, "I do not know," is not the same as, "I am incapable." Lots of times in the beginning, supervisees are very, very hesitant to say:

 "I have no idea.”

 "I do not know what to do with this client.”

 "I didn't know how to respond."

 "I said, 'Okay, thanks,' "because I wasn't sure what to do next." 

Supervisees have a lot of concern about being inferior, about being incapable, and about the possibility that they will not be good enough for the position. Without expressly naming, the ability to say, "I do not know," supervisees may really hold back from that, and then that development of being able to express needs and vulnerabilities is also going to lag. 

Learning to Sit with Discomfort

Supervisees also have to learn to sit with discomfort. Supervisees have to sit with their own discomfort in that growth place, their discomfort around not knowing, and their discomfort around being in a challenging first session with a client.  Supervisees have to be able to hold space and learn which feelings really are theirs and which feelings are those that have been projected onto them, that now they got to figure out what to do with.

Leaning Into the Professional Growth Facilitated Through Supervision

The supervisee’s role is also to lean in to professional growth, to say:

 "I'm here to learn." 

"I'm here to listen." 

"I'm here to be present." 

"I am here to know the things I do not know."

That is not a reflection on someone's personal value or someone's capacity or potential for the future. It is about that in many ways, supervision is an apprenticeship within the social work field, that it is this process of, we learn from others who have been there before, and we hope that in that learning, we see some things that maybe they did not see, and they see some things that the supervisee has not yet seen. 

Supervisory Relationship

Within that supervisory relationship  we have talked about this place of there is a negotiation, there is that beginning, that ritual, that routine, that understanding of what are the scope and boundaries of this relationship in front of us?

Is it that I am here as a consultant for a six month period of time, or in some situations, supervisors are engaged without limit. The individual that I get supervision from, I have gotten supervision from for four years, with no intentions of stopping that contract. And so, what does that mean? 

How are we setting up expectations on that relationship so that supervisees and the supervisor have an understanding on scope and boundaries and what that means? What are the goals? Are the goals fidelity to a model, are the goals to get somebody to licensure, are the goals to get them off of a performance improvement plan? What is the purpose of this time together? 

Co-Creating the Supervisory Relationship

What do we need to know about each other? Is it important that I know that when you get overwhelmed, you take your dog for a walk? Is it important for my supervisees to know that I tend to talk in sports analogies, and sometimes if you are not a big football fan, that could be confusing? 

How do we learn each other in this place of being in relationship? In that place of building satisfactory supervisory relationships, it is about co-creating, it is about thinking through things together.

How are we going to define those roles? How do we want to set ritual and routine? How do we want to be able to navigate when hard topics come up, when, a supervisor has to challenge a supervisee because they missed something, or because they avoided something?

Basically, how are we going to navigate that together? What is it going to look like to really show up in those roles and expectations. Brene Brown in her "Daring to Lead" book talks about this idea of painting done, of being able to sit down with a team with a project, however that may be, and to say, “what would it look like if we painted done?”

So at the end, when our predetermined time, again, depending on the goal of this relationship, is finished, what do we  want to be able to say we accomplished? We are going to be together for six months, what are we hoping has been finished in that time together? What does it look like for you to show up and do that, and for me to show up and do that?

And so for, in that place, that co-creation of expectations, both the supervisor and the supervisee have very clear ideas of what they need to do to show up and paint done in this place. 

Ethical Considerations in Supervision

Within supervision, there are also a considerable number of ethical considerations. This is a place that I think, as supervisors, we get there for a couple of reasons. We get there because we have had longevity with an agency and we got promoted. We get there because we were good at our documentation timeliness, and so that meant we got promoted because we had pretty good oversight over things. Sometimes being able to supervise the next generation of professionals is something we have always wanted to do. Although, sometimes we get to supervisory positions, without a pretty thorough training process and what it actually means to step into those roles.

Identifying the Supervisor’s Role and Responsibility to the Larger Agency

There are a lot of ethical considerations to think about when we take on that additional responsibility, and some of those responsibilities and ethical considerations are going to vary based in context. If you are supervising interns, that is going to look very differently than if you are a consultant within an agency overseeing staff who maybe are employed with your agency, but you do not actually have any oversight over them. 

When we think about larger mental health organizations, it is not uncommon that the social worker who provides supervision may be within the adult unit, but they have got paid staff that they are providing licensure supervision for, that they do not oversee on a day-to-day basis, therefore they are not 100% familiar with how their workflow may be. So, what are the potential inherent difficulties based on the context in which we are providing supervision? 

So, within that, the first piece is, what is the supervisor's role and responsibility to the larger agency? 

Identifying What Information May be Taken Back for Annual Review or Performance Evaluation

Years ago, we had a staff where there were some real concerns around performance. The staff was not a social worker, and so we had to get outside consultation from somebody who did not work for our organization. 

The beginning conversation was, what do we need to know? What are the points at which, I really do not care if you talk about all these things, but what are the red flags? What are the points that the organization has to know about the content of what is going on in supervision? 

The answers to these questions have to be clear for both the supervisor and the supervisee. The supervisee must be aware that in entering into that supervision relationship (just like we tell clients these are the reasons I am going to break your confidentiality), these are the reasons I am going to call your employer.

These are the things that would cause me concern enough to talk about performance improvement plans and professional write-ups. We want to know what we are sending back for annual review, and also the things that need to go back more emergently. As well as the things that we would consider to be large ethical conflicts that someone needs to be notified immediately due to safety concerns. 

What Is the Crisis Plan?

Another ethical consideration is what is the crisis plan? Does the agency have a crisis plan where the supervisor is involved, or that is sound enough that the supervisor does not need to be involved? Is there a crisis plan that if this is a supervisor who is outside of the employing agency, that they know how to communicate that there has been a crisis, and that they know how to ensure that checks and balances around safety have been insured? 

Who is that supervisor's point of contact? How does all of this get navigated when a concern, especially around client safety comes up? If a crisis plan involves the supervisor in question, then what is the plan if the supervisor is absent? If there are expectations within an agency that you go to your licensure supervisor when there is suicidal ideation, what happens if your supervisor is out sick? How are we ensuring that everyone involved in the provision of services really is capable of doing that well to their own level of risk and liability?

How Will Ethical Dilemmas be Navigated?

The same thing comes up with ethical dilemmas. Ethical dilemmas are just that, the black and white things are never particularly difficult to solve. It is that place when we live in gray that things get complicated. If the supervisor has a concern that this is an ethical dilemma, how does that get communicated to the agency at large? What is the supervisee's relationship for taking up that ethical dilemma? What is the concern if not a social worker, but we had an intern who has agreed to go on a date with a client? Who gets notified about that? Who is the person who gets to call and tell the school? Who is the person who gets to have a conversation with the supervisee? Who is the person that gets to determine whether or not that is an ethical dilemma? How are we negotiating those things, and how do we have that written out so that everybody is aware on the front end of the beginning of that supervisory relationship?

Expressing Concerns About Work to the Supervisee

There will be difficult conversations about work. It was a difficult conversation with that particular supervisee about agreeing to go on a date. So how do we do that? How do we agree on the front end that part of growth means stretch, it means being pushed, it means that not everything is going to be comfortable the whole time? When those moments come, how are we going to navigate that? How are you going to accept feedback? What do you need to be able to hear the words that we have to say? What would be the place that we cross over from, "Let's talk about it," to, "I need you to listen?" We have to communicate those expectations in ways that are clear.

Summary

You have my contact information if you have any questions. I love to hear from people, so please know that. If you have any questions or anything that you have got curiosities about, do not hesitate to reach out. We did discuss a little bit in this presentation the role of race and equity and cultural awareness in a variety of settings, but if you want additional information, you can check it out on the NASW's website. 

Questions and Answers

What would you say, especially for a new practitioner, is the single most important benefit of supervision?

When I started practice years ago, and it has been years at this point, I think it was the idea that someone knew where we were going. It was that place of having that co-pilot. It is almost like getting your driver's license of somebody who could say like, "Oh, oh, you're going to turn up here," like, "Yeah, the road's bumpy, "but that is not because you ran over something "and flattened the tires." Like, that there was a guide there who could say, "I see where we are going even if you do not," and that I could really ask those questions to, that again, that place of acknowledging need and vulnerability is such a big deal, of being able to say, "Hey I got a thing, and can I get some support?" And generally, people are really eager to show up in that manner, and to really be those co-pilots who help us find our way.

As far as social workers who want to be in the role of a supervisor or want to provide supervision, do you have any resources, any books or anything you recommend, that a practitioner could use to strengthen their supervisory skills?

Absolutely, there is a book by Sherryl Scott Heller and Linda Gilkerson, it is a "Guide to Reflective Supervision." I adore that book. Really it is about that place of really slowing down and thinking about emotional processes. That book provides some concrete examples, and it is digestible. You can read the chapters independently and it is not going to take days and days to get through. The chapters are five to seven pages, so it is accessible and really does provide some scaffolding, because just as we are in this process of doing for, doing with, standing back, and admiring on supervisees, if you're a new supervisor, you need somebody who can do that for you, too.

So, I would definitely encourage that book specifically. I also think that it is really important for people to get supervision on their supervision. If you are just now starting out and this is your first time being in a position where you have got interns, administrative oversight, or whatever that may be, that you have got your own person that you are going to, to be able to ask those questions, to be able to think together about what might be occurring. Because we all need somebody in those beginning phases of developmental trajectories, wherever we are at.

Can you kind of speak to how supervision plays into the obligation of self-care for social workers?

I tell people frequently that my supervision is my self-care. I do not say that lightly. I have had the same supervisor for four years. This is somebody I meet with three hours a month. And again, part of that is my belief that you need supervision on your supervision, but it is the place that I know is predictable, that I know somebody is going to have my best interests at heart, and is not going to ask me for something. As social workers, regardless of where you are in the field, people come to you with a list of things, and so just like therapy provides individuals with a place where no one is going to ask something of them in return, supervision does the same thing for us.

There is a lot of conversation in the research around supervision as the idea of therapy on the work. It is not therapy on your personal stuff, it is not therapy on your relationships, or your healthy and unhealthy coping skills; but it is about the emotional process of what it is to show up and do the work in front of us. Therefore, that is self-care, to be able to identify and contain your emotional response, to have somebody to help you ground and gain perspective on the things that are occurring. Those are pretty big deals, especially when we look at the research and the impact of supervision on vicarious trauma and burnout and turnover.

References

Refer to the course handout for a complete list of references. 

 

 

Citation

Peak, A. (2021). Foundations of supervision in social work practice. Continued.com - Social Work, Article 119. Available at www.continued.com/social-work

 

 

 

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alison d peak

Alison D. Peak, MSW, LCSW, IMH-E

Alison D. Peak, LCSW is the Executive Director of Allied Behavioral Health Solutions in Nashville, TN. Alison has spent the majority of her career dedicated to two primary passions: integrated behavioral health services in primary care settings and Infant Mental Health. Alison is privileged to be a member of ZERO TO THREE 2020-2022 Fellows and to work alongside state and national colleagues to further Infant and Early Childhood services and workforce development.  Clinically, Alison is passionate about working with families with children who are adopted, who have histories of early trauma, and families with infants/very young children.



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