Clinical Supervision in Alcohol and Drug Abuse Counseling - Part 1


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Powerpoint presentation created by Nick Lessa on Clinical Supervision in Alcohol and Drug Abuse Treatment. Nick is the CEO of Inter-Care and Chat 2 Recovery. Intercare is an outpatient addiction treatment program in New York City and Chat 2 Recovery is an innovative online addiction treatment program. For more information, visit

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Clinical Supervision in Alcohol and Drug Abuse Counseling - Part 1

  1. 1. Presented by: Nick Lessa, LCSW, MA, CASAC
  2. 2.  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
  3. 3.  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
  4. 4.  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
  5. 5. A good supervisory relationship is one of the most satisfying aspects of the counselor’s work
  6. 6.  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
  7. 7.  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
  8. 8. Towards a Working Definition of Supervision
  9. 9.  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.
  10. 10.  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.
  11. 11.  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
  12. 12. “Clinical supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical, and supportive.”
  13. 13.  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
  14. 14.  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
  15. 15. 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.
  16. 16.  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
  17. 17.  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
  18. 18.  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
  19. 19.  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
  20. 20.  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
  21. 21.  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
  22. 22.  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
  23. 23.  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
  24. 24. 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
  25. 25.  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
  26. 26.  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
  27. 27.  Owners  Employees  Customers – most critical element of agency  Vendors  Competitors  The Community at Large
  28. 28. “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.”
  29. 29.  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)
  30. 30. 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
  31. 31. 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
  32. 32. Models of Supervision