Clinical Supervision

Danielle Burns, a Licensed Clinical Social Worker and Doctor of Philosophy, brings a rich perspective to her role as a Clinical Supervisor. Her work involves collaborating with Quality Management team members, Directors, and Program Managers to support staff and maintain an integrated, trauma-informed treatment process for children, youth, and adults with co-occurring mental health and substance use conditions. Let’s delve into the key aspects of her approach:

Systemic Thinking: Danielle views clinical supervision through a systemic lens. Rather than seeing participants as isolated individuals, she considers the interconnectedness of all parts. Systemic thinking acknowledges that each part relates to others, creating a complex whole. It emphasizes understanding the dynamics within the system.

Participant Experience: Danielle recognizes that participants’ subjective experiences matter. The act of participation itself informs and shapes understanding. Systemic thinking allows her to explore hidden thoughts, feelings, and meanings beneath the surface, illuminating the richness of human experiences.

Goals and Purpose: Participation aims to foster shared meanings and relationships among staff. Danielle supports unlicensed staff and BBS-registered trainees. Her commitment extends beyond training; she actively engages in evidence-based practices, quality improvement, and knowledge dissemination.

Supervisory Roles: As a supervisor, Danielle wears multiple hats: mentor, coach, teacher, and administrator. She values relationships and employs reflective supervision and consulting to generate fresh ideas. The parallel process—the supervisor’s relationship with the worker—remains central.

Reflective Practice: Reflective supervision weaves throughout the process. It helps participants gain deeper insights, analyze complex situations, and explore their own possibilities. Danielle combines reflective and collaborative practices, fostering self-awareness and professional growth.

Sensitivity to Context: Danielle’s model embraces neurodiversity. She recognizes cognitive differences as part of natural biodiversity. Her supervision environment is flexible, strength-based, and accommodating, considering individual contexts and changing circumstances.

Ethics and Legal Factors: Ethics and legal issues are integral. Danielle uses an ethics genogram to examine ethical and legal aspects of clinical cases. The parallel process—where the supervisor acts as the therapist—ensures high professional standards and client well-being.

In summary, her approach embodies a holistic, systemic approach to clinical supervision, emphasizing relationships, self-reflection, and ethical considerations. From that stance, systemic thinking includes anything that is directly correlated with participants involved in the supervision process. Centering on the concept of wholeness and the sum of all parts, each part relates to all other things and creates a complex mixture.

Systemic thinking also relies on the individual’s subjective experiences and direct encounters. From that understanding, the participation process alone is a way of being informed, a way of knowing. Systemic thinking offers an attitude and approach geared toward reflecting on that which is, as it is. It provides an epistemological approach and ontological perspective on all things that are recursively connected to subjective experiences. The changes in one part that effect changes in all other parts can be the relationship parts that are still unknown. This is particularly relevant to human interactions that accentuate the nature and meaning of experiences in phenomenological and psychotherapeutic terms.

As practitioners, we want to understand what goes on inside the minds of our participants. We want to explore their feelings, perceptions, senses, intuitions, knowledge, and behaviors. To these points, Danielle defines the essential nature of systemic thinking, eschewing all variants, as that which enables a participant to fully capture the inward memory, image, and meaning of an experience that both enhances knowledge, but also illuminates understanding and the self of the participant.

Understanding the depths of a participant's personal experience is important to the meeting process and how it can be used to depict situations, conversations, events, relationships, values, and beliefs through detailed descriptions of direct first-person accounts. Thoughts and feelings influence each other in systemic and systematic contexts. What goes on inside the mind of one individual may also interact with another individual’s personal experience, and in that context of the various systems, subsystems, and relationships among the contextualized parts, the meeting process uncovers the meaning of human experiences through self-reflection and self-exploration.

Purpose and Goals for Participation and Supervision

The purpose of participation is to foster shared meanings and good-enough relationships that support the work of all staff. Therefore, these goals for participation include providing a clear understanding of the things that characterize effective couple and family therapy or relational processes. Participation goals are based on the distinction between education and training, whereby participants dictate to some extent the training contexts influenced by the requirements of governmental and organizational accrediting bodies, theoretical orientations and philosophies, developmental levels and contexts, and the theoretical approaches that they are learning.

Within her role, Danielle provides support to unlicensed staff and to Board of Behavioral Sciences (BBS) registered MFT Trainees, AMFTs, ACSWs, and APCCs. She works hard to explore and research evidence-based practices and to spread best practice outcomes to other cohorts using Continuous Quality Improvement (CQI) methods and procedures. Her intention is to spread knowledge throughout the system to further inform the research and quality of improvement processes. This highly reinforcing style of engagement provides an equally enriching learning experience and actualizes practitioner potential. Utilizing reflective supervision, clinical supervision, and experiential learning approaches, Danielle's intention is to help participants learn new skills, improve competencies, and to work with licensed practitioners as change agents through relationship alliances, finding their own voices, and teaching others to do the same. This also includes overseeing the quality of care for clients as well as the development of the self as the process unfolds.

Supervisory Roles and Relationships

Education in this context is about acquiring a knowledge base for participants to determine the goals that help them move toward increased competence and self-awareness. Having said that, participation encompasses the whole of the self of the participant. These roles include mentor (professional competence and specific situations), coach (clinical competence and specific situations), teacher (clinical competence, general topics, and theoretical or approach-level competencies), and administrator (professional competence and general topics).

Relationships are essential to these practitioner values, clinical relationships, and supervision philosophy. For that reason, Danielle utilizes both reflective supervision (RS) and consulting in the mental health setting to render new ideas. Reflective supervision is a collaborative, relationship-based approach to professional development with an emphasis on reflection. The relationship existing between the practitioner and participant, and the parallel processing of the supervisor's relationship with the worker represents an important focus of the process. Neglect of this aspect of supervision renders other aspects of supervision, such as theoretical approaches or specific interventions, ineffective. The relationship must also be continuously monitored and cultivated.

Reflective supervisors evaluate trainees’ skills, competencies, and potential at the beginning of the supervision experience. The purpose here is to 1.) determine whether a supervisory relationship is appropriate and 2.) determine what skills and competencies may require further development. Screening includes some determination of “fit” between the supervisor and worker in terms of philosophical approach to therapy, desired goals, working style, and personal sense of fit.

Personal and Professional Experiences in Reflective Supervision

Reflective practice developed as a way for educators, practitioners, and social workers to learn from real life experiences. Reflective practitioners think over their encounters with students and clients, analyzing how something was carried out, and how practice might be improved for better learning outcomes. Some points of consideration in reflective practice are: 1.) why the practice is being studied, 2.) and how well the student is receiving the information to promote various resilience, improve safety, and reduce harm to clients.

Reflective practice is interwoven throughout the supervision process to help participants gain a deeper understanding, to make judgements about theoretical interpretations through small group meetings, role playing, storytelling, art, music, film, and portraiture. Reflective and collaborative practices combined creates an environment wherein supervisees cooperate by sharing experiences, taking on different perspectives through learning, and becoming aware of their own possibilities in terms of professional standards, gender, language, ethnicity, and how these impact the therapeutic process.

The goals here are threefold: 1.) to understand how knowledge and perceptions fit into a therapy, 2.) to understand how reflective supervision can be used to identify specific interventions for clients and 3.) to identify supervision principles that promote achievement of desired organizational outcomes. Conflict in the supervisory relationship often results from vicarious trauma, compassion fatigue and burnout when overlapping roles are embedded in larger systemic environments. Navigating supervisory relationships through these systems is not always easy. Organizational settings are informed by the diverse needs for safety and wellbeing in supervision parallels. This may result in some supervisors being unnecessarily directive or do therapy through their participants. This may be a way of helping a participant experience a particular intervention and its consequences.

Preferred Therapy Models and Approaches

Relationship aspects fall on a continuum of directive to collaborative. Danielle's thinking about supervisory models helps to view this notion in a different and broader context. Common factors are believed to cut across all dimensions of supervision: 1.) emphasis on clinical materials versus professional development; 2.) specificity or focus on specific clinical case concerns versus more general therapy concepts, philosophy, or context; and 3.) the nature of the supervisory relationship as collaborative versus hierarchical. Similarly, this supervision model recognizes the parallel process in the supervision model as useful with supervisees who want to think about and analyze complex situations. Danielle is a facilitator, thereby promoting ownership of the decisions by a supervisee. She develops a shared understanding of the knowledge base, a container for the supervisees’ emotional responses, and provides the space and context for exploring the factors influencing their practice decisions.

Sensitivity and Attention to Contextual Factors

Differences between individuals in the training context, and between the training context and larger communities, are important to consider. Danielle explores how influences, experiences, and orientations shape the way that people view the world and act within it. Neurodiversity is the concept that different cognitive styles exist as a natural and essential part of biodiversity. The term includes, but is not limited to, cognitive differences such as, attention deficit hyperactivity disorder (ADHD), dyslexia, obsessive-compulsive disorder (OCD), Tourette Syndrome, bipolar, anxiety, brain injury, and other mental health conditions.

Her participation model affords sensitivity and attention to the contextual factors that involve professional, lifelong learning goals, and those that include attention to, acceptance of, and respect for individual neurodiversity differences throughout the supervision, treatment, and training systems. The differing contexts and changing circumstances of individuals on the developmental spectrum requires a supervision environment that is flexible, strength based, solution focused, reflexive, and accommodating.

Preferred Relationship Processes

It is particularly important to establish the relationship as a two-way process. Danielle prepares a contract to specify the process and ensure that supervisees are prepared for the developmentally appropriate case consultation; integration of theory, assessment, and technique; increasing emotional awareness, acquisition of self-evaluative skills, and cultivation of social support; social learning, and professional standards, per the contractual agreement.

Her supervision contract specifies that supervisees complete summary case notes for the cases they wish to discuss. It identifies how to support supervisees as they begin to work through their concerns in supervision settings; personal issues processed in dyadic supervision may be taken into the group setting (with permission) to inform the work there. Protocols are developed and administered for case consultation and feedback so that training information can be shared responsibly and so that issues raised in group settings inform what takes place in the dyadic work.

Ethics and Legal Issues

Ethics and legal issues should be a part of all graduate and postgraduate training, both in the abstract, and as they relate to clinical cases. Therefore, a shared understanding of what constitutes one’s own values, ethics, and personal perspectives regarding clinical therapy is supported. An ethics genogram is used in supervision to examine the ethical and legal factors associated with clinical cases and includes the parallel process. The parallel process is an approach used in clinical supervision between a therapist and their supervisor in which the client's experience is recreated in therapy, with the therapist acting as the client and the supervisor acting as the therapist. Danielle's model provides a systemic understanding of the factors impacting the case and work of supervisees. Her contextual lens enhances decisions having to do with factors other than laws and regulations that are fundamentally important to ensuring the highest possible professional standard to do no harm to clients.

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