7 Steps for Onboarding a Therapist Into Clinical Supervision
Originally published on April 10, 2018, and updated on January 27, 2022.
Clinical supervisors are lifelines for therapists. As a newly graduated therapist seeking licensure, my supervisors guided me in theory, practice, self-of-the-therapist matters, and more. I not only felt competent once I received my license, I felt confident.
I decided to become an AAMFT-Approved supervisor, and a supervisor for supervisors, because of the mentoring and valuable direction I received as a supervisee.
I know not all therapists have meaningful experiences in supervision, and many leave the process disoriented. We supervisors, despite having extensive training, also need ongoing support and resources to direct us as we navigate difficult cases and parallel processes with supervisees.
In this post, I cover a brief template for ensuring that you and your supervisee are starting your relationship with collaboration, understanding, and open communication.
1 | Make sure you and your supervisee are a great fit!
A face-to-face meeting, during which you and a potential supervisee get to know each other, is an important first step in learning if you should work together long-term. A supervisor-supervisee relationship, when the supervisee is seeking licensure, lasts at least two years. Of course, either party can terminate the relationship at any time, but certainly that is not the goal. An initial inquiry call can serve as a brief screening for when he supervisor and supervise may not be a great fit, and a face-to-face meeting can be reserved for potential supervisees who are a great match, and you believe will benefit most from your supervision.
2 | Describe how you work
Make sure to explain your theoretical orientation, supervision style, as well as how you handle ethical concerns and professional gatekeeping responsibilities. Supervisee therapists may not fully understand the collaborative and "authoritative" responsibilities of the supervisor role, or how these are navigated between supervisors and supervisees.
3 | Assess supervisees' desired outcomes
Invite potential supervisees to explain their goals for supervision, or to come to your initial meeting with ideas for what they'd like to learn or accomplish via supervision. This invitation serves two purposes—you, the supervisor: 1) become familiar with the supervisees' desired outcomes for superivison, and 2) give the supervisee an experience of being self-directed in your collaborative relationship.
In order to balance a supervisee's goals with what I offer during supervision meetings, I have found it helpful to set an agenda in the first five minutes of each meeting. I write down the agenda, and we move from item to item. If the conversation leads to an item not on the agenda, I ask supervisees how much time they'd like to spend on the topic, and/or if they'd like to replace an agenda item. In this way, the supervisee is responsible for the agenda, and I am responsible for keeping our meeting on track. There are many ways to master the "battle for structure" in supervision; this is a simple habit that has worked for me.
3 | Discuss the supervision timeline
State statutes explain the minimum amount of time therapists must be in supervision for their licensure process, as well as the ratio of client hours per supervision hours they must accrue. Each state may also have regulations that are specific to the state. For example, in Florida, the board requires registered interns to remain in supervision until they are licensed, even if they have already met all clinical hours; in New York, pre-licensed therapists must register for a “limited permit” to practice, and must be employed as W2s for the entirety of their pre-licensed clinical experience.
Supervisee therapists aren't typically aware of the state requirements governing the supervisor-supervisee relationship, including the length of the supervision relationship. Some may also not know of additional options that exist for supervision, such as changing supervisors and participating in group supervision. Providing this information orients supervisees to the supervision process and emphasizes the commitment required for pursuing licensure.
If supervisees plan to use additional supervisors, clarify your role as a supplemental or main supervisor. In some states, the main supervisor is required to send a letter to the state board in order to register as the supervisor of record.
4 | Create a plan for solving a grievance
Most supervisors and supervisees do not enter into a relationship with the expectation that they will have a disagreement. However, disputes can happen. While these may involve differences in clinical perspectives, they are also often related to the presence of a dual relationship between supervisors and supervisees. Some examples of dual relationships include having an established friendship with the supervisee, serving as both the private practice "boss" and license supervisor, renting space to the supervisee, among others. In order to prevent grievances, take necessary precautions to prevent, or end, a dual relationship.
Create an initial contract that includes steps for solving a grievance. The AAMFT includes a "plan for handling stumbling blocks" and disagreements in their sample supervision contract. I offer a mediation process in my contract, allowing the supervisee to choose a third party in the event of a dispute.
5 | Explain approved topics for supervision
If you are a state qualified supervisor, consult with your state on approved topics for supervision. Generally, supervision must be focused on the development of clinical skills necessary to provide ethical, effective psychotherapy. Business topics, staff meetings, and peer supervision do not qualify as approved supervision. For specifics regarding AAMFT supervision, see the Approved Supervision Designations Standards Handbook.
6 | Understand differences between disciplines
In a recent consultation with a supervisor candidate, I explained some differences between the counseling field (ACA) and the marriage and family therapy field (AAMFT), and how these fields hold different assumptions. The candidate was struggling to understand her supervisee's clinical conceptualization. The candidate was a COAMFTE graduate, and the supervisee was a CACREP (couple and family therapy) graduate.
Once the supervisor understood the differences between these orientations, she was able to adopt a different stance with her supervisee, because it put their differences in context.
I supervise both mental health/counseling and marriage and family therapy interns, and while my style remains consistent—I practice and supervise from a systemic orientation—it's essential that I understand the mental health field in order to guide supervisees in developing a style that incorporates both their training and a larger systemic framework.
Early in your supervisor-supervisee relationship, discuss with your supervisees their training background. This is especially important if you supervise across disciplines. It is also becoming important for supervisees seeking the marriage and family therapy license, because both CACREP and COAMFTE graduates meet most states' requirements for the license. Take the time to learn from where supervisees graduated, as well as their program's accreditation. This will give you ongoing insight into their perspective, as well as how to partner with each supervisee in ways that enhance their clinical work.
7 | Ask for feedback.
The AAMFT sample supervision contract also includes a section for planning how you and your supervisee will provide feedback to one another. Whether or not you are governed by the AAMFT, consider creating a plan for feedback; it contributes to building a trusting superivsor-supervisee relationship. Providing and requesting regular feedback also establishes feedback as a comfortable process within supervision.
I ask for feedback at the end of every meeting, in order to make immediate shifts when necessary. Typically, at the end of every supervision session, I ask, "What's one thing from today's meeting that will make a difference in your work in the coming week(s)?", or a variation of this question. As a result, the meeting ends for the supervisee therapist, and for me, on a positive note. I also may ask "Is there anything I can offer to make our next meeting more meaningful to you?"
Summary
When supervisors have a process and are well-prepared from initial contact through initial meeting with potential supervisees, it sets the stage for a collaborative and open relationship. While supervisees are responsible for managing their learning and desired outcomes for supervision, supervisors are responsible for orienting supervisees to the process of supervision, protecting supervisees from dual relationships, and keeping supervision meetings on track. A specific onboarding process ensures that both supervisors and supervisees are on the same page for the ongoing supervision relationship.
I've created a Supervisee Onboarding Checklist to help you stay on track. Grab the download in the free resource library.
Let's Chat
Let me know in the comments below:
If you are a supervisor, what can you add from this list to your onboarding process? What do you already do that I could add to this list?
If you are a supervisee or potential supervisee, what one question, plan, or process would help you feel oriented to the supervision process?