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Trying to find that elusive great clinical supervisor? Supervisor refuses to sign forms, APC who violates boundaries….good LPC supervision in Georgia defined. Here are answers to your burning questions and suggestions for avoiding unethical supervisors.
“Eric was a fantastic supervisor. He prioritized my own professional and clinical growth and agency throughout our relationship. I felt comfortable bringing up and receiving supervision on my thorniest and most difficult struggles and dilemmas feeling secure that he had both the knowledge of the ethical and legal obligations and also the mindset and professional skills to help me fulfill both my obligation to my clients and my own obligation to my professional growth without compromising either. I would easily recommend him to others who are seeking a supervisor skilled in helping them navigate the bureaucratic elements of the counseling profession AND figuring out the boundaries and clinical elements of the therapeutic relationship.” -Girish Kumar Krishan
Difference between your supervisor boss and clinical supervisor.
Director V. Supervisor
In most states, a distinction is made between your boss and clinical supervisor. Your boss enforces employer policies and disciplinary procedures and can hire and terminate employees. They might not involve themselves directly in your counseling skills development. Some states such as Georgia does not require they be licensed. In fact, no level of education is specified. Georgia views your supervisor boss as whoever that employer chooses to manage their employees.
As stated in Georgia Board Rule 135-5-0-.01(a) 4:
“Supervision means the direct clinical review, for the purpose of training or teaching, by a supervisor of a Professional Counselor’s interaction with their client(s). The purpose of supervision is to promote the development of the practitioner’s clinical skills.”…
On the other hand, it is the role of the clinical supervisor to develop and have direct oversight of your psychotherapy skills and management of ethical practice.
In Georgia, boss and clinical supervisor are defined as “Director” and “Supervisor” respectively– Director because they direct your work activities and Supervisor because they oversee your clinical work.
In some states, it is assumed that your clinical supervisor is the person who employs you.
Who cannot be your supervisor?
Conflicts of Interest/ Dual Relationships
There are important exceptions to who can be your supervisor. Most states including Georgia, prohibit certain dual relationships. The most common is that a supervisor cannot be a family member. Some boards for example the Missouri Committee for Professional Counselors has written into rules that LPC supervision by certain non blood extended family members is prohibited.
There are also supervision relationships while not prohibited, can devolve into legal catastrophy for both supervisor and supervisee.
Choosing an LPC supervisor that is right for you.
Your supervisor will interview you. You should also prepare questions for them. You might explain that you understand the six important 6 dimensions (below) are important for understanding how they will supervise you. Ask them which dimensions they place the most emphasis.
You can even ask them for a rough percentage breakdown of the 6 dimensions. They may describe their work in a different manner, but asking them these questions will invariably be a step further towards having a meeting of the minds.
Can your boss be your clinical supervisor?
Again, theoretically if your state accepts them as an approved supervisor the answer is yes.
Who Governs Supervision Requirements?
State Licensing Boards
Ultimately, state government. Specifically, subdivisions of state government that regulate businesses and professions. Issuing and determining these requirements may be regulated by the Board of Health, entities created solely for licensing purposes or other commissions. They are referred to as licensing boards. This can apply to all professions including medicine, nursing, massage therapy, dental hygienists and so on. And they also apply to all matters of maintaining your license including ethics and continuing education.
In addition, state licensing boards often involve independent professional associations in creating licensing requirements. An example is LPCAGA, the Licensed Professional Counselors Association of Georgia. These associations represent and serve their licensees and membership– you pay for annual membership, they provide you benefits and services. Other professional are NBCC, AAMFT, NASW, and APA.
Since psychotherapy is a specialized area of healthcare, licensing boards members are often licensed mental health professionals.
Definition of LPC supervision.
Supervision is defined by Powell, D. & Brodsky A. (2004) states as “Clinical supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical and supportive.”
In order to be licensed in most states to perform psychotherapy, state licensing boards require a minimum masters level education and additional supervised experience after all degree requirements have been completed.
(In some states there are broad exemptions under the law for faith-based counselors (see page 6). Whereas these counselors cannot imply or advertised they are licensed, they are permitted to perform psychotherapy.)
With the exception of these exemptions, since psychotherapy is a form of healthcare treatment, state boards and the mental health profession assume that a graduate school education is not sufficient to qualify one to provide psychotherapy.
This is not only true for licensed professional counselors, but social workers, psychologists and marriage and family therapists, and other mental health professionals.
Supervised experience essentially means, “Now that you have completed graduate school you need X number of years or hours of guidance and professional development by a more experienced fully licensed peer while you are practicing at your mental health job. This process then prepares you to practice independently.”
Methods of LPC Supervision
Theoretical Orientations To LPC Supervision
I will not elaborate on the numerous theoretical approaches to supervision as these are better described elsewhere. Instead, since professional and personal compatibility are critical, I present these orientations in a manner which will aid in knowing what to expect with various supervisors.
A clinical supervisor approaches reflect their:
• personal values and attitudes.
• beliefs about how to approach psychotherapy.
• preferred methods of education
• perception of roles of the supervisor and supervisee.
• beliefs about necessary level of oversight of the supervisee’s counseling work.
• beliefs about what their role should be in the professional community at large.
• beliefs about autonomy.
• beliefs about their use of power.
A supervisor’s approach also evolves from their level of confidence.
Supervisory Styles and Dimensions
First, whereas there are activities of clinical supervision that are administrative, in all 50 states a clinical supervisor is usually required to also focus on development of the supervisee’s clinical skills. The following are 6 dimensions of clinical supervision. Together, they provide an overall picture of interventions used by a given clinical supervisor.
In addition to teacher / student , the relationship between a supervisor and supervisee is a peer relationship. You are equals. For example, in Georgia an APC (associate professional counselor) is licensed and has the same scope of practice under the law including APCs in Georgia can diagnose with the exception they must work while under direction and clinical supervision.
You are two licensees who have each made a legal agreement with the board to abide by all applicable law and rules.
A mentoring relationship is a relationship of equals where one is an eager pupil who submits to an experienced and wiser therapist. Supevisees have clear responsibilities under board rules–know and understand them.
It is also understood that the mentor does not have all the answers or solutions to a student’s questions. Both understand and respect that the mentor also is in a constant state of learning.
Example: Supervisor A: Views their role as engaging your participation and involvement in decision making. Expects you to make most decisions. Is comfortable working with supervisee mistakes and blunders. Is comfortable helping a supervisee develop an area of expertise that may be beyond the supervisor’s expertise.
Supervisor B: Is comfortable with a more didactic instructional approach. Expectations are that the supervisee implements all recommendations. Supervisee prefers to defer to supervisor for most decisions and desires clear instructions.
Evaluation comes in many forms.
1) Formal written feedback on clinical work.2) Verbal feedback on clinical work.3) Feedback designed to propel and challenge the supervisee that is guided by evaluation.4) Other feedback based upon direct observation.
Supervisor A: Is also comfortable with informal and fluid verbal feedback which prompts the supervisee to reflect and discover solutions that work best.
Supervisor B: Prefers use of objective measures in evalution of LPC progress.
Use of Authority
Specifically, the use of sapiential authority. This type of authority differs in that it is not the use power in a non-consensual manner. It requires from the supervisor:
1) ability to work with decisively and with conviction.
2) wisdom both personal and professional.
3) confidence in their ability as a therapist and supervisor.
4) an awareness of their own strengths and weaknesses.
Supervisor A: Uses wisdom and experience in a manner that conveys confidence and uses a power of suggestion.
Supervisor B: May be more inclined to active intervention and assuming control in challenging situations.
Research and conventional wisdom differ regarding the use of psychotherapy in supervision. Some believe it is a boundary crossing and personal therapy should be handled by the supervisee’s therapist. Others believe it is a tool for the supervisee’s personal and professional growth.
There is general agreement that supervision should not BE psychotherapy. Some view psychotherapeutic techniques as essential since they facilitate awareness transference and countertransference which is fundamentally related to managing boundaries with clients and that ultimately it helps the supervisee develop ethical practices.
Supervisor A: Explores intrapersonal supervisee issues in the same manner as they would with a client in therapy.
Supervisor B: Errs on the side of referring the supervisor to their therapist for all personal issues.
Active Intervention and Decision Making for the Supervisee
There are times when a supervisor believes they need to exert power and require you take action in some instances. For example, dealing with an acutely suicidal client or terminating a client where there is a clear conflict or dual relationship.
Supervisor A: Is comfortable allowing supervisee to take more risks and make mistakes.
Supervisor B: Believes that learning can best be supported by taking proactive measures to prevent the supervisee from causing injury to the client.
Gatekeeping refers to a supervisor’s responsibility to the profession that may conflict with their responsibility to you. For example, an ethical dilemma in which the supervisor believes a licensing board should be notified of either your situation or an unethical situation of which you are aware.
Supervisor A: Views their role as providing a service to the supervisee and their primary obligation is to the supervisory relationship.
Supervisor B: Seeks to eradicate poor quality or incompetent supervisees from the profession and that serving the profession first and foremost serves the best interest of the public at large.
State to State Requirements.
This List of All 50 states licensing requirementswill be helpful.
In Georgia, an individual with a masters degree in professional counseling is required to obtain 3 years of post masters supervised experience. This includes 3000 hours of employment while simultaneously completing 105 supervision hours from a board eligible supervisor. Half of the license applicant’s supervised experience must be provided by a board eligible LPC supervisor. Detailed requirements can be found at the Georgia Composite Board of Professional Counselors, Social Workers and Marriage and Family Therapists web site.
To illustrate how much they vary, some states LPC supervision and licensing requirements range from:
1) The Nevada Board of Examiners for Marriage and Family Therapists and Clinical Professional Counselors requires a minimum number of hours delivering direct clinical care.2) The Iowa Board of Behavioral Sciences requires a specific maximum percentage of supervision hours that can be obtained, online or electronically.3) The majority of state boards including the Louisiana State Board of Professional Counselors set out in board rules all supervisor training requirements or have recommended or board approved private training organizations. 4) The Wisconsin Dept of Safety and Professional Services LPC license requires no specified number of years post masters–only required hours.
Requirements for becoming an approved LPC supervisor.
Again the requirements range widely and could be any of the following.
1) An approved supervisor only needs to demonstrate minimal clinical experience.2) An approved supervisor must hold a state issued credential.3) Of 50 states, only Georgia’s board requires a supervision credential issued and maintained by one of two professional associations, The Licensed Professional Counselors Association of Georgia (LPCA) and The National Board for certified Counselors (NBCC).
Who can be your supervisor?
Theoretically, any board approved supervisor could provide your clinical supervision.
Finding an LPC Supervisor in Georgia
How do I find a LPC clinical supervisor in Georgia? How do I choose a supervisor that is a good match? How can I ensure I find the best supervisor for me?
These are questions every new therapist confronts in their mental health clinical work. I provide local and distance clinical supervision for LPC and consultation with fully licensed clinicians who are facing difficult ethical dilemmas.
Essential Supervision Skills
While on the Composite Board, for six months in addition to the LPC complaints, I handled all of the Social Worker and Marriage and Family Therapist consumer complaints. As an Atlanta CPCS and national ACS Supervisor I have been exposed to many clinical, legal, and ethics issues related to practicing psychotherapy.
Your supervisor should be able to help you work through ethical dilemmas. They should also know how to distinguish ethics from legal matters and refer you to an attorney when needed– learn how to avoid incompetent supervisors.
Even though you may not work in a psychiatric hospital or residential treatment program, your supervisor should have broad experience in clinical mental health including residential facilities.
Areas of competence include severe depression and suicide, addiction, traumatic stress–all of those areas that can be frightening for new therapists–your clinical supervisor should be able to work confidently and with conviction on complex clinical issues.
My Model of Supervision
Balancing Low Structure and High Structure in Supervision
There are many models of supervision. A key concept is high versus low structure. Each has their advantages. The advantages of high structure in supervision is that by erring on the side of caution, the supervisor has greater day to day control of the therapist’s activities. The advantages of moderate structure are ability to take risk and make decisions on their own.
This pie chart describes the role of structure in my supervision. Whereas there is a structure in evaluation and feedback, gatekeeping has a minor role. The struggle of most new therapists is problem solving and self confidence and moderate structure promotes development in those areas.
Combined Authority and Mentoring
My supervision is a hybrid of mentoring and authority. Authority doesn’t refer to claiming to know everything. In fact, expect that you will have knowledge in areas I do not. It is referred to as sapiential authority and involves asserting conviction in helping you because I am experienced in clinical aspects of psychotherapy and ethics.
Through experience, I can often provide clarity on clinical and ethical dilemmas efficiently. And quickly. I have managed many high risk clients and can make this much less overwhelming for you. I combine this with a mentoring and coaching approach. Directed experience under supervision need not be frightening.
All of us have “blind spots”. Whether in our personal lives or as professionals. Sometimes we struggle to find a solution to an ethical dilemma or a clinical intervention with a client. Often we learn it is because we have a blind spot. This partly owes to countertransference. As therapists, we are mindful of countertransference as an obstacle- or facilitator- of change with our clients. In a supervisory relationship, we apply the same principles to promote professional growth within our supervisees.
Psychotherapeutic techniques therefore are an important role in therapist’ development. Not psychotherapy per se, but applying the principles of it.
The manner of evaluation I employ is as much critique as a tool for helping you become a better and more confident therapist. I will provide you both formal written and real-time verbal evaluation. You will view and participate in all of my written documentation and evaluation of your work.
How much can I expect to pay for LPC supervision?
Or simply, how much is clinical supervision to get my LPC license. Fees for private individual supervision in the Atlanta area range from $100- $150 per supervision session. Some may charge more, some less but these are good approximations. My fees range from $90-$120. I also provide LPC telesupervision / LPC distance supervision.