Supervision Blog

Aspects of being a good enough clinician includes:

• Self awareness and self insight

• Deep and active listening

• Empathy and compassion

• Training, skill and experience

• Management of counter transference (how to handle moments of overwhelm and discomfort in session when things get stirred up inside of us)

• Management of biases and limitations

• Having a strong foundation in how change occurs / a theoretical orientation

• Adhering to professional boundaries

• Deliberate practice

• Humility

• Respect and engagement with difference

• Openness and flexibility

I encourage all supervisees to be engaged in their own healing work and therapy.

Being a clinician, especially in the early stages, can activate many of our wounds and areas of pain/discomfort and having ongoing/regular support is necessary.

Therapy can offer us more self awareness, self insight, emotional capacity, and ultimately accept and/or change the patterns that no longer serve us.

While supervision will have therapeutic aspects, I cannot provide you therapy.

Good Fit For Those Who Prefer A Supervisor Who:

• Is direct, engaged, authentic, and relational

• Emphasizes the relational aspects of supervision

• Spends time exploring my personal feelings and responses to my work (counter transference)

• Emphasizes the importance of self-awareness, personal thoughts, and personal feelings in my development

• Has extensive personal experience as a practitioner and shares from that experience (successes and failures)

• Encourages my independent functioning and decision-making ability

• Challenges me to integrate ideas and information from a number of different sources

• Evaluates my success based on mutually determined goals and objectives

Poor Fit For Those Who Prefer A Supervisor Who:

• Is more objective, more neutral, and passive in session

• Gives detailed instructions as to how the work should be done

• Provides them a steady flow of client referrals if in private practice (supervisee must be willing to put in weekly hours to learn marketing, networking and how to run a business)

• Makes most of the decisions

• Expects me to learn by watching how they do the work

• Emphasizes the task aspect of the work

• Gives very specific instructions and feedback for any changes

• Closely monitors my work

• Micro manages

• Strictly and rigidly follows rules and procedures

Check application processing times here.

Washington State Department of Health - Provider Search (Verify License)

Click here and here.

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WAC

• Regulations of executive branch agencies are issued by authority of statutes. Like legislation and the Constitution, regulations are a source of primary law in Washington State. The Washington Administrative Code (WAC) codifies the regulations and arranges them by subject or agency.

RCW

• The Revised Code of Washington (RCW) is the compilation of all permanent laws now in force. It is a collection of Session Laws (enacted by the Legislature, and signed by the Governor, or enacted via the initiative process), arranged by topic, with amendments added and repealed laws removed.

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Other relevant RCWs are:

• Chapter 19.68 RCW - Rebating By Practitioners of Healing Professions

• Chapter 18.130 RCW - Regulation of Health Professions – Uniform Disciplinary Act

• RCW 26.44.030 - Abuse of Children and Adult Dependent Persons

• Chapter 34.05 RCW - Administrative Procedures Act

• Chapter 42.56 RCW - Public Records Act

• Chapter 70.02 RCW - Medical Records-Health Care Information Access and Disclosure

• RCW 70.225.020 - Prescription Monitoring Program

• Chapter 74.34 RCW - Abuse of Vulnerable Adults

• Chapter 71.05 RCW - Mental Illness

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Other relevant WACs are:

• WAC 246-12 - Administrative Procedures and Requirements for Credentialed Health Care Providers

• WAC 246-15 - Whistleblower Complaints in Health Care Settings

• WAC 246-16 - Standards of professional conduct

Educator & Teacher

• Aids in development of counseling knowledge and skills by identifying learning needs, determining counselor strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth.

• Supervisors are teachers, trainers, and professional role models.

Consultant

• Provides case consultation and review, monitoring performance, counseling the counselor regarding job performance, and assessing counselors.

Support & Coach

• In this supportive role, supervisors provide morale building, assess strengths and needs, suggest varying clinical approaches, model, cheer-lead, and prevent burnout.

• For entry-level counselors, the supportive function is critical.

Mentor

• The experienced supervisor mentors and teaches the supervisee through role modeling, facilitates the counselor's overall professional development and sense of professional identity, and trains the next generation of supervisors.

Effective supervision depends on a variety of factors including:

• A good fit between supervisor and supervisee (personality, temperament, values, communication styles, etc.).

• Consider what your preferences are in a supervisor and what makes you feel comfortable (age, ethnicity, race, gender, sexuality, ability, etc.) as this can be a good starting point.

• Discussing boundaries, expectations, and ground rules in the beginning and ongoing to avoid miscommunication, misunderstandings, and unmet needs/wants.

• A strong collaborative supervision relationship based on sharing power, shared values, making meaning, empathy, direct communication, and more.

• Balance between support and challenge, validation and constructive feedback, etc.

For Supervisors

• An active listener

• Open and curious

• Open to feedback and toward growth

• Has a beginner’s mind and is open to learning and growing vs. thinking they already know everything

• Provides direct, helpful, and specific feedback

• Adaptable and flexible

• Understands how power, privilege, and difference shapes the supervision relationship and dynamics and brings this up

• Honest when they are unable to help the supervisee and offers resources or connections to other contacts/people

• Repairing ruptures and disagreements as they arise

• Regularly attends training and education on providing effective supervision

• Understands the role of a supervisor

• Adheres to their profession’s code of ethics

• Offers a consistent schedule for supervision meetings and offers backup when they cancel, are ill, and/or on vacation

For Supervisees

• Ready to discuss topics

• Open and curious

• Open to feedback and toward growth

• Has a beginner’s mind and is open to learning and growing vs. thinking they already know everything

• Provides direct feedback

• Asks for what they need

• Does the work outside of supervision

• Is honest with themselves through self-reflection and self-understanding

• Practices self compassion

• Understands the role of a supervisee

• Adheres to their profession’s code of ethics

• Attends supervision as agreed upon and notifies when they will be absent due to illness or vacation

• To protect clients from harm and ineffective therapy

• To provide a third ear or outside perspective on client cases

• To help therapists do their best work with clients through refinement of skills, orientation, and interventions

• To help therapists with the basics of psychotherapy (ethics, documentation, diagnosis, risk assessment, ending/termination/discharge, skills and interventions, treatment planning, etc.)

• To help therapists become more competent and confident as they become independently licensed

Definitions

• “Supervision is a disciplined, tutorial process wherein principles are transformed into practical skills, with four overlapping foci: administrative, evaluative, clinical, and supportive” (Powell & Brodsky, 2004, p. 11).

• “Supervision is an intervention provided by a senior member of a profession to a more junior member or members. … This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s); monitoring the quality of professional services offered to the clients that she, he, or they see; and serving as a gatekeeper of those who are to enter the particular profession” (Bernard & Goodyear, 2004, p. 8).

• Supervision is “a social influence process that occurs over time, in which the supervisor participates with supervisees to ensure quality of clinical care. Effective supervisors observe, mentor, coach, evaluate, inspire, and create an atmosphere that promotes self-motivation, learning, and professional development. They build teams, create cohesion, resolve conflict, and shape agency culture, while attending to ethical and diversity issues in all aspects of the process. Such supervision is key to both quality improvement and the successful implementation of consensus- and evidence-based practices” (CSAT, 2007, p. 3).

There are several domains of supervision. This includes:

Administrative

Focuses on organizational accountability such as: case records, referrals, performance reviews, other tasks that do not directly relate to client services.

Clinical

Focuses on supporting the supervises professional development, clinical skills, and client services, including: the therapeutic relationship. assessment and interventions, client welfare.

Ethical and Legal

Focuses on ethical dilemmas, boundary issues, and ensuring the well-being of clients and supervisees, promoting responsible and trustworthy practice.

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You might talk about:

• Legal issues and liability

• Countertransference issues (feelings you have about your clients)

• Documentation and note taking

• Clinical skills and interventions

• Theoretical orientations and frameworks for change

• Measuring outcome and asking for feedback (evaluation)

• Fees and finances

• Endings and terminations

• Receiving support and guidance

• Receiving education about possible professional trainings, development, and seminars

• Receiving education on possible career routes as a clinical social worker or therapist

• Receiving education on marketing and advertising if you are in private or group practice

• Becoming more confident as a therapist

• Managing impostor syndrome

• Self care

• Managing compassion fatigue and secondary trauma

• Noticing signs toward burn out

• How to bounce back from burn out

• And more

Sample Topics You Might Discuss In Supervision

Client Caseload Management

• Protection and monitoring of client welfare

• Reviewing clients (treatment, goals, risks, etc.)

• Assessing to see how your caseload feels (e.g. reducing or increasing client hours)

Taking Time Off

• How to take time off, when to notify clients, and how to notify clients

• Unexpected time off due to illness, accident, or unforeseen circumstances

• Backup coverage for clients when you are on extended leave

Marketing & Advertising

• If you are working for a group practice or operate your own private practice, you may be unsure how to run a small business

• School taught us the basics of clinical skills and therapy, but did not teach us the business aspects of running a small business

• Your supervisor can help you find authentic and congruent ways for you to market and advertise to your ideal client and areas of niche(s)

Strengthening Clinical Skills

• Perhaps you want to specialize in a therapeutic approach such as CBT, CPT, PE, EMDR, IFS, SE, etc.

• Your supervisor may have advanced clinical training and consultation in such approaches and can help you learn and refine your clinical skills with clients

• Deliberate practice is a great way to strengthen your clinical skills through the use of practical and applicable clinical exercises and practices

• Reviewing videos and audio clips are another way to strengthen clinical skills

• Lastly, writing up a process recording is another way to strengthen your clinical skills

Specialities & Areas of Focus

• How and if you want to develop an area of focus (generalist vs. specialist)

• The benefits and limits to certifications post-grad

• Lifelong learning and continuing education

• Professional development opportunities

Ethics

• Dual relationships

• Boundary crossings and boundary violations

• Informed consent

• Confidentiality and its limits

• Client welfare and “do no harm” principle

• Therapist violations and unprofessional conduct

Self Care

• How do we hold a wide range of human experiences like suffering, pain, hurt, joy, and love without personalizing and taking on the client’s “stuff”?

• How do we continue to do this work in a sustainable, long-term way honoring our boundaries and limits?

• Understanding the reality of compassion fatigue and ways toward personal joy, liberation, and resilience.

Defenses & Anxiety

• How do we work with resistance and psychological defenses and avoiding crashing into them?

• The difference between defense and anxiety

• Ways to bypass defenses

• Ways to regulate anxiety

• Building client capacity to reflect, tolerate, and relate to their emotions and thoughts in a manageable way

Trauma

• How do we avoid re-traumatizing clients with a history of complex and developmental trauma?

• How do we avoid re-traumatizing ourselves as a therapist with a history of trauma?

Culturally Attuned Care

• How do we build and increase our awareness, knowledge, understanding, and skills working with different dimensions of difference?

• How do we manage our own cultural countertransference so it doesn’t interfere with our client’s cultural “stuff”?

• How do we continually practice culturally responsibility and reflective practice so we can open up difficult conversations around trauma, oppression, micro/macroaggressions, and difference?

Congruence

• How do we learn to listen to our authentic selves/intuiton in addition to using evidenced based practices?

• How do we develop our own therapeutic style unique to our identities and experiences?

Boundaries

• What is the therapeutic frame and how can we hold strong therapeutic boundaries in service of both our clients and ourselves?

• How do we flexibly use the therapeutic frame toward healing for our clients?

Therapeutic Relationship

• How do we repair ruptures, conflicts, and misalliances?

• How do we ensure that we are building consistent therapeutic progress?

• How do we become more comfortable with endings and saying goodbye (termination)?

• Conversations and explorations around transference and countertransference

Pacing

• How do we become more comfortable with imperfection, tension, patience, uncertainty, and not knowing?

• How do we incorporate collaborative client-centered care into our practice?

Suicidality

• Suicide assessments

• Safety plans

• Assessing for self harm

• Assessing for non-suicidal self injurious behaviors

• Limits to confidentiality

Endings & Terminations

• How to say goodbye to clients

• Reviewing and summarizing treatment

• Anticipating future client obstacles and challenges

• Letting the client matter to you

• Gifts and rituals

Referrals

• When to refer out for a higher level of care than outpatient care (IOP, PHP, IP)

• When to refer out due to client need for specialized therapy training and skill

• How to start the conversation around referring out

As of 2026, associates in private practice without a niche/speciality are finding it more difficult to gain new clients due to a variety of issues including: the rise of AI, more therapists graduating from programs in the last few years, being generalists, the current economy, etc.

I recommend finding a part time job while you build your caseload in private practice, if money is a significant issue for you.

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1. Assess your strengths and areas you thrive/your gifts

   1. Are you or can you learn to be a good enough small business owner?

2. Assess your areas of growth, continued challenges, and weaknesses

   1. Are you or are you willing to do your own work around your areas of limitations?

   2. Do you have the patience, compassion, time, energy, and money to support the early stages of owning a small business as a therapist?

   3. Do you have good enough strength and a support system to continually grow and change without being reactive vs. reflective?

3. Working on and refining areas of growth, continued challenges, and weaknesses

4. Awareness and active exploration and management of scarcity, anxiety, worthiness, shame, guilt, and money mindset issues/core beliefs you hold

5. Understands and is comfortable with the reality of opening and building a private practice. Takes anywhere from 10-16 months to have a full caseload (depends on what you consider a full weekly caseload is)

   • Click here to read my post blog titled How Long Does It Take To Get A Full Caseload?

6. Is okay making limited income in the beginning stages of business (0-9 months)

7. Comfortable with making variable income based on the seasons of the year (e.g. summer is slower so take vacation then, fall is busier so working more) and/or due to client cancelations

8. Has a partner/spouse, savings fund, and/or disposable income in the beginning stages or is okay working part-time or per diem to supplement income in the beginning stages when you are building a caseload

9. Comfortable with consistent and ongoing networking with other colleagues (talking about themselves and reciprocal building relationships)

10. Comfortable with consistent and ongoing professional marketing with whatever method that they prefer and works for them and their ideal client such as : Google ads, Google My Business, SEO, blogging, social media, networking, a good website, writing a book, presenting workshops, going on podcasts, etc.

11. The traits and skills needed to be in private practice include, but not are limited to:

    • Identification of values and goals of your business (Why do you want to open a private practice. Who will you serve? What are your business values? What are your personal values?)

    • Go getter, self motivated and proactive

    • Active learner

    • Problem solver

    • Financial literacy

    • Strong clinical skills and judgement

    • Evidence based practice

    • Strong foundation of basic counseling skills

    • Customer service

    • Marketing and advertising

    • Adaptable

    • Okay with taking risks

    • Patience

    • Organized

    • Communication skills

    • Self awareness and insight

    • Okay with taking risks

    • Self confidence

12. Assessing your comfort with being a business owner and everything related to owning a business.

    • This can include: marketing, advertising, having your income directly related to bringing in new clients consistently, paying for your own health insurance, paying your own and taking out your own federal taxes.

13. Assessing your comfort working with clients long term vs. short-term (e.g. crisis work)

14. Finding a good fit supervisor who can help you with both clinical and business related issues and meeting with them weekly

15. Continually learning, researching, studying, etc. due to being isolated in a private practice setting vs. working for an agency which has support and training embedded already in it such as grand rounds, case consult, group supervision, etc.

16. Referring clients out if supervision, consultation, studying, researching, and ongoing learning is not helping you

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Those Who Tend To Thrive & Be Attracted To Private Practice

1. Valuing freedom and autonomy to make their own choices such as setting your fee, scheduling, time off, etc.

2. Valuing flexibility of working for yourself such as modifying your schedule, modifying your fee, taking as much time off as you want, working overseas, being 100% telehealth, being 100% in person, hybrid scheduling, etc.

3. Wants to work less and see less clients per week

4. Wants to make a desired income that is not offered in group practice or agency (e.g. six figures)

5. Does not like working for others

6. Embraces the challenges of being a small business owner

7. Enjoy the nitty gritty parts of business such as taxes, renewing licenses, etc.

8. Are confident in who they are

9. Are congruent (inside matches the outside)

10. Are authentic to who they are

11. Practice assertive communication vs. passive, passive aggressive, or aggressive communication

12. Have a beginner’s mind vs. believing they know everything and are an expert

13. Are comfortable making mistakes

14. Are comfortable taking risks

15. Can repair and negotiate relationships after disagreements/ruptures/conflicts

16. And more

Click here to read my blog post titled Private Practice Is Not For Everyone.

Group practices are a good option for those who:

1. Want to have greater ability to make more money than in an agency setting

2. Want traditional benefits offered such as health insurance, time off, etc.

3. Want to provide therapy, but not deal with the administrative and marketing aspects of therapy such as returning emails and phone calls, marketing, advertising, etc.

4. Do not want to be business owners

5. Want to have a team of other people to work with and consult with (rather than working alone)

6. Who need more business, supervision, clinical, administrative, and ethical support

7. Who are more anxious, fearful, apprehensive about going into private practice

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Agencies such as hospitals, schools, colleges, and community mental health clinics are a good fit for those who:

1. Want traditional benefits offered such as health insurance, time off, retirement fund, pension, etc.

2. Want to know exactly how much they will make annually

3. Want to work for a certain agency due to their history, value, reputation, etc.

4. Want to serve a particular population or presenting symptom

5. Want to work with the public and those underserved

6. Want to have a team of other people to work with and consult with (rather than working alone)

From RCW 18.225.145:

Associates may not provide independent social work, mental health counseling, or marriage and family therapy for a fee, monetary or otherwise.

Associates must work under the supervision of an approved supervisor.

Beginning October 1, 2025, an applicant for an associate license under this section may practice without a license under the direct supervision of an approved supervisor for 120 days after the department receives the applicant's completed application or the applicant's license is issued or denied, whichever is sooner.

National Associate of Social Workers (NASW) recommends a minimum of two years of post-master's experience in a supervised clinical setting.

Fees/prices vary and are influenced by several factors, including:

1. Geographical location

2. Fees of other mental health professionals who provide psychotherapy services in the area, and

3. Reasonable and customary fees that insurance companies set

There is no legal or professional requirement regarding the amount to be charged.

Conduct a survey of psychotherapy fees in your area, and decide on an amount that is fair and reasonable for your practice and the context of your life (e.g. student loans, cost of living, supporting other family members, solo parenting, etc.).

1. Consider if you want to panel with insurance as an associate

2. Consider if you want to operate solely as cash/private pay

3. Consider if you want a hybrid model of insurance and cash/private pay

4. Consider if you want to offer a reduced or adjusted fee

5. Consider if you want to offer pro bono slots

6. As an associate, you can operating your own private practice under the supervision of a licensed therapist to accept insurance through contracting with a third party or company like:

   • Mindful Therapy Group

   • Lemon Squeezy

   • Colorful Minds

   • Alluvial Counseling

   • Lycan Counseling

   • And more

7. If this is too overwhelming, you can work for a group practice that will panel you with insurance under the independent therapist’s license.

Click here for a list of Post MSW Fellowships.

Not sure or ready to open your practice?

There are so many practices hiring associates and licensed clinicians due to the demand in mental health services.

Make sure to read your contract in detail and find out whether out will be a W-2 or IC (Independent Contractor) as this impacts fee split and benefits offered as well as legal rights.

What Is A Group Practice?

• A therapy/mental health group practice is a collective of mental health professionals who come together to offer a variety of therapeutic services to individuals in need owned by a lead therapist/director.

• Often group practices are created to expand services to serve more clients with a specific value, skillset, and/or training.

• Some group practices take on interns/student therapists to offer lower fee services and to mentor/shape/educate/train the next generation of therapists.

• These services can include therapy, counseling, psychiatric medication management, and more, all provided by a team of skilled and specialized clinicians.

• Some group practices only provide psychotherapy.

What is a W2 Employee?

• Considered an employee

• W-2 employees are typically eligible for a range of benefits, including health insurance, retirement plans, paid time off, and workers' compensation.

• The employer usually withholds income taxes, Social Security, and Medicare taxes from the therapist's paychecks, making tax compliance simpler.

• Often greater job security, as they are protected by labor laws, such as minimum wage and overtime regulations.

• Employers usually provide a structured work environment, including set working hours and supervision.

• May have less autonomy over their practice and patient load, as their employer makes decisions about scheduling and caseload assignments.

• Might have less flexibility in choosing their therapeutic methods and approaches (group practice owner can dictate the approach, modality, specialties, etc.).

What is an Independent Contractor?

• Independent contractors (1099) have more control over their schedules, caseloads, and therapeutic approaches. They can set their own hours and choose their clients.

• Freedom to build their own practice and brand.

• Responsible for handling their own taxes, including income tax, self-employment tax, and estimated quarterly tax payments.

• While they may have more tax-related responsibilities, they can also take advantage of tax deductions for business expenses like office rent, supplies, and continuing education from their taxable income, potentially reducing their tax liability.

• Do not receive employee benefits, such as health insurance or retirement plans, and must provide these benefits for themselves if desired.

• They are not eligible for workers' compensation, so they need to have their own insurance coverage.

Typical Fee Splits For W-2 Unlicensed

• 45% employee / 55% employer

Typical Fee Splits For W-2 Licensed

• 55% employee / 45% employer

Typical Fee Splits For IC Licensed

• Ranges from 60%/40% to 80%/20%

Group Practices Hiring in Washington State

1. Catalyst Counseling

2. Navigate Family Therapy

3. Healing Moments

4. Lycan Counseling

5. Modern Therapy

6. Wellness Counseling

7. Mindful Therapy Group

8. Protea Wellness

9. Resonant Relationships

10. Steffen Counseling Services 

11. Pacific Behavior Care

12. Seattle Anxiety Specialists 

13. Interconnections Healing Center

14. Whole Valley Therapy

15. Self Space Therapy

16. Satya Wellness

17. Life Stance

18. Riverbank Therapy

19. Cedar Valley Counseling

20. Ohana Behavioral Health

21. Seattle Psychology

22. Clarity Counseling

23. Optimism Counseling

24. Radiant Counseling

25. People Bloom

26. Nua Counseling

27. Sunrise Nutrition 

28. Optimal Life Wellness

29. Bellevue Counseling

30. Zane Counseling

31. Trauma Informed Therapies

32. Alliant Therapy Group

33. Atlas Counseling

34. Sandbox Therapy

35. Talk Heal Thrive

36. Insight Mental Health

37. Sunrise Family Therapy

38. Wayfinder Counseling

39. Inside Passage Counseling

40. Anchor Light Therapy Collective 

41. Peninsula Psychological Center

42. Shelterwood Collective

43. Alluvial Counseling

44. Infinitely Well

45. 253 Therapy

46. Peaceful Soul Healing

47. Garden Wellness

48. Paradox Therapy

49. Salveo Counseling

50. Lightheart Associates

51. Seattle EMDR Associates

52. Greenlake Wellness Group

53. Dayspring Behavioral Health

54. Kirkland EMDR

55. DBT Eastside

56. Bene Therapy

57. And more!

Hospitals

• University of Washington Medical Center

• Harborview Medical Center

• Swedish Health Services

• Virginia Mason Medical Center 

• Evergreen Health

• Veteran’s Administration Puget Sound

• Kindred

• Seattle Children’s

• Seattle Cancer Care Alliance/Fred Hutch Cancer Center

• Smokey Point Behavioral Hospital

• Fairfax Hospital

• Overlake Hospital

• And more!

Managed Care/Health Care Systems

• Kaiser Permanente 

• Multicare Health Systems

• Pacific Medical Centers

• International Community Health Services (ICHS)

• Telecare

• And more!

Eating Disorder Clinics, Substance Use, IOPs, PHPs, and IPs

• The Emily Program

• Eating Recovery Center 

• Northpoint Seattle

• Pathlight

• Lakeside Milam

• Evergreen Treatment

• Thira Health

Mental Health Agencies & Nonprofits

• Sound

• Real Escape From Sex Trade

• King County Sexual Assault Resource Center

• Pioneer Health Services 

• Cowlitz Indian Tribe

• Navos

• Jewish Family Services

• Lutheran Community Services Northwest 

• Seamar

• Asian Counseling Referral Services (ACRS)

• Compass Health

• Seneca Family of Agencies

• Wellspring Family Services

• Friends of Youth

• Refugee Women’s Alliance (ReWA)

• Ryther

• Youthside East Services 

• YMCA

• Catholic Community Services 

• Downtown Emergency Services (DESC)

• Valley Cities

• Atlantic Street Center

• Therapeutic Health Services

• Center for Human Services

• Childhaven

• Crisis Connections

• And more!

If you want to learn how to open your private practice in Washington State, I recommend the following resource here which outlines step-by-step instructions at no cost.

Click here for a list of free supervision resources.

Click here for referrals to other supervisors.