Common Issues & Topics Explored In Supervision

Many supervisees are nervous, anxious, and stressed about supervision.

This makes sense because supervision can be vulnerable and uncomfortable to discuss parts of you and your practice that you find challenging and difficult.

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

• 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

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