Clinical Supervision Guidelines Organized Around Seven Domains
When it comes to the guidelines for clinical supervision it is comprised of seven different domains. These domains are based on a review of literature based on supervision as well as competency-based training and education. Even though each domain can be independent of each other they do overlap and should be considered in their entirety.
Domain A – Supervisor Competence
The guidelines see supervision as a distinct professional practice that includes skills, attitudes, and knowledge that these supervisors require and receive training for. Supervisors are required to have the most current knowledge and skills regarding the different areas they are supervising. They need to be knowledgeable when it comes to diversity, age, gender, race, ethnicity, national origin, religion, culture, sexual orientation, language, disability, and individual differences of diversity dimension.
With the guidelines supervisors strive to become competent in the psychological services provided to patients by the therapists they are supervising. They need to be able to take reasonable steps to ensure that the competence of their work protects others from harm.
Supervisors also need to attain and maintain their competence in their practice of supervision through their own formal training and education.
The guidelines call for them to coordinate with other professionals that are responsible for the education and training of the therapist being supervised and to make sure that there is communication and a coordination of expectations and goals.
Domain B – Diversity
Diversity competence is inseparable and an essential component of supervision competence. This is referring to developing competencies for working with diversity issues and diverse individuals, even those from their own background.
The supervisor needs to develop as well as maintain good self-awareness when it comes to diversity competence and should include knowledge, skills, and attitudes. They also should try to improve their own diversity competence in order to establish a respectful relationship with the therapist they are supervising.
A supervisor needs to be able to recognize the value of and go after ongoing training of diversity competence when needed to help with their development professionally and their life-long education. They must have knowledge about the different effects of prejudice, bias, and stereotyping.
Domain C – Relationship
The quality of the supervision relationship is vital in order to offer effective clinical supervision. This, in fact, is the central factor in clinical supervision. The supervisor is responsible for collaborating, managing, and discussing the power within the relationship with the therapist.
The guidelines point out that supervisors need to value and try to make and manage a collaborative relationship that helps to promote the therapists competence in their overall work. Supervisors need to start collaborative discussions that include the goals and tasks of the supervision going on. By doing this, they will be establishing a good working relationship that sincerely values the dignity of others, responsible caring, transparency, engagement, honesty, attentiveness, humility, professionalism, flexibility, and responsiveness.
Supervisors are encouraged to discuss explicitly with the therapist the aspects of the entire process of supervision like the program goals, roles and responsibilities, individual learning goals, description of the structure of the supervision, activities, performance evaluations, reviews, and the limits of the supervision confidentiality. They also need to review on a regular basis the progress that the therapist has shown.
Domain D – Professionalism
Professionalism is something that should go hand in hand with the social responsibility of the profession. It needs to take into consideration the welfare and the needs of those they serve. Professionalism components should include:
- Personal responsibility
- Adherence to professional values
- Concern for the welfare of others
- Professional identity
The guidelines encourage supervisors to provide an ongoing formative evaluation of the progress of the therapist and help them meet the expectations for professionalism that is appropriate for every level of training and education.
Domain E – Feedback – Assessment – Evaluation
Feedback, assessment, evaluation are all essential components of the ethical supervision. To be an effective evaluation, assessment, and feedback needs to directly link to specific competencies, be timely, and should include observed behaviors.
Supervisors need to promote transparency and openness in the feedback and the assessment which needs to be anchored in the competency development of the therapist being supervised. Supervisors are responsible for monitoring along with providing feedback about the therapists’ performance. There should be live observations or at least review of any recorded sessions.
The feedback provided by the supervisor needs to be clear, timely, behaviorally anchored, direct, and responsive to the therapists’ reactions. They also need to be mindful of the impact there can be on the supervisory relationship.
The supervisor needs to be able to recognize the value of and to support the therapists’ skill in their self-assessment of competence and then incorporate this self-assessment into the evaluation process.
Supervisors need to make sure to seek feedback from the therapists being supervised because this feedback can help them improve their supervisory competence.
Domain F – Professional Competence Problems
There’s only a small amount of therapists in mental health services that actually demonstrate some significant problems when it comes to their professional competence. However, there are reports from academic and internship programs that there is at least one therapist that does seem to have competence problems in the past few years. A supervisor needs to be prepared to protect the well-being of patients and the general public, while at the same time support the professional development of the therapist.
It is vital that the supervisors give priority to protecting the patients above the therapist. If therapists show problems dealing with their professional competence and the decision they have made then these issues need to be addressed in a timely manner.
Every supervisor needs to have an understanding of and stick to the supervision contract as well as to the program, institutional policies, legalities, and all procedures that relate to performance evaluations. Supervisors must be able to identify any possible performance problems quickly and communicate this to the therapist and then take steps to focus on these issues quickly and in a way in which it allows for an opportunity to make changes.
It is important that the supervisor is competent in both develop and implement all plans that are needed to help address any performance problems the therapist is having. They need to also be aware that they are considered the “gatekeeper” and then be able to take the appropriate and ethical action when responding to the performance issues of the therapist.
Domain G – Ethics, Regulatory, and Legal Considerations
All supervisors must value and model their ethical behavior and their adherence to all relevant regulatory and legal parameters in the supervision process. This is vital in upholding the highest duty of any supervisor because it’s protecting the public.
Supervisors need to support the development of the therapist they are supervising and ensure that they follow all the ethics of their profession, their professionalism and also the integration of these ethics into their own professional behavior.
The guidelines stress the importance of the supervisor always putting the welfare of the patient first. It is their top priority to protect patients at all times. It is their job to have a balance of protection while increasing the therapists’ competence and their professional development. They need to ensure that the therapist understands the variety of aspects of this responsibility when it comes to their clinical performance. Supervisors are ultimately responsible for the clinical work that the therapist does.
As the “gatekeeper”, the supervisor is responsible for assessing the therapist and if they are qualified to enter or stay in the mental health field. They need to provide them with information that is clear about what the expectations and parameters are of their supervision, most often done through a written contract.
The guidelines provided for clinical supervision are there to offer specific suggestions in each of the domains that point out essential practices in providing competency-based clinical supervision. The goal of these guidelines is to promote the provision of high-quality supervision in the mental health service by using a competency framework that will enhance the development of the competence of each supervisor being supervised. At the same time, these guidelines help to ensure that patients and the general public are protected.
Since guidelines can change on occasion it is important that they are reviewed periodically so that supervisors are informed of any new developments including any changes in evidence-based clinical supervision.