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by: Hamaseh Kianfar, LMFT
Clinical supervision provides registered associates with the opportunity to expand upon the foundational knowledge obtained in graduate school, increase effective clinical skills, and provide appropriate, empathic, and ethical clinical work.
I had the wonderful opportunity to interview three different mental health practitioners, each of whom brings a diverse breath of clinical, professional, and cultural experience.
What I found incredibly impactful was the consistency in all of their answers and messages regarding why supervision is important.
I have included a brief description of their biographies below:
Maria Donnell-Abaci, LCSW Maria (she/her) has been a licensed therapist since 2012. Maria has a wealth of experience working in government, hospital settings, and nonprofit mental health and substance use service agencies. Her work has included working with victims of violent crimes, at risk adults and children and those who are severely mentally ill. Maria has led Diversity, Equity and Inclusion (DEI) initiatives as a workplace leader and advocate for racial justice, and is very committed to systems’ change and transformation. Currently Maria is a Supervisor at Marin County Behavioral Health.
Lisa De La Rue, Ph.D. Lisa (she/her) is an Associate Professor in the Counseling Psychology program at the University of San Francisco. She serves as the Program and Fieldwork Coordinator of the Marriage and Family Therapy program.
Jamal Lawrence Granick, Ph.D., LMFT Jamal (he/him) is a licensed psychotherapist in California and New Mexico. He has taught counseling and related courses at the master’s and doctoral levels at Sofia University (formerly Institute of Transpersonal Psychology) and Southwestern College. Dr. Granick has supervised Registered Associates in both agency and private practice settings. He has also extensively assisted in multiple postgraduate training.
Based upon your experience, why do you think it is important to have a good supervisor?
Maria Donnell-Abaci: We work in a highly stressful field. Our clinicians, staff and Registered Associates need all of the support, information, and tools available. As a supervisor, it is important to try and provide all that we can to our staff so that they are successful and satisfied, which means better client service/outcomes and retention.
Lisa De La Rue: A good supervisor is able to meet a supervisee where they are at and provide appropriate scaffolding to help the individual develop as a clinician. They also create a supervision space that makes it feel comfortable for the supervisee to be vulnerable and share their insecurities, mistakes, and to ask all questions (even when they feel like it is something the supervisee should know).
Jamal Granick: I think it is critical to have a good supervisor for multiple reasons. I believe that most of the learning in becoming an effective psychotherapist is experiential. Most graduate programs in psychology focus on knowledge and theory. Even those that include experiential training cannot provide enough to ensure that graduates are adequately prepared to practice. Therefore, much of the learning, and probably the most significant learning, happens in the Registered Associateship setting working with actual clients. Supervision is a central aspect of that learning because it provides both supportive and corrective feedback that enables Registered Associates to integrate their theoretical learning in actual practice contexts. Feedback is critical because one is not able to fully, accurately observe oneself without external reflection. Integration is generally a highly redundant process requiring much repetition to fully internalize theoretical principles so that they become reliable procedures. So, the answer to why it is important to have a “good” supervisor is because supervision itself is so important.
What qualities do you think are essential in a good supervisor?
Maria Donnell-Abaci: The ability to lead with kindness, while also understanding and being clear about my role and the teams’ role so the organization's goals are clear and reachable. In addition, openness and the ability to provide safety so team members can ask for assistance and share their thoughts even if changes can’t be made. I also believe in providing space for professional goals to be pursued and supporting team members so they can be happy.
Lisa De La Rue: Cultural humility, understanding of different worldviews, patience, and openness to feedback.
Jamal Granick: There are two levels of the answer to this question: One, what are the qualities that are essential in a good supervisor in general? And two, what are the essential qualities of a good supervisor for any particular trainee or associate? In general, good supervisors have a comprehensive knowledge of the field, both factual, practical, and theoretical. In addition to this, they need to be effective practitioners themselves so that they can draw on their own tacit knowledge of what constitutes effective psychotherapy. This will enable them to recognize the strengths and growth areas of their trainees, offer useful feedback and, if necessary, model competencies that their trainees/Registered Associates need to develop. In addition, they need to have good teaching and interpersonal skills to effectively communicate in a supportive way. Attitudinally, they need to be accepting toward their trainees while being willing to challenge them to grow past their limitations.
It is also very helpful if the supervisor is knowledgeable about the specific approaches the associate is attempting to learn. No practitioner, and no student, can know every approach to psychotherapy completely, so it is very helpful if there is a match.
I will add that I have a bias toward supervision that includes working with recordings of sessions, rather than just relying on trainees’/Registered Associates’ self-reports or notes. A good supervisor would be competent in working in this way.
What questions would you recommend new trainees/Registered Associates ask when evaluating potential traineeship sites, specifically relating to assessing the quality of supervision they will receive?
Maria Donnell-Abaci: Is the environment welcoming, safe and supportive? A trainee or associate needs to learn and make mistakes. Will the environment treat the trainee/associate as a professional who may have knowledge and contribute to the exchange during supervision so both can grow?
Jamal Granick: I would recommend that trainees/Registered Associates begin with open-ended questions about the supervisors’ approach, both to psychotherapy practice and supervision. This will enable them to both gather information but also draw inferences about the supervisor’s presence and way of responding. If there are particular theoretical approaches that they are trying to learn, then it would be important to inquire about the supervisor’s knowledge, competence, and resonance with those approaches.
One especially important area would be to explore the supervisor’s approach to working with transference and counter-transference, in general, and assess whether this is resonant with the trainees’/Registered Associates’ own perspective. An important follow-up question would be to ask how the supervisor would work with them when transference/counter-transference issues come up with their clients.
What do you think separates a great supervisor from a good one?
Maria Donnell-Abaci: I believe a great supervisor is not perfect, but they possess the ability to change and grow as they lead. They must have the ability to critically reflect and discuss processes and actions when challenging cases arise or if interactions are difficult. A great supervisor will also recognize shortcomings and continually try to improve. It’s also important to know when to say you are sorry.
Lisa De La Rue: A great supervisor is invested in seeing their supervisees grow and improve during their time together. They make individualized plans for their supervisees.
Jamal Granick: In addition to the competencies named above, a great supervisor is highly congruent, both interpersonally and professionally. This means that they relate to people in an authentic way, that they represent themselves accurately, and that they do what they say they are going to do. They are highly engaged in the practice of psychotherapy, and are highly motivated toward excellence, both with their clients and their supervisees. They are deeply caring and have a well-developed capacity for empathy, so they are invested in motivating their trainees’/Registered Associates’ learning and growth. And they have well-honed teaching skills.
How does a trainee/associate evaluate whether they are getting the most out of supervision?
Maria Donnell-Abaci: Goals should always be outlined in the beginning, with regular check-ins during supervisory sessions. In addition, safety should be provided so trainees/Registered Associates can change their goals and let the Supervisor know. An agenda can be set at each meeting for those who like structure and for those who want to talk about what is most important that day. Flexibility is important. I always say that supervision is what you need.
Lisa De La Rue: Are they able to ask questions and get helpful tips on how to intervene with clients? Are they given specific strategies? Does the supervisor listen to what they share about clients?
Jamal Granick: I believe you know you are getting value from supervision if you experience being both supported and challenged. Their strengths and accomplishments need to be acknowledged, as this is motivating. At the same time, supervision is not necessarily comfortable and you should feel like your “edges” are identified. That means that one should feel stretched to reach for deeper competency and also supportively challenged to explore internal barriers to fully “showing up” as a therapist.
As a supervisor, what has been the most challenging part of your role?
Maria Donnell-Abaci: The power dynamic and how it affects interactions. No matter how approachable you feel you are as a supervisor, the power dynamic is still there. As a supervisor, it is important to be honest about limitations and possibilities to be consistent and give team members a sense of grounding. Another challenge is that there will always be staff members who never feel that you do enough, are kind enough, or give enough opportunities, but that is to be expected. It is important to give 100% each day.
Lisa De La Rue: Supervisees who struggle with receiving feedback or lack humility and willingness to learn.
Jamal Granick: The most challenging aspect of supervision with me has been to effectively communicate to Registered Associates the value of being transparent about what they do not know or feel competent in. Despite my strong intention to create a “safe learning environment,” I have often found Registered Associates resistant to being challenged, even when I have done my best to offer that in a supportive and empathetic way. Another challenging aspect, though not as much so, is inviting Registered Associates to rely less on their theoretical formulations and focus more on their own experiential learning.
What barriers have you found prevent Registered Associates/trainees from verbalizing discomfort or issues they are having with a supervisor?
Maria Donnell-Abaci: I feel a barrier is when they lack a sense of safety. If an Associate/Trainee does not feel safe they in all likelihood will not speak up. Another barrier may be a lack of feeling wanted or welcomed.
It is so important to give Registered Associates/Trainees a voice in all spaces. I have a spot on our agenda each week so they feel like equals and they feel heard. Also, Registered Associates may feel if they make a mistake they may be judged for that. Trainees/Registered Associates should be given room to grow. Everyone should be given room to grow.
Lisa De La Rue: The power dynamic and fear of retaliation.
Jamal Granick: Well, here I’m inferring, but my guess is that it is part of the inherent power dynamic. Supervisors are generally gatekeepers and therefore hold power over their supervisees. If trainees/Registered Associates have had challenging experiences with authority such that their own perspectives have been minimized, suppressed, or punished they may be inhibited to express dissenting or dissonant perspectives for fear of reprisal.
What would you want a new trainee/associate to know as they navigate clinical supervision?
Maria Donnell-Abaci: Supervisors are not perfect. Each supervisor is different. Please speak your truth and ask for what you need. It allows for growth in the exchange for the Associate/Trainee and Supervisor. Some of my most important interactions have come from difficult discussions and or situations. Your truth is a gift to those of us who would learn from it.
Lisa De La Rue: Be humble and willing to learn. Give yourself grace as this is a new experience for you. You will experience hiccups along the way.
Jamal Granick: Ultimately, the goal of supervision is to maximize the opportunity for you to become the most effective therapist you can be. This requires, though, that you also be authentic. The point is not to turn you into an automaton. In order to be authentic, you need to be able to trust yourself, but that also means to become discerning about what within your habitual way of experiencing yourself is trustworthy and what is not. So, it is important to take risks, and that might mean being willing to trust another to challenge you. At the same time, the goal is not compliance with authority, and you are still responsible to discern if the challenges you are presented with are appropriate and relevant. So, it is a delicate balance between openness and discernment. This is inherently challenging, but the hope is that you ultimately develop a highly refined capacity to challenge yourself. If so, this will serve you well in your profession, as the need for this level of self-reflection is lifelong.
Hamaseh Kianfar, LMFT, Ed.D. has worked with the criminal justice department, psychiatric emergency, and in community mental health for over 18 years. In addition, she is a trained facilitator in a number of curricula, including Parenting from the Inside Out, Thinking for a Change, Seeking Safety, Criminal conduct and substance abuse, and Anger Management. Hamaseh currently works as a Licensed Behavioral Health Practitioner for the County of Marin's Behavioral Health and Human Services and is an Adjunct Professor at the University of San Francisco.
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