Clinical Supervision Horror Stories

Did you know that therapists are imperfect people? 

Shocking- I know! We all come to this profession down a different path- and we all have our baggage that we bring with us. Becoming aware of our "stuff" and doing our own work is often an important piece of being healthy and effective ourselves. Just one reason why doing your own personal therapy work can be so powerful as a therapist. 

However, personal therapy work isn't always required, and just because we experience therapy- doesn't mean we are ready to be transformed from it. Getting licensed as a therapist doesn't require a clean bill of emotional health, nor does being emotionally unhealthy keep you from becoming a clinical supervisor. 

What do you do when your clinical supervisor is struggling? 

I remember going into my first meeting with a clinical supervisor and feeling completely out of my depth and unsure. I had no sense of choice, no direction, and I had no idea what to do. My poor clinical supervisor was overworked, overscheduled, and mentioned that she didn't know how or when she would fit me in. 

I left the meeting feeling disheartened and lost. She was a wonderful clinical supervisor, always made time for me- but I remember feeling rejected and unwanted in that first meeting. Now I know this was my own stuff coming up. At the time, I remember not even being sure if she was going to have time- thinking maybe I wouldn't have any supervision at all. She wasn't anything like that. She was an amazing supervisor in SO many ways! 

I was blessed to have a simple misinterpretation or misunderstanding when meeting my first clinical supervisor. However, I've heard more than a few stories that were far from misunderstandings or misinterpretations. So, what do you when clinical supervision isn't going so well? 

Here are some steps to take to get out of a nightmare clinical supervision situation: 

1. Start to write things down

Start to write down what is happening. Consider keeping a journal that just has dates, times, incidents, and a second one where you explore your thoughts, feelings, and reactions to the situation. Make sure to create a balanced list and include any good experiences you have with your supervisor.

Best case scenario, this will help you create some distance, and explore if there are areas that you will need to grow in- self-advocacy, boundary setting, verbalizing needs, etc. You may become aware of some misinterpretations you are having, or aware that your clinical supervisor isn't perceving you accurately. What is the best thing to do when someone isn't getting an accurate picture of you? Model who you truly are. Feelings of defensiveness don't bring out the best parts of me, and they may not bring out the best parts of you. Take care of you, and try to get into a calm state where more of the real you can come out. 

Worst case, this will be documentation if things go too far south. 

2. Explore your part without blaming yourself

In a true nightmare or bullying situation, people commonly take 100% of the blame for the nightmare situation. Start to work out areas where you do have options, power, control- areas where you can grow-without taking responsibility for the other person's behavior. Best case you find that this is just a rocky start to the relationship, or you grow in some areas that will help you in your clinical practice.

Worst case, you will come to a realization that you've done all you could, conducted yourself with integrity, did your best to solve the problem- and that you can move on with no second guessing or inaccurate levels of self-blame. 

3. Explore your supervisor's part without villianizing them

I didn't even realize when I started my practicum and internship that I had somehow put my clinical supervisor on a pedestal. I assumed that the things they told me were absolutely right 100% of the time. Truth is, supervisors are infallible just like the rest of us. As a clinical supervisor, I modeled for my supervisees the skills I wanted to take with them- like calling for legal consultation- or looking up documentation. I didn't just tell them what was right, or what I wanted them to do- I showed them the processes that I used and helped them practice the same process. Why? Because I don't want my supervisees to put me on a pedestal- I want them to learn good judgment skills. 

Explore multiple perspectives and try to view your clinical supervisor as a human. Have they ever been a clinical supervisor before? Are they feeling unsure or anxious? Are they overwhelmed personally or professionally? While you these may not be excuses for poor behavior, creating a sense of understanding can sometimes lead to resolutions of issues. 

Worst case: Think of this as practice in your work analyzing people's patterns or behaviors and creating a sense of separation. 

4. Finally, look for ways to create options and movement

I've seen particular non-profit, agency, and for-profit organizations where there is very little room to get support or feedback if there is a big issue. Create options for yourself by networking, looking at alternate jobs, and reaching out for support within your organization. 

No matter how nasty the situation is with your current supervisor, focus on developing ways to avoid bad-mouting or complaining about your current supervisor. Find a true way to talk with joy about what you have learned, and to verbalize what you are looking for in your next position. If you aren't already in therapy- consider getting a therapist. Therapy can be an amazing experience to help you keep things in perspective- and any type of nightmare or bullying situation is sure to bring some stuff to the surface- why not use this as an opportunity to get this stuff taken care of in therapy?! 

What about your? What advice do you have for peope in nightmare clinical supervision relationships? Share your advice and comments below! 

p.s. I'm really excited and proud to be co-leading the next Business School Bootcamp for Therapists. If you are looking for support in building a private practice- click here

In the Trenches: Good Supervision

Miranda Palmer, LMFT (Your MFTGuide) here to introduce our very first "in the trenches" post from an MFT Intern current gathering hours. I had the pleasure of meeting Michaela Renee Johnson at the 2013 California MFT (CAMFT) Conference in Sacramento, CA. I would love for you to hear her thoughts and recommendations about finding a good clinical supervisor while gathering hours for California licensure! 

When I was in Grad school, people talked about the concept of a “good” supervisor and a “bad” supervisor.

The concept was lost on me as people told horror stories of “bad” supervisors in practicum.
It wasn’t until I was half way through my practicum that I finally understood. The first supervisor I had was everything I had envisioned a supervisor to be, she was easy going, a great listener, educated, theoretical yet tactical and humorous. She was exactly what I needed in that first experience to get my bearings and build confidence at such a pivotal moment. But, I only could only fully "see" that in retrospect. 

Halfway through my practicum she announced she was moving out of State, and we would be assigned a new supervisor.

I was incredibly sad, because I’d come to appreciate and enjoy her as a supervisor and a mentor, but it wasn’t until my new supervisor was assigned that I started to truly appreciate what I’d had, and lost.

Every supervisor has a different skillset and style that they bring to the experience.

And not knowing what I didn't know- I sort of expected supervision was a standard thing. That there was a specific formula and that my new supervisor would be just like my old supervisor. 

Supervision is a very personal thing, and every supervisor has strengths, and areas that could be improved.

  • There are supervisors who are more oriented toward the technical details of being a therapist, making sure to verify your assessments match your treatment goals and that your prog notes have every “I” dotted. This can really help build your confidence with record-keeping. 
  • Then there are supervisors who are lackadaisical, letting you swim the river of BBS paperwork, insurance paperwork and clients on your own. You almost have to track them down to get five minutes outside of your weekly hour to ask questions as they come up. This will teach you to own your experience and build assertiveness skills to get what you need. 
  • There are also supervisors who are more focused on your talents and what happens in the office with your clients…you could say, your instinctual ability to be a good therapist (or a bad one). These supervisors sometimes feel like those one in a million experiences. And, that person who "gets you" just perfectly may be different for each of us! 
At some point in your clinical development, finding a supervisor who meshes with your personal style is critical to your success as a therapist. Here’s why:
  1. You aren’t going to be under supervision forever, at some point you are going to have to either work for an agency or branch out into your own private practice.
  2. Your supervisor isn’t going to be sitting next to you as you take the state exam.
  3. It’s ultimately up to you to find your personal style, theoretical orientation and beliefs about finances and insurance.
  4. A supervisor who doesn’t connect with you on a personal level, means you are missing out on a great deal of inherent learning through osmosis.
  5. A supervisor who doesn’t encourage the strengths they see in YOU means you never get the opportunity to feel confident before you are out on your own. 
  6. A supervisor who isn’t the kind of therapist you want to be, isn’t going to make a great coach or mentor.
While as therapists we may be good at letting go of judgment, finding a supervisor that is best for you, is one place you should be able to be clear about your needs and assess whether someone can meet them. At the beginning of internship, 3,000 hours feels like a life time away. I can assure you, 1500 hours  and four supervisors into the process, it goes quicker than you realize.
I have been afforded the opportunity to work with supervisors who fell into all the categories above. I’ve also turned down opportunities to work at some facilities based upon the person who would be supervising me.  
I’ve learned that sometimes we have to accept a supervisor because it’s the best financial position, but that doesn’t mean that we can’t consult with other supervisors who have more experience, or just better match with our personal goals as therapists. After all, the point of supervision is not just to have someone to bounce cases off of, but for our own personal growth.

Michaela Renee Johnson is a Board Registered Marriage and Family Therapist intern who works in private practice as well as in non profit. MichaelaRenee.com

 
(Would you like to submit an article for publication? We are currently accepting anonymous as well as byline pieces to share with therapists around the country. Send to miranda@mftguide.com We accept stories that tell a story, and that while they may talk about the difficult parts of this profession- offer real strategies to be successful.)