Clinical Supervision Handbook - CAMH Knowledge Exchange ...

preventing further illness episodes. And I’ve noticed that isn’t of
much interest to you right now.”
Client: nodded her head in agreement
Clinician: “I’m wondering how you’re feeling about this illness
right now (pause) and I’m thinking that it must really suck. It’s
really interrupted your plans.”
Client: Tears start to well up in her eyes as she says angrily, “I hate
it. I don’t want to take medication. I don’t want to be sick. Why
can’t things just be the way they were before? It’s just not fair!”
Clinician: “Yes. You’re right. It’s not fair. It’s awful when something
disrupts your life like this, especially an illness. I can understand
why you feel so angry and sad and just want it all to go away.
Client: nods and begins to weep.
This vignette illustrates how an empathic approach allowed the clinician to attend to
the subjective experience of the client and validate that her understanding was an
accurate reflection of the client’s experience. She gained entrance to the client’s inner
world and was able to better understand the client’s experience. The result was a
strengthening in the bond between the clinician and client as the client felt the comfort
of being understood. This interaction opened the door to addressing the client’s
experience of illness and the meaning it had for her. The client no longer felt that
the clinician was “pushing” her agenda onto the client. Eventually, the client was able
to negotiate with the clinician and her psychiatrist a medication regime that she the
client felt comfortable with.
Boundaries
Clinical Supervision Handbook
Clinicians have an obligation to put client needs before their own and to act in the
client’s best interests. “Sometimes, our own conscious or unconscious wishes make
it hard to recognize boundary violations” (rnao, 2002). A very important function
of individual clinical supervision is the development in the clinician of an awareness
and understanding of the boundaries and limits of the professional role. This understanding
of boundaries is crucial to providing safe and ethically sound clinical
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