Clinical Supervision Handbook - CAMH Knowledge Exchange ..

Clinical Supervision Handbook
In addition to the above, clinicians in this program consider information related to
traumatic re-enactments. With this comes the understanding that a common feature
in these clients’ relationships are the roles of perpetrator, victim and rescuer and
how the client can assume these roles interchangeably with others in their lives based
on their childhood experiences. This includes their relationships with clinicians.
After presenting this information to the clinical supervisor and the group, the team
and the clinician working with the client have a better understanding of the underlying
dynamics and can use this to help the client look at alternatives and make sense
of how this pattern continues to be problematic.
Adapted from Luborsky, L. (1997). In T. D. Eells (Ed.), Handbook of Psychotherapy Case Formulation: The Core
Conflictual Relationship Theme. New York, NY: The Guilford Press.
SPONTANEOUS CLINICAL SUPERVISION:
CLINICAL SUPERVISOR AS LIGHTHOUSE
Using the lighthouse as a metaphor for the clinical supervisor presents the image
of a steady beacon for temporarily lost and stranded ships in the fog. The clinical
supervisor can provide direction, guidance and support for safe passage when it is
most needed. The lighthouse connotes a symbol of leadership, assurance, safety
and hope.
In the busy life of a program, it’s important to consider how adhering to a too-rigid
definition of clinical supervision may be a barrier to staff receiving important support
in their work. Requests for clinical supervision can come in many forms. Important
supervision issues, especially in an inpatient setting, often arise spontaneously and,
although it may be unrealistic to expect that the supervisor can provide a totally
comprehensive supervision in a short time (within 10 to 20 minutes), unscheduled
conversations about client care can be consistent with a traditional definition of
clinical supervision. These conversations may also be a starting point for more formal
supervision. Supervisors should be encouraged to consider multiple, brief clinical
conversations that include Socratic questions, affirmation of the supervisee’s skills
and capacities, and promoting client-centred care within a program—as very real
examples of clinical supervision. In other words, the sum of multiple effective contacts
can equal or exceed one scheduled formal session.
If supervision is limited to scheduled conversations, many opportunities for responding
to staff needs for consultation will be lost. Staff needs for support, education and
guidance cannot be totally addressed without this more open access to the clinical
66