Supervision Satisfaction: Situations where you might not sign off on Supervisee hours

Your supervisee has worked hard to grow professionally. Your relationship is evolving as they build confidence in their abilities. As they move closer to accruing their hours for licensure, you are preparing to sign off on both hours of client work and hours of clinical supervision with you during that time. Not only does your signature indicate the accuracy and truth of their reported hours, it also represents your comfort and belief in their abilities. Are they a competent clinician ready to navigate the next steps of their career? Have you identified any concerns and spoken to your supervisee to address and resolve them? In other words, are you prepared to sign off on their character and skillset as a mental health professional when signing off their hours of experience?

The desired answer is YES! Yes they are ready and competent. Yes they are a quality clinician with your stamp of approval. Yes they’ve completed their requirements to gain licensure. What about the times when you aren’t so sure? Have you documented your efforts to share concerns with supervisees in a timely manner? Is there a Corrective Action Plan in place to solve the problem? It’s uncomfortable to think about times where the supervision relationship changes as the result of conflict and concern. Consulting with your attorney and malpractice insurance as needed to document your justification and concerns in supervision can be another step.

In order to feel more prepared for these challenges, here are some times when you might not sign off on supervisee hours.

Neglecting their Notes

This is a common concern in supervision when our passion is for the client work. We are drawn to helping others, not completing paperwork. And yet notes are the paper trail to indicate your supervisee’s efforts with their clients. It is a measure of their skills when you aren’t in the room. And frankly, it’s how they get paid by insurance companies who need documentation to process claims for services rendered. In a nutshell, notes are a big deal. So when your supervisee is gearing up to finish their hours and begins asking you about your signature on their application for licensure, you may have some paperwork of your own that requires attention.

Sandra is an unlicensed therapist who is wrapping up her time at your organization with you as her assigned supervisor. Sandra has been asked multiple times to get caught up on her notes after taking a vacation two weeks ago. Sandra calls you to share she’s given her notice at the agency and would like your signature on her hours. Your response? Something like: “Sandra, I am happy to sign off on your hours when I can see that your incomplete notes are done. What kind of time frame do you need to support this goal?” Once you get a concrete timeline identified with your supervisee, you can put it in writing with some implied next steps from your organization if it isn’t completed in a timely manner.

Away from the Agency

Sandra in the above example gave her two weeks’ notice, allowing systems and processes to continue to support a transition of her clients and her exit from the agency. However, there will be times that supervisees leave a job suddenly, challenging the transfer of clients process as well as notes completion. Julio is a mental health therapist who has been called away to tend to a sick parent in another state, preventing his active participation with clients on his caseload.  Depending on Julio’s abilities in that stressful time, a plan will need to be identified to notify clients of a transfer as Julio doesn’t foresee returning anytime soon. Most likely, as his supervisor within the agency, you will be tasked with helping identify new clinicians for his caseload. Julio would be asked to contact each of his clients about the change and provide the assigned clinician information to prevent client abandonment. If he is unable to complete this task AND return client files to support a smooth transition to a new clinician, this could be justification to deny signing off on his supervision hours until the tasks have been resolved.

Massive Mistakes

Client abandonment is one of several concerns to be mindful of as a supervisor tending to your supervisee and their caseload. Supervision is an opportunity for learning, especially in the early stages of a therapist’s career. The hope is that supervisees take opportunities to learn and grow with their clients in tandem with the support and empowerment of an encouraging supervisor by their side. Yet one of the biggest fears of a supervisor is that their supervisee will make a mistake from which they cannot recover. 

What if they make a choice that warrants not just action by the agency, but filing of a grievance because the supervisee violated the ACA Code of Ethics with their conduct?  As a supervisor myself, I know this is a place of discomfort for many in leadership roles. It feels like risk. It feels like the unknown. The hope is that through your interview process, supervisee selection, and relationship development that you’ve identified any warning signs or opportunities for ethics education with your supervisee in a meaningful, proactive way. However, there may be times where we must respond reactively instead of proactively, which can result when learning that a critical incident has already occurred. 

Times where you learn:

1.     Your supervisee engaged in sexual contact with a client

2.     Your supervisee engaged in dual roles with a client or a client family member

3.     Your supervisee broke confidentiality rules

4.     Your supervisee failed to file a mandated report or critical incident

Based on your licensure, training, ethics, and protocols within your agency or organization, you are asked to lead and respond to these ethical concerns in a timely manner in order to look out for clients' best interests.  From concerns come clarity, so we also hope that your supervisee sees these moments as opportunities to learn and grow. That being said, sometimes the hardest lesson to learn is being fired or realizing supervision hours will not be signed off by a supervisor due to serious concerns about their conduct as a mental health professional.

Proactive Problem-solving

Supervisors work with supervisees to give back to the community and contribute to the next generation of professionals. They put their licenses on the line to support the development of their supervisees and change the mental health field for the better. With this in mind, proactively exploring ethical dilemmas and critical incidents within your organization or agency and the populations they serve can be one strategy to reduce the risk of massive mistakes. Learning from others and developing protocols for critical incidents can support you and your supervisee in having a plan should something unexpected happen. 

Therefore we’ve taken the initiative to highlight 33 critical incidents and challenges of clinical supervision when working with diverse populations. We encourage you to explore these with your supervisee by visiting our website and purchasing our book The Empowerment Model of Clinical Supervision: A Roadmap through the Complexities of Community Mental Health for supervision self-discovery, preparedness, and increased confidence at empowermentmodelsupervision.com

Written by Khara Croswaite Brindle, MA, LPC, ACS

Edit: Please consult your professional board and attorney in further exploration of supervision concerns and challenges related to signing off on hours.