Learning objectives in Clinical Supervision

 Daryl Chow has posted a good article on 12/07/22 entitled "The 7 Mistakes of Clinical Supervision."

How many people on this list are interested in this topic? We all have been subject to it and some of us provide it. So what thoughts do you have about it?

The seventh mistake Dr. Chow identifies is "Lack of focus on learning objectives." We all have to do _____number of CEUs to get our licenses renewed so I ask clinicians what topics are they interested in and want to take a CEU in?

As we enter a new year, 2023, I am curious what your learning objectives might be for 2023?

I asked one of my supervisees yesterday and she said she wanted to learn more about "overthinking" and how to help her clients develop more self confidence. We talked about these learning objectives for a whole hour.

I have several learning objectives for 2023. The big ones I have been working on are "estrangement" in family systems, and spiritual intelligence and how this can be assessed and nurtured in our psychotherapeutic work.

What about you?

Iatrogenic consequences of CPS system

Iatrogenic consequences occur as a result of human service provision occasionally. There is an interesting article published in the Washington Post on 12/07/22 about CPS in Massachusetts removing two young children from their parents care over dubious suspicions of physical child abuse. The infant was found to have had a cracked rib found on an x-ray in an emergency department where the mother had taken the child for a fever.

In the article, there is a quote that about 1/3 of American parents will be subject to a child protective investigation. This seems very high to me.

“There are statistics from a couple years ago that estimate that 37 percent of all American children will be subjected to one of these investigations before they turn 18,” Arons says. “That is a huge, kind of mind-boggling number that speaks to the scale of the system.”

Arons’s research into child welfare practices in New York City has led her to believe that a vast, invasive surveillance apparatus is not necessary to keep children safe. “That experience is forced on millions of families around the country every year, and fewer than 20 percent of reports end up being substantiated,” she says.

There is another quote stating that the child investigation process is traumatizing to the parents with long lasting effects.

It is the adults, he says, who are more likely to shoulder a lasting emotional burden.

“With proper support, with a family with access to the resources they need, this should all be in the rear-view mirror on the part of the child in months,” he says. “But the parents — the parents are going to be traumatized. They’re going to be reviewing this episode forever.”

This trauma to parents comes up often in my sessions with parents.

Accusations are common in conflicted divorce situations.

Mental health practitioners are mandated reporters and I have often been involved with clients caught up in the CPS system. It is very rare that I have made a referral to CPS myself. My experience with the competence of the CPS workers varies widely from county to county.

I have learned over the years to be very careful when interacting with representatives of the CPS system. I often find myself advocating for clients as most of the accusations wind up being unfounded. However having one's parenting and family under investigation seriously undermines a parent's confidence, self worth, and status in the community. Support and validation when appropriate can be soul saving.

Mental health professionals are usually respected by the CPS system and have authority to help make decisions about whether a CPS complaint is founded or unfounded. It is the mental health professionals job to advocate for the well being of children, parents, and families.

Clinical Supervision in a substance abuse agency.

 Back in October of 2008 John Bennett, the Director of Outpatient Treatment Services at the Genesee Council on Alcoholism and Substance Abuse in Batavia and Albion NY, and I met to discuss clinical supervision.

Even though it has been 14 years, this interview is still relevant in today's world. I retired from GCASA as Executive Director in 2011 and John became the Executive Director, a position he still holds today.

Take the client where they're at.

 

Regulatory expectations and requirements or "paperwork."

Dear Michael:

In response to your concerns about all the insurance regulations which must be followed to bill for services I jotted down some of my thoughts.

We can get caught up in the regulations, expectations, and requirements of running a business and practicing a profession when we manage a career in psychotherapy. This obsession with the trees precludes us from seeing the forest. The more basic questions that we overlook are:

What ultimately is the purpose of psychotherapy? 

Who are we ultimately working for?

One of the foundational concepts in TQM (Total quality management) is to know your customer. Who is your customer? There usually are many stakeholders in the business being managed. So these stakeholders can be put in priority.

The managed care model was built on a three legged stool. The model intended three things: good outcomes, achieved cost competitively, with customer satisfaction. Or as the bumper sticker says "Good, cheap, fast pick two."

At the end of the day I am on a mission from God and the client's needs and wishes are my ultimate concerns.

I went to a conference once presented by Michael White, the father of Narrative Therapy. He was asked a question by somebody in the audience who probably was a graduate student "Is Narrative Therapy research based?" Michael paused for a moment and then said, "Well, I am not a researcher. I am a practitioner. I don't know if Narrative Therapy is research based or not and it isn't my biggest concern. My concern is that it be ethically based."

Obviously, I have never forgotten this very important principle. We can worship at the altar of data or we can do the right thing. Hopefully these will usually be the same thing, but sometimes they are not and at the end of the world I'd rather be on the side of the ethical.

There is a line in A Course In Miracles, "Would you rather be right or be happy?" The need to be right may ultimately miss the point, right?

What have you learned being a Social Worker for 53 years?

 Topic One

What have you learned being a Social Worker for 53 years?

David Markham at Park Ridge Mental Health Center in Brockport, NY on 12/07/1988

When I graduated from SUNY Albany in 1972 with a Master’s Degree In Social Work, students were expected in the second of their two years of study to concentrate in casework, group work, or community organization. This was the standard way of organizing graduate social work education until the 80s when Social Work education shifted to a generalist model emphasizing the major competencies as assessment, service planning, implementation, and evaluation at three levels of social organization, individual, group, and community, This led to practice at the micro, mezzo, and macro levels.

The career path I have followed has taken me through all these methodologies and levels. I have provided individual, family, and group counseling as a clinician and also systems management as a supervisor, program director, deputy director for programs, and finally as an executive director. I have also functioned as an adjunct college professor in Health Sciences and in Social Work.

Some people might say cynically that I have been a “jack of all trades and a master of none.” I certainly have been a generalist with wide ranging career experiences but I have mastered some of them and consider myself to have some knowledge, expertise, and skills that are valuable to the right people, in the right places, at the right time, delivered in the right way.

I am very grateful for the career I have engaged in and all the mentors and teachers who taught me along the way. This blog will, hopefully, capture some of this knowledge, experience, and practice wisdom that has been accumulated over 53 years of practice.

Social Work: A Lifetime Of Practice is back up and running.

 After 9 1/2 years Social Work: A Lifetime of Practice is up and running. It is the mission of this project is to capture a lifetime of knoweldge, skills, and practice for the use of subsequent generations of Social Workers and Human Service professional. Feedback and sharing is welcome.