Most mental health professionals currently engage or have engaged in supervision during their careers. Some view this as a chore to be completed as soon as possible during the week. Some view supervision as an opportunity to learn and grow professionally. Some see this as only an administrative task where the “numbers” are examined. Unfortunately, many supervisees do not view supervision as a venue to raise countertransference or vicarious trauma issues that they may be experiencing for fear of being judged, ridiculed, deemed incompetent, shamed, or other reasons. Often, this is the result of a supervision environment that feels unsafe or untrustworthy to the supervisee. Implementation of trauma-informed principles into supervision can provide a remedy for this as well as allow for reflective practice to effectively occur between the supervisor and supervisee within the context of countertransference and vicarious trauma.
Trauma-Informed Supervision
In regard to trauma-informed supervision, Knight (2018) states “The basic requisites of trauma-informed supervision include knowledge of trauma and its effects on clients, indirect trauma, core skills of clinical supervision, and core precepts of trauma-informed practice and care” (P.18). Safety, trust, choice, collaboration, and empowerment make up the five main principles of trauma-informed supervision (Knight, 2018; Knight, 2018; Narouze, et al. 2023; Berger and Quiros, 2014; Varghese et al. 2018). “Mirroring principles of trauma-informed direct practice, central to supervision for such practice is creating a supervisory environment that promotes emotional and physical safety, trustworthiness, choice, collaboration, and empowerment” (Varghese et al. 2018, P. 4). Hurless (2024) indicates that a supervisor who practices trauma-informed principles as well as supervision through the perspective of trauma may provide benefits for the supervisee especially those experiencing countertransference or other issues.
Trauma-informed supervision is supported by the principles of safety, trust, choice, collaboration, and empowerment. In terms of safety, the supervisee should feel safe enough to openly share the experiences, thoughts, and feelings that are present and the supervisor should be cognizant of the factors needed to make the environment feel safe (Narouze et al, 2023). Trust builds and grows when the supervisor ensures that professional boundaries are maintained in the supervision session, expectations are clear, and the supervisor has been consistent in professional behavior, reactions, and feedback (Narouze, et al. 2023). Choice is formed when supervisees have an active part to play in identifying options, alternatives, and choices in which to apply in their work with clients (Berger and Quiros, 2014; Narouze, et al. 2023). Collaboration occurs when the supervisor works with the supervisee in identifying the options and choices which appear to be the most effective. This helps to build an aligned professional relationship in supervision where the input of the supervisor does not automatically supersede or overrule the input of the supervisee (Berger and Quiros, 2014; Narouze, et al. 2023). Finally, there is empowerment. This occurs when supervisees are given opportunities to learn and put what they have learned into practice as well as receiving validation and approval when appropriate (Berger and Quiros, 2014; Narouze, et al. 2023).
Another element of trauma-informed supervision is awareness of trauma and its effects on the supervisee. Berger and Quiros (2014) state that “Ongoing supervision has been recognized as a major protective factor because it can serve as a buffer against vicarious trauma, that is, trauma reactions triggered in clinicians because of working with traumatized clients (P.298). These trauma effects include over identification with the client, indirect trauma, vicarious traumatization, compassion fatigue, neglecting self-care, and burnout (Berger and Quiros, 2014, Berger and Quiros, 2016; Knight, 2013; Quinn, Ji, and Nackerud, 2019). Quinn et al. (2019) posit that a supervisor who provides “a genuine, open, understanding, and accepting environment for the supervisee” (P.521) may provide a protective environment for supervisees on reducing the effects of secondary trauma symptoms. Considering this, the supervisor must take care to maintain professional boundaries and not transform a supervision session into a therapy session (Knight, 2013). Conversely, the supervisor needs to balance this with what the supervisee may be experiencing. Knight (2013) indicates that a supervisor may concentrate too heavily on the clinical work with the client and not provide any or ample time for the supervisee to share feelings, etc. thus leading to resentment. Hurless (2024) states “A supervisor who is knowledgeable of trauma-informed practice and applies trauma-informed practices in their work may be able to supervise more effectively by offering supervisees a safe, trusting, transparent, and empowering relationship” (P.3).
Reflective practice
Reflective practice, also known as reflection, use of self, and/or critical reflection is a well-known method of looking into oneself to learn about oneself ultimately resulting in increased understanding of oneself (Asakura and Maurer, 2018). Reflection consists of stopping and truly thinking about what one heard from the client, supervisee, or supervisor as well as what ideas, preconceived notions, memories, etc.one may have inside that may skew or affect what is heard.
Related to this is inquiry. This occurs when one (supervisor) asks or respectfully probes for more information from the other (supervisee) so both can gain a deeper understanding (Varghese et al. 2018). Varghese et al. (2018) recommend two strategies to assist the supervisor in creating an environment conducive to reflective practice. One strategy includes engaging in dialogue with the supervisee. Engaging in dialogue entails listening, suspension of judgment, identifying biases, and reflection. It is actual engagement in a conversation and not listening to another with the goal to only respond. The second strategy is locating oneself. Locating oneself entails reflecting on one’s personal identities and where one may fall at the intersection of many identities to better learn about oneself and be able to accept what the other person is presenting (Varghese et al. 2018). As countertransference and other forms of vicarious trauma affect a supervisee, they evoke emotions, feelings, memories, and other personal from a supervisee’s life which not only influence the work in supervision but with clients as well. Reflection and the use of self is an effective tool to confront this when presented in a supervision atmosphere that makes one feel safe enough to be vulnerable and share their true feelings.
To improve the supervision experience so both the supervisor and supervisee can not only feel safe, trusted, validated, and valued, trauma-informed principles can be very effective when utilized in this setting. When this type of supervision environment is achieved, reflection can be utilized more effectively as well as the participants feel safer to probe deeper into themselves and be able to make themselves more vulnerable with their feelings, emotions, experiences, biases, and whatever else is found inside them.
Marc Liff, LCSW, ACSW, is a Senior Clinical Social Worker at SUNY Downstate Health Sciences University, Special Treatment and Research Program (STAR). He can be reached at 718-270-2299 or marc.liff@downstate.edu.
References
Asakura,K., & Maurer, K. (2018). Attending to social justice in clinical social work: Supervision as a pedagological space. Clinical Social Work Journal. https://doi.org/10.1007/s10615-018-0667-4
Berger, R. & Quiros, L. (2014). Supervision for trauma-informed practice. Traumatology. 20 (4). 296-301. http://dx.doi.org/10.1037/h0099835
Berger, R., & Quiros, L. (2016). Best practices for training trauma-informed practitioners: Supervisor’s voice. Traumatology. 22 (2). 145-154. http://dx.doi.org/10.1037/trm0000076
Hurless. N. (2024). Trauma history and trauma-informed practice relate to counseling student’s satisfaction with supervision and rapport with supervisor. Journal of Counselor Preparation and Supervision. 18 (3). http://dx.doi.org/10.70013/vmxaa48h
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Knight, C. (2019). Trauma-informed practice and care: Implications for field instruction. Clinical Social Work Journal. (2019). 47:79-89. https://doi.org/10.1007/s10615-018-0661-x
Narouze, M., Smithbauer, S., Quaranta-Leech, A., & Zaporozhets, O. (2023). Rising above the battle scars: Integrating trauma-focused concepts into clinical supervision using the discrimination model in Ukraine. International Journal for the Advancement of Counseling. Published online September 20, 2023. https://doi.org/10.1007/s10447-023-09529-w
Quinn, A., Pengsheng, Ji., & Nackerud, L. (2019). Predictors of secondary traumatic stress among social workers: Supervision, income, and caseload size. Journal of Social Work. 19 (4). 504-528. DOI: 10.1177/1468017318762450
Varghese, R., Quiros, L., & Berger R. (2018). Reflective practices for engaging in trauma-informed culturally competent supervision. Smith College Studies in Social Work. https://doi.org/10.1080/00377317.2018.1439826
