Wednesday, December 11, 2013

Providing the Light: Supervision of Counselors who work with Trauma
Tamarine M. Foreman

“What is to give light, must also endure burning.” -Viktor Frankl

            Viktor Frankl’s quote illuminates the challenge supervisors face as they supervise counselors working with clients who have experienced the trauma of abuse, neglect, and violence.  As supervisors, we are ethically obligated to ensure supervisees are not emotionally or physically impaired and are capable of providing services to clients without doing harm. The following information provides suggestions on how to best support and supervise counselors working with clients who have experienced trauma.  
Creating a Safe Space
            Supervisors can create a space for supervision that is safe, non-evaluative, supportive, and educational.  It is best when different supervisors provide clinical and administrative supervision.  If this cannot be done, it is recommended that clinical and administrative supervision be conducted in separate sessions. 
Educate Supervisees
            Supervisors need to educate supervisees about the risks of working with clients who have experienced trauma.  Those risks include experiencing compassion fatigue, which entails the physical and emotional exhaustion from providing counseling services over time; vicarious traumatization which encompasses changes to how a counselor perceives their self as capable, others as fair and just, and the world as safe; and burnout which is a result of working with difficult clients and leads to feelings of being overwhelmed. Supervisors can also educate the supervisee that observing the resilience and healing of clients facilitates personal and professional growth.
Inquire about the Supervisee’s Thoughts and Emotions
            Supervisors need to ask supervisees about their personal experience of working with specific clients who have experienced trauma.  Ask supervisees about their thoughts and feelings before, during, and after the session. Supervisors can also ask if the supervisee is having any intrusive or unwanted thoughts or images (e.g., nightmares, reoccurring images related to client stories, worries about one’s own safety or safety of loved ones, or suspicion of other people’s motives).
Pay Attention to Common Themes
            Supervisors need to pay attention to common themes counselors share in supervision, either through the same client story or a collection of the types of stories being shared. Paying attention to common themes provides insight into how the supervisee is being impacted.  Supervisors can also pay attention to any changes in supervisees’ behavior or reactions to clients or specific types of clients. 
            Be aware if the supervisee shows signs of distress or has difficulty maintaining self-care practices.  It is equally important for supervisors to be aware of their own limitations, model healthy boundaries, and practice self-care.  Recall the airline stewardess who emphasizes the importance of putting your own oxygen mask first before helping others.  
Implement Mindfulness
            Supervisors can employ the use of mindfulness, breathing exercises, and stories to support the wellness of supervisees.  The use of mindfulness and breathing exercises can assist supervisees in developing self-awareness skills in the present moment of supervision that may transfer to facilitating counseling sessions.
            Supervisors can also seek out additional training in trauma theory and improve their knowledge about therapeutic interventions designed to assist traumatized clients.

For Additional Information about trauma, please look into reading the following books:
Hill, M. (2004).  Diary of a country therapist.  New York: Hayworth Press.

McCann, I. L., & Pearlman, L. A. (1990). Psychological trauma and the adult survivor: Theory, therapy, and transformation. New York: Brunner/Mazel, Inc.

Pearlman, L. A. & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference
            and vicarious traumatization in psychotherapy with incest survivors. New York:
            W.W. Norton.

Saakvitne, L., & Pearlman, L. A. (1996). Transforming the pain: A workbook on vicarious traumatization. New York: W.W. Norton.

For Additional Information about supervision related to trauma, please look into reading the following articles:

Knight, C. (2004). Working with survivors of childhood trauma: Implications for clinical supervision. The Clinical Supervisor, 23, 81–106. doi:10.1300/J001v23n02

McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131-149. doi: 10.1007/BF00975140

Warren, J., Morgan, M., Morris, L. B., & Morris, T. M. (2010). Breathing words slowly: Creative writing and counselor self-care—The writing workout. Journal of Creativity in Mental Health, 5(2), 109–124. doi:10.1080/15401383.2010.485074
Wells, M., Trad, A., & Alves, M. (2003). Training beginning supervisors working with new trauma therapists: A relational model of supervision. Journal of College Student Psychotherapy, 17, 19–39. doi:10.1300/J035v17n03

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