What is Competency Based Clinical Supervision?

The job of Clinical Supervision in behavioral health is likely the most complex, multifaceted, stressful and rewarding positions in our field. Our goal when we first get into the job is to help new clinicians to become the best possible providers possible. This is a very admirable and lofty goal which comes up against several hard realities of the work we do. On the job we have to manage conflicting directives, maintain funding contracts, provide administrative oversite, and strategize how to manage underperforming employees. Under all this pressure we can lose sight of the original goal in supporting counselors in becoming great at their work.

The concept of Competency Based supervision was developed to help create a baseline for clinicians regardless of theoretical orientation. It was designed to help us work with any supervisee towards commonly accepted standards for an exceptional clinician. The competencies are meant to be a “light house in the storm” in that they provide us a point of reference under any conditions. Like a light house under the best of circumstances, you might question whether you even need this point of reference but under the worst conditions you can’t imagine what you would do without it.

In 1998 SAMSHA published its first Technical Assistance Publication 21 (TAP 21) Addiction Counseling Competencies: The Knowledge, Skills and Attitudes of Professional Practice. This was the first manual of setting forth competencies that all addictions counselors need to be effective in the field. Over the next decade all of the behavioral health professions created their own set of competencies however, the TAP 21 is still by far the most comprehensive.

I find that when using the competencies I am consistent with supervisees on what is expected. When conditions are good and a supervisee is progressing well we don’t refer much to the competencies. However when there is a problem the competencies help me identify the issue, giving the supervisee the best chance possible to correct course. Further, by knowing the competencies well I am far better at making sure there are no gaps in my supervisee’s development.

An example: A supervisor is struggling with developing a professional development plan for a supervisee. It was challenging for this supervisor to articulate the types of development they wanted the clinician to focus on. Through familiarizing themselves with the TAP21, this supervisor was able to identify the two areas that seemed most critical to address and construct the professional development plan in a cohesive manner.

Example: A practitioner approached their supervisor with the desire to discuss how to improve their group counseling skills. Looking through the TAP 21 the clinician and supervisor were able to identify the exact facilitation skill that was needed and create a clear plan to develop that skill.