Last week I was listening to an interview on NPR’s Fresh Air. A chef with Michelin stars by his name was describing his passion for cooking for the displaced. Jose Andres described how his non-profit had gone into Puerto Rico after hurricane Maria and cooked thousands of meals for survivors (read his book We Fed an Island). In my mind I could imagine this magnificent cooking machine where trained chefs would train other chefs to train volunteers who would then have the responsibility for cooking meals for the needy. “I must do this!” I thought. Then I realized; I already do.
When I decided to supervise interns, I accepted the responsibility to teach an apprentice my skills. Sometimes I was Emeril Legasse and we would laugh and enjoy our time; sometimes I was Gordan Ramsey and my trainee would leave my office in tears. Regardless of my methods, when I signed on the dotted line, I was confident that the counselor I trained would go on to serve his or her community and do good work.
Supervising interns led to my decision to train licensed professional counselors to supervise. Thirty-five cohorts later I look back and realize (if we follow the metaphor) I have trained hundreds of cooks to train other cooks to serve meals to countless communities. The number of people served is mind-boggling! Still I want to do more. I want to teach supervisors to provide their own counselor supervisor training.
Let’s do the math. One training creates five new supervisors. Those five supervisors take on two interns each. Those ten interns each take on a caseload of twenty clients per week for eighteen months. And since they won’t see the same twenty clients for the entire eighteen months, let’s guesstimate that each intern will impact five hundred individuals and families over the course of their internship via individual and group counseling. Check my numbers, but that sounds like five thousand people impacted by a single supervisor training.
That is why I must teach you to train others. I must teach you to go beyond supervising interns and make the leap to train counselors to become supervisors. This will require skills that look more like opening a restaurant than counseling a client, but you can do it. There is no end to disasters, loneliness, grief, and war, so why stop with just serving a small group, or one community? Let’s go save the world, one meal at a time.
On May 19 2018 Dr. Chris Taylor and I traveled to El Paso and delivered a train the trainer course to twenty licensed professional counselors. Why? Because there is a massive shortage of licensed mental health providers in the El Paso and surrounding areas and the domino effect is devastating. Where there are few licensed providers there are few approved supervisors and where there are few approved supervisors there are few interns. Bottom line: we can’t attract new professionals into rural communities unless we establish a pipeline of licensed professionals willing to become approved supervisors.
Create content that safeguards the public and your license
Become a CE Provider
First, fill out the form, write your check to the state, and become a CE provider. As of the date of this published blog, in Texas both LPC and LMFT rules require that you must become an approved CE provider before you can sell seats to your own 40 hour training. LPC rules go on to stipulate that 40 hour teachers must also be approved supervisors and approved 40 hour training providers.
Next, you must have content that is compliant with the rules for the training you wish to teach. This includes not only checking out LPC and LMFT rules for the content you must include, you must also make sure you cover recent rule changes, trending complaints, and policies the board may have adopted but not published yet. Creating compliant content means as a trainer you must attend board meetings so you will be familiar not only with the rules but with the latest board actions and policies.
In addition to compliant content, you must deliver practical tools. As a wise man once told me, “I’ve never heard a complaint against someone because they didn’t know their theories.” Most board complaints against supervisors are administrative in nature. The supervisor didn’t keep accurate records; the supervisor wasn’t aware of the number of supervision hours needed each month; or the supervisor didn’t provide enough documentation. When you teach a supervision course you must provide practical tools so new supervisors are successful.
Content that Safeguards the Public
Finally, you must provide content to help new supervisors safeguard the public, their license, and your license. How do you teach a new intern to assess suicidal and homicidal ideation? Assess and report abuse? Stay safe with violent clients or dicey work settings? These are things your participants may KNOW because they are seasoned practitioners. As the instructor you must teach your participants how to ‘teach that skill’ to level 1 interns who may think they already know it all. At Kate Walker Training we devote time to helping our participants go beyond a supervision contract so they are able to confidently teach new interns these skills before they ever start seeing clients.
We need more supervisors! We also know that designing and delivering an effective supervisor training can be hard. If you are interested in becoming a trainer, stay tuned. We’ll have more info coming the end of August.
Here’s the thing. In light of recent events I want to speak to all of the problems Texas has when it comes to providing excellent, accessible, and affordable mental health care. I want to outline solutions, propose law changes, and rally the troops. Texas seems to enjoy competing for 49th or 50th place when it comes to quality mental health care in America and this little blog post probably won’t change that. So, as a counselor supervisor, counselor educator, and practicing clinician, I will talk about what I know. This post is about counselor intern supervision and supervisor training.
For those readers who aren’t familiar with Texas rules governing licensed professional counselors:
Every Licensed Professional Counselor (LPC) in Texas must spend 3000 hours as a Licensed Professional Counselor Intern under the supervision of a Licensed Professional Counselor Supervisor (LPC-S).
There are places in Texas where there are no licensed professional counselors or supervisors (see the white areas in the map below).
There are strict limits on the number of supervision hours interns can accrue using technology.
Training more supervisors in rural areas and lifting the restrictions on webcam supervision would be easy first steps to helping Texans gain access to quality mental health care.
Counselors and Webcams
Increasing allowable intern supervision hours via technology is a no-brainer. The Telemedicine Wellness, Intervention, Triage, and Referral Project at the Texas Tech University Health Sciences Center is pioneering the use of technology to screen junior high and high school students, identify those most at risk for committing violence in schools, and intervene before anything happens. Data are already showing that the screenings have helped avert violent incidents and provide students the help they need. Why can’t interns attend supervision using the same technology? Counseling graduates on the fence about where to practice might choose underserved areas if they did not have to travel long distances to receive face to face supervision. Arguments against using technology in mental health are archaic and have become a roadblock to care.
Counselor Supervision Training
Changing the rules about technology and supervision is only a start. Long story short, we need seasoned counselors and counselor supervisors in underserved areas. One LPC Supervisor Course attended by five participants who agree to take on just two interns can impact hundreds of people in need of quality mental health care. Recently I, along with Dr. Christopher Taylor offered a six hour course to twenty participants in El Paso interested in offering their own 40 hour training. How exciting is that? Twenty seasoned licensed professional counselor supervisors near one of the most underserved areas in the state are now trained and willing to provide their own courses. Their impact alone could be a game-changer for interns who feel called to work in underserved areas.
Lifting limits on technology and increasing the number of supervisors won’t solve everything but it’s a start. We still need to give interns the ability to bill Medicaid. We still need to convince the military and Tricare to hire licensed professional counselors. And we need to help Medicare understand that refusing to allow counselors to be credentialed under their plans makes them part of the problem. Texas, we need counselors and supervisors more than ever before. And we need them now.
“What is holding you back from creating your own 40-hour supervisor training?”
This question was part of the presentation I was giving with Dr. Paul Carrola and Dr. Amy Wilson at the Texas Association for Counselor Education and Supervision Mid-Winter conference. I was speaking to a room of about fifteen people curious about how to pull off a forty-hour supervisor training in their community. The most common barrier? Time. Participants worried about the time they would need to divert from their practices to create content and manage participants. In my article “The Good, the Bad and the Ugly: Creating a Counselor Supervisor Course,” I described some key components to help potential course designers. After my TACES presentation, however, I realized I need to talk about content, systems, and tools.
Supervisor Training Content
Supervisor training course content is prescribed by state licensing boards, accrediting bodies, and universities. In many states this is spelled out explicitly. The Texas LPC code, for example, defines the topics that must be covered in a supervisor training course. Unfortunately, since most potential supervisor trainers are not professional educators they don’t have easy access to powerpoints and textbooks. In those instances the content must be generated the old fashioned way, outsourced to content developers for a fee, or borrowed from public domain sources.
Participant Management Systems
Potential supervisor training participants will go through three stages: pre-purchasers, participants, and course graduates. Supervisor trainers must be able to manage expectations at each stage. Good participant management systems, organizational systems, and financial systems can help. Pre-purchasers need information about eligibility and law. They need quick responses to email and phone queries. Most will also need to know your refund policy before they decide to follow through with their purchase. Participants have assignments to complete and deadlines to meet. If your supervisor training course requires online or outside assignments, then you must have a system to keep track of successful completion. Course graduates will need support and access to replacement certificates. Remember graduation from your course doesn’t mean the course graduate is automatically granted supervisor status. There may be a waiting period to gather more experience. In Texas the course is only good for two years and Texas LPCs only have ninety days to complete it. You must have a system to track and be able to prove when the course graduates officially began and successfully (or unsuccessfully) completed your course.
Course graduates appreciate helpful tools to help them begin integrating supervision into their private practice. It’s great if you can offer them supervisor toolkits, helpful software ideas, and economical apps. Remember your course graduates are your best source of good reviews and new referrals so help them leave your course feeling fully equipped! Follow up with them through emails and social media and help them stay connected with state organizations and other course graduates.
Content, systems, and tools are just a few things that will really make your supervisor training stand out and benefit your participants. Keep checking this blog for more great ideas!