Ohio SAMI CCOE emphasizes need for focused clinical supervision, provides useful methods

—by Matthew K. Weiland and Paul M. Kubek

Cleveland, OH—In the Fall 2007 issue of our SAMI Matters newsletter, we began an ongoing discussion about the organizational structure—known as the General Organizational Index (GOI)—of Integrated Dual Disorder Treatment (IDDT) services (click here). This discussion is an effort to help service providers better understand the seamless relationship between the organizational characteristics and the treatment characteristics of the IDDT fidelity scale and the scale's vital role in assisting consumer recovery. We continue the discussion with this audio eConsult that focuses on supervision, which the consultants and trainers of our Ohio Substance Abuse and Mental Illness Coordinating Center of Excellence (SAMI CCOE) initiative have identified as among the most important components of the fidelity scale's GOI.

Clinicians Benefit From Immediate Feedback in the Community

One of the hallmarks of effective clinical supervision is real-time observation of service providers at work in the community with consumers.

There is certainly value in sitting with team members in the office engaged in discussion on approaches and techniques. However, seeing an individual provider in action with a person who receives services reveals much more information. In real-time situations, there is the chance for a supervisor to observe her team member and offer rich feedback about body language, tone of voice, timing, and the various nuances of different interventions such as motivational interviewing.

Ric Kruszynski, MSSA, LISW, LICDC, director of SAMI consulting and training initiatives at the Center for Evidence-Based Practices, tells a story that illustrates how 20 minutes of real-time clinical supervision in the community with immediate feedback helped one team member refine her approach and find the tools she needed to help one woman's journey toward health, wellness, stable housing, and recovery.

‘What Is It You Do Want?'

Kruszynski's story comes from his own experience as a consultant and trainer in which a service provider asked for his counsel on how to connect with a woman diagnosed with co-occurring severe mental and substance use disorders who was resistant to all outreach efforts and had otherwise remained unengaged in services.

Kruszynski joined the client and case manager for a conversation over iced-tea in a family restaurant, an encounter that turned out to be an instance of real-time supervision of motivational interviewing. Kruszynski emphasizes that this is a prime example of how the investment of no more than a half hour of time produced results that ultimately changed two lives: the professional life of the service provider and the personal life of the consumer.

Lesson Learned

It is perhaps helpful to listen for how the clinician is guided to roll with resistance, to find the motivation that matters to the consumer, and the ways in which real-time supervisory feedback can have an immediate and lasting impact. 

Matthew K. Weiland, MA, is senior writer, producer, and new-media specialist and Paul M. Kubek, MA, is director of communications at the Center for Evidence-Based Practices at Case Western Reserve University.