How to Use Clinical Supervision When There Aren’t Clients

What do you talk about when there aren't ​enough clients to talk about? Here are some tips ​for both ​students and supervisors ​to help ​you have rich, engaging, and educational ​supervision meetings.

Students have told me about challenges they are having in clinical supervision during the COVID-19 crisis. For most, the problem is that their caseload has suddenly decreased by a large percent and consequently they have little to talk about during their sessions. Unfortunately, it seems like many clinical supervisors and students alike have been thinking of supervision as a rather one-dimensional undertaking where all you do is run down the list of clients you are seeing and focus on the most urgent risk management issues. Supervision can be so much more, but it takes active effort on the part of both the student and the supervisor. Below are some ideas for how to use your time.

1- Case presentations and discussion. Just because there aren’t as many current active cases doesn’t mean there’s no cases to talk about. Dive deeper into students’ past work and do a more in-depth case conceptualization. Students can spend time writing about their work. Supervisors can share about the cases that have taught them the most. Find vignettes that you can both work from together.

2- Do role plays. Supervisors can demonstrate their own clinical practices by having the student pretend to be a client. Supervisors can also describe a conversational exchange with a client, role playing both sides. Students can then take a turn, and practice skills like active listening, how to explain and complete a thought record, etc.​

​3- Talk about student and supervisor research. If students have a big project like a dissertation or thesis in the works, spend some time talking about it. Supervisors can share their thoughts on the topic, method, or how the findings might be clinically useful. If supervisors have research going on, this is a good opportunity to talk it over with someone. Encourage students to apply critical thinking and think about other ways of researching the same or similar topics.

4- Share cool stuff you are reading. Some training sites have a weekly or monthly journal club where people get together and discuss one or more scholarly journal articles. Students and supervisors can do this in their meetings as well, and can take turns finding the readings.

5- Learn something together. There are volumes of free resources and trainings available online right now. You could spend some supervision time together watching and discussing the same content.

6- Have the supervisor share some weird niche expertise they have. There is probably something the supervisor knows that makes them unique in some way. If you are the student, look at the books on the supervisor’s bookshelf or ask them about any special clinical expertise or favorite continuing education they have done. If you are the supervisor, think about the special skills you have been honing and share it with your student. If you have given presentations before, maybe your student would be interested in learning what you taught.

7- Help the student develop their own weird niche expertise. Spend some time brainstorming the topics that most interest the student and create a project to enhance knowledge and expertise in this area. Maybe there’s a mini literature review they can do, or even a short presentation they could prepare to give others at the training site.

8- Supervisors: Practice mentorship. Take an interest in students’ professional development in a more holistic sense. Ask them about their overall professional goals and discuss different pathways to getting there. Consider ways that you can be helpful, e.g. by making introductions, collaborating on projects, and helping students set and achieve goals.

9- Students: Elicit mentorship. Tell supervisors that you would love to talk with them about your overall professional development and get their input and feedback. Ask for advice about specific challenges.

10- Talk about ethical imperative of self care. Particularly during the current COVID-19 crisis, it’s a great time to talk about self care, burnout prevention, and the importance of not being impaired in our clinical practice. Supervisors, talk about what you do for self care – or what you wish you were doing.

11- Help students revise their CV or resume. Students and supervisors can initiate this conversation. There are templates available online to follow, or students can get information from the career services department of their school.

12- Have a two way human interaction. When all else fails, remember that you are two human beings with at least one shared interest. Talk about what excited each of you to enter the field. Find other areas of synergy and shared interest. Particularly in this time when many people are isolated and feeling lonely, don’t underestimate the power of a human encounter. Let the professional veneer soften a little bit and share a little bit about your own personal human journey.

​In closing, a few words ​of advice for students and supervisees alike:

Students: Don’t expect your supervisors to figure it all out. To the extent possible, show up prepared with your own ideas and questions. Make suggestions about how to use the time. Be patient with your supervisors, who may be going through a lot right now in their personal and professional lives. If you tend to be fairly boundaried, be willing to bring a little more of your whole self to the encounter.

Supervisors: Don’t expect students to show up with an agenda, even if that is your usual practice. This pandemic is impacting everyone differently, and students might have a lot going on in their personal lives that they are not comfortable sharing with you yet. Take your role as an educator seriously and have a few ideas in your own mind about how to use the time. Make suggestions to your students and see what interests them. ​As with ​students, if you tend to be fairly boundaried then you might try bringing a little more of your whole self to the encounter.

Even in the best of times, supervision takes mutual effort and creativity to become truly great. I believe these current challenges can be salutary in the long run and could potentially make clinical supervision even better than it was before.