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Unread August 3rd, 2008, 11:15 AM
sk8rgrl23 sk8rgrl23 is offline
Join Date: Dec 2005
Posts: 53
Default clinical autonomy in an agency

I have been bestowed upon by a new clinical supervisor and I am already having some heated disagreements with her on several points.

Despite her being young enough to be my child and I have been in social services on some level since before she was even born, she seems to have gotten her head full of authority and I've noticed a tendency for her to disagree on me about just about anything, seemingly just for her own need to be right, as she tends to state her point in globalized statements as if they were commonly understood facts when in fact she has no clue.

some issues that have been disputed:

I am a clinical supervisor and have taken on two interns so far. we as an agency are discussing the idea of establishing ourselves as a teaching facility and deciding on some basic issues to consider, one being competence of interns coming in and how to evaluate that. I am realy having my eyes opened about how unprepared and at times unsuitable some people are to be functioning in this profession. I've seen interns not seem to have a clue about what confidentiality means, be able to describe basic theoretical approaches, not seem to even know how to show up for work. The dispute with this young full-of-herself supervisor came up when I was discussing a concern I was having about my current intern with her, and we ended up arguing about some hypothetical situation of how to deal with an intern who comes in without the most basic of skills. Her spirited "can do it all" attitude is that we should never assume that an intern has basic competencies and that as a supervisor it is in fact part of our role to teach these things.

I say not. I went online and discussed this matter over the phone with two professors in the field who both said that interns are required to have certain core classes completed and not just to have been a warm body in the classroom either, but to be able to function iwth the information they were expected to learn.

Then I thought about the Egg Who Wants to Teach the Chicken here and thought abott her expecting me to assume that kind of liability and expect me to take someone on my license that isn't prepared to treat clients and I thought "wow."

There have been other instances similar to this where I feel her judgment is superceded by her need to be in authority,her new thing is that we clinicians are going to be required to take whatever clients she refers to us regardless of the appropriateness of the referral and that she is considering not letting clients switch therapists if they don't feel the one they got assigned to isnt' working, because, as she states, "sometimes that can be a learning experience for a client to have to work through how to get along with someone they don't like." sometimes that is true, and I agree with putting a limit on therapist-hopping, but to have this as a general policy seems unethical to me.

the agency power people seem to have given her a green light to do as she sees fit, and she's done a lot for this financially strapped agency in terms of bumping up productivity and tightening up paperwork quality. but it's only a matter of time till I have enough money saved up to open my parachute and jump out of the plane and into private practice.

My former supervisor was always good at listening to my point of view and respecting my clinical judgment on things. but now she's in "senior management" and slowly delegating her supervisory responsibilities to The Egg. I've thought of talking to her about my concerns but I don't want to come off as trying to put her in the middle or just being a complainer, and some of these issues are just so fundamental in terms of working styles and communication styles and philosophy that I don't ever see us working well long term, not as long as she has authority over me. when we were in parallel positions we were great and played off each other's strengths, but now it's all her way or no way.

so bottom line, I'd like to hear people's thoughts on clinical autonomy in a financially strapped public mental health agency, this supervisor's expectations and how would you deal with the situation, short of leaving which is not an option until I am ready to get into private practice.
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