TIP 52: A Guide for Clinical Supervision
Clinical supervision has become the cornerstone of quality improvement in the substance abuse treatment field.
“Supervision ensures that counselors continue to increase their skills,” said H. Westley Clark, M.D., J.D., M.P.H., Director of SAMHSA’s Center for Substance Abuse Treatment (CSAT). “That increases treatment effectiveness, client retention, and staff satisfaction.”
CSAT’s new Treatment Improvement Protocol 52 (TIP 52), Clinical Supervision and Professional Development of the Substance Abuse Counselor, offers best-practice guidelines and basic information for clinical supervisors and program administrators.
Providing a bridge between the classroom and the clinic, clinical supervision improves client care and develops the professionalism of clinical personnel. Clinical supervision also helps maintain ethical standards in the field and ensures those standards are widely shared.
“TIP 52 focuses on teaching, coaching, consulting, and mentoring functions,” said the protocol’s Consensus Panel Chair, David J. Powell, Ph.D., president of the International Center for Health Concerns, Inc., East Granby, CT.
According to Dr. Powell, clinical supervision is “a disciplined, tutorial process in which principles are transformed into practical skills.”
The clinical supervisor also serves as liaison between administrative and clinical staff. “Teacher, coach, mentor, consultant—the roles of the clinical supervisor are key to staff retention and morale,” said John Porter, M.S., Northwest Frontier Addiction Technology Transfer Center (ATTC), Wilsonville, OR. “Our clients are better served in a collegial, team-building atmosphere.”
Effective clinical supervision ultimately ensures that clients receive appropriate and competent services.
Topics include cultural competence, ethical and legal issues, dual relationships and boundary issues, informed consent, confidentiality, and supervisor ethics. Divided into three major sections, TIP 52 includes the following:
- Part 1: Designed for supervisors, this section presents the basics of clinical supervision, including representative vignettes of specific scenarios, master supervisor notes and comments to show the thinking behind the supervisor’s approach in each vignette, and how-to descriptions of effective techniques.
- Part 2: A hands-on guide, this section helps program administrators understand the benefits and rationale behind providing clinical supervision for their program’s substance abuse counselors. Tools are described to ease tasks associated with implementing a clinical supervision system.
- Part 3: A literature review is included online only for clinical supervisors, interested counselors, and administrators.
To order print copies of TIP 52, call SAMHSA’s Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727). Request publication number SMA09-4435.
Download TIP 52. Download the online literature review.
The Consensus Panel identified 11 central principles:
- Clinical supervision is an essential part of all clinical programs.
- Clinical supervision enhances staff retention and morale.
- Every clinician, regardless of level of skill and experience, needs and has a right to clinical supervision. In addition, supervisors need and have a right to supervision of their supervision.
- Clinical supervision needs the full support of agency administrators.
- The supervisory relationship is the crucible in which ethical practice is developed and reinforced.
- Clinical supervision is a skill that has to be developed.
- Clinical supervision in substance abuse treatment most often requires balancing administrative and clinical supervision tasks.
- Culture and other contextual variables influence the supervision process; supervisors need to continually strive for cultural competence.
- Successful implementation of evidence-based practices requires ongoing supervision.
- Supervisors have the responsibility to be gatekeepers for the profession.
- Clinical supervision should involve direct observation methods.