Vermont Clinical Supervision: Considerations for the new professional

clinicalsupervision supervisedbilling vermont Apr 03, 2023
Vermont Clinical Supervision:  Considerations for the new professional

In the counseling field, the purpose of clinical supervision is to establish a relationship between an experienced therapist and a newly trained therapist.  This structure is designed to promote the development of professional responsibility, competence, skills, and ethical standards.  The main responsibility of the clinical supervisor is accountability for client care falling within the scope of the counselor’s practice and ensuring ethical standards are being met.  This is done by the supervisor having oversight and guidance in diagnosis and treatment of each client, reviewing documentation, providing feedback and mentorship in the clinician’s professional journey.  Supervision is a critical component of the professional growth and development of the counselor. 

Selecting a clinical supervisor is much like selecting a therapist.  It is important to find someone who matches your professional value set, has experience with the population you’d like to work with, and has an understanding of how ethical standards and state regulations apply to clinical practice.  When exploring a good fit for a clinical supervisor consider the following:

Vermont Clinical Supervision 

Current State Regulations:

  • A clinical supervisor must have been practicing for a minimum of 3 years with an unencumbered license

Recommendations from Vermont Counseling Network:

  • Clinical supervision is a specialty area and most states require advance training and credentialing.  Vermont does not require these for clinical supervisors.  However, it is best practice to not practice outside of our area of competence.  Does your clinical supervisor participate in ongoing training?
  • It is best practice to have a contract for supervision.  A contract should outline how you will be supervised and assessed, what the expectations are for the supervisor and supervisee, and fee structure for supervision.  Additionally there should be information about how to reach your supervisor in an emergency situation, and what to do when they are not available.  
  • If you choose to do supervised billing under the same supervisor, there should be a separate contract or section within your contract with regards to supervised billing.  It is strongly encouraged that you familiarize yourself with Vermont Rules of the Board of Allied Mental Health Practitioners Rule 3.20(b) and (c).  How does the supervisor navigate this?  According to this regulation, it is not appropriate to charge a license use fee to a supervisee to bill insurance.  In an email Lauren Layman, OPR Attorney states, “Rule 3.20(b) and (c) of the Vermont Rules of the Board of Allied Mental Health Practitioners prohibit supervisors from personally financially gaining from the practice of the supervisee.  This does not mean that the supervisor may not bill for these services.  It does mean that any compensation the supervisor receives for providing supervision services must be independent of the amount, quality, and timing of the supervisee’s practice and the reimbursement received for that practice.  For example, a supervisor may bill for the supervisee’s services and pass the full reimbursement received through to the supervisee.  The supervisor could then receive a set, flat fee for providing supervision services.”  
  • It is recommended there be a cap on the number of clients a pre-licensed clinician will be able to treat at one time.  It is also best to have an understanding of how many supervisees the potential supervisor supports at a time, and if they maintain their own caseload of clients.

Where do I find a clinical supervisor?  Vermont Counseling Network is working on building a directory for finding a supervisor.  We will send updates as this develops.

What do I do if my supervisor is not practicing in accordance with Vermont statutes?  This question comes up quite frequently.  First step is to talk to your supervisor about your concerns.  It is recommended that you document these questions in email as well, when there is a difference in opinion on interpretation so that you both have proper documentation.  If you still feel as though your supervisor is not practicing in accordance with the current state statutes, you may file a report with OPR online.

Since the regulations related to clinical supervision are vague it can be challenging to a newly trained therapist to determine who is a good fit.  Additionally, as you develop your skills and interests you may want to switch to a clinical supervisor who offers more specialized supervision.  I would also consider asking, “what happens if I decide I want to switch supervisors once I become established in my practice?  What are the supervisors' policies around transitioning to a new supervisor?”  Ultimately, clinical supervision is another huge investment in your career and professional growth. Investing in quality supervision that prepares you for independent licensure pays big dividends in the future.