Show Notes

Welcome back to The Designer Practice Podcast, and I’m your host, Kayla Das.

In today’s episode, Kristi Kerford, registered psychotherapist and clinical supervisor, will discuss how to deliver strategic and deliberate clinical practice through learning goals.

Hi, Kristi. Welcome to the show. I’m so glad to have you here today.

Hi. Nice to be here.

Kristi, before we dive into today’s episode, please introduce yourself, where you’re from, and tell us a little bit about your practice journey.

Sure. I’m based in Ontario and I’m a registered psychotherapist. And I would say that I’ve had a meandering career path.

I started out in career counseling and then pretty soon into that practice began to appreciate how integrated it was with mental health. And yeah my path has then moved more directly into psychotherapy. And now I would say my work is probably, 80% in the psychotherapy side of things, and then 20% in the career transition type side of things.

Amazing. So when we’re thinking about supervision, what do you see as both the purpose and the value of clinical supervision?

Yeah. So for me, supervision is a vehicle for learning because it allows us to reflect on our work. Dialogue with someone else, a peer or a supervisor to ideally learn, grow, make change. And so it’s a real critical part I think of most professions of most things that we do. So at the same time, I also think in a lot of provinces there’s a supervision requirement and I think there’s pros and cons about having a supervision requirement. I love that it’s supported and that it is then encourages more people to engage in it, but then we also run the risk of it feeling like a checkbox versus it really being substantive and a positive learning experience.

So when we’re thinking about supervision, what is the difference between reactive supervision and proactive supervision?

Yeah, in some ways it’s fairly self-evident, but I’ll let you know my perspective on that.

For, I think a lot of us, we will be involved in a therapy session and something will happen in the session or when we’re doing our notes, we’ll reflect on the session and there’ll be something that we’ll think, Ooh, I feel like I should probably check in with somebody about this, whatever it is. I feel like I should get a second opinion on this, and that’s what I would see as more reactive supervision where something happens and then I react and I’m reaching out.

Whereas I think of proactive supervision as, almost if you imagine that you had no clinical issues to discuss. What would you then be talking about in supervision? So it might be that you were talking about the longer term learning, goals that you had in your practice or the trajectory of where you wanted to go with clients and looking more at not what just happened, but more what can I envision happening?

I think that does happen sometimes. I shouldn’t say sometimes I think probably a fair amount, but when you’re working with folks with very small caseloads, supervision tends to be very proactive because you’re you pick something that you’re going to spend some time on and it becomes more about learning than simply about this happened and now what this happened, and now what.

I love that. And that makes me think of some things that I’ve heard in the past from various therapists, is I don’t have anything to speak about in clinical supervision. Why should I go? So tell me your answer to that question, like, why should someone go if they, are not in reactive clinical supervision? Because everything is going great.

Yeah, it’s such a good question. And for me, I would say it would probably depend on the person as to what do you do next? Do you go to supervision? But for most of us, there’s something that we are exploring or curious about that would be helpful to be in supervision to help us integrate that learning into the therapeutic practice.

Or there may be something that we are ourselves working through as a therapist, right? So maybe it’s not a particular client, but say we are, struggling with the ebbs and flows of client numbers and the anxiety that makes us feel in terms of our practice, right? So there can be things outside of just the therapy specifically that we might want to discuss with a supervisor.

And I also think that there are clinical issues, so to speak, that sort of transcend an individual client. So things like how you’re going to conceptualize a case or things like how you’re going to manage transference or things like termination. And those things are iterative and we learn about them as students and then sometimes we then don’t go back to them. So that would be another example of something that would be like is there something in the process of therapy, sort of the A to B process that. Would be helpful for you to dig into a little bit as it relates to your practice in general.

That’s helpful. And this actually makes me think of, say, group clinical supervision. Often when you’re in group clinical supervision, there’s always someone talking about something that might be reactive to them, but may not yet have happened to you. And bringing those insights and what could happen in the future so that you can prepare yourself and think about those situations before they arise for you.

Ah, I completely agree. Yeah.

So how might a clinician approach developing learning goals with a supervisee, and how does supervision specifically support this development?

So I think a lot of it has to do with where a person is in their career. So first and foremost, I think folks who are still students their clinical learning goals may be very much about, getting the basic skills, feeling comfortable as a therapist understanding what is therapy. And then as you’re moving into the field. Probably people’s clinical goals are a little bit more about what modality speaks most to me. What am I going to draw from? What are the presenting issues I’m most comfortable with? So on and so forth. And this kind of develops over time.

I think a lot of us, we’re learners at heart, and so we’re drawn to learn more. And so the idea of having learning goals not only does it support and encourage people to keep learning, but I think it maybe also helps us to deliberately think about what we learn versus following the email that comes in with the new training that’s available. And so you’re trying to step back and be like, what learning will support me where I’m at?

And so then the second piece of that is, so how do I decide that? And so part of that, I think you react to the market and your client base. And so if I’m noticing a trend of presenting issues in a certain area, and it’s an area. That I am not familiar with. And that might be an indicator to me that is that something that I want to develop that skill so I can serve that client population.

Another way we decide our learning goals, I think is personal interest. Because I certainly wouldn’t encourage, this is the career counselor in me, but I certainly wouldn’t encourage someone to just follow the trends if it wasn’t something that was of interest to them. There is a balance that I want to be thinking about. What do I want to learn about and also what do my clients need? And then how do I develop a learning plan or develop my learning goals to meet that?

The second part of your question was around how does supervision support this? And I think if your supervisor or if you’re the person being supervised, but in that dialogue. If both parties know what their long-term learning goals are, what they’re focusing on, what they’re paying attention to, then that supervisor can support them in integrating that knowledge into their therapeutic work.

In some cases the supervisor may be an expert in the modality or the thing that person is learning. And so they can provide like direct supervision, but in other cases, just them knowing that’s that person’s learning goal allows them to help them to reflect and integrate even though they may not be a subject matter expert.

I love that. So how do you incorporate this approach into your practice as a clinician and of course as a supervisor as well?

Yeah, so as a clinician, I can just speak for myself, but certainly when I was first coming out of my graduate degree, which feels like some time ago now, it felt like I needed to learn everything. And I very quickly realized that wasn’t going to be possible and probably wasn’t going to be helpful for anyone.

And so, I did exactly what I alluded to there is I stepped back, over the course of a year, I stepped back and tried to think about what do I really enjoy? What really speaks to me, like when I read about different modalities or if I’m even just reading blogs or, Q and As, what stuff really resonates to be able to, break my learning into buckets, as to where I think I need to spend my time.

And then at the same time I was like, and who is coming to my door? What clients are coming to my door? And in some cases there’s learning because they’re coming. And in other cases there’s the ability to say, you’re not in my scope. And it takes time and it doesn’t ever stop. So I’m still doing it. And so I learn new things as I go.

So the second piece that you talked about is as a supervisor, and what I tend to do with everyone that I supervise is I ask them if they currently have any learning goals. And if they do, then I just try and get a sense of what does that look like for them? What are they doing? Are they reading about it? Are they taking a course? How can I best support them? How can I weave it into what we do? And sometimes we’ll go so far as to pick out an article about it and then have a bit of a discussion about it in the context of the cases that they’re working on.

And in many cases. I’m not the subject matter expert on everybody else’s learning goals, but I can be a facilitator of their learning to help them weave it in when we are talking about, their cases or their reactions to cases.

That’s really helpful. When we think about learning goals in general, I know in social work when we do our practicums, we have to create a learning plan. And for many practitioners, that can be really overwhelming because it’s so formalized. But at the end of the day, all of us have things we want to learn, things we need to learn, and things that are just going to help us grow moving forward.

And I love that you identified that you can create different buckets, right? The stuff that you want to learn, the stuff that you might need to learn because of course you have clients coming in and you got to learn how to work with them. But then also the other side is, okay, what is outside of my scope? And being very comfortable about referring people out that may not fit within your current scope yet. Or maybe you have no interest in a particular area and that’s okay because I think that sometimes we feel like we have to work with everyone, but it’s really better for us to go small and go out as we start growing our skills.

One, it’s good marketing strategy, but two, it’s also very clinically appropriate. No one expects us to work with everyone. I actually know when I first started my private practice, it was only a month that I worked with everyone and then I really honed in. But I felt I spent more time outside of the therapy room trying to find the right activity, the right therapeutic modality, the right thing to do next day because I had, I don’t know, 20 clients and 10 to 15 of them all have different problems or different situations or different needs that I had to achieve. So I was spending more time outside of the therapy room than inside of it, just trying to find the right thing to do.

Whereas when I finally, after that one month said, I’m just going to focus on workplace stress and burnout, and this is where I’m going to focus. I was able to grow my skills because everything that I learned was either adaptable or just like complimentary to my approaches and I was able to build my clinical approach much quicker, and I also developed a lot more confidence into my approach because of that.

It’s so wonderful when someone is able to find that niche, right? And I don’t know that that all of us, myself included, get to that place where you can be quite specific. But you’re right that’s part of what the learning goals help people do.

Absolutely. I love that. Kristi, I know you offer clinical supervision who might be a good fit to work with you, and how can they connect if they’re interested?

Great question. I would say I generally work with early to mid-career psychotherapists and counselors from across Canada. Supervision serves different purposes for different people. And for me, while I understand it, it sometimes feels like a requirement. I also want to make sure that it feels worthwhile and like a learning opportunity and an opportunity for self-reflection.

So while I practice from an emotion-focused lens in therapy, in supervision, I just pull out that focus on process and try and use that in my supervision sessions. And that tends to cross a lot of different modalities. I did want to mention as well that I understand that cost is sometimes a factor in supervision.

And so I do offer small group sessions. I generally try and keep them to four people, so that way it can still be fairly intimate and intensive, and we can incorporate some of that learning and self-reflection in a small group setting. So if that appeals to you, then I would be a fit for you.

Amazing. So check out Kristi’s website at ptbotherapy.ca or simply scroll down to the show notes and click on the link.

Kristi, thank you so much for joining us on the podcast today to discuss how to deliver strategic and deliberate clinical practice through learning goals.

Thanks for having me.

Thank you everyone for tuning in to today’s episode, and I hope you join me again soon on The Designer Practice Podcast.

Until next time, bye for now.

Credits & Disclaimers

Music by Denis Pavlov Music from Pixabay

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