Image: Episode 491 artwork for Modern Therapist’s Survival Guide titled “Burnout Before Licensure: A Supervision Problem.” The image shows an overwhelmed person sitting at a laptop with their head resting in their hand. Text notes that the episode is a Continuing Education podcourse.
Google PodcastsApple PodcastsStitcherSpotifySubscribe on AndroidShare Listen in a New WindowDownloadSoundCloudLeave a ReviewSubscribe via RSSKeep me updated!Player Embed

Burnout Before Licensure: Why Prelicensed Therapist Exhaustion Is a Supervision Problem, Not a Time Management Problem

Curt Widhalm, LMFT, and Katie Vernoy, LMFT examine why prelicensed clinicians are entering the workforce already depleted, and why that exhaustion is so often misread as a time management failure. Drawing on workforce research, supervision literature, and their own years in supervisory roles, they trace prelicensee burnout to caseload acuity, administrative load, financial precarity, and evaluation anxiety, then look at what can actually change inside a single supervision hour.

This is not a self-care episode, and Curt and Katie say so directly at the top: no toxic positivity, no bubble bath prescriptions. The focus is on clinical supervision as a structural intervention, with concrete strategies for both sides of the desk and a case vignette that walks through what a drowning supervisee looks like before anyone names it as burnout.

This is a continuing education podcourse.

Transcript

Click here to scroll to the podcast transcript.

(Show notes provided in collaboration with Otter.ai and Claude AI.)

 

In This Podcast Episode: Prelicensee Burnout, Parallel Process, and Supervision as a Protective Buffer

Today’s early career clinicians are carrying caseloads that look nothing like the ones their supervisors trained on. Client acuity climbed during the pandemic and has not come back down, and the newest clinicians in the field are frequently the ones assigned to the most complex work. Add student loan debt, low paid and still unpaid associate and practicum positions, a cost of living that has outpaced entry level wages, and a job where roughly a third of the week goes to compliance, tracking, and billing, and the result is exhaustion that arrives long before licensure.

Curt and Katie argue that this was never solvable at the individual level, and it is even less solvable now. They also refuse to locate the problem entirely in supervisees. Supervisors are absorbing the collective clinical weight of an entire cohort while managing their own productivity metrics, compliance demands, and often their own caseloads. Many step into supervision with no training in how to supervise. When as much as 90 percent of a supervision hour gets consumed by administrative work, what gets modeled is that documentation comes first and clinical development comes later, if at all.

The second half of the episode gets practical. Curt and Katie offer strategies supervisees can use without waiting for a supervisor to change, strategies supervisors can build into the structure of supervision itself, and a composite case vignette featuring an associate named Taylor whose 16 late progress notes get read as a capacity signal rather than a character flaw.

Continuing Education Objectives

Upon completion of this CE episode, participants will be able to:

  • Analyze at least three systemic and organizational trends driving elevated rates of burnout among psychology graduate students and prelicensed therapists.
  • Identify and differentiate the unique clinical, emotional, and administrative pain points experienced by both prelicensed supervisees and their clinical supervisors.
  • Formulate and implement actionable, values-aligned intervention strategies within the clinical supervision relationship to mitigate exhaustion, manage parallel processes, and protect ethical client care.

In this episode, Curt and Katie discuss:

“So, just a big warm hug going out to everyone in this system, because the system has not caught up to what’s actually happening in the world right now.”

— Katie Vernoy, LMFT 

  • Why post-pandemic client acuity has not receded, and why the least experienced clinicians are so often assigned the most complex cases
  • The financial reality of prelicensure, including student loan debt, low paid and unpaid associate and practicum roles, and the disappearance of loan forgiveness pathways
  • How burnout presents differently before licensure, showing up as physical exhaustion, brain fog, vicarious trauma, and personal distress rather than the cynicism and sarcasm more familiar in seasoned clinicians
  • Why treating early career exhaustion as a rite of passage is a supervisory failure rather than a developmental frame
  • The narrow line between normalizing a supervisee’s exhaustion and inadvertently invalidating it
  • The quiet existential questioning underneath the fatigue: did I spend three years and six figures to feel like this every day
  • What new supervisors face with no training in supervision, and how their own anxiety and administrative load travel downhill
  • How supervisors absorb collective vicarious trauma from cases they oversee but never sit with directly
  • Transition rituals between clients, boundary architecture, and end of day shutdown routines that keep documentation from bleeding into nights and weekends
  • Managing up in supervision, and Katie’s caution that asking for restorative space is itself additional emotional labor
  • Restorative check-in questions, modeled vulnerability, and reconnecting supervisees with their core clinical why
  • A case vignette that reframes note lag as a symptom of clinical capacity rather than poor organization

“We would want to talk about this in terms of the note lag as a symptom of clinical capacity, not of laziness.”

— Curt Widhalm, LMFT 

Pain Points on Both Sides of the Supervision Hour

One of the more useful moves in this episode is the refusal to treat burnout as a single experience. What it looks like, and what it costs, depends heavily on which seat you are sitting in.

The Supervisee Seat

  • The competency trap. Law and ethics often arrives in the first semester of graduate training, and for many students it lands as pure liability terror before any clinical confidence has formed. There is very little developmental ramp before the expectation to perform.
  • Different burnout signals. Prelicensed clinicians tend to present with deep physical exhaustion, cognitive fog, and distress carried home from client material, not the cynicism supervisors are watching for.
  • Missing calluses. The vicarious trauma skills and internal psychological boundaries that seasoned clinicians developed over years are not yet in place.
  • Less community than previous cohorts. Hybrid, virtual, and field based work has removed the mandatory togetherness of in person group supervision and the incidental connection around it.
  • More personal load. Curt notes seeing more trainees and associates over the last five years carrying caregiving responsibilities and heavier personal circumstances than previous cohorts did.

The Supervisor Seat

  • The supervision paradox. Supervisors are asked to prescribe self-care to trainees while managing their own productivity metrics, compliance checks, and in dual roles, their own caseloads.
  • No training in how to supervise. Being a strong clinician does not translate automatically into being a strong supervisor, and the default becomes teaching what worked for you.
  • An unexpected mental load. Evaluating, employing, and developing another clinician is substantially more work than most people anticipate when they move into supervision.
  • Bottom up parallel process. Supervisors hear the hardest material from every caseload they oversee. Katie describes the worst clinical story she still carries as one she heard in supervision 15 years ago, not one from her own caseload.
  • The restorative deficit. When administrative tracking consumes most of the hour, there is no room left for emotional processing or case conceptualization, and urgent clinical needs get handled ad hoc instead.

Practical Strategies for Both Sides of the Desk

For Supervisees

  • Build a transition ritual. Something that closes out the session you just finished before the next one starts. Curt suggests anything that works, including a dramatic collapse onto the office couch. Katie shares a physical shake-out she picked up from Laura Reagan, and recommends getting outside when possible.
  • Manage up, with realistic expectations. Ask explicitly for restorative time. Katie adds an important qualifier: supervisees should not have to do this, and some supervisors require so much managing up that it becomes another burden. Where possible, negotiate the structure of supervision rather than fighting for space week by week.
  • Build boundary architecture into the day. Firm end of day shutdown routines keep work from following you home. Curt makes the case for finishing notes before leaving. Katie names who that advice does not fit, including field based clinicians and people without workspace separation at home, and offers a closing ritual as the alternative.
  • Close the open loops. Write down the first three things you need to do tomorrow so your brain stops rehearsing them tonight.

For Supervisors

  • Change the opening question. Move from “How’s your caseload?” to “What about your caseload feels heaviest today?” The second question invites an actual answer and treats burnout as a process that can be tended to.
  • Check in on the human, with permission. Katie encourages supervisors to follow up on the caregiving, the schedule pressures, and the personal circumstances the supervisee has chosen to share, rather than only on the clinician.
  • Model vulnerability carefully. There is a version of this that is harmful, and a version that strips away shame. Naming clinical struggle, acknowledging mistakes, and showing what repair looks like all counter the prescribed perfectionism of the field.
  • Teach boundaries explicitly. Define what counts as urgent, what waits for supervision, and how you handle after hours contact, rather than letting supervisees learn boundaries by running into them.
  • Reconnect supervisees with their clinical why. Meaningful work is one of the strongest buffers against early career burnout. Auditing where the original motivation actually shows up in the current workload is a concrete way to do this, and it is easy to model.
  • Make structural adjustments, not just supportive ones. Cap back to back high acuity clients, block documentation time during the workday, complete a note together in supervision, and argue upward for the infrastructure your supervisees need.

Curt and Katie run these strategies through a composite case in the back half of the episode: Taylor, an associate 18 months post-graduation carrying 28 high acuity clients and three weeks behind on progress notes. The reframe they land on is that note lag is a capacity signal rather than an organizational one, and that the supervisor’s job in that moment is psychological safety and structural adjustment, not compliance enforcement. Listen to the full episode for how both sides can open that conversation without triggering remediation fears.

Resources on Prelicensee Burnout, Clinical Supervision, and Sustainable Early Career Practice

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

(Research citations are listed below.)

Continuing Education Information

Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode. Therapy Reimagined is bringing you the Modern Therapist Learning Community!

Once you’ve listened to this episode, to get CE credit you just need to:

Once completed, your CE certificate will appear in your profile and can be downloaded for your records.

You can find this full course (including handouts and resources) here: [COURSE URL TO BE ADDED]

Continuing Education Approvals

When we are airing this podcast episode, we have the following CE approval:

Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for continuing education credit as required by the California Board of Behavioral Sciences. Please check with your licensing board to confirm eligibility.

Please check back as we add other approval bodies: Continuing Education Information including grievance and refund policies.

References Mentioned in This Continuing Education Podcast

Relevant Episodes of MTSG Podcast

Meet the Hosts: Curt Widhalm & Katie Vernoy

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Join the Modern Therapist Community:

Linktree

Patreon | Buy Me A Coffee

Podcast Homepage | Therapy Reimagined Homepage

Facebook | Facebook Group | Instagram | YouTube | LinkedIn | Substack

Consultation services with Curt Widhalm or Katie Vernoy:

The Fifty-Minute Hour

Connect with the Modern Therapist Community:

Our Facebook Group – The Modern Therapists Group

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW

Music by Crystal Grooms Mangano https://groomsymusic.com

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements)

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist Survival Guide, where therapists live, breathe, and practice as human beings. To support you as a whole person and a therapist, here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:15
Hey, modern therapists! We’re so excited to offer the opportunity for one unit of continuing education for this podcast episode. Once you’ve listened to this episode, to get CE credit, you just need to go to moderntherapistcommunity.com, register for your free profile, purchase this course, pass the post test, and complete the evaluation. Once that’s all completed, you’ll get a CE certificate in your profile, or you can download it for your records. For a current list of our CE approvals, check out moderntherapistcommunity.com.

Katie Vernoy 0:48
Once again, hop over to moderntherapistcommunity.com for one CE once you’ve listened. Woohoo!

Curt Widhalm 0:54
Welcome back, modern therapists. This is the Modern Therapist Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that go on in our practices, the things that happen in our lives, the things that happen in supervision, and this is one of our continuing education eligible episodes. So check out the beginning and end of the episode or the show notes to find out how you can get your CEs through us. This is really an episode where we’re going to dive in about earning a master’s degree or a doctorate degree, where you can rack up six figures of student debt, immediately take on 30 high acuity client caseload, and have what someone tell you that your growing pile of unfinished progress notes is a time management issue that is fixed by bubble baths and

Katie Vernoy 1:43
pizza parties.

Curt Widhalm 1:44
Pizza parties. Look, if you’re a pre-licensee, a lot of, especially the transition into the workforce, especially after graduation, it feels like you’re running a marathon in concrete shoes before you’ve even reached the starting line, and this episode goes out to not only you but also to the supervisors who are helping you to be able to not drown while you’re doing all of this. So today, Katie and I are doing a full clinical autopsy on pre-licensee burnout, how we can do it in supervision. I think consistent with Katie and I: No toxic positivity. No useless self care lectures. Strictly zero bubble bath recommendations. Let’s get into it.

Katie Vernoy 2:34
No bubble bath recommendations?

Curt Widhalm 2:36
All right, bubble baths!

Katie Vernoy 2:37
Not even if people like bubble baths. I think people can have bubble baths if they want them.

Curt Widhalm 2:41
Sure. So we have some continuing education objectives. In this episode we’re going to analyze at least three systemic and organizational trends driving elevated rates of burnout amongst graduate students and pre-licensed therapists. Two, we’re going to identify and differentiate the unique clinical, emotional, and administrative pain points experienced by both supervisees and supervisors. And three, we’re going to formulate and implement actionable, values-aligned intervention strategies within the clinical supervision relationship to mitigate exhaustion, manage parallel processes, and protect ethical client care. Bringing this in, maybe I did lie in the cold open of the episode, but bubble baths-if they fit, great. But we’re going to take the both/and approach to pre-licensee burnout, self-care. We’ve done episodes in the past on a lot of this. We’re focusing this episode specifically on the supervision structure and ways that both the individual can do things such as bubble baths and murder mystery marathons on your streaming service of choice, your true crime podcast, if that’s what you listen to on your way to and from work, but also very consistent with Katie and my work that this also has structural implications that go along with the workforce and the workplace environment, and ways that supervisors can bring that in. Because really the research shows that today’s caseloads are heavier than ever. Really, going back to the pandemic, more and more people who are coming into treatment are coming in with higher levels of acuity. They’re coming in with longer treatment, and you know it’s always been something that’s been kind of discussed in our field that some of our most vulnerable populations are being seen by those who are fresh out of grad school and maybe the least equipped to actually being able to work with them. And this goes back to research even published by the American Psychological Association in 2021, that showed since the pandemic hit, this has been going higher. It has not tailed off in the last five years. We’ll have all of our references available at mtsgpodcast.com as well as over in the Modern Therapist Community, where you can purchase this course, where you can find all of the research that shows this. But things got bad about five years ago, and then they still really have not gotten better. And while we’re trying to catch up as having more people in the workforce, those more people are getting to see more difficult clients sooner than even you and I did when we first started out in our careers, Katie.

Katie Vernoy 5:47
It’s really frustrating the knowledge or the the insight that caseloads are getting more acute, that they’re heavier caseloads. There’s a lot going on. It’s not surprising, but it’s very disappointing because I know that you and I have talked about trying to advocate for trauma-informed workplaces and appropriate caseloads, manageable caseloads, living wages. I guess to start for me, it’s this disappointment that as a field, as a profession, we continue to work our newest clinicians hardest without the support, and I think the the balance to that is we’ve got new, brand new clinicians, pre provisionally licensed students, folks who are newly licensed, and their supervisors are also overworked and burnt out. And in a system that, especially, I think within the last couple of years, has fewer and fewer financial resources. There’s a devaluing of what we do. There’s more and more administrative work that oftentimes can happen. I think there’s probably a mix with the the dawn of AI supporting administrative work, and so some folks might have more or less of that work available to them or required of them. But the fact that things have gotten so much harder and we’re we’re going through all of the things that we talked about at the beginning of this month the the shared traumas, the overwhelm and and burnout just with the world the world as it is right now. I feel like it’s it’s so obvious that what we’re doing is harming our our profession and our professionals, and it’s not getting better. It’s it’s in fact getting worse. And so, I just want to acknowledge for the the systemic changes that we’re going to want to talk about, and the things, the interventions that we’re going to want to talk about. This ends up falling on supervisors who are are equally as unresourced as the clinicians coming in. Sometimes and even in in skill level, new supervisors who have been therapists forever aren’t necessarily great supervisors, and new clinicians who just are fresh out of their training in grad school may not be great clinicians, and so it can be something where it’s the inexperienced leading the inexperienced, and so so we’re providing this in a in a in a place of care and a place of support because this isn’t easy, and it’s not designed for what we’re talking about in this episode, it’s designed for efficiency. It’s designed for almost literally robots. There are some trends in the behavioral tech world where some of the work that is happening here is going to be taken over by AI, and so they are assessing and addressing clinicians in this work as though they are robots that can see a client and then another client and then another client and then another client. They can remember everything, and their documentation is instantaneous, and that’s not fair. So, just a big warm hug going out to everyone in this system because the system has not caught up to what’s actually happening in the world right now, and so we have good ideas, we have some experience to to lay in with these ideas, but what we are talking about is way more complicated than one hour provides us to to really get into the details of.

Curt Widhalm 9:40
I’m going to start out with a couple of corrections. I think that I said that that APA article was in 2021. It was actually in 2023. Minor correction on my part. Katie, you’re saying that there’s equal burnout in supervisees and supervisors, and I’m here with science to say: while both experience burnout, the research over the last five years is saying that those who are pre-licensed are experiencing 50% more burnout than those who are practicing and potentially in the supervision roles. So, supervised…

Katie Vernoy 10:17
Well, what does the study actually stay? I’d be really interested in that because you’re saying licensed longer and potentially providing supervision, was it actually with supervisors in in large systems?

Curt Widhalm 10:30
So in large systems, the pre-licensed burnout rate sits at 50% higher than licensed burnout rate. So my statement that not everybody who’s licensed is providing supervision.

Katie Vernoy 10:45
Sure.

Curt Widhalm 10:46
But we have conjectured on this long in the past. I know that as we are getting into 9 and 10 years of our podcast, we’re actually going back and listening to some of our early episodes. We’ve talked about how the people who’ve been in the field the longest tend to seemingly experience less and less burnout, but that’s not necessarily that they have better skills. It’s just that people who are in this field long enough sometimes just burn out of the field completely altogether, and we can forget just how intense that burnout is immediately after graduation and joining into the workforce, especially as such vicious people as student loan providers want their money back. And so there really is a financial crisis that ends up happening, particularly at times with low and I can’t believe that they’re still out there; unpaid associate positions and practicum roles. The cost of living has exploded since the pandemic, and it is really a sharp and rude learning curve into the workforce with a lot less of the structure that’s been provided by being in an academic setting. And especially for going into agency type settings where there’s a lot of administration burden. Where I have never presented a CE workshop and gotten a positive response of who joins this field to do notes. But when roughly a third of the job is focused on compliance and tracking and billing versus actually doing the therapy that a lot of people get into this field on, you have this perfect storm of getting there. And I think that especially for those of us in supervisory positions that have been doing this long before the pandemic, it’s a different world that’s here, and so it’s not the same kind of individual responsibility that existed 10, 20, years ago, that…

Katie Vernoy 13:03
I don’t know if it existed then, though. I think it was, I think it was framed that way, but I don’t think it was solvable on an individual level, even 10 or 20 years ago.

Curt Widhalm 13:13
And it’s even less solvable on an individual level now, is the point that I’m trying to bring up because you know as things such as student loan forgiveness programs go away, as you know a lot of the pathways for the people entering into the field, the ability and the privilege to fail is gone, and the the safety nets for for the people who are entering into the workforce, these are specific pain points that the cohorts of people in the last five years, as they enter the workforce, are things that we might not take into account, just as the background of some of the contributing factors to burnout in entering into this profession.

… 14:06
(Advertisement Break)

Katie Vernoy 14:07
So you mentioned the phrase pain points, and I think it it makes sense to talk through the pain points both from the supervisee angle as well as a supervisor angle. Which one do you want to cover first?

Curt Widhalm 14:22
Let’s go into competency first.

Katie Vernoy 14:24
Okay. Okay. Sounds good.

Curt Widhalm 14:26
I taught law and ethics in a master’s program where I live. I love I love teaching law and ethics, and in some ways, it feels like a cruel joke to teach this in the first semester to a lot of students because…

Katie Vernoy 14:45
People took it in the first semester?

Curt Widhalm 14:47
I took it in first semester of my program.

Katie Vernoy 14:49
I don’t remember when I took it.

Curt Widhalm 14:51
But you talk about entering into a field where everything is you’re going to get sued for everything. You’re going to make everybody end up just failing. You are going to get in trouble no matter what you do. It is nothing but anxiety. I did teach it more positively than that, but that is you know bright-eyed, bushy-tailed grad students who are, yeah, I’m going to get sued for this, and I’m going to get sued for this, and if I breathe wrong, it’s unethical, and I have stopped listening to the rest of the lectures. So there’s just nothing but terror and and anxiety that ends up coming out of this, and it can’t be backed off in a way, no matter how much supervision, how much practicum support ends up coming out of this, there’s this I have to perform at the absolute peak of where I can possibly operate from the very beginning of my experience. There’s not a lot of just kind of developmental step up, and especially you know when we’re talking about the people who are seeking services are coming in at that higher level of acuity.

Katie Vernoy 16:03
I know that the competency challenges are are most often described in the supervisee seat, but I’m just reflecting on brand new supervisors who get no training on supervision and who all of a sudden have have to figure out how to do something beyond: Well, this worked for me, and this is how I was a successful clinician. And there’s this additional level of I have to make sure someone’s meeting productivity if they’re in an agency, or I have to make sure that the billing makes sense and and that my practice will continue to run if I have this person, or I’m taking on employment stuff. So I think there’s a parallel that can be happening for new supervisors, where that that level of terror about we’re doing it wrong, we’re going to harm. You know, it’s not just I’m going to harm the clients. It’s going to be I’m I’m I’m going to harm my supervisee or my supervisee’s clients because I don’t know what I’m doing. And so that level of anxiety isn’t good when you’re trying not to be burned out and not not trying to get become exhausted. So I think that’s pretty much there. I think the other thing, and this is something that’s kind of interesting, is that understanding burnout is very different depending on what seat you’re sitting in. For the supervisors that I keep talking about, it’s oftentimes this cynicism.

Curt Widhalm 17:36
No, it’s not. You’re wrong.

Katie Vernoy 17:41
It’s sarcasm, exhaustion. It’s all of those things. But for for new folks who maybe are a little tiny bit cynical because it’s hey, I got into you know I just finished grad school and I’m already tired. I’m already burned out. It feels more like it feels more physical: exhaustion, brain fog, and it’s it’s something where I think the calluses that you build around some of the emotional content that you’re engaging with or or life that that I think more seasoned clinicians have developed, and and also like the vicarious trauma and resilient skills that that clinicians hopefully learn over time. Those things are are not really present, and so the the vicarious trauma, the the distress, the physical exhaustion, the brain fog, like those those things are more likely to be seen by supervisees, and it’s not clear that we’re really looking for them in the same way. We might just be, we might think of it as more they’re they’re exhaust they’re overwhelmed or they’re they’re anxious, not oh they’re running on empty.

Curt Widhalm 18:56
Or that it’s a rite of passage.

Katie Vernoy 18:59
Yes, yes.

Curt Widhalm 19:00
That it just is something where oh they haven’t learned how to deal with this yet. This is, and I think that there is a little bit of a grain of truth to these are skills that somebody has to develop as they’re coming into the field, but we can’t hand wave it off as this is a rite of passage into the workforce. It’s something that we have to have the responsibility as supervisors to be able to say this is a normal developmental step, and here’s ways that you can help manage this, rather than good luck, kids, deal with it, keep your chin up, because while…

Katie Vernoy 19:40
And it’s it’s that normalizing versus invalidating,

Curt Widhalm 19:44
Right.

Katie Vernoy 19:44
Because I I think if you normalize it too well, supervisees might think they can’t actually talk about it, and it becomes truly invalidating, and it becomes a lost opportunity to have those conversations of yeah, this is normal, and it’s intense, and here are some skills. I think it becomes really challenging if, if as a supervisor, you’re already burnt and exhausted, and kind of like, well, buck up and deal. I had it worse than you.

Curt Widhalm 20:15
And a lot of times, what’s going on in the background with supervisees is without that support, they’re going through all of this quiet existential questioning. Did I really just spend this amount of money to feel like this every single day? And…

Katie Vernoy 20:31
Did I pick the wrong career?

Curt Widhalm 20:33
Exactly. And I’m noticing, in particular, in the last five years, more and more trainees, pre-licensed associates who are being tasked with caring for aging parents or dealing with a lot more intense personal lives than some of the supervisee stories that I had heard before really, the pandemic.

Katie Vernoy 20:58
Yeah.

Curt Widhalm 20:59
So I think that there’s even just making a lot more space around kind of the balancing out the human role that goes on in the way that impacts what their professional approach is, and…

Katie Vernoy 21:12
And there’s this other this other piece of lack of community. There are different ways that supervisees are engaging in clinical work, some of it is virtual, some of it’s field-based, so they’re driving in their cars and getting to people’s homes. Some of it is a traditional one-on-one in a more you know family session and whatever in a an office, and maybe there are other clinicians in that office. But it feels like there is less mandatory togetherness with these more flexible work from home, partially remote jobs, and so there’s this additional piece of: Did I do this? Is this what I really signed up for? And I don’t have that strong cohort in the same way that I’ve had before, or that the profession has had before, where you’re sitting in person in a clinical group supervision all together consistently. I can see that happening more with: it’s every other week. It’s virtual. It’s you know there’s there’s other ways and there’s not that additional time outside of supervision where you’re hanging out with friends at lunch. It’s it’s a lot more isolated.

Curt Widhalm 22:33
And for supervisors this is something where we can get pulled into that trap of demanding self care for trainees while we’re going through some of that burnout that you were talking about earlier, because recognizing that supervisors are having agency demands about productivity metrics, about administration overload, about compliance checks. If you’re in a dual role where you’re also seeing clients yourselves, and you’re managing your own caseload on top of that, and your own personal lives, and everything else, and being able to attend to not just the administration effects that end up taking over supervision. I mean, I’ve seen in some studies that up to 90% of supervision hours get swallowed up by administrative work.

Katie Vernoy 23:24
Yeah.

Curt Widhalm 23:25
And it ends up being something where inadvertently what we’re modeling is that we just have to deal with administration first, rather than what clinical supervision actually is in being able to help clients and to be able to help develop as a professional.

Katie Vernoy 23:44
Well, and I think the thing that that often has happened, whether it’s in private practice or in an agency work, is when someone decides to supervise. I mean, there are the folks that end up, please, please, your two years post license. We need somebody. Just do it, right? But oftentimes, when someone is choosing it, it’s I’m burnt out on client work. I want to have a different experience, and then you don’t realize until you start doing it how much of that additional administrative work happens. How removed you feel from the clinical cases, your own cases, you’re sitting right in there with them, and then clinical cases, you’re having to go based on what your supervisee knows to say, and so there’s a little bit more of a disconnect. And then there’s this additional piece of I have to manage someone else in some way, and and that can look differently. Some people are able to keep the clinical supervision purer, but the administrative work is providing feedback. It’s making sure things are done and and compliant, but it’s also navigating that interpersonal relationship with someone who you’re training, over-seeing, evaluating, and it’s a lot more than what someone expects. It’s you know, especially I’ve I’ve seen it talked about in group practice where it’s like, hey, this is a way to to work less at some point, right? You got to work more to get it started, but then now you’re getting you know a percentage of your supervisees’ cases, and you know you’re you’re only doing like an hour to three hours of supervision a week with them, and it’s wait a second. There’s

Curt Widhalm 25:26
You’re just offloading all of the stress onto people who are less equipped than you.

Katie Vernoy 25:30
Sure, there’s that, but it’s also a different stress that it’s it’s a higher level stress that’s that’s not I think fully understood. And I think the problem can be if folks don’t get it and they don’t do it properly, it becomes a a burden on the supervisees because you’ve got someone who did it well enough to make enough money or to be promoted at their agency who doesn’t know how to supervise, doesn’t know how to teach, and is just saying, “Well, do it the way I did it.” And so, and then there’s the being the bad supervisor. So we have we have episodes on on giving and getting good good supervision that are a million years old. But I think the the the challenge is recognizing the individual struggles of the supervisor and how, when unaddressed, they can negatively impact the supervisees with a lot of impact. So I think it’s more to discuss there, we can continue on, but I think there’s that that element of this job is a lot more than it than it seems. There’s a lot of mental load that you carry.

Curt Widhalm 26:36
And another additional way that this shows up for supervisors is when we aren’t spending supervision talking about administrative tasks, we’re talking about usually the highest acuity cases that can take up a lot of supervision time, energy, and supervisors absorb that collective trauma from their supervisees.

Katie Vernoy 27:01
I actually have my worst story that I still think about that is hard, and I don’t tell anybody about because I don’t want anyone else to have this picture in their mind. And maybe I should talk to my therapist about it after at this point. But it’s it’s from a supervision conversation. It is not my own case. It is a horrific trauma that I heard from a supervisee, and I think that’s that’s telling that my worst story that I I hold to today is probably from 15 years ago supervision.

Curt Widhalm 27:32
If you’d like to hear that story, become a Patreon member, and you can get that.

Katie Vernoy 27:36
You are not going to hear that story. You’re not going to hear that story, even if you become a Patreon member. But it is something where I think that that supervisors, instead of having the the caseload of 15 to 30 of their own cases, depending on how many supervisees you have, I think at one point I recognized I was overseeing a couple hundred, and especially I was supervising supervision, so it was a little bit less direct, but a couple hundred, 500 cases, and I was not fully up to date on all of them. But I heard the worst stories from those 500 cases.

… 28:10
(Advertisement Break)

Curt Widhalm 28:11
So we don’t want to have this episode be entirely doom and gloom, but we actually want to be able to provide some strategies, and we’re going to speak first for strategies to supervisees. That a lot of times coming into this workforce, whether you work in an agency or in private practice, this is something where there’s still a lot of isolation. You know, in agency kind of work, you at least get to have the option of having lunch with somebody else who you work with. There’s moments in between sessions where you can see somebody in the hallway. But in the magical world where 10 minutes between sessions includes writing your notes, going to the bathroom, prepping for the next client, and now having a social life where you get to interact with somebody else who’s accomplishing those things, the the balance there is not always the easiest thing to have.

Katie Vernoy 29:05
Yeah.

Curt Widhalm 29:06
So one of the things that I’m going to start by recommending to supervisees is having some kind of transition ritual between each of your clients. Something that you do that helps to leave the session that you just completed behind you, and being able to kind of set that aside and get ready for the next session that is ending up happening. This could be dramatically, you know, falling onto the couch in your office like you’re fainting in Victorian times. I don’t care how it looks. Have some kind of transition in order to be able to not just have that emotional momentum from one session into the next.

Katie Vernoy 29:51
I actually had a really good transition for, especially for more traumatic sessions, that I got from Laura Reagan actually from one of my conversations with her, and it was kind of shaking your, shaking it out, shake your whole body, like stand up, shake, jump around, like just let that physical release. And whether it’s a nervous system thing or just it feels a bit ridiculous to shake your whole body and jump around, it really helps. I mean, I try to get outside. I think if you’re able to get outside, that can be very helpful. I think being able to to have something that closes out, maybe even an internal psychological boundary between you and the client, and and you know shoring that up. I think those in between transition rituals are really critical because you don’t want to spend the next, the first five minutes of the next session still shifting gears because it feels bad to you and it’s also not good clinical work. But it’s it’s there’s so many different options. I think there’s some really good resources out there for how do you do that transition. But the the dramatic couch fall, I think it, I think it hit some of the boxes too.

Curt Widhalm 31:09
Depending on how how you do that, that could involve the dancing or the jumping that you’re talking about.

Katie Vernoy 31:15
Sure, sure, sure.

Curt Widhalm 31:18
My next suggestion is managing up in supervision. Now, sometimes you are going to have to be the one who can bring in an agenda to supervision, and it might be depending on the week. But explicitly requesting restorative space, and you know, call it counter transference development or anything such as, hey supervisor, I need five minutes at the beginning of the session. I have my treatment plan down. I have goals. I I know what I’m going to do in the next session. Maybe I don’t, but for the next five minutes, I need to talk about the way that this case is having an impact on me.

Katie Vernoy 32:07
I like that. I think it’s empowering to supervisees, and I know we’ll talk about the the mirror for supervisors. I don’t feel like supervisees should have to ask for that. I know that realistically they’re going to, and that’s fine, but managing up can be an additional emotional burden, and so I wanna I wanna shift it a little bit in in how I would make this suggestion. I think it’s talking with your supervisor about what is the structure of supervision, what are the opportunities in supervision, and how do I ask for those things? And even in in asking the supervisor to to check in on emotional stuff on a on a week to week basis, if that’s not something that’s on their agenda. Attending supervision and and taking it full advantage of it is identifying your needs ahead of time and being able to ask for them, but some supervisors require so much managing up, and a lot of folks don’t have the capacity to change them. And so I’m just I’m acknowledging that that kind of sucks.

Curt Widhalm 33:17
It does, and I think somewhere between the wonderful world where everybody follows all of our advice. Supervisees won’t have to do this.

Katie Vernoy 33:26
Yes.

Curt Widhalm 33:28
And until that world is accomplished, this is an option for you as supervisees. And…

Katie Vernoy 33:34
Yeah

Curt Widhalm 33:35
…what I’m encouraging is if you didn’t think that you can do this, it is an option.

Katie Vernoy 33:40
Yeah, yeah.

Curt Widhalm 33:43
We have a past episode on structuring self care.

Katie Vernoy 33:47
Yes.

Curt Widhalm 33:47
And I think that it’s an incredible episode. It’s one of out of our back catalog of things. One of the episodes that I’m most proud about. I’m bringing up a point that we talked about in that episode, which is having an architecture to your workday and establishing some really firm end of day shutdown routines to prevent bleed over, carry over into your nights and weekends. Things to allow work to stay at work and for home to be home. And one of the things that I talked about in that episode is: don’t take your notes home. You know, I get it. Home is more exciting than work. But if you are saying, “Hey, it’s the end of my workday. I want to go home, and I will just do my notes at home.” Congratulations, you’re bringing that emotional space home. But if what you could do is spend those same 10 minutes just at the office before taking those notes home, guess what? You could leave all of work at work.

Katie Vernoy 34:52
I think that’s a great idea if it fits into folks’ schedules. I think there’s so many folks that have parenting responsibilities, caregiving responsibilities of other kinds, and other pieces that go in, and potentially even not a space at work to do their notes if they’re mostly field based. And so, if you can’t do all your notes before you go home because that’s where you do your notes is at home, I think even having a a shutdown structure where you close your laptop, you put it in your backpack, or you have a separate space in your home if you if you have that capability, so that that that space is the workspace at home, and there’s some other space where you can you can you shut that down, you close it down, and you move elsewhere. I think the challenge really becomes if you’re in you know a one bedroom studio apartment you’re doing your notes and all your work at your table. I think you have to sort through what is that closing out ritual so that you can truly be off of work because too often if work just consumes your whole living space, exactly what you’re saying, Curt. That’s the that’s the problem. It it emotionally it’s still there, but I I don’t know that everyone has the space to be able to to create a pristine work at work, home at home, and so I think there’s there’s ways to do that that feel very helpful. I think the other thing about the the the kind of architecture of your day, and we may have talked about this in structuring self care, but I think being able to close out the day in in a way that that not just shuts it aside to the other day, but also to make sure that you don’t have pending items in your brain to keep working, and so it could be identifying what are the first three things I need to do in the morning. Obviously, if you’ve got to the end of the day, you did all your notes, and there’s nothing that’s there’s no documentation pending. Maybe that’s already done. But let’s say you need to do and write up an assessment, and it’s you know 7o’clock at night, you don’t have any juice left on the tank. I think you can say tomorrow morning, this is the first thing I’m doing is writing up this assessment, and so making a list, whatever that looks like for you in your phone, on your calendar, on a piece of paper that you put right at the front of your backpack. I don’t know, whatever it is, but being able to say, “Hey, I already know that’s there, and not rehearse it can be really really helpful to make sure that you found ways to close that down.

Curt Widhalm 37:28
And not making all of the supervision responsibilities fall on the supervisees. Supervisors, these next steps are for you.

Katie Vernoy 37:35
Yes, absolutely.

Curt Widhalm 37:37
Through the course of my career, I know that there’s a lot of times, shorthand language ends up being something that we just start sessions with. We start supervision sessions with.

Katie Vernoy 37:49
How are you doing? What’s going on?

Curt Widhalm 37:51
Yeah, and at least as an American society, that doesn’t actually cut to the core of the questions. And as supervisors, we need to potentially be a little bit more intentional, shifting away from questions such as “How’s your caseload?” to more directive questions such as “What about your caseload feels heaviest today?” and brings it more into the moment. It helps to bring in restorative check-ins and questions that help to realize that burnout is a is a process and it’s something that can be tended to rather than just kind of colloquial language that we do in everyday conversation.

Katie Vernoy 38:37
I agree. I think it’s really important. I think to add to that, there’s oftentimes little space to address the human that’s in front of you, and so I think being able to ask that question about the caseload-what’s heaviest on your caseload right now, or what’s what’s what are you struggling with today on your you know with the work that’s put out in front of you. I think that’s important. I think it’s also something for setting up boundary exploration of the person in front of you, and that can be primarily professional if that’s the preference of your supervisee. It can be looking at you know their, what their hopes and dreams and goals are, and how you kind of continue to follow up on those things if they’re learning something and you want to check in on their learning, but I think for some some individuals in your in your supervisee caseload, they’re going to want to talk about the the caregiving that they’re giving and how that’s potentially impacting their ability to stay focused or or get enough rest or to or even their schedule might be impacted, and so making sure that you have, with permission, some check-ins on the person in front of you, and not just the clinician. I think that’s it’s it’s easy to forget, and maybe that’s just me, but it’s easy to forget when there’s so many administrative burdens and the cases are are on fire, and there’s so much going on, and so being able to just say, “How are you doing?” and obviously, I get that that’s not a great question when we’re talking about more specifics, but your adjustment of that question to the person’s situation in front of you-how’s How’s your mom doing, for example, or those types of things versus, okay, let’s get started. What’s going on?

Curt Widhalm 40:27
Part of this too, and there is a way that you can do this really terribly and harmfully, and there’s a way where you can do this very supportively, but it’s modeling vulnerability.

Katie Vernoy 40:41
Yeah.

Curt Widhalm 40:42
Now, you don’t want to be the supervisor who complains about your life and everything that’s going on in it to your supervisees all of the time under this flag of…

Katie Vernoy 40:51
And you’re a mess.

Curt Widhalm 40:52
I’m yeah. But there is so much about our field that is just this prescribed perfectionism that we can’t be human and everything needs to be managed all of the time, that skips over the part of the process that there is clinical struggle and things do impact us, and that is a very very normal thing, and being able to be transparent about there are things that hey you as a supervisee it’s normal to feel frustrated by the parents of a client that you’re working with that no matter how much clinical work you do the parents are putting this pressure on you because they’re just trying to offload all of their parenting onto anybody else who’s not them. Anybody in your situation would be frustrated. I’ve had times like this in the past. This is how I handled it. That is a great way to do it. Talking about…

Katie Vernoy 41:55
You also, I think it’s also important to to acknowledge mistakes. And again, this is another one to be cautious about because I think there’s that element of if you normalize mistakes that are pretty harmful and awful, that that can be bad. But I think there’s this element of sorting through and and showing what mistakes look like, what repair looks like, and that can be mistakes that you’ve made with clients and in clinical work. It can be a mistake that you’ve made with your supervisee in the moment, and so I think it’s it’s something where transparency and and vulnerability are both really important. But I think it’s also humility about hey, I’m yes, I’m your supervisor. Yes, I know more than you do about some things, and that’s why I’m in this role, and I’ve been at this a bit longer than you. But it’s not I’m better than you, and I’m perfect, and you must align with me. It’s hey, we all make mistakes. This is what it looks like.

Curt Widhalm 42:58
And being able to talk about how to set personal boundaries, what that looks like in action, how to set professional boundaries. That there, you don’t want your supervisees to be learning that by experience. You know, there there are going to be times where they run into you know boundary crossing, whether it be from clients, whether it be people in their personal lives, but being able to talk about personal boundaries, and this might even be between you and your supervisee.

Katie Vernoy 43:33
Yeah.

Curt Widhalm 43:34
That as long as you’re kind of transparent about your process around it, you know, I tend to have a very open door policy with a lot of the staff in my practice. That if I’m available and I’m at work and it’s appropriate, ask your questions, pop in. I want to create that supportive kind of atmosphere. And sometimes the questions arrive super late at night, and I say this doesn’t seem to be something that we can resolve in this particular moment. Let’s meet tomorrow morning. And being able to just kind of normalize that there are legitimate actual emergency situations, and there are situations that not everything has to have the fire brigade come out right this second and put out all of the flames.

Katie Vernoy 44:24
Well, and I think being able to to talk through what it is that communication can look like when you’re seeking support. Because here’s what’s urgent. This is what a crisis looks like. This is how you reach me in a crisis. Here the things that are less urgent. These and this is what what it looks like. This is what can happen today. This is what holds on for supervision, and so it’s it’s something where not only normalizing you setting your boundaries, but actually showing some structure and and giving very clear guidance on what it looks like to be able to have nice, strong boundaries. I think when we talk about boundaries as well, I think there’s this other piece that, for me, was the what I sought most in supervision and what I tried to provide most as a supervisor, which is the the normalization and the reassurance from challenging cases, whether it’s difficult clinical material or hard clinical choices or strong boundaries you had to set with clients or any of those things, there’s that element of I’m with you. Let’s talk it through. I like your choice. Here’s what it looks like. Here’s how you create an internal psychological boundary so that you can take care of yourself and not carry this with you for however long until the next session. Because I think that normalizing it and teaching how to engage with it I think is really important, especially for a lot of our folks who might be hypersensitive, might be very empathic, and also very nervous because they’ve not had to sit in that one to two week timeline between sessions. Where oh, I think I might have messed up. I’ve got to do a repair next week. Ah, that feels really horrible. I don’t want to sit with that. And so I think being able to talk it through, normalize it, and teach can be really, really helpful.

… 46:23
(Advertisement Break)

Curt Widhalm 46:25
One of the other things that really helps supervisors to do in these situations is helping your supervisees, trainees, counselors-in-training, associates reconnect with their core clinical why they are in this field, and this actually serves as one of the most positive buffers against pre-licensee burnout is being able to engage in meaningful work.

Katie Vernoy 46:54
Yeah.

Curt Widhalm 46:54
It’s a really good article on PESI written by Amy Bryant. She’s an LCSW and clinical supervisor that talks about reconnecting with values, and especially what originally drew the person into this work and continues to sustain them as being a really powerful buffer against exhaustion, and helping to do kind of an audit across somebody’s caseload or workload as a way of being able to say where is what got you into this field being done in the work that you do. You know, I’ll come back to that. I’ll come back to that joke around if 60% of the work that you’re doing is clinical documentation, and you did not get into this field to do clinical documentation, no wonder you’re feeling burnt out, and you’re feeling the development of moral injury about what the work is that we’re doing.

Katie Vernoy 47:49
Yeah, for sure. I think the the core clinical why is really really important. Being able to tie into that for yourself and for your supervisees because it’s the work can be super hard and it and your clients aren’t always grateful. Your supervisees aren’t always grateful for what you’re doing, and so remembering how how you got into the work, why you’re doing it, and how you want to show up can be very, very restorative. I like that a lot.

Curt Widhalm 48:23
And this one is also super easy to model as far as what you do as the supervisor, because if part of your workforce or part of what your why is into being in the workforce is resenting, here’s another part of my job that got thrown at me, and I’m coming into supervision resentful because this is not part of my why. That’s going to come across.

Katie Vernoy 48:47
Yeah.

Curt Widhalm 48:47
And if you’re able to talk about what continues to inspire you, you’re also modeling how to be able to build that into the workforce that you end up doing, and it becomes excitable, and it almost becomes really easy to talk about things that you’re excited about.

Katie Vernoy 49:05
It feels inspiring. It feels connected, and I think sometimes it can feel like a decadent conversation to have, especially when the work feels so important and so heavy. And so, reminding yourself to have those conversations about what inspires you, about why you’re doing this, and and continuing to connect on that keeps the focus there. It’s I don’t know why I’m thinking of it this way, but it it feels like the the task that I give some of my clients around finishing the day and and writing down something that was connecting, something that was they’re grateful for, something positive that happened, just to try to encode and shift the conversations, shift how you’re remembering things, and I think that that ability to force not not toxic positivity. But true connection, true meaning into the conversations that you’re having with your supervisees, and making sure that they have a practice of of working to encode the positives and and to focus in on what’s going well, more of a strength based approach. I think that can be be very helpful, especially when you tie it back to how how it aligns with their morals, values, their their their their why.

Curt Widhalm 50:31
So, Katie, I want to bring in case vignettes. I want to break this down so that way we can kind of illustrate what this might look like successfully in action.

Katie Vernoy 50:41
Sounds like a plan.

Curt Widhalm 50:43
So let’s imagine a supervisee. Let’s call this supervisee Taylor. Taylor’s an associate marriage and family therapist working in a high volume community mental health setting. Taylor’s about 18 months post grad. They’re seemingly far enough along after graduation, after becoming registered with the board, to be able to have a lot of the workflow tasks down, should be built into their schedule. Taylor’s carrying a caseload of 28 clients, and it is heavily skewed towards high acuity, trauma, and chronic suicidality. So a lot of lot of stressful cases. Taylor’s also three weeks behind on case notes. Taylor’s missed administrative deadlines. Taylor’s showing up to supervision looking exhausted, disengaged, just feeling like supervision is another space of something that has to get done that makes getting all of the other work tasks just preventing from being able to complete them and move on with their lives. Taylor feels severe evaluation anxiety. Taylor’s terrified that admitting that they are drowning will result in a negative review. Hours aren’t going to get signed. They’re going to be labeled unfit. They’re going to get fired. Putting this into the framework of how we’re talking about this episode, I know that there are a lot of other things that we can and should involve in a vignette, but looking at where we’re at in the time for this workshop, we would also acknowledge cultural and other impacts that might come into this. We’re just going to go with kind of a straightforward vignette in this. So let’s break down what we’ve just talked about here. We can maybe build out another one of these workshops to go more in depth on just this practical scale, but let’s level up supervisors just with kind of a straightforward approach here.

Katie Vernoy 52:47
So, I agree. I think that’s a good idea, and I think a piece of this would be making sure that there weren’t any external experiences based on their identities or those types of things that are also impacting their ability to manage the caseload as it is currently set up. So it seems like if we look at this from the harshest perspective, here’s someone that’s behind on notes and they’re exhausted and they probably are a little bit disengaged during supervision, they might appear that way because they don’t want to bring anything up because they’re worried they’re going to get judged. And too often, I see this framed as poor organizational skills, or not caring about the work, or an assumption that they’re not doing the notes because they are lazy. I mean, there’s there’s some really harsh negative criticisms that can happen, and I think when we pair that with, you know separate from any emotional load that’s coming from their personal life, from you know the world at large, and those types of things. If we’re just looking at a really high acuity caseload with lots of suicidality, lots of risk that they’re they’re paying attention to, I think it can it can feel like well the notes you just got to complete the notes, but if you’re dysregulated, overwhelmed, exhausted, writing notes may not be on the on the table. They may not be available to you, and that’s that’s kind of the the pushback I was giving a little bit around like finish the notes at the end of the day. There are definitely times when I get to the end of the an end of a a session day, and I am so fried that trying to do notes will take me three hours. Whereas if I wait till the next morning, it’ll take me 15 minutes. And so I think it’s it’s recognizing that there are some real capacity issues, and they’re transient capacity issues. You know, get them on vacation. And they could probably knock out a bazillion notes the next day, but I think there’s that that element of huge sympathetic arousal, fight or flight, anxiety, all of those things that make it very challenging to complete the very practical, logical parts of the progress notes or or other documentation, or even tracking, and so I think it’s it’s something where trying to assess what exactly is going on versus assuming it’s just a unskilled, uncaring, irresponsible supervisee. Because I think when someone becomes that person on your your list that has the the un the notes that are not completed, you can turn them into you can kind of objectify them into like a problem versus a human that’s facing real challenges.

Curt Widhalm 56:01
There’s also a parallel process for the supervisor that goes on here, and this is now the apprehension that the supervisor has. You’re looking, you’re responsible for a supervisee that is not meeting their job demands, and you’re also noticing that Taylor is holding vicarious trauma from nearly 30 clients, and supervision is potentially becoming more and more focused just on administrative checkoff boxes. You’re not getting your notes done, and there’s this trap, this draw into just following into whatever the agency metrics are about not performing, as opposed to being able to cut into the relational process and to be able to talk about how this is now adding into Taylor’s feelings around negative reviews and being unfit, and therefore being less likely to ask for help.

Katie Vernoy 57:10
I completely agree. I think the other element to that is if you turn all of supervision into administrative supervision. We’re talking about notes. We’re talking about processes, we’re managing your schedule, we’re micromanaging your schedule, whatever it is. There’s not the clinical support for these high acuity cases, except usually ad hoc, and so you’re getting calls right after a session. Everything feels more urgent because you’re not planning and and doing that case formulation that is, I think, really critical, and so it it’s it’s something where I almost want to to to add the supervision of supervision that that supervisor as well, where the higher up you go, the more it becomes about numbers and not people, and so if the supervisor of the supervisor is is talking about compliance and those types of things, and really pushing that angle, and you know, supervision become can become primarily primarily administrative, and that disconnect with the clinical work and the asking for help gets even even bigger. I think one of the things I tried when I was in this role in an agency, is I would add so there’d be an administrative supervision and a clinical supervision, and so then now all of a sudden it’s fine. I mean, it’s better than nothing in some ways. At least you’re getting the clinical supervision, but now it’s an extra hour to try to fit into your work week, and so the clinicians are even more overtaxed unless you are really able to do work in that administrative supervision hour. And then the other thing, when folks are getting further and further behind, all of a sudden now they’ve got two supervisions that are completely taken over by administrative work, and so it’s it’s something where being able to hold really sacred that clinical supervision that is only focused on the clinical work becomes truly very important, and I think that’s that’s hard in a lot of the ways things are set up because the supervisor may not have the extra hour, the supervisee probably doesn’t have the extra hour, and the administration is still saying, well, hey, these numbers don’t look right. You got to fix these numbers.

Curt Widhalm 59:25
So, taking this as both a supervisee and a supervisor, there’s hopeful, responsible ways to be able to approach this problem. So, talking about this from Taylor’s perspective, completely valid as far as fears about remediation, about poor performance reviews, but we would want to talk about this in terms of the note lag as a symptom of clinical capacity, not of laziness. So if you’re in Taylor’s shoes, you might want to be able to say something. Hey, my current caseload is overwhelming. It’s taking up my complete bandwidth. I want to be able to build a strategy to get caught up on these without burning out. That’s that’s a be you know, hopefully developing kind of a self awareness around where you might be at in the burnout cycle to be able to approach this with your supervisor as a collaborator, as opposed to the enemy that is having to make all of these metrics end up happening.

Katie Vernoy 1:00:39
Yeah, I think the the the biggest concern I have with that piece of advice is oftentimes it gets shorthanded into my caseload is too big, I need fewer cases, or I can’t take on any more cases, or I’m overwhelmed, this is too hard. And so I like the the the nuance that you put in there, which was specific to the current clinical picture, is too heavy for my processing, and so I need help to to manage it. But with caseloads and acuity being to a certain extent out of the control of the supervisor, you may both be just sitting there banging your heads together because, like, well, yeah, you’re behind 16 notes, your cases are all on fire, and I have to give you another case this week. It’s it’s a problem with the system, and if you can open the conversation in a very collaborative way, like what you’re talking about, I think it can be helpful with the right supervisor, and there may need to be other other steps that you take to to protect your job. Because I think oftentimes these conversations can get pretty confrontational, and then what happens is that there is this challenge where both you and your supervisor are fighting for the same thing against the system, and there’s no answer. So again, the big warm hug of this is really hard, and hopefully, you and your supervisor can be in collaboration. I think going to the supervisor seat, I think we can make assumptions that a supervisee is is behind on notes for one reason or another. I think it’s important to be curious because each person’s experience, their skills, their way of managing are very different, and they also have different level of insight. And so, I think being able to to be curious help them the supervisee be self reflective and talk through what they understand about what’s happening, because if they are going to a place of well, I just can’t do it. I’m you know I’m I’m horrible. I’m not skilled, and they’re going into a negative spiral. I think you can then normalize when your caseload is overwhelming, of course, you can’t write your notes immediately. Like of course that’s challenging, but if they have a flippant, well, everybody’s behind on notes. Who cares? That’s a very different conversation, and so I think it’s it’s something where being able to also come from a very collaborative space, a curious space of hey, what’s going on here? This is new behavior, or this is this is something that you’ve struggled with for a long time. How do we support you in getting this done, and what does that look like for you individually? And yes, this is normal, and you can’t get behind on notes. That actually is something that we have to to rectify. So let’s let’s sort this through together.

Curt Widhalm 1:03:36
So, and any kinds of structural fixes that can also be put in there, helping to be able to schedule, not putting, you know, all of the super high level people, high acuity people back to back to be able to help, and some of those momentum might be other strategies that you end up doing there. So.

Katie Vernoy 1:03:56
And and even like I’ve done in the past, like documentation blocks, helping people to time block. It’s it’s looking at how do you get that together so that that there’s whatever structure you can provide. Because the argument that if if supervisors have to manage up, the argument is we don’t get paid if these notes don’t get done, and if these supervisees can’t actually manage their caseloads, we have higher liability risk, and so we need to get them into a place where their caseloads feel more manageable. Which could be training; it also could be capping their caseload. It can also be providing structure within the organization to have blocked out documentation time, decreased requirement for stupid meetings. Like there’s, there’s, there, there is stuff there, and I think if you argue it correctly upwards, you might get the support that you need to actually create that infrastructure that supports the supervisee better.

Curt Widhalm 1:04:58
So I’d like to wrap up here, that the key takeaways that we want is pre-licensee burnout is systemic. It’s relational. It’s not necessarily a personal failing. It’s likely not a personal failing.

Katie Vernoy 1:05:18
Yeah, I think it’s, I don’t know how it would be a personal failing. It starts systemically. They’re they’re learning. It’s up to you to teach them better.

Curt Widhalm 1:05:28
And I think that that’s really the takeaway: is these are people who are learning how to be in the field and not just less experienced colleagues. Your responsibility is to teach them, and so for supervisors, we want to have your call to action for this episode be change something structural in your supervision in the next supervision hour that specifically addresses burnout and make it transparent. Make it obvious that this is something that needs to be addressed. It is a maintenance aspect, and that supervisees can help. Supervisees can help to claim things as part of their restorative space in order to be able to do the work that they do, and not only be able to maintain their professionality, but to be able to grow in their professionality.

Katie Vernoy 1:06:29
I like it. I think that’s good. And if you have questions, I know that both Curt and I do supervision, a supervision or consultation, and so we’ve got some ideas. We can share them with you.

Curt Widhalm 1:06:41
You can find our show notes over at mtsgpodcast.com. Check out the CE course in our Modern Therapist Learning Community. We’ll include a link to that in our show notes as well. Follow us on our social media. Join our Facebook group, the Modern Therapist Group, to continue on with this and other conversations. And until next time, I’m Curt Widhalm with Katie Vernoy.

… 1:07:01
(Advertisement Break)

Katie Vernoy 1:07:02
Just a quick reminder: if you’d like one unit of continue education for listening to this episode, go to moderntherapistcommunity.com, purchase this course, and pass the post test. A CE certificate will appear in your profile once you’ve successfully completed the steps.

Curt Widhalm 1:07:17
Once again, that’s moderntherapistcommunity.com.

Announcer 1:07:21
Thank you for listening to the Modern Therapist Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter. And please don’t forget to subscribe so you don’t miss any of our episodes.

 

/0 Comments/by
0 replies
SPEAK YOUR MIND

Leave a Reply

Your email address will not be published. Required fields are marked *