Clinical Supervision in Alcohol and Drug Abuse Counseling / Edition 1

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This is the thoroughly revised edition of the groundbreaking, definitive text for supervisors in substance abuse counseling. When it was originally published by Lexington in 1993, the book was the first to synthesize the various approaches and techniques of clinical supervision. The "blended model" of supervision offered easy-to-follow guidelines on supervisory contracting, observation, case presentation, modeling, feedback, intervention, and evaluation. In the years since the first edition (and the subsequent paperback reprint JB published in 1998), the author has gathered fresh, new data to update the blended model, which is presented throughout this revision. Also, since the previous edition, the role of the supervior has changed. In the wake of the managed care revolution and several new federal and state regulations, supervisors find themselves absorbed in conformity and compliance issues, financial management, various legal issues, and the completion of an endless array of mandated forms. These, in addition to assuring the clinical knowledge and skill of their counselors, are part of a supervisors new job description. This revisions deals with all of these issues and how to balance them and assure quality treatment.In addition, there is a new Introduction, a new final chapter on current and future trends in alcohol and drug abuse counseling, and the bibliography is "the most complete and current the field of clinical supervision." The back matter includes assessment forms, evaluation letters, and development plans in template form for supervisors to use.

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What People Are Saying

From the Publisher
“Powell’s blended model of supervision is a presentation on the art of the practice of effective supervision in counseling. Dr. Powell provides the practical guidance and wisdom that all supervisors need to create a powerful and stimulating learning experience.”
—Carina Borges, addiction counselor, director, Chemical Dependency Office Consultation and Treatment, Lisbon, Portugal

“Dr. Powell has produced a compendium of sound, pragmatic techniques for effective clinical supervision based on decades of personal experience and  best practices research. Here at St. Joseph’s all clinical supervisors are  trained in his approach. His professional reputation in the field of clinical supervision is unsurpassed and well deserved.”
—Karl Kabza, pesident and CEO, St. Joseph’s Rehabilitation Center, Inc., Saranac Lake, New York; former director, United States Marine Corps Substance Abuse Program

“Dr. Powell’s dedication and commitment to the field of clinical supervision in alcohol and other drugs is unequaled. His leadership and guidance found in continues to set the standard for the field.”
—Bernard Murphy, Pacific Institute for Research and Evaluation; former clinical preceptor, U.S. Navy and Marine Corps

“The latest version of David Powell’s classic book, Clinical Supervision in Alcohol and Drug Abuse Counseling, includes much more in-depth coverage of the most current knowledge and issues in clinical supervision practice. Drawing from his highly successful and diverse international clinical supervision training and consultation practice, David Powell seeks to help readers integrate and apply practical and invaluable lessons to their own supervisory experiences.”
—Tony Ting, president, Association of Professional Substance Abuse Counselors, Singapore

“Powell’s book and his model of clinical supervision are the gold standard for supervision in the addictions field. Our field is better and our clients safer because of David’s book and work. Do not just read this book—study it, use it as a guide in your work.”
—Craig Nakken, author, The Addictive Personality

“As a former director of a treatment program in Australia, I would suggest to the reader that no one can effectively facilitate the complex issues facing treatment teams without this book at their beck and call.”
—George Thompson, Clinical Living Solutions, Somerville, Victoria, Australia

“One of the lesser known but great successes of clinical supervision over the past 25 years has been Dr. David J. Powell’s innovative adaptation of this methodology to the U.S. Navy’s alcohol treatment program. Under the title Clinical Preceptorship, it provided licensed and credentialed mentors to the Navy-trained counselors. Dr. Powell started this program in 1976 at the U.S. Naval Alcohol Rehabilitation Center in Norfolk, Virginia. Over the years, he has overseen its expansion to about fifty bases worldwide, from Iceland to Cuba and from Diego Garcia in the Indian Ocean to Sicily in the Mediterranean Sea. The program also operates on the U.S. Navy aircraft carriers. As a former commanding officer of the Naval Alcohol Rehabilitation Center, Norfolk, I have experienced the Clinical Preceptorship Program’s great value to the counselors. Further, having the ability to confer with an impartial, knowledgeable person from outside of the organization is of inestimable value to the commanding officer—a person who may or may not have training in the substance abuse field. Dr. Powell’s clinical supervision expertise and his vision created a program that helped save the military career and possibly the lives of thousands of Navy and Marine Corps personnel, including my own.”
—Capt. Thomas J. Glancy Jr., United States Navy, retired

“David Powell has trained tens of thousands of substance abuse professionals worldwide in the fine art of clinical supervision. In addition to his vast expertise, his wisdom, warmth, and genuineness have all contributed to making Clinical Supervision in Alcohol and Drug Abuse Counseling the premier text in the field.”
—Patricia A. Burke, faculty, Rutgers Summer School of Alcohol and Drug Studies

“David Powell, internationally recognized leader in clinical supervision, has helped to significantly shape the way in which addiction policy makers and counseling professionals understand and perform critical supervisory functions. The blended model, described in Clinical Supervision in Alcohol and Drug Abuse Counseling, is user friendly and theoretically sound. More than nine hundred clinical supervisors throughout New York State attended his training and have incorporated the book’s principles and techniques. This result is being seen in increasing qualitative patient care. Clinical supervisors are well advised to use this book as a foundation for their practice.”
—Pamela Mattel, president, Changing Dynamics Consulting and Training

“Clinical supervision is a significant part of quality alcoholism and drug abuse treatment. This comprehensive book, based on David Powell’s blended model of clinical supervision is of paramount importance to the alcoholism and drug abuse field today.”
—Gail Gleason Milgram, director of education and training, Center of Alcohol Studies, Rutgers University

“Powell’s text on clinical supervision continues to be a mainstay in the  development of supervisory skills for the counseling profession. This landmark guide has become the principal manual for trainers and clinicians who promote the practice of clinical supervision in addiction treatment.”
—Thomas G. Durham, director, Clinical Preceptorship Program for U.S. Navy and Marine Corps, Danya International, Inc.

“Dr. Powell’s text continues to be the foundational operational reference for our clinical supervisors. Even more useful has been the training conducted by David for our Provincial staff that further develops these essential concepts, strategies, and their applications.”
—Dan Davies, senior clinical team leader, Addiction Services, Saskatoon Health Region, Saskatoon, Canada

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Product Details

  • ISBN-13: 9780787973773
  • Publisher: Wiley
  • Publication date: 5/14/2004
  • Edition description: Revised Edition
  • Edition number: 1
  • Pages: 448
  • Sales rank: 279,026
  • Product dimensions: 6.00 (w) x 9.00 (h) x 1.07 (d)

Meet the Author

David J. Powell, Ph.D., LADC, CCS, is president of the International Center for Health Concerns, Inc., a health consulting company. He assists worldwide in the education and training of behavioral health professionals. Formerly he was president of ETP Inc. and in that capacity oversaw clinical supervision training programs for the U.S. Navy and Marine Corps worldwide.
Archie Brodsky is senior research associate at the Program in Psychiatry and the Law, Massachusetts Mental Health Center, Harvard Medical School.

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Table of Contents

Figures and Tables.


Introduction to the 2004 Edition.

Introduction to the 1993 Edition.

Part One: Principles.

1. A Historical Review of Supervision.

2. A Working Definition of Supervision.

3. Leadership Principles for Supervisors.

4. Traits of an Effective Clinical Supervisor.

Part Two: Models.

5. Building a Model of Clinical Supervision.

6. A Developmental Approach to Supervision.

7. The Psychodynamic Model.

8. The Skills Model.

9. Family Therapy Models.

10. A Blended Model of Clinical Supervision for the Alcoholism and Drug Abuse Field.

Part Three: Methods.

11. Establishing a Supervisory Contract.

12. Basic Supervisory Techniques.

13. Evaluation and Feedback.

14. Innovative Techniques in Supervision.

15. Ethical and Legal Concerns.

16. Special Issues in Supervision.

17. New Directions for the Future.


A. Competencies of Supervisors.

B. Role Delineation Study for Clinical Supervisors.

C. Assessing One’s Preparation as a Clinical Supervisor.

D. Determining Readiness to Be a Supervisor.

E. Counselor Evaluation of the Supervisor.

F. Evaluation of the Counselor.

G. Individual Development Plan.

H. Use of the Sociogram.

I. Suggested Outline for Case Presentations.

J. Counselor Assessment Forms.


About the Authors.


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First Chapter

Clinical Supervision in Alcohol and Drug Abuse Counseling

Principles, Models, Methods
By David J. Powell Archie Brodsky

John Wiley & Sons

ISBN: 0-7879-7377-7

Chapter One

A Historical Review of Supervision

A first step toward the recognition of clinical supervision as a profession in its own right-and, in turn, toward the consistent provision of high-quality supervision in treatment facilities-is to establish a clear, succinct, comprehensive, broadly applicable definition of supervision. There seem to be as many definitions as there are fields in which clinical supervision is practiced-perhaps even as many as there are people writing about supervision. On the basis of the following brief survey of some definitions employed by the mental health professions as well as by society as a whole, I will formulate a definition for the substance abuse field in the following chapter.


The term supervisor has its roots in Latin; it means "looks over." It was originally applied to the master of a group of artisans. One hundred years ago, it was not uncommon for the master in a New England shop to have almost complete power over the work force. The master would bid on jobs, hire his own crew, work them as hard as he pleased, and make a living out of the difference between his bid price and the labor costs.

The other source of our notion of a supervisor was the person in charge of a group of towrope pullers or ditchdiggers. That person was literally the foreman, since he was up forward of the gang. His authority consisted mainly of chanting "One, two, three, up," which set the pace of the rest of the workers. In Germany a supervisor is still called a Vorabeiter ("fore worker"); in England the analogous term charge hand is used.

Today the supervisor's job combines some of the talents of the master (or skilled administrative artisan) with those of the foreman (or leader). As the term is generally understood, supervisors are front-line managers who normally report to middle managers. Supervisors plan, motivate, direct, and control the work of non-managerial employees at the operational level of the organization. Their responsibility is to see that staff carry out the plans and policies set by executives and middle managers.


Legal definitions of supervision are worth looking at as indicators of the social recognition, legitimacy, and authority of the occupation. According to the Taft-Hartley Act of 1947, a supervisor is

any individual having authority, in the interest of the employer, to hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, or discipline other employees, or responsibility to direct them or to adjust their grievances, or effectively to recommend such action, if in connection with the foregoing the exercise of such authority is not merely of a routine or clerical nature, but requires the use of independent judgment [Biddle and Newstrom 1990, pp. 507-8].

Further specifications are found in the 1938 Fair Labor Standards Act, which states that a supervisor is someone who devotes no more than 20 percent of his or her working hours to activities not closely related to managerial work. This law stipulates that the supervisor be paid a salary, regardless of the number of hours worked. Together, these two laws make supervision a bona fide function, an established part of management.


Supervision has an administrative dimension that is emphasized in the traditional and legal definitions. Since clinical definitions are the focus of this chapter, it is important to draw a clear distinction between the administrative and clinical domains, as the Association for Counselor Education and Supervision (1989), Falvey (1987), Borders and Leddick (1987), and others have done.

Administrative supervision occurs in most settings, from universities to human services organizations. The administrative supervisor helps the supervisee function more effectively within the organization, with the overall intent of helping the organization run smoothly. Toward this end, the administrative supervisor addresses managerial requirements such as case records, referral procedures, continuity of care, accountability, hiring and firing, and performance evaluations (Abels and Murphy 1981; Hart 1982; Simon 1985; Slavin 1985).

In contrast, clinical supervision is concerned with the actual work of the supervisee in such areas as the counseling relationship, client welfare, clinical assessment and intervention approaches, clinical skills, and prognosis. Hart (1982) summarizes the distinction as follows: "Administrative supervision is aimed at helping the supervisee as part of an organization, and clinical supervision focuses on the development of the supervisee specifically as an interpersonally effective clinician" (p. 13). In other words, clinical supervision attends to the supervisee's professional and personal needs as they directly affect the welfare of the client.


Looking to the mental health fields for guidance, we find many definitions of clinical supervision, each shaped by the theoretical model from which it is derived.

Supervision as Therapy

Some define supervision as a form of therapy, or at least a therapeutic process. For example, Abroms (1977) views supervision and therapy as distinct but parallel processes, the distinction being that supervision is a therapy of the therapy, not of the therapist. Abroms believes that although the supervisor should not become the supervisee's therapist, therapeutic issues can and should be addressed in supervision. That is, if a counselor is experiencing problems that interfere with his or her clinical functioning, such blockages are grist for the supervisory mill. The supervisory milieu is to be a safe sanctuary for the supervisee to explore personal and professional growth issues. In such a milieu, the supervisor's behavior constitutes a compelling model of how a therapy session should be conducted.

Lane (1990, p. 10) defines supervision as "a therapeutic process focusing on the intra- and interpersonal dynamics of the counselor and their relationship with clients, colleagues, supervisors, and significant others." The focus of supervision is on personal and professional growth, transference and countertransference, defenses, analytic processes, and the use of self as an emotional force in therapy. With this definition, the supervisee looks more like a patient than a student. Supervision uses the transference relationship as the principal vehicle to promote the supervisee's growth as a clinician.

Supervision as Education

Others view supervision as more of an educational process-a matter of learning skills and developing professional competence. Bartlett (1983) defines counseling supervision as "an experienced counselor helping a beginning student or less experienced therapist learn counseling by various means" (p. 9). According to Blocher (1983), supervision is "a specialized instructional process in which the supervisor attempts to facilitate the growth of a counselor-in-preparation, using as the primary educational medium the student's interaction with real clients for whose welfare the student has some degree of professional, ethical, and moral responsibility" (p. 27).

There are other variations on these themes:

Brammer and Wassner (1977, p. 44): "Supervision is the assignment of an experienced person to help a beginning student to learn counseling through the use of the student's own case material."

Saba and Liddle (1986, p. 111): Family therapy supervision is "the specific development of trainee's therapeutic abilities within the context of treating families."

Stoltenberg and Delworth (1987, p. 34): "An intensive, interpersonally focussed, one-to-one relationship in which one person is designed to facilitate the development of therapeutic competence in the other person."

Hart (1982, p. 12): "An ongoing educational process in which one person in the role of supervisor helps another person in the role of the supervisee acquire appropriate professional behavior through an examination of the supervisee's professional activities."

The key elements of Hart's definition, one of the more comprehensive definitions available, are an ongoing relationship between supervisor and supervisee, the addressing of specific behaviors, and the goal of developing a professional role identity.

Perhaps the most ambitious of the educationally oriented definitions comes from the field of social work. Kadushin (1976, p. 20) defines clinical supervision as "an administrative and clinical process designed to facilitate the counselor's ability to deliver the best possible service to clients, both quantitative and qualitative, in accordance with agency policy, procedures, and the context of a positive relationship between counselor and supervisor." This definition is primarily focused on education (skill development) but nevertheless weaves in administrative with clinical themes.

A Composite Definition

Since the Association for Counselor Education and Supervision (ACES) is a trade organization rather than a school of therapy, it has had to adopt a definition broad enough to encompass its diverse membership. Borders and Leddick (1987) stipulate that counselor supervision is performed by experienced, successful counselor-supervisors who are prepared for the task by learning the methodology of supervision. ACES goes on to state that supervision involves facilitating the counselor's personal and professional development as well as promoting counselor competencies for the welfare of the client. Supervisors oversee the counselor's work through a set of activities that include consultation, counseling (if provided for by one's model of supervision), training, instruction, and evaluation. The mention of counseling and personal development makes this definition broad enough to cover the therapeutic as well as educational dimensions of supervision.


Taken together, the various definitions indicate that the purpose of supervision is to bring about change in the knowledge, skills, and behavior of another individual, typically one with less training and experience than the supervisor. These definitions have five main components:

1. An experienced supervisor-one who is, at least, more experienced than the supervisee.

2. Actual clients in clinical settings.

3. A paramount concern with the welfare of both the client and supervisee. The number one rule of counseling and of supervision, like that of medicine, is primum non nocere-"first, do no harm."

4. Monitoring of the counselor's performance by indirect or direct observation.

5. The goal of changing the counselor's behavior.

The various schools of therapy and counseling differ in the extent to which they demand the shaping of behaviors and even personality to fit that of the supervisor or agency. Some schools disavow any such intention to clone the supervisor, viewing supervision instead as a consultative process, educational in nature. As Part Two will make clear, different practitioners and disciplines also differ as to whether they view supervision as (in addition to skills training) a form of therapy or counseling.

All agree, however, that one does not learn to practice therapy or counseling simply by undergoing therapy or counseling, any more than one learns to perform surgery by being operated on. On the other hand, supervision is something more than counselor education alone. Supervision amounts to the clinical preparation of a counselor for the practice of therapy; as such, it involves transforming principles into practice. In supervision, a successful counselor guides a supervisee's professional development, so that the supervisee acquires essential skills and learns to take independent actions through sound clinical reasoning and judgment. The supervisor helps the counselor fashion a personally integrated therapeutic style that sustains the counselor through a professional lifetime.


Excerpted from Clinical Supervision in Alcohol and Drug Abuse Counseling by David J. Powell Archie Brodsky Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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