Episode 243 | How to Instill Clinical Confidence in Your Therapists with Shannon Heers

Maureen Werrbach (00:00:02) – Welcome to The Group Practice Exchange Podcast, where we talk about all things related to group practice ownership. I’m your host, Maureen Werrbach. 

 

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Hey everyone, welcome to another episode of the Group Practice Exchange podcast. Today I have Shannon Heers. She’s a therapist. She’s been on the podcast before. It’s been a little bit of time, but we’re going to be talking about how to instill confidence in your therapist.

 

Maureen Werrbach (00:01:22) – She is an approved clinical supervisor. She’s the founder of Firelight Supervision. And what firelight does is provide clinical supervision with a clinical consultation to therapists in private practice. And it has a focus on professional growth and development. She’s also the owner of Catalyst Counseling. It’s a private practice in Colorado, and I’m just excited to have you on, again, specifically to talk about this, because it’s something that I think has been coming up a lot, specifically because the hiring landscape has been shifted so much that a lot of people are now starting to focus on hiring newer therapists, provisionally licensed therapists, maybe bringing on interns as a way to broaden, you know, their scope. And with that comes the realization that it’s not the same as bringing on fully licensed therapist who maybe don’t need some of that skills training in their own clinical growth training. So I’m excited to chat with you about how you help people with this. And I just have a, you know, a few questions on that.

 

Shannon Heers (00:02:21) – Great. Let’s get started.

 

Shannon Heers (00:02:22) – It’s great to be back here again. And I’m really excited to talk to all the group practice owners who are listening to this. Yeah.

 

Maureen Werrbach (00:02:28) – So the thing that I was thinking about when I saw that you were on my calendar to talk about this, was the discussion that’s being had, you know, the past couple of years about imposter syndrome. And what are your thoughts on how practice owners can support and recognize and address issues around imposter syndrome as a way to foster more resilience and more confidence as a team?

 

Shannon Heers (00:02:54) – I think that’s something that is a great topic, so I’m glad we’re starting here. I also just want to point out that clinical confidence is not the same as competence. So competence is, you know, the skills that you have and how you use them. It is certainly one factor in therapists developing the confidence that they have. And there’s a lot of research that shows that confidence equals better client outcomes. Yep. So now we have competence leading into confidence leading into better client outcomes. And imposter syndrome happens with everyone.

 

Shannon Heers (00:03:26) – It happens with even, you know, advanced really experienced therapists. So what you want to do is you want to try to, with each one of your therapists, break down what triggers their particular imposter syndrome, what tends to bring it up more often because it’s not a case of do they have it or don’t they have it? It’s when do they have it? When does it tend to come up more? And you’ll see answers to that could be like, well, when I work with populations that I don’t have a lot of experience or training and working with, it could be when I have, you know, eight sessions back to back and I’m seeing my ninth client that day. I mean, that could be something that could trigger it. Also, it could be when a therapist is starting a new specialization or learning a new set of skills, and they haven’t had the chance to apply it as much as possible. So there’s a lot of different potential answers to what brings up imposter syndrome. So I think the group practice owner role is really getting to the bottom of what triggers that in each therapist.

 

Shannon Heers (00:04:24) – And then once you have that, it’s kind of like assessment. You know, when you’re seeing a client, you want to figure out what’s going on first. Once you assess it, once you figure it out, then you can kind of move into the treatment plan phase. Okay, we know what we’re working with now. Great. You don’t have a lot of experience working with adolescents. That’s the need that’s coming into our practice right now. How can we get you more experienced? How can we get you the skills that you need? And then how can you get confidence in applying the skills that you need?

 

Maureen Werrbach (00:04:51) – I love that I like your also distinction between competence and confidence and how that might show up, because I think a lot of people do sort of, you know, merge those two ideas together. So at firelight, when your team is providing supervision, what strategies do you find to be most useful? And I guess, as I’m saying this, that, you know, all of us are different, our learning styles are different, so things can look different.

 

Maureen Werrbach (00:05:14) – But like, what do you recommend for group practice owners to do if they have clinicians that they’re providing supervision to? Maybe provisional folks will just leave it at that to make it easier answer for you. But like, how do you help them or what are your suggestions for supervisors when it comes to helping provisional folks learn how to, like step into a theoretical orientation or a specialty, especially when a lot of times when they’re coming in, they’re not quite sure. And also some practices are maybe more niche than others. You mentioned, you know, in your example like this practice now getting more adolescents, whereas you might have like a practice where certain specialties are just that, you know. Yeah, I.

 

Shannon Heers (00:05:57) – Think it is easier to develop clinicians more. And to really focus on their confidence and competence when you’re a more niche practice. But that doesn’t mean you can’t do that when you’re a generalist practice, because there are many generalist practices out there. So from a supervisor perspective, working with them on developing what are their theoretical orientations that they really align with? And of course, everyone comes out of graduate school, you know, choosing 2 or 3, which is great.

 

Shannon Heers (00:06:27) – And are those theoretical orientations, are they a good match for the clients at that particular therapist is seeing? Because that might not always be the case. If you’re seeing a lot of people who may be dealing with kind of high anxiety and perfectionism, you know, CBT is an evidence based practice for that. Maybe the narrative therapy is not going to be quite as effective for something like that. So it really you want to align who the therapist is as a person with their theoretical orientation, with the clients they’re seeing. There’s a lot of work you can do as a supervisor in case consultation also. So if a therapist, if your supervisor gets stuck on a case, instead of maybe giving them lots of options, your question to them could be what theoretical orientation are you using right now with this case, with this issue, with this client? And what would that orientation say your intervention should be versus like, hey, here’s 20 different ideas. Choose from those really kind of having like a roadmap for conceptualizing and viewing that case in that particular issue within that case.

 

Shannon Heers (00:07:32) – So I think that’s one of the things that supervisors can do. I mean, group practice owners can also play a role with that and that even if you’re a more generalist practice, you still want to get the therapists on your team, the clients that they work best with. And everyone’s going to work better with some clients than other clients, if possible. It may not always be possible, but if you have someone who loves working with kids, give them as much kids as possible. If you have someone who loves, you know, working with a different, maybe a certain presenting concern or issue, give them as many of that as you can and then encourage some of that cross consultation and supervision. I mean, even with provisionally licensed therapists, they don’t have to only go to their supervisor to get ideas on a case. If you really want to kind of create a team atmosphere of learning and professional development, you want to encourage some of that cross consultation and cross supervision, even if it’s informal, right?

 

Maureen Werrbach (00:08:30) – I actually love that idea.

 

Maureen Werrbach (00:08:32) – On that note, what suggestions do you have for supervisors who struggle with supporting their supervisees when it comes to accepting feedback and getting feedback? Because obviously not every person who’s in supervision either feels comfortable or realizes how feedback is an important part of supervision. And I know my own supervisors in my practice have had experiences like this, and I know it’s not uncommon to have a supervisee who maybe is struggling with the accepting of feedback. What are your thoughts on it, and what are your suggestions for people who are trying to step into that supervisory role and do it effectively and in a way that really supports that person, while also sort of working through feedback.

 

Shannon Heers (00:09:21) – I think that is a really common challenge. So what I would encourage the supervisor to do first is to be really comfortable with providing the feedback. How do you like to provide the feedback? And of course, we know that feedback is always more effective when it’s specific, not when it’s broad. I mean something like, you’re not doing a great job with your clients like that.

 

Shannon Heers (00:09:41) – It’s so nebulous. You just, you know, what does that mean? Yeah. So it could be real specific. Like I noticed that, you know, 25% of your clients are staying beyond four sessions. That’s real specific. That’s based on data. It’s based on numbers. It’s not a judgment. It’s real specific information. You know, why do you think that is? So really kind of making the feedback process collaborative also instead of a one way street because feedback is a two way street, it’s always like, hey, here’s what I noticed. What do you think? Or here’s what the data says. Does this align with what you think is going on? So you’re making it into a two way conversation rather than a one way street. Of course, you will always have those clinicians that getting feedback may trigger something in them personally. And if that happens and they just really get really escalated for some reason or just refuse to kind of listen, then you know that it’s something else going on.

 

Shannon Heers (00:10:37) – And that’s the supervisor’s role to gently point that out and not work through it with them necessarily. But say, this is impacting your work as a clinician and maybe you should do your own work on that. So I think we have those extreme examples. But I think in general, if the supervisor is comfortable with what they’re saying, they’re confident in how they’re saying it and they’re not nervous. About giving the feedback.

 

Maureen Werrbach (00:11:02) – Which is a whole big issue too, right?

 

Shannon Heers (00:11:04) – Right. It sure is. Well, because if you also think about supervisors, it’s hard to be a good supervisor unless you’ve gotten great supervision. And if you haven’t had great supervision where someone has given you feedback in an effective way, it’s really hard then to turn around and do that with your own supervisors. So I guess one of the things I would offer with that is before you even jump into supervision, is making sure you’ve gotten really great supervision yourself.

 

Maureen Werrbach (00:11:32) – I like that, and, you know, I remember at least for my license type, to provide supervision, you had to take like two courses on supervision like once.

 

Maureen Werrbach (00:11:44) – And then that’s sort of it. And I remember first taking them many years ago and it provides you information, but it didn’t provide enough information for me to like at that time, actually be able to be a good supervisor beyond, like what? You know, the ACA American, because I’m a counselor once and there’s so much more to it, like transparency, sharing in like decision making when it comes to a person’s growth. Right. Like coaching, which is, I think, you know, not talked about a lot in the supervision training world, at least back when I first started getting trained in supervising. I don’t do supervision anymore. But, is like this understanding of just what coaching looks like during supervision of here’s the issue. The issue is not you, me and you are together side by side. We’re looking at the issue together and I’m, you know, here to support and provide resources and feedback for your growth, but also want you to feel the autonomy of being able to choose some directions that you think might help your own growth.

 

Maureen Werrbach (00:12:49) – And then I’m here to provide like resources and support and feedback, and a lot of training programs don’t go there. So I think on top of not getting their own supervision, there’s a lot of supervisors who haven’t actually been properly trained on how to give supervision.

 

Shannon Heers (00:13:05) – Right. You think about supervision. It’s a completely different field than therapy. Yeah. And I think a lot of people think it is very seamless to transition from being a therapist to a supervisor. And it’s actually, like I said, it’s a completely different discipline. Yes, you have a lot of transferable skills, you have a lot of therapy and clinical knowledge. But the act of providing supervision is very different than the act of providing therapy. Yes. Ideally you want who you are as a person to align with your theoretical orientation, how you present as a clinician and how you present as a supervisor. But that development takes a while. So I would say at a minimum, clinical supervisors should have some sort of training. Every state is so, so different, and every discipline is so different in terms of what they require of supervisors.

 

Shannon Heers (00:13:51) – I’m based in Colorado and to be an LCC social work supervisor, you don’t have to have any training or any credentials or anything. You can just do it when you’re licensed. Other states. I know you have to have maybe 45 50 hours of training and X number of years in providing supervision and postgraduate. So it just varies so much. So I’d encourage at a minimum to get some sort of formal training in how to provide clinical supervision, figure out what clinical supervision model really aligns with you and that you want to provide. And then once you have that, I think that’s great. That’s kind of like a minimum requirement, I would say. But then it’s applying the knowledge again, same as when you’re a therapist. You can go out and do all these fancy trainings and learn the stuff, learn new interventions, but it’s how you apply it. And that’s what supervision and ongoing consultation is for. So if you’re a newer supervisor, you’re going to come up with a lot of situations that you’ve never experienced before and you want someone to bounce ideas off of.

 

Shannon Heers (00:14:52) – You want someone you know and trust that can kind of help you through that. And that’s what I think. Kind of consultation or sup of sup, supervision of your supervision could be really helpful for.

 

Maureen Werrbach (00:15:02) – Yeah. What advice would you give to group practice owners who want to create a more supportive and confident environment for their team of therapists?

 

Shannon Heers (00:15:14) – I think the first thing is to ask think about what what motivates your therapists. You know, why do they want to be in this field in the first place? Most of the time, people really like it. They want to be a good therapist because they want to help other people, but they want to become a better therapist. So how can you design some things in your group practice that can help people become better therapists? Maybe you can’t send them to a really expensive training. I know we can’t afford to do that either, but what we can do is we could provide in-house or if not in-house, kind of bring in an external expert to do mini trainings, or we can provide ongoing monthly clinical consultation as well as supervision in the areas that the specific that your therapists are interested in growing and developing in.

 

Shannon Heers (00:16:00) – So it really could be sitting down with each therapist in your practice and saying, hey, where do you want to grow clinically over the next couple of years? Five years is really hard to plan out that far. But, you know, maybe the next couple of years. What is really interesting, you about the clients you’re having, what do you want to learn more about? How can I help you learn more about that? Can we create a plan for you to listen to podcasts or read more books about this topic, or look into some more expensive trainings about that? And how can we provide you with the clinical support to learn some of those skills and get some of that competence so then they can increase their confidence in the area. So I think that’s something great that practice owners can do that we often forget about. We think about, oh, let’s offer more benefits. Let’s offer more pay, when in reality that’s not what motivates most therapists. Sure. Maybe some. We all have to live right and make a decent wage, but that’s not what motivates therapists to continue to stay in the field long term.

 

Maureen Werrbach (00:16:59) – Yeah, that makes a lot of sense. So I want to end this with if you can talk a little bit about firelight, because I actually don’t know a lot about firelight. What does it do. What about it might be beneficial for group practice owners specifically? I think this business offers clinical supervision to clinicians. Right. So like practice owners who don’t want to offer supervision or don’t have that capacity, that’s something that you can offer. Yeah.

 

Shannon Heers (00:17:24) – So using the word clinical supervision very broadly. Yes. We offer supervision I call it consultation. Once therapists are fully licensed just to differentiate between what you’re, you know, although it’s really all the same thing. So primarily we’re a virtual kind of one stop shop for clinical consultation professional and development clinical supervision needs. So once you’re fully licensed, you’re not limited by location about where you want to get your clinical consultation. So I’ll focus on that. So we offer individual and group consultation. It’s all virtual led by experienced supervisors. We have a lot of different specializations and niche areas that we can provide consultation in.

 

Shannon Heers (00:18:04) – Not everything of course, but a lot of them. So if you’re not able to offer in-house consultation for your licensed therapists in order to help them develop a new niche or new specialization or your practice or something like that, then you can see if we can offer it, I love that, yeah. So that’s one way we could support group practice owners. We also offer monthly I call them like mini trainings. They’re just an hour long. So like an introduction to that really exposes a lot of people, a lot of therapists, provisionally licensed therapists in particular to a lot of different clinical concepts that if they don’t know what they want to specialize in, they can say, oh, I really like that one. Our training you did on IFRS, I think I want to go, you know, pursue, you know, doing a more extensive training on that. And we don’t provide the more extensive training, of course, but it’s really just like a exposure to different areas. We also provide support for supervisors.

 

Shannon Heers (00:18:58) – So we do have a supervision and supervision program. So we provide that individually and within group. I think kind of at that level, group sup of sup is is really effective because you’re learning from other supervisors. In addition. Plus the higher you get up, you know, the more you start to supervise. Even as group practice owners, the more isolated it gets, the more lonely you get. The less peers you have, the less support you have in general. So this is a nice way to come together with people and say, oh my gosh, my supervisor said this and I really think of this in a different way. What are some approaches that you guys would have to this situation could even include giving feedback, like, how do I give feedback when I’m noticing this in my supervisee? So I think it can be used for a lot of different things.

 

Maureen Werrbach (00:19:43) – I love that share where people can find more information about this. Yeah, just.

 

Shannon Heers (00:19:48) – Go to our website. It’s www.firelightsupervision.com. Super easy.

 

Shannon Heers (00:19:52) – And if you’re more interested in clinical confidence, we have a clinical confidence ebook that you can grab. It’s on our homepage. It’s fairly long I will say, but has a lot of great information in there about a lot of different areas, clinical areas to help support your supervisees or your therapists. If you’re a group practice owner in developing some of that clinical competence.

 

Maureen Werrbach (00:20:14) – Thank you. I really appreciate you coming on again and talking about this topic specifically and just from like a personal perspective within my own group practice, because we have a whole provisional education program for when we bring our provisional team members on just an awareness of how much work is actually involved in effectively training and supervising and case consulting with team members, it’s not as simple as just blacking an hour off. So I appreciate you sharing some of this insights, and then also having a service that can really support people in this way. So thank you.

 

Shannon Heers (00:20:51) – Thanks, Maureen. It’s really fun. I love supervision, I love learning, I love helping other therapists learn and grow professionally and develop themselves.

 

Shannon Heers (00:21:00) – And if we can help other people do the same, we’re happy to.

 

Maureen Werrbach (00:21:03) – Yeah. Well, thank you so much. And I’ll also put the link in the show notes as well.

 

Shannon Heers (00:21:06) – Thanks, Maureen.

 

Maureen Werrbach (00:21:08) – Thanks for listening. Give us five stars on whatever podcast streaming service you use and I’ll see you next week.