Supervision of Mental Health Services

An introduction to the topic from Teresa Huizar, Executive Director, National Children's Alliance.

Key Points for CAC Directors to Know

The Purpose and Function of Supervision of Mental Health Professionals Providing Treatment to Children Through a CAC.

Supervision of mental health professionals requires both administrative and clinical functions. The purpose of Administrative supervision is to oversee billing, productivity and case management of mental health service delivery. The function of administrative supervision is to monitor mental health services provided to clients of the CAC including the number of clients served, the service delivered and any other demographic or service data required by the agency/organization. In collaboration with the mental health clinical supervisor, a system for documenting the mental health services provided must be developed. The collections of this data can be accomplished via the data base used by the CAC and can be monitored by administrative staff in consultation with the CAC director and mental health staff. Administrative supervision also involves governance, planning and policies issues including the processes of recruiting and screening new hires, reviewing background checks and professional training and credentials; identifying funding and the resources needed to implement and sustain the delivery of effective evidence-based trauma informed treatment including training, consultation and credentialing; working with the clinical supervisor to develop systems to monitor staff performance and overall program functioning and managing legal and liability issues. The data collected can then be used by the CAC director in making program, staffing and professional development decisions.

The purpose of clinical supervision is to monitor the quality of the mental health services delivered and includes clinical skill building, the delivery of evidence-based treatments vs. general clinical therapy skills; case conceptualization; client engagement and ensuring treatment model fidelity. Clinical supervision functions involve oversight of the clinical staff providing direct care services and include the development of policies and procedures for CAC clinical practice (i.e., client confidentiality, recordkeeping, HIPAA compliance, and intake/assessment) and overseeing the delivery of quality, evidence-based treatment.

How Can a CAC Establish and Monitor Both Types of Supervison?

The decision regarding how to structure both administrative and clinical supervision involves close collaboration and coordination between the CAC administrative and clinical supervisors.
There are a number of models available for CACs to consider when establishing both clinical and administrative supervision. 

 When mental health services are not provided on site and are provided through referral to community based professionals, the purpose, function and responsibility for clinical supervision and the sharing of information and data will need to be defined in the linkage agreement with the providing professional/agency.  In addition, a system for monitoring service delivery and outcome and data sharing required by the CAC for administrative supervision will also need to be included in that agreement. 

When a CAC provides on-site mental health services, clinical supervision can be provided by a senior mental health professional with significant training and experience in the delivery of mental health services as well as training and experience in the delivery of evidence-based  treatment models.

 When a CAC does not have a mental health professionals with the experience required to provide clinical supervision, the CAC director can look into their community to identify an individual with the necessary credentials and negotiate for clinical supervision for their staff. 

Whether the CAC provides on-site or services by referral, the CAC provides administrative supervision of mental health services and are required to track services provided. 

What is the Role of the CAC Director in Clinical Supervision?

NCA, through the Mental Health Standard, has taken the position that children and families served through CACs deserve mental health treatment that has evidence of effectiveness. The primary role of the CAC Director is to provide proactive leadership in the effective implementation and sustainment of trauma informed, evidence-based mental health treatments for the children and families served through their CAC.  This requires that the CAC Director understand how critical clinical supervision is to this process.  CAC directors will need to advocate for these treatments from community professionals and will need to seek out training in one or more of these treatment modalities for any on-site or community mental health professionals and for themselves.  Although many CAC directors do not have mental health training, it is important for the CAC director to participate in training as a senior leader to understand the purpose and function of clinical supervision.  The CAC director also provides leadership in identifying and addressing barriers and challenges to implementation, provide the necessary infrastructure and ensuring appropriate training and supervision for clinical staff.  These functions are in collaboration and coordination with clinical staff, on or off site.  The CAC director and administrative supervisor also work collaboratively to gather data and to monitor clinical supervision. Clinical supervision can provide the CAC director information to use in consultation with mental health staff in identifying the needs of mental health staff development and program decisions.


Questions and Answers

Q: What Is The Difference Between Administrative and Clinical Supervision?

Dr. Rochelle Hanson, a professor at the National Crime Victims Research and Treatment Center, defines the difference between administrative and clinical supervision.


Length of the video - 1 minute and 18 seconds

Q: How Can Clinical Supervision Be Established In a CAC?
Dr. Rochelle Hanson, a professor at the National Crime Victims Research and Treatment Center, discusses how to establish clinical supervision in CACs.


Length of the video - 2 minute and 27 seconds

Q: Does Supervision Involve Setting an Agenda for The Process?

Dr. Rochelle Hanson, a professor at the National Crime Victims Research and Treatment Center, describes agenda setting in supervision. 


Length of the video - 1 minute and 48 seconds

Q: What Is Meant By Fidelity in The Delivery of Mental Health Treatment?

Dr. Rochelle Hanson, a professor at the National Crime Victims Research and Treatment Center, defines fidelity.

Length of the video - 1 minute and 29 seconds

Q: How Is Fidelity to an Evidence-Based Treatment Monitored By The Clinical Supervisor?

Dr. Rochelle Hanson, a professor at the National Crime Victims Research and Treatment Center, identifies how fidelity can be monitored during supervision.

Length of the video - 2 minute and 58 seconds

Q: What Are The Critical Elements of Clinical Supervision?

Dr. Rochelle Hanson, a professor at the National Crime Victims Research and Treatment Center, identifies the critical elements of clinical supervision.

Length of the video - 1 minute and 42 seconds


Additional Resources

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25 Ways to Infuse New Life Into Evidence-Based Supervision Article