Out On The Couch

As an associate or pre-licensed therapist within the LGBTQIA+ community, you will find that identifying a clinical supervisor who is supportive of your unique needs and identities is essential for professional growth and wellbeing. The supervisory relationship plays a crucial role in shaping therapist development, client outcomes, and supervisee wellness (Burkard et al., 2009). To ensure a positive and affirming experience, it is important to be aware of certain “red flags” and “green flags” when interviewing potential clinical supervisors. Here are some key factors to consider during the interview process:

 1. LGBTQIA+ Affirmative Care and Cultural Humility

Look for supervisors who demonstrate a strong understanding of LGBTQIA+ issues and who are willing to continue learning and expanding their knowledge. There is a significant difference between a supervisor who is “LGBT-friendly” and one who is able to provide affirmative care. The latter supervisor is one who has sought to further their education on LGBTQIA+ care, received consultation to challenge implicit biases, and conducted their own personal self-reflection to create an inclusive and affirmative environment for both their clients and their supervisees (Burnes et al., 2017). One of the primary red flags to watch for is a supervisor’s lack of knowledge about or sensitivity to LGBTQIA+ issues. A supervisor’s inability to address biases or provide insight on affirmative approaches directly affects a clinician’s ability to provide appropriate care (Lenz, 2014). A queer- and trans-inclusive supervisor demonstrates cultural humility by recognizing the limits of their knowledge and being open to learning from clinicians’ unique experiences. 

During the interview: Pay attention to the supervisor’s level of familiarity with LGBTQIA+ terminology and experiences as well as the challenges faced by queer and trans individuals. Inquire about their experience and training with letter writing and their willingness to support letter writing for their associates.  

2. A Supportive Feedback Style 

A supervisor who provides constructive and supportive feedback is essential for professional growth. Not only must supervisors understand the unique challenges and experiences of queer and trans clients–they must also be able to provide affirmative supervision in a manner that allows for exploration and growth (Hagler, 2020). Displaying a judgmental or dismissive attitude towards queer and trans identities or experiences is a major red flag. Supervisors have the power to challenge or reinforce heteronormative and cissexist biases among early-career queer and trans therapists (Messinger, 2007). A supervisor who does not make an effort to use correct pronouns or who blames their lack of an affirmative approach on “generational differences” is not likely to provide a safe and empowering environment for queer and trans therapists. 

Supervision should be a collaborative and dynamic process, allowing for individual differences and advancement. If a supervisor demonstrates inflexible approaches or insists on conforming to outdated or binary perspectives, this may hinder your ability to explore diverse therapeutic interventions and affirming practices. Your supervisor should foster a safe and non-judgmental space to allow for associate therapists’ exploration of identity and holistic growth (Porter, 2014). A supervisor who offers guidance and encouragement and fosters a growth-oriented environment is invaluable. 

During the interview: Ask about the supervisor’s preferred feedback style and their approach to addressing challenges or concerns. If it is not already part of the interview process, propose bringing in a case and doing a “mock supervision” to see if their approach to supervision and feedback style is a match.

3. Advocacy 

Political Activism

Activist supervisors actively support their supervisees in advocating for their LGBTQIA+ clients’ rights and wellbeing. LGBTQIA+ affirmative therapists and supervisors recognize that therapy and social justice are interconnected. Affirmative supervisors should be aware of policies, laws, and resources that impact LGBTQIA+ communities and help supervisees navigate ethical considerations related to activism within their professional roles. Activism can expose supervisors and supervisees to a wider range of LGBTQIA+ experiences, intersectional identities, and social justice issues. This provides opportunities to learn from diverse voices within the community, deepen understanding, and challenge biases. Furthermore, affirmative supervisors engaging in activism can provide valuable resources, connections, and opportunities to their supervisees to be part of community initiatives and advocacy efforts. These connections foster a sense of belonging, provide ongoing education, and expand professional networks for queer and trans associate therapists.

Power and Privilege Dynamics

It should be the responsibility of the supervisor, not the supervisee, to address power imbalances and initiate conversations about empowering the associate therapist and recognizing their unique needs (Green & Dekkers, 2010; Porter, 2014). Affirmative supervisors demonstrate a commitment to client advocacy, personal and professional integration, expanding affirmative care, and challenging oppression. An inclusive and affirmative approach to supervising queer and trans therapists encourages activism and supporting supervisees in integrating their own identities into their work.

Diversity, Equity, & Inclusion

LGBTQIA+ affirmative supervisors who engage in activism understand that therapy is not separate from their clients’ social, cultural, and political contexts. This entails recognition of the need to challenge systemic oppression and working towards creating more inclusive environments for LGBTQIA+ individuals. Through advocacy, a supervisor demonstrates a commitment to addressing the root causes of the challenges their queer and trans supervisees and clients may face. Affirmative supervision models the importance of working toward social justice and creating an empowering and inclusive environment for LGBTQIA+ supervisees and clients.

During the interview: Inquire about the supervisor’s past experiences advocating for queer/trans clients or their commitment to staying informed about relevant research and best practices. 

4. Affirming and Inclusive Language

A supervisor who uses inclusive and affirming language during the interview is more likely to create a welcoming and supportive environment for both queer and trans associate therapists and their LGBTQIA+ clients (Hagler, 2020). An affirmative supervisor realizes the importance of embracing inclusivity, decolonizing therapy, challenging heteronormativity, and understanding the intersectional experiences of queer and trans therapists and clients. Look for a supervisor with awareness of power dynamics who actively seeks to provide and maintain a safe environment in which the supervisee is seen, heard, and empowered (Hernandez & McDowell, 2010). Affirmative supervisors should be capable of and committed to practicing empathetic understanding, appropriate self-disclosure, and humility (Lenz, 2014). 

During the interview: Listen for the supervisor’s use of gender-inclusive terms, correct pronouns, and respectful language when discussing LGBTQIA+ topics.

5. Commitment to Professional Development

Supervisors’ commitment to staying updated on current research, attending relevant workshops or trainings, and seeking supervision themselves demonstrates a dedication to providing informed and competent support. A degree in clinical psychology or counseling is clearly not enough to assure LGBTQIA+ competency, as we work in a field that was founded on heterocentrist and racist research coupled with a history of pathologizing gender diversity and sexuality (Alessi, 2013; Burnes et al., 2017). This means that it is the responsibility of therapists, especially therapists who are themselves clinical supervisors, to stay updated on current research, seek training and consultation in areas related to affirmative care, engage in self-reflection regarding privilege and oppression, and promote an affirming atmosphere for clients and supervisees.  

During the interview: Inquire about the supervisor’s ongoing professional development related to LGBTQIA+ issues.

Choosing a clinical supervisor is a significant decision for any associate or trainee therapist, particularly when you identify as part of the LGBTQIA+ community. Being aware of the “green flags” to watch for during the interview process can help you find supervisors who will provide the necessary support and guidance to help you thrive as a queer/trans therapist. Remember to prioritize knowledge and experience in working with LGBTQIA+ community members, inclusivity, a commitment to professional growth, and advocacy for your development and wellbeing. By selecting a supervisor who understands and affirms your unique experiences, you can cultivate a supervisory relationship that fosters both personal and professional development.

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References 

Alessi, E. (2013). Acknowledging the impact of social forces on sexual minority clients: Introduction to the special issue on clinical practice with LGBTQ populations. Clinical Social Work Journal, 41(3), 223-227. http://dx.doi.org/10.1007/s10615- 013-0458-x 

Burkard, A. W., Knox, S., Hess, S. A., & Schultz, J. (2009). Lesbian, gay, and bisexual supervisees’ experiences of LGB-affirmative and nonaffirmative supervision. Journal of Counseling Psychology, 56(1), 176–188. https://doi.org/10.1037/0022-0167.56.1.176

Burnes, T. R., Rowan, S. F., & Paul, P. L. (2017). Clinical supervision with TGNC clients in health service psychology. In A. Singh & l. m. dickey (Eds.), Affirmative counseling and psychological practice with transgender and gender nonconforming clients (pp. 175–190). American Psychological Association. https://doi.org/10.1037/14957-00

Green, M. S., & Dekkers, T. D. (2010). Attending to power and diversity in supervision: An exploration of supervisee learning outcomes and satisfaction with supervision. Journal of Feminist Family Therapy, 22(4), 293–312.