Clinical Supervision

Course Case Study Lily began supervising an intern, Jack. A few months after supervision began, Lily discovered that she would need to go on medical leave. Because the leave would only be for about six weeks and she was the only licensed mental health professional in the office, she and Jack decided that he would be fine working without her involvement until she got back. He would simply keep all the reports she needed to sign on her desk, and she would sign them all when she returned. Jack felt very competent in his ability to carry on while Lily was out until he conducted an intake assessment on a client who seemed to be having some breaks from reality. Jack was unsure how to determine if there really was psychosis occurring and what to do about it. He tried to contact Lily but was unable to get in touch. Anxious, he searched online for ideas on how to work with the new client and tried out a few techniques during sessions. He reassured himself that no matter what he did, ultimately Lily was responsible anyway. A week before Lily returned to work, the client was arrested as he tried to “fly” off a building, convinced that he could fly without difficulty. Upon being taken into custody, the client’s demeanor concerned the police officer and he was taken to the emergency room where an evaluation was conducted. It was determined that he was indeed experiencing psychosis, and antipsychotic medication was started. Once the client was stable, he filed a complaint against Jack and Lily with the state licensing board and threatened legal action. Understandably, Jack was scared and Lily was angry. She accused Jack of practicing without her consent, stating that he was to have continued with the clients he had when she left, not accept new ones. She subsequently informed him that she would no longer be his supervisor. Jack was furious that he was put in the position to make decisions on his own and did not receive support from his supervisor. Jack, in turn, filed a complaint against Lily due to lack of supervision.

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