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Essential: Clinical Supervision of Paraprofessionals

Updated: Jun 5, 2023

It is no secret that there is a behavioral health provider shortage in New Mexico. It is also no secret that New Mexico has benefited from the inclusion of peer support workers, community support workers, and other certified professionals who consistently contribute to positive behavioral health and recovery outcomes.

As the paraprofessional workforce grows, there is an increasing need to orient our clinical practices to be supportive and inclusive work environments. While paraprofessionals like Community Support Workers (CSWs) and Certified Peer Support Workers (CPSWs) may not be licensed to provide therapy, the services they provide are often therapeutic and complement the work of licensed providers. Minimizing their contribution would be a great disservice to the communities we serve.

But how do you provide clinical supervision to paraprofessionals effectively?

First is building a clear understanding of their scope of practice. CPSWs are certified by the Office of Peer Recovery and Engagement (OPRE). CSWs provide Comprehensive Community Support Services (CCSS), a Medicaid and BHSD funded program to improve life skills for people living with serious mental illness, substance use diagnoses, and/or a social emotional disturbance diagnosis. Both of these certifications require training, practice, and supervision.

While they may serve a variety of roles, they are often working out in the community, meeting with clients sometimes multiple times per week, helping them navigate systems of care, and providing ongoing support and encouragement. This means that the boundaries they have with clients may need to look different than a typical outpatient therapists’, while remaining ethical in their practice.

It’s also important to remember that our paraprofessional colleagues are part of the clinical team even if they do not diagnose, assess, or treat. They are often the ones with the clearest understanding of our clients’ environments. They have important insight and awareness about your clients’ needs, challenges, and strengths. They need to be consulted and included as integral members of the treatment team to serve the best interests of our clients.

With this context in mind, the need for clinical supervision of non-licensed colleagues becomes clearer. CPSWs, CSWs, and other paraprofessionals are constantly interfacing with clients and navigating challenging situations that may occur in the home or community, often alone. Building a supportive practice of clinical supervision is critical for maintaining ethical obligations to our clients as well as to our staff.

Some of the common, overlapping themes clinical supervision of paraprofessionals might include are developing plans and protocols for safety, for both clients and staff, communicating boundaries, as well as navigating transference and countertransference. As we consider these needs, we can better orient clinical supervision to include paraprofessional staff. When we do, we provide better support for our paraprofessional colleagues; we help them build the skills they need to grow as a behavioral health professional, and - we are more likely to retain the wisdom, talent, and service they provide to our agencies.

Amanda Browne, LCSW, MPH, founder of Black Moon Coaching and a key contributor to ENVIVE Solutions, will be leading our upcoming training on clinical supervision of paraprofessionals.

Supervising Paraprofessionals in Clinical Settings is a free training is available to all New Mexico-based Behavioral Health supervisors (2.0 CEUS). We have eight training dates available in May and June. Funding provided by New Mexico Behavioral Health Services Division.


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