Who Cares for the Caregivers: Clinical Supervision and Why REACH Does It


If you’re familiar with REACH, hopefully you know that we try to offer the best support possible to domestic violence survivors by being knowledgeable about, and sensitive to, the effects of trauma. But have you ever wondered how our advocates come to understand so much about trauma? Or how domestic violence advocates avoid burnout? How do they hear difficult stories day in and day out without becoming overwhelmed?

The answer to all of these questions lies in the clinical supervision we provide to our staff members. Clinical supervision refers to a model common in human services where someone receives guidance that is not necessarily related to their job performance or work flow. Clinical supervision (which does not mean ‘clinical’ in the medical sense) is different – that’s where a staff member can build their competence around understanding trauma, check that they’re providing the most ethical care possible, and reflect on how the work is affecting them.

While our Clinical Supervisors are licensed therapists, clinical supervision is different than therapy. Therapy is usually for a defined mental health diagnosis, but the focus of clinical supervision is specifically on work – how you are doing at work, what you are doing to take care of yourself so you can be present at work.

Clinical Supervision helps the survivors we work with by ensuring that we’re doing good work. Good work in our context is nonjudgmental; it involves laying out options for a survivor but not attempting to influence their choices. Our Clinical Supervisor Erica likes to say that curiosity is the best treatment for judgment. She can help an advocate by pointing out possible trauma symptoms in survivors they’re working with. She often simply asks questions like “what do you think is going on with (that survivor)? What is that about? What things have happened in their lives that might lead them to make that choice?”

One of our Community Advocates recently shared a story about a survivor who had relapsed in her struggle with substance abuse. Despite knowing intellectually that addiction is deep and complicated, this Advocate was still struggling with feeling like she should have done more to somehow keep the survivor from using. She was able to process her feelings of guilt and self-blame with Erica, so that she could then go on being supportive to the survivor.

Clinical supervision also offers an opportunity to watch our staff members for signs of secondary trauma, which is when someone who hears about trauma or cares for traumatized people experiences similar effects as those who experienced the trauma firsthand. Clinical supervisors can help guard against that by offering suggestions for self-care, and help staff members who might be feeling overwhelmed.

A clinical supervisor can also offer insights into the interpersonal dynamics that influence so much of the work. Shelter, for example, is a community living situation. At any given time we have eight different adult shelter guests, each with their own trauma history and things they find triggering; some with kids, some without; some struggle with substances, others with mental health diagnoses. All sharing kitchen and bathroom spaces. Conflicts are inevitable, and when they arise, advocates can discuss them with their clinical supervisor and come up with strategies for navigating these tricky situations. And advocates themselves work as part of a team, made up of members who each have THEIR own life experiences. How can we best approach situations as a team, and build on one another’s strengths, and work well together for the good of survivors?

“If we are taking care of ourselves,” Erica explains, “we are better able to do the work, and take care of others, and do all of the things that make for good advocacy. Those things are hard to do if you don’t have a place to put your feelings…So much of the work is about realizing that really bad things happen in the world, and no matter how hard you work you don’t have control over those things. We have to be able to keep going and not be ok with it…but be ok.”