Improve Your Clinical Competence with Clinical Consultation
By Shannon Heers
As a mental health therapist, one of your primary goals is to provide the highest quality care to your clients. However, whether you’re in private practice or working in an agency without access to regular clinical supervision, the pressures of managing complex cases, ethical dilemmas, and personal challenges can often leave you feeling uncertain or isolated. This is where clinical consultation becomes invaluable.
Clinical consultation serves as a tool for professional growth, offering therapists just like you a space to reflect on your work, gain fresh insights, and continuously improve your clinical competence. Here, we’ll break down what clinical consultation is, how it differs from supervision, why it’s crucial for improving clinical competence, and how to find the right consultation group or individual consultant for your needs.
And if you’re a therapist wondering how to take your practice to the next level, this post is for you.
What Is Clinical Consultation?
Clinical consultation is a professional practice where therapists seek guidance and feedback from peers or more experienced clinicians regarding client cases, therapeutic techniques, and ethical concerns. Unlike clinical supervision, which is often required for licensure and focuses on developing core competencies under the supervision of a licensed clinician, consultation is typically voluntary and collaborative.
In clinical consultation:
- You can present challenging cases and ask for input on therapeutic approaches.
- You can discuss personal concerns about your clinical work, such as countertransference or burnout.
- You receive feedback and perspectives from colleagues, which can lead to enhanced clinical insight and competence.
Let’s say you’re a therapist who specializes in dialectical behavioral therapy (DBT). You may find yourself working with a client whose issues don’t seem to respond well to your usual techniques. In a consultation session, you could bring up this case, receive feedback from colleagues trained in different modalities, and gain new ideas for how to approach the client’s needs. This collaborative exchange fosters deeper understanding and improved clinical skills.
How Does Clinical Consultation Differ from Supervision?
One of the most common questions therapists ask is, How is clinical consultation different from supervision?
While both practices are designed to enhance clinical skills and ensure ethical care, there are key differences between the two:
1. Supervision Is Required; Consultation Is Voluntary
Supervision is often required as part of the licensure process for new therapists, both counselors and clinical social workers. It is typically structured, with a formal power dynamic where the supervisor evaluates and mentors the supervisee. Supervisors also bear legal and ethical responsibility for the supervisee’s work.
Clinical consultation, on the other hand, is voluntary and occurs among peers or between a therapist and an external consultant or clinical supervisor. There is no formal power dynamic, and the consultant does not hold legal responsibility for the consulting therapist’s work.
2. Supervision Focuses on Core Competencies; Consultation Focuses on Refinement
In supervision, the focus is often on helping new therapists develop core clinical competencies, such as diagnosis, treatment planning, and therapeutic techniques. Consultants, however, often work with more experienced clinicians who seek to refine their skills, address specific challenges, or gain new perspectives on difficult cases.
3. Supervision Is Evaluative; Consultation Is Collaborative
Supervision often involves an evaluative component, where the supervisor assesses the supervisee’s competence and readiness for independent practice. In contrast, consultation is a more collaborative process where both parties engage in an open dialogue, exchanging ideas without formal evaluation.
Why Clinical Consultation Is Essential for Improving Clinical Competence
Even the most seasoned therapists need space to reflect on their work, challenge their assumptions, and deepen their clinical understanding. Clinical consultation provides exactly that.
Here’s why clinical consultation is essential for improving clinical competence:
1. Receive Feedback on Challenging Cases
No matter how experienced you are, there will be times when a client’s issues leave you feeling stuck. Perhaps you’ve tried several therapeutic techniques, but nothing seems to work. Or maybe you’re unsure whether your approach is ethically sound or aligned with the client’s goals.
Clinical consultation provides a space to present these challenging cases and receive feedback from peers who may offer a fresh perspective. For example, if you’ve been working with a client who is experiencing severe trauma-related symptoms but hasn’t responded well to CBT, a consultant might suggest trying EMDR (Eye Movement Desensitization and Reprocessing) or another trauma-focused approach. This outside perspective can open up new avenues for treatment that you may not have considered.
2. Gain Insight into Your Blind Spots
Even the most self-aware therapists have blind spots. These are areas where your personal experiences, biases, or emotional reactions might cloud your clinical judgment. One common example is countertransference, where a therapist’s emotional responses to a client’s situation mirror their own unresolved issues.
In a clinical consultation, you can explore these blind spots with a trusted colleague or consultant. For instance, if you find yourself feeling overly protective of a client who reminds you of a family member, discussing this with a consultant can help you understand how countertransference is influencing your work and how to manage it effectively.
3. Enhance Ethical Decision-Making
Ethical dilemmas are an inevitable part of clinical practice, and navigating them alone can feel overwhelming. Whether you’re grappling with confidentiality concerns, mandatory reporting obligations, or dual relationships, consultation provides a supportive environment for exploring ethical challenges.
Imagine you’re working with a teenager who discloses that they’re engaging in risky behavior, but they beg you not to tell their parents. This puts you in a difficult position, as you need to balance your ethical obligation to protect the client’s confidentiality with your responsibility to ensure their safety. By seeking consultation, you can discuss the case with colleagues, review ethical guidelines, and make a more informed decision about how to proceed.
4. Keep Up with Emerging Clinical Trends
The field of mental health is constantly evolving, with new therapeutic modalities, research findings, and best practices emerging all the time. Staying up-to-date on these developments can be challenging, especially if you’re practicing in isolation.
Clinical consultation offers an opportunity to engage with other therapists who may have expertise in different modalities or who are aware of emerging trends in the field. For instance, a colleague in your consultation group might introduce you to Acceptance and Commitment Therapy (ACT) techniques that could benefit one of your clients, or they could share recent research on grief that informs how you approach your clients who have experienced significant loss.
5. Increase Confidence in Your Clinical Skills
Therapists often experience imposter syndrome, where they doubt their abilities or feel inadequate despite years of experience and positive client outcomes. Clinical consultation can help you combat these feelings by offering reassurance and validation from peers.
For example, let’s say you’ve been working with a client who has made significant progress, but you worry that you’re not doing enough to help them reach their full potential. Bringing this concern to a consultation group allows you to receive feedback on your clinical approach, and more often than not, your colleagues will help you recognize the valuable work you’ve done with the client. This feedback can boost your confidence and reaffirm your sense of competence.
How to Find the Right Clinical Consultation for Your Practice
Finding the right clinical consultation group or individual consultant is key to getting the most out of the process. Here are some tips to help you find the best fit for your needs:
1. Consider Your Goals
Before you start searching for a consultation group or consultant, it’s important to reflect on your goals. What are you hoping to gain from consultation? Are you looking for feedback on specific cases, help with ethical dilemmas, or guidance on developing new skills? By identifying your goals, you’ll have a clearer idea of what kind of consultant or group will best meet your needs.
2. Look for Consultants with Relevant Expertise
If you’re seeking consultation on a specific therapeutic modality or client population, it’s important to find a consultant or supervisor with expertise in that area. For example, if you primarily work with children and adolescents, look for a clinical supervisor who has experience in child and adolescent therapy. Similarly, if you’re interested in deepening your knowledge of trauma therapy, seek out a consultant who specializes in trauma-informed care.
3. Seek Out Group Consultation for Collaborative Learning
Group consultation can be a particularly valuable way to improve your clinical competence, as it allows for a diversity of perspectives and creates a supportive learning environment. When joining a consultation group, look for a group that has therapists from a range of backgrounds and experience levels. This will give you the opportunity to learn from your peers while also contributing your own insights to the group.
For example, a consultation group with therapists who specialize in different modalities—such as Motivational Interviewing, psychodynamic therapy, and somatic therapy—offers a wealth of knowledge and diverse approaches to treatment. You may leave each group with new ideas and interventions that can enhance your clinical practice.
4. Prioritize Trust and Confidentiality
The success of clinical consultation relies on creating a safe space where therapists can openly discuss their challenges without fear of judgment. When choosing an individual clinical supervisor or consultation group, it’s essential to prioritize trust and confidentiality. Look for consultants who emphasize the importance of maintaining confidentiality and who foster a nonjudgmental, supportive atmosphere.
You’ll want to feel comfortable sharing your struggles and uncertainties, knowing that your colleagues will offer feedback in a constructive and respectful manner.
5. Evaluate Cost and Availability
Clinical consultation can be a valuable investment in your professional growth, but it’s important to consider your budget and availability when choosing a consultant or group. Some consultants charge hourly rates, while group consultation may offer a more affordable option with regular meetings.
If cost is a concern, you might consider forming a peer consultation group with trusted colleagues, where everyone contributes their expertise without any formal fees. Know that while you may save money engaging in peer consultation, you will likely spend more time and effort creating, organizing, and facilitating the group.
Common Questions About Clinical Consultation
Therapists often have questions about clinical consultation, especially if they’ve never participated in a formal consultation process before. Here are answers to some of the most common questions:
How often should I seek consultation?
The frequency of consultation depends on your needs and the complexity of your caseload. Some therapists seek consultation on a monthly basis, while others might reach out for support when they’re dealing with particularly challenging cases. Group consultation typically occurs on a regular schedule, such as biweekly or monthly.
Will my cases remain confidential?
Yes, confidentiality is a cornerstone of clinical consultation. Just as you maintain client confidentiality in therapy, consultants and group members are expected to keep all case discussions private. Be sure to establish clear confidentiality agreements before beginning any consultation process.
Can I still benefit from consultation if I’m an experienced therapist?
Absolutely! In fact, many seasoned therapists find clinical consultation to be even more valuable as they advance in their careers. Consultation offers a space to explore complex cases, refine your skills, and stay current with emerging trends in the field.
Improve Your Clinical Competence Through Consultation
If you’re feeling stuck in your clinical work, facing ethical challenges, or simply looking for ways to grow as a therapist, clinical consultation can be a game-changer. By engaging in regular consultation, you’ll receive feedback, broaden your therapeutic approaches, and deepen your clinical competence, all while enhancing the care you provide to your clients.
Firelight Supervision offers a variety of virtual clinical consultation options for you to help improve your clinical competence. Both individual consultation and group consultation are great choices, and our experienced and trained clinical supervisors specialize in working independently licensed therapists to support your clinical needs.
How we can help
Are you ready to take the next step? Schedule a Free 20-minute Phone Consultation today to learn more about how clinical consultation can help you improve your skills and elevate your practice.
Author Bio
Shannon Heers is a psychotherapist, approved clinical supervisor, guest blogger, and the owner of a group psychotherapy practice in the Denver area. Shannon helps adults in professional careers manage anxiety, depression, work-life balance, and grief and loss. Follow Firelight Supervision on Instagram and Facebook.
