May 2026 Clinical Supervision Topic: Accountability in Clinical Work
Hello.
We’re continuing our conversations on rupture and repair in the clinical space, in line with our annual theme of Returning to Connection.
The step, according to our post back in February, is “making it better”. Yes, I realize this is something we say to children, make it better. And I guess I’d like to bring the child-like mindset to this month’s work. Something I find so special about children is that they are so good at having a non-defensive, non-protected stance. Yes, they do lie sometimes, and try to get away with things, especially when going through their experimental phases of learning cause and effect. But they are not sophisticated in their defenses, and they drop them pretty quickly, generally speaking.
Why does this matter?
Well, I don’t know about you, but it’s very hard to not go into my own protective/defensive strategies when I’ve made a mistake, and especially when I harm someone. It takes me a minute to settle, to tolerate the exposure of being seen in a mistake, to deal with the guilt (and sometimes shame) that can come up after learning I’ve caused another harm (and the greater the harm, the greater the protectiveness, at times). I deeply care about the people I work with. I hate when I’ve made a mistake that causes them harm. I do not wish to cause them any suffering.
Ok, that got heavy. And this work can be heavy, but it doesn’t have to be in order to be effective. Not all the time anyway.
So, back to children. Let’s learn from them and their approach. Let’s be open and curious when we cause harm in the clinical space. Let’s trust the process of learning from our mistakes. And most of all, let’s listen, with an open heart, to understand the impact of our mistake. If a client is willing to share this, and sit with us and allow us to learn, change, and grow right in front of them, than we can do what is needed to repair the harm.
(Not all clients will give us this opportunity. And that’s a really good thing to bring to supervision. You deserve support too.)
When they do, we can listen closely to the exact way the rupture impacted them, and we can try and find ways to take accountability (naming the exact action, and the precise harm), and move into doing differently going forward. It will likely take some good listening, and some consistent nurturing of the relationship, along with not repeating the mistake.
I mean, it’s really, at the end of the day, just like any true, real relationship.
Ok, so this is a long, meandering way of saying: we’ll be practicing accountability statements this month. In whatever way that looks for you.
What does an accountability statement actually sound like? Here are some bare-bones examples, organized loosely by the type of rupture. These are starting points, not scripts. Your genuine words, in the moment, will be shaped by your client, your relationship, and what actually happened.
Misattunement / missing the emotional tone:
"I think I moved too quickly past something that really mattered to you. I was focused on [X] and I missed how much pain was underneath what you were sharing. I'm sorry for that."
"I responded in a way that felt clinical when you needed something warmer. That's on me."
Saying something that landed wrong:
"When I said [X], I can see now that it came across as [dismissive / minimizing / judgmental]. That wasn't my intention, but I hear that it hurt, and intention doesn't erase impact."
"I used a word or framing that didn't fit your experience. You know your experience better than I do, and I should have led with curiosity."
A boundary or structural rupture (lateness, scheduling error, etc.):
"I was late and that cost you time. I probably sent a message I don't want to send, that your time doesn't matter. It does."
"I made an error with [scheduling / billing / a note] and I want to own that directly rather than gloss over it."
Pushing too hard / moving too fast:
"I kept returning to something you'd already told me you weren't ready for. I didn't honor your pace, and I can understand if that felt like pressure."
One thing to notice across all of these: the structure is generally name the action → name the impact → resist over-explaining your intention. The temptation is always to explain why you did the thing. Resist it, at least at first. Your client doesn't need your reasoning first. They need to feel seen in their experience first. The explanation, if it's even needed, can come after.
More to come, see you all in supervision.
