August '26 Clinical Supervision Topic: Listening for Needs and Feelings
This month we’re keeping things simple. Our focus is on listening. Specifically, listening to needs and feelings.
We’ll pull from Marshall Rosenberg’s work around non-violent communication and his thoughts on empathy. The two things I’d like you to learn about from this video (which we’ll reference in group) is the concept of listening deeply to people so that we understand their needs and feelings.
You can see lists of feelings and needs as well, which will help as you tune into clients.
By the way, did you know that Rosenberg built on Carl Rogers’ work? Isn’t that great? Love that guy.
Come ready to practice. See you soon.
July 2026 Clinical Supervision Topic: Congruence, Authenticity, and Internal Family Systems
We are on the sixth and final step of our rupture and repair series. Nice work!
Here it is:
enjoy a stronger, more honest, more real relationship with the lovely human in front of you.
I mean, I did kind of write this step just for fun. But, why not spend a month on it? Maybe it will indeed be fun!
When I think about when I most enjoy the person and relationship in front of me in a clinical setting (which I’m differentiating here from a social setting, as the expectations are a bit different socially than clinically), I realize it is when I am the most relaxed, present-focused, easy-going-but-intentional, curious, and compassionate. Not the polished or performing parts of me that tend to show up when I'm anxious or disconnected from my own intuition. The parts trying to get it "right." The parts operating from shoulds, pressure, obligation, fear, or guilt.
When I’m just, well, me. And, likely, you. To some extent, I’d guess?
I kind of believe the Internal Family Systems and AEDP ideas that we are all sooo good and golden at our core. So I’m guessing the Cs that I feel when I’m at my best as a clinician are similar to what you experience when you’re at your best in your role.
And, good news. Not only is it good for US to feel good in our work, turns out, according to common factors research, us being our most genuine, authentic and congruent selves has a very positive effect on the people we interact with daily, even our clients!
That got me wondering: if congruence of the clinician is one of the common factors in effective clinical work, where does it come from in us?
What creates the conditions where I naturally become more myself?
Because I’m not always in that state all the time. No one is. So I’m guessing we all have this question: what makes me feel most myself with: a. another person in general, and b. my clients?
For many of us, a big part of the answer is physical and psychological safety, which then creates the conditions where we can begin listening inward.
External safety matters. If my nervous system doesn't feel physically or psychologically safe, authenticity isn't really the goal—survival is.
But once enough safety is present, another question emerges:
How do I become more connected to myself while I'm with another person?
What I've found is that I feel most connected to myself when I'm in relationship with all the different parts of myself, and when they feel seen, heard, and respected enough that we can work together instead of against one another.
As that internal relationship has strengthened, something interesting has happened: congruence has required less effort. It seems to emerge naturally. I'm simply more me with the person sitting across from me. And, perhaps not surprisingly, I enjoy them more, too.
The person and relationship before me are enjoyed. :)
For me, that inner parts work has looked surprisingly simple.
It's becoming more familiar with my own internal system.
Learning to notice my parts.
Listening to them.
Thanking them.
Understanding what they're trying to do/what they need.
Helping them trust that they don't have to take the lead in the clinical work, but I’ll let them know if I want them to, thank you very much.
Congruence isn't a performance. It's a byproduct of an internal relationship.
Here are a few videos that will show you a bit more of what I'm talking about (using more IFS language, which may be helpful): 1, 2.
See you all soon.
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.
September 2025 Clinical Supervision Topic: Self-Compassion + Internal Family Systems
September is Self-Compassion Month in our clinical supervision practice. In past years we have leaned on Kristen Neff’s research and practices (see here). For 2024, I attempted (and mostly succeeded) in doing the “Tender Self-Compassion Break” meditation every day. That simple practice helped dislodge some of the self-loathing and pain-avoidance habits I had carried from complex trauma, and it opened up so much more room for honest kindness and acceptance toward myself. It also very much influenced my ability to love this work and extend so much care and compassion towards my clients, and you, my dear supervisees.
This year we are exploring self-compassion through the lens of Internal Family Systems (IFS). When you learn to meet your own parts with curiosity and kindness, you expand your ability to guide others to do the same.
Wherever you work, whether in a hospital, community agency, crisis line, or therapy room, you already know how much is asked of you. Long hours, high stakes, constant demands. It is easy to give compassion outward and forget to turn some of it inward.
Internal Family Systems (IFS) offers a practical way to practice self-compassion while you work. It seems abstract or fluffy, but it’s not, I promise. It is grounded, simple, and doable even in high-pressure settings. IFS reminds us that we are made up of many “parts,” and each of those parts deserves kindness. Here are five skills you can use in your own practice, and often in the moment with the people you serve.
1. Spot the Hijack
For yourself: Notice when a part takes over, maybe the perfectionist, the critic, or the exhausted part that wants to shut down. Ask yourself: Is this my grounded Self, or is this a part running the show? Just naming it gives you breathing room.
With clients/patients/members: Help people notice the early signs of a hijack. You might ask, “When did you notice the panic start?” or “Where do you feel that shift in your body?” This helps them catch parts in real time instead of after the fact.
Quick script: “I noticed your voice sped up. When did that show up?”
2. Speak in Parts
For yourself: Instead of saying, “I’m overwhelmed,” try: “A part of me feels overwhelmed, and another part wants to keep going.” This small shift reminds you that you are bigger than any one reaction.
With clients/patients/members: When someone feels torn, invite them to expand the picture: “Is there another part of you that feels differently about this?” This normalizes ambivalence and helps people see themselves as complex, not broken.
Quick script: “It sounds like one part wants to leave and another part wants to stay safe. Did I get that?”
3. Listen to the Body
For yourself: Ask where you feel the part in your body, or around your body. Does it have a shape, a color, a voice? Noticing this grounds you and gives the part dignity. Even a quick shoulder check or a hand on your chest between calls can reset your system.
With clients/patients/members: Invite them to notice their own body cues. “Where do you feel that stress in your body, or around your body?” or “If it had an image or a sound, what would it be?” This shifts people out of analysis and into embodied connection.
Quick script: “Where do you feel this stress in or around your body right now? Let’s name it.”
4. Befriend the Part
For yourself: When you notice a reactive part, get curious instead of pushing it away. If it were a person, how old would it be? What makes sense about the way it acts? Often these parts are younger or protective. They just need some care.
With clients/patients/members: Encourage them to meet their own parts with gentleness. You might say, “That angry part is probably trying to protect you in some way. What would it be like to get to know it instead of fighting it?” This can transform shame into compassion.
Quick script: “That angry part is trying to protect you. What would help it feel a little safer right now?”
5. Step Back Into Self
For yourself: After spotting parts and making contact, take a breath and intentionally return to your Self, the calm, curious, compassionate center of you. Even three slow breaths before walking into the next room can reset your presence. I like to put a hand over my heart briefly to settle back into my Self energy.
With clients/patients/members: Model Self energy in small, concrete ways. Soften your voice, slow your pace, make gentle eye contact. These micro-moments of curiosity and calm can de-escalate tension and create trust, even in a brief encounter.
Quick script: “Let’s slow down for a second. What would be most helpful first?”
Why It Matters
These five skills are not just for therapists. They are for anyone in the field who sits with suffering. For you, they build resilience and keep you grounded. For the people you serve, they open up pathways to self-compassion and healing, sometimes in just a few moments of contact.
Self-compassion is not about excusing or ignoring. It is about making space for all the parts of you, the tired parts, the sharp parts, the hopeful parts, and extending the same grace to the people in front of you. And just as we said at the start, when you learn to meet your own parts with curiosity and kindness, you expand your ability to guide others to do the same.
Let’s listen to my friend Laura’s conversation with Dick Schwartz about IFS. I’m really looking forward to hearing your perspectives on this!
August 2025 Clinical Supervision Topic: Eliciting Feedback and Motivational Interviewing
It’s easy to assume clients will tell us if something isn’t working. But most won’t…at least not directly. They might show up less engaged, try to push through, or quietly stop coming. We can prevent a lot of that by making feedback a regular part of the process, early and often.
Therapists who build space for honest feedback tend to have stronger alliances, better client retention, and better outcomes overall.
A few things we know about feedback:
Outcomes improve when we ask. Inviting client feedback using simple tools or open-ended questions significantly improves therapy outcomes and reduces dropout rates.
The best therapists get the most negative feedback. Not because they’re doing something wrong, but because they’ve created enough safety for clients to be honest.
Most clients won’t tell you directly. Especially if they think it might hurt your feelings. We have to actively invite it.
Motivational Interviewing is especially helpful here. It’s grounded in the belief that clients are the experts on their experience, including their experience of us. MI gives us a way to ask for feedback without making it feel clinical or pressured.
One MI framework I find especially helpful is OARS:
Open-ended questions
Affirmations
Reflections
Summaries
Each of these helps feedback feel collaborative rather than evaluative. For example:
Open-ended question: “What’s been most helpful—or not helpful—about today?”
Affirmation: “I really appreciate you saying that; it helps me understand how to support you better.”
Reflection: “It sounds like I might’ve missed what felt most important there.”
Summary: “So what I’m hearing is that this pace feels fast, and you’d like a little more time to process?”
Here are some other sentences that can gently open the door to process feedback:
“How is this feeling so far?”
“Did I miss anything important just now?”
“What’s been helpful today—and what hasn’t?”
“Is there anything I’m doing that gets in the way?”
“What do you wish I better understood about where you’re at?”
These questions are simple, but they matter. They let clients know their experience of the work—and of us—is part of the work. And when we respond with curiosity instead of defensiveness, it strengthens the alliance rather than threatening it.
Want to learn more?
May 2025 Clinical Supervision Topic: Congruence, Genuineness, and Internal Family Systems
I love the topic of congruence and genuineness. I don’t know if anything creates more safety besides a regulated nervous system (which we talked about last month), and you being your realest, truest self.
Internal Family Systems (I like the video on this page) does such a good job explaining just what our self is, so I thought it’d be a good model to bring into our common factors study this month. What does IFS state the self is? Well, it explains it through the 8 Cs: Calm, Curiosity, Clarity, Compassion, Confidence, Courage, Creativity, and Connectedness.
These are qualities that emerge when we’re not blended with a part—when we’re leading from Self-energy.
Which brings us back to congruence.
Carl Rogers wrote, “Do I dare to communicate myself as I am?... Or must my communication be somewhat less than or different from this?”
Congruence, in his view, was about two things:
Awareness of our internal experience
The willingness to share that experience in real time
IFS adds a twist. It suggests that even our "internal experience" isn't just one thing. It’s often made up of many parts—some protective, some wounded, some wise. So the question shifts from just “What am I feeling?” to “Which part of me is feeling this?”
This model gives us a more clear internal compass for congruence. Sometimes, what wants to be shared in session comes from a Manager part (maybe a part that wants to sound competent or kind). Other times, it might be an Exile; a younger part who feels seen by the client’s story. Occasionally, it might be a Firefighter, trying to say something just to get out of the moment.
Congruence, then, isn’t just about saying what’s real. It’s about knowing which part inside us wants to speak, and whether it’s useful to let them.
So here’s what I’d love for us to reflect on together this month:
Which parts of you most often take the lead in therapy sessions? (The helper? The expert? The one who wants to be liked?)
How do you distinguish between a genuine urge to self-disclose and a part that wants to manage the space?
Has there ever been a time you spoke from a part, and it went well? What made it land?
Has congruence ever backfired? What did you learn about timing, tone, or part activation?
See previous years here.
Can’t wait to hear your reflections.
See you soon.
April '25 Clinical Supervision Topic: Unconditional Positive Regard (and Polyvagal Theory)
Most of us became therapists or social workers because we wanted to be a safe place for people. We wanted to offer deep presence, acceptance, and care, especially for clients who hadn’t received much of that elsewhere. In grad school, we learned about unconditional positive regard as a cornerstone of ethical, client-centered work.
But we didn’t always learn what makes it possible.
Unconditional positive regard (UPR) isn’t a personality trait. It’s not something you’re born with, or something you summon through sheer clinical willpower. It’s a physiological state. One that depends on your nervous system feeling grounded and safe enough to offer warmth, curiosity, and steadiness, even in the face of complexity, pain, or rupture.
Polyvagal theory gives us language and structure for this. It helps explain why sometimes we can access that steady, accepting presence, and other times, we just... can’t.
UPR Lives in the Ventral Vagal System
According to polyvagal theory, the part of the nervous system that allows for connection and openness is called the ventral vagal system. When we’re in this state, we can be flexible, attuned, responsive. We’re able to offer real empathy, not just because we should, but because we can.
This is the ground where unconditional positive regard can actually take root. But we don’t live there all the time. Neither do our clients.
When Our Nervous System Says “Nope”
Sometimes we move into sympathetic activation—urgency, irritability, anxiety. Other times we collapse into dorsal shutdown—numbness, dissociation, going through the motions.
In either case, we’ve left ventral. It becomes much harder to feel open or generous. We might start reacting instead of responding. We might get stuck in judgment, resentment, performing, or clinical detachment. We might feel off and not know why. And when we’re not in ventral, our clients’ nervous systems are picking up on it.
Moving out of ventral isn’t a personal failing. It’s neuroception, our body’s built-in system for scanning safety and danger. It operates below conscious awareness, and it’s trying to protect us.
What Gets in the Way of UPR?
Clients whose stories stir our own trauma
Behaviors that feel defensive, rigid, or rejecting
Sessions where we’re running on fumes
Work environments that don’t feel safe or supportive
Old countertransference that hasn’t been metabolized
Even if we want to offer unconditional positive regard, it can be hard to access in certain moments. Especially when our own system is activated, depleted, or trying to manage threat.
So What Helps Us Get Back?
The question isn’t “How do I offer UPR all the time?”
It’s: How do I return to presence when I’ve left it?
Soften your shoulders, jaw, or breath
Slow down the pace of the session
Let silence stretch for a few extra seconds
Privately acknowledge you feel distant or stuck
Use rituals or grounding before and after sessions
Tend to your body’s needs, not just your clients’
UPR doesn’t mean self-sacrifice. It doesn’t mean dissociating from your own responses in order to be a “good therapist.” It means working with your body, not against it.
A Closing Word
If you’re struggling to feel warmth with a client, or if you’ve found yourself moving into judgment, withdrawal, or shutdown, that doesn’t mean you’re failing.
It means you’re a body, a nervous system.
And your body is giving you information.
That’s not in the way of the work. That is the work.
Unconditional positive regard isn’t a fixed quality we either have or don’t. It’s a state we return to—again and again—through the pathways of our nervous system. When we’re anchored in a ventral vagal state, we have access to warmth, curiosity, and flexibility. We can see the whole person in front of us, not just their symptoms or survival strategies.
But ventral isn’t a permanent home. We lose it, often without realizing it. The work is learning how to find our way back.
And the more we practice offering that same regard to ourselves—especially in the moments when we feel disconnected, ashamed, or not enough—the more accessible it becomes to the people we sit with. We don’t offer unconditional positive regard instead of being human. We offer it through our humanity. Through our capacity to regulate, to repair, and to return.
Check out this resource (a short youtube video) and this one (a longer podcast with Deb Dana).
See previous years here.
New! Perinatal Mental Health Consultation and Supervision Group by Margot Strauhull
You are welcome to join Margot’s new group!
Perinatal Mental Health Supervision and Consultation Group
Facilitated by Margot Strauhull, LCSW
Join a supportive and knowledgeable clinical supervision group designed for licensed and unlicensed therapists and social workers serving perinatal clients. Led by Margot Strauhull, LCSW, a seasoned perinatal mental health specialist, this group offers a space for clinicians to deepen their expertise, navigate complex clinical cases, and connect with others in the field.
Margot brings extensive experience working with clients through pregnancy, postpartum transitions, birth trauma, loss, and reproductive challenges. With a warm and engaged approach, she fosters a collaborative environment where clinicians can build confidence, refine interventions, and explore the nuances of perinatal mental health care.
This group is ideal for:
* Therapists providing care to pregnant and postpartum clients
* Clinicians seeking specialized support around perinatal mood and anxiety disorders (PMADs), birth trauma, and parental identity shifts
* Providers who value a relational, trauma-informed, and inclusive lens in their work
What to expect:
Case consultation and clinical discussion
Evidence-based approaches for perinatal mental health
Ethical considerations and best practices
Community and professional support
This is a small-group format, ensuring space for meaningful discussion and individualized feedback.
Location: virtual via Google Meet
Schedule: 2nd Friday of each month, 11:30am-1:30pm
Cost: $60/hr
For more details or to join, contact margot@rootandbloomcounseling.com.
November 2024 Clinical Supervision Topic: Cultural and Identity Adaptation
As therapists, counselors, and social workers, we know cultural and identity adaptation isn’t a “done and dusted” checkbox—it’s more like maintaining a houseplant: constant care, awareness, and yes, maybe a little sunlight. We’ve moved from “cultural competence” (like it’s some level to unlock) to “cultural humility,” which is more about staying curious, being real about our biases, and knowing there’s always more to learn. Here’s a toolkit for keeping up with evolving identities and perspectives.
Cultural Humility, Not Cultural Superpowers
Let’s be real: we’ll never “know it all” about any culture, even our own. Cultural humility means approaching every session with open-mindedness, respecting power dynamics, and having the courage to reflect on our biases. It’s less about “I’ve mastered this” and more about “What don’t I know yet?”
Practicing Intersectionality Like a Pro
Clients don’t walk in carrying just one label. Race, gender, class, sexuality—they’re all woven together and impact life experiences in ways that textbooks can only skim. Seeing clients as complex, layered humans helps us offer more real, compassionate support. It’s about noticing how these intersecting identities shape their lives and tuning our approach to reflect that understanding.
Adaptive Therapy (Because Textbook Methods Are Outdated)
Think of this as “choose your own adventure” therapy. Adaptability isn’t optional; it’s essential. Maybe that means rethinking our language, drawing from models outside our usual toolbox, or involving family or community if it fits. Let’s drop the template and focus on what resonates most with each client.
Understanding Cultural Trauma (Beyond the Usual Checklist)
Trauma is never a one-size-fits-all experience. Systemic oppression, generational trauma, and cultural values all influence how clients experience and heal from trauma. Recognizing these elements helps us provide trauma-informed care that’s actually informed by our clients' realities—not just a list of guidelines.
Keeping Up with Gender and Sexuality
As our collective understanding of gender and sexuality evolves, it’s on us to stay current. Gender-affirming practices, inclusive language, and the nuances of LGBTQIA+ challenges are no longer “nice-to-haves”; they’re essential for creating a space where all clients feel understood and respected.
Supervision and Peer Learning: Adaptation Isn’t Just for Clients
We don’t just adapt in sessions with clients; we need to be doing it in supervision and peer meetings, too. Engaging with colleagues who have diverse perspectives, reflecting on our biases, and bringing power dynamics into our discussions makes us better, more responsive therapists. Plus, it keeps us growing in real time.
Conclusion: We’re All a Work in Progress
Cultural and identity adaptation isn’t something we achieve; it’s a muscle we strengthen daily. Staying open, curious, and intersectionally aware makes for a therapy space where clients feel safe to be themselves, complexities and all.
October 2024 Clinical Supervision Topic: Choose Your Own Skill
Hi there.
This month we’re doing something different for our clinical supervision groups.
I’d like you to choose a skill and come to the group ready to share about it. This could be a skill you use all the time, or a new one that you’re just curious about. As a major introvert myself, I understand that this may not appeal to all of you. Don’t worry: whatever you share will be much appreciated. Here’s a cheat sheet too!
See you all soon.
August 2024 Clinical Supervision Topic: Eliciting Feedback
Why do we elicit feedback?
Eliciting feedback is crucial for several reasons:
1. Enhances Therapeutic Alliance: Feedback helps build and maintain a strong therapeutic relationship. It shows clients that their opinions and feelings are valued, fostering trust and collaboration.
2. Improves Treatment Effectiveness: Regular feedback allows us to adjust our approach based on the client's experiences and responses. This can lead to more effective and tailored interventions.
3. Identifies and Addresses Issues Early: Gathering feedback can help identify any issues or misunderstandings early in the clinical process. Addressing these can prevent future problems.
4. Empowers Clients: When clients provide feedback, they actively participate in their treatment. This can empower them, enhance their self-awareness, and promote a sense of ownership over their progress.
5. Facilitates Continuous Improvement: Feedback highlights areas for our improvement and reinforces effective practices, contributing to ongoing growth and skill enhancement.
6. Monitors Progress: Regular feedback helps in tracking progress over time. It provides concrete data on what is working and what might need adjustment, helping the work remain on track.
So how do you elicit feedback? Let’s pool our mental resources, wisdom and experience and come together to discuss!
July 2024 Clinical Supervision Topic: Therapist Effect
See our previous years here.
Therapist effect is the part of the research that is unknown, it seems, but it basically says that we know that therapy is different based on the clinician. Seems pretty straightforward, right? But how do you enhance your therapist effect? Besides becoming proficient with the common factors, what else can you do?
Let’s explore this together. What are you curious and passionate about in your work? What elements of it excite you or pique your interest? What are you experimenting with? What are you hoping to bring to your clients?
For me, I’ve been thinking more about:
humor in clinical practice
self-disclosure as it relates to what I’m feeling on a somatic level in response to my clients’ experiences
and always, the practice of self-compassion both for the practitioner and the client.
Looking forward to hearing your ideas!