Clinical Supervision & Consultation

SERVICES I OFFERClinical Supervision & Consultation

It is very common for Gianna Elms, LCSW to see someone new to the profession of mental health, domestic violence, or rehabilitation counseling trying to navigate their way by learning the job from someone who doesn’t have the same level of training or licensure that is required for the person for whom they are acting as a supervisor.

This happens because the person often works for the government, a non-profit organization, or some law allows for the unqualified person to do it. Or worse, the person who is supervising them may actually have the degree and licensure but doesn’t take things seriously and has never really tried to learn what psychotherapy, trauma and abuse or disability is really all about.

Instead, the supervisor believes in doing whatever the next “New Age” thing to do is so that he or she can say that there was another “success” in psychotherapy as fast as possible. Or worse he or she focuses on the number of “successful” case closures that he or she needs to “cook the books” and keep the funding each year, even though it’s not really helping the clients. But that’s not how people work and there are those of us who entered this field because we really wanted to help people. My first priority is always the client, and I will not engage in and/or continue clinical supervision of a clinician who believes differently. You must start with that high standard of ethics first and if you don’t have it, but desire it and want to learn, you should start with a clinical consultation.

a man in his reflective thoughts as he site on an outdoor chair overlooking a waterfront lake at dusk

Clinical Supervision

Clinical supervision is typically required at different stages during training and after graduation from a degree program if a person has completed the requirements to receive his or her provisional license.

In order to provide psychotherapy, a person must be under the supervision of someone who is independently licensed by the state that they are in or already have an independent license to practice psychotherapy. It is also encouraged, and in some cases required, that even if a person is independently licensed to practice psychotherapy that they receive clinical supervision if they are using a new method or working with a client that is beyond what they usually do. The definition of a “qualified or registered clinical supervisor” varies state-to-state and this can also vary based on a certification, which may require supervision, in addition or in place of a licensure.

My approach to clinical supervision is to serve as your mentor and supervisor. This is not a dual-role, rather I believe that it’s important that you and I understand that I perceive myself as a mentor, first, and a supervisor second. That’s because I understand the reality that the word ‘supervisor’ carries a negative connotation, and many supervisors (and supervisees) are responsible for this negativity. However, the word ‘mentor’ typically has a more positive connotation of collaboration and learning, rather than ‘authoritative’.

This is a critical period of growth for every clinician, and while a ‘bad’ clinical supervisor can teach you just as much as a ‘good’ clinical supervisor (if you are willing to learn from ‘bad’ experiences), I believe that I have a duty to teach you what I have learned, and to share how I have grown as a clinician so that you can too. But make no mistake, I will not simply tell you all of the ‘secrets’ to psychotherapy that I’ve learned. That would be detrimental to your learning process. There is, after all, a major difference between knowledge and wisdom. The goal is for you to gain wisdom as part of the clinical supervision that you receive so that you may become one of the best clinicians, resulting in more healing.

I do not accept all supervisees who inquire with me about my availability or willingness to provide clinical supervision. It is imperative that you review all of the information on this page, the Consent to Clinical Consultation, as well as any other information on my website(s) that may be relevant prior to contacting me to schedule an initial consultation. I believe that all clinicians should participate in their own serious, long-term psychotherapy, which involves interpretations of transference and countertransference, and the resolution of any prior life events that may impact clinical work, either prior to working with clients or as part of being under clinical supervision for the purpose of client protection. Most people who are seeking a clinical supervisor are not willing to do so because they are blind to the fact that they need this, just as much as their clients do. This is unfortunate.

Consultation for Clinicians and Others

Clinical and other professional consultation is also a common practice for those who are providing psychotherapy, counseling, and case management services when unfamiliar, rare or complex situations arise that the clinician or agency simply wants to get perspective from a more seasoned professional, a clinician who specializes or has specific knowledge or expertise in the particular area in question, or in some situations a lawyer.

I am available to help you if you are currently under supervision or are already independently licensed and have questions about your current practice or working with another practitioner, including other psychotherapists who you may be receiving treatment or who may be providing you supervision.

I recommend that for both the person providing consultation and the person or agency seeking the consultation document the consultation, regardless of whether the person or agency chooses to follow any guidance that they receive. When consultation is received, the person or agency is not required to follow the guidance that is provided. This is generally different than when a person is under clinical supervision. The reason is because the licensee is typically working under the license of the clinical supervisor, so the clients are actually the clinical supervisor’s clients, not the person who is seeking licensure or may be otherwise mandated to have clinical supervision. The exception to this rule is if the clinical supervisor provides erroneous direction that is illegal, at which point in time, the person who is under supervision has a legal and ethical obligation to seek consultation and, in some cases, legal advice or even make a report to the licensing Board if the situation cannot be resolved through other means.

My approach to consultation is not always designed to tell you exactly what to do. Rather it is sometimes designed to help you think through the decision-making process and refer you to the resources that you need so that you can do what is best for the client and manage your risks. This approach can help you understand what is getting in the way of you being able to identify what needs to be done and help you recognize that you already knew the answer to your question(s). In other cases, my approach to consultation is clear-cut and directive, combined with an explanation so that you can understand the “how” and the “why”.


  • Who should schedule a clinical consultation with you?
  • Who is able to receive clinical supervision from you?
  • How do I know if you are the right clinical supervisor for me?
  • What advice do you have for me to choose a clinical supervisor? I’m afraid I’ll choose the wrong one.
  • Do you accept interns in your private practice?
  • What are your fees for supervision and consultation?
  • Are you available for public speaking? Do you offer trainings or workshops?

I provide clinical consultation to licensed mental health professionals, including those who are provisionally licensed, and those who are in an approved graduate school training program in all areas that I currently treat or have experience treating. I also provide expert consultation to individuals, other professionals such as lawyers, businesses, and government agencies, on a wide range of topics related to disabilitydomestic violence, and more.

All potential applicants for clinical supervision should begin by using the ‘Book a Call‘ feature and selecting ‘Clinical Consultation’ for Daytime or Evening, depending on the time of day that you need to have your questions answered, if they are not already answered here. Alternatively, if you believe that you prefer to receive a general consultation and that your interest in services may be more, in line with personal growth, such that psychotherapy and counseling may yield, then you may select ‘Consultation’ for Daytime or Evening.

While I am independently licensed as a clinical social worker in Missouri and Arizona, I am currently only able to provide clinical supervision in the state of Arizona. There is, however, an effort amongst several of the state legislatures to offer what is known as a “Compact License”[1], which may take effect as early as 2023, so that may change for the number of states that I will hold an independent license as a clinical social worker, and it may also affect who I can provide clinical supervision. However, at this time, I am authorized to provide clinical supervision throughout the state of Arizona for social work, counseling, marriage and family therapy, and substance abuse counseling throughout the state of Arizona.

I am also qualified to be a supervisor nationwide for those who need supervision to obtain their Certified Rehabilitation Counselor (CRC) credential because I am also a CRC. The current language typically states that the supervisor is required to be a faculty member with a CRC at the university through which you complete your internships or an “on-site” supervisor who has a CRC. This language is not entirely clear when they say, “on-site” and it may change to include supervision that includes video, so that may be a question that we can ask on a case-by-case basis if you are unable to find a CRC to provide supervision.

[1]The National Center for Interstate Compacts (2022). The Social Work Licensure Compact. The National Center for Interstate Compacts, The Council for State Governments. Retrieved on January 14, 2023, from https://compacts.csg.org/compact-updates/social-work/

This is a mutual decision that we will need to make together to determine whether we are a good match. I don’t provide supervision just because someone wants it, or it’s required for licensure or certification. I’m a very direct clinician when it comes to training others because clients need good clinicians. If you can’t handle it with me, how are you going to handle a so-called ‘difficult client’?

Clients have rights, which are often denied to them. I will not provide clinical supervision to clinicians who are only trying to work out their own issues through their clients, rather than focusing on helping clients heal. You should also be advised that I do not use “buzz-words” or clichés like, “client-centered”, when speaking about the type of clinician that I am. I will not ‘cheat’ you. I will speak the truth.

This is a valid concern because there are some clinical supervisors who can become vindictive if you do not do exactly what they want you to do, or that will become upset if you try to talk to them about your concerns or even try to make a change. As long as it doesn’t get to this point, remember, you can learn just as much from a ‘bad’ supervisor as you can from a ‘good’ one. It’s often all about ‘perspective’. My advice is to meet with several potential clinical supervisors, some you may need to meet with a couple of times, and don’t base your decision solely on money. My contract will be with your employer, anyway.

Some clinical supervisors will meet with you the first time, at no-cost, because all they care about is getting someone to pay them for supervision for as long as it’s convenient for them. Alternatively, someone who works at an agency is ‘mandated’ to supervise you because of their job. If you go with either one, you will be signing yourself up for failure. The supervisor likely doesn’t value themselves enough to require payment for the initial consultation(s) or is willing to accept any licensee in order to keep their job, which is actually unethical or presents a conflict of interest, at minimum. Therefore, you will end up right where you started because you didn’t learn anything because the person had no interest in you. You may also end up feeling frustrated the entire duration of supervision because you elected to do supervision with someone who is overly controlling, and you ‘lost your voice’.

Remember, you have an expectation that you are paid for your services, so it’s reasonable that you should value your supervisor for their time too. You will know when you get the right supervisor for you, even if there are bumps in the road along the way. Every client who participates in therapy feels those bumps at times too. Effective supervision, like effective psychotherapy, shouldn’t be “touchy-feely”; it should help you grow. Take it slow and you will find the right supervisor for you, when the time is right. If you rush it, you may end up with someone who won’t let you go when you want out of the contract so that you can work with ‘the right one’.

No. For both licensure and certification supervision, I do not accept interns to see clients within my private practice. It is your responsibility to find a proper location of employment to see clients. Additionally, although the law in Arizona allows for provisionally licensed candidates to have a private practice so long as they are under the supervision of a licensee, I will not accept you as a supervisee if you choose to operate a private practice.

My fees are the same for supervision and consultation as what I charge for my time when I meet with a client. You should not expect a different rate than what a client is required to pay. If we meet through the use of technology, the current rate is $175 per hour or $250 per hour for sessions that starts at or after 6:00pm (Arizona time). You will be charged extra for time that goes over the scheduled time, which is billed in 5-minute increments and rounded up to the nearest $5.

There’s a minimum charge of one hour for concierge (on-site) consultations, whereas if we meet through the use of technology, the time may be prorated based upon the amount that you need. If we meet on-site within Flagstaff, Arizona the rate is $250 per hour. Additional fees are charged based on time and travel for areas outside of the Flagstaff, Arizona city limits.

Note, in the event that I agree to provide clinical supervision, my contract for supervision is not with you; it is with your employer. I will not provide clinical supervision to you, if you are in private practice, even though Arizona law allows it. All other clinical consultations, counseling, and psychotherapy are paid by you. If you request, I will provide you with a statement, for a $25 fee per statement. This statement will include the date of service, the amount you paid, the billing code (if applicable), which you may submit for reimbursement. It is up to you to determine if you are eligible for reimbursement under these terms and how much you will be reimbursed. This may also qualify as a medical, work, or business expense. You are advised to consult a tax professional.

You may Book a Call to schedule an initial consult. I will not respond to emails or phone calls regarding supervision and consultation without you having made a minimum donation of $45 in gratitude for this website and the minimum amount of time that it will take for me to attend to your phone or email question.

I am highly qualified to speak, train other professionals, offer workshops to the general public, and write on a number of topics. However, I believe that it is necessary for me to make a clear boundary between my clinical practice, which deals with individual psychological and forensic expert matters, and any other type of work that I may be asked to do, including public speaking, training other professionals in group settings, providing general information to the public, and any publications that are not based on this website. Therefore, I invite you to email or call me at 928-890-4642 with inquiries so that I may provide you with additional information.


[1]The National Center for Interstate Compacts (2022). The Social Work Licensure Compact. The National Center for Interstate Compacts, The Council for State Governments. Last retrieved on January 14, 2023, from https://compacts.csg.org/compact-updates/social-work/

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