IJSP Number 5, 2023

54 lack of proficiency of the supervisor, ineffective supervision possibly due to the supervisee’s inability to use supervisor input, faulty enactment in which the supervisee is not able to adequately implement the strategy, faulty organization in which the structure is flawed, inadequate quality improvement systems, leadership failure. Considering systemic approaches rather than simply the supervisee dyad provides greater insight into the complexity of communication, power, leadership, and consequences to the process of clinical supervision. An additional perspective is proposed by Kaslow and colleagues in what they have framed as a better concept: a “capability-informed competence approach” [44 p. 183] with potential to address factors impacting behavioral health problems and social inequities. Through their more holistic biosocial frame, an intentional focus and orientation, consideration of intersectional constellations would occur. These would include both psychological and physical health, disease conditions, as well as sociopolitical, sociocultural, and economic, generally harmful, conditions that co- determine mental and physical health. A disproportional health burden results for at-risk populations as a result of interactive syndemic factors. Syndemic refers to identification of inevitable interactions among diagnoses and societal factors. It relates to the synergistic interactions among multiple threats to health and their exacerbation by societal factors. We add to this formulation cultural humility—the mere fact interactions exist may not alter the clinician’s nor society’s response to the client experiencing these. Thus, we propose integration of competence (not simply at the entry level), but an ongoing process of self-reflection and additive experiential and cumulative learning and accommodation with cultural humility and respectful process. We acknowledge the many practical realities that impact the implementation of competency-based approaches to clinical supervision, e.g., time, resources, managerial leadership, etc. We appreciate the contributions of others that bring competency-based approaches to practice [45] and encourage collaborative research efforts, including the study of supervisor and supervision effects on the development of competence and on treatment outcomes. 6. FINAL THOUGHTS Competencies approaches lead to assessment of supervisee competency outcomes, bringing accountability to supervision practice; all of which translate to protection of the client. Such approaches instill an orientation to self-assessment and reflective practice that can be used to enhance competence throughout one’s professional career, to “scale-up” the implementation of evidence-informed effective treatments to address the acute mental health needs within our communities, and ensuring the welfare of future clients as well as those treated during training.