The short version: Anti-oppressive clinical supervision makes power, privilege, and social context explicit, not background noise. For Oregon LPC Associates, it combines the structure and feedback OBLPCT requires with honest attention to how identity and systems shape clinical work, and to where you sit inside those systems yourself.
An associate sat across from me in our first session together, legal pad open, and asked the question she’d been sitting on for weeks: what do you do when the client’s real problem is the system around them, not the client?
This is the question this whole approach exists to handle.
First, the answer
You don’t treat the system as context. You treat it as clinical material.
That sounds like a slogan, so here’s what it means in practice. A client arrives exhausted, irritable, and unable to concentrate. She works two jobs on an unpredictable schedule. The exhaustion is not a symptom obscuring a disorder; it’s an accurate response to her conditions. Your clinical job doesn’t get smaller; it gets more precise: you are no longer looking for pathology that explains her state; you’re helping her distinguish what’s hers to change from what isn’t, and reducing the harm of what isn’t.
Joseph Nahem’s work is useful here because it’s specific where most structural talk is vague. In A Marxist Approach to Psychology and Psychiatry (1982), he locates alienation in the production process itself, not in loneliness or existential drift. A person estranged from the product of their labor and from their working life is describing a material arrangement, not a mood. When you can name the arrangement, you stop pathologizing the response to it, and your client usually feels that shift before you’ve explained it.
I think a common clinical error with these presentations isn’t missing a diagnosis. It’s offering coping skills before naming the situation that needs naming. Coping skills come second, and they still matter.
What an anti-oppressive framework actually is
Anti-oppressive clinical supervision treats power, privilege, and social identity as part of the work, not as background. That includes the power in the room between supervisor and supervisee, and between therapist and client.
There’s a literature behind this. In Critical Therapy: Power and Liberation in Psychotherapy (2022), Silvia M. Dutchevici argues that power operates inside the clinical encounter itself, not only outside it, and that naming it is part of treatment. The same holds for supervision, with one possible addition: in supervision the power differential can also be an employment relationship, and I’ll come back to that.
Where you sit in this, which most supervision never mentions
Here’s the part I think most conversations about anti-oppressive practice miss: it’s about you as well as your clients.
Psychiatry and the wider mental health industry are real sites of profit extraction and social control. Diagnostic expansion has tracked what’s useful to capital at least as closely as it’s tracked disease.
But the psy-professions aren’t the ruling class, and you aren’t a beneficiary of the ruling class. An LPC Associate is close to the clearest case in the field: pre-licensure, accumulating supervised hours, often in agency work, paid less than the revenue you generate, with your path to independent practice gated by a requirement you have to buy. That’s a structural description, not a complaint, and it isn’t an accusation of anyone you work for.
It matters clinically for a reason that isn’t obvious. A supervisee who has never had their own position named tends to carry the whole weight of a client’s circumstances personally and burns out. A supervisee who can see the arrangement they’re working inside can hold a client’s situation without either absorbing it or dismissing it. I’d rather you learn that in supervision than four years into practice.
So in our work this gets said out loud. What your caseload size is doing to your clinical judgment. What your agency’s productivity target is measuring. Whether a treatment plan is serving your client or a billing requirement. These are supervision topics, not complaints to take elsewhere.
Disability justice, and why it belongs in supervision
Disability justice is not an accommodations checklist bolted onto this. Disabled queer activists of color launched it in 2005: Patty Berne, Mia Mingus, and Stacey Milbern, soon joined by Leroy Moore, Eli Clare, and Sebastian Margaret. Berne later set out its ten principles through Sins Invalid, and interdependence and collective access are two of them, not accommodations added later.
Two things follow for supervision.
The first is about your clients. A body’s limits are not a problem to be optimized away. Chronic pain and chronic illness get taken seriously on their own terms, not as obstacles to a better outcome. If your treatment plan’s implicit goal is a client who no longer has limits, the plan is wrong, and we’ll look at it.
The second is about the frame. Healing isn’t only for the individual who buys it. Leah Lakshmi Piepzna-Samarasinha’s Care Work: Dreaming Disability Justice (Arsenal Pulp, 2018) describes care webs, where access is produced collectively rather than purchased. That’s a useful thing for a clinician to have seen, because it’s a working model of support that doesn’t route through a market. I’m not going to tell you or your clients what you owe the world. I am going to say that getting better is partly about having more room to be in community, and that’s a different goal than symptom reduction alone.
What the sessions look like
The structure is ordinary, and it meets the board’s requirements.
- Clear agreements up front about roles, expectations, documentation, and how feedback works.
- Case consultation every session, with specific clinical material rather than general check-ins.
- Direct feedback at regular intervals — clear, specific, and written where it needs to be.
- Meta-conversation about our own relationship, including when something I did landed badly. This is the part people assume is optional. It’s the part that teaches the clinical skill.
- Attention to your own position, as above: caseload, targets, what the job is doing to you.
When we review your client work, we look at the interventions and how your identities and your client’s are operating in the room. Sometimes that’s the most useful thing on the table. Sometimes it isn’t, and I’ll say so rather than performing the framework.
It is uncomfortable, and that is not a selling point
Looking at your own biases is unpleasant. Being told your intervention reproduced something you oppose is worse. I’d rather be honest that this is part of it than describe discomfort as an opportunity.
What I can say is what it’s aimed at: supervision where you can bring the case you handled badly, so that the pattern gets caught here instead of with your next client.
My approach
I’m a Licensed Professional Counselor with a PhD in clinical psychology, and a qualified Supervisor Candidate on the OBLPCT Supervisor Registry. My supervision is structured and supportive: clear guidance, regular feedback, and room for you to disagree with me.
I’ll also be plain about my limits. I recognize that my providing supervision, like my providing therapy, exists within capitalism and is therefore exclusive and limited. The requirement that you pay for supervised hours is a barrier, and I’m part of how it’s enforced.
If this approach matches what you need, I offer a 15-minute consultation so we can work out whether this supervision serves your practice. The conversation is about fit, not about selling you on it.
Schedule a free 15-minute consultation
Frequently Asked Questions
What is anti-oppressive clinical supervision?
It’s clinical supervision that treats power, privilege, and social identity as clinical material rather than background context. Sessions cover everything standard supervision covers: case consultation, skill development, feedback, and licensure requirements. The difference is that how identity and systems shape your work, your clients’ lives, your own working conditions, and the supervisory relationship itself is part of the conversation, not an occasional add-on.
Does this count toward OBLPCT-required supervision hours?
Yes. I am a qualified Supervisor Candidate on the OBLPCT Supervisor Registry, and our work together counts toward Oregon’s supervised-experience requirements for LPC licensure. The board’s specific hour and format requirements change periodically, so confirm the current rules for your registration date on the OBLPCT website or with your board contact.
How is this different from standard clinical supervision?
The structure is the same: regular meetings, case review, documentation, clear feedback. What differs is scope. Standard supervision often treats a client’s social context as background; anti-oppressive supervision examines it directly, including how your own identities interact with your clients’, how your working conditions shape your clinical judgment, and how the supervisory relationship models the therapeutic one.
Do I have to share your politics for this to work?
No, and I’m not going to try to recruit you. The framework is a set of clinical skills: reading a client’s circumstances accurately, noticing power in the room, telling the difference between a disorder and a reasonable response to conditions. You can use all of that and disagree with me about why the conditions are that way. What I do ask is that you’re willing to look at the question rather than rule it out.
What if I’m not sure this approach is right for me?
It’s reasonable to be unsure. Fit matters for both of us. I offer a 15-minute consultation to discuss what you want from supervision before either of us commits. If this isn’t the right match, I can refer you to other Oregon supervisors.
Questions first? Get in touch.
Peter H. Addy, PhD, LPC, LMHC is a Portland-based licensed psychotherapist specializing in psychedelic-informed and harm-reduction psychotherapy, ketamine-assisted psychotherapy, and chronic pain. His research background includes postdoctoral work at Yale School of Medicine on psychedelic substances. Learn more about my practice →
