Clinical supervision

Clinical supervision (CS) is a regular meeting with one or more other professionals to discuss casework in a structured way so that participants can learn from their experiences. CS can also be called Practice Development, Practice Reflection, Professional Supervision, or Supervised Field Education. This bridges the gap between CS and PD.

Senior practitioners in therapeutic service roles participate in structured CS. Some organizations already provide it as part of its duty of care to prevent brownout and burnout.

Although different people have different needs at different times, the purposes and benefits are broadly as follows:

  1. Professional Development and education: staff improve their skills and increase their confidence.
  2. Staff have personal and emotional support, including the opportunity to debrief stress and transferance issues.
  3. Services are effective, ethical, safe, evidence-based, and appropriate.
  4. Services comply with professional and organizational standards.
  5. Diagnose and treat the most difficult cases, essentially becoming a kind of case conference.
  6. Reflection and evaluation of practice, both at individual and program level.
  7. Set goals and solve problems.

The term "supervision" is not a used in a management sense; the supervisor and supervisee are often peers. If you are a student in a group with more experienced professionals, you might need to learn to see yourself as a peer professional. You will need to learn when to ask questions and when to listen, and how to view the strengths and limitations of others.

CS can take various forms. The supervisor can be either external or internal to the organization. CS meetings can be a group or a one-to-one. The supervisor could be a peer or could be much more experienced. It can be either scheduled or unscheduled; it is good practice for CS to follow a schedule, but you might also need unscheduled meetings from time to time.

 

Initiating CS

Many community service organizations do not arrange CS for employees and might not even have a policy. You need to be able to initiate CS arrangements yourself.

Finding supervisors is probably easier if you already have a good professional network. Of those available, you need to find one that is right for you. Compare your learning, experience and area of practice with those available. But don’t look for someone who is just like you. While you wouldn’t want someone you really don’t like or whose views are quite incompatible with yours, you might learn more from someone who isn’t exactly the same as you.

 

Meeting with a supervisor

In your first meeting with your new supervisor, tell them about your goals and expectations of CS. Make a formal written agreement that includes goal-setting and timeframes for supervision. It should say when, where, and how long sessions will go, and what will happen in them. Confidentiality of personal information is obvious but essential. The supervisor should keep records of when, where, and how long meetings went, including missed meetings.

 

Are you effective?

Use supervision to evaluate your practices and techniques and find ways to improve. While you can follow the lead of the supervisor, you also need to initiate opportunities to learn.

Expect to prepare for CS meetings. Keep records of your personal growth and professional learning, such as observation and reflective notes on cases, a reading journal, writing projects, or a journal of questions and ideas. Then put what you learn from supervision into writing, although this can vary according to your practice needs.

Some sessions take a more academic tone. You can use sessions to discuss current clinical literature, professional research, and program evaluations on the topics you most need. For it to be useful, you’ll need to reflect on how to apply it in real situations. Some topics have specific legal and ethical implication that you should explore.

Most sessions, however, are given to discussing the difficult aspects of existing cases, analyzing yourself, and evaluating your responses to residents. Then put what you learn into practice, evaluate how it went, and bring it back to CS for discussion. Ask for feedback, both positive and negative. It can be difficult to respond to comments appropriately if you don’t like them, but it is better to accept them and think about them. Consider these possible reactions: