Clinical supervision

Supervision is used in counselling, psychotherapy, and other mental health disciplines as well as many other professions engaged in working with people. It consists of the practitioner meeting regularly with another professional, not necessarily more senior, but normally with training in the skills of supervision, to discuss casework and other professional issues in a structured way. This is often known as clinical or counselling supervision or consultation. The purpose is to assist the practitioner to learn from his or her experience and progress in expertise, as well as to ensure good service to the client or patient.

Clinical supervision is used in many disciplines in the British National Health Service. Registered allied health professionals such as occupational therapists,^[1] physiotherapists,^[2] dieticians,^[3] speech and language therapists^[4] and art,^[5] music and drama therapists are now expected to have regular clinical supervision. C. Waskett (2006) has written on the application of solution focused supervision skills to either counselling or clinical supervision work.

Some practitioners (e.g. art, music and drama therapists, chaplains, psychologists, and mental health occupational therapists) have used this practice for many years. In other disciplines the practice may be a new concept. For NHS nurses, the use of clinical supervision is expected as part of good practice.^[6] In a randomly controlled trial in Australia,^[7] White and Winstanley looked at the relationships between supervision, quality of nursing care and patient outcomes, and found that supervision had sustainable beneficial effects for supervisors and supervisees. Waskett believes that maintaining the practice of clinical supervision always requires managerial and systemic backing, and has examined the practicalities of introducing and embedding clinical supervision into large organisations such as NHS Trusts (2009, 2010).^[8][9][10]

Practising members of the British Association for Counselling and Psychotherapy^[11] are bound to have supervision for at least 1.5 hours a month. Students and trainees must have it at a rate of one hour for every eight hours of client contact.

The concept is also well used in psychology, social work, the probation service and other workplaces.

Models or approaches to supervision

There are many different ways of developing supervision skills which can be helpful to the clinician or practitioner in their work. Specific models or approaches to both counselling supervision and clinical supervision come from different historical strands of thinking and beliefs about relationships between people. A few example are given below

Peter Hawkins and Robin Shohet (1989, 2000 and 2006), developed an integrative process model which is used internationally in a variety of helping professions. Their "Seven Eyed model of Supervision" is taught on the courses of the Centre for Supervision and Team Development [1] as well as many other supervision training courses.

S. Page and V. Wosket describe a cyclical structure.

F. Inskipp and B. Proctor (1993, 1995) developed an approach based on the normative, formative and restorative elements of the relationship between supervisor and supervisee. The Brief Therapy practice^[12] teaches a solution focused approach based on the work of Steve de Shazer and Insoo Kim Berg which uses the concepts of respectful curiosity, the preferred future, recognition of strengths and resources, and the use of scaling to assist the practitioner to progress (described in [2]). Waskett has described teaching solution focused supervision skills to a variety of professionals^[13]

Counselling or clinical supervisors will be experienced in their discipline and normally then have further training in any of the above-mentioned approaches, or others.

See also

• Deinstitutionalisation
• The works of Lawrence Shulman
• Behavioral psychotherapy

Notes

1. ^ http://www.cot.org.uk
2. ^ http://www.csp.org.uk/
3. ^ http://www.dietetics.org.uk/
4. ^ http://www.rcslt.org/
5. ^ http://www.baat.org/
6. ^ http://www.clinical-supervision.com
7. ^ White E, Winstanley J, Does clinical supervision lead to better patient outcomes in mental health nursing? Nursing Times; 106: 16, pp 16-18, 2010.
8. ^ Waskett C', Clinical Supervision using the 4S model 1: considering the structure and setting it up' Nursing Times 106: 16, pp12-14, 2010
9. ^ Waskett C', Clinical Supervision using the 4S model 2: training supervisors to deliver effective sessions' Nursing Times 106: 17, pp19-21, 2010
10. ^ Waskett C, 'Clinical supervision using the 4S model 3: Keeping it going. Nursing Times 106: 18, 2010
11. ^ http://www.bacp.co.uk
12. ^ http://www.brieftherapy.org.uk
13. ^ Henderson P (Ed), Supervisor Training: issues and approaches; Waskett; Learning to supervise using a solution focused approach. Karnac, 2009.

References

1. C Waskett. The SF Journey, in Therapy Today', March 2006, Vol 17, No 2, pp 40–42
2. P Hawkins, R Shohet. Supervision in the Helping Professions: an organisational, group and organisational approach; Open University Press, Maidenhead, 2nd ed 2000 3rd Edition 2006
3. S Page, V Wosket. Supervising the Counsellor: a cyclical model; Routledge, London & New York, 1995
4. F Inskipp, B Proctor. The Art, craft and tasks of Counselling supervision, Part 1 – making the most of supervision, Cascade Publications 1993, and Part 2 – becoming a supervisor, 1995
5. C Waskett. The pluses of solution-focused supervision, in Healthcare Counselling and Psychotherapy Journal, Vol 6, No 1.
6. C Waskett. An Integrated Approach to introducing and maintaining supervision: the 4S model. Nursing Times,105:17, 24-26.

External links

• Clinical Supervision for Nurses and Allied Health Professionals: the 4S Model
• Models of Clinical Supervision

• Implementing clinical supervision in healthcare http://www.supervisionandcoaching.com