Even when management supervision is good, it’s NOT enough.

I know from bitter personal experience how important clinical supervision is.

What is clinical supervision & why do we need it?…


Burnout is a real risk for anyone working with troubled children and young people – it comes with the territory. But it can be avoided.

Good supervision – if it’s working properly – can go a long way to offering people the support, guidance and accountability that we all need.

But it’s not enough.

It’s long been my contention that staff working with troubled kids – at least at the more challenging end of the spectrum – need something more.

They need clinical supervision.

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Clinical supervision – what it IS…

Here are a couple of definitions of clinical supervision – one from nursing and one from psychology.

Clinical supervision is:

“…a formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and safety of care in complex clinical situations”.

Source: DoH, 1993:

“…the formal provision, by approved supervisors, of a relationship-based education and training that is case-focussed and which manages, supports, develops and evaluates the work of junior colleagues.”

Source: Milne, 2007:440

Clinical supervision – what it ISN’T…

…or what it shouldn’t be allowed to become:

– a people management activity allowing for monitoring of subordinates performance

– a forum to generate information linked to a disciplinary process

– mainly focussed on time-keeping, workflow, governance

– a punitive or gratuitously negative experience for the supervisee

– a continuous discussion of errors and shortcomings on the part of the employee

Clinical Supervision should not be confused with other ‘supervisory’ activities, such as annual appraisal or performance review systems, or workplace mentoring.

It is also qualitatively different from the normal management or supervisory type supervision that most child care professionals get.

For me – and this is just my view – the difference is about the relational quality of it and the fact that it deals with the way the person (worker) and the task (work) come together.

Benefits of clinical supervision…

Clinical supervision provides a safe and relational opportunity for us to:

Photo courtesy of ©123rf/nyul

Photo courtesy of ©123rf/nyul

– Reflect on and review our practice.

– Discuss individual cases in depth.

– Change or modify our practice and identify training and continuing development needs. (CQC, 2013:4)

Walking through this process regularly with a trusted professional is extremely beneficial – it changed my practice for the better, quite radically.

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As well as helping to stave off burnout, there are a number of other benefits to agencies and individuals from investing in clinical supervision for staff.
Among them are:

– Improved quality of care and services

– Professional growth and development

– Lower sickness rates

– A focus on clients’/patients’ needs

– Better morale

– Reduced stress

– Improved relationships with peers and management

– Identification of training needs

– Better work culture

– Improved risk management

– Increased staff retention  (Source: RCN, 1999)

For me, the nub of why we need clinical supervision is this – the kids we serve get a better deal from us when we have it.

For me, the nub of why we need clinical supervision is this: we serve troubled kids better when we have it.

How to do it…

There are many different models and approaches to clinical supervision:

Photo courtesy of ©123rf/Mauricio Jordan De Souza Coelho

Photo courtesy of ©123rf/Mauricio Jordan De Souza Coelho

– One-to-one supervisor (supervisor-supervisee) – for me, this is the gold standard. When you get to sit with a qualified professional supervisor and talk everything through. They can guide the conversation, offer insights and/or pose questions that allow us to review our practice.

– Group Supervision (supervisor-supervisees) – when a supervisor conducts discussions with a group of supervisees. There is one advantage of this – possibly two. The main one is that it’s cheaper! The other is that a group conversation can directly challenge group culture, albeit in a subtle way.

– Peer Group Supervision (Dual Roles: Supervisors/Supervisees) – again there are clear financial benefits in this approach. And though roles can more easily become blurred, this kind of clinical supervision is better than none at all.

Where the supervision is done in a group and/or by peers, the BPS requires an appropriate amount of one-to-one individual clinical supervision on top. (BPS)

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Final thought…

As often happens, this is one area where dosh – or lack of it – gets in the way of best practice.

As a result some practitioners arrange and pay for their own supervision. Most do without it altogether.

One thing is undeniable though – those working with damaged and difficult children need clinical supervision…

Question…

  • What are your experiences of supportive – if not clinical – supervision?
  • Is there anything you can do – practically – to ease the load you’re carrying at work?

Please let me know – join the conversation by leaving a comment below or by clicking here.

More on self-care…

For a more thorough look at the subject of self-care, check out my eBook: Looking After No.1 – Self-Care for People Working with Troubled Children

Learn more about Looking After No.1 – click here…

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Book…

If you’re going to buy a book on supervision, buy this one. It’s pricey, but better to buy one book that does the business than 3 that don’t, right?

Whilst it’s not about clinical supervision, for a great book on supervision in social care generally, this is the best in my view:

Morrison T (2001) Staff Supervision in Social Care: Making a real difference for staff and service users. Pavilion Publishing Ltd: Southampton

Reference links…

(Full references are listed below)

Related previous posts…

Beating burnout – en route to clinical supervision…

Supervision – how to know if it’s working…

Self-care tips for carers…

Reflection: why we need it…

How to keep caring: 6 lessons for success…

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© Jonny Matthew 2015

References:

  • British Psychological Society – Guidelines on Clinical Supervision
  • DoH (1993) A Vision for the Future. Report of the Chief Nursing Officer. HMSO, London
  • Duarri, W., & Kendrick, K. (1999) Implementing clinical supervision. Professional Nurse; 14: 12, 849–852.
  • Milne, D. (2007) An Empirical Definition of Clinical Supervision. British Journal of Clinical Psychology, 39, 111-127
  • Power, S. (1999) Nursing Supervision; A Guide for Clinical Practice. Sage, London
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