Regression,Self-Disclosure,and the Teach or Treat Dilemma: Implications of a Relational Approach for Social Work Supervision

This paper presents a brief review of a relational approach to clinical supervision and argues for its application in social work settings. Although an integral and essential part of practice, clinical supervision is underrepresented in the practice literature. Given this paucity of writings on supervision, the recent book by Mary Gail Frawley-O'Dea and Joan Sarnat, The Supervisory Relationship: A Contemporary Psychodynamic Approach, stands out as a seminal contribution because the authors present a fully developed relational model of supervision that fills a major gap in the development of contemporary relational theory and practice. We selectively review the basic concepts and principles of Frawley-O'Dea and Sarnat's model and apply this supervisory approach to current social work practice. Our focus will be on exploring three controversial and much-debated topics: self-disclosure, regression, and the teach or treat dilemma. Case vignettes from two supervisory experiences will serve to illustrate how a relational approach enhances both the treatment and the supervisory relationship.     

Trust,Power and Safety in the Social Work Supervisory Relationship: Results from Australian Research

Social work, as a discipline, places considerable importance on the provision of supervision, promoting it as a key process supporting critical reflection and practice improvement. A supervision relationship built on trust has the potential to provide a safe context within which practice issues can be explored. This article reports on an Australian study of social work supervision and the ways in which a trusting supervision relationship supports safe practice and critical reflection. A context of trust within the supervisory relationship is found to promote safe practice, providing the basis for what supervisees felt was satisfying supervision. Within a trusted and supportive supervisory relationship participants wanted and valued challenge which was seen to promote professional growth and positive client outcomes. Whether this occurs, however, depended on how power was exercised and how safe they felt in the supervisory relationship. The research argues the need for social work to reclaim supervision through a revitalised commitment to advancing supervision practice, research, and research-based policies.     

Black women talk about stereotypical transference enactments in cross-cultural supervision

ABSTRACT

Little is known about cross-cultural supervision dynamics between Black, female supervisors who provide clinical supervision of White supervisees. This study examined transference enactments which occurred between Black, female clinical supervisors (N = 57) and White supervisees. The results show that White supervisees’ racist and sexist behaviors towards the Black, female supervisors demonstrated remnants of stereotypical images historically attributed to Black women (i.e., Mammy, Jezebel, and/or Sapphire). Moreover, the findings highlight the need to initiate multicultural awareness, knowledge, and skills to enhance clinical skills. The paper concludes with recommendations for cross-cultural supervisory dyads and implications for future research.     

Less assessment and more suggestions please: Factors contributing to effective supervision of counsellors at different experience levels

Abstract

Twenty-two supervisors and 60 supervisees working in community counselling services in Melbourne were asked to rate the importance of 46 supervisory behaviours to good supervision, as well as listing behaviours that contribute to and detract from good supervision. In general, supervisors saw good supervision as relating primarily to feedback to the supervisee, while supervisees were interested in learning new skills and gaining assistance with conceptualisation in supervision. The responses confirmed evidence of differing supervisee and supervisor perceptions of supervision seen in previous research of students' supervisory needs in America.

Differences in responses from supervisees in this sample to the American sample suggest some cultural differences and some differing needs attributable to different levels of experience. Responses in the current research support a developmental model of supervision; that supervisees have different needs as they gain experience. Applying a process model to behaviours believed to contribute to and detract from good supervision revealed that the bulk of responsibility for a good supervisory relationship is attributed to supervisors. Neither supervisors nor supervisees indicated a high level of supervisee qualities and skills that contribute to good supervision. This has obvious training implications.     

Supervision and social work students: relationships in a team-based rotation placement model

Social work has historically privileged one-to-one supervision in field education. However, in recent decades, the relentless pressure on organisations to innovate for efficiency gain has created an impetus to explore alternative placement formats. This article reports on how students and supervisors experienced their placement relationships in the context of one such alternative—a team-based rotation placement model where students routinely engaged in group and peer supervision as well as one-to-one supervision with various supervisors. A total of 128 Masters of Social Work students and 92 student supervisors participated in rotation placements across five hospitals over a three-year period; 2011–2013. The study adopted a mixed methods approach using online surveys and post-placement interviews each year. The findings suggest that, although both supervisors and students viewed the one-to-one supervisory relationship as pivotal, they experienced this relationship differently. Supervisors were more likely to highlight the interpersonal connection within the supervisory relationship as the primary vehicle for practice learning. Students were more likely to view their supervisory relationships as the conduit to the practice experiences that aligned with their placement goals. Ultimately, the study highlights the centrality of role and positioning when exploring perceptions and experiences of teaching and learning relationships on placement.     

Restoring Meaning to Supervision Through a Peer Consultation Group in Rural Australia

The establishment of a cross-discipline peer consultation group in regional Australia is described. A research project, which explored the impact of the peer consultation on participants, using pre-group and post-group evaluation surveys along with data from an externally facilitated group evaluation session is discussed. Key findings reveal the value of access to varied modes of supervision; the importance of supervision not feeling like being subjected to surveillance; and the contribution that positive experiences of peer consultation have for our participants' well-being. The potential for improved connection and mutual benefits for practice and academia in sponsorship of professional peer consultation by regional universities also emerges from this research. The effectiveness of contemporary workplace counselling supervision arrangements, and of what, precisely, the enjoyment of engaging in case discussions in peer consultation groups is constituted are areas for more exploration.     

Operationalising professional supervision in this age of accountabilities

Abstract

The paper reviews the tensions, complexities, risks and ambiguities of the role and tasks of the social work supervisor: these can surface in efforts to negotiate individualised supervision agreements with colleagues and with students. Given the marked lack of national and international research attention to processes in social work supervision, the paper explores the skills, principles and arguments for a suggested model of ‘Developmental Supervision’ — in the context of a framework of supervision practice congruent with the knowledge, skills and values of social work. Finally, there is some exploration of the unintended consequences of ‘Quick-Fix’ Supervision for the cutture of decision-thinking and professional practice.     

The therapy-supervision dialectic

It is widely agreed that supervision has an emotional load which should be dealt with in the supervisory relationship as means of increasing effectiveness in the learning process. This situation makes it difficult for the supervisor to keep adequate distance between supervision and therapy. Current literature on this subject offers no tools for this matter. This paper suggests a model that uses some basic ideas derived from Winnicott's thinking. Our model integrates the dynamic forces operating in the supervisory space and can be used as a compass to help the supervisor in his or her movements while preventing crossing the boundary between supervision and therapy.     

Supervising Mental Health Clinicians in The Context of Complex Organisational Dynamics

This article discusses the complex dynamics and challenges of providing supervision to mental health clinicians working within an organisational context when the supervisor is not part of the organisation and has no formal managerial or accountability responsibility. It considers two models of supervision and their application to three supervisory relationships in an organisational context. It concludes that for supervision to be effective there needs to be a consideration of the social defences in operation within the organisation and how they are met by the anxieties and defences of the supervisor and supervisee. This requires a mixed approach by the supervisor of the technical with the inter-subjective as a reliance on one model of supervision risks limiting the effectiveness of the intervention. The role of the supervisor can enable the supervisee to establish a clinical framework and the necessary environment essentials for their practice.     

The Recovery Approach to Rehabilitation: Implementation in Supervision

The recovery approach to psychiatric rehabilitation has introduced a new set of challenges, enabling consumers to set goals and redefine their role in obtaining them. This has revolutionized the management of the relationship between service providers and consumers. In the present paper, we suggest that one of the important ways to supervise professionals interested in internalizing the recovery approach is to implement its major principles in the supervision work itself. The paper draws on intersubjective therapy concepts and guiding principles, which emphasize the development of the professional–consumer relationship in which the consumers' sense of agency can be respected and promoted. The principles we suggest here which may underlie supervision are: (1) clients or supervisees, with their own decisions and interests, are at the center of the rehabilitation therapy and supervision; (2) mutuality in the rehabilitative/supervisory relationship and ongoing discussion of the interactants' power and authority; and (3) the promotion of positive and empowering narratives and self-perceptions in the process of rehabilitation/supervision.     

The role of empathy in supervision

Empathy plays an important role in clinical supervision. It is the link between the client whose treatment is being supervised, the clinician/supervisee, and the supervisor. The supervisor uses an empathic capacity as well as theoretical knowledge to understand the clinical work and build the supervisory relationship. Often the progress of a case can be traced through the development of empathic understanding in the supervision. The transmission of empathy requires creativity and openness and is one of the major challenges in supervision. By analyzing the different uses of empathy in clinical supervision we can increase our understanding of the supervisory process.     

Safety as a Fifth Dimension in Supervision: Stories from the Frontline

Child and family practice is recognised as a field of social work that has become increasingly complex. While evidence is growing in relation to effective supervision, there has been little research about the attributes of an effective supervisor, or the components of effective supervision. This paper reports on research undertaken in Victoria, Australia, which explored practitioners’ and supervisors’ experiences of effective supervision in this field. Data collection involved in-depth interviews with experienced supervisors and supervisees in order to explore the concept of effective supervision from participants’ perspectives. The data were systematically interrogated using a thematic inductive process, designed to enhance the voice of participants in the research. The study findings confirmed the complexity and centrality of the supervisory relationship, with the experience of a safe supervisory relationship proving essential. The importance of contemporary knowledge, leadership skills, and an enabling organisational and community context were also highlighted.     

Lifting the Lid: Perspectives on and Activity within Student Supervision

Practice teaching is central to social work education. Significant changes have occurred in the past 10 years affecting social work education in Scotland. This article reports on the findings of a small-scale study involving the audio recording of supervision sessions and the interviewing of students and practice teachers engaged in a 65-day assessed placement. The research reveals a high level of congruence between students and practice teachers in perspectives on the supervisory relationship, confirms the findings of other studies concerning effective supervision and provides some vivid evidence of practice teacher and student activity within supervision perceived to be conducive to student learning. A specific finding was the association between the use of ‘exploring’ by practice teachers and students engaging in practice analysis. It is concluded that the changes affecting social work education over the past 10 years, on the evidence of this small sample, overall have had a positive impact on the supervisory relationship within practice learning. One area suggested for further study is the potential link between ‘expressing opinion’ by practice teachers and students within supervision and the development of evidence-based practice.     

FIELD NOTES: A CONCEPTUAL APPLICATION OF ATTACHMENT THEORY AND RESEARCH TO THE SOCIAL WORK STUDENT-FIELD INSTRUCTOR SUPERVISORY RELATIONSHIP

This article conceptualizes an attachment-based model of the student–field instructor relationship, based on empirical research concerning internal working models of attachment, which continue into adulthood and serve as templates for life-long relating. Supportive relationships within a noncritical context are salient for effective supervision; attachment theory provides a framework for developing supportive supervisory relationships and augments existing theories of supervision. Ideal and problematic supervisory relationships are presented followed by recommendations for interventions and future research. The supervisory relationship will be most successful when the field instructor is guided by attachment theory and its conceptualization of a "secure base" (Bowlby, 1988).     

Supervisor multicultural competence and its relation to supervisory process and outcome

This study investigated the direct and indirect effects of marriage and family therapy trainees' perceptions of their supervisors' multicultural competence in supervision on the supervisory working alliance, trainees' multicultural competence (case conceptualization abilities in etiology and treatment), and perceived supervision satisfaction. Path analyses revealed supervisor multicultural competence to be positively associated with supervisory working alliance and perceived supervision satisfaction. In addition, supervisor multicultural competence seemed to have a negative effect on trainee etiology conceptualization abilities. Finally, results suggested supervisory working alliance to be a significant mediator in the relationship between supervisor multicultural competence and supervision satisfaction. Findings are discussed within the context of theoretical, empirical, and practical implications for multicultural supervision.     

Intentions to leave supervision among social work supervisors: contributing factors

The study shows the evolution of intentions to leave supervision among students’ supervisors in their first year of supervision. A total of 168 social work supervisors in 10 academic institutions in Israel, during their first year of supervision, answered the questionnaires at the beginning (October 2014) and end (June 2015) of their supervisors training course. The findings indicate that the most powerful predictor of intentions to leave supervision at T2 was intentions to leave supervision at T1. This interesting finding shows that the supervision course does not necessarily address the issue of long-term commitment to supervision, and it is crucial that more attention be paid to this issue. Furthermore, we also found a significant contribution of organizational climate at T1 and of role overload at T2. Practical implications challenge the current structure of supervision courses, in order to encourage students’ supervisors to retain their supervisory role over time.     

Clinical supervision in child protection for community nurses

Community nurses have been recognized as having a key role in the protection and care of children, particularly in relation to the identification and detection of child abuse. In order to fulfill this role in a competent manner, they need to have access to appropriate supervision. The aim of this paper is to explore community nurses' and health care managers' understanding and experience of clinical supervision in child protection. The findings presented here were collected as part of a larger study commissioned by the Greater Glasgow Primary Health Care National Health Service (NHS) Trust. Ninety‐nine nurses and nursing managers were interviewed, either individually or in groups, about their professional involvement in child protection issues and support for their involvement in child protection work, as well as their current knowledge and perceived training needs. The interview data was subjected to a thematic analysis. A lack of consensus was found among nurses and managers in Glasgow as to what constitutes clinical supervision and a good deal of variation in nurses' experiences of clinical supervision in the field of child protection. The historical difficulties with regard to supervision were attributed to several aspects of nursing culture. However, both nurses and managers emphasized the need for formal, regular, systematic supervision for all nurses regardless of their specific role with regard to child protection. Copyright © 2005 John Wiley & Sons, Ltd.     

On Parallel Process in Social Work Supervision

The recognition and study of parallel process in social work supervision offers both the social work supervisor and supervisee a rich learning opportunity at the moment when an impasse seems unworkable. The parallel process is an unconscious replication in the supervisory session of therapeutic difficulties which a supervisee has with a client. This replication may originate with the supervisor unwittingly modeling behavior that is then taken by the social worker into the therapeutic interaction with the client. This paper reviews the need for social workers to grasp the dynamics of the parallel process, discusses the literature for the historical development of the phenomenon, addresses supervisory methods that will uncover the process, and illustrates the supervisor's stages of exploration and modeling in addressing the parallel process.     

The Role of Community Assessments,Place, and the Great Recession in the Migration Intentions of Rural Americans

Many rural areas of the United States are experiencing population decline due to out‐migration. However, others—especially those places rich in natural amenities and recreational opportunities—are attracting new residents and losing less of their native population. In this article we investigate the predictors of rural Americans' migration intentions by examining how individual‐level community assessments, including community attachment and perceptions of community‐level problems, shape rural Americans' migration decision making while controlling for individual and place effects. Drawing on survey data from 17,000 residents in 11 different rural areas around the United States, we find that community attachment is a key predictor of rural migration, even during periods of economic recession, and regardless of individual and place characteristics or perceptions of community‐level problems. We also find that multiple dimensions of community attachment (e.g., practical, natural, family, community trust) have independent effects on the propensity of rural residents to migrate. Our research contributes to knowledge on migration trends among rural Americans by exploring the complicated reasoning behind why people stay in, or move to, certain rural communities and not others.