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.     

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.     

Developing Culturally Responsive Supervision Through Yarn Up Time and the CASE Supervision Model

ABSTRACT

This article explores a culturally focused supervision training program supporting Aboriginal and non-Aboriginal supervisors to provide cross-cultural supervision for Aboriginal staff within mainstream and Aboriginal community and human service organisations. The key features of the training program, Yarn Up Time and the CASE supervision model are a culturally respectful approach to cross-cultural professional supervision practice with the purpose of contributing to the development of culturally responsive supervision with Aboriginal staff and their clients. The article concludes with feedback from participants who attended the training and supports the future advancement of cross-cultural supervision practice and models in Australia.

IMPLICATIONS

• There continues to be a need for more culturally responsive supervision for Aboriginal staff and for non-Aboriginal social work practice with Aboriginal people.

• Yarn Up Time and the CASE model is a culturally appropriate approach for supervising Aboriginal staff and non-Aboriginal social workers’ supervision of social workers’ practice with Aboriginal communities.

• Social work supervisors need to be able to use an effective cultural supervision model to support Aboriginal staff in Yarn Up Time.

     

A good fit: the contribution of action learning to supervision practice

This paper discusses the value of action learning for social work supervisors. Recent years have seen renewed focus on supervision as a reflective space and some indications that the tide may be turning in regard to the dominance of managerial priorities within the supervision of direct practice. It is less evident that a similar shift is taking place for supervisors themselves and, anecdotally, many describe their own supervision as having a business focus with limited scope for reflective dialogue. While the traditional functions of supervision need to adapt to fit the responsibilities of those in management positions, it remains true that these staff provide a vital containing role within the organisational hierarchy. For that to be sustained, it is important that supervisors have space and structure within which to process the emotional, intellectual and practical challenges of their work. The integration of action learning sets within post-qualifying courses for supervisors has demonstrated a useful dual function. Firstly, they provide an effective model for group supervision, facilitating in-depth reflection on complex practice issues. Secondly, they offer managers a peer supervision forum; a safe place to explore dilemmas and share the vulnerabilities which belong to management roles as well as practice.     

Supervising emotionally focused therapists: a systematic research-based model

Emotionally Focused Therapy (EFT) is an empirically validated relational therapy that recognizes the complexity of couple's therapy and supports the need for specialized training of therapists. Until now, there has been little research on effective methods for EFT supervision and no systematic model for conducting EFT supervision. The findings of a qualitative study of certified EFT therapists' experiences with EFT supervision and training are presented in this study, along with a systematic model of EFT supervision. The model of EFT supervision is based on the findings of this study, relevant research regarding effective clinical supervision, and the authors' experiences with EFT supervision. This model of EFT supervision is isomorphic to the clinical practice of EFT, in that it is theoretically grounded in attachment theory and emphasizes experiential and emotionally based processes.     

The State of Social Work Supervision in Victoria According to the Practitioners

Though supervision has been an integral part of social work practice since its inception there has been relatively little professional writing in this area since the 1950s and even less research. Two surveys were conducted in Victoria (with practitioners and administrators) to obtain information on the state of staff supervision. Data from the practitioners (N=102) indicate supervision is more available than it used to be; is considered to be necessary for effective practice; and most respondents believe it should continue indefinitely. While the quality of supervision has improved, one third of the respondents believe it needs up-grading. A majority think there should be more training programs in supervision, and that the Australian Association of Social Workers has a leadership role to play in this regard.     

Good enough decision‐making? Improving decision‐making in adult protection

This paper examines decision‐making in adult protection based on arrangements operating in a local authority social services department and discussion generated in a specialist training intervention. The paper seeks to identify ways in which approaches to decision‐making can be made both more effective and more user centred. The need for good information for efficient and effective decision‐making is highlighted, along with the need for user involvement for the production of positive and valued outcomes. The paper looks at how user centred arrangements can be put into practice and discusses the potential for advocacy, outlining possible approaches for adult protection casework. With local authority social services departments struggling to implement No Secrets (2000), with adult protection a key social care competence and with the implementation of PCP and similar approaches a priority (Valuing People, 2001), it is important to improve decision‐making in adult protection in ways that are not only time and resource efficient, but place service users and their advocates at the centre of related processes.     

Commitment and agency in social movements

Any movement that hopes to sustain commitment over a period of time must make the construction of a collective identity one of its most central tasks. Social relationships that embody values of participation and community in their concrete practices contribute to empowering people. But such arguments need additional specification before their theoretical potential can be realized. I have taken the coincidence of this talk with the anniversary of the first teach-in against the war in Vietnam and the assassination of Archbishop Romero in El Salvador as a directive for examining these two cases—with an eye toward learning more about how identity building and social relationships in social movement practice foster long-term commitment and agency.An earlier version, titled Democratic Participation in Social Movements, was presented as a presidential address to the Eastern Sociological Society, March 24, 1990.     

Live supervision in the same room

Following a brief explanation of live supervision, its advantages as a practice teaching method are outlined. The main part of the article focusses on detailed and practical suggestions for the preparation and conduct of live supervision sessions. Discussion then centres around some of the pitfalls and ethical issues which need to be considered. The article concludes by advocating that live supervision can make an important contribution to the current drive to improve practice competence in social work.     

A Framework for Enabling Evidence-based Practice in Allied Health

Evidence-based practice (EBP) is upheld as best practice in health and human services but there is a need for more research on how this approach can be enabled in day-to-day practice. This qualitative study examined EBP with allied health managers and practitioners in a health service network (n = 17). The findings highlight the systemic nature of EBP and the extent to which it involves both individual and environmental attributes. Individual attributes include clear understanding of EBP, relevant knowledge and skills, and motivation and passion. Environmental attributes are the presence of an organisational culture that values and prioritises EBP and an integrated mix of research support services, professional development activities, supervision and mentorship, and university partnerships. Theoretical frameworks can be useful for making sense of complex processes, planning, and evaluating change. Therefore, the findings are presented as a framework incorporating reflective questions relating to the elements identified as enabling EBP.     

Promoting supervisory practice change in public child welfare: lessons from university/agency collaborative research in four states

This article describes qualitative findings regarding lessons learned from research and demonstration projects in four states focused on the implementation of clinical supervision within their public child welfare agencies. This was part of a larger mixed methods study of the effectiveness of these new clinical supervision models on practice, organizational, and client outcomes. Themes from 15 focus groups with frontline supervisors participating in the projects are provided; they focused on the challenges experienced while participating and working to use clinical supervision techniques, recommendations regarding implementing such projects in the public child welfare environment, and those aspects of the implementation that were most effective in supporting their work. These themes provide direction for states and localities wishing to shift frontline supervision to a more clinical model within the public child welfare setting.     

Social networks, informal child care, and inadequate supervision by mothers

The purpose of this study is to determine whether less informal child care support from family and friends is related to supervisory neglect and, if there is a relationship, to test several explanations for why some mothers receive less child care. Thirty-two low-income mothers who did not adequately supervise their children were matched to 32 mothers who provided adequate supervision. The results showed the mothers who provided inadequate supervision received less child care support from their partners and relatives, but not their friends. These differences appear to be linked to several properties of the mothers' social networks. For example, the majority of the mothers who provided inadequate supervision either did not have a partner or knew them for less than one year. They had fewer family members living nearby and more negative relationships with them than the mothers who provided adequate supervision. To reduce chronic supervisory neglect, mothers may need assistance with both informal and formal child care support.     

An Instrument for Person-of-the-Therapist Supervision

This article introduces a tool that serves as a guide for building an effective bridge between the personal and technical aspects of therapy in supervision. The instrument is based on a model of clinical supervision that emphasizes the purposeful utilization of self—in the moment, with both flaws and strengths—in the therapeutic relationship in combination with the technical interventions with clients. The article also offers some aid to promote a personal integration of the philosophy underlying this supervisory model into a therapist's clinical thinking and practice .     

Overconfidence in absolute and relative performance: The regression hypothesis and Bayesian updating

Studies have found that people are overconfident in estimation involving difficult tasks but underconfident in easy tasks. Conversely, they are overconfident in placing themselves in easy tasks but underconfident in hard tasks. These findings can be explained by a regression hypothesis that implies random errors in estimation as well as by rational Bayesian updating (that implies no random error). We test these hypotheses in five experiments. We find overconfidence in estimation involving hard tasks but underconfidence in easy tasks. However, for placement (involving both easy and hard tasks) we find no overconfidence, regression effects due to low and high anchor points, and extreme underconfidence when people choose between multiple alternatives. On the other hand, when given precise information about absolute performance, people’s re-assessments of relative performance are consistent with the Bayesian model. Since placement judgments are important in many competitive settings, our results emphasize the need for more research to identify their determinants.     

Marginal Man: The Identity Dilemma of the Academic General Practitioner*

The study of the relationship between group membership and identity has been central to symbolic interaction. This paper describes one instance of problematic identity, that experienced by members of the newly established academic discipline of general practice. ¹By outlining their dilemma as ‘marginal men’ to both service doctors and other academics within the medical faculty,² attention is focussed upon the strained intraprofessional relationships when core tasks—in this case teaching and service work—are allocated very different values.     

Being the University: Liaison Persons' Reflections on Placements with Off-Site Supervision

Social work as a profession, social work practitioners and organisations, as well as social work educators are under strain due to global, economic, social and political changes and workplace pressures. Field education is recognised as pivotal in preparing social work students for professional practice. As social work practitioners, organisations and social work educators are exposed to external and internal pressures, social work practice learning with off-site supervision is becoming more prevalent. This paper reports on research that explored the experiences of key stakeholders in social work practice learning with external or, in other words, off-site supervision. This paper explores the experiences of university liaison persons who provided supported field education arrangements with off-site supervision. A range of themes have emerged, including reflections about bringing the university to the placement experience, creating student centred placement opportunities, the complexity of connecting the various players and the extra support and resources needed to support placements with off-site supervision. Findings suggest that quality learning experiences are about more than modes of supervision, that placements with off-site supervision increase the workload of liaison persons and that clear models and structures need to be developed to support emerging field education models.     

A New Breed of Social Actionist Comes to Social Work: The Community Organization Student

Professionals in all fields are pressing for more autonomy in their work. Social work has never achieved full professional status because of its reluctance to grant autonomy to practitioners. The hierarchical bureaucratic structure of social agencies, which enforces prolonged individual supervision of workers, has achieved uniformity of practice at the expense of creativity and innovation. The author proposes Georg Simmel's model of superordination—subordination as a framework for considering new forms of supervision. Peer group supervision, consultation, and in-service training are potentially more democratic training methods than individual supervision, and could encourage self-confidence and creativity.     

Instrumentalism,knowledge and gender in social work

Abstract

The new public sector managerialism of the 1990s has introduced a profound cultural change within social work organisations. It involves a substitution of knowledge which is primarily instrumental in character for the discursive, interpretive and reflexive knowledge on which social workers have traditionally relied in client-centred practice. This paper draws on perspectives from critical theory and psychoanalysis and argues that, despite the apparent neutrality of managerialist discourse, it is both ideological and gendered. It encourages the construction of rigid socially structured defence systems within welfare organisations and is inimical to the kind of thought which can engage with interwoven emotional and material needs to develop reparative practice. Furthermore it is in danger of undermining precisely those forms of supervision that can sustain professionals in the face of the emotional impact of relationships with distressed and damaged people.     

Strengthening Supervision in Systems of Care: Exemplary Practices in Empirically Supported Treatments

The last few decades have witnessed major growth in the evidence base on effective client interventions used by social workers and other health and social service professionals. As the pressure for service agencies to offer empirically supported treatments has been increasing, financial and time constraints have driven a decline in the frequency and amount of supervision provided within many of these organizations. While the reduction in staff supervision presents a challenge for effective implementation of all treatments, there are comprehensive empirically supported treatment models for clients that serve as exemplars of supervisory practice through their explicit requirements, processes and tools for supervision and supervisor development. After a review of the current status of supervision nationally, an implementation science-based approach is described, which builds organizational support for supervision and promotes optimal supervisory practice through training and consultation of supervisors and supervisees. The elements of this comprehensive approach, developed by the Yale Program on Supervision, are detailed. Supervisory policies, practices, and tools created by the developers of empirically supported treatments and similarly grounded in the principles of implementation science are offered as further examples of strategies for ensuring effective supervision.