Clinical Supervision

Supervision is a dynamic, interpersonal, focused experience promoting the development of therapeutic proficiency. One of the primary reasons for all supervision is to ensure that the quality of therapeutic intervention with the patient is of a consistently high standard in relation to the patient’s needs. Consequently, supervision is recognised as a cornerstone of clinical practice.

What is clinical supervision?

Supervision is the term used to describe planned regular periods of time that supervisor and supervisee spend together discussing the supervisee’s work and learning progress. Supervision is a multi-dimensional process which should provide the following functions:

• To evaluate performance

  • Attitude (Development and maintenance of personal qualities)

  • Ability (Techniques and their delivery)

  • Application (Methods of work)

• To ensure awareness and understanding of latest research

• To review individual cases

It should provide a forum to assess the therapeutic relationship and professional development. It should be supportive and motivational, educative and modelling. Clinical supervision looks at the therapist’s approach and activity within the therapeutic relationship.

Why do we need supervision?

If therapists are to treat patients as human beings, they in turn need to be treated in the same way by those who manage and educate them. Studies have shown that receiving supervision contributes significantly to reduce emotional exhaustion among therapists. If the experience of stress is not alleviated, the consequences for therapists are problems with maintaining standards and quality of care offered to patients. Supervision gives us the means to develop professional skills and judgement, and a commitment to achieving professional growth in order to improve the standards of service.

Supervision arrangements

Arrangement for supervision should be agreed between supervisor and supervisees, and formalised in either verbal or written contract covering:

• The roles of the parties

• Aims and objectives

• Supervisor’s expectations

• Supervisee’s expectations

• Group expectations

When negotiating contracts, the following should be taken into account:

• The focus

• The content

• The methods

• The arrangements

Role of the supervisor

Supervisors are therapists who are appropriately qualified and experienced, have received some preparation for the role, and who possess the following as skills:

• Communication skills

  • To be attentively and actively listening and being able to comment openly, objectively and constructively.

• Supportive skills

  • To be able to identify when support is needed and offer supportive responses.

• General skills

  • Specific knowledge of clinical hypnotism.

• Specialist skills

  • Therapists who specialise in particular therapies or fields of work should have access to supervision by someone with appropriate expertise.

Supervisors must be able to meet with other supervisors, to continue to improve their own skills. It is important that anyone who undertakes the role of supervisor should clarify any feelings on what is to be achieved.

Clinical supervision in practice

There are three ways that supervision sessions can be organised for therapists, two of which I offer:

1. Peer supervision, either on a one-to-one basis or within a small group setting. The obvious advantage is that the universal identification provided by peer supervision provides a sound platform from which to launch supervised sessions. The team leader or manager’s role in peer supervision is purely as a monitoring exercise. They would not be included in the actual supervision session.
2. Group supervision, which involves focusing on the group objectives as opposed to individual work. Usually facilitated by one identified supervisor.
3. Tutorial supervision. The tutor supervises an individual therapist formally and privately.

Identifying the types of supervision required should be carried out in conjunction with the supervisee, and in the light of their professional development and practice requirements. All supervision should be continuously evaluated for effectiveness. For these types and processes of supervision to be effective, there must be mutual trust and respect between supervisor and supervisee. Supervision should cover the following four principal areas:

• Clinical work

• Professional standards

• Personal growth and development

• Evaluation of work performance.

Clinical supervision is a model that must continue throughout professional life, thus providing a supporting as well as an educative purpose. Currently, supervision is often carried out on an ad hoc basis, and types of supervision offered vary across the profession. Careful consideration should be given to the qualifications, skills and experience required of supervisors, and to their ability to meet the individual needs of the supervisees.