Clinical Supervision Handbook - CAMH Knowledge Exchange ..

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Components of Clinical Supervision Components of Clinical Supervision ROLES Clinician In clinical supervision, clinicians can achieve a higher level of expertise in their discipline and/or specialized area of practice. A hallmark of clinical supervision is the opportunity to reflect on one’s own practice, to gain others’ opinions and hence develop a more accurate self-appraisal and, through discussion, to draw the links between theory and practice. Clinical supervisors and clinicians work together to develop and maintain productive, goal-oriented supervision. They negotiate the framework in which clinical supervision is carried out, including establishing the frequency of meetings, avoiding outside interference and being prompt. Clinicians define their own learning goals. The goals often arise from the case examples they select. These goals can be met through learning from supervision and from activities clinicians undertake beyond the supervisory session. Clinicians prepare for clinical supervision by having an agenda and information pertinent to the case or to clinical dilemmas. Information can include case notes, segments of tapes, a care plan and case questions. Case material should represent challenges and difficulties as well as successes. By choosing to discuss cases where they have encountered difficulties, clinicians demonstrate their willingness to take risks and learn from others. The learning process involves dialogue, openness to in-depth reflection on practice, and receiving both challenging and supportive feedback. The clinician records the supervisor’s recommendations and the actions or outcomes he or she has taken as a result of clinical supervision in the outpatients’ progress notes and in the interdisciplinary plan of inpatients. Clinicians are active participants in clinical supervision and give feedback to the supervisor so they can jointly evaluate the process in relation to the verbal or written supervision contract. Contracting at regular intervals allows the clinician to discuss learning goals, and the clinical supervision process, and to adjust the contract as necessary. It is the responsibility of the clinician to apply what he or she has learnt with clients. Self-evaluation is imperative and allows clinicians to determine when learning goals are met and when the clinician is ready for a more active or autonomous role with clients, such as in leading a group. 9
Clinical Supervision Handbook Learning is not relegated to the confines of the supervision session. The clinician and clinical supervisor, working together, must negotiate and agree on the expectations for learning between sessions. Activities may include reading, viewing videos and writing process recordings or detailed notes of sessions. Clinical supervisor Clinical supervisors demonstrate substantive or content knowledge in multiple domains through discussion of clinical issues, examination of organizational development and inter-professional practice. The ability to work with the content of multiple domains engenders confidence in supervisory skills. Clinical supervisors’ credibility, based on formal education and depth of experience, is an important contributor to the supervisor-clinician relationship. Another factor is the availability of clinical supervisors for both scheduled and unscheduled supervision, since concerns related to clients also arise beyond the usual hours of the working day. Good clinical supervisors recognize and value diverse perspectives. They also acknowledge the clinician’s previous work experiences. These factors contribute to a rich, heterogeneous work environment. Shared responsibility The supervisor and the clinician share responsibility for creating a safe environment for clinical supervision. Safe environments are characterized by respect, openness, support, trust and the provision of non-judgmental feedback. The establishment of a safe environment allows creativity to flourish when dealing with challenging situations and expands the possibilities of service delivery. Power and authority The hierarchical aspect of the supervisor-clinician relationship can lead to conflict, stress and tension. Effective clinical supervisors don’t ignore the inevitable power dynamics. Instead they model a parallel process of journeying together. Supervision experts note as crucial the ability to exercise supervisory responsibility in a respectful, fair and objective manner and to purposefully avoid the abuse of power (Centre for Substance Abuse Treatment, 2007). 10
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