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Beginning Clinical Supervision time frames. Contracts can be verbal or written. The following case example illustrates the process of establishing a verbal contract. CASE EXAMPLE: DISCUSSING THE GOALS OF CLINICAL SUPERVISION Regina, a new clinician who recently graduated from school, starts a permanent position as an addiction therapist in the residential program. As part of her orientation, Regina is asked to meet with the clinical supervisor (an advanced practice clinician) and manager to discuss roles and expectations, the role of clinical supervision in this setting, the process of group clinical supervision and the scheduling of individual clinical supervision. The clinician is also offered a few definitions of clinical supervision that are used in this setting. Because she will report to both the clinical supervisor and manager, Regina is given some guidelines about areas appropriate for discussion with the clinical supervisor and other areas to be discussed with the manager. The APC role focuses on practicerelated issues through education and support while the manager’s role is more administrative, as well as being supportive. In building the relationship with the clinical supervisor, Regina is asked questions about past clinical supervision as a student as well as any questions or concerns she has about working with the clinical supervisor in this setting. From this discussion, the clinical supervisor learns that Regina experienced her student supervisor as holding grudges and often felt punished for earlier mistakes in her placement. This information leads the clinical supervisor to be sensitive when giving feedback, to acknowledge that the clinician cannot always make perfect choices and to articulate her hope that the clinician approach her if she were unsure of her work in the early days, as a way to obtain help and support. The clinical supervisor also discusses circumstances that are somewhat unique to the program. Unlike other settings, there is opportunity for the clinician to connect with the clinical supervisor around daily clinical issues. Also, there are some situations such 27
Clinical Supervision Handbook as discharging a client, where a consultation from a representative from management is required. The clinical supervisor would share, upon request from the manager, the level of participation negotiated for clinical supervision, consistent with the initial discussion of roles and responsibilities. Finally, the clinician is asked to reflect on her work as a student and identify some goals she has for this staff position. Regina is also asked if there are any resources or courses that might enhance her clinical practice. WHEN CLINICAL SUPERVISION IS AT THE REQUEST OF THE MANAGER When clinicians are told that they are required to attend clinical supervision, a variety of feelings may arise for both clinician and clinical supervisor. The clinical supervisor may believe that he or she should have offered supervision earlier or may wonder if he or she could have provided a more supportive environment so the clinician could have come to supervision sooner. From the perspective of the clinician, there may be positive feelings because the clinician has struggled with a clinical situation and now feels supported by the added attention or help. Alternatively, clinicians can feel very stressed as they may feel targeted as having done something wrong. Clinicians may feel that they have been betrayed by sharing their struggle with another member of the team, and telling the truth about a difficult situation or be embarrassed because other clinicians told management about unsafe clinical practices. In circumstances when a clinician is returning to the workplace after disciplinary action, there can be feelings of anger and embarrassment. Clinicians may be told to attend clinical supervision because they need to: • comply with the mandatory regulating body • acquire skills (required by the program) that can be learned in clinical supervision • attend clinical supervision as part of a disciplinary action or as part of a return to work procedure • integrate evidence-based practice into their work • focus on client-centred care 28
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