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Beginning Clinical Supervision GIVING FEEDBACK ON PERFORMANCE The clinical supervisor and clinician should regularly review the clinical supervision process and recontract when necessary. Later in the handbook, we will discuss ways the clinical supervisor can request and receive feedback (see p. 92); this section is meant to provide some ideas about offering feedback to clinicians. Clinicians will usually have many opportunities to receive feedback. Although clinicians will learn from a variety of sources, the clinical supervisor has an explicit responsibility to assist in the clinicians’ development and growth. The task of providing feedback may feel quite strange especially if the clinical supervisor has recently been promoted from the role of clinician. A discussion with peer supervisors about the change of roles at this time can be invaluable. There are many reasons why a clinical supervisor will have the capacity to provide unique and valuable feedback. The clinical supervisor: • can often compare strategies used by a variety of supervisees and offer opportunities to develop consistency among clinicians • has more time to look at the bigger picture of the organization’s values and goals and help to match practice to the organizational context • is not working directly with the client and therefore has the opportunity to review issues with more distance and perhaps clarity • is simply able to provide alternate perspectives that have not been considered. Feedback should highlight strengths as well as identify opportunities for learning. It is important to take any opportunity to offer positive feedback. If a clinician shows strength in some aspect of the work, the clinical supervisor can use this as an opportunity to highlight the work. By offering this strength-based approach to feedback early and often, the clinician can place any difficult or change-oriented feedback in the overall context of a positive work environment that values the clinician’s strengths and need for continuous learning. When offering feedback that may be difficult for the clinician to hear, the clinical supervisor will want to provide an optimal learning environment. The best option is to offer the feedback in regular individual sessions. If this is not possible, it is wise to find a time that the clinician can meet without interruption in a confidential space. 31
Clinical Supervision Handbook It is helpful to offer the feedback in a way that is specific and concrete. Sometimes the feedback is about a particular situation and will allow an opportunity for the clinician to respond and perhaps offer more information. If the issue is not linked to a specific incident or situation, the clinical supervisor might need to provide concrete examples to support the feedback. Providing the clinician with an example illustrates the precise nature of the concern and also gives the clinician a chance to clarify any misunderstandings. The clinical supervisor may also wish to provide this feedback in writing. It is important to offer the feedback in a timely fashion. Although it can seem timeconsuming to give clinicians feedback that may seem minor, early feedback can give clinicians the opportunity to absorb the information, respond faster and use other resources in addition to clinical supervision to assist with making changes to their practice. CASE EXAMPLE: FEEDBACK ON PERFORMANCE Janet is a clinical nurse in an outpatient addiction treatment service. At her bi-weekly clinical supervision, Janet described working with a client who was “mandated” by the child protection authority Children’s Aid Society (cas) and who she felt was “just going through the motions” to get her child back. The client had stopped using crack cocaine; however, she reportedly used marijuana occasionally. The marijuana use and the fact that the client was not interested in making any psychological changes concerned Janet and were the reasons she was asking for clinical supervision. The fact that the client was intending to end treatment in two more sessions also caused Janet to worry that she had not done all that she should to help effect change. The clinical supervisor first wanted to point out how the sessions with the client appeared successful in relation to her goals of treatment, part of which was to see the client stop using crack. Janet could agree that the previous sessions may have been helpful but was unsure about whether she had sufficiently addressed her client’s cannabis use. They discussed the importance of the therapeutic relationship apart from the client’s 32
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A Pan American Health Organization
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