Clinical Supervision Handbook - CAMH Knowledge Exchange ..

Clinical Supervision Handbook
more meaningful understanding of the client. In this way, the supervisor-clinician
relationship parallels the clinician-client relationship.
Beginning individual clinical supervision
The first task of the clinical supervisor is to create a safe space in which the clinician
can re-experience clinical difficulties and the feelings associated with them. Creating a
safe space and a supervisory alliance with the clinician involves developing a trusting
relationship and providing education regarding clinical supervision: what it is and
how it works (Gallop, 2004). This is particularly important because clinicians will
bring their own perceptions of clinical supervision to the supervisory relationship.
Exploring previous experiences with clinical supervision and the feelings associated
with these will provide an opportunity to correct any misconceptions that the clinician
has about the supervisory process. Even if the clinician has not had clinical supervision
before, it will be important to explore preconceived notions about it. The word
supervision itself may conjure up negative feelings, particularly from nursing staff
where historically, it was associated with management and surveillance. On the other
hand, social workers view clinical supervision as a crucial component of their practice.
Education regarding supervision should also establish clear boundaries by not only
addressing what clinical supervision is, but also addressing what it is not; for example,
clinical supervision is not personal therapy. The focus is on the clinician-client
relationship. Having said that, there may be times when personal issues are having
an impact on the clinician-client relationship and this needs to be acknowledged.
A safe space is further constructed by scheduling regular time to meet with the clinician
in a private place, such as the supervisor or clinician’s office. Scheduling a minimum
of 45 minutes to one hour every four weeks for individual clinical supervision is
recommended in the nursing literature (Butterworth et al., 1997; White et al., 1998)
while social work supervision is usually provided weekly or every second week.
Winstanley and White (2003) note that clinicians in monthly or bimonthly sessions
scored higher on the Manchester Clinical Supervision Scale (Winstanley, 2000), a scale
that measures the effectiveness of clinical supervision. Supervision time is protected,
uninterrupted time that both clinical supervisor and clinician respect. The clinical
supervisor demonstrates his or her availability, consistency, respect and reliability
by being present and punctual, which not only serves to establish a trusting, safe
relationship with the clinician but also models qualities that clinicians ideally transfer
to their clinical practice to build therapeutic relationships with their clients. Some
clinicians may be reluctant to engage in scheduled supervisory sessions or may feel
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