Clinical Supervision

Takeaways From This Episode

Mental health practitioners provide care for people living with severe mental health conditions, and one way that they receive support and guidance is by speaking to their supervisors. Yet, a common misunderstanding about supervision is that it should only focus on the logistics such as documentation, client flow, tracking hours or vacation days. Clinical supervision is the type of supervision that really helps mental health practitioners do their jobs of helping others by supporting their well-being and offering feedback about how they can deliver an intervention.

There are many different models of clinical supervision. Unfortunately, while there are many different models of supervision very few have been researched to understand how they improve staff or service recipient outcomes. One model that has been utilized in many mental health and psychiatric rehabilitation programs is the Alliance Model created by Bridget Proctor. The Alliance Model has three main functions of clinical supervision including Restorative, Normative and Formative.

Restorative functions in clinical supervision are very important because they can help with staff well-being, burn-out, compassion fatigue and retention. There are many ways to offer restorative supervision like checking in with a the staff member or following up after a difficult encounter, or basically any action that helps the staff feel that their supervisors care about their well-being. Without actions in restorative functions, it may be very hard to engage staff in the other areas of supervision. The Normative function are the accountability functions such as timesheets, record-keeping, callouts and other administrative tasks needed to keep the organization running. While the organization tasks may be required for external sources, this type of function will not support staff growth or improve service recipient outcomes.

The last type of function is the Formative function, or the type of clinical supervision that helps mental health practitioners improve their service delivery. For example, this might be clinical supervision that builds motivational interviewing or cognitive behavior therapy skills. One practice that has been studied is called Audit and Feedback, which means that a supervisor observes a clinical practice with a service recipient and then offers a summary with what went well and suggestions for the practice with the mental health practitioner. In order for staff to feel safe in learning new skills or being vulnerable in this way, restorative functions are needed to build a positive relationship between supervisor and mental health practitioner.

Clinical Supervision can be very helpful to mental health practitioners managing burn-out or adopting new practices, but it is important that the supervisor and staff have a positive relationship. Another challenge to clinical supervision is a mis-match between personal values and the intervention or between values and the organization. No amount of clinical supervision will feel supportive or improve practices if a mental health practitioner does not believe in the interventions delivered.