Clinical Supervision

Copyright © Donald Robertson, 2012.  All rights reserved.

I offer clinical supervision to hypnotherapists, counsellors, and psychotherapists, either in groups or individually.

I’ve jotted down some headings below with notes on “what to expect from supervision” as newly-qualified therapists have sometimes received little information on supervision and are unsure how things should be approached.

If you’re a therapist or counsellor looking for more information on supervision, please feel free to email me or call and I’ll do my best to answer any questions you may have.

Purpose of Supervision

“Supervision is like normal vision only better”, so the joke goes.  People sometimes confuse clinical supervision with managerial supervision in the workplace.  Clinical supervision is normally a collaborative relationship and, in private practice, the supervisor is normally chosen and paid for by the supervisee.  So he is really providing them with a service and offering support and sometimes, in a sense, mentoring.  The main purpose of supervision is to help the supervisee solve clinical problems and learn from reflection on their practice, so the focus is normally upon the presentation of client case material.  Where possible, this should be based on a structured case conceptualisation rather than just a general description.  However, needs vary and supervision should be flexible enough to accommodate a range of goals and functions.  Some newly-qualified therapists may seek help from a supervisor in consolidating and developing their basic knowledge and skills or even in building their private practice.  Sometimes supervision can be used to actually practice techniques through brief role-play.  In CBT and certain other approaches it’s common to record therapy sessions and share them in supervision, although client permission is required for this.

Duration and Frequency

I normally recommend about 2 hours of supervision per month for experienced practitioners but this will vary depending upon the requirements of your professional body, level of experience, caseload, etc. Newly-qualified therapists with a substantial caseload may require weekly supervision.

Online Supervision

Online supervision using online video-communication software like Skype or Microsoft Messenger can be a good alternative to face-to-face supervision.  This works well in combination with the use of online shared documents and logs via software such as Microsoft’s Skydrive, which is based on the MS-Office applications (and uses the same account as MS Messenger).  Online supervision can be significantly cheaper than face-to-face meetings because the cost doesn’t have to cover major overheads like room hire and travel.  Online and face-to-face supervision can be combined in various ways, e.g., by alternating them.

Professional Requirements

You should always check with whichever professional registers you are a member of, or plan to join, to find out exactly what their supervision requirements are, and a written record of this should be kept as part of your supervision contract for future reference.  I’d also advise you to check in writing (by email) whether your register will approve me as your supervisor because criteria vary and it’s often useful to have a record of their response.

Supervision Contract

I always recommend having a written supervision contract that makes it clear how the responsibilities of all parties are defined.  Suggested formats are provided by organisations such as BABCP but these should normally be modified and adapted for your individual needs.  This can be the focus of the first supervision meeting, which can be used to plan the format of subsequent sessions, although some preparation can also be done in advance of the first session.

Supervisee’s Needs & Goals

From the outset the needs of the supervisee should be clearly stated, ideally summarised in writing.  It’s often also useful to draw up a kind of “mission statement” for your practice as a therapist or a list of the core values that are most important to you in your work.  This can be used to help ensure that supervisor and supervisee are working in the same direction.  Sometimes it may also be helpful to specify practical goals that you’re trying to achieve over time, e.g., obtaining a higher level of accreditation or expanding your ability to work with different clients, etc.

Case Presentation

The focus of most supervision should be the presentation of client case material.  Priority is normal given to any cases that demand immediate attention.  It’s useful therefore if you can maintain a simple document summarising your current caseload, which your supervisor can consult to get an overview of your work.  It’s also very useful, and can save time, if you agree a basic format for presenting individual cases.  The standard Case Formulation and treatment plan worksheets designed by Jacqueline Persons are used by many CBT practitioners to summarise client material.  This would include, e.g.,

• Anonymous personal details of client, such as age, gender, occupation, etc.
• Diagnosis, if relevant.
• List of main presenting problems.
• Summary of conceptualisation or working hypothesis, or a conceptualisation diagram.
• List of main treatment goals and outcome measures.
• Basic outline of treatment plan or approach taken and homework assignments, etc.

Documents like these can be made available online (securely and anonymously) in advance of supervision sessions, so that your supervisor has basic information ready-to-hand on the clients you’re planning to present.  Presenting recordings of therapy sessions for feedback from a supervisor is common practice in some therapeutic approaches, although permission must be obtained from the client to do this.

Collaborative Problem-Solving & Reflective Practice

Methodological approaches to problem-solving and reflective practice exist that can be used collaboratively in supervision, if you prefer to have more structure.  (The diagram above shows the components of positive problem-solving orientation identified by researchers in this area.)  This can help you to develop skills that are also used with clients in therapies such as CBT.  There will be some situations where seeking the supervisor’s advice or opinion may be helpful.  However, supervision should normally help you to become better at solving clinical problems yourself and learning by reflection on your own experiences, rather than the supervisor telling you what to do.  Ideally, supervision provides an environment within which you can be helped to reflect on your cases and problem-solve more effectively.

Supervision Logs

It’s very important to keep appropriate records of supervision.  To some extent this can be helped by using shared online documents to record the date, time, format, and duration of supervision sessions, and the agenda items and conclusions or action points arrived at.  Similar records may be required for some forms of accreditation.  The agenda items should normally consist, in part, of specific questions to be answered in supervision.  Near the end of the session you can then check to ensure these have been adequately addressed or answered.  Homework or issues to be carried over should be recorded and any action points can be followed-up at the next meeting.

If you’re a therapist or counsellor looking for more information on supervision, please feel free to email me or call and I’ll do my best to answer any questions you may have.