Supervision in the Mental Health Professions: A practitioner’s guide pdf

Supervision in the Mental

Health Professions

A practitioner’s guide

Supervision is of increasing significance in the practice of mental health

professionals, especially since the advent of voluntary and mandatory

registration, managed care and clinical governance. Little, however, has been

written to address the practical and theoretical needs and questions of those

involved.

In Supervision in the Mental Health Professions, Joyce Scaife, along with

her guest contributors, draws on over two decades of experience to illustrate

ways of thinking about and doing supervision. Using practical examples, she

explores often-encountered dilemmas, including:

• How can supervisors facilitate learning?

• What are the ethical bases of supervision?

• What helps to create a good working alliance?

Supervision in the Mental Health Professions is a comprehensive, practical

and indispensable text for supervisors and supervisees involved in mental

healthcare, including clinical psychology, counselling, psychotherapy,

counselling psychology, psychiatry, nursing and social work.

Joyce Scaife is a Consultant Clinical Psychologist with North Derbyshire

Community Health Care NHS Trust and Director of Clinical Practice for the

Doctor of Clinical Psychology training course at the University of Sheffield.

She has over twenty years of experience as a supervisor of clinical practice.

Supervision in the Mental

Health Professions

A practitioner’s guide

Joyce Scaife

With contributions from

Francesca Inskipp, Brigid Proctor,

Jon Scaife and Sue Walsh

First published 2001 by Brunner-Routledge

27 Church Road, Hove, East Sussex BN3 2FA

Simultaneously published in the USA and Canada

by Taylor & Francis Inc

325 Chestnut Street, 8th Floor, Philadelphia PA 19106

Brunner-Routledge is an imprint of the Taylor & Francis Group

© 2001 Joyce Scaife; individual chapters, the contributors

All rights reserved. No part of this book may be reprinted or

reproduced or utilised in any form or by any electronic,

mechanical, or other means, now known or hereafter

invented, including photocopying and recording, or in any

information storage or retrieval system, without permission in

writing from the publishers.

British Library Cataloguing in Publication Data

A catalogue record for this book is available

from the British Library

Library of Congress Cataloging-in-Publication Data

Scaife, Joyce, 1950.

Supervision in the mental health professions: a practitioner’s

guide / Joyce Scaife; [with contributions by Francesca Inskipp . . .

[et al.].

p. cm.

Simultaneously published in the USA and Canada.

Includes bibliographical references and index.

ISBN 0-415-20713-4 (hbk)—ISBN 0-415-20714-2 (pbk.)

1. Mental health services—Administration. 2. Health services

administrators. 3. Mental health personnel. 4. Supervisors.

5. Personnel management. I. Inskipp, Francesca. II. Title.

RA790.5.S285 2001

362.2′068—dc21 00-059261

ISBN 0-415-20714-2 (pbk)

0-415-20713-4 (hbk)

This edition published in the Taylor & Francis e-Library, 2003.

ISBN 0-203-36094-X Master e-book ISBN

ISBN 0-203-37350-2 (Adobe eReader Format)

For George and Edith

Contents

List of illustrations ix

List of contributors x

Preface xi

Acknowledgements xii

1 Introduction 1

2 Supervision and learning 15

JOYCE SCAIFE AND JON SCAIFE

3 The emotional climate of work and the development of self 30

JOYCE SCAIFE AND SUE WALSH

4The contracting process and the supervisory relationship:

avoiding pitfalls and problems 52

5 Frameworks for supervision 70

6 Group supervision 99

BRIGID PROCTOR AND FRANCESCA INSKIPP

7 Ethical dilemmas and issues in supervision 122

8 Use of audio and videotapes in supervision 145

9 Live supervision and observation 160

10 Creative approaches 173

11 The influence of different models of therapy and counselling on

the supervisory process 189

12 Learning logs in supervision 206

13 Challenge and evaluation 215

14The supervisor’s role in coursework 231

Conclusion 239

Appendix 1 Self-assessment schedule for supervisees 240

Appendix 2 Examples of rating scales of supervision 243

Appendix 3 Sample consent form 245

Appendix 4 Core skills in the helping professions 247

Appendix 5 Sample notice for clients 250

References 251

Author index 268

Subject index 274

viii Contents

Illustrations

Figures

2.1 The experiential learning model 28

3.1 Levels of the helping system 31

5.1 General supervision framework 75

5.2 A process model of supervision 85

5.3 A cyclical model of supervision 90

6.1 Overall map for running group supervision 103

6.2 Russian dolls 106

10.1 A drawing of the client as a fish 176

10.2 A man drowning in a glass of beer 178

Tables

6.1 Typology of groups 104

Contributors

Brigid Proctor and Francesca Inskipp met at the first BAC (then SCAC)

Trainers’ Conference in 1973 when they were both employed as full-time

counselling trainers – Francesca at NE London Polytechnic and Brigid at

SW London College. Since then they have been engaged in the develop￾ment of counselling and supervision training as trainers, supervisors,

external assessors, consultants and writers. Joint publications include a set

of three audiotapes and two booklets entitled The Skills of Supervising and

Being Supervised, produced in 1989. In 1993 and 1995 they produced The

Art, Craft and Tasks of Counselling Supervision, two workbooks – Making

the Most of Supervision and Becoming a Supervisor, both illustrated with

audiotapes. They have both published books on counselling and counsel￾ling skills and Brigid has a new publication Group Supervision: A Guide to

Creative Practice.

Dr Jon Scaife is a lecturer in Education at the University of Sheffield. His

background is in physics and mathematics, and he became interested in

learning as a result of teaching these subjects. He is now interested in

learning and knowing per se.

Dr Sue Walsh is a senior lecturer in Clinical Psychology at the University of

Sheffield. She completed her Ph.D. at the Social and Applied Psychology

Unit, University of Sheffield and her clinical training at the University of

Exeter. Her primary interests lie in the interface between clinical and

organisational psychology.

Preface

Supervision, particularly as a component of initial training, and increasingly

as a contributory element in continuing professional development, is deeply

embedded in the cultures of the helping professions. This is despite the claim

(Holloway and Neufeldt, 1995) that there is no research on standardised and

empirically validated training programmes for supervisors. Client outcome is

the ultimate test of the effectiveness of supervision. But the relationship

between supervisor interventions and client change is subtle and complex.

Not surprisingly, attempts to account for and understand this relationship

have produced little of substance, and serious methodological deficiencies

prevail (Ellis, Ladany, Krengel and Schult, 1996; Holloway and Neufeldt,

1995; Russell, Crimmings and Lent, 1984).

Nevertheless, when Holloway and Neufeldt (1995) ask, ‘Would you choose

to see a therapist who had never received direct supervision of her or his

work?’, the likely answer would be ‘No’. The message from this to practi￾tioners is to use the available literature on supervision to inform our own

practice and experiences in supervision. This book is an attempt to broaden

the supervision literature, both by taking a panoramic view of the work of

other authors and by drawing on my own experiences.

Jon Scaife and Sue Walsh jointly authored with me Chapters 2 and 3

respectively. This reflects the fact that my ideas about learning and about

emotions at work have developed enormously through the many lively and

enjoyable conversations we have had over a number of years.

I first encountered Brigid Proctor and Francesca Inskipp through the very

helpful sets of books and tapes on supervision that they had produced. Hav￾ing listened to their work on tape I invited them to lead a supervisor training

workshop in which these two ‘retired’ counsellors delighted and entertained

us whilst ensuring that we went away with a wealth of new ideas and evolving

skills. Their experience of group supervision is much wider than my own and

I wanted this breadth to be reflected in this book. My grateful thanks are due

to Jon, Sue, Brigid and Francesca, both for their contributions and also for

their inspiration in my work.

Acknowledgements

In my career I have been very fortunate to work with many colleagues who

have stimulated and contributed to my ideas about supervision. These

include, in particular, many supervisors and supervisees to whom I am espe￾cially grateful for allowing me to try out my ideas and for sharing their ideas

about supervision. Many thanks also to those who commented on earlier

drafts – Jon Scaife, Gerry Kent, Margaret Roberts, Sue Walsh, Penny Allen,

Mike Pomerantz, Jan Hughes, Zoe Bradshaw, Linda Buchan and Liza

Monaghan.

Special thanks to Hannah, Jonny and Jon for putting up with me when I

was plugged into the keyboard rather than to their needs, and to Pat and Ray

for a peaceful and loving place in which to write.

Acknowledgements are also due for permission to reproduce illustrations

as follows: Routledge and Cassell for Figure 3.2, which was published on

page 46 of Counselling Supervision by M. Carroll in 1996 and adapted from

illustrations in Supervising the Counsellor: A Cyclical Model by S. Page and

V. Wosket in 1994; the American Counseling Association for Figure 10.2,

which was published on page 157 of volume 28 of Counselor Education and

Supervision © ACA in an article by Ishiyama in 1988: reprinted with per￾mission; Figure 6.1 which was originally published on page 57 of Supervision

in the Helping Professions by P. Hawkins and R. Shohet in 1989.

Introduction

I believe that the word ‘supervision’ conjures up a variety of ideas and

emotions in people. The prior experiences of practitioners in the helping pro￾fessions can lead them both to seek and to avoid further involvement in

the process. I have met people who have felt wounded by the words of a

supervisor twenty years earlier and are still smarting. There are others who

feel unsupported if the work context does not offer ongoing supervision

throughout their professional career.

I became interested in supervision when first faced with the prospect of

becoming a supervisor, and after my initial experience of the role. I was

worried about being ‘found out’ as an inadequate practitioner and I had the

idea that supervisors required much expertise and gravitas. Despite my pre￾qualification training, it was the first time that my clinical work had been

observed in progress by anyone and I found the experience nerve-racking.

After this I set out to ‘arm’ myself with information and ideas that would

protect me from such experiences in the future.

This book is an attempt to draw together ideas from sources I have dis￾covered over the last twenty years, to describe some of my own experiences in

supervision and to attempt to make them useful to people who are interested

in developing their own ideas and skills in supervision. It is principally

intended as a book for practitioners and I hope that it reflects both the

scientist-practitioner and reflective-practitioner groundings of the helping

professions.

Different chapters address the purposes for which supervision might be

undertaken, ways of understanding supervisory processes and ideas about

how to carry out supervisory tasks. Some of the dilemmas that accompany

the role are explored, including ethical and other philosophical issues. The

quality of the supervisory relationship is taken as central to the achievement

of the aims of supervision, especially in regard to the construction of a

climate of safety which allows the vulnerabilities of the participants to be

shown and managed.

Professional helping is carried out within a number of different disciplines

that include counselling; psychotherapy; educational, clinical, counselling

Chapter 1

and health psychology; psychiatry; social work; nursing; art, speech and lan￾guage, and occupational therapies. The book is addressed to these and related

professions. It is also intended to be of relevance to work across different

client groups, and whilst reference is made to ‘the client’ this is not to imply

that the client is an adult or an individual – the client could just as well be a

child, family, group, carer or organisation.

Some terms are used interchangeably. The supervisee is variously

described as the therapist, professional helper, clinician, and practitioner.

The work carried out is referred to as therapy, counselling and case-work.

This approach is meant to indicate an inclusiveness that represents the diver￾sity of terms used in different helping professions, in all of which supervision

is a feature of training relationships and/or continuing professional

development.

This chapter discusses some of the different ways of viewing supervision in

order to clarify for the reader the underlying assumptions upon which the

remainder of the book is based.

What is supervision?

Aims and purposes of supervision

A distinction between the purposes and functions of supervision is helpfully

made by Carroll (1996). Following Carroll, the primary purposes of supervi￾sion are defined here as ensuring the welfare of clients and enhancing the

development of the supervisee in work. In order to effect these purposes the

supervision should perform the functions of education, support, and evalua￾tion against the norms and standards of the profession and of society. This

is the case irrespective of employment arrangements and applies both in

private practice and public service.

Many attempts have been made to define supervision, but, as with all such

attempts, none entirely does it justice:

Supervision provides an opportunity for the student to capture the

essence of the psychotherapeutic process as it is articulated and modelled

by the supervisor, and to recreate it in the counselling relationship.

(Holloway, 1992: 177)

Supervision is a working alliance between a supervisor and a worker

or workers in which the worker can reflect on herself in her working

situation by giving an account of her work and receiving feedback and

where appropriate guidance and appraisal. The object of this alliance is

to maximise the competence of the worker in providing a helping

service.

(Inskipp and Proctor, 1988: 4)

2 Supervision in the mental health professions