Annotated Bibliography

Development of a Supervision Training Series

Annotated Bibliography

Bogo, M., Paterson, J., Tufford, L., & King, R. (2011). Interprofessional Clinical Supervision in Mental Health and Addictiion: Toward Identifying Common Elements. The Clinical Supervisor, 124-140.

This article describes a study of interprofessional clinical supervision at the Centre for Addiction and Mental Health (CAMH) in Toronto. Researchers from the University of Toronto and CAMH conducted a qualitative inquiry which included 77 participants from six professions in 14 focus groups. The authors discuss their findings and conclude there are a number of general principles and interacting factors associated with effective clinical supervision across professions. The article describes the supervisors’ professional designation as less of a factor in quality supervision than their knowledge of client needs and interventions, and approaches to learning. Also valued by participants, was “supportive, clinician-focused, content-oriented supervision” (p. 135). Although the authors are cautiously endorsing a cross-professional supervision model as potentially beneficial, there are also some concerns described. For example, new graduates prefer leadership from within their primary profession. Additionally, a self-regulating tradition in the nursing profession was presented as one reason to maintain access to supervision within that profession. Caution should be taken in generalizing the study findings and author endorsements to other mental health agencies due to the self-selection sampling, low number of nurse participants in proportion to agency population, and the involvement of only one agency.

Borders, L. D., Glosoff, H. L., Welfare, L. E., Hays, D. G., DeKruyf, L., Fernando, D. M., & Page, B. (2014). Best Practices in Clinical Supervision: Evolution of a Counselling Specialty. The Clinical Supervisor, 26-44.

The authors of this article provide guidelines for best practices in clinical supervision as published by the Association for Counselor Education and Supervision (ACES), and describe the process that led to their development. This process is presented as the evolving and legitimizing of clinical supervision in the United States as a specialty profession in its own right; emerging out of the publication of Standards for Counseling Supervisors in 1990. The document, “Supervision Best Practices Guidelines” is included as an appendix and details 12 supervision topics including: 1) Initiating Supervision, 2) Goal Setting, 3) Giving Feedback, 4) Conducting Supervision, 5) The Supervisory Relationship, 6) Diversity and Advocacy Considerations, 7) Ethical Considerations, 8) Documentation, 9) Evaluation, 10) Supervision Format, 11) The Supervisor, 12) Supervisor Preparation: Supervision Training and Supervision of Supervision. Also included in the article are recommendations for utilization of the guidelines and direction for further research. Although the guidelines may provide a useful tool for educators, supervisors and regulatory bodies, the article does not provide an implementation model for agencies. Further, the publisher of the guidelines is an American organization and thus may reflect cultural perspectives that don’t directly translate to a Canadian application.

Bransford, C. L. (2009). Process-Centered Group Supervision. Clinical Social Work Journal, 119-127.

This article endorses a specific approach to group supervision, referred to as “Process-Centered Group Supervision”. First introduced in the 1990’s by Christopher Bollas, PhD, the Process-Centered Group Supervision model is grounded in psychodynamic perspectives and elements of social constructivism. Bransford (2009) discusses theoretical foundations of relational psychoanalytical theory and object relations theory, then reviews several psychoanalytical processes which may be identified in the group supervision process such as acting out, parallel process, transference, counter-transference, and projective identification. Two case examples are presented to illustrate the model being implemented with social work students in field placement and classroom settings. As explained in the article, the model is geared toward clinical practice settings, and focuses on a specific client being presented, then discussed by all group members. The article explains the goal for this supervision model is to increase practitioner openness and awareness of self as a means to achieving deeper client understanding. While the article explains benefits and areas of further study for Process-Centered Group Supervision, it does not address logistical challenges and practical realities of supervision such as administrative, corrective feedback, and disciplinary duties.

Hair, H. J. (2013). The Purpose and Duration of Supervision, and the Training and Discipline of Supervisors: What Social Workers Say They Need to Provide Effective Services. British Journal of Social Work, 43, 1562-1588.

Professor of social work, Heather Hair (2013) describes a research study on the supervision needs of social workers in Ontario, which included online survey responses from 636 participating members of the Ontario Association of Social Workers (OASW). The survey is described as self-administered and included questions designed to collect both quantitative and

qualitative data from social workers about their supervision needs. The article includes a review of the existing literature, and discusses topics such as the purpose of supervision, length of supervision, training needs of supervisors, and the growing trend of “cross-discipline supervision” (pg. 1567). The study findings show that social workers want supervision to focus on skill development, emotional support and administrative accountability. The study also revealed participants had concerns about perceived conflict of interest for supervisors who provide emotional support and are also responsible for conducting performance evaluations. Hair (2013) aligns the survey responses with a social constructionist framework for supervision and advocates this perspective as most representative of social workers’ self-reported needs. While the findings are an important contribution to this area of study, Hair acknowledges how survey wording may have had the effect of limiting responses from community workers, and advises that future studies may be enriched by conducting focus groups or interviews in addition to surveys.

Kaplan, D. B., Silverstone, B., Zlotniks, J. L., Herman, C., & Toumas, S. (2018). NASW’s Supervisory Leaders in Aging: An Acceptable and Feasible Model for Trainig and Supporting Social Work Supervisors’. Clinical Social Work Journal. doi:https://doi.org/10.1007/s10615-018-0673-6

This article presents the Supervisory Leaders in Aging (SLA) development model for training supervisors in the gerontology social work field. The authors describe the context and specific practice challenges faced by social workers and their supervisors within the gerontology profession, and how the SLA was implemented in New York City, Florida, Illinois, and Maryland, United States between 2015 and 2017. The authors reference adult learning theory by

Malcolm Knowles, as the basis for the program design. The training is delivered to groups of 20 social work supervisors in ten, five-day workshops per group, and address topics related to leadership proficiency, teaching assessment skills, gerontology-specific issues, and cultural competence. The article details an overall successful outcome and positive feedback from participants in the SLA workshops, but warns of possible reliability and validity issues, and limited generalization potential. Thus, caution should be taken when comparing, or incorporating aspects of the SLA model to other supervisor development programs.

Kilminster, S., Cottrell, D., Grant, J., & Jolly, B. (2007). AMEE Guide No. 27: Effective educational and clinical supervision. Medical Teacher, 2-19.

This article outlines a recommended framework for clinical supervision based on a review of the literature and survey feedback from a UK research project in 2000. The authors begin by defining supervision as “the provision of guidance and feedback on matters of personal, professional and educational development in the context of a trainee’s experience of providing safe and appropriate patient care” (pg. 3). There is concern expressed about a lack of consistency in how and when supervision is practiced in a medical environment, and the stated need for an effective supervision system. The comprehensive guide provides extensive advice for clinical supervisors on a range of topics that include best practice tips for achieving positive client outcomes, supervisee development, constructive feedback and supervision continuity, among others. The article also touches on some expected responsibilities of the supervisee, and stresses the importance of relational obligations falling on both supervisor and supervisee. The article offers useful methods of implementing practical skills. However, since the authors and referenced study are located in the UK , their contributions originate from within a specific,

medical and cultural context that may differ from the experience and needs of Canadian workers in the mental health field.

Knight, C. (2018). Trauma-informed supervision: Historical antecedents, current practice, and future directions. The Clinical Supervisor, 37(1), 7-37.

This article addresses clinical supervision from a trauma-informed perspective, applying relevant principles to the supervisor/supervisee relationship. A discussion of trauma-informed practice lays out its assumptions and progression of popularity with understanding and helping clients in the mental health community. Five principles that inform client care are presented as safety, trust, collaboration, choice, and empowerment, and the concept of “indirect trauma” (pg. 11) is introduced as an unavoidable repercussion for practitioners working with trauma survivors. After unpacking the elements of trauma-informed care and indirect trauma, the author convincingly argues the need for a parallel approach to supervision described as “trauma-informed supervision” (pg. 18). The author further advocates for a mixed model of supervision which combines trauma-informed supervision with Bernard’s discrimination model of supervision which requires the supervisor to simultaneously assume three distinct roles of teacher, counsellor and consultant. Knight (2018) provides detailed instructions with examples of how the five principles of trauma-informed practice can be integrated into the discrimination model. However, as previously identified in other literature, the common practice of supervisors also evaluating worker performance may interfere with establishing the trust required to effectively develop the relationship roles described in this model. Solutions to this and other challenges would need to be considered if a trauma-informed model of supervision were to be used.

Mor Barak, M. E., Travis, D. J., Pyun, H., & Xie, B. (2009). The Impact of Supervision on Worker Outcomes: A Meta-analysis. The University of Chicago Press Journals, 3-32. Retrieved from https://www.jstor.org/stable/10.1086/599028

This review details the findings of a meta-analysis study of 27 research articles published between 1990 and 2007 on the topic of supervision in the social work and human services domain. Three aspects of supervision—task assistance, social and emotional support, and interpersonal interaction—are identified as related to worker outcomes and positively influence factors such as job satisfaction, organizational commitment, effectiveness, retention, and psychological well-being. The three aspects of supervision are also identified as being negatively related to harmful outcomes such as burnout, job stress, turnover, worker anxiety and depression. According to the authors, this relationship is best explained from the perspective of social exchange theory. The findings of this study emphasize the importance of directing attention, training and resources toward effective supervision.

Ripisarda, C., Desmond, K., & Nelson, J. (2011). Student Reflections on the Journey to Being a Supervisor. The Clinical Supervisor, 109-123.

This qualitative study attempts to understand the transition into a supervisory role for doctoral students in counselling and supervision programs, and what they found helpful or challenging throughout the process. Included is a review of the literature, revealing that relatively little research has been done on the experience of transitioning from supervisee to supervisor. A development model called the “Supervisory Complexity Model” (pg. 110) is

discussed as part of the literature review and describes a process of shock, recovery and transition, consolidation and mastery with respect to taking on the role of supervisor. Interviews conducted as part of the study reveal two main themes that were salient to participants: (1) establishing supervisory relationships; (2) developing supervisor skills. As part of the experience, participants were exposed to parallel processes with their own supervisors. In this sense, they were both supervisee and supervisor in an intentional “supervision of supervision” process. This process appears to have been especially significant to the participants’ development and experience, as it allowed for reflection of their evolving role from a dual perspective. However, the results from this study must be tempered with an acknowledgment of the limitations, including a lack of heterogeneity in the sample and difficulty with maintaining respondent anonymity. In addition, more information could have been gleaned if the study had included interviews with the faculty supervisors who oversaw the transition of their pupils.

Sarnat, J. (2010). Key Competencies of the Psychodynamic Psychotherapist and How to Teach Them in Supervision. Psychotherapy Theory, Research, Practice, Training, 47(1), 20-27.

This article presents an example of how effective supervision can improve therapists’ skills and ultimately achieve transformational outcomes for both therapist and client. The author references works by Tuckett (2005) and Rodolfa et al. (2005) to qualify the subsequent illustration of psychodynamic supervision as an effective means of training and assessing new therapists—a case vignette depicting supervision sessions with a new trainee working as a psychodynamic psychotherapist. As seen in other research, the supervision provides opportunity for a parallel process in which skills are modelled by the supervisor. The author emphasizes the therapeutic relationship, self-reflection, competent assessment and diagnosis, and appropriate

intervention as four key competencies of psychodynamic practice. The case vignette is then analysed within this frame of reference to provide a thorough explanation of how each competency is illustrated.

Vito, R. (2015). Leadership Support of Supervision in Social Work Practice : Challenges and Enablers to Achieving Success. Canadian Social Work Review, 32(1-2), 151-165.

This article looks at findings that emerged from a 2012, Southern Ontario research project on the use of self in social work. During participant interviews, a sub-theme of how self-reflection is supported (or not) by supervisors and leaders became a salient topic. The author explains that qualitative data specific to supervision was analysed independent from the broader study and revealed two further areas of interest as “the challenges of organizational pressures and power differentials; and the vital role of social work leaders in modelling values and creating a safe organizational culture” (pg. 156). After presenting and discussing material from the interviews within the context of each theme, the author draws conclusions and presents practical recommendations for social work at the organizational level. In particular, the article identifies that access to supervision and reflective learning should be a priority. In addition, organizations would benefit from reducing power differentials, creating a culture of trust, and investing in supervisory training. However, caution should be exercised when applying these findings since the sample was small—only 10 participants—and data does not reflect correlation to outcomes.