Supervision as professional development

Frozen Cabbage     It’s still rather cold here in the far south.

I have been interested in supervision for some time and was involved in doing a small qualitative study that looked at supervision of occupational therapists in New Zealand. There were two parts to the study firstly participants in the study were asked what supervision is.

In defining supervision participants spoke of the activities of supervision, the nature of the supervisory relationship and identified three key concepts that described the purpose of supervision. The activities of supervision were raising issues and talking through problems: generating solutions. Raising issues gave a starting point from which supervision could begin. The issues raised were seen as emerging from a wide variety of contexts; those that relate to one’s professional and personal self, those that highlight one’s interactions and interventions with clients, and lastly those that relate to the wider context in which the person worked, for example the team or the organisation. Supervisees were clear that the activity of talking through problems: generating solutions was not about being given answers but rather enabling supervisees to work through their own solutions with guidance and support from a supervisor.

The quality and nature of the supervisory relationship was seen as critical to the effectiveness of these activities. In defining supervision participants described the nature of the supervisory relationship as one of mentoring which suggests as important the notion of nurturing within the relationship. All of the participants saw that the supervisory relationship must be supportive and trusting. These concepts provided a picture of a relationship that should be non-judgemental, respectful, encouraging, and that felt caring. It excluded the elements of oversight, checking and evaluation indicated in much of the literature. Interestingly mentoring was a term that was less frequently used as the interviews progressed and the characteristics of a supervisor became clearer.

For participants the purpose of supervision related to three key concepts; keeping safe, the opportunity for reflecting on practice and the provision of knowledge by the supervisor. Participants were concerned that their role and practice as an occupational therapist put them at risk. They felt at risk firstly by, being in situations where they might find their competence questioned. Secondly, due to the nature of working with people who were under stress or thirdly where they themselves felt physically or psychologically unsafe. Having a means to explore ways of keeping safe was therefore essential. Supporting this by looking at what they were doing in practice and how they were doing it, through reflection on practice and the feedback they received when involved in reflection were important purposes of supervision. Not all therapists have sufficient experience or resources for the variety of challenges that arise within their work place, particularly those new to occupational therapy or those settling into a new role. For these people the provision of knowledge is important. More skilled therapists likewise acknowledged that the knowledge supervisors impart as a part of offering different perspectives or suggesting resources is beneficial.

What really struck me about how the participants defined supervision is that they were showing that they saw that this was a process that could work for them. They clearly wanted to be able to lead in the supervision by having a system that enabled them to work through their own challenges, and at the end to feel that they had come to their own solutions. I think the other thing that strikes you is the committment the therapists were wanting to make to ensure that they were continuing to grow as therapists. In looking at the ability technology now gives us we clearly need to ask if there is a role for web 2 and the internet in this process.


5 responses to “Supervision as professional development

  1. Speechie Keen

    I really like your post.. I’m also interested in supervision. Your project sounds really interesting.

  2. occupationaltherapyotago

    Thanks Speechie Keen it’s nice to know someone reads this small blip on the web.
    It prompted me to get on with telling about the rest of the study. So…
    From the whole data set – From Cause for to Consequences of supervision.
    Participating in supervison emerged as the core concept.
    The study identified two causal conditions to supervision, ‘being an occupational therapist’ and ‘becoming an occupational therapist’. With a more concrete focus of needing the skills to do the job, ‘being an occupational therapist’ resulted in supervisees wanting supervision for affirmation that they are ‘doing ok’, and to assist them in ‘searching for ideas’ and in ‘getting to grips’ with the role and contexts in which they work. ‘Becoming an occupational therapist’ brings therapists at a different level into supervision. These are therapists confident in their role and the processes and systems of their job. Engaging in supervision enables them to explore the concept of ‘me as a therapist’, looking at how they impact on and affect the outcome of therapy. Supervision for these therapists also encourages ‘gaining a wider perspective’, allowing supervisees to gain an understanding of the effect of wider issues such as culture, poverty, organisational and government policy on the provision and outcome of therapy.
    Arising from the causal conditions that draw supervisees to participate in supervision is the phenomenon of ‘growth’. Supervisees want to improve their skills, knowledge and delivery of occupational therapy services. Growth is supported by; the expectations supervisees bring to supervision, their willingness to consider ‘doing things differently’ and the possibility that by participating in supervision that they can realise the dream of ‘being a better therapist’.
    Subsequently, the phenomenon of growth is influenced firstly by contextual factors. These are identified as ‘structuring for supervision’ as seen by ‘training’ and having a contract and importantly by the type of ‘power relationship’ between the parties to the supervision. The ‘power relationship’ is a powerful contextual factor. Firstly, for supervisees it is important to be ‘seen in a good light’, supervisees in the study had a uniform desire to be seen positively, as someone doing a good job. Supervisees are however concerned about the conflicting interests inherent in many of the relationships where their supervisor is also their line manager. Additionally they are strongly affected by the power differential within the relationship and are concerned, scared and at times threatened by the power over them held by some supervisors. They wanted their supervisors to have social rather than positional power. A supervisory relationship based on social power and respect was clearly empowering. Ironically they could also see that supervisors who had power over them also had the power to access resources and opportunities for them.
    Secondly the possibility for growth is impacted by the intervening conditions of ‘pitching it right’ and ‘finding other ways’. ‘Pitching it right’ is a skilled activity. It necessitates energy being invested in ‘preparing for supervision’ sessions by both supervisee and supervisor. It then required a balance within supervision sessions of ‘building on strengths’ and ‘challenging’. The skills of the supervisor are identified as a significant factor in the impact these intervening conditions will have on the outcome of supervision. Equally ‘finding other ways’, such as those of ‘using others’ and ‘accessing resources’ empowers supervisees by facilitating access to a range of perspectives, skills and knowledge. Together with the contexts for supervision, these intervening conditions impact on the strategies supervisees use when participating in supervision.
    Data analysis identified two overarching strategies supervisees use in supervision; that of ‘building trust’ and ‘guarding’. These can be seen as opposite ends of a continuum. ‘Building trust’ requires time, but if successful provides an optimal environment for participating in supervision. ‘Building trust’ requires supervisees to feel comfortable, with the relationship, to have respect for their supervisor, and to be in a position were they will also be given respect. At the other end of the continuum, some supervisees are caught into a cycle of ‘guarding’. ‘Guarding’ occurs where supervisees see the need to put up defences. By protecting themselves they were not opening themselves to risk. ‘Not making time’ appeared as a passive non confrontational way of ‘guarding’. The quality of the supervisory relationship alters the strategy supervisees choose. It has the potential to support and encourage active participation in supervision or alternatively results in supervisees and at times supervisors distancing themselves from supervision.
    These strategies are not without consequence. Participants to the study identified two consequences which can largely be predicted by the strategies supervisees employ. The first, based on a relationship where there is trust is the concept of ‘making the most’ with subcategories of a ‘safe place’, ‘feeling affirmed’, ‘having insights’, and ‘feeling inspired’. The second is the concept of ‘fighting shy’ that emerged largely as a consequence of the strategy of ‘guarding’ with subcategories of ‘avoidance’ and ‘frustration’.
    Many of the findings of this study support the existing literature and research into supervision across the allied health professions.
    the thesis that this comes from can be found on google scholar “Exploring the Supervision of Occupational therapists in New Zealand. For what I learnt from the research – you will have to wait for part three.

  3. Speechie Keen

    Very interersting, the emotional aspects of supervision is largely neglected in the literature but it’s an important part of the supervisor and supervisee relationship.

    Too many supervisors fail to recognise the important aspects they bring to the supervision table.

    Do you have any plans to have your work published?

  4. Hello I’m responding from the UK where we are currently experiencing our usual British summer (extremely wet with flood warnings for a couple of weeks now) although things should begin to calm down soon -fingers crossed! Of course it’s Wimbledon tennis fortnight so we should expect nothing less. I too am an educator and have recently been pushing my comfort zone out into the world of web 2.0 technologies.
    I have also been interested in supervision issues for many years although recently my interest has taken me into other directions.
    I thought I’d share with you some thoughts I had a couple of years ago intended as a discussion piece that I never got round to publishing.
    Within occupational therapy in the UK, a first line-management approach has been adopted to deal with the issue of supervision whereby the supervisee receives regular supervision from their immediate line manager. This is common practice and means that the role of supervisor becomes part of the role of a professional once they are in a line management position, the key assumption being that qualification and experience as a clinical practitioner is enough training to be a supervisor . However, there is little evidence to support the relationship between expertise as a clinician and that of expertise as a supervisor. There is a tendency for supervisors to be fearful of being unpopular and disliked, preferring to provide support rather than challenge professional and emotional growth. Matched to this are the concerns of supervisees of their line manager’s ability to respond objectively to disclosures of incompetence and/or weakness given the conflict that may exist between responsibility to the service and to the supervisee . It could be seen that the role of supervisor may be better placed outside of the immediate service delivery environment.

    It may therefore be useful to consider the extension of the academic role into the role of clinical supervisor. One may therefore suggest that the academic would have skills as a supervisor given that a major part of the role involves supervision of students and personal tutees and constructive evaluation of performance on a regular basis. Providing clinical supervision to identified clinical practitioners will facilitate the academic’s direct contact with the clinical environment, enhance their own and the supervisee’s skills, thus enhancing and developing quality client care. In addition this will contribute to the continued development of the profession .
    Within the supervisor role, the academic can embrace the opportunity to share and experience the impact of changes in practice and legislation, consider recent trends that have rapidly affected how the knowledge used in practice grows and spreads and creates challenges for practitioners to address.
    In acknowledgement of the different roles and agendas within supervision I am not ruling out line management supervision – this of course creates an ideal relationship through which to discuss caseload management and organisational issues and the role of a mentor who would focus on pastoral and attitudinal issues.
    I don’t know if this fits in at all with your research. I would be happy to be contacted if you would like to discuss further or if I haven’t made much sense here.Good luck with the remaining research – I will be interested to see installment 3 when it is ready.

  5. occupationaltherapyotago

    Hi Angela
    I agree that there are negatives in having a line manager as a supervisor, and most of them come down to issues related to power – that is the power over the supervisee that the line manager has given they are usually also responsible for performance appraisals and salary reviews. It appears to have a marked effect on the level of disclosure a supervisee is willing to have.

    However I am not sure whether an academic is the answer either. I think the most important thing is that it is someone trained in supervision. I think it is time we recognised being a supervisor as a career pathway in its own right. This person could be a clinician, an academic or indeed someone from another profession trained in supervision. In some situations it might be advantageous to have an occupational therapist trained in supervision as a supervisor and that is with new graduates or when people enter a new area of practice – however if there is a good orientation programme and day to day management even then someone trained in supervision regardless of their professional background could still be ok.

    Supervision is usually seen as having three parts the educative, supportive and accountability. I believe there is an advantage in leaving the accountability to a senior or line management person responsible for the day to day management, and encouraging supervision to focus on the educative and supportive roles. I wonder sometimes whether the word supervisor is the best one for us to use for this role? – as you say ?? mentor ???

    To me the research I did with supervisees indicates the old saying that the carrot is better than the stick – eg education and support works better than a focus on accountability. I would be interested to hear what you and others think.

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