The idea of counsellor’s receiving supervision to enhance their practice and gain assistance for the work they are doing with clients has a long history (Carroll, 2007). Supervision is an ongoing process of support for practitioners to monitor, develop and refine their skills (Bernard & Goodyear, 2014).

Supervision can be provided in numerous ways, from structured individual one-to-one sessions with a more experienced colleague, to small group discussions between peers, or `on the job’ practical guidance for a trainee while they perform a specific task or skill (Kilminster & Jolly, 2000).

The process can involve direct observation, audio/video presentations or a verbal review of case notes (Todd & Storm, 2002). The supervisor/supervisee relationship is important and ideally should be based on a collaborative approach built on trust and mutual respect, where both parties have a singular purpose of improving outcomes for clients and enhancing clinical skills through review, discussion and feedback.

There are three primary goals of supervision; (1) building knowledge and consolidating therapeutic skills, (2) monitoring and maintaining ethical standards and responsibilities, and (3) gaining support at a personal and professional level (Milne, 2009).

Building knowledge and consolidating therapeutic skills

Being able to discuss various aspects of the counselling process with a supervisor and receiving supportive and constructive feedback about strengths and areas for improvement enables practicing counsellors to reflect on their own performance and gain some objective insight into the skills they need to develop. Supervision can provide an opportunity to learn and practise new techniques and explore helpful ways of working with clients.

Monitoring and maintaining ethical standards and responsibilities

The supervision process also allows counsellors to manage a range of ethical dilemmas that invariably arise as part of their clinical practice. Counsellors need to be aware of their ethical responsibilities and follow strict codes of conduct to ensure that professional standards are maintained. Sometimes it can be difficult to navigate the correct path, and guidance and support from a supervisor is helpful in determining the most appropriate course of action that will not compromise the client’s safety and well-being or undermine the therapeutic alliance.

Gaining support at a personal and professional level

Counselling can be stressful, particularly when clients are disclosing highly sensitive personal information of a distressing nature. Empathic responding requires that counsellors understand and validate the client’s position and can accurately reflect those feelings without getting too caught up in the emotional intensity of the information being revealed. Supervisors can assist counsellors to process difficult material and are skilled in reading the early warning signs of stress and burnout, and can intervene to support the counsellor before they become over-involved and in danger of blurring the lines of professional conduct.

State of the evidence

Research has identified a range of benefits to engaging in supervision, including improved client outcomes (Bambling et al., 2006; Callahan et al., 2009; Milne, Aylott, Fitzpatrick, & Ellis, 2008; Watkins, 2011), enhanced capacity to monitor and regulate ethical practice (Schoenwald, Sheidow and Chapman, 2009), and an increase in general counselling skills (Kilminster & Jolly, 2000).

Wilson, Davies and Weatherhead (2016) examined trainee therapist reports of their experiences with supervision. For the most part, the trainee’s reported positive benefits of supervision on their personal and professional development. However, some also identified feeling distressed and self-doubt regarding the power differential in the relationship, suggesting that supervisor’s need to be mindful of promoting a collaborative partnership with supervisees that avoids emphasising the differences in the level of skill and experience, and instead focuses on a shared understanding that invites the trainee therapist to offer feedback to the supervisor about whether the supervision process is meeting their needs (Vallance, 2005).

“Benefits to engaging in supervision include, including improved client outcomes, enhanced capacity to monitor and regulate ethical practice, and an increase in general counselling skills.”

Trainee therapists derive the most benefit from supervision when supervisors can provide direct guidance on clinical work, help link theory to practice, engage in joint problem solving and brainstorming, and offer strategic targeted feedback that helps to correct mistakes (Kilminster & Jolly, 2000). Perhaps unsurprisingly, the single biggest predictor of effectiveness in supervision is the relationship between the supervisor and the supervisee. Trust and respect are critical to developing a sustainable and fruitful partnership.

In summary, supervision is central to the process of counsellor training, and it remains an important ingredient in professional practice. However, the evidence for the benefits of supervision remain under-explored and require more detailed analysis to fully understand the specific aspects that can help counsellors become better equipped to protect the client’s best interests and enhance the positive clinical outcomes for the people they serve.

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References

Allan, R., McLuckie, A., & Hoffecker, L (2016). Clinical supervision of psychotherapists: A systematic review. The Campbell Collaboration. Retrieved from: http://www.campbellcollaboration.org/lib/project/365/

Bambling, M., King, R., Raue, P., Schweitzer, R., & Lambert, W. (2006). Clinical supervision: Its influence on client-rated working alliance and client symptom reduction in the brief treatment of major depression. Psychotherapy Research, 16(3), 317-331.

Bernard, J. M., & Goodyear, R. K. (2014). Fundamentals of clinical supervision (5th ed.). Boston: Pearson.

Callahan, J. L., Almstrom, C. M., Swift, J. K., Borja, S. E., & Heath, C. J. (2009). Exploring the contribution of supervisors to intervention outcomes. Training and Education in Professional Psychology, 3(2), 72-7

Carroll, M. (2007). One more time: What is supervision? Psychotherapy in Australia, 13(3), 34-40.

Kilminster, S.M., & Jolly, B.C. (2000). Effective supervision in clinical practice settings: a literature review. Medical Education, 34, 827-840

Milne, D. (2009). Evidence-based clinical supervision: Principles and practices. London, UK: Wiley-Blackwell.

Milne. D., Aylott, H., Fitzpatrick, H., & Ellis, M. V. (2008). How does clinical supervision work? Using a “best evidence synthesis” approach to construct a basic model of supervision. The Clinical Supervisor, 27(2).

Schoenwald, S.K., Sheidow, A.J., & Chapman, J.E. (2009). Clinical supervision in treatment transport: Effects on adherence and outcomes. Journal of Consulting and Clinical Psychology, 77(3), 410-421.

Todd, T. C., & Storm, C. L. (2002). Thoughts on the evolution of MFT Supervision. In T.C. Todd & C.L. Storm (Eds.) The complete systemic supervisor: Context, philosophy, and pragmatics (pp. 1-16). Needham Heights, MA: Allyn & Bacon.

Vallance, Kate, (2005), Exploring counsellor perceptions of the impact of counselling supervision on clients. Counselling and Psychotherapy Research, 5(2), 107-110

Watkins, C.E. (2011). Does psychotherapy supervision contribute to patient outcomes? Considering thirty years of research. The Clinical Supervisor, 30(2), 235-256.

Wilson, H.M.N, Davies, J.S., & Weatherhead, S. (2016). Trainee therapists’ experiences of supervision during training: A meta-synthesis. Clinical Psychology and Psychotherapy 23(4), 340-351.