Clinical Supervision

The importance of receiving clinical supervision to support your work with forensic AOD clients cannot be overstated. Clinical supervision differs from line supervision (which may focus on compliance with organisational procedures) by providing a safe, reflective space to explore your therapeutic work with clients. As described by Scott (1999) from a family therapy perspective:

“Supervision is a process of discovery. It is a time when two or more people reflect on their work together in order to liberate them to be as creative as possible in their work. It may be a time to decide where and how to increase skills or to change some work practices. It may also be a time when administrative issues can be discussed. It may be a time when the wisdom of one person is passed on to another person as a form of mentorship.”

Clinical supervision provides numerous benefits for staff well-being and professionalism by providing opportunities for workers to:

• Seek guidance, and practical information for client cases
• Maintain professional competence (e.g., staying up to date with workplace demands)
• Maintain professional identity and purpose (e.g., staying on track with workplace roles)
• Maintain professional integrity (e.g., ethical practice).

Whilst clinical supervision is beneficial for work with all clients, the complexities of forensic work make it particularly valuable. Forensic clients may present additional challenges for their AOD workers with particular issues relating to risk (to themselves, to others and to the broader community); complexities in relation to information sharing which differ from other clients; challenges for the clinicians in responding to antisocial or criminal attitudes and behaviours of their clients; and working with the dual systems of AOD treatment and Corrections.

To manage some of these challenges effectively it is important that agencies working with forensic clients place a priority on providing clinical supervision – separate to standard line supervision – to their staff.

Tips for Supervision:

• Establish and case-note the expectations, roles and commitments of the supervisory relationship at the commencement of the supervision – such as how the supervision sessions will work, what areas of practice the supervisee wants to develop, what client information will be recorded, and what is expected of the supervisee;
• Prioritise higher risk clients for discussion in supervision. This will ensure that you are optimising the time you have available, by focusing on the most challenging clients, targeting the greatest risk issues and gaining insights that can be applied to other lower risk clients.
• Use supervision to help develop case formulations. It can be highly beneficial to be able to explore and test your assessment/interpretation of a client’s presentation with another experienced clinician, as a way to focus your work with this client and to develop your clinical skills more broadly.
• Consider establishing regular group clinical supervision or peer reflective practice sessions. There are significant benefits to reflecting on your client work with your peers and sharing knowledge and insights. Clear ground rules should be established, however, to ensure that all participants feel safe to share their experiences without judgement or criticism from their peers.
• Be mindful of client confidentiality during supervision – either conceal the identity of the client and associated parties, or ensure that your client consent process clearly explains how and when their personal information may be disclosed with supervisors.
• Consider opportunities to engage external clinical supervisors. For some agencies, where there are limited clinical supervisors internally, it may be appropriate to engage external supervisors to provide group or individual clinical supervision to staff. External supervision can be beneficial in providing clear differentiation between the “line” supervision of the agency, and the clinical development of workers.

References:

Scott, L. (1999). The nature and structure of supervision in health visiting with victims of child sexual abuse. Journal of advanced nursing, 29(3), 754-763.

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

Day, A. (2012). The nature of supervision in forensic psychology: Some observations and recommendations. The British Journal of Forensic Practice, 14(2), 116-123.

Mullarkey, K., Keeley, P., & Playle, J. F. (2001). Multiprofessional clinical supervision: Challenges for mental health nurses. Journal of psychiatric and mental health nursing, 8(3), 205-211.