Supervision for the helping & health professions

by Claudia Gross

About professional supervision

Supervision for psychotherapists, counsellors and other practitioners and the helping and health professions is a collaborative professional relationship between a supervisor and a practitioner which is concerned with enhancing the quality of the practitioner’s work. Supervisor and practitioner collaborate in regular meetings by reflecting on all aspects of the work.

Trust and openness are essential for the relationship to work well, for the supervisee to make good use of the perspective, support, feedback, problem solving, and learning the supervisor can provide.

Psychotherapists may be of particular use as supervisors to other health practitioners, because they are trained to listen, not only for what a practitioner says in relation to their work, but also for what is not said and hard to express, for what may be out of awareness, for emotions and feelings, all of which then can be thought about together and made available to the work.

It is useful to distinguish three core elements of supervision: Case work, Professional ethics & Self care.

Case work

Supervision has a strong formative element by providing a space to attend in detail to case work and the development of the practitioner’s skills as well as to the development of their professional identity. A supervision relationship offers collaborative reflection and analysis of work with particular clients where the supervisor provides another mind and a third perspective on what is going on in the practitioner-client relationship. Discussions of the work and the supervisee’s experience helps a practitioner to better understand their clients and the dynamics of their relationships with clients, and to think collaboratively about the effectiveness of interventions. Reflection and analysis then lead to plans for future directions of the work.

Especially when there are difficulties or impasses in the work, such collaborative reflection with a trusted supervisor opens up more creative and imaginative thinking which anxieties, stress or bias tend to hinder.

In supervision for psychotherapists and other mental health practitioners, such collaborative case work reflection is an important space to explore emotional and feeling responses to clients and to gain deeper understanding of how they influence the therapeutic relationship and the practitioner’s use of themselves in approaching particular work.

Over time the supervisor develops a close knowledge of specific client work and of a practitioner’s strengths, as well as their developmental needs. Supervision helps to define areas of further learning and skills development, as well as a general trajectory of professional practice based on the practitioner’s strengths.

Professional ethics

Supervision is crucial to attend to the ethics of one’s practice. A supervisor helps the practitioner to conduct their work within the ethical frameworks and standards set by their profession, to be alert to ethical issues as they arise in their work and find ethical solutions to challenging problems.

In that sense a supervisor has ethical oversight, yet in a good working relationship it is part of the way in which the supervisor is having the supervisee’s back. Most importantly the ethical aspect of the supervisory relationship helps practitioners to think about ethics in their everyday work and relationships with clients, colleagues, other professionals with whom they are collaborating and within the professional communities to which they belong.

In our specific Aotearoa New Zealand context ethics includes both cultural competence, in recognition of the critical position of indigenous perspectives, and a commitment to work against existing inequalities in the provision of health care services. Supervision also helps practitioners to foster self-awareness of how culture is part of their relationships with clients of various cultural backgrounds and with diverse identities. Because part of culture involves tacit understandings about oneself, other people and the world, things we take largely for granted, the supervisory relationship helps to bring cultural elements to awareness. Seeking specific cultural supervision from a culture expert ensures culturally competent and sensitive practice.

Self-care

Finally, supervision has a strong restorative and nourishing element. The relationship is a source of support with the emotional effects of the work and provides resources on how to manage stress and foster self-care. Here a supervisor will have in mind the whole person of the practitioner and their well-being.