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Supervision Practice

Are you getting enough? – (1) Supervision in context
Sam Simpson and Cathy Sparkes begin this new series with an exploration of why supervision is so important and a practical activity to help you make sense of your own supervision history.

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e have been given a great opportunity to bring the topic of ‘supervision’ into the public arena for discussion and debate. In the current political climate pressures are ever increasing and our own well-being is paramount. We are both specialist speech and language therapists with many years experience of working with people with brain injury in a wide range of settings, including hospitals, rehabilitation units (in and out patient) and a variety of community services. Cathy is also a trained counsellor and Sam starts her counselling training in April. We are both fully committed to our own professional development and recognise the need to develop our knowledge and skills by attending courses, seminars and conferences. In addition, we both access regular non-managerial supervision which enables us to maintain a spotlight on our own personal needs and strengths in the wider working context as a means to self-care. This article is the first in a series of four in which we hope to introduce, develop and validate your understanding and insight into supervision practices. Our articles are underpinned by relevant theory and guidelines, personal stories and reflections, as well as reference to two focus groups we have run specifically for this series. Each one ends with a practical activity for you to take away in order to invite enquiry and comment. Early in both our careers we were exposed to a high standard of ‘managerial’ and ‘non-managerial’ supervision on a regular basis and have recognised the need to continue this as our professional journeys have progressed. In turn, our experience in the role of supervisees has affected our role as supervisors by allowing us to develop flexible approaches and styles – we offer independent nonmanagerial supervision to speech and language therapists and other healthcare professionals. From consultation with a variety of speech and language therapists we know that others have not been as fortunate in their supervision experience, in particular in the area of non-managerial supervision. This could be for a variety of reasons including the culture of the organisation, absence of suitable specialists, not seeing supervision as a priority and external pressures and targets limiting time. Sadly guidance and practice appear to be very different and supervision provision is reported to be inequitable across organisations and trusts. Furthermore, a recurring question for people we consulted was:‘How do I know what‘good’supervision is and where do I go to experience it?’ Fully negotiated relationship The term ‘supervision’ is difficult to define. Hawkins & Shohet (1989, p.5) suggest ‘supervision can be a very important part of taking care of oneself and avoiding feelings of staleness, rigidity and defensiveness which can easily occur

Cathy (L) and Sam (R)

in professions where you have to give so much of yourself’. Syder & Levy (1998, p.268) say Inskipp & Proctor (1993) ‘…stress that both the supervisor and supervisee play an equal, if different role, in arriving at the agreement. As the relationship needs to be flexible to meet a variety of needs, each contract is likely to be unique to the particular dyad or group involved’. In truth it can take many forms, but an underlying principle is that it is a fully negotiated relationship. The Royal College of Speech & Language Therapists supports the notion of ‘good professional supervision’ in CQ3 (2006, pp.103-106). It differentiates between: 1. Line management supervision which includes topics related to person specification, job description, caseload management, individual performance reviews, meeting objectives, adherence to such professional standards, continuous professional development. 2. Clinical (non-managerial) supervision which includes reflections on interventions, the feelings that are engendered, issues arising out of the dynamics of the therapeutic relationship, enabling the supervisee to talk about areas of their work that are thought to be ineffective. In our experience, supervision is not a static, defined set of skills and roles. It is a fluid relationship encompassing a wide range of skills and techniques. In conversations with speech and language therapists and others there is often confusion as to the use of terminology around this topic. Some of the other associated terms include: • Support – access to a range of people in an informal / formal way, for example the management structure, colleagues within / outside the service, Royal College of Speech & Language Therapists Special Interest Groups, managers and Association of Speech & Language Therapists in Independent Practice groups • Mentoring - access to someone for information and advice who is more experienced than the mentee in their given area • Coaching - access to someone who is not more experienced in the area the coachee works in. The relationship between the coach and coachee is equal and it is defined by goals identified and worked towards. • Action Learning – access to a group in which work-based problem-solving occurs which offers scope for personal learning and development

Box 1 Your supervision journey Consider your career and the supervision you have received (as a student, junior clinician, senior clinician, specialist, manager) as well as any other life experiences of supervision you may have had. Take 20 minutes to represent your supervision journey visually (drawing / mind mapping / writing) considering the three dimensions of: • Time • Turning points / significant events • Feelings. Either on your own, or with a colleague with whom you feel comfortable to share your journey, reflect on your experiences using the questions below: • What are your first impressions as your track your experiences of supervision? • How do you judge the quality of the supervision you have received? • What relationship does the quality of the supervision you received have with your feelings about work and your career development? • How have your supervision needs changed over time? • What influencing factors have shaped your preferred style of supervision? We believe the reason why supervision is so difficult to define is that it incorporates a unique combination of these styles and approaches. What is important, however, is that roles are transparent and determined by the supervisee. Space for reflection As careers progress, we need to understand our own learning path in relation to Continuous Professional Development (CPD). The Health Professions Council defines CPD as ‘a range of learning activities through which health professionals maintain and develop throughout their career to ensure that they retain their capacity to practise safely, effectively and legally within their evolving scope of practice’ (2002, p.1). The range of activities this encompasses is vast. However, we strongly believe that supervision provides a pivotal opportunity to address many aspects of our learning. It creates a space for reflection on not only what we are doing, but how and why we are doing it and who we are in the process. Access to regular supervision is also embedded within the ‘work based learning’ section of the NHS Knowledge & Skills Framework (2004). We look forward to hearing any comments you have in relation to this article and the practical activity in box 1 (www.speechmag.com/Members/). Next issue we will be discussing different models and styles of supervision as well as exploring people’s personal beliefs about supervision and the influence these have in supporting or hindering access to it. Sam Simpson and Cathy Sparkes are specialist speech and language therapists and Cathy is also a trained counsellor. Together they are www.intandem.co.uk.
References Hawkins, P. & Shohet, R. (1989/1993) Supervision in the Helping Professions. Milton Keynes: OUP. Syder, D. & Levy, C. (1998) ‘Supervision’, in Syder, D. (ed.) Wanting to Talk: Counselling Case Studies in Communication Disorders. London: Whurr, pp. 256-288. HPC (2006) Your guide to our standards for continuing professional development. London: Health Professions Council. NHS KSF (2004) The NHS Knowledge & Skills Framework and the Development Review Process Appendix 1: Overview of the NHS KSF. Oct. Available at: http://www.dh.gov.uk/en/ Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4090843 (Accessed: 1 February 2008). RCSLT (2006) Communicating Quality 3. London: Royal College of Speech & Language Therapists.