The importance of supervision

Supervision can be provided in a variety of formats and styles and can include not only professional and clinical supervision, but also managerial supervision. As a clinician progresses through their career there is often a move away from clinical supervision into more managerial supervision. The emphasis here may be on setting priorities and objectives in line with the organisation’s needs, as well as identifying training and CPD needs. This type of supervision is often completed with a professional from a different background. Within this context clinical supervision may take a backseat. For clarification, by ‘clinical supervision’ I mean a clinician meeting regularly with another professional from the same discipline, normally with training in the skills of supervision, to discuss casework and other professional issues in a structured way. The purpose being to help you learn from experience and progress in expertise/knowledge.  The other aim would be to ensure a good service to the client or patient.  Some professions refer to this as ‘professional supervision’ or ‘practice supervision’.

As a clinician leading a service, I feel that the more senior you become the more important it is to ensure regular and appropriate clinical supervision. From a personal perspective I can recall attending clinical supervision both as a trainee and newly qualified therapist wanting to know ‘what to do’. Over time this has changed to supervision being more of a space to discuss complex clinical issues without necessarily coming away with ‘the answer’. Over the years I have come to realise that there isn’t necessarily a right or wrong thing to do or say, and have found this uncertainty easier to manage. In addition supervision has provided me with a space to discuss recruitment and supervision of more junior staff.  I have often felt that I lack skills in this area and that other colleagues have some knowledge that I am missing. Perhaps as if I missed the vital lectures in this area.  Supervision has helped me realise that in fact there was no lecture!

As a more senior member of staff you are also often supervising others on their clinical work and may not have a safe space to reflect upon your own skills and abilities in this area. Clinical supervision can provide a confidential space where you don’t need to ‘know all the answers’. Within this context a forum is provided to discuss issues for patients on your own caseload and those being seen by other members of your team. Clinical supervision can also provide a place where you can reflect on your style of supervision and how to develop this further. With increasing demands upon our time and the use of resources continually being questioned, your own clinical supervision may not always seem like a high priority. This may be compacted by the fact that supervision may need to take place away from your place of work, with a peer or colleague.  It is all too easy to cancel arrangements due to competing demands upon our time.  In my own experience this is counterproductive. I continue to ensure that I diarise regular clinical supervision and do not let it become squeezed out for competing demands.  Regular and appropriate clinical supervision is paramount in maintaining not only good patient care in line with current evidence based practice, but also good care of ourselves. Following my own supervision I leave feeling re-energised and with new goals to try and achieve.

Dr Heather Liddiard
Consultant Clinical Psychologist
Blackheath Brain Injury Services