Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-05T22:27:21.991Z Has data issue: false hasContentIssue false
  • English
  • Français

Clinical Supervision in Four Mental Health Professions: A Review of the Evidence

Published online by Cambridge University Press:  22 February 2012

Susan H. Spence ,
Jill Wilson ,
David Kavanagh ,
Jenny Strong  and
Linda Worrall
Susan H. Spence*
Affiliation:
University of Queensland
Jill Wilson
Affiliation:
University of Queensland
David Kavanagh
Affiliation:
University of Queensland
Jenny Strong
Affiliation:
University of Queensland
Linda Worrall
Affiliation:
University of Queensland
*
*Address for correspondence: Susan H. Spence, School of Psychology, University of Queensland, Brisbane, QLD 4075, Australia.
Get access

Abstract

This paper examines a range of theoretical issues and the empirical evidence relating to clinical supervision in four mental health professions, namely clinical psychology, occupational therapy, social work, and speech pathology. Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in this area. It is not clear whether supervision actually produces a change in clinician behaviour, nor whether it produces benefits in terms of client outcomes. To date, there is insufficient evidence to demonstrate which styles of supervision are most beneficial for particular types of staff, in terms of their level of experience or learning style. The data suggest that directive forms of supervision, rather than unstructured approaches, are preferred by relatively inexperienced practitioners, and that experienced clinicians also value direct supervision methods when learning new skills or dealing with complex or crisis situations. The available evidence suggests that supervisors typically receive little training in supervision methods. However, to date, we have little information to guide us as to the most effective ways of training supervisors. While acknowledging the urgent need for research, the paper concludes that supervision is likely to form a valuable component of professional development for mental health professionals.

Type
Research Article
Information
Behaviour Change , Volume 18 , Issue 3 , 01 September 2001 , pp. 135 - 155
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, J. (1988). The supervisory process in speech-language pathology and audiology. Boston: College Hill.Google Scholar
Baker, S.B., Daniels, T.G., & Greeley, A.T. (1990). Systematic training of graduate-level counselors: Narrative and meta-analytic reviews of three major programs. Counseling Psychologist, 18, 355–421.CrossRefGoogle Scholar
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist, 37, 122–147.Google Scholar
Baranchok, J.S., & Kunkel, M.A. (1990). Clinical supervision training in counseling psychology. The Counseling Psychologist, 8, 685–687.Google Scholar
Barrow, M., & Domingo, R.A. (1997). The effectiveness of training clinical supervisors in conducting the supervisory conference. Clinical Supervisor, 16, 55–78.Google Scholar
Beck, A.T. (1986). Cognitive therapy: A sign of retrogression or progress. Behavior Therapist, 9, 2–3.Google Scholar
Benshoff, J.M. (1993). Peer supervision in counselor training. The Clinical Supervisor, 11, 89–102.CrossRefGoogle Scholar
Bernard, J.M., & Goodyear, R.K. (1998). Fundamentals of clinical supervision (2nd ed.). Boston, MA, USA: Allyn & Bacon.Google Scholar
Borders, L.D. (1989). Developmental cognitions of first practicum supervisees. Journal of Counseling Psychology, 36, 163–169.Google Scholar
Borders, L.D. (1991). Supervisors’ in-session behaviors and cognitions. Counselor Education and Supervision, 31, 32–47.Google Scholar
Bordin, E.S. (1983). Supervision in counseling: II. Contemporary models of supervision: A working alliance based model of supervision. Counseling Psychologist, 11, 35–42.CrossRefGoogle Scholar
Bradley, L.J. (1989). Couselor supervision: Principles, process, and practice (2nd ed.). Muncie, IN: Accelerated Development.Google Scholar
Brewer, D.P. (1995). The effects of supervisory support, counselor characteristics, the work setting, and social influences on burnout in mental health counselors. Disertations Abstracts International Section B: The Sciences and Engineering, 55(9B), 4100.Google Scholar
Burgoyne, R.W., Santini, S., Kline, F., & Staples, F.R. (1976). Who gets supervised? An extension of patient selection inequity. American Journal of Psychiatry, 133, 1313–1315.Google Scholar
Burns, C.I., & Holloway, E.L. (1989). Therapy in supervision: An unresolved issue. Clinical Supervisor, 7, 47–60.Google Scholar
Central Queensland Therapist Task-Force. (1991). Work conditions and professional development in a rural area: The central Queensland therapist task-force submission. Rockhampton, QLD: Author.Google Scholar
Cherniss, C., & Egnatios, E. (1977). Styles of clinical supervision in community mental health programs. Journal of Consulting and Clinical Psychology, 45, 1195–1196.Google Scholar
Cherniss, C., & Egnatios, E. (1978). Clinical supervision in community mental health. Social Work, 219–223.Google Scholar
Christie, B.A., Joyce, P.C., & Moeller, P.L. (1985). Fieldwork experience: I. Impact on practice preference. American Journal of Occupational Therapy, 39, 671–674.Google Scholar
Cohen, B.-Z., & Laufer, H. (1999). The influence of supervision on social workers’ perceptions of their professional competence. The Clinical Supervisor, 18, 39–49.Google Scholar
Copeland, W.D. (1982). Student teachers’ preferences for supervisory approach. Journal of Teacher Education, 33, 5–9.Google Scholar
Crutchfield, L.B., & Borders, D. (1997). Impact of two clinical peer supervision models on practicing school counselors. Journal of Counseling and Development, 75, 219–230.Google Scholar
Daniels, T.G., Rigazio DiGilio, S.A., & Ivey, A.E. (1997). Microcounseling: A training and supervision paradigm for the helping professions. In C.E., Watkins, Jr. (Ed.), Handbook of psychotherapy supervision (pp. 277–295). New York: Wiley.Google Scholar
Davis, D.A., Thomson, M.A., Oxman, A.D., & Haynes, R.B. (1995). Changing physician performance: A systematic review of the effect of continuing medical education strategies. Journal of the American Medical Association, 274, 700–705.Google Scholar
Dodenhoff, J.T. (1981). Interpersonal attraction and direct supervisor influence as predictors of counselor trainee effectiveness. Journal of Counseling Psychology, 28, 47–52.Google Scholar
Ellis, M.V., & Ladany, N. (1997). Inferences concerning supervisees and clients in clinical supervision: An integrative review. In C.E., Watkins, Jr. (Ed.), Handbook of psychotherapy supervision (pp. 447–507). New York: Wiley.Google Scholar
Ellis, M.V., Ladany, N., Krengel, M., & Schult, D. (1996). Clinical supervision research from 1981 to 1993: A methodological critique. Journal of Counseling Psychology, 43, 35–50.Google Scholar
Evans, W.N., & Hohenshil, T.H. (1997). Job satisfaction of substance abuse counselors. Alcoholism Treatment Quarterly, 15, 1–13.CrossRefGoogle Scholar
Farrington, A. (1995). Models of clinical supervision. British Journal of Nursing, 4, 876–8.CrossRefGoogle ScholarPubMed
Fenell, D.L., Hovestadt, A.J., & Harvey, S.J. (1986). A comparison of delayed feedback and live supervision models of marriage and family therapist clinical training. Journal of Marital and Family Therapy, 12, 181–186.Google Scholar
Friedlander, M.L., & Ward, L.G. (1984). Development and validation of the Supervisory Styles Inventory. Journal of Counseling Psychology, 31, 541–557.Google Scholar
Garrett, K.J., & Barretta-Herman, A. (1995). Moving from supervision to professional development. The Clinical Supervisor, 13, 97–110.Google Scholar
Getz, H.G., & Agnew, D. (1999). A supervision model for public agency clinicians. The Clinical Supervisor, 18, 51–61.Google Scholar
Greenspan, R., Hanfling, S., Parker, E., Primm, S., & Waldfogel, D. (1991). Supervision of experienced agency workers: A descriptive study. The Clinical Supervisor, 9, 31–42.Google Scholar
Harkness, D. (1995). The art of helping in supervised practice: Skills, relationships, and outcomes. Clinical Supervisor, 13, 63–76.CrossRefGoogle Scholar
Hart, G. (1982). The process of clinical supervision. Baltimore: University Park Press.Google Scholar
Henry, W.P., Schacht, T.E., Strupp, H.H., Butler, S.F., & Binder, J.L. (1993). Effects of training in time-limited dynamic psychotherapy: Mediators of therapists’ responses to training. Journal of Consulting and Clinical Psychology, 61, 441–447.Google Scholar
Heppner, P.P., & Roehlke, H.J. (1984). Differences among supervisees at different levels of training: Implications for a developmental model of supervision. Journal of Counseling Psychology, 31, 76–90.Google Scholar
Heron, J. (1990). Helping the client: A creative practical guide. London: Sage.Google Scholar
Hewson, D. (1992). Supervising counsellors. The Australian Counselling Psychologist, 8, 9–22.Google Scholar
Holloway, E.L., & Hosford, R.E. (1983). Supervision in counseling: II. Integration and evaluation: Towards developing a prescriptive technology of counselor supervision. Counseling Psychologist, 11, 73–77.Google Scholar
Holloway, E.L., & Neufeldt, S.A. (1995). Supervision: Its contributions to treatment efficacy. Journal of Consulting and Clinical Psychology, 63, 207–213.Google Scholar
Hooper, D. (1998). The preparation of counsellors in Europe: Possible solutions for an impossible task? British Journal of Guidance and Counselling, 26, 119–125.CrossRefGoogle Scholar
Hummell, J. (1997). Effective fieldwork supervision: Occupational therapy student perspectives. Australian Occupational Therapy Journal, 44, 147–157.Google Scholar
Hummell, J., & Koelmeyer, L. (1999). New graduates: Perceptions of their first occupational therapy position. British Journal of Occupational Therapy, 62, 351–358.Google Scholar
Joshi, S., & McAllister, L. (1998). An investigation of supervisory style in speech pathology clinical education. The Clinical Supervisor, 17, 141–155.Google Scholar
Kadushin, A. (1974). Supervisor–supervisee: A survey. Social Work, 19, 288–297.Google Scholar
Kadushin, A. (1992). Supervision in social work. New York: Columbia University Press.Google Scholar
Kavanagh, D.J., Piatkowska, O., Clark, D., O’Halloran, P., Manicavasagar, V., Rosen, A., & Tennant, C. (1993). Application of cognitive-behavioural family intervention for schizophrenia in multidisciplinary teams: What can the matter be? Australian Psychologist, 28, 181–188.CrossRefGoogle Scholar
Ladany, N., Ellis, M.V., & Friedlander, M.L. (1999). The supervisory working alliance, trainee self-efficacy, and satisfaction. Journal of Counseling and Development, 77, 447–455.CrossRefGoogle Scholar
Lambert, M.J., & Ogles, B.M. (1997). The effectiveness of psychotherapy . In C.E., Watkins, Jr. (Ed.), Handbook of psychotherapy supervision (pp. 421–446). New York: Wiley.Google Scholar
Larson, L.M., & Daniels, J.A. (1998). Review of the counseling self-efficacy literature. Counseling Psychologist, 26, 179–218.Google Scholar
Larson, L.M., Suzuki, L.A., Gillespie, K.N., & Potenza, M.T. (1992). Development and validation of the Counseling Self-Estimate Inventory. Journal of Counseling Psychology, 39, 105–120.Google Scholar
Leddick, G.R., & Bernard, J.M. (1980). The history of supervision: A critical review. Counselor Education and Supervision, 20, 186–196.Google Scholar
McBride, M.C., & Martin, G.E. (1986). Dual-focus supervision: A nonapprenticeship approach. Counselor Education and Supervision, 25, 175–182.Google Scholar
Mercaitis, P.A., & Peaper, R.E. (1987). Factors influencing supervision evaluation by students in speech-language pathology. Clinical Supervisor, 5, 39–52.Google Scholar
Mollon, P. (1997). Supervision as a space for thinking. In G., Shipton (Ed.). Supervision of psychotherapy and counseling: Making a place to think (pp. 24–34). Bristol, PA: The Open University.Google Scholar
Neufeldt, S.A., Karno, M.P., & Nelson, M.L. (1996). A qualitative study of experts’ conceptualization of supervisee reflectivity. Journal of Counseling Psychology, 43, 3–9.Google Scholar
Neufeldt, S.A., & Nelson, M.L. (1999). When is counseling an appropriate and ethical supervision function? Clinical Supervisor, 18, 125–135.CrossRefGoogle Scholar
Newsome, M., & Pillari, V. (1991). Job satisfaction and the worker/supervisor relationship. Clinical Supervisor, 9, 119–129.Google Scholar
Nolinske, T. (1995). Multiple mentoring relationships facilitate learning during fieldwork. The American Journal of Occupational Therapy, 49, 39–43.Google Scholar
O’Connor, F.W., Devine, E.C., Cook, T.D., & Wenk, V.A. (1990). Enhancing surgical nurses’ patient education: Development and evaluation of an intervention. Patient Education and Counseling, 16, 7–20.Google Scholar
O’Donovan, A., Dyck, M., & Bain, J.D. (2001). Trainees’ experience of postgraduate clinical training. Australian Psychologist, 36, 149–157.Google Scholar
O’Saben, C.L. (1995). The impact of cognitive complexity, supervisory experience and supervision: Training on the effectiveness of counseling supervision. Dissertations Abstracts International Section B: The Sciences and Engineering, 56(1B), 532.Google Scholar
Palsson, M.B., Hallberg, I.R., Norberg, A., & Bjoervell, H. (1996). Burnout, empathy and sense of coherence among Swedish district nurses before and after systematic clinical supervision. Scandinavian Journal of Caring Sciences, 10, 19–26.Google Scholar
Perkins, J.M., & Mercaitis, P.A. (1995). A guide for supervisors and students in clinical practicum. Clinical Supervisor, 13, 67–78.Google Scholar
Powell, D. (1996). A peer consultation model for clinical supervision. Clinical Supervisor, 14, 163–169.Google Scholar
Proctor, B. (1994). Supervision: Competence, confidence, accountability. British Journal of Guidance and Counselling, 22, 309–318.Google Scholar
Prosser, D., Johnson, S., Kuipers, E., & Szmukler, G. (1996). Mental health, “burnout” and job satisfaction among hospital and community-based mental health staff. British Journal of Psychiatry, 169, 334–337.Google Scholar
Rabinowitz, F.E., Heppner, P.P., & Roehlke, H.J. (1986). Descriptive study of process and outcome variables of supervision over time. Journal of Counseling Psychology, 33, 292–300.Google Scholar
Reid, Y., Johnson, S., Morant, N., Kuipers, E., Szmukler, G., Bebbington, P., Thornicroft, G., & Prosser, D. (1999). Improving support for mental health staff: A qualitative study. Social Psychiatry and Psychiatric Epidemiology, 34, 309–15.CrossRefGoogle ScholarPubMed
Rich, P. (1993). The form, function, and content of clinical supervision: An integrated model. The Clinical Supervisor, 11, 137–178.Google Scholar
Rita, E.S. (1998). Solution-focused supervision. Clinical Supervisor, 17, 127–139.Google Scholar
Rodenhauser, P. (1995). Experiences and issues in the professional development of psychiatrists for supervising psychotherapy. The Clinical Supervisor, 13, 7–22.CrossRefGoogle Scholar
Ronnestad, M.H. (1977). The effects of modeling, feedback, and experiential methods on counselor empathy. Counselor Education and Supervision, 16, 194–201.Google Scholar
Rosenblatt, A., & Mayer, J.E. (1975). Objectionable supervisory styles: Students’ views. Social Work, 20, 184–189.Google Scholar
Savickas, M.L., Marquart, C.D., & Supinski, C.R. (1986). Effective supervision in groups. Counselor Education and Supervision, 26, 17–25.Google Scholar
Schiavone, C.D., & Jessell, J.C. (1988). Influence of attributed expertness and gender in counselor supervision. Counselor Education and Supervision, 28, 29–42.Google Scholar
Schroffel, A.E. (1999). To what extent does the availability, quality, and style of supervision correlate with the degree of clinician job satisfaction? Disertations Abstracts International Section A: Humanities and Social Sciences, 59(8A), 3212.Google Scholar
Shanfield, S.B., & Gil, D. (1985). Styles of psychotherapy supervision. Journal of Psychiatric Education, 9, 225–232.Google Scholar
Shanfield, S.B., Mohl, P.C., Matthews, K.L., & Hetherly, V. (1992). Quantitative assessment of the behavior of psychotherapy supervisors. American Journal of Psychiatry, 149, 352–357.Google Scholar
Siddle, S., & Wilson, J. (1984). Mapping murky waters: Describing content and techniques in student supervision. Australian Social Work, 37, 6–12.Google Scholar
Singo, W.E. (1998). The effects of peer group supervision and individual supervision on the anxiety, selfefficacy, and basic skill competency of counselor trainees in practicum. Disertations Abstracts International Section A: Humanities and Social Sciences, 59(3A), 738.Google Scholar
Sorlie, T., Gammon, D., Bergvik, S., & Sexton, H. (1999). Psychotherapy supervision face-to-face and by videoconferencing: A comparative study. British Journal of Psychotherapy, 15, 452–462.Google Scholar
Spence, S.H., Nurcombe, B., Yellowlees, P.M., Sturk, H., & Eakin, M.J. (1998). Professional development strategy for child and youth mental health services: Report 2. Competency standards. Brisbane: University of Queensland and Queensland Health.Google Scholar
Spence, S.H., Yellowlees, P.M., Nurcombe, B., Sturk, H., & Eakin, M.J. (1998). Professional development strategy for adult mental health services: Report 2. Competency standards. Brisbane: University of Queensland and Queensland Health.Google Scholar
Stanard, R.P. (1999). The effect of training in a strengths model of case management on client outcomes in a community mental health center. Community Mental Health Journal, 35, 169–179.Google Scholar
Steinhelber, J., Patterson, V., Cliffe, K., & LeGoullon, M. (1984). An investigation of some relationships between psychotherapy supervision and patient change. Journal of Clinical Psychology, 40, 1346–1353.Google Scholar
Stoltenberg, C.D., McNeill, B.W., & Crethar, H.C. (1994). Changes in supervision as counselors and therapists gain experience: A review. Professional Psychology: Research and Practice, 25, 416–449.Google Scholar
Stritter, F.T., Hain, J.D., & Grimes, D.A. (1975). Clinical teaching reexamined. Journal of Medical Education, 50, 876–882.Google Scholar
Sumerel, M.B., & Borders, L.D. (1996). Addressing personal issues in supervision: Impact of counselors’ experience level on various aspects of the supervisory relationship. Counselor Education and Supervision, 35, 268–286. Google Scholar
Swanson, J.L., & O’Saben, C.L. (1993). Differences in supervisory needs and expectations by trainee experience, cognitive style, and program membership. Journal of Counseling and Development, 71, 457–464. Google Scholar
Talen, M.R., & Schindler, N. (1993). Goal-directed supervision plans: A model for trainee supervision and evaluation. The Clinical Supervisor, 11, 77–88.Google Scholar
Tracey, T.J., Ellickson, J.L., & Sherry, P. (1989). Reactance in relation to different supervisory environments and counselor development. Journal of Counseling Psychology, 36, 336–344.Google Scholar
Tryon, G.S. (1999). Counseling dropout relative to client attractiveness, disturbance, and expected number of sessions. Counselling Psychology Quarterly, 12, 285–291.Google Scholar
Watkins, C.E., Jr. (Ed.). (1997). Handbook of psychotherapy supervision. New York: Wiley.Google Scholar
Wise, P.S., & Lowery, S. (1989). Applying family supervision models to counselors and supervisors of groups. Journal for Specialists in Group Work, 14, 53–60.Google Scholar
Worthington, E.L., & Roehlke, H.J. (1979). Effective supervision as perceived by beginning counselorsin- training. Journal of Counseling Psychology, 26, 64 – 73.Google Scholar
Worthington, E.L., & Stern, A. (1985). Effects of supervisor and supervisee degree level and gender on the supervisory relationship. Journal of Counseling Psychology, 32, 252–262.Google Scholar
Wykes, T., Stevens, W., & Everitt, B. (1997). Stress in community care teams: Will it affect the sustainability of community care? Social Psychiatry and Psychiatric Epidemiology, 32, 398–407.Google Scholar