The other supervisions – By Nick Berbiers

[Note: We in social work / social care remain unresolved as to what we call people who receive services. Terms such as clients, service users, and cases all arise. I do not like referring to people as ‘cases’, but discovered to my frustration when writing this that unless I used terms such as ‘case’ ‘caseload’ and ‘caseholder’, I could not construct grammatical, readable sentences. I apologise for that in advance.]

Formal individual supervision is of course the keystone of social work supervisory systems. It is fundamental, and will undoubtedly receive much analysis and comment within the next SWSC Twitter live social work debate. Lest it receive a preponderance of the spotlight, I would like to take the opportunity to give an honourable mention to its somewhat less celebrated though equally important siblings: the other supervisions. In case they are unfamiliar, I will briefly summarise them.

Co-supervision is a model which is familiar in academia and psychotherapeutic work, but is less common in social work/care settings. There are a number of variations, but the standard social work model is where two individuals of the same level or role (two senior practitioners for example) co-supervise each other. This does not replace formal individual supervision, but rather it is designed to compliment it.

As Professor Munro, the SWRB, and many others have said, supervision should be reflective. Co-supervision could be described as an even more focussed version of reflective supervision. Whereas individual supervision considers a practitioners’ caseload or her/his work with a group of service users, and includes the various other components which good individual supervision requires (see, for example, the SWRB Supervision Framework), co-supervision would normally focus on only one case, or a family, where the assessed needs and outcome aims are highly complex. One of the co-supervisees is the caseholder, whilst the other has no direct involvement. The co-supervision session creates the space for the two practitioners to reflect upon the case in great detail, to analyse and consider practice methodology and theoretical and evidence-based underpinnings, and to test-out and think-through potential future aims and actions.

Unlike formal individual supervision, in co-supervision sessions there is no decision-making or supervisory hierarchy in operation. The two practitioners utilise their combined skill, knowledge and experience to reflect upon the complex case in detail, one from the perspective of direct involvement, the other from ‘outside’ the case, but it is then for the caseholder to take those thoughts on future actions and improvements to practice into individual formal supervision.

In the past I have seen some extremely problematic, somewhat stuck interventions ‘unlocked’ (for want of a better term) through the effective use of co-supervision. I particularly recall one extraordinarily difficult situation involving Munchausen by proxy syndrome, where co-supervision created a major breakthrough in thinking as to how best to protect the children and address the mother’s mental health needs, which then resulted in a successful intervention.

I see no reason in principle why co-supervision could not involve co-supervisees from different agencies – a social worker and a health visitor for example – which would surely enhance partnership working and assist in improving outcomes in complex cases. Such sessions would of course have to strictly adhere to confidentiality and information-sharing guidance and protocol. My view would be that if cross-agency co-supervision were to be utilised then the co-supervision concept should be discussed with clients/service users and their consent to information sharing sought – though I of course recognise that may not always be possible or appropriate. It is beyond my scope here to proffer an opinion on the technicalities of whether co-supervision should take place where consent has not been obtained.

Group supervision is essentially a learning tool which can be undertaken by a team or a group of inter-agency colleagues. Again there are various possible permutations, but the one I am most familiar with is where the team or group meet to consider and discuss a real but anonymised case study. The norm would be to consider an older, closed case where there is little prospect of client identification – indeed the presenter should be at pains to ensure that anonymising fully protects client confidentiality.

Again, this is an entirely non-hierarchal process. The presenter may be a student or a director of the service: it matters not. S/he presents the case study and answers questions arising. The purpose is to openly, objectively, and non-judgementally consider and reflect upon the efficacy and outcomes of the intervention and the services provided; the theoretical and evidence-based underpinnings; what other practice methodologies could or should have been utilised; and to identify what was and was not successful. And learn from that.

I am, I admit, a great believer in and advocate of group supervision, as various local authorities will groaningly testify – I tend to introduce it wherever I go!  In my experience it is an extremely effective learning tool, the sessions are unfailingly dynamic and constructively challenging, and, to say it straightforwardly, they really make people think.

Group supervision would be in my top five methods to improve practice and outcomes.

Live supervision seems to be the supervision that time forgot. Anyone who has a dusty book on social work supervision from the 1980’s will undoubtedly find it in the index.

The concept is straightforward. The supervisory relationship from formal individual supervision is transposed episodically to the ‘live’ work setting. So, for example, if the supervisee is on duty, the supervisor sits alongside for an hour observing and, in a balanced so as to not be obtrusive manner, reflecting with the supervisee on such aspects of practice as communications skills, recording skills, intervention methodologies and options (the possibilities are wide). Equally, the supervisor might, with the service user’s permission, sit in on a visit, to allow for subsequent reflection with the supervisee on such similar practice facets.

Clearly, there is a built-in limit as to how often live supervision can or should occur, not least as supervisors will frequently have many supervisees and much additional work of their own to undertake. None the less, I see it as a very useful form of supervision used sparingly and appropriately which can greatly enhance and add depth to the supervisory relationship.

Whilst I have referred to these three supervision formats primarily in relation to practitioners, live supervision is equally applicable to managers. When in senior management roles, I utilise live supervision as one supervision component with the managers I manage. In my experience it is a very useful tool in management, in that it gives a far greater, truer insight into managerial performance than simply sitting in a room discussing management issues, and, no different to practitioners, it enhances the supervisory relationship. I personally see no distinction between practice and management in regard to the need for reflective supervision. The subjects and specifics may at times be different, but the necessity to reflect and continuously improve is the same.

Nick Berbiers (@NickBerbiers) is a Social Care Interim Manager and Consultant at Neist Point Limited.

Also read Nick Berbiers’ article in Community Care: Which debate tells us more about social work today; NCAS of Twitter?

Join our debate @SWSCmedia on “Supervision, its’ concept, content and context” on 15 November, at 8:00 to 9:00 PM (London) 3:00 to 4:00 PM (New York).

 

 

 

 

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