This case study is taken from an article published in Therapy Today in 2009 by Judith Sullivan, which refers to the setup of an innovative clinical supervision programme for Leicestershire and Rutland Probation Trust, which is now part of the National Probation Service.
By Dr Judith Sullivan
For the past five years Leicestershire and Rutland Probation Service has commissioned an innovative clinical supervision service to provide personal and professional support for a team of individuals who work in ‘high-risk’ jobs.
This initiative began modestly with members of the victim contact team attending and has expanded to include a mixture of probation officers, psychologists and other employed professionals who work with high-risk offenders throughout the service, including those within a prison setting. I manage the small team of supervisors who deliver the service – all are qualified humanistic psychotherapists and supervisors.
The background to this project stems from my period of employment as a senior counsellor with my local police force, where I maintained useful links with partner agencies, including the local probation service.
As part of my role I reorganised the service provision to include clinical supervision for such teams as firearms, family liaison, victim liaison, rape-trained officers, members of the press office, and traffic investigators.
Scheduled, routine clinical supervision appointments were offered to high-risk teams in accordance with Home Office guidelines for the police.
This supervision programme was intended to act as an early intervention and provide psychological health maintenance for officers who faced disturbing material or situations on a daily basis, for example those involved with sex/dangerous offenders and paedophiles. As with any employing organisation, the constabulary needed to fulfil its duty of care to all its members of staff by complying with current Health and Safety legislation.
The programme was viewed as a model of good practice and, as a result, management of Leicestershire and Rutland Probation Service learned of it when it was looking to commission a clinical supervision pilot scheme for its victim contact team.
After a year, having evaluated the transferability and efficacy of the intervention, it was rolled out throughout the service. Since that time the service provision has expanded, with interest also being shown by other probation services within the Midlands.
Recently, Nottinghamshire Probation Service has started to offer clinical supervision for its public protection team.
The use of the term ‘clinical supervision’ within this framework perhaps requires scrutiny. It is possibly not the clearest definition for the intervention, but at the onset it was the one preferred by probation management. It was also important to make the distinction between this kind of planned, consistent support, and counselling, which was available to members of staff through their employee assistance programme (EAP).
One useful alternative phrase is ‘consultative support’ which may be more appropriate for this purpose. Dave Mearns describes supervision in the following way:
"Supervision within counselling is based on a “developmental” rather than a “deficiency” model of the person. In other words, counselling supervision is not about “policing”, where the emphasis is solely on “checking up” on you. Instead, the aim is to develop a relationship in which your supervisor is regarded as a trusted colleague who can help you to reflect on all dimensions of your practice and, through that process, to develop your counselling role"
Although this description refers specifically to counselling supervision it is equally applicable to cross-discipline supervision support and, arguably, for anyone who would describe themselves as a practitioner.
The specific model utilised within Leicestershire and Rutland Probation Service is based on Michael Carroll’s Seven Tasks of Supervision, which are:
- to monitor administrative aspects;
- to set up a learning relationship;
- to teach;
- to evaluate;
- to monitor professional ethical issues;
- to counsel;
- to consult.
Using this model allows sessions to be flexible and fluid, depending upon the issues raised by the attendee, and is completely different in intent and process from line management supervision.
According to Carroll, this kind of consultative supervision is ‘characterized by mutuality, less formal evaluation, and more of an ad hoc nature’, and it provides confidential space for individuals to process.
Or, as Wyn Bramley states: ‘Supervision is not a question and answer session, but two people learning to think together.
There is no element of instruction or advice giving and appointments generally tend to incorporate elements of other clinical processes, such as coaching and mentoring. As there is usually around a four-week gap between sessions, adopting this flexibility in approach allows space for some therapeutic alliance and also containment of the process within the organisational framework.
With regard to the substance of the sessions, they are undertaken from a proactive and personcentred stance and often look both at ways of improving consistent mental and emotional health and validating existing healthy coping strategies. Space is set aside for reflective practice in a holistic way, particularly in reviewing interventions made with offenders.
I have found that those attending sessions have demonstrated an open attitude and have been prepared to engage in the process, offering an appropriate amount of self-disclosure as part of their review of practice. Space is often set aside to look at a variety of issues, which may include:
• Relationship concerns (personal and in the workplace)
• Challenges of establishing and maintaining boundaried relationships with serious and high-risk offenders
• The impact of the emotional content of their role and ways to deal with this
• Monitoring and improving fitness to practice
• Communication skills
• Managing conflict
• Professional and personal development
• Healthy coping mechanisms
• Team and organisational aspects of the work.
In terms of the less positive aspects which arise in sessions, once a trusting relationship is formed, most attendees are prepared to explore their concerns openly. Some of the main stressors are to do with time management, staff absences and shortages, plus busy workloads, and these are discussed within the context of maintaining a healthy work-life balance.
In connection with the emotional content of their work, attendees have demonstrated their understanding of the extent to which their effectiveness may be compromised (to the potential detriment of not only themselves, but of their client groups and colleagues) when they are experiencing personal emotional stress.
It has proved invaluable for me, if not life saving. About two years ago I was desperately struggling to find a balance between managing a sizeable caseload of very high-risk sexual and violent offenders, satisfying what seemed like a never ending list of targets, processes and new initiatives, together with caring for and taking an active role in my young family.
Attending clinical supervision assisted me to look at the volume, nature and responsibilities attached to work in a way that wasn’t framed by the employer, but by someone with my welfare at the forefront of their mind and who wasn’t bound to “toeing the party line” in terms of pressure placed on me by the organisation’s expectations and requirements.
I found that it assisted me in putting together an action plan to achieve a better work-life balance; not only that but with ongoing checks to make sure that I was doing all the things I said I would do in order to make the plan work, such as taking lunch breaks (an alien concept to me at the time), visiting the gym in order to de-stress, and sticking to work exit times that I’d plan in advance.
With the best will in the world, in-house supervision does not, and given the increasingly pressured environment in which we work, cannot deal with the issues that I bring to my clinical supervision sessions.
For instance, there are some personal issues touched upon that I wouldn’t feel comfortable sharing with a manager. And appropriately, of course, line management supervision is about the business of supervising offenders, managing risk and discussing performance and development; there is not enough room in that agenda to look adequately at personal pressures and related issues.
I also feel compelled to say that during a period of time when work related pressures were at their most prominent and my health was clearly beginning to suffer, that clinical supervision helped me to negotiate my way through that period and quite possibly saved me from an episode of stress-related sick leave.
I found, and still continue to find, the sessions therapeutic and come away from them feeling very positive
The clinical supervision service is evaluated annually by means of anonymous questionnaires. To date the feedback has been extremely encouraging and management of Leicestershire and Rutland Probation Service has made positive links between this service provision and sickness absence management.
The kind of space for reflective practice and exploration of personal and professional issues which can impact work performance is no longer located just within the domain of counselling, psychology and medicine. For an employing organisation, to recognise the emotional and negative psychological impact of the working life of a police officer, social worker, mental health nurse and probation employee is vital.
To decide to practically support its staff and fund a structured clinical supervision process, as Leicestershire and Rutland Probation Service has done, is one tangible way to demonstrate its commitment to attempt to limit any negative impact upon its staff.
For more information about the programme and how it can be implemented into your organisation please contact us.