Egalitarian consultation meetings: an alternative to received wisdom about clinical supervision in psychiatric nursing practice

Abstract

Clinical supervision (CS) has become a watchword for psychiatric nursing. Yet, there are contradictions and controversies in academic and professional discourse in relation to the nature of CS, both structure and process, its effectiveness and how this is ascertained, the preparation of supervisor and supervisee, and the quality of the supervisory relationship. The perception of such discord encouraged the authors of this paper to step outside the debate and enact a different kind of CS, which came to be known as egalitarian consultation (EC). Egalitarian consultation meetings (ECMs) were established with the postmodern turn in psychiatric nursing as a reference point. A space was created in which participants could construct their particular version of CS. The authors and six G-grade community psychiatric nurses engaged with each other for six videotaped meetings. The data from the recordings were analysed using a hermeneutic grounded theory approach (Strauss & Corbin 1994), in keeping with the style of the research, which combined the roles of researcher and practitioner for the authors. The aim was to produce local knowledge of CS. The ECMs were characterized by a sense of freedom in relation to existing rules about hierarchy and truth. The participants, each as expert in her/his own case world, produced engrossing narratives about and for practice. The group developed a cohesiveness based in closeness and this encouraged radical talk and action--a questioning of practice systems. However, for some group members, radical equated to dangerous in terms of the watchful organization and a return to 'real' work (case supervision) was observed. Innovation in relation to CS may benefit from a change in institutional culture.

Introducing clinical supervision across Western Australian public mental health services

“…The progression of clinical supervision in WA may benefit from a change in institutional culture (Stevenson & Jackson 2000) and this is something that occurs over time. Further energy is required for clinical supervision to continue as a key strategy in supporting the mental health nursing workforce, in maintaining their own mental wellbeing through the provision of professional and emotional support, and attracting people into the mental health workforce.…”

Clinical supervision revisited

“…Stevenson and Jackson (2000) have pushed the boundaries in relation to existing meanings of CS and arrived at a meaning of CS as egalitarian consultation. They established a different kind of CS group founded on the idea that current meanings of CS are problematic.…”

Postmodernising Clinical Supervision in Nursing

“…ECMs were an approach to CS that grew out of the desire of Stevenson and Jackson (2000) to take the "super" out of supervision (Williams, 1992). As researchers and practitioners, they favoured a postmodern stance that provided the underpinning philosophy for the ECMs (adapted from Stevenson & Jackson, 2000).…”

“…As researchers and practitioners, they favoured a postmodern stance that provided the underpinning philosophy for the ECMs (adapted from Stevenson & Jackson, 2000).…”

“…More importantly, the multiple versions can be processed by the expert practitioner in relation to what he or she understands might be a story of interest for the person experiencing mental health difficulties. Stevenson and Jackson (2000) were interested in how real group supervision based in the above philosophy might be constructed by participants. Accordingly, CS and BJ engaged a group of G grade Community Psychiatric Nurses (CPNs) for a series of six ECMs within which they divested themselves of the role of "expert" 1 by inducting the attendees into the postmodern approach.…”