The experience of therapy supervision within a UK multi‐centre randomized controlled trial

Abstract

This study was set within the UK inter-professional multi-centre randomized controlled PACE Trial of manual-based therapy (BMC Neurology, 2007, 7: 6). The aim of supervision within 'the trial' was to maintain specificity of manual-based therapy, sustain retention of therapists, manage quality control and assurance of the therapy, monitor competence in delivering therapy and enhance professional development. The rationale for the study was that the approach to supervision within the trial appeared to be different from the previous experience of supervision for many of the therapists, especially occupational therapists and physiotherapists. A self-report questionnaire utilizing survey methodology identified differences in therapists' previous clinical supervision and current supervision experience within the trial. All respondents (n = 14) indicated that they liked and preferred supervision that was agenda structured, one to one and regular (at least once a month), interspersed with group (team supervision), peer support meetings, review of taped therapy sessions by supervisor and ⁄ or peer for feedback and competency rating. In the main this combination of supervision methods had not been previously experienced. This has implications for practice and future therapy research that both therapists and managers will need to consider. In particular the implementation of group supervision and review of audio taped therapy sessions for analysis, review and feedback in practice to enhance learning and client care. RationaleThis survey was set within the UK inter-professional multi-centre randomized controlled PACE Trial of manual-based therapy. The PACE Trial aims to compare the efficacy, for adults with chronic fatigue syndrome, of three manual-based therapies: adaptive pacing therapy (APT), cognitive behaviour therapy (CBT) or graded exercise therapy (GET) when added to specialist medical care against specialist medical care alone (White et al. 2007). The aim of supervision within 'the trial' was to maintain specificity of manual-based therapy, sustain retention of therapists, manage quality control and assurance of the therapy, monitor competence in delivering therapy and enhance professional development.The study rationale was that the types of supervision used within the trial appeared to be different ª

Twelve tips for effective clinical supervision based on a narrative literature review and expert opinion

“…There are mixed views in the literature regarding the preferred type of supervision (Spence et al 2001;Abbott et al 2006;Clough 2003). The preferred type of supervision tends to vary according to the discipline, with some disciplines such as occupational therapy and psychology traditionally preferring the one-to-one method (Cox & Araoz 2009;Palomo et al 2010) and disciplines such as speech-and-language therapy preferring the group method (Horton et al 2008).…”

“…Giving and receiving constructive feedback on a regular basis has been cited as the most powerful but underused strategy in supervision (Hunter & Blair 1999). To be effective, feedback should be clear, regular, balanced with both positive and constructive elements, non-threatening, and specific (Sweeney et al 2001c;Cox & Araoz 2009). In addition to the supervisor giving feedback on the supervisee's performance, the supervisor should request and respond to feedback from the supervisee about the process of supervision, his/her style as a supervisor, and the content and climate of supervision sessions (Sweeney et al 2001c).…”

“…Recommendations made by experts in the field of clinical supervision include scheduling supervision sessions regularly and for a sufficient length of time to be effective (Edwards et al 2005;Cox & Araoz 2009). In a study of social workers (Kilminster & Jolly 2000), the amount of supervision received was significantly correlated with supervisee satisfaction with supervision.…”

“…Deciding on the most suitable type of supervision Three types of clinical supervision delivery often cited in the literature are one-to-one supervision, peer group supervision or a combination of both (Edwards et al 2006;Horton et al 2008;Cox & Araoz 2009). There are mixed views in the literature regarding the preferred type of supervision (Spence et al 2001;Abbott et al 2006;Clough 2003).…”

“…Clinical supervision as defined here may be equated with terms such as ''guided supervision, '' ''professional supervision'' or ''intervision. '' Clinical supervision is an essential component of a clinician's continuing professional development (Kilminster & Jolly 2000;Fone 2006;Herkt & Hocking 2007;Cox & Araoz 2009;Hall & Cox 2009). Clinical supervision differs from related activities, such as mentoring and coaching by incorporating an evaluative component (Milne 2007).…”