Supervision in Occupational Therapy

1
Supervision in Occupational Therapy

• Tanya Pugh
• Occupational Therapist
• Supervisor and Supervisee

2

• Sweeny et al 2001 p 427 explain there is
  confusion in occupational therapy concerning
  clinical supervision that is based from -
• ..the lack of training in supervision, a lack
  of exposure to theoretical models of supervision,
  an absence of adequate role models and a lack of
  awareness of effective supervisory strategies

3
Why ask the question?

• Is there a difference between supervision
  styles in different professions?
• Are we confused about the type of supervision
  we practice?
• What is the COT position concerning supervision?
• What is clinical supervision?
• Can Occupational Therapists practice clinical
  supervision
• Proposed a framework to assist therapists in
  choosing a model of supervision

4
Assumptions

• Supervision is valuable vital
• Continuous professional development
• Accountability
• Imbedded in our profession - Ethics and
  Professional Conduct (2005), states all
  therapists will participate in supervision.
• 5.4.4. Occupational Therapy personnel shall be
  supported in their practice and development
  through a regular professional supervision within
  an agreed structure or model Pg 16

5
COT

• as made a number of statements-
• A professional relationship which ensures good
  standards and encourages professional
  development 1990
• Supervision is not the equivalent of performance
  review and responsibility for work carried
  out 1997

6
COT continued

• Defined professional and clinical (day-to-day)
  supervision
• is concerned purely with occupational therapy,
  professional specific matters
• It may incorporate professional development,
  particular skills or knowledge, or quality and
  standards of practice, when these are explicit to
  occupational therapy
• is related to an individuals practice, and be
  dependent upon the role they hold.
• 2006 p1-2

7
COT continued

• Three main functions
• Management
• Education
• Support

8

• Is this tripartite function recommended by the
  COT clinical supervision?

9
What is Clinical supervision?

• Butterworth (1995)
• Clinical supervision is an exchange between
  practising professionals to enable development of
  professional skills.
• Bond Holland (2001 p12)
• Clinical supervision is the regular, protected
  time for facilitation, in-depth reflection on
  clinical practice...The process of clinical
  supervision should be continued throughout the
  persons career, whether they remain in clinical
  practice or move into management, research or
  education.

10
What is Clinical supervision?

• Bullman Schutz (2004 p 85)
• The expectation of clinical supervision is a
  practitioner would develop a different
  perspective on his or her work and identify
  alternative approaches to practice.
• Howaston-Jones (2004 p 38)
• Clinical supervision is a designated reflective
  exchange between two or more professionals in a
  safe and supportive environment which critically
  analyses practice through normative, formative
  and restorative means to promote and enhance the
  quality of care.

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• There is no one clear definition of clinical
  supervision
• There are different perspectives
• There are different functions
• This may explain the present confusion concerning
  range of interconnected types of supervision

12
The features and underpinning philosophy of
clinical supervision

• Each individual has the right to choose their
  supervisor
• Clinical supervision should never be forced upon
  an individual and there should be mutual consent
• All parties hold equal status
• The process should be person centred and not
  organisational or corporate objected
• There should be a set of ground rules mutually
  agreed

13
The features and underpinning philosophy of
clinical supervision

• All parties have a right to express their
  feelings, opinions and anxieties without fear of
  ridicule
• Should be centred around the individual
• Clinical supervision should be confidential with
  the ground rules
• Notes should be available to both parties and
  should remain confidential

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• So can Occupational Therapists Practice Clinical
  Supervision?

15
Biomedical
Biopsychosocial
Social
Paternalistic
Locus of control for the supervisee
Humanistic
Frame of reference
Operational Supervision
Clinical supervision
Professional supervision
Models
Cognitive
Friendship
Developmental
Proctors Three Function
Approaches by the supervisor
Herons
Johns framing
Learning styles
Core skills
Reflection on action and in action
Reflective practice
Learning cycles
Clinical reasoning
Organisational targets
Professional bodies
Direction of education
Individuals aspirations
Government policy
Influences on the final decision on which type of
supervision is used
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Challenges

• The term clinical supervision should not be used
  to describe sessions that have function described
  by COT
• Supervision / clinical supervision mean different
  things to different professions
• The title of clinical supervision should be
  replaced by personal development sessions

17
references

• Bond, M. Holland, S. (2001) Skills of clinical
  supervision for nurses. Open university press.
• Clouder, L. (2000) reflective practice realising
  the potential Physiotherapy Vol 86(10) p 517-521
• College of Occupational Therapists (2003).
  Professional Standards for Occupational Therapy
  Practice. The College of Occupational Therapists
  London
• College of Occupational Therapists (2005). Code
  of Ethics and Professional Conduct. The College
  of Occupational Therapists London
• Commission for Health (2004) National Staff
  Survey HMSO
• Driscoll, J. (2000) Practising clinical
  supervision. A reflective approach. Bailliere
  Tindall
• Driscoll, J. and Teh, B. (2001) The potential of
  reflective practice to develop individual
  orthopaedic nurse practitioners and their
  practice. Journal of orthopaedic nursing Vol 5 p
  93-103
• Holloway, E. (1987) Developmental models of
  supervision is it development? Professional
  psychology research and practice. Vol 1893) p
  209-216
• Hopkins, H and Smith, H (1994) Willard and
  Spackmans Occupational Therapy. Lippincott
  Company London
• Howaston-Jones, I. (2003) Difficulties in
  clinical supervision and long life learning.
  Nursing standard Vol 17913) p 37-41
• Jasper, M. (2003) Beginning reflective practice
  foundations in nursing and health care. Nelson
  Thornes Ltd

18
references

• Johns, C. (2004) 2nd Edition Becoming a
  reflective practitioner. Blackwell Publishing
• Johns, C. Freshwater, D. (2005) Transforming
  nursing through reflective practice. Blackwell
  Publishing
• Ooijen, E. (2003) Clinical supervision made easy.
  Churchill Livingstone
• RCN Institute (2000) Realising clinical
  effectiveness and clinical governance through
  clinical supervision. Radcliffe Medical press
• Roberts, A (2002) Advancing practice through
  continuing professional education the case for
  reflection. . British journal of Occupational
  Therapy Vol 65(5) p237-240
• Smith, G. (2000) Friendship within clinical
  supervision A model for the NHS. on line
  http//www.clinical-supervision.com/Geo20cardiff
  20presentation20notes.htm (accessed on 8th March
  2006)
• Spouse, J. Redfern, L. (2000) Successful
  supervision in Health care practice. Blackwell
  science
• Sweeny, G. Webley, P. Treacher, A. (2001a)
  Supervision in Occupational Therapy, part 1 the
  supervisors anxieties. British journal of
  Occupational Therapy Vol 64(7) p 337-345
• Sweeny, G. Webley, P. Treacher, A. (2001b)
  Supervision in Occupational Therapy, part 2 the
  supervisees dilemma. British journal of
  Occupational Therapy Vol 64(8) p 380-386
• Sweeny, G. Webley, P. Treacher, A. (2001c)
  Supervision in Occupational Therapy, part 3
  Accommodating the supervisor and supervisee.
  British journal of Occupational Therapy Vol 64(9)
  p 426-431
• Unsworth, C. (2004) Clinical reasoning how do
  pragmatic reasoning, worldview and
  client-centredness fit? British journal of
  Occupational Therapy Vol 67(1) p 10-19