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Schubert S, Buus N, Monrouxe L, Hunt C. Interrogation in clinical supervision sessions: Exploring the construction of clinical psychology trainees’ professional identities. Soc Sci Med 2023; 325:115887. [PMID: 37062143 DOI: 10.1016/j.socscimed.2023.115887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/29/2023] [Accepted: 04/01/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Professional socialisation is a complex process through which learners become healthcare professionals. This process occurs in relational spaces: learners are exposed to norms and expectations of them in interactions during formal and informal learning activities. Research exploring socialisation into the healthcare professions is extensive yet inadequately captures details of the actual processes of socialisation and forming of professional identity. Our study offers a moment-by-moment examination of clinical psychology trainee supervision to provide a deeper exploration of novice healthcare professionals' identity development within formal educational interactions. AIMS We sought to explore how, and in what ways, supervision interactions impact clinical psychology trainees' professional identity development. METHOD Our data comprises 12 audio recordings of supervisor-trainee interactions in a clinical psychology training clinic. Initial data engagement identified 20 instances of interrogation instigated by supervisors (i.e., repetitive questioning, enquiry) as being key events in which identities are contested and re-negotiated. These sections were transcribed verbatim. Drawing on positioning, framing and impression management theories, we explored identity construction in interrogations using discourse analysis. RESULTS Supervisors approached interrogations of trainees from either a quality control or a reflective frame focusing on the client or trainee respectively. These frames influenced the positions being made available to trainees. Reflective frame interrogations often defaulted back to quality control. Trainees employed impression management tactics to manage perceived face-threat. DISCUSSION Findings highlight challenges with maintaining a reflective space in supervision during interrogations. Supervisors had authority to initiate interrogations that could be taken up, negotiated or resisted by trainees, ultimately maintaining certain professional knowledge and truths. We illuminate the ways in which socialisation processes at the interactional level during formal learning activities ultimately make available (and restrict) certain ways for trainees to think, feel and be.
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McEwan HE, Tod D. Trainee clinical, and sport and exercise psychologists' experiences of professional development: A longitudinal study. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 64:102343. [PMID: 37665798 DOI: 10.1016/j.psychsport.2022.102343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 09/06/2023]
Abstract
The aim of this study was to examine longitudinal professional development in distinct types of UK psychologists. We interviewed 9 trainee clinical psychologists (TCPs), and 9 sport and exercise psychologists' (TSEPs) 3 times at a minimum of yearly intervals during their 3-year (TCP) or 2-year (TSEP) training programme. Participants were registered on either the British Psychological Society (BPS) Qualification in Sport and Exercise Psychology (QSEP; Stage 2), or a doctorate in clinical psychology. We applied a reflexive thematic analysis to transcripts based on a counsellor development framework. Our findings indicate that diverse types of trainee psychologists experience similar patterns of development. Participants: (a) were developing their practice consistent with their personality; (b) experienced changes in emotions and presence during training; and (c) internal developmental processes were influenced by external sources (supervisors, and peers). Findings may help us to understand how trainees fuse their personal and professional selves during training.
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One Developmental Model, Two Developmental Stages: Supervisees’ Experiences of the Developmental Comprehensive Supervision Model. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2022. [DOI: 10.1007/s10447-022-09486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Maciag R, Travers‐Hill E, Morrison NR, Kim Y. Paraprofessionals delivering brief psychological interventions: Qualitative accounts of training and supervision. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Rachel Maciag
- Cambridgeshire and Peterborough NHS Foundation Trust Fulbourn Hospital Cambridge UK
| | - Emma Travers‐Hill
- Cambridgeshire and Peterborough NHS Foundation Trust Fulbourn Hospital Cambridge UK
- School of Psychology University of Kent Canterbury UK
| | | | - Youngsuk Kim
- Cambridgeshire and Peterborough NHS Foundation Trust Fulbourn Hospital Cambridge UK
- Harvard Medical School, Home Base, a Red Sox Foundation and Massachusetts General Hospital Program Massachusetts General Hospital Charlestown Massachusetts USA
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Seabrook M. ‘The Golden Question’. Addressing supervisee self‐care in clinical supervision. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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McMahon A, Jennings C, O’Brien G. A naturalistic, observational study of the Seven-Eyed model of supervision. CLINICAL SUPERVISOR 2022. [DOI: 10.1080/07325223.2021.2022060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Aisling McMahon
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Ciaran Jennings
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Gillian O’Brien
- Jigsaw, the National Centre for Youth Mental Health, Dublin, Ireland
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What matters in mental health care? A co-design approach to developing clinical supervision tools for practitioner competency development. Glob Ment Health (Camb) 2022; 9:491-498. [PMID: 36618724 PMCID: PMC9807002 DOI: 10.1017/gmh.2022.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/27/2022] [Accepted: 09/20/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Specialised mental health (MH) care providers are often absent or scarcely available in low resource and humanitarian settings (LRHS), making MH training and supervision for general health care workers (using task-sharing approaches) essential to scaling up services and reducing the treatment gap for severe and common MH conditions. Yet, the diversity of settings, population types, and professional skills in crisis contexts complicate these efforts. A standardised, field tested instrument for clinical supervision would be a significant step towards attaining quality standards in MH care worldwide. METHODS A competency-based clinical supervision tool was designed by Médecins Sans Frontières (MSF) for use in LRHS. A systematic literature review informed its design and assured its focus on key clinical competencies. An initial pool of behavioural indicators was identified through a rational theoretical scale construction approach, tested through waves of simulation and reviewed by 12 MH supervisors in seven projects where MSF provides care for severe and common MH conditions. RESULTS Qualitative analysis yielded two sets of competency grids based on a supervisee's professional background: one for 'psychological/counselling' and another for 'psychiatric/mhGAP' practitioners. Each grid features 22-26 competencies, plus optional items for specific interventions. While the structure and content were assessed as logical by supervisors, there were concerns regarding the adequacy of the tool to field reality. CONCLUSIONS Humanitarian settings have specific needs that require careful consideration when developing capacity-building strategies. Clinical supervision of key competencies through a standardised instrument represents an important step towards ensuring progress of clinical skills among MH practitioners.
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Rothwell C, Kehoe A, Farook SF, Illing J. Enablers and barriers to effective clinical supervision in the workplace: a rapid evidence review. BMJ Open 2021; 11:e052929. [PMID: 34588261 PMCID: PMC8479981 DOI: 10.1136/bmjopen-2021-052929] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES We aimed to review the international literature to understand the enablers of and barriers to effective clinical supervision in the workplace and identify the benefits of effective clinical supervision. DESIGN A rapid evidence review. DATA SOURCES Five databases (CINAHL, OVID Embase, OVID Medline, OVID PsycInfo and ProQuest) were searched to ensure inclusion and breadth of healthcare professionals. ELIGIBILITY CRITERIA Studies identifying enablers and barriers to effective clinical supervision across healthcare professionals in a Western context between 1 January 2009 and 12 March 2019. DATA EXTRACTION AND SYNTHESIS An extraction framework with a detailed inclusion/exclusion criteria to ensure rigour was used to extract data. Data were analysed using a thematic qualitative synthesis. These themes were used to answer the research objectives. RESULTS The search identified 15 922 papers, reduced to 809 papers following the removal of duplicates and papers outside the inclusion criteria, with 135 papers being included in the full review. Enablers identified included regular supervision, occurs within protected time, in a private space and delivered flexibly. Additional enablers included supervisees being offered a choice of supervisor; supervision based on mutual trust and a positive relationship; a cultural understanding between supervisor and supervisee; a shared understanding of the purpose of supervision, based on individual needs, focused on enhancing knowledge and skills; training and feedback being provided for supervisors; and use of a mixed supervisor model, delivered by several supervisors, or by those trained to manage the overlapping (and potentially conflicting) needs of the individual and the service. Barriers included a lack of time, space and trust. A lack of shared understanding to the purpose of the supervision, and a lack of ongoing support and engagement from leadership and organisations were also found to be barriers to effective clinical supervision. CONCLUSIONS This review identified several enablers of and barriers to effective clinical supervision and the subsequent benefits of effective clinical supervision in a healthcare setting.
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Affiliation(s)
- Charlotte Rothwell
- School of Medical Education, Newcastle University, Newcastle upon Tyne, UK
| | - Amelia Kehoe
- Health Professions Education Unit, Hull York Medical School, York, UK
| | - Sophia Farhene Farook
- Emergency Medicine, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | - Jan Illing
- Health Professions Education Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
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Tugendrajch SK, Sheerin KM, Andrews JH, Reimers R, Marriott BR, Cho E, Hawley KM. What is the evidence for supervision best practices? CLINICAL SUPERVISOR 2021. [DOI: 10.1080/07325223.2021.1887785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Jack H. Andrews
- Clinical Psychology, University of Missouri, Columbia, Missouri, USA
| | - Rachel Reimers
- Counseling Psychology, University of Missouri, Columbia, Missouri, USA
| | | | - Evelyn Cho
- Clinical Psychology, University of Missouri, Columbia, Missouri, USA
| | - Kristin M. Hawley
- Clinical Psychology, University of Missouri, Columbia, Missouri, USA
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Watkins CE, Vîşcu LI, Cadariu IE. Psychotherapy supervision research: On roadblocks, remedies, and recommendations. EUROPEAN JOURNAL OF PSYCHOTHERAPY & COUNSELLING 2021. [DOI: 10.1080/13642537.2021.1881139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- C. Edward Watkins
- Department of Psychology, University of North Texas, Denton, TX, USA
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Keane S, Ryan A, Adams N, Dowling M. Palliative care nurses' experiences of clinical supervision: a qualitative evidence synthesis. Int J Palliat Nurs 2020; 26:413-423. [DOI: 10.12968/ijpn.2020.26.8.413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: Clinical supervision provides support and facilitates professional and personal development. Aim: To identify and synthesise all available qualitative research on palliative care nurses' experiences of clinical supervision. Methods: Guided by the ‘enhancing transparency in reporting the synthesis of qualitative research’ (ENTREQ) statement, eight databases were searched using a systematic search strategy (Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsycINFO, Medline, Web of Science, ProQuest, Embase, Psychological and Behavioural Sciences). The findings of all included studies were analysed guided by Thomas and Harden's approach. Confidence in the review findings was determined guided by Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual). Findings: Nine qualitative studies were included in this synthesis and four analytic themes were identified: negative experiences and misunderstandings of clinical supervision; clinical supervision needs structure and clarity; supervisor needs to be a conductor and a producer; finding your ‘inner supervisor’. Conclusion: The review illuminates the benefits of clinical supervision as a renewal process for palliative care (PC) nurses, but also highlights the challenges in its provision. Organisations should provide designated time and opportunities for PC nurses to attend clinical supervision sessions during working hours.
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Affiliation(s)
- Sinéad Keane
- Staff Nurse, Galway Hospice Foundation, Renmore Galway, Ireland
| | - Aoife Ryan
- Assistant Psychologist, London Borough of Sutton, Sutton Civic Offices
| | - Niamh Adams
- Librarian, Irish Nurses and Midwives Organisation
| | - Maura Dowling
- Senior Lecturer, School of Nursing and Midwifery, National University of Ireland, Galway, University Road, Galway, Ireland
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Hiebler-Ragger M, Nausner L, Blaha A, Grimmer K, Korlath S, Mernyi M, Unterrainer HF. The supervisory relationship from an attachment perspective: Connections to burnout and sense of coherence in health professionals. Clin Psychol Psychother 2020; 28:124-136. [PMID: 32691477 PMCID: PMC7891645 DOI: 10.1002/cpp.2494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 07/19/2020] [Accepted: 07/19/2020] [Indexed: 11/13/2022]
Abstract
Supervision is an essential part of the training and work environment of health professionals, especially of psychotherapists and clinical/health psychologists. However, although the supervisory process is always a relational one and may therefore be influenced by attachment dynamics, the importance of the supervisory relationship for the professional's performance and the well‐being of the supervisee has yet to be fully examined. In this cross‐sectional observational study, the Experiences in Close Relationships‐Revised (ECR‐RD; avoidant and anxious attachment), the Supervisory Relationship Questionnaire (SRQ), the Maslach Burnout Inventory (MBI) and the Sense of Coherence Scale (SOC‐13) were analysed for 346 (81.8% female) health professionals. Considering professional experience and number of supervision sessions as control variables, a better supervisory relationship negatively predicted burnout symptoms (β = −.31) but positively predicted sense of coherence (β = .31, both p < .01). The final model, including avoidant and anxious attachment as additional predictors, explained 30% of the variance in burnout symptoms and 41% of the variance in sense of coherence. The results underline the importance of the supervisory relationship for the well‐being and the professional performance of health professionals. Interactions between the supervisory relationship and underlying attachment parameters should be further explored in future studies.
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Affiliation(s)
- Michaela Hiebler-Ragger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.,Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
| | - Liselotte Nausner
- Specialist Faculty of Integrative Gestalt (IG) Therapy, Austrian Working Group for Group Therapy and Group Dynamics (ÖAGG), Vienna, Austria
| | - Anna Blaha
- Specialist Faculty of Group Psychoanalysis (GPA), Austrian Working Group for Group Therapy and Group Dynamics (ÖAGG), Vienna, Austria
| | - Karl Grimmer
- Specialist Faculty of Psychodrama (PD), Austrian Working Group for Group Therapy and Group Dynamics (ÖAGG), Vienna, Austria
| | - Silvia Korlath
- Specialist Faculty of Group Dynamics and Dynamic Group (DG) Therapy, Austrian Working Group for Group Therapy and Group Dynamics (ÖAGG), Vienna, Austria
| | - Margarete Mernyi
- Specialist Faculty of Systemic Family (SF) Therapy, Austrian Working Group for Group Therapy and Group Dynamics (ÖAGG), Vienna, Austria
| | - Human F Unterrainer
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.,Center for Integrative Addiction Research (CIAR), Grüner Kreis Society, Vienna, Austria
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Watkins CE. What do clinical supervision research reviews tell us? Surveying the last 25 years. COUNSELLING & PSYCHOTHERAPY RESEARCH 2020. [DOI: 10.1002/capr.12287] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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King C, Edlington T, Williams B. The "Ideal" Clinical Supervision Environment in Nursing and Allied Health. J Multidiscip Healthc 2020; 13:187-196. [PMID: 32110033 PMCID: PMC7034973 DOI: 10.2147/jmdh.s239559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 12/22/2019] [Indexed: 11/23/2022] Open
Abstract
Background The importance of effective clinical supervision for emerging clinicians is well recognised, not only for practice preparation, but also for reducing future attrition rates. Also recognised are the challenges faced by both students and supervisors during the supervision experience. This study aimed to identify the qualities of the “ideal” clinical supervision environment from the perspective of clinical supervisors from both nursing and allied health. Design A qualitative study using an interview method based on action research. Methods The convergent interview method was used with 20 clinical supervisors and educators from nursing and allied health across Victoria. Interviews were recorded and data analysis occurred at the end of each pair of interviews to develop deeper questions in line with the method. Results 12 major themes emerged as “ideal” qualities with a range of suggestions on how these can be achieved. Conclusion The “ideal” qualities can be used in assessing and improving current contexts, as well as designing new clinical supervision processes, models, programs and guidelines or policies. The convergent interview method allowed for deeper level analysis than previous research.
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Affiliation(s)
- Christine King
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia
| | | | - Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia
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