Distance supervision: What does a focussed rural, remote and regional Clinical Supervision Programme contribute to clinical practice within a child and youth mental health setting?
From the abstract
The presentation will address the structure of the current practice supervision programme and outline the formal and informal links developed by positioning the programme within a major metropolitan CYMHS health district. The presentation will highlight the additional benefits which augment the individual supervision such as enabling access to supervision of supervision and supervision and consultation from clinical service specialists, thereby offering resources that otherwise might not be available to rural and remote clinicians. Key factors that have been identified to assist the distance supervisory process and supervisory models that underpin these will be addressed.
The Clinical Practice Supervision Programme provides clinical supervision and supervision of supervision to rural and remote allied health staff when local options have been exhausted. Supervision is provided mostly by telephone, although VC and MOVI are also options. There is one full-time position, divided across three disciplines, Psychology, Social work and Occupational Therapy.
The CPS is centrally sited with Child and Youth Mental Health Services within Children’s Health Queensland in Brisbane Qld, which yields two main benefits, the first for supervisees and the second supervisors.
The first is that supervisors can facilitate supervisee access to consultation and short term supervision in a range of specialist areas that may not be available locally. This includes perinatal and infant, transcultural and forensic mental health services and eating disorders. Supervisors can also advise new staff about upcoming intensive clinical skills training offered by CHQ, and assist supervisees with options for work-shadowing within CHQ.
The second benefit is that CPS staff can access their own supervision of supervision from senior, clinically experienced CHQ staff. Additionally, access to funding for travel to rural and remote sites is increased.
Factors that enable the development of a healthy face-to-face supervisory relationship are even more salient in distance supervision. Structural processes include: Development of formal supervision agreement including attention to issues around goals, outcomes and responsibilities within the supervisory relationship; Regular review of alliance; Written notes of supervision provided by the supervisor to facilitate transparency and accountability;; Regular review of supervisory goals, evaluation of supervision outcomes and renewal of supervision agreement; Use of interpersonal process and reflective models of supervision, and finally, an evaluative feedback process around supervisory goals that is owned by the supervisee.
Relational factors that have been identified as assisting the supervisory process include: A clear process of communication about professional background and supervisory experience at the commencement of the supervision; Use of clearly articulated supervisory models that emphasise a collaborative adult learning rather than hierarchical expert ‘teaching’; a feedback process that uses observational rather than evaluative comments (I noticed.. vs it was good….), and finally at least one face to face meeting during the supervisory process.
By Fiona Heath, Clinical Practice Supervisor – Rural and Remote Child and Youth Mental Health Service (CYMHS)
Children's Health Queensland Hospital and Health Service
This article was updated from a presentation at the 2016 8th Rural and Remote Mental Health Symposium.