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www.speechpathologyaustralia.org.au
JCPSLP
Volume 19, Number 2 2017
89
Supervision can assist in improving client outcomes,
developing the knowledge, skills and attitudes of
supervisees, increasing communication and relationship
skills, and reducing stress and burnout (Kilminster & Jolly,
2000; Lyth, 2000; Pack, 2009).
What is the evidence base for
supervision?
While there is very little published on supervision specific to
SLP, several literature reviews have examined the evidence
across a range of disciplines including allied health
(Fitzpatrick, Smith & Wilding, 2012; Dawson, Phillips &
Leggat, 2013), nursing (Lyth, 2000), social work (Pack,
2009), counselling and psychotherapy (Wheeler & Richards,
2007) and across several disciplines (Kilminster & Jolly, 2000;
Milne, Aylott, Fitzpatrick, & Ellis, 2008). Although there is
broad agreement regarding the benefits of supervision,
these reviews highlight some of the complexities in
researching supervision including a lack of clear definitions
of supervision, with significant overlap with other terms
such as mentoring, and variability in the supervisory models
employed. A lack of agreement regarding what constitutes
effective supervision, the functions and features of
supervision, and what training and skills are required for
effective supervision, still exists. In considering best practice
for supervision in SLP the following areas will be discussed:
the process of supervision, the organisational context, the
supervisory relationship, reflection in supervision, and
models of supervision.
Best practice for supervision
The process of supervision
Pack (2009) recommends that supervision has a clear
purpose and contract that addresses the nature of
feedback, relationship evaluation, support strategies, and
negotiation of clear roles and responsibilities. This can
include specific learning objectives, clear plans for
supervision sessions (regular agreed times, agenda) and
recordkeeping (Kilminster & Jolly, 2000; Milne et al., 2008;
Wheeler & Richards, 2007). Supervisors require training for
their role (Kilminster & Jolly, 2000; Milne et al., 2008) and
both supervisors and supervisees need to be committed to
the process (Lyth, 2000; Milne et al., 2008).
Organisational context
Endorsement and recognition of the value of supervision for
staff is important. Optimal supervision begins with the
broader organisational context including professional and
administrative support for supervision, incentives and
training for supervision, and a needs led, system-wide team
approach (Milne et al., 2008). King (2009b) also highlighted
the importance of the organisational context in considering
effective client-centred practice and the development of
clinical expertise (King, 2009a) with a focus on support,
relationships, and learning required. The development of
expertise requires “an environmental context that provides
supports, resources and opportunities for optimal
experiences and the processing of experience” (King,
2009a, p. 187).
It is recognised in SLP that competencies develop
on a continuum, continuing a developmental trajectory
throughout the career (McAllister, Lincoln, Ferguson &
McAllister, 2013). Novices need more direction, explicit
instruction, structured learning situations and scaffolding
for reflection (King, 2009a) which requires additional
access to continuing professional development for allied
health practitioners is vital in providing quality health service
delivery based on contemporary practice” (Mason & DHA,
2013, p. 310). Supervision can support SLPs to deal with
these increasing pressures, develop the relationship and
communication skills required in contemporary practice,
and support their ongoing development as professionals.
High-quality supervision contributes to the development of
the workforce and helps equip staff to negotiate the ever-
changing, increasingly complex work environment. This
paper shows how these aims may be achieved.
What is supervision?
Recently supervision has received increased attention in the
literature across a range of disciplines and there are a
number of definitions of supervision. For the purposes of
this paper, we will use the definition of supervision
developed for SLPs by SPA:
a contractual, relational, collaborative process, which
facilitates the ethical and professional practice of the
supervisee…an opportunity for the supervisee to
reflect on their practice to gain a broader perspective,
opening up opportunities for personal and professional
growth…a means to ensure the supervisee is
accountable to the personal and professional
standards of their profession. (SPA, 2014b, p. 4)
Supervision may take many forms, such as individual,
group or peer supervision.
What are the benefits of
supervision?
Supervision has been found to improve client outcomes
across a range of disciplines including medicine, social
work, teaching, psychotherapy and nursing (Butterworth,
Bell, Jackson, & Pajnkihar, 2008; Kilminster & Jolly, 2000;
Lyth, 2000). Further, practitioners under supervision have
been shown to improve their skills more rapidly compared
to those who are unsupervised (Kilminster & Jolly, 2000). In
nursing, supervision has facilitated both personal and
professional development of supervisees, increasing
creativity, self-confidence, knowledge and participation in
reflection (Lyth, 2000) – all factors which contribute to the
development of professional expertise (King, 2009a). In
social work, Pack (2009) notes supervision is a “co-created
space in which a sustained reflection on practice can occur
from a mutual understanding of process and a shared
experience of learning” (p. 666) allowing supervisees to “tell
their story in new ways that promote personal and
professional growth” (p. 658).
In terms of developing communication and relationship
skills, supervision has been shown to improve practitioner–
patient relationships and reduce patient complaints (Lyth,
2000). Improvements in the supervisees’ awareness of
their own emotional responses to clients, impacting their
ability to build and maintain relationships, and manage the
dynamics of relationships are noted (Wheeler & Richards,
2007). Supervision can reduce stress in workers, increase
morale, job satisfaction and retention, and support staff
in the pressure of the complex workplace (Lyth, 2000).
Supervision has also been shown to improve self-care,
promote personal well-being and resilience and be a
protective factor against vicarious trauma (Pack, 2009;
Wheeler & Richards, 2007).
Therefore, supervision may be said to be vital for
sustaining staff in the provision of quality health care.