Information on Supervision

The information on this page is also available from the BACP at: www.bacp.co.uk

Introduction
The purpose of this information sheet is to describe the type of supervision required by therapists for their practice, as well as why it is required and who may offer it. The ways in which supervision may be offered are also described. The information sheet is designed to help therapists in private practice to arrange their own supervision and also so that organisations can ensure that their therapists are being appropriately supervised.What is Supervision
Supervision is a formal arrangement for therapists to discuss their work regularly with someone who is experienced in both therapy and supervision. The task is to work together to ensure and develop the efficacy of the therapist! client relationship. The agenda will be the therapy and feeling about that work, together with the supervisor’s reactions, comments and challenges. Thus supervision is a process to maintain adequate standards of therapy and a method of consultancy to widen the horizons of an experienced practitioner. In choosing a supervisor, therapists need to assess their position on a scale ranging from newly qualified to very experienced, to decide the main focus of the therapy work undertaken and to take into account their own training, philosophy and methods. The setting for therapy may be an important factor. Agencies and institutions may have their own criteria for supervision and provide supervisors from within the organisation. Where outside supervision is more appropriate, considerable discussion and negotiation may be needed to arrange time away from work, financial support and assurance of confidentiality. Private practitioners must arrange their own supervision.

Why supervision is essential for the practising therapist
By its very nature, therapy makes considerable demands upon therapists who may become over-involved, ignore some important point, become confused as to what is taking place within a particular client or have undermining doubts about their own usefulness. It is difficult, if not sometimes impossible, to be objective about one’s therapy and the opportunity to discuss it in confidence with a suitable person is invaluable. Good therapy also requires the therapist to relate practice to theory and vice versa. Supervision can help the therapist to develop their practice and in this sense, it is one aspect of continued training. The supervisor can ensure that the therapist is addressing the needs of the client, can monitor the relationship between the therapist and client to maxi mise the therapeutic effectiveness of the relationship and ensure that ethical standards are adhered to throughout the therapy process. Though not concerned primarily with training, personal therapy or line management, supervisors will encourage and facilitate the ongoing self-development, continued learning and self-monitoring of the therapist.

Choosing a Supervisor
The less experience the therapist has, the more experience the supervisor should have. Supervisors should be sufficiently experienced and qualified in therapy or in a closely related field (e.g. a psychologist or psychiatrist) for others to have confidence in their professional skills. It is important for the professional chosen as supervisor to be experienced in supervision and in therapy compatible with or relevant to that of the supervisee and have rapport with the therapist concerned. Ideally the supervisor should have some training and qualification in supervision. The main focus of the therapist’s work (one-to-one, couples, families, groups) should be taken into consideration and whether it is short or long term work that is being undertaken. The therapist should comprehend fully the training, methods and theoretical orientation of the proposed supervisor. Though at times a therapist may prefer to get differing insights and perceptions from another orientation (e.g. psychodynamic, person centred, behavioural or Gestalt), this can be confusing in supervision, for example in the discussion of the therapist’s process and methods. As therapists work from different philosophical backgrounds, it is important at an initial interview for the therapist to discover whether the potential supervisor is someone with whom it will be possible to work and learn. Since it is the responsibility of therapists to ascertain the qualifications and experience of the potential supervisor, they should enquire about this before making a formal supervision contract. Choosing a line manager as supervisor can lead to difficulties since a conflict of interests may arise between the needs of the unit or institution (the priority of the line manager) and the needs of the therapist – see Jacobs, M. (2007) and the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy (2007:05) (the Ethical Framework). If line management supervision is mandatory then there must be access to other consultative support (the Ethical Framework, 2007:06). Finally, it is essential to bear in mind that ultimately the supervisor must place responsibility to the client over and above responsibility to the therapist.

The Supervision Contract
A contract with a supervisor of the therapist’s choice should be for a fixed period, subject to review. It will cover such practical arrangements as fees, privacy of venue, length of contact time and frequency of contact. The minimum requirement for supervision for BACP accreditation purposes is one and a half hours individual or equivalent per month (see Mearns, D., 2008). The amount of supervision should be proportionate in relation to the nature and amount of therapy, for example intensive trauma work or heavy case loads may require more intensive supervision than the minimum 1 V2 hours each month. The therapist should know and feel that this time is set aside for this particular purpose, the importance of which is emphasised by the care with which the time agreed is protected from erosion, interruption and postponement. As a general principle, supervisors should maintain confidentiality with regard to information about therapists and clients. When the initial contract is made, expectations regarding tasks, roles and responsibilities need to be clarified. The status of client notes and supervisor and supervisee notes also needs to be clarified. There must be an agreement about the boundaries of confidentiality with regard to the people to whom the supervisor is accountable. This is necessary particularly where the therapist is not in private practice. Here the lines of accountability and responsibility between therapist, client, supervisor and organisation need to be very clearly defined. The contract may be verbal or written. A three-way written agreement between organisation, therapist and supervisor or between training organisation, trainee and supervisor is a helpful way to clarify accountability and responsibility.

Forms of Supervision
One-to-one, Supervisor- Therapist
A single supervisor provides supervision for one other therapist. Inexperienced therapists particularly should choose a suitably trained and qualified supervisor who has been a practising therapist for a number of years.

One-to-One, Co-supervision
Two participants provide supervision for each other by alternating the roles of supervisor and therapist. Normally the time available for supervision is divided equally between them.

Group Sepervision with identified supervisor
There is a range of ways of providing group supervision. At one end of the spectrum, the supervisor, acting as leader, will take responsibility for apportioning the time between the therapists, then concentrating on the work of individuals in turn. At the other end of the range, the therapists will allocate supervision time between themselves using the supervisor as a technical resource. In group supervision, the total time in the group must be apportioned between each of the supervisees for the purposes of compliance with BACP requirements for minimum supervision hours. Group supervision can be a useful adjunct to individual supervision.

Peer group supervision
Three or more therapists share the responsibility for providing each other’s supervision within the group context. Normally they will consider themselves to be broadly of equal status, training or experience. Experienced therapists may at times find peer group supervision sufficient. It is not, however, recommended for the trainee or newly qualified therapist. Peers may be reluctant to confront and may lack the wider experience and perspective considered and essential ingredient of supervision. Where a peer group does exist, it is essential that there is a clear understanding of where the final responsibility for the clients’ welfare rests. Some therapists use a combination of these methods. In group supervision, the total time in the group must be apportioned between each of the supervisees for the purposes of compliance with BACP supervision requirements.

Finding a suitable Supervisor
It is recognised that supervisors may be difficult to find, especially in areas away from major cities. BACP supervisors may be found in the online BACP Find a Therapist Directory by choosing the word ‘supervisor’ using the dropdown arrow. If no therapists specifically working as supervisors are available, it is suggested that an accredited therapist e.g. UKRC, BACP or UKCP (preferably with experience in supervision) might be suitable. These can also be found in the BACP online directory.

Conclusion
Supervision, or ‘consultative support’ as it is sometimes known, is essential for effective therapy. All BACP members working as therapists are bound by the Ethical Framework (2007:05) to monitor their therapy through ongoing supervision.

References and Further Reading
BACP (2007) Ethical Framework for Good Practice in Counselling and Psychotherapy. Lutterworth: BACP
Dryden, W. and Thorne, B. (1991) Training and Supervision for Counselling in Action. London: Sage
Feltham, C. and Dryden, W. (1994) Developing Counselling Supervision. London: Sage
Hawkins, P. and Shoet, R. (1989) Supervision in the Helping Professions. Milton Keynes: Oxford University Press
Jacobs, M. (2007) Dual roles – blurring the boundaries in professional relationships. BACP Information Sheet G3. Lutterworth: BACP
Jacobs, M. (1996) In Search of Supervision. Buckingham, Oxford University Press
King, G. (2008)Using Supervision. In Reeves, A. (Ed) Key Issues for Therapy in Action. Second Edition. London:
Sage
Mearns, D. (2008) How much supervision should you have? BACP Information Sheet S1.Lutterworth: BACP
Page, S. and Woskett, V. (1994) Supervising the Counsellor: a cyclical model. London: Routledge
Wheeler, S. and Richards, K. (2007) The impact of clinical supervision on therapists and therapists, their practice and their clients: A systematic review of the literature. Lutterworth: BACP