Clinical Supervision Modalities

Choosing Internal or External Supervision

In many services today, clinical supervisors also double as line managers for the workers they supervise. This dual role can be vexed, given that the same person who seeks to encourage an open-hearted discussion of the supervisee’s most vulnerable feelings in the work is also in the position of evaluating the supervisee’s work more broadly. Nevertheless, if the two roles are negotiated, kept separate and processes made transparent, it can be experienced as advantageous to have those roles combined. (Section 7.1 provides further guidelines for line managers or team leaders who hold a dual position).

Another alternative for organisations preferring to use their own staff to supervise, or in which funding cannot be found for external supervisors, is the use of internal clinical supervisors who meet the following criteria: they are not managerially responsible for the worker, they do not work in the same program as the worker, and they are perceived to be an appropriate and desirable choice by the worker. Ideally supervisees will have some influence over the selection of an appropriate internal supervisor.

Supervisors can be externally contracted. When organisations contract external supervisors, it is important that the needs, expectations and values of the organisation are clearly communicated to and accepted by these other parties. Also, the supervisor should contract with managers to provide regular reviews of supervision, and should negotiate a method of providing feedback. 

The key benefits and challenges of the three supervision provider options are outlined below.

Table 1 Internal Clinical Supervision via Line Management Structure

Table 2 Internal Clinical Supervision, outside Line Management Structure

Table 3 External Clinical Supervision

Choosing Individual, Group, and/or Peer Supervision

There are many and varied supervision formats, each with its own benefits and limitations. In order for supervision to be effective, it is necessary to take into account both the needs of the individuals and the requirements and constraints of the organisation when considering the format to be offered.

Individual supervision has traditionally been the cornerstone of professional skill development and the needs of workers will not necessarily be met if this is excluded from their working lives, though this will vary depending upon workers’ individual needs. Supervision can be provided in groups, which may be facilitated or peer-led. Group and peer supervision, as well as intensive case consultation on a case-by-case basis, are useful and less costly additions to a clinical supervision plan, but they may be inadequate as substitutes for one-on-one support. An exception to this might be highly experienced, well-educated and very competent counsellors who are able to review their work with an equally competent peer group on a regular basis and who have some knowledge of effective peer supervision processes.

Several different supervision formats are listed below, along with some of the key benefits and challenges presented by each.

Table 4 Individual Clinical Supervision

Table 5 Facilitated Group Clinical Supervision

Table 6 Peer Group Clinical Supervision (without a Supervisor)