Unscrambling supervision

Supervision has always been an important construct in the provision of psychological services. However, with national registration bringing substantial changes to supervision requirements, along with the introduction of peer consultation, the complexity around supervision has increased. Unscrambling this complexity is a critical task for both supervisees and supervisors.

Getting started

Because psychology is a registered profession, those from 4+2 and 5+1 pathways cannot practice psychology without first having their arrangements for work and supervision approved by the Psychology Board of Australia (PsyBA), and those completing six-year training cannot practice until their General Registration has been granted. Some graduates will obtain positions titled "psychologist" with a trained and approved supervisor at the workplace, but others may widen their search for work to include more general appointments, such as being a counsellor. However, this will not count towards their registration or endorsement unless the Board approves it. Students should therefore familiarise themselves with the PsyBA's requirements for supervision and the application process (see Psychology Board of Australia Forms).

Where an approved supervising psychologist is not available at the place of work it may be possible to negotiate to take supervision external to the place of work, but how this is to be paid for, the relationship the supervisor has to the place of work and confidentiality of information released by the supervisee all need to be negotiated. The PsyBA lists approved supervisors on its website (see www.psychologyboard.gov.au/Registration/Supervision/Search).

Developments in supervision instigated by the PsyBA

Since its inception, the PsyBA has introduced two major changes with regard to supervision:

• The first has been the development of detailed supervision requirements for provisional psychologists to undertake during their internship including written case reports, ethical dilemmas and limitations of practice which must be submitted every six months for evaluation by the Board (see PDF document on Codes, guidelines and policies.
• The second development has been the requirement for supervisors to be trained in supervision (see
  Requirements for supervisors)

The impacts of these developments are several. Gone are the days when psychologists could take a new 4 + 2 graduate into their place of work and supervise as they saw fit for the trainee to reach full registration. The aim of the internship program and the training of supervisors, has been to enhance and standardise the quality of practice of those acquiring General Registration. However, the workload for both the provisional psychologist supervisee and their supervisor has increased greatly, there are fewer psychologists eligible or willing to supervise reducing work opportunities for provisional psychologists, and the nature of this supervision has changed markedly. With the emphasis on the academic tasks there is the potential for less time to be available for sensitive discussion about the supervisee's work with clients, leading to risk that important matters of practice might be overlooked.

Those seeking endorsement in a particular field of psychology must obtain supervision from a psychologist who is both endorsed in that field, and an approved supervisor. The form and content of this supervision is more flexible, and while addressing the competencies of the chosen field, can be more individualised. The supervisee has the opportunity to grow in the level of complexity of casework which they can handle.

Techniques and competencies of supervisors

Good supervision fosters reflective practice, encouraging psychologists to think about and evaluate what they do as practitioners. Supervision most commonly entails a weekly or fortnightly face-to-face consultation between the supervisee and supervisor, in which the supervisee presents the work that they have been doing for discussion and the supervisor may provide comment, advice and feedback. The supervisor may also ask about certain aspects of the supervisee's work or set some tasks for the supervisee to do and bring to the next session. Direct observation of the supervisee's work by attendance during sessions or audio or video recording allows the supervisor to note details of the supervisee's manner and conduct of their work and provide micro-skills training. However, the client must give free and informed consent to these methods of observation, and it needs to be appreciated that such observation may interfere with and alter what takes place.

Where the focus of supervision is on the supervisee's record keeping or report writing, it might be considered that written feedback is helpful. Supervisors might also demonstrate or model certain psychological methods, approaches and techniques as another teaching tool. The PsyBA has recognised group supervision as an appropriate tool for provisional psychologists and those seeking area of endorsement, but has set limits on how much of the supervision can be delivered in this mode.

The above description of what might take place in supervision has been given from the perspective of what the supervisee might expect to experience, but in terms of supervisor training, there are over-arching competencies which supervisors are required to demonstrate to become Board (PsyBA) approved supervisors. These are summarised in the box below, and fully defined at on the PsyBA website (see pdf document on Guidelines for Supervisors at www.psychologyboard.gov.au/Standards-and-Guidelines/Codes-Guidelines-Policies.aspx).

A period of supervision may be set as a condition of practice by the Board where a psychologist's work has been found to be unsatisfactory. The Board will require both parties to submit reports as to the progress of supervision at specified intervals. This supervision should focus on the areas identified as sub-standard, but should also be more general to cover the supervisee's ongoing practice and competencies.

Ethics in supervision

The supervisory relationship may appear to bear some similarities with the therapeutic relationship, such as the need to establish a level of rapport and trust that allows the supervisee to disclose faults and insecurities about their work. None-the-less a clear distinction must be made: supervisees must not be required to disclose personal information, and where the supervisee needs psychological counselling or therapy, they should attend a separate psychologist for this.

For supervisors there is an important responsibility, which the supervisee must understand from the outset, this being that where client safety is at risk or has been compromised, the workplace and possibly the PsyBA would need to be informed. Balancing this responsibility with the rapport and trust needed for effective supervision requires considerable skill on the part of the supervisor.

Both supervisee and supervisor can find guidelines on how to deal with any conflicts that may arise in the supervision relationship (see APS Ethical Guidelines for Supervision)

Distinguishing between supervision, peer consultation and mentoring

Peer consultation

Once a psychologist has completed their formal supervised training, they are still required to engage in discussion about issues arising in their practice with a colleague as part of their ongoing continuing professional development (CPD) for ten of the 30 hours per year. This is called peer consultation and has a less hierarchical relationship than that of supervision. Many psychologists arrange to exchange peer consultation with one another. The psychologist who is being consulted, can count these hours towards CPD but only the hours focussed on their own practice counts as their peer consultation. Concern may be felt that peer consultation is occupying the majority of CPD hours, limiting the amount of time psychologists will be spending on other forms of CPD, such as attendance at seminars, workshops and conferences and reading scientific journals and text books.

Mentoring

The mentoring process is also different from supervision. It involves identifying a relevant senior colleague who is willing to be consulted and who can guide another less senior colleague through stages of transition in their careers. The APS is currently exploring the viability of establishing a system of mentoring within the profession. Further information about mentoring can be found on the APS website at www.psychology.org.au/earlycareer/connecting.

Efficacy of supervision and peer consultation

It is surprising that in a profession so keen on scientific evidence to support its practices, that so much supervision and peer consultation has been mandated with almost no research into its efficacy. Of course conducting such research will pose significant difficulties in design and measurement of the quality of both the supervision/peer consultation and of the improvement (if any) in the supervisee's service delivery. What supervision approaches work and what outcomes for supervisee competencies, client problem resolution and the reduction in complaints made against psychologists are some angles that need to be explored. It is to be hoped that supervision can be found to benefit the quality of psychological services.

In the meantime, students and early career psychologists must sort through the many regulatory requirements around supervision and peer consultation, as well as consider the value of a mentor relationship, to ensure they fulfil their obligations and establish professional supports at this formative time in their journey in psychology.

The author can be contacted at [email protected]