Considerations in Group Supervision

by Claudia J. Dewane, D.Ed., LCSW, BCD

By day, I’m a social work professor, by night, a social work clinical supervisor.  Some social workers do not get the benefit of social work supervision in the workplace; many are supervised by those in other professions.  The intense and sometimes emotionally-depleting work of our profession demands that the work (and worker) be supervised by someone who knows what the work entails and the toll it can take on the worker.

    In addition, social workers looking for clinical licensure sometimes do not have clinical supervision available to them on the job, and therefore need to seek it privately. When I realized that  many of the MSW graduates I had taught had no social work supervision, a colleague and I started a clinical supervision group. It is in a social work supervision group that social workers can be heard, understood, guided, protected, validated, supported, and reassured!

    The specialization I chose in my MSW program was group work, and my doctoral dissertation was about learning in self-help groups, so doing supervision in a group format provides the best of several worlds to me. It can include the “teaching” aspect that I love, it keeps me aware of system and social justice issues in our field, and I get to be involved in client work without having to endure some of the unpleasant facets of direct care, such as billing and on-call work!

    Several supervision group members have commented that they appreciate the opportunity to be with like-minded workers in the group. Some of them may be the only social worker in their agency and often have no one who views situations through the multiple lenses that social workers do. Most importantly, when ethical dilemmas arise, social workers become what I call “the conscience of the agency.” At times, workers from other disciplines fail to see the potential consequences of a sticky ethical boundary crossing or some other situation with potential ethical implications.  

    Freda Brashears (1995) calls social work supervision a form of social work practice. She claims that making social work practice and social work supervision two separate entities is constructing a false dichotomy. Her re-conceptualization of supervision is one based on mediation and mutual aid. The most fascinating part of group work for me is the concept of mutual aid.  In self-help groups, this concept is known as the “helper-therapy principle.” When one helps someone else, the helper is also helped. This concept is especially salient in group supervision. All help all in a supervision group, including the leader. I learn so much from the group sessions and members!

    It is particularly satisfying to see social workers from different work areas be able to generalize concepts across settings.  For example, there may be six people in a group: one working in hospice, one in private therapy practice, another in family-based services, one in the VA, another in medical oncology, and another working in a brain injury program.  The group membership is sufficiently heterogeneous to provide diversity and a variety of experiences to discuss, yet homogeneous enough to find common practice issues and similar professional development needs.

    Supervision groups can be theme-centered, case-centered, or worker-centered. For theme-centered sessions, we may discuss a topic such as self-disclosure in social work interventions, or I may introduce a particularly relevant journal article for discussion. For case or work-centered sessions, we may discuss a particular case for which a member would like collegial input, or an interdisciplinary conflict, or a difficult systems issue or co-worker!  And finally, and perhaps what I consider the most important aspect of group supervision, is discussing the impact of the work on the worker. What emotional toll might the worker anticipate?  What personal impact may give a clue to countertransference issues?  And what can be done to ameliorate some of the stresses incurred at and because of the work? One purpose of the group is to provide a safe and rejuvenating place where people can share fears and emotional consequences of their profession and discover ways to deal with work-related stress.

    An unintended benefit of the group has been the networking that has occurred. More than one person has changed jobs as a result of information learned in the group, and participants have gleaned many referral sources.  

    One of the downsides of any type of supervision is the concept of “Respondeat Superior,” which means the supervisor must respond for the supervisee’s actions. This vicarious liability risk may be compounded in group supervision, not only because risk increases exponentially with more supervisees, but also because a member may more easily “hide” in the safety of numbers and not reveal a potentially litigious situation. It is extremely important for both supervisor and supervisees to maintain malpractice insurance.

    A social work supervisor should role-model continuous learning and professional development. To that end, I have taken courses and workshops regarding supervision.  In addition, I completed a two-year certification program in Advanced Clinical Supervision at Smith College School of Social Work.  Even in that wonderful program, there was little that spoke to group supervision, so I have continued to do my own self-directed learning about it.  

    It is important to evaluate the effectiveness of our interventions, and evaluating the effectiveness of supervision is no different. I have tried to measure the impact of group supervision in a variety of ways. First, through a type of goal-attainment scaling, members have noted where they were at the beginning of supervision, where they wanted to go, and in what ways that goal may or may not have been accomplished.  We also have evaluated group participation through instruments such as the Group Rating Session Scale developed by Scott Miller and colleagues (2003). I especially like to use the American Board of Social Work Examiners Professional Development and Practice Competencies (2002) to help members assess how their professional development is evolving.  These standards delineate what levels of competence social workers should demonstrate immediately upon graduation, after two years of experience, and within 3-5 years of supervised clinical experience.  

    Finally, as another self-report measure of effectiveness, we have adopted  what Brigid Proctor (2008) calls the Four C’s of supervision: to increase confidence, competence, compassion, and creativity.  Each member thinks of ways in which the group has contributed to increasing his or her confidence. Examples might be increased confidence in dealing with a difficult co-worker, in performing suicide assessments, or in ability to diagnose. Increased competence might be demonstrated in a member developing a clear theoretical orientation, gaining expertise in a particular model or technique, or working with a particular population. Compassion is measured in increased sensitivity to different client populations and cultures, and even in increased compassion toward oneself in self-care and balancing work and family demands. Creativity is evidenced in different or innovative approaches taken.  For example, play therapy with adults (Schaefer, 2003) has recently been addressed in social work literature, and a member successfully utilized some of those techniques with a particularly guarded and reticent adult client.

    Perhaps the most important aspect of group supervision is the ability to explore and resolve ethical dilemmas.  Group members can help one another decide the severity of an issue and indeed if it represents an ethical dilemma or just a complicated practice decision. All social work models of ethical decision-making call for consultation with experts and colleagues.  The group can provide such consultation.

    Using a group format for social work supervision replicates the best there is of group work.  It is vibrant, fluid, and dynamic.  You can pretty much count on the sum being greater than the parts!

References

American Board of Social Work Examiners. (2002, March). Professional development and practice standards in clinical social work. Retrieved from the ABSWE website: http://www.abecsw.org/images/Competen.PDF.

Brashears, F. (1995). Supervision as social work practice: A re-conceptualization. Social Work, 40 (5), 692-99.

Miller, S.,Duncan, B., Brown, J., Sparks, J., & Claud, D. (2003). The outcome rating scale.  Journal of Brief Therapy. 2 (2), 91-100.

Proctor, B.  (2008). Group supervision: A guide to creative practice (2nd ed.). Thousand Oaks, CA: Sage.

Schaefer, C. (Ed.). (2003). Play therapy with adults. New York: Wiley & Sons.

Additional Resource

Social work supervision podcast: http://socialworkpodcast.blogspot.com/2008/01/supervision-for- social-workers.html.

Claudia J. Dewane, D.Ed., LCSW, BCD, is an Associate Professor at Temple University School of Social Work.  Her clinical work has focused on PTSD and military sexual trauma among veterans. She is certified in Advanced Clinical Supervision.