Sue Walsh and Katherine Hildyard

17 November 2016

ISW Day 4

Programme Day 4 Thursday 17th November 2016

  �    �  9:00 Tea/coffee and registration �    �  9:30 Reviewing learning and development �    �  9:45 Methods in supervision – Live supervision: Learning from family therapy �    �  11:00 Problem-based learning presentations �    �  11:30 Tea/coffee �    �  11:45 Problem-based learning presentations �    �  1:00 Lunch �    �  1:30 Organisational metaphorical analysis �    �  2:45 Tea/coffee �    �  3:00 Peer supervision of organisational process �    �  3:30 Action Plans

Self-evaluation: Goal attainment scaling, LO questionnaire �  Evaluation of Day 4 �    �  4:00 End

Aims of the day

■ To review learning and development ■ To consider varied methods of

supervision ■ To gain knowledge and experience of

two different methods of supervision ■ To engage in the PBL exercise ■ To plan for further learning and

development

Method 1 Live supervision

▪  A potted history from family therapy

▪  Behind the screen

▪  Reflecting teams

▪  Outsider witnesses

Method 1 Live supervision

■  “It is the theory that determines what we observe” Einstein

■ Theoretical rationale for live supervision ■  Levels of communication, punctuation

and the meta position ■ The notions of curiosity and mystery ■ Deconstruction and narrative

approaches

Method 1 Live supervision

■ Pitfalls of live supervision ■  “Robotisation” i.e. loss of creativity,

dependence on supervisor, performance anxiety

■ Parallel patterns, stuckness ■ Supervisor ego

Method 1 Live supervision

■  Avoiding pitfalls ■  Good planning, negotiation and review ■  Clear role for the live supervisor depending

upon stage of training of trainee ■  Collaborative and focused upon enabling the

trainee to develop their learning – ‘both/and’, not ‘either/or’

■  Restrain from “saviour tendencies!” ■  Share with client or family the plan ■  Consider a break midway through session

Skills exercise

■  Form groups of 3 or 4 ■  One or two people to choose the client scenario ■  One person to be the therapist ■  One person to be the supervisor ■  10 minutes for conducting initial session ■  5 minutes for supervisor-therapist reflective

discussion ■  Deconstruct/reflect upon this discussion with the

client/family ■  5 minutes to feedback to the group

Method 2

Creativity and the use of metaphor ■ A focus on organisations

Supervision as an organisational process

■  Supervision as a medium through which we do our jobs

■  Supervision is about change leadership/ assessment of good practice/management

■  Thus, work contexts have an impact upon the work we do [Austin and Hopkins (2004); Cooper and Lousanda (2005); Pullen, A. and Simpson, R. (2009); Kihlgren and Hansebo (2014)]

■  Supervision as an evidence-based approach (Milne, 2014)

For example…

■  Supervision encourages staff to continue to engage with difficult clients

■ Reframing of problems so that staff endure, remain helpful and confident

■  Enhance work effectiveness and therefore service quality

■  Sometimes issues between supervisee and client are located in service policy and procedures [Kaiser (2004), in Austin and Hopkins (2004)]

Other examples of organisational impacts…

■  The community within which a service is located impacts upon work/supervisory priorities

■  Upon supervisory boundaries – assessment/crisis intervention/rehab/physical heath

■  Upon the centrality of confidentiality and risk – e.g. Forensic

■  Focus and depth – hospice work ■  Contracting framework – GP commissioning

groups (is supervision costed within service bids?)

‘The pull towards perversion’

■  Taken from Ballatt and Campling (2011) ■  Perversion captures the inherent

“contradictions and destructive dynamics at work that draw cynicism and worse out of the most well-intentioned, hard working staff member” (p140)

■ Mid Staffs – “The Trust was galvanised into radical action by the imperative to save money and did not properly consider the effect of reductions in staff on the quality of care”

Corrupting forces? (Ballatt and Campling, 2011)

■  The promotion of a competitive market economy that works against the idea of an integrated service

■  Industrialising healthcare - undermines skilled individuals in relationships with patients and turns it into a mechanical process

■  The framework of specification, regulation and performance management

■  What are the effects of dysfunctional organisations on individuals Campling (2016)

■  The role of supervision -

Factors indicative of perversion

�  Taken from ‘The perverse organisation and its deadly sins’ (2008) Author Susan Long

�  Individual pleasure at the expense of others �  Acceptance and denial of reality �  Engagement of the accomplice �  Instrumental relations in society �  Perversion begets perversion

¡  Is it useful to make links between the internal world and the world of the system?

Using metaphors as a tool

■ Bernard and Goodyear’s ‘super’ ‘vision’

■ Metaphors representing an objective/subjective perception of internal or external reality

Why are metaphors useful?

■  Language as central and metaphors can determine how we think and act in the world

■ Mental pictures which are highly graphic ■ Transformative + creates compact

descriptions of complex phenomena ■ Tool within organisational literature egg.

Morgan, G. (2006), Images of organisations

Having a go

■ What metaphor best describes the organisation in which you or your supervisee works?

■ Draw it ■ From your drawing what may impact

upon your supervision or your supervisees’ practice? Discuss in your groups

Avoiding the traps in using metaphors

■ Using specific metaphors inappropriately (lack of fit, lack familiarity)

■ Metaphors carry ambiguous meanings ■ Need multiple metaphors ■ Changing metaphors in use can be

difficult Abkin and Palmer (2000)

Checklist for Portfolio Submission ISW 2016

■ Self Evaluation of Learning Outcomes Questionnaire

■ Peer supervision contract ■ Goal Attainment Scaling Exercise

[was set at workshop 1 (and completed on Day 3) and review progress at workshop 4]

Checklist for Portfolio Submission ISW 2016 (cont’d)

■  A reflective log containing 3 x 500-word personal accounts considering: ■  An issue of difference and diversity ■  The relevance of a theoretical model of supervision ■  An ethical aspect of supervisory practice

■  Structured feedback received from someone the participant has supervised during the course of the programme using the Supervisory Relationship Questionnaire developed by Palermo and Beinart in Oxford (plus commentary)

■  A record of the Problem-Based Learning exercise, presented on Day 4

■  Supervision of Supervision – Feedback from your Supervisors (plus confirmation of recorded session by supervisor)

Evaluation

Please complete: ■ The Learning Objectives

Questionnaire ■ The Goal Attainment Scaling ■ The Training Evaluation form