Definition of Clinical Supervision
In this book, we use the term “supervision” synonymously with “clinical supervision” and “psychotherapy supervision.” However, what is meant by these terms requires some consideration, as there has been a wide range of practices across the mental health professions (e.g., “management” supervision, clinical “case” supervision), with the use of correspondingly different definitions. There are also differences of emphasis internationally. A popular definition in the United States regards supervision as
In the United Kingdom, supervision has been defined within the National Health Service (NHS) as “A formal process of professional support and learning which enables practitioners to develop knowledge and competence, assume responsibility for their own practice, and enhance consumer protection and safety of care in complex situations” (Department of Health, 1993, p. 1). However, prior reviews suggest that these definitions of supervision are problematic (e.g., Hansebo & Kihlgren, 2004; Lyth, 2000). For example, the popular Bernard and Goodyear (2014) definition does not specify the nature of the “intervention.” Additionally, surveys indicate that practitioners are unclear over the nature and purposes of supervision (e.g., Lister & Crisp, 2005).
To develop an improved, empirical definition of clinical supervision, a systematic review of 24 empirical studies was reported by Milne (2007). The first part of that review was “logical,” clarifying the criteria for such an improved definition. This indicates that a definition needs to state the precise, essential meaning of a word or a concept in a way that makes it distinct (COED, 2004), the “precision” criterion. This requires comparisons and examples to distinguish related concepts (e.g., therapy, coaching, or consultancy). Second, a sound definition also needs “specification,” namely a detailed description of the elements that make up the concept of supervision (COED, 2004). The next task is to operationalize the key relationships in supervision, so that appropriate forms of measurement are indicated, and so that we know what it means to manipulate supervision with fidelity (e.g., to prepare a manual or guideline). The fourth and final logical condition for an empirical definition of supervision is that it has research support: it is corroborated by the available evidence. Milne then applied these logical criteria to the available definitions, building on Bernard and Goodyear, to offer a definition that synthesized those available: “The formal provision, by approved supervisors, of a relationship-based education and training that is work-focussed and which manages, supports, develops and evaluates the work of colleague/s. It therefore differs from related activities, such as mentoring and therapy, by incorporating an evaluative component and by being obligatory. The main methods that supervisors use are corrective feedback on the supervisees' performance, teaching, and collaborative goal-setting. The objectives of supervision are “normative” (e.g., case management and quality control issues), “restorative” (e.g., encouraging emotional experiencing and processing, to aid coping and recovery), and “formative” (e.g., maintaining and facilitating the supervisees' competence, capability, and general effectiveness). These objectives could be measured by current instruments (e.g., Teachers' PETS; Milne, James, Keegan, & Dudley, 2002).” This definition was then tested through a systematic review, to assess whether it was consistent with and supported by the findings of the most relevant supervision research (a sample of 24 studies). Overall, the systematic review indicated that the definition was valid. We have shared this definition with the contributors to this handbook, with the aim of working from a clear and shared definition.
