What do clinical supervision research reviews tell us? Surveying the last 25 years

Abstract

What do clinical supervision research reviews across the last 25 years tell us? That question is subsequently examined. Based on database and literature searches, 20 reviews appearing from 1995 through 2019 were identified for survey examination; consistencies, inconsistencies and other defining features were determined across reviews; and the survey findings and their implications are considered. Primary findings are as follows: (a) ‘proof’ for supervision appears to be more ‘proof by association’ than otherwise, being primarily a product of ex post facto, cross‐sectional, correlational study; (b) evidence supporting supervision impact of any type is weak at best, especially so for worker and client outcomes; (c) supervision models generally lack empirical foundation; (d) evidence‐based supervision appears to be more a hope and dream than supervision‐based reality at present; and (e) the primary methodological problems that plagued supervision research in the 1990s are still all too frequent in modern research. Some questions to entertain about supervision going forward, and some remedies for improving its research, are proposed.

Impact of clinical supervision on healthcare organisational outcomes: A mixed methods systematic review

“…This review found various methodological concerns across many studies reviewed, which is consistent with findings from a recent survey of 20 systematic reviews on clinical supervision reported between 1995 to 2019 [3]. Methodological concerns include predominance of ex post facto, cross-sectional, correlational designs, small sample sizes, over reliance on self-report measures, lack of psychometrically sound supervision measures, and lack of experimental and longitudinal designs [3].…”

“…Healthcare organisations also need to support clinical supervisors to build and foster positive supervisory relationships with their supervisees. This has commonly been reported to be the single most important factor that influences the effectiveness of clinical supervision [3,11,54], and requires investment of both time and resources. Supervisors and supervisees can also be guided by evidence-informed principles that facilitate effective clinical supervision.…”

“…For example, Martin and colleagues [11] provide several practical recommendations for supervisors and supervisees to enhance the effectiveness of clinical supervision, such as the development of a supervision contract, undertaking sessions at an optimal length and frequency, utilising different modes including telesupervision, evaluating supervision, and working on skills and abilities such as open communication, flexibility, trust and availability to foster a positive supervisory relationship [11]. Health professionals can be provided with continuing professional development opportunities to upskill in evidence-informed supervision practices [3,55]. There is evidence from a longitudinal, multi-methods study to support the delivery of supervision training in various modes such as videoconference, online and blended modes, thereby catering to those that can't access face-to-face training.…”

“…Whilst efforts are growing to strengthen the evidence for clinical supervision, there is also criticism about a vast majority of evidence on supervision, as being proof by association or tentative [3]. While there is a growing evidence base for the impact of clinical supervision on patient outcomes such as reduced risk of mortality, reduced risk of complications and more effective care [4][5][6][7], and health professional outcomes such as being better supported in their roles [8], there remains a need to systematically review the evidence for the impact of clinical supervision of post-qualification health professionals, on organisational outcomes, to further strengthen the evidence base on clinical supervision.…”

Supervision of a Sample of Clinical and Counselling Psychologists in the UK: A Descriptive Study of Their Practices, Processes and Perceived Benefits

“…Clinical supervision is essential to psychotherapists' professional development Falender and Shafranske (2004); Orlinsky and Rønnestad (2005) and to monitoring the quality of client care that supervisees provide (Goodyear, Falender, & Rousmaniere, 2017). Commensurate with its importance, a robust literature has emerged to inform our understanding of supervision processes (Bernard & Goodyear, 2019) and impacts (see e.g., Allan, McLuckie, & Hoffecker, 2017;Watkins Jr., 2020;Wheeler & Richards, 2007), as well as expected supervisory best practices (American Psychological Association, 2014Association, , 2015Borders et al, 2014;Ellis et al, 2014). However, the focus of this literature has been primarily on the supervision of trainees, with only a very few studies focusing on the supervision of practicing psychologists.…”