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Humanistic school
The humanistic school views supervision
as being concerned with the development
of a supervisees self-understanding, selfawareness and emotional growth, the
emphasis being centred on the supervisees
cognitions. The supervisee has responsibil
ity for the content of the learning, the
focus of supervision and the way in which
he/she completes the task. Supervision
concentrates on the here and now and
focuses on the feelings of the client and
supervisee.
Psychoanalytical school
British Journal of Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 26, 2015. For personal use only. No other uses without permission. . All rights reserved.
An integrative approach to
clinical supervision
The final model of clinical supervision
originates from the work of Hawkins and
Shohet (1993) who suggest the use of a
double matrix model which differs signifi
cantly from other ways of looking at clini
cal supervision.
The model turns the focus away from the
context and wider organisational issues and
looks more closely at the process of the
supervisory relationship. Hawkins and
Shohet (1993) argue that different styles of
supervision cannot be explained by develop
mental stages, primary tasks or intervention
styles. Instead they suggest that different
styles of clinical supervision are connected
to the constant choices and decisions that
supervisors make about what to focus on in
the tripartite relationship between supervi
sor and the supervisee client.
Situations involving supervision can be
divided into four main components:
1. Supervisor
2. Supervisee
3. Client
4. Work context.
Hawkins and Shohet (1993) argue that
the process can also be separated into
two interlocking systems or matrices.
These are:
1. The therapy system which interconnects
the client and the supervisee through an
877
British Journal of Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 26, 2015. For personal use only. No other uses without permission. . All rights reserved.
KEY POINTS
Clinical supervision is commonly seen in counselling and
psychotherapy practice and to some degree in mental health
nursing.
Several different models of clinical supervision have been
used to good effect.
The four main components of clinical supervision are:
supervisee, supervisor, client and practice situation.
Models of clinical supervision can be adapted for use in
general nursing practice.
Research needs to examine if models of supervision can be
effective in general nursing.
878
Conclusion
Effective models of clinical supervision in
counselling and psychotherapy are well
grounded and are becoming more estab
lished in mental health practice, as advan
tages for supervisor and supervisee can be
seen in terms of increased professional
autonomy, improved self-esteem and effec
tiveness in dealing with uncertainties in
clinical practice.
While supervision in midwifery has been
in existence for some time, only recently
has supervision started to break through
into general nursing practice, no doubt
spurred on by the higher profile given
recently to clinical supervision, e.g. the
Kings Fund Centre (Kohner, 1994),
Nursing Times (1995), and the U K C C
(1995).
It is argued that the models currently in
existence in mental health care, particularly
an integrative approach to clinical supervi
sion, can be transferred and used in general
nursing practice. Some adjustments and fine
tuning will clearly have to be made to these
models in order to ensure that they have
meaning for those using them. However,
more research is obviously needed in order
to establish whether they can be used effec
tively in general nursing.
Department of Health (1994) Working in Partnership
A C ollaborative Approach to C are. HMSO,
London
Farrington A, Telford A (1995) Naming the problem
assessment and formulation. In: Marshall S,
Turnbull J, eds. Cognitive Behaviour Therapy: An
Introduction to Theory and Practice. Baillire
Tindall, London (in press)
Faugier J (1992) The supervisory relationship. In:
Butterworth CA, Faugier J, eds. C linical
Supervision nd Mentorship in Nursing. Chapman
and Hall, London: 18-36
Hawkins P, Shohet R (1993) Supervising in the
H elping Professions. Open University Press,
Milton Reynes
Heron J (1990) Helping the Client A Creative
Practical Guide. Saee, London
Kohner N (1994) Clinical Supervision in Practice.
Kings Fund Centre, London
Milne D (1986) Training B ehaviou r Therapists:
Methods, Evaluation and Im plem entation with
Parents, Nurses and Teachers. Brookline,
Cambridge
Nursing Times (1995) News item: A project funded
by the Department of Health to examine clinical
supervision at 23 sites in England and Scotland.
Nurs Times 91(22): 8, 31
Proctor B (1991) On being a trainer. In: Diyden W,
Thorne B, eds. Training an d Supervision fo r
Counselling in Action. Saee, London: 49-73
Ramirez III M (1991) Psychotherapy and Counselling
with M inorities: A C ognitive Approach to
Individual and Cultural D ifferences. Pergamon
Press, Oxford.
UKCC (1995) Clinical Supervision fo r Nursing and
H ealth Visiting. Registrars letter. 24 January.
UKCC, London
British Journal of Nursing, 1995, Vol 4, No 15
British Journal of Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 26, 2015. For personal use only. No other uses without permission. . All rights reserved.