The Value of Supervision

Providing supervision is a familiar requirement for many health care professionals. Receiving and giving supervision within most therapy departments is accepted as a normal procedure and indeed expected amongst qualified and unqualified staff. Good supervision has been recognised as a vital pre-requisite to the delivery of high quality services by highly skilled staff (Skills for Care and Children’s Workforce Development Council 2007 cited in Davys and Beddoe 2010 p 16). Accountability for ensuring efficient and effective services to all individuals who require health care has been endorsed by many health care organisations and also the British government which has also reinforced their expectations of quality standards via legislation of national service frameworks and other Department of Health papers. Supervision therefore, is not a practice to be taken lightly.

The College of Occupational Therapy in its Code of Ethics and Professional Conduct states:

5.2.1. Occupational Therapists shall provide supervision appropriate to the level of competence of the individual for whom they have responsibility.

There is a common understanding within Occupational Therapy of ones responsibility to participate in supervision on a regular basis. This responsibility normally handed over to practitioners, even those who are still at the novice stage of their practice. Developing skills in supervision can take considerable time and when it works well can be rewarding and satisfying for both supervisor and supervisee. Irrespective of when a practitioner supervises, expectations of supervision can influence a participant in several ways. Supervision should enable the development of professional competence, introduce a mechanism for clinical practice accountability, support continuous professional development, provide personal support and help practitioners engage with the strategic plan of the organisation (Davys and Beddoe 2010 p25).

A number of models of supervision exist. The developmental model devised by Butler in 1996 distinguishes the various stages of professional development from novice to expert and within this process acknowledges the changing role of each participant as they journey through their own stages of development. The reflective model of supervision is also likely to be another approach used. Reflection is one of the four phases of experiential learning, created by Kolb in 1984. Creating an atmosphere of constructive critical reflection may be a particularly useful approach used in supervision to aid another person’s development.

A range of supervisory models exist, however the evidence for promoting the use of any particular model over another is sparse. Sadly, the evidence based research for identifying effective supervisory models has not been studied to the same extents of clinical trials. What is apparent is a growing and demanding need for organisations to be creative as they grow in complexity and as the demands for patient quality care increases. A recent article written by Clark (2013) refreshingly writes of positive outcomes following exploration of the supervisory role and process within an Occupational Therapy Department based in Fife, Scotland. This department eventually achieves provision of formal supervisory training, introduction of audit procedures as well as achieving COT endorsement of supervisory processes which are now in place.

The skills of a good supervisor include excellent communication skills. Being attentive to information being shared and demonstrating a high standard of active listening skills are crucial. Providing an atmosphere where information can be explored, analysed and carefully and sensitively challenged may help develop professional and personal confidence. There is a relationship of mutual respect between both participants. Supervision should always be time protected with no interruptions. Participants should also be allowed time for self-reflection including how their experiences made them feel and how they may improve or alter actions or behaviour should they encounter similar challenging experiences in the future. A competent and experienced supervisor will be able to offer many examples of professional experiences which have impacted on the way they approach particular clinical or personal situations. It is recommended to always conclude supervision with a summary of what has been discussed, actions agreed and who will be responsible for achieving them. This should prevent any misunderstanding or misinterpretation of information.

It is recommended to formally agree the terms of supervision by agreeing a supervision contract. Conditions of supervision may include any of the following however this is not an exhaustive list:

· Who will be involved in supervision
· Frequency of supervision
· Duration of supervision
· Maintaining confidentiality, other factors that may alter the confidentiality rule should also be discussed and agreed
· Responsibility of agenda preparation
· Responsibility for note taking
· Period when supervision review to be completed and who will be involved
· Procedure should supervision relationship not be amicable

Clinicians at Independent Rehabilitation Services are highly skilled in providing supervision to health care professionals. We have supervised qualified and unqualified staff over many years both in the National Health Service and Private sector of health care. It is a responsibility we take seriously but also get a great deal of satisfaction from. If you would like to discuss supervision or are seeking formal supervision either for yourself or your staff and would like to discuss opportunities for regular supervision we would be most happy to explore this with you. Please do not hesitate to contact either Angela Gordon or Birgit Rathje-Vale at Independent Rehabilitation Services.


Clark N (2013) ‘OT clinical supervision: a journey of service development’, OT News, 21(3) 42-43

College of Occupational Therapists (2005) College of Occupational Therapists Code of Ethics and Professional Conduct London: College of Occupational Therapists

Davys A and Beddoe L (2010) Best Practice in Professional Supervision. London: Jessica Kingsley Publishers


Declan McNichol

Bill Young

Angela Gordon

Birgit Rathje-Vale

Helen Smart