Supervision
Historically, there has been a strong emphasis in behavioral health on the supervision of the workforce. However recent changes in the field have created an even more compelling argument for enhancing that supervision:
- Care is increasingly provided in the community where workers receive less observation and have more autonomy
- The clinical and social complexity of individuals and families has increased and
- Services and service systems have become much more complicated.
Research findings suggest that receiving supervision increases supervisee competence, job satisfaction, and job retention, and that training supervisors also improves their competence and job satisfaction (Hoge et al., 2011). Well-designed studies suggest that supervision can increase client and family engagement, adherence to prescribed treatment, satisfaction with treatment, and clinical outcomes (Henggeler et al., 2002; Schoenwald, Sheidow & Chapman, 2009).
Unfortunately, there is considerable evidence that the amount of supervision being provided has declined substantially. To contain costs, provider organizations have eliminated many supervisory positions; supervisors are often assigned to oversee the work of a large number of staff members, while carrying their own caseload; and the focus of supervision has become heavily oriented toward administrative and compliance issues, with less attention to the quality of care or employees’ work life. New supervisors infrequently receive training on best practices in supervision.
The Annapolis Coalition Senior Science and Policy Advisor, Dr. Michael Hoge, has spent a decade working to improve supervision in behavioral health and related areas of health and social services. He launched the Yale Program on Supervision to address the need for a model relevant to supervising workers in publicly-funded services. With input from a national Advisory Board, the following products were developed:
- A model of supervision
- Recommended standards
- A comprehensive set of supervision competencie
- A training curriculum
- A coaching curriculum
- A group supervision curriculum.
A learning collaborative approach to model implementation was adopted, in which multiple agencies from a geographic area participate in a cohort. Agency administrators received technical assistance in reviewing and revising their supervision standards and policies, after which workers at multiple levels within each organization are trained in the standards, the policies, and the supervision model. This model has been disseminated in multiple U.S. states and in Canada. It has been adopted in mental health, child mental health, addictions, child welfare, juvenile justice, correctional mental health, and adult corrections. Descriptions of the model and its implementation are available in the published literature (Hoge, M. A., Migdole, S., Cannata, E., & Powell, D. J., 2014).