Clinical Supervision in Child and Youth Mental Health

Abstract

Objectives

The purpose of this research study is to evaluate clinical supervision and clinical supervision training provided by the Ministry of Child and Family Development (MCFD) for team leaders and clinicians in Child and Youth Mental Health (CYMH). This report will recommend best practices for CYMH-specific clinical supervision in order to guide MCFD in the development of a clinical supervision training model. The present study used a mixed methods approach to explore CYMH clinicians’ and team leaders’ perceived strengths, challenges, and needs for clinical supervision and clinical supervision training.

Methods

This study involved two mixed methods surveys. One survey was designed for CYMH clinicians to evaluate the effectiveness of clinical supervision; another survey was designed for team leaders to evaluate existing clinical supervision training provided by MCFD. Two focus groups were held via teleconference using semi-structured interview guides to further explore clinicians’ and team leaders’ perceived strengths, challenges, and needs of clinical supervision and clinical supervision training. Focus group transcripts and survey qualitative responses were analyzed using thematic analysis while quantitative survey data was analyzed for descriptive statistics including univariate and bivariate analyses.

Results

Quantitative results indicate that clinicians and team leaders generally reported low satisfaction ratings toward the quality, frequency, and effectiveness of clinical supervision and clinical supervision training to enhance clinical competence, behavioural competencies, and diversity and multicultural competence. Four thematic categories emerged from the qualitative data from the surveys and focus groups related to clinicians’ and team leaders’ perceived strengths, challenges, and needs for clinical supervision and clinical supervision training, including (a) content and competencies, (b) time, consistency, and access, (c) professional development and expertise, and (d) structural limitations.

Recommendations

Based on the study findings, this report produced concrete recommendations toward a systematic, CYMH-specific, and culturally-responsive clinical supervision training model and a clinical supervision structure. These key components may be used by MCFD to guide the future development of clinical supervision training. The five core recommendations include: 1) provide CYMH-specific clinical supervision training to enhance team leaders’ competence in clinical supervision; 2) improve team leaders and clinicians’ access to training for a wide range of relevant CYMH clinical modalities; 3) separate administrative and clinical supervision roles to improve safety in the supervisory relationship; 4) provide systematic clinical supervision training for team leaders; and 5) prioritize diversity and cultural competence in clinical supervision training.

Conclusions

Clinicians face multiple barriers in accessing effective clinical supervision. These barriers include: (a) lack of safeguards for clinicians’ clinical supervision, (b) team leaders’ dual clinical and administrative roles, (c) prioritization of administrative supervision, (d) lack of systematic clinical supervision training, (d) lack of access to professional development opportunities, (e) lack of training in diversity and cultural competence. This study prompts further consideration and action to improve both clinical supervision and clinical supervision training within CYMH in order to improve treatment outcomes for children and youth in BC.