What is the impact of supervision on direct practice with families?

https://doi.org/10.1016/j.childyouth.2019.104428Get rights and content

Highlights

  • Pairs observations of systemic supervision with observations of direct practice.

  • Supervision and direct practice independently assessed for quality.

  • Systemically-informed supervision associated with skilful practice with families.

  • This includes both relationship-building and use of “good authority” skills.

  • Systemically-trained clinicians associated with improved supervisory and practice.

  • High quality supervision has the potential to support and shape “practice-making.”

Abstract

Supervision has been described as the “pivot” upon which the integrity and excellence of social work practice can be maintained. However, there is little research that examines its impact on how social workers work directly with children and their families. Where effectiveness studies exist, they tend to explore the impact of supervision on organisational and staff-related outcomes such as retention rates or worker well-being. The current study focuses on one specific sub-category of the wider supervision and practice literature: systemic group supervision or “systemic supervision” and is based on a wider evaluation of systemic social work practice in the UK. The paper pairs observations of systemic supervision (n = 14) and observations of direct practice (n = 18) in peoples' homes. It presents correlational data on the relationship between supervision quality and direct practice quality to assess whether there is an association between the two practice forums.

The paper demonstrates that there is a statistically significant relationship between supervision quality and overall quality of direct practice. Supervision was also associated with relationship-building skills and use of “good authority” skills; that is, practice that was more purposeful, child-focused and risks to children better articulated. Interestingly, where a clinician qualified in systemic family therapy was present in supervision, this was associated with both improved supervisory and direct practice quality. This suggests that there may be an important association between the discussions held in systemic supervision, particularly where a clinician is present and the quality of conversations that practitioners have with children and families. These findings contribute to a growing body of knowledge about the relationship between effective supervision and direct practice within children and families social work.

Introduction

Supervision has been described as the “pivot upon which the integrity and excellence of social work practice can be maintained” (Hafford-Letchfield & Engelbrecht, 2018: 329). In recognition of its importance, supervisory standards have been developed to articulate and support professional supervisory practice in social work settings across the globe. Unguru and Sandu (2018) conducted a recent review of international frameworks for best practice in social work supervision developed in Aotearoa New Zealand, Australia, Canada, Romania, Singapore, the UK and USA. They found that social work supervisory guidance was relatively uniform across the world. In line with Kadushin and Harkness' (2014) definition of supervision, they found that standards focused on the following three functions: administrative case management, including the recognition of the mediatory aspects of supervision whereby supervisors acted a bridge between individual social workers and the organisation; personal support to provide a safe space to explore the emotional impact that social work can have on practitioners and in turn, how their emotional state might be impacting their practice; and education, to enable reflection on and learning from practice with a view to identifying the best solutions and achieving positive outcomes with clients experiencing difficulties (Unguru & Sandu, 2018). Such frameworks are premised on the assumption that there is a direct link between supervisory practice and direct practice between social workers and people using social work services. Yet, international reviews of the literature on social work supervision have struggled to identify studies that explore this relationship (Carpenter, Webb, Bostock, 2013; Bogo & McKnight, 2006; O'Donoghue & Tsui, 2012). In part, this may reflect difficulties unraveling the distinct impact of supervision on worker practice or client outcomes, but it may also reflect an underlying preoccupation with the impact of supervision on outcomes for workers and organisations.

Where effectiveness evidence exists, most supervision research focuses on the impact that supervision makes on workers, often relying on supervisee self-reporting, rather than differences made to their practice or outcomes for clients (Banuch, 1999; Collins-Carmargo & Royse, 2010; O'Donoghue & Tsui, 2015; Wheeler & Richards, 2007). For example, Lietz (2008) used self-report questionnaires to assess the impact of a newly introduced group supervision model on practitioner critical thinking. She found that the level of perceived critical thinking amongst practitioners had increased following the introduction of the new model. However, the study did not account for whether this learning had been transferred into practice with and about families. Therefore, we cannot know if practitioners naturally perceive themselves as thinking more critically by simply being part of a project designed to help them think more critically. By interpreting supervisee perceptions in this way, rather than supervisee practice, researchers are at risk of over-attributing the impact of supervision on one of its primary functions: shaping practice. Conversely, calls from reviewers such as O'Donoghue and Tsui (2015) to focus greater attention on the impact of supervision on client outcomes, while perhaps justified, runs the opposite risk: identifying statistical associations without theorising the process through which such associations take effect.

Nevertheless, where correlational studies have been conducted, associations have been identified between worker ratings of supervisory skills and alliance with improved client goal attainment (de Greef et al., 2019; Harkness, 1995). Critically, client-focused supervision – that is supervision that used questions designed to help staff explore client's understanding of their presenting problem – was associated with improved client satisfaction with goal attainment, worker helpfulness and working alliance (Harkness & Hensley, 1991). To explore this relationship further, this paper presents correlational data on the relationship between supervision quality and direct practice quality to assess whether there is an association between the two practice areas. It-tests the hypothesis that there was a positive association between supervision quality and direct practice quality, with supervision rated as higher quality associated with more highly skilled practice in people's homes and conversely, supervision rated as lower quality associated with lower skilled practice. The paper is based on an exploratory study that presents correlational data on the relationship between supervision quality and direct practice quality. It focuses on one specific sub-category of the wider supervision practice and research literature: systemic group supervision or “systemic supervision” and is based on a wider evaluation of systemic work practice in the UK (Bostock et al., 2017). The paper pairs observations of “live” systemic supervision (n = 14) and observations of home visits (n = 18) that were independently assessed for quality to build knowledge on the practice shaping function of supervision within child and family social work.

Over recent years, there has been an international move toward developing new, more therapeutically informed models of practice within child and family social work. In Aotearoa New Zealand, Australia, the UK and US, the following new approaches have evolved: restorative practice (Pennell, 2006); motivational interviewing (Luckock, Hickle, Hampden-Thompson, & Dickens, 2017); signs of safety (Turnell & Edwards, 1999); and solution-based casework (Antle, Barbee, Christensen, & Martin, 2008). Within the UK, systemic social work practice has been the focus for reform in many services (Cameron, Elliott, Iqbal, Munro, & Owen, 2016; Laird, Morris, Archard, & Clawson, 2017; McNeish, Sebba, Luke, & Rees, 2017). Systemic social work practice is informed by the principles of systemic family therapy but adapted to the child protection context. It is a relational and strengths-based approach that positions service users as experts in their unique family situation. Within systemic approaches, families are understood as systems rather than individuals, with the family system interacting with the wider economic and social context including extended family, local community or professional systems (Forrester et al., 2013).

Consequently, a key concept in systemic theory is considering multiple perspectives and multiple possibilities. Systemic group supervision or systemic supervision provides the pivotal practice forum for understanding risk to children and planning interventions to support families. It is a group-based forum whereby children and families are discussed by the team. Like other forms of supervisory practice, it is designed to provide the most effective service to clients as defined by national and organisational professional standards in social work (Carpenter et al., 2013: 1844). However, in systemic group supervision the organisation's mandate to the supervisor is implemented in the group and through the group (Kadushin & Harkness, 2014: 275). Group supervision has been identified as a model that lends itself well to enhanced critical thinking, both to better understand practice or assess the difficulties that clients face (Beddoe & Davys, 2016). However, the overwhelming emphasis within the supervision literature has been on the learning potential that group supervision models afford to social work students (Alschuler, Silver, & McArdle, 2015; Arkin, Freund, & Saltman, 2007; Bogo, Globerman, & Sussman, 2004; Geller, 1995; Walter & Young, 1999; Wilbur, Roberts-Wilbur, Morris, Betz, & Hart, 1991), with the notable exception of qualified social workers by Lietz (2008). This may reflect that group supervision is less prevalent within child and family social work, hence subject to less research. Nevertheless, group supervision appears to be gaining transaction as a practice forum within child welfare services and has been identified as a core component of some strengths-based family-centered practice models (Lietz, 2013; Lietz & Julien-Chinn, 2017; Lietz & Rounds, 2009).

Systemic supervision is a multi-disciplinary forum generally made up of senior social workers, social workers, child practitioners and a clinician trained in systemic family therapy. It is led by a senior social worker, known as a consultant social worker (CSW) who has supervisory and management responsibility and where available, supported by a clinician with advanced expertise in systemic practice (Forrester et al., 2013; Bostock et al., 2017; Dugmore, Partridge, Sethi, & Krupa-Flasinska, 2018; Cross, Hubbard, & Munro, 2010). The purpose of this multi-disciplinary supervisory forum is to explore risk to children from multiple perspectives - including families and other professionals – and enables practitioners to “think aloud” or reflect with colleagues about their practice and suggested interventions (Beddoe & Davys, 2016). This enables practitioners to generate multiple explanations and surface multiple solutions for the difficulties facing families, although it is recognised in child protection social work not all solutions are acceptable to protect the welfare of children (Koglek & Wright, 2013).

To assess the relationship between supervision and direct practice, it is necessary to define and rate practice skills evident in both forums. Wilkins et al. (2019) have developed a framework for coding the quality of one-to-one supervision. Interestingly, Wilkins, Lynch, and Antonopoulou (2018) applied this framework within an exploratory study of newly-instigated systemic group supervision and compared supervision quality with the quality of direct practice within people's homes. This framework categorizes supervision quality as “supportive of practice” - practice that is focused on the “what, why and how” of social work - and “other–focused” – supervisory practice that is lacking in curiosity and the sense that social worker's practice is his or her responsibility alone. Wilkins et al. (2018) found significant associations between systemic supervision that is supportive of practice and two dimensions of direct practice: overall practice skills and the use of good authority e.g. practice that was more purposeful, child-focused and risks to children better articulated. Crucially, they were able to triangulate data on supervisory and direct practice quality with questionnaire data collected from parents. They found that where supervision was assessed as practice focused, parents reported higher engagement, improvements in life rating over time and greater goal agreement with social workers. These differences were significant for goal agreement but not for the other variables. Wilkins et al. (2018) conclude that this provides evidence for a “golden thread” between quality of supervisory practice, direct practice and parental engagement and goal-agreement.

These findings are critical to our understanding of the relationship between supervision and direct practice and what differentiates “good” practice in supervision. More recently, we have described the development of coding framework designed specifically to assess the quality of systemic supervision (Bostock, Patrizo, Godfrey, Munro, & Forrester, 2019). It was based on analysis of 29 “live” observations of group supervision across five local authority children's services departments in England. Supervisory conversations were assessed as follows: 8 as non-systemic; 12 as demonstrating “green shoots” or a high incorporation of systemic ideas into interactions; and 9 supervision sessions demonstrating a full incorporation of systemic concepts and practice. To illuminate differences in practice quality, it presents qualitative data of practitioner talk within supervisory sessions. What marked systemic sessions from “green shoots” supervision was the move from hypothesis generation about family relations and risk to children to purposeful, actionable conversations with families: “the move from reflection to action” (Bostock et al., 2019: 515).

In this paper, we argued that conversations with children and families can be conceptualized as central to social work intervention. It is through planned, purposeful and focused conversation that positive change for children can hopefully be achieved. This was why the use of supervision as a “rehearsal space” to plan such conversations with families was so striking. We observed that within systemic supervision, group members would draw on the expertise of colleagues to actively plan their conversations: together they would generate questions to ask the family, imagine a family's response and reflect on what conversational turns might keep their interaction with the family child-focused, collaborative and curious about family dynamics and risk to children. Clinicians, in particular, seemed to play a pivotal role in supporting colleagues plan systemically-informed conversations with families. We argued that this approach within systemic supervision provides the “foundation for more purposeful, effective practice with children and families” (Bostock et al., 2019: 523). This paper explores this assertion further and poses the question: what is the impact of systemic supervision on direct practice with families?

To address this question, we pair “live” observations of supervision and audio recordings of social worker home visits to families that were independently assessed for practice quality. This approach aimed to capture and evaluate what happens in these two respective practice fora and explore what relationship might exist between them. These data are analysed quantitatively to identify correlations in practice quality to assess how systemic thinking and interaction within supervision was reflected in subsequent practice with families outside supervision.

Section snippets

Background

In England, local authorities have specific legal duties to safeguard and promote the welfare of all children in their area (Department for Education, 2018). Local authorities are local government organisations responsible for the provision of public services within their geographical jurisdiction. Within local authorities, “children's services” are the department charged with delivering on these duties. Children's services' social workers, and their managers, are therefore responsible for

Ethics

The wider study received ethical approval via the Research Institute's ethics committee from the lead author's university (reference number IASR 25/14). Verbal consent was obtained prior to the family visit observation and written consent confirmed at the end once families were fully aware of the information that they were consenting to share via their recording. They were informed of their right to withdraw at any point up to the end of data collection and to have all their research data

Findings

What relationship did we find between the quality of systemic supervision and quality of family visits? The following sections provide our assessment of supervisory practice quality, direct practice quality and how they are related. We also report on what difference the presence of a qualified clinician makes to both ratings of supervision and direct practice quality.

Limitations of the study

This is a small-scale, exploratory study carried out in specific locations and times. Replication with a larger sample in different settings is necessary before high confidence can be placed on the results. We were reliant on social workers' negotiating access to interviews with families, and this may have contributed to some selection bias. There was some clustering, with some supervision having more than one practice episode associated with it. The sample size precluded statistical methods to

Discussion of findings

So, what do these findings mean for social work supervision with families and supervision more generally? First, we found a statistically significant association between staff supervision and the quality of direct practice in people's homes. Previous research on the effectiveness of supervision has tended to focus on organisational and staff-related outcomes, such as retention rates and social worker well-being rates (Carpenter et al., 2013; Bogo & McKnight, 2006; O'Donoghue & Tsui, 2015). This

Implications and conclusions

Once a social worker has left the “rehearsal space” of supervision, they join with families in home visits, supporting them to protect the welfare of their children, often in poor functioning and improvised circumstances. In these practice moments, social workers are often quite literally entering the unknown and acting alone. Ferguson (2018) argues that there is “no blueprint for home visiting” rather: “social workers have to make their own practice by improvising their ways into and through

Declaration of Competing Interest

None.

Acknowledgements

This research was funded by the Department for Education's Children Social Care Innovation Programme, England, United Kingdom. The views expressed are those of the authors and may not reflect those of the Department for Education. We would like to acknowledge the participating local authorities who supported the wider evaluation study and research colleagues who carried out some of the fieldwork.

References (52)

  • J.S.W. Carpenter et al.

    The surprisingly weak evidence base for supervision: findings from a systematic review of research in child welfare practice (2000-2012)

    Children and Youth Services Review

    (2013)
  • D. Forrester et al.

    A randomized controlled trial of training in Motivational Interviewing for child protection

    Children and Youth Services Review

    (2018)
  • M. Alschuler et al.

    Strengths-based group supervision with social work students

    Groupwork

    (2015)
  • B. Antle et al.

    Solution-based casework in child welfare: Preliminary evaluation research

    Journal of Public Child Welfare

    (2008)
  • N. Arkin et al.

    A group supervision model for broadening multiple-method skills of social work students

    Social Work Education

    (2007)
  • M. Banuch

    The worker's view: Strategies and coping skills in a family preservation program

    Child and Adolescent Social Work Journal

    (1999)
  • L. Beddoe et al.

    Challenges in professional supervision: Current themes and models for practice

    (2016)
  • M. Bell

    Working in partnership in child protection: The conflicts

    The British Journal of Social Work

    (1999)
  • M. Bogo et al.

    The field instructor as group worker: Managing trust and competition in group supervision

    Journal of Social Work Education

    (2004)
  • M. Bogo et al.

    Clinical supervision in social work: A review of the research literature

    The Clinical Supervisor

    (2006)
  • L. Bostock et al.

    Scaling and deepening Reclaiming Social Work model: evaluation report. London: Department for Education

  • L. Bostock et al.

    Diffusion theory and multi-disciplinary working in children’s services

    Journal of Integrated Care

    (2018)
  • L. Bostock et al.

    How do we assess the quality of group supervision? Developing a coding framework

    Children and Youth Services Review

    (2019)
  • C. Calder

    Child protection: Balancing paternalism and partnership

    The British Journal of Social Work

    (1995)
  • C. Cameron et al.

    Focus on practice in three London boroughs: An evaluation

  • C. Collins-Carmargo et al.

    A study of the relationships among effective supervision, organizational culture promoting evidence-based practice, and worker self-efficacy in public child welfare

    Journal of Public Child Welfare

    (2010)
  • S. Cross et al.

    Reclaiming social work London borough of hackney children and young people's services: Independent evaluation

  • Department for Education

    Working together to safeguard children: A guide to inter-agency working to safeguard and promote the welfare of children

    (2018)
  • P. Dugmore et al.

    Systemic supervision in statutory social work in the UK: Systemic rucksacks and bells that ring

    European Journal of Social Work

    (2018)
  • H. Ferguson

    Child protection practice

    (2011)
  • H. Ferguson

    Making home visits: Creativity and the embodied practices of home visiting in social work and child protection

    Qualitative Social Work

    (2018)
  • D. Forrester et al.

    Reclaiming social work? An evaluation of systemic units as an approach to delivering children’s services

    (2013)
  • D. Forrester et al.

    Family Safeguarding Hertfordshire: evaluation report

    (2017)
  • D. Forrester et al.

    What is the relationship between worker skills and outcomes for families in child and family social work?

  • C. Geller

    Group supervision as a vehicle for teaching group work to students: Field instruction in a senior center

    The Clinical Supervisor

    (1995)
  • S. Goodman et al.

    Social work reclaimed

    (2011)
  • Cited by (16)

    • Evaluating the effectiveness of the systemic practice model of children's social care – A pilot study on child- and family-level outcomes

      2023, Children and Youth Services Review
      Citation Excerpt :

      Second, it is possible that the quality of service-as-usual equals that of the SPM, even if fully implemented. However, In England, Bostock et al. (2019) found an association between truly systemic case discussion in weekly team meetings and better quality practice. This would indicate that at least some components of the practice model, e.g., case supervision, should outperform service-as-usual.

    • Why does systemic supervision support practitioners’ practice more effectively with children and families?

      2022, Children and Youth Services Review
      Citation Excerpt :

      Systemically trained clinicians were identified as key in helping colleagues to plan systemically informed conversations with family members (Bostock et al., 2019a). In a second related paper, Bostock et al. (2019b) paired a sub-sample of 14 observations of supervision with 18 audio recordings of social worker home visits to families that had been independently assessed for practice quality. Findings demonstrated a strong, positive and statistically significant association between quality of supervision and quality of overall social worker direct practice skill (r = 0.64; p =.004).

    • Fidelity and influencing factors in the Systemic Practice Model of children's social care in Finland

      2020, Children and Youth Services Review
      Citation Excerpt :

      Given that the training should give a clear and coherent picture of systemic practice that its users will understand, and equip them with necessary skills, future implementers should assess whether the ToT is the most effective solution. Furthermore, it is vital to maintain high-quality supervision to support systemic practice (Bostock et al., 2017, 2019). The need for ongoing technical assistance has also been noted in other studies (Meyers et al., 2012; Sanclimenti et al., 2017).

    • Effectiveness of child protection practice models: a systematic review

      2020, Child Abuse and Neglect
      Citation Excerpt :

      The studies were also poorly reported making further assessment of bias difficult. While a number of studies have also found positive practitioner experiences regarding the use of other models such as SoS and RSW (e.g., Bostock et al., 2017; Sheehan et al., 2018) and a statistically significant relationship between systemic supervision quality and overall quality of direct child protection practice (Bostock, Patrizo, Godfrey, & Forrester, 2019), the current findings suggest that there is still a lack of rigorous evidence demonstrating that these models lead to better outcomes for children and families. Furthermore, as a result of the focus on models as a whole, the findings of this review do not enable us to assess to what extent the presence or absence of different components are influencing the results, something that requires a much larger body of evidence to be able to assess.

    View all citing articles on Scopus
    View full text