By Jane Benanti, consultant chartered psychologist
As a senior consultant psychologist who has worked in multidisciplinary teams in child and adolescent mental health services (CAMHS) as well as other NHS and private sector roles, I have been struck by the minimal emotional support offered to social workers I come into contact with. The needs of extremely disadvantaged service users they are trying to support and the issues they are facing make social work emotionally draining, even after years of experience.
Cases that ‘trigger’
It is not necessarily the very severe case of, say, child cruelty that triggers stressful emotions and consequently practitioners’ own painful memories. It could be an adult fighting for a voice within chaotic circumstances, or the caretaking child who puts the self-serving needs of a parent and the daily requirements of younger siblings ahead of their own.
This last one is a classic example of family dysfunction, sadness and false hope that many in the caring professions will understand: the intrinsic, compulsive need to “save” others.
It is for reasons like this that clinical supervision is vitally important; emotions linked to difficult past memories buried deep in the unconscious will almost inevitably be processed during casework. This has a significant impact on practice – personal memories can suddenly “pop up” and cloud our judgment.
Our professional decision-making is affected when we emotionally cut off and reject a particular client (perhaps with that feeling of “this one particularly irritates me”), or when we are drawn into a collusive relationship with a parent and are not alert enough to the potential harm to a child.
I have witnessed social workers and psychologists become emotionally remote and detached when overwhelmed by stress. This may help the professional survive toxic situations but it can damage our work with service users.
We are humans with feelings and failings. We have our own family stresses, professional difficulties with managers and even with our colleagues within the team.
Yes, other professions face the same challenge, but the difference is that they are not exposed to distress and negativity at work almost every day of their lives and expected to process it like an automaton.
‘If there is no distress, social workers are not needed’
Social work in many fields is about helping those who are distressed or struggling. All professionals deserve and should expect support to process these emotions, not least to help ensure continued good practice with service users.
So what type of clinical or therapeutic (as opposed to managerial/workload) supervision should social workers be getting? How should it be structured, who should deliver it and how often? I would suggest something along the lines of the model below:
- In my view, appropriate professionals to deliver this type of supervision are applied psychologists (counselling or clinical) who are some years post qualification or mental health nurses with a robust training in psychotherapy or counselling (for example, a counselling model studied and practiced for a minimum of two to three years). Previous experience of providing supervision is essential.
- Junior social workers should be offered a 60 minute session of clinical supervision fortnightly, in groups no larger than three. One or two of the group may have something substantial to bring whilst the remaining one observes and contributes.
- Other times, two or all three may want to bring cases and the time is divvied up accordingly. The session is structured so that the social worker decides which case(s) to bring, but the supervisor will ask why that particular case has been chosen over another.
- A more senior social worker may need an hour of clinical supervision per month where issues can be brought, whether related to complex social work cases or responsibilities within the team, as well as relationships with senior and junior members of staff. However, it should be clear that it is not an open forum to discuss personal life outside of work, unless in exceptional circumstances.
- At times, supervision may need to be scheduled ad-hoc following a difficult home visit or traumatic event but this could be by phone, outside the more formal face-to-face scheduled sessions.
Setting up the system
Quality assurance covering supervision will apply and the framework of the supervisor’s professional body, as well as the social worker’s organisation, should be adhered to. An audit trail will be needed to assess the added value as well as costs.
Initially, there may be some teething troubles but these should straighten out so long as the will to provide a better service is there, best practice is there, and quality assurance overarches all.
Getting support from the top
Experience tells me that challenges will lie at the top of the safeguarding tree, in the carpeted council offices, with people a million neurological images away from a neglected or abused child.
I would suggest that anyone in those top floor offices (senior management, councillors and the local MP) spends three days shadowing a junior social worker. This would demonstrate at least an attempt to understand the realities of practice and, I believe, show them how seriously clinical supervision is needed.
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