Clinical Supervision in the Public Sector: A Child Welfare Exemplar
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1 Clinical Supervision in the Public Sector: A Child Welfare Exemplar Scott Migdole, MSW, LCSW Chief Operating Officer, Yale Behavioral Health Assistant Clinical Professor Department of Psychiatry Yale School of Medicine
2 A Special Welcome Child Welfare Staff Child Welfare Supervisors Some background data
3 Child welfare: Just the facts 3.5 million children were involved in investigations of alleged abuse or neglect in the US (2004) 872,000 children were determined to have been abused or neglected and1,490 children died because of abuse or neglect (2004)
4 Culture of compliance
5 A model of supervision Assures effective practice and the safety of children and families Promotes a practice culture that is familycentered, strength based, and solution focused
6 Today s 4 objectives Understand the current state of child welfare supervision in the public sector Understand the key organizational elements in developing a model of child welfare supervision Understand the key supervisory functions for supervisors working in the child welfare system Understand how to synthesize the key organizational and individual elements together to form a functional model of child welfare supervision
7 Status of supervision nationally
8 Public sector: The larger context for today Programs and services financed primarily by public funds with mandates to serve indigent individuals and others with moderate to severe behavioral health and/or substance abuse problems
9 Child Welfare Services In-home family preservation services foster care/residential treatment mental health/substance abuse care parenting skills classes employment assistance financial/housing assistance How do we assure the quality of these services?
10 4 key organizational infrastructure elements
11 Organizational infrastructure element #1 Articulation of organizational supervision standards Hess, P., Kanak, S., & Atkins, S. Building a Model and Framework for Child Welfare Supervision, National Resource Center for Family-Centered Practice and Permanency Planning & National Child Welfare Resource Center for Organizational Improvement
12 Supervision Standards Plan approved by CEO Standards Implemented by Human Resources (Frequency/Duration/Modality) Documentation
13 Organizational infrastructure element #2 Articulation of the organization s practice philosophy and evidence-based approach to service delivery Hess, P., Kanak, S., & Atkins, S. Building a Model and Framework for Child Welfare Supervision, National Resource Center for Family-Centered Practice and Permanency Planning & National Child Welfare Resource Center for Organizational Improvement
14 Quality of Care Meeting minimum professional standards. 1. Do no harm 2. Assessing risk 3. Accessing help in a crisis 4. Reach required compliance standards
15 Organizational infrastructure element #3 Articulation of performance evaluation standards Hess, P., Kanak, S., & Atkins, S. Building a Model and Framework for Child Welfare Supervision, National Resource Center for Family-Centered Practice and Permanency Planning & National Child Welfare Resource Center for Organizational Improvement
16 Approach #1 x%$%, I have to complete a Performance Review!
17 Approach #2 Process versus an Event in Time Copy of job description, expected competencies, and performance review form Jointly identify strengths and areas for skill development Ongoing feedback Opportunity to discuss annual review
18 Organizational infrastructure element # 4 Articulation of how supervisors are supported in their roles as unit leaders and change agents How do we get there? Hess, P., Kanak, S., & Atkins, S. Building a Model and Framework for Child Welfare Supervision, National Resource Center for Family-Centered Practice and Permanency Planning & National Child Welfare Resource Center for Organizational Improvement
19 Support supervisors in their roles as unit leaders a. QAI activities(compliance) b. Redesign of systems, forms, etc c. Policy changes
20 Organizational Infrastructure Elements: A summary Supervision standards Practice standards Performance evaluation Empowerment of supervisors
21 Functions and Phases: Structuring Supervision
22 3 Phases of Supervision 1. Engagement Phase 2. Work Phase 3. Ending & Transition Phase
23 The Informed Consent What is an Informed Consent approach? A form to foster and document the discussion
24 Supervision and the Unspoken Issues Why don t we talk about these things?
25 Who are my supervisors? The roles and responsibilities of each Who to turn to in their absence After hours supervisory coverage
26 What kind of meetings will we have? How often will we meet? How long will we meet? Will it be individual and/or group supervision? What if I need to cancel?
27 Are you qualified to supervise? Supervisee s concerns or question AND Supervisor s personal doubts
28 Purpose of Supervision Ensure quality of care and strengthen the quality of services provided Ensure administrative tasks are completed Provide support in the face of work-related challenges Help to grow and develop skills
29 Evaluating Performance You ll get a copy: job description expected competencies performance review form with criteria Ongoing feedback Annual review
30 Confidentiality Strategies Supervisors handle sensitive information carefully and don t actually share most of it. None of the information is truly confidential Used for crisis intervention, mandated reporting, performance reviews, personnel actions, and maintaining staff safety Secrets are never OK!
31 Dual Relationship Strategies Acknowledge and inform supervisor about dual relationships with clients With respect to supervisors & supervisees: Some dual relationships are clearly unethical All dual relationships create complications Reasons to avoid them Sometimes unavoidable (promoted from within) Placing a boundary around work related issues if a dual relationship exists
32 What are my rights? Do they really have any?
33 Your rights Respect Dignity Cultural sensitivity Free of abuse/harrassment
34 What if I really disagree with you? Can they really go over your head?
35 Appeals Process 1. Start discussing the disagreement with your supervisor 2. If we can t resolve this, you can meet with my supervisor 3. Human Resources or Administration as another level of appeal
36 Work Phase
37 Quality of care Knowledge of evidence-informed practice Ability to operationalize knowledge into practice Promote critical thinking and decisionmaking (patterns of action, practice situations and case practice knowledge)
38 Administrative
39 Influencing a Culture Assure accountability (authority) Establish expectations and standards Identify, manage and evaluate performance Provide leadership to the unit and manage change
40 Professional Development
41 Most occasions, events, and problems are viewed as a learning opportunity Learning is continuous Learning is organized Identify needs Plan and complete learning experiences Reassess learning needs Supervisor is learning Models that it is OK not to know Is willing to learn from the supervisee
42 Support
43 Strategies for support Intervening & advocating on behalf of staff Being available or making time Anticipating issues related to safety and risk management Debriefing & support after stressful incidents
44 Transitions & Endings
45 Strategies Announce the transition or ending early Negotiate the tasks to be done and the timelines Do an exit interview Ask for feedback about the job Ask for feedback about your supervision Discuss the nature of the contact you ll have in the future (can I still call you if things get tough?) If leaving the agency If moving to another role in the agency
46 A model of child welfare supervision: Implementation and Sustainability
47 CEO: Pathways to success 1. Set forth supervisory standards 2. Set forth practice guidelines for organization 3. Develop organizational climate that supports positive supervisory relationships 4. Empower agency supervisors
48 Human Resources: pathway to success Assure compliance with standards Assure supervisor job descriptions are accurate Assure annual professional development plans Assure supervisors are competent and have received training in how to supervise
49 Training/education: pathways to success Establish learning communities for direct care supervisors Identify staff to sustain model in the future
50 Senior managers: Pathway to success Implementation of supervisory standards Guide learning communities
51 Direct care supervisors: pathways to success Establish an Informed Consent Utilization of the 4 core functions of supervision Attendance at monthly learning community Meeting with their supervisor biweekly
52 Direct care staff: pathways to success Utilization of evidence-based practices Meeting with supervisor at scheduled time
53 Where have we been? CEO Human Resources Training/Education Senior Supervisors Direct Care Supervisors Direct Care Staff
54 Finally. Social workers who act as supervisors in child welfare shall work to develop and advance the social workers skills and ensure quality service delivery to clients NASW Standards for Social Work Practice in Child Welfarehttp://
55 Got a Question? Scott.migdole@yale.edu
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Department of Social Work - Field Program LEARNING AGREEMENT PURPOSE The student Learning Agreement is a written agreement between the student and agency Field Instructor that outlines student goals and