Participating in Supervision: Perceptions of Occupational Therapists in New Zealand

Article excerpt

Occupational therapists in New Zealand entrust important outcomes to supervision, including supporting and empowering therapists; promoting anti-discriminatory, culturally safe, and gender appropriate practice (New Zealand Association of Occupational Therapists; NZAOT, n.d.); and assisting therapists to maintain "the 'culture' of occupational therapy" while practising in multidisciplinary teams (Christie, 1998, p. 12). Other purposes include promoting critical reflection and ongoing professional development, ensuring clinical competence and accountability (NZAOT, n.d.; Occupational Therapy Board New Zealand, 2000), and providing a means of monitoring health practitioners' competence (Health Practitioners Competence Assurance Act, 2003). To further inform supervisors, supervisees and the organisations that require therapists to be supervised, this article reports the findings of a small scale qualitative study of occupational therapists' experiences of the process of providing and receiving supervision in New Zealand. The article includes the theory developed to explain therapists' experiences and the circumstances that influence that experience.

Literature review

Early accounts of supervision in New Zealand describe it as a structured, weekly process within which projects were monitored and feedback given, ideas brainstormed, objectives set, and problem solving facilitated (Campbell, 1982-3). Supervision might extend to observation of therapy sessions and demonstrating techniques to the supervisee. Within a decade, consistent with the health reforms of that time, its objectives included ensuring staff met departmental standards (Kendall, 1994) and supporting staff recruitment and retention (Hocking, 1988). More recently, despite acknowledgement of its complexities (Moulder, 2000a, 2000b), regular supervision has been endorsed by the New Zealand Association of Occupational Therapists, the Occupational Therapy Board, and many employers (Ministry of Education, 2005; Simmons Carlsson, Coups, Mueller, Neads, & Thornley, 2007).

Purposes and types of supervision

Current supervisory practices have been identified as having distinct purposes. The professional development focus is on the personal growth and creativity of therapists (American Occupational Therapy Association; AOTA, 1999; Fone, 2006). The managerial focus is on competence (Ung, 2002), accountability (Morris, 1995), the level (AOTA) and quality of practice (Bond & Holland, 1998) and implementing organisational change (Ferguson, 2005). Integrating the two can be difficult, because although many clinical and administrative decisions and directions are inseparable (Mosey, 1986), supervisors tend to address only those functions with which they feel comfortable (Hawkins & Shohet, 2000). Tension between these purposes has been widely recognised, with some recommending that managerial and clinical functions remain separate (Kleiser & Cox, 2008) while others hold that professional development should always be the focus (Williams & Irvine, 2009). Given the very different perspectives the Association, the Board and employers bring to supervision in New Zealand, we have previously argued that the profession needs to debate the purpose of supervision in this country (Herkt & Hocking, 2007).

The process of supervision is internationally accepted to entail a supervisee being guided by someone more experienced (Bond & Holland, 1998), who assures the confidentiality of the process (Kudushan, 1992). Group supervision, which seems to be more usual in nursing (Cummins, 2009), includes individual supervision in a group setting, co-supervision by the supervisor and other supervisees, and group members supervising each other (Bond & Holland, 1998). Peer supervision spans one-to-one arrangements to groups of six or so people, and is characterised by mutuality, respect and perceived equality (Hawken & Worrall, 2002; McNicoll, 2001). …