Academic journal article The Qualitative Report

Group Supervision Attitudes: Supervisory Practices Fostering Resistance to Adoption of Evidence-Based Practices

Academic journal article The Qualitative Report

Group Supervision Attitudes: Supervisory Practices Fostering Resistance to Adoption of Evidence-Based Practices

Article excerpt

With the push from funding sources, whether mandated or not, to incorporate best practices into social services (MH, 1999), clinical supervision plays an increasingly important role in sound clinical procedures toward adopting best practices within agencies. Evaluating and monitoring these clinical practices through specific clinical supervision activities should be at the forefront of any agency. Attention to factors which augment workers' resistance to the adoption of new practices could likely make the bridge from research to practice an easier path to cross. In this study, an internal, mixed model self-administered survey collected workers' attitudes about supervision from 51 participants. The qualitative data were analyzed using Moustakas' adaptation of the Stevick-Colaizzi-Keen method of analysis of phenomenological data (Moustakas, 1994).

Background

Because little research has been devoted to supervision in the bio-psychosocial services field (Spence, Cantrell, Christie, & Samet, 2002), a breakdown between assimilation and successful implementation of EBPs could exist resulting from the lack of effective clinical supervision processes. Cleary and Freeman (2005) describe nurses' passive resistance to clinical supervision in mental health settings as attributable, in part, to a perception that sufficient supervision is contained within continuing education licensure requirements. Few articles outlining specific worker-reported attitudinal barriers to the adoption of EBPs appear in the published literature. Fewer transfer this data to group supervision practices which may improve workers' assimilation of important EBPs. Of interest to organizations seeking to improve service quality through the implementation of EBPs would be specific, no-cost measures supervisors could take to reduce workers' attitudinal resistance to the adoption of EBPs through the group supervision methods already in place.

In addition to general organizational change-resistance described in professional mental health settings, there have been other hypotheses to explain why EBPs often fail to transition from research to practice. For example, organizational culture and climate factors are beginning to be linked with barriers to implementation and adoption of EBPs (Aaron, 2005; Glisson & Hemmelgarn, 1998; Glisson & James, 2002; Hemmelgarn, Glisson, & Dukes, 2001; Hemmelgarn, Glisson, & James, 2006; Nadler & Tushman, 1997; Rogers, 1995; Rousseau, 1997). Other primary care clinicians, such as general practitioners, have noticed a movement away from supervision of any type--an independence mindset which often seems fitting in a fast-paced and busy work environment (Launer, 2007). This project expands on the knowledge learned from organizational research and targets those internal structures which possibly impede EBP implementation; specifically, the lack of informed, structured, and effective clinical supervision activities. While there are many EBPs available to human services organizations, there seems to be a gap between empirically-based best practices and the implementation of these clinical practices throughout community-based organizations (Hoagwood, Burnas, Kiser, Ringeisen, & Schoenwald, 2001; Weisz & Jensen, 1999). If community-based organizations remain capable of providing clinical supervision to their workers by strategically overcoming organizational cost constrains or lack of matched supervisor and worker educational training (see, Berger & Mizrahi, 2001; Gibelman & Schervish, 1997), there is still little known about workers' attitudes toward supervision in general, how these attitudes might create barriers to adopting best practices, and the adaptive clinical group supervision practices which could be used.

While there could be many reasons for favoring a specific form of clinical supervision, 65% to 75% of community-based organizations chose group supervision over individual (Power, Bogo, & Litvack, 2005; Riva & Cornish, 1995). …

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