Peer supervision for trainee and newly qualified clinical psychologists David Green University of Leeds, UK Jacqui Akhurst York St John University, UK 21/04/2017

Professional context The NHS wants newly qualified clinical psychologists to take responsibility for supervising other staff members from an early stage in their careers However our trainees do not feel they have the skills or the credibility to take on this role immediately they qualify Their experience of supervision is predominantly as recipient not provider 21/04/2017

Individual supervision Types of peer group supervision -----------l--------------------------------l----------------------------l-----------------------------l----------- Individual supervision within a group Participative group supervision Cooperative group supervision Peer group supervision Continuum of forms of group supervision adapted from Inskipp, 1996 Increasing level of peer interactions from left to right Decreasing levels of facilitator intervention from left to right

Peer supervision Our trainees make spontaneous use of peer support when on placements together but do not see this informal experience as helping them develop supervisory skills We wanted to encourage them to take themselves seriously as potential supervisors and to experiment with an extended commitment to peer supervision in a structured group format 21/04/2017

When left to their own devices... Two groups of recently qualified clinical psychologists in Band 7 posts had clubbed together spontaneously to supplement the one-to-one supervision they received from senior colleagues with a commitment to ongoing peer group supervision What did they discuss? How did they organise themselves? Was the group “fit for purpose?

When trainees experiment… We also gained access to two independent sets of clinical psychology trainees who had been encouraged by their programmes (in Leeds and Limerick) to commit themselves to an officially sanctioned peer supervision schedule At Leeds ground rules were established but the format was trainee led In Limerick the course team introduced a Structured Peer Supervision Group

Part One of the PLAT miniproject 3 x focus group discussions Recently qualified clinical psychologists based at SJUH in Leeds who had devised their own way of running peer supervision groups Ex-Leeds trainees from the Leeds programme reflecting on how they had spontaneously organised peer supervision for their cohort Current Limerick trainees reflecting on their experience of using a structured peer supervision group following Wilbur’s model

Results of thematic analysis conducted by Jacqui Akhurst New qualifiers Wanted to formalise a shared impulse to talk Fell into a schedule of monthly meetings Committed to a shared planning schedule Intimate naturally occurring group size (3-4) Trust in core group but accepted new members Initial informal rules but groups tended to drift into ad hoc agenda setting Helped with NWW roles with other disciplines All at similar developmental stage in careers

Former Leeds trainees (Year 3) Semi-official – following local precedents Met every 3 or 4 weeks at end of day Varied group size (according to specialty) Same year group and developmental level Informal and occasional record-keeping Became more formal in placement setting Safer place to explore v course supervisor Responsive to varying individual needs Tendency to digress to common themes

Limerick trainees using Wilbur model Format set by external supervisor (former student of Jacqui Akhurst) Given official status by programme Big group size – all 10 trainees participated Same developmental level again (Year 3) Initial anxiety about structure; then group valued “beginning-middle-end” shape and separation of presenter and discussants; then drifted again Promoted focussed discussion leading to changes in clinical practice and formulation

Maybe trainees would benefit from using a structured model of peer supervision? The model we have employed was initially developed and described by Michael Wilbur and colleagues in the USA in 1991 Jacqui Akhurst adapted the model for use with counselling and clinical psychologists in training in her doctoral research in South Africa that was completed in 2000 Summarised in Akhurst and Kelly (2006) article in Psychology Teaching Review 21/04/2017

Our preferred learning medium Illustrate with a “live” performance recorded on DVD Put the material online using “LUtube” Make 100 copies freely available to other training programmes in applied psychology in the UK and to trainees themselves Invite experiment and feedback Funded by the Higher Education Academy Psychology Network in the UK with whom we have also produced similar supervisor training material (on ethical issues) 21/04/2017

The format Phase One: Request for assistance from presenter (5-10 minutes) Phase Two: Questioning period and identification of focus (5-10 minutes) Phase Three: Reflective feedback and discussion (15-20 minutes) Pause period for presenter to consider comments of peers and form a response Phase Four: Presenter response (5-10 minutes) 21/04/2017

Illustration: the story so far… Sarah has sought help on what to do next with with a young woman from her LD placement The teenager, who is from an Asian background, has shared her excitement at the news that she is soon to be married But she has a moderate learning difficulty and Sarah doubts she is capable of giving informed consent for the union to proceed Sarah’s supervisor is not too concerned… 21/04/2017

Structured Peer Group Supervision 21/04/2017

The reference/The DVD AKHURST J and KELLY K (2006) Peer group supervision as an adjunct to individual supervision: Optimising learning processes during psychologists’ training Psychology Teaching Review 12, 1, 3-15 Copies of the DVD can be obtained from David Green (email d.r.green@leeds.ac.uk ) Online access at http://lutube.leeds.ac.uk/avsmas/videos/347 21/04/2017