Principles and Guidance
Supervision is a key activity, which will determine the success of the IAPT programme. We are in the process of supporting the commissioning of training for all IAPT supervisors throughout the SHA regions based on a supervision framework specifically developed for IAPT (http://www.iapt.nhs.uk/2008/02/24/supervision-comptences-framework/ ).
We recognise that as most services and training courses are about go live in October 2008, a summary of principles of IAPT supervision is required for Clinical and Course Directors.
Principles of supervision for an IAPT service
This guidance applies equally to all staff employed and working therapeutically within an IAPT service including both IAPT trainees and qualified staff, and those delivering high and low intensity interventions. Supervision for all these staff should entail:
Amount of supervision:
- Be provided weekly on a regular basis and consist of a minimum of one hour of individual supervision with an experienced and trained supervisor, and located within the IAPT service.
- In some circumstances, group supervision will be appropriate but will require sessions of a longer duration to be effective.
- Supervision should address the review of all ongoing clinical cases, and routinely be informed by an individual client's IAPT outcome measures. For low intensity practitioners this will consist of individual supervision provided from a case management perspective.
- The discussion of individual clinical cases during supervision should be prioritised according to clients' needs and a pre-determined schedule. All cases should have been regularly reviewed within a reasonable period of time (2-4 weeks).
Trainees:
- High Intensity IAPT trainees should also receive during their two-day attendance on the course, additional in depth supervision of training cases, usually in groups of two to three trainees, and lasting for around 1.5 hours per week.
- Low Intensity IAPT trainees should also receive, in addition, to case management supervision, both individual and group supervision aimed at case discussion and skills development. This should normally be around 1 hour per fortnight.
Supervisors:
Supervisors should have a working knowledge and experience of the interventions for which they are providing supervision. Where there are gaps in experience (e.g. low intensity working), these might be addressed by supervisor training and familiarisation with specific services.
Supervision of trainees will be shared between supervisors who might be university-based and provide specific input into training cases, and supervisors providing routine clinical supervision within the service. Clinical directors and course directors should ensure that appropriate governance arrangements exist for all supervision provided and where appropriate university-base supervisors have honorary contracts etc.
IAPT is commissioning short training courses (5 days) for supervisors within IAPT services, although these are not currently available in all SHA regions. It is expected that most IAPT supervisors will eventually be trained around the specifics of supervising within an IAPT service by attending one of these courses. Courses will address IAPT requirements for supervision of both high intensity practitioners, together with case management supervision for the low intensity practitioners.
Download the IAPT Guidance for Commissioning Superviser IAPT Training
Other considerations:
- Low intensity practitioners should have access to an experienced supervisor to consult on assessment and risk issues. Clinical decisions to either step up treatment to high intensity, discharge or refer on to specialist services will need to be discussed within regular case management supervision.
- Services should consider how they support their supervisors and ensure that they have sufficient time and adjusted caseloads to allow them to provide quality supervision. They should also have access to peer/group support and continuing professional development.
- All staff should access to professional and managerial supervision, as appropriate to their role, which will be in addition the clinical supervision arrangements detailed above.
- It should also be stressed that the number of hours of supervision identified within this document are the minimum recommended for full-time staff. Flexibility should be adopted for staff on part-time contracts or with reduced caseloads arising from other non-clinical responsibilities.
- A named senior therapist should be responsible for overseeing and monitoring the effectiveness of supervision provided within the IAPT service, in conjunction with the Clinical Director and Course Directors concerned.
Future supervision guidance is provided will include the different forms of supervision expected within an IAPT service and the importance of issues such cultural sensitivity and how supervision can be tailored to meet the needs of clients, supervisees and the service.
Download the IAPT Supervision Guidance December 2008