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An Evaluation of Clinical
Psychology led Supervision Groupsfor Clinical Nurse Specialists
working in Oncology
Laura Charlton
Commissioned by Dr Nicky Tschernitz and Dr Merry Womphrey (Clinical
Psychologists), Department of Psycho-oncology, St James University Hospital, Leeds.
Word Count: 5000 words
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Table of contents
....................................................................................................Background 4
.................................................................. Political context for clinical psychology 4
.................................................................................................Clinical Supervision 4
....................................................................Stress and coping in oncology services 4
....................................................................Supervision need in oncology services 6
......................................................Clinical group supervision in oncology nursing 7
............................................................................The commissioning of this project 7
...................................................................................................Methodology 8
...................................................................................................................... Design
.............................................................................................................. Participants
................................................................................................................. Procedure
.................................................................................................................... Analysis
........................................................................................... Ethical Considerations
...........................................................................................................Results 11
........................................................................................................... Pilot Results
.................................................................................................Main Study Results 13
.........................................................................Discussion and conclusions 23
............................................................................... Reflections on a parallel study 24
............................................................................................................. Limitations
.................................................................................................. Recommendations
......................................................................................................... Dissemination
....................................................................................................References 26
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...................................................................................................Appendices 27
..................................................................................... Appendix 1: Questionnaire
............................................................ Appendix 2: Participant information sheet 31
............................................................................. Appendix 3: Interview schedule 3
............................... Appendix 4: Qualitative information from the questionnaires 34
................................................................................................. Appendix 5: Poster
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stresses that has an impact on oncology nurses, we might be better able to provide the
support that effectively ameliorates this stress. Hinds (1994) found that stressors and their
related reactions and consequences changed as time working as an oncology nurse
increased. Although there was overlap in some areas, new and more experienced nurses
were found to have distinct stressors. New nurses experienced stress as related to them
personally (for example, concerns about perceived ability) whereas more experienced
nurses cited stress being more related to systemic issues (such as poor management). Of
interest, is the nurses (3/9) that remained in post 12 months on, had developed similar
coping strategies as the experienced nurses, six months into their working life. They also
felt more supported and trusted by peers than the nurses that resigned from their posts.
This study makes clear that peer support may be a factor in the development of coping
skills in new nurses. Even gender differences were found in one study (Arvidsson et al.,
2008) with female nursing students feeling more supported, educated and professionally
developed as a result from process orientated group supervision than their male
counterparts who cited no significant changes. This finding may suggest that generic
support systems that are put in place may only be effective for a percentage of the group.
In an American study, Florio et al., (1998) used a transactional approach to
examine stress and coping amongst 59 oncology nurses. They found clusters of stresses/coping strategies and examined them in light of three cognitive appraisals; frequency,
intensity and controllability. Stresses that were rated high in frequency and intensity, were
rated as less controllable. These were also associated with increased levels of patient
contact and stresses that related to dealing with others (e.g. organisational issues).
Interestingly, the clusters relating to the personal impact of oncology nursing (e.g.
carryover stress) were rated as least frequent and intense and more controllable. Nurses
felt able to deal with stresses that had a personal association, but needed increased levelsof support when dealing with systemic stresses.
The evidence base has shown that stress cannot be considered to be a generic
concept and oncology nursing is associated with different types of stresses, all of which
are evaluated differently by nurses and have discrete levels of impact. As Florio
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demonstrated, work-related stress concept mapping may allow interventions to be
tailored specifically to nurse needs. However, the studies described here are innovative
and costly to carry out. Resources within NHS services are scarce and personal
reflections as a clinician is that the focus of resources tends to be on reducing waiting
times for treatment rather than improving the pastoral care of staff. Tailoring support
services for oncology nurses is clearly a goal that the NHS should be working towards,
but it may not be in a position to offer currently.
Supervision need in oncology services
Mental health difficulties, specifically anxiety and depression, are highly prevalent after
diagnosis of cancer (National Institute for Clinical Excellence; NICE, 2004). In oncology
services, NICE describes part of the role that support staff (such as clinical nurse
specialists) undertake, as ensuring that the mental health needs of patients are monitored
and attended to appropriately. This would either involve the correct identification of
mental health difficulties in patients and appropriate referral to specialist services or
containment of sub-clinical difficulties by staff members. As such, supervision groups
facilitated by staff with more specialist mental health training (such as clinical
psychologists) are recommended to assist with this process.In addition to training and supervision, clinical psychology has a role in
monitoring and preventing staff burn-out. Leiter, Harvie, and Frizzell, (1998) describe
burn-out as an umbrella term that covers three elements; increased exhaustion and
cynicism, leading to decreased levels of professional efficacy. Exhaustion, where one is
overextended in their role and as a result is lacking in physical and emotional resources.
As a result, cynicism may occur where the professional may feel indifferent towards
ones work. Finally, this leads to a lack of professional efficacy, which can be defined asa lacking sense of professional competence and accomplishment. This is common in
professions where there are busy schedules and a high emotional loading attached to the
job. Leiter et al., (1998) looked at the link between nurse burnout and patient satisfaction,
using patient satisfaction questionnaires (N=913) and compared this to scores of staff
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burnout (n=711) who worked on the unit the patient was treated on. They found negative
correlations with scores of patient satisfaction and nurse exhaustion (-0.73 p
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Aims
To understand what participants find most useful about the group and the impact
on their work.
To determine the perception of the current role of the Clinical Psychologist in the
group.
To explore the effects of the mix of professionals within the groups.
Methodology
Design
A mixed methods design was used to explore the research question. A
questionnaire used in a previous service evaluation project (MacIntyre, 2009) was
shortened and adapted to contain both fixed and open-ended questions (see appendix 1).
The questionnaire was intended to gather basic information and opinions about the
usefulness of the supervision groups. As this research area is still clearly in its infancy,
qualitative methodology was used to develop ideas about the impact of supervision on
nursing practice. A semi-structured interview schedule was developed from the
questionnaire responses to achieve this. The participants recruited for this study were
working under extreme time pressures and as such, the interviews had to be fairly time
limited. Developing an interview schedule from the questionnaire responses was felt to
be a way of conducting time-conscious interviews that fit within the bounds of
appropriate amounts of time that the staff had to offer, whilst still remaining a flexible
research method.
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Participants
The three clinical psychologists in the Psycho-Oncology department offer six
supervision groups across the Trust. Three of these are consist mainly of clinical nurse
specialist (CNS) staff members and three are mixed professional groups. For this study,
all participants were recruited from three CNS supervision groups. The other three groups
were evaluated as part of another evaluation project running parallel to this one. Seven
out of the twelve group members completed questionnaires. Of the seven who completed
the questionnaires, six agreed to interviews and five completed interviews. There was one
candidate who was unavailable to interview within the data collection time period. Four
participants were CNSs and one was a radiographer.
Procedure
Participants were approached either at the end of a regular supervision group
where the aims of the project were presented or via email. They were given an
information sheet (appendix 2) and invited to fill out the questionnaire and complete the
interview opt-in form at the end of the questionnaire. This was followed up with a
telephone call asking participants if they would like to take part. Participants who did
want to take part were then contacted by phone at a time convenient to them to take part
in the semi-structured interview (see appendix 3 for interview protocol). Interviews were
carried out over the phone or face-to-face and were tape recorded. Participants were made
aware that their responses were confidential and that they could stop the interview at any
time. The interviews were transcribed by the researcher.
Analysis
As little is known about oncology nurses experiences of supervision groups,
transcribed interviews were analysed using thematic analysis. Thematic analysis was
chosen as it looks for themes when individual experiences may differ significantly
(Ritchie, Spencer & OConnor, 2004). For this study, themes have been identified
through inductive analysis as this is data driven rather than theory driven (deductive
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analysis) and helps to reduce the impact of researchers preconceptions (Braun and Clark,
2006). Braun and Clarke describe 6 phases of thematic analysis (see Table 1).
Table 1. Phases of thematic analysis
Phase Description of the process
1 . F a m i l i a r i s i n g
yourself with your data
Transcribing data (if necessary), reading and re-reading
the data, noting down initial ideas.
2. Generating initial
codes
Coding interesting features of the data in a systematic
fashion across the entire data set, collating data relevant to
each code.
3. Searching for themes Collating codes into potential themes, gathering all data
relevant to each potential theme.
4. Reviewing themes Checking if the themes work in relation to the coded
extracts (Level 1) and the entire data set (Level 2),
generating a thematic map of the analysis.
5. Defining and naming
themes
Ongoing analysis to refine the specifics of each theme,
and the overall story the analysis tells, generating clear
definitions and names for each theme.
6. Producing the report The final opportunity for analysis. Selection of vivid,
compelling extract examples, final analysis of selected
extracts, relating back of the analysis to the research
question and literature, producing a scholarly report of the
analysis.
(Braun and Clarke, 2006, p.87)
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These phases were adhered to ensure reliability and the analysis was quality checked by
another researcher. In order to do this, a selection of data was sorted into the themes
generated by the researcher and was discussed with the researcher conducting the parallel
study with mixed professional groups.
Ethical Considerations
The Leeds Teaching Hospitals NHS Trust Research and Development department
confirmed that ethical approval would not be needed to carry out this evaluation project.
Informed consent was sought after using an information sheet (appendix 2) and consent
form. Participants were made aware that comments from the interviews may be made
available in the report or on a poster but anonymised to ensure confidentiality.
Results
Pilot Results
To make the questionnaire data more meaningful, the data from the CNS groups (N = 7,
60% response rate) were combined with data from the mixed professional groups (N=9,
45% response rate). Analysis of the questionnaires (N=16) revealed that the mean number
of groups attended was three. The mean number of years in role was three. Most people
had no previous experiences of supervision groups (9/14 respondents). The rest of the
pilot questionnaire data was completed using a likert scale (range 0-7). Higher scores
reveal greater levels of agreement with the statement and for the purposes of analysis,
scores above the halfway point (4) were regarded as indicating agreement with the
question. Most people agreed that the supervision groups were helpful (Mean rating 5.93
SD = 1.23). Respondents were asked about the helpful aspects of the supervision groups.
Table 2 demonstrates that Support was the most strongly advocated helpful aspect of
the groups (Mean 5.8 SD=1.2). The least agreed upon was that the supervision groups
changed practice, although this fell above the halfway mark and so was agreed to be a
moderately helpful aspect (Mean 4.3 SD =2.2).
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Service Evaluation Project Evaluation of CNS Supervision Groups
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Figure
2-thebenefitsofattendinggroupsupervision
Staff
W ellbeing
Sh
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Gu
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Team
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N ew
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Val id
at
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In
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un
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of
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Supportin
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others
Expertise
ofclinical
psycholo
gists
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Validation
Four out of the five professionals described sharing experiences within the supervision
groups as a validating experience. The professionals commented that the stressful nature
of work and decision making left them feeling doubtful that they had made the right
decision (as evidenced by box 1, participant 2.1). Supervision groups provide a forum to
share that experience with professionals in the same situation (2.2).
Box 1
Staff Wellbeing
All five participants identified supervision groups as an agent of maintaining staff
wellbeing. The main sub-theme was that the supervision group was able to provide an
appropriate outlet for feelings, with all five participants citing this as a useful element to
group supervision (For an example see participant 2.1 in box 2). With little time allowing
for reflection and the expression of feelings, supervision groups were an important factor
for maintaining staff well-being (Participant 1.2). Participant 1.2 also linked this
expression of emotion as not only important for them as an individual, but for the way
that they relate to patients problems as well.
Participant 3.1: I think it does help to discuss complex cases, just to talk them through.
Participant 2.1: if the team that youve had to interact with have reacted in a way that
you havent expected its useful to have that peer support not be able to talk through what
should you have done differently and often its nice to hear the others say, actually I
would have done it like that.
Participant 2.2: maybe some of it is reassurance so when I have found something really
difficult its good to know that its normal to find that difficult.
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Box 2
Team Building
Team building was not only a theme that was reflected when teams met for supervision,
but was also reflected when professionals who worked individually and then met for
group supervision. Team in this sense was the group membership to the supervision
group. There were two main sub-themes to team building. One of these was increasing
understanding about team members (two participants) and their differences and the other
was the opportunity to support others (three participants).
Increasing understanding about team members
Participants from one CNS team in particular talked about the supervision group offering
an opportunity to get to know your colleagues ( see Participant 1.2, box 4). The groups
help develop an appreciation and acceptance for working practice differences and ways
of doing things (See participant 1.4).
2.1sometimes its useful to offload somebody that you know has struck and chord and
you know what you shouldnt carry around that sort of baggage .
1.2: I suppose the main reason that motivates me is that its a time out phase.
1.2: some people say to do this job you have to be hard but the minute that happens, you
should not do this anymore. You need to remain human in my job and I need an outlet for
the way that I feel too.
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Box 4
Supporting others
The sense of improving team dynamics is carried over into this theme (see box 5) . It
seemed that staff got a sense of well being and a good feeling when they were able to
offer support to colleagues. There was also the opinion that supporting colleagues would
inevitably improve work and benefit patients (participant 2.2, box 5)
Box 5
Participant 1.2: it makes everything much more out in the open and helps you to realise
that we all have our own issues and our own ways of looking at things.
Participant 1.4 said, we all are very different in the way we handle situations and things
I feel comfortable with, others wont I suppose. So you know, although we can look and
think of different solutions we all have to be very aware that individuals will deal with
things very differently.
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Participant 1.2: youve got here is an opportunity to give something back to others i think it
helps with team building because you get to know your colleagues a bit more and i think it
stops you from being judgmental about your collegues.
Participant 2.1: its erm sometimes still beneficial to listen to other peoples issues and it
feels positive when your able to give somebody that support that maybe last month theyve
given you .
Participant 2.2: my primary motivation for attending is to help my colleagues but the
offshoot is that you benefit patients as well.
Participant 1.1: offering the support for colleagues is really valuable .
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What impact, if any, has the supervision group had on your own work?
There is a lot over overlap with the themes that emerged from this question and the
previous question. One of the reasons why the participants are motivated to attend the
groups is that it has an impact on their clinical work. The participants seemed to struggle
with this question and found it hard to articulate the direct impact that the supervision
group had on their work, although all five participants felt that there was an impact. There
was a sense that the group helped the professionals communicate with patients better and
in some cases feel more confident in further engaging in conversations.
New perspectives
All five professionals cited this as an important reason for attending the supervision
group. The focus was about gaining new perspectives on complex cases from both the
supervisors and other work colleagues. For examples see box 6.
Box 6
Increasing sense of competence in communicating with patients
Four participants reported feeling an increasing sense of competence as a result of
attending supervision groups. Respondents spoke of improving communication skills (for
example, Participant 3.1, box 7). One participant (2.1, box 7) linked improved
communication skills to improving the supervision she was able to give colleagues. One
participant linked the supervision group to helping her engage more with patients,
enabling her to have more conversations about difficult topics; (participant 2.2, box 7)
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Participant 2.1 (the group) helps give you some direction if your not sure where you
want to go with somebody so yeah I think it helps improve my patient care.
Participant 3.1 you get different angles form the different professionals that are other
CNSs and from psychology services as well, I think thats the main reason that I go
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Box 7
How does group supervision differ from your other experiences of supervision?
For many of the nurses, this was their first experience of formal supervision. Three
themes were yielded from this question.
No previous experience of supervision
None of the interviewees had attended group supervision before and only two participants
(1.2, 2.1) had received clinical supervision before. One had supervision with one of the
clinical psychologists in the psycho-oncology department and the other because she had
worked in a mental health service previously. The other professionals had not
experienced supervision where they discussed clinical cases.
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Participant 3.1: I know it has been helpful for our workloads and improving communication skills
with patients, I know it has.
Participant 2.1 Interviewer: do you think its changed the way that you work with colleagues and
had an impact in those ways? Respondent: well I suppose in some ways because I suppose to a
certain extent I provide supervision for other professionals and they can come and offload to me. So
I suppose to a certain extent it does because you improve your communication skills with interaction
skills.
Participant 2.2: Theyve given me advice for specific patients that made me feel more enabled to dig
a bit further and expose myself more to their anger and to do it in a positive way where Im sort of
trying to engage with them more ... I did feel that Id dealt with it well and I was able to say I can
see you are really angry and this is hard and I felt more able to engage with him about that and
that came out... I felt that we tried for a bit further and I think since then I felt that I can dig around
and I felt brave about it.)
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Patient focus
One other nurse (2.2) talked about how they had been to meetings that focused on the
managerial aspects of the role.Participant 1.2 agreed with this statement but enjoyed the
group aspect of discussing patient scenarios as she found this less attacking to her
personally than when the focus is on her as an individual practitioner.
Protected space
Two nurses (1.4, 3.1) talked about how they had sought advice through less formalised
peer support networks but this was different because of the time and space boundaries
imposed the group. This nurse also said that the regular time slot initiated more
reflection, as she would do this in preparation for group supervision.
Box 8
What is it like having a clinical psychologist supervise the group?
Expertise of psychologists
All five participants felt that the psychologists had a high level of expertise and two main
themes emerged; knowledge and skills and skill at facilitating group processes.
Psychological knowledge and skills
Four interviewees discussed how the knowledge and skills that clinical psychologists
bring to group supervision help with the quality of supervision received.The nurses value
the high academic standard that the clinical psychology profession demands (see
participants 3.1 and 1.2, box 9). One person (1.4) also talked about how the experience of
the psychologist helped with the process of supervision.
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Participant 2.2: Other experiences of supervision were about how to manage my
caseload, equity of careand that the group gives more focus to the more psychological
side of things
Participant 3.1: youve got a regular time slot so its very good that you can prioritise
your time.
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Box 9
Skill at facilitating group processes
Three participants commented on the expertise that clinical psychologists demonstrate in
facilitating the supervision groups. Two participants valued the way that everybody was
included in discussion and participation is encouraged (see participants 1.4 and 1.2, box
10).One participant (2.1) doubted whether the group function as well without facilitation
by a clinical psychologist.
Box 10
Participant 3.1: they are very good.
Participant 1.2: you need someone clever enough to push your buttons .
Participant 1.4: shes got a great understanding of our role and sort of the patient that
we are meeting so very infrequently do we have to explain in any great detail.
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Participant 1.4: although we meet in a group everyone is asked is this something they
want to discuss .
Participant 1.2:its sometimes about sharing how youre feeling and getting it off your
chest and you have the advantage of a supervisor... they encourage you to do that .
Participant 2.1:if we try to do it without the clinical psychologist then it would be more
difficult to make sure that the quieter members of the group get as much either
encouraging or you know that there voice in heard and that their issues are discussed.
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Challenges
There were some challenges identified by participants. Two nurses cited difficulties in
attendance and linked these to high workloads and feeling that some clinical situations
take precedence (participants 2.1 box 11). One participant (1.2) spoke about the finding it
challenging to share some things in a group environment. Another spoke about how
sometimes there were remaining difficulties after supervision. This participant seemed
unsure about how these issues should be dealt with, especially when some need was
identified in the supervision group (see participant 1.4, box 11).
Box 11
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Participant 2.1: its just that because we have to stick to a rigid time now its more
difficult to always be able to get to whereas before we had some flexibility
Participant 1.4: its just hard to deal with if youve got somebody who've talked about
a problematic issues theyve then show their emotion theyre upset and you dont
want to make that worse but youve still got a patient problem with that individual
that you've got to resolve. i
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Reflections on a parallel study
Meeting the needs of multiple people in group supervision is a difficult task. A service
evaluation project was conducted in parallel to this study, using the same methodology
(and the same clinical psychologists supervising) with groups that contained mixed
professionals as opposed to clinical nurse specialists. The poster in appendix 5
summarises the results of this study. The mixed professionals groups overall felt less
positive about their supervisory experiences than did the CNSs. One major difference
was that discussions of challenges within the NHS system dominated the interviews for
this study.
This study reflects the challenges associated with offering generic support
systems to staff and corroborates the findings of the literature review. More importantly,
it also is evidence of how it may be necessary to have groups of staff members who
experience similar types of stressors in their role. It is possible that the current study
yielded a more positive response than the parallel study because the groups were more
homogenous. However, with the limited resources and time of austerity for the NHS,
individual supervision of oncology nurses might prove too costly for administrators to
justify. One has to question however, the effectiveness of the group supervision at all
when it may be too general to meet the specific needs of the professional attending.
Limitations
There were a number of limitations to this evaluation project. This study is limited by the
small number of CNS available to interview. It is possible that the data set would have
been enriched by a greater number of interviewees.
Another limitation was that the questions asked as part of the interview may have
been slightly biased generate positive answers. The benefits to attending supervision
group were asked, but not the limitations. However, the interview questions were
developed from the responses received from the quantitative part of the study. As these
questionnaires yielded positive comments, the questions asked at interview followed on
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from these. The interviews were time limited ( to ensure greater participation in the
project) and so only a small amount of questions were asked at interview.
Recommendations
The following clinical recommendations are made as a result of this evaluation project:
It is recommended that clinical psychologists continue to provide group supervision to
the oncology CNSs. This is based on the fact that benefit is derived from the group and
that clinical psychologists were valued as facilitators.
As this was the first experience of supervision for many of the nurses, the aims and
objectives of supervision need to be made clear and regularly re-negotiated.
As attendance is difficult for the CNSs due to high workloads, it should be negotiated
that the supervision groups should be included in their job plans to make attendance
easier.
Following on from the literature review and differences between this study and the
parallel project, group membership should be made as homogenous as possible. This
may mean that different groups are offered for newer and more experienced group
members, particularly those in a leadership role.
The focus of the supervision group should be tailored to meet the needs of the particular
stresses experienced by the professionals at that time. As such, the topics of the group
should continue to be group led.
Dissemination
A brief summary of results was delivered at the doctorate in clinical psychology SEP
conference (University of Leeds) in October 2010. It will also be arranged that the results
will be discussed with the CNS supervision groups at their request. This will be arranged
in collaboration with the clinical psychologists who facilitate the groups. In addition, the
results will be disseminated at a staff meeting for the clinical psychologists and their
associates.
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References
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National Institute for Clinical Excellence (2004). Improving Supportive and Palliative
Care for Adults with Cancer: the manual.Ritchie, J., Spencer, L. & OConnor, W. (2004). Carrying out qualitative analysis. In J.
Ritchie & L. Lewis (Eds.). Qualitative Research and Practice: A guide for social
science students and researchers. London: Sage
Scaife, J. (2001). Supervision in the Mental Health Professions. East Sussex:
Brunner-Routledge.
AppendicesAppendix 1: Questionnaire
1. Gender (please tick):Female Male
2. Professional Role (please write below):
---------------------------------------------------------------------------------------------------------------
3. Number of years in this role (please tick):
0-2 3-5 5-10 10-15 15-20 20+
4. During the last year, approximately how many supervision groups have youattended?
1-2 3-5 6-8 8-10 11+
5. Have you attended a similar supervision group in the past?
YES NO
10. How helpful do you find attending the supervision group?
Not at 1 2 3 4 5 6 7 Extremelyall helpful neutral helpful
11. What are the most helpful aspects of the supervision group?
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12. What are the least helpful, or unhelpful, aspects of the supervision group?
13. What could be done to improve the supervision group to suit your needs?
14. Have you ever found it difficult to attend the supervision group?
YES NO
If yes, please describe what has made it difficult to attend:
15. What do you feel you gain from attending the supervision group?(Please circle the number you feel best corresponds with your experience)
a) Support from peers
Doesnt AppliesApply 1 2 3 4 5 6 7 Very Much
b) Changing the way I practice
Doesnt AppliesApply 1 2 3 4 5 6 7 Very Much
c) Dealing with difficulties or challenges in the work
Doesnt AppliesApply 1 2 3 4 5 6 7 Very Much
d) Dealing with the emotional impact of the work
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Doesnt AppliesApply 1 2 3 4 5 6 7 Very Much
e) Understanding of self in relation to the work
Doesnt AppliesApply 1 2 3 4 5 6 7 Very Much
f) Personal coping strategies
Doesnt AppliesApply 1 2 3 4 5 6 7 Very Much
g.) Developing psychological knowledge and skillsDoesnt AppliesApply 1 2 3 4 5 6 7 Very Much
If there are any important things you feel you gain from supervision groups thatare not listed above please describe below:
Any other feedback:
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MANY THANKS FOR TAKING THE TIME TO COMPLETETHIS SURVEY WE VERY MUCH APPRECIATE IT
Evaluation of Supervision Groups Questionnaire
Request for Further Information:
If you would be willing to take part in a brief telephone interview lasting 20-30minutes regarding your experiences of attending the supervision group thenplease write your name, a telephone number that you wish to be contacted on(mobiles/personal phones are fine), and a convenient time for us to give you acall. We are happy to talk at evenings and weekends or whenever might be mostconvenient for you. If you would rather talk in person then we are also happy tomeet with you at St James. All personal information will be kept confidential andwill be destroyed once we have completed the interviews.
Name: __________________________________________________
I would be happy to speak with you on the telephone / meet with you in person(please delete as appropriate).
Telephone numbers (in order of preference): ______________________________________________________________________________
Convenient times (24h clock):________________________________________________________________
For those who do not wish to take part:We understand that not everyone will wish to take part or may not be able to. Ifyou do not wish to take part in this section of the evaluation it would be veryuseful for us to know what it was that prevented you. We would be most gratefulif you could briefly describe your reasons below. We are very grateful for yourcompleting our survey.
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THANK YOU FOR YOUR TIME.Appendix 2: Participant information sheet
Participant information sheet for the Service Evaluation Project
This is an invitation to take part in a service evaluation project.
What is the purpose of the project?
Clinical Psychologists provide supervision to staff individually and in group settings,
however there is little research about the contribution this makes to staff, in particular those
working in Oncology settings. The project aims to evaluate the staff supervision groups led
by Clinical Psychology within Oncology services. We are interested in looking at the
contribution these groups make to you and your work.
Do I have to take part?
It is up to you to decide whether to take part or not. If you decide to participate you will be
given this information sheet to keep and asked to sign a consent form. If you decide to take
part you are free to withdraw at any time and without giving a reason. A decision to
withdraw or not to take part will not affect your supervision in any way. The information
that you give is confidential and will not be shared with the supervisors until it has been
analysed and made anonymous. If you are interested in taking part we are happy to answer
any questions you may have.
What will I have to do if I take part?You will be asked to a complete a short survey. Once these have been collected, we hope
that some people will agree to participate in a more in-depth interview lasting roughly 15 to
20 minutes. This will be done at your convenience; face-to-face or over the telephone if
preferred.
Are there any possible advantages of taking part?
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There are no personal advantages to taking part; however, the evaluation of this service may
provide useful information for the development of future supervision groups offered by
Clinical Psychology.
What happens to the information about me and to the service evaluation project ?
All of the information you provide is confidential and will be anonymous once the data iscollected and written up no one will be able to tell who you are. At the end of the project
we will prepare a poster presentation and brief report documenting our findings. You are
welcome to attend the poster conference if you so wish. Details of this can be obtained
from the university below.
Ms Laura Charlton and Dr Bridie Ghallagher.Psychologists in Clinical Training (DClinPsychol)
Clinical Psychology Programme
Institute of Health Sciences
University of Leeds
Charles Thackrah Building
101 Clarendon Road
Leeds
LS2 9LJ
Appendix 3: Interview schedule
Questions
1. What are the reasons that motivate you to attend the supervision groups?
Prompts
What do you gain?
Is it a requirement?
What do you like about it?
2. How is the supervision group different from your other experiences of
supervision?
Prompts
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Appendix 4: Qualitative information from the questionnaires
Question 8: What are the least helpful, or unhelpful, aspects of the supervision group?
1.3 While I appreciate the importance and support it has provided, I always feel that
time constraints of work seem to dominate my thinking.
Sometimes discussion dominated by vocal members of the group.
Nothing feels unhelpful!
None
Possible work in more specific things we could do differently - personallychallenge us more or maybe do educational bits. This might not suit everyone in
a group setting. ? Use tapes, videos...
When we chatter - enjoyable - but off the point sometimes and waste of time; if
pushed for time/stressed can be annoying - even when I do it!
Question 10: Please descibe what has made it difficult to attend
1.4 If patient in clinic feel I need to support them but usually negotiate that I will
ring them later. However it increases my stress levels.
2.1 Last minute clinical situations I wasnt expecting have occasionally occurred but
I dont think these can be resolved!
of the group.
2.2 Clinical workload and last minute referrals. But this is as good a time for asession as any other!
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Appendix 5: Poster
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