GENERIC GUIDELINES and REQUIREMENTS for COLLEGES STANDARDS of SUPERVISION For UKCP College of Hypno-Psychotherapy WORKING WITH ADULTS

1. Introduction

1.1   This document outlines a framework for standards of Supervision for members of the College of Hypno-psychotherapists working with adults. For the purposes of this and all other UKCP documents the term adult is understood to refer to any person who is 18 years and over in age. The term child is understood to refer to anyone under the age of 18 years.
1.2   The development of these standards is essential for Colleges/OMs offering trainings in Psychotherapy and Psychotherapeutic Counselling, Supervision for working with adults or where the OM is an accrediting organisation for the purpose of putting people to a register of UKCP Supervisors.
1.3   For the purpose of this document the term psychotherapeutic practitioner throughout will refer to both psychotherapists and psychotherapeutic counsellors. The term Trainee Practitioner will refer to those trainees on either psychotherapy or psychotherapeutic counselling trainings starting to / seeing clients.
1.4   The authors wish to acknowledge the contribution to this current document from present and previous members of the UKCP Training Standards Committee (TSC) working groups on supervision and the work done by the UKCP Psychotherapy with Children Committee (PwCC) in helping to create part of the format of this current version.
1.5   This document takes the view that the supervision of clinical practice with clients whether by a psychotherapeutic counsellor or a psychotherapist requires similar levels of attention to the nature and standards of supervision. Such an approach is seen as being in line with the principles of protection of the public interest and of safeguarding the client.

1.6   Definition Supervision is understood as a process conducted within a formal working relationship in which a qualified or trainee psychotherapeutic practitioner presents client work to a designated supervisor, as a way of learning how to work more effectively with clients. The purpose is to ensure safe and competent practice through regular meetings.
1.7   It is acknowledged that no document can be exhaustive in its scope, however the guidelines set out below are intended to set a tone, character and attitudinal approach to supervision.
1.8   As with all the Training, Education and Practice Guidelines and Requirements of UKCP, these guidelines should be understood as forming part of the quality assurance and regulatory map of UKCP, its Colleges and its OMs.
1.9   Please see the list at the end of this document for the correct titles of all other UKCP documents relating to minimum generic guidelines and requirements for education and training standards of supervision and routes to supervisor accreditation, including specific documents relating to working with children.

2. Minimum Standards for Supervision of Psychotherapy Practitioners working with Adults

2.1. The Nature of Supervision

a. Supervision is a process conducted within a formal working relationship in which a qualified or trainee psychotherapeutic practitioner presents his or her client work to a designated supervisor as a way of enhancing their practice through careful reflection and reflexive practice on the process.
b. Supervision can take place on a one to one basis or in groups. Supervision can take place through a variety of media (e.g. face to face, telephone, e-mail); and using different methods (e.g. live, audio or videotaped, written and reported).

2.2. Purpose

a. The primary purpose of supervision is to enhance the professional development of the supervisee so as to ensure the best possible psychotherapeutic practice for their client. To this end supervision should perform the functions of education, support and evaluation against the norms and standards of the modality, profession and of society. This is the case irrespective of employment or voluntary arrangements and applies both in private and public service.
b. Supervision can also contribute towards a gate-keeping process that allows for the recognition of certain situations, e.g. burnout, where because of the supervisee’s physical, mental, psychological or emotional state it is unsuitable for them to work with clients.

2.3. Tasks of supervision

Supervisors need to be aware of the broad range of tasks that their role entails. These include:

a.   Creating an open, trusting working alliance with supervisees in which the supervisee is confident to reveal the difficulties within his/her work.
b    Being supportive – providing affirmation of good practice, colleagueship in assisting the supervisee in handling the difficulties encountered in their practice. c.   Taking an educative role - using coaching skills, or aspects of mentoring to enlarge the supervisee’s theoretical knowledge and to highlight areas of further training.
d    Recognizing that there is a normative role in supervision that includes upholding the standards of good professional practice, guiding and supporting supervisee’s in addressing ethical issues, balancing the needs of supervisee and client and addressing issues of safety and right conduct.
e.   Ensuring that any client protection issues are being dealt with effectively.
f.    Addressing and encouraging understanding of any diversity and equalities issues in the work.
g.   Enabling new insights and understanding to emerge in the process of the work.
h.   Where there is a requirement by the organization the therapist is employed by there may be an evaluative role.

3. Psychotherapeutic Practice with Adult Clients

Working with different client groups therapeutically can present unique challenges to the practitioner.

3.1. Potential Emotional Pressures for Psychotherapeutic Practitioners

These pressures can include:

a.            Pressure to change the client to meet the norms of society, culture, or organizations.
b.            Feeling overly responsible for very vulnerable clients.
c.            The ability of the client to be in control of their therapeutic process. Examples of this include issues around referral, fees, timing, termination, autonomy and confidentiality.
d.            The extra emotional demands that dealing with severely troubled clients can place upon the practitioner and the need to be supported in working with such clients. Psychotherapeutic work with all clients can at times accumulate as strong reactions that can be consciously or unconsciously acted upon or experienced psychosomatically.
e.            Dealing with difficult feelings around the lack of adequate care, protection and psychotherapeutic support for vulnerable and / or marginalised client groups.
f.             Dealing with one’s feelings, thoughts and ability to cope with own limitations, prejudices and / or lack of understanding of a particular client group or socio-cultural group.

3.2. Clinical Issues

a.   Dealing with complex legal and ethical issues such as confidentiality, record keeping and client protection especially when dealing with highly vulnerable adults, particularly those who may be receiving more than one form of care / intervention.
b.   Working within systems that provide support, care and protection for highly vulnerable adults.
c.   Referring and liaising with other professionals and managing appropriately the different relationships and roles they may undertake at any given time. This requires a high degree of flexibility and alertness to possible conflicts of interest.
d.   Dealing with the complexities of third party referrals and the problems that can be generated in such circumstances
e.   The referral of clients who may be exhibiting symptoms of undiagnosed mental ill-health or developmental deficits that require specialist assessment, and / or onward referral where it is felt beyond the competence or remit of the practitioner.
f.    The need to be responsive, creative and flexible in order to meet the client appropriately and effectively.
g.   A willingness to refer the client to a more suitable approach / practitioner when necessary.
h.   An understanding of the clinical applicability and an ability to work with issues of diversity and equalities in the psychotherapeutic relationship.

4. Professional Obligations

a. Being able to recognise and act appropriately when the situation requires a heightened duty of care towards vulnerable and / or unstable clients.

b. It is recommended that even very experienced practitioners seek the guidance and support of professional supervision (non-peer) from time to time.

c. It is mandatory that recently qualified practitioners (less than three years in practice as a registrant) and ALL trainees working with clients are in professional supervision.

d. In the case of the recently qualified practitioner normally they should have regular professional supervision alongside any peer supervision arrangements that may be in place.

e. For the first three years post registration a supervisionary relationship must be in place with a supervisor who meets the current requirements of the College for being a supervisor. It is the joint responsibility of the supervisor and supervisee to determine the appropriate frequency and duration of supervision sessions and the justification of these factors will form part of the registrant’s renewal of membership with their organisational member (if they belong to one) or with the College (if they are a direct registrant).

f. The College believes that face to face supervision is ideal. Any other contact would need to be justified as above.

g. In the first three years participation in peer support groups is to be encouraged, as a CPD process, but does not replace supervision as above.

h. Following the first three years of registration the registrant may opt for peervision. In this case the responsibility for frequency and duration is held jointly by all members of the peergroup and all would be expected to take part in the justification as above.

i. For all practitioners it is recognized that working with severely disturbed, traumatized or abused clients will require higher rates of supervision. j. Supervisors may advise additional supervision where deemed necessary.
k. Failure on the part of the supervisee to heed such advice must be addressed in supervision and should be noted by the supervisor.
l. Supervisors should be encouraged to seek guidance, advice and support from their own supervision supervisor, from the College or UKCP centrally dependant on the nature of the issue.
m. Where the refusal to heed the advice given is understood by the supervisor as in any way an endangerment to the client the supervisor must inform the appropriate professional bodies of the practitioner. The supervisor must inform the supervisee in writing of this action and keep a copy on file.

5. Ratios for Group Supervision and additional obligations

a. Group supervision provides the practitioner with invaluable opportunities for shared learning and support.

b Group supervision normally should be on a ratio of a minimum of 30 minutes of supervision per supervisee.

c. The maximum group size normally would be four.

6. The Supervisors Responsibility to Self

These responsibilities include:
i. Receiving appropriate supervision of their supervision.
ii. Appropriate continuing professional development to keep up to date with developments in the field of child psychotherapy.
iii. Awareness of their own limitations including awareness of overload and potential burn-out; the supervisor must take adequate steps to allay these, including being willing to take a break from practice when necessary.

6.1 Standards for Supervisors

a.   That the supervisor has undertaken training in psychotherapeutic supervision. (See documents on Grandparenting and for Supervision Training)
c.   The supervisor must hold a qualification or demonstrate experience in line with the UKCP standards for registered Psychotherapists and Psychotherapeutic Counsellors. (See documents on Grandparenting and for Supervision Training)
d.   The supervisor must have a recognized qualification appropriate to the level of supervision being offered.
e.   Wherever possible, they should also have training and / or qualifications relevant to working with the client group (group work, couples, minorities etc.).
f.    If the supervisor has no formal training to work as a supervisor of that client group, then they must have substantial experience of working psychotherapeutically with the specific client group or groups and have received supervision for such work.
g. The supervisor must have a thorough understanding of current legal and ethical issues that pertain to working with clients. They must work to the Code of Practice and Complaints Procedure relevant to the UKCP, UKCP Section and / or the service provider they are employed by.
g.   Supervisors should have experience of working with more than one socio-cultural identity group (gender, race, class, age etc.)
h. Supervisors must have suitable Professional Indemnity Insurance for their work.

6.2 Responsibility to the Supervisee
a.   The supervisor must make a contract with the supervisee incorporating into the contract a clear understanding of their clinical responsibilities
b.   If the supervisor is to have an evaluative role and be required to report on the supervisees work then this should be discussed in the initial contracting session. c.   Supervisors must be clear when contracting with supervisees, as to what action they would take if they were concerned about the supervisee’s work or capacity to practice.
d.   Supervisors must clarify if the supervisee is covered by Professional Indemnity Insurance; and should request that the supervisee addresses this immediately if they are not covered.

Acknowledgement: Please note these guidelines are the culmination of work done by several organisations and individuals within and without the UKCP over a number of years across several modalities. All the contributors, known and unknown, are thanked for their thoughts, ideas, efforts and contributions.

DocumentsTraining Standards of UKCP - 1993
UKCP Training Standards: Policy and Principles – 2001
Psychotherapy with Children; UKCP Guidelines for Training -2003
Psychotherapy with Children; Principles, Aims and Guidelines for Training –2007 and 2008
UKCP Standards of Education and Training -2008