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ASSOCIATION FOR DANCE MOVEMENT PSYCHOTHERAPY UK
(ADMP UK)
CLINICAL SUPERVISION GUIDELINES
1. Context with reference to Health Professions Council (HPC)
2. Introduction
3. Clinical Supervision: format, aims and content
4. Who can provide clinical supervision for Dance Movement
Psychotherapists?
5. Frequency of clinical supervision
6. Contracting for Supervision
Suggesting readings for DMP supervisors
1. Context with reference to Health Professions Council (HPC)
1.1 ADMP UK‘s application for state regulation has been formally recommended by HPC (2004) and currently awaits final parliamentary agreement/ratification. State regulation will bring regulatory parity with the three other Arts Therapies (Art, Music, and Drama) which are already state regulated.
1.2 Once ADMP UK is officially state regulated, HPC standards of proficiency and standards of conduct, performance and ethics will become legally binding for all DMP practitioners. These standards can be found in full at www.hpc-uk.org. Dance Movement Psychotherapists (DMPs) are advised to be mindful of these in considering their clinical supervision arrangements.
1.3 In anticipation of the forthcoming change to HPC registration, this document focuses upon requirements and procedures for clinical supervision, whilst also remaining aware of the particular implications of integrating movement and dance as a specialist field of arts psychotherapy.
1.4 ADMP UK standards will continue to be membership standards as outlined within www.admt.org.uk, to which members agree when they join their professional association.
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2. Introduction
2.1 Clinical Supervision is a term that will be used throughout this document. It is also known as Dance Movement Psychotherapy supervision, or non-managerial supervision. It is an essential part of good practice for DMP. For the purposes of this document clinical supervision is defined as ‘a formal, confidential and collaborative process in which two or more professionals meet to discuss the clinical content and process of the supervisee’s work’. It is an integral part of the ongoing process of psycho therapeutic work.
2.2 It is important to be able to differentiate clinical supervision from line management which has a different purpose. Training, personal development and personal therapy are also different from clinical supervision, although there can be overlaps of some issues being addressed.
2.3 Regular clinical supervision is an essential and integral part of dance movement psychotherapy practice. The ADMP's Code of Professional Practice states that -
Dance Movement Therapists (Psychotherapists) should be aware of the limitations of their particular training and competence, and restrict their work accordingly. Therapists have a responsibility to arrange adequate supervision for all aspects of their work. In addition to this, specialist advice should be sought where necessary.
(see www.admt.org.uk/mem_codepractice.html)
2.4 It is therefore important for ADMP UK to provide guidance about the aims, content and frequency of such supervision, as well as advising on who is qualified to provide it.
2.5 ADMP UK acknowledges that dance movement psychotherapists are a diverse group of people, working across a wide variety of settings and circumstances. This document is therefore given for reference and guidance only in order to equip members with sufficient information to make informed choices and evaluations in respect of their supervision provision.
2.6 ADMP UK recognises that members’ arrangements for clinical supervision will be made according to a variety of factors including the supervisee's experience, work place requirements and supervisor availability. DMPs are expected to evaluate the strengths and limitations of their supervision arrangements and to ensure that any deficiencies are addressed, perhaps using other aspects of Continued Professional Development (CPD) to support clinical supervision.
2.7 All dance movement psychotherapists have an individual professional responsibility to assess their clinical supervision needs, in conjunction with managers / employers where appropriate, and to ensure their practice meets HPC standards.
2.8 HPC Standards of Proficiency (SoP) and Standards of Conduct Performance
and Ethics (SCPE) reflect the importance of clinical supervision and require the
therapist to:
- recognise the role and value of clinical supervision in an arts therapy context;
- understand the value of reflection on practice and the need to record the outcome of
such reflection (SoP 2c2);
- act in the best interests of your clients, and users (SCPE 1);
- make sure your knowledge, skills and performance are of a high quality (SCPE 5);
- carry out your duties in a professional and ethical way (SCPE 13)
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3. Clinical Supervision: format, aims and content .
3.1 In most cases clinical supervision involves regular meetings between an experienced supervisor and one or more supervisees, (i.e. individual / 1:1 clinical supervision or group clinical supervision). It is either a provision arranged and financed by the workplace or is purchased privately, by the supervisee, for a pre-arranged fee.
3.2 Group supervision has the advantage that supervisees may learn through the rich variety of experiences of their peers, and may enable some practitioners to attend more frequently, as it may be less expensive than individual supervision. It is recommended, however, that each supervisee, especially those who have not yet completed the equivalent of 3 years post qualifying full time practice discuss with their supervisor whether they may need in addition individual supervision to cover their client work adequately.
3.3 Peer clinical supervision involves two or more therapists of similar experience meeting as equals to discuss their clinical work. This is still a formal arrangement, with appropriate boundaries, but does not involve payment. Peer supervision is not suitable as the only clinical supervision of inexperienced therapists (including all those who have not yet completed the equivalent of 3 years post qualifying full time practice).
3.4 Clinical supervision involves verbal discussion and often the use of movement or other non-verbal communications (e.g. other art forms or video). It is essential to protect the confidentiality of clients discussed and this is especially important to remember in group supervision and when video recordings are used. When establishing a contract for supervision, supervisors and supervisees will agree together how best to maintain the confidentiality of clients and of the supervisory work, (i.e. the need for confidentiality of the supervisees’ process in supervision).
3.5 The principle aim of supervision is to support practitioners in developing their reflective practice within an ethical framework. This is parallel to CPD which is a separate requirement for the practitioner and falls under a different guideline, ( see Criteria for Registration, section 8, CPD). The supervisee remains responsible and accountable for his/her clinical work. The supervisor is expected to bear in mind the interests of the clients throughout the supervision process.
3.6 Further aims of clinical supervision may include:
- ensuring that the needs of the client are being considered
- monitoring the effectiveness of therapeutic interventions
- providing elements of education/learning to develop technique
- integrating theoretical knowledge
- guiding and encouraging supervisees in critical reflection and self regulation
- constructively confronting any unhelpful patterns of thinking or responding.
3.7 Clinical supervision may include discussion and analysis of the non-verbal and verbal, the emotional/psychological world of the client including conscious and unconscious processes, the relationships between the client and the therapist or in the case of group work, between client and other clients.
3.8 Clinical supervision may also include exploration of the dynamic between the supervisee and the supervisor (and in group supervision also between group members) where this reflects or parallels aspects of the clinical work, and between the supervision process and the organisational / clinical context of the work.
3.9 Clinical supervision is expected to provide a secure context within which personal or work pressures on a therapist can be recognised and discussed. For example such issues might include: pregnancy, a period of ill health, bereavement, family difficulties or moving home. Supervision can provide an important space to think about the way in which these personal events in a therapist's life can impact upon the therapeutic work and to identify times when the therapist needs extra support. As an environment of trust is core to developing a sense of containment, it is important to remember that trust is a two-way process within the supervisory relationship.
3.10 Other forms of therapeutic communication with or about clients (letters, telephone calls, e-mails) may also be appropriate material for clinical supervision. As integral components of the therapeutic transaction, these need to be considered with as much care as DMP session material.
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4. Who can provide clinical supervision for Dance Movement Psychotherapists?
4.1 Currently Senior DMP (SrDMP) registered members are eligible to provide supervision. It is anticipated that from September 2009 ADMP UK will publish and maintain a specific Register of Supervisors to assist members looking for DMP clinical supervision or specialist advice.
4.2 A suitable clinical supervisor will normally be an DMP Registered Supervisor or a senior practitioner in a related discipline, e.g. other regulated arts therapies. They should be familiar with the concept of clinical supervision as it is understood and practised within the arts therapies, and other psychological therapies, and be competent to provide supervision within the definition and aims given within this document (3.1 – 3.10). It is important that the supervisor and supervisee openly discuss the psychological orientations informing their work and that the supervisor agrees whether there is a good enough fit between their approaches to benefit the clients. Supervisors should also have access to clinical supervision themselves
4.3 When it is not feasible for reasons of availability / location, to have regular supervision from a DMP Registered Supervisor, other possibilities may be considered. It is crucial that the supervisee check whether the alternative supervisor is registered /accepted as capable to supervise within his/her own field.
4.4 Where therapists receive their regular clinical supervision from a practitioner who is not a dance movement psychotherapist, they should be mindful of the requirement to meet
'profession specific' standards of practice via other CPD experiences ( see /www.admt.org.uk/ContinuousProfessionalDevelopement.html )
4.5 A clinical supervisor should be familiar with the clinical field the therapist is working in, and be aware of any statutory / legal issues pertaining to the client group and / or the setting of the clinical work.
4.6 A supervisor may work within the same institution as the supervisee (providing there is no conflicting role relationship between them) or may be an external professional paid by that institution to conduct individual or group supervision sessions. Alternatively a supervisor may be consulted privately.
4.7 Clinical supervision does not necessarily imply a hierarchical relationship in terms of status, grading, or managerial responsibilities. A clinical supervisor is likely to be a more experienced practitioner but, in the case of therapists who are themselves experienced, a suitable supervisor may be a practitioner of similar grading / status who has skills and training in supervision. More senior DMP’s may wish to consult a supervisor who is not a DMP, yet who may offer specialist expertise in an area in which the practitioners needs further development, e.g. forensic psychotherapy / psychiatry.
4.8 It is strongly recommended that supervision is regular and face to face. However, there might be a situation when a DMP may prefer to seek on-going clinical supervision via regular telephone contact with an experienced DMP Registered Supervisor, rather than with a professional from another field. This would ONLY be appropriate after a period of face to face supervision with the DMP supervisor, which includes an assessment of the suitability of this type of supervision for this particular supervisee. There would need to be a contracted arrangement for face to face contact at least once a year. Meticulous attention to confidentiality issues would need to be addressed.
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5. Frequency of clinical supervision
5.1 The frequency of clinical supervision needs to be decided between supervisor and supervisee according to the volume of clinical work, the complexity of the work, the experience of the supervisee, the workplace requirements and any especially stressful circumstances.
5.2 It is strongly recommended that in the first 3 years post qualification practicing therapists receive regular sessions equivalent to no less than one hour of individual DMP clinical supervision per month (even if also in group supervision) however few their clients / sessions. This enables supervisor and supervisee to establish their working relationship and helps ensure that supervision remains a coherent and productive process. This minimum standard will not, however, be sufficient for most practising DMPs, who will need weekly or twice monthly supervision.
5.3 Hours of client contact can be helpful in calculating supervisory needs but the volume of work needs to be considered with regard to a number of other issues. One of these is whether the supervisee is providing individual and group therapy. Although group work is usually approached by looking at the group dynamics as a whole, it does involve responsibility for a number of clients whose individual needs must also be considered and may, therefore, need more supervision time than for 1:1 client work.
5.4 The context for clinical work may also affect the amount of supervision needed. Working within a supportive and well functioning team, who regularly discuss clients in some depth, can sometimes reduce the supervision needs of an individual therapist. Conversely, difficult team relationships may well need to be explored in clinical supervision in order to support the therapeutic work.
5.5 Private practice or taking full responsibility for working at depth with clients on one's own, as the primary therapist will need to be well supported by clinical supervision. In situations where a client is vulnerable, presents risk to themselves or to other people or where other complex issues exist the therapist should discuss with the supervisor how much supervision would be adequate.
5.6 It is the responsibility of the clinical supervisor within their contract with the supervisee to negotiate the adequate amount of supervision needed, identifying with the supervisee where ,and how else, the supervisee can get support. While it is not recommended that practitioners have more than one supervisor at a time, this situation might arise if specific needs were identified. In these cases it is important for all parties to know what kind of support is being offered by whom in order to ensure there are no conflicts of interest or confusion for the supervisee, and the best interests of the clients are central.
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6. Contracting for Supervision
6.1 It is recommended that the supervisor and supervisee establish either in writing or verbally basic contractual arrangements at the beginning of their supervisory relationship and reviewed at regular intervals. These arrangements will include such issues as:
- Establishing that both supervisor and supervisee have appropriate qualifications, registrations, and insurance
- The fee and arrangement for absences
- Regularity and amount of supervision following a review of supervisee’s experience and needs (taking into account the recommendations within this document)
- Confidentiality of clinical and supervisory work
- Matching ways of working and approaches within supervision to supervisee’s needs
- Number of supervisors: if therapist has more than one supervisor, clarify how this will work in the best service of the clients.
Drafted by SrDMPs: Prof. H Payne, S. Holden, P. Best
Ratifies May 2009
Suggesting readings for DMP supervisors
Best, P (1999). Improvised narratives: dancing between client and therapist, e-motion, XI.4 17 – 26
Calisch, A. (1989) ‘Eclectic blending of theory in the supervision of art psychotherapists’, The Arts in Psychotherapy, 16: 37-43.
Campbell, D. & B. Mason (eds). Perspectives on Supervision. London: Karnac.
Carroll, M. and Tholstrup, M. (eds). (2001). Integrative Approaches to Supervision. London: Jessica Kingsley.
Clarke, I. (2001). Supervision in dance/movement therapy. E-motion, 13.3, pp.3-5.
Edwards, D. (1993). ‘Learning about feelings: The role of supervision in art therapy training’, The Arts in Psychotherapy, 20, pp.213-222.
Gilbert, M. & Evans, K. (2000). Psychotherapy Supervision: An Integrative Relational Approach to Psychotherapy Supervision, Buckingham: Open University Press.
Jones, P. & Dokkter, D. (2008). Supervision of Dramatherapy. London : Routledge.
Lahad, M. (2000). Creative Supervision: The Use of Expressive Arts Methods in Supervision and Self-Supervision, London: Jessica Kingsley.
Lett, W. (1993). ‘Therapist creativity: the arts of supervision’, The Arts in Psychotherapy, 20: 371-386.
O’Dell-Miller, H. & Richard, E. (2009). Supervision of Music Therapy: A theoretical and practical handbook. London: Routledge.
Payne H. (ed.) (2008). Supervision in Dance Movement Psychotherapy. London: Routledge.
Ryan, S. (2004). Vital Practice: Stories for the healing arts: the homeopathic and supervisory way. Portland, Dorset: SeaChange.
Scarth, S. (1995). Supervision on the move. ADMT.UK Newsletter, 7.2, pp.12
Shavarien, J. & Case, C. (2007). Supervisions in Art Psychotherapy. London: Routledge.
Tselikas-Portmann, E.(ed.) (1999.) Supervision and Dramatherapy, London: Jessica Kingsley.
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