Choy-Brown Mimi, Stanhope Victoria
University of Minnesota.
New York University.
Clin Soc Work J. 2018 Dec;46(4):271-280. doi: 10.1007/s10615-018-0687-0. Epub 2018 Oct 15.
Clinical supervision is an embedded resource for practice quality in community mental health organizations. Supervision has been found to increase provider competence and decrease stress. In addition, supervision has been associated with service user outcomes including decreased depressive symptoms. However, little is known about the availability and nature of supervision in real world settings. The primary aims of this study were to identify available supervision and the extent to which contextual factors are related to that availability. The data source for this study was a multi-state and multi-site (N=14) NIMH-funded trial survey of providers (N=273). Supervision was measured by hours per week (quantity) and by utilization of best practice activities (content). Univariate, chi-square, independent samples t-tests, and ANOVA analyses were used to assess supervision content and quantity and to examine subgroup differences. Participants reported an average of 2.17 hours of supervision per week and 28.6% of participants endorsed best practice content. Supervision quantity varied significantly across sites (p<.05) and program type (p<.05) while content did not. Individual role within the organization had a significant relationship with reported supervision content (p<.001). In these settings, organizations are exercising discretion in how to utilize supervision within the available time. Supervision time also varied by program type, increasing with the intensity of services. Findings demonstrate that reports of availability vary according to position within the organization and the intensity of services within a given program type. Implications for workforce development, access to quality services, and implementation of evidence-based practices are discussed.
临床督导是社区心理健康组织中提升实践质量的一项内在资源。研究发现，督导能提高从业者能力并减轻压力。此外，督导还与服务使用者的成效相关，包括抑郁症状的减轻。然而，对于现实环境中督导的可获得性及性质，我们知之甚少。本研究的主要目的是确定可获得的督导情况以及背景因素与该可获得性的关联程度。本研究的数据来源是一项由美国国立精神卫生研究所（NIMH）资助的针对多州多地点（N = 14）的从业者（N = 273）的试验性调查。督导通过每周时长（数量）以及最佳实践活动的利用情况（内容）来衡量。采用单变量分析、卡方检验、独立样本t检验和方差分析来评估督导的内容和数量，并检验亚组差异。参与者报告称平均每周接受2.17小时的督导，28.6%的参与者认可最佳实践内容。督导时长在不同地点（p <.05）和项目类型（p <.05）之间存在显著差异，而内容方面则无差异。在组织中的个人角色与报告的督导内容存在显著关联（p <.001）。在这些环境中，组织在如何利用可用时间进行督导方面拥有自主权。督导时间也因项目类型而异，随服务强度增加。研究结果表明，督导可获得性的报告因组织内的职位以及特定项目类型中的服务强度而异。文中还讨论了对劳动力发展、优质服务获取以及循证实践实施的影响。
