Case Studies

Case 6 With a colleague: receiving professional supervision

Jack is a dietitian who frequently uses counselling skills in his work. He has individual casework supervision for 45 minutes once a month. Although the sessions are confidential, he feels nervous as the time for his next session gets nearer, as he is not sure how to make best use of it. He decides to tell his supervisor about a recent interview with a patient.

Reflecting on a difficult interview

Jack recalls the interview and remembers how the patient broke down in tears as soon as she arrived to see him.

‘Ah ha,’ Jack thought at the time. ‘This is where I use my counselling skills!’ He focused on giving his attention to the patient, acknowledging how upset she seemed and inviting her to talk about what was troubling her. Jack felt pleased that he was able to do this calmly, yet he was not prepared for the long and involved story which the patient then told him. He began to feel overwhelmed and worried that he was not going to have time to focus on her diet. He hastily diverted the patient on to this by reassuring her that all would be all right in the end. He had covered all he had meant to by the end of the interview, but he was not sure the patient understood his advice about the diet. Afterwards, he felt awkward and uncaring, yet what else could he have done?

In his supervision session, he describes what happened and explores, with his supervisor, different ways in which he could have ended on time more appropriately and less abruptly. He begins to understand more clearly how his patient’s distress affected him and led him to deal with the situation in the way he did. He leaves the session feeling more able to distinguish between his role as a dietitian and his role as a helpful listener. He decides to read again about setting appropriate boundaries and to practise doing this more often.

Reflecting on a difficult encounter with a registrar

In the following session, Jack talks about an incident with a registrar on a ward round when he advised a certain dietary modification. He was taken aback when the doctor disagreed with him in a sarcastic way. At the time, he thought he had responded quite smartly, and he felt surprised later to be so upset. During the session, he explores what happened and realises how he could apply his new understanding in other interactions and modify his approach in similar situations.

Reflecting on supervision of students

At another session, Jack talks about his concerns about having students with him – how best to respond to them and his anxiety about being observed by someone else. He considers ways of applying his counselling skills with his students and comes away with a clearer idea of how he can provide effective support for the students and for himself.

Summary of reflections and learning from supervision

In a later session, Jack reviews what he has learned in supervision. He finds this review session helpful and decides to write a brief report as evidence of his reflective practice for his continuing professional development portfolio. He outlines the situations he has talked about, the issues that he has explored, what he has learned and how he has made use of this in his work. He also notes that at first the idea of having 45 minutes set aside for him alone seemed a luxury he could not justify. At times, he felt frustrated because there seemed no simple answers, only more for him to think about. However, before long he realised that far from being an indulgence, the sessions were challenging and stimulating work. He concludes his report by noting that he has found the sessions a valuable way of consolidating his learning about counselling skills and developing his knowledge. As a result of the support he has received, he feels more supported himself and more able to offer support to others, as well as being more confident, motivated and encouraged to continue using his skills.

You are recommended to use the book...

To read about setting boundaries (Chapter 4).

To read about supervision and support (Chapter 16).

To read about reflective practice (Chapters 1 and 16).