Courtney O’Donnell
With support from Brisbane North PHN, we are continuing our work to address the need for increased access to effective clinical/practice supervision among AOD workers in Queensland. QNADA’s Sector and Workforce Development Officer, Courtney O’Donnell, is undertaking this work as part of her PhD study at the University of Queensland (UQ) under the supervision of Professor Leanne Hides (UQ), Professor Nicole Lee (National Drug Research Institute) and Sean Popovich (QNADA).
The first phase of this project took the form of a qualitative study, which aimed to identify barriers and facilitators to accessing high quality clinical/practice supervision. Twenty-one qualitative interviews were conducted with frontline workers and service managers from eight government and non-government AOD treatment services across Brisbane. Thematic analysis indicated that there is a perceived need for all AOD workers to receive regular and frequent clinical/practice supervision from AOD specialists. Consistent with previous research, clinical/practice supervision was also perceived to have a variety of benefits for workers, their employing organisations and people who access services. Frontline workers and managers felt that barriers and facilitators to accessing effective clinical/practice supervision included limited time, the high cost of providers, availability of skilled clinical/practice supervisors, supervisor-supervisee matching and supervision modality (ie external, internal, group or individual).
During interviews, participants were also asked about their perceptions of a clinical/practice supervision exchange model. This model was developed by QNADA with the aim to increase access to effective clinical/practice supervision among workers using the limited sector resources available. A key feature of this model is that it operates on an exchange basis, whereby a worker from one organisation provides clinical/practice supervision to staff of another organisation, and vice versa. While the idea of a supervision exchange partnership was previously been suggested as a possible solution to the issue of under-resourcing in the sector, an AOD-specific clinical/practice supervision exchange model has not previously been implemented and evaluated.
Interviews revealed that frontline workers and service managers considered implementation of a clinical/practice supervision exchange model to be a resource-effective strategy to increase access to external, individual clinical/practice supervision while also exposing workers to a greater diversity of perspectives, increasing sector collaboration and improving the perceived value of clinical/practice supervision among the workforce. Participants considered potential barriers and facilitators to implementation to include willingness among services to participate, sustainability of the model and flexibility in clinical/practice supervision delivery. Data obtained from these interviews were used to inform the second phase of the study.
The second phase of this project was implementation and evaluation of a clinical/practice supervision exchange model with six participating AOD treatment services in Queensland. In late 2020, twenty frontline AOD workers (supervisees) were randomly allocated to the supervision exchange (n=10) or supervision-as-usual (n=10) arms of the study. Participants in the supervision exchange arm of the study were matched with a supervisor (n=5) employed by another participating treatment service. Supervisors and supervisees were pragmatically matched based on characteristics including years of experience in the sector, age, qualifications, expertise and interests. Monthly supervision for participants in the supervision exchange arm of the study commenced in December 2020. All participants were asked to complete a survey at baseline (0 months; pre-), 5 months (mid-supervision exchange), 10 months (post-supervision) and 15 months (follow-up). Participants were recently asked to complete the final survey and results from this trial will be available shortly.
The third phase of this project aims to identify opportunities at the service system level to increase access to effective clinical/practice supervision among the AOD workforce. As part of this project, a review of guidance documents that inform and facilitate the commissioning of AOD treatment services in Queensland is currently underway. The purpose of the review is to determine whether, and in what capacity, commissioners of services are guided to support workforce development activities, such as clinical/practice supervision, through service funding mechanisms. In addition to the review, a series of qualitative interviews with commissioners of Queensland AOD treatment services and other relevant stakeholders are being conducted. The purpose of these interviews is to: identify the perceived role and scope of commissioners of services to support the provision of clinical supervision among the AOD workforce; understand how commissioners currently support the provision of clinical/practice supervision; and identify opportunities for policymakers and commissioners of services to increase access to effective clinical/practice supervision among the workforce. Together, the review of guidelines and interviews will allow us to identify potential systemic barriers to supporting increased access to effective clinical/practice supervision, and potential opportunities to address them.
You can read the full phase one study in the journal, Drug and Alcohol Review, here – https://onlinelibrary.wiley.com/doi/full/10.1111/dar.13450