Structured peer group supervision: Systematic case reflection for constructing new perspectives and solutions

In this article, we present a case example of structured peer group supervision (PGS) in child protection, using the experience of social work undergraduate students. The idea was motivated from the point of view that since social work supervision has become an integral component for ensuring continuous professional and skill development, supervision-related knowledge and skills should, at the very least, be introduced at the undergraduate level (Schmidt and Kariuki, 2019). According to Lietz (2010), critical thinking in the context of supervision can enhance the analytic skills necessary to consider the complexity commonly found in child welfare practice.

Supervision has become increasingly important to the social work profession, as it enables reflection upon practice in a safe environment (Wilkins et al., 2017, 2018). Providing PGS during education serves two purposes. First, it is educational, as students must learn what supervision is about, and second, they become more aware of the challenges and complexities of practising social work.

To begin with, we apply a definition of supervision drawn from Sandu and Unguru (2013), who define supervision as the opportunity to receive support in the form of recommendations, ideas or suggestions. Studies undertaken in Estonia have previously established the need for supervision among child protection workers. According to Toros and LaSala (2019), child protection workers believe supervision enhances self-reflection and can be an integral part of continuous professional development. This line of supervision is also known from other and more established professions, such as medicine and teaching (Kilminster and Jolly, 2000). Furthermore, child protection workers consider supervision crucial for reducing stress and burnout and is thereby a crucial part of the profession (Toros et al., 2016).

Peer supervision in general provides the opportunity to receive and offer (1) feedback about working with difficult clients, (2) consultation on ethical and professional issues and (3) support for isolation and burnout (Yeh et al., 2008: 2890). In the Estonian language, peer supervision is called ‘kovisioon’, which directly translated means ‘co-vision’ and alludes to finding possible solutions and new perspectives in a collaborative process. Despite its huge benefits for professionalisation, Nickson et al. (2016) highlight the practical challenges in that traditional supervision in rural areas for many practitioners is rare. The same can be said about social workers and child protection workers in Estonia, but not only in rural areas – supervision is scarce for social workers and child protection workers in general. As supervision is not accessible, but rather seen as a need for ensuring continuous professionalisation, it has led social workers in Estonia to find alternative methods to reflect on their daily practices and difficult cases among fellow workers in a supportive environment – they have discovered PGS.

Although supervision is on the rise both in education and in professional practice, it is not a new ‘invention’ in the field of social work and can be traced back to at least 1986, when Marks and Hixon described PGS implementation in a public child welfare service with the aim of developing a training method that would upgrade the overall quality of services. They implemented PGS in a public child welfare agency and argued that it enhanced the training of staff in the management and treatment of protective services cases in a cost-effective, growth-producing manner. The focus of this article is on the PGS, specifically on the structured format of group supervision and how the structured peer group format encourages skill development, conceptual growth, participation, instructive feedback and self-monitoring (Borders, 1991: 248). Participants of the PGS are non-hierarchical (Akhurst and Kelly, 2006; Newman et al., 2013), they provide support and encouragement (Crutchfield and Borders, 1997), and empower critical thinking about the case/client from new perspectives. The structured format adapted is based on the structured group supervision model described by Newman et al. (2013) and peer supervision training by Aava (2013), and stretches across five phases: information, clarification, analysis, feedback and reflection.

We reflect on the experience of introducing the five-phased structured PGS model with nearly completed third-year undergraduate social work students who have no previous experience of participating in a PGS. Our student group consisted of seven students, all with some experience of working with clients. Akhurst and Kelly’s (2006) study suggests that six to seven participants serves as a good group size. All students agreed to participate for the purpose of reflecting on the structured format of PGS for this article. PGS was conducted in February 2019 by the first author. In the experience of the first author, this model can be employed both by novice and experienced practitioners after becoming familiar with the structure of PGS. Ordinarily, one of the group members serves as the facilitator of the supervision process, including monitoring of the time. As the experience of PGS for the students described in this article was obtained through practical exercises, and they had no prior experience with the structure of PGS, the first author took the role of group facilitator. Regarding the time, each phase can last 10–15 minutes, depending on the size of the group and the severity of the case, in total lasting from an hour to one and a half hours. In the following, we describe the model through the use of a case example.

In the first phase (information), one of the group members presents a case. The case selection can be decided based on a vote after the group has shared several cases, taking turns (on the regular basis of PGS) or negotiating other terms. We call the case presenter the ‘case-holder’. At the end of the sharing of the case, the case-holder formulates a statement/question that indicates what assistance is requested from the group. While the case-holder is sharing the case information, group members write one or two questions on the paper to gain clarifying details for understanding the case. The questions are handed to the case-holder:

In the case example of the students, one of the students had a complicated case and she requested case assistance. In short, the case involved a single mother with two children, a 14-year-old girl and a 10-year-old boy, who attend a children’s day care centre where the case-holder works as a social worker. The case-holder learned from the children that most of the time they live alone, as the mother lives with the boyfriend apart from her children. The daughter takes care of the younger brother, who has ADHD. This situation has been going on about three years. The mother believes that the children are capable of living alone and that she has her own life to live. Children were directed to the day care centre from the child protective services, The question the case-holder formulated was ‘What else can I do to support these children?’.

In the second phase (clarification), the case-holder provides further details about the case, based on the group members’ questions on what they need to be clarified. Depending on the complexity of the case, a second round of questions can be applied:

There was a vast variety of necessary clarifications. To illustrate: Why doesn’t the mother want to live with her children, what does the daughter think of the situation?, is there any family member available to support the family, and what measures have been applied by child protection workers? Hence, clarification questions were posed regarding parent, child, extended family and protective services.

In the third phase (analysis), group members analyse the case by themselves; the case-holder does not take part in the discussion, but only listens. At the end of the discussion, each group member writes a suggestion to the case-holder regarding the case at hand – a take on what to do or what to decide:

Students mainly emphasised the role of the case-holder within this case, her possibilities as the social worker and her personal feelings related to parenting. [In Estonia, it is the child protection worker who has the right and duty to intervene in such cases and not the social worker in the day care centre.] It was an emotional discussion, as there were strong concerns regarding the harmful situation of the children.

In the fourth phase (feedback), group members provide feedback and suggestions on the case, namely what they would do in that situation. Written suggestions from the end of the third phase are presented orally to the case-holder. The case-holder does not respond to feedback in this phase but only listens:

Students’ suggestions mainly related to three themes: (1) the role and the boundaries of the case-holder – the case-holder’s involvement has become too personal and emotional; (2) collaboration with the social services and extended family; and (3) support and monitoring of the well-being of the children.

In the fifth phase (reflection), first, the case-holder reflects on the suggestions provided by the group members and what was helpful, and describes the next steps to proceed with the case as well as acknowledging the most valuable ones from the suggestions. Second, each group member reflects on what he or she learned from this supervision process:

The case-holder acknowledged the aspect of becoming too personal and emotional, mostly due to being a mother of five children and therefore having a personal conflict related to parenting values. Although the child protection worker has the main duty and right in this case, nevertheless, the case-holder saw the possibility of working with the grandmother as part of the work in the day care centre. She affirmed that she had obtained the answer for the question she formalised in the beginning phase – she will work on building a relationship with the grandmother and children, something she had not focused on before. Group members found the peer group supervision to be a beneficial experience, suggesting that the highest value was the empowering support from the members and acknowledging the importance of self-reflection supported by this kind of supervision process. This kind of systematic case reflection enables students to gain a better perspective of the case and to generate and critically explore not only alternative solutions and decisions but also gaps in the existing information. Students emphasised that this is a useful method for case supervision and that it is feasible to apply it after one-time or short training/experience.

Conclusion – Reflection on the PGS experience

One of the benefits of the PGS recognised by the students was self-reflection. This kind of reflection can promote the search for new perspectives and new solutions, developing the practitioner’s strengths, abilities and potential in practice (Yip, 2006). Thus, a collegial exchange of experience can lead to increased self-awareness and contribute to positive professional development during education as well as in practice environments (Brink et al., 2012). Furthermore, the gain from the PGS process is bi-directional: it not only contributes to the case-holder, giving insights into how to proceed with the case, but also serves a purpose of ensuring professional decision-making and reasoning for all participants in the process (Mills and Swift, 2015). PGS is thereby not about case-work, but serves a larger purpose of professionalisation: supporting the professional growth of the others and oneself, and stimulating more conscious thinking about one’s competencies/lack of competencies, how decisions are reached and how to be self-critical. Goodsett (2014) argues that the ability and willingness to reflect can be an essential tool when learning to grasp case complexity and chisel out solutions. This is especially so in the deliberation between the case-holder and the rest of the group, and where thinking critically about the case-example can add new perspectives and new solutions (Pappas, 2010). Learning from these experiences may help widen one’s horizon and provide new understandings about social work practice, including constructing new solutions for ongoing and future cases whenever feasible.

PGS can be applied to the field of practice and in education to develop a professional habit of self-reflection during the process of reaffirming professionality through practice (Rosenfeld, 2014). This should also be the aim of education – promoting students to think about their learning experience and questioning parts of their experience as part of their role as professional practitioners (Pappas, 2010). What, then, is called upon is to approach supervision much more systematically, both from an academic and from a practice point of view, using evidence-informed practices (Sewell, 2018).