effective supervision in social work and social care · ‘case management supervision’ and...

Key messages• Research has demonstrated that good

supervision is associated with jobsatisfaction, commitment to theorganisation and retention.

• Supervision appears to help reduce staff turnover and is significantly linked to employees’ perceptions of the support they receive from the organisation.

• Good supervision is correlated withperceived worker effectiveness. There issome evidence that group supervision canincrease critical thinking.

• Supervision works best when it paysattention to task assistance, social andemotional support and that workers have a positive relationship withsupervisors.

• The emotionally charged nature of thework can place particular demands on

people in the field. It is important toprovide opportunities for reflectivesupervision.

• In an inter-professional context, workersrelate job satisfaction and professionaldevelopment to their supervisor’s expertknowledge, regardless of whetherrespondents shared the same professional background.

• The impact of supervision on outcomes for service users and carers has rarely been investigated. Anecdotal evidencesuggests that supervision may promoteempowerment, fewer complaints and more positive feedback.

• Overall, the empirical basis for supervision in social work and social care in the UK is weak. Most of the evidenceis correlational and derives from childwelfare services in the US.

October 2012 Review date: April 2015

43RESEARCH BRIEFING

Effective supervision in socialwork and social careProfessor John Carpenter and Caroline Webb, Bristol University Dr Lisa Bostock and Caroline Coomber, SCIE

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IntroductionThis research briefing provides an overview of theevidence concerning the value of supervision insupporting the practice of social care and socialwork. It is relevant to both children’s and adultsocial care services and includes a considerationof supervision in integrated, multi-professionalteams. While the focus is on social work andsocial care, some of the research reviewedincludes participants from other professions such as nursing and psychology.

The briefing covers evidence on the use ofdifferent models of supervision and outcomes for workers, employers, service users and carers.It considers evidence on the costs of supervision and concludes with implications for policy-makers, practitioners, organisations,service users, carers and researchers.

What is the issue?Learning from supervised practice is an essentialcomponent of the education and training ofsocial workers. Through regular, structuredmeetings with a supervisor, students learn howto manage a caseload, apply theory and researchevidence to practice, perform the key tasks ofassessment, planning and intervention, andreflect on their own professional development.Supervision is also an opportunity to seek andreceive emotional support for undertaking whatcan often be a demanding and stressful role.

Supervision is, according to Lord Laming,1 the‘cornerstone’ of good social work practice – anopinion reiterated by the Monro Review.2 Thisperspective is an important alternative to themanagerialist approach which, according toNoble and Irwin,3 is preoccupied with supervisiongeared toward efficiency, accountability andworker performance.

A survey undertaken for the Social Work TaskForce indicated that social workers in Englandwere receiving very variable access to supervision

RESEARCH BRIEFING 43

and that it was process-driven and overly focused on the management of cases at theexpense of reflection and professionaldevelopment.4 A related concern, expressed by Davys and Beddoe,5 is that rather thanbenefiting staff and ultimately service users,supervision:

becomes part of a system of surveillance ofvulnerable and dangerous populations.5, pp 220

The benefits of developing a positive supervisionculture across wider social care and children’sservices are now widely recognised. Nationalguidance is limited, but regulations such as theNational Minimum Standards, linked to the CareStandards Act 2000, require that supervision incare homes, for example, takes place six times ayear and that it focuses on all aspects of practice,philosophy of care and career development.6More recently in England this has been expressed as:

receiving appropriate training, professionaldevelopment, supervision and appraisal.7

This research brief applies to both social care and social work whilst recognising that there is a gap in the research evidence relating to socialcare. Few studies overtly address the supervisionneeds and experiences of social care workers,although child welfare workers in the US mayhave no social work training, depending on Staterequirements.

Internationally there has been concern about theretention of social workers. This has long been amajor problem in child welfare services in the US,with a number of initiatives designed to promotesupervision, increase job satisfaction, decreasestress and burnout, and encourage workers tostay. Evidence from these initiatives features inthis briefing.

In the UK, there has also been concern about the supervision of social workers and social care workers working in integrated and multi-disciplinary teams,8 where professionals

may not be supervised by others from the samediscipline. Does this matter, if the key ingredientsare the same? Or are there some things, such asvalues and working practices, which are special tothe individual disciplines and therefore to theprofessional development of their practitioners?

What then do we mean by ‘supervision’? The primary functions are:

• administrative case management

• reflecting on and learning from practice

• personal support

• mediation, in which the supervisor acts as abridge between the individual staff memberand the organisation

• professional development.

Although terminology differs, these functionshave consistently been identified in the practiceliterature.5,9,10 Authors often seek to highlightparticular functions − for example, referring to‘case management supervision’ and ‘reflectivesupervision’.10 Authors with a behavioural healthbackground11,12 and social workers in NorthAmerica who provide clinical social work (i.e. with an emphasis on counselling andpsychotherapy) refer to ‘clinical supervision’.11,13–15 Definitions of reflective andclinical supervision are very close, essentiallyemphasising learning from case work with a view to professional development. Nevertheless,as the review by Spence et al.16 observed, there is a proliferation of models, but little evidencethat these have had any significant impact on the practice of supervision or outcomes forservice users.11

The method employed in supervision is primarilythe one-to-one meeting with a supervisor − inthe UK usually the worker’s line manager. But thisis not inevitably so: reflective and professionaldevelopment supervision may be given by asenior practitioner or external consultant, andgroup supervision may also be used. We need tounderstand which of these methods is mostuseful, for whom and in what circumstances.

Why is it important?The overall aim of professional supervisionshould be to provide the best possible support to service users in accordance with theorganisation’s responsibilities and accountableprofessional standards. Organisations are likelyto achieve this aim through workers who areskilful, knowledgeable, clear about their roles and assisted in their practice by sound advice and emotional support from a supervisor withwhom they have a good professionalrelationship. The secondary aim should be for the wellbeing and job satisfaction of workers, not simply because satisfied workers may bemore likely to remain in their jobs, but because a duty of care for staff working indifficult and challenging roles is important in its own right.

Despite the many of models of supervision, few, if any, are based on empirical research. This isironic since many supervisors actively seek topromote evidence-based practice. It is widelyassumed by policy-makers, educators andpractitioners that supervision is a good thing. But does the available research support thisassumption? This research briefing aims to assess the evidence. It begins by summarisingwhat we know.

What do we know already?The search identified three reviews of theliterature concerning the outcomes ofsupervision for social workers and equivalentprofessionals. The narrative review by Spence et al.16 examined research on clinical psychology,occupational therapy and speech pathology aswell as social work. It was not clear whethersupervision had any effect on workers’ practice orwhether it led to improved outcomes for serviceusers. There was some evidence to suggest thatdirective, as opposed to unstructured, approacheswere preferred by less experienced practitionersand also by the more experienced when facedwith new challenges. All supervisees preferred

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Effective supervision in social work and social care

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a supportive style of supervision. The authorsobserve that supervisors reported little or notraining in how to supervise. Nevertheless, thosefrom the different disciplines engaged in verysimilar supervision practices. Althoughsupervisors claimed to adapt their supervisionstyles to the needs of individual supervisees, the majority did not appear to do so.

Bogo and McKnight17 reviewed 13 peer-reviewedarticles from the US based on 11 separate studies.Like Spence et al.,16 they found little evidence onthe outcomes of supervision, but conclude thatthere is emerging evidence about the aspects ofsupervision valued by supervisees − specificallyavailability, positive relationships, mutualcommunication, support and delegatingresponsibility. Skilful supervisors with expertisewho were able to provide practical support wereparticularly appreciated.

Most recently, Mor Barak et al.18 conducted ameta-analysis of data from 27 papers whichprovided information about the relationshipsbetween three dimensions of supervision andvarious outcomes for social workers, childwelfare and mental health workers. Thedimensions were:

• task assistance, defined as the supervisor’sability to provide tangible, work-relatedguidance

• social and emotional support in responding toemotional needs, including stress

• interpersonal interaction, which reflects thesupervisee’s perceptions of the quality of therelationship and the extent to which this hashelped them be more effective in their work.

These dimensions were all positively andsignificantly associated with beneficial outcomesfor workers, including job satisfaction,commitment to the organisation, wellbeing andperceived effectiveness. Conversely, they werenegatively associated statistically withdetrimental outcomes such as stress, burnoutand intention to leave.

The evidence for Mor Barak’s meta-analysis wasdrawn from correlational and cross-sectionalstudies in which a large number of variables areinvestigated for their statistical associations withoutcomes for workers. In other words, thisevidence is not causal. It does not, and cannot,prove that the observed effects at the time thedata were collected can be attributed to theoutcomes of supervision. Nevertheless, thisresearch provides good circumstantial evidence forthe effects of supervision on workers, and alsohelpful definitions of key dimensions of supervisionand a framework for analysing outcomes.

What this research briefing addsThe review undertaken for this research briefingupdates the evidence base to 2012 and extendsprevious reviews by focusing on outcomes fororganisations and service users in addition toworkers. The briefing extracts information aboutthe nature and focus of the supervision asdescribed in the studies. It also assesses thequality of the evidence and its relevance forsocial work and social care practice in the UK.

The briefing identifies empirical studies thatreport on the association between the process ofsupervision and outcomes for service users,workers and organisations. Intervention studiesare included. However, due to resourceconstraints, studies addressing the perspectivesof supervisors have been excluded. The methodsused to identify and organise material weredeveloped by the Social Care Institute forExcellence (SCIE). These involved undertakingsystematic and reproducible searches of theresearch literature, identifying relevant studiesand assessing their quality. Empirical data wasextracted using a structured pro-forma whichfocused on various outcomes of supervision.

The literature

The briefing aims to provide a signpost for furtherreading, rather than a definitive account of ‘what


works’. It is based on papers published in peerreviewed journals only between 2000 and 2012.Fifty papers were identified, reporting 48separate studies. The literature is predominatelyUS-based,19 with another seven studies reportingdata from Australia, Canada and Israel. Just threestudies were based in the UK.

The majority of papers focus on social work with children and families,20 with just fourconsidering adult social care. Most studies21

are cross-sectional surveys and report onlycorrelational evidence in which supervisionfigured as one factor among many that wereassociated with practitioners’ job satisfaction,stress, retention and intention to leave. Only fourstudies report the results of interventions usingsupervision to improve outcomes.

Just two papers report on associations betweenthe process of supervision and outcomes forservice users. No study reports on theperspectives of service users, hence the literature is silent on users’ and carers’ views on supervision.

Two papers specifically focus on inter-professionalworking within integrated teams, of which bothconcern practice with adults. One, focused onchildren and families, briefly addresses intra-agency working.

Both social work and social care staff areincluded in this review. However, it is not alwaysmade explicit whether some papers refer to staffqualified in social work, unqualified workers orthose with other related qualifications. Because asubstantial amount of research literature is fromthe US and from child welfare services, it isimportant to note that the educationalrequirements for child welfare workers in thatcountry vary by state and even region andmunicipality, meaning that many child welfareworkers have no social work qualification ortraining. Hence, supervisors in these settingsoften have to teach basic social work knowledge,values and skills which it is likely social workers inthe UK would already possess. There is just one

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study which explicitly examines the perspectivesof social care staff, in this case home careworkers (HCWs) in Northern Ireland.

A significant problem faced by the reviewers was that few papers provided information on the nature, quality and regularity of supervision.This, together with the fact that most of theevidence is correlational and drawn extensivelyfrom services in the US, makes it impossible todraw definitive conclusions about the outcomesof supervision in the UK. Nevertheless, thisbriefing does identify a range of possibleoutcomes for practitioners, employers andservice users and assesses the extent of evidence for each.

What does the researchshow?Models of supervision

Few of the 50 studies reviewed provideinformation about the nature of supervision. This was noticeably the case in the majority ofstudies included which investigated thestatistical associations between supervision andoutcomes for workers. This lack of specificityunfortunately limits their usefulness.

In general, the majority of studies concernedone-to-one supervision. Although it was not clearwhether this was provided by the worker’s linemanager or another person, the assumptionseems to be that it was the former. Of the fewstudies which evaluated an intervention toimplement a new or enhanced approach tosupervision within an organisation, three describethe model of supervision in some detail.13,22,23

These interventions all took place in child welfareservices in the US. The first three involved group-based supervision, either alone or in combinationwith individual supervision. Where the focus ofsupervision was described, it was generally‘reflective’ or ‘clinical’ supervision as opposed to‘administrative’ or ‘case management’supervision.

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Smith et al.23 report on the IntegrativeSupervision Model (ISM) in Georgia, US. The four stages of ISM focus on case management,educational/professional development, clinical skills/reflective problem-solving andemotional support. Experienced supervisors were bought in and trained in ISM. The lengthand frequency of the group supervision sessions is not described, but the project lasted around 18 months. A pilot studyemploying pre-post measures with 17 socialworkers indicated a statistically significantchange in participants’ perceived levels ofprofessional knowledge and skills. This findingwas supported by focus group data from socialworkers and supervisors.

There were no studies comparing the outcomesor cost-effectiveness of different models ofsupervision. However, in a pilot study, Lee et al.24

assessed the job satisfaction ratings of mentalhealth workers in one service agency in the USand conclude that participants who perceivedtheir supervision to involve mentoringrelationships were more satisfied with the work itself, their supervision and their co-workers than staff who did not. Mentoring, defined as assigning tasks, teachingthe job, giving support, and providing inspirationand advocacy, was also identified as a keycomponent of job satisfaction for supervisors in a large-scale survey of child welfare services in the US.25

Outcomes for workersThe importance of supervision to outcomes forworkers was the focus of most of the studiesreviewed. The conceptual model by Mor Barak et al.18 identifies both beneficial and detrimentaloutcomes associated with the dimensions ofsupervision and provides a framework for this section.

Job satisfactionThe quality of supervision is consistently associatedwith positive worker outcomes, with a significantnumber of papers addressing the impact of

supervision on job satisfaction.12,14, 15,24,26–33 Jobsatisfaction coheres around the following three themes:

• structure, focus and frequency of supervision

• task assistance (supervisor’s tangible, work-related advice and instruction to asupervisee)

• support to access resources for service users.

Structure, focus and frequency of supervisionWhere reported, greater frequency of supervisionis associated with higher levels of satisfaction,with one study reporting a minimum of twohours per week as a perquisite to job satisfactionand retention for urban child welfare workers inthe US.26

In a qualitative study that attempted to get togrips with the structure, focus and frequency ofsupervision, Bogo et al.14,28 explored theexperiences and perceptions of frontline healthand social care staff in relation to clinicalsupervision and best practice. The context wasthe merger of two addiction services and twomental health facilities to create the Centre forAddiction and Mental Health (CAMH) in Toronto. Programme management wasintroduced to improve patient care, meaning that professionals no longer necessarily receivedsupervision from someone of their ownprofessional background.

Bogo et al. found that job satisfaction andprofessional development, regardless of whetherrespondents shared the same professionalbackground, were related to the followingimportant components of supervision:

• that it was regular

• that it was provided by those with expertknowledge and clinical intervention skills forthe specific client population

• that it was able to teach new, effectivetreatment methods and that there wasreciprocity and active involvement fromsupervisees.


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audio-visual aids. Problems identified with thedelivery of supervision included:

• high clinical workload

• availability of supervision partner and sessionsnot frequent enough

• insufficiently experienced supervisors

• lack of guidelines

• a need for training in supervision skills.

Kavanagh’s study goes beyond the description ofsupervisory practices and characteristics andexamines which features were associated withperceived impact on practice. Analysingresponses from supervisees only, due tosupervisors rating multiple relationships, thestudy found:

• satisfaction with supervision and positiveattitudes to supervisors were stronglyassociated with perceived impact on practice

• a positive relationship between frequency ofcontact with supervisors from the samediscipline and perceived impact, but not withcross-professional supervision

• that giving priority to discipline-specific skillswas strongly associated with impact, but timespent on generic skills was not.

The authors conclude that:

from a management point of view, itsuggested that supervision may contributeto better patient care and to staffretention. A need for a more targetedapproach to skills acquisition wasidentified, as was a discipline-specific focusin sessions. Positivity of the supervisionrelationship emerged as a key feature ofeffective supervision, both in terms of itsimpact on practice and on job satisfaction.

Accessing resourcesIn a study of home health social workers in the US, Egan and Kardushin30 report on taskassistance in relation to accessing resources for service users and its impact on job

Staff suggested that the emotional climate ofsupervision − meaning a ‘safe, confidential space’− was key in helping them to process the personalimpact of practice experiences. In contrast, whensupervision was focused on administrative issuesor performance management and productivity, itwas experienced negatively as being critical andundermining of staff confidence.

Task assistanceTask assistance involves a supervisor’s tangible,work-related advice and instruction to asupervisee and focuses on training, skills andsolutions for practice.18 It is primarily related tojob satisfaction in this review, underlining itsimportance to positive outcomes for workers,supporting them to perform effectively. Taskassistance was of particular importance toworkers in terms of role clarity, supporting themwith perceived role competence and with taskknowledge and problem-solving.27

In Australia, Kavanagh et al.12 examined thefrequency and characteristics of practice-relatedsupervision in allied health staff, including socialworkers in mental health services acrossQueensland. The research reports supervision aslargely individual and face-to-face, with some byteleconferencing in rural and regional areas.There was a monthly median of two hours.Almost all respondents had a supervisor fromtheir own profession and 45 per cent hadmultiple supervisors. The primary focus ofsupervision was on practice improvement ratherthan therapeutic discussion for the supervisee.Both supervisors and supervisees reported themain focus of the supervision as:

• discipline-specific competencies (56 per centsupervisors; 46 per cent supervisees)

• generic practice skills (15 per cent supervisors;25 per cent supervisees)

• personal issues and career development (8 per cent for both supervisors andsupervisees).

Supervisees reported little observation of theirclinical practice, practice skills or use of

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satisfaction. The helpfulness of ‘administrators'(i.e. budget-holders) in resolving difficultiesbetween patient access to services and financialpriorities contributed significantly to greater job satisfaction. The authors conclude that‘administrative’ supervision, whereby supervisorshelp their staff access resources to meet patientneed and thus resolve their own ethical conflictsor uneasiness about not being able to offer theservices needed, is more important than‘emotional’ supervision focused on professionaldevelopment and mentoring in this cost-conscious context.

Supervision of the workerSocial work and social care are conducted throughpersonal relationships and interactions, with orwithout practical support or personal care. Theyplace particular demands on staff and it is theemployer’s responsibility to ensure this dimensionof supervision is provided as part of their duty ofcare. Outcomes should include making sure thatpractice is safe, from the point of view of peopleusing services and their families as well asworkers, through personal risk assessment,debriefing after difficult situations and reviewingdecisions for learning. Outcomes of supervisionshould also concern consideration of the workeras a professional practitioner, entitled todevelopment and learning opportunities, statusand standing alongside other professionals, andcapable of representing the agency in joint andintegrated working. Positive outcomes for workersreported in the literature include:

• social and emotional wellbeing

• improved self-efficacy and sense ofempowerment

• organisational commitment and intention to stay.

Detrimental outcomes include:

• stress

• burnout

• role conflict

• intention to leave.

Social and emotional wellbeingSupporting the social and emotional needs ofworkers entails listening to them attentively asthey discuss job difficulties and making empathiccomments. It may also include relating to theemotional needs of workers when they feeloverwhelmed, stressed or confused about their work.18

In a study of job satisfaction among hospiceinter-disciplinary team members in the US,Deloach29 reports qualitative responses fromopen-ended survey questions on the aspects ofsupervision that staff found most supportive.Social and emotional support figured highly. For social workers, being supportive came in theform of feeling valued as a unique member of aspecific discipline, being supported in clinicaldecision-making and supportive comments bysupervisors that ‘back you up’.

Self-efficacy and empowermentA perceived sense of control, or self-efficacy, is also associated with job satisfaction forworkers.34 Where supervisors are socially andemotionally supportive to supervisees, studiesshow that self-efficacy is related to jobsatisfaction15 and intention to stay.24 In Cearley’sstudy35 of child welfare workers in the US,supervisors’ empowering behaviours significantly affected workers’ sense ofempowerment, specifically increasing theirability to make decisions. These quantitativeassociations were confirmed with qualitative data − for example, one worker stated that her supervisor:

allows workers to make their own decisionsand she supports those decisions after theyare made.

Organisational commitment and intention to stayOrganisational commitment to the developmentof supervisory practice,13 the willingness ofsupervisors to help employees carry out theirjobs effectively and provide aid in stressfulsituations,25 and whether supervisees feelemotionally supported by supervisors31,36–38 are


effective if a supervisor and a worker interactwith each other in a supportive way, directlyreducing intention to leave. Professionaldevelopment through supervised practice wasalso associated with workers’ attachment to theorganisation. Where frontline workers werereadily able to communicate their opinions andfeelings to management, this reduced the role ofstress on burnout.

Burnout is also associated with workers’perception of their relationship with thesupervisor, not just whether they received help orsupport.18 In Mena and Bailey’s33 study of childwelfare workers in the US, workers’ sense ofrapport within the supervisory relationship wasrelated to job satisfaction. Conversely, whereworkers reported feeling negative about rapport,this was associated with both emotionalexhaustion and depersonalisation, wherebyworkers feel detached, no longer see themselvesas valuable and lose track of their personal needs.

In another US-based study of child welfareworkers, Boyas and Wind43 found that emotionalexhaustion was significantly higher for workersreceiving increased supervisory support. Thiscounterintuitive finding highlights the difficultyof drawing conclusions from correlationalevidence. Having controlled for key individualcharacteristics, such as age, tenure and job title,Boyas and Wind speculate that emotionalexhaustion is higher among experienced workerswho have greater involvement in difficultdecision-making processes and handle the morecomplex child protection cases.

Supervising the emotionally charged nature ofchild protection work requires a refocusing ofsupervision so that it explores the impact of thethoughts and feelings of workers on practice. In asmall-scale qualitative study by Gibbs44 of childprotection workers in two rural regions inVictoria, Australia, it was found that the model of supervision gave insufficient attention to theemotional intrusiveness of the work.Respondents reported that the overriding priorityfor supervisors was to ensure the work was

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all associated statistically with workers’ decisionto stay employed.

The degree to which employees feel supported by their supervisor affects their emotionalsatisfaction with the job and contributes to theappraisal of how the organisation values themand cares about them. In Landsman’s31 study oforganisational commitment by child welfareworkers, it was found that supportive supervisionwas associated with both job satisfaction andperceived organisational support.

Kavanagh et al.12 found that while there was noassociation between the amount of supervisionand job satisfaction or intention to stay, therewas a link with positive attitudes to supervisorsand high supervision impact. Relationships thatwere characterised by accessibility, empathy andpraise appeared especially important forretention. Retention and intention to stay arealso related to access to supportive peer relationsat work.39–41

Stress, burnout and role conflictSupervisory support has clear associations withworker stress, burnout and role conflict. Lack of emotional support, inadequate supervisionand feeling out of one’s comfort zone areassociated with higher burnout.42 Job-relevantcommunication, another facet of task assistance, is also reported as important topositive worker outcomes.

Kim and Lee32 used statistical modelling toinvestigate the effects of different types ofsupervisory communication on burnout andintention to leave among 211 social workers inhealth or mental health settings in the US.‘Supportive relationship communication’, definedas informal and supportive interaction betweensupervisors and social workers, appeared toreduce worker stress and indirectly reducedburnout and intention to leave. ‘Job-relevantcommunication’, defined as performancefeedback, information about rules, policies, work schedules and assignments, task-specificinstructions and goals, was found to be more

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completed and conformed to acceptablestandards, at the expense of reflection onpractice, discussion about high workloads, stress and anxiety. This meant that workersexperienced role ambiguity, stress and concernabout things going wrong. Gibbs concludes thatsupervision must:

• convey the value of workers

• explore feelings and thoughts in action andperception

• take account of adult learning theory and therole of the supervisor in promoting effectivelearning by staff.

Intention to leaveNine papers look at the association betweensupervision and intention to leave. Findings are contradictory. Two papers by Strolin-Goltzman45,46 report that supervisorysupport does not predict intention to leave, witha related paper by McGowan47 suggesting thatcareer satisfaction was the most important factor determining intention to leave. In contrast,six studies found that supervision plays animportant role in determining whether socialworkers consider leaving their jobs.32,39–41,48–50

Fakunmoju49 found that gender played amoderate role in regard to supervisory supportand intention to leave, with men more likely toreport higher intention to leave than women inrelation to low supervisory support. However, it is difficult to unravel which particular aspectsof supervision make a difference to workers’intention to leave because data on the structure, focus and frequency of supervision is rarely reported.

In one of the few UK-based studies, and the onlystudy that explicitly addressed social careworkers without a social work qualification,Fleming and Taylor51 looked at the retention ofhome care workers (HCWs) in Northern Ireland.Based within an integrated health and social care service, this small-scale study surveyed 45 HCWs and focus groups to explore thegrowing problem of retention of HCWs from their own perspective. On the whole, HCWs were

positive about supervision, but a significantminority identified the need for more support,better communication and more responsive out-of-hours and emergency systems.Emergencies were a particular crunch point, with about a third of staff saying that theysometimes or never felt supported.

The type of support thought to be beneficialincluded:

• extra time and support available in a crisis (e.g. death of a client or preparing for hospital)

• information about clients requiring temporary cover

• better out-of-hours contact arrangementswith supervisors

• weekly contact from a supervisor

• more consideration given to HCWs regardingclient care

• a stand-by HCW available in the evenings andweekends to assist with emergencies.

Outcomes for organisations

Many of the studies also consider outcomes ofsupervision that are beneficial to organisations.Supervision focused on task assistance for theworker may improve performance, whilesupervision which provides social and emotionalsupport may reduce staff turnover.

Job performanceIncreasingly, supervision of social workers hasbecome focused on performance management,ensuring that organisational procedures havebeen followed and that workers are practisingwithin agency expectations. However, there isvery little evidence that supervision affectsperformance.

Kavanagh et al.12 found that satisfaction withsupervision and positive attitudes to supervisorswere strongly associated with perceived impacton practice, but only if supervisors were from thesame profession. This, they suggest, may be


because certain features of supervision areimportant, such as direct instruction and skillsacquisition, thereby emphasising the taskassistance function.

The study by Smith et al.23 evaluated the impactof the Integrative Supervision Model (ISM)described above. There were changes inparticipants’ self-perceived levels of knowledgeand skills during the project, and it was believedthat this had a beneficial impact on service useroutcomes, but there was no direct evidence tosupport this assertion.

While the evidence suggests an associationbetween supervision and perceptions of jobperformance in general, this review found nostudies evaluating the impact of supervision onspecific aspects of job performance. Neither wasthere sufficient detail on the supervisionprocesses to draw any conclusions about howsupervision positively affects job performance. It may be that the task assistance function ofsupervisors has a direct impact, but equally,increased worker perceptions of job performance may also be an indirect effect of increased self-efficacy as a result ofsupervision. Once again, this is a limitation ofcorrelational evidence.

Workload managementJust two studies consider the potential bufferingeffect of supervision on workload management,although this is not addressed in any detail andthe studies do not provide detailed descriptionsof caseloads. In a US study of child welfareworkers, Juby and Scannapieco52 found that staff who received more support from theirsupervisors saw their work as more manageable.They suggest that this may reflect the taskassistance function of supervision as it increasesworkers’ skills and knowledge by providingeducation and training. Collins-Camargo andMillar54 report on the outcomes of clinicalsupervision projects with a particular emphasison the development of learning cultures whichpromote self-reflection, evidence-informedpractice and outcomes-focused approaches to

working with families. They found that workers’time management improved as a result of thenew supervisory processes, however it is notclear from this research why supervisory practiceresulted in these impacts.

Case analysis and planningFour studies consider the impact of supervisionon case analysis and planning. In one of the fewintervention studies found in this review, Leitz22

evaluated a group supervision project designed to develop critical thinking skills (termed a‘supervision circle’) for over 300 child welfareworkers in Arizona, US. This one-year projectbegan with five training sessions for supervisorswho then provided group sessions for five toseven workers on a fortnightly or monthly basis.The focus was on peer case review and othercritical thinking exercises.

There was a statistically significant increase inperceived levels of critical thinking among theparticipants. The quality of the relationshipbetween participants and lead supervisor, alongwith the extent of participation in groupsupervision, predicted the level of critical thinkingat the conclusion of the project. The number ofhours spent in supervision did not significantlypredict perceived levels of critical thinking, whichsuggests that it may be quality of supervisionrather than quantity which is important.

In a further study which considered therapistsworking with survivors of domestic abuse inIsrael, Ben-Porat and Itzhaky27 found thatsatisfaction with supervision correlated positivelyand significantly with two components of rolecompetence: general competence and knowledgeand problem-solving.

Improved case analysis and planning was also atheme in the study by Smith et al.23 Using theISM, these researchers found that workersreported they were able to apply ideas from theirsupervision group directly to their caseloads, aswell as being able to identify specific clinical skillsused by other group members. Collins-Camargoand Millar54 also report improved case analysis

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via critical thinking and realistic targeting ofinterventions, although no further in-depthanalysis of these results is offered.

Actual turnover and retentionIn this review, workers’ intention to leave isconsidered as an outcome for the individualworker and was therefore discussed in a previoussection. Actual turnover – and its converse,retention – are considered as (detrimental)outcomes to organisations.

Fourteen studies examined the links betweensupervisory support and actual turnover andretention rates. The general consensus is thatgood supervision can help workers to stay in theirjobs, while leavers often cite poor supervision asa reason for having left.

In a study of US child welfare workers who hadrecently left their jobs, Gonzalez et al.55 reportthat 29 per cent cited problems with supervisionas their reason for leaving (65 per cent of thesedue to ‘poor supervision’ and 35 per cent due totheir relationship with their supervisor), while 25 per cent said changes in supervision wouldhave made them stay (including more supervisoravailability).

Quality of supervisionDifferences between stayers and leavers in thequality of supervision received were apparent inresearch by Dickenson and Perry.56 They reportthat those workers remaining in public childwelfare rated their supervisors at a significantlyhigher level in terms of willingness to listen towork-related problems, the extent to which theycould be relied upon ‘when things get tough atwork’, and helping workers get their job done.Significant differences were also observed interms of stayers’ views on the skills andcharacteristics of their supervisors. This staffgroup rated their supervisors as more competent,more concerned with staff welfare, more likely toshow approval of a good job done, more likely tohelp in completing difficult tasks and more likelyto be ‘warm and friendly’ when workersexperience ‘problems’.

Similarly, Maertz et al.57 report that stayers gavehigher ratings than leavers on how theirsupervisor facilitated their learning andenthusiasm for the job as well as significantdifferences in the average number of hours spentwith their supervisor each month.

The supervisory relationshipOne notable aspect of supervision associatedwith turnover and retention rates concerns thesupervisory relationship. Yankeelov et al.58 andGibbs44 both report that those workers whostayed were more attached to their supervisorsthan those who had left; some staff were able to vividly describe the experience of beingsupervised by one particular person, even if thiswas some years previously. This suggests thatstayers feel a sense of security in theirrelationships with their supervisors and that thisrelationship is highly significant to them.

In a qualitative comparison of child welfareworkers in the US conducted by Morazes et al.,59 304 stayers and 82 leavers found nodifferences in terms of dedication to children and families and social work values. While allparticipants acknowledged workload and stressas job challenges, stayers illustrated experiencesthat buffered job pressures, particularlyencounters with supportive supervisors. As onestayer reported:

I think I stay [because] … my unit is good,my supervisor is excellent and that reallymakes a difference. I think if I had asupervisor I wasn’t getting along with orwasn’t helping me I would really want toleave. You need that support while you arehere because it’s a hard job and you aredealing with difficult things …

This study goes on to suggest that leavers tendednot to experience these buffers, although theyrecognised the value of them, and they weremore likely to describe experiences in which theyactually felt worn out by the same influenceswhich stayers had experienced as supportive,such as supervisors.


Other studies report mixed findings regarding thelink between supervision and retention (as do thestudies reporting on workers’ intention to leave).Faller et al.60 found that workers who indicatedtheir supervisor made life difficult weresignificantly more likely to have left their job. Yetnot all aspects of supervisor support influencestaff retention, and it was found that thesupervisory roles of providing useful informationwhen needed, or helping with new or unfamiliartasks, were not significantly associated withretention. Strolin-Goltzman45 found that therewere no significant differences in supervisoryfactors between organisations classed as havinghigh versus low turnover rates, therebycontradicting prior research findings. Theassociation between supervision and retention islikely to depend on both the type of supervisionprovided and whether it is provided in thecontext of a supportive relationship.

The long-term impact of supervisionThere are also questions regarding the long-termimpact of supervision on staff retention rates.Renner et al.13 found that at one-year follow-upafter implementing a state-wide supervision planamong child welfare workers in Missouri, US,retention rates improved, although only a little(from 75 to 78 per cent), but by two years thesehad fallen back to 74 per cent.

It should also be remembered that high turnoveramong supervisors could leave frontline staffquite vulnerable if the job commitment of staff is tied closely to perceptions of supervisorsupport − as the literature suggests.38 In the UK,Holmes et al.61 note that two local authoritiesidentified particular difficulties recruiting teammanagers, and that these posts were seen ascritical in supporting teams as well as drivingimprovements in practice.

Perceived organisational support (POS)Perceived organisational support (POS) is theidea that employees form a global beliefconcerning the extent to which the organisationvalues their contributions and cares about theirwellbeing. Research into POS is increasing,

particularly in relation to its links with staffturnover. In this review, seven studies considerthe relationship between supervision and POS.

In the US, Maertz et al.57 suggest that POS mayremain fairly stable over time, and may be lesssalient to employees than supervisory support,because supervisors have more regular contactwith workers. However, for employees who arenot receiving effective supervisory support, POSbecomes more important as they turn to theorganisation instead. This research concludesthat employees require a certain level of supportand this may be supplied by the supervisor, theorganisation itself or a combination.

Landsman31 found that supervisory supportsignificantly affected ratings of POS, andconcludes that the degree to which employeesfeel supported by their direct supervisor affectstheir emotional satisfaction with the job andcontributes to their appraisal of how theorganisation values them and cares about them.Gibbs44 also reports that for some staff a lack ofeffective supervision to enable them to managethe emotional demands of the job left thembelieving they had been poorly supported withinthe organisation, but for others this response wasinternalised and workers saw themselves ashaving failed in what they were doing whenthings had gone wrong.

Collins-Camargo and Millar54 report that overallchanges in supervisory practice had a positiveimpact on worker perception of organisationalculture, and Collins-Camargo and Royse53 foundthat effective supervision was highly correlatedwith staff perceptions of an organisationalculture that promoted evidence-based practice.

Bourn and Hafford-Letchfeld62 suggest thatfrontline managers in the UK have a key role in mediating organisational culture. Their small-scale qualitative study of recordings andtranscripts of trainee managers’ supervisorysessions indicates that supervisors frequently use humour, somewhat ironic apologies or other tactics for diffusing conflict and

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aggravation or for gaining compliance with theimplementation of otherwise unwelcomeprocedural changes. The authors conclude thatthe supervisory relationship has an importantmediation function: it is a channel through which organisational culture is conveyed tosupervisees as well as providing an opportunityfor staff to convey information upwards to theorganisation.

Chenot et al.37 suggest that organisationalculture only impacts on workers in the earlyphase of their career, after which staff becomeaccustomed to agency norms, which could bedetrimental in a negative organisational culture.Maertz et al.57 caution that distinctiveattachments to supervisors may even increasevoluntary turnover when a loyalty-inspiringsupervisor leaves.

Supervision in multi-disciplinary settings

The qualitative study of supervision in an inter-agency setting carried out by Bogo et al.14,28

is discussed above. They focused on workers’views about supervision arrangements followingthe amalgamation of two mental health and twoaddiction services in Canada. Programmemanagement meant that professionals no longernecessarily received supervision from someone of their own professional background.

Mixed reactions were found. Some staff reported that supervisors would not discussclinical issues or would focus solely onperformance management, whereas other stafffelt more positive. Overall, workers valuedsupervisors who attempted to understand theframeworks of their professions, although theymissed the connection with their professionaldiscipline and the ability to ‘talk in their ownlanguage’. Some social workers also:

experienced tension between the … focuson client/public safety, and social workvalues of being non-judgemental andpromoting empowerment.

Staff found the new inter-professional teams avaluable source of support which providedspontaneous and informal feedback in the face ofcritical and emotionally provocative experiences.These views did not appear to be related to theirperceptions of the supervisor, suggesting they areseparate constructs.

In the second paper, Bogo et al.28 report thatparticipants perceived safety and trust to bemore important than whether the supervisor wasfrom the same profession (although as noted inKavanagh et al.’s12 paper, having a supervisorfrom the same profession was important for jobperformance). Almost all participants agreed thatthe key elements of valued supervisors are theirclinical expertise and their ability to provide newand relevant practice knowledge and promotelearning in a respectful and safe way. These were more important than their professionalaffiliation. However, some participants didcomment that where they were the lone memberof the profession on the team, meetings withothers from their own profession were importantas inter-professional supervision may not includeprofession-specific work.

Inter-agency workingNo studies were found in relation to the impactof supervision on inter-agency working. AlthoughCollins-Camargo and Millar54 report that the new supervisory processes used in the clinicalsupervision projects resulted in improved intra-agency working (same agency but betweencounties), as well as increased agency credibilityfrom external sources, no analysis of why thisoccurred is offered.

Outcomes for service users and carers

The impact of supervision on outcomes forservice users and carers has rarely beeninvestigated. In part, this may reflect thedifficulties of unravelling the distinct impact ofsupervision on service user outcomes, but mayalso reflect a preoccupation with outcomes forworkers and organisations. Where evidenceexists, the outcomes are defined by professionals,


making it difficult to assess the impact ofsupervision on outcomes that matter to serviceusers themselves, which may differ from policyand practice imperatives. This means that theliterature presents only a partial picture of theoutcomes that count, with no attention paid tothe potential differences between professionalsand users. It also means that any changes to thesupervisory process are not informed by theperspectives of service users and carers and missa crucial aspect of understanding howsupervision impacts on practice.

Empowerment, participation and positivefeedbackWhere studies have attempted to assess theimpact of supervisory focus on workersatisfaction and ultimately outcomes for children and families, positive outcomes for users have been identified. These includepromotion of empowerment and userparticipation, fewer complaints and an increase in positive feedback.

Collins-Camargo and Miller54 looked at theintroduction of new supervisory processes in four state public child welfare agencies in the US.This involved a shift from supervision focused onadministrative and crisis-driven approaches toclinical supervision designed to promote:

• a supportive organisational culture

• an outcomes-oriented approach

• enhanced workers’ ability to think critically andmake good decisions regarding assessment oftheir cases

• evidence-based practice.

Supervisors participating in this project wereasked to assess the impact on service users of changes to supervisory practice throughdiscussion in focus groups. This data wastherefore anecdotal. The following areas were identified:

• active participation in services

• increased engagement in case planning

• families demonstrating positive empowermentand a desire for positive change

• fewer complaints and more positive feedbackfrom users.

The authors do not offer an in-depth analysis ofwhy changes to supervisory practice might havehad the claimed impacts.

There was also a perception among supervisorsthat cases were moving more quickly, and ananecdotal belief that children were going homesooner or not being removed from their homes in the first place. Quantitative data was notanalysed to support this. Quotes suggest thatsupervisors attribute this to closer workingrelationships with families, addressing issues asthey came up rather than leaving cases to drift.However, the anecdotal nature of this evidencemeans that claims made about the impact of thisintervention on service users should be treatedvery cautiously.

Placement safety and family functioningIn a paper exploring how organisationalcharacteristics have the potential to have apositive or negative impact on outcomes forservice users, Yoo63 looked at the role of the casemanager as the service provider with mostcontact with users, and who acts as a bridgebetween clients and agency.

Exploring a family preservation service in the US,Yoo found that while the agency was successfulin terms of placement safety and familyfunctioning, the organisational climate wasperceived by workers as not conducive toeffective practice.

Drawing on secondary data from the agency’sprogramme evaluations, Yoo found that atcompletion of the programme, out of 108 clientfamilies, 101 had children remain at home withno safety issues present and family functioningincreased significantly. However, unravelling the role of supervision as a contributor to thissuccess is complicated. Case managers

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reported various organisational challenges, such as low pay and benefits, harsh workingconditions and poor leadership as having anegative effect. They also reported organisational characteristics perceived aspositive strengths, such as commitment to client families and the support they receive from supervisors and co-workers.

While case managers were unable to identify inspecific terms what and how organisationalcharacteristics impacted on their work withservice users, the author notes that:

the case managers’ performance incontributing to positive outcomes for their clients seems to occur despite theirdissatisfaction with many aspects of theirorganisation, including compensation, workconditions and leadership.

Cost and cost-effectiveness

There was only one study identified whichconsidered the costs of supervision. In this UK-based paper examining children’s social care services, Holmes et al. (cited in Munro2)calculated that the unit cost of a supervisionsession lasting 1.5 hours is £87 per frontlinesocial worker. They note that if the frequency ofsupervision sessions is increased from monthly to fortnightly (to allow greater time for otheraspects of supervision as well as casemanagement, for instance), this would result inan annual increase in costs of £1,217 (per worker),and for a referral and intake team with five socialworkers and three family support workers anadditional cost of £9,408. While any paperoffering an estimation of costs is noteworthy,without a clearer idea about the benefits oroutcomes of supervision this data remainssomewhat arbitrary. However, since some studiessuggest that supervision is associated with staffretention, and as turnover results in increasedorganisational costs, reduced effectiveness andpoorer outcomes for service users, furtherconsideration of the cost-effectiveness ofsupervision is crucial.

Implications from theresearchThis review of the research has identified asubstantial volume of evidence that the provisionof supervision is associated with positiveoutcomes for workers (e.g. job satisfaction) andorganisations (e.g. job retention). However, thereis as yet little evidence that the implementationof structured supervision can improve theseoutcomes, and the evidence for its effects onworkers’ practice is weak. Further, it has not yetbeen demonstrated that supervision directlyaffects service user outcomes (e.g. child safety,mental health, reablement).

Implications for the policy communityThe present emphasis in policy-making on theimplementation of reflective supervision fornewly-qualified social workers is supported bythe evidence in this review. Supervision is alsoassociated with beneficial outcomes for moreexperienced workers and policy-makers shouldcontinue to promote its use more widely.Supervision may enhance worker effectiveness,maintain job satisfaction and promote retentionof staff.

Implications for practitionersSupervision works best when it pays attention totask assistance, social and emotional support anda positive interpersonal relationship betweensupervisors and supervisees. In particular, taskassistance and the importance of supervision inthe acquisition of new skills and problem-solvingare valued by workers. This is true for bothrelatively inexperienced practitioners and moreexperienced workers when learning new skills,working with new service user groups, in newmulti-disciplinary teams or dealing with criticalor complex situations.

Given the evidence that supervision is associatedwith job satisfaction and protects against stress,practitioners should insist that good supervisionbe provided by their employers. The emotionallycharged nature of the work places particular


kinds of demands on people working in the fieldwhich need to be contained by the organisation.This means moving beyond a focus on task andprescription, and providing opportunities forreflective supervision.

Implications for organisations Supervision plays a key role in social work andsocial care. Effective supervision is a crucialelement of an organisation’s duty of care to itsemployees, and to the users and carers it serves.Supervisors occupy a unique role whereby theycommunicate the organisation’s duties andpriorities to the worker, and also feed backworkers’ comments to the wider organisation.

The studies in this research briefing have shownthat the task assistance, emotional and supportfunctions of supervision have positive effects on avariety of organisational outcomes. Effectivesupervision results in more positive perceptions ofjob performance and a greater ability to manageworkloads, while employees’ case analysis andplanning skills are honed. Supervision also appearsto help reduce staff turnover and is significantlylinked to employees’ perceptions of the supportthey receive from the organisation.

Implications for service users and carersIt is reasonable to assume that well-supervisedsocial care workers who are supported both in

their roles and tasks and also in dealing with theemotional aspects of their jobs will be able toprovide a better service and improved outcomesfor users and carers. However, at present, theevidence to support this view is anecdotal andtherefore weak.

Service user-defined outcomes may differ frompolicy and practice imperatives. They are a crucialaspect of understanding the effectiveness ofservices from the perspectives of those who usethem and consequently are important forsupervisors to appreciate. And yet, no study hasaddressed what service users consider to be theoutcomes that matter most from supervision.

Implications for researchersIn spite of the strong commitment in policy andpractice to the use of supervision, the evidencebase is surprisingly limited, almost all of it being correlational. The most obvious gap is in good evidence that the implementation ofclearly defined models of supervision in an organisation leads to improved outcomes forworkers and better services for users and carers.There is no shortage of models of supervision,and so their costs and effectiveness should betested and compared. Research on the skills andeffectiveness of training supervisors in integratedteams as well as social care agencies should alsobe developed.

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Useful linksBritish Association of Social Workers (BASW) The College of Social Work (CoSW)BASW/CoSW have collaborated on a reportlooking at their members’ experience ofsupervision, with a view to developing a code ofgood practice for supervision in social work, withspecial reference to social workers working inmulti-disciplinary teams: http://cdn.basw.co.uk/upload/basw_13955-1.pdf

Care Council WalesSupervision and appraising well: a guide to effectivesupervision and appraisal: www.ccwales.org.uk/supervising-and-appraising-well/

Care Quality Commission (CQC)The CQC’s Essential Standards of quality and safetyinclude Outcomes 12 and 14 that state staff shouldbe properly trained and supervised, and have thechance to develop and improve their skills:www.cqc.org.uk/organisations-we-regulate/registering-first-time/essential-standards

Department for Education (DfE)The defunct Children’s Workforce DevelopmentCouncil (CWDC) produced a guide to developingan integrated approach to supervision in children’strusts: www.education.gov.uk/publications/eOrderingDownload/IW115-2010.pdf

Department of Health, Social Services andPublic Safety (DHSSPS)In Northern Ireland there is a mandatory regionalpolicy and guidance which sets out the minimumstandards for supervision of social workersemployed by health and social care trusts. Whilstprimarily focussed on childcare workers, it isbroadly adopted for all social workers, It statesthat supervision must be delivered monthly withsessions of 1.5–2 hours in duration, with enhancedrecommendations for newly qualified workers.www.dhsspsni.gov.uk/supervision_policy__standards__and_criteria___regional_policy_for_northern_ireland_health_and_social_care_trusts.pdf

Local Government Association (LGA)In response to evidence submitted to the SocialWork Task Force, the Standards for employers and supervision framework builds on existingguidelines for employers of social workers:www.local.gov.uk/c/document_library/get_file?uuid=7e6d2140-fc0e-47cd-8b2f-2375812700ad&groupId=10171

Skills for CareThis workforce development tool has beenproduced by Skills for Care and the now defunctCWDC to promote the widespread provision ofhigh-quality supervision across adult andchildren’s social care:www.skillsforcare.org.uk/home/home.aspx

Related SCIE resourcesGuide 1: Managing practicewww.scie.org.uk/publications/guides/guide01/

Care Skillsbasewww.scie.org.uk/workforce/careskillsbase/

Guide 24: Learning together to safeguard children: developing a multi-agency systemsapproach for case reviewswww.scie.org.uk/publications/guides/guide24/index.asp

Guide 27: Leading practice: a developmentprogramme for first-line managerswww.scie.org.uk/publications/guides/guide27/

Guide 38: Social care governance: a workbookbased on practice in Englandwww.scie.org.uk/publications/guides/guide38/

Knowledge review 16: Improving social and health care serviceswww.scie.org.uk/publications/knowledgereviews/kr16.asph

Learning organisations packwww.scie.org.uk/publications/learningorgs/index.asp

http://cdn.basw.co.uk/upload/basw_13955-1.pdf

www.ccwales.org.uk/supervising-and-appraising-well/

www.cqc.org.uk/organisations-we-regulate/registering-first-time/essential-standards

www.education.gov.uk/publications/eOrderingDownload/IW115-2010.pdf

www.dhsspsni.gov.uk/supervision_policy__standards__and_criteria___regional_policy_for_northern_ireland_health_and_social_care_trusts.pdf

www.local.gov.uk/c/document_library/get_file?uuid=7e6d2140-fc0e-47cd-8b2f-2375812700ad&groupId=10171

www.scie.org.uk/publications/guides/guide24/index.asp

www.scie.org.uk/publications/knowledgereviews/kr16.asp

www.scie.org.uk/publications/learningorgs/index.asp

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About the development of this product Scoping and searchingFocused searching was carried out between January and March 2012. The searches looked forempirical studies on the association between the process of supervision and outcomes for serviceusers, workers and organisations. Searches addressed both children and adult’s social work andsocial care, including joint and integrated settings.

This research briefing identifies empirical studies that report on the association between the process of supervision and outcomes for service users, workers and organisations. Interventionstudies are included. The methods used to identify and organise material in this briefing weredeveloped by the Social Care Institute for Excellence (SCIE). These involved undertaking systematicand reproducible searches of the research literature, identifying relevant studies and assessing theirquality. Empirical data were extracted using a structured pro-forma which focused on variousoutcomes of supervision.

Peer review and testingThe authors have research and topic expertise. The briefing was peer reviewed internally formethodology. It was peer reviewed externally by Professor Marion Bogo, Faculty of Social Work,University of Toronto, Canada. We are grateful for her comments.

About SCIE research briefingsSCIE research briefings provide a concise summary of recent research into a particular topic andsignpost routes to further information. They are designed to provide research evidence in anaccessible format to a varied audience, including health and social care practitioners, students,managers and policy-makers. They have been undertaken using methodology developed by SCIE.

The information on which the briefings are based is drawn from relevant electronic databases,journals and texts, and where appropriate, from alternative sources, such as inspection reports andannual reviews as identified by the authors. The briefings do not provide a definitive statement ofall evidence on a particular issue. SCIE research briefing methodology was followed throughout(inclusion criteria; material not comprehensively quality assured; evidence synthesised and keymessages formulated by author): for full details, seewww.scie.org.uk/publications/briefings/methodology.asp

SCIE research briefings are designed to be used online, with links to documents and otherorganisations’ websites. To access this research briefing in full, and to find other publications, visitwww.scie.org.uk/publications/briefings/


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The implementation of individual budgetschemes in adult social care

Identification of deafblind dual sensoryimpairment in older people

Obstacles to using and providing ruralsocial care

Stress and resilience factors in parents with mental health problems and their children

Experiences of children and young peoplecaring for a parent with a mental healthproblem

Children’s and young people’s experiencesof domestic violence involving adults in aparenting role

Mental health and social work

Factors that assist early identification of children in need in integrated or inter-agency settings

Assistive technology and older people

Black and minority ethnic parents withmental health problems and their children

The relationship between dual diagnosis:substance misuse and dealing with mentalhealth issues

Co-production: an emerging evidence base for adult social care transformation

Access to social care and support for adultswith autistic spectrum conditions (ASC)

The contribution of social work and socialcare to the reduction of health inequalities:four case studies

Communication training for care homeworkers: outcomes for older people, staff,families and friends

Black and minority ethnic people withdementia and their access to support andservices

Reablement: a cost-effective route tobetter outcomes

Mental health service transitions for young people

Mental health, employment and the socialcare workforce

Preventing loneliness and social isolation:interventions and outcomes

End of life care for people with dementialiving in care homes

Factors that promote and hinder joint andintegrated working between health andsocial care services

Returning children home from public care

Effective supervision in social work andsocial care

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effective supervision in social work and social care · ‘case management supervision’ and...

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