File Name: child and adolescent services research center contract .zip
In , after years of teaching, we embarked on the journey to start our own fellowship. As one of 75 pediatric specialties, our Child and Adolescent Psychiatry Program provides unique opportunities to work with a diverse patient population and be part of an interdisciplinary team. Housed within the renowned Barrow Neurological Institute, we provide outpatient, inpatient and consultative services throughout the hospital and state. We aim to provide a comprehensive program that fosters self-directed, compassionate, knowledgeable physicians who come out of training well equipped to tackle the ever-growing mental health needs of our society. Our faculty have a variety of interests including maternal-fetal care, early childhood trauma, addictions, and urgent psychiatric services.
Youth work is complex, multifaceted and, by its nature, a stressful profession Australian Youth Affairs Coalition, Working with adolescents demands constant energy and often on-the-spot crises response. Time at work is typically spent supporting people through unsafe or difficult experiences.
It exposes workers to traumatic circumstances, with the added challenge of having to remain hopeful and impartial when supporting the young client. The astuteness and independent reasoning required of youth workers benefits from regular supervision, to assist in examining why decisions are being made and how interactions affect both the client and worker Bunston, This practice guide provides an overview of clinical supervision for practitioners directly supporting adolescents, stressing the significance of reflective practice on worker wellbeing and client outcomes.
It emphasises the prevalence of workers' exposure to traumatic events and the potential for countertransference of emotions, as well as the documented benefits of identifying issues as they arise Jenkinson, The guide highlights the effectiveness of strengthening interventions and pathways of practice through discussion.
For managers and supervisors, this resource examines supervision in the context of workplace culture, and introduces current methods and trends in suitable clinical support for youth workers. It is predicted that in their role, the youth worker is required to make complex interpretations about the young person's circumstances and needs, and contribute directly to an associated intervention.
Supervision helps youth workers gain a clearer understanding of the function and purpose of adolescent clients' behaviour Pfeifer, , and gain insight into their own reactions through reflective practice Herman, The nature of this holistic-style supervision is often referred to as clinical supervision, and is distinct from the traditional administrative support provided by senior staff or managers.
This paper will use the terms "supervision"and " clinical supervision" interchangeably, interpreting both as a scheduled activity that uses reflection as an instrument to review work and understand client-related challenges and tensions.
Clinical supervision shares some of the developmental characteristics of coaching and mentoring, such as encouraging continual improvement of competencies and fostering personal growth for professional gain. Both coaching and mentoring are notably different from supervision, however, in that the interactions are not orientated toward the emotive effect of the work undertaken. Coaching involves a facilitated process to progressively reach specific goals, and uses the expert for problem solving and instruction.
Mentoring typically involves discussions about non-clinical issues, yet provides guidance and expertise. Supervision prompts practitioners to reflect on their judgements and biases to better understand the impact of their client's behaviour as it relates to their own Munro, The reflective nature of clinical supervision invites supervisors to explore unique youth work experiences, with the potential for deeper understanding of adolescents, allowing for new perspectives of practice to occur Herman, Trust, rapid engagement and authenticity are required in all of these relationships for them to be effective.
Clinical supervision shares some of the developmental characteristics of coaching and mentoring, such as encouraging continual improvement of competencies, fostering personal growth for professional gain and implementing new ideas. One-on-one supervision is common within the youth and child protection sectors and is generally provided by an external supervisor, often taking place outside of the normal work setting.
The dialogue between the supervisor and supervisee may vary according to pressing issues, but will generally focus on current practice, such as reviewing outcomes of current interventions; discussing any countertransference of emotion of the client; and understanding client behaviours and responses. Discussions should be confidential and explorative and elicit the skills of the worker.
In this setting, one leader supervises multiple workers, and the content may be worker-centered, case-centered or theme-centered. Discussions aspire to build capacity of the practitioners by sharing their advanced understanding of adolescent development and exploring best practice interventions. Supervision takes different shapes and forms, and may reflect the nature of the work being undertaken, or the resources available. Supervisors have a significant role in delivering the best outcomes for clients, although not engaging directly with them Herman, The functions of supervision, and the subsequent roles of the supervisor, largely incorporate these essentials: supportive counsellor ; educative teacher ; and organisational administrator.
As youth work attracts people with varying professional motivations Bowie, , the self-awareness provoked by supervisors creates a foundation for workers to reflect and mature, thereby helping themselves in order to better help others.
A skilled supervisor is aware of signs of distress or the onset of vicarious trauma, and ought to guide the worker to think clearly when considering the emotional impact of their work.
Working collaboratively with practitioners, supervisors facilitate the implementation of new interventions and evaluate their outcomes. Within numerous settings and diverse roles, youth workers are tasked with building rapport with clients whose experience of adult relationships may be adverse, and whose external environments may be volatile, further challenging the development of a trusting, professional relationship.
As the pioneer of research in supervision in youth work, Professor Tash argued that the purpose of the supervisory relationship is to provide ongoing specialist training about youth specific issues. In order to be effective, youth workers must understand the environment in which they work, the context to their work, and the specific effects of their interactions with clients Gilmore, Professionals working with adolescents enter their roles through a number of different pathways and therefore have backgrounds in a range of fields including social work, education, public health and community education.
Some youth workers enter the profession without formal education and training and gain knowledge and skills on the job Bowie et al. Smith discerned that due to the diversity of the sites and interventions for youth work, the practice itself varies incredibly.
However, it has been recognised that youth workers, while operating across often radically different environments, share a general intent to support and resource the development of adolescents into adulthood Bessant, The difficult nature of working with adolescents highlights the weight of non-managerial supervision for youth workers. Maintaining an understanding of adolescents and how they interact with their environment is an adequate reason to engage in supervision.
Throughout adolescence many biological and psychosocial changes occur in a fairly short period of time. Some of these changes are discernible, others more discreet.
The complex changes experienced by adolescents can be confusing, and may make it difficult for them to recognise the support they may require.
Most adolescents navigate this stage of their life without encountering significant issues. A comprehensive understanding of adolescent development is critical to working effectively with young people and contributes to a skillset of rapid responses to the distinct issues that clients present with.
Working with adolescents requires precise, skilled communication due to the differences in development and capacity of the client to be involved in decision-making. Supervision provides focused, uninterrupted periods in which to gain superior knowledge of youth development; explore how trauma impacts the adolescent's brain; and strengthen theory-based practice. While exposure to traumatic narratives can affect workers across various modalities and practices, youth workers may be particularly prone to witnessing helplessness or self-blame through the eyes of a client who may be a victim of harm or neglect.
Bunston credits adolescent protective work as being too difficult and too painful to deal with at times, placing enormous emotional impact on workers. Clinical supervision provides the platform to rigorously monitor, clarify and understand workers' own reactions to their clients' behaviour and life experiences. Research confirms that when the possibility of vicarious trauma is not recognised, the effect may be more detrimental as little effort is made to prevent or reduce the harm Morrison, Reflective practice explores personal issues and perceptions, identifies judgements, and develops workers' awareness of self.
In supervision, the supervisor prompts the worker to reflect on the decisions they have made and analyse their context and consequences. Workers are also provided with a safe, trusting environment to disclose any stresses or concerns that they may be experiencing and to get them to think critically about their practice.
While not all youth work presents challenging circumstances or difficult clients, integrating emotions and logic through reflective practice strengthens youth workers' competence Pfeifer, Understood and used with caution, emotional reactions to clients have been shown to be a valuable source of evidence, and discussing the influence of emotions and biases should not be discredited Munro, Effective, or g ood supervision is planned, focused and facilitated by a skilled and confident supervisor.
It relies heavily on the capabilities of the supervisor as a facilitator of reflective practice. The process similarly relies on active participation and honesty from the worker. Good supervision is focused on the self-awareness of the worker, and prompts a deep understanding of their reactions to their client's experiences and behaviour.
Great supervisors ask questions. They have expertise but don't have a need to be experts. Table 1 provides a guide to the elements of good supervision for practitioners working with adolescents, as indicated throughout this practice guide. The responsibilities listed are shared by the youth worker and the supervisor. Working with challenging adolescents requires having a system in place to support staff in fulfilling the great responsibility that comes with the profession Pfeifer, The provision of good supervision ultimately begins when decision-makers understand the demands of working with adolescents and the role of reflective practice in supporting workers that do so Riley, Employers and program funders can demonstrate the value of worker wellbeing by building in policies that guarantee supervision as part of their practice.
In doing so, organisations are not only able to reduce the likelihood of staff burnout and ensure staff competency in basic clinical skills, but ultimately improve outcomes for their teenaged service users Pfeifer, Implementing clinical supervision into practice requires strategic consideration of workplace resources and staff competencies, and an appreciation of the demands of the work itself.
There are various ways in which employers can ensure the requirement to participate in professional supervision but, at a minimum, it should be included as a core activity in occupational health and safety policies. A supervision policy can establish guidelines, define processes, and outline the roles and responsibilities of all parties involved. Clinical supervision is ensured to child protection workers by its inclusion in organisational policies and procedures.
In this environment, clear worker expectations, appropriate workloads, the wellbeing of staff and workplace stability are all attributed to participating in regular supervision. Clinical supervision in youth work not only contributes to the wellbeing of the worker, but also directly affects the experience of the client. A youth worker who engages in good supervision develops superior self-awareness abilities, and is more equipped to prevent, or rapidly respond to, signs of vicarious trauma.
The learning component of supervision provides a regular, committed platform for workers to enhance their specialist skills and knowledge, discuss complex issues presented by their adolescent clients, and decide on appropriate, evidence-based interventions. The YAPA website provides model policies for different areas, including caseload and supervision.
The considerations of self-care, learning styles and reflective practice are transferable to other practices and provide useful insights for both leaders and their staff. There are valuable tools for understanding thoughts and feelings, and building collaborative relationships with workers for better client outcomes.
This code provides an example of a framework for ethical practice when engaging with young people. Supervision outcomes such as specialist skills and knowledge of adolescents, self-care, and self-awareness are identified as key contributors to working effectively with young people.
While the discussions are not youth work specific, the multidisciplinary considerations represent relatable issues of clinical supervision and its tensions within service delivery. The resource focuses on adolescents, their development, and how past trauma and other events affect development. It provides information, strategies and tips to engage young people and their families.
It recognises supervision as an appropriate component of workforce development. Australian Youth Affairs Coalition. Sydney: Australian Youth Affairs Coalition. Baxter, R. Supervision scrapbook. Wellington: Authors. Beddoe, L. A Delphi study of supervision in social work. Supervision in Social Work. Bessant, J. Aristotle meets youth work: A case for virtue ethics. Journal of Youth Studies , 12 4 , Bonino, S.
Adolescents and risk: Behaviors, functions and protective factors.
Well-Child Visits in the First 15 Months of Life : Assesses children who turned 15 months old during the measurement year and had 0—6 well-child visits with a primary care physician during their first 15 months of life. Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life : Assess children years of age who received one or more well-child visits with a primary care practitioner during the measurement year. Assessing physical, emotional and social development is important at every stage of life, particularly with children and adolescents. They are a critical opportunity for screening and counseling. Figures do not account for changes in the underlying measure that could break trending. Learn more about pandemic program and policy changes.
Youth work is complex, multifaceted and, by its nature, a stressful profession Australian Youth Affairs Coalition, Working with adolescents demands constant energy and often on-the-spot crises response. Time at work is typically spent supporting people through unsafe or difficult experiences. It exposes workers to traumatic circumstances, with the added challenge of having to remain hopeful and impartial when supporting the young client. The astuteness and independent reasoning required of youth workers benefits from regular supervision, to assist in examining why decisions are being made and how interactions affect both the client and worker Bunston, This practice guide provides an overview of clinical supervision for practitioners directly supporting adolescents, stressing the significance of reflective practice on worker wellbeing and client outcomes.
Children and Youth Services Review provides an international and interdisciplinary forum for rigorous scholarship relevant to policies, interventions, programs and services intended to improve the well-being of children and youth.
We would like to acknowledge the individuals listed below for their contributions to this report. A special thank-you to all of the members of the National Advisory Mental Health Council Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment, whose dedication and hard work made this report a reality:. Marilyn Benoit, M. Michael English, J.
Pragmatic measures of therapist delivery of evidence-based practice EBP are critical to assessing the impact of large-scale, multiple EBP implementation efforts. As an initial step in the development of pragmatic measurement, the current study examined the concordance between therapist and observer ratings of items assessing delivery of EBP strategies considered essential for common child EBP targets. Possible EBP-, session-, and therapist-levels factors associated with concordance were also explored. Greater therapist-observer concordance was observed in sessions where a structured EBP was delivered and in sessions where therapists reported being able to carry out planned activities.
There have been two cohorts of children enrolled in the survey, which makes available data drawn from first-hand reports from children, parents, and other caregivers, as well as reports from caseworkers, teachers, and data from administrative records.
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