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Managing anxiety – a case for supervision
When I’ve been involved in providing supervision training to health and social workers, I’ve used theory of how organisations work as the basis for understanding how supervision works. I have focused particularly on how organisations manage the issue of coping with anxiety in their work as a basis for seeing how supervision can help the worker, their team and the organisation. Russ Vince (2002) provides the source of this theory which can be found in an article about organisations where he says: ‘There is an unwritten rule in many organisations that it is inappropriate to bring emotions to work.’
Red teams and green teams
Let us consider the advantages and disadvantages of this ‘unwritten rule’ in a health and social care organisation. Here, the nature of the work is anxiety-provoking, dealing with vulnerable people’s daily living needs. Certainly, life in this organisation could be very difficult if staff were so emotionally burdened by anxiety they could not get on with the task in hand, but there are real dangers in trying to sweep staff emotions out of the way, and there is a key role for supervision in managing this.
Think of two possible scenarios, both in a busy, sometimes stressful environment, where people with mental and physical care needs are being supported. This is an environment which can be anxiety-provoking; this is only natural, where hopefully staff are thinking about doing the right thing in the course of their work. So, the two scenarios are this: one is a ‘green team’ approach, and one is a ‘red team’ approach. In his organisational theory, Vince talks about two different circles of how organisations respond to anxiety. In the red team, the way anxiety is dealt with is to ignore it, or perhaps dismiss staff anxieties as somehow weak or not relevant to the job in hand. So what do staff do with their anxieties? Hide them and perhaps struggle in their work, or become ‘burnt-out’? In the green team, anxieties are dealt with differently. Here, staff are encouraged to voice their anxieties, and from these we can learn what provokes the anxiety. Should we be doing things differently? Has something changed to provoke anxiety that we need to address? These are issues that can be worked through in supervision. I think the red team they will struggle to get supervision or, at least if they do, it will not give staff opportunity to offload about how they are feeling. Now which team would you rather work with? And which team do you think is likely to provide better outcomes for service users and their families? And if you were an outsider, perhaps a GP visiting a resident, or an inspector conducting a visit, do you think you’d notice a difference in the atmosphere in the home?
Creating the right environment for supervision
I want this article to be a useful guide into some aspects of supervision, rather than just introducing you to some organisational theory, so here are some ideas:
- Read some of Tony Morrison’s textbooks on supervision, particularly where he identifies the different functions of supervision, including the importance reflection time. Tony Morrison was an inspirational supporter of the importance of supervision, and adapted Vince’s theory of functional and dysfunctional environments as a basis for identifying the circumstances in which supervision can thrive. An article by Tony Morrison (2002) titled Supervision: Now or Never Reclaiming Reflective Supervision in Social Work is a good introduction to his model of staff supervision. You’ll find a reference for this at the end of this blog.
- Make supervision regular. In stressed environments it is often the first thing to go – in fact it should be the last! If managing anxiety is an issue, staff need to know when they are getting their next supervision session. Individual supervision is important, but consider other forms, such as group supervision. Your staff may be getting good supervision, but where does the manager get their supervision?
- Find out about staff members’ previous history of supervision – if they have had bad experiences of supervision, or no supervision at all, then you’ll need to discuss what they can expect from supervision from now on.
- Have an agenda for each supervision session, and make sure that is a genuinely agreed agenda between worker and supervisor. Without an agenda the session can be dominated by one issue. You want time to address staff anxieties, but you don’t want the session to be overwhelmed by them.
- Individual staff are different. Some just want to get on and do; others want to think through why they are doing something, and what worries them. Supervisors must work with these different ‘styles’, and respect them. It might be attractive for a manager to have a team of ‘doers’, but if you had staff who were not thinking through their anxieties about their work, I think you’d be worried! Such workers would just do what they’ve always done – and that might not be the best course of action. A staff team approach needs to be balance of thinking and doing!
- Try to ensure your organisation is building a green environment – and I’m not talking about good ecology policies. I’m describing a team where anxieties are acknowledged, and where staff are encouraged to voice them, try different ways of working, be willing to undertake positive risk-taking, and learn from the experiences of the whole team. This is an environment where there is regular supervision and ideas are shared amongst the team. People from outside the team should be able to observe this! This is something you and your team will need to work at, and perhaps test out, through staff satisfaction surveys, or comments from service users and their families.
- Supervision can be a positive selling point for your organisation. Staff value supervision, and families would want to know that staff working with their loved ones get regular supervision. This is evidence of quality care, and after all, that’s what we’re all about.
David Beckingham – QCS Expert Mental Health Contributor