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Name: Student Number: Subject code: WEL409 Sue Pairama 11512476 Melissa Ryder 11641229 Monica Mitry 11618555 Assessment Topic: Community of practice created to make a sustainable network report on Supervision in the therapeutic practice domain; in particular within the micro system. Assessment number: 2 Assessment value: 25% Assessment Length: 3000 words Word count: 3354 Subject Code: HSS300 Lecturer: Neil Barber 1

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Page 1: cpb-ap-se2.wpmucdn.com€¦  · Web viewThis report aims to demonstrate how supervision, in the therapeutic practice domain, acts as a sustainable network practice in the micro,

Name: Student Number: Subject code: WEL409Sue Pairama 11512476 Melissa Ryder 11641229Monica Mitry 11618555

Assessment Topic:

Community of practice created to make a

sustainable network report on Supervision in the

therapeutic practice domain; in particular within the

micro system.

Assessment number: 2

Assessment value: 25%

Assessment Length: 3000 words

Word count: 3354

Subject Code: HSS300

Lecturer: Neil Barber

1

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Name: Student Number: Subject code: WEL409Sue Pairama 11512476 Melissa Ryder 11641229Monica Mitry 11618555

Sustainable network report:Supervision in the

therapeutic practice domain; within the micro

system. By the Community of practice group comprised of: Sue Pairama, Melissa Ryder and Monica

Mitry.

2

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Name: Student Number: Subject code: WEL409Sue Pairama 11512476 Melissa Ryder 11641229Monica Mitry 11618555

Table of Contents

Executive Summary 4

Supervision in Counselling by Monica Mitry 5

1.0 EXEMPLAR 5

1.1 WHAT IS COUNSELLING? 5

1.2 WHY DO COUNSELLORS NEED SUPERVISION? 6

1.3 FORMS OF COUNSELLING SUPERVISION 6

1.4 KADUSHIN MODEL OF SUPERVISION AS APPLIED TO COUNSELLING SUPERVISION 7

1.41 Education 7

1.42Administration 9

1.43 Supportive 9

1.5 LINKS TO FURTHER READING ABOUT COUNSELLING SUPERVISION 11

Supervision in Rehabilitative case management by Sue Pairama 12

2.0 SUPERVISION IN GROUP WORK OUTLINE 12

2.1 HOW THE MICRO LEVEL OF PRACTICE AFFECTS THE MESO AND MACRO LEVELS

13

2.2 EXEMPLAR 13

2.3 LINKS TO ONLINE RESOURCES 14

Supervision in Group work by Melissa Ryder 15

3.0 HOW TO APPLY SUPERVISION IN REHABILITATIVE CASE MANAGEMENT 15

3.1 BURNOUT AND MONITORING 15

3.2 EXEMPLAR 16

3.3 USEFUL LINKS 17

Conclusion 18

References 19

Image References 22

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Executive Summary

This report aims to demonstrate how supervision, in the therapeutic practice

domain, acts as a sustainable network practice in the micro, meso and macro

systems, but particularly within the micro system. The therapeutic practice domain

consists of three professions; counselling, group work and rehabilitative case

management. Each of these vocations will be separately addressed, regarding the

unique impact supervision has on their systems, using an exemplar to elucidate.

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Supervision in Counselling

1.0 ExemplarReferral

Service name Dubbo rural social service.

Supervisor name Tia

Counsellors name Bella

Counsellors information Bereavement counsellor who drives into Lightning Ridge once a week from Dubbo.

Client information

Name Alinta

Age 47

Address Lightening Ridge, rural NSW

Nationality Indigenous background

Occupation Opal mines for 25 years.

Children 2

Reason for referral Five months ago, Nullah, Alinta’s husband passed away suddenly in a mining accident, they were married for 16 years. Alinta has started self-medicating with alcohol to deal with her parenting, financial and emotional experiences

1.1 WHAT IS COUNSELLING?

In the therapeutic practice domain, exists the profession of counselling. Counselling is the provision of a

therapeutic relationship provided by a counsellor who facilitates an environment to help clients self-

actualize; the innate propellant within an individual to travel towards self enhancement, (Rodgers, 1959,

p. 196, para.2) and address life concerns using inherent strengths.

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1.2 WHY DO COUNSELLORS NEED SUPERVISION?

In order to provide counselling, therapists must adopt a multi-disciplinary practice. Regarding the

exemplar, Bella would amalgamate, mottled theories; such as social-ecological, existential and grief

concepts, skills; micro skills and counselling techniques requiring her to ‘attend from self to other;’

(Neimeyer, 2012, p. 4, para. 2). Via reframing, questioning, encouraging, paraphrasing and reflecting

feelings, by exhibiting cultural competency; knowledge, values and skills applied to embrace Alintás

conceptions of her Indigenous heritage, within therapy.(Ranzijn, McConnochie & Nolan, 2009, p.5, para.

4) Bella must also incorporate industry commitments; observing natural justice by ensuring procedural

fairness to see Alinta despite caseload levels and minimal weekly visits, (McDonald, Craik, Hzawkins, &

Williams, 2011, p. 207, para. 1) whilst balancing, fiscal, ethical and legal obligations, (Grace, Meurk,

Head, Hall, Harris & Whiteford, 2017, para. 8) as per industry and Dubbo rural social service policies.

Bella needs to encapsulate counselling in a person centred experience, exercising respect for

Alinta’s “inherent dignity,” (Australian Association of Social Workers, 2010, p.12, para. 3)

and autonomy in relation to life choices and personal agency. (Connolly & Harms, 2013, p.

53, para.5) It is due to this panoply of responsibilities that sustainability of counselling

practice can only exist by, necessitating supervision. Supervision is therefore necessary to

oversee that the array of obligations in service are honoured (Australian Association of

Social Workers, 2000, p. 3, para. 1) in ‘micro’ levels; individual relationships such as

therapeutic alliances and supervisor to supervisee relationships. ‘Meso’ levels; organizations

and ‘macro’ levels; politics, socio and geo-economics and legislation.

1.3 FORMS OF COUNSELLING SUPERVISION

Tia can provide counselling supervision in didactic or 1-2-1 form. Didactic supervision is centred on

teaching and exercises in either, expository didactic teaching; a power orientated relationship where

explicit dispersal of information from a supervisor is aimed at teaching a supervisee. Or dialectical

hypothetical indirect teaching; an equal relationship where the supervisor probes the supervisee using

micro skills, to evoke critical reflection on therapeutic situations that assists therapists finding answers on

their own. (Kadushin & Harkness, 2014, p.107, para. 2) This method is preferable to deter dependence

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based practices. (Australian Association of Social Workers, 2000, p. 3, para. 1) Didactic supervision may

utilized in different casework models; one to one model, group supervision, peer supervision, team

service delivery model; team consultant groups and autonomous practice; through self-motivated

professional development endeavours through seminars and reading. (Tsui, 2004, p. 9)

1-2-1 supervision refers

to the delivery of

supervision within the

intimacy of one

supervisor to one

supervisee. This model

individualizes

supervision based on the

inimitable

amalgamation of

experience, skills,

culture, personalities, agency guidelines and the particular clientele

being discussed. It creates a unique experience which cannot be

replicated, (Kadushin & Harkness, 2014, p.157, para. 4) with

sophisticated tailored support.

1.4 KADUSHIN MODEL OF SUPERVISION AS APPLIED

TO COUNSELLING SUPERVISION

1.41 Education

In supervision, Tia must create an opportunity to present information about therapeutic models,

knowledge and skills, (Australian Association of Social Workers, 2000, p. 3, para. 8) so Bella can

integrate the knowledge into Alinta’s therapy. (Winokuer & Harris, 2012, p. 8, para.3) Counselling is a

treatment orientated service, the dissemination of knowledge maximizes micro environment experiences

(Erera & Lazar, 1994, p. 111, para. 3) by enriching alliances, service outcomes, collegial bonding and

7

“1-2-1 supervision refers to the delivery of

supervision within the intimacy of one supervisor to one

supervisee.”

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professional progression for both supervisor and supervisee. (McDonald, Craik, Hzawkins, & Williams,

2011)

Tia must also train Bella to engage in critical self-analysis (Australian Association of Social Workers,

2000, p. 3, para. 9) of her thinking, doing and being, intra-personally and inter-personally. This awareness

will facilitate sustainable practice (Kadushin, & Harkness, 2014, p. 99, para. 5) by stimulating intentional

use of counselling micro skills to “engage, address, participate and make

changes,” (Mlcek, 2017, p. 1, para. 10) conducive to effective

counselling. In the micro level, this creates an ‘Ethos of scholarship;’

incessant learning applied in service, with praxis, (Mlcek, Moorhead,

Morrissey, & Norris, 2014, p. xiv, para. 2) allowing Bella to communicate

intently to normalize Alinta’s

experiences and camouflage

deficits within her chosen

lifestyles; (Cambridge, 2008, para

11) emancipating her from clinical

judgments. (Moore, 2009, p41,

para. 2)This strengthens bonding and therapeutic alliances;

(Geldard & Geldard, 2012, p.13, para. 3) seminal for therapeutic

success, (Flowers, 2015) and expedites client determination to

positively participate within the wider economic, social and

political macro system; pairing social care and social control.

(Moore, 2009, p. 41) In the meso level, staff are retained (Wilson,

1993, p.115, para. 7) as this practice, especially if practiced using

dialectic hypothetical indirect methodology, stimulates professional

creativity and independence. (Cambridge, 2008) Thus organizations produce better outcomes and may

become eligible for scarce funding. (Moore, 2009, p18, para. 2)

Lastly education in supervision assists in the macro environment by developing practice theory based on

experiential evidence; counselling research and academia. (Sheppard, 2017, p. 3, para. 3) Both

supervisors and supervisees collect ‘practice wisdom’ by comparing therapeutic experiences and

developing ‘practice theories,’ (Australian Association of Social Workers, 2000, p. 3, para. 10) also

benefitting the micro system; supervision alliance, through collaborative professional development.

8

“This strengthens bonding and therapeutic alliances;

seminal for therapeutic success.”

“Both supervisors and supervisees collect

‘practice wisdom’ by comparing therapeutic

experiences and developing ‘practice

theories,’ also benefitting the micro system;

supervision alliance, through collaborative

professional development.”

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1.42 Administration

In supervision, Tia must support Bella’s administrative duties through record

keeping, confidentiality issues and report writing, (Geldard & Geldard, 2012,

p.350, para. 2) as well as therapeutic formulation; considering neoliberal

service rations. (Moore, 2009, p.419, para. 1)

Tia must also, clarify performance standards, negotiating learning objectives,

assess performance, (O’Conner, 2005) review clients development, cultivate

professional networking and familiarity with community resource brokerage;

availability, appropriateness, accessibility, eligibility criteria, quality and

limitations of services. (Stebnicki, 2015, p. 87, para. 2) Tia also has a

responsibility to ensure inter-organizational unity during referrals to protect

the organizational alliances that align with Dubbo rural social services

political agendas; to protect funding interests. (Moore, 2009, p.38, para. 2)

Within the micro system administrative supervision also reduces service

hidebound, service attrition and facilitates Alinta’s engagement; reducing

no-show appointments, premature withdrawal, (Kapke & Gerdes, 2016, p.

338, para, 4) recidivism and minimizes the client’s future reliance on the

system. (Wilson, 1993, p.115, para. 7)

1.43 Supportive

Tia must offer support in three subsumed purviews; clinical, administrative

and integrative support. Clinical support requires Tia to, care for Bellas counsellor’s career (Open

Colleges, 2014) by encouraging reflective practices constantly, (Randle. S, 2010) explain the basis for

using certain strategies, interpret therapeutic breakthroughs and challenge Bella to expand her

experiences, counselling framework, and technique usage. (O’Conner, 2005) This will enhance the micro

systems outcomes and prevent burnout. (Geldard & Geldard, 2009, p. 390, para. 1). Tia must also monitor

and direct Bella’s therapeutic interactions to promote both Alinta’s and Bella’s mental health by

supporting the use of evidence based theory besides monitoring self-harm.

9

“administrative supervision also reduces service

hidebound, service attrition and facilitates

clients engagement; reducing no-

show appointments,

premature withdrawal,

recidivism and minimizes

client’s future reliance on the

system.”

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Administrative support requires Tia to oversee Bella’s developing commitment to the issues under the

above heading, of administration, however relating to the stress those duties induce. Besides facilitating

the growth of healthy attitudes and ‘perspective transformation;’ resigning longstanding perceptions,

employing new ones based on experiences afresh, that demand those differences to be reconciled, (Mlcek,

2017, p. 1, para.12) and geared towards professional values. (McDonald, Craik, Hzawkins, & Williams,

2011, p. 144, para. 1) Integrative support requires Tia to, recognize Bella’s personal and professional

limitations, offer confidential (Geldard & Geldard, 2009, p. 379) support when debriefing after

overwhelming therapeutic experiences and offer self-care strategies. This practice enhances, micro-

systems; minimizing traumatic work situations for both therapists and clients, meso-system outcomes;

preserving employee performance, and macro systems; enhancing public health.

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1.5 Links to further reading about counselling supervision

Holloway, E. L., & Carroll, M. (Eds.). (1999). Training counselling supervisors: strategies, methods

and techniques. Retrieved from https://ebookcentral-proquest-com.ezproxy.csu.edu.au

Pelling, N., Barletta, J., & Armstrong, P. (Eds.). (2009). The practice of clinical supervision.

Retrieved from https://ebookcentral-proquest-com.ezproxy.csu.edu.au

Proctor, B. (2008). Group supervision: a guide to creative practice. Retrieved from

https://ebookcentral-proquest-com.ezproxy.csu.edu.au

Wright. J., & Griffiths. F. (2010). Reflective practice at a distance: using technology in counselling

supervision. Reflective practice (11)5, 693-703. doi: 10.1080/14623943.2010.516986

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Supervision inGroup work

2.0 SUPERVISION IN GROUP WORK OUTLINEThe People’s Institute is a community-based, non-profit bereavement centre for children and families located in Western Sydney. We are committed to contributing to the diverse needs of the bereaved in a supportive therapeutic setting. By integrating practice, research and community, The People’s Institute is focused on creating social change around the issue of bereavement. We serve as a national leader in the effort to increase access to effective, individualised care for the bereaved. These integral factors are vital to the integrity, success and sustainability of the case management approach within the social ecological framework.

As Supervisor of the case management team my duties and responsibilities are underpinned by three core values; compassion, accountability and respect. My primary focus is to train the case managers toward achieving the organisation’s vision, while working within the guidelines of company policies and procedures. The main objective is to inspire each case manager, leading by example to ensure that my evolvement in theory based compassion and empathy is conducted professionally and transparently. “The primary purpose of professional supervision is to facilitate competent, independent practice and not to perpetuate dependency” (McDonald et al., 2014, p. 142).

There are clear guidelines to follow when working in a group setting at the micro level. The implementation of ‘open door policy’ raises awareness within the team, who are encouraged to discuss impending issues, concerns or problems experienced on a daily basis. These discussions generate interesting points of view on a range of topics while the feedback provides supportive, positive and

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constructive criticism. The direct outcome is a reduction in stress related incidents, paving the way for a clearer understanding of each other as a functioning team. To work with clients who are suffering loss or grief, we must practice through the lens of our informed theory and training. If we think about the way in which we approach people it directs them to respond to us in the same manner, in addition, if we are to be effective supervisors and social workers the onus is on us to express our views on new ideas, developing trends and interchangeable landscapes.

As supervisors, we not only have to understand how other people experience personal and structural oppression (Connolly, & Harms, 2013, p. 379), but the understanding of our own personal and oppressive experiences guides our training techniques. As explained in (Moore, 2016), the core principles of collaboration and engagement with people comes down to building relationships and networks. The points of discussion highlight the need to articulate expert communication skills. In effect it streamlines the process and is a foundational backdrop to the art of managing tensions, frustrations, practice models and theories. “There is no one way to implement case management” (Gursansky, Kennedy, & Camilleri, 2012, p. 20).

2.1 HOW THE MICRO LEVEL OF PRACTICE AFFECTS THE MESO AND MACRO LEVELSThe provider driven model emphasises the efficiency of the service provided. The nature of this model is driven by the system of the organisation, and is delivered at the macro level. The case manager works from a professional viewpoint and is trained to fit the client’s circumstances into the service with the ultimate goal of addressing the needs of the service as determined by the funding body. Our organisation works within a structured system driven by goals according to the deliverance schedule. As a supervisor my responsibility is to provide the interface between the meso level (middle management) and the macro level (senior management). The ideas at the macro level will ultimately have a trickledown effect to all levels beneath. “The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action” (Caldwell, & Mays, 2012, p. 1).

In terms of the macro level, in various organization’s it is difficult to have close connections or relationships with senior management however there is an obvious awareness of their presence because of the influence they have, which is inevitably felt throughout the organisation. Unfortunately, the disconnection can be significant due to management styles and/or possible operational limitations, but fortunately there are industries that promote open door policy throughout all levels of the framework. My previous work experience relates to the later which highlights the importance of having the ability to confidently communicate on all levels at any given time.

2.2 EXEMPLARAs stated in (Thomson et al, 2011), training at different stages while other learning needs must be specifically targeted can be a challenging task for Supervisors. Time constraints and limited resources will impact the training process. Peer pressure can result in case managers feeling disconnected from the programme which is motivated by fear of inadequacy and judgement. There are also fundamental barriers that need to be considered as explained in (Valentino et al, 2016). The difficulties of matching

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group members according to their individual skill sets and the need to individualise specialised training can aggravate limitations on time commitments and programme initiatives. There are a range of other problems that can permeate from within as a supervisor, which can subconsciously, transfer to trainees. There are moments of weakness, days of preference in working with certain skill sets. Depending on how people react to the style of conflict resolution can also affect the capacity to supervise. It is imperative to take time for self-reflection and self-care. This is interconnected to professional performance and sustainability of the duties we perform at a supervisory level. These attributes are consistent with a successful career in a social ecological framework.

2.3 LINKS TO ONLINE RESOURCESCollingwood, P. (2005). Integrating theory and practice: The Three-Stage Theory Framework retrieved from https://www.Users/Workventures/Downloads/Collingwood%20Three-stage%20theory%20framework.pdf

Online Field Education Supervision Training retrieved at https://www.aasw.asn.au/professional-development/online-field-education-supervision-training

Retrieved from https://www.open.edu/openlearn/health-sports-psychology/social-care/social-work/introduction-social-work/content-section-1.3

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Supervision in Rehabilitative case management 3.0 How to apply Supervision in Rehabilitative case managementSupervision in Rehabilitative case management is necessary to provide ongoing support to enable maintenance of staff and staffing ratios. As per section 1.4 above addressing (Kadushin and Harkness 2002), it has been outlined Administration, Education, and Support as fundamental in the facilitation of competent, independent and purposeful implementation of professionals within practice (McDonald et al., 2014, p.p. 142-144). Those working within rehabilitative case management are met with high stress and emotionally taxing circumstance within their job outline. The position requires the provision of social care that comprises of developing awareness of the needs of another, engaging within responsible planning of client self-determination and providing transparent and empathetic care (Moore, 2016, p. 3).

3.1 Burnout and MonitoringDidactic or 1-2-1 form within (Kadushin & Harkness, 2014, p.107, para. 2) outlines self-reflection through supervision as significant within the micro levels seen outlined above in section 1.3. This is extremely relevant within the section of rehabilitative case management as it provides a structure and framework that can be actively engaged with to address immediate issues arising to the case worker. ‘Burnout’ emotional mental and physical exhaustion may result from continual and long term stress, resulting in poor mental and physical health and loss of motivation and interest within the workplace. This is a serious and often occurrence that effects those within this therapeutic domain. (Luther, et al., 2017) outlines within their writings that work-related influences of workload and relationships at work as key determinants for burnout. Although role clarity, and employee professional autonomy, a sense of fair treatment, and contact with regular clinical supervision appear to be defensive. Debriefing is a way in which rehabilitative case workers can effectively monitor own self whilst professionally supporting

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clients in the best way. Monitoring is a specific form that is used within a Meso system that delivers great impact upon a micro level to help with burnout through clarity and regular contact. Monitoring is delivered ideally in a routine and unremitting delivery process of tracking service and its conveyance appositeness for individuals. Moxely (1989) attends to both conceptual and practical detail specifically within his case management monitoring matrix. Specifically focusing on Effort, Adequacy, Quality, Outcome in informal and formal data with its purpose to ensure relevant case plans. Such a system delivers clarity of role to rehabilitative case managers (Gursansky et al., 2012 p.p. 118-121).

3.2 EXEMPLARWithin rehabilitative case management many forms are used to assist individuals. A specific area may be that of specialising in helping those with a disability acquire and maintain employment. This can be done through assessment of strengths, work skills, capabilities and interests in order to create and achieve employment goals. Work skill assessment, Counselling and guidance, Assistive technology acquisition and training, Job training services, Job placement services, Independent living services are examples of additional services that may be needed. The National Disability Insurance Scheme (NDIS) is the current person-directed service brought to Australians through policy with the aim to bring about social inclusion through self-choice (Moore, 2016, p. 55). Rehabilitation case workers service human beings by impacting the Individual (micro) enabling self-esteem, learned skillsets and independence. Their families (meso) reducing stresses on families that become accustomed to providing help and resources to disabled family members decrease familial stress to emotional and financial areas. Society (macro) through increases trained labour force, helps employers conform to statutes around equal opportunity employment, reduces dependence on government assistance, empowers members of society toward independent living (Commission for Case Manager Certification (CCMC), 2018 para. 2-5).

© CCMC 2011. All rights reserved.

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3.3 Useful LinksAASW (2015) Scope of Social Work Practice - Case Management & Care Coordination,Retrieved: https://www.aasw.asn.au/document/item/8310

Australian Department of Human services(National Disability Insurance Agency) Retrieved 11/09/2018 https://www.ndis.gov.au/people-disability

Hall, G. E., Hord, S. M., Huling-Austin, L., & Rutherford, W. L. (1987). Taking charge of change. Alexandria, VA: Association for Supervision and Curriculum Development.

Productivity Commission. (2017). National Disability Insurance Scheme (NDIS) Costs. Study Report, Canberra.

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ConclusionThis paper has expounded the three therapeutic domains of Counselling, Supervision

in group work and Rehabilitative case management, as well as effects of micro, meso

and macro impacts in each domain. An extensive overview of how supervision is

applied throughout each domain has also been significantly outlined along with the

importance of supervision within the workings of human service related job areas.

Forces such as policy (macro), organisation/family (meso) and individual (micro) are

examples used to clearly outline the direct impact they have upon each other. This

knowledge is then applied within practice, implementation and intervention strategies

within the social services area, with a clear movement toward a person centred

approach with the aim of social inclusion, good mental health and self-actualisation

for all individuals including that of the human services worker.

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ReferencesAustralian Association of Social Workers. (2000). Practice standards for social workers:

supervision. Retrieved from https://www.aasw.asn.au/document/item/18

Australian Association of Social Workers. (2010). Australian Association of Social Workers Code of Ethics 2010. Retrieved from https://www.aasw.asn.au/practitioner-resources/code-of-ethics

Caldwell, S., & Mays, N. (2012). Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London. Retrieved from https://www.healthy.policy-systems.com/content/10/1/32

Collier, R. (2012). Person-first language: What it means to be a “person.” CMAJ : Canadian Medical Association Journal, 184(18), E935–E936. http://doi.org/10.1503/cmaj.109-4322

Connolly, M., & Harms, L. (2013). Social work: contexts and practice (3rd ed.). Melbourne: Oxford University Press.

Erera. I. P., & Lazar. A (1994). Operationalizing Kadushin's Model of Social Work Supervision. Journal of Social Service Research, 18(3-4), 109-122. doi: 10.1300/J079v18n03_05

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Proctor, B. (2008). Group supervision : a guide to creative practice. Retrieved from https://ebookcentral-proquest-com.ezproxy.csu.edu.au

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Valentino, A., LeBlanc, L., & Sellers, T. (2016). The Benefits of Group Supervision and a Recommended Structure for Implementation. Behav Analysis Practice (2016) 9:320-328 doi.10.1007/s40617-016-0138-8

Winokuer, H., & Harris, D. (2012). Principles and practice of grief counseling. Retrieved from https://ebookcentral-proquest-com.ezproxy.csu.edu.au

Wright. J., & Griffiths. F. (2010). Reflective practice at a distance: using technology in counselling supervision. Reflective practice (11)5, 693-703. doi: 10.1080/14623943.2010.516986

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