Group supervision is indispensable to effective Strengths Model Case Management practice. It serves as a critical vehicle for continuously reinforcing the philosophical orientation, principles, and spirit of Strengths Model practice on a team level. Case managers spend a significant amount of time each week individually providing direct services to people. Consistent contact with a skilled clinical supervisor is key to ensuring they have the guidance and support to remain intentional, purposeful, and goal-directed in their work, especially when dealing with challenging situations. While weekly individual supervision for case managers is equally important, there is evidence that Strengths Model group supervision offers additional benefits toward impacting staff skill development and learning, team cohesion, and the generation of effective strategies for goal achievement (Pullman et al., 2022, Mendenhall, 2020; Rapp, Goscha, & Fukui, 2014; Petrakis, Wilson, and Hamilton, 2012).
Purpose of Strengths Model group supervision
Strengths Model group supervision is designed to accomplish three purposes: (1) support and affirmation, (2) ideas, and (3) learning.
Support and Affirmation
Case management is a demanding job that requires high levels of skills and energy to achieve ambitious ends in the face of often intractable situations. Furthermore, this work is often done alone. Strengths Model group supervision is a mechanism for workers to feel connected to a group sharing the same mission and challenges. Its aim is to affirm workers’ efforts, ingenuity, and accomplishments. Strengths Model group supervision should be an uplifting experience, enjoyable if not fun. When group supervision is really working, team members look forward to group supervision because it creates an environment where they feel supported and encouraged despite the difficult and demanding work they do.
Ideas
The central task of Strengths Model group supervision is the generation of promising ideas to work more effectively with people receiving services. Even the most skilled Strengths Model practitioner will encounter a situation where “nothing seems to be working.” It is one thing to know the tools, methods, and interventions of the Strengths Model, and another to apply these to the myriad of idiosyncratic client situations. Brainstorming is central to group supervision. Groups are more likely to generate a richer set of potential strategies that are relevant to the person being discussed than people acting alone or in dyads. This is a major advantage of group supervision over individual supervision.
Learning
The third purpose of Strengths Model group supervision is to facilitate learning. By placing individual case situations “under the microscope,” workers have an opportunity to learn things that would apply to similar situations. An important task of the supervisor is to help the team generalize from idiosyncratic client situations to other client situations. Group supervision also provides information on community resource options that could be useful for other clients.
Who attends Strengths Model group supervision?
In its most frequent form, group supervision involves a team of Strengths Model case managers and their supervisor. For multi-disciplinary teams, this could also include clinicians, employment specialists, housing specialists, substance use counselors, peer support staff, prescribers, etc.). It is helpful to keep the size of group supervision participants to no more than eight staff so that all case managers have an opportunity to do a presentation at least once a month. Larger teams might consider breaking into two smaller teams, each with their own group supervision, to keep the group supervision size manageable.
What is the length and frequency of group supervision?
Group supervision meetings vary in length and frequency. The recommended and most frequent scheduling is once a week for 90 minutes. This allows for two to three case presentations during each group supervision. Smaller teams can opt to meet for one hour a week, or for very small teams (3 or under), even twice a month for one hour. The key to calculating group supervision length and frequency is that each case manager on the team should have an opportunity to do a case presentation at least once a month.
What type of situations are best suited for Strengths Model group supervision case presentations?
Case presentations in Strengths Model group supervision are typically reserved for client situations where the case manager feels “stuck” and desires new ideas to help them get movement in their work with a particular person. Particularly amenable to Strengths Model group supervision case presentations are situations where:
1: People are having difficulty achieving or making progress toward a goal they have.
2: There is difficulty engaging or developing a working relationship with a person.
3: The worker is having difficulty helping a person identify a goal or aligning with a person on a goal.
4: Ideas are needed to generate multiple options for achieving a goal or overcoming a barrier/obstacle to goal achievement.
5: The worker is having challenges engaging a person around the use of the Strengths Assessment or Personal Empowerment Plan.
6: Challenges around supporting a person to use naturally occurring resources rather than primarily the formal supports/services offered by the organization.
7: Situations where the team can benefit from mutual learning
Crisis situations are rarely appropriate for group supervision; instead, the worker should consult directly with the supervisor during the crisis rather than wait for group supervision.
The Six-Step Strengths Model Group Supervision Case Presentation Process
The structure of the Strengths Model group supervision case presentation is designed to keep the team focused on generating creative strategies rather than venting or rehashing problems. For each client discussed, the process consists of six steps (Figure 1). Each step is distinct and critical to the success of the process. A typical case presentation takes approximately 25-40 minutes to complete. As teams become more familiar and comfortable with the process, most case presentations can be conducted within 30 minutes.
Figure 1. Strengths Model Group Supervision Case Presentation Process
Step 1: Distribute Strengths Assessments
The presenting staff person makes copies of the client’s Strengths Assessment for every team member. When conducting group supervision virtually, these can be emailed to each team member. The process will NOT work unless each team member has his or her own copy of the Strengths Assessment for the person being presented. If Personal Empowerment Plans have been started, these should be distributed as well.
Step 2: State the client’s goal(s) and what help the worker needs
This should take less than one minute and be completed in two simple sentences, preferably. The first sentence should be the client’s primary goal. For example, “Joe has a goal to go back to work.” You do not need to mention every goal the client has; just one or two that seem most important to the person and are most relevant to the discussion. The second sentence is what help the worker wants from the group. For example, “I would like some ideas on jobs that might match his interests.” Another example “Mary wants more friends in her life. I would like some ideas on where she might go to meet more people and ideas to help her manage social anxiety.” The client’s goal(s) takes center stage in this process. If the client does not have a specific goal, then the question to the group should revolve around how to engage with the person to find a goal that is passionate and meaningful to him or her. Being specific at this point in the process keeps the team focused on what is to be accomplished.
Step 3: What has been tried?
This should take approximately one to two minutes. The presenting staff person quickly mentions a few strategies they have tried related to supporting the client make movement toward their goal or address any challenges they have faced. The presenting staff person is also welcome to state any relevant information related to the challenging situation that will help the group formulate questions and eventually brainstorm strategies.
Step 4: Questions of Clarification (based on information on the Strengths Assessment)
This should take approximately ten to fifteen minutes. At this point, it is helpful for the team to take a few minutes to look over the Strengths Assessment. Then, the team asks questions of the presenting staff person to clarify anything that is written down on the Strengths Assessment or areas that may not have been fully explored. For example, “It says here that the grandmother is supportive. Tell us more about her role in the person’s life.” Or “Can you tell us more about why this person is interested in going back to work?” Or “Are there any social situations in this person’s life where anxiety doesn’t seem to interfere as much?” No advice or suggestions can be given in this step. The intent here is to understand as much about the person as possible so that creative and specific suggestions can be offered in the next step to help the person achieve their goal.
Step 5: Brainstorming
This should take approximately ten to fifteen minutes. Here the team brainstorms as many ideas as possible. It is important that these ideas are related to the person’s goal(s) or what the worker asked for help with. It’s also important that the presenting staff person stay silent during this step to allow them to just listen to all the ideas without evaluating them (eliminates “yes, buts”). It also allows the team to get creative, solution-focused, and build off each other’s ideas. Often some of the best ideas come toward the end of brainstorming as the ideas begin to build. The presenting staff person or another member of the team should write down all the brainstorming suggestions. A good brainstorming session will generate between 20 to 40 ideas.
Step 6: Plan of Action
The presenting staff person reviews the ideas and picks out the top two or three ideas they would like to try next time they meet with the person. For example, “I like the idea of taking Jim out to the zoo since he loves animals. While we are there, I will use motivational interviewing techniques to gauge where he is at in his goal of sobriety. I will also build on the Strengths Assessment to see what supports have been helpful to him in the past when he has been sober.” While workers may like several (or all) of the ideas on the list, the intent is to make sure they have a few things they can immediately test out with the person. It is also fine for the plan of action to include taking the entire list out when they meet with the client to get their feedback. For example, “I meet with Jean this Thursday. I will take this list with me and see if she wants to pursue any of these suggestions to help her get more involved in the community.”
It is important that the presenting staff person lets the team know when they will meet with the client next. This way the supervisor can follow up with the worker and see how things went.
Benefits of Strengths Model Group Supervision
When the first Strengths Model Group Supervision was conducted in a pilot project in 1982, it was unclear what the impact would be. The initial reaction exceeded our expectations as workers found the approach refreshing and more aligned with how they wanted to have discussions about the people they served. Over four decades later, the Strengths Model group supervision process has remained relatively unchanged and is one of the most recognizable and valued features of Strengths Model Case Management implementation.
Strengths Model group supervision is a clear departure from traditional client staffings and team meetings found frequently in behavioral health organizations that quickly go through numerous clients, continuously rehashing the problems experienced by people, and frequently offering the same solutions. Solutions are typically packaged in some combination of: medication, behavior, and money management; coping skills; or increases in services. While any of these interventions may have their place, traditional staffings and team meetings reinforce the reactive, problem-based, transactional, and crisis-driven approaches to case management (and care coordination) that have long been deemed ineffective and dehumanizing of the people we are called to serve.
Over the past four decades, focus groups with teams implementing Strengths Model Case Management have routinely commented on the following benefits of Strengths Model group supervision:
1: Reinforces the belief in the client as a fellow human being with unique values, aspirations, capabilities, and personal and environmental strengths.
2: Recognizes that people are more than the diagnosis they have received, the symptoms they exhibit, the trauma they have experienced, and any life challenge or problem encountered.
3: Helps to step back from complex situations and not jump immediately to simple solutions. It also helps to understand the situation from multiple perspectives without judgment.
4: Elicits highly individualized strategies that are more likely to be relevant, meaningful, and effective.
5: Reinforces person-centered, strengths-based, recovery-oriented, trauma-informed, and culturally responsive approaches.
6: Creates opportunities for team learning that can be applied across multiple situations.
7: Acknowledges and validates why many case managers get into this field — to make a difference in people’s lives.
Our direct-service staff are our greatest assets in behavioral health or any human services organization. Ensuring they have continual support, opportunities for learning and skill development, and practical guidance around challenging situations is critical to their wellbeing at work and longevity in the field. Laying a foundation of effective supervisory support mechanisms underneath the work they do is an investment that pays off with improved outcomes for the people we serve.
