The Practice of Compassion in Supervision in Residential Treatment Programs for Clients with Severe Mental Illness

Clinical supervision for residential care staff is essential, and yet has rarely been studied. Drawing from the reflective practice tradition, we interviewed residential care supervisors about their clinical decision-making process, and analyzed the data qualitatively to identify common themes and distill their beliefs and reported practices. We found supervisors prioritized a compassion-based model of supervision characterized by fostering staff self-care, developing staff’s empathy and responsiveness to clients, helping staff with disappointments in their relationships with clients, accurately evaluating client progress, preserving safety, and nurturing teamwork. Supervisor’s subjective experience of their caregiving of staff could be explained using a second-level analytic concept we termed a caregiving heuristic – one’s beliefs, values, and guidelines for action as a caregiver – of which compassion was, for these supervisors, a foundational element. The supervisors envisioned compassion as a central means by which they could prevent compassion fatigue, develop their staff’s caregiving heuristics, and improve job satisfaction and quality of client care.