• burnout;
  • clinical supervision;
  • health-care assistants;
  • nurses;
  • secure psychiatric services

Accessible Summary

  • Clinical supervision is a key component of effective service development.
  • The study explores the importance of clinical supervision in Secure Psychiatric Services for Women and the implications for service development.
  • Comparisons are made between qualified nurses and health-care assistants' uptake of clinical supervision along with type of supervision used.
  • Factors identified in relation to potential improvements in the current provision of clinical supervision are discussed, and recommendations are made.


In secure psychiatric services where the potential for ‘burnout’ by nurses is high, clinical supervision is viewed as a key to reflective practice to support staff in stressful working environments. Barriers to the uptake of clinical supervision in such service settings are personal and organizational. The study was prompted by the need to evaluate the effectiveness of supervision for registered nurses and health-care assistants (HCAs) and a desire to use survey findings to improve the quality and uptake of supervision. The study examined the perceived benefits, the best practice elements and the practical aspects of clinical supervision including how to improve practice. An approximate uptake of clinical supervision by 50% of staff confirmed previous findings; that HCAs were significantly less likely to engage in supervision and less likely to perceive benefit from it. Initiatives to address the training and managerial obstacles to the provision of formal supervision are described.