Clinical supervision: outsider reports of a research-driven implementation programme in Queensland, Australia

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The aim of the present study was to explore substantive issues related to the implementation of Clinical Supervision (CS). Historically, the treatment of mental illness in Australia has been inadequate. CS has shown promise as a positive contribution to the clinical governance agenda, as a structured staff support mechanism. Within the wider context of a randomized controlled trial (RCT) of CS, semi-structured interviews (n = 17) were conducted with staff who worked alongside colleagues that attempted to implement CS. Senior managers embraced CS and were disappointed when junior managerial colleagues did not hold a similar conviction, when tested by the realities of CS implementation. If CS was regarded as an additional activity, it stretched human resources and created inter-staff tensions. The personal testimony of these 'outsiders' spoke about the practicalities of implementing CS and the prevailing culture into which they were introduced. When perceived as a tour de force for culture change, CS was polarized as an opportunity by many, but also as a threat by some. A single, cohesive and explicit management position on CS in each Health Service entity may obviate some of the impediments to CS implementation.