Introduction
Since August 2021, Geruka Healing Centre entered into a partnership with Sugira Muryango, a home-visiting program and evidence-based intervention that offers active coaching to caregivers by community lay-workers trained to deliver sessions including early stimulation promotion, play, nutrition, hygiene, non-violent discipline, and responsive parenting. The partnership sought to provide services around Team Clinical Supervision, Training and Risk of Harm Advising. The supervision and training conducted by professionals who on a biweekly basis engaged with teams supporting community members in the family strengthening program in supporting them respond to the immersive cases and issues that are affecting them in the line of work.
The Sugira Muryango teams work on a day-to-day basis with very sensitive and challenging situations that involve supporting families experiencing Gender-Based Violence, Intimate Partner Violence, Sexual Abuse among others. All of which impact the wellbeing of the staff and their families.
The supervision sessions therefore intended to develop and build a safe space and a team of support among members of Sugira Muryango to find collective ways of responding to the challenging ways of work.
This was done for all staff across all levels from the national level to sector level associates in the 3 districts of Rwanda.
Structure of supervision sessions
The clinical supervision sessions included a rich understanding and description of the team member's work-related difficulties and vulnerabilities brought about in supporting families and communities experiencing hardships. Sessions also included team building exercises that fostered understanding and listening skills for the entire team and establishing space for members to share the challenges and issues that are affecting their wellbeing and ultimately affect their work productivity and mental health.
The first session focused on establishing a common understanding of the space through setting up background rules and safe space measures for all members. That’s to feel safe and secure in sharing their stories of hardships from their workplace. Members shared how they have been affected by their work and the supervising team working on providing group support for an individual who experienced the problem.
Getting to know you each other
All Clinical supervision sessions started by an exercise of getting to know each other as an icebreaker. The purpose of it was to engage the group in early conversation within their individual comfort zones. Most participants appreciate beginning a training session with quiet laughter and the chance to share something about themselves in a comfortable and supportive environment. During the exercise they shared one thing that surprised them in their life, two things that they like the most and two things they don’t like. This also help the members to trust each other and to work in a safe environment. The experience has taught us that it is important to be properly introduced to someone so that one can trust you as a colleague.
As it was mentioned at the end of each session, members found out that there are a lot they didn’t know about each, and the fun part provided a unique opportunity to speak about sensitive things that were affecting their lives without re-traumatizing and in non-traumatizing ways.
Setting Ground Rules and team expectations
Ground rules are a significant part of the clinical supervision. That’s because they establish the purpose of the dispute resolution process at hand and shape how sessions will be conducted. By setting down rules about who may participate and how decisions will be made, parties can ensure that these processes run more smoothly.
During the clinical supervision the staff agreed on the following ground rules.
- During discussions, value other participants' contributions
- Attend the supervisions sessions with positive expectations
- Arrive on time for the supervision
- Give positive feedback to other people's ideas
- Keep an open mind
- Respect of others’ opinions and
- Confidentiality
When setting these ground rules for the teams, teams identified those they considered as “golden rules” for which members were key in holding the safe spaces together.
Throughout the sessions in the 3 months period included having a member bring a problem that they had faced in their line of work and that was impacting their wellbeing and with the help of a Geruka supervisor, a supportive team and a team of reflection would be formed to share knowledge and wisdom in responding to problems affecting their line of work. Collective ways that have been helping in keeping other members’ wellbeing intact would be shared, and a sharing member would pick off what he/she felt resonated with their experience with the issue.
Evaluating the effects of supervision sessions
Understanding the effects of the conversations and spaces was fundamental for both the Geruka Healing Centre teams and the Sugira Muryango Intervention program and in so, members were asked how they felt in taking part in the sessions.
Individual Level
A question inquired members to share how the supervision sessions had helped them in responding to the issues they were facing at work or in their own lives.
Members responded that clinical supervision had enabled them to share and get relieved of the burden of feeling that issues were solely impacting them. The sessions empowered and made visible of their strength in dealing with daily difficulties which were overshadowed by individual failures experienced in the project.
Honestly, clinical supervision has helped me because it is a good platform where a person has freedom to share his/her mind especially what burdened her in her work, which brings peace to heart. Another thing it has helped me is to know of my colleagues or co-workers, how to live with them, as well as those that I supervise. That lead me to discovering challenges they meet with and how they managed to overcome them. In general, clinical supervision is a good platform to share ideas - Respondent 10.
Another respondent added that a feeling of guilt that is usually associated with handling risk of harm cases and other suicide-related issues that had made the staff get feelings of guilt and shame but through sharing, “I feel like I went back to my good times as usual, and I am emotionally stable”. This was possible because of collective efforts in which members shared what had been helpful whenever they faced a suicide case and how members established a space of emotional safety whenever they dealt with the situation."
At Workplace
As part of the objectives for the supervision sessions to improve employee wellbeing and support staff in handling day-to-day stressors at the workplace, the team wanted to know how members’ workplace had improved, and their relationship might have been impacted because of the supervision sessions. As evident in the feedback from groups, members indicated that being in supervision sessions helped them to acknowledge and build solidarity amongst, as knowledge of sameness in experiences of hardships because of their work was being shared. Individuals felt belonging and not alone in the things they were facing at work.
“The way I see it, these sessions of clinical supervision have helped us a lot because before a person could meet with the problem in their work and think that he or she is the only one facing that problem, your employer doesn't care about it, but in this session, people share their experiences and help them as a team. In general, it has benefited us since we found a place to share our problems and feel rested from it and if there were never clinical supervision in existence, I wouldn't find a place where to share it.” - Respondent 3
Additionally, as members got to know each other more through the team building exercises and offering reflective and outside witness teams, a strong bondage was established amongst teams. Furthermore, the knowledge and wisdom sharing of how members were responding to issues at work enabled transfer of skills and knowledge to other members who mentioned that they have been able to respond to some cases and issues at work because of listening to ways others did solve them, this enabled the creation of a ripple effect at work.
The side graph indicates the percentages of those who indicated that they have taken initiatives in solving and responding to cases at work after knowledge from clinical supervisions.
The side graph indicates the percentages of those who indicated that they have taken initiatives in solving and responding to cases at work after knowledge from clinical supervisions.
In summary, members were asked to rate the overall satisfaction with the supervision sessions against the goals and expectations of the members as set at the beginning of the sessions.
Above is a graph that indicates the level of their satisfaction, those who responded 1= not helpful; 3= neutral; 4= helpful and 5= very helpful. Overall, the results show that clinical supervision is dominating to be very helpful and has zero record of being unhelpful to those who had clinical supervision.
Conclusions
In general, given the Covid-19 circumstances that prohibited physical meetings, supervision sessions helped in building a team of support and strengthened solidarity for members working in complex situations. The safe spaces offered alternatives of an environment from which collective support was possible building upon cultural and traditional sharing.
Establishing such spaces for community workers who on a day-to-day basis are overwhelmed with social, and health problems affecting our communities seemed fundamental in caring for caregivers and caretakers who often carry a burden from responding to such traumatizing cases.