Examining supervision outcomes in relation to human service workers in settings addressing violence against women

The World Health Organization estimates that globally 852 million women have survived physical and/or sexual violence in their lifetime (2018). One way violence against women (VAW) is addressed is through the provision of human services (HS) which aim to prevent and intervene against acts of violence, and advocate with and support women who have survived violence (Kulkarni et al., 2012). These services rely on staff/workers who knowledgeably and sensitively understand the dynamics of violence against women and have the capacity to witness/hold the emotional experiences of survivors. As a result, workers in the VAW sector are at risk of exposure to trauma, burnout, and compassion fatigue (Tarshis & Baird, 2019; Taylor et al., 2019; Voth Schrag et al., 2022). Supervision is positioned as a potential avenue for buffering such negative worker outcomes, yet little is known about the impact of such supervision. In this review, we identify the importance of supervision in workplaces that address VAW and present a sub-set of a scoping review on the organizational outcomes of supervision in the HS which summarized the evidence published between 2011 and 2022 (Sewell et al., 2024) to capture the available evidence of workplace-based supervision within VAW settings.

Supervision in the VAW Sector

VAW includes a range of experiences, including physical, sexual, emotional, financial, and psychological violence. VAW includes intimate partner violence (Viero et al., 2021). The VAW sector has expanded greatly over the last several decades to provide a large range of preventative and supportive services to female-identifying survivors of violence (Friesema, 2022) and services to prevent and support people of all genders involved in gender-based and family violence (Crooks et al., 2019), including those who identify as trans and nonbinary.

The practitioners in this sector provide a variety of supportive services to survivors, including counseling, advocacy, and housing support (Voth Schrag et al., 2022). Due to the emotional demands of working in this sector, work-related stress outcomes are very common, such as secondary traumatic stress (i.e., the emotional duress that results when a worker hears about the firsthand trauma experiences of clients; Ben-Porat & Itzhaky, 2011; Dworkin et al., 2016) and burnout (i.e., the state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress; Tarshis & Baird, 2019). Workplace-based supervision of staff is considered particularly important for this sector and in social work broadly, and with the potential to reduce the negative impacts of exposure to indirect trauma and burnout.

Supervision in settings that address VAW has been identified as a valuable contribution (Friesema, 2022; Tarshis & Baird, 2019). Supervisors provide support and foster the development of knowledge and skill (Akesson & Canavera, 2018; Beddoe et al., 2016; Kadushin & Harkness, 2014), while holding a climate of safety and trust for supervisees to develop a sense of professional identity (NASW, 2013). The purpose of such supervision can be theoretically understood as improving worker outcomes, enhancing their work and leading to better client outcomes (Kadushin & Harkness, 2014).

Current Scoping Review

The current scoping review derives from a larger scoping review which was conducted in 2022. This scoping review mapped the outcomes of supervision across international, multi-disciplinary HS literature, providing a unique contribution to the human service organizations (HSO) literature (see Sewell et al., 2024 for full methodology). A varied evidence-base surrounding supervision in HSOs was found in the 175 included articles, reflecting diversity in published outcomes, settings, disciplines, and regions. Within HSO literature, supervision was reported predominately beneficial, including impacting worker competence and implementation; preventing anxiety and burnout; fostering the ability to cope with stress; and improving administrative adherence.

Within the larger scoping review, inclusion criteria were peer-reviewed studies, HS workers and HSOs, supervision of HS workers or supervision in HSO, and organizational outcomes. While informative in synthesizing a large body of literature relevant to HS, the size of the sample prohibited an in-depth understanding of supervision in specific sectors. We sub-sampled the data from this comprehensive review to better understand supervision within VAW services, including all articles which specifying a VAW setting.

Our objective in the current review was to summarize the evidence published between 2011 and 2022, mapping the available evidence of workplace-based supervision within VAW settings. We were guided by the overarching research question: What is the extent and type of evidence in the empirical literature (i.e., key characteristics) related to the organizational outcomes of supervision in the HS employed in settings addressing VAW? Our sub-questions asked: What concepts are used in the literature to describe and evaluate supervision in relation to organizational outcomes? and what organizational outcomes are measured and addressed in the literature?

Methods

As outlined in Sewell et al., (2024) the original scoping review was guided by Arksey and O’Malley’s (2005) five-step scoping review framework and methodologically informed by Joanna Brigg’s Institute recommendations (2015) and the PRISMA-ScR reporting guidelines (Tricco et al., 2018).

Identifying Relevant Studies, Study Selection, and Data Extraction

The main scoping review included 175 studies seeking to hold relevance for the broad spectrum of HS. The full number of records resulted from a database search was 16 843, and 8692 after duplicates were removed. 994 full text articles were assessed for inclusion, and 160 studies from database searches and 15 studies identified through a reference check of included articles were extracted in this main scoping review. From the derived data in the larger scoping review (N=175), we subsampled by selecting articles which specified the study took place with participants in VAW settings (n=7).

Results

State of the Empirical Literature

To answer our main research question, extent and type of evidence in the empirical literature (i.e., key characteristics) related to the organizational outcomes of supervision for HS in VAW settings, we synthesized data related to the following characteristics: the publication year, the location of study, the method employed, the study design, the participant discipline in relation to social work, the participant role, and the sample size. See Table 1: Key Characteristics of Studies, for a summary of the key characteristics of the studies.

Most studies took place in Australia (n=4, 57%), followed by Israel (n=2, 28%), and the United States (n=1, 14%). As supervision is an important part of social work research, education, and practice, and in the larger review, the predominant discipline was social work, we organized participant disciplines in relation to social work. Three studies (42%) included participants whose professions were mixed with social work. Two studies (14%) only had social workers in their participant disciplines reported. Two studies (14%) did not report participant discipline.

All studies were interested in the outcomes of supervision in relation to supervisees reports. Only one study (14%) included supervisors and supervisees in their participant role. Most studies (n= 4, 57%) included 101 to 200 participants in their sample size, only one study (14%) – which was qualitative had 20 or less participants, and two studies (14%) included over 500 participants. Most articles were published by the Journal of Interpersonal Violence (n=2, 28%), however, other social work, mental health, supervision, and violence journals published about the organizational outcomes of supervision in the HS working in VAW. See Table 2: Journals publishing about supervision in violence against women settings for a summary of these journals.

Design and Methods

Methods and research design used for data collection and analysis varied across studies. We grouped method and study design. In terms of the methods used, most studies (n= 6, 85%) reported quantitative outcomes with studies deriving from cross-sectional survey data, with only one study (14%) using a qualitative, phenomenological approach (Friesema, 2022). Of quantitative surveys, two studies (28%) used validated measures (i.e., the Multifactor Leadership Questionnaire, Bass, 1985 in Ben-Porat & Itzhaky, 2011; i.e., Job Satisfaction Survey, Spector, 1985 in Wood et al., 2019), one study (14%) used an established survey (Cortis et al., 2021), and three studies (42%) used surveys created by the researchers for the purposes of the study (Choi, 2011; Dworkin et al., 2016; Rizkalla et al., 2021).

Supervision concepts

Relating to the concepts that are used in the literature to describe and evaluate supervision in relation to organizational outcomes, we synthesized data related to the following characteristics: supervision type, supervision modality, supervision aspect examined or explored, and supervision description (see Table 3: Supervision concepts reported).

Most articles did not report whether supervision being received by the workers was internal or external to the workplace, with only two articles specifying that supervision was provided within the organization (Choi, 2011; Dworkin et al., 2016).

While one article specified that supervision occurred on a one-to-one or individual basis (the same that noted that it was internal supervision; Dworkin et al., 2016), and another identified that both individual and group were being explored for a comparative purpose (Ben-Porat & Itzhaky, 2011), all other articles did not report whether supervision occurred for workers on an individual or group basis.

Most prominently, supervision was examined by asking participants about frequency of supervision (Dworkin et al., 2016; Rizkalla et al., 2021) and their satisfaction with supervision (Ben-Porat & Itzhaky, 2011) or their supervisor (Wood et al., 2019). Only two (28%) articles defined supervision in the reported study, three specified what was meant by supervision, whereas six articles measured supervision. Only three of the six studies which measured supervision either defined and/or specified what was meant by supervision (Cortis et al., 2021; Dworkin et al., 2016; Rizkalla et al., 2021), where three did not (Ben-Porat & Itzhaky, 2011; Choi, 2011; Wood et al., 2019).

Outcome concepts

We synthesized data related to outcomes explored and the impact of supervision in relation to these outcomes. See Table 4: Organizational outcomes concepts reported for a summary relating to organizational outcomes are measured and addressed in the literature.

Five studies (71%) reported beneficial outcomes of supervision, one study (14%) reported mixed relationships between supervision and organizational outcomes (i.e., highlighting both positive elements and areas for growth), and two studies (28%) displayed no relationship or no statistically significant relationships between supervision and organizational outcomes. From these studies, there were nine (64% of outcomes) reported outcomes that showed benefits of supervision.

Four studies (57%) measured secondary traumatic stress (Ben-Porat & Itzhaky, 2011; Choi, 2011; Dworkin et al., 2016; Rizkalla et al., 2021). One study (14%) found that supervision leads to beneficial outcomes (lessening of secondary traumatic stress; Dworkin et al., 2016), two studies found no statistically significant relationship between supervision and secondary traumatic stress (Ben-Porat & Itzhaky, 2011; Choi, 2011), and one study found a mixed outcome between supervision and secondary traumatic stress – supervision being a mediating variable between exposure to vicarious trauma and secondary traumatic stress (Rizkalla et al., 2021).

Intention to leave was explored in two (28%) articles but had three reported outcomes (Cortis et al., 2021; Wood et al., 2019), as one article measured the impact of supervision on intention to leave in both group and individual modalities (Cortis et al., 2021). This article found that there were positive outcomes reported between individual supervision and a person’s intent to leave, supervision lessening the likelihood of intent to leave an organization, however it indicated no relationship between group supervision and intention to leave (Cortis et al., 2021). Wood et al. (2019) did not specify the type of supervision (group or individual), however it found that supervision reduced likelihood of turnover intentions (Wood et al., 2019).

Other studies reported that there were good outcomes between supervision and the following outcomes: competence, well-being/morale, knowledge, organizational commitment, professional development/growth, and psychological safety (Ben-Porat & Itzhaky, 2011; Friesema, 2022). These articles displayed statistically significant (if applicable) positive correlations between the receipt of supervision and outcomes that benefit workers and workplaces in the VAW sector.

Discussion and Conclusions

This review is the only synthesis existing examining the organizational outcomes of supervision for workers employed in VAW settings. In this sub-set, we found that supervision was found to have beneficial impacts on organizational outcomes including competence, knowledge, well-being/morale, organizational commitment, professional development/growth, psychological safety, and intention to leave. At a time where the well-being and retention of workers is paramount for the ability of VAW organizations to provide services aligned with their mandates to address VAW, the beneficial impact of supervision on workers holds promise as a key resource.

The seven articles synthesized for this scoping review present that the state and nature of the current literature on the organizational outcomes of supervision in workplaces that address VAW is limited. Only three countries were represented in published studies, mainly presenting quantitative and cross-sectional data. However, sample sizes and participant groups varied. Further research can be enhanced through qualitative research including the perceptions of both supervisors and supervisees. Such research can enable a deeper understanding of the content and quality of beneficial supervision, as well as the strategies employed, and the barriers to and facilitators of supervision arrangements which enhance organizational outcomes (Denzin & Lincoln, 2017).

The empirical literature published also depicts a lack of clear description of what is meant by supervision within each setting. Only one (14%) article defined, measured, and specified what was meant by supervision (Rizkalla et al., 2021) and troublingly, two articles did not define, measure, or specify what was meant by supervision (Choi, 2011; Friesema, 2022). Better understanding of what researchers mean when referring to supervision is essential for creating evidence-informed supervision arrangements in settings that address VAW that can enhance organizational outcomes. Theoretically, this can lead to more supportive services and better outcomes for their clients (Kadushin & Harkness, 2014).

Studies discussed positive outcomes, such as competence, knowledge, well-being/morale, organizational commitment, professional development/growth, and psychological safety. They also noted the negative outcomes of secondary traumatic stress, burnout, and intention to leave. Supervision was shown to have beneficial outcomes for workers in these articles. However, the focus on measuring secondary traumatic stress and intention to leave displays a need for research to continue to explore what this supervision includes, so that supervision can not only can buffer against such negative outcomes but can enhance worker experiences and create worker safety and trust (NASW, 2013). Our findings suggest that more research is needed to better understand how organizations can set up supervision arrangements that can lead to outcomes such as lessening secondary traumatic stress and intention to leave, increasing worker competence and knowledge, improving well-being and morale, and promoting psychological safety.

As a sub-set of a larger scoping review, this review has limitations. Although the larger scoping review used a methodology which directed the development of an a priori protocol to guide the work and identify relevant studies, some articles may have been missed or not identified through this comprehensive search strategy (Peters et al., 2020). Further, we report on the information derived for this larger scoping review based on data extracted, assessed by a team for a broader research purpose. As the review took place in 2022, we expect more recent literature and future research and scholarship to inform the future of supervision these settings because of learning and innovation, especially in a post-COVID reality.

In this review we mapped the available evidence of workplace-based supervision in settings that seek to address VAW published between 2011 and 2022. Findings of the current review identify how future research can be enhanced to ensure empirically supported establishment of supervision arrangements that can enhance organizational outcomes. This is critical moving forward to support women in need of services addressing VAW.