Caring for carers: A psychosocial supervision intervention for mental health practitioners

Principal Investigators: Ruth Wells and Simon Rosenbaum, University of New South Wales

Research Snapshot: Clinical supervision for humanitarian mental health workers

Clinical supervision significantly benefited mental health and psychosocial support (MHPSS) practitioners working in Türkiye/ Syria, improving wellbeing and reducing burnout: but results are affected by context and implementation factors.

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What did the study set out to achieve?

Local MHPSS practitioners in humanitarian settings often face the same challenges as the communities they serve. Supervision may play a role in supporting their wellbeing and ensuring service quality. Recent evidence has highlighted the need for culturally and contextually appropriate supervision models for MHPSS frontline workers in humanitarian settings, while evidence gaps exist on how to prevent burnout. However, implementation, contextual and cultural factors must be addressed to ensure cultural responsiveness of supervision

This quasi-experimental, mixed methods study compared wellbeing outcomes of a co-developed context-specific supervision program for 6 months before the program, and then during the 16-month online supervision program in Türkiye/NW Syria and Bangladesh. Service user interviews were conducted to assess service satisfaction and understand priorities for MHPSS services.

What were the key findings?

The Caring for Carers study examined how online fortnightly group supervision impacts MHPSS practitioners in two challenging humanitarian contexts: Syrians in Türkiye/Northwest Syria and those working with Rohingya communities in Bangladesh.  Supervision was associated with improved MHPSS practitioner wellbeing. However, effectiveness of supervision (and its benefits for practitioners) depend on context and implementation factors. Supervision may also support MHPSS services that are responsive to community priorities. More research is needed to understand whether positive impacts on practitioners translate to quality improvements or positive outcomes for service users.

Improvements in wellbeing: In Türkiye/NW Syria, practitioners reported significant improvements in compassion satisfaction (sense of meaning from helping work) and reduced clientrelated burnout during supervision compared to the control period. The online supervision model continued during the 2023 earthquakes, providing crucial support.  

Service users: More than 90% of service users in both settings rated the quality of service they received as excellent or good. Follow up service user interviews (378 with displaced Syrians) revealed that what mattered most to them was time and understanding (62%), dignity (43%), confidentiality (36%), and continuity of care (31%).  

Context and implementation barriers: In Bangladesh, no overall improvements were observed in practitioner wellbeing compared to the active control period. However, practitioners who attended more sessions reported significantly better wellbeing. Implementation factors like internet connectivity, work interruptions, and practitioner self-efficacy significantly influenced outcomes, demonstrating that supervision effectiveness is context-dependent.

What does this mean for policymakers and practitioners?

MHPSS programs should integrate regular supervision as standard practice to enhance practitioner wellbeing and service responsiveness. By supporting compassion satisfaction and client burnout, supervision may help practitioners develop the trusting relationships beneficiaries prioritise, potentially improving service effectiveness.  

A key question still to be addressed is whether the positive benefits of supervision for practitioners translate into improved service quality and positive outcomes for service users. Funders should balance scale-up goals with protected time for supervision and empathetic care delivery.  

Localised supervision models that address contextual barriers- like internet connectivity, short-term contracts and employment insecurity- are essential for successful implementation. Investment in supervision can strengthen MHPSS workforce sustainability and improve service responsiveness in humanitarian settings. With the mainstreaming of MHPSS, supervision may benefit other professionals providing psychological first aid or case management.