Report on A Study* of the Role of the Social Work Supervisor in Acute Care Hospitals

James Donnelly, DSW, LCSW

This study of social work supervision is a reflection of the very high level of interest and the cooperation of the members of the Metropolitan New York Chapter of the Society for Hospital Social Work Directors of the American Hospital Association. For the first time an attempt was made to define the social work supervisor’s role in terms of both the professional functions of the supervisor as described in the literature and the complex organizational realities of acute care hospitals in a city such as New York.

Role sets of directors, supervisors and workers from 17 social work departments in New York City were asked to rate their expectations for the role performance of their supervisors as described by a list of 45 supervisory behaviors.

The normative role definition of the supervisor in the literature involves three specified areas of functioning: administrative, educational and supportive (Kadushin, 1985). However, in order to obtain a role-set definition of the supervisor’s role, the role definition for this study was further segmented by categorizing each role behavior of the supervisor in terms of its reference to specific counter-position occupants in the role-set: director and worker (Merton, 1957). By segmenting the role of the supervisor in such a manner the following five role-sectors of the supervisor’s role in the context of his/her role-set were as follows:

  1. 1. Director-Administrator Role-Sector. (DA) This sector of 12 items describes those role activities of the supervisor that involve interaction with the director. These are generally considered to be administrative in nature.
  2. 2. General-Administrative Role-Sector. (GA) This sector of 6 items describes those role activities of the supervisor that do not involve direct interaction with either the director or worker but define routine administrative activities and responsibilities in the agency.
  3. 3. Worker-Administrative Role-Sector. (WA) This sector of 9 items describes the supervisor’s administrative activities that involve direct interaction with the worker.
  4. 4. Worker-Educational Role-Sector. (WE) This sector of 11 items describes the supervisor’s educational activities that involve direct interaction with the worker.
  5. 5. Worker-Supportive Role-Sector. (WS) This sector of 7 items describes the supervisor’s supportive activities that involve direct interaction with the worker.

Ratings on these items from each position indicated that directors, supervisors and workers expect very different things from supervisors.

Directors gave their strongest emphasis to activities of the supervisor that insure accountability and support the workers in their performance. Their next strongest emphasis was on being kept informed. Least emphasis was given to supervisors’ systemic and general administrative activities. Overall, directors expect supervisors to help them with workers’ performance more than with departmental or hospital systems.

Supervisors’ response patterns indicate that they define personnel management differently than do the directors.  Their highest emphasis was on their supportive activities with workers. Although they gave almost equal emphasis to accountability and education, their second highest priority was on systemic and general administrative activities.

As a group, although supervisors have considerable agreement with directors, supervisors defined their own role in a much broader way and indicated a strong commitment to the impact on overall systems in the department and hospital.

Workers had the lowest levels of consensus regarding their expectations for supervisors’ performance. Given that, however, their highest priorities were support and accountability in that order. Their least emphasis was education and they had no significant consensus on activities not directly involving them.

It seemed from their responses that workers were most concerned with their needs vis-à-vis the hospital and department than with help in dealing with clients. Workers want to know what is expected of them, where they stand and help with hospital systems that affect them directly.

All three groups gave support and accountability more emphasis than education. However, there were two educational behaviors that were strongly endorsed by all groups.

First was in assisting workers with counter-transference issues and use of self.

Second was assistance in gaining conceptual clarity about the role of the social worker in hospital setting.

The very different response patterns among the three groups was felt to be a reflection of the different tasks, and consequent positional needs, imposed upon directors, supervisors and workers in a complex organization.

The area of role performance where disagreement was strongest was the systemic and general administrative activities of the supervisor.

This aspect of the role, which is so important to supervisors, is the least clearly defined in the department. On the other hand, the activities related to accountability have the strongest agreement between all three groups. This is the most clearly defined area of the supervisors’ role in the department.

In analyzing these disagreements, some alliances between groups were found.  Supervisors and directors were strongly allied on supportive activities whereas supervisors and workers were allied on the activities that were related to caution in sharing information about the worker with the director.

With regard to information sharing in general, it was found that supervisors feel fewer obligations to share information than what is expected by directors and workers alike. Monitoring information appeared to be an important instrument in the supervisors’ maintenance of their middle position in the role-set.

Although the accountability function of the supervisor may be the most clearly defined in the department, it is the least comfortable for the supervisors.

Supervisors feel most conflicted when they must confront workers and hold them accountable.  The findings indicate that supervisors would rather confront directors than workers.  Despite their discomfort, responses show that the supervisors do perform these activities.

There are undoubtedly many implications that could be drawn from a close review of the findings this study but there are three that stand out initially.

First, it seems clear that the nature of the organization and the role of the social worker in that organization impacts directly on the role definition of the supervisor. The function of the supervisor is agency linked and could be expected to be defined differently in varying kinds of organization. The interdisciplinary nature of the hospital world appears reflected in the supervisor’s role definition.

Second, the administrative functioning of the supervisor appears to be a highly complex one and in need of further clarification and understanding.

Third, in light of the high degree of conflict between directors, supervisors and workers about the role, a sine qua non for the selection of the suitable candidates for the role would be and ability to endure, recognize as legitimate – and use in a professionally purposeful way these conflicting expectations. A strong need to clear up ambiguity and resolve contradictions makes it difficult to function effectively as a supervisor in a hospital setting

Implications for a Theoretical Understanding of Social Work Supervision.

The use of the role-set concept (Merton, R.K., 1957) as an analytical tool has proven to be extremely valuable in highlighting the organizational realities in which supervisors must function. Role-set analysis of supervision in the context of different agency settings can yield valuable information that would greatly enhance our understanding of supervision and assist in more effectively preparing social workers for the supervisory role.

Much of the literature on social work supervision has focused on the inter-personal, rather than the transactional and contextual aspects of the role.  This approach focused attention on the partialized areas of supervisory activity vis-à-vis the worker and the inter-personal tasks and problems relate to the supervisor’s performance in these areas.  In recent years, theory-building in social work has evidenced attempts at a paradigmatic shift (Hearn, G., 1958;  Janchill, Sr.M., 1969; Vigilante, et al., 1981) from a linear to a systems perspective.  This trend is also reflected in recent approaches to conceptualizing social work supervision (Middleman and Rhodes, 1985; Schulman, 1982).

A linear perspective on the supervisor’s role, no matter how comprehensive, cannot do justice to nor adequately identify systemic realities of the supervisor’s role. The inclusion of the reality of context and a multi-positional perspective on the role can yield information relevant to a systemic understanding of the role and support theoretical elaborations in a systems perspective. Focusing on the separate areas of the supervisor’s activities is essentially limited to what supervisors do and the value of what they do vis-à-vis the worker, agency and profession.  A role-set analysis, however, that places what the supervisors do within a real organizational context and multi-positional perspective, yields valuable data and information about the overall function of the supervisory position in the organization. Such an analysis provides the first step towards a theoretical elucidation of the function supervision plays systemically, i.e. the transactional function of supervision in the overall system.

A systemic perspective on supervision needs a database that can both support it and anchor it to organizational realities. Role-set analysis can be a powerful research tool to build this database. A role-set analysis of supervision in various kinds of agency contexts leads to the real integration of both function and context and clear elucidation of the systemic meaning of the supervisory process in the context of different social organizations.

Throughout the literature on social work supervision, it has long been recognized that conflict is inherent in the supervisor’s role. By virtue of the supervisor’s ‘middle position’, conflicting expectations come with the territory.  There appears to be an implicit assumption that this conflict is crucial to the role as evidenced by a general reluctance in the literature to split the functions of supervision. Important attempts at a theoretical approach to supervision (Berkowitz, 1952; Berl, 1960; Middleman and Rhodes, 1985; Towle, 1962; Schulman, 1982) emphasize the integrating and systems balancing function of the supervisor that transcends any particular area of supervisory activity. These approaches reflect the importance of tension and conflict for the theoretical understanding of supervision.

The specification of role-set conflict in this study has linked conflict to role task and function that has meaning for all the groups of position-occupants, and has provided data as to how the supervisors my actually negotiate these conflicts.  Role-set conflict is clearly related to the positional needs of the different group of the Role-set.  The specification of the precise nature of these conflicts leads to a clearer understanding of the different functions each position plays in the context of the social organization of the agency and hospital.

An examination of self-role conflict of the supervisors also sheds light on the function of supervision in context of the social organization of the hospital and the agency.

The greatest contrasts in self-role conflict for supervisors were within the administrative aspect of the role and not between the three traditionally defined aspects of the role: administration, education and support. To the extent that self-role conflict for supervisors has been discussed in the literature at all, the general assumptions have been that supervisors do not like the exercise of the authority of their position, nor do they like routine administrative chores.

With regard to this issue, the multi-positional perspective of a role-set analysis, again, yields valuable information missed in more linear approach.  Both ‘authority’ and ‘administration’ have very different meanings in the context of the role-set than in a linear analysis.  ‘Administration’ has different meanings for each position and these differences must be considered as legitimately related to differential role tasks and functions within the organizational context. Positional ‘authority’ must also be related to positional function. The positional mandates, as seen by the supervisors in this study, are very much related to the integrating and systems balancing function of the supervisory position. This is quite different from the positional mandates of the director that puts more emphasis on the personnel management and accountability functions.

The supervisor’s holding of the ‘middle position’ is related to the maintenance in daily practice of the legitimacy of the differences in positional mandates for the administrative functioning of both the director and supervisor positions.

Since theorizing about supervision has only recently begun to incorporate a systemic perspective (Middleman and Rhodes, 1985), it may have been more difficult to theoretically clarify the maintenance of such distinction of legitimate administrative mandates.  As reflected in the study’s findings, self-role conflict for supervisors is most intense in activities where the distinction may be most difficult to maintain.  In a systems perspective, the high degree of self-role conflict among supervisors must be seen not simply as a personality or psychological aversion to exercise power, but also as a function of the meaning of the role in the context of the social organization. If the use of role-set analysis can lend theoretical clarity and legitimacy to the precise relationship of ‘administration’ and ‘authority’ to positional differentiation, this in itself would be a step in the direction of a more adequate preparation of social workers for the tasks of this role; tasks that are quite different from that of administrator nor direct line practitioner.

The supervisor is neither a “sub-administrator” nor a “supra-practitioner” (Towle, 1957, 1962). The supervisor is a supervisor. The role must be defined in relation to its counter-position-occupants, but not in terms of them.

Supervision in social work has always been seen as an agency function (Kadushin, 1985).  The uniqueness of social work supervision reflects the uniqueness of the agency structure as an instrument of professional service delivery. The findings of this study indicate the value a role-set analysis has for understanding unique aspects of specific agency contexts and their impact on all the position occupants. The specifics of hospital social work practice are reflected in the findings, and yield information that can be used to clarify the function of the agency in terms of its specific social context.  Further research on the supervisor’s role in the contexts of other agency settings can help to specify both the challenges and the opportunities being presented to social work agencies. Such research could serve as an indicator as to how social workers on all levels of the organization are responding to them.

The more accurately the complex realities of social work supervision in an agency context can be identified and placed within a theoretical framework that links social work supervision to social work practice, the better social workers can be prepared for the tasks of supervision. The personality characteristics and talents required for an effective supervisor may be quite different from those required for an effective direct line practitioner or an administrative position such as director. The capacity to endure contradiction and respond purposefully and effectively to conflicting expectations would seem to be an essential requirement for an effective supervisor. Furthermore, the kinds of skills needed to accomplish the role tasks of supervisor can be identified more clearly, and differentiated from those required as either worker or director.

References

Berkowitz, S. The administrative process in casework supervision. Social Casework 33, December 1952.

Berl, F. An attempt to construct a conceptual framework for supervision.  Social Casework 33, December 1952

Hearn, G.  Theory building in social work.  Toronto: University of Toronto Press, 1958.

_________  The general systems approach: Contributions toward an holistic conception of social work. New York: Council on Social Work Education, 1969.

Janchill, Sister Mary Paul.  Systems concepts in casework theory and practice. Social Casework 50, February 1969.

Kadushin, A.  Supervision in Social Work. New York: Columbia University Press, 1985.

Merton, R.K. The role-set: Problem in sociological theory. British Journal of Sociology VIII, June 1957.

Middleman, R.R., and Rhodes, B.G. Competent Supervision: Making imaginative judgments. Englewood Cliffs:  Prentice-Hall, 1985.

Schulman, L. Skills of supervision and staff management. Itaska: Peacock Publishers, 1982.

Vigilante,  J.E., Lodge, R., Lukton, R., Kaplan, S. and Manson, R. Searching for a  theory: Following Hearn. Paper presented at annual program meeting, Council on Social Work Education. Louisville, Kentucky, 1981.

*A Role-set Analysis of the Position of Social Work Supervisor in Hospital Settings.

James Donnelly, C.S.W.

Doctoral Dissertation

Adelphi University Graduate School of Social Work

October, 1986

UMI reference No. 8701932

© 2014 James Donnelly, DSW.LCSW

All rights reserved

South Garden Press, New York

For thoughts and comments, please e mail to: jdonnellydsw@gmail.com