Triadic Clinical Supervision
Ronnie Mitchell
Senior Charge Nurse
Directorate of Forensic Mental Health &
Learning Disabilities
• As supervision is mandatory there was
a need for standardising supervision
provision across the directorate
• Provide increased support to clinical
supervisors, many of which were new
• Ensure that supervision sessions
remain focused on clinical practice
Triadic Approach
• First implemented across the directorate
in 2011
• Initially a small number of Band 6 and 7
nurses trained as Triadic Consultants
• Following this, there was a roll-out of
additional Clinical Supervisor training
across the directorate
Triadic Model
• Involves three people taking part in a
supervision session
– Supervisor
– Supervisee
– Triadic Consultant
Role of Triadic Consultant
• To advocate the benefits of clinical
supervision within their area of
• To attend (at least) the first three
supervision sessions delivered by new
• Thereafter attend regular supervision
sessions with each supervisor in order
that standards are maintained.
Role of Triadic Consultant
• Main source of support for clinical
supervisors during sessions
• Ensure that the focus of each
supervision session remains on clinical
• Is able to provide constructive feedback
to the clinical supervisor at the end of
each session
In Practice
• Supervisor can seek advice from
Consultant on up to 3 occasions during
a supervision session, (typically lasting
1 hour)
• If deemed necessary, the Consultant
can interrupt the session no more than
• Supervisee cannot interact directly with
the Consultant
• Supervisees can initially feel
uncomfortable having a third person in
the room.
• The Consultant has to endeavour to
remain as unobtrusive as possible.
• Maintaining a regular calendar of
supervision for each nurse (typically
every 6 weeks)
• Uniformity of supervision delivery
across the directorate.
• Regular, timeous sessions provide staff
with an ongoing source of clinical
• Supervisors are able to seek
advice/feedback from Consultants
almost at the point of delivery.
• A record of attendance for each
supervision session is kept at individual
ward level
• Monthly Audits are submitted by SCNs
to Lead Nurse detailing number of
sessions delivered
What’s Next?
• Additional Clinical Supervisors can be
trained as required.
• Triadic Consultants will continue to take
part in sessions with each of their
• Refresher training (if required) for
supervisors is available.