What this is
External clinical supervision for organisations: residential and outpatient addiction treatment, private psychiatric units, eating disorder services, and psychotherapy practices with more than one clinician.
Dr Jacquet supervises clinical teams in private residential addiction treatment and in a private psychiatric hospital, alongside his own practice. That combination is the point. Supervision of a treatment team is not the same activity as supervising a single therapist with a private caseload, and it is not well done by someone who has only ever done the latter.
The staffing problem nobody says out loud
There is a structural difficulty in this sector and it is worth naming plainly.
Treatment services train people. They take clinicians early in their careers, give them exposure to acute and complex presentations that private practice will not provide for years, and support them through qualification. And then, reliably, the ones who become genuinely experienced leave, because private practice pays better and demands less.
The consequence is that many services are permanently staffed by clinicians who are still developing, supervised by whoever is currently the most senior person in the building. The expertise that a service most needs is precisely the expertise it cannot retain.
External supervision is the ordinary answer to that. It brings in a level of experience the organisation cannot hold on its payroll, and it does so without asking a clinician to bring their difficulties to the person who writes their appraisal.
What the work attends to
The clinician’s own responses. Boredom, dread, irritation, the wish to rescue, the patient who is disliked and the one who is favoured. In a residential setting these are amplified by proximity and shift patterns, and they drive far more clinical decisions than anyone records. Treated as information rather than as lapses, they are among the most useful material available.
Parallel process, at team scale. A splitting patient reproduces the split in the staff group. A team that is in conflict about a case is usually telling you something about the case. This is visible to an outsider in a way it is not from inside.
Risk, without collapsing into it. Risk management is necessary and is not supervision. A session that is only a risk review leaves the actual clinical work unexamined, and services under pressure drift towards exactly that.
The transition out. This is the part most relevant to residential services, and it is the subject of a wider argument I would make to any centre.
The part after discharge
Abstinence inside a residential setting is not an achievement of the patient’s. It is an achievement of the container: no access, no triggers, a timetable, staff on the corridor, and everyone around them doing the same thing. Speaking honestly to a therapist is easier there for the same reason.
Then they fly home, and every one of those supports disappears at once. Nothing compels attendance. Nothing prevents access. The only thing holding the work together is whether a person turns up on a Tuesday during the stretch where they feel fine and can no longer remember why they started.
Keeping someone in treatment when nothing obliges them to stay is a distinct clinical skill, and it is not the skill a residential programme develops in its staff, because the residential setting does that job structurally. Teams that recognise this and prepare for it explicitly get better outcomes after discharge. Teams that treat completion of the programme as the endpoint tend not to.
That is a supervision subject, and it is one I would want to work on with any residential team.
Format
Group supervision for the clinical team, individual supervision for senior clinicians or for those holding the most complex work, or a combination. Monthly or fortnightly, in person in London or by secure video.
Delivery by video makes this workable for centres outside the United Kingdom, including in places where no supervisor of this seniority is available locally. Sessions run in UK hours, which for most regions falls somewhere usable in the clinical day.
Background
Doctorate of Professional Practice, University of Essex, on male eating disorders from an analytical psychology perspective. Jungian analyst trained with the Association of Jungian Analysts. International Diploma in Addiction Counselling from the Hazelden Foundation. More than twenty years of EMDR practice. Twenty-five years of clinical work across addiction, eating disorders and trauma, in private practice and alongside residential and inpatient services.
Dr Philippe Jacquet is a UKCP registered psychotherapist, a Jungian analyst and an HCPC registered art psychotherapist, with twenty-five years of clinical practice. His Doctorate of Professional Practice at the University of Essex examined male eating disorders from the perspective of analytical psychology. Registration can be checked on either public register.
A note on what this practice does and does not do
It is worth being direct, since organisations reasonably ask.
This practice does not provide residential treatment and is not an alternative version of it. It offers specialist psychotherapy to people who will not enter a residential programme, at whatever point they arrive: often the last conversation before someone decides about rehab, and frequently the first one after they leave it. That is a different service to a different person, and it is why supervising a treatment centre presents no conflict.
See also: clinical supervision for individual practitioners, executive addiction treatment, and clinical supervisor in London.
To discuss supervision for your service, get in touch.
Common questions
Who is this for?
Residential and outpatient addiction treatment centres, private psychiatric units, eating disorder services, and psychotherapy and counselling practices employing more than one clinician. The supervision is arranged and paid for by the organisation rather than the individual practitioner.
What does external supervision provide that internal supervision cannot?
Independence, and a level of experience that is difficult to hold internally. An internal supervisor is a colleague, often a line manager, and there is material a clinician will not bring to the person who writes their appraisal. There is also the practical problem that most services cannot retain clinicians senior enough to supervise the rest, which is discussed below.
Individual or group?
Both, and most organisations use a combination. Group supervision for the clinical team, which is where shared blind spots become visible, and individual supervision for senior staff or for those carrying the most complex work. The balance is set after seeing how the service actually runs.
Can this be delivered internationally?
Yes. Team supervision is delivered by secure video and works well across time zones, which makes it viable for centres in places where no local supervisor of this seniority exists. Sessions run in United Kingdom hours, and for most regions that falls somewhere workable in the clinical day.
Does it meet professional body requirements?
Dr Jacquet is a senior clinician registered with UKCP and HCPC, and his supervision meets the requirements of BACP, UKCP and other professional bodies for the practitioners receiving it. Organisations should confirm the specifics against their own regulatory or accreditation framework, and that is a sensible thing to check rather than assume.
Is this consultancy or supervision?
Clinical supervision. It attends to the work with patients and to the clinicians doing it. It is not service design, not management consultancy, and not quality assurance auditing, though a supervisor who sees a whole team's caseload will inevitably notice patterns worth raising with a clinical director.
Would you supervise a service that competes with your own practice?
This does not arise in the way it appears to. The practice offers something residential treatment does not, to people who will not enter residential treatment, and the two do not compete for the same patients. Supervision arrangements are held in confidence in either case.