Supervision​​​​

What Does a Supervisor Need to Know?

The implementing agency must decide who is best suited to supervise the Peer Counselors. This may be the person who directs HIV prevention/treatment or transgender women’s programs, or it may be someone with clinical or counseling expertise. The Supervisor should be familiar with trans women’s needs, have experience working with trans women, and should also be trained in facilitation of Healthy Divas, so that they may provide relevant support to the Peer Counselors. 

It is extremely important that the Supervisor be familiar enough with Healthy Divas to know when core elements are not being implemented, or to know when they are not being implemented with fidelity to the original design. For instance, if the Project Supervisor does not know what Healthy Divas sessions consist of, how often they are being held, or how many clients are attending, the Supervisor will have a difficult time determining hwo best to support the Peer Counselors and ensure an effective program.

How Should Supervision be Structured?

The amount of supervision that Peer Counselors need will vary substantially according to their needs, skills, and previous experience. Many trans women have had few formal work opportunities and may not have experience doing the type of administrative work necessary to implement Healthy Divas successfully. Others may have had considerable experience in these areas. Therefore, Peer Counselor supervision must be adjusted accordingly. However, even staff experienced in HIV prevention will benefit from the support obtained through regular supervision.

Healthy Divas Peer Counselors should be trained and supervised in an ongoing way. The Peer Counselor job is multifaceted and its demands are great. Many Peer Counselors are relatively inexperienced with having this much responsibility, so close supervision and support is important. In particular, supervision should be especially active when Healthy Divas is just starting. During this period, the Project Supervisor can hold both individual meetings and weekly group meetings with the Peer Counselors to review together how Healthy Divas is going and to problem solve together. Since many of the Peer Counselor duties are interdependent, meeting as a group helps the Peer Counselors to identify gaps in activities. These group meetings allow the Supervisor to create a process whereby not only the Supervisor, but also the Peer Counselors review and provide feedback on each other’s job performance and goals. Over time, the Supervisor may not need to attend these meetings every week, but the Project Peer Counselors can continue to meet weekly to support each other, to review progress on various items, and to coordinate their activities.

Following the weekly team meetings, we have found it helpful for the Supervisor to hold individual meetings with each Peer Counselor, particularly at the start of Healthy Divas or when the Peer Counselors are new. The purpose of these meetings is to make certain that each Peer Counselor knows exactly what is expected, and to provide whatever individualized support is needed to accomplish the required tasks. As the Peer Counselors grow in experience through running Healthy Divas, their need for intensive supervision will decline substantially.

What are the Performance Expectations of Peer Counselors?

It is important to set clear, measurable objectives for the project, such as the number of Healthy Divas clients to recruit in a certain amount of time. These objectives should be very specific and achievable given the agency’s resources (such as staffing and funding) to implement Healthy Divas. The Peer Counselors and the Supervisor may decide upon these objectives jointly as they consider the capacity of the staff and the funding. Often the objectives may be specified by the nature of the funding (e.g., sometimes a project is funded to produce a certain number of “deliverables” or units of service).

Examining the progress towards achieving objectives is a key part of process evaluation and is generally the focus of supervision. Process evaluation involves examining the process of implementing the intervention, and may include keeping track of how many activities are conducted or how many trans women are being reached. Conducting process evaluation is an essential way for the Peer Counselors and the Supervisor to have a “yardstick” by which to assess the performance of the project.

One of the most important aspects of the Peer Counselors’ role is to reflect on the extent to which the Project is effectively reaching new groups of trans women and helping them reach their goals, and to frequently analyze their own role in the project (e.g., Am I affirming the clients? Am I supporting them to reach their goals? Am I helping to conduct outreach and in-reach to achieve our recruitment goals?). The Supervisor can help the Peer Counselors learn how to make this reflection and analysis process an automatic and ongoing part of their job.

How Can Supervisors Best Provide Support?

In addition to reaching the project goals, Peer Counselors will need guidance and support to navigate the emotional labor that is required of them to conduct the Healthy Divas sessions. Peer Counselors will likely share many of the challenges and struggles that clients describe, which can be triggering emotionally and can potentially lead to burnout among Peer Counselors if the emotions are not effectively processed. The Supervisor can help identify resources for Peer Counselors, provide emotional support, and can help the Peer Counselors learn to set and maintain practical and emotional boundaries with clients. This can be especially challenging in tight-knit communities of trans women, where Peer Counselors and clients may know each other outside of Healthy Divas. Therefore, it is very important that the Supervisor is skilled and experienced in helping staff distinguish their personal and professional roles.

The most effective way to accomplish this is by modeling the process for the Peer Counselors, that is, by being reflective and analytic about the project. This approach to supervision comes out of the literature on empowerment; when people analyze their own problems and then come up with solutions themselves, this facilitates an empowerment process. How supervision is conducted can facilitate or hinder the extent to which Peer Counselors are reflective. An overly directive style on the part of the Project Supervisor is unlikely to facilitate such reflection and self-analysis. We suggest the use of questioning as an effective supervision tool to facilitate the Peer Counselors’ self-reflection.