As naturopaths it’s important to work within our scope of practice but how can you gain the experience needed to support clients with conditions that are new to you? Case supervision is the perfect way to learn new skills with the support of an experienced practitioner.
Any knotty clinical issue is appropriate for supervision. It may be slow progression, when you can’t work out why the client isn’t improving. Or perhaps a client comes to you with an unexpected life challenging diagnosis.
Especially when we have an existing relationship with a client, it might be the push we need to extend our knowledge.
As I’ve had extensive clinical experience with some types of cancer over the past 30 years, increasingly I’m approached to mentor practitioners through their first oncology cases.
What is professional supervision?
Supervision can encompass a wide scope of clinical skills. You may be encouraged to reflect on how you’ve dealt with your client’s care from a practical perspective and also any emotional response it may have triggered in you.
Professional supervision can include ethics, setting client expectations, exploring your personal blocks and of course, mentoring cases.
In supervision my aim is to support you in the areas you need to grow, to become an ace practitioner.
How working together on cases improves your business
Exploring a case with a mentor isn’t about outsourcing your client’s treatment to a more experienced practitioner. Supervision literally means to ‘over see’. For example, an academic supervisor offers a post-graduate student support, insight and guidance, they don’t write the thesis for them.
When you seek supervision to work together on a presentation that you’re unfamiliar with, it’s an opportunity for learning.
Professional supervision: clients with cancer
I frequently supervise practitioners who want to grow their oncology skills to work with people with cancer. I have worked with clients with different cancers for over 30 years, as well as personally journeyed through the lived experience.
Cancer clients are a very vulnerable patient group. For some, it’s literally life and death and they’re notoriously prey to false claims of cures. They may also be financially vulnerable. We might be tempted to throw everything in the oncology dispensary at them but always consider the potential impact of financial toxicity. Make every remedy or treatment suggestion sustainable for them.
Professional supervision means someone’s got your back, that the plan you devise is well considered and safe. Sometimes it’s also about supporting you emotionally, if triggered or upset by the work .
Some observations on working with people newly diagnosed with cancer
It’s literally a shock to be diagnosed with cancer or any potentially life changing/limiting condition.
Many newly diagnosed patients can appear very calm even clinical (while others may be very emotional). That doesn’t mean they’re “coping” with their diagnosis. Remember the duck gliding on top of the water? They might look serene but they’re paddling like hell underneath.
Often our oncology clients, or others around them, may have already researched everything to the nth degree and sometimes come demanding unproven but ‘internet recommended’ treatments!
Remember it’s illegal for us to ‘treat cancer’ and offer an alternative. Some clients approach a naturopath because they don’t want conventional treatment. This is one thing I always check out before accepting a recently diagnosed new patient.
What we can do is support our clients physically and emotionally through their conventional treatment. Providing lifestyle and remedies where sanctioned by their specialists.
After treatment is finished our real work begins – helping their body recover from the rigors of conventional treatment. This is where naturopathy really excels. But we need to set that expectation for the client well in advance and reinforce it.
It’s also useful to get a sense if the client has chosen to see you themselves, or doing so to appease a partner/family/friend. It’s ok to address the elephant in the room during the conversation, and ask the clients what they want to get out of the session. Ideally you can see them alone or at least for some of the consultation.
Clients in recurrence
Sometimes clients come to us when there’s been a bump in their cancer journey. Recurrences are complex. Often by this stage our clients know more about their condition than we do (if you’re not experienced in this area).
There are many ways we can support clients in recurrence but remember not everyone with cancer survives, despite the best conventional and complementary treatment. If you’ve not experienced the death of a client before, supervision can valuable to support you through this experience.
How to get the most out of case supervision
When working together through a case, please complete the mentoring case review questionnaire in advance and turn up prepared. While some of these tips are specifically around working with cancer clients, most still apply to any casework.
Remember to obtain your client’s permission to discuss their care with an experienced colleague. If you’ve not explicitly got permission from the client, be sure to de-identify any information you share verbally or in writing in mentoring.
Rather than sending through your entire file, review all your information and pull out the relevant past history, family history, concomitant conditions, symptoms, info about their condition, lifestyle etc. When you review and precis a case, you can gain new insight. Give yourself an hour or two for this task
After reviewing the case for your summary – have you found any gaps? Make a note of further information you want to get from your client. In your summary, include any after the fact observations or revelations.
Share your plan (based on what you already know) and reasoning behind it, e.g. reduce inflammation, through diet (specifics), specific herbs etc By sharing your work in progress it gives us a base-level, before we starting the supervision process.
If you haven’t created a plan for your client yet – send your theoretical plan, even if it’s a work in progress. Remember to include your reasoning.
Do your research. What do you know about the condition? Learn as much as you can. All cancers aren’t the same, even cancers of the same organ/system.
For example, I work with a lot of women with ovarian cancer. Every subtype and grade of ovarian cancer is different. Here’s the kicker – even within that sub-type, each woman’s tumour is different, caused by different mutations! If a condition is new to you, find out as much information as possible about the condition before our session, as well as what the client has been told about it.
As well as the type, subtype and potentially tumour genetic mutations – know the grade/stage and research how that can potentially impact your client.
Understand the conventional treatment they’ve had or are currently being offered. Chemo, for example ,is not one size fits all. The drugs, treatment schedules and potential side effects all make a huge difference.
Talking about treatment – remember we are not permitted to give our opinion, let alone direct a client, regarding conventional treatment. During some treatments we also cannot prescribe any internal treatments without their oncologist’s agreement. Even external treatments for radiation require consent from the radiation oncologist. You write a lot of letters and emails when you work with clients with cancer, and may not always get a response. But its still a good practice to get into.
Book your mentoring session
For a case review, you are welcome to book a follow up (55 minute) mentoring appointment. (rather than an initial/exploratory mentoring session) Please fill in this Mentoring case review questionnaire and email at least two working days before our meeting