No clashes intended

The AMBIT approach stresses the need for robust and clear SupervisoryStructures, but it does not prescribe a rigid and specific formal supervision process for AMBIT, in recognition of the many different kins of teams and settings in which it is being used. Importantly it does not seek to replace or alter existing supervision arrangements that may be dictated by professional bodies.

The intention is to present a mentalization based approach which can be adapted to a wide range of organisational arrangements or settings for teams working in both the voluntary sector or statutory services. So without undermining the place of formal supervision sessions (which may potentially, however, be usefully conducted along the lines we present) the approach strongly emphasises the informal but explicit role that should be played by all team members in supporting colleagues to maintain a mentalizing stance (see The Therapist's Mentalizing Stance) in their work (see SupervisoryStructures).

Mentalization in supervision

Mentalization-based supervision can be provided in a number of ways in formal settings - either by a named supervisor within the team, or by supervisors from outside the team, and in individual or group settings (see Team Meetings).

The exact service design is less significant than the question of whether or not the team as a whole recognises the central importance of this as part of the clinical care being provided, and shares an understanding of the outcome it is designed to achieve - which is primarily to sustain or restore accurate mentalizing in the KeyWorker and via that to promote safer and more effective interventions for the young people. Note that it is NOT to offer access to an expert who can inform the worker "what is really happening" for the young person or family they are working with.

OK, there is some prescription...!

• There is a page for Suggested structure for an (internal) AMBIT Supervision session
• There is a page for Team Meetings which are often the setting for group supervision.

Despite the AMBIT project's determination to avoid too prescriptive an approach to formal supervision, our experience over the last four years has suggested that it may be helpful for teams to consider a number of aspects of formal supervision within their service.

1. We recognise that supervisors will come from a range of professional backgrounds and may well have well established methods of supervision.
2. We believe that a mentalizing approach is consistent with most therapeutic modalities of work with young people.
3. Evidence from Implementation Science indicates that new methods of working will not become established unless it is used as part of staff supervision.

We suggest therefore that supervisors for an AMBIT informed team should:-

• have done some basic training in AMBIT
• be familiar with the AMBIT approach and understand its key features.
• explicitly explore the theme of mentalization as part case supervision.
• have some knowledge of the AMBIT manual and how to access it.
• encourage the use of the manual in problem solving around practice issues

Our experience is that, if these basic requirements are not in place, the development of a mentalizing approach within a team is unlikely to prosper and that staff will not be enabled to integrate new ideas of practice into their work.

It may be helpful to consider this as part of your team's Implementation Plan