“I see your punitive measure and I raise you a person-centered bar”: Supervisory Strategies to Promote Adoption of Person-Centered Care


Person-centered care remains a high priority within community mental health services. Clinical supervision is an embedded resource for professional development and promotion of high quality care. This study examined supervisory strategies during the implementation of person-centered care planning (PCCP) across two northeastern US States. A criterion sample of supervisor-provider teams participated in qualitative interviews (N = 34) and direct observation from 2016 to 2017. Modified grounded theory analyses were conducted and three supervisory strategies were identified. Supervisory attunement to providers (knowing their audience), active collaborative engagement with providers (practicing together), and infusing reminders and opportunities for feedback (chipping away) were critical strategies to engage providers in adopting PCCP. These strategies changed providers’ practice patterns by improving supervisors’ calibration to dynamic contextual and individual needs during implementation and communicating supervisors’ expectations of PCCP enactment. Workplace-based clinical supervision holds promise as a key intervention point to embed high quality care.

This is a preview of subscription content, access via your institution.


  1. Aarons, G. A., Ehrhart, M. G., & Farahnak, L. R. (2014). The implementation leadership scale (ILS): Development of a brief measure of unit level implementation leadership. Implementation Science, 9(1). https://doi.org/10.1186/1748-5908-9-45.

  2. Adams, N., & Grieder, D. (2004). Treatment planning for person-centered care: The road to mental health and addiction recovery. https://doi.org/10.1176/appi.ps.56.11.1464.

  3. Anthony, W. A. (1990). Recovery from mental illness: The guiding vision of the mental health service system in the. In Psychosocial Rehabilitation Journal, 16.

  4. Atterbury, K. (2014). Preserving the person: The ethical imperative of recovery-oriented practices. American Journal of Orthopsychiatry, 84(2), 182–189. https://doi.org/10.1037/h0099362.

    Article  Google Scholar 

  5. Bailin, A., Bearman, S. K., & Sale, R. (2018). Clinical supervision of mental health professionals serving youth: Format and microskills. Administration and Policy in Mental Health and Mental Health Services Research, 45(5), 800–812. https://doi.org/10.1007/s10488-018-0865-y.

    Article  PubMed  Google Scholar 

  6. Bearman, S. K., Weisz, J. R., Chorpita, B. F., Hoagwood, K., Ward, A., Ugueto, A. M., & Bernstein, A. (2013). More practice, less preach? The role of supervision processes and therapist characteristics in EBP implementation. Administration and Policy in Mental Health and Mental Health Services Research, 40(6), 518–529. https://doi.org/10.1007/s10488-013-0485-5.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bearman, S. K., Schneiderman, R. L., & Zoloth, E. (2017). Building an evidence base for effective supervision practices: An analogue experiment of supervision to increase EBT Fidelity. Administration and Policy in Mental Health and Mental Health Services Research, 44(2), 293–307. https://doi.org/10.1007/s10488-016-0723-8.

    Article  PubMed  Google Scholar 

  8. Beidas, R. S., Edmunds, J. M., Marcus, S. C., & Kendall, P. C. (2012). Training and consultation to promote implementation of an empirically supported treatment: A randomized trial. Psychiatric Services, 63(7), 660–665. https://doi.org/10.1176/appi.ps.201100401.

    Article  PubMed  Google Scholar 

  9. Birken, S. A., Lee, S.-Y. D., & Weiner, B. J. (2012). Uncovering middle managers’ role in healthcare innovation implementation. Implementation Science, 7(1), 28. https://doi.org/10.1186/1748-5908-7-28.

    Article  PubMed  Google Scholar 

  10. Boblin, S. L., Ireland, S., Kirkpatrick, H., & Robertson, K. (2013). Using stake’s qualitative case study approach to explore implementation of evidence-based practice. Qualitative Health Research, 23(9), 1267–1275. https://doi.org/10.1177/1049732313502128.

    Article  PubMed  Google Scholar 

  11. Bunger, A. C., Birken, S. A., Hoffman, J. A., MacDowell, H., Choy-Brown, M., & Magier, E. (2019). Elucidating the influence of supervisors’ roles on implementation climate. Implementation Science : IS, 14(1), 93. https://doi.org/10.1186/s13012-019-0939-6.

    Article  Google Scholar 

  12. Charmaz, K. (2006). Constructing grounded theory. Thousand Oaks: Sage Publications.

    Google Scholar 

  13. Choy-Brown, M., & Stanhope, V. (2018). The availability of supervision in routine mental health services. Clinical Social Work Journal, 46(4), 271–280.

  14. Choy-Brown, M., Stanhope, V., Tiderington, E., & Padgett, D. (2016). Unpacking clinical supervision in transitional and permanent supportive housing: Support or scrutiny? Administration & Policy in Mental Health & Mental Health Services Research, 43(4), 546–554. https://doi.org/10.1007/s10488-015-0665-6.

  15. Choy-Brown, M., Stanhope, V., Williams, N., & Bond, L. (2020). Delivering person-centered care in community mental health programs. Research on Social Work Practice. https://doi.org/10.1177/1049731520944568.

  16. Department of Health and Human Services. (2003). New freedom commission on mental health: Achieving the promise: Transforming mental health care in America. Final report. Rockville.

  17. Dorsey, S., Pullmann, M. D., Kerns, S. E. U., Jungbluth, N., Meza, R., Thompson, K., & Berliner, L. (2017). The juggling act of supervision in community mental health: Implications for supporting evidence-based treatment. Administration and Policy in Mental Health and Mental Health Services Research, 44(6), 838–852. https://doi.org/10.1007/s10488-017-0796-z.

    Article  PubMed  Google Scholar 

  18. Dorsey, S., Kerns, S. E. U., Lucid, L., Pullmann, M. D., Harrison, J. P., Berliner, L., et al. (2018). Objective coding of content and techniques in workplace-based supervision of an EBT in public mental health. Implementation Science, 13(1). https://doi.org/10.1186/s13012-017-0708-3.

  19. Fenwick, K. M., Brimhall, K. C., Hurlburt, M., & Aarons, G. (2019). Who wants feedback? Effects of transformational leadership and leader-member exchange on mental health practitioners’ attitudes toward feedback. Psychiatric Services, 70(1), 11–18. https://doi.org/10.1176/appi.ps.201800164.

    Article  PubMed  Google Scholar 

  20. Glaser, B., & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine Publishing Company.

    Google Scholar 

  21. Hamilton, A., Cohen, D., Crabtree, B., Damschroder, L., Leeman, J., Padgett, D., et al. (2018). Qualitative research in implementation science (QUALRIS): Strong methods for strong science. Implementation Science, 13(3).

  22. Institute of Medicine. (2006). Improving the quality of health care for mental and substance-use conditions. Washington D.C.

  23. IOM (Institute of Medicine). (2015). Psychosocial interventions for mental and substance use disorders: A framework for establishing evidence-based standards. Washington, DC: The National Academies Press.

  24. Lloyd, K. J., Boer, D., & Voelpel, S. C. (2017). From listening to leading: Toward an understanding of supervisor listening within the framework of leader-member exchange theory. International Journal of Business Communication, 54(4), 431–451. https://doi.org/10.1177/2329488415572778.

    Article  Google Scholar 

  25. Matthews, L., Stanhope, V., Choy-Brown, M., Doherty, M., & Jessell, L. (2018). Do providers know what they do not know? A correlational study of knowledge acquisition and person-centered care. Community Mental Health Journal, 54(5), 514–520. https://doi.org/10.1007/s10597-017-0216-6.

  26. May, C., & Finch, T. (2009). Implementing, embedding, and integrating practices: An outline of normalization process theory. Sociology, 43(3), 535–554. https://doi.org/10.1177/0038038509103208.

    Article  Google Scholar 

  27. May, C. R., Mair, F., Finch, T., MacFarlane, A., Dowrick, C., Treweek, S., et al. (2009). Development of a theory of implementation and integration: Normalization process theory. Implementation Science, 4(1). https://doi.org/10.1186/1748-5908-4-29.

  28. Miles, M., Huberman, A., & Saldana, J. (2014). Qualitative data analysis: A methods sourcebook. Thousand Oaks: Sage Publications.

    Google Scholar 

  29. Milne, D., & Reiser, R. P. (2012). A rationale for evidence-based clinical supervision. Journal of Contemporary Psychotherapy, 42(3), 139–149. https://doi.org/10.1007/s10879-011-9199-8.

    Article  Google Scholar 

  30. Morgan, D. L. (2007). Paradigms lost and pragmatism regained: Methodological implications of combining qualitative and quantitative methods. Journal of Mixed Methods Research, 1(1), 48–76. https://doi.org/10.1177/2345678906292462.

    Article  Google Scholar 

  31. O’Connell, M., Tondora, J., Croog, G., Evans, A., & Davidson, L. (2005). From rhetoric to routine: Assessing perceptions of recovery-oriented practices in a state mental health and addiction system. Psychiatric Rehabilitation Journal, 28(4), 378.

    Article  Google Scholar 

  32. Padgett, D. (2016). Qualitative methods in social work research (3rd ed.). Thousand Oaks: Sage Publications.

    Google Scholar 

  33. Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., et al. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65–76. https://doi.org/10.1007/s10488-010-0319-7.

    Article  Google Scholar 

  34. Pullmann, M. D., Lucid, L., Harrison, J. P., Martin, P., Deblinger, E., Benjamin, K. S., & Dorsey, S. (2018). Implementation climate and time predict intensity of supervision content related to evidence based treatment. Frontiers in Public Health, 6(OCT). https://doi.org/10.3389/fpubh.2018.00280.

  35. Schriesheim, C., Castro, S., & Cogliser, C. (1999). Leader-member exchange (LMX) research: A comprehensive review of theory, measurement, and data-analytic practices. The Leadership Quarterly, 10(1), 63–113.

    Article  Google Scholar 

  36. Schriger, S. H., Becker-Haimes, E. M., Skriner, L., & Beidas, R. S. (2020). Clinical supervision in community mental health: Characterizing supervision as usual and exploring predictors of supervision content and process. Community Mental Health Journal, 0123456789. https://doi.org/10.1007/s10597-020-00681-w.

  37. Stanhope, V., Ingoglia, C., Schmelter, B., & Marcus, S. C. (2013). Impact of person-centered planning and collaborative documentation on treatment adherence. Psychiatric Services (Washington, D.C.), 64(1), 76–79. https://doi.org/10.1176/appi.ps.201100489.

    Article  Google Scholar 

  38. Stanhope, V., Tondora, J., Davidson, L., Choy-Brown, M., & Marcus, S. C. (2015). Person-centered care planning and service engagement: A study protocol for a randomized controlled trial. Trials, 16(1). https://doi.org/10.1186/s13063-015-0715-0.

  39. Tondora, J., Miller, R., & Davidson, L. (2012). The top ten concerns about person-centered care planning in mental health systems. International Journal of Person Centered Medicine, 2(3), 410–420. https://doi.org/10.5750/IJPCM.V2I3.132.

    Article  Google Scholar 

  40. Tondora, J., Miller, R., Slade, M., & Davidson, L. (2014). Partnering for recovery in mental health : A practical guide to person-centered planning. Hoboken: Wiley.

    Google Scholar 

  41. Zhou, X., & Schriesheim, C. A. (2009). Supervisor-subordinate convergence in descriptions of leader-member exchange (LMX) quality: Review and testable propositions. Leadership Quarterly, 20(6), 920–932. https://doi.org/10.1016/j.leaqua.2009.09.007.

    Article  Google Scholar 

Download references


The National Institute of Mental Health funded this study (F31MH110120-01A1).

Author information



Corresponding author

Correspondence to Mimi Choy-Brown.

Ethics declarations

Conflict of interest

The author declares that they have no conflict of interest.

Ethical approval

The study protocol was approved by the author’s University Committee on Activities Involving Human Subjects (Reference #: FY2016-1316). This article does not contain any studies with animals performed by the author.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Choy-Brown, M. “I see your punitive measure and I raise you a person-centered bar”: Supervisory Strategies to Promote Adoption of Person-Centered Care. Community Ment Health J (2021). https://doi.org/10.1007/s10597-021-00783-z

Download citation


  • Clinical Supervision
  • Implementation Strategy
  • Evidence-Based Practice
  • Person-Centered Care