Clinical supervision in CBT training: what do participants view as effective?

Nicola Kelly,Alex Hassett

doi:10.1017/s1754470x21000222

Abstract

AbstractLiterature pertaining to cognitive behavioural therapy (CBT) supervision is limited, particularly about CBT supervision during training. This exploratory study outlines the thoughts of supervisors and supervisees in a training context about which elements make supervision effective. Four supervisees and four experienced CBT supervisors (all from a CBT training programme and independent of one another) were interviewed and asked to consider what makes CBT supervision during training effective. Their responses were evaluated using thematic analysis (TA) and key themes identified. The fit with existing literature was considered via the use of an adapted Delphi poll. Two main themes, containing seven subthemes, were identified from the thematic analysis: ‘supervision as structured learning’ and ‘supervisory relations and process’. The adapted Delphi poll was divided into six categories denoting important characteristics of CBT supervision: (1) the supervisory relationship, (2) ethical factors, (3) generic supervisory skills, (4) mirroring the CBT approach, (5) the supervisor’s knowledge and (6) addressing difficulties. There was a good fit between the TA themes and the Delphi categories. For those engaging in CBT supervision, establishing a structure that mirrors a CBT session, alongside a supportive supervisory alliance, may promote effective CBT supervision during training.Key learning aims(1)To consider what might make CBT supervision during training a better experience for participants, such as alliance factors and structured learning.(2)To discover how supervisors’ and trainees’ perspectives fit with existing research on CBT supervision.(3)To consider some potential supervisory implications related to aspects of CBT supervision that participants find useful.

Highlights

Given the prominence of cognitive behavioural therapy (CBT) in terms of evidence-based practice, including the Improving Access to Psychological Therapies (IAPT) initiative, several authors (Corrie and Lane, 2015; Kennerley and Clohessy, 2010; Milne et al, 2011b; Reiser and Milne, 2012) have noted a paucity of research about CBT supervision
(A) Supervision as structured learning This theme pertains to the format of supervision; how it works in a practical sense, attending to the individual learning needs and styles of supervisees, incorporating a range of methods to promote learning and mirroring CBT sessions in terms of structure
This study suggests that structure within CBT supervision, mirroring that of a CBT session (Liese and Beck, 1997; Padesky, 1996), alongside a safe, supportive supervisory alliance (Corrie and Lane, 2015), is considered by participants to lead to effective supervision

Summary

Introduction

Given the prominence of cognitive behavioural therapy (CBT) in terms of evidence-based practice, including the Improving Access to Psychological Therapies (IAPT) initiative, several authors (Corrie and Lane, 2015; Kennerley and Clohessy, 2010; Milne et al, 2011b; Reiser and Milne, 2012) have noted a paucity of research about CBT supervision. Despite this relative lack in comparison with CBT at large, there have been several relevant studies more recently. It differs from related activities, such as mentoring and coaching, by incorporating an evaluative component.’ (p. 439 and 440)

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Results

Discussion

Conclusion