Abstract
Abstract Clinical supervision is widely considered to be an essential component in the translation of evidence-based treatment protocols into routine clinical practice. Experts in the field have produced guidance on the structuring of CBT supervision, yet previous surveys on everyday practices have consistently found that supervisors and supervisees appear to drift from these recommendations. Surprisingly, little has been written on the origins and maintenance of supervisory drift and thus it remains a poorly understood phenomenon. To assist supervisors, supervisees and meta-supervisors in recognising and responding to signs of drift, this paper seeks to build on the understanding of therapist drift by conceptualising how supervisor and supervisee cognitions, emotions and behaviour could intentionally or unintentionally render the supervision process ineffective or at worst harmful. Drawing on therapist schema literature, hypothesised pre-disposing factors for drift are presented together with clinical examples and a range of steps for managing indicators of drift in practice. Further research is needed to gather empirical support for the mechanisms proposed. Key learning aims As a result of reading this paper, readers should: (1) Understand what supervisory drift is and the various forms it might take. (2) Recognise some of their own behaviours within supervision which might affect the quality and effectiveness of supervision. (3) Identify ways in which problematic elements of supervision could be addressed within supervision, or supervision of supervision (SoS), through the use of a bespoke formulation and action-based methods.
Highlights
Clinical supervision (CS) is an integral part of the working life of a cognitive behavioural therapist. It provides an opportunity for qualified supervisees and those in training to reflect upon their clinical skills and for supervisors to assist in skill development and refinement (Liness et al, 2019; Pugh and Margetts, 2020) and the monitoring of safe and ethical practice (Milne, 2017)
Using either a written questionnaire or a pre-supervision interview, the supervisor can ascertain important aspects of how to manage the supervisory relationship by asking the supervisee questions such as ‘what background information do you think it is important for me to know about you?’ or ‘how might we address differences of opinion?’
It aimed to draw together the minimal existing knowledge about the identification and management of supervisory drift within cognitive behavioural therapist (CBT). This involved a review of the extant literature on the functions of supervision, the state of play in supervision research and extracting potentially relevant concepts from neighbouring literature
Summary
Clinical supervision (CS) is an integral part of the working life of a cognitive behavioural therapist. It provides an opportunity for qualified supervisees and those in training to reflect upon their clinical skills and for supervisors to assist in skill development and refinement (Liness et al, 2019; Pugh and Margetts, 2020) and the monitoring of safe and ethical practice (Milne, 2017). CS has been defined as ‘the formal provision, by senior/qualified health practitioners, of an intensive, relationship-based education and training that is case-focused and which supports, directs and guides the work of colleague/s (supervisees)’ It is a mandatory requirement for achieving and maintaining cognitive behavioural therapist (CBT) practitioner accreditation with the British Association of Behavioral and Cognitive
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