Does Psychotherapy Supervision Contribute to Patient Outcomes? Considering Thirty Years of Research

Abstract

After a century of psychotherapy supervision and over half a century of supervision research, what do we know empirically about the contribution of psychotherapy supervision to patient outcomes? In this article, I address that question by (1) assembling all identified supervision-patient outcome studies, from 1981 to 2006, referenced in four reviews (Ellis & Ladany, 1997; Freitas, 2002; Inman & Ladany, 2008; Wheeler & Richards, 2007) and (2) identifying additional post-review studies by means of computer searches, spanning January 2006 through May 2011. A total of 18 supervision outcome studies emerged, spanning the past generation of supervision scholarship. Unfortunately, after closely scrutinizing each investigation, eliminating misidentified studies (constituting over one-third of the 18 studies), and weighing the gravity of various methodological deficiencies across investigations, the collective data appeared to shed little new light on the matter: We do not seem to be any more able to say now (as opposed to 30 years ago) that psychotherapy supervision contributes to patient outcome. What did emerge of considerable promise, however, were three recent studies that were developed, organized, and prosecuted with the primary objective of evaluating the effects of supervision on patient outcome. Those investigations were highlighted because, in my view, they point the way for future studies to follow (in ways not done before) and are prototypal in their design and execution. Although the difficulty in researching the supervision-patient outcome matter has long been lamented in the supervision literature, those few studies (especially Bambling, King, Raue, Schweitzer, & Lambert, 2006) indeed show us for the first time that research on supervision-patient outcome can be done and be done well.