Setting the stage for an evidence-based model of psychotherapy supervisor development in clinical psychology.

Abstract

In Canada and in the United States, psychotherapy has been defined as a core professional competency within mental health professions, and more specifically in clinical and counselling psychology (Canadian Psychological Association, 2002; Falender et al., 2004). However, how supervisors develop competencies in psychotherapy remains an understudied area (Barker & Hunsley, 2013; Belleville & Viau-Quesnel, 2014; Watkins, 2012b). Given that (a) psychotherapy supervisors do not spontaneously acquire skills necessary for supervising effectively (Hoffman, 1994), (b) experience alone does not adequately prepare one to become a psychotherapy supervisor (Worthington, 2006), and (c) the development of specific competencies are necessary for the ethical and professional practice of psychotherapy (Watkins, 2012b), it is crucial that we increase our understanding of makes for the effective teaching of effective supervision (Hunsley & Barker, 2011, p. 144). This study aims to provide a critical assessment of the existing literature using a BES methodology to inform future research and the development of Canadian training and practice guidelines in this area.A Proposed Definition of Psychotherapy Supervisor DevelopmentOne of the major challenges in this area of research has been a lack of a clear conceptualisation of what psychotherapy supervisor development is and how it works. A definition is an important starting point for any assessment of the research literature by delineating the construct; that is, what constitutes psychotherapy supervisor development and what does not. Given that a systematic review tries to identify, appraise, select, and synthesize all high quality research evidence on a given research question, a sound definition provides a clear frame of reference to orient and anchor its execution. This is especially necessary in this case, because whereas there have been numerous reviews in the area of clinical/ psychotherapy (at least 32 by the mid-90s) and more since then (Ellis, Ladany, Krengel, & Schult, 1996; Milne & James, 2000; Milne, Sheikh, Pattison, & Wilkinson, 2011), only a few have focused on psychotherapy supervisor development per se (see Barker & Hunsley, 2013). This distinction is crucial, because it is the difference between reporting on what works for delivery of clinical/psychotherapy versus how a supervisor becomes effective at delivering what works.To help us formulate a valid and useful definition for the construct of supervisor development, we are guided by Milne (2007), who noted four criteria necessary for a useful definition: (a) precision (e.g., it has an essential meaning that makes it distinct); (b) specificity (e.g., it defines a concept clearly and completely); (c) operationalization (e.g., it is stated in a form that permits measurement); and (d) corroboration (e.g., it receives adequate support from research). A reasonable starting point for formulating a definition of psychotherapy supervisor development was recently proposed by Watkins (2012a):The process of growth involved in being and becoming a psychotherapy supervisor, its unfolding and evolution over time; the factors (e.g., openness, defensiveness) that facilitate or fracture that growth process; the developmental issues (e.g., independence vs. dependence) that potentially affect and permeate that process; and the tailoring of supervisory interventions to match of needs. (p. 46)This definition represents a synthesis of Watkins' review of 30 years of literature on the subject of psychotherapy supervisor development and incorporates concepts from all four extant developmental models that describe how supervisors develop their skills and professional identities (Hess, 1987; Roenhauser, 1994; Stoltenberg & McNeill, 2009; Watkins, 2012a).However, when Milne's (2007) criteria are applied to Watkins' (2012a) definition of psychotherapy supervisor development, several gaps and limitations become apparent:(a) The process of growth involved in being and becoming a psychotherapy supervisor is not defined precisely in behavioural terms, that is, what is meant by growth and development? …