Supervising Cognitive-Behavioral Psychotherapy: Pressing Needs, Impressing Possibilities

Abstract

While accounts of the practice of cognitive behavioral therapy (CBT) supervision have been available over the past 15 years and have demonstrated consistency in terms of an overall model specifying the structure, process and content of supervision sessions, a number of gaps can be identified in the literature on the clinical supervision of CBT. Comprehensive consensus statements of the competencies underlying clinical supervision have been developed both in the United States (Falender et al., J Clin Psychol, 60, 771–785, 2004) and in the United Kingdom (Roth and Pilling, IAPT supervision competencies framework, University College London, 1992), but there has been a lack of attention to relevant theory and to procedural detail. As a consequence, the literature on CBT supervision has only recently begun to assimilate concepts from the wider supervision field (e.g. developmental models), and there is as yet no manual that would allow supervisors to make explicit determinations of competency. Furthermore, supervision in general continues to suffer both from the absence of compelling empirical support demonstrating its effectiveness in improving clinical outcomes, and there is a lack of explicitly-defined supervisory procedures that can be reliably observed and measured. Unfortunately, this combination of factors hampers the development of CBT supervision (e.g. it complicates efforts to provide a standardized framework for training in supervision). As an important starting point in ‘treating’ the underdeveloped state of CBT supervision, we outline a formulation of its current condition, then suggest some promising interventions.