Mitigating the power imbalance in supervisee/supervisor co-leadership teams

Association of cotherapy supervision with client outcomes, attrition, and trainee effectiveness in a psychotherapy training clinic

OBJECTIVE

Cotherapy supervision has been hypothesized to enhance client outcomes and trainee effectiveness, but there is little empirical evidence relevant to either claim. This study tested both hypotheses, using data from the supervision of psychology doctoral students conducting cognitive behavioral therapy in a university-based clinic.

METHOD

Groups of clients treated by supervisor-trainee duos and groups of clients treated by solo trainees with varying exposure to cotherapy supervision were compared on changes in symptoms as measured with the Outcome Questionnaire (OQ-45) and on dropout rates.

RESULTS

Clients showed statistically significant reductions in symptoms from pretreatment to posttreatment. However, there were no significant group differences in the magnitude of change or in client retention.

CONCLUSIONS

No support was obtained for the hypothesized benefits of cotherapy supervision. Clients treated by a cotherapy (supervisor and supervisee) team did not improve more than did clients treated by solo trainees. Furthermore, clients treated by (solo) trainees who had received cotherapy supervision did not improve more than did clients treated by trainees who had not received cotherapy supervision.

Supervisees' perspectives of power use in supervision

In this study, we examined the use of power in the supervisory relationship from supervisees' perspectives. Semistructured interviews of 11 supervisees in a Commission on Accreditation for Marriage and Family Therapy Education training program were conducted. From analysis of interview transcripts, themes about the ways in which supervisors and supervisees used power in the supervisory relationship emerged. Supervisors' power uses included discussions of power, empowering supervisees, promoting an atmosphere of safety, collaborating with supervisees, imposition of style/orientation, and misuses of power, such as violation of confidentiality. Themes for supervisees' power uses included supervisee-peer power, supervisees as consumers, and withholding information. Implications for researchers, supervisors, and supervisees are presented.