Technology for evidence-based cognitive behavioural supervision: new applications and research to improve organizational support

There has recently been an increasing call for new research and development in cognitive behavioural supervision, particularly in the area of evidence-based clinical supervision. New developments in supervision technology offer the potential to answer this call by providing greater objective measurement and corrective feedback in supervision. In this article, two new technologies that hold particular promise in this area are described: software for routine outcome measurement and videoconference for internet-based live one-way-mirror supervision. Notable challenges involved in supervision technology are discussed, and an example of technology being integrated into a graduate clinical training programme is described.

Participant supervision: supervisor and supervisee experiences of cotherapy

Participant supervision is a unique application of live supervision in which a supervisor and supervisee see clients conjointly. Although minimally discussed in the family therapy literature, it has notable advantages, chief among them being a shared clinical experience that increases attunement to supervisee skill and development, the modeling of skillful intervention, and a higher degree of collegiality. However, it is not without its challenges, including supervisee vulnerability and anxiety, diffusion of responsibility, and limited time for case discussion. This article highlights the experience of one supervisor and three doctoral-level supervisees engaging in participant supervision over the course of a 2-year period. Using illustrative examples, we discuss our experience of the advantages and challenges of participant supervision, and provide recommendations for establishing a collaborative relational context within which supervisory benefits can be maximized.

Training Methods in Cognitive Behavioral Therapy: Tradition and Invention

Cognitive behavioral supervisors influence new generations of clients and clinicians. Accordingly, the task is meaningful, rewarding, challenging, and critically important. This article describes traditional and unconventional approaches to supervising clinicians in cognitive behavioral therapy (CBT). Traditional methods such as the use of the Cognitive Therapy Rating Scale, videotape/audiotape review, live supervision, and cotherapy are reviewed. Further, inventive procedures for teaching supervisees cognitive flexibility, empathy, tolerance for ambiguity, and remaining steadfast when faced with negative emotional arousal are explained. Popular media, improvisation and acting exercises, and working with professional actors as teaching methods are explained.

Does live supervision make a difference? A multilevel analysis

While the benefit of live supervision on clinical training is largely unquestioned, research that examines how live supervision affects the therapeutic process is lacking. Although marriage and family therapy has embraced this method of supervision, there is little empirical evidence suggesting it "works." This study uses hierarchical linear modeling to examine how therapy cases utilizing live supervision affect perceptions of progress on the problem. Findings indicated that live supervision does appear to make a difference for therapists' ratings of progress on the problem over the course of therapy; however, clients did not rate their progress as improving to the same degree. Implications for the use of live supervision as well as limitations of the study are discussed.