The Juggling Act of Supervision in Community Mental Health: Implications for Supporting Evidence-Based Treatment

Abstract

Supervisors are an underutilized resource for supporting evidence-based treatments (EBT) in community mental health. Little is known about how EBT-trained supervisors use supervision time. Primary aims were to describe supervision (e.g., modality, frequency), examine functions of individual supervision, and examine factors associated with time allocation to supervision functions. Results from 56 supervisors and 207 clinicians from 25 organizations indicate high prevalence of individual supervision, often alongside group and informal supervision. Individual supervision serves a wide range of functions, with substantial variation at the supervisor-level. Implementation climate was the strongest predictor of time allocation to clinical and EBT most relevant functions.

Implementing evidence‐based treatment protocols: Flexibility within fidelity.

“…Although it does not reduce the amount of resources required, Bearman et al (2013) describe strategies that may optimize supervision and increase the likelihood that activities discussed in supervision will actually be implemented in practice. Although more work is needed to understand the best strategies for supervision/consultation, Dorsey, Pullmann, et al (2017) have identified the importance of implementation climate as one predictor of the amount of time dedicated to clinical and EBT-related discussions in supervision.…”

Agreement and Discrepancy Between Supervisor and Clinician Alliance: Associations with Clinicians’ Perceptions of Psychological Climate and Emotional Exhaustion

“…The extent to which supervisory alliance is a relevant and important construct in supporting the implementation of evidence-based psychosocial interventions is largely unstudied. Research has focused more on clinical supervision, including techniques used by expert consultants (e.g., Bearman et al 2013, 2016) and content of supervision (Accurso et al 2011; Dorsey et al 2017). In public mental health, supervisors often have both clinical, administrative and managerial responsibilities, with about 20–30% of supervision focused on administrative and other non-clinical functions (Accurso et al 2011; Dorsey et al 2017).…”

“…Research has focused more on clinical supervision, including techniques used by expert consultants (e.g., Bearman et al 2013, 2016) and content of supervision (Accurso et al 2011; Dorsey et al 2017). In public mental health, supervisors often have both clinical, administrative and managerial responsibilities, with about 20–30% of supervision focused on administrative and other non-clinical functions (Accurso et al 2011; Dorsey et al 2017). While ongoing supervision appears to be necessary in the successful implementation of evidence-based treatments (EBTs; Beidas and Kendall 2010; Herschell et al 2010; Schoenwald et al 2013), the supervisory working relationship has received little attention.…”

Implementation Climate and Time Predict Intensity of Supervision Content Related to Evidence Based Treatment

“…Workplace-based supervision includes both clinical supervision as well as oversight for administrative issues, professional development, and emotional support, provided by internal staff employed within an organization ( 18 ). In a study by our research group examining workplace-based supervision within organizations participating in a state-funded EBT initiative, weekly occurrence of supervision was mostly upheld [75% reported weekly supervision for ~1 h ( 19 )].…”