Topics and techniques in clinical supervision in psychotherapy training

Abstract

Clinical supervision is regarded as one of the most important components of psychotherapy training. In clinical practice, it has been found that the implementation of clinical supervision varies substantially and often differs from the recommendations made in the literature. The objective of the current study was to investigate the frequency of topics (e.g. ethical issues) and techniques (e.g. role play) in the clinical supervision of psychotherapy trainees in Germany. To this end, we considered supervisions in cognitive behavioural therapy (CBT) and psychodynamic therapy (PT). A total of 791 psychotherapy trainees (533 CBT and 242 PT) were asked via the internet to provide information about their current supervision sessions. We found that clinical supervision in psychotherapy training addressed topics that are central for the effective treatment of supervised patients (i.e. therapeutic interventions, therapeutic alliance, maintaining factors, and therapeutic goals). However, the most frequently used intervention in clinical supervision in psychotherapy training was case discussion. Rarely were techniques used that allowed the supervisor to give the supervisee feedback based on the supervisee's demonstrated competencies. For example, 46% of the supervisors never used audiotapes or videotapes in the supervision. Differences between CBT and PT were rather small. Current practice regarding the techniques used in clinical supervision for psychotherapy trainees contradicts recommendations for active and feedback-oriented clinical supervision. Thus the potential of clinical supervision might not be fully used in clinical practice.

Clinical supervision in CBT training: what do participants view as effective?

“…Given the prominence of cognitive behavioural therapy (CBT) in terms of evidence-based practice, including the Improving Access to Psychological Therapies (IAPT) initiative, several authors (Corrie and Lane, 2015;Kennerley and Clohessy, 2010;Milne et al, 2011b;Reiser and Milne, 2012) have noted a paucity of research about CBT supervision. Despite this relative lack in comparison with CBT at large, there have been several relevant studies more recently (including Reiser and Milne, 2016;Törnquist et al, 2018;Weck et al, 2017), but few about supervision within training settings.…”

Videogestützte Supervision in der psychotherapeutischen Ausbildung

“…Historisch gesehen werden videogestützte Supervisionen in der psychotherapeutischen Ausbildung mit Beginn der technischen Voraussetzungen in den 1940er Jahren genutzt [8].EsistfürPsychotherapeutenjedochnichtungewöhnlich,Behandlungendurchzuführen,ohnejemalsdirekt bei der Arbeit beobachtet worden zu sein [9]. In einer Online-Fragebogen-Studiewurden533verhaltensthera-peutischeund242tiefenpsychologischeundpsychoana-lytischeAusbildungskandidateninDeutschlandzurHäufig-keitspezifischerInhalteundTechnikeninihrenklinischen Supervisionenbefragtundeszeigtesich,dass46%der TeilnehmerimLaufeihrerAusbildungnochkeinevideo-gestützteSupervisiondurchgeführthatten [2].…”

Recording client sessions during psychotherapy training: From “an absurd idea” to “potent learning”

“…This is significantly higher than that reported in an earlier British study (Townend, Iannetta, & Freeston, 2002), where approximately 48% of 170 CBT therapists reported using recordings in supervision. In Australia, 71% of 113 supervisors of psychology trainees reported reviewing recordings (Gonsalvez, Wahnon, & Deane, 2017), while 54% of supervisors in Germany did so (more commonly with CBT than psychodynamic trainees; Weck, Kaufmann, & Witthöft, 2017). In the United States (US), just 21% of APA supervisors reported using audio or video supervision, with a further 10% using live observation (DeRoma, Hickey, & Stanek, 2007).…”