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An N = 1 Evaluation of Enhanced CBT Supervision

Published online by Cambridge University Press:  28 May 2012

Derek L. Milne*
Affiliation:
Newcastle University, UK
Robert P. Reiser
Affiliation:
Palo Alto University, USA
Tom Cliffe
Affiliation:
Newcastle University, UK
*
Reprint requests to Derek Milne, Doctorate in Clinical Psychology, 4th Floor, Ridley Building, Newcastle University, Newcastle NE1 7RU, UK. E-mail: [email protected]

Abstract

Background: Clinical supervision plays an essential role in the development of mental health professionals and is increasingly viewed as a discrete professional specialization. However, research has rarely addressed core issues such as the measurement and manipulation of clinical supervision, so there are very few direct comparisons between the different supervision methods. Aims: To operationalize two related approaches, cognitive-behavioural (CBT) and evidence-based clinical supervision (EBCS), demonstrate their fidelity, and then evaluate their relative effectiveness in facilitating the experiential learning of one supervisee. Method: Within a multiple-baseline, N = 1 design, we rated audiotapes of supervision on a competence rating scale. Results: Findings generally favoured the EBCS approach, which was associated with higher fidelity by the supervisor and increased engagement in experiential learning by the supervisee. Conclusions: This preliminary but novel evaluation indicated that CBT supervision could be enhanced. Implications follow for supervisor training and a more rigorous N = 1 evaluation.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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References

Bambling, M., King, R., Raue, P., Schweitzer, R. and Lambert, W. (2006) Clinical supervision: its influence on client-rated working alliance and client symptom reduction in the brief treatment of major depression. Psychotherapy Research, 16, 317331.CrossRefGoogle Scholar
Beidas, R. S. and Kendall, P. C. (2010). Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17, 130.Google ScholarPubMed
Bellg, A. J., Borrelli, B., Resnick, B., Hecht, J., Minicucci, D. S., Ory, M., et al. (2004). Enhancing treatment fidelity in health behavior change studies: best practices and recommendations from the NIH behavior change consortium. Health Psychology, 23, 443451.CrossRefGoogle ScholarPubMed
Blackburn, I-M., James, I. A., Milne, D. L., Baker, C., Standart, S. H., Garland, A., et al. (2001). The revised Cognitive Therapy Scale (CTS-R): psychometric properties. Behavioural and Cognitive Psychotherapy, 29, 431446.CrossRefGoogle Scholar
Borckardt, J. J., Nash, M. R., Murphy, M. D., Moore, M., Shaw, D. and O'Neil, P. (2008). Clinical practice as natural laboratory for psychotherapy research. American Psychologist, 63, 7795.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences. New York: Lawrence Erlbaum.Google Scholar
Culloty, T., Milne, D. L. and Sheikh, A. I. (2010). Evaluating the training of clinical supervisors: a pilot study using the fidelity framework. The Cognitive Behaviour Therapist, 3, 132144.CrossRefGoogle Scholar
Falender, C., Cornish, J. A. E., Goodyear, R., Hatcher, R., Kaslow, N. J., Leventhal, G., et al. (2004). Defining competencies in psychology supervision: a consensus statement. Journal of Clinical Psychology, 60, 771785.CrossRefGoogle ScholarPubMed
Harris, A. D., McGregor, J. C., Perencevich, E. N., Furuno, J. P., Zhu, J., Peterson, D. E., et al. (2006). The use and interpretation of quasi-experimental studies in medical informatics. Journal of the American Medical Information Association, 13, 1623.CrossRefGoogle ScholarPubMed
Hersen, M. and Barlow, D. H. (1976) Single-case Experimental Designs: strategies for studying behavioral change. New York: Pergamon.Google Scholar
Holloway, E. L. (1995). Clinical Supervision: a systems approach. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Improving Access to Psychological Therapies (IAPT) (2011). Guidance for Commissioning IAPT Supervisor Training. London: Department of Health.Google Scholar
James, I. A., Blackburn, I. M., Milne, D. L. and Freeston, M. (2005). Supervision training and rating scale for cognitive therapy (STARS - CT). (unpublished manuscript). Newcastle Cognitive Therapy Centre, England.Google Scholar
Kazdin, A. E. (1998). Research Design in Clinical Psychology. Boston: Allyn Bacon.Google Scholar
Landis, J. R. and Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159174.CrossRefGoogle ScholarPubMed
Lewis, K. (2005). The Supervision of Cognitive and Behavioural Psychotherapists. BABCP Magazine, Supervision Supplement, 33, Accrington: BABCP.Google Scholar
Liese, B. S. and Beck, J. S. (1997). Cognitive therapy supervision. In Watkins, C. E. (Ed.), Handbook of Psychotherapy Supervision (pp.114133). Chichester: Wiley.Google Scholar
Lipsey, M. W. (1990). Design Sensitivity. London: Sage.Google Scholar
McKnight, S. D., McKean, J. W. and Huitema, B. E. (2000). A double bootstrap method to analyze linear models with autoregressive error terms. Psychological Methods, 5, 87101.CrossRefGoogle ScholarPubMed
Milne, D. L. (2008). CBT supervision: from reflexivity to specialization. Behavioural and Cognitive Psychotherapy, 36, 779786.CrossRefGoogle Scholar
Milne, D. L. (2009). Evidence-Based Clinical Supervision: principles and practice. Chichester: BPS/Blackwell.Google Scholar
Milne, D. L. (2010). Can we enhance the training of clinical supervisors? A national pilot study of an evidence-based approach. Clinical Psychology and Psychotherapy, 17, 321328.CrossRefGoogle ScholarPubMed
Milne, D. L. and James, I. A. (2000). A systematic review of effective cognitive-behavioural supervision. British Journal of Clinical Psychology, 39, 111127.CrossRefGoogle ScholarPubMed
Milne, D. L. and James, I. A. (2002). The observed impact of training on competence in clinical supervision. British Journal of Clinical Psychology, 41, 5572.CrossRefGoogle ScholarPubMed
Milne, D. L., James, I. A., Keegan, D. and Dudley, M. (2002). Teachers PETS: a new observational measure of experiential training interactions. Clinical Psychology and Psychotherapy, 9, 187199.CrossRefGoogle Scholar
Milne, D. L., Reiser, R., Aylott, H., Dunkerley, C., Fitzpatrick, H. and Wharton, S. (2010). The systematic review as an empirical approach to improving CBT supervision. International Journal of Cognitive Therapy, 3, 278294.CrossRefGoogle Scholar
Milne, D. L. and Reiser, R. P. (2011). Observing competence in CBT supervision: a systematic review of the available instruments. The Cognitive Behaviour Therapist, 4, 123138.CrossRefGoogle Scholar
Milne, D. L., Reiser, R. P., Cliffe, T., Breese, L., Boon, A., Raine, R., et al. (2011). A qualitative comparison of cognitive-behavioural and evidence-based clinical supervision. The Cognitive Behaviour Therapist, 4, 152166.CrossRefGoogle Scholar
Milne, D. L., Reiser, R. P., Cliffe, T., and Raine, R. (2011). SAGE: preliminary evaluation of an instrument for observing competence in CBT supervision. The Cognitive Behaviour Therapist, 4, 123138.CrossRefGoogle Scholar
Milne, D. L. and Westerman, C. (2001). Evidence-based clinical supervision: rationale and illustration. Clinical Psychology and Psychotherapy, 8, 444457.CrossRefGoogle Scholar
Newman, C. F. (2010). Competency in conducting cognitive–behavioral therapy: foundational, functional, and supervisory aspects. Psychotherapy: Theory, Research, Practice, Training, 47, 1219.CrossRefGoogle ScholarPubMed
Oliver, J. R. and Fleming, R. K. (1997). Applying within-subject methodology to the transfer of training research. International Journal of Training and Development, 1, 173180.CrossRefGoogle Scholar
Onghena, P. and Edgington, E. S. (2005). Customization of pain treatments: single case design and analysis. Clinical Journal of Pain, 21, 5668.CrossRefGoogle ScholarPubMed
Padesky, C. A. (1996). Developing cognitive therapist competency: teaching and supervision models. In Salkovskis, P. M. (Ed.), Frontiers of Cognitive Therapy. London: Guilford Press.Google Scholar
Parker, R. I., Hagan-Burke, S. and Vannest, K. (2007). Percentage of all non-overlapping data (PAND): an alternative to PND. Journal of Special Education, 40, 194204.CrossRefGoogle Scholar
Parker, R. I., Vannest, K. J. and Davis, J. L. (2011). Effect size in single-case research: a review of nine non-overlap techniques. Behavior Modification, 35, 303322 CrossRefGoogle Scholar
Pezzullo, J. C. (2008). Two-way contingency table analysis: online resource for calculating Phi coefficient. Accessed on 13 May 2008 from http://statpages.org/ctab2×2.html.Google Scholar
Pretorius, W. M. (2006). Cognitive-behavioural therapy supervision: recommended practice. Behavioural and Cognitive Psychotherapy, 34, 413420.CrossRefGoogle Scholar
Reese, R. J., Usher, E. L., Bowman, D. C., Norsworthy, L. A., Halstead, J. L., Rowlands, S. R., et al. (2009). Using client feedback in psychotherapy training: an analysis of its influence on supervision and counselor self-efficacy. Training and Education in Professional Psychology, 3, 157168.CrossRefGoogle Scholar
Roth, A. and Pilling, S. (2008). A Competence Framework for the Supervision of Psychological Therapies. Retrieved from http://www.ucl.ac.uk/clinical-psychology/CORE/supervision_framework.htm Google Scholar
Townend, M., Iannetta, L. and Freeston, M. H. (2002). Clinical supervision in practice: a survey of UK cognitive-behavioural psychotherapists accredited by the BABCP. Behavioural and Cognitive Psychotherapy, 30, 485500.CrossRefGoogle Scholar
Townend, M., Iannetta, L., Freeston, M. and Harvey, J. (2007). Supervision practices of UK cognitive-behavioural psychotherapists, 2001 and 2006. Paper presented at the 5th World Congress of Behavioural and Cognitive Therapies, Barcelona, 11–14 July.Google Scholar
Uys, L. R., Minnaar, A., Simpson, B. and Reid, S. (2005). The effect of two models of supervision on selected outcomes. Journal of Nursing Scholarship, 37, 282288.CrossRefGoogle ScholarPubMed
Watkins, C. E. (1997). Handbook of Psychotherapy Supervision. Chichester: Wiley.Google Scholar
Watkins, C. E. (1998). Psychotherapy supervision in the 21st century. Journal of Psychotherapy Practice and Research, 7, 93101.Google Scholar
Wheeler, S. and Richards, K. (2007). The impact of clinical supervision on counselors and therapists, their practice and their clients: a systematic review of the literature. Counseling and Psychotherapy Research, 7, 5465.CrossRefGoogle Scholar
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