Hostname: page-component-745bb68f8f-mzp66 Total loading time: 0 Render date: 2025-01-13T23:37:59.712Z Has data issue: false hasContentIssue false
  • English
  • Français

Guiding CBT supervision: how well do manuals and guidelines fulfil their promise?

Published online by Cambridge University Press:  25 January 2016

Derek L. Milne
Derek L. Milne*
Affiliation:
School of Psychology, Newcastle University, Newcastle upon Tyne, UK
*
*Address for correspondence: Dr D. L. Milne, School of Psychology, Newcastle University, 4th Floor, Ridley Building, Newcastle upon Tyne NE1 7RU, UK (email: [email protected]).
Get access Rights & Permissions [Opens in a new window]

Abstract

Written guidance is part of a coherent support system for CBT supervisors, consistent with general developments in evidence-based practice. In theory, training manuals can help by specifying educational procedures and providing support materials so as to foster fidelity, expertise and effectiveness among supervisors. Supervision guidelines can help by offering supervisors the fruits of research and expert consensus. Together with related resources, such written guidance promises to empower professionals and to benefit patients. But progress with written guidance is very limited within clinical supervision, particularly in controlled research. In marked contrast, locally developed guidance appears to have been implemented successfully within pragmatic studies, a marked achievement when also contrasted with the general healthcare literature. Using eight criteria, the available supervision research is reviewed and conclusions drawn on developing written guidance so as to better fulfil its promise.

Keywords

CBT supervisionimplementationsupervision guidelinetraining manual
Type
Education and supervision
Information
the Cognitive Behaviour Therapist , Volume 9 , 2016 , e1
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

Beauchamp, S, Drapeau, M, Dionne, C (2015). The development of practice guidelines in the social and human sciences. Canadian Psychology 5, 357–367.CrossRefGoogle Scholar

References

Addis, ME, Krasnow, AD (2000). A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. Journal of Consulting & Clinical Psychology 68, 331–339.CrossRefGoogle ScholarPubMed
Addis, M, Waltz, J (2002). Implicit and untested assumptions about the role of psychotherapy treatment manuals in evidence-based mental health practice. Clinical Psychology Science and Practice 9, 421–424.Google Scholar
Bagnall, G, Sloan, G, Platz, S, Murphy, S (2011). Generic supervision competencies for psychological therapies. Mental Health Practice 14, 18–23.CrossRefGoogle Scholar
Baltimore, ML, Crutchfield, LB (2003). Clinical Supervisor Training: An Interactive CD ROM Training Programme for the Helping Professions. London: Allyn & Bacon.Google Scholar
Bambling, M, King, R, Raue, P, Schweitzer, R, 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, 317–331.Google Scholar
Barkham, M, Parry, G (2008) Balancing rigour and relevance in guideline development for depression: the case for comprehensive cohort studies. Psychology & Psychotherapy: Theory Research & Practice 81, 399–417.CrossRefGoogle ScholarPubMed
Beauchamp, S, Drapeau, M, Dionne, C (2015). The development of practice guidelines in the social and human sciences. Canadian Psychology 5, 357–367.CrossRefGoogle Scholar
Becker, EM, Smith, AM, Jensen-Doss, A (2013). Whos’ using treatment manuals? A national survey of practicing therapists. Behavior Research & Therapy 51, 706–710.Google Scholar
Beidas, RS, Kendall, PC (2010). Training therapists in evidence-based practice: a critical review of studies from a systems-contextual perspective. Clinical Psychology: Science & Practice 17, 1–30.Google ScholarPubMed
Bellg, AJ, Borelli, B, Resnick, B, Hecht, J, Minicucci, DS, Ory, M, Czajkowski, S (2004). Enhancing treatment fidelity in behaviour change studies: best practices and recommendations from the NIH Behavior Change Consortium. Health Psychology 23, 443–451.Google Scholar
Borders, LD, Bernard, JM, Dye, HA, Fong, ML, Nance, DW (1991). Curriculum guide for training counselling supervisors: rationale, development and implementation. Counselor Education & Supervision 31, 58–80.Google Scholar
Borelli, B, Sepinwall, D, Ernst, D, Bellg, AJ, Czajkowski, S, Breger, R, DeFrancesco, C, Levesque, C, Sharp, DL, Ogedegbe, G, Resnick, B, Orwig, D (2005). A new tool to assess treatment fidelity and evaluation of treatment fidelity across 10 years of health behaviour research. Journal of Consulting and Clinical Psychology 73, 852–860.Google Scholar
Bradshaw, T, Butterworth, A, Mairs, H (2007). Does structured clinical supervision during psychosocial intervention education enhance outcome for mental health nurses and the service users they work with? Journal of Psychiatric & Mental Health Nursing 14, 4–12.Google Scholar
Buus, N, Cassedy, P, Gonge, H (2013). Developing a manual for strengthening mental health nurses clinical supervision. Issues in Mental Health Services 34, 344–349.CrossRefGoogle ScholarPubMed
Carroll, KM, Nuro, KF (2002). One size cannot fit all: a stage model for psychotherapy manual development. Clinical Psychology: Science & Practice 9, 396–406.Google Scholar
Chambless, DL, Ollendick, TH (2001). Empirically supports psychological interventions: controversies and evidence. Annual Review of Psychology 52, 685–716.CrossRefGoogle ScholarPubMed
Chorpita, BF, Daleiden, EL, Weisz, JR (2005). Identifying and selecting the common elements of evidence-based interventions: a distillation and matching model. Mental Health Services Research 7, 5–20.Google Scholar
Clark, DM (2001). Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience. International Review of Psychiatry 23, 375–384.Google Scholar
Clinical Supervision Resource Kit (2005). Adelaide: Flinders University.Google Scholar
Culloty, T, Milne, DL, Sheikh, AI (2010). Evaluating the training of clinical supervisors: a pilot study using the fidelity framework. The Cognitive Behaviour Therapist 3, 132–144.Google Scholar
Dobson, KS, Shaw, BF (1988). The use of treatment manuals in cognitive therapy: experience and issues. Journal of Consulting and Clinical Psychology 56, 673–680.Google Scholar
Ducharme, JM, Williams, L, Cummings, A, Murray, P, Spencer, T (2001). General case quasi-pyramidal staff training to promote generalization of teaching skills in supervisory and direct-care staff. Behavior Modification 25, 233–254.Google Scholar
Falender, CA, Shafranske, EP, Ofek, A (2014). Competent clinical supervision: emerging effective practices. Counselling Psychology Quarterly 27, 393–408.CrossRefGoogle Scholar
Fall, M, Sutton, JM (2004). Clinical Supervision: A Handbook for Practitioners. Boston, MA: Allyn & Bacon.Google Scholar
Gordon, PK (2012). Ten steps to cognitive behavioural supervision. The Cognitive Behaviour Therapist 5, 71–82.CrossRefGoogle Scholar
Grimshaw, JM, Russell, IT (1993). Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet 342, 1317–1322.Google Scholar
Grol, R, Grimshaw, J (2003). From best evidence to best practice: effective implementation of change in patients’ care. Lancet 362, 1225–1230.Google Scholar
Gupta, S, Warner, J (2014). NICE mess. Journal of the Royal Society of Medicine 100, 442–443.CrossRefGoogle Scholar
Gyani, A, Shafran, R, Layard, R, Clark, DM (2013). Enhancing recovery rates: lessons from year one of IAPT. Behavior Research and Therapy 51, 597–606.Google Scholar
Hancox, K, Lynch, L, Happell, B, Biondo, S (2004). An evaluation of an educational programme for clinical supervision. International Journal of Mental Health Nursing 13, 198–203.CrossRefGoogle ScholarPubMed
Hayes, SC (2002). Getting to dissemination. Clinical Psychology: Science and Practice 9, 424–429.Google Scholar
Heaven, C, Clegg, J, Maguire, P (2006). Transfer of communication skills training from workshop to workplace: the impact of clinical supervision. Patient Education & Counselling 60, 313–325.CrossRefGoogle ScholarPubMed
Henggeler, SW, Schoenwald, SK (1998). The MST Supervisory manual: Promoting Quality Assurance at the Clinical Level. Charleston, SC: Multisystemic Therapy Institute.Google Scholar
IAPT Education and Training Group (2011). Guidance for commissioning IAPT supervisor training (http://www.iapt.nhs.uk/silo/files/guidance-for-commissioning-iapt-supervisor-training-revised-2011.pdf).Google Scholar
Kendall, PC, Chu, B, Gifford, A, Hayes, C, Nauta, M (1998). Breathing life into a manual: flexibility and creativity with manual-based treatments. Cognitive & Behavioral Practice 5, 177–198.CrossRefGoogle Scholar
King, NJ, Ollendick, TH (2008). The elegant psychosocial intervention: a heuristic conceptual framework for clinicians and researchers. Behavioural & Cognitive Psychotherapy 36, 253–261.Google Scholar
Kosmerly, S, Waller, G, Robinson, AL (2015). Clinician adherence to guidelines in the delivery of family-based therapy for eating disorders. International Journal of Eating Disorders 48, 223–229.Google Scholar
Kretz, DR, Krawczyk, DC (2015). Expert analogy use in a naturalistic setting. Frontiers in Psychology 5, 1–8.Google Scholar
Kyle, C, Sloan, G, Davies, J (2012). Improving access to psychological therapies: the HEAT is on. British Journal of Mental Health Nursing 1, 193–197.CrossRefGoogle Scholar
Layard, R (2005). Therapy for all on the NHS. London: Sainsbury Centre Lecture (6 September 2005).Google Scholar
Leng, G, Baillie, N, Raj, T (2008). NICE guidance and mental health settings: supporting change. Psychology & Psychotherapy: Theory, Research & Practice 81, 351–364.Google Scholar
Lewis, K (2005). The supervision of cognitive and behavioural psychotherapists. BABCP Magazine (Supervision Supplement) 33, Accrington: BABCP.Google Scholar
Liese, BS, Beck, JS (1997). Cognitive therapy supervision. In: Handbook of Psychotherapy Supervision (ed. Watkins, C. E.), pp. 114–133. New York: Wiley.Google Scholar
Lynch, L, Happell, B (2008). Implementation of clinical supervision in action: Part 2: Implementation and beyond. International Journal of Mental Health Nursing 17, 65–72.Google Scholar
Lucock, MP, Hall, P, Noble, R (2006). A survey of influences on the practice of psychotherapists and clinical psychologists in training in the UK. Clinical Psychotherapy and Psychotherapy 13, 123–130.Google Scholar
Michie, S, Fixsen, D, Grimshaw, JM, Eccles, MP (2009). Specifying and reporting complex behaviour change interventions: the need for a scientific method. Implementation Science 4, 40.CrossRefGoogle ScholarPubMed
Miller, RM, Yahne, CE, Moyers, TB, Martinez, J, Pirritano, M (2004). A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting & Clinical Psychology 72, 1050–1062.Google Scholar
Milne, DL (2009). Evidence-Based Clinical Supervision. Chichester: Wiley.Google Scholar
Milne, DL (2010). Can we enhance the training of clinical supervisors? A national pilot study of an evidence-based approach. Clinical Psychology & Psychotherapy 17, 321–328.Google Scholar
Milne, DL, Dunkerley, C (2010). Towards evidence-based clinical supervision: the development and evaluation of four CBT guidelines. The Cognitive Behaviour Therapist 3, 43–57.CrossRefGoogle Scholar
Milne, DL, Reiser, R (2012). A rationale for evidence-based clinical supervision. Journal of Contemporary Psychotherapy 42, 139–149.CrossRefGoogle Scholar
Milne, DL, Reiser, R (in press). Supporting our supervisors: sending out an SOS. The Cognitive Behaviour Therapist. doi:10.1017/S1754470X15000616.Google Scholar
Milne, DL, Reiser, RP, Cliffe, T, Raine, R (2011 a). SAGE: preliminary evaluation of an instrument for observing competence in CBT supervision. The Cognitive Behaviour Therapist 4, 123–138.Google Scholar
Milne, DL, Sheikh, AL, Pattison, S, Wilkinson, A (2011 b). Evidence based training for clinical supervisors: a systematic review. The Clinical Supervisor 30, 53–71.Google Scholar
Neufeldt, SA (1994). Use of a manual to train supervisors. Counselor Education and Supervision 33, 327–336.Google Scholar
Newman-Taylor, K, Gordon, K, Grist, S, Olding, C (2012). Developing supervisory competence. Preliminary data on the impact of CBT supervision training. The Cognitive Behavioural Therapist 5, 71–82.Google Scholar
NICE (2003). Guideline Development Methods. London: National Institute for Clinical Excellence.Google Scholar
NICE (2012). The Guidelines Manual. London: National Institute for Health and Clinical Excellence.Google Scholar
NICE (2013). Draft guideline: Psychosis & Schizophrenia in Adults: Treatment & Management. London: National Institute for Health and Clinical Excellence.Google Scholar
Phillips, AC, Lewis, LK, McEvoy, MP, Galipeau, J, Glaszion, P, Hammick, M, Moher, D, Tilson, JK, Williams, MT (2014). A Delphi survey to determine how educational interventions for evidence-based practice should be reported: Stage 2 of the development of a reporting guideline. BMC Medical Education 14, 159.CrossRefGoogle ScholarPubMed
Pretorius, WM (2006). Cognitive-behavioural supervision: recommended practice. Behavioural and Cognitive Psychotherapy 34, 413–420.Google Scholar
Reid, DH, Rotholz, DA, Parsons, MB, Morris, L, Braswell, BS, Green, CW, Schell, RM (2003). Training human service supervisors in aspects of PBS: evaluation of a state-wide, performance-based programme. Journal of Positive Behaviour Interventions 5, 35–46.Google Scholar
Reiser, RP (2014). Supervising cognitive and behavioural therapies. In: The Wiley International Handbook of Clinical Supervision (ed. Watkins, C. A. & Milne, D. L.), pp. 493–517. Chichester: Wiley.Google Scholar
Reiser, RP, Milne, DL (2014). A systematic review and reformulation of outcome evaluation in clinical supervision: applying the fidelity framework. Training and Development in Professional Psychology 8, 149–157.Google Scholar
Richards, D, Borglin, G (2011). Implementation of psychological therapies for anxiety and depression in routine practice: a two-year prospective cohort study. Journal of Affective Disorders 133, 51–60.CrossRefGoogle Scholar
Richards, D, Chellingsworth, M, Hope, R, Turpin, G, Whyte, M (2010). Reach Out: National programme supervisor materials to support the delivery of training for psychological wellbeing practitioners delivering low intensity interventions. London: Rethink.Google Scholar
Richards, DA (2014). Clinical case management supervision: using clinical outcome monitoring and therapy progress feedback to drive supervision. In: The Wiley International Handbook of Clinical Supervision (ed. Watkins, C. E. & Milne, D. L.), pp. 518–529. Chichester: Wiley-Blackwell.CrossRefGoogle Scholar
Roth, AD, Pilling, S (2008). A competence framework for the supervision of psychological therapies (http://www.ucl.ac.uk/clinical-psychology/CORE/Supervision_Competences/competences_map.pdf).Google Scholar
Roth, AD, Pilling, S, Turner, J (2010). Therapist training and supervision in clinical trials: implications for clinical practice. Behavioural & Cognitive Psychotherapy 38, 291–302.Google Scholar
Schoenwald, SK, Sheidow, AJ, Chapman, JE (2009). Clinical supervision in treatment transport: effects on adherence and outcomes. Journal of Consulting & Clinical Psychology 77, 410–421.Google Scholar
Sholomskas, DE, Syracuse-Siewert, G, Rounsaville, BJ, Ball, SA, Nuro, KF, Carroll, KM (2005). We don't train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioural therapy. Journal of Consulting & Clinical Psychology 73, 106–115 Google Scholar
Spence, SH, Wilson, J, Kavanagh, D, Strong, J, Worrall, L (2001). Clinical supervision in four mental health professions: a review of the evidence. Behaviour Change 18, 135–155.CrossRefGoogle Scholar
Stokes, TF, Baer, DM (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis 10, 349–367.Google Scholar
Thouless, RH (1930). Straight and Crooked Thinking. London: Pan Books.Google Scholar
Turpin, G, Wheeler, S (2011). IAPT Supervision Guidance. London: IAPT (Department of Health).Google Scholar
Uys, LR, Minaar, A, Simpson, B, Reid, S (2005). The effect of two models of supervision on selected outcomes. Journal of Nursing Scholarship 37, 282–288.CrossRefGoogle ScholarPubMed
Wilson, GT (1996). Manual-based treatments: the clinical application of research findings. Behavior Research & Therapy 34, 295–314.Google Scholar
Watkins, CE (1997). Some concluding thoughts about psychotherapy supervision. In: The Handbook of Psychotherapy Supervision (ed. Watkins, C. E.), pp. 603–616. New York: Wiley.Google Scholar
Watkins, CE (2012). Psychotherapy supervision in the new millennium: competency-based, evidence-based, particularized, and energized. Journal of Contemporary Psychotherapy 42, 193–203.CrossRefGoogle Scholar
Watkins, CE (2014). Clinical supervision in the 21st century: revisiting pressing needs and impressing possibilities. American Journal of Psychotherapy 68, 251–272.Google Scholar
Watkins, CE, Milne, DL (2014). Clinical supervision at the international crossroads: current status and future directions. In: The Wiley International Handbook of Clinical Supervision (ed. Watkins, C. E & Milne, D. L.), pp. 673–696. Chichester: Wiley-Blackwell.Google Scholar
Watkins, CE, Wang, DC (2014). On the education of clinical supervisors. In: The Wiley International Handbook of Clinical Supervision (ed. Watkins, C. E & Milne, D. L.), pp. 177–203. Chichester: Wiley-Blackwell.Google Scholar
White, E, Winstanley, J (2009). Implementation of clinical supervision: educational preparation and subsequent diary accounts of the practicalities involved, from an Australian mental health nursing innovation. Journal of Psychiatric & Mental Health Nursing 16, 895–903.Google Scholar
Submit a response

Comments

No Comments have been published for this article.