Training Cognitive Behavioral Therapy Supervisors: Didactics, Simulated Practice, and "Meta-Supervision"

Article excerpt

The delivery of competent clinical supervision is vital to the successful training of new cognitive behavioral therapists, and-in the case of peer supervision and consultation-a boon to the maintenance of therapists' high professional standards throughout their careers. However, it is only recently that the field of psychotherapy in general and cognitive behavioral therapy (CBT) in particular has implemented formal methods of training clinicians to be competent supervisors. Drawing on recent findings from evidence-based programs of CBT supervision, this article highlights the contents and processes of a graduate training course in CBT supervision involving didactics, readings, and experiential exercises. The 6 major modules of this seminar are explicated, including such topics as the supervisory relationship, enhancing CBT competencies in supervisors and supervisees alike, promulgating ethical practices, and successfully managing the administrative aspects of supervision. In addition, the concept of "meta-supervision" is described and illustrated in the form of a transcript from a long-distance, computer-assisted meeting between a senior consulting supervisor and his junior "supervisor-evaluee." The transcript highlights the key features of meta-supervision, including the cross-cultural considerations that must be addressed when doing international training.

Keywords: supervision; training; meta-supervision; competencies; cross-cultural; role-playing

After being largely neglected for most of the history of psychotherapy, the training of clinical supervisors has become a topic that has come to the forefront (Watkins, 2011). Professional accrediting bodies are now requiring that supervisors have systematic instruction in overseeing the work of therapists-in-training (e.g., American Psychological Association and Commission on Accreditation, 2009; British Psychological Society, 2003). Ongoing programs of research are aiming to delineate and validate the key elements of supervision that are most effective in guiding practitioners to deliver evidence-based therapies (e.g., Bennett-Levy, McManus, Westling, & Fennell, 2009; Milne, Aylott, Fitzpatrick, & Ellis, 2008; Milne et al., 2010; Milne, Sheikh, Pattison, & Wilkinson, 2011) and to identify the core competencies in which supervisors themselves need to be schooled (e.g., Falender & Shafranske, 2004; Kaslow & Bell, 2008).

Ideally, the training process for supervisors needs to be ongoing, and should begin early in their career, such that students at the graduate level have exposure to courses in the fundamentals of supervision well before they are ever in charge of their first supervisees. This sort of early career training serves multiple functions, including (a) providing trainees with ongoing instruction that facilitates practice and retention; (b) making them more aware of what to expect and how to benefit from the clinical supervision that they themselves are receiving; (c) preparing them for the significant, abrupt, and sometimes intimidating leap from the status of unlicensed supervisee to licensed practitioner and clinical supervisor; and (d) alerting them to the reality that clinical supervision involves considerably more than just assisting students with case management. A comprehensive course on clinical supervision, based as much as possible on the current knowledge base in the field, can help supervisors-in-training to be ready for the myriad skills, tasks, and professional attitudes inherent in the role of supervisor.

This article will focus largely on this sort of early training of cognitive behavioral therapy (CBT) supervisors, describing a formal course whose contents and process of instruction are significantly informed by the programs cited earlier. Later in this article, we will also discuss the topic of "meta-supervision," in which a senior supervisor monitors and advises the work of a junior supervisor who in turn oversees trainees of his or her own. …