From CBT Therapist to CBT Supervisor

 Judith S. Beck and Daniella Cavenagh

How do you become a skilled CBT supervisor? Delivering effective CBT supervision requires a highly specialized, advanced set of competencies for which clinical acumen is essential but not sufficient. A growing body of literature indicates the importance of:

  • developing the relationship with supervisees, including eliciting and responding effectively to their feedback
  • setting goals with supervisees
  • accurately assessing supervisees’ strengths and weaknesses
  • developing effective individualized plans for supervision to implement within supervision sessions and across sessions
  • structuring supervision sessions (in a similar way to therapy sessions)
  • providing experiential exercises in and between supervision sessions (including having supervisees practice CBT conceptualization and treatment techniques on themselves)
  • regularly reviewing and providing feedback on therapy recordings and on the progress of the supervisee
  • teaching supervisees how to engage in effective self-reflection
  • using self-reflection yourself
  • engaging, on an ongoing basis, in activities to improve your own clinical and supervisory competence

When we train CBT supervisors, we first train them to be effective CBT therapists. Most of the competencies listed above have parallels in CBT treatment. Once therapists have developed a sufficient level of competence as a therapist, we provide training and supervision in CBT supervision, which includes reading the literature on CBT supervision, attending workshops on training and supervision, and receiving supervision on doing supervision (based on tape reviews of both client sessions and one’s own supervision sessions).

Judith S. Beck, PhD

Judith S. Beck, PhD

Self-reflection is also a crucial part of effective supervision. Supervisors need to objectively examine their knowledge and skill set and attitudes (about supervision, trainees, clients, and CBT in general). We first teach clinicians how to rate therapy sessions they conduct with their own clients (using the Cognitive Therapy Rating Scale), then how to rate the therapy sessions of their supervisees.

We also help them assess how they conducted the supervision session. For example, did they appropriately attend to the supervisee’s developmental stage? (In our experience, supervisees with relatively little CBT experience may benefit from a somewhat more directive approach than an experienced CBT supervisees for whom greater collaboration is effective). Did they use experiential learning strategies such as role plays? Did they competently handle any ethical issues? Were they attuned to cultural and diversity issues between the trainee and themselves, the trainee and the client, and indirectly, the client and themselves? Did they actively seek feedback and respond appropriately to it?

Finally, we teach supervisors (and supervisors-to-be) to reflect on the effectiveness of the supervision session as a whole. What did they do well? What might they need to improve upon? What can they do to increase their competency?

Providing CBT supervision is an incredibly rewarding experience when you see your supervisees becoming more competent and confident and their clients making good progress.  But a strong CBT clinician will not necessarily be a strong CBT supervisor. We encourage researchers to continue conducting studies to establish evidence-based CBT training and supervision competencies and practices — and we encourage clinicians who wish to become supervisors to seek out effective training.

Teaching and Supervising CBT: A 3-Day Workshop

When:    June 11-12, 2016
Where: Beck Institute, Suburban Philadelphia
Time:   8:15am – 4pm
Faculty: Donna Sudak, MD
Enrollment:  Limited to 42 participants
CE/CMEs:  12




Topics covered include:

  • Structuring and conducting CBT supervision
  • Measuring and evaluating therapist progress and competence
  • Adapting CBT supervision to the trainee’s level of development
  • Special issues in group supervision
  • Working effectively with a problematic trainee
  • Using measures to improve patient outcomes with informative feedback
  • Creating a comprehensive CBT curriculum based on core competencies necessary for practice
  • Teaching Socratic questioning and other specific competencies
  • Distance learning and use of technology
  • Advocating for CBT in training programs and competing for resources

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