Clinical supervision, by definition, is referred to as aspect of training recognized to be
integral for Cognitive Behavioral Therapy (CBT) therapists (Townend, Iannetta, & Freeston,
2002). Clinical supervision is not only critical during training but also in the subsequent
professional practice for mental health therapists. Currently, it has been determined that there is a
demand on rapid growth pertaining to the requirement of the accredited professional therapists to
become supervisors. The requirement can be quite a daunting prospect considering that
supervision is an activity that is highly complex in nature characterized by numerous overlapping
purposes. The overlapping purposes dictate that the supervisors must be involved in the enacting
multiple roles and use several models of activity. Owing to the consideration that the promotion
and provision of mental health services is regarded as a key component of the U.K. public health
policy, clinical supervision has been identified as one of the main settings for action (Townend,
Iannetta, & Freeston, 2002). The government policies, specifically the evaluations of clinical
practice, has indicated the steadily growing importance and necessity of supervision. Supervision
has been deemed critical in the process seeking to foster professional development of
practitioners with the ultimate goal of helping improve the fidelity of therapies. CBT supervision
facilitates the development and maintenance of therapist competence (Gordon, 2012). Therefore,
in the U.K., there is the existence of numerous multidisciplinary and profession-specific
programmes tailored towards training cognitive behavioral psychotherapists, and clinical
supervision is the fundamental features of these programmes. In this paper, the primary aim is to
offer a critical and comprehensive discussion of the steps, theories/models, competences
framework, and evidence of cognitive behavioral therapy for clinical supervision.
Steps for Effective CBT Supervision
In the U.K., there are ten steps that have widely been recognized to be used as the basis
for establishment of effectively structured professional work within the CBT clinical supervision.
The first step is clarifying the supervision question. As a therapeutic process, there is the need for
establishing a negotiated and specific agenda that forms the basis of supervision. The
formulation and clarification of question for supervision bring numerous advantages. It provides
clarity regarding the goals to be achieved by the ensuing discussions, ensures that the intended
work is on the right tract, and promotes adherence to an active stance that strengthens the
supervisor-supervisee working alliance (Pretorius, 2006). Having an agreement on the
supervision questions to be used at the start of the discussion is critical. It ensures that the
supervision process is collaborative and be guided to achieve the required learning needs of the
supervisees. As argued by Gordon (2012), clarifying supervision question also serves to allow
the supervisors to have a good judgment of the information that they will need so they can have
the best understanding and response to the issues raised and presented by the clients.
The second step is eliciting relevant background information. Scott (2013) explains that
to ensure the supervision process has been efficiently implemented, it becomes an imperative
necessity to consider that the information-giving part of the supervision is succinct and avoid any
activity that might cause distraction from the tasks. It is necessary for the supervisors to be
adequately prepared for the supervision so that they can give essential detailed information for
their respective questions, rather than just providing the next installment of their clients’ stories.
Therefore, ensuring that the supervisors are adequately prepared helps foster their development
(Gordon, 2012). The situation subsequently makes the supervisees think through the problems
and be active participants in the supervision process.
CLINICAL SUPERVISION 3
The third step is requesting and providing problem example. In therapy, we often gain
more information from working on concrete and substantive instances of the difficulties
experienced by the clients than through holding intellectual discussions on broad ideas and
concepts, and the similar case applies in supervision. Gonsalvez, Brockman, and Hill (2016)
inform that the example of the problem required for supervision is usually best illustrated by
audio or video recording of the points presented during the therapy sessions on the issues to be
addressed. The situation allows for the provision of rich information concerned with specific
needs of the clients and approaches and skill of the therapists (Gordon, 2012). Setting the
problem examples thus serves to illustrate the client-therapist interactions and opens the
opportunities for constructive providing constructive feedback.
The fourth step is checking the supervisees’ current understanding. It is mandatory for the
supervisors to understand how the supervisees conceptualize the problems to be solved prior to
supervision. In the therapy context, the situation increases the information known by the
therapists about their clients, and the same understanding is required in supervision (Gordon,
2012). The knowledge can be enhanced through the formulation of CBT concepts to help know
how the supervisees see the current issue. Understanding how the supervisees see and understand
the current problem helps ensure that the supervisors do not make the unnecessary attempt of
telling about the information they already know (Townend, Iannetta, & Freeston, 2002).
Checking the current supervisees’ understanding of the problem thus helps in preventing gaps in
the skills and knowledge of the supervisors from being overlooked to ensure that maximal
learning takes place.
The fifth step is deciding the level and focus of the supervision work. It is necessary to
consider how to achieve the needs that have been presented for tackling and the suitable type of
learning to be targeted. To do this, the decisions concerning the most productive level and focus
of supervision work has to be deliberate and overt (Grey, Deale, Byrne, & Liness, 2014). The
situation safeguards against any avoidance or blind spots on the parts of either supervisees or
supervisors. Therefore, the solution options for the questions to be answered regarding the
identified problems sought to be addressed are required to be reviewed with the supervisees.
Gordon (2012) informs that the supervisees can also be asked to consider the list of established
supervision components so that they can decide the most relevant ones to the current problem.
The sixth step is using active supervision methods. CBT supervision emphasizes on the
significance of applying methods that parallel the active and problem-solving therapy stance.
The active methods of supervision includes recorded and live observation, demonstrations and
role play, and personal change strategies and co-therapy such as behavioral experiments
(Gordon, 2012). These methods facilitate case discussion that support dialogue and action
process during the supervision. The process aids reflection by the supervisees and help create
theory and practice links to support the generation of new effective ideas for action (Grey et al.,
2014). The clinicians thus become involved not only in talking therapies but also doing therapies,
which enhance effective CBT focusing on behavioral and cognitive changes.
The seventh step is checking to affirm whether the supervision question has been
comprehensively and correctly answered. Following the conclusion of the active part of
supervision, there is the need to check and evaluate the state of the information learned. Scott
(2013) recommends that one of the suitable ways of facilitating the evaluation of what has been
learned is by asking the clients to summarize the sessions during the therapies. The supervisors
must thus encourage the supervisees to draw out learning from the discussions so that it can both
encourage and allow for reflection as part of the process. To ensure that the supervision question
CLINICAL SUPERVISION 4
has been answered, there are additional questions that need to be asked such as “Have you
gained any new ideas from our work?” “How do you see the problem now?” (Gordon, 2012,
p.78). The supervisors must require the supervisees to ask the clients these questions. By doing
so, the process promotes adult learning by moving from concrete experiences to the practices of
observation and reflection.
The eighth step is forming client-related action plan. The process requires that the
implications of the concepts in new situations be tested to ensure that they are applicable to
current problem to address the clients’ needs. To establish the action plan that meets the clients’
needs, new insights are required to be translated into new behaviors, and these behaviors can
themselves be subjected to evaluation (Scott, 2013). In the context of supervision, the testing of
new behaviors is based on the changes in the activities of therapists within the therapy sessions
(Gordon, 2012). To facilitate this change, the supervisors should advice the supervisees to come
up with ways on how they put the new ideas into practice with their clients.
The ninth step is homework setting. After the action plan aimed at specifying the steps to
take within the clients’ therapies to foster and consolidate generalized learning by the therapists
has been established, homework setting becomes necessary. Homework setting seeks to ensure
that the plan is carried through and facilitates judging the effectiveness of its benefits (Grey et
al., 2014). Therefore, homework setting is used in supervision with the specific objective of
extending learning beyond the session to fill the gaps discovered in the therapists’ skills and
knowledge. The supervisors can suggest such homework as reading to be undertaken or
experiments to challenge any unhelpful assumptions that might have been uncovered during the
therapy sessions (Gordon, 2012). The situation thus creates the need for homework to be
followed up in the subsequent supervisions.
The tenth and final step is eliciting feedback on the supervision. Gordon (2012) explains
that as clinical supervision for the therapy sessions comes to an end, examining the usefulness of
the sessions and evaluating any problems that might have arisen during the supervision is
compulsory. It is through these processes that feedback on the supervision may be provided. It is
necessary to ensure that there is the provision of a three-way feedback, that is, the feedback from
the supervisors, supervisees, and clients. As hypothesized by Gonsalvez, Brockman, and Hill
(2016), the process whereby feedback are elicited is frequently effective in facilitating the
determination of the level and extent to which the distinct needs of the clients were met. In case
there is the failure of meeting the clients’ needs, then change will be needed for the next
sessions. The feedback also serves to check whether the supervisees completed the sessions with
a sense of positivity and engagement. Therefore, the feedback serves to benefit the supervisors
by guiding their future supervision work and ensuring that the supervision bond is intact when
the meeting closes.
Theories and Models of Clinical Supervision
Integrative Development Supervision Model
Integrative development model is the one of the most common model of supervision, and
it was first developed by Stoltenberg in 1981 (Basa, 2017). The model offers detailed description
of the distinctive three levels applied in the professional development of counselors. The first
level considers supervisees as entry-level students with high motivation, but faced with the
problems of anxiety as well as being fearful for evaluation. The second level views supervisees
at a mid-level experiencing fluctuating motivation and confidence that link them to their own
moods to success when working in therapeutic sessions with their respective clients. The third
and final level considers the supervisees as secure and with stable motivation coupled with
CLINICAL SUPERVISION 5
accurate empathy primarily tempered by objectivity and the use of therapeutic self in the
intervention process. The model vests its emphasis on requiring the supervisors to utilize
knowledge, skills, and approaches that are effectively corresponding to the distinctive levels of
the supervisees (Falender & Shafranske, 2004).
Holloway System Approach Supervision Model
The model emphasizes on examining the relationship between the supervisor and
supervisee as the heart of the supervision process, and was originally published by Holloway in
1995. The relationship is required to be mutually involving with the specific aim of seeking to
bestow power to both parties (Holloway, 1995). Holloway offers description of six dimensions
of supervision, and all these dimensions have a connection to the established central supervisory
relationship. These dimensions are regarded to be the inherent basis for the functions of the
supervision process, the tasks of the supervision, the client, the trainee, the supervisor, and the
institution. The functions and tasks of the supervision are embedded in the foreground of the
interaction, while the latter four dimensions are representations of the unique contextual factors
that, according to Holloway (1995), are responsible for converting influences in the supervisory
process.
Competences Framework of Clinical Supervision
Generic supervision is the most widely recognized and common competences framework
applied in clinical supervision. Generic supervision is a domain entailing the competences
underpinning the supervision pertaining to all the CBT modalities, whether configured as low or
high intensity interventions. The first area of competence activity is the ability to employ
educational principles tailored towards enhancing learning specifically intended to be employed
in supervision. Supervision is recognized a process of education coupled with the benefits to
employ well-established principles that enhance learning process (Roth & Pilling, 2008). The
ability to enable ethical practice is also regarded to be critical. Supervisors are required to have
the competency for ensuring that the supervisees have an awareness of the broad range of
professional codes and ethical principles of conduct, and ensure that these practices are
embodied in their respective clinical practice (Milne, 2017). The distinct area where an
understanding of ethical practice is imperatively needed relates to the principles underpinning the
confidentiality management, both related to clinical practice and supervision itself. In the context
of supervision relationship, ethical practice requires having an understanding of the risks that are
inherent in dual role-relationships. As posited by Roth and Pilling (2008), dual role-relationships
allows supervisors to develop relationship with the supervisees leading to conflict of interests or
the risk to create abusive relationships.
Ethical and professional practice in supervision relationships is concerned with the ability
to work with difference. It indicates the broad spectrum of demographic and cultural variations
in client populations faced with the disadvantages of being subjected to discrimination and
marginalization. Therefore, difference includes age, gender, ethnicity, social class, cultural
background, sexuality, disability, and religion. The primary goal for promoting the consideration
of these issues of difference is to maximize the efficacy and effectiveness of clinical in meeting
the needs of all targeted clients (Milne & Reiser, 2011). To improve the efficacy and
effectiveness of clinical practice, the supervisors need to help the supervisees to acknowledge the
potential relevance and importance of difference so that they can consequently facilitate the
integration of this thinking into their respective professional work. The process of supervisees
integrating difference in their work entails reflecting on the distinct assumptions that have
introduced by the supervisors. The difference in the supervisees’ experience can be either from a
CLINICAL SUPERVISION 6
minority or majority cultural perspective. It has been determined that the problems relating to
these cultural differences are often affiliated to the situations when the language skills of the
clients either make it quite difficult to be easily understood or to understand the therapists
(Bagnall, Sloan, Platz, & Murphy, 2011). The challenge creates the need to develop the
important skills of preparing the supervisees to have the ability of working in collaboration with
the interpreters.
The clinical setting of the supervisees often have an influence on the way they work, and
consequently impacts how supervision is delivered. The situation creates the need of making the
supervision process to be adapted to the governance and organizational context within which
supervision occurs for the roles that the supervisees are practicing. The ability to adapt
supervision to the governance and organizational context is associated with the evidence on the
risk that poor alliances can cause prejudice to the efficacy and effectiveness of supervision. The
formation of good supervisory alliance is thus crucial to the establishment of good training
relationships (Milne & Reiser, 2011). Hence, the factors that can either hinder or foster the
development and sustenance of good supervisory alliances are clearly identified. The skills
linked with the remediation and recognition of threats to the working relationships between
supervisors and supervisees are also explicated. The quality of the alliances have an impact on all
the areas of supervision guided by important areas in the context of the “supervision structure,”
“presenting clinical information,” “reflection,” “giving feedbacks,” “gauging competence level
of supervisees,” “measures for gauging progress,” and “capacity of the supervisors to reflect”
(Roth & Pilling, 2008, p.11). These areas are dependent on the presence of collaborative working
relationships.
The ability to structure supervision has been determined to involve the establishment of
professional framework for supervision. The framework facilitates the establishment and
maintenance of appropriate professional and personal boundaries. The goal is to ensure there are
contacts for supervision covering both concrete issues such as duration, timing, and agreements
regarding the content of supervision. The supervisees are often required to have knowledge on
how best to present clinical information (Milne, 2017). The presentation of clinical information
is an important skill in its independent right. Hence, it is considered a compulsory necessity for
the supervisors to accord suitable help needed by the supervisees for the specific purpose of
assisting them to think on how best to conduct the identification of relevant content and
determine the less pertinent ones by implication (Taylor, Gordon, Grist, & Olding, 2012). The
supervisors need also to advice the supervisees on the ways on how best the identified
information should be presented.
The ability to reflect and undertake accurate practice of self-appraisal is regarded to be a
significant element of adult process of learning. The situation is of the implication of both the
capacity to be open to experience while the learning process takes place and to review and learn
from the experience after its occurrence (Burnham, Alvis Palma, & Whitehouse, 2008). The
process is critical owing to the fact that reflection is considered to be one of the ways through
which learners are able to acquire knowledge. Without this ability, it is impossible for the
learners to have the skills needed to shift from the positions of being dependent on others (Roth
& Pilling, 2008). Therefore, it is an important competence to enhance the ability of the
supervisees to reflect.
The process of giving constructive and accurate feedback is an aspect of supervision that
has been reported to be quite challenging. The difficulty is embedded on the requirement of
considerable skills critical for the detection of what the focus should be based on and the suitable
CLINICAL SUPERVISION 7
method for delivering the feedback. Bagnall, Sloan, Platz and Murphy (2011) elucidate that the
supervisors often have the liberty and ability to detect the diverse aspects of the behaviors
exhibited by the supervisees that require improvement. The failure of the supervisors to deliver
the feedback in an appropriate way makes it impossible for the supervisees to implement it as
might be required. Hence, unless the process of delivering the feedback is done in a positive
way, it is irrelevant. The feedback must be delivered in a manner that makes it possible to be
effectively utilized by the supervisees (Roth & Pilling, 2008). It is only through this approach
that the feedback will be heard or considered relevant, hence making it possible for it to be acted
on and make the supervision a success.
Evidence for and against CBT Supervisory Model
Evidence support that the Integrative Development Supervision Model and Holloway
System Approach Supervision Model have been reported to be of relevant application in clinical
supervision when performing therapeutic sessions with the patients. These CBT supervisory
models are regarded to be suitable for clinical supervision (Patalay & Fitzsimons, 2016).
Supervisors and supervisees are encouraged to pursue an expansion of their professional
identities through receiving CBT training combined with these three therapeutic modalities as
this serves to enable them have a more integrative and expanded approach to counseling and
supervision. When applying these models to clinical supervision, licensed professional
counselors and supervisors take into account the institutional environment including the
provision of clients and appropriate professional qualifications (Milne, 2017). It has been
determined that counseling in clinical supervision is informed by theoretical orientation,
professional counselors with additional supervision qualification as part of their license should
maximally adhere to the given CBT modality. The situation enables the supervisors and
supervisees to become firmly grounded in the practice and gain experience prior to being
imparted with alternative training in diverse forms of modalities.
Integrative Development Supervision Model (IDSM)
Integrative Development Supervision Model (IDSM) has been determined to be drawing
on the clinical information that are inherent to the theoretical orientation of transference and
countertransference, defense mechanisms, and affective reactions (Smith, 2009). IDSM strength
in promoting clinical supervision is embedded in promoting supervisor-centered supervision,
supervisee-centered supervision, and supervisory-matrix centered supervision. Supervisor-
centered supervision focuses on considering the recommendations and complying with the
instructions provided by the supervisor. The role of the supervisor is didactic, with the primary
goal of providing the necessary help to that allows the supervisees to understand the material of
the patients. The supervisors are considered to be the uninvolved experts who have the skills and
knowledge to offer necessary assistance to the supervisees, thus according the supervisors
considerable authorities (Falender & Shafranske, 2004). Supervisee-centered supervision focuses
on the process and content of the experience of the supervisees as counselor based on the
supervisees’ learning problems, anxieties, and resistances. The role of the supervisors is still that
of an uninvolved and authoritative expert. The attention is shifted to the supervisees’ psychology
making the supervision be more experiential than didactic (Liese & Beck, 1997). Supervisory-
matrix centered supervision focuses not only on attending to the supervisees and clients, but also
facilitates the examination of the relationship between the supervisors and supervisees. The role
of the supervisors is no longer that of uninvolved experts. Supervision becomes relational and
the role of the supervisor is to participate in, process enactments, and interpret and reflect upon
CLINICAL SUPERVISION 8
the relational themes arising within either the supervisory or therapeutic dyads (Haynes, Corey,
& Moulton, 2003).
In the situations where the supervisors use similar CBT models with their respective
trainees (supervisees), the supervisees are accorded the opportunity to gain therapeutic
knowledge and acquire different skills that they can use with their clients in an effort to promote
mental health (Wells, Barlow, & Stewart‐Brown, 2003). The phenomenon is further supported
by the research of Cummings, Ballantyne, and Scallion (2015) that not only does the deliberate
use of CBT skills foster clinical development processes and professional competency, but it also
serves as a model for the best trainers providing their clients. Through the provision of the
training for the CBT practitioners about supervision, IDSM facilitate the development of the
ability that can allow them to apply these same learned clinical skills to clients (Cummings,
Ballantyne, & Scallion, 2015). In addition, the type of the supervisees and clienteles seeking for
the supervision and counselling therapies respectively is the determinant factor of whether or not
the sessions are a good match for the respective health agencies depending on the expert
testimonials and the professionals’ credentials within the practice (Heffler & Sandell, 2009). The
supervision process need to observe utmost adherence to the three CBT supervisory models
(Psychodynamic Approach Supervision Model, Integrative Development Supervision Model,
and Holloway System Approach Supervision Model). These models promote having knowledge
of the environment, clienteles to be served, and the qualifications of the professionals
(supervisors), which promotes quality practice in the mental health setting.
IDSM recognizes that the environment and standards of agency might present unique
challenges for many supervisees in training. IDSM compel the supervisees to adhere to the rules
and guidelines set by the supervisor (Murrihy & Byrne, 2005). However, in the health settings
for private practice, they are characterized by different structures of operations compared to
those in hospitals, centers of vocational rehabilitation, and settings of public mental health. The
setting of private practice settings make it possible for the counselors to provide services in the
different ways utilizing the available resources (Neuer & Anita, 2013). In the private practice,
counselors rely heavily on insurance companies to undertake the compensation of the services
they provide. The managed care system should strive to create a balance between the interests
and priorities of the three groups: the consumer, the provider, and the payer. The consumer and
the practitioners are often compelled to describe their activities in ways that are both purposeful
and deliberate with the third parties’ interests in mind; the process must be followed due to the
need for accountability. IDSM allows the supervisees in the mental health practice environment
are obliged to make an independent decision whether the practice is the right match for them.
Some supervisees may be skeptical by having reservations about learning a modality where they
have not been trained. It is at this point that the supervisees must make decisions to determine
whether their respective practice environments where they will be receiving supervision is
appropriate for their needs (Harrington, 2013). The familiarity of the supervisees with the CBT
models and environment allow them to conduct didactic sessions that are chiefly oriented
towards solving the problems presented by the clients.
Holloway System Approach Supervision Model
Holloway System Approach Supervision Model (HSASM) enable the supervisees to be
trained on the CBT techniques. The CBT techniques allow the supervisees to stay with the
difficult clients presenting the problem needed to be addressed in the therapy sessions. Owen-
Pugh (2010) informs that the supervisees must additionally be helped to adopt the collaborative
CLINICAL SUPERVISION 9
stance of the CBT therapists. The stance is usually more directive than other forms of therapy, so
that they may not find it challenging to impose structures on the work of their clients. In essence,
environments that manage to utilize HSASM as a CBT model in the supervision process become
more didactic in nature. The didactic nature allows the supervisees who might be having the
willingness to learn the CBT modality acquire critical knowledge on the necessary coping skills
that can help enhance therapy with clients and improve the supervisees’ repertoire (Owen-Pugh,
2010). Finally, CBT is an adaptable and a flexible modality that encourages clinical supervision
which serves a significant purpose in private practice mental health setting.
HSASM promote the ability of mental health counselors to receive training in a
therapeutic environment where supervision takes place as a significant requirement for
facilitating the supervisee-client relationship. In such an environment, supervisees are taught
CBT techniques and techniques and how to use them with their clients in counseling (Baer,
2005). Cummings, Ballantyne, and Scallion (2015) argue that the specific supervisory
procedures used in these three CBT supervision models have the ability to foster professional
learning. These CBT supervisory models have been used regularly and purposefully include
setting a supervision agenda for each meeting/counseling session, encouraging trainees to resolve
any existing problems before receiving specific supervisory input, and regularly providing
formative feedback required to be repeated by supervisees and their clients (Cummings,
Ballantyne, & Scallion, 2015). It has been reported that the majority of clients served in clinical
supervision environment often suffer from addiction problems, dysthymia, anger issues,
parenting issues, anxiety, PTSD, and adjustment disorders. CBT supported with the Holloway
model is considered to be an effective modality whose application can be used to teach coping
skills, practice new skills, and meet the clients’ needs.
The Holloway model is regarded to be effective in meeting the challenges in clinical
supervision practice for the clients with mental problems. Holloway model as a CBT supervisory
modality is considered to be good fit for clinical supervision for addressing mental health
problems in diverse groups of patients because of their empirical grounding and action
orientation. The approach adopted by the model make it appropriate in addressing different types
of issues often presented by the diverse groups of clients during counseling/therapeutic sessions
in clinical supervision (Patalay & Fitzsimons, 2016). If counselors receive CBT supervision
training coupled with the engagement of positive aspects of isomorphism dynamics and parallel
process, the supervisees are reported to have the likelihood of increasing the use of evidence-
based CBT interventions with their respective clients. Many clients and supervisees usually
exhibit good response to the more organized environments offered by CBT (Owen-Pugh, 2010)
In clinical supervision, using CBT model involve the setting of agenda, conducting domestic
reviews, carrying out 10-15 minute skills training, providing case discussions, and issuing new
homework (Baer, 2005). Therefore, HSASM offers supervisees’ training which includes role
modeling, behavioral rehearsal, provision of feedback and information, and conducting
interactive discussions.
The effectiveness of qualified counsellors is increased by the elements of the CBT model
through practice, repetition, and years of experience. HSASM as a CBT supervisory model is,
therefore, an appropriate to be used in private practice mental health setting owing to their nature
of being empirically grounded and action oriented. CBT facilitated by the application of
Holloway model in clinical supervision is thus the most preferred choice considered to be
effective for the treatment of mental health problems (Zivor, Salkovskies, & Oldfield, 2013).
HSASM is grounded in clinical practice and research, which makes it have a high potential of
CLINICAL SUPERVISION 10
promoting integrative and developmental psychotherapy for the clients. HSASM serves as the
gold standard approach to effective treatment of mental health problems. The phenomenon
serves as the evidence for CBT supervisory models when it comes to the use of HSASM in
clinical supervision. The only evidence against HSASM as a CBT supervisory model in clinical
supervision is its inability to address the transference and countertransference issues in
constructive and meaningful ways (Neuer & Anita, 2013). The downside of HSASM is due to
the failure to incorporate therapeutic relationship theory and models in supervision as it only
considers the developmental and psychotherapy-based supervision approaches.
Conclusion
As an integral element of CBT, clinical supervision is an activity that is extremely
complex in nature. The competent clinical supervisor, to assist the supervisee in establishing
good working relationships with the clients during therapy sessions, must embrace the domain of
psychological science in supervision. The supervisors should also consider the purviews of
trainee (supervisee) development and client service to facilitate an effective therapeutic process.
Therefore, it is imperative to facilitate the development of competent, effective, and
collaborative supervisors to promote the success of clinical supervision. The supervisors must
adhere to the CBT supervisory modalities to allow them evolve and thrive in their professional
practice. There are steps that must be considered for promoting effective CBT supervision. These
steps are coupled with the application of suitable models/theories of clinical supervision. The
steps and models of clinical supervision are guided by the general competence framework for
CBT modalities. The CBT modalities provide evidence that justify the use of CBT supervisory
models in private practice for mental health treatment.
CLINICAL SUPERVISION 11
References
Baer, M. (2005). Establishing a private practice. Annals of the American Psychotherapy
Association, 8(3), 31.
Bagnall, G., Sloan, G., Platz, S., & Murphy, S. (2011). Generic supervision competencies for
psychological therapies. Mental Health Practice, 14(6).
Basa, V. (2017). Models of supervision in therapy, brief defining features. European Journal of
Counselling Theory, Research and Practice, 1(4), 1-5.
Burnham, J., Alvis Palma, D., & Whitehouse, L. (2008). Learning as a context for differences
and differences as a context for learning. Journal of Family Therapy, 30(4), 529-542.
Cummings, J. A., Ballantyne, E. C., & Scallion, L. M. (2015). Essential processes for cognitive
behavioral clinical supervision: Agenda setting, problem-solving, and formative
feedback. Psychotherapy, 52(2), 158-163.
Falender, C. A., & Shafranske, E. P. (2004). Clinical supervision: A competency-based
approach. Washington, DC: American Psychological Association.
Gonsalvez, C. J., Brockman, R., & Hill, H. R. (2016). Video feedback in CBT supervision:
review and illustration of two specific techniques. The Cognitive Behaviour Therapist, 9.
Gordon, P. K. (2012). Ten steps to cognitive behavioural supervision. The Cognitive Behaviour
Therapist, 5(4), 71-82.
Grey, N., Deale, A., Byrne, S., & Liness, S. (2014). Making CBT supervision more effective. Los
Angeles, LA: John Wiley & Sons Ltd.
Harrington, J. (2013). Contemporary issues in private practice: Spotlight on the self-employed
mental health counselor. Journal of Mental Health Counseling, 35(3), 189-197.
Haynes, R., Corey, G., & Moulton, P. (2003). Clinical supervision in the helping professions: A
practical guide. Pacific Grove, CA: Brooks/Cole.
Heffler, B., & Sandell, R. (2009). The role of learning style in choosing one's therapeutic
orientation. Psychotherapy Research, 19(3), 283-292.
Holloway, E. (1995). Clinical supervision: A systems approach. Thousand Oaks, CA: Sage.
Liese, B. S., & Beck, J. S. (1997). Cognitive therapy supervision. In C. E. Watkins, Jr. (Ed.),
Handbook of psychotherapy supervision (pp. 114-133). New York: John Wiley & Sons.
Milne, D. L. (2017). Evidence-based CBT supervision: Principles and practice. John Wiley &
Sons.
Milne, D. L., & Reiser, R. P. (2011). Observing competence in CBT supervision: a systematic
review of the available instruments. The Cognitive Behaviour Therapist, 4(3), 89-100.
Murrihy, R., & Byrne, M. K. (2005). Training models for psychiatry in primary care: A new
frontier. Australasian Psychiatry, 13(3), 296-301.
Neuer C. & Anita, A. (2013). Endless possibilities: Diversifying service options in private
practice. Journal of Mental Health Counseling, 35(3), 198-210.
Owen-Pugh, V. (2010). The dilemmas of identity faced by psychodynamic counsellors training
in cognitive behavioural therapy. Counselling and Psychotherapy Research, 10(3), 153-
162.
Patalay, P., & Fitzsimons, E. (2016). Correlates of mental illness and wellbeing in children: are
they the same? Results from the UK millennium cohort study. Journal of the American
Academy of Child & Adolescent Psychiatry, 55(9), 771-783.
Pretorius, W. M. (2006). Cognitive behavioural therapy supervision: recommended
practice. Behavioural and Cognitive Psychotherapy, 34(4), 413-420.
CLINICAL SUPERVISION 12
Roth, A. D., & Pilling, S. (2008). A competence framework for the supervision of psychological
therapies. Retrieved August, 18, 2011.
Scott, M. J. (2013). Simply effective CBT supervision. New York, NY: Routledge.
Skovolt, T. M., & Ronnestad, M. H. (1992). The evolving professional self: Stages and themes in
therapist and counselor development. Chichester, England: Wiley.
Smith, K. L. (2009). A brief summary of supervision models.
Stoltenberg, C. D. (1981). Approaching supervision from a developmental perspective: The
counselor complexity model. Journal of Counseling Psychology, 28 (1), 59-65.
Taylor, K. N., Gordon, K., Grist, S., & Olding, C. (2012). Developing supervisory competence:
Preliminary data on the impact of CBT supervision training. The Cognitive Behaviour
Therapist, 5(4), 83-92.
Townend, M., Iannetta, L., & Freeston, M. H. (2002). Clinical supervision in practice: A survey
of UK cognitive behavioural psychotherapists accredited by the BABCP. Behavioural
and Cognitive Psychotherapy, 30(4), 485-500.
Wells, J., Barlow, J., & Stewart‐Brown, S. (2003). A systematic review of universal approaches
to mental health promotion in schools. Health education.
Zivor, M., Salkovskis, P. M., & Oldfield, V. B. (2013). If formulation is the heart of cognitive
behavioural therapy, does this heart rule the head of CBT therapists? The Cognitive