1

Individual Written Report – Models of Supervision

Rohit Choudhary

Stott's College

COU303 Supervision and Debriefing

Dr. Judy Esmond

July. 14, 2020.

MODELS OF SUPERVISION 2

Introduction

Clinical supervision has been an area of interest for the researchers for a long time.

Theories and models for supervision have been presented by many researchers (Basa, 2017,

p. 2). Psychotherapy requires clinical supervision which makes the job of supervisors

important not only for the education and training of the supervisee but also for their eventual

clients (Prasko et al., 2012). Although clinical supervision has been researched extensively,

but there is no single agreed-upon definition of the term. Bernard and Goodyear (2014)

defined supervision as “Supervision is an intervention provided by a more senior member of

a profession to a more junior colleague or colleagues who typically (but not always) are

members of that same profession” (p.9). This definition seems to be widely accepted.

There are many ways to classify the models of supervision. There are supervision

models that are based on psychotherapy theory while some other models are based on

development cognitive complexity of the supervisee. There’s a third category that divides

supervision models on the basis of the process of supervision (Bernard and Goodyear, 2004,

p. 22; Baka, 2017, p. 2). Models grounded in psychotherapy theory include psychodynamic

supervision, humanistic-relationship supervision, cognitive-behavioural supervision, systemic

supervision, and constructivist supervision. Those based on developmental models include

the Loganbill, Hardy, and Delworth Model, the Integrated Development Model (IDM),

Systematic Cognitive-Developmental Supervision Model, Reflective Developmental Model,

and Life-Span Model. Lastly, supervision models based on processes include Discrimination

Model, Events-based Model, Hawkins and Shohet Model, and the Systems Approach to

Supervision Model (Bernard and Goodyear, 2004).

From this wide range of supervision models, this paper will focus on only one:

cognitive-behavioural model of supervision. This paper will provide an overview of the

MODELS OF SUPERVISION 3

cognitive-behavioural supervision and explore the processes and goals of this type of

supervision while also looking at the issues in contemporary cognitive behavioural

supervision field.

Goals of Cognitive-Behavioural Supervision

Cognitive-behavioural supervision is focused on helping the therapist improve the

quality of therapy sessions with their client. The primary goal of this this type of supervision

is to facilitate the therapist as they attempt to adopt the cognitive-behavioural therapy (CBT)

and the philosophy associated with it. In CBT supervision, the therapist helps the therapist

maintain focus on changing the behaviours, emotions, and cognitions of the clients in order to

facilitate their recovery and improvement. That can be considered as the primary goal of the

cognitive-behavioural supervision (Pretorius, 2006, p. 414). The secondary goal of this type

of supervision can be defined as improving the therapist’s particular techniques and skills

related to the CBT philosophy (Pretorius, 2006, p. 414).

Boyd and Aubrey (1978) also outlined a number of goals of CBT supervision. They

considered proficient performance of the therapist as a consequence of acquired skills as

opposed to a personality trait and insisted that CBT supervision should teach the right

behaviours to the therapists and identify and discourage the inappropriate ones. The therapist

has to do some specific tasks to facilitate the improvement and recovery of a client and

supervisor should teach the therapist the specific skills required to complete the tasks (Boyd

and Aubrey, 1978).

Process of Cognitive-Behavioural Supervision

Even though supervision has been identified as an essential part of providing a high

quality therapy to clients by therapists practicing CBT, the research on one constitutes as
MODELS OF SUPERVISION 4

effective supervision has only been actively explored in the last two decades. Liese and Beck

(1997) provided a model for cognitive behavioural supervision involving nine steps: check-

in, agenda setting, bridge from previous supervision sessions, inquire about previous cases,

review of homework, discussion and prioritisation of agenda items, assigning homework,

capsule summaries of supervisor, and eliciting feedback from supervisee. While this model

had been accepted as standard for many years, Gordon (2012) came up with a list of ten steps

that the supervisors can take in order to effectively guide the therapists in developing skills

and knowledge towards providing effective CBT to clients. The models presented by Liese

and Beck (1997) has many overlaps with the one presented by Gordon (2012) but the latter is

more refined and provides clearer roadmap for effective supervision. The ten steps for

cognitive behavioural supervision suggested by Gordon (2012) are discussed as follows.

Step 1: Clarification of Supervision Question

It is important to have a clear and focused agenda of the supervision session, not

unlike the therapy. This should be formatted as a question so that the goal of the further

discussion is clear and the supervisor can keep track of the progress by exploring if the

question has been answered (Gordon, 2012, p. 73). An example of this question would be,

“Which questionnaire should be used to measure the client’s self-esteem?”

Step 2: Obtain Background Information

The next step is for the supervisor to obtain the relevant background information. This

part needs to be concise but the supervisee should ensure that they give this information at the

start so that the discussion does not get side-tracked later (Gordon, 2012, p. 75). An example

of this would be telling the supervisor about the concise history of substance abuse related to

the current predicament of the client.

MODELS OF SUPERVISION 5

Step 3: Request an Example of the Issue

The supervisor should ask the supervisee to give a clear example of the issue they are

facing, directly from the audio or video recording of the therapy session. This would help the

supervisor not only understand the client better but also help them judge the supervisee’s

skills and techniques more deeply (Gordon, 2012, p. 75).

Step 4: Check the Supervisee’s Understanding

Before the supervisor gives advice or teaches, they should explore the supervisee’s

current understanding of the problem and see how they have contextualised it so that the

supervisor does not waste time teaching them what they already know. This should be done

by asking the supervisee to briefly describe what they think of the problem (Gordon, 2012, p.

76). Questionnaire proposed by Padesky (1996) for this purpose can be helpful.

Step 5: Outline the Focus of Supervision Work

After knowing the background and supervisee’s understanding of the work, the

supervisor should decide on the level of the supervision work required and where the

supervision work will be focused on. This decision should be deliberate and overt so that all

blind spots are covered. For example, a question about how to engage the client can be

approach through various ways like motivational interviewing challenges, the therapists’

feelings and beliefs about the client’s level of motivation, etc. The supervisor must make this

decision with the help of supervisee in a collaborative manner in order to model the therapy

(Gordon, 2012, p. 76-77).

Step 6: Usage of Supervision Methods

MODELS OF SUPERVISION 6

Now, the supervisor should move forward with one of the supervision method to help

facilitate the supervision process in an effective manner. Pedasky (1996) has identified a

number of supervision methods. These methods include behavioural experiments,

demonstrations, role-plays, and live and recorded observations. The supervisor should ensure

that whatever activity they choose answers the question identified in step 1 (Gordon, 2012).

Step 7: Review of Supervision Question

After finishing the activity, the supervisor should explore with the supervisee if the

supervision question remains to be answered or if it has been adequately answered. This may

involve asking the supervisee reflective questions about the activity such has “What have you

learned in this activity that can help your current or future clients?” The answer of this

question will tell the supervisor if the supervision question has been answered (Gordon, 2012,

p. 78).

Step 8: Formation of Action Plan

The supervisor will now have to make sure that the therapist’s learning can translate

into changes in therapist’s behaviour in the therapy sessions with their client. For this purpose

they need to help the therapist outline a specific action plan with new behaviours (Gordon,

2012, p. 78).

Step 9: Homework Setting

In order to ensure that the action plan doesn’t remain restricted to one client and

learning is extrapolated as a new skill for the therapist, the supervisor may employ homework

setting to extend their learning beyond the specific session. This needs to have a follow-up in

the next session as well (Gordon, 2012, p. 78).

MODELS OF SUPERVISION 7

Step 10: Feedback

The last step in cognitive behavioural supervision session is to elicit feedback from

the supervisee about the usefulness of the supervision and the problems that may have risen

in the process (Gordon, 2012, p. 78-79).

Issues in Cognitive Behavioural Supervision

After understanding the main goals and process of cognitive behavioural supervision,

it is important to explore the issues that remain in this particular field. Reiser and Milne

(2011) outlined a number of issues that persist in the field of cognitive behavioural

supervision. They identify that even though cognitive-behavioural therapy is largely well-

researched and has strong empirical basis, the training processes and competencies related to

cognitive-behavioural supervision are still evolving and are in formation stage. There is a

lack of empirical based research around the practices and processes involving cognitive-

behavioural supervision in both the US and the UK. They concludes by saying, “Harshly, one

might conclude that CBT supervision is still in an infantile state of development. This is

particularly unsatisfactory, viewed in the context of the strong empirical heritage of CBT”

(Reiser and Milne, 2011, p. 169). However, Watkins (2011) insists that there has been a sea

of change in the research related to cognitive behavioural supervision and the coming times

will see more standardization and improvements in training programs in the field. He insists

that competency based culture has already taken hold in cognitive behavioural supervision

while evidence based culture is increasingly becoming the norm as a result of increasing

research in the field. Accountability will also soon become the standard in supervision, so

there is hope for the drastic improvements in this field in the near future (Watkins, 2011, p.

201).

Conclusion
MODELS OF SUPERVISION 8

A number of models have been developed for clinical supervision. One of the most

prominent models is cognitive behavioural model because it has been based on the cognitive

behavioural therapy, one of the most widely accepted models of therapy. The main goals of

cognitive behavioural supervision have been identified as improving the skills and behaviour

of the therapist in helping their client make changes in their behaviours and thinking for

improvement or recovery. After that, a ten-step process of cognitive behavioural supervision

has been identified including clarification of supervision question, obtaining background

information, requesting an example of the issue, checking the understanding of the

supervisor, outlining the focus and level of supervision, using the established supervision

methods to facilitate an activity, reviewing the supervision question for completeness,

formation of action plan, homework setting, and feedback. Lastly, the contemporary issues in

cognitive behavioural supervision have been identified.

MODELS OF SUPERVISION 9

References

Basa, V. (2017). Models of supervision in therapy, brief defining features. European Journal

Of Counselling Theory, Research And Practise, 1(4), 1-5. Retrieved 14 July 2020,

from https://www.europeancounselling.eu/wp-content/uploads/2017/04/EJC-TRAP-1-

4.pdf.

Bernard, J., & Goodyear, R. (2014). Fundamentals of clinical supervision (5th ed.). Pearson

Education Limited.

Boyd, J. D., & Aubrey, R. F. (1978). Counselor supervision: Approaches, preparation,

practices. Accelerated Development Incorporated.

Gordon, P. (2012). Ten steps to cognitive behavioural supervision. The Cognitive Behaviour

Therapist, 5(4), 71-82. https://doi.org/10.1017/s1754470x12000050

Liese, B. S., & Beck, J. S. (1997). Cognitive therapy supervision. In C. E. Watkins, Jr.

(Ed.), Handbook of psychotherapy supervision (p. 114–133). John Wiley & Sons Inc.

Padesky CA (1996). Developing cognitive therapist competency: teaching and supervision

models. In: Frontiers of Cognitive Therapy (ed. P. Salkovskis), pp. 266–292. New

York: The Guilford Press.

Prasko, J., Vyskocilova, J., Slepecky, M., & Novotny, M. (2012). Principles of supervision in

cognitive behavioural therapy. Biomedical Papers, 156(1), 70-79.

https://doi.org/10.5507/bp.2011.022
MODELS OF SUPERVISION 10

Pretorius, W. (2006). Cognitive Behavioural Therapy Supervision: Recommended

Practice. Behavioural And Cognitive Psychotherapy, 34(04), 413.

https://doi.org/10.1017/s1352465806002876

Reiser, R. P. (2014). Supervising cognitive and behavioral therapies. The Wiley international

handbook of clinical supervision, 493-517.

Reiser, R., & Milne, D. (2011). Supervising Cognitive-Behavioral Psychotherapy: Pressing

Needs, Impressing Possibilities. Journal Of Contemporary Psychotherapy, 42(3),

161-171. https://doi.org/10.1007/s10879-011-9200-6

Watkins, C. (2011). Psychotherapy Supervision in the New Millennium: Competency-Based,

Evidence-Based, Particularized, and Energized. Journal Of Contemporary

Psychotherapy, 42(3), 193-203. https://doi.org/10.1007/s10879-011-9202-4