The cognitive behavioral model belongs to the broader category of psychotherapy based clinical supervision that mostly provides the basis for the theoretical development of supervisees and tends to focus mainly on strategies and skills. It uses the methods and processes exploited in cognitive behavioral therapy (CBT) to train therapists and give them an opportunity to get the experience similar to that of their future patients.
Thus, therapists in training would be able to evaluate the state of their patients’ with the help of their insights and, as a result, successfully implement the acquired knowledge and skills for effective treatment. The cognitive behavioral model also helps supervisees to master planning, decision-making, to shape their research, and monitor the progress of their patients, because it is parallel to the cognitive model. I have chosen this model for review because it engages supervisees in the active process of self-understanding, which should produce a positive effect on their therapy.
It is important for supervisors to establish trustful and comfortable relations with their supervisees to help them in the learning progress and encourage questions. Moreover, it is also necessary to eliminate any inconvenience and shame that might be related to the process of learning and self-discovery. According to Bakos and Kristensen (2013), “supervisors and supervisees should be more aware of their emotional responses (in therapy and regarding the supervision relationship) and recognize how their thoughts and beliefs can contribute to their emotions and behaviors during supervision sessions” (p. 43).
The ultimate aim of supervisors is to aid their supervisees in their professional growth to the extent when they would be capable of practicing independently. Furthermore, supervisees should be prepared for the realities of clinical practice and be aware that they sometimes significantly differ from the training settings under the supervision. They should understand that they would have to work with complicated patients that might have different unfavorable living conditions and life circumstances. Sometimes they might need to resort to more general methods of influencing patients as empathy, warmth, and sincerity, which, being largely personal traits of character, cannot be properly trained by supervisors.
Efficient performance of a therapist is comprised of the acquired professional skills and learned experience, thus, the personal characteristics of a supervisee play a secondary role in CBT supervision. Its primary concern is related to theoretical and technical aspects and the practical approach to therapy. CBT supervision has parallels to cognitive therapy as it is focused, structured, educational, and collaborative (Newman, 2013).
Its focus lies with the development and progress of the therapeutic competence of the supervisee, to provide them with all the necessary knowledge, skills, and competences for their further practice. The supervision process is structured in a way to achieve initially targeted results from the very early stages of the joined work of the supervision alliance.
The working process consists of individual sessions in a particular format that helps to measure supervisees’ progress, outline existing problems, and guide their research and scope of work. From the educational aspect, CBT supervision provides all the relevant information for supervisees, trains their skills, suggests feedback that should guide them in the learning process and help them solve problematic learning questions.
Most importantly, a supervision alliance should work as a team, where supervisee should participate in the sessions actively, formulate questions, and contribute to the agenda. Supervision of CBT also consists of different methods, namely: the discussion of the care process; the study of video and audio recordings or live observations; demonstrations through role-playing; and co-therapy, which can be conducted between the supervisor and the supervisee, or between two supervisees.
The primary objective of therapists under the supervision consists of the acute awareness of their own emotions, behavior, and cognition processes, and how they influence and determine their therapeutic work with patients. They should not let their hasty judgments or prejudices about their clients, their practice, or their supervisor affect their work. On the contrary, they should make use of the better understanding of their cognition processes to the benefit of the supervision alliance and the results of their practice.
The main advantage of the cognitive behavioral model is that it encourages supervisees to observe and reflect on their practice, discuss it in detail in sessions with their supervisor, and get immediate feedback, support, and advice. Moreover, this way of learning through experience helps to consolidate the existing skills and acquire new ones more efficiently. Moreover, supervisors have an opportunity to monitor supervisees’ work very closely, which enables them to analyze their progress and consequently take an individual approach and set exact and relevant goals for each supervisee.
However, there is not enough evidence of the efficiency of this model, presumably to the nature of the educational process that implies the self-exploration and perfection of individual understanding of the therapeutic processes from each supervisee. Moreover, as it mainly focuses on practical and methodological objectives which should be mastered by supervisees, it might discourage supervisors from developing more general but none the less crucial individual traits of supervisees.
References
Bakos, D., & Kristensen, C. (2013). Supervising cognitive behavioral therapy practitioners in urban Brazil. Journal of Cognitive Psychotherapy, 27(1), 42-50.
Newman, C. (2013). Training cognitive behavioral therapy supervisors: Didactics, simulated practice, and “meta-supervision”. Journal of Cognitive Psychotherapy, 27(1), 5-18.