Clinical supervision based on video vs. verbal report: a randomized controlled trial

Clinical supervision is considered important in psychotherapy training, but little is known about the efficacy of specific supervision methods. We investigate two such methods (video-based vs. verbal report-based supervision) in a randomized controlled trial. Seventy-three supervisees were trained in common cognitive-behavioral therapy methods (i.e. behavioral activation and cognitive restructuring) by means of written information and a modelling video demonstrating the techniques. Supervisees had to apply the techniques in role plays with standardized patients (presenting depressive patients). Subsequently, supervisees were randomized to supervision, based on the video, or supervision based on the verbal report of the supervisees. Subsequently and after a three-month follow-up period, supervisees had to demonstrate the therapeutic techniques again. Therapist competence, therapeutic alliance, empathy, and anxiety were assessed through various different perspectives (i.e. independent raters, standardized patients, and supervisees' self-evaluation). Both supervision conditions lead to a significant improvement of therapeutic competences, therapeutic alliance, and empathy. No significant differences were found between the two supervision conditions. At three-month follow-up, training effects decreased on all perspectives except standardized patients. A training condition without supervision would be necessary to demonstrate that improvements are specific effects of the supervision conditions. Moreover, further supervision seems necessary to maintain training effects over time.