Transfer of individual supervision goals into the subsequent therapy session: implementation quality, not adherence, is linked to therapeutic skills

This study examined how well undergraduate psychology students adhered to supervision goals and how effectively these goals were implemented in subsequent therapy sessions. A secondary analysis with four sub-studies was conducted using data from three randomized controlled trials with standardized patients (<i>N₁</i> =71, <i>N₂</i> =71, <i>N₃</i> =80). Students received either delayed or live supervision. Independent raters identified supervision goals from audio-recorded supervision sessions and evaluated goal adherence, implementation quality, and therapeutic skills in later sessions. On average, students adhered to nearly 90% of supervision goals; however, implementation quality was only moderate. Adherence itself was not associated with students' therapeutic skill levels. In contrast, higher implementation quality was related to better prior skills and predicted skill improvement. Specific supervision techniques (e.g. video analysis, role-play) showed no association with adherence or implementation quality, whereas a higher number of positive reinforcements was unexpectedly related to poorer implementation quality. Perceptions of successful transfer differed between students, supervisors, and independent raters. Supervision can influence students' behavior, but goal adherence alone is insufficient to improve performance. Enhancing the quality of goal implementation appears crucial for effective skill development. Future studies should develop strategies to enhance goal implementation quality in therapies with advanced trainees.