One of the key areas related to our developmental efforts is in the realm of clinical supervision.

Clinical supervision is the signature pedagogy of choice in psychotherapy. I’ve benefited a great deal from the lessons of my supervisors. Some of their words from a decade ago still echo, and have become first principles I keep close in my own work. Most of us regard clinical supervision as integral to our professional development. It’s hard to imagine not having someone to turn to for case consultation and guidance, especially when stuck in a rut and not making expected or desired progress with a particular client.

Given the benefit we often feel from clinical supervision, the logical next question is whether clinical supervision translates into meaningful impact on our client’s well-being.

At least that’s what we would hope for.

Edward Watkins Jr., a researcher from the University of North Texas, conducted a review of 18 empirical studies that examined the impact of supervision on client outcomes. Based on the big picture analysis, Watkins Jr said,

“…the collective data appears to shed little new light on the matter. We do not seem to be able to say anything new now, (as opposed to 30 years ago), that psychotherapy supervision contributes to client outcomes.”

Watkins, 2011, p. 235.

Watkin Jr. made his point clear:

“If we cannot show that supervision affects patient outcome, then how can we continue to justify supervision?”

Eight years later, Watkins published yet another review article called What do clinical supervision research reviews tell us? Surveying the last 25 years (2019). Again, back to Watkins Jr:

Supervision, found to be positively associated with job satisfaction, job retention and ability to manage workload appears to be seen as helpful by supervisees and may even benefit their therapeutic competence (e.g. enhanced self-awareness, enhanced sense of self-efficacy).

But supervision’s favorable impact on outcomes is weak at best, yet to be proven.

Furthermore, the client has been, and continues to be, summarily neglected in supervision research: supervision’s impact on client outcome has yet to be proven.

Practising supervisors and supervisees tend to believe in, and have conviction about, the benefits, power and potential of supervision. But belief and conviction do not necessarily translate into empirical reality.” (emphasis mine)

Watkins, 2019, p. 13, p. 16.

Take a moment and let Edward Watkins Jr’s, one of the leading researchers in clinical supervision, words sink in.

I’ve wrote elsewhere about clinical supervision, as well as a 3-part series on Frontiers Friday #30, #31, and #32.

Here’s a summary our my speculations of where we falter.

(Note: The following is an excerpt from the book, Creating Impact)

Here are my seven speculations of why the default approach to clinical supervision has not significantly improved client outcomes (Chow, 2018, 2019a):

1. Explainoholic
2. Pat on the back
3. Lack of Monitoring Client Progress
4. Lack of Monitoring Engagement Level in Supervision
5. Not Analysing the Game
6. Overemphasis on the Self and Neglecting the Impact on Client
7. Lack of Focus on Therapist’s Learning Objectives.