What do trainee cognitive behavioural therapists need from clinical supervision to develop their skills in working with people with psychosis? A qualitative analysis

Abstract

Background: Clinical supervision is assumed to be essential to the development of competent psychological therapists. While the evidence for effective psychological therapy training remains sparse, there is some support for the role of supervision and the experiential learning cycle in trainees’ progression. Despite a growing demand for cognitive behavioural therapy for psychosis (CBTp), no research has investigated the components of CBTp supervision necessary for skilful therapeutic practice. Methods: We completed a qualitative thematic analysis of 385 supervision questions from 11 trainee CBTp therapists. Results: The analysis yielded three main themes–knowledge/content (What?) questions; procedure/process (How?) questions; and course requirements/assessment methods (Training) questions. What? questions decreased over the 20 weeks of supervision, How? questions were raised throughout, and Training questions increased prior to academic deadlines. The thematic analysis also showed that active experimentation (the final stage of the experiential learning cycle) may be omitted from supervisory practice. Discussion: These results indicate that CBTp supervision should prioritise knowledge, procedural learning and active experimentation, in training therapists to deliver high quality CBT for people with psychosis.