By Katrina Rast, Daniel Herman, Tony Rousmaniere, Jason Whipple and Joshua Swift 

SAGE Open 

Review written by: Dr David Wilkins

What question does this study focus on? 

This study considers two questions – (i) what is the perceived impact of supervision on client outcomes and (ii) how important is it to supervisors and supervisees that supervision affects client outcomes? The study was undertaken in relation to psychotherapy training and clinical supervision.

How did they study it?

The study used a survey to investigate the views of supervisors (n=189) and supervisees (n=185). The survey asked questions about the impact of supervision on clients and the importance of supervision having an impact on clients. Most of the questions called for a Likert-style response, with a 5-point scale (from 1 = do not agree, to 5 = totally agree). 

What did they find?

Supervisors and supervisees alike were positive about the impact of supervision on client outcomes, with overall average scores of 3.65 and 3.54 respectively (out of 5). In relation to the importance of supervision having an impact on client outcomes, supervisees were more positive than supervisors, with overall average scores of 4.06 and 3.87 respectively (ditto). Supervisors and supervisees agreed that supervision made a difference in relation to the impact of counselling / psychotherapy for clients and that it could help reduce client deterioration (problems getting worse). 

Supervisors also said that supervision helped with the personal and professional growth of their supervisees, for example by helping identify areas for professional development. Supervisors also said they helped supervisees by supporting them to develop collaborative relationships with their clients. Supervisees said that supervision helped by making them feel validated and well supported, and by providing them with ideas, activities, techniques and strategies to try out with their clients. 

They found no significant differences in the views of respondents in relation to gender, age, type of degree qualification, type of therapy offered, length of experience, number of clients or the use of outcome measures. 

What are the implications? 

Supervisors and supervisees in counselling / psychotherapy settings agree that supervision can and should make a difference for clients and feel this is an important aim for supervision. However, this link between supervision and client outcomes has yet to be empirically established (in counselling / psychotherapy, or in social work). The best evidence we have currently does not support the contention that supervision makes a major difference for people in counselling, or those using social work services, despite the views reported here. In two of the best designed studies of counselling supervision, the amount of variance in client outcomes explained by supervision ranged between 16% and 0.01%. In summary, these results indicate that supervisors and supervisees believe that supervision impacts on client outcomes, but there is no evidence or consensus to explain how this happens, or to what extent. 

Review written by

Dr David Wilkins