Clinical supervision in cognitive behavior therapy improves therapists’ competence: a single-case experimental pilot study

ABSTRACT

Clinical supervision is a cornerstone in psychotherapists’ training but there are few empirical evaluations on the effects of supervision on therapists’ competencies. The aim of this study was therefore to evaluate the effects of standardized supervision on rater-assessed competency in Cognitive Behavior Therapy (CBT). Six therapists with basic training in CBT were provided with protocol-based clinical supervision in CBT in a single-case experimental multiple baseline design. The supervision focused on specific CBT competencies and used experiential learning methods such as role-play. Each therapist recorded weekly treatment sessions during phases without and with supervision. The therapists’ CBT competence was assessed by third-party raters using the Revised Cognitive Therapy Scale (CTS-R). Statistical analyses showed that the therapists’ CTS-R scores increased significantly during the phase with supervision with a mean item increase of M = 0.71 (range = 0.50–1.0) on the supervision focus areas. This is one of the first empirical studies that can confirm that supervision affect CBT competencies. The results also suggest that supervision can be manualized and that supervisees have a positive perception of more active training methods. Further studies are needed to replicate the results and to find ways to improve the impact of supervision.     

Pogge on Poverty: Contribution or Exploitation?

Thomas Pogge argues that affluent people in the developing world have contribution‐based duties to help protect the poor. And it follows from Pogge's most general thesis that affluent people are contributing to most, if not all, instances of global poverty. In this article I explore two problems with Pogge's general thesis. First, I investigate a typical way in which affluent people would be contributing to global poverty according to Pogge: that affluent countries use their superior bargaining power to get poor countries to accept trading schemes that are unduly favourable to the affluent. I suggest that this type of relation is best understood as exploitation, and that Pogge's general thesis is better understood as a thesis about how affluent people exploit poor people rather than about how they contribute to poverty. Second, I argue that the exploitation does not have the normative content of doing harm. Although exploiting people is often morally wrong, it is not at all clear how demanding exploitation‐based duties are.