The relation between training asymmetry and supervisory working alliance: implications for the role of supervisors in implementation

ABSTRACT

Clinical supervision can effectively support the use of evidence-based treatments (EBTs) in community settings. However, implementation of multiple EBTs can lead to different training experiences for therapists and supervisors, such that therapists might learn EBTs their supervisors do not, and vice versa. We explored whether such training asymmetry impacted supervisory working alliance (SWA). In a community sample, more than half of supervisory dyads disagreed about SWA quality. When supervisors had training in fewer EBTs than their supervisees, supervisors rated working alliance lower. We conclude that incorporating supervisors in implementation from the outset could minimize negative side effects of training asymmetry.

KEYWORDS:

• Clinical supervision
• implementation
• training
• evidence-based practice
• working alliance

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Notes

1. The PracticeWise Youth Mental Health Services Literature database contains treatment summaries of interventions featured in published research. An EBT was considered an appropriate treatment for a target problem if it was identified in the PWEBS database as having “good support” for the problem area, meaning that two or more studies showed the EBT was better than waitlist/no treatment or that one study showed the EBT was better than another treatment or control condition or that one study showed the EBT was equal to another established EBT (see Chorpita et al., 2011, for more details).

Additional information

Funding

This research was supported in part by the William T. Grant Foundation (Award #187173) to Drs. Chorpita (PI) and Becker (Co-PI) : “Coordinated Knowledge Systems: Connecting Evidence to Action to Engage Students in School Mental Health”.

Notes on contributors

Meredith R. Boyd

Meredith R. Boyd, M.A., is a doctoral student in clinical psychology from UCLA. Her research focuses on improving the effectiveness of community mental health services, with a special interest in strategies for developing a strong provider workforce.

Alayna L. Park

Alayna L. Park, Ph.D., is an Assistant Professor in the Department of Psychology at Palo Alto University. Her research focuses on improving the effectiveness of mental health services through promoting evidence-based practice in dynamic contexts. She has published more than 20 scientific papers on the topics of treatment design, clinical decision-making, and dissemination and implementation. 

Kimberly D. Becker

Kimberly D. Becker, Ph.D. is a licensed psychologist and an Associate Professor in the Department of Psychology at the University of South Carolina. Dr. Becker’s research focuses on improving the effectiveness of children’s mental health services, with specific interests in clinical decision-making and treatment engagement.

Bruce F. Chorpita

Bruce F. Chorpita, Ph.D., currently holds the position of Professor of Psychology at the University of California, Los Angeles, and is the President of PracticeWise, LLC. He has worked in multiple academic and government leadership positions related to children’s mental health and practice improvement. Dr. Chorpita is committed to making knowledge and science work better to improve the lives of children and families.