Discrepancies between guidelines, preferences and actual activities in psychotherapy supervision

Abstract Background Clinical supervision, also known as consultation, is a key component of professional growth for psychotherapists, often involving activities like case discussions or practical exercises. However, the extent to which the content of supervision follows practice guidelines and whether supervision meets the preferences of psychotherapists is largely unclear. Aims This study aimed to understand what psychotherapists prefer to do in clinical supervision and contrast that to what their supervision comprises. A secondary aim was to explore whether there were any differences in preferred activities between psychotherapists with different background variables, such as profession and training, and to examine associations between activities, supervision satisfaction and effectiveness. Materials & Methods Psychotherapists ( N = 243, 84% women, mean age 46.3 years, SD = 10.6) completed an online survey regarding their supervision preferences and actual supervision activities. Results The psychotherapists reported that formative activities, such as concrete exercises, discussing recorded material and modelling, were significantly more preferred than they were occurring in clinical supervision. The activities of teaching, modelling and discussions on emotional reactions, which are more associated with restoration, were associated with supervision satisfaction and competence. Psychotherapists with a cognitive behavioural therapy orientation preferred more active learning activities than other psychotherapists. Conclusions Overall, neither the preferred nor the actual activities aligned with existing guidelines for supervision practices. Still, the therapists reported a preference for more experiential learning activities rather than more verbal activities.