“Now we can think about it together” – A thematic analysis of what characterizes (in)effective supervision sessions for novice CBT supervisees

Clinical supervision is considered an important aspect of therapist training. However, little is known about which elements of supervision impact on therapist skills. The current study used a qualitative approach to identify patterns of (in)effective supervision sessions for novice CBT supervisees. Sixteen supervision sessions were selected, based on deviant case sampling from a larger randomized controlled trial investigating the effect of clinical supervision for psychology students. Nine effective and seven ineffective supervision sessions were chosen, based on changes in independently assessed competence and alliance scores from pre- to post-supervision. Transcripts of these sessions were analyzed using thematic analysis. The analysis yielded four themes, each structured into two sub-themes: Shaping Supervision through Supervisee Agency, The Supervisor as a Tailor, Co-Constructing Supervision, and Creating a Space to Learn. Effective supervision sessions were characterized by supervisees working actively on their individual goals, the use of a variety of supervisory techniques tailored to the supervisees' needs, a collaborative exchange at eye level, and a supportive and empowering atmosphere. Our analysis identified theoretically and clinically relevant processes in supervision that may foster novice CBT supervisees' skills. It emphasizes the potential of personalized approaches, building on a supportive atmosphere.