How to Conduct a CBT Supervision Session

Conducting a Cognitive Behavioral Therapy (CBT) supervision session might seem like a pretty simple topic. If you are a clinical supervisor, you may even think you know what CBT supervision is and how to use it. The problem? CBT Supervision is not just about teaching CBT concepts or teaching someone to use CBT. This blog will help you to have a better understanding of what CBT supervision is, what it's not, and when to use it.

TCCBB #28 How to Conduct a CBT Supervision Session

What is CBT Supervision?

When we think CBT in counseling, we may think about investigating our clients' schemas and core beliefs. Our job as a counselor is to help the client identify thinking errors or cognitive distortions and then help them dispute and replace them with new ones.

One of the first things I think people taking the Kate Walker Training 40-hour course to become a LPC or LMFT supervisor in Texas learn right away is that supervision is not counseling. It has its own interventions, theories, and techniques. 

Additionally, the clinical supervisor must take on different roles during supervision. Roles that a clinical supervisor might take on temporarily include the teacher role, the counselor role, and the consultant role.

CBT supervision is a theory most often utilized with the clinical supervisor is in the role of teacher.

Is CBT Supervision the same as CBT therapy?

While CBT supervision and CBT therapy may use similar techniques and interventions, the goals and objectives of each process are different. CBT supervision aims to help trainees improve their skills and enhance the quality of their work, while CBT therapy aims to help clients achieve their treatment goals and improve their mental health.

What CBT supervision is not, is teaching CBT concepts. For example if your supervisee comes to you and they’re very curious about CBT and they’re choosing you as their supervisor because you are a CBT expert, you may teach them everything you know about CBT.

That, however, is not CBT supervision; that is teaching CBT concepts. In other words, teaching your supervisee the definitions of mental filtering, overgeneralization, and the fortune teller error is not CBT supervision; that’s teaching your supervisee how to use cognitive behavioral therapy concepts.

CBT supervision on the other hand, is very structured, it is very goal oriented, and there are specific interventions designed to elicit specific outcomes. 

When should a clinical supervisor conduct a CBT supervision session?

As a clinical supervisor, when I put on my teacher hat, I will most likely be using CBT supervision.

If we use the metaphor of parenting, imagine a ‘helicopter' parent and a ‘laissez-faire' parent. CBT supervision would fall into the camp of being more ‘helicopter' or hands-on supervision. An example of CBT supervision might look like:

1. At the beginning of the CBT supervision session check-in with your supervisee
2. Set the agenda for the supervision today
3. Bridge from a previous supervision
4. Inquire about previous and cases, homework, issues
5. Intervene with the supervisee (role play, mindfulness, Socratic questioning, remediate)
6. Ask the supervisee if there is anything they'd like to discuss or set to the next supervision agenda

You can imagine CBT Supervision is very appropriate for a level one, or novice supervisee. It's also appropriate when an experienced supervisee is in a new job setting, or when they are struggling with issues that impair their ability to deliver counseling services. 

Knowing when and how to conduct a CBT supervision session is important for any clinical supervisor. Don't settle for teaching CBT concepts and calling it CBT supervision. Level one and experienced supervisees alike will benefit when you are able to put on your teacher hat, break concepts down, and provide a structure.

Blog post by Kate Walker Ph.D., LPC/LMFT Supervisor in Texas

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