Current Supervision Practices Have Not Prevented the Poor Outcomes In IAPT

 

With a 10% recovery rate in IAPT https://doi.org/10.1177/1359105318755264, serious questions have to be asked about the quality of supervision.  But it could be that Supervisors in IAPT feel that their role is constricted or the use of practitioner league tables sabotages their endeavours. Clearly something is going badly wrong. However it could also be that current supervision practices whether or not they take place in IAPT are not fit for purpose, they are eminence rather than evidence based.

 

‘Its’ about monitoring, personal development – a bit like treating a client, has to be tailored to the supervisee’ this seemed to be the consensus at a BABCP Supervision Workshop I attended with about 40 others in Liverpool last week.  The presenter Jason Roscoe, asked the 40 attendees what model of supervision they followed, there was a deafening silence. He then presented the Roth and Pilling competencies for supervision, I opined that just looking at the rows and columns gave me ‘mental  indigestion’.  Given the outbursts of laughter I think that this was a widely shared view.  I had a sense that people feel rudderless with regards to supervision, and there was no enthusiasm about becoming a BABCP accredited supervisor.

I suggested that the prime function of supervision is to act as a conduit for evidence based treatment. Since the Workshop I have reflected that no alternative definitions of the prime  function were offered rather the Bennett-Levy model of supervision involving 3 different types of knowledge declarative, procedural and reflective was recommended. The implication was that one might need to do more or less on any one of these forms of knowledge with any particular supervisee. Hmm I thought, this is no different to what one would do with a client in treatment. The offering at the Workshop was I found typical of what passes for evidence in BABCP with regards to supervision, but there is sparse evidence such supervision makes a real world difference to client’s lives. What is known is that supervision has been an integral part of randomised controlled trials and that type of supervision can be considered evidence based. It follows that to the extent that this type of supervision is adopted, with its’ emphasis on reliable diagnosis and fidelity checks for adherence and competence one is still in the ball park of evidence based supervision ( see Simply Effective CBT Supervision London: Routledge).

Dr Mike Scott

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