Supervisory Alliance as a Moderator of the Effects of Behavioral Rehearsal on TF-CBT Fidelity: Results from a Randomized Trial of Supervision Strategies
Year: 2023
Type: article
Abstract: Exposure is an important element of treatment for many evidence-based treatments but can be challenging to implement. Supervision strategies to support exposure delivery may be an important tool to facilitate the use of exposure techniques; however, they must be considered and used in the context of the supervisory alliance. The present study examined relations between supervisory alliance and fidelity to the trauma narrative (TN; i.e., imaginal exposure) component of Trauma-Focused Cognitive Behavioral Therapy. We also examined how supervisory alliance moderated the effect of behavioral rehearsal use in supervision on TN fidelity. We analyzed data from a randomized controlled trial, in which forty-two supervisors and their clinicians (N = 124) from 28 Washington State community-based mental health offices participated. Clinicians were randomized to receive one of two supervision conditions-symptom and fidelity monitoring (SFM) or SFM with behavioral rehearsal (SFM + BR). Supervisory alliance alone did not predict delivery (i.e., occurrence) or extensiveness of delivery of the trauma narrative. Client-focused supervisory alliance moderated the effectiveness of behavioral rehearsal-as client-focused alliance increased, the odds of delivering the TN also increased significantly. Future research should further investigate how to appropriately match supervision techniques with supervisory dyads and explore the interplay of alliance with supervision techniques a supervisor might employ.
Institution: University of Washington
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Awards: Optimizing Evidence-Based Practice Implementation for Clinical Impact: the IMPACT Center, Applying Human-Centered Design to Inform Mobile Technology-Mediated Supervision with Lay Counselors in Kenya, Improving Practice in Community-based Settings: A Randomized Trial of Supervision, G6265405358, Machine learning methods for identifying person-level mechanisms of alcohol use among sexual and gender minority intersections, Attending to the “whole” child in mental health care: Utilizing a partnership approach to address social risk factors alongside an evidence-based psychotherapy, Alcohol Research in the Science/Practitioner Model
OpenAlex ID: W4390412552