Evidence-based practice (EBP), a preferred psychological treatment approach, requires training of community providers. The systems-contextual (SC) perspective, a model for dissemination and implementation efforts, underscores the importance of the therapist, client, and organizational variables that influence training and consequent therapist uptake and adoption of EBP. This review critiques the extant research on training in EBP from an SC perspective. Findings suggest that therapist knowledge improves and attitudinal change occurs following training. However, change in therapist behaviors (e.g., adherence, competence, and skill) and client outcomes only occurs when training interventions address each level of the SC model and include active learning. Limitations as well as areas for future research are discussed.

/pdf/training-therapists-in-evidence-based-practice-a-critical-35h8h4htwo.pdf

Training Therapists in Evidence-Based Practice: A Critical Review of Studies From a Systems-Contextual Perspective.

Context
Clinical supervision has a vital role in postgraduate and, to some extent, undergraduate medical education. However it is probably the least investigated, discussed and developed aspect of clinical education. This large-scale, interdisciplinary review of literature addressing supervision is the first from a medical education perspective.

Purpose
To review the literature on effective supervision in practice settings in order to identify what is known about effective supervision.

Content
The empirical basis of the literature is discussed and the literature reviewed to identify understandings and definitions of supervision and its purpose; theoretical models of supervision; availability, structure and content of supervision; effective supervision; skills and qualities of effective supervisors; and supervisor training and its effectiveness.

Conclusions
The evidence only partially answers our original questions and suggests others. The supervision relationship is probably the single most important factor for the effectiveness of supervision, more important than the supervisory methods used. Feedback is essential and must be clear. It is important that the trainee has some control over and input into the supervisory process. Finding sufficient time for supervision can be a problem. Trainee behaviours and attitudes towards supervision require more investigation; some behaviours are detrimental both to patient care and learning. Current supervisory practice in medicine has very little empirical or theoretical basis. This review demonstrates the need for more structured and methodologically sound programmes of research into supervision in practice settings so that detailed models of effective supervision can be developed and thereby inform practice.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2923.2000.00758.x

Effective supervision in clinical practice settings: a literature review

The role of therapist training in the implementation of psychosocial treatments: a review and critique with recommendations.

Assessment of Personality and Psychopathology: Psychodiagnosis Case Formulation Behavioural Predication Treatment Planning Neuropsychological Assessment Methods and Recommendations for Making Judgements Clinical Judgement Computers and Judgement Improving Psychological Assessment.

Studying the Clinician: Judgment Research and Psychological Assessment

Clinical Supervision is a comprehensive, up-to-date scholarly resource for training and supervising mental health practitioners. It guides readers through a science-informed process of supervision that clearly delineates the competencies required for good practice. The authors have geared this integrative approach to mental health professionals who currently provide supervision in academic, training, and treatment settings as well as to students and practitioners who are studying the supervision research and theory for the first time.

Clinical Supervision: A Competency-Based Approach

Michael V. Ellis University at Albany, State University of New York Nicholas Ladany Temple University Maxine Krengel Boston Veterans Affairs Medical Center and Boston University School of Medicine Deborah Schult University at Albany, State University of New York The empirical studies in clinical supervision published from 1981 through 1993 were investigated to assess scientific rigor and to test whether the quality of methodology had improved since the review by R. K. Russell, A. M. Crimmings, and R. W. Lent (1984). The 144 studies were evaluated according to 49 threats to validity (T. D. Cook & D. T. Campbell, 1979; R. K. Russell et al., 1984; B. E. Wampold, B. Davis, & R. H. Good III, 1990) and 8 statistical variables (e.g., effect size, statistical power, and Type I and Type II error rates). The data revealed a shift to realistic field studies, unchecked Type I and Type II error rates, medium effect sizes, and inattention to hypothesis validity. Recommendations for designing and conducting a feasible and well-designed supervision study are offered. It can be argued that a primary goal of research in clinical supervision is to test and improve theory and to guide the practice of supervision (Ellis, 1991b). A thorough under- standing of the strengths and weaknesses of supervision research would ostensibly expand supervision theory and provide practitioners with information on how to train ef- fective counselors who, in turn, will provide more effective therapy. Although there have been numerous calls for in- creasing the scientific rigor of research on counselor super- vision and training (e.g., Ellis, 1991b; Hansen & Warner, Michael V. Ellis and Deborah Schult, Department of Counseling Psychology, University at Albany, State University of New York; Nicholas Ladany, Department of Counseling Psychology, Temple University; Maxine Krengel, Psychology Section (1168), Boston Veterans Affairs Medical Center and Department of Psychology, Boston University School of Medicine. Earlier versions of this article were presented at the 96th Annual Convention of the American Psychological Association, Atlanta, Georgia, August 1988, and at the meeting of the North Atlantic Regional Association of Counselor Education and Supervision, Albany, New York, October 1991. Maxine Krengel completed some of this research while a doc- toral student in the Department of Counseling Psychology, Uni- versity at Albany, State University of New York. We are grateful to Micki Friedlander, Richard Haase, and Erica Robbins Ellis for their insightful comments on earlier versions of this article. We express our appreciation to Eric Adams, Mafoozal Ali, Elizabeth Bhargava, Virginia Flander, David Hahn, Gohpa Khan, Michelle Mautner, Deborah Melincoff, Michael Remshard, Greg Savage, Heidi Weiss, Donna Wilson, and Bradley Wolgast for their data coding and entry assistance. Correspondence concerning this article should be addressed to Michael V. Ellis, Department of Counseling Psychology, Educa- tion 220, University at Albany, State University of New York, 1400 Washington Avenue, Albany, New York 12222. Electronic mail may be sent via Internet to me464@cnsibm.albany.edu. 35 1971; Holloway & Hosford, 1983; Russell, Crimmings, & Lent, 1984), a comprehensive and in-depth investigation of the actual state of scientific rigor has yet to be conducted. If supervision research is going to meet the goal of informing theory and practice, then a thorough assessment of its meth- odological limitations and implications is warranted. At least 32 reviews of empirically based articles pertain- ing to clinical supervision and counselor training have ap- peared in the literature. Although these reviews have made substantial contributions to the field, many did not evaluate systematically the methodological or the scientific rigor of the examined studies (e.g., Harkness & Poertner, 1989; Holloway, 1984, 1992; Holloway & Neufeldt, 1995; Kaplan, 1983; Lambert & Arnold, 1987; Leddick & Ber- nard, 1980; Liddle & Halpin, 1978; Matarazzo, 1971, 1978; Matarazzo & Garner, 1992; Matarazzo & Patterson, 1986; Russell & Petrie, 1994; Stoltenberg, McNeill, & Crethar, 1994; Yutrzenka, 1995) or did so in a cursory fashion (i.e., Baker & Daniels, 1989; Baker, Daniels, & Greeley, 1990; Ford, 1979; Hansen, Pound, & Petro, 1976; Robins, & Grimes, 1982; Hansen & Warner, 1971; Holloway & Johnston, 1985; Holloway & Wampold, 1986; Kurtz, Mar- shall, & Banspach, 1985; Loganbill, Hardy, & Delworth, 1982; Stein & Lambert, 1995; Worthington, 1987). Only four reviewers presented details of the methodological flaws encountered in the studies reviewed (Alberts & Edelstein, 1990; Avis & Sprenkle, 1990; Holloway, 1987; Russell et al., 1984). The result of not systematically evaluating the methodological issues may have erroneously led to (a) equating (or even outweighing) the findings of excellent research with poor research (Hogarty, 1989; Kline, 1983), (b) exacerbating the theoretical ambiguity in the field (Meehl, 1990), and (c) drawing inaccurate inferences and conclusions (Cooper, 1989; Ellis, 1991a). The most recent review of research in individual clinical supervision that

Clinical Supervision Research from 1981 to 1993: A Methodological Critique.

Etude des erreurs d'ancrage dans le jugement clinique. Le sexe n'intervient pas ici. Confrontation de deux hypotheses renales (hypothese de l'ajustement, hypothese de l'attenuation des effets d'ancrage initiaux par un effet d'ajustement

Deborah Schult

Papers

Clinical Supervision Research from 1981 to 1993: A Methodological Critique.

Anchoring Errors in Clinical Judgments: Type I Error, Adjustment, or Mitigation?.