Implementation Climate and Time Predict Intensity of Supervision Content

Course overview

Course Description: This course is based upon material published in the Frontiers in Public Health journal and is available as an open-access article. Objective: Children infrequently receive evidence-based treatments (EBTs) for mental health problems due to a science-to-practice implementation gap. Workplace-based clinical supervision, in which supervisors provide oversight, feedback, and training on clinical practice, may be a method to support EBT implementation. Our prior research suggests that the intensity of supervisory focus on EBT (i.e., thoroughness of coverage) during workplace-based supervision varies. This study explores predictors of supervisory EBT intensity. Methods: Participants were twenty-eight supervisors and 70 clinician supervisees. They completed a baseline survey, and audio recorded supervision sessions over 1 year. Four hundred and thirty eight recordings were coded for supervision content. We chose to explore predictors of two EBT content elements due to their strong evidence for effectiveness and sufficient variance to permit testing. These included a treatment technique ("exposure") and a method to structure treatment ("assessment"). We also explored predictors of non-EBT content ("other topics"). Mixed-effects models explored predictors at organizational/supervisor, clinician, and session levels. Results: Positive implementation climate predicted greater intensity of EBT content coverage for assessment (coefficient = 0.82, p = 0.004) and exposure (coefficient = 0.87, p = 0.001). Intensity of exposure coverage was also predicted by more time spent discussing each case (coefficient = 0.04, p greater than 0.001). Predictors of greater non-EBT content coverage included longer duration of supervision sessions (coefficient = 0.05, p greater than 0.001) and lower levels of supervisor EBT knowledge (coefficient = -0.17, p = 0.013). No other supervisor- or clinician-level variables were significant predictors in the mixed effects models. Conclusion: This was the first study to explore multi-level predictors of objectively coded workplace-based supervision content. Results suggest that organizations that expect, support and reward EBT are more likely to have greater intensity of EBT supervision coverage, which in turn may positively impact clinician EBT fidelity and client outcomes. This course on evidence based supervision is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors, who do clinical work. In addition, this course is appropriate for intermediate and advanced level practitioners who wish to develop their knowledge of evidenced based supervision. It may also be useful for licensed clinicians who require continuing clinical education courses for license renewal. The course is based on a journal article that includes research. It contains statistical analysis and data that some clinicians enjoy reading and others do not. A significant benefit of reading research-based articles for continuing education is they provide practitioners with the latest findings in their field. Authors: Pullman, Lucid, Harrison, Martin, Deblinger, Benjamin & Dorsey Learning Objectives: This course will provide the practitioner with detailed information about evidenced-based treatment (EBT) supervision. Specifically, a professional will: Discriminate between workplace supervision and evidence-based treatment coverage supervision Identify organizational factors that predict EBT content in supervision Describe supervisor factors that predict EBT content in supervision Identify clinician factors that are associated with coverage intensity for EBT supervision Citation: Pullman, M. Lucid, L., Harrison, J.P., Martin, P., Deblinger, E., Benjamin, K.S. and Dorsey, S. (2018). Implementation climate and time predict intensity of supervision content related to evidence-based treatment. Frontiers in Public Health, October, V6, article 280.