Throwing the doors open on clinical supervision in CBT

Shazna Khanom, UK Clinical Director, tells us how she ensures her team of 700 therapists become the best therapists that they can be.

Before Covid-19, most therapy took place face to face, behind closed doors. Once qualified, CBT therapists had very little direct feedback in relation to their clinical work compared to the feedback they received during their CBT training.

Whilst some CBT therapists provide recordings of their clinical work to their supervisor most avoid doing so. There are a number of reasons a therapist might shy away from recording themselves during clinical work and presenting this to a supervisor. Fear of judgement, time pressure and assumption that a patient may not like the session to be recorded all can all play a part in why a therapist will avoid this activity. We have found that when therapists do present a recorded session to their supervisor they often will pick a session they think went well instead of picking a session that may have gone ‘badly’ in some way thus missing the opportunity to learn and grow from the experience.

Many Services have no way of knowing why some therapists get better outcomes than others. They also have no way of tracking whether the supervision therapists receive impacts positively on their clinical work. There is a belief that is does but this has not been widely researched. Working digitally brings many advantages and gives us unique insights into what works for whom. I’d like to talk you through the supervision capability that our platform offers and what it means mean for long-term quality of care and career progression.

All clinicians have access to the Ieso on-demand supervision and case management tool which is monitored and tracked by our clinical team. It offers both proactive and reactive supervision from assessment to discharge. What normally happens in supervision is that a therapist approaches their supervisor with a problem or

attends a supervision group with a prepared supervision question relating to a case but the supervisor has no way of knowing if that advice helped with that patient’s care, or even if the therapist chose to follow the advice.

By using our clinical support tools, a supervisor can see what actions a therapist has taken and if their advice had an impact on the patient’s recovery and/or engagement. It also gives us a data set to find out what supervision methods have the best impact on therapy.

All of our therapy sessions are recorded and analysed against our historic data set. Our supervision tools automatically flags issues to a supervisor so that they can proactively offer advice to the therapist on how best to treat a patient.

Ieso clinical supervisors have transparency into all their therapists’ cases. As well as the ability to review all patient case transcripts and notes for retrospective and live analysis, we have the ability to track which therapists perform better for different conditions over time. This allows them to specialize if they wish, and only treat patients that suit their skillset, or for us to offer tailored training on areas of weakness. This means that we can offer tailored training to therapists to ensure that they become the best that they can be.

All supervision notes related to a case are kept in one place, as part of the patient’s clinical records. It also provides case management support for urgent risk, step up, suitability and session extension.

The purpose of these tools is to create a close alliance between supervisors and therapists. It is as much about improving patient care as it is about creating a data set to see what actually works in supervision. It’s an exciting part of ensuring the best possible care for patients and ultimately improving outcomes.