International Journal of Supervision in Psychotherapy

Received: 12.03.2025; Accepted: 22.03.2025; Published: 15.05.2025

   Clinical supervision is the cornerstone of professional development in the mental health field (Falender & Shafranske, 2004, 2021). It is “a critical if not the most critical facet of the psychotherapy training endeavor” (Watkins, 1997, p. 9). Supervision ensures the quality of care and the welfare of clients, facilitates the trainee’s emerging clinical competence and professionalism, and safeguards the public and profession by serving as a gatekeeper (Shafranske & Falender, 2016). The supervisory relationship provides a context for developing clinical competence, enhancing self-awareness, supporting metacompetence, and establishing the supervisee’s emerging professional identity. In that regard, supervision has been found to have salutary effects on the supervisee (Knox & Hill, 2021). However, variability exists in the quality of supervision provided. Regretfully, inadequate and harmful supervision occurs, compromising the supervisory relationship and negatively impacting patient care as well as the supervisee’s professional development (Falender & Shafranske, 2021). In this article, we discuss the role of clinical supervision during the initial training phase and throughout the ongoing development of the psychotherapist. We emphasize the benefits of implementing a competency-based approach by highlighting essential principles. Also, we suggest that supervision quality contributes to either the supervisee’s experience of clinical work as a healthy involvement or may accentuate personal and professional stress and exacerbate difficulties in psychotherapy practice.

Clinical supervision, Professional development, Psychotherapy training, Professional identity

1. Bang, K., & Goodyear, R. K. (2021). Unsatisfactory supervisory experiences reported by South Korean supervisors: Types, responses, and cultural context. Journal of Contemporary Psychotherapy: On the Cutting Edge of Modern Developments in Psychotherapy, 51(3), 191–199. https://doi.org/10.1007/s10879-021-09498-4
2. Dennhag, I., & Ybrandt, H. (2013). Trainee psychotherapists’ development in self-rated professional qualities in training. Psychotherapy, 50(2), 158–166. https://doi.org/10.1037/a0033045
3. Ellis, M. V., Berger, L., Hanus, A. E., Ayala, E. E., Swords, B. A., & Siembor, M. (2014). Inadequate and harmful clinical supervision: Testing a revised framework and assessing occurrence. The Counseling Psychologist, 42(4), 434–472. https://doi.org/10.1177/0011000013508656
4. Ellis, M. V. (2017). Narratives of harmful clinical supervision. Clinical Supervisor, 36(1), 20–87. https://doi.org/10.1080/07325223.2017.1297752
5. Ellis, M. V., Creaner, M., Hutman, H., & Timulak, L. (2015). A comparative study of clinical supervision in the Republic of Ireland and the United States. Journal of Counseling Psychology, 62(4), 621–631. https://doi.org/10.1037/cou0000110
6. Evers, O,. Schröder-Pfeifer, P,. Möller, H., & Taubner, S. (2019). How do personal and professional characteristics influence the development of psychotherapists in training: Results from a longitudinal study. Research in Psychotherapy, 22(3), https://doi.org/10. 4081/ripppo.2019.424
7. Falender, C. A. (2018). Clinical supervision—the missing ingredient. American Psychologist, 73(9), 1240–1250. https://doi.org/10.1037/amp0000385
8. Falender, C. A. & Shafranske, E. P. (2004). Clinical supervision. A competency-based approach. Washington, DC:  American Psychological Association.
9. Falender, C. A., & Shafranske, E. P. (2007). Competence in competency-based supervision practice: Construct and application. Professional Psychology: Research and Practice, 38(3), 232-240.
10. Falender, C. A., & Shafranske, E. P. (2012). Getting the most out of clinical training and supervision: A guide for practicum students and interns. American Psychological Association. https://doi.org/10.1037/13487-000
11. Falender, C. A., & Shafranske, E. P. (2014).  Clinical supervision in the era of competence. In W. B. Johnson & N. J. Kaslow (Eds.), Oxford handbook of education & training in professional psychology (pp. 292-331). New York, NY: Oxford University Press.
12. Falender, C. A., & Shafranske, E. P. (2016) Competency-based clinical supervision:  State of the art and dynamic global and multicultural tensions. Australian Psychologist, 52(2), 86-93.
13. Falender, C. A., & Shafranske, E. P. (2014). Clinical supervision: The state of the art. Journal of Clinical Psychology, 70(11), 1030-1041. doi:10.1002/jclp.22124
14. Falender, C. A., & Shafranske, E. P. (2012). The importance of competency-based clinical supervision and training in the twenty-first century: Why bother? Journal of Contemporary Psychotherapy, 42(3), 129-137. doi:10.1007/s10879-011-9198-9
15. Falender, C. A., & Shafranske, E. P. (2016) Competency-based clinical supervision:  State of the art and dynamic global and multicultural tensions. Australian Psychologist, 52(2), 86-93.
16. Falender, C. A., & Shafranske, E. P. (Eds.). (2020). Consultation in psychology: A competency-based approach. American Psychological Association. https://doi.org/10.1037/0000153-000
17. Falender, C. A. & Shafranske, E. P. (2021). Clinical supervision. A competency-based approach (2nd Ed.). Washington, DC:  American Psychological Association. https://doi.org /10.1037/0000243-000
18. Falender, C. A., & Shafranske, E. P. (2023). Revisiting competence in clinical supervision. International Journal of Clinical Supervision in Psychotherapy, 5, 47-58.
19. Hendricks, S., & Cartwright, D. J. (2018). A cross-sectional survey of South African psychology interns’ perceptions of negative supervision events. South African Journal of Psychology, 48(1), 86–98. https://doi.org/10.1177/0081246317698858
20. Heinonen, E., Orlinsky, D. E., Willutzki, U., Rønnestad, M. H., Schröder, T., Messina, I., Löffler-Stastka, H., & Hartmann, A. (2022). Psychotherapist trainees’ quality of life: Patterns and correlates.Frontiers in Psychology, 13, Article 864691. https://doi.org/10.3389/fpsyg.2022.864691
21. Hutman, H., Ellis, M. V., Moore, J. A., Roberson, K. L., McNamara, M. L., Peterson, L. P., Taylor, E. J., & Zhou, S. (2023). Supervisees’ Perspectives of Inadequate, Harmful, and Exceptional Clinical Supervision: Are We Listening? The Counseling Psychologist, 51(5), 719-755. https://doi.org/10.1177/00110000231172504
22. Knox, S., & Hill, C. E. (2021). Training and supervision in psychotherapy: What we know and where we need to go. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change: 50th anniversary edition (7th ed.), (pp. 327–349). John Wiley & Sons, Inc..
23. Ladany, N., Ellis, M. V., & Friedlander, M. L. (1999). The supervisory working alliance, trainee self-efficacy, and satisfaction. Journal of Counseling and Development, 77(4), 447–455. https://doi.org/10.4064/sm193-2-5
24. Muran, J. C., & Eubanks, C. F. (2020). Therapist performance under pressure: Negotiating emotion, difference, and rupture. American Psychological Association. https://doi.org/10.1037/0000182-000
25. Orlinsky, D. E. (2022). How psychotherapists live: The personal self and private life of professional healers. Routledge. https://doi.org/10.4324/9781003217572
26. Orlinsky, D. E., Botermans, J.-F., & Rønnestad, M. H. (2001). Towards an empirically grounded model of psychotherapy training: Four thousand therapists rate influences on their development. Australian Psychologist, 36, 139-148.
27. Orlinsky, D. E., Rønnestad, M. H., & Collaborative Research Network of the Society for Psychotherapy Research. (2005). How psychotherapists develop: A study of therapeutic work and professional growth. American Psychological Association. https://doi.org/10.1037/11157-000
28. Orlinsky, D. E., Rønnestad, M. H., Willutzki, U., Schröder, T. A., Heinonen, E., Löffler‐Stastka, H., Messina, I., Pirke, J., & Hartmann, A. (2024). Healing involvement and stressful involvement experienced by psychotherapy trainees: Patterns, correlates and perceived development. Counselling & Psychotherapy Research, 24, 1442-1453. https://doi.org/10.1002/capr.12788
29. Rodolfa, E., & Schaffer, J. (2019). Challenges to psychology education and training in the culture of competence. American Psychologist, 74(9), 1118–1128. https://doi.org/10.1037/amp0000513
30. Rønnestad, M. H., Orlinsky, D. E., Schröder, T. A., Skovholt, T. M., & Willutzki, U. (2019). The professional development of counsellors and psychotherapists: Implications of empirical studies for supervision, training and practice. Counselling & Psychotherapy Research, 19(3), 214–230. doi:10.1002/capr.12198 DOI: https://doi.org/10.1002/capr.12198
31. Rønnestad, M. H., Orlinsky, D. E., & Willutzki, U. (2024). Exploring influences of supervision on psychotherapists’ professional development: correlates across career-level cohorts. Counselling Psychology Quarterly, 1–23. https://doi.org/10.1080/09515070.2024.2378879
32. Safran, J. D., & Muran, J. C. (1996). The resolution of ruptures in the therapeutic alliance. Journal of Consulting and Clinical Psychology, 64(3), 447–458. https://doi.org/10.1037/0022-006X.64.3.447
33. Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. Guilford Press.
34. Shafranske, E. P., & Falender, C. A., (2016). Clinical supervision. In J. C. Norcross, G. R. VandenBos & D. K. Freedheim (Editors-in-Chief), APA Handbook of Clinical Psychology Volume V: Education and Profession (pp. 175-196). Washington, DC:  American Psychological Association.
35. ten Cate, O. (2005). Entrustability of professional activities and competency-based training. Medical Education, 39(12), 1176–1177. https://doi.org/10.1111/j.1365-2929.2005.02341.x
36. Watkins, C. E., Jr. (1997). Defining psychotherapy supervision and understanding supervisor functioning. In C. E. Watkins, Jr. (Ed.) Handbook of psychotherapy supervision (pp. 3-10). John Wiley & Sons, Inc.