Live Supervision in Psychotherapy: Study Protocol for a Single Case Experimental Design Study (SCED)

Although clinical supervision is an essential part of psychotherapy training and development, the empirical evidence for effects on therapist competence and patient outcome is limited. However, a novel format, Live Supervision (LS), enables real time feedback during the patient session which counteracts on several of the major identified problems with standard supervision. Pilot studies of LS show promising results, but the effects of LS has never been assessed in a clinical setting with licensed psychologists. Furthermore, manualized LS with a stringent focus at therapists' idiosyncratic challenges has never been evaluated.The primary aim of this study is to evaluate the effects of LS on therapist competence and perceived therapy challenges in a clinical outpatient setting with licensed psychologists as therapists. Secondary aims are to examine when and how LS is optimal for clinical supervision.

Patients:Inclusion Criteria:At least one diagnosis of the following DSM-5 disorders: mood disorders, anxiety disorders, OCD or related disorders, orTrauma or stress related disorders, comorbid severe disorder such as schizophrenia or development disorder,Being able to attend to regular treatmentAccepting recording of therapy sessions and providing a written consentAbove 16 years oldExclusion Criteria:a) Comorbid severe disorder such as schizophrenia, developmental disorder, severe eating disorder, or severe substance use disorder.Therapists:Inclusion criteria:Licensed psychologistWorking in outpatient psychiatric care or primary care in SwedenCurrently providing CBTAt least one year work experience of providing psychological treatments in outpatient careSupervisors:Inclusion criteria:At least 2 years experience working as a clinical supervisor for CBTFormal supervision training