In Search of the Common Elements of Clinical Supervision: A Systematic Review

Mimi Choy-Brown, Daniel Baslock, Charissa Cable, Scott Marsalis, Nathaniel J. Williams

Research output: Contribution to journalArticlepeer-review


The importance of clinical supervision for supporting effective implementation of evidence-based treatments (EBTs) is widely accepted; however, very little is known about which supervision practice elements contribute to implementation effectiveness. This systematic review aimed to generate a taxonomy of empirically-supported supervision practice elements that have been used in treatment trials and shown to independently predict improved EBT implementation. Supervision practice elements were identified using a two-phase, empirically-validated distillation process. In Phase I, a systematic review identified supervision protocols that had evidence of effectiveness based on (a) inclusion in one or more EBT trials, and (b) independent association with improved EBT implementation in one or more secondary studies. In Phase II, a hybrid deductive-inductive coding process was applied to the supervision protocols to characterize the nature and frequency of supervision practice elements across EBTs. Twenty-one of the 876 identified articles assessed the associations of supervision protocols with implementation or clinical outcomes, representing 13 separate studies. Coding and distillation of the supervision protocols resulted in a taxonomy of 21 supervision practice elements. The most frequently used elements were: reviewing supervisees’ practice (92%; n = 12), clinical suggestions (85%; n = 11), behavioral rehearsal (77%; n = 10), elicitation (77%; n = 10), and fidelity assessment (77%; n = 10). This review identified supervision practice elements that could be targets for future research testing which elements are necessary and sufficient to support effective EBT implementation. Discrepancies between supervision practice elements observed in trials as compared to routine practice highlights the importance of research addressing supervision-focused implementation strategies.

Original languageEnglish (US)
Pages (from-to)623-643
Number of pages21
JournalAdministration and Policy in Mental Health and Mental Health Services Research
Issue number4
StatePublished - Jul 2022

Bibliographical note

Funding Information:
We want to acknowledge all of the generous authors for sharing their supervision protocols for this study and Sarita Kundrod for her work to strengthen our search.

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Clinical supervision
  • Evidence-based practice
  • Implementation strategy
  • Systematic review

PubMed: MeSH publication types

  • Journal Article
  • Systematic Review


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