3 - (SYM 65) Supervisory Considerations in Youth CBT and Evidence-based Supervision for Youth: Is It Really Evidence-based?

Abstract Body
Emerging research on the generalizability and dissemination of CBT presents challenges for CBT supervisors. Specifically, the CBT youth treatment implementation has stressed the importance of implementation fidelity or treatment adherence (Breitenstein et al., 2010; Smith et al., 2017) and “good training” is often equated with a high level of consistency between what is specified in a given treatment protocol and supervisee behavior. However, Weisz et al. (2013) have pointed out that when deployed in community settings, the benefits of rigorous fidelity to EBPs could be surpassed by flexible implementation that is more sensitive to client need. Specifically, “treatment needs can shift during episodes of care, and youths are likely to respond well to some aspects of treatment and not so well to others” (Weisz et al, 2013, p. 283). While improvements in treatment outcome in community settings are of obvious benefit, the implications for CBT supervision are unclear. Should supervisors continue to provide training in specific CBT protocols, or abandon such efforts in favor of training in “common factors”? It seems likely that some exposure to core strategies (e.g., contingency management, communication training, problem solving), is needed, but the sequence, depth, and level of mastery required by supervisees to achieve these results is unclear. Also unclear are the relative benefits of community care, traditional EBPs and the “flexible modular approach” (Chorpita & Daleiden, 2009) as all appear capable of producing therapeutic benefit. This presentation will discuss how CBT training and supervision should look in light of contemporary treatment outcome research with youth.