“There's a Six-Foot Monkey That’s Not Being Talked About” Improving Access to Psychological Therapies (IAPT): Cognitive Behavioural supervisors’ and supervisees’ experiences of interpersonal processes in the supervisory relationship. An Interpretative Phenomenological Analysis

Improving Access to Psychological Therapies (Department of Health 2008) has transformed the treatment of common mental health problems through the development of evidence-based CBT training for therapists, which recognises the centrality of evidence-based clinical supervision for both trainees and qualified therapists. Within psychotherapy literature, the supervisory relationship is recognised to play a crucial role (Carroll 1996; Ybrandt et al. 2016; Bordin 1986). Yet, a review of supervision literature suggests that ‘significant’ non-disclosure within the relationship is the norm (Mehr et al. 2010; Ladany et al. 1996). Whilst clinical supervision research and literature has expanded, few studies focus upon relational processes, and studies of supervision undertaken in the last couple of decades have tended to use quantitative research methods retrospectively, typically from a supervisee’s perspective (Watkins 2014).
This study sought to address the gap via semi-structured, in-depth interviews of five CBT supervisory dyads working within IAPT on their experiences of being in a supervisory dyad. The ten participants were interviewed separately, following which recorded interviews were transcribed and analysed for recurring themes using Interpretative Phenomenological Analysis (IPA). Three inter-related superordinate themes and seven sub-themes were identified. These themes are presented and discussed in relation to extant literature. Findings suggest that one’s self-concept and internal representation of the self-play a significant part in how one perceives experiences, and in turn, how one feels and behaves within the supervisory relationship. Implications for CBT supervision practice include the role of reflection in enhancing therapist self-awareness and the ability to identify self-care needs, given the emotional labour involved in being an IAPT therapist.