Do supervisors and independent judges agree on evaluations of therapist adherence and competence in the treatment of cocaine dependence?
Open accessAbstract
The current study examined the agreement between supervisors' and independent judges' evaluations of therapist adherence and competence in three treatments of cocaine dependence: supportive expressive therapy (SE), cognitive therapy CT), and individual drug counseling (IDC). We used data from The National Institute on Drug Abuse Collaborative Cocaine Treatment Study (n = 295). Trained and experienced supervisors and independent judges rated treatment fidelity. At the therapist level of analysis, the agreement between supervisors' and independent judges' ratings was weak for SE competence, CT adherence, and CT competence. Moderate relations were found for IDC adherence and competence. Supervisors consistently rated adherence and competence more positively than judges in CT and IDC. The potential bias in supervisors' ratings is discussed.
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Supervisors overestimate clinicians' competence and adherence to treatment model, relative to independent judges.
“supervisors overestimate clinicians ' competence and adherence to treatment model, relative to independent judges (Dennhag, Gibbons, Barber, Gallop, & Crits-Christoph, 2012).”
From Clinicians' concerns about delivering cognitive-behavioural therapy for eating disorders (2014) · cites this paper as Dennhag, Gibbons, Barber, Gallop, & Crits-Christoph, 2012
The Results (Mean Levels for Supervisors’ Ratings Compared to Judges’ Ratings; page unavailable) show higher supervisor ratings for adherence and competence in CT and IDC, but not for competence in SE. The Discussion says higher ratings could reflect upward bias or supervisors’ better contextual knowledge, so the study does not establish that supervisors overestimated clinicians’ performance. (LLM, conf=0.90)
Experimental — accuracy not yet measuredSupervisors of therapists substantially over-estimate the ability of their supervisees.
“For example, the objectivity of clinical supervision is questionable, given evidence that supervisors of therapists substantially over-estimate the ability of their supervisees (Dennhag et al ., 2012).”
From Supervisor practice when guiding therapists working with depression: The impact of supervisor and patient characteristics (2018) · cites this paper as Dennhag et al., 2012
The Results section reports substantially higher supervisor ratings of therapist competence than independent-judge ratings in cognitive therapy and individual drug counseling, but not in supportive-expressive therapy (page unavailable). The Discussion says the higher ratings might reflect bias or supervisors’ greater contextual knowledge; it does not establish that supervisors overestimated their supervisees’ actual ability. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSupervisors consistently overrate the abilities of their supervisees, relative to independent judges and even relative to the supervisees' own perceptions.
“supervisors consistently overrate the abilities of their supervisees, relative to independent judges and even relative to the supervisees' own perceptions”
From Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track (2016) · cites this paper as Dennhag, Gibbons, Barber, Gallop & Crits-Christoph, 2012
Clinicians and supervisors tend to believe that they are far better than the average clinician.
“Why should we be concerned about our abilities if we already believe that we (and our supervisees) are far better than the average clinician (e.g., Dennhag et al., 2012; Parker & Waller, 2015; Walfish et al, 2012)?”
From Therapist drift redux: Why well-meaning clinicians fail to deliver evidence-based therapy, and how to get back on track (2016) · cites this paper as Dennhag et al., 2012
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- Authors
- Dennhag, I., Gibbons, M. B. C., Barber, J. P., Gallop, R., & Crits-Christoph, P.
- Affiliations
- Umeå University (SE)
- University of Pennsylvania (US)
- West Chester University (US)
- Corresponding author
- Dennhag, Inga
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2012-11
- Volume
- 22
- Issue
- 6
- Pages
- 720-730
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- PMC
- PMC4550095
- OpenAlex
- W1996381035
- Cited by
- 30
- References
- 51
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 4 · 2014: 1 · 2013: 2
- FWCI
- 2.53
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (U18DA007090, R01DA012249)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- cocaine dependence, intervention fidelity, therapist adherence, therapist competence, supervisor ratings, interobserver agreement, supportive-expressive therapy, cognitive therapy, rating bias
- MeSH terms
- Adult, Clinical Competence, Counseling, Female, Health Personnel, Humans, Male, Middle Aged, Psychotherapy, Observer Variation, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Practice Guidelines as Topic, Cocaine-Related Disorders, Guideline Adherence
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