Supervised therapist and supervisor impact on client therapy outcomes

Objective: We examined the impact of supervisor and supervised therapist factors on client psychotherapy outcomes as measured by the Outcome Questionnaire 45.2 (OQ-45). We hypothesized that random effects would account for only a small portion of the variance in client change scores and in the trajectory of client change over time.Methods: A total of 4,691 clients, 146 supervised therapists, and 43 supervisors from a large college counseling center in the Western United States were included in the study. Hierarchical linear modeling (HLM) was used to analyze the data.Results: While random supervised therapist effects accounted for a small but significant proportion of variance in change scores, random supervisor effects were not significant. Fixed effects of initial severity and clinic type were significant predictors. This corroborated findings from the previous studies. Results of the growth model revealed time as the only significant random effect, and supervisee experience along with its interaction with time as the only significant fixed effects.Conclusion: These findings suggest that supervisees have small and unique influences on client therapy outcomes, while supervisor direct impact on client outcomes appears statistically insignificant.