Clinical supervision plays a recognized role in facilitating practitioner development and in promoting therapeutic fidelity, but instruments that can support such activities by measuring competence in supervision are rare and often psychometrically compromised. As part of a research programme intended to raise the empirical status of supervision, we describe the initial psychometric development of a new instrument for observing competence (Supervision: Adherence and Guidance Evaluation; SAGE). This instrument is suitable for measuring CBT supervision, and can be administered by self-rating or by an independent observer. Preliminary tests of the reliability and validity of SAGE suggest that it is a promising tool for evaluating supervision. In addition, SAGE can be applied readily and has good utility. In these respects, SAGE appears to have some advantages over existing instruments, and may therefore provide a basis for enhancing research and practice in CBT supervision. Suggestions for future research on SAGE are outlined, particularly the need for a generalizability analysis.

Cognitive behaviour therapy (CBT) has been found to be effective in treating mental health problems in the UK, but little has been done to evaluate the potential of CBT in developing countries. This paper aims to discuss the development and implementation of a CBT training course for clinicians working in Tanzania's main psychiatric hospital in the capital city, Dodoma. A 12-session training course in CBT was delivered to nine clinicians. An outcome evaluation was conducted using multiple measures and methods, taken before and after the training. Information on cultural adaptations of the training was obtained. All participants completed the course, but there were several obstacles to full completion of the evaluation measures. Despite this, there were significant improvements in clinicians’ basic understanding of CBT concepts, and their ability to apply the CBT model to formulate and recommend treatment strategies in response to a clinical case. Qualitative information indicated the potential of developing CBT training and implementation further. As a pilot study, this investigation shows the promise that CBT holds for mental health services in Tanzania. Further research into the training and clinical effectiveness of CBT in Tanzania is indicated.

Despite the acknowledged importance of clinical supervision, controlled research is minimal and has rarely addressed the measurement or manipulation of clinical supervision, hampering our understanding and application of the different supervision methods. We therefore compared two related approaches to supervision, cognitive-behavioural (CBT) and evidence-based clinical supervision (EBCS), evaluating their relative effectiveness in facilitating the experiential learning of one supervisee. Drawing on a multiple-baseline N = 1 design, we gathered mostly qualitative data by means of an episode analysis, a content analysis, a satisfaction questionnaire, and interviews with the supervisor and supervisee. We found that the EBCS approach was associated with higher supervision fidelity and increased engagement in experiential learning by the supervisee. This case study in the evaluation of supervision illustrates the successful application of some rarely applied qualitative methods and some potential supervision enhancements, which could contribute to the development of CBT supervision.