Supervising Culturally Informed Modified Trauma-Focused Cognitive Behavioral Therapy.

Supervision can be a dynamic and fluid process where the relationship between a supervisor and supervisee evolves and enhances the supervisee's knowledge, attitudes, and skills through the use of various assessments and interventions. As a student encounters clients who have experienced trauma, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)-an empirically based model-can be implemented with diverse populations. Supervisors must ensure that the supervisees can adequately adapt TF-CBT to maintain the fidelity of the model while addressing the contextual variables of the client. Specifically, supervisors must ensure that supervisees have a solid understanding of trauma, child development, and the culture they are addressing. This article will address the role supervisors must take to teach supervisees how to implement the components of TF-CBT, including both application and collection of outcome measurements; how the model can be modified to reflect culturally informed practices; and how supervisors can process with supervisees the challenges of working with trauma-related cases.Keywords: supervision; culturally informed modified TF-CBT; supervisee; traumaThe number of cases involving trauma that are being brought to supervision are increasing, requiring supervisors to ascertain that the supervisee has professional knowledge of human development, including clinical understanding of the causes and types of trauma, and ability to implement intervention practices which are empirically supported and culturally informed to address the client's symptoms. Trauma can be defined as an event of maltreatment so unexpected that it is overwhelming, involving events that are idiosyncratically experienced as shocking and life threatening, while provoking feelings of intense terror, horror, and/or helplessness (Cohen, Mannarino, & Deblinger, 2006, 2012). Treating trauma is no different than treating anything else in that it is not a one-size-fits-all model. There are several approaches used to treat trauma, such as the work by Goodyear-Brown (2010), Gil (2006), and Shapiro (2001). Supervisors and supervisees should know how to use these models in a culturally informed manner.The Child Sexual Abuse Task Force and Research & Practice Core, National Child Traumatic Stress Network (2004) identifies Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) as one of the widely used models for children and adolescents who have experienced childhood PTSD and trauma. However, there is a dearth of literature discussing TF-CBT from a culturally informed perspective. This article discusses important points to consider when supervising the TF-CBT model through a culturally informed lens.Role of SupeRviSoRProper clinical supervision ensures that students provide services in a competent manner. Supervisors, in turn, have responsibilities and roles that must be fulfilled. Hess, Hess, and Hess (2008) supported work originally done by Hess (1980), which described a total of eight roles that supervisors ascribe to when supervising: lecturer, teacher, case reviewer, monitor, collegial/peer, psychotherapist, educator, and coach. These roles are applicable regardless of the clinical model of intervention used.Supervisors should be able to assume that supervisees come to practica with some core knowledge and basic skills pertaining to abnormal psychology, interviewing, and human development. Nevertheless, supervisors take on the role of a lecturer, teacher, and educator for sharing information about specific disorders and interventions. In particular, as a lecturer, supervisors provide global conceptual schemes as well as their theory, and demonstrate techniques in which supervisees take on the role of the listener. Supervisees are apprised of the various theoretical orientations, such as psychodynamic or cognitive-behavioral theory, which could be used to address trauma. Prior to the use of TF-CBT, supervisees need to know how best to implement Cognitive Behavioral Therapy (CBT). …