Good CBT Supervision Starts with Curiosity
You know that feeling when you’ve just finished a first, a second, or even a session further into therapy with a client and you’re just left feeling confused, deskilled, and full of doubt?
Maybe something didn’t make sense. Or the things the client said felt contradictory. Or it was just something you’d never worked with (or even heard about) before.
So, like any thoughtful therapist, you start wondering what you’re missing. You might feel a little anxious because you don’t know where to start. And your mind might be serving you all sorts of “maybe I’m not as good as I thought”, “I should spend the night going through that CPD”, or “sh*t, how am I gonna do this?!”.
It can feel almost as though there’s this wealth of information and expertise that you have no access to because you just don’t know enough. And if only you learned more, read more, attended more training, you’d have the perfect answer.
Now, I’m not saying that gaining more knowledge isn’t valuable - of course it is. But no amount of extra reading or training is going to get you unstuck from every situation. Because often, it’s not really about knowledge, but about knowing how to handle the messiness and uncertainty that inevitably comes with being a therapist. And about learning how to be, and stay, curious until things start to make sense.
There are rarely neat answers in therapy
Pretty much the whole field of mental health has, and perhaps still is, trying to make things clear and neat and tidy. The DSM, ICD, NICE guidelines, disorder-specific models, RCTs - they all help us define, diagnose, differentiate, and understand.
And rightly so. You need to be able to recognise when a client has OCD, so you don’t accidentally reinforce it. Or when a client has low self-esteem hiding behind generalised anxiety - so you can work with them at the right level, rather than hand out plasters to put over wounds.
But you’ll rarely find clients who neatly fit into the boxes of the DSM criteria, or of the formulation diagrams you got from your training course.
And that’s not only OK, it’s actually what makes working as a therapist so exciting and rewarding. No two clients will be the same. A big part of our job is making sense of what’s going on alongside them, with the understanding that the picture often becomes clearer over time, rather than all at once.
The tricky bit is that, when we feel stuck, our minds often assume there must be a perfect formulation or intervention that we just haven't thought of yet. But more often than not, the next step isn't finding the answer - but becoming curious enough to discover what we don't yet know.
Curiosity helps you notice what certainty can miss
This has happened time and time again - a supervisee comes to supervision feeling confused or stuck. They present the case, and then either say they have no idea what to do next, or clearly express what they feel confused about, while still hoping I’ll have the answer.
Often, unsurprisingly, I, the supervisor, am also confused. So my response will often involve more questions. Sometimes those questions help the supervisee start to piece things together. Other times, they just help us work out what we still need to find out from the client.
But we don’t stop there. We also try to think about what we might learn from approaching things this way. Maybe it’s something about slowing down. About not being afraid to ask more questions. About figuring out what you need to know before things can make sense, rather than assuming you should already know. Or about letting go of the idea that there are perfect questions to ask. Often, it’s all of these.
That’s why "be curious" has become one of the phrases I use most often in supervision.
Good CBT supervision creates space to think, not just solve
I know many of us will either have worked in busy NHS services where supervision often meant finding an answer quickly and moving onto the next client - or simply live in today's urgency-filled world that tells us we should have answers straight away.
So we come to expect the same of ourselves. We expect to come up with quick answers, or for someone else to give them to us just as quickly.
But what do we miss when we rush? Maybe nuance. Maybe depth. Maybe opportunities to learn so much more about what therapy is really about.
We might miss the opportunity to really sit with questions like:
What am I assuming?
What don't I know yet?
What surprised me?
What happens if I ask about this differently?
What might the client understand about this that I don't yet?
Good supervision creates space for this to happen - for you to ask these kinds of questions and, by allowing yourself to do so, become a more thoughtful, flexible, and confident therapist. Sometimes much more so than just being given the "right" answer ever could.
Curiosity applies to you, too
A big part of developing as a therapist is developing as a person. Because we know, of course, that a lot of who we are as people influences who we are therapists.
As therapists, we spend a lot of time helping clients explore the meanings they make of themselves, other people, and the world. But we sometimes forget that we're doing exactly the same thing ourselves. And these meanings often get in the way of you allowing yourself to slow down, ask questions, not have perfect answers and plans.
If I don’t know for sure what to do next, it means I’m incompetent.
If I don’t plan everything to a T, it means I’ll be caught off guard and “found out”.
So, maybe, a big part of supervision is becoming curious about the meanings you're making, too - and how they might be getting in the way.
Not just asking “what is going on for the client?” or “what do I do if they say X?”, but, sometimes a little more importantly, asking “why do I feel so stuck?” or “why am I getting so impatient?”
Those might sometimes be the more interesting questions.
The ones that allow you to show up for your clients as your best self - which, as far as I’m concerned, is the version of you that's allowed themselves to be human, imperfect, and vulnerable. And, in doing so, is far better able to hold the client.
If you're looking for a CBT supervisor who will think with you, not just give you answers...
This might be the space for you. You can read more about my approach to CBT supervision and also, a guest post I wrote on CBT supervision over on The Supervisor Platform, where I explore cultural humility (as opposed to cultural competence) in supervision.
Hi, I’m Carina - an experienced, but very human BABCP-accredited CBT supervisor with experience supervising on one of London’s largest BABCP-accredited CBT courses, and previously working as a Senior CBT Therapist in the NHS.
I can help with continuing to develop your CBT skills, getting you through your training year or towards BABCP accreditation, and, maybe most importantly, thinking about process issues and who you are (and want to be) as a therapist.
Apart from “second-wave” CBT, I love ACT and mindfulness (I’m also a trained mindfulness teacher) - and also research (I’ve published a few peer-reviewed papers). I’m also often found sipping tea, having a rant, and showing my dog to my supervisees.
If you’re curious about whether we might be a good fit, I offer a free, no-pressure initial chat.
