Live versus delayed supervision: A randomized controlled trial with psychology students.

Abstract

To test the hypotheses that supervision improves therapeutic skills and therapeutic alliance (Hypothesis 1) and that this effect is stronger for immediate rather than for delayed supervisory feedback (Hypothesis 2). Eighty psychology students (M = 24.29 years; 72.5% identified as female; 75.0% were studying for a bachelor's degree) conducted three consecutive sessions with a standardized patient in a simulated therapy. These students were randomly assigned to live supervision (LS) or delayed video-based supervision (DS). While the LS group received support from a supervisor during the second session, the DS group received such support after the second session. Several outcomes (students' skills, self-efficacy, fear of negative evaluation, therapeutic and supervisory alliances, and supervision quality) were assessed from different perspectives (i.e., independent raters, students, patients). From all perspectives, supervision significantly increased students' skills and self-efficacy, and the therapeutic alliance (d = 0.29-0.49, Hypothesis 1). Moreover, LS was not significantly superior to DS in any of the outcomes (Hypothesis 2). In addition, students subjectively perceived DS as more effective (d = 0.83, 95% confidence interval [0.37, 1.29]), but they identified the supervisory relationship as equally pleasant and the feedback as equally helpful in both conditions. Supervision positively influenced students' skills and self-efficacy, and the therapeutic alliance, and both LS and DS were viewed as high quality. Thus, live and delayed supervision formats have comparable effects. However, future research should further investigate the specific mechanisms through which they exert their positive influences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).