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The transtheoretical model (TTM) has been applied to varying areas of physical health, e.g. diabetes. However, research into its applicability to psychotherapy is mixed. The TTM is applied through the University of Rhode Island Change Assessment (URICA). Investigating the utility of the URICA is needed to improve patient care and outcomes. This study aims to assess whether the URICA scores relate to patient outcomes; patient attendance; practitioner ratings of patient readiness, appropriateness, insight, motivation and potential for improvement; and to explore practitioner’s perspectives on the URICA.

Correlational methods were used to assess the relationship between the URICA and therapeutic outcome, attendance and practitioner-rated areas. Content analysis was used to analyse practitioner qualitative data.

The URICA did not correlate with either therapeutic outcome or attendance. A significant negative correlation was found between the URICA and practitioner-rated appropriateness of the referral. This means practitioners perceived individuals with lower URICA scores to be a more appropriate referral, despite the score indicating a reduced readiness to change. Qualitative categories included positive views, negative views, ambivalence and changes to measure and process. To conclude, the URICA does not explain a patient’s outcome or attendance. The URICA may not be appropriate to use in its current format in mental health services; therefore, assessing the TTM verbally may be more helpful.

This study provides research into suitability of using the URICA to assess the TTM and its applicability to attendance and outcome in psychological therapies.

The purpose of this paper is to systematically identify, appraise and synthesise qualitative literature exploring the experience, both positive and negative, of clinical supervision from the supervisor’s perspective.

A systematic search of three databases, grey literature, reference lists and citations was conducted. Six articles met the inclusion criteria and their quality was critically appraised by using a modified version of the Critical Appraisal Skills Programme tool. Data extracted from the articles were synthesised using meta-ethnography.

Four key themes were identified: experiencing difficulties in clinical supervision, responsibility, similarities to therapy and capabilities as a supervisor. These demonstrated that the role of a supervisor has the potential to be both beneficial and harmful to personal and professional development.

The quality of the studies was variable. Further research is required to explore how supervisors manage difficult experiences to ensure personal development and growth.

Clinical implications include the need for employers to consider the additional pressure associated with providing clinical supervision and to ensure that appropriate support is available. Results complement previous research on the bi-directionality of parallel process in clinical supervision.

This review presents an original synthesis of the supervisor’s experience of delivering clinical supervision to qualified therapists. This is achieved by utilising a systematic methodology and appraising the quality of the studies included. The review highlights how the effects of clinical supervision are not limited to the supervisee, but also experienced by the supervisor. The competing demands and responsibilities associated with clinical supervision impact upon the supervisor’s experience, both positively and negatively. When beneficial, delivering clinical supervision can lead to personal and professional growth in addition to the acquisition of new skills.