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Skills Classes

Training, supervision, and credentialing

Transforming CBT Supervision: Real-Time Feedback and Deliberate Practice Using the CTRS-R

Skills Class 1 - Transforming CBT Supervision: Real-time Feedback and Deliberate Practice Usingthe CTRS-R

Thursday, June 25, 2026
9:30 AM - 11:00 AM PDT
Location: Yerba Buena Salon 2, B3 Level
Earn 1.5 Credit
Keywords: Supervision, CBT, Service Delivery
Level of Familiarity: Moderate
Recommended Readings: Gonsalvez, C. J., Brockman, R., & Hill, H. R. (2016). Video feedback in CBT supervision: Review and illustration of two specific techniques. The Cognitive Behaviour Therapist, 9, e24.,   Miller, A. (2022). Cognitive Therapy Rating Scale – Revised (CTRS-R) - Beck Institute. https://beckinstitute.org/cbt-resources/resources-for-professionals-and- students/cognitive-therapy-rating-scale-revised-ctrs-r/,   Alfonsson, S., Lundgren, T. & Andersson, G. (2020). Clinical supervision in cognitive behavior therapy improves therapists’ competence: a single case experimental pilot study. Cognitive Behaviour Therapy, 49 (5), 425-228.,   ,  
Cognitive Behavioral Therapy (CBT) supervision often relies on reviewing clinical cases after the fact, which can restrict opportunities for direct skill development (Gonsalvez, Brockman, & Hill, 2016). This workshop presents a supervision approach that utilizes Miller’s (2022) Cognitive Therapy Rating Scale-Revised (CTRS-R), shifting its role from a simple evaluative tool to a collaborative learning resource. Instead of acting as a "report card," the CTRS-R functions as a "GPS" that supports competency growth in a safe, structured environment.
Inspired by Kaiser Permanente's Mental Health Training Program, this model combines observation, structured feedback, and deliberate practice. In a pilot project, trainees consistently achieved satisfactory CBT competency, defined as a CTRS-R score of 22 or above. Participants called the model an "invaluable roadmap," emphasizing its clarity and structure throughout the learning process.
The interactive workshop consists of three main sections: a didactic overview that explains a shift from evaluation to collaborative guidance, including a review of the CTRS-R 11-item framework and feedback principles to encourage psychological safety while maintaining standards; a supervision demonstration focusing on item-level feedback, with strategies for identifying specific trainee behaviors, providing actionable guidance, and collaborative planning for skill enhancement; and practical exercises where attendees design questions to foster self-discovery and metacognitive skills.
Participants will leave with practical tools, a Socratic question bank specific to supervision, and a customizable plan for implementation in their own settings. The workshop highlights behavioral specificity, a collaborative process, and deliberate practice as essential for competency development in CBT. By reframing supervision as a skill-building process rather than a subjective evaluation, this method offers effective CBT training for supervisors and practitioners seeking evidence-based ways to improve training outcomes.

Learning Objectives:

  • Apply the CTRS-R framework as a collaborative learning tool rather than an evaluative measure.
  • Deliver item-level feedback that promotes trainee metacognitive awareness.
  • Structure supervision sessions using deliberate practice methodology.
  • Develop effective questions that facilitate guided discovery in supervision.
  • Better understand the perspective of the trainee in supervision when using feedback.