Training and Education in Professional Psychology

© 2021 American Psychological Association 2021, Vol. 15, No. 4, 284–289

ISSN: 1931-3918 https://doi.org/10.1037/tep0000362

COVID-19 and Beyond: Telesupervision Training

Within the Supervision Competency
Lindsay A. Phillips1, Jade N. Logan2, and David B. Mather3
1
Department of Psychology and Counseling, Marywood University
2
CHC Internship Consortium, Chestnut Hill College
3
Mental Health Directorate, Naval Medical Center San Diego

The COVID-19 pandemic produced a rapid and pervasive shift to provision of telepsychology services
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

throughout health service psychology. Simultaneously, an equally rapid and pervasive shift to telesupervi-
This document is copyrighted by the American Psychological Association or one of its allied publishers.

sion of trainees has occurred, at all levels of graduate professional training. These shifts have clearly
outpaced a much more gradual increase in training in telesupervision as part of the supervision competency.
The authors provide an overview of the somewhat limited research on telesupervision, and propose rapid
adoption of training in telesupervision for both trainees and supervisors. Several areas of research into
telesupervision are proposed, including comparative efficacy and acceptance of telesupervision, the
potential impact of information technology expertise on supervisory relationships, and potential differential
impact of diversity factors in telesupervision as compared to in-person supervision.

Public Significance Statement

The COVID-19 pandemic resulted in increased use of telesupervision in health service psychology
training, despite limited research and training specific to telesupervision. Continued research and
incorporation of education and practice of telesupervision to develop trainees’ supervision competency
could help alleviate the gap between practice and training in telesupervision beyond the pandemic.

Keywords: telesupervision, psychology training, supervision competency, COVID-19

Provision of clinical supervision is a core competency of psy-
chologists, and the understanding of competency-based supervision
and training has grown over the past two decades (American
Psychological Association [APA], 2014; Falender & Shafranske,
2004, 2007, 2014). APA’s Commission on Accreditation’s (CoA)
Standards of Accreditation for Health Service Psychology (2015)
require that doctoral students and doctoral interns be trained to
provide supervision. The associated Implementing Regulations
(Section C; APA, n.d.) state that training and competency evaluation
of supervision provision begins in the doctoral program (where
students are expected to “demonstrate knowledge of supervision
models and practices,” p. 20) and continues with interns (who
“apply this knowledge in direct or simulated practice with psychol-
ogy trainees, or other health professionals,” p. 20). The CoA’s

This article was published Online First March 11, 2021.
Lindsay A. Phillips https://orcid.org/0000-0003-3907-3226
David B. Mather https://orcid.org/0000-0002-2540-4840
LINDSAY A. PHILLIPS, PsyD, ABPP, is Assistant Professor of Psychology at
Marywood University, and a core faculty member of the PsyD program in
clinical psychology. She received her doctorate from Chestnut Hill College
and completed her predoctoral internship at Veterans Affairs Medical Center,
Coatesville, Pennsylvania. She is Board Certified in Clinical Psychology by
the American Board of Professional Psychology, and is Vice President and
Northeast Regional Coordinator of the American Board of Clinical Psychol-
ogy. Her research and professional interests include clinical psychology
training and practice, as well as stigma and community integration following
incarceration, homelessness, and acute psychiatric care.
JADE N. LOGAN, PhD, ABPP, is a board certified clinical psychologist. She
serves as the training director of the Chestnut Hill College Internship
Consortium and as an assistant professor of professional psychology in
the doctoral program at Chestnut Hill College. She received her doctorate
from the University of Massachusetts at Amherst and completed her clinical
internship at the University of Maryland College Park's Counseling Services.
Her research and professional interests include multicultural supervision and
training, culturally humble psychotherapy with African American clients, and
treatment of sexual trauma.
DAVID B. MATHER, PhD, ABPP, is Director of Psychology Training and
Chair of Psychology at the Naval Medical Center San Diego, CA. He holds a
PhD in clinical psychology from the University of Connecticut, and com-
pleted internship at the National Naval Medical Center in Bethesda, Mary-
land. He is Board Certified in Clinical Psychology by the American Board of
Professional Psychology, and is President of the American Board of Clinical
Psychology. His primary professional and research interests are in profes-
sional training in psychology, predictors of psychology intern success in
training programs, leadership of mental health programs, and integration of
Positive Psychology in clinical practice.
The views expressed in this article are those of the authors and do not
necessarily reflect the official policy or position of the Department of the
Navy, Department of Defense, or the U.S. Government.
The authors have no conflicts of interest to disclose.
CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Lindsay
A. Phillips, Department of Psychology and Counseling, Marywood Univer-
sity, 2300 Adams Avenue, Scranton, PA 18509, United States. Email:
lphillips@marywood.edu

284
 TELESUPERVISION TRAINING
Standards of Accreditation do not require that accredited postdoctoral
programs train residents in the delivery of supervision. However, when a
program includes the delivery of supervision as a competency in which
its residents are trained and evaluated, the achievement of advanced
competency is expected under the Standards of Accreditation.
When the World Health Organization declared COVID-19 a
pandemic in March 2020, there was a rapid shift to online provision
of higher education, as well as telehealth provision of psychological
services (APA, 2020; Sammons et al., 2020). With supervisors
making a rapid shift to providing telesupervision (Bell et al.,
2020; Hames et al., 2020), an opportunity is now emerging to
engage in more research on telesupervision (Bell et al., 2020).
We propose that there is also an opportunity to engage trainees
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
in education and practice of telesupervision as part of their supervi-
This document is copyrighted by the American Psychological Association or one of its allied publishers.
sion competency training. Jordan and Shearer (2019) noted of the
increase in telesupervision prior to COVID-19, “it is important to
ensure that the knowledge base of use of technology within super-
vision continues to expand in tandem” (p. 330).
CoA defines telesupervision as, “supervision of psychological ser-
vices through a synchronous audio and video format where the
supervisor is not in the same physical facility as the trainee” (p. 27),
and in-person supervision as, “supervision of psychological services
where the supervisor is physically in the same room as the trainee”
(p. 27). Past literature utilized several different terms for telesupervision
(see Inman, Bashian, et al., 2019). It typically involves the use of
audiovisual technology for live, synchronous sessions, and for the
purposes of this article, we will focus on provision of supervision
sessions using such technology. The telesupervision umbrella could also
involve use of telephone, email, and other communication applications
(Jordan & Shearer, 2019) so long as they provide sufficient security.
The COVID-19 pandemic illuminated the increasingly common
utilization of telesupervision. Telesupervision is likely the predom-
inant way to deliver supervision at the present as the pandemic has
evolved and lengthened. Both the CoA’s Standards of Accreditation
and the associated Implementing Regulations, and APA’s Guide-
lines for the Practice of Telepsychology, discuss telesupervision.
With mention and the use of this modality within professional
standards, it only stands to reason that training specific to providing
telesupervision should be a topic considered in trainees’ develop-
ment. APA’s (2013) Guidelines for the Practice of Telepsychology
briefly address provision of telesupervision: “Psychologists using
telepsychology to provide supervision or consultation remotely to
individuals or organizations are encouraged to consult others who
are knowledgeable about the unique issues telecommunication
technologies pose for supervision or consultation” (p. 4). In addi-
tion, the guidelines note as follows:
In providing supervision and/or consultation via telepsychology, psychol-
ogists make reasonable efforts to be proficient in the professional services
being offered, the telecommunication modality via which the services
are being offered by the supervisee/consultee, and the technology medium
being used to provide the supervision or consultation. In addition, because
the development of basic professional competencies for supervisees is
often conducted in person, psychologists who use telepsychology for
supervision are encouraged to consider and ensure that a sufficient amount
of in-person supervision time is included so that the supervisees can attain
the required competencies or supervised experiences (p. 4).
Hames et al. (2020) discussed concerns with the rapid shift to
telesupervision in training clinics immediately after declaration of
285
the pandemic. Both supervisors and trainees had to adapt to the new
platform and navigate the details of necessary technology, as well as
manage stress as a result of the transition. Bernhard and Camins
(2020) provided perspectives of two trainees providing telepsychol-
ogy services and receiving telesupervision to demonstrate support
for the use of telesupervision during the pandemic.
Telesupervision has been discussed in the training literature since
at least 1990 (Inman, Bashian, et al., 2019). Telesupervision prac-
tice will certainly continue in use beyond the pandemic, and time
will tell if experiences with its use during the pandemic lead to
sustained increase following the pandemic. Although CoA, for
example, recognizes the benefits of in-person supervision (and
requires at least 50% of trainee supervision to be delivered in-
person), CoA also recognizes that “accredited programs may utilize
telesupervision in their program curriculum,” (p. 20). Of important
note, CoA has relaxed the 50% limit on telesupervision during the
COVID-19 pandemic, recognizing that in many instances, in-person
supervision may be impossible for health safety reasons. Moving
beyond internship, questions remain about telesupervision hours for
licensure applications (Bell et al., 2020); however, some states have
now included tele-means as a viable option for face-to-face super-
vision requirements (Association of State and Provincial
Psychology Boards, 2020). Given uncertainty about licensure con-
siderations, one might wonder if telesupervision was implemented
less frequently prior to COVID-19 due to the lack of clarity in ability
to meet licensure requirements.
If training in telesupervision increases as a result of the pandemic,
is it conceivable that provision of telesupervision could improve for
use in a variety of postpandemic situations? Bell et al. (2020) predict
that research on telesupervision will increase due to its prevalence
during COVID-19. Deane et al. (2015) provided a rationale for
telesupervision prior to the pandemic to support trainees in Australia
who are in remote areas, and Wood et al. (2005) provided a rationale
(as well as caveats) for trainees in rural areas of the United States.
Indeed, beyond COVID-19, competency in providing telesupervi-
sion might be valuable to those providing services in remote areas,
supervisor/trainee dyads separated for extended periods from in-
person interaction (e.g., due to medical reasons, military, or disaster
relief deployment), and quite simply, even during brief times of
inclement weather when travel is unsafe (Inman, Soheilian, et al.,
2019). This article aims to discuss opportunities to include tele-
supervision research in supervision coursework, as well as utilize
telesupervision in trainees’ experiences providing supervision.
Of significant note, clinical supervisors, in addition to graduate
students and postdoctoral trainees, will need training in telesupervi-
sion. Many, if not most supervisors, have pivoted to telesupervision
during the pandemic without formal training in the modality. To
illustrate this point, one of the authors did an informal polling of
supervising psychologists, current psychology interns, and incom-
ing psychology interns in a large academic medical center predomi-
nantly utilizing telesupervision during the COVID-19 pandemic. Of
the 16 supervising psychologists, 8 current interns, and 9 incoming
interns who responded, only 1, an incoming intern, has had any
formal training in telesupervision. The 17 total interns all are
enrolled in APA-accredited doctoral programs, where training in
delivery of supervision has been required under the CoA’s Stan-
dards of Accreditation. The eight current interns are completing an
APA-accredited internship, which includes training utilizing simu-
lated delivery of supervision. This brief poll suggests that the pivot
 286 PHILLIPS, LOGAN, AND MATHER

Table 1
Research on Telesupervision

Author Method Key findings

Inman, Bashian, Analyzed 35 empirical studies from 25 peer- Telesupervision was typically perceived as equally effective as in-person supervision
et al. (2019) reviewed journals and one book chapter (particularly when live and using audiovisual programs).
published on telesupervision between 1990 and
2016.
Martin et al. Analyzed 11 articles. Identified eight themes that contribute to effective and high-quality telesupervision
(2018) in their analysis, including supervisee characteristics, supervisor characteristics,
supervision characteristics, supervisory relationship, communication strategies,
prior in-person contact, environmental factors, and technological considerations.
Jordan and Shearer Surveyed 12 former trainees in the Veterans Trainees experienced both in-person and telesupervision (in this study, supervisors
(2019) Affairs Health Care System on the perception providing in-person were different from those providing the telesupervision) and
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

of telesupervision, asking both qualitative and rated them to be equitable in quality and that telesupervision was perceived as
This document is copyrighted by the American Psychological Association or one of its allied publishers.

quantitative questions. valuable.

Tarlow et al. Multiple baseline single-case study, incorporating
(2020) objective measures related to supervision as
well as qualitative interviews for three
psychology trainees (doctoral students on
practicum experiences).
Feeling supported and having a strong alliance with the supervisor were important
for both in-person and telesupervision.
Supervisees had high levels of satisfaction and alliance with their supervisor in both
in-person and telesupervision modalities (all three trainees had the same
supervisor for in-person and telesupervision). Qualitative interviews indicated that
supervisees perceived the two supervision modalities similarly. Supervisee
preference of modality (in-person vs. telesupervision) is also a variable that is
important to consider when providing telesupervision as a facet of one’s training.

to telesupervision during COVID-19, while certainly essential for Telesupervision likely has many similarities to in-person super-
the preservation of the health of trainees and supervisors, quite vision. For example, themes identified in an article analysis by
clearly preceded any pivot to training in telesupervision. Martin et al. (2018) included supervisee characteristics, supervisor
characteristics, supervision characteristics, supervisory relationship,
communication strategies, prior in-person contact, environmental
Research on Telesupervision factors, and technological considerations. The first five of these
parallel themes are cited by numerous authors as critical to
In educating trainees about telesupervision, it is important to note
effective in-person supervision (e.g., Falender & Shafranske,
that research is limited (Jordan & Shearer, 2019; Martin et al., 2018).
2004; Norcross & Popple, 2017), while the final three are more
A review of key studies on telesupervision is shown in Table 1.
specific to telesupervision.
Studies find that telesupervision is typically perceived as equally
The need for continued research on telesupervision is clear
effective as in-person supervision, particularly when live and using
(Jordan & Shearer, 2019; Martin et al., 2018) and there are several
audiovisual programs (Inman, Bashian, et al., 2019); however, most
unanswered questions and issues to consider. These issues could be
studies have both an in-person and a telesupervision component with
addressed as part of the telesupervision training experience. Further
the same supervisor, so it is difficult to isolate how telesupervision may research can determine if factors important to both forms of supervi-
specifically contribute to development of the relationship. sion operate in equivalent versus varied ways for in-person versus
telesupervision. Research can seek to determine specific impacts of
Table 2 prior in-person contact, environmental factors, and technological
Factors Trainees in Telesupervision Should Consider for Ethical considerations on telesupervision. For example, there is some evidence
and Competent Practice that prior in-person experience with a supervisor is beneficial for
Factor Relevant reference(s)
telesupervision (Martin et al., 2018) and some evidence that this might
not be necessary (Jordan & Shearer, 2019; Tarlow et al., 2020). Is
Ethics (particularly security and Deane et al. (2015) prior in-person contact more important for early practicum trainees
confidentiality) Inman, Bashian, et al. (2019) (with relatively limited clinical skills and confidence), as compared to
Inman, Soheilian, et al. (2019)
Nonverbal communication perception Inman, Soheilian, et al. (2019) postdoctoral residents (with more advanced competence and associ-
concerns ated confidence)? Until there is more research, particularly with larger
Self-care/self-reflection Tarlow et al. (2020) sample sizes, existing research offers insight into factors that should be
Supervisory relationship/working alliance Deane et al. (2015) considered in telesupervision provision. Trainees should examine
Inman, Bashian, et al. (2019)
these factors as they receive didactic education on providing
Inman, Soheilian, et al. (2019)
Jordan and Shearer (2019) telesupervision (see Table 2).
Technology use and difficulties Deane et al. (2015)
Inman, Bashian, et al. (2019)
Inman, Soheilian, et al. (2019) Incorporating Specific Education on Telesupervision
Jordan and Shearer (2019)
Martin et al. (2018) Into Training Programs
Tarlow et al. (2020)
Training programs will likely begin the endeavor of telesupervi-
Trainee comfort Jordan and Shearer (2019)
sion training by incorporating discussion of relevant research on
 TELESUPERVISION TRAINING
telesupervision into their training (e.g., assigned readings in doc-
toral supervision courses, intern didactic training, or research
lunches). A variety of developmentally sequenced opportunities
for supervision training, role-played sessions, and eventual super-
vised practice of supervision skills will allow for trainees to develop
skills in both telesupervision and in-person supervision.
The opportunity to engage in role-played or preliminary super-
vised telesupervision might be beneficial in early experiences in the
doctoral program, such as one’s supervision coursework (in addition
to ensuring that trainees engage in in-person supervision when able).
For example, in doctoral students’ coursework on supervision, an
early opportunity for practice is to pair each student in the supervi-
sion course with a junior student enrolled in their introductory
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
psychotherapy course as “supervisees.” This allows junior students
This document is copyrighted by the American Psychological Association or one of its allied publishers.
to receive feedback from both the supervision student and introduc-
tory psychotherapy instructor on their early mock/role-play psy-
chotherapy sessions throughout the course. This experience also
provides the supervision students an early experience that allows
them to receive feedback from both the supervisee and supervision
course instructor. CoA describes experiences like this for interns as
“direct or simulated practice” and provides supervision examples
such as, “role-played supervision with others, and peer supervision
with other trainees” (p. 20).
During the COVID-19 pandemic, if institutions of higher educa-
tion have safety restrictions for in-person activities, this could be an
ideal time to engage in the utilization of telesupervision simulations
for these early experiences. The caveat of this option is that students
might need to be monitored to ensure that they also have adequate
training and practice in providing in-person supervision later in their
training. For example, some programs may have embedded experi-
ences for trainees to provide ongoing supervision of junior students
in training clinics. Ongoing experiences embedded in training may
allow for adequate practice and applied experience with in-person
and telesupervision.
In these early supervision experiences, supervision-of-supervision
is vital for both in-person and telesupervision; Newman (2013)
discussed “self-supervision” (viewing one’s own work) and “me-
tasupervision” (supervision-of-supervision) as techniques for
growth in these experiences (pp. 12–13), and both are possible
with in-person and telesupervision. Duan et al. (2019) described a
successful supervision-of-supervision experience in which super-
visors based in the United States facilitated groups of supervisors in
China, providing preliminary evidence that, if needed, this entire
experience and supervision of the experience could likely occur
online for training during the pandemic and when needed beyond
the pandemic.
If supervision experiences involve confidential information (i.e.,
not role-play sessions), this factor must be considered for telesu-
pervision. Students would require specific guidance in protecting
their space and confidentiality (much like what would have been
considered for provision of teletherapy). Confidentiality and secu-
rity issues were identified as concerns related to telepsychology in
prior research (Table 2).
For trainees receiving training in group telesupervision, this
opportunity might provide new ways of incorporating live feedback
while the trainee is leading group telesupervision. For example, the
supervisor could observe with camera and microphone off (to be less
intrusive) and could share typed messages with the trainee con-
ducting the session (not the group), providing the trainee live
287
feedback in a manner that would not be possible during in-person
supervision. Supervisors could also split the supervision time in
half, allowing supervisees to exit or go to a virtual waiting room for a
break, and provide a midway discussion so that the trainee could
incorporate additional feedback in the second half of the group
supervision session.
Inman, Soheilian, et al. (2019) described a supervision-of-
supervision training model for doctoral students that has incorpo-
rated telesupervision since 2008. Surveying 15 alumni and doctoral
students who were trained within this model, Inman, Soheilian,
et al. (2019) identified various challenges with telesupervision
(indicated in Table 2), as well as benefits experienced by trainees
in this model (including exposure to diverse cultures and diverse
work environments, flexibility, development in the supervision
competency, feeling that the experience helped them in the psy-
chology profession, and feeling that they were staying abreast of
developments in the field). Further research would need to deter-
mine if these benefits are different or enhanced in any way from
what is experienced with in-person supervision.
Diversity Considerations in Telesupervision Training
Diversity considerations are unfortunately underaddressed in the
current literature on telesupervision (Falender et al., 2014; Inman &
Luu, 2019; Jordan & Shearer, 2019). We include this discussion of
diversity considerations not only because it is important to consider
in telesupervision training but also because there is not enough
literature to fully understand if diversity considerations differ
between in-person supervision and telesupervision. In the previ-
ously noted Duan et al. (2019) exemplar of cross-cultural supervi-
sion, researchers indicated cross-cultural considerations as well as
definitional and structural differences in supervision between China
and the United States. Inman and Luu (2019) provided a case study
on cross-cultural telesupervision, noting that technology can lead to
challenges but also increased availability of cross-cultural experi-
ences. They recommend that in telesupervision experiences, super-
visors engage in “multicultural discussions” (p. 404) and remain
mindful of context, both supervisor and trainee identities, power
differentials, and working alliance.
There is ample evidence that diversity competence is vital in
supervision provision (Falender & Shafranske, 2014) and across all
trainee/psychologist competencies. Table 3 includes recommended
readings about diversity considerations in supervision that could be
utilized to help trainees explore specific factors that might warrant
special consideration in telesupervision. In addition, hypotheses
about diversity considerations that may be of greater importance in
telesupervision than in in-person supervision should be generated
and empirically tested. For example, are there are differences in the
perception of telesupervision based on experience with technology?
Some supervising psychologists might be less technologically
sophisticated or comfortable than their significantly younger trai-
nees. Could this result in decreased trainee satisfaction with
supervision and decreased perception of value of supervision?
With evidence that trainees have experienced problematic situa-
tions, comments, and nonaffirming behavior from supervisors
(e.g., Constantine & Sue, 2007; Hagler, 2020; Jendrusina &
Martinez, 2019), do these experiences seem more noticeable in
telesupervision, with possibly increased attention to supervisor facial
expressions and reactions? Note that Inman, Soheilian, et al. (2019)
 288 PHILLIPS, LOGAN, AND MATHER
Table 3
Diversity in Supervision Readings to Explore Considerations in
Telesupervision
Constantine and Sue (2007)
Falender et al. (2014)
Hagler (2020)
Inman and DeBoer Kreider (2013)
Jendrusina and Martinez (2019)
McKinley (2019)
Patallo (2019)
Pearlstein and Soyster (2019)
Pieterse (2018)
Thrower et al. (2020)
Note. * Note that this list represents several possible readings and is not an
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
exhaustive list.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
identified concerns with the perception of nonverbal communica-
tion in telesupervision. Further research and literature involving
students’ experiences are needed to better understand diversity in
telesupervision.
Closing Thoughts
Provision of clinical supervision is a core competency of psy-
chologists and we have provided a rationale and preliminary
suggestions for incorporating training specific to providing tele-
supervision to trainees of all levels, as well as for supervisors who
have not had training on telesupervision themselves. Although
further research is needed on telesupervision, providing training
specific to telesupervision and embedding diversity considerations
into such training will promote competency during and beyond the
pandemic. Supervisors can utilize the existing literature to begin
education and discussion of skills, experiences, and considerations
in the provision of telesupervision. The COVID-19 pandemic has
illuminated the viability of telesupervision and the need to actively
engage in training specific to provision of telesupervision.
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Received August 18, 2020
Revision received November 2, 2020
Accepted December 2, 2020 ▪