Case conceptualizations from 120 counselors-in-training and post-master's-level counselors were examined for inclusion of positive and negative client characteristics. Conceptualizations of clients with whom counselors felt effective were more positive than negative, whereas conceptualizations of clients with whom counselors felt less effective were more negative than positive. Differences across counseling specialization, duration of counseling experience, and counselor cognitive complexity were explored.

Case conceptualizations from 120 counselors-in-training and post-master's-level counselors were examined for inclusion of positive and negative client characteristics. Conceptualizations of clients with whom counselors felt effective were more positive than negative, whereas conceptualizations of clients with whom counselors felt less effective were more negative than positive. Differences across counseling specialization, duration of counseling experience, and counselor cognitive complexity were explored.

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Clients rarely present with prototypical presentations for which an “off the shelf” cognitive-behavioural therapy (CBT) approach can be used, and the most frequently cited rationale for case conceptualisation is matching clients’ unique presentations and therapy goals with available theory and research. In this, it is argued that case conceptualisation guides therapy by ensuring that individual cognitive and behavioural processes are targeted, thereby maximising therapy efficacy. Therefore, therapists who are competent in case conceptualisation should achieve better outcomes. However, little is known about the relationship between competency in case conceptualisation and general CBT competence, or how competency in case conceptualisation is linked to therapy outcome. Forty audiotapes selected from an ongoing study (CoBalT: Cognitive Behavioural Therapy as an adjunct to Pharmacotherapy for Treatment Resistant Depression in Primary Care: a randomised controlled trial) were rated for competency in case conceptualisation and competence in CBT using the Collaborative Case Conceptualisation – Rating Scale (CCC-RS) and Cognitive Therapy Scale – Revised (CTS-R) respectively. The assessment of competence was carried out by independent groups of researchers with expertise in these assessments, blind to treatment outcome. Therapy outcome was measured using The Beck Depression Inventory II (BDI-II). The results showed that 1) competence in case conceptualisation shared a strong and positive relationship with general CBT competence and, 2) that competence (in case conceptualisation and general CBT competence) was associated with better treatment outcome for depression. The results highlight competence in case conceptualisation as an important facet of therapist CBT competence, and indicate that investing in the training and selection of therapists competent in case conceptualisation as well as CBT competence has the potential to enhance treatment outcomes.

This study examined the supervision effectiveness of three online peer supervision models as measured by the two outcome variables of case conceptualization skills and self-efficacy. Also, it explored the impact of developmental levels of school counselors on the outcomes of supervision. Practicing school counselors from a national sample were randomly assigned to three groups: the Online Structured Peer Supervision Group (S group), the Online Peer Discussion Group (D group), and the Control Group. Two instruments measuring the outcome variables (dependent variables) were administered: the Clinical Hypothesis Exercise Form (CHEF) and the Counselor Self-Efficacy Scale (CSES). The independent variables were the two experimental conditions and the supervisee years of experience. In addition, the Counselor Supervision Experience Questionnaire collected information regarding the overall on-line supervision experience. No significant differences were found before and after the online peer supervision groups by statistical analysis; however, positive feedback regarding the supervision experience was provided by participants in response to qualitative questions.

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