Providing feedback on patient progress to therapists improves clinical outcomes for patients, particularly those who are failing to improve with therapy. The encouraging research has been carried out by a small group of researchers, largely working in the United States health care context. The samples studied have been young people attending university counselling services, suffering from mild mental health disorders. The group studies are therefore not similar to patients seen for psychological therapy in the NHS. Also given that therapists are not necessarily alert to treatment failure, have an overly optimistic view of their patients progress even when provided with evidence to the contrary, clinical supervision may be a more effective method through which to provide patient informed clinical outcomes than directly to therapists themselves.

We will assess if providing feedback through the supervision process is more effective than providing this information to therapists themselves in terms of improving clinical outcomes, particularly for patients who are failing to improve with routine NHS Psychological therapy.

As above

Inclusion Criteria:

Patients

Able to give informed consent Male or female (>18 years of age) Requiring psychological treatment or therapy in routine Mental Health Services Able and competent to understand and complete CORE questionnaires

Supervisors and their therapists

Able to give written informed consent Any NHS Greater Glasgow and Clyde applied psychologist who is supervising therapists offering routine psychological therapy to patients in NHS Greater Glasgow and Clyde and whose therapists agree to take part in the study.

Exclusion Criteria:

Patients

Below the age of 18 years Inability to give written informed consent Inability to understand and complete CORE questionnaires

Supervisors and their therapists

Those supervisors and therapists who are unlikely to be able to stay in the study for its duration.