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We welcome the opportunity provided by the letter from Drs Silberman and Mazza to amplify (and hopefully clarify) what we see as the implications of our findings for training psychotherapists. We found that ratings of psychotherapist skills from different sources (supervision, videotaped sessions, and didactic examination) were largely independent, and that therapist ratings based on traditional supervision were significantly correlated with patient outcome. We suggested that a possible explanation for the correlation between supervisor's ratings of therapist skill with patient outcome was that the supervisor's ratings of therapist's work with the patient may be biased by the therapist's report of the patient's satisfactory progress.In that a significant correlation between two ratings cannot provide information about whether a causal relationship exists or the direction of causality, Drs Silberman and Mazza have correctly pointed out that alternative explanations are likely. They have suggested that supervisor ratings of the therapist's skill
Chevron E. Supervision of the Psychotherapeutic Process-Reply. Arch Gen Psychiatry. 1985;42(7):740. doi:10.1001/archpsyc.1985.01790300108020