A particular barrier to effective dissemination of CBT is the lack of a system for training, supervision, and feedback to clinicians. Although ongoing monitoring and demonstration of clinician skill in delivering treatment and fidelity to manual guidelines is a methodological requirement for clinical trials evaluating behavioral therapies (Chambless & Hollon, 1998; Luborsky & DeRubeis, 1984; Rounsaville, Carroll, & Onken, 2001), systematic monitoring and feedback on clinicians’ implementation of evidence-based therapies is rare in clinical practice (Henggeler, Schoenwald, Liao, Letourneau, & Edwards, 2002; Hoffman & McCarty, 2013; Knudsen, Ducharme, & Roman, 2008; Martino et al., 2016; Roche, Todd, & O'Connor, 2007; Sholomskas et al., 2005). In recent years, multiple trials evaluating different methods of training clinicians to use evidence-based therapies have demonstrated that monitoring and supervision is significantly more effective than workshop-based training alone in a range of therapies (Beidnas & Kendall, 2010; Henggeler, Chapman, Rowland, Sheidow, & Cunningham, 2013; W.R. Miller, Yahne, Moyers, Martinez, & Pirritano, 2004; Schoenwald, Sheidow, & Chapman, 2009), including CBT (Rakovshik, McManus, Vazquez-Montes, Muse, & Ougrin, 2016; Rakovshik et al., 2013; Sholomskas et al., 2005). The
