Supervision practices and the supervisory working alliance as factors supporting the therapeutic alliance: A systematic review

ABSTRACT Supervision is foundational for therapist development and treatment effectiveness, potentially influencing the therapeutic working alliance (TWA) with clients. This systematic review examines how supervision factors (including the supervisory working alliance) impact the TWA. Following PRISMA guidelines, 11 empirical studies were analyzed. Results suggested structured supervision strengthens the TWA through clear protocols, though excessive structure may limit therapist autonomy, while live supervision was linked to higher initial alliance levels. The supervisory alliance correlated more with therapist-rated than client-rated TWA, primarily boosting therapist confidence. These findings highlight the need for adaptive supervision models integrating structure, flexibility, and reflective learning.