The CBT fidelity platform for clinical trials.
Standardise therapist training across every site. Track delivery of any protocol-specific skill — and score how well each is being deployed against the CTS-R framework. Audit-ready records for REC, sponsors and reviewers. Customisable for your specific RCT protocol — pivot the platform on a dime.
We turn your trial manual into a live rehearsal system
We take your manualised protocol — every technique, every session structure, every novel intervention — and build it into a working training programme. AI clients to rehearse on. Trainer commentary in every module. Therapists practise every protocol-specific skill until graded competent — before they see a single trial participant. Existing techniques are pulled from Supervisia’s library; novel or trial-specific techniques are built bespoke by our team.
A training partner across the whole trial lifecycle.
Therapist variance is the difference between an effect and a null result.
Imaginal exposure in PTSD is severely underutilised even by trained therapists. In routine practice that's a quality issue. In a clinical trial, it's a contamination of your effect size.
Most trials still rely on quarterly tape-rating by an overstretched supervisor. By the time drift surfaces, it's been happening for months — and the data is already collected.
Supervisia builds fidelity into the training itself — on two layers. Skill-use tracking shows whether any protocol-specific technique is being deployed at all. CTS-R scoring shows how well each one is being delivered. Drift detection runs across cohorts. Refresher modules trigger automatically when a therapist crosses your trial's threshold.
The audit trail is ready before REC asks for it. Your methods section writes itself.
Why continuous fidelity infrastructure matters
Supervisia's design isn't founder opinion. It maps to four decades of CBT fidelity, drift and supervision research — the same literature your reviewers will be reading.
“Therapist drift can be conceptualised as our failure to deliver treatments that we have been trained to deliver, or failure to deliver them adequately, even where resources exist to allow us to do so.”
In a randomised comparison of fidelity measurement methods, behavioural rehearsal aligned closely with direct observation, while therapist self-report and chart-stimulated recall significantly overestimated adherence — making them poor substitutes for observed practice.
Standardised CBT supervision improved therapists' competence ratings on the CTS-R, indicating that protocol-based active supervision strengthens delivery beyond initial training alone — competence is a process, not an event.
The great majority of psychological therapists rate their skill level as “well above average”, with very few seeing themselves as falling in the lower half of clinicians — a self-assessment bias that disqualifies therapist self-report as a credible fidelity instrument.
Further reading: Borrelli et al. (2005) on fidelity as an interpretability prerequisite; APA Measurement-Based Care guidance (2020); Cambridge review on video feedback in CBT supervision. Full reference list available on request.
What Supervisia gives a trial
The same infrastructure trial teams build by hand — training, fidelity scoring, drift monitoring, audit trail — delivered as software, tailored to your protocol, ready in days not months.
From manual to rehearsal — built for your trial
We turn your manualised protocol into a working training programme. Library skills pulled where techniques match; novel or trial-specific techniques built bespoke by our team. AI clients to rehearse on. Every therapist on the trial gets the same teaching, in the same sequence, graded against the same standard.
Two layers of fidelity, monitored continuously
Track delivery of any protocol-specific skill in your trial — was the technique used at all? — and score how well each is being deployed against the CTS-R competency framework. Continuous, not quarterly. Cohort means, individual therapist trajectories, configurable trial-specific thresholds.
Cohort drift detection
Multi-site, multi-therapist comparison. Outliers flagged before drift contaminates your data. Refresher modules triggered automatically and recorded for your audit trail.
Real session validation
Therapists upload session recordings or transcripts. Supervisia scores protocol adherence, CTS-R competence, and paralinguistic markers (tone, pace, pauses, alliance signals) — automatically. Move from monitoring rehearsals to validating the therapy actually delivered to participants.
Inter-rater reliability built in
When supervisors and the platform score the same session, IRR is calculated automatically and included in your audit export. Reviewers asking how you validated fidelity scoring get a defensible answer — with Cohen’s kappa values they can quote in their report.
Audit-ready records
Training records, CTS-R scores, real-session analysis, drift events, refresher completion — exportable as a formatted report ready for REC, your sponsor, NIHR portfolio review, or your methods section.
Built per trial when your protocol needs them.
These aren’t part of every Supervisia engagement — they’re configured for trials where the methodology demands them. Tell us what you need; we build it into your trial’s instance.
Dose–response analytics
Correlate cohort fidelity scores against participant outcome data — PHQ-9, GAD-7, PSWQ trajectories from your trial database. Answer the question reviewers will actually ask: did higher fidelity produce better outcomes? Configurable per trial’s outcome measures.
Real-time safety event extraction
Automatic flagging of sessions containing risk markers — PHQ-9 Q9 elevations, alliance ruptures, adverse-event language. Trial-specific thresholds and PI alert routing built into the platform. Auditable log for your DMC and REC committee.
Adherence and competence — scored separately
Some methods sections need them distinct: “Was the protocol followed?” (adherence) versus “How well was it delivered?” (competence). Supervisia scores and reports each separately, with configurable weighting per trial, when your reviewers expect that distinction.
Need something else? Tell us during the research consultation — we've built unusual capabilities for unusual protocols and we'll be honest about what's in scope.
Who Supervisia for Research is for
Trial teams running CBT-based interventions where therapist fidelity is a quality issue worth protecting.
NIHR, charity and grant-funded trials
A treatment fidelity infrastructure your reviewers expect, costed into your grant from the start. Methods section ready, REC documentation built in, fidelity scoring you can cite.
Multi-site evaluations and service trials
Standardised training across NHS trusts. CTS-R scoring aligned with the metrics NHS Talking Therapies services already track. UK data residency available. Built around the standards your governance committees already use.
Industry, charity and contract research
A turnkey CBT therapist training and fidelity programme — reduces sub-site variance, cuts the cost of bespoke training delivery, and produces evidence packs sponsors and ethics boards accept.
Tell us about your trial.
We'll come back with a tailored proposal — protocol-specific customisation, fidelity infrastructure costed against your grant, and a timeline that fits your IRAS approval window. Typically within one working day.