Recent attention to gaps and inadequacies in U.S. community mental health systems has revived efforts to improve access and the quality of mental health care to underserved, diverse, rural, and seriously mentally ill populations. The importance of elements such as evidence-based practice importation, needs assessment and evaluation, and mental health care disparities in this effort calls for innovation and leadership from professional psychologists. Yet, psychologists have been diminishing in representation from public mental health settings, and there have been limited efforts to comprehensively define the competencies required of practice in the public psychology specialty. This article presents the unique functional and foundational competencies required of psychologists to lead a transformation in the public mental health system. These public psychology competencies provide a foundation for professional psychologists to meet the challenges of a changing public mental health services context and promulgate effective evidence-based community systems of care. With education and training efforts, exposure to the public psychology competencies established in this study can aid in the transition of more psychologists into the public sector.

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Although a strikingly diverse range of outcomes have been measured within clinical supervision research, a dominant perspective is that clinical outcomes remain the "acid test" of its effectiveness (Ellis & Ladany, 1997). We question the wisdom of this acid test logic in 2 ways. First, we summarize alternative conceptu alizations of outcome from within the supervision field, highlighting several important reasons for considering clinical benefit as but one of several equally valid, stepwise outcomes. The fidelity framework (Borrelli et al., 2005) is drawn upon to show how these complementary outcomes may be logically and advantageously combined. This framework's dimensions are the design, training, delivery, receipt, and enactment of an intervention. Second, a sample of 12 interpretable studies of the clinical outcomes of supervision is evaluated in terms of the studies' attention to these 5 dimensions. From this conceptual and empirical review, it is concluded that an overemphasis on clinical outcomes carries unnecessary risks (e.g., weak causal reasoning and a failure to identify mechanisms of change), while underemphasizing the several benefits of a more inclusive approach (e.g., increasing outcome research and improving supervision).

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While accounts of the practice of cognitive behavioral therapy (CBT) supervision have been available over the past 15 years and have demonstrated consistency in terms of an overall model specifying the structure, process and content of supervision sessions, a number of gaps can be identified in the literature on the clinical supervision of CBT. Comprehensive consensus statements of the competencies underlying clinical supervision have been developed both in the United States (Falender et al., J Clin Psychol, 60, 771-785, 2004) and in the United Kingdom (Roth and Pilling, IAPT supervision competencies framework, University College London, 1992), but there has been a lack of attention to relevant theory and to procedural detail. As a consequence, the literature on CBT supervision has only recently begun to assimilate concepts from the wider supervision field (e.g. developmental models), and there is as yet no manual that would allow supervisors to make explicit determinations of competency. Furthermore, supervision in general continues to suffer both from the absence of compelling empirical support demonstrating its effectiveness in improving clinical outcomes, and there is a lack of explicitly-defined supervisory procedures that can be reliably observed and measured. Unfortunately, this combination of factors hampers the development of CBT supervision (e.g. it complicates efforts to provide a standardized framework for training in supervision). As an important starting point in 'treating' the underdeveloped state of CBT supervision, we outline a formulation of its current condition, then suggest some promising interventions.