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This Mixed Methods Multiple Case Study with Explanatory Sequential Component design investigated 240 teachers’ and 23 principals’ perceptions of teacher supervision practices in Catholic primary schools in the Cayo district of Belize. A quantitative survey was followed by focus group interviews with 36 teachers and individual interviews with six principals. These data were then used to create and implement an Adapted Teacher Supervision Model (ATSM) through a multiple case study. Clinical Supervision, Walk-throughs and Spot Checks were the main teacher supervision practices; however several effective supervision practices were not observed. Teachers and principals in the case study schools agreed that the ATSM had positive influences on teachers’ instructional practices. Principals should adopt a comprehensive framework for effective supervision.