Academic and clinical instruction are the foundations of training for professional counselors. In order to develop professional competence, students need to step outside of the classroom and practice their skills in laboratory or clinical settings. Fieldwork experiences (e.g., practicum, internship) provide opportunities for development through experiential learning. Because counselor development and competence is not simply related to experience, but is related to supervised practice, supervision is a vital aspect of fieldwork experiences. In addition, because development as a professional counselor does not end with a degree, working effectively with supervisors is a key element in professional growth and development throughout one’s career.
As a student, it is natural for you to rely on your supervisor to facilitate the supervision process and choose interventions to aid in your growth and development as a counselor. It is important to understand that YOU also contribute to a successful supervision experience. This module is designed to facilitate your learning to work productively with a supervisor and to use supervision effectively. Supervision time is valuable. Being prepared for, and intentional throughout, supervision increases the likelihood of a rewarding learning experience.
A variety of definitions for clinical supervision exist. Differences typically reflect aspects of the author’s discipline and training focus. Bernard and Goodyear (1998) offer this definition that has come to be accepted within the counseling profession:
Supervision is an intervention that is provided by a senior member of a profession to a junior member or members of that same profession. This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the junior member(s), monitoring the quality of professional services offered to the clients she, he, or they see(s), and serving as a gatekeeper of those who are to enter the particular profession.
Within the definition, there is mention of several components of supervision:
There are unique competencies and skills involved in supervision that allow the supervisor to help the supervisee. Models of supervision exist that provide a framework for the process. In addition, supervisors incorporate various modes and interventions to facilitate supervisee development.
Awareness of these models, modes, and interventions will help the supervisee understand the underlying processes of supervision and therefore, be a more active participant in the supervision process. A dialogue can develop between supervisor and supervisee as a means to share personal styles and preferences for frameworks and interventions to be used in supervision.
A clinical supervisor is more advanced, at least in some important ways, than the supervisee. During fieldwork experiences, supervisors typically include a course instructor and an individual clinical supervisor. Depending on the level of the fieldwork experience and the program, the clinical instructor may be the course instructor or other professor from the training program, a doctoral student from the training program, and/or a professional counselor affiliated with the site at which the student is engaged in the fieldwork experience.
It is important that the supervisee understand the roles and expectations of each supervisor.
The process of supervision occurs within the relationship established between the supervisor and supervisee. It is important to keep in mind that both the supervisor and supervisee contribute to the relationship and have responsibilities within the process. As assumption of supervision is that it will last long enough for some developmental progress of the supervisee. Supervision is differentiated from brief interactions (such as workshops), and consultation that, by definition, is time and session limited, although all of these interactions share common goals (e.g., training in a skill, clarification of process, regaining objectivity). The fact that supervision is ongoing allows for the relationship to grow and develop. The importance of the supervisory relationship has received much attention in supervision literature.
While not the sole determinate of the quality of supervision, the quality of the relationship between the supervisor and supervisee can add or detract from the experience. It is important that the “relationship” aspect of supervision not be overlooked or neglected.
In addition to enhancing the professional functioning of counselors, supervisors have an ethical and legal responsibility to monitor the quality of care that is being delivered to the supervisee’s clients. In order to enhance the professional functioning of the supervisee and assure quality of care, the supervisor constantly monitors and provides feedback regarding supervisee performance. This formative evaluation forms the basis of the work done in supervision. The supervisor also serves as a gatekeeper for those who want to enter the counseling profession. The supervisor is charged to evaluate the counselor based on work done with current clients, and to assess potential for working with future clients. As part of this role, supervisors formally evaluate supervisees. These summative evaluations occur after there has been enough supervision to expect a certain degree of competence. For example, during fieldwork experiences, summative evaluations typically occur at the midpoint and end of semesters.
Evaluation is a crucial aspect of the supervision process, and one that is often the source of discomfort for both the supervisor and supervisee.
Theories and models serve to help us make sense of and organize information. Operating within a model grounds our practice and helps practitioners with intentionality and consistency. Supervisors should outline their model of supervision, discuss how decisions regarding the focus of supervision are generally determined, discuss their expectations of the supervisee, and how the process will be evaluated for effectiveness. Often this information is included in a Professional Disclosure Statement that is presented to the supervisee.
Supervisees should take the opportunity to discuss their general preferences for receiving feedback, their methods of learning, their expectations of support and critical feedback, and question what to do if they perceive that something is not going effectively in supervision. This discussion, at the beginning and throughout the course of the relationship, may aid in facilitating a positive relationship that leads to counselor development. Training in theory and models of supervision increases supervisor knowledge, and provides guidance for how to direct student learning, as well as how to understand the supervisee experience and development.
In general there are four types of clinical supervision models:
While it is acknowledged that there are models of supervision that are based on theories of psychotherapy, Bernard and Goodyear (1998) state that an indicator that supervision is coming into its own is that there is an increase in models that were developed independent of psychotherapy. Therefore, this section will focus on the developmental and social role models of supervision.
Developmental models of supervision have dominated supervision thinking and research since the 1980s. Developmental conceptions of supervision are based on two basic assumptions:
Three influential models reflecting the developmental perspective are presented (see Bernard & Goodyear, 1998).
This model attempts to match supervisor behavior to the developmental needs of the supervisee. Briefly summarized, there are four stages to this model:
Stoltenberg and Delworth revised the earlier contribution of Stoltenberg (1981) and included aspects of the Loganbill, Hardy, and Delworth model (1982). Stoltenberg and Delworth described three developmental levels of the supervisee and eight dimensions:
The three structures proposed to trace the progress of trainees through the levels on each dimension are:
This model, one of few that is grounded in research, went beyond focus on trainee development and recognized that therapist development continues throughout the lifespan. A brief description of the stages follows.
Bernard and Goodyear (1998) recognize that “a developmental approach to supervision is intuitively appealing, for most of us believe we have [or will] become better with experience and training” (p. 26). It is also important to keep in mind that most empirical investigations of developmental modes report “partial” or “some” support. See Worthington (1987) and Stoltenberg, McNeill, and Crethar (1994) for reviews of developmental models of supervision.
As differentiated from the premise of the developmental models, social role models focus on the roles in which the supervisor engages, and the focus of supervision. Two models will be presented.
The discrimination model attends to three separate foci for supervision:
Once a supervisor has made a judgment about the trainee’s abilities within each focus area, a role is chosen to accomplish the supervision goals. Within the supervision process (or session), three roles may be assumed by the supervisor:
Example: The supervisor and supervisee are discussing a client who is presenting for career counseling. The client has repeatedly expressed fear of the interview process, which the supervisee has heard, but he is unsure of how to help. The supervisor decided to focus on a lack of intervention skills.
The supervisor’s role is to offer support and reassurance, but also to contain any overwhelming affective responses that a supervisee might have. There are six foci that are addressed in this model.
In truth, it is likely that most supervisors behave as integrationists or eclectics. Indeed, supervisors who operate within the social role models also attend to the developmental levels of the supervisee. Norcross and Halgin (1997) suggested that supervisors should attend to the “cardinal principles of integrative supervision.” Among these principles are to:
Because most supervisors develop their own, unique, integrationist perspective, it is important that the supervisor and supervisee engage in a discussion about the processes and model of supervision that will be used.
There are four modes of supervision delivery.
There are a variety of supervision interventions that can be incorporated into the supervision process. Borders and Leddick (1987) listed six reasons for choosing different supervision methods: “the supervisee’s learning goals, the supervisee’s experience level and developmental issues, the supervisee’s learning style, the supervisor’s goals for the supervisee, the supervisor’s theoretical orientation, and the supervisor’s own learning goals for the supervisory experience” (p. 28).
Each mode of supervision lends itself to a variety of interventions. Some of the more popular interventions will be presented. A thorough discussion of supervision interventions can be found in Bernard and Goodyear (1998).
Supervisors of group supervision must attend to a variety of dynamics. These dynamics include the relationship between each supervisee and the supervisor, the relationships between the group members, and the individual clinical experiences and needs of each supervisee. The supervisor needs to attend to the issues present in “groups” as well as “supervision.” For this reason, group supervision activities tend to focus on didactic presentation, case conferencing, individual development, and group development.
Case presentations are an example of a “typical” group supervision intervention. There are a variety of methods for case conferencing. Bernard and Goodyear (1998) include two models. It is important to discuss group supervision expectations with the supervisor.
Live supervision is distinct from either individual or group supervision. The paradigmatic shift consists of two components: 1) the distinction between therapy and supervision seems less pronounced than in traditional supervision, and 2) the role of the supervisor is significantly changed to include both coaching and co-therapist dimensions (Bernard & Goodyear, 1998). Obviously there are many logistics and issues to be addressed when using live supervision. It is dependent upon the supervisor to clearly address these issues with trainees and clients.
One of the purposes of this module is to educate the student about the process of supervision so that it is not “mysterious.” By knowing about the processes, content, and focus of supervision, you can be an active participant in the supervisory relationship. This knowledge can also provide a basis for “knowing yourself” as a supervisee. By engaging in self-exploration, you can become aware of your hopes and expectations regarding supervision. You can also get in touch with your concerns about engaging in this process. It is natural to have mixed emotions. You want feedback and support, but you may also be apprehensive about having your work scrutinized. The supervisor also brings expectations and their own concerns to the relationship.
So, why is this important? The content and processes of supervision are carried out through the supervisory relationship. Indeed, a positive and productive relationship is critical to successful supervision. Bernard and Goodyear (1998) state, “the supervisory relationship is a product of the uniqueness of two individuals, paired with the purposes of meeting for supervision and modified by the demands of the various contexts that are the subject or content of that experience” (p. 34).
Because each supervisory relationship is unique, there is not a recipe for creating the perfect experience. However, knowing your own thoughts and feelings about the process, coupled with an understanding of supervisor expectations, may serve to aid in the development of a positive and productive relationship.
It is natural to have mixed feelings about the process of supervision. Although you want to learn, you might also have concerns about having your work scrutinized. The prospect of supervision may be both reassuring and anxiety provoking. Think about what characteristics you consider to be ideal in a supervisor. Some traits of “ideal supervisors” include: is available, is knowledgeable, directs the student’s learning, has realistic expectations. What would you add to the list? What hopes and expectations do you have about supervision? What particular concerns or worries do you have about supervision? What do you know about how you tend to respond to critical feedback? The answers to these questions will affect your views of what happens in supervision. It may be helpful to share your thoughts with your supervisor. Establishing good communication with your supervisor forms a solid foundation of your work together.
“The qualities that you bring to the relationship and the manner in which you communicate with and relate to your supervisor are critical to the quality of your relationship and how much you learn from supervision” (Kiser, 2000, p. 86). It is also helpful to know what expectations supervisors bring to the relationship.
Supervisors have a responsibility to the supervisee AND the clients the supervisee is counseling. The supervisor bears responsibility for facilitating a positive learning experience for the student. Supervisors may look for the following characteristics in supervisees:
This list is not exhaustive, but it does give a picture of the “ideal supervisee.” It may be more important and productive to ask your supervisor about his or her expectations. In addition, to questions about qualities and characteristics of the supervisee, it may also be helpful to inquire about supervision style and philosophy. The point is to verbalize expectations so that there can be greater understanding between the supervisor and supervisee.
As with any relationship, respect, genuineness, willingness to listen, seeking to understand, and communication are key components. Although most supervisory relationships develop fairly easily, sometimes there can be special challenges to developing positive relationships. Age, gender, cultural, background, theoretical orientation, and cognitive and learning style differences may influence the development of the supervisory relationship. Indeed, supervisors and supervisees “can simply have very different personalities and personal styles, resulting in distance that may take a longer time to bridge the relationship (Kiser, 2000, p. 85). Regardless of the challenges, awareness, communication, patience, and flexibility are key to building a satisfactory relationship. While you do not have sole responsibility for a positive learning experience, you have a powerful role in shaping the supervisory relationship.
The process of supervision requires work on the part of the supervisee and supervisor. How a person prepares for supervision is primarily dependent on the process and goals that have been agreed upon by the supervisor and supervisee. Both supervisees and supervisors have a responsibility to prepare for supervision sessions. It is expected that the supervisor manages sessions, comes prepared to discuss topics related to goals and information gained between sessions, and has an idea of the interventions that are to be used during the sessions. Supervisees must also do their part. Some ideas for supervisees are described below.
Supervision can be an excited and anxiety filled experience. While some focus of supervision is on successes, much time is spent on facilitating growth in the areas of skills, conceptualization, professional behaviors, and personal reactions. It is important that the supervisee enter the supervision session mentally prepared to address these important issues. Any anxiety may be reduced through a moment of personal mediation prior to the session. Supervisees can remind themselves to be open to the supervision experience. Taking a moment to mentally prepare can help supervisees focus, relax, and “be” in the supervision session thereby leading to an intentional growth experience.
Supervisors have an ethical and legal responsibility to monitor the quality of care that is being delivered to the supervisee’s clients. In order to enhance the professional functioning of the supervisee and assure quality of care, the supervisor constantly monitors and provides feedback regarding supervisee performance.
Evaluation is the “nucleus of clinical supervision” (Bernard & Goodyear, 1998, p. 152). As important as evaluation is to supervision, both supervisors and supervisees may find it stressful. Supervisors are charged to balance an understanding of individual differences in conducting counseling sessions with the notion of competent practice as ascribed by the profession. The supervisor utilizes two general methods of evaluation: formative and summative.
It is acknowledged that evaluation can be an anxiety provoking experience. There are steps that can be taken to facilitate a growth-producing experience.
In addition to the flow of feedback from supervisor to supervisee, part of on-going evaluation could include feedback from the supervisee to the supervisor. Attention to the process of supervision helps to facilitate a positive growth experience for all involved. In addition to regular feedback, supervisees should have an opportunity to evaluate the supervisor. Although supervisors and supervisees may have different views on what constitutes “good” supervision, feedback provided by supervisees can reveal important information.
Perhaps the greatest clinical and ethical challenge of supervision is that the supervisor must attend to the best interests of the client and supervisee simultaneously. There are a number of ethical and legal issues that must be considered by supervisors and their supervisees. The topics of direct and vicarious liability, duty to warn, confidentiality, dual relationships, and informed consent will be discussed.
If a professional fails to follow acceptable standards of practice and harm to a client results, the professional can be held liable for the harm caused. Direct liability would be charged when the actions of a supervisor were themselves the cause of harm to a supervisee or a client (for instance, if a supervisor suggested (and documented) an intervention that was determined to be the cause of harm). The supervisor does not have to actually carry out the intervention, but if the supervisee follows the suggestion of a supervisor and this results in harm – this is direct liability. Vicarious liability is being held liable for the actions of the supervisee when these were not suggested, or even known, by the supervisor. Therefore, if a supervisory relationship exists, the supervisor can potentially be held liable for any negligent acts of the supervisee. It should be obvious that the supervisor is very invested in the actions of his/her supervisee – and must take the responsibility of supervision very seriously.
The duty to warn is as relevant for supervisors as counselors working directly with clients. In fact, in the Tarasoff case (the impetus for the duty to warn standard/law) the supervisor, in addition to the counselor, was implicated in the case. The supervisor has a responsibility to advise the supervisee of conditions under which it is appropriate to warn an intended victim.
The Tarasoff Principle: If the counselor knows or has reason to know of probable harm to another identifiable person or the property of an identifiable person, a warning must be issued if the client’s behavior cannot be controlled.
The “Tarasoff Principle” was established by a court ruling in the Tarasoff v. Regents of University of California case in 1976 (17. Cal. 3d 425 – July 1, 1976. S. F. No. 23042). For more information on the Tarasoff principle see Ethical, Legal, and Professional Issues in Counseling by Remley and Herlihy (2001). For more information on the application of Tarasoff to supervisors see: Fundamentals of Clinical Supervision by Bernard & Goodyear (1998)
Supervision allows for third-party discussion of therapy situations. It is important to remember that the type and depth of discussion allowed in supervision, is unethical in other situations. Supervisees must keep confidential all client information except of the purposes of supervision. It is sound practice to keep explicit identifying information confidential (for instance, use only first names and reveal few specific demographics). Supervisees also have a right to privacy and it is the supervisor’s responsibility to keep information obtained in supervision confidential except for the exceptions recognized by the profession and law.
Exceptions to privileged communication as reported by Corey, Corey, and Callanan (1993):
The general consensus about sexual dual relationships is that there is much more potential for harm and negative outcomes, than the potential for good or even acceptable outcomes. Supervisees and supervisors are encouraged to seek discuss these issues and/or seek consultation. The secrecy that typically occurs in the development of dual relationships is an important signal that there is a strong potential for unethical conduct and harm.
There is a general consensus that dual relationships between supervisors and supervisees (particularly in counselor education programs) are inevitable. Unlike therapy relationships, persons who work together will share other experiences with each other. In counselor education programs, faculty members may be instructors, supervisors, academic advisors, personal confidants, and mentors.
The potential for negative outcomes, as a result of dual relationships, centers on the power differential between the two parties. Dual relationships may be problematic in that they increase the potential for exploitation and for impairment of the objectivity of both parties, and they can interfere with the professional’s primary obligation for promoting the student’s welfare.
Some authors acknowledge that dual relationships are not tantamount to negative outcomes Indeed, with appropriate attention to the power differentiation, there can be great flexibility in non-sexual dual relationships. While there is the potential for harm, there are also training and personal benefits. These relationships tend to attract more confusion than harm.
Supervisors have a responsibility to openly acknowledge and discuss the management of the multiple relationships that may exist between supervisor and supervisee. Supervisees are encouraged to ask for clarifications regarding any confusion resulting from dual relationships.
The concept of informed consent is being addressed last, as it has the potential for impacting the ethical/legal issues discussed to this point. Informed consent is the best defense against the difficult and confusing issues that arise in supervision.
Supervisors have an obligation to determine that clients have been informed by the supervisee regarding the parameters of therapy. Clients must not only be aware of therapeutic procedures, but also of supervision procedures. The supervisor assures that clients are informed of the parameters of supervision that may affect them.
In addition, supervisors have a responsibility to inform supervisees about the supervision process, potential for dual relationships, limits of confidentiality, and the conditions of their success or advancement (evaluation criteria and process). Supervisors may use a Professional Disclosure Statement as a to facilitate the informed consent discussion.
Ethical dilemmas are inevitable in counseling and supervision. To increase your ability to successfully manage dilemmas, consider the following: