Edited Version1

Critical Elements of Effective Supervision

With the Experienced Counselor

A Dissertation

Submitted to theFaculty of Argosy University Schaumburg Campus

College of Psychology and Behavioral Sciences

In Partial Fulfillment of theRequirement for the Degree of

Doctor of Education

by

Alice H. Crawford

August 2010

Critical Elements of Effective Supervision

With the Experienced Counselor

©2010

Alice H. Crawford

All rights reserved

ii

Critical Elements of Effective Supervision

With the Experienced Counselor

Abstract of Dissertation

Submitted to theFaculty of Argosy University Schaumburg Campus

College of Psychology and Behavioral Sciences

in Partial Fulfillment of theRequirements for the Degree of

Doctor of Education

by

Alice H. Crawford

Argosy University Schaumburg

August 2010

Katherine Miley, PsyD

Dale Septeowski, PhD

La-Don Jackson, PhD

Department: School of Behavioral Science

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Abstract

The current research project explored answers to the question, what are the critical

elements to conduct effective supervision with experienced counselors? A three round

electronic Delphi study was conducted with a panel of eight clinical supervisors. The

study, conducted over a nine week period, gave participants an opportunity to answer

four open-ended questions in the first round and address consensus of the group during

the second and third round. Results of the study identified four critical elements for

conducting effective supervision with experienced counselors: the supervisor; the

supervisee/experienced counselor; the supervision process; and the supervision

relationship. Conclusions of the study direct further research in the area of diversity and

outcome of supervision with experienced counselors.

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Table of Contents

TABLE OF TABLE…………………………………..…………………………………vii

TABLE OF APPENDICES………………………………………..……………………viii

CHAPTER ONE: THE PROBLEM...................................................................................2Problem Background...........................................................................................................2Purpose of the Study............................................................................................................6Research Question...............................................................................................................7Limitations of the Research.................................................................................................9Definitions.........................................................................................................................10Importance of the Study.....................................................................................................11

CHAPTER TWO: REVIEW OF THE LITERATURE....................................................12Administrative Supervision...............................................................................................12Clinical Supervision...........................................................................................................17Components of Clinical Supervision.................................................................................22

Working Alliance...........................................................................................................22Supervisor’s Style..........................................................................................................28Feedback........................................................................................................................30Communication..............................................................................................................35Gender Issues and Communication...............................................................................37Multicultural Issues and Communication......................................................................39Ethical Issues.................................................................................................................46

Good Supervision vs. Bad Supervision.............................................................................50

CHAPTER THREE: METHODOLOGY.........................................................................58Research Design................................................................................................................58

Selection of Subjects......................................................................................................59Instrumentation..............................................................................................................65Assumptions..................................................................................................................66Procedures......................................................................................................................67

Data Processing and Analysis............................................................................................69

CHAPTER FOUR: FINDINGS........................................................................................71

CHAPTER FIVE: SUMMARY, LIMITATIONS, AND FUTURE RESEARCH...........88 Characteristics of the Supervisor...................................................................................88

Characteristics of the Supervisee...................................................................................94Characteristics of the Supervision Process....................................................................98

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Characteristics of the Supervision Relationship..........................................................103Limitations of the Study..................................................................................................107Future Research...............................................................................................................108

REFERENCES................................................................................................................110

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Table of Tables

Table Page

1. Panel Members by Education Degrees, Professional Title, Work Setting,Counseling Theoretical Approaches, Supervision Theoretical Approaches................74

2. Supervisor Characteristics Panel Rating......................................................................79

3. Supervisee Characteristics Panel Rating......................................................................81

4. Supervision Process Characteristics Panel Rating.......................................................83

5. Supervision Relationship Characteristics Panel Rating………………….…………..85

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Table of Appendices

Appendix A: Electronic Invitation ................................................................................... 123

Appendix B: Informed Consent ...................................................................................... 127

Appendix C: Study Description ...................................................................................... 130

Appendix D: Nominee Invitation .................................................................................... 132

Appendix E: Round One Questionnaire and Demographics ........................................... 136

Appendix F: Application for IRB Review and Certification of Compliance ................. 139

Appendix G: Round One Response ................................................................................ 152

Appendix H: Additional Comments Round 2 ................................................................. 165

Appendix I: Additional Comments Round 3 ……………………………………… ….. 167

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Acknowledgements

The author would like to express sincere gratitude to committee members,

Dr. Katherine Miley, Dr Dale Septeowski, and Dr. La-Don Jackson, for their invaluable

support and guidance in the planning and implementation of this research project. The

deepest appreciation is further offered to Dr. Jeffrey Edwards for his guidance in the

research methodology of the project and Robert Racine for help with data analysis. The

most heartfelt appreciation is offered to my editor, Amy Gralewski, for quick completion

of the task. The deepest appreciation is further offered to the Clinical Supervisors of the

Linked In groups for their participation in the research study. Without their contributions

of time and resources, this study would not have been possible.

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Dedication

To my husband, Bryant, for your patience during this process and my son, Christopher,

for understanding when Mom was in a “grumpy mood.” To my Mother and Father who

are my prayer warriors, my sister who always asked “are you getting something done?”

and family members whose prayers, love, and support have helped turn this dream into a

shared reality. It could not have been possible without you.

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CHAPTER ONE: THE PROBLEM

Supervision is a common occurrence and major part of training and licensure for

beginning and novice counselors (Grant & Schorfeld, 2007). As part of a counseling

curriculum, the counselor-in-training is expected to complete hours of supervision in

order to meet degree requirements as well as continue postgraduate supervision to obtain

licensure. Bhat and Davis (2007) stated “supervision is the primary vehicle in the

counseling profession through which trainees provide services to clients in a monitored

environment” (p. 80).

However, the discussion of supervision and its focus on the beginning or novice

counselor discounts a population of counselors who continue to receive supervision, the

practicing or experienced counselor. Grant and Schorfeld (2007) found that not only do

counselors engage in supervision after licensure, they often engage in supervision for

years after licensure. Their study focused on members of the Psychotherapy and

Counselling Federation of Australia and found that a large percentage of the respondents

continued to engage in supervision, with 79% engaging in individual supervision rather

than peer or group supervision (Grant and Schorfeld, 2007). While the literature speaks

to effective ways for supervisors to conduct supervision for the counselor in training, it

does not speak specifically to how supervisors conduct supervision with experienced

counselors and how it may differ from supervision of a counselor-in-training.

Ronnestad and Skovolt (2003) discussed the changes experienced by the

counselor as he or she gains experience. Goodyear, Wetheimer, Cypers, and Rosemond

(2003) acknowledged this finding and pointed out that there should be more in-depth

discussion about the impact of supervision on the experienced counselor as the

experienced counselor gains experience. The authors contended that supervision with the

experienced counselor should be investigated to understand the impact of supervision on

this type of counselor.

Problem Background

Campbell (2000) stated, “effective supervisors need a broad range of

competencies in a variety of areas” (p. 5). The supervisor must assess and monitor the

supervisee no matter the level of skill or experience. This baseline helps the supervisor to

get to know the supervisee and meet the needs of the supervisee within the supervision

realm. According to Campbell, the important supervision skills include knowledge of

clinical supervision; understanding of the supervision models, methods and techniques;

understanding the importance of the supervisory relationship; understanding of cultural

issues and environmental factors; understanding of legal and ethical issues; and

familiarity with assessment and evaluation. While Campbell’s list is not exhaustive, it is

extensive; however, Campbell did not state whether the listing could be generalized

across all levels of counselor skills and experiences. Campbell also did not specify

whether these same factors are addressed in supervision with an experienced counselor or

if additional or fewer factors are needed.

While the major counseling and psychotherapy organizations in the US (i.e.,

American Psychological Association and American Counseling Association) do not

require ongoing supervision after licensure, many experienced counselors, like the

beginning or novice counselors, engage in supervision for personal and professional

growth. Not only do the experienced counselors express a desire to participate in

supervision, they have been known to seek it out if it is not provided in their work setting.

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The difference in the experienced counselor and the novice/beginning or counselor-in-

training is how they define their personal and professional growth and what is needed in

supervision to achieve this growth. Ronnestad and Skovholt (2003) contended that the

professional development of the experienced counselor should not only encompass the

issues of the novice/beginning counselor, such as anxiety and supportive work

environments, but also include the counselor’s personal life challenges and experiences.

Roberts and Borders (1994) agreed that supervision is to focus, among other things, on

“one’s personal traits and issues affecting counseling performance” (p. 1). Borders

(1991c) further stated, “although skill enhancement frequently is the specified goal, the

supervision process also encourages greater self-awareness and fosters an integrated

professional and personal identity as a counselor” (p. 254).

According to Stoltenberg’s (1981) developmental model, the experienced

counselor is a professional who is considered Level 4 or Master Counselor:

The counselor has personal security based on awareness of insecurity; is insightful, with full awareness of the limitations of insight; and is able to function adequately, even with some occasional changes in degrees of motivation. (p. 63)

The experienced counselor is one who has practiced for a number of years, is

independently licensed, and can be found in various work contexts from educational

programs and schools to agencies and hospitals. Further, the experienced counselor is

aware of and understands the role of being a counselor. Experienced counselors are open

to new ideas and experiences, in touch with their inner feelings and their emotions,

possess trust, possess self-awareness, and have different personality characteristics,

which can help enhance the supervisory relationship Ronnestad and Skovholt (2003).

3

This professional is expected to incorporate theories of counseling, the

importance of the therapeutic relationships and processes, setting boundaries, approach to

counseling, distinction between their personal and professional life, ethical and legal

issues, the impact of diversity and environmental factors on client issues, and positive

client outcomes. The experienced counselor, not unlike the novice counselor, also

recognizes the importance of ongoing supervision for professional development

(Shechtman & Wirzberger, 1999). Though experienced counselors are viewed as self-

regulating, self-monitoring, and competent in the field of counseling, Barretta-Herman

(1993) argued that the emotional demands placed on counselors to deal with traumatic,

pervasive, intractable individuals and social problems warrant continued support. This

support can be achieved through clinical supervision. The supposition that the

experienced counselor may not need supervision defines supervision only as a teaching

tool for those who must learn how to be counselors rather than as an enhancement tool

for continued growth and competence. While there are many different approaches to

supervision for the counselor-in-training or the novice, it is not known if these same

approaches can be just as beneficial for the experienced counselor or if the experienced

counselor is looking for other factors to address. Unlike the novice counselor, the

experienced counselor has a wider knowledge base on counseling techniques and

therefore may need a different or additional focus in supervision. Supervisors may know

of the demand for additional focus and address those issues in supervision with an

experienced counselor, but to date nothing in the literature describes those issues.

The experienced counselor can bring many different perspectives to supervision

due to their experiences with counseling clients. The supervisor could learn from the

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experienced counselor in supervision rather than the traditional theory that the supervisee

is to learn from the supervisor. Holloway (1988) questioned the developmental model of

supervision, since the emphasis is more on the counselor-in-training than the experienced

counselor. She stated that training helps the emerging counselors develop within the

supervisory context and the development results in a counseling professional. She asked

whether someone who has been a counselor and then furthers their professional training

is to be viewed as someone who is now an inadequate counselor during supervision. She

emphasized the idea that supervisees bring experiences to the table, which are not to be

dismissed but rather embraced to enhance the supervision process. Holloway (1988)

commented, “ultimately, of course, investigators in the field must engage in confirmatory

research in which they test the efficacy of various supervisory approaches with trainees

of various levels of experience, learning styles and motivational attributes” (p. 139).

Barretta-Herman (1993) concurred with Holloway regarding the developmental

model and recognition of the experience of the counselor in supervision:

It is important that the supervisor is not assumed to hold superior knowledge and skill vis-à-vis the practitioner, who in this model is experienced, licensed, often a specialist and in some cases a recognized expert. The supervisor of a competent practitioner recognizes and acknowledges the practitioner’s expertise and views the supervisor role as one of reflection, critique, challenge and support. (p. 60)

According to Worthington (2006), experience level adds to personal autonomy

and self-assurance. Counselors’ needs and abilities change as they gain experience, and

therefore, supervision should be conducted differently based upon the counselor’s level

of experience. This difference across the experience and skill levels leads to the

conclusion that supervisors’ approaches to supervision should be different for

experienced counselors in order to address the differences of the experience levels.

5

Purpose of the Study

Literature has stated that the experienced counselor looks for supervision in order

to enhance accurate case conceptualization (Gainor & Constantine, 2002), address

transference-countertransference issues (Worthen & McNeill, 2001), deflect experiences

of burn-out (Niebrugge, 1994), increase self-efficacy (Larson & Daniels, 1998), decrease

job dissatisfaction (Kavanagh et al., 2003), adhere to ethical and legal guidelines

(Cormier & Bernard, 1982), increase their knowledge of diverse populations (Sue, 1991),

and elicit feedback on performance (Pistole & Roberts, 2002) in order to increase positive

client outcomes (Worthen & McNeill, 1996). Tromski-Klingshirn and Davis (2007) also

stated that supervision promotes development or maintenance of counseling skills. Since

the experienced counselor is concerned with these issues in the supervision process, it is

possible the supervisor is addressing more than what is documented in the literature.

Many authors have discussed the fact that research is badly needed to understand

the applied methods of supervising experienced counselors (Goodyear et al., 2003;

Herbert & Trusty, 2006; Skovholt & Ronnestad, 1992; Spence, Wilson, Kavanagh,

Strong, & Worrall, 2001). Supervisors conduct supervision with this skill level counselor

and yet there is a lack of in-depth literature on how supervisors conduct the process and

whether or not it is different from supervising a counselor-in-training. Understanding the

practices and techniques of supervisors engaged in supervision with the experienced

counselor will add to the supervision literature regarding the best practices of effective

supervision with this population.

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Research Question

What are the critical elements of effective supervision with experienced

counselors? Wheeler and Richards (2007) advocated that a research agenda needs to be

formulated that takes into account long-term supervision and experienced practitioners.

Since there is sparse literature regarding supervision with an experienced counselor, the

literature reviewed will build upon the factors that are currently discussed in supervision.

At no time is the list considered all-inclusive, but rather a beginning point of exploration

into possible supervision practices currently done with experienced counselors.

Utilizing the outline of Campbell’s (2000) workbook of becoming an effective

supervisor, this study explored the important and critical elements of effective

supervision with experienced counselors from the supervisor’s point of view. In addition

to Campbell’s outline of factors for effective supervision, the guidelines of supervision

by the Association for Counselor Education and Supervision (ACES) (1993) were also

included as a guide to the exploration of supervision with an experienced counselor.

ACES establishes guidelines in order to enhance the counseling profession. “The

Association for Counselor Education and Supervision (ACES) is composed of people

engaged in the professional preparation of counselors and people responsible for the

ongoing supervision of counselors” (ACES, 1993).

Since the literature is sparse regarding the important and critical elements

involved in the effective supervision of an experienced counselor, a Delphi study was

utilized to enlighten the field of supervision with this particular population. A Delphi

method of research is practical to use “…when there is an absence of theoretical body of

knowledge to point to a particular decision” (Jenkins & Smith, 1994, p. 413).

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The Delphi method, first developed by the RAND Corporation, is a technique in

which a panel of “experts” is queried about their opinion on a specific topic (Dalkey &

Rourke, 1971; Dalkey & Helmer, 1963). Once query and review takes place, a consensus

of the panel of the important factors of a topic result. The Delphi method used in this

study possessed several advantages such as anonymity for participants, participants who

were geographically dispersed which added to discourse, and being a method that utilized

both qualitative and quantitative aspects of research and was effective for conducting this

pilot study. Since the current study was a pilot study of preliminary research, the Delphi

method was an appropriate research vehicle.

The researcher looked for the supervisor’s interpretations of the important and

critical elements necessary, in their opinions, to conduct effective supervision with

experienced counselors in contrast to conducting supervision with a counselor-in-

training. The information was elicited from the Delphi panel through three rounds of

questionnaires. The first round consisted of open-ended questions exploring what were

considered to be important and critical elements of effective supervision with

experienced counselors and novice counselors, the advantages of conducting supervision

with experienced counselors, and the disadvantages and the comparison between the

experienced counselor and the novice counselor in supervision. The information

gathered from the first round was thematically analyzed and then coded as a survey for

the second round. The second round consisted of confirmation and ranking of the

researcher’s analysis on emerging themes quoted by the panel members in the first round,

along with any additional comments on missed themes. The third round consisted of a

review of the rank order of the themes and gave the panelists an opportunity to make any

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final comments. The results of the study contributed to further understanding of

supervision practices.

Limitations of the Research

The disadvantages of the Delphi technique were possible poor analysis,

summarization and presentation of the panel’s responses by the researcher, the

construction of the questions to encourage rich data and discourse, sample size, and

rigorous data analysis (DeVilliers, DeVilliers, & Kent, 2005). The solicitation for

participants resulted in a diverse sample with participants from the East Coast, Midwest,

and West Coast. The participants worked and supervised in various organizations within

the counseling field. The results possess a low generalizability across the profession due

to the small sample size. However the study added to the current body of work on

supervision. The study was a pilot to begin to understand the aspects of supervision with

the experienced counselor; however, the study did not address all aspects of effective

supervision with the experienced counselor, but rather resulted in an initial point of

discussion for further exploration. The focus of the study was from the supervisor’s

perspective and did not encompass the experienced counselor’s perspective on being

supervised.

Since the supervisor is considered the “gatekeeper” of the profession and works to

address many issues presented by the counselor in supervision, supervisors can enlighten

the supervision literature by discussing their experiences in supervision with the

experienced counselor. Rather than suggest the supervisor conduct supervision with the

experienced counselor based upon the criteria for the counselor-in-training, it was more

beneficial to hear the supervisors’ experiences of this phenomenon.

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Definitions

The term experienced counselor refers to counselors who are independently

licensed and have practiced for a number of years.

The term counselor-in-training refers to individuals currently involved in

counselor education classes. The term beginning counselor refers to individuals who are

involved in practicum phase and the term novice counselors refer to those who are pre-

licensure.

The term clinical supervision is in accordance with the definition given in the

Preamble of the ACES Ethical guidelines, which states, “Clinical supervision includes

the supportive and educative activities of the supervisor designed to improve the

application of counseling theory and technique directly to clients” (ACES, 1993, p. 1). In

addition, clinical supervision includes support and expansion of the counselor’s skills,

abilities, and talents as a counselor. The term supervision is used interchangeably with

the term clinical supervision for the purposes of this study.

The term administrative supervision is in accordance with the definition given in

the Preamble of the ACES Ethical guidelines, which states, “Administrative supervision

refers to those supervisory activities which increase the efficiency of the delivery of

counseling services” (ACES, 1993, p. 1).

The term organization refers to organizations, schools, counselor training

programs, mental health facilities, agencies, and companies that train, educate, or employ

the experienced counselors.

The term supervisor is used interchangeably with clinical supervisor and refers to

the individual who performs clinical supervision.

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The term administrative supervisor is used to designate those individuals

responsible for the delivery of counseling services.

The term supervisee designates a counselor in clinical supervision. For the

purposes of this study, the supervisee also refers to the experienced counselor.

Importance of the Study

The literature on supervision has placed emphasis upon the counselor-in-training,

beginning, or novice counselor rather than any other stages in a counselor’s career.

While various studies have investigated the reactions, thoughts, and feelings of

experienced counselors and supervisors, the studies have not looked specifically at what

practices are being used to accomplish effective supervision with experienced counselors

nor have the studies investigated whether the accepted practices in the field are uniform

or variant. The current study focused upon the initial exploration or pilot study of what

supervisors think are critical elements of supervision with this profession and addressing

the issues and concerns of this profession.

Understanding what is done in supervision with the experienced counselor will

better prepare supervisors who deal with this population to be most effective in

addressing their needs. Since the current literature on supervision does not particularly

separate counselors-in-training from the experienced counselor, but does address much of

what is discussed by ACES and Campbell regarding supervision, the framework will give

a starting point to review supervision practices in the literature. This will allow an

opportunity to formulate questions that can be explored during the data collection phase

of research. Therefore, the literature review explored those predominantly listed factors

of clinical supervision.

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CHAPTER TWO: REVIEW OF THE LITERATURE

The list of factors within this literature review is by no means all-inclusive or

exhaustive, but rather a list of the frequently discussed topics within the existing

supervision literature. The factors discussed within this literature review are presented as

enhancements for effective supervision. While the literature primarily addresses the

counselor-in-training, beginning, or novice counselor more so than the experienced

counselor, many of the factors may be applied to the supervision process with

experienced counselors. The following literature review will utilize Campbell’s (2000)

workbook on effective supervision as an outline. Additionally, the literature review will

discuss the topics of the ACES components of effective supervision.

Administrative Supervision

Counselors work in private practice, schools, companies, organizations or

agencies. For counselors employed in all work settings but private practice it is not

uncommon to frequently receive supervision. The focus of supervision is both

administrative and clinical. Clinical and administrative supervision are often collapsed

into one function and provided by one individual, which could lead to task-oriented

administrative supervision becoming more critical than clinical supervision (Barretta-

Herman, 1993).

Henderson (1994) stated that administrative skills in supervision are helpful for

the ongoing development of counselors. Administrative skills include the leadership of

the counselor workforce, dealing with organizational issues, and program effectiveness.

Administrative supervisors can create a framework for the counselor to have a stable and

salient environment in which to practice; in addition, administrative supervisors address

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the structure of the clinical program, coordination of clinical services, and evaluation

mechanisms for the counselor to function as an employee of the school, company,

organization, or agency. The supervisor performing administrative supervision may not

be viewed as a resource for personal and professional growth but rather “the

administrative supervisor is the person whom the counselor supervisee considers her or

his ‘boss’ at the counseling site” (Tromski-Klingshirn & Davis, 2007, p. 295). Tromski-

Klingshirn and Davis (2007) further stated that the administrative supervisor is

responsible for the managerial tasks such as overseeing case record, implementing policy

and procedures for continuity of care, quality assurance and accountability, the hiring,

firing and corrective actions of staff, and evaluating the counselor as an employee. The

authors warned that the dual role of administrative and clinical supervisor can threaten

the supervisory trust since the supervisor possesses increased power from being the

evaluator as well as the teacher. As a result of their study, the participants who had

difficulty in supervision because of the supervisor holding both roles of administrative

and clinical reported negative consequences from discussions in supervision regarding

their inadequacies because the submissions are utilized in evaluations, affecting monetary

and promotional opportunities. In order to avoid poor evaluations the counselors would

refrain from discussing their inadequacies and weaknesses which could result in a greater

risk of the counselor providing poor or unethical treatment. According to Herlihy, Gray,

and McCollum (2002) “…many supervisors must also deal with the administrative

supervision of counselors within organizations” (p. 55) as well as the clinical supervisor

role. Since the supervisors are to monitor the counselors’ actions and behaviors as an

employee and give feedback with regard to work performance, there is the concern that

13

supervisees will not disclose everything they are doing with clients during supervision.

Any areas of problematic issues with clients may not be disclosed due to the supervisee

feeling it could be counted against them when it comes to evaluation.

With demands upon the supervisors to contain costs and streamline daily

functions, the benefits of clinical supervision may compete with the administrative

supervision tasks. When an organization does not have a clear direction of the benefits of

clinical supervision, the result may be that there are not enough clinical supervisors

trained to handle the clinical supervision workload, resulting in task-oriented supervision

rather than growth supervision (Ask & Roche, 2005). Due to the demands on schools,

companies, organizations, and agencies to become more cost effective, supervisors may

have no choice but to conduct both the administrative and the clinical supervision. These

competing focuses can make it difficult for the supervisor to prioritize what aspect of

supervision is most important at any given moment.

Roberts and Borders (1994) studied existing supervision practices among school

counselors. The participants consisted of a random selection of North Carolina School

Counselor Association members. While 450 surveys were mailed, 168 usable surveys

were returned. A three-part survey was constructed to gather demographic information,

existing supervision practices, and preferences of supervision at this point of the

participants’ careers. The participants were asked to categorize the existing supervision

practice in one of three areas of supervision: administrative, clinical, and the counseling

program for school counselors. The participants answered questions about the type of

supervision received and whether this was their preference. The results indicated that the

school counselors were receiving more administrative supervision than any of the other

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two types. However, the counselors preferred the other two types of supervision, which

allowed them personal and professional growth. Oberman (2005) concurred with the

findings of Roberts and Boders (1994) and concluded that the main barrier experienced

by school counselors receiving clinical supervision was that the supervisors did not have

the training to perform clinical supervision. The supervisors were usually school

administrators who did not understand the significance and importance, nor possess the

training in order to perform clinical supervision with the school counselor.

Barretta-Herman (1993) stated that the administrative function of the supervisor is

just as important as clinical supervision. “The supervisor… is charged with the

responsibility to facilitate the professional development of the practitioner and to create,

maintain and evaluate systems of client and agency accountability that enhance service

delivery” (Barretta-Herman, 1993, p. 61). The administrative supervisor is helpful in

organizing the counselor’s work duties (Herbert & Trusty, 2006), and gives structure to

the work. “The over-riding aim is to optimize the service provided to clients in line with

the goals, expectation and ethical and profession concerns” (Spence et al., 2001, p. 136).

This is to say that administrative supervisors can be beneficial for the counselor when

identifying goals, expectations, processes, and the philosophy of the counseling work

within the organization. Administrative supervisors can also be used to provide personal

support to increase worker motivation, morale, and commitment. At the same time, they

can help to decrease staff burnout, workplace problems, worker stressors, and coworker

conflicts.

Niebrugge (1994) found the desire to leave the job and the profession is

significantly related to satisfaction with supervision and the number of years the

15

counselor is engaged in supervision. Robinson, Murrells, and Smith (2005) examined

high attrition rates within a psychiatric hospital, which were attributed to work overload,

lack of management support, violence to staff from clients, lack of flexible work,

uncertainties about roles of different staff groups (role conflict and role ambiguity),

anxieties about adapting to new approaches to care for clients, and lack of opportunities

for career progress and continuing professional development. Supervision is expected to

aid in retention of the mental health worker. The study reported mandatory policies

instituted ongoing supervision of mental health nurses at a lower work grade with a

person of higher grade to assist in personal and professional growth. Results of the

program evaluation demonstrated a decrease in attrition, more work satisfaction, a

continued vigilance to professional interaction with patients, and a decrease in burnout.

Supervision can help counselors set realistic goals, address counselor shortcomings, and

alleviate work difficulties (Raquepaw & Miller, 1989). “Given the significant cost to

mental health organizations of staff turnover and absenteeism resulting from burnout and

work stress, there is a clear need for research to examine the parameters of supervision

that could assist staff to cope with the stressful aspects of their employment” (Spence et

al., 2001, p. 6).

While the administrative supervision gives structure to the counselor clinical

supervision solely focuses on ways of improving the counselor’s clinical skills. “Clinical

supervision needs to focus on clinical issues, such as clinical case review and processing

counselor-client dynamics as it is these clinical activities by which close supervision of a

supervisee’s clinical skill is maintained” (Tromski-Klingshirn, 2006, p. 59).

16

Clinical Supervision

Barnett (2007), in a discussion of supervision for psychologists, stated “clinical

supervision is an essential aspect of each psychologists’ training and as psychologists, we

each may participate in it throughout various phases of our careers” (p. 268). Just like the

psychologist, counselors can participate in clinical supervision throughout their entire

careers.

In a discussion regarding the continual competence of licensed psychologists,

Carroll (1998) discussed new challenges arising for the practitioner and the fact that there

is no formal program to monitor whether the practitioner remains competent throughout

his or her career. Clients present new challenges and counselors must continue to address

those challenges. Kanz (2001) concurred with Carroll, stating that experienced

psychologists should have ongoing clinical supervision due to the challenges of client

problems and difficulties, and that “the wide-range of client issues that psychologists

encounter also lends support to the need for supervision” (p. 45).

Warnke, Duys, Lark, and Renard (1998) indicated that supervision is beneficial

for the counselor when met with new and unfamiliar tasks. The counselor could “loop”

back through the initial stages of uncertainty experienced as a novice counselor when

faced with an unfamiliar task. Clinical supervision allows for discussion of intervention

strategies, case conceptualization, and new counseling approaches. While clinical

supervision is believed to be an effective way to obtain professional development, there

are many who have not received clinical supervision since licensure. The empirical data

is scarce on exactly how many continue with supervision and how many do not continue

after licensure. Henderson (1994) asked how a professional continues to remain

17

competent in their role, since clinical supervision plays a major part in addressing the

continued competence of the counselor. The counselor will continue to have issues of

dealing with new areas and challenges, which may not have been encountered before.

Cohen and Laufer (1999) concurred with Henderson regarding the importance of clinical

supervision for continued professional competence. Cohen and Laufer (1999), in their

research on Israeli social workers and their perception of their continued competence,

concluded that if clinical supervision is viewed as satisfactory by the participant it can

result in high levels of self-confidence and professional competence.

Worthen and Lambert (2007) discussed the importance of understanding client

outcomes to adjust the focus of supervision. The authors noted that understanding the

outcome of the intervention should change the focus of supervision and thereby promote

the most appropriate interventions. Monitoring of the client’s progress during therapy

and whether or not the interventions work is of great importance. The authors attempted

to make sense of the findings that whether the counselor is experienced or new, the

outcomes of therapy appear to be the same. Therefore, it is important to understand the

outcome of intervention to adjust the focus of supervision. Stoltenberg, McNeill, and

Crethar (1994) reviewed the current literature that discussed developmental models of

supervision, and suggested “experience is a crude indication of development and

expertise” (p. 421). Just like the psychologist, the counselor could need clinical

supervision to deal with more complex clinical situations and case conceptualization.

According to Worthington (2006), experience level adds to personal autonomy

and self-assurance. Counselors change in needs and abilities as they gain experience, and

clinical supervision changes based upon the counselor’s level of experience. Since there

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is a difference across the experience level it leads to the conclusion that supervisors’

approaches to supervision must address the differences in the supervisees’ experience

levels. Supervisors must meet the counselors at their level of experience; otherwise the

supervision is not beneficial for either the supervisor or the supervisee. Supervisors

cannot use a one-size fits all approach because the needs of supervisees are different

depending on experience level. As time goes on, counselors may disengage in utilizing

the necessary skills to do effective interventions with their clients.

Schaefle, Smaby, Maddux, and Cates (2005) demonstrated that there is a decline

in counseling skills and non-transfer of skills of counseling students after beginning to

practice. Their study evaluated preparation for the counselor to engage in counseling

skills continually during and after training, and demonstrated an increase in retention of

skills. Supervisors who continue to engage in clinical discussion may help the counselor

to continue to adhere to appropriate clinical skills. Supervisors are gatekeepers to ensure

not only the quality of service for the clients, but also to ensure that the supervisees are

protected from losing their rigor for the services.

Schroffel (1999) explored clinical supervision and job satisfaction. The author

offered four arguments for why good supervision is important: life-long skill

development; emotional support; the need to maintain practice boundaries (e.g.,

transference and counter-transference issues); and the exchange of knowledge to

minimize a sense of isolation. Supervisors who remain distant are viewed as less

effective and out of touch with the counselor, while supervisors who are viewed as

accessible and engaging are seen as a resource and mentor. “Supportive supervision

includes reassurance, encouragement, approval and recognition, expressions of

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confidence, ventilation, desensitization, and attentive listening” (Schroffel, 1999, p. 50).

In this study the supervisor was viewed as the bonding agent or linking pin. Effective

supervisors must do more than sustain a bureaucratic machine or clinical tutoring, in

addition they are communicators who must be competent in team building and mediation

skills, encourage autonomy and self-direction, and foster empowerment for the

supervisee. Such a supervisor demonstrates a sense of confidence and accomplishment.

Clinical and interpersonal skills, along with building trust, possessing open

communication, sharing information, and encouraging the counselor’s involvement, are

factors included in Campbell’s (2000) model of effective supervision. The participants

revealed the desire for routine and relevant clinical supervision to help in skill

enhancement. All respondents felt clinical supervision should never be eliminated and

those satisfied with clinical supervision demonstrated more satisfaction with their jobs.

The author suggested that the supervisor should periodically take a pulse as to whether

the supervision continues to address relevant issues and remains effective. The study

demonstrated that the quality of the clinical supervision helped the counselors feel more

empowered. Results further demonstrated an increase in counselor job satisfaction and

the fact that supervision needs to be tailored to individual needs. The clinical supervisor

needs to possess competence and accessibility. “The major point of this finding is that it

is not the amount of supervision but the quality of the supervisor that was the most

helpful and most valued by respondents” (Schroffel, 1999, p. 170). Schroffel (1999)

further stated, “based on the results of this finding it appears that workers want to be

clinically challenged in order to be introduced to new thoughts, ideas, and insights” (p.

172). The supervisor’s clinical quality of supervision is considered by the supervisees as

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one of the factors that contribute to staff satisfaction and retention within counseling

organizations, because supervision is a forum to resolve clinical issues.

Clinical supervision can offer an increase in techniques and case

conceptualization for the supervisee (Borders, Cashwell, & Rotter, 1995). There is a

general consensus that supervision is different from therapy, though personal issues can

arise in both settings. There is a suggestion that advanced stages of counseling are the

appropriate time to discuss the impact of personal issues on counselor performance.

Advanced counselors repeatedly examine any personal issues that affect the counseling

relationship. They are concerned about involvement with the client and the process of

counseling. Supervisors can discuss those personal issues as they, too, gain experience in

the supervision process (Sumerel & Borders, 1996).

Borders and Usher (1992), in conducting a quantitative study on post-degree

counselors, found the primary goal of post-degree counselors in supervision was to

receive professional support and create skill-oriented goals within supervision. The data

reported that 32.1% of the 357 usable surveys were not receiving any type of clinical

supervision. Nearly 35% of the respondents reported receiving clinical supervision at

least once a month. The other approximately 32%, while receiving clinical supervision,

received it less often. While it was found that the post-degree counselor had less frequent

clinical supervision after achieving the degree than during the acquisition of the degree,

the post-degree counselor still preferred to have clinical supervision. In fact, the more

experienced counselors in the study were shown to seek out clinical supervision.

Earley (2004) discussed the relationship factors in clinical supervision and how

those factors impact a counselor’s usage of supervision based upon Bandura’s definition

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of self-efficacy. Earley’s study described how clinical supervision and counselor

performance may correlate in practicing counselors. Supervision is found to demonstrate

supportive instruction, increase counselor confidence, and moderate counselor anxiety,

which increases counselor self-efficacy. Self-efficacy is built on interactive mastery of

skills, vicarious learning, verbal persuasion, and emotional arousal. One limitation is the

difficulty of finding someone who has something to teach the more experienced

counselor with regard to conceptualization, personal, and professional growth.

Performance feedback mechanisms, specific counselor tasks, and a variety of supervisor

orientations contribute to counselor self-efficacy. The counselors in the study viewed

clinical supervision as critical no matter the type or frequency. The counselors further

stated that clinical supervision is helpful in improving confidence and counselor

performance.

Components of Clinical Supervision

Working alliance. The supervisor’s style deals with the elements of

attractiveness, interpersonal sensitivity, and task orientation. The attractive style is

defined as the supervisor being warm, friendly, open, and supportive. Interpersonally

sensitive means the supervisor is therapeutic, invested, and perceptive regarding the

supervisee. The task-oriented style means the supervisor is one who is focused on the

goals of learning and structure. The supervisory style is related to the supervisory

relationship and particularly the working alliance (Ladany, Walker, & Melincoff, 2001).

A counselor entering supervision is looking for a competent supervisor to assist with the

learning process whether the counselor is a novice or experienced. The counselor, in this

case the experienced counselor, is looking for a supervisor who offers the opportunity to

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learn and to progress in different aspects of the counseling profession. The supervisor

can be instrumental in helping with this endeavor. “Good supervisors seem to have many

of the same qualities of good teachers and good counselors. They are genuine, open

flexible, respectful of individual differences.” (Borders, 1994, p. 45).

The supervisory working alliance is based upon mutual agreement of goals, tasks,

and emotional bonds, and considered an essential factor of effective supervision. A

strong working alliance between the supervisor and supervisee will enable both

participants to grow. Bordin (1979) developed the concept of the working alliance,

stating that “…a working alliance between a person seeking change and a change agent

can occur in many places besides the locale of psychotherapy” (p. 252). The working

alliance includes three features: goals, assignment of tasks, and emotional bonds. Goals

demonstrate the outcome of achievements, while the tasks are the agreed upon contract of

how to reach those goals. The bond, essentially made of trust and attachment, is the

foundation that facilitates this process. A strong working alliance has a significant

impact on the supervision process and constitutes active involvement of the supervisee

and promotes development and acquisition of complex skills (Kavanagh, Spence, Wilson,

& Crow, 2002).

Coll (1995) explored preferential types of supervision alliance of experienced

college counselors. The college counselors wanted to discuss, through self-report, the

types of clients and counseling interventions during their supervision sessions. The

author noted that the problem with self-report is that the counselor may neglect, whether

intentionally or not, to mention very critical information regarding intervention

techniques, client characteristics, and counselor involvement. The counselor may feel

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anxiety exhibiting a sense of vulnerability in dealing with a specific client, because they

often believe that they should be able to handle any situation presented by a client and

never appear inept in their counseling duties. However, this is an incorrect assumption as

there are many different clients who present with various issues that are not necessarily

the same as those the counselor may have previously encountered. The results of the

study concluded that counselors wanted to receive ongoing supervision with a

knowledgeable, experienced counseling professional.

Usher and Borders (1993) found post-degree counselors preferred a collegial

relationship-oriented supervisor and one with emphasis on conceptual personalization

and process skills. Considered the “practicing counselor,” this counselor seeks out a

supervisor who operates out of a peer-like collegial relationship. The authors

investigated three different classifications for the counselor: novice, intermediate, and

experienced. Utilizing the Supervisory Styles Inventory Revised (SSI-R) and the

Supervisor Emphasis Rating Form Revised (SERF-R), the authors explored the preferred

styles of supervision for the three categories.

The SSI-R, developed by Friedlander and Ward (1984), possesses three sub-scales

used to holistically measure supervisory style: attractive, interpersonally sensitive, and

task-oriented. The instrument measures the supervisor’s self-perception and the

supervisee’s perception of the supervisor. The attractive subscale measures the

supervisor’s collegial dimension, meaning the supervisor’s warmth, support, friendliness,

and openness. The interpersonally sensitive subscale measures the supervisor’s

relationship-oriented approach to supervision, meaning the supervisor is committed,

therapeutic, and perceptive. The task-oriented subscale reflects a content approach to

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supervision, meaning the supervisor is goal-oriented, thorough, focused, practical, and

structured in supervision.

The SERF-R, which was developed by Lanning and Freeman (1994),

demonstrates measurements of supervisors’ emphasis within the supervision process.

The four sub-scales of the SERF-R are professional behavior, process skills,

personalization, and conceptualization. The professional behavior subscale defines the

supervisor’s behavior within supervision. The process skills subscale is defined as the

way in which the supervisor conducts supervision. The personalization subscale

addresses the supervisor’s ability to see the supervisee as a counselor possessing warmth

and positive regard. The conceptualization subscale is defined as the appropriate

interventions and techniques utilized at the appropriate time in supervision. The

participants within the study were drawn from a listing of National Certified Counselors.

Two hundred seventy four participants responded to the research request to complete the

surveys. The results of the survey demonstrated that counselors with more post-degree

supervision have a stronger preference for an emphasis on personalization skills and less

on professional behaviors, and the results also demonstrated that all categories of

counselors wanted a collegial-relationship-oriented supervisor. Usher and Borders

(1993) concluded the highest-level professionals, considered the experienced counselor,

preferred a focus on personalization skills and a preference for the collegial-relationship-

oriented supervisor.

The supervision dyad, not unlike the counseling dyad, is noted to go through

weakening and repair of the alliance resulting from the resistance to change or self-

defeating behaviors and mistakes of either participant. This conflict will either result in a

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strengthening or a deterioration of the bond. Burke, Goodyear, and Guzzard (1998)

studied the weakening and repairs of 10 supervisory dyads over time. Utilizing a

modified Working Alliance Inventory, the researchers explored the impact of weakening

and repair upon the supervisory alliance. The weakening-repair of the supervisory

alliance is considered the conflict between the supervisor and the supervisee and how

those conflicts are resolved. The conflicts can occur because of supervisee resistance,

supervisee’s self defeating behavior, or the supervisor’s mistakes. One of the results of

the study indicated the more experienced supervisee set the tone of the supervisory

sessions focusing upon his or her own needs. Another result of the study demonstrated

that more experienced clinicians attended to the repairing of the alliance more often than

novice clinicians.

Actions taken by the supervisor in the context of a strong working alliance can

minimize role difficulties, thus reducing the likelihood of negative consequences within

supervision. Working alliance is significantly related to supervisee’s perception of role

conflict and role ambiguity within supervision. Stronger bonds result in working through

conflicts, which decreases role conflict for both the supervisor and the supervisee. The

concept of the working alliance is just as salient in the supervisor-supervisee working

alliance as it is in the therapist-client relationship. “Presumably, when supervisors and

trainees discuss expectations, set goals, and agree on the tasks of supervision within the

context of a positive relationship, trainees are less likely to experience confusion or

conflict in supervision” (Ladany, Friedlander, & Nelson, 2005, p. 220). As supervisees

gain experience they may be reluctant to follow supervisor recommendations. They may

feel they are in the counseling relationship and better understand the client than the

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supervisor. Being treated as a novice can result in role conflict for the supervisee who

may identify as a competent clinician but feels that he or she is being treated as if

incompetent. Due to the very essence of supervision, the supervisor is supposedly the

“expert” and should know best how to intervene. This type of role conflict could affect

confidence in the working alliance for both. Role ambiguity could also result,

diminishing self-confidence and resulting in a sense of futility. If the supervisor views

supervision in which the “expert” is teaching the “student,” this can cause role ambiguity

particularly for the experienced counselor, who does not need to be taught how to do

counseling. In this case, the experienced counselor may not benefit from supervision if

the counselor believes that his or her expertise and experience are being dismissed (Kirk-

Brown & Wallace, 2004; Olk & Friedlander, 1992).

Worthen and Isakson (2003) contended that the working alliance is “thus being

able to understand the elements of effective supervisory relationships, monitoring those

relationships and intervening as needed...” (p. 4). The authors presented a discussion of

the variables that mediate the supervisory relationship: the matching variable;

developmental or experience level; role induction processes; settings for practice;

previous experience with supervisor; supervisee variables; supervisor issues; dual role

concerns; evaluation issues; cultural variable; impression management and previous

supervision experience. All have an impact upon supervision. The authors indicated that

addressing the variables within supervision will enhance the supervision process.

Supervision is often a hierarchical relationship and therefore the role conflict

could escalate because of the relationship. Strength based supervision is “a non-

hierarchical supervisory relationship. One where there exists a give and take, where the

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supervisor does not assume to have more ‘correct’ privileged knowledge of both the

supervisee’s and client’s goals, intentions or views and where the supervision works

intentionally to create a strength based supervision” (Edwards & Chen, 1999, p. 10).

Milliren, Clemmer, and Wingett (2006) agreed that a non-hierarchical supervisory

relationship is of more benefit for the supervisee. In the authors’ discussion of Adlerian-

based supervision, they posited that a democratic relationship is much more beneficial for

the supervisee. The Adlerian-based supervision utilizes Respectfully Curious Inquiry.

Respectfully Curious Inquiry is comprised of seven components, which focus upon

mutual goals: attentive reflective listening on the part of the supervisor; assessing the

strengths; resilience and social interest; validating and encouraging useful behavior;

sharing humor, clarification, intuition, imagination to develop understanding; problem

conceptualization; and identification of socially useful solutions. The outcome of the

Adlerian-based supervision is the Therapeutic Empowerment in the supervisory

relationship, which produces equality, empathy, encouragement, and education for both

the supervisor and the supervisee.

Supervisor’s style. The supervisor’s style, whether task-oriented, supervisee-

focused, or clinically based, has an impact upon the comfort level of the supervisee in

supervision. Ladany et al. (2001) conducted a study to examine the relationship between

supervisory style and the supervisory working alliance, and predicted a strong

relationship between the two concepts. Supervisors who are comfortable with self-

disclosure appear to possess characteristics of more warmth, attractiveness, and

interpersonal sensitivity, thereby modeling openness. Results indicate that those

supervisors who are perceived as attractive have a greater emotional bond and more

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agreement on tasks and goals with the supervisee than those who are not. Those who

perceived themselves as interpersonally sensitive and task-oriented possessed the most

agreement on tasks in supervision. The more attractive and interpersonally sensitive

supervisors did self-disclose the most in supervision. The more task-oriented supervisors

did not self-disclose as often. Both the supervisor and the supervisee who viewed the

relationship as warm, friendly, and trusting saw the supervisory relationship as very

beneficial.

The various styles of supervision are underlined by support and direction.

Support shows empathy and building rapport, while direction refers to instructing,

teaching, and challenging the supervisee. The adaptive counseling and therapy model

proposed by Hart and Nance (2003) stresses these concepts. The model comprises four

concepts of style, which include telling, teaching, supporting, and delegating, changes for

the supervisee with the development of skills, competency, and experience. The study

asked what type of supervision is preferred by supervisees and whether it matches the

level of supervision requested and received by the supervisees. The four styles are

designated as A, B, C, and D. Style A is the directive/expert teacher; Style B is the

supportive/teacher; Style C is the counselor role; and Style D is the consultant. The

results were that supervisors prefer to be viewed as Style C and the supervisees preferred

Style B, meaning the supervisees were looking for a supervisor who was supportive but

was also a teacher. This was the preferred style of supervision across all levels of

experience. Experienced counselors appeared to prefer a supportive style of supervision.

The age of the counselor may be of importance in looking at the supervisory style.

As a counselor ages and experiences life, the influences can have an impact upon the

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counselor's approach to counseling and supervision. Gorrell (1997) performed a study to

understand supervisory styles for seasoned clinicians. Beginning with six hypotheses to

guide the study, Gorrell looked at how supervisees’ level of experience and age would

relate to preference of supervisory style; supervisees with up to 10 years experience

would have preference for the task-oriented supervisory style; supervisees with more than

11 years experience will prefer the interpersonally sensitive and attractive supervisory

style; supervisees between the ages of 23 and 45 prefer task oriented style of supervision;

supervisees between the ages of 46 and 60 would prefer interpersonally sensitive

supervisors; and supervisees 61 and older prefer attractive supervisory styles. As

mentioned in the study, people mature at various levels and their worldviews differ based

upon life experiences. The same is true for experience levels, due to clinicians dealing

with different populations possessing different mental and emotional disorders, which has

an impact upon their clinical expertise. The study resulted in the null set for all

hypotheses. The experienced counselors’ preference of style appeared to be more about

the experience level of the supervisor rather than the experienced counselors’ ages.

Feedback. Feedback is an important component of supervision. Blackwell,

Strohmer, Belcas, and Burton (2002) stated “failure to provide evaluative feedback raises

a serious ethical concern because the supervisor fails to provide one of the most essential

tasks of supervision and this can compromise both the supervisee’s growth as a counselor

and the client’s progress in counseling” (p. 242). The feedback given can lead to an

enhancement in skills; however, “counselor educators and field supervisors often feel

uncomfortable about assessing trainee skills and struggle to find an appropriate vehicle

for delivering essential constructive feedback regarding performance” (Harris, 1994, p.

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19). Problems with feedback in supervision are often a result of poorly navigating the

delicate balance of encouraging trust in the relationship and giving meaningful

constructive feedback. Chur-Hansen and McLean (2006) discussed using formative

feedback, which can help the supervisee to identify abilities and improve strengths. The

reasons given for supervisors not giving summative feedback include lack of time to

provide the feedback and possible fear of litigation. These are some of the components

of feedback that can cause anxiety for the supervisor.

However, Daniels and Larson (2001) found that positive feedback can increase

the counselor’s self-efficacy and minimize anxieties. Negative feedback can result in a

lowering of counselor-self-efficacy and an increase in anxiety. The way in which the

supervisor gives feedback is apparently important and has an impact upon the supervision

relationship. Supervisors are encouraged to examine methods of giving feedback.

Problems with the supervisor’s methods of feedback could cause threats to the

supervisory bond (Goodyear & Bernard, 1998).

Ladany et al. (2005), in a discussion of negotiating role conflicts within

supervision, stated that there is role conflict due to the feedback component of

supervision. However, the authors stated that if the feedback component is missing, the

supervisee may not trust the supervisor due to wanting the opportunity to learn more or

focus on personal issues. Without feedback the supervisee is unclear about the tasks and

direction of the process. It is advisable for supervisors to offer constructive feedback

when evaluating counselor performance to help counselor growth (Harris, 1994).

King and Wheeler (1999) conducted a survey of supervisors who engaged in

supervision with private practice counselors. The study investigated whether the

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supervisors felt any responsibility for the work of their supervisees and what

responsibility the supervisor should assume for the counselor’s work. The qualitative

study interviewed 10 individuals who were considered supervision experts due to length

of practice. The results of the survey stated that supervisors do have some professional

and ethical responsibility for the quality of the counselor’s work, but do not have legal

responsibilities. One of the participants in the study expressed the view that supervisors

are aware when counselors engage in unethical behavior but that it is another thing for

them to report the improprieties, most often as a result of supervisors viewing the

supervisory relationship as one between peers rather than one of a hierarchical nature.

Though the study was conducted in the UK, it does posit a question as to whether

supervisors in the United States have the same view.

The supervision relationship should challenge, stimulate, and encourage the

supervisor as well as the supervisee. The dilemma of the supervisor of having to both

encourage and give feedback effectively places them in the vicarious position of

balancing the dual role of encourager and critic. The dual role of the supervisor as

educator and critic could lead to the supervisee not reporting everything during

supervision and therefore missing the opportunity to address important issues (Minnes,

1987).

The evaluative aspect of supervision can also cause anxiety for the supervisor.

The experienced counselor would have no problems revealing areas of competence, but

may have problems in revealing areas of weaknesses. With an evaluative component of

supervision, the experienced counselor may not trust the supervisor enough to reveal

weaknesses therefore leading to problems of truly addressing issues within the counseling

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relationship as well as personal challenges of the experienced counselor. Supervisors as

well as supervisees experience this double bind. The counselor, in an effort to look good

and yet manage their anxiety, may find themselves either becoming over accommodating

or defensive when feeling vulnerable. The supervisor may find it difficult to address and

confront incompetencies of the experienced counselor since the counselor is also seen as

a peer (Lizzio, Stokes, & Wilson, 2005).

Boyd, McNaughton, and O’Shea (2008) investigated a way to enhance

supervision by having formal feedback developed from counselor self-audit. The authors

contended that counselors can become better at delivering services if they are able to

share self-audits in consultation supervision. The authors invited counselors and

supervisors to be part of a focus group to offer views regarding self-audit and its place in

supervision. The focus groups were divided into three groups. One group was comprised

of counselors who decided to do the self-audit, another group was comprised of

counselors who decided against self-audit, and the third group consisted of consultative

supervisors. The qualitative study asked each group to address reactions to conducting

self-audit, positive and negative aspects, impact of self-audit on the client, impact of self-

audit on the counseling process, impact of self-audit on the counselor, ethical

responsibilities to the client having the feedback to inform the counseling, individual

progress, and mandatory vs. voluntary usage of self-audit. The data was transcribed

using thematic and SWOT analyses. The groups explored the strengths, weaknesses,

opportunities, and threats of utilizing self-audit to improve service. The results of the

study indicated that using the self-audit had more positive than negative aspects. There

was concern the counselors would be afraid to review the self-audit in supervision

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because it would demonstrate their weaknesses; however, this was not the case because

the supervision was consultative rather than an evaluative relationship. The counselors

were able to examine areas that were positive outcomes for the client and therefore help

them to focus upon areas for personal growth. Counselors felt the self-audit information

had little impact upon the supervisory relationship and they were able to openly and

honestly discuss issues with the supervisor. Counselors were resistant to collecting the

data initially but after the positive experience of using the information for discussion in

supervision they found this to be very beneficial to their practice, so much so they began

to use the data to explore other areas such as clients leaving prematurely and the best

practices for addressing client issues.

In order for the experienced counselor to reveal areas of vulnerability and

weaknesses, the supervisor is tasked with promoting a level of trust. Not unlike the

therapeutic relationship, the need to build trust is pertinent when revealing information

during the supervision process. Unlike the therapeutic relationship, the supervision

relationship calls for a deeper level of trust because of the feedback component. “…

Counselors and supervisors are both vulnerable. Supervision requires a level of two way

trust unmatched in the counseling relationship” (Pearson, 2000, p. 285). Supervisory

relationships can last for years; therefore, the trust becomes imperative for the

relationship to flourish. This demands special attention to the trust within the supervision

relationship. Pearson (2000) stated that the success or failure of the relationship depends

upon the trust developed between the supervisor and the supervisee. Anxiety resulting

from the act of supervision and the evaluative component should be discussed in the

supervision process in order to minimize any reluctance or resistance and build trust.

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Ladany et al. (2001) concurred, stating “a unique feature of the supervisory

working alliance is that the relationship is considered to be based on perception of mutual

connections between supervisors and trainees. In other words, the supervisor perceives

mutual trust exists with the trainee, rather than a unidirectional notion of trust” (p. 265).

The supervisee will open up to the supervisor if supervision is a safe haven to

demonstrate vulnerabilities and inadequacies. Supervisee resistance to supervision can

result from a fear of being perceived as inadequate as a counselor.

Counselors are human and can therefore make mistakes. The importance of the

ethical behavior is being able to own up to the mistakes and having supervision can offer

a forum to discuss those mistakes. Cormier (1988) discussed the fact that many first time

counselors cover up their mistakes in order to look good to the supervisor. The problem

of appearing inept can cause stress and anxiety. If trust is built within the supervision

relationship, the counselor will be able to own mistakes, avoid unproductive blaming, and

shatter myths about the counseling process. Cormier also discussed the “veteran

counselor” and their problematic beliefs that they know everything about how to do good

therapy, they are an effective and powerful therapist, they are the expert on the client’s

behavior, they know about life and death, they are always self-aware, and they know

what is needed to save the world. The impact of life experiences will change worldviews

and the counselor is not immune to having these experiences. Having the trust to talk

with the supervisor about these mistakes and perform corrective action becomes

imperative.

Communication. In order to build trust in the supervision relationship, effective

communication must take place. The communication sets the tone of the relationship by

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relating the respect the supervisor has for the supervisee, understanding the supervisee’s

worldview, and accepting their differences. “Current descriptions of counseling

supervision invariably include a discussion of the supervisor-counselor relationship and

the means by which the individuals communicate, manage the process of reciprocal

influence, affiliate, make decisions, and accomplish their respective tasks” (Dye, 1994, p.

9).

The communication is influenced by characteristics such as gender, race,

ethnicity, developmental level of supervisor and supervisee, theoretical approach, and the

power differential (Dye, 1994). Supervisors are expected to be aware of individual

differences, including experience levels, gender, multiculturalism, supervisee attributes,

self-efficacy, and supervisee conceptual level. Contextual elements that affect

supervision include the clientele being serviced, and the relationship and communication

between supervisor and supervisee (Goodyear & Bernard, 1998).

The way men and women communicate could impact supervision. Sells,

Goodyear, Lichtenberg, and Polinghorne (1997) stated that women demonstrate

behaviors to enhance the strength of relationships whereas men demonstrate more of a

task orientation in relationships. Using a quantitative index, the researchers measured the

amount of communication patterns between supervisors and supervisees of different

gender and the perception of effective supervision for the participants. Utilizing 44 dyads

they found that in male-male dyads the focus was more task-oriented, but the other three

types of dyad, female-male, male-female, and female-female showed no significance of

communication and impact upon ratings by the supervisees of effective supervision. The

researchers attributed the minimal significance of communication within the female-

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male, male-female and female-female dyads to trying to do what was expected rather

than following their own values and beliefs of counseling thus not demonstrating any

conflict. However the study did point out a significant difference of communication due

to gender issues. Gender issues are important to examine in the supervision process.

Gender issues and communication. “Gender is a complex construct that is

defined by what society believes is true of males and females and the stereotypes placed

upon the sexes” (Doughty & Leddick, 2007, p. 18). Gender differences can interfere with

the supervision relationship particularly when it comes to communication styles.

“Women may be viewed as needing more help and this perspective can cause problems

of effective supervision and communication” (Doughty & Leddick, 2007, p. 18).

Lichtenberg and Goodyear (2000) studied structure in the supervision relationship and

found that male supervisors were expected to give more structure to the process than

female supervisors, as it was reported the male supervisors seem more directive in their

discussions.

Martin, Goodyear, and Newton (1987) performed a qualitative study examining a

supervision dyad between a male supervisor and a female supervisee with seven years

experience over a 10-week period. The exploration was to understand the best and worst

sessions of supervision from both the supervisor’s and the supervisee’s point of view.

Both stated the best session for each focused upon personal issues and their ability to be

vulnerable with one another. The worst session in the viewpoint of the supervisee

occurred when the supervisor placed the supervisee in the position of counselor. The

worst session for the supervisor was the one in which the supervisee did all the talking.

Scores of the supervisee went up in task orientation, interpersonal sensitivity, and

37

attractiveness during the course of the supervision sessions, adding to the importance of

supervision and communication. However, it makes one wonder if the scores for

supervision did not increase because of becoming familiar with one another during

supervision and therefore understanding the expectations within the supervision sessions.

When the supervisee and supervisor were both able to do more talking during the

supervision session, they rated the session as the best.

Twohey and Volker (1993) stated that women run the risk of not being heard due

to communication or relational styles devalued in a male dominant supervision

relationship. The authors explored the power differential in supervisory dyads between

men and women. It appeared that when men supervise women, a power imbalance

results from the hierarchical nature of supervision and the societal norms. A woman

supervising a man can result in the same power imbalance, because the woman may be

considered less experienced. Research in business literature has demonstrated

stereotyping of women in management positions, and women being viewed as not

possessing the expertise to lead and manage. Similar notions may exist in supervision.

Twohey and Volker (1993) discussed two different camps with regard to women in

supervision. One side argues that gender differences have no impact upon supervision

and the other side argues that these differences do have an impact upon the supervision

process and relationship. However Twohey and Volker did state that there is a

stereotyping of males as well as females regarding the supervision communication. The

male supervisors may be viewed as not being able to speak in a caring and nurturing

voice in order to encourage the supervisee; rather it is thought the male supervisor will

only focus on tasks. Women speak from a voice of care while men speak from a voice of

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justice; however, both voices are necessary in supervision in order to have a balance of

support and yet have a voice of instruction. “It is important for supervisors to be aware

of both voice of justice and the voice of care within themselves and within their

supervisees” (Twohey & Volker, 1993, p. 196).

Gender differences are important to address within supervision, and supervisors

can do this by remaining vigilant in understanding the existence of gender bias. Nelson

et al. (2006) documented discussions among sixteen members of the Section for the

Advancement of Women conference. As a result of the discussion, the members felt that

it is up to the supervisor to approach the subject of gender and cross cultural issues within

the supervisory relationship. However, the supervisor could run the risk of alienating the

counselor if the counselor is not able to deal with a discussion about race, culture, or

gender. The group felt that in order to minimize the risk of alienation, the supervisor as

well as the counselor should explore philosophies about these issues and perspectives

regarding their impact upon the supervisory relationship.

Addressing the gender differences can make supervisors and supervisee more

aware of gender biases that can affect supervision and ultimately affect client outcome.

“Challenging our own biases, prejudices and issues is one of the most critical parts of the

process” (Paisley, 1994, p. 14). Both men and women counselors prefer the supervisor to

possess expert power during supervision, but the preference for power base does not

appear to be tied to gender, but rather to the trust of the supervisee in the supervisor not

to abuse their power (Robyak, Goodyear, Prange, & Donham, 1986).

Multicultural issues and communication. Multiculturalism looks at the

differences of race, gender, socioeconomic background, ethnicity, sexual orientation, and

39

many other areas that demonstrate differences in supervision and the counseling

relationship. “The multicultural perspective will become essential as we move into the

twenty-first century” (Fong, 1994, p. 15). It is recommended that supervisors conduct

cultural responsiveness in supervision. Garrett et al. (2001) investigated the development

of a paradigm of cultural responsiveness for supervisors. In their discussion of cultural

responsiveness, the authors stated the importance for the supervisor to be able to

communicate with the supervisee about the cultural differences not only within the

therapeutic realm but also in the supervision realm. Being able to have discussions about

the cultural differences would result in the supervisee being able to understand the impact

of culture upon the communication patterns and thus upon supervision. Nilsson and

Duan (2007) concluded in their study regarding role difficulties, counseling self-efficacy,

and prejudice for minority supervisees working with White supervisors, that if the

supervisee perceives prejudice within the supervision relationship the supervisee will not

feel the freedom to speak freely about various issues encountered in the counseling

relationship. They concluded, “these findings support the ideas that supervisory

relationships are not isolated from the social contexts in which we live and that racial and

ethnic minority students’ experiences of perceived prejudice, among other factors, are

associated with their experience in supervision” (Nilsson & Duan, 2007, p. 226).

Guanipa (2002) created an instrument to help in evaluating how multicultural

issues are addressed in supervision and promoting the discussion of multicultural issues.

The Evaluating Multicultural Issues in Supervision is a scale that scores the inclusion of

multicultural issues in marriage and family supervision. The instrument contains a 31

question Likert scale and four qualitative questions that monitor how and if multicultural

40

issues are addressed in supervision. The author utilized a broad term of multicultural by

including any differences in background between the supervisor and the supervisee,

including culture, gender, ethnicity, education, language, and any other differences that

could affect the supervisory relationship. The instrument is not meant to evaluate the

supervisor’s and supervisee’s competence as much as it is to promote discussion of

multicultural issues within the supervision process. The author recommended taking the

instrument at the end of each supervision session in order to monitor the discussions of

multicultural issues within the supervision process and to help each participant to reflect

and think about the multicultural issues that could affect the counseling relationship. The

author concluded that one instrument is not enough to address all the nuances of complex

multicultural issues, but rather is useful for initiating the processing of these issues by

both the supervisor and supervisee.

Mori, Inman, and Caskie (2009) examined the influence of acculturation and

cultural discussion in supervision and the level of satisfaction in supervision with a

population of international students. The authors wanted to see whether the influence of

acculturation and the supervisee’s cultural issues could contribute to supervision being

beneficial. The authors contended that communication has an impact in the supervision

relationship because international students may be at a disadvantage when articulating

their thoughts, since English is their second language. If the supervisee is more

acculturated he or she will be more able to speak fluently within the English language

and the supervision experience will be more supportive and helpful in their training. One

hundred and four supervisees took the electronic survey on-line. As a result, the authors

found that the level of acculturation and the discussion of cultural issues in supervision

41

did contribute to a higher level of satisfaction. However, the authors also found

satisfaction with supervision was still present for those who had lower levels of

acculturation. The authors contributed this to the fact that supervisors who are culturally

competent and initiate cultural discussion help the supervisee have a better supervision

experience. The authors offered the conclusion that supervisors should initiate and

promote discussions of cultural issues in supervision in order to result in better

supervision outcomes.

Burkard et al. (2006) explored the impact of responsiveness and unresponsiveness

in cross-cultural supervision with supervisors of color and supervisors of European

American decent. Twenty-six female doctoral students across the United States agreed to

participate in the study. The authors examined the impact of supervision satisfaction with

regard to the responsiveness and unresponsiveness of the supervisor surrounding cultural

issues. The participants were broken up into groups of supervisees with supervisors of

color and supervisees with supervisors of European American decent. The authors found

that the supervisees who had supervisors who were responsive in discussion of cultural

issues found supervision to be more satisfying. While the participants with supervisors of

color felt more growth as individuals, supervisees with European American supervisors

felt they were given the opportunity to discuss not only the topic of cross cultural issues

but the opportunity to discuss any issues in supervision. The reports of participants of

unresponsive supervisors listed dissatisfaction with supervision and reported participants

becoming emotionally upset. The result was that the responsiveness of supervisors

regarding cross cultural issues in supervision added to the trust in the supervisory

relationship.

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The supervisor will benefit from this exchange and enhance his or her own

abilities to relate to culturally different supervisees if he or she is willing to explore and

understand the communication patterns in diverse groups of supervisees. “Supervisors

demonstrating a wide range of competencies included in the areas of cultural awareness,

knowledge and communication skills are more fully and effectively able to facilitate the

competence and continued development of the supervisees” (Garrett et al., 2001, p. 147).

The supervisor should become more culturally competent and responsive in order to help

the supervisee to become more culturally competent and responsive to clients.

Discussion of spirituality, beliefs, and values can also help to enhance the

supervisory experience (Polanski, 2003). Polanski went on to state, “…addressing the

supervisee’s professional functioning can also be viewed as including personal reflection

and values clarification” (p. 131). Discussions of the counselor’s spirituality and beliefs

will help both the counselor and the supervisor to understand the differences in their

worldviews. Berkel, Constantine, and Olson (2007) also recommended discussing

religion, spirituality, and counseling within supervision. Understanding spiritual and

religious issues helps the supervisory relationship and the counseling process. The

authors stated, “…it is, imperative that supervisors first increase their level of awareness

about their own values, related to these issues and then help supervisees recognize their

values and how these values might be expressed in therapy” (Berkel et al., 2007, p. 11).

Supervisors dedicated to understanding their own values and spiritual perspectives can

help the counselor to examine and appreciate their values and spiritual perspectives and

how this impacts both the supervision and counseling relationships.

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While multicultural issues in supervision include language barriers, prejudice, and

bigotry, lack of knowledge of cultural differences and the counselor’s defensiveness can

add to these barriers. Supervisees who perceive prejudice in supervision will have

difficulty self-disclosing to their supervisor and will thus miss opportunities for growth

(Nilsson & Duan, 2007). Minority supervisors have reported being questioned about

their competence and acceptance of their expertise in supervision by both majority and

minority supervisees (Stoltenberg et al., 1994).

Bhat and Davis (2007) discussed the impact of race, racial identity, and the

working alliance. The authors found a strong working alliance between supervisors and

supervisees who reported high levels of racial identity and a weak alliance when the

supervisor and supervisee had low levels of racial identity. The authors felt if the

supervisor had a low level of racial identity they had an elevated sense of the working

alliance. The results of their study also demonstrated that race did not have a significant

impact upon the working alliance. The supervisee was able to freely discuss diversity

issues within supervision.

Multicultural competence addresses stereotyping not only in counseling but also

in supervision. The supervisor is charged with the importance of exploring multicultural

competence with the supervisee and helping the supervisee to enhance cultural

competency skills (Priest, 1994). “Effective supervisors are aware of the impact they

have on their supervisees’ attitudes and views and use the supervisory relationship and

supervision process to promote attention to and respect for the full range of diversity of

those they serve” (Barnett, 2007, p. 270). Discussion of diversity issues can enhance not

only the skills for the experienced counselor but also the supervision process. “In

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addition to considering multiculturalism with clients and working to increase self-

awareness in the supervisee, using the supervisory relationship itself to explore diversity

is often valuable” (Erickson, 2007, p. 273).

Erickson (2007) conducted research to address the strength of the Supervisory

Working Alliance (SWA) and satisfaction in supervision as it pertains to cultural

variables. The results were that supervisees who discussed similarities and differences

regarding ethnicity in supervision reported higher SWA with their supervisors and more

satisfaction with supervision. There were higher bond levels reported on the SWA

subscale. Gender and sexual orientation showed no difference of view between

supervisors and supervisees. Supervisees who discussed gender and sexual orientation

similarities and differences had higher levels of satisfaction in supervision. Supervisees

had no preference of similar supervisors but felt more akin to the supervisor if the

cultural issues were discussed; therefore, it was not necessary for the supervisor to have

the same cultural background for the supervisee to feel a strong alliance in supervision.

Erickson’s result demonstrated that sexual orientation appears to be the least discussed

concept in supervision, which could be due to there being less training for supervisors on

this subject matter. Supervisees did more initiation of cultural discussions, which could

be due to more emphasis being placed on diversity issues during counselor training today

than it was when many supervisors were in school (Gatmon et al., 2001).

Sue (2006) presented three concepts for cultural competency: cultural awareness,

cultural knowledge, and cultural skills. The levels of analysis are the individual, the

agency/organization, and the community for cultural competency. Cultural competency

is both a process and a content area. Parra-Cardona, Holtrop, and Cordova (2005) stated

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that as time goes on the counselor’s cultural competency can wane, leaving it up to the

counselor to seek out support, possibly in supervision, to sustain and maintain the cultural

competencies. The authors also stated that there are problems in supervision in which the

counselor may not share their inadequacies which will result in the counselor missing out

on an opportunity to examine and re-examine their cultural competencies. While the

authors acknowledged that counselors may have good intentions to remain culturally

competent, their reluctance to talk about these issues in supervision will stagnate their

opportunities for growth.

Worthen and McNeill (2001) presented five categories to improve the cultural

competency of supervisees: didactic education; discussion of client characteristics in

supervision; exploring personal experiences with diversity; ensure a diverse caseload; and

providing diverse supervisors/consultants. An additional category labeled as “other”

included developing guidelines for multicultural supervision. The relationship of client,

counselor, and supervisor will incorporate diversity issues due to a growing number of

minorities being serviced in the mental health field. “…All counseling and supervision

contacts have cultural, racial-ethnic aspects, which shape core assumptions, attitudes and

values of the person involved and which may enhance or impede counselor effectiveness”

(Fong, 1994, p. 15). Multicultural issues should be explored in supervision early on to

understand the biases of the supervisor as well as the counselor. Challenging core

assumptions of the counselor and encouraging expression will help in promoting growth

regarding cultural issues.

Ethical issues. Professional ethics is considered to be of the utmost importance

in counselor competency (Menne, 1975). The supervisor is confronted with ethical

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dilemmas such as transference-countertransference issues, power and dependency, dual

relationships, gender-role or stereotyping other roles, and the supervisors posing their

beliefs and value systems on the counselor (Kurplus & Gibson, 1991). Other ethical and

legal issues to address in supervision include informed consent, due process, and

confidentiality (Cormier & Bernard, 1982).

Dual relationships occur when the supervisor and supervisee do not adhere to the

boundaries of their existing relationship and form another relationship. The concept of

dual relationships has two components present that make them unethical: exploitation and

objectivity. In a study by Neukrug, Healy, and Herlihy (1992) regarding ethical

complaints against counselors, one of the complaints was having sexual relationships

with clients, which is clearly an ethical violation. This type of exploitation is possible in

supervision due to the power differential. Understanding the existence of the power

differential between the supervisor and supervisee and conducting open discussions about

this imbalance can help deter this behavior. Informed consent is helpful to document

what will transpire in supervision and what the expectations are for the supervisee

regarding participation in supervision. If the supervisee is aware of what to expect they

will more freely engage in the supervision process. The supervisor informs the

supervisee of the evaluative criteria and expectations of supervision in the beginning of

supervision. Due process is a legal term, which means the rights of the supervisee are to

be protected in supervision.

Ethically, the supervisor should ensure that the rights of the supervisee are not

violated in any way. The supervisee will build trust with the supervisor if it is known the

supervisor will hold their rights as individuals in high regard. Confidentiality within

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supervision is not unlike that in the counseling process. The psychological contract

between the supervisee and the supervisor is that the supervision meetings are held in

confidence and no information will be shared with outside sources. Again, this will build

on the trust factor within supervision. Supervisors need to be prepared to discuss a

myriad of ethical and legal concerns, including the supervisor’s own liability (Bernard,

1994).

Clinical supervisors have to deal with increasing ethical issues within and about

supervision. If engaged in supervision, the counselor is more apt to adhere to ethical

guidelines (Vallance, 2005). Tarvydas (1995) stated that:

Additionally, the general climate within political, economic and technological content will place increasing pressures on supervisors for accountability in their practices. Examples of ethical issues for supervisors may include a) increasing need for knowledge and technical advancement in the profession b) increasing complexity and severity of client situations c) tightening of standards for supervision d) increased customer empowerment and self-advocacy with greater numbers of grievances and malpractice litigations e) movement toward the use of managed care and f) increased financial and business competition. (p. 295)

Ethical issues also include the problem of supervisors not having formal training in

supervision, which goes against the ACA Code of Ethics (American Counseling

Association, 2005). Supervisors are responsible for the accountability and liability with

regard to the quality of services provided by counselors to clients. Supervisors who are

able to explore ethical dilemmas and confront ethical issues are able to help the

supervisee learn the importance of conducting ethical practice. If the supervisor does not

engage in ethical practice it can only serve to demonstrate to the supervisee that ethical

behavior is of no importance. Supervisors who are able to model ethical behavior in the

supervision process are able to help the supervisee not only engage in ethical decision

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making, but understand the importance of ethics within the counseling profession (Cobia

& Pipes, 2002).

Severinsson and Hummelvell (2001) discussed the importance of ethical behavior

in the psychiatric nursing profession regarding work stress and appropriate patient care.

The ethical behavior demonstrated by the supervising nursing staff helped the nurses not

only to achieve personal growth, but also to make sound decisions regarding patient care.

The nurses reported less stress from feeling inadequate in their duties. Psychiatric nurses

who attended supervision experienced less work-related stress and decreased

shortcomings in performing their duties. This is a result of clinical supervision bringing

about more self-awareness of moral issues and values. Due to supervision, it was shown

that the nurses did not feel the constraints of rules and ethical dilemmas. The nurses were

given the opportunity to reflect on those values and therefore make moral decisions about

patient care.

Worthen and McNeill (2001) also discussed ethical issues and client welfare as

they relate to supervision. The supervisee’s counseling competency, boundary issues,

confidentiality and informed consent; mandated reporting and multiple roles; high-risk

situations and follow-up were not as overwhelming for the supervisee if discussed in

supervision. The other category included how to teach/model corrective learning,

supervisee motivations for career, and bad supervisors. The opportunity to discuss

ethical dilemmas helped the supervisee to internalize appropriate ethical behaviors.

Cobia and Boes (2000) suggested using professional disclosure statements to

outline the supervision services and formal agenda of supervision. Supervisors are

instructed to sign an informed consent, which has the stated and agreed upon goals of

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supervision between the supervisor and the supervisee. Informed consent can also

include discussion of the supervisor’s competence in providing services not only in

supervision but also in counseling. Just as the counselor can encounter problems if they

engage in counseling techniques in which they are not well versed or trained, so too can

the supervisor encounter problems if they engage in supervision and are not well versed

and trained.

Good Supervision vs. Bad Supervision

It is important to have a supervisor who is trusted and who will stretch the

knowledge base and personal growth of a counselor. The supervisor should have the

ability to challenge the counselor and help the counselor gain insight into his or her own

competencies and inadequacies (Kahan, 2006). Each time counselors enter into

supervision the outcome could be one of good interaction or poor situations.

Worthen and McNeill (1996) conducted a qualitative phenomenological study

involving intermediate to advanced supervisees to understand the experience of “good”

supervision from the perspective of the supervisee. The authors stated that the research

approach is appropriate because the quantitative approach would miss very vital

information that could only be elicited from personal accounts. After conducting

interviews with eight different supervisees, they concluded that the supervisory alliance is

the most important factor of “good” supervision. The “good” supervision experience

factors include the relationship empathy, respect for the supervisee, and encouragement

to explore and experiment. The authors, further, stated that the outcome of good

supervision is an increase in self-confidence, an increase in the ability to see complex

issues, conceptualization, and intervention enhancement. Counselors within the study

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felt re-energized and ready to try new strategies as a result of supervision and claimed

continued professional identity growth, which further increased their commitment to

supervision. The study however, did not address the impact of diversity issues upon the

supervision process. The participants were all of Euro-American decent and therefore

could not speak to the perspective from a different cultural background. Further, the

background of the supervisors was not discussed. The impact of similar backgrounds

also had an impact on the supervisory relationship, which resulted in a perspective of

“good” supervision.

Worthen and McNeil (2001) conducted a study in which they surveyed the

“experts” in the field of counselor supervision. They purported the two main focuses of

supervision were the relationship and promoting learning, which would result in effective

client outcomes and continued counselor competency. Surveys were sent to the “experts”

in the field chosen from a list of authors of supervision articles in various journals. The

Supervision Beliefs and Practices Survey was developed specifically to elicit the data to

examine effective supervision in the study. The survey addressed supervision

effectiveness, outcomes, ethical concerns, evaluation, negative experiences, important

literature, multicultural counseling competencies, supervision as art or science, process

versus outcome orientation, and the role of theory. The study took an exploratory

approach rather than trying to confirm an all-inclusive definition of effective supervision.

The data analysis looked comparatively at training experts and literature experts. The

training experts were those who engaged in the teaching and training of counseling

students in Counselor Education and Supervision, while the literature experts were those

who engaged in research of supervision. Training experts appeared to emphasize

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procedural goals more than the literature experts. They further emphasized neglecting

authority role, and negative supervision experiences. Development of a supervisor was

noted by two important influences, course work/reading and mentors/colleagues. The

experts noted nine concepts warranting further research, supervision outcomes,

multicultural and diversity issues, process issues, ethics, measuring and evaluating

supervision, developmental issues, matching issues, relationship factors and supervision

models. An “other” category encompassed supervision limitations and options and a way

of rating supervision experiences. The literature and training experts, though slightly

different in their perspectives on supervision, for the most part believed that supervision

should be a science rather than an art. The training experts felt that increased self-

awareness was the most important factor affecting supervision outcome. Evaluating

effective supervision resulted in objective measures, self-report/evaluation, supervision

interviews/feedback, evaluating client outcomes, and evaluating video/audio sessions.

However, again, this is from the perspective of counselors in training. Worthen and

McNeil (2001) stated:

In summary, effective supervision according to the experts consists of a good working alliance, an attitude of serious commitment to supervision science informed practice, clearly articulated tasks and procedures and attention to developmental levels. There also needs to be more attention to the continual training of effective supervisors, developing multicultural counseling competence, clarity in regard to desired outcomes, effective evaluation instruments and methods to evaluate those outcomes and a commitment to informed ethical practice. (p. 21)

Magnuson, Wilcoxson, and Norem (2000) sought to identify the problem patterns

in supervision that can result in ineffective supervision and to develop a schema of the

patterns to help supervisors understand what not to do during supervision. The

uniqueness of this study was that the data collected consisted of retrospective

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observations of experienced counselors and experienced supervisors. Done as a

qualitative study, the participants were limited to only counselors who practiced for a

minimum of five years. Eleven counselors with professional experience ranging from

seven to 23 years participated in research interviews. Participants were selected to reflect

diversity with regard to geographic location, work setting, experience, and cultural

background. The data collection occurred during semi-structured interviews, which

ranged in time from 45 minutes to 75 minutes. The participants were asked questions

about exemplary supervision characteristics. The supervisory relationship emerged as the

central theme with four dimensions: preparation for supervision; participation in

supervision; demonstration; and stimulation. The participants characterized the

exemplary supervisory relationship as one in which “…supervisors’ communicating

respect for supervisees’ developmental and dynamic needs” (Magnuson, Wilcoxon and

Noreem, 2000, p. 97). A description of poor supervision included being unbalanced,

being developmentally inappropriate, participants being intolerant of differences,

modeling poor professional/personal attributes, being untrained, and being professionally

apathetic. In addition factors such as supervisors not addressing conflicts, neglect initial

assessment of developmental level, unprepared for supervision, inadequate as counselors,

rigidity in inadequate supervision. While the study asked questions of experienced

clinicians it still addressed supervision issues from a “counselor-to-be perspective.” The

study was a confirmation that trust, diversity, ethics, and communication are important

aspects of good supervision.

Hess et al. (2008) investigated the reasons for nondisclosure in supervision. The

authors conducted a qualitative study in which they queried 14 pre-doctoral interns about

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the reasons for nondisclosure in supervision. The reasons for the investigation were to

explore participants’ experiences of nondisclosure, reasons for intentional nondisclosure,

the content of nondisclosures, factors to facilitate disclosure, the impact of nondisclosure

on personal development, and satisfaction with supervision. The researchers

administered the Supervisory Styles Inventory (Friedlander & Ward, 1984) and the

Supervisory Satisfaction Questionnaire (Ladany, Hill, Corbett, & Nutt, 1996), along with

conducting 45 to 60 minute interviews with the participants. Utilizing the CQR method

of analysis the researchers divided the participants into two groups, those with good

supervisory relationships and those with problematic supervisory relationships. The

results were that both groups of participants felt an impact of nondisclosure; however, the

impact was different for each group. For the good supervisory relationship group, the

participants contributed the anxiety of nondisclosure to their own personal barriers. For

the problematic group, the participants stated that the nondisclosure was due to

difficulties within the relationship. The problematic group felt that the lack of trust due

to the supervisor’s behavior contributed to their nondisclosure. The impact of the

supervisor’s behavior was such that the participants of the problematic group dismissed

their supervision experience all together and sought out other sources for personal

growth. Both groups pinpointed the main issue of nondisclosure as having to do with the

power differential present in the supervision process. Since supervisors were evaluating

them, discussion of any issues in which the intern appeared incompetent was withheld.

The interns in both groups noted that the evaluative aspect gave the supervisor a higher

power level which made it difficult to either disappoint the supervisor, if the intern was in

the good group, or not trust the supervisor to give a good review, if the intern was in the

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problematic group. The conclusion was that the nondisclosure did have an impact upon

the supervisory relationship as well as the counseling relationship because of anxiety,

fear, and lack of confidence.

Cutting (2004), in a qualitative study, investigated the positive and negative

experiences of in-group supervision (i.e., where one supervisor does the facilitation of

participants’ groups) during Clinical Pastoral Education. The participants in the study

were designated as either part of a positive experience group or a negative experience

group. Both groups discussed the positive and negative experiences of supervision.

Oddly enough, both groups cited personal growth and learning whether the supervision

experience was reported as negative or positive. More critical incidents during

supervision were reported in the negative supervision experience group. The positive

experience group described the supervisor and supervision as competent, experienced,

knowledgeable, sharp, astute, empathic, compassionate, supportive, present, invested,

respectful, validating, and affirming. The negative experience group described

supervision and supervisors as “not present, did not listen well, arrogant, patronizing,

disrespectful, demeaning, critical, judgmental, hostile, abusive and enraged” (Cutting,

2004, p. 39). The negative experience group further discussed contributing factors with

regard to gender/cultural background issues not being addressed in supervision, which

contributed to the negative experience. The positive experience group saw growth as a

result of supervision, which fostered a need within them to receive ongoing supervision.

Nelson and Friedlander (2001) investigated conflictual relationships within

supervision that resulted in detriment to the supervisee. They conducted a qualitative

research study using 13 participants, 11 of whom were in doctoral programs. Eleven of

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the participants reported prior supervision and the average age of the participants ranged

from 29 to 52 years. Given the age and prior supervision experience, it is possible that

the participants were experienced counselors, though the study did not designate how

long they had practiced. The supervisees demonstrated a pattern of role conflict with the

supervisor particularly if the supervisee possessed more clinical expertise or was older

than the supervisor. This appeared to be of some threat to the supervisor. Some of the

reported conflicts included dual relationships where the supervisee was placed in more

than one role, and unethical behavior from the supervisor involving sexual matters. The

major conflict involved what should take place in supervision. The supervisee looked

more for a collegial relationship and if met with authoritarian supervision, saw this as a

major source of conflict. The supervisees further reported problems of inflexibility,

anger, denial of conflict in the relationship, and loss or lack of trust. The supervisees

reported extreme stress during the supervision process and found they would attempt to

address the conflict more often than the supervisor; however, some would not talk about

the experience due to fear of retaliation, as the power differential was of major concern.

The positive outcomes were that the supervisees found a sense of resiliency and they

possessed the ability to seek out support in other resources. The supervisees were

empowered for being assertive with the supervisor and attempting to address issues, and

learned what not to do during supervision should they ever find themselves in a

supervisory role. The negative outcomes resulted in some of the supervisees becoming

cynical about the counseling profession, experiencing distrust of supervisors, and

considering changing their professional plans. The study demonstrated a need for

supervisors to think about interactions with experienced counselors. Unlike the novice

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counselor, the experienced counselor has many expertise and life experiences that can

have an impact on the supervision process. Supervisors who conduct supervision with an

experienced counselor need to have insight into their relation to others, particularly with

regard to power.

Ladany and Friedlander (1995) emphasized the working alliance and minimizing

role conflict for the supervisee. If the working alliance is strong the role conflict is

weakened. Should the power differential promote role conflict, it can result in lower

levels of satisfaction with supervision (Keller, 1975). As the literature has pointed out,

the working alliance in supervision is crucial to the effectiveness of supervision. The

supervisee must feel comfortable enough to trust the supervisor. The communication

within the supervisory relationship must enhance the working alliance.

Henderson (1994) asked how a professional continues to remain competent in

their role. Clinical supervision plays a major part in addressing the continued

competence of the counselor. Supervisors must address many different factors in

supervision, including ethical issues, diversity issues, multicultural issues, and gender

issues. As the literature demonstrates, all of these factors are important, but it is unclear

which is the most important in supervising an experienced counselor. The current study

attempted to define the critical factors needed to conduct effective supervision with

experienced counselors.

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CHAPTER THREE: METHODOLOGY

Research Design

It is important to ask supervisors who have either supervised or are supervising

experienced counselors their opinions of the critical elements involved in supervision

with this population of counselors. In order to gather this information, the researcher

utilized a Delphi. The Delphi method is a technique that enables a panel of “experts” to

collectively offer their opinions on a particular subject when there is limited information

available (Dalkey & Rourke, 1971; Dalkey & Helmer, 1963). For this particular study

the Delphi was conducted electronically. The Delphi method offered an opportunity to

explore both qualitatively and quantitatively the critical elements necessary to conduct

supervision with experienced counselors. Understanding the experiences of supervisors

who conduct such supervision can help to understand the current practices and also to

create a pilot study to enhance the process of supervision.

The Delphi consisted of three rounds of questions with the panel of supervisors.

The first round consisted of four open-ended questions requesting the panel’s perspective

regarding elements of supervision with the experienced counselor. The second round

consisted of a presentation of the researcher’s interpretations of the various elements

offered by the panel, in addition a request to the panel to attempt to reach a first

consensus of the critical elements. The third round consisted of a confirmation by the

panel regarding the critical elements voted on by the panel to result in a final consensus

of the critical elements to conduct effective supervision with experienced counselors.

The researcher was interested in how the participants experienced the phenomenon of

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supervision with experienced counselors in order to pinpoint what is critical and

important to them in conducting the supervision.

According to Caelli (2001), phenomenological inquiry seeks to answer the

question “is this what the experience is really like?” (p. 274). Patton (2002) stated that

the phenomenological approach to inquiry is a way of exploring how human beings make

sense of their experiences and transform them into consciousness. He further stated, “this

requires methodologically, carefully and thoroughly capturing and describing how people

experience some phenomenon – how they perceive it, describe it, feel about it, judge it,

and remember it, make sense of it and talk about it with others” (Patton, 2002, p. 104).

Therefore, the original questions developed for the first round were designed to elicit

responses from the supervisors regarding their experiences of conducting supervision

with the experienced counselor.

Selection of subjects. The participants chosen for a Delphi study is one of the

most critical steps of the research because the criteria for choosing participants dictates

the rigor of the data collected. The panel of participants must be well chosen because the

results of the study are contingent upon their qualifications (Pollard & Pollard, 2008).

Therefore, the participants in this study consisted of a purposive sampling of supervisors

who met the following selection criteria for inclusion:

The supervisor conducts one-to-one supervision. While the other modalities of

supervision, such as group and peer are discussed in the field, the current study

was only interested in the one-to-one supervision modality.

The supervisor engaged in both clinical and administrative supervision.

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The supervisor has or does conduct supervision with experienced counselors.

Again the experienced counselor is post-licensure and is practicing independently.

The supervisor received training in supervision whether through a formal program

or through continuing education classes that included ethics, diversity issues,

administrative supervision, clinical supervision, an understanding of the feedback

process, supervision models, working alliance, and supervision style.

The supervisor is a licensed clinician who conducts direct client services. This

criterion was included in order for the supervisor to possess some understanding

of the demands upon the experienced counselor.

The supervisor currently conducts or has conducted supervision with at least two

different experienced counselors. This criterion was included in order to

demonstrate contrast in the individual demands of supervisees.

The supervisor also supervised counselors-in-training, who are pre-licensed. This

criterion was included because the supervisor was expected to give a contrasting

understanding, if any, of the supervision of an experienced counselor.

The supervisor is to at least meet the accreditation of the Center for Credentialing

and Education of a clinical supervisor with the exception of criteria 6, which was

deemed unnecessary for this research.

The Center of Credentialing and Education (CCE) “… was created in response to

ongoing requests from other organizations to the National Board for Certified

Counselors, Inc. and Affiliates (NBCC) for assistance with credentialing, assessment, and

management services” (Center for Credentialing and Education, 2009, paragraph 2).

CCE is recognized internationally for its standards in credentialing and accreditation, and

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has an accreditation of the Approved Counselor Supervisors (ACS). Counselors who

hold this accreditation meet the following criteria:

1. Licensure, certification, accreditation, or approval: Must be one of A to E:

A. National Certified Counselor

B. Licensed or Certified Mental Health Provider

C. Licensed or Certified Clinical Supervisor

D. Mental Health Related Educator

E. Mental Health Related Doctoral Candidate

2. Educational Training: Minimum of a master’s degree in a mental health field.

3. Specialized Training: Must document either A or B:

A. A graduate course in clinical supervision

B. A total of 30 contact hours of workshop training in clinical supervision

4. Mental Health Related Experience: Minimum of three years of post-master’s

degree experience in mental health services, with a minimum of 1,500 hrs direct

service with clients.

5. Supervision Experience: Must have provided a minimum of 100 hr. of clinical

supervision of mental health services with supervisees OR an endorsement from a

mental health professional attesting to the applicant's supervisory activity.

The Center for Credentialing and Education’s Approved Clinical Supervisors are

represented in all states with the exception of Alaska, District of Columbia, Hawaii, and

West Virginia. With the exception of West Virginia, the credentialing for the missing

representative states does not meet the same rigorous certification criteria.

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In the state of West Virginia, a supervisor is designated to meet the requirements

for accreditation as an Approved Licensed Professional Supervisor (ALPS) by the West

Virginia Board of Examiners (2009) in Counseling if the individual meets the following

criteria:

Supervisors must be permanently licensed as a Counselor for at least two years.

Supervisors must have five years counseling experience, licensed or unlicensed,

that can be documented.

Supervision Experience is demonstrated by two professional endorsements from

either a former supervisor or supervisee and the endorser must have worked with

the supervisor for at least a year and acknowledged reading the Supervisor’s

Professional Disclosure and Professional Statement.

Professional Disclosure consists of counselor license number, place of business,

education, and degree date, along with counselor specialties.

Professional Statement includes categories such as education, contextual

influences, professional credentials, therapy experience, theoretical influences,

supervision experience, supervision orientation, supervision philosophy, and any

other items deemed important by the Supervisor such as supervision specialty.

Coursework or Continuing Education with LESS THAN 10 years documented

counseling experience that reflect at least 30 contact hours in clinical supervision

training. All trainings must contain the term clinical supervision in the title and

all trainings must be completed prior to being approved as a professional

Supervisor.

62

Coursework or Continuing Education with MORE THAN 10 years documented

counseling experience that reflect at least 15 contact hours in clinical supervision

training. All trainings must contain the term clinical supervision in the title and

all trainings must be completed prior to being approved as a professional

Supervisor (West Virginia Board of Examiners, 2009, paragraph 2).

The criterion for the ALPS is similar to the criteria listed for the Center of

Credentialing and Education’s ACS with only minor differences between the two

accreditations. The ACS does not state how long the supervisor should possess licensure

as a counselor, and requires two less years of counseling activity than in West Virginia.

The ALPS criteria distinguish the amount of coursework or continuing education

between supervisors with less than 10 years and supervisors with more than 10 years.

In order to find participants who could meet the Center for Credentialing and

Education criteria, this researcher posted invitations to participate on four different

groups on the LinkedIn website. The LinkedIn website was created in December 2002

and launched in May 2003, to facilitate professional networking and allow members of a

group to share ideas, share information, and exchange best practices. The four groups

chosen for posting were the American Counseling Association LinkedIn Group, Illinois

Mental Health Professionals LinkedIn Group, Psychologist-Psychotherapist-Counselors

LinkedIn Group, and the United States Mental Health Professionals LinkedIn Group. In

addition, the researcher contacted the clinical supervisors of West Virginia listed on the

Board of Examiner’s of West Virginia website. The missions of the four LinkedIn

groups are as follows:

63

American Counseling Association LinkedIn Group is for user experience design

professionals to expand our network of people and ideas (1,271 members).

Illinois Mental Health Professionals LinkedIn Group is to improve collaboration

amongst counselors, licensed clinical professional counselors (LCPC), licensed

professional counselors (LPC, LMFT), licensed clinical social workers (LCSW),

psychologists (Ph.D. or Psy.D.), in/near Illinois (counselor, counseling, therapist,

social worker, psychologist) (291 members).

Psychologist, Psychotherapist and Counselors LinkedIn Group is a community of

psychologists, psychotherapists, and counselors whose aim is to create a network

of professionals, facilitate job opportunities, and knowledge sharing

(psychologist, psychology, psychotherapist, psychotherapy, counseling,

counselor, coach, coaching, mentor, mentoring, LCSW, LICSW, PhD, Psy.D,

Psy.D) (3,914 members).

United States Mental Health Professionals LinkedIn Group is designed to improve

collaboration amongst marriage & family therapists (MFT), LCSW, psychologists

(Ph.D. & Psy.D.), & psychiatrists in the US (therapist, therapy, psychotherapy,

psychotherapists, psychotherapist, psychologist, psychology, psychiatrist,

psychiatry, social worker, counselor, counseling) (3,716 members).

Following the example of Edwards (2003), an electronic invitation was posted on

the general discussion board of each group and followed by invitations sent to individual

members of the four groups who designated their title as Clinical Supervisor, in the event

that the general post was not read by the members. Individual invitations were

electronically sent to the West Virginia clinical supervisors. The criteria for inclusion as

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a panel member was posted as well as sent with the individual invitations. The members

were asked to respond to the researcher by private email in order to receive further

instructions regarding the study. When the members of the groups responded directly to

the researcher and agreed to participate, an electronic informed consent was sent to the

member by email.

A minimum of six and a maximum of 20 participants were anticipated for the

panel of supervisors as this is considered an appropriate number of participants for a

Delphi study (Van De Ven & Delbecq, 1974). The researcher was interested in recruiting

supervisors in service areas that included behavioral organizations, community agencies,

schools, and private practice in order to achieve a cross section of supervisors thus

enriching the data collected to give different perspectives of supervision. The researcher

also sent a request to the respondents who agreed to participate asking if they knew of

colleagues who also met the criteria for inclusion and were interested in participating in

the study. A nomination invitation was sent to those colleagues. Considered

“snowballing” in qualitative research terms, this enabled the researcher to find more

participants who met the criteria and were considered subject matter experts.

Instrumentation. The Delphi was dependent upon the participants who were

able to illuminate the experience under investigation (DeVilliers et al., 2005; Edwards,

2003; Hycner, 1985; Jenkins & Smith, 1994; Morrow, 2005; Morse, Barrett, Mayan,

Olson, & Spiers, 2002). The method is a mixture of exploratory qualitative and

confirmatory quantitative and offered an opportunity for the participants to come to a

consensus about the critical elements for conducting effective supervision with the

65

experienced counselor. Very little literature was available regarding the critical elements;

therefore this type of study was beneficial.

Pollard and Pollard (2008) presented a model for conducting an electronic Delphi

study. The electronic Delphi, like the traditional Delphi, lends itself to anonymity from

other panelists, iteration, controlled feedback, and statistical aggregation of the group

response. The participants were sent individual links to the survey inquiries and were

further notified not to forward the link as it was tied to their private email address. The

three rounds of questions consisted of with open-ended questions in round one, a four

point Likert Scale survey to rate the responses of the panelists along with any additional

comments, and a final round reviewed the results and made a request for any further

submissions or clarifications by the participants.

Assumptions. Due to electronic interactions, it was assumed the participants

would be internet savvy and able to manipulate the instrument. When the solicitation for

participants was sent, the researcher had to rely upon the respondents regarding their

meeting the criteria for inclusion. In addition, it was assumed that the participants would

not request that a colleague who was not approved to be involved in the study complete

the surveys. The researcher depended upon those who volunteered to truthfully attest to

meeting the criteria of inclusion ensuring the integrity of the data collected. The

researcher also depended upon participants to complete the entire research study in each

round of the Delphi study. The researcher expected each participant to respond from

experience rather than what the participants deemed as an appropriate answer to the

questions. In other words, the supervisors were to report what they were doing or had

done in supervision rather than what they should be doing. It was further assumed that

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the website utilized worked properly for the participants and no technical problems were

encountered.

Procedures. The electronic invitation (See Appendix A) was posted to all

general discussion boards of the LinkedIn groups along with individual invitations sent to

the members of the groups. The individuals were chosen by searching for members with

current or previous job titles and descriptions of “Clinical Supervisor.” The member was

allowed to respond to the researcher through the LinkedIn email system. This was

helpful for the participants so as to know the researcher was not seeking any personal

information which the participant was not confident in sharing. The electronic

environment does, unfortunately, allow for unsavory characters to attempt to gain

advantage over others. If the participant met the criteria and was comfortable with the

solicitation being legitimate, a request was sent for the participant to send a private email

address to contact the participant directly. An informed consent (See Appendix B) was

then forwarded to the member. The informed consent stated that the study met approval

of the Institution Review Board and included direct contact information for the researcher

and the dissertation chairperson.

The individual invitations were sent one at a time to recipients so as to avoid the

possible security controls within the LinkedIn environment and the individual email

security environments. The emails invited participants to contact this researcher

regarding the criteria of inclusion in the study. Once it was determined that the

participant met the criteria for inclusion, an informed consent consisting of the purpose

for the research, the risk and benefits of the research, the voluntary nature of research

participation, the participant’s right to stop the research at any time, and the procedures

67

used to protect confidentiality was sent to the volunteer. In addition, the email also

included the study description (See Appendix C).

Once volunteers for the panel were obtained, the researcher forwarded an email

notifying the participants to contact this researcher to nominate a colleague for

participation. Once a nomination was received the researcher forwarded an invitation by

email to the nominee (See Appendix D) stating that a colleague felt they met the

researcher’s criteria for inclusion in the study and felt the nominee would be interested in

participation. The nominee was requested to electronically reply just as the initial

participants were requested. The researcher reviewed and printed all informed consents

in order to protect the confidentiality of the participants and emails from the participants

were then permanently deleted from the researcher’s electronic environment.

During the first round, participants were asked to complete the initial open-ended

questions and demographic questionnaire (See Appendix E & F). Participants were

requested to complete the task within a three week timeframe. Once the information was

collected, the researcher compiled and analyzed the responses by thematic analysis

(Braun & Clarke, 2006; Fereday & Muir-Cochrane, 2006). The results from the thematic

analysis were then constructed as a survey for the second round. The participants who

had not responded, a week before the conclusion of the round, were sent a reminder email

of the survey closing date. The researcher included an election statement for the

participant to opt out of the study. At the deadline date and time announced, the survey

was then closed by the researcher.

During the second round, the participants were sent an email announcing the

opening of the second round survey. The participants were given three weeks to review

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and rate the themes based upon a four point Likert scale ranging from 4-Critical element,

3-Important element, 2-Somewhat unimportant element and, 1-Not an important element.

The researcher chose an even-numbered Likert scale in order to force the participants to

give an opinion on each element. Avoiding a “neutral” response encouraged the

participants to really think about their opinion of the critical elements to conduct effective

supervision with experienced counselors. A space was provided if the participants

wanted to add additional comments forgotten during the first round. A week before the

ending of the second round survey a reminder email was sent to any participant who had

not responded, notifying them of the survey closing date.

During the third round, the consensus of the important and critical elements of

supervision ratings from round two were published for review and a request was made of

the participants to indicate their agreement or disagreement with the consensus of the

panel. A comment line was provided if a participant wanted to provide input about the

results. The researcher followed up with the participant regarding any additional

comments by email.

Data Processing and Analysis

According to Braun and Clarke (2006), “thematic analysis is a method for

identifying, analyzing and reporting patterns (themes) within data” (p. 79). The process

of thematic analysis requires the researcher to view and determine the themes one

response at a time (Fereday & Muir-Cochrane, 2006). The themes can be identified

either inductively or deductively. According to Patton (2002), the inductive process is

not driven by the researcher’s theoretical interest but rather from the data; therefore the

researcher conducted inductive thematic analysis. Groenewald (2004) cautioned

69

researchers to bracket their biases while reviewing data so as not to impose their ideas

and suppositions upon the data. The themes were identified at a semantic level and coded

within a spreadsheet to keep track of the themes. Braun and Clarke (2006) stated, “the

analytic process involves a progression from description, where the data have simply

been organized to show patterns in semantic content, and summarized, to interpretation,

where there is an attempt to theorize the significance of the patterns and their broader

meanings and implications” (p. 84).

The researcher performed a review of the data by copying and pasting the

participant responses from the Excel spreadsheet. The process of “cut and paste” into the

spreadsheet provided an opportunity to begin analyzing the data. Upon completion of the

analysis of the first round data, the researcher reviewed the findings with a colleague who

was a post-licensure clinician, had practiced for over 20 years, and was a recipient of

supervision for those years. The colleague assisted with the interpretation of the open-

ended answers and then a comparison was conducted with the researchers. The review of

the themes with the colleague helped to strengthen reliability, validity, and credibility of

the initial data analysis resulting in the compilation of themes. This step also aided in

reduction of researcher bias. The website utilized to gather the data possessed a built in

program to conduct simple statistics on the ratings and generated the final report. The

participants were sent the final findings.

The Delphi method allowed the participants to do member checking on the data,

with the exception of the initial theme generation, therefore adding further validation of

the data.

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CHAPTER FOUR: FINDINGS

The current pilot study explored what supervisors consider are the critical

elements in conducting effective supervision with experienced counselors. Utilizing an

electronic Delphi method the researcher sought to gather consensus from a panel of

“experts” regarding the question, what are the critical elements of effective supervision

with the experienced counselor?

An invitation was posted on the discussion board of 4 different counseling groups

of the professional networking site Linked In. In addition the researcher sent individual

invitations to members of the Linked In groups, which designated their current or former

job titles or specialties as Clinical Supervisors for both pre-licensed and post-licensed

counselors. The researcher also sent individual electronic invitations to a list of

Approved Licensed Professional Supervisors (ALPS) from the state of West Virginia.

The email addresses of the ALPS were posted on the Board of Examiners for the state of

West Virginia. The individual invitations were sent to the members of the Linked In

groups because the general post to the groups’ discussion boards may not have been seen

by everyone in the group and to also avoid the electronic security environments for blast

emails. The invitations were posted on the discussion boards of United States Mental

Health Professionals, Illinois Mental Health Professionals, American Counseling

Association and Psychologist, Psychotherapist and Counselors, the 4 Linked In groups.

The researcher sent 303 individual invitations to the LinkedIn group members and

the ALPS requesting participation. Thirty five individuals responded with interest to

participate in the study, resulting in an 11.55% rate of return. While 35 responded to the

request, only 14 met the criteria for inclusion as an “expert” panel member. Several

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ALPS from West Virginia expressed interest in participating; however, the individuals

who responded were only experienced in conducting supervision with pre-licensed

counselors. Some individuals did not meet various aspects of the inclusion criteria.

Reasons for exclusion from the panel included conducting supervision with experienced

counselors, the length of time of conducting supervision with experienced counselors,

supervision training whether through continuing education units or a formal university

program, geographically not from the United States, or did not adhere to the deadline for

participating in the first round. Interestingly, the researcher was contacted several times

by some individuals interested in participating but who had been excluded from

participation. The individuals wanted to understand the reasons for exclusion by the

researcher. After discussion with the individuals it was understood that the researcher

was specifically looking for those individuals who met the criteria in order to sustain

reliability and validity of the study. The reliability and validity of the Delphi study is

heavily reliant upon the criteria of the panel.

A study description, schedule for the study, and an informed consent were

forwarded to the 14 individuals who met the criteria and showed interest in participation.

All 14 informed consents were returned electronically to the researcher, which were then

reviewed and secured. Of the 14 respondents, four did not respond to requests to

complete the first round of study. Two of the remaining 10 respondents did not complete

all the questions of the first round survey, leaving eight respondents who completed all

three rounds of the Delphi.

The panel members were geographically located on the East coast, the Midwest,

and the West coast of the United States. Demographic information was gathered from

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the panel members requesting highest educational degree, professional title, and work

setting. Panel members were also asked about their counseling and supervision

theoretical approaches. All of the participants were Masters Level with either an MA or

MS degree. Some of the panelists listed more than one degree. Some of the panel

members listed more than one professional title, more than one work setting, more than

one counseling theoretical approach, and more than one supervision theoretical approach.

Table 1 presents the demographic information gathered on each of the panel members

with regard to education, professional title, work setting, counseling theoretical approach,

and supervision theoretical approach. For the purposes of this study, the panel members

are identified as Panelist 1-8.

Fifty percent of the panelists reported supervisor/supervising in their professional

title. Sixty-two and a half percent of the panel members worked in private practice, while

an additional 25% worked in hospitals and 37.5% worked in social agencies. Twenty

five percent of the panel members were Art Therapists, while another 37.5% obtained

degrees in psychology or clinical psychology. Fifty percent of the panel members noted

cognitive or cognitive behavioral theory as one of their counseling theoretical

approaches, while 50% of the panel members noted their supervision theoretical approach

as developmental. Three of the panelists had conducted supervision for 3-5 years, three

panelists had conducted supervision for 6-10 years, and two panelists had conducted

supervision for 16-20 years. Five of the panelists had conducted supervision with

experienced counselors for 2-5 years. One panelist had conducted supervision with

experienced counselors for 6-10 years, one panelist for 11-15 years, and one panelist for

16-20 years.

73

Table 1

Panel Members by Education Degrees, Professional Title, Work Setting,Counseling Theoretical Approaches, Supervision Theoretical Approaches

Panel Member

Education Degrees

ProfessionalTitle

WorkSetting

CounselingTheory

SupervisionTheory

1 Social Work

Supervising Clinician

Hospital Structural Family

Task-Centered

2 Psychology Clinical Supervisor

Private Practice

Object Relations

Integrated

3 Counseling Education

Counselor Agency;Private Practice

Cognitive;Humanistic

Competency Based; Developmental*

4 Art Therapy; Clinical Pastoral; Ph.D. Student

Art Therapist; LICDC; Private Practitioner; Teaching Fellow

Hospital;Private Practice; University

Art Therapy; Dialectical Behavioral; Person-Centered

AlternativeTherapies;Competency Based; Developmental

(continued)

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Table 1 (continued)

Panel Members by Education Degrees, Professional Title, Work Setting, Counseling Theoretical Approach, Supervision Theoretical Approach

Panel Member

Education Degrees

ProfessionalTitles

WorkSettings

CounselingTheories

SupervisionTheories

5 Social Science; 4-year Clinical Training

Clinical Supervisor

Agency Infant Mental Health; Psychoanalytic

Developmental

6 Clinical Psychology

Clinical Supervisor

Agency Cognitive Behavioral; Systems;Trauma-Informed

Integrated;Systems

7 Art Therapy

Art Therapist; Supervisor Rehabilitation

Hospital; Private Practice; University

Cognitive Behavioral; Eclectic; Humanistic; Person-Centered; Psychodynamic

Humanistic;Person-Centered;Psychodynamic

8 Psychology;Social Work

Private Practitioner

Private Practice

Choice; Cognitive; Psychodynamic; Systems

Developmental

Note. *Researcher labeled categories according to panel member’s description of theoretical approach.

75

Two of the panel members stated formal training or coursework while the other six

panelists obtained training through continuing education units (CEU). One of the

panelists listed informal training and self-study in addition to CEUs, and another panelist

listed yearly online CEUs.

The panel members reported conducting supervision for 3-8 individuals with an

average caseload of five individuals. The panel members reported a range of 25% -

100% of their caseloads being spent supervising experienced counselors. The panel

members further reported that the frequency of conducting supervision was daily,

weekly, bi-weekly, and monthly, with the range of 60-120 minutes for a supervision

session. The average length of time panel members spent in supervision was 68.75

minutes per session.

Each panel member was sent an individual survey link for the first round of the

study, which was tied to their email address. The panel members were instructed not to

forward the link to colleagues since it was tied to their email address. Panel members

were sent a separate nomination invitation for any colleague the panel member felt would

be interested in participating in the study. This was sent under separate email. The first

round consisted of 4 open-ended questions. The panel members were instructed the

survey would be available for 3 weeks and if there was no response from the members a

week before the survey closed, the researcher sent out a reminder e-mail, which prompted

panel members to complete the survey. Appendix G lists the responses of each panelist

during the first round of the study.

The researcher applied thematic analysis to the responses by the panel members.

Each response was analyzed and themes were recorded in a Word document. The

76

researcher reviewed the response of each panelist and then reviewed the response again

after waiting 24 hours for any additional themes not noted in the first review. Each

panelist’s response was then cross tabbed with the responses of the other panelists for any

redundant themes.

The researcher requested a colleague who is a long time recipient of supervision

to review the data and record any themes which emerged from the colleague’s

perspective. Comparison of the researcher’s themes and the colleague’s theme was then

conducted. Any themes which appeared on both lists were documented for inclusion in

the second round survey. Discussion took place regarding the discrepancies between the

researcher and the colleague. As a result if the researcher and colleague came to an

agreement the theme was included in the list if no agreement was reached the theme was

then eliminated. In addition the interpretation of the meanings of the themes was also

discussed and agreed upon between researcher and colleague. As a result of the thematic

analysis, the researcher noted four elements as being critical to supervision of the

experienced counselor, which were the characteristics of the supervisor, characteristics of

the supervisee/experienced counselor, characteristics of the supervision process, and

characteristics of the supervision relationship.

During the second round, the researcher listed the characteristics in a four point

Likert scale for rating by the panelists. A four point Likert scale was purposely utilized

so the panelist had to make a forced choice on the characteristics. The panelists were

asked to vote on the characteristics and indicate whether the researcher had the correct

interpretation of the characteristic. In addition, the panelists were asked to include any

77

comments or characteristics not listed by the researcher (See Appendix H). Results from

the second round voting for each of the critical elements are listed in Tables 2-5.

Round three of the Delphi consisted of the panelist voting on the list of

characteristics based upon the consensus criteria of Green (1982). The purpose of the

final round was to confirm the consensus of the panelists and again to allow any

additional comments. The consensus criterion was greater than or equal to 75% of the

panelists with a mean score of greater than or equal to 3.25. A definition followed each

characteristic and represented this researcher's interpretation of the panel's discussions in

the first round. If panelists disagreed with the interpretation they were to include

additional comments. The panelists had 3 weeks to complete the survey and submit any

additional comments. A reminder e-mail was sent a week before the closing of the

survey. The panelists voted to keep the remaining characteristics of the critical elements

on the lists and added additional comments.

The consensus of the panel regarding the characteristics of the supervisor, in rank

order, included:

1 ability to promote trust

2 sets boundaries in the supervision session

3 promotes respect in the supervision session

4 being supportive in the supervision session

5 possessing credibility as a supervisor

6 personally comfortable in the role of supervisor

7 competent in the practice of supervision

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Table 2

Supervisor Characteristics Panel Rating

Themes Not Important

Somewhat Important

Important

Critical

Rating Average

Percentage Agreement

Broad Theoretical Counseling Base

1 2 5 0 2.50 62.5

Broad Theoretical Supervision Base

1 4 3 2.25 37.5

Set Boundaries

0 0 3 5 3.63 100

Promote Trust

0 0 2 6 3.75 100

Promote Respect

0 0 4 4 3.50 100

Supportive 0 0 4 4 3.50 100

Empathic 0 2 5 1 2.88 75

Continued Training

0 4 3 1 2.63 50

Receptive to Criticism

0 1 6 1 3.00 87.5

Appropriate Interventions

0 3 4 1 2.75 62.5

(continued)

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Table 2 (continued)

Supervisor Characteristics Panel Rating

Themes Not Important

Somewhat Important

Important

Critical

Rating Average

Percentage Agreement

Competent 0 1 4 3 3.25 87.5

Confident 0 1 6 1 3.00 87.5

Credible 0 1 3 4 3.38 87.5

Comfortable in Supervisor role

0 1 3 4 3.38 87.5

Available 0 3 3 2 2.88 62.5

Teacher/Educator

0 5 2 1 2.50 37.5

Patient 0 0 7 1 3.13 100

Role Model 0 1 5 2 3.13 87.5

Empower 1 1 5 1 2.75 75

80

Table 3

Supervisee Characteristics Panel Rating

Themes Not Important

Somewhat Important

Important

Critical

Rating Average

Percentage Agreement

Open to Supervision

0 0 4 4 3.50 100

Understand Supervision Expectations

0 2 4 2 3.00 75

Understands Goals of supervision

0 1 5 2 3.13 87.5

High Standard Client Care

0 0 4 4 3.50 100

Receptive to Corrective Feedback

0 0 2 6 3.75 100

Confident in Counselor Identity

0 5 3 0 2.38 37.5

Open to Suggestions

0 0 6 2 3.25 100

Integrates Information Quickly

1 3 4 0 2.38 50

Self-Reflective

0 1 4 3 3.25 87.5

81

(continued)

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Table 3 (continued)

Supervisee Characteristics Panel Rating

Themes Not Important

Somewhat Important

Important Critical

Rating Average

Percentage Agreement

Self-Directive 0 2 3 3 3.13 75

Self-Motivated 0 3 2 3 3.00 62.5

Challenge supervisor

0 2 4 2 3.00 75

Continual Counselor Training/Education

0 2 5 1 2.88 87.5

Empathic 0 2 4 2 3.00 75

Broad Theoretical Base

1 4 3 0 2.25 37.5

Professional Development

0 4 4 0 2.5 50

Vulnerable with Supervisor

0 2 1 5 3.38 75

83

Table 4

Supervision Process Characteristics Panel Rating

Themes Not Important

Somewhat Important

Important Critical

Rating Average

Percentage Agreement

Protect the Client’s Best Interest

0 1 1 6 3.63 87.5

Monitoring Case Progression

0 5 2 1 2.50 37.5

Address Ethical Guidelines

0 1 4 3 3.25 87.5

Providing Effective Feedback

0 1 3 4 3.38 87.5

Model Appropriate Counselor Behavior

0 2 4 2 3.00 75

Setting Boundaries 0 0 3 5 3.63 100

Setting Goals 0 1 5 2 3.13 87.5

Setting Expectations 0 2 5 1 2.88 75

Assessing Counselor Developmental Level

0 1 6 1 3.00 87.5

Tailoring Supervision to Meet Developmental Level

0 1 4 3 3.25 87.5

Education of Various Theoretical Methods/Approaches

1 4 3 0 2.25 37.5

(continued)

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Table 4 (continued)

Supervision Process Characteristics Panel Rating

Themes Not Important

Somewhat Important

Important Critical

Rating Average

Percentage Agreement

Adherence to Ethical Guidelines

0 0 4 4 3.50 100

Transference-Countertransference Issues

0 0 5 3 3.38 100

Expand Supervisee's Knowledge base

0 1 5 2 3.13 87.5

Refining skills of the Supervisee

0 0 5 3 3.38 100

Beneficial for Supervisor/Supervisee

0 2 5 1 2.88 75

Case Conceptualization

0 1 5 2 3.13 87.5

Addressing Role Conflict

0 2 2 4 3.25 75

Addressing Safety Concerns

0 1 2 5 3.50 87.5

Explore Counselor Complacency

0 2 3 3 3.13 75

Challenge Supervisee Assumptions

0 1 2 5 3.50 75

Creating Structure for Supervisee

0 3 3 2 2.88 62.5

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Table 5

Supervision Relationship Characteristics Panel Rating

Themes Not Important

Somewhat Important

Important

Critical

Rating Average

Percentage Agreement

Collegial 0 3 4 1 2.75 62.5

Collaborative

0 0 3 5 3.63 100

Empowering 0 0 6 2 3.25 100

Supportive 0 0 3 5 3.63 100

Trustworthy 0 0 1 7 3.88 100

Encouraging 0 0 6 2 3.25 100

Challenging 0 2 2 4 3.25 75

Growth 0 0 1 7 3.88 100

Respectful 0 0 3 5 3.63 100

Open 0 0 5 3 3.38 100

Reciprocal 0 2 4 2 3.00 75

Inspiring 0 2 6 0 2.75 75

The consensus of the panel regarding the characteristics of the supervisee/experienced

counselor, in rank order, included:

1 being receptive to corrective feedback

2 open to supervision

3 committed to high standards of client care

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4 willing to be vulnerable in supervision

5 open to suggestions

6 self-reflective

The consensus of the panel regarding the characteristics of the effective supervision

process included:

1 protecting the client’s best interest

2 setting boundaries

3 adhering to ethical guidelines

4 addressing safety concerns for both the supervisee and the client

5 challenging the supervisee’s assumptions

6 providing effective feedback

7 exploring transference-countertransference issues

8 refining the supervisee’s skills

9 tailor the supervision process to match the developmental level of the supervisee

10 addressing ethical guidelines

11 addressing role conflict

Finally, the consensus of the panel regarding the characteristics of the supervision

relationship included:

1 being trustworthy

2 enabling growth

3 collaborative

4 supportive

5 respectful

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6 open

7 empowering

8 encouraging

9 challenging

The researcher applied thematic analysis to qualitative information provided by

the panel in the first round and developed interpretations for each of the elements.

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CHAPTER FIVE: SUMMARY, LIMITATIONS AND FUTURE RESEARCH

The panel of eight clinical supervisors submitted their ideas in an electronic

Delphi study exploring what are the critical elements of conducting supervision with an

experienced counselor. As the study unfolded, the panel pinpointed four critical elements

that were considered necessary for effective supervision with this population. The

critical elements focused upon characteristics of the supervisor, characteristics of the

supervisee/experienced counselor, characteristics of the supervision process, and the

supervision relationship. In Campbell’s (2000) discussion of conducting effective

supervision it was noted that the supervisor should include models of supervision,

methods and techniques of clinical supervision, role of the relationship in supervision,

methods and techniques to help the supervisee grow, legal and ethical issues in

supervision, multicultural issues in supervision, administrative tasks in supervision, and

the role of personal development in supervision. The four elements discussed by the

Delphi panel coincided with Campbell’s definitions of effective supervision.

Characteristics of the Supervisor

To promote trust was interpreted by this researcher as the supervisor’s ability to

relay reassurance to the supervisee/experienced counselor regarding the supervisor's

knowledge, skills, and abilities in supervision. However, one of the panelists gave an

addendum to the definition of promoting trust that addressed the interpersonal issues

between the supervisor and the supervisee/experienced counselor. The

supervisee/experienced counselor needs to know that the supervisor cares about him or

her. Understanding the interpersonal aspects of the relationship, Panelist 7 stated that the

supervisor should possess “a personal comfort and sense of competence, knowledge of a

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variety of theories and methods, and a personality that means that experienced counselors

respect your opinion”. Promoting trust sets the tone of supervision if the

supervisee/experienced counselor know the supervisor cares about their wellbeing.

Just as the supervisor should possess the ability to promote trust, the panel stated

that the supervisor should possess the ability to promote respect. The researcher

interpreted this characteristic to be the ability to recognize and appreciate the

supervisee's/experienced counselor’s knowledge, skills, and abilities in counseling. This

characteristic, like promoting trust, is a part of the supervisor’s interpersonal skills. The

supervisor’s ability to acknowledge the supervisee’s/experienced counselor’s expertise

promotes a feeling of mutual respect. As Panelist 3 stated, the supervisor needs to have

“trust as well as respect” in order to have effective supervision. The characteristics of

trust and respect were also discussed in the supervision relationship. The panel was in

complete agreement that it is important for the supervisor to have appreciation for the

supervisee's/experienced counselor’s viewpoints and vice versa; the relationship is

trustworthy because the relationship is authentic, dependable, and ethically conducted.

Respect for one another changes the relationship to one of collegial rather than teacher-

pupil. Panelist 3, in discussing the difference between a novice counselor and an

experienced counselor, stated “the relationship between novice and supervisor is more

teacher/pupil, whereas the supervisor/experience counselor relationship is more

collegial.”

Setting boundaries and remembering their role as supervisor was a characteristic

frequently mentioned by more than one panelist for both the novice and experienced

counselor supervisees. The researcher interpreted this characteristic as one in which the

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supervisor understands his/her role as the supervisor and adheres to the role during

supervision. Campbell (2000) concurred that the supervisor must, in order to be

effective, decide upon a role and adhere to that role in supervision. Panelists 2, 3, and 6

all discussed the characteristic of setting boundaries. The panelists stated the supervisor

needs “the ability to have strong boundaries,” “a clear understanding of the boundaries,

expectations and roles of the supervisor and counselor,” and “a clear understanding of

what is expected, required,” respectively. Panelist 3 further pointed out, not setting

boundaries, results in a drawback to supervising experienced counselors. “A drawback

might be remembering your role as the supervisor. It feels great to have experienced

counselors to speak with about cases and if the boundaries aren't clear it could become

merely peer supervision.” Interestingly enough, one of the panelists, while agreeing the

supervisor should possess this characteristic felt it is a more critical element for the

supervision process, rather than for the supervisor.

The panel unanimously agreed about the importance of setting boundaries within

the supervision process. The researcher interpreted this characteristic as a formal

structure within the supervision sessions, which follows supervision policy and

procedures. Panelist 2 stated, “the ability to have strong boundaries and to have the

ability to provide input and feedback to the supervisee to assure that the case is

progressing,” is an important aspect of the supervision process. In addition, Panelist 8

added that setting boundaries is a way to model for the counselor on how to set

boundaries in counseling, stating “more than the formal supervision structure,

[supervision] role models interpersonal limits and respect, to be reflected in the

counseling provided by the supervisee.”

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Not unlike the novice counselor, the panel stated that the experienced counselor

also needed to feel supported; therefore, the supervisor needs to have the ability to be

supportive. The researcher interpreted this characteristic as the supervisor’s ability to

attend to the needs of the supervisee/experienced counselor during supervision.

According to Panelist 7, the supervisor needs to be supportive within the supervision

environment because “supportive environments enable clinicians to do their best work.”

Panelist 8 added that being supportive also includes the supervisor's ability to encourage

the supervisee's/experienced counselor’s “ability to make sound clinical decisions.” The

panel was in agreement that the supervisor as well as the supervision relationship should

be supportive. The researcher interpreted the characteristic of supportive within the

supervision relationship as a complimentary alliance between supervisor and

supervisee/experienced counselor. However, while there was a general consensus that

the supervisor should be supportive, two of the panelists did not agree that it was

necessary for the supervision relationship. Seventy five percent of the panel still agreed

it is an important and critical characteristic of the supervision relationship.

Credibility was the next characteristic noted by the panel; however, only 87.5% of

the panel agreed that it was critical. A panelist felt it necessary to add an addendum that

the supervisor must be able to leave room for differing opinions and points of view. The

researcher interpreted the idea of being credible to mean that the supervisor’s information

is both dependable and reliable and the interpretation appeared to be supported by

comments from the panelists. Panelist 4 stated, “I believe it is critical for the supervisor

to be available and intentional about supervision,” while Panelist 7 stated “ongoing

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training and updates on research and effective methodologies” are needed to conduct

effect supervision.

Personal comfort was the next supervisor characteristic that the panel felt was

important for effective supervision with the experienced counselor. The researcher

interpreted this characteristic to mean that the supervisor is not intimidated by the

demands and duties of supervision; 85% of the panel agreed that this was necessary for

the supervisor. The panelists made reference to the fact that an experienced counselor

may have expertise which is beyond that of the supervisor, therefore causing discomfort

for the supervisor. The supervisor should be able to deal with this in supervision and not

allow this to influence interactions with the supervisee/experienced counselor. Panelist 2

stated the supervisor should have “a clear understanding of role of the supervisor along

with a personal comfort and sense of competence.” Panelist 7 stated the supervisor

should possess a “personality that means that experienced counselors respect your

opinion.” If the supervisor is to appear credible to the experienced counselor, it is

expected that the supervisor is personally comfortable in the role of supervisor. Panelist

8 discussed the fact that experienced counselors are much more interactive and

challenging to the supervisor and the supervisor must be able to handle his or her own

feelings when challenged by this population. The supervisor should have the “ability to

allow for the experienced counselor to advance beyond the supervisor's expertise.” The

panelist went on to state that the supervisor will meet professional and personal

challenges with the experienced counselor but must “set aside their expertise in order to

learn from the experienced counselor.” Panelist 1 concurred with Panelist 8, stating the

supervisor needs to “be comfortable with discomfort and be able to handle intense

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moments and differences in supervision.” The experienced counselor already possesses

expertise from practicing and the supervisor will be challenged more regarding opinions.

The supervisor must be comfortable with his or her abilities in order to meet the

challenges. Panelist 8 did point out that there is a level of discomfort for supervisors who

are just starting out with this population, stating “you have to become a new supervisor at

some point, and you would not be fully comfortable at that point.” Therefore, one must

make allowance for new supervisors.

The final characteristic deemed important and critical to supervision with the

experienced counselor was that the supervisor must be competent. Competent was

interpreted as being adequate, appropriate, and effective in supervision. Panelist 5 stated

that supervision presents “the opportunity to put your own knowledge into words and see

how much you know.” The supervisor must have a broad theoretical base regarding

supervision approaches in order to accommodate the many different learning styles of the

supervisees/experienced counselors. Panelist 2 stipulated that the supervisor must

possess “the ability to have a theoretical knowledge base that is broad enough to support

many different areas of learning.” Campbell (2000) concurred, stating “effective

supervisors need a broad range of competencies in a variety of areas” (p. 5).

Two of the panelists noted additional comments regarding the characteristics of

the supervisor. Panelist 4 felt that the supervisor should have the ability to provide

structure in supervision and be accepting of diverse thinking, while Panelist 1 included

the importance of the supervisor being able to “understand personality differences (i.e.,

supervisor is extroverted vs. introverted supervisee, etc.).” The additional comments

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made by the panelists were included in the last round to determine whether the other

panelists would agree with the inclusion of the characteristics.

Characteristics of the Supervisee

The panel concluded that the characteristics of the supervisee/experienced

counselor are a major contributory factor of effective supervision. Along with some of

the characteristics mentioned above, the panel discussed other characteristics that are

important or critical to effective supervision. The characteristics listed by the researcher

as a result of analyzing the first round of the Delphi resulted in total agreement on all of

the characteristics of the supervisee.

The panel felt the most important characteristic of the supervisee/experienced

counselor is the ability to be receptive to corrective feedback, which was interpreted as

the supervisee being amenable to adjusting his or her counseling approach or techniques

in order to better serve the client. Panelist 2 stated, “some experienced counselors also

enter supervision as if they are fully trained and don't need case consultation,” though

Panelist 5 stated that it is expected in any supervision realm to encounter resistance and

obstacles with the supervisee/experienced counselor. However, as Panelist 4 stated, the

supervisor must “be able to provide both supportive and challenging feedback at well-

timed moments in supervision.” This will nurture the growth of the supervisee.

Campbell (2000) stated, “challenging and giving corrective feedback can be a positive

experience, helping supervisees to explore what they’re saying or doing, to discover their

own resources and personal strengths” (p. 95).

In order for the supervisee to grow, he or she needs to be open to supervision.

Being open to supervision was interpreted as being receptive and appreciative of the

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benefits of supervision. The supervisee/experienced counselor must see the benefits of

supervision, again to enhance personal and professional growth. If the

supervisee/experienced counselor struggled with supervision, they can benefit from the

information shared within the process. Panelist 6 contributes this to “greater tendency

for clinicians to become ‘set’ in their style and methods, and some experienced

counselors struggle with supervision, especially if from a less experienced counselor.”

While the experienced counselor does possess the expertise to practice independently,

they are not as experienced within the first year of practice as they are in the tenth year of

practicing. The experiences of counseling continue to change the experienced

counselor’s perspective on counseling as they encounter different types of clients and

situations (Ronnestad & Skovholt, 2003).

The next characteristic the panel felt was of importance or critical for effective

supervision was that the supervisee/experienced counselor be committed to high

standards of client care, which was interpreted as the supervisee/experienced counselor

engaging in best practices to provide efficient and effective services and interventions to

their clients. Panelist 7 agreed there should be a discussion of best practice but indicated

that this could come later; rather, the most important idea is for the

supervisee/experienced counselor to be invested and value the importance of high

standards of client care. Panelist 4 discussed the importance of the

supervisee’s/experienced counselor’s behavior in supervision, stating “I also believe the

supervisee’s openness, ability to initiate and collaborate and values regarding high

standards of client care are critical.” Panelist 5 concurred by stating the

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supervisee/experienced counselor should have the “ability to hold the best interest of the

client as a very important aspect of supervision.”

In order to commit to high client care standards, the supervisee/experienced

counselor must be willing to discuss his or her deficiencies, and to be vulnerable in

supervision. This was interpreted as the supervisee/experienced counselor being able to

expose deficits and weaknesses even though considered an expert professional. Panelist

5 stated that while it is necessary for the experienced counselor to be vulnerable in

supervision, this may be a lot to “expect from those new to the process of supervision.”

The experienced counselor needs to feel comfortable in the supervision process in order

to expose vulnerabilities. Panelist 3 stated that supervision has to afford the novice

counselor the “freedom for the counselor to process counter-transference and fears,”

which appears to be the same for the experienced counselor. Panelist 7 noted that the

experienced counselor, unlike the novice counselor, is often more open to discussing

some of the more difficult subjects in supervision. Panelist 7 stated “experienced

counselors are able to integrate more quickly and are more open to bringing issues to

supervision.” Therefore, the experienced counselor needs to be “open to sharing their

insecurities, vulnerabilities or transference issues.”

The experienced counselor also must be open to suggestions from the supervisor.

The researcher interpreted this characteristic as the willingness to learn new and different

approaches to the counseling process. Panelists mentioned that while the experienced

counselor is open to suggestions, problems can arise if the experienced counselor is “set”

in his or her ways and does not hear the suggestions made by the supervisor. Panelist 1

mentioned “the know-it-all attitude that sometimes pervades or they are stuck in a certain

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modality and have difficult time adapting to new ideas.” Panelist 1 further discussed that

there are times when the novice counselor “outshines” the experienced counselor.

Panelist 5 discussed this difficulty of dealing with the experienced counselor as the

“potential drawback is that they think they know things, which they do, but have not yet

made it a part of who they are.” Panelist 1, however, stated the advantage of supervising

the experienced counselor is that “they GET IT more quickly without the need for

repeating oneself.”

The experienced counselor, due to independent practice, will likely have engaged

in self-reflection regarding interactions with the client, approach to helping the client, and

many other aspects of the counseling sessions. The final characteristic that emerged as a

theme was the ability to self-reflect, interpreted as the supervisee’s/experienced

counselor’s willingness to be introspective and studious regarding his or her own

behaviors in supervision as well as counseling. Panelist 3 stated that the experienced

counselor possesses “a clear understanding of the role of the counselor.” The panelist

went on to say “an experienced counselor has had prior supervision and is intuitively

more aware of what they might need from their supervisor.” Knowing their role as

counselor rather than having to develop their counselor identity appears to contribute to

the panel agreeing that this is an advantage of supervising this population. Panelist 7

stated that the experienced counselor is “quicker at integration and understanding of

concepts- a thirst for understanding of self and patient relationships,” which is unlike

novice counselors who are developing their counselor identities. As an additional

comment, Panelist 2 stated that self-reflection is “more than just with behaviors; self-

reflective should include, by definition, how one is affected on a cognitive, affective and

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somatic level.” Panelist 4 included an additional comment regarding the importance of

the experienced counselor following up immediately with safety issues and ethical issues

by addressing them in counseling and in supervision. The next element of focus for the

panelists was on the characteristics of the supervision process itself. This element

generated the most discussion and themes from the panelists.

Characteristics of the Supervision Process

The characteristics of the supervision process were the most discussed area by the

panel. The panelists were in total agreement with regard to all the characteristics and

provided the most additional comments in this area.

The number one characteristic the panel felt important and critical to supervision

of the experienced counselor was protection of the client, which is also a goal with novice

counselors. This characteristic was interpreted as ensuring the wellbeing of the client and

committing to high standards of client care. Panelist 5 discussed this as a primary focus

in supervision and noted that the supervisee should have the “ability to hold the best

interest of the client.” Panelist 2 stated that supervision and the focus within supervision

should address “areas of clinical development…greater with regard to diagnosing and

assessing clients.” In addition, Panelist 2 further stated “an experienced counselor will

have an idea of case progression and intervention strategies that are more sophisticated

than the trainee.” Therefore, supervision needs to focus on protecting the client.

Campbell (2000) discussed the fact that the supervisor is the gatekeeper of the profession

and protection of the client is a gate keeping function.

Two other characteristics of the supervision process are adherence to ethical

issues as well as addressing ethical issues in supervision. Adherence to ethical issues was

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interpreted as the ability to address the appearance of dual relationships, manipulation of

the supervisee/experienced counselor by the supervisor, and manipulation of the

supervisor by the supervisee/experienced counselor, as well as adherence to appropriate

behaviors in supervision. Addressing ethical issues refers to the ethical behaviors of the

counselor with the in the counseling session. Panelist 8 stated that adherence to ethical

guidelines also “encourages the supervisee's use of professional ethics as an integral part

of clinical decision-making.” “The ethical guidelines to practice as a clinician and to

educate and guide the supervisee within these parameters” was mentioned by Panelist 6

regarding the integral part of addressing ethical guidelines in the counseling realm. The

Association for Counselor Education and Supervision (ACES) (March 1993) as well as

Campbell (2000) emphasized the importance of ethical behavior in supervision as well as

monitoring ethical behavior in the counseling relationship.

Addressing safety concerns in supervision is yet another characteristic the panel

felt was a goal of the supervision process. This characteristic was interpreted as

exploring a client’s risk issues and implementing procedures to ensure the client’s safety.

Panelist 4 stated this is imperative particularly with regard to “assessing for risk issues as

well as substance abuse issues.” Panelist 5 mentioned it is critical to “assess for risk

issues and act upon those issues.” Ensuring the safety of the client is important, but the

panel members also addressed safety for the supervisee. Panelist 2 talked about the fact

that the experienced counselor could practice in an area which endangers their wellbeing,

stating that the need is to address “the safety of the supervisee, i.e., some are in

communities and schools that have safety concerns for the counselor themselves.”

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The ability to challenge the experienced counselor’s assumptions drew a lot of

comments from the panel. The researcher interpreted this characteristic as being able to

address presumptions regarding counseling philosophies. Panelist 1 mentioned that it

helps if the experienced counselor and the supervisor share the same model, though it is

not critical in order to conduct supervision. However, having the same model could still

result in challenging the experienced counselor regarding their interpretation of the

model. If the supervisor and the experienced counselor do not have the same philosophy

or model of how to deal with the issue, Panelist 8 stated that “possible clinical and

professional impasses due to difference in philosophy/approach could occur in the

supervision process.” Additionally, this panelist stated that there is a “degree of

responsibility for the supervisor’s decisions and ability/willingness/necessity to override

supervisee’s decisions,” particularly with regard to case conceptualization. Panelist 5

gave credit to the experienced counselor for having a great deal of clinical knowledge,

but stipulated “for the experienced counselor, they know things intellectually, but have

not yet made clinical thinking part of who they are.” Panelist 7 concurred, stating the

experienced counselor “may feel that they have mastered certain areas that still need

improvement.”

Challenging the experienced counselor results in providing the experienced counselor

with critical and corrective feedback which was discussed as a characteristic the

supervisee/experienced counselor should possess for effective supervision.

Another goal of the supervision process is a discussion of transference and

countertransference issues. This characteristic was interpreted by the researcher to mean

monitoring the experienced counselor to ensure they are addressing the client’s issues

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rather than their own personal issues during counseling. Panelist 6 stated “as a counselor

progresses, discussions move to more of an overview of the case, discussions about

dynamic and system issues and countertransference issues.” Within the supervision

process, the supervisor is called upon to examine the case presentations to bring forth

discussions of countertransference issues. Panelist 7 stated that a goal in supervision is to

have “the ability to look beyond the counselor’s report of their work with their clients and

catch any countertransference that may be impacting their clinical relationships.”

Panelist 5 also stated that transference and countertransference issues need to be

examined not only in the counseling relationship but also in the supervision relationship.

Campbell (2000) discussed that transference and countertransference issues can indicate

problems with supervisees in supervision as well as the supervisor having to explore this

concept with the supervisee in the counseling session with the client. Helping the

experienced counselor to discuss these issues will help enhance their skills.

Refining the skills of the experienced counselor was the next characteristic

discussed by the panel. The researcher interpreted this to mean the ability of the

supervision process to enhance the counseling skills of the supervisee. The supervision

of the experienced counselor does not have to be directive, provide technical assistance,

nurture passion for the work, provide crisis management, review basic counseling

techniques, help to develop their own style of counseling, or support the counselor’s

identity like the novice counselor, but rather is utilized as a means to address case

conceptualization. Panelist 2 stated “an experienced counselor will have an idea of case

progression and intervention strategies that are more sophisticated than the trainee. Areas

of clinical development will be greater with regard to diagnosing and assessing clients.”

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Panelist 8 stated that refining skills is “the ability to provide less technical expertise and

instruction and more eliciting the experienced counselor’s self-determination and self

directedness.” Unlike the novice, the experienced counselor is “refining skills and

becoming an expert.” Refining the counselor’s skills is the goal not only with novice

counselors, but also experienced counselors.

Some of the panelists mentioned that though the counselor is experienced it does

not necessarily mean that the counselor is proficient in all areas of counseling. Therefore,

the panel felt that supervision still needed to be tailored to meet the needs of the

experienced counselor. Tailoring supervision was interpreted as addressing the needs of

the supervisee based upon their professional experience level. Panelist 2 noted that the

experienced counselor could have “limited exposure to certain areas in their traineeship

and may actually be at a very beginning stage.” Panelist 8 further stated that there is a

need in supervision to allow “the ability to accurately assess the degree of professional

development of the experienced counselor” because the supervisor “cannot assume the

same degree of competency, skill implementation, critical thinking, ability to think on

one’s feet, intervention creativity, and attention to details.” Assessing for the

experienced counselor’s developmental level will help “to be receptive to working with

the supervisee’s style.” Campbell (2000) stated that it is not only the supervisee who

must be assessed for their developmental level, but that the supervisor needs assessment

as well.

The experienced counselor may have difficulty being treated as a “beginning

counselor” because of needing guidance in an area in which they are not proficient. This

could set up role conflict for the experienced counselor. Role conflict was interpreted as

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the ability to discuss and resolve any confusion which arises with regard to knowledge

and experience of both supervisor and supervisee. The experienced counselor is post-

licensed and practicing independently, but supervision may cause the counselor to feel

inadequate at times. This could cause conflict for the counselor and therefore conflict

within the supervision process. Panelist 2 stated “some experienced counselors also enter

supervision as if they are fully trained and don’t need case consultation.” Both the

supervisor and the experienced counselor have many demands within their roles and the

difficulty of fitting supervision into this schedule can contribute to more role conflict.

Panelist 4 stated, “there can be moments when both the supervisor and the supervisee

wonder whether the service is fully needed in the context of a challenging work schedule.

However, typically both see the overall value in that it is such a rewarding experience.”

The experienced counselor is able to talk in the counseling jargon and the discussions can

be more in-depth with an experienced counselor. Panelist 3 stated, “…remembering your

role as supervisor. It feels great to have experienced counselors to speak with about

cases…” The experienced counselor is then viewed as a colleague rather than a

supervisee. The panel agreed that the experienced counselor and the supervisor can both

experience role conflict within supervision. It is important to keep the relationship within

the boundaries of supervision. The relationship is considered an important and critical

element to perform effective supervision with the experienced counselor.

Characteristics of the Supervision Relationship

The panel discussed characteristics of the supervision relationship that are

considered a critical element of supervision. As discussed previously, the relationship

needs to foster trust and the participants need to be authentic, dependable, ethical,

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supportive, and respectful in the relationship, and the supervisor and the

supervisee/experienced counselor need to have an appreciation for the other’s opinions,

thoughts, and ideas. However, the panel discussed other characteristics of the

relationship that they deemed important or critical to the supervision relationship.

Supervision must enable growth for the experienced counselor. This

characteristic was interpreted as allowing the supervisee/experienced counselor the

opportunity for advancement and improvement in their counseling skills. The entire

panel agreed that growth is an essential component of the supervision relationship.

Panelist 5 stated that enabling growth is the “ability to teach so the counselor develops

professionally; capacity to allow the counselor to develop their own way of working; you

can help people get to the next level in their work.” So not unlike the novice counselor,

the panel felt it is important for the counselor to achieve growth and enhancement

through supervision.

Collaboration was the next characteristic reviewed by the panel. Eighty seven

and half percent agreed this was an important characteristic in the supervision

relationship. Twelve and a half percent did not agree this was a critical characteristic to

the supervision relationship. The researcher interpreted the characteristic as a concerted

effort by the supervisor and the supervisee/experienced counselor to work jointly on

issues with equal responsibility. The supervisor and the counselor should have a give and

take communication about issues, rather than a unidirectional conversation in which the

supervisor holds the only opinion that counts in the supervision relationship. Panelist 5

stated that the relationship is “the ability to make supervision more of collaboration and

less teaching/oversight/directives” when it comes to the interaction with the experienced

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counselor. In previous statements, this panelist alluded to the characteristic of

collaboration in the supervision process and that it was a necessary to have effective

supervision.

Another characteristic the panel agreed was important to the supervision

relationship was that of being open. The supervisor and counselor must be flexible and

non-judgmental toward one another in the supervision relationship. Again, only 87.5%

of the panel agreed this was a critical characteristic for the supervision relationship.

Twelve and half percent did not feel it was a critical part of the supervision relationship.

Panelist 8 discussed the openness of the supervision relationship as “the ability to remain

flexible in setting the supervision agenda and focus.” The relationship being open will

allow both the supervisor and the counselor to address what is important to them at that

moment rather than sticking to a rigid agenda. This will allow the opportunity for growth

for the counselor.

The final characteristics of the supervision relationship were that it must be

empowering, encouraging, and challenging for both the supervisor and the counselor.

Empowerment enables the counselor to make decisions about the counseling process.

Encouragement enables the supervisor and the counselor to strengthen their bond in the

supervision relationship. Being challenging, as discussed in the supervision process,

means that the supervisor and the counselor investigate assumptions of the supervisor and

the experienced counselor in supervision. Inclusion of the characteristics appeared to

allow the counselor to have autonomy in the supervision process. Panelist 5 stated that

supervision is the “capacity to allow the counselor to develop their own way of working.”

Panelist 4 discussed the ability to have challenge in the relationship, stating “be ready to

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be challenged, allow for questioning and experimentation. It is important for the

supervisor to be able to allow the supervisee to challenge the supervisor and to

experiment with new ideas.” This in turn will help the counselor to grow and enhance

their counseling skills and techniques.

As a final opportunity for the panel to include any characteristics that were not

mentioned in the previous rounds the researcher asked for input about comments made

during the initial and second round. The panel was requested to answer whether the

additional characteristics listed by various members should be included as a characteristic

for the critical elements of supervision. One of the additional characteristics listed was

the importance of the supervisor providing structure in supervision. Seventy five percent

of the panel felt this was critical while 25% did not. The panel was asked if the

supervision process needed to embrace diverse thinking and the panel was in total

agreement. The panel was also in 100% agreement with the characteristic that the

supervisor accepts different viewpoints and is tolerant of personality differences. Eighty

seven and a half percent of the panel stated it is not necessary for the experienced

counselor to implement suggestions made in supervision quickly. Therefore, they felt

this characteristic was not critical to effective supervision with the experienced counselor.

The panel concluded the critical elements of effective supervision with an experienced

counselor are the supervisor, the counselor, the supervision process, and the relationship.

Since four of the supervisors preferred the developmental model of supervision

and a fifth preferred a developmental type model, it would seem logical that the panel

would develop characteristics for the supervisor, supervisee, the supervision process, and

the supervision relationship. The developmental model places focus upon these areas of

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supervision. One of the panelists preferred a psychodynamic approach which coincides

with the developmental model regarding the supervisee. The task-centered approach

espoused by another panelist added to the focus of the supervision process.

Limitations of the Study

Due to the small sample of participants for the study, its generalizability across

various supervisor populations is limited. While the participants were from different

work areas of supervision, the panel only represented a very small portion of the

supervising population. If a larger sample were accessed the outcome may have been

different. The panel reported from their experiences and if there were more participants

more experiences could have contributed to the outcome. The Delphi study outcome is

reliant upon a representative panel of experts within the field of study. The researcher

was reliant upon the self-report of the participants, and while this researcher did not

doubt the credentials of the participants, the study was done electronically and the

researcher could not validate the backgrounds of the participants.

The researcher is a novice in conducting research studies, particularly the Delphi

study, and while many articles and books regarding the Delphi study were read and

reviewed by the researcher, there is still novice error to contend with in the study. The

researcher is also a novice in thematic analysis and though many resources were also

reviewed in this area, the study may have had a different outcome if the researcher were

more experienced in the technique. The interpretation of the data was based upon the

researcher’s perspective and background, and therefore biased towards the researcher’s

experiences of supervision and counseling even though the interpretations were also

reviewed by a colleague.

108

Future Research

The pilot study explored supervisors’ perspectives of the critical elements of

effective supervision with the experienced counselor. However this is their perspective

of the process. The process could be viewed very differently from the counselor

regarding the critical elements of conducting effective supervision. Therefore, it is

important to explore this area with the recipients of the supervision to see if the outcome

of the present study is confirmed or refuted.

According to Campbell’s (2000) model of effective supervision, diversity is an

important issue to deal with in supervision; however, the panel did not mention this as a

critical element of supervision. It is not clear if the panelists were from different cultural

dimensions whether the responses would have been different responses. While one of the

panelists did mention the phrase “diverse thinking,” the panelist was not referring

specifically to diversity issues within the supervision realm, nor giving attention to

diversity in the counseling process for the experienced counselor. It is possible that

supervisors assume that the experienced counselor is aware of exploring diversity issues;

however, the experienced counselor may not be proficient in addressing diversity issues

nor the supervisor. This area needs further exploration.

The current instruments to explore supervision are geared more towards the

supervision of the novice counselor rather than the experienced counselor. The

instruments do not include some of the characteristics addressed by the panel. Some of

the panelists mentioned assessment of the experienced counselor in order to determine

their familiarity with different theoretical approaches. An assessment tool that can

determine the developmental level of the counselor with regard to certain theoretical

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approaches and theoretical skills may be of help in pinpointing where to begin in the

supervision process.

Some of the panelists had more than one degree, held more than one professional

title, and worked in more than one setting. The question arises as to whether the panelists

found it necessary to have more than one degree in order to enhance their supervision

expertise. Research into whether more than one degree could help the supervisor to have

a broader perspective on supervision is another area which needs further exploration.

One of the last areas to explore in future research is the outcome of supervision

with experienced counselors. The benefits of supervision for the experienced counselor

have not been widely explored. Given the discussion about counselor burn-out and

continued education, supervision may be a way to help the experienced counselor to

remain vibrant within the profession. Supervision could also be a deterrent to

improprieties within the counseling profession. Is supervision a way to help deal with

ethical issues, so the counselor does not blur the lines in counseling services or

supervision services? Research has stated that the experienced counselor seeks out

supervision if not offered. This is an area which needs further exploration along with the

reasons that experienced counselors seek out supervision. The goal of the study was to

provide a starting point of exploration within this area of supervision since there scant

literature regarding this population. The critical elements needed to conduct effective

supervision with experienced counselors are an area that warrants further exploration.

110

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APPENDICES

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APPENDIX A

Electronic Invitation

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Experienced supervisors are being considered for participation as panelist on an

electronic three-round Delphi forum to explore the critical elements necessary to conduct

effective supervision with experienced counselors. Experienced counselors are

considered post-licensure and practicing independently for at least two years. The Delphi

forum will enable the expert panelists to name and prioritize critical elements they

believe necessary to effectively supervise experienced counselors based upon the group’s

consensus.

In order to be considered for participation on the panel the supervisor must meet

the following criteria:

The supervisor conducts supervision with experienced counselors. Again the

experienced counselor is post-licensure and is practicing independently for at least

two years.

The supervisor must conduct one-to-one supervision with the experienced

counselor.

The supervisor engages in both Clinical and Administrative Supervision.

The supervisor has received training in supervision whether through a formal

program or through continuing education classes specifically in the areas of

ethics, diversity issues, administrative supervision, and clinical supervision, an

understanding of the feedback process, supervision models, working alliance and

supervision style.

The supervisor is a licensed clinician who currently conducts direct client

services.

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The supervisor has conducted supervision with at least 2 different experienced

counselors. The greater the number of supervision events with experienced

counselors will improve chances for the supervisor to be considered a part of the

panel.

The supervisor has experience with supervising counselors-in-training, who are

pre-licensed.

Licensure, certification, accreditation or approval: Must be one of A to E:

A. National Certified Counselor

B. Licensed or Certified Mental Health Provider

C. Licensed or Certified Clinical Supervisor

D. Mental Health Related Educator

E. Mental Health Related Doctoral Candidate

Educational Training: Minimum of a master’s degree in a mental health field

Specialized Training: Must document either A or B

A. A graduate course in clinical supervision

B. A total of 30 contact hours of workshop training in clinical supervision

Mental Health Related Experience: Minimum of 3 years of post-master’s degree

experience in mental health services, with a minimum of 1,500 hrs direct service

with clients.

If you meet the above criteria, have access to a computer, can provide an email

address for contact, and would like to be considered for possible participation you are

asked to copy and paste the informed consent (listed below) with your name typed in

the blank provided in an email to this investigator. After review of the informed

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consent the researcher will provide a web link to the invited participants. Please

contact the investigator by email at [email protected]. Participants may

withdraw from the study at any time. If you have any questions regarding the

research or concerns regarding the investigator you may contact me by telephone at

630-670-3168 or the Dissertation Chairperson, Dr. Katherine Miley of Argosy

University- Schaumburg 999 Plaza Dr. Schaumburg, IL 60195, at

[email protected]. Thank you for your consideration.

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APPENDIX B

Informed Consent

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Informed Consent

I understand I am being asked to participate as a panelist for a research study to

investigate supervision practices with experienced counselors and I was selected as a

possible participant because I meet the criteria stipulated above for inclusion. The study

will be conducted using a Delphi Method with the purpose of this study being to explore

supervisors’ perception of critical elements for conducting supervision with experienced

counselors.

If I participate, I will be requested to complete a demographic form, in addition to

three rounds of query in the Delphi study. The investigator will send me a web link to a

secure website in which I will answer open-ended questions in the first round, rating of

responses from all participants in the second round, and a final review of the outcome and

any additional comments made by the participants in the third round. The risks

associated with this study are extremely marginal and if risk is present it is only in the

likelihood of my disagreement with the outcome of the study. The benefits of

participation are nominal.

I understand I will receive no monetary gains for participation in the study, that it

is anonymous, and will be accomplished by posting answers to a secure website. The

investigator will have an email address to contact me and will only be utilized for follow-

up during the study. The records of this study will be kept private. No identifiers linking

me to the study will be included in the published report. Research records will be stored

securely by the investigator and in addition the investigator will permanently delete any

electronic transmissions from participants in the investigator’s electronic environment.

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My decision, whether or not to participate, will not affect my current or future

relations with Argosy University. If I decide to participate, I am free to refuse to answer

any of the questions that may make me uncomfortable. I can withdraw at any time with

out my relations with the university, job, benefits, etc., being affected. I can contact

Alice Crawford at [email protected] and Dr. Katie Miley at

[email protected] with any questions about this study.

I understand that this research study has been reviewed and certified by the

Institutional Review Board, Argosy University–Schaumburg. For research-related

problems or questions regarding participants' rights, I can contact the Institutional

Review Board through the IRB Chair at Argosy University-Schaumburg 999 Plaza Dr.

Schaumburg, IL 60195.

I have read and understand the explanation provided to me. I have had all my

questions answered to my satisfaction, and I voluntarily agree to participate in this study.

I have been given a copy of this consent form. By signing this document, I consent to

participate in the study.

Signature: __________________________________ Date: __________________

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APPENDIX C

Study Description

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Study Description

The Delphi Method, which was first implemented in the 1960s by the Rand

Corporation, will be utilized to obtain supervisors’ opinions of the critical elements

necessary to conduct supervision with experienced counselors.

Experienced counselors are considered post-licensure and practicing

independently for at least 2 years. The Delphi study will consist of three rounds which

will enable the participants to list the critical elements believed to be necessary to

supervise experienced counselors and prioritize those elements based upon the group’s

consensus.

The first round questions will request a narrative of your supervision experiences

along with demographic questions. The second round will consist of a compilation of the

generated responses and a request to review and rate the responses based upon a 4 point

Likert Scale. The third round will consist of participants reviewing the outcome of their

ratings and an opportunity to add additional comments for any issues which may have

been overlooked. The researcher may also contact you by telephone for further

clarification of your additional comments.

Each round will have a three week period for participants to respond. The

researcher will send a reminder email a week before the ending of each round to request

responses if participants have not responded by that time. It is hoped the results of the

study will generate areas of discussion, study, and future research in the field of

Counselor Supervision. Thank you for your participation.

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APPENDIX D

Nominee Invitation

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I am contacting you because a colleague has nominated you as a possible panelist

on an electronic three-round Delphi forum to explore critical elements necessary to

conduct effective supervision with experienced counselors. Experienced counselors are

considered post-licensure and practicing independently for at least two years. The Delphi

forum will enable the expert panelists to name and prioritize critical elements they

believe necessary to effectively supervise experienced counselors based upon the group’s

consensus.

In order to be considered for participation on the panel the supervisor must meet

the following criteria:

The supervisor conducts supervision with experienced counselors. Again the

experienced counselor is post-licensure and is practicing independently for at least

two years.

The supervisor must conduct one-to-one supervision with the experienced

counselor.

The supervisor engages in both Clinical and Administrative Supervision.

The supervisor has received training in supervision whether through a formal

program or through continuing education classes specifically in the areas of

ethics, diversity issues, administrative supervision, and clinical supervision, an

understanding of the feedback process, supervision models, working alliance and

supervision style.

The supervisor is a licensed clinician who currently conducts direct client

services.

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The supervisor has conducted supervision with at least 2 different experienced

counselors. The greater the number of supervision events with experienced

counselors will improve chances for the supervisor to be considered a part of the

panel.

The supervisor has experience with supervising counselors-in-training, who are

pre-licensed.

Licensure, certification, accreditation or approval: Must be one of A to E:

A. National Certified Counselor

B. Licensed or Certified Mental Health Provider

C. Licensed or Certified Clinical Supervisor

D. Mental Health Related Educator

E. Mental Health Related Doctoral Candidate

Educational Training: Minimum of a master’s degree in a mental health field

Specialized Training: Must document either A or B

A. A graduate course in clinical supervision

B. A total of 30 contact hours of workshop training in clinical supervision

Mental Health Related Experience: Minimum of 3 years of post-master’s degree

experience in mental health services, with a minimum of 1,500 hrs direct service

with clients.

If you meet the above criteria, have access to a computer, can provide an email

address for contact, and would like to be considered for possible participation you are

asked to copy and paste the informed consent (listed below) with your name typed in

the blank provided in an email to this investigator. After review of the informed

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consent the researcher will provide a web link will to the invited participants. Please

contact the investigator by email at [email protected]. Participants may

withdraw from the study at any time. If you have any questions regarding the research

or concerns regarding the investigator you may contact me by telephone at 630-670-

3168 or the Dissertation Chairperson, Dr. Katherine Miley of Argosy University-

Schaumburg 999 Plaza Dr. Schaumburg, IL 60195 at [email protected].

Thank you for your consideration.

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APPENDIX E

Round One Questionnaire and Demographics

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Round One Questionnaire:

1) An experienced counselor is considered a counselor who is post-licensure and has

practiced independently for at least two years. Reflecting on your supervision

experiences, what do you consider to be the most critical elements necessary to conduct

supervision with an experienced counselor?

2) A novice counselor is considered a counselor who is pre-licensure and practicing

under supervision. Reflecting on your supervision experiences, what do you consider to

be the most critical elements necessary to conduct supervision with a novice counselor?

3) What do you consider to be the major differences in conducting supervision with an

experienced counselor as opposed to a novice counselor?

4) What are the major benefits of supervising an experienced counselor? What are the

major drawbacks of supervising an experienced counselor?

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Demographic Information

1) Highest education degree

2) Professional position

3) Work setting (i.e., agency, EAP, Hospital, School, etc.)

4) Supervision theoretical Approach

5) Length of time in the counseling field

6) Length of time conducting supervision

7) Length of time conducting supervision with experienced counselors

8) Number of counselors supervised in a typical caseload

9) Ratio of experienced counselors supervised compared to novice counselors supervised in a typical caseload

10) Type of supervision training received (i.e., formal program or CEUs)

11) Frequency of conducting supervision (i.e., daily, weekly, monthly)

12) Average length of supervision sessions

13) Gender

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APPENDIX F

Application for IRB Review and Certification of Compliance

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Application for IRB Review and Certification of Compliance:Expedited Application Form Checklist

Expedited Review (Level 2) Application, Moderate Risk

(Review by the designated IRB member or the IRB Chair).

Application Form Checklist

To the Principal Investigator of a research project:

1. Please review the documents listed below that pertain to your research project. In the event that your project does require the use of any of the listed documents, attach a copy of that document to the application submitted for IRB review.

2. Please be advised that research projects involving interaction with human participants must have an Informed Consent Form(s) attached. If a minor or incapacitated individual of any age is involved, parent/guardian permission must be included.

3. Parental permission does not negate the child’s right to chose to not participate.

4. If you are conducting a research project in another institution (e.g., a hospital or school), you must attach a signed permission letter from a supervisor/administrator who is in a position to grant you permission to conduct the research at that site. The letter must be on institutional letterhead and must have an original signature.

5. If that institution also has a Human Subjects Review Committee--often referred to as the Institutional Review Board (IRB)-- then written permission from the participating institution’s IRB must be attached to your IRB application.

6. If you are conducting the research outside of the United States, attach a letter of assurance that where the research is being conducted.

Please check: The attached Application for Certification of Compliance contains

Institutional Permission Letter (where research is taking place)

Assurance of Adherence to Governmental Regulations concerning Human Subjects (if research project is conducted outside the US)Letter(s) of Informed Consent

Parent/guardian Permission Letter (must have provision for written signature)

Oral statement of Assurance (used with minors)

Data-gathering instruments(s): Observation, Interview, Survey

Conflict of Interest Disclosure Statement

Also required on your application:

CRP or Dissertation Chairperson/Research Supervisor’s signature

Principal Investigator’s signature (2 places)

Packet reviewed by CRP or Dissertation Chairperson/Research Supervisor Initials ______

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Application for IRB Review and Certification of ComplianceExpedited Cover Sheet

IRB# ________

Date Logged: _______

Expedited Review (Level 2) Application, Moderate Risk

(Review by one or more IRB Members—May lead to Full IRB Review)

Principal Investigator/Researcher’s Name: Alice H CrawfordStudent ID Number: 00047452

Type of Research Project (CRP, Dissertation, describe other) Dissertation

Title of Research Project: Critical Elements of Supervision with Experienced Counselors-A Delphi Study

Principal Investigator/Researcher’s Address: 832 McCormick Lane West Chicago, IL 60185

Telephone Number: 630-670-3168

Dissertation Committee Chair’s Name: Dr. Katherine Miley

College: BUS PBS EDUC

HS OTHER

Program of Study: Counseling Psychology Degree Ed. D.

Project Proposed Start Date: December 1, 2009 Project Proposed Completion Date: May 1, 2009

Signature of Principal Investigator/Researcher __________________________/_______ Date

Signature of Dissertation Committee Chair: ____________________________________________________/_____________

Date

IRB Certification Signatures:

__________________________________________________________/_____________ Date

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The above named research project is certified for compliance with Argosy University’s requirements for the protection of human research participants with the following conditions:

1. Research must be conducted according to the research project that was certified by the IRB.

2. Any changes to the research project, such as procedures, consent or assent forms, addition of participants, or study design must be reported to and certified by the IRB.

3. Any adverse events or reactions must be reported to the IRB immediately.

4. The research project is certified for the specific time period noted in this application; any collection of data from human participants after this time period is in violation of IRB policy.

5. When the study is complete, the investigator must complete a Completion of Research form.

6. Any future correspondence should be through the principal investigator’s research supervisor and include the assigned IRB research project number and the project title.

**************************************************************************************************

NOTES: Please complete this cover and the Petition in detail. Every question must be

answered. Please type your answers. Attach the appropriate documents and submit the entire application materials

under the cover of a completed Application Checklist to the CRP or Dissertation Chairperson.

Do not proceed with any research work with participants until IRB Certification is obtained.

If any change occurs in the procedure, sample size, research focus, or other element of the project impacts participants, the IRB must be notified in writing with the appropriate form (see ancillary forms).

Please allow 30 days for processing.

DO NOT COLLECT DATA PRIOR TO RECEIVING IRB CERTIFICATION

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Application for IRB Certification of ComplianceExpedited Application

Expedited Review (Level 2) Application, Moderate Risk

(Review by one or more IRB Members—

May lead to Full Review)

Research with minors, prisoners, mentally/emotionally/physically challenged persons, pregnant women, fetuses, in vitro fertilization, and/or individual or group studies where the investigator manipulates the participants/ behavior or the subject is exposed to stressful or invasive experiences do(es) not qualify for Expedited status.

Please completely answer the requested information (NA is not acceptable for any question). Begin typing in the gray boxes.

1. Purpose of the Study:The investigator is interested in what Counselors Supervisors deem the critical elements of conducting Counselor Supervision with an Experienced Counselor. An Experienced Counselor is considered post-licensure and practicing independently for at least 2 years.

2. Summary of the Study. Methodology (Be Specific--attach extra page if needed).The project is going to approach the West Virginia Board of Examiners Approved Certified Supervisors. In addition this researcher is requesting to invite members of the following Linked In Groups to participate in the research project:

American Counseling AssociationIllinois Mental Health Professionals

Psychologist, Psychotherapist and CounselorsUnited States Mental Health Professionals

The researcher currently subscribes to the aforementioned groups purely as a member and does not gain any monetary or professional assets as a part of the groups. The groups are made up of mental health professionals and a description of the groups is as follow:

American Counseling Association Linked-In GroupThis is a group for User Experience Design professionals to expand our network of people and ideas (1,271 members)

Illinois Mental Health Professionals Linked-In Group

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To improve collaboration amongst counselors, licensed clinical professional counselors(LCPC), licensed professional counselors(LPC),(LMFT),licensed clinical social workers(LCSW), psychologists(PhD.&Psy.D., PsyD), in/near Illinois (counselor, counseling, therapist, social worker, psychologist) (291 members)

Psychologist, Psychotherapist and Counselors Linked-In GroupThis community of psychologists, psychotherapists, and counselors aims to create a network of professionals, facilitating job opportunities and knowledge sharing (psychologist, psychology, psychotherapist, psychotherapy, counseling, counselor, coach, coaching, mentor, mentoring, LCSW, LICSW, PhD, Psy.D, PsyD) (3,914 members)

United States Mental Health Professionals Linked-In GroupTo improve collaboration amongst marriage & family therapists (MFT), LCSW, psychologists (PhD &Psy.D., PsyD), & psychiatrists in the US (therapist, therapy, psychotherapy, psychotherapists, psychotherapist, psychologist, psychology, psychiatrist, psychiatry, social worker, counselor, counseling) (3,716 members)

I am requesting participation of Counselor Supervisors who meet the following criteria: The supervisor conducts supervision with experienced counselors. Again the

experienced counselor is post-licensure and is practicing independently.

The supervisor conducts one-to-one supervision. While the other modalities of supervision, such as group and peer are discussed in the field of supervision, the current study is only interested in the one-to-one supervision modality.

The supervisor engages in both Clinical and Administrative Supervision.

The supervisor has received training in supervision whether through a formal program or through continuing education classes.

The supervisor has received training in the areas as they pertain to supervision, which include ethics, diversity issues, administrative supervision, and clinical supervision, an understanding of the feedback process, supervision models, working alliance and supervision style.

The supervisor is a licensed clinician who conducts direct client services. This criterion is included in order for the supervisor to possess some understanding of the demands upon the experienced counselor.

The supervisor has conducted supervision with at least 2 different experienced counselors. This criterion is included in order to possess some contrast in individual demands of supervisees. The greater the number of supervision events with experienced counselors will improve chances for the supervisor to be considered a part of the panel.

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The supervisor has experience with supervising counselors-in-training, who are pre-licensed. This criterion is included because the supervisor is expected to give a contrasting understanding, if any, of the supervision of an experienced counselor.

The supervisor is to at least meet the accreditation of the Center for Credentialing and Education of a clinical supervisor with the exception of criteria 6, which is deemed unnecessary for this research.

6. Licensure, certification, accreditation or approval: Must be one of A to E:A. National Certified Counselor B. Licensed or Certified Mental Health ProviderC. Licensed or Certified Clinical Supervisor D. Mental Health Related Educator E. Mental Health Related Doctoral Candidate

7. Educational Training: Minimum of a master’s degree in a mental health field 8. Specialized Training: Must document either A or B

A. A graduate course in clinical supervision, Or B. A total of 30 contact hours of workshop training in clinical supervision

9. Mental Health Related Experience: Minimum of 3 years of post-master’s degree experience in mental health services, with a minimum of 1,500 hrs direct service with clients.

10. Supervision Experience: Must have provided a minimum of 100 hr. of clinical supervision of mental health services with supervisees OR an endorsement from a mental health professional attesting to the applicant's supervisory activity.

11. Self-Assessment and Professional Disclosure: Submit a Professional Disclosure statement which assesses the understanding of multiple responsibilities of clinical supervision. The invitations will be sent in small groupings of recipients so as to avoid the

possible security controls each participant may have on their electronic environment, resulting in the email solicitation being sequestered as “spam”. Spam is considered unsolicited advertisement sent electronically. Many email filters can be built into email servers, email software, antivirus software or internet service providers to protect the recipient from unwanted emails.

The initial email will invite participation in the study along with the informed consent consisting of the purpose for the research, the risk and benefits of the research, the voluntary nature of research participation, the participant’s right to stop the research at any time and the procedures used to protect confidentiality in addition the email will describe how the study will be conducted and include instructions in the email explaining to send a reply email to the researcher, which includes a “cut and paste” of the informed consent with their name placed in the agreement, along with an email address to contact the participant during the study. Participants must respond by a deadline date.

The invitee will be informed if they are willing to participate the researcher will send a link to the website of the study in a later email. In addition the email will state, the study meets approval of the Institution Review Board, direct contact information for the researcher, and direct contact information for the dissertation chairperson (See Appendix

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A). If participants do not have an email address listed for initial contact, a printed invitation will be sent to the ALPS and ACS by the researcher using United States Postal Service. The invitation will include all elements mentioned in the electronic invitation. The participants will be notified the study is to be conducted electronically and ask if they have access to a computer and an email address in order to participate. The researcher will include an email address for the researcher so invitees can send this information.

Once volunteers for the panel are obtained, the researcher will send the information regarding the procedures for the study, the schedule of the rounds of questions and the link to the study website (See Appendix B). As stated above, should the researcher not receive enough responses from participants solicited, the request will be made of participants to nominate other supervisors who may not be listed with the Center of Credentialing and Education or West Virginia Board of Examiners but meet the criteria of inclusion. The researcher will send nominees a secondary email or hardcopy of the email invite stating they were nominated by a colleague, who felt the supervisor meets the researcher’s criteria for inclusion and ask their consent for participation along with the same information included in the initial participants’ invite (See Appendix C). The nominee will be requested to electronically reply as the initial participants. Once the returned emails and envelopes are received from the participants, all informed consents will be printed or reviewed and will be kept by the researcher in order to protect the confidentiality of all participants’ identity. The emails will then be permanently deleted from the researcher’s electronic environment.First Round

Participants will be asked to complete a demographic information questionnaire along with the initial open-ended questions (See Appendix D). Participants will be requested to complete the task within a three week period. Once the information is collected the researcher will compile and analyze the responses by qualitative means. The results will then be constructed as a survey for the second round. The participants will be given 3 weeks to respond to the initial questionnaire and as the participants respond the researcher will compare against a master list of participants who agreed to be in the study to tally the response rate. After two weeks of the initial round opening, a reminder email will be sent to participants who have not responded. After three weeks an email announcing the website will be closed will be sent by the researcher. The themes which emerge from round one will then be placed in survey formSecond Round

The participants will be sent an email stating the second round has begun. The participants will be given three weeks, again, to review and rate the themes based upon a 4 point Likert scale ranging from 1-Critically important, 2-Important, 3-Unimportant and 4-Definetly unimportant. The researcher has chosen an even-numbered Likert scale in order to avoid neutral responses. The researcher wants to avoid a neutral response in order to make the participants really think about the elements presented and choose which are critical. A space will also be provided in which the participants may add any additional comments forgotten during the first round. The researcher will compare the respondents to the master list of participants and will send reminder emails to participants who have not responded a week before the ending of the second round. The researcher will close the survey after three weeks.

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Third RoundThe results of the ratings will then be published for the participants to review and

a request will be made if the participants are in agreement with the outcome. If participants are not in agreement a comment line will be provided for any last minute comments about the results. The researcher will follow up with the participant regarding any additional comments by telephone.

3. Subject/participant Demographics:

a. Anticipated Sample Size: 20

b. Special Ethnic Groups (describe): Requesting Diverse Population of Participants

c. Institutionalized Y N Protected Group (describe): No

d. Age group: 18 years and above

e. General State of Health: Participants possess general good health

f. Other details to describe sample group. Counselor Supervisors either accredited or approved certification as a Counselor Supervisor

4. Will deception be used in the study? Y N (please describe) No

5. Will audio or videotapes be used in the study? Y N (please explain) No

6. Confidentiality protection issues (pertains to audio and video as well as written documents.)

a. What precautions will be taken to insure the privacy and anonymity of the participants? (i.e. closed doors, private rooms, handling of materials where participant’s identify could be discovered, etc.). Participants will be able to complete the inquiry on a specifically specified website, which is only accessed by a website link provided by the investigator. The investigator requests email addresses of participants merely for follow-up. Once

147

follow-up is completed the email addresses will be permanently deleted from the investigators electronic environment.

b. What specific precautions will be taken to safeguard and protect subject’s confidentiality while handling the data (audio/video/paper) both in researcher’s possession and in reporting the findings? (i.e. coding, removal of identifying data) Participants will respond to an on-line environment. The on-line environment is secured by individual usage to access the electronic surveys. The on-line environment utilized will be Survey Monkey, which is a highly utilized and dependable research tool.

c. Describe procedures where confidentiality may be broken by law (e.g., child abuse, suicidal intent). Participants are addressing professional relationships and not involved in any area in which confidentiality has to be broken by law.

7. Review by institutions outside of Argosy University/XX Y N (Attach copies of permission letters, IRB certifications, and any other relevant documents). Application to Center for Credentialing and Education requesting permission to access the database of Accredited Counselor Supervisors (see attached)

8. Informed Consent and Assent (Attach copies of all relevant forms). If consent is not necessary (e.g., anonymous interview), describe how you will inform all participants of the elements of consent (see instructions). See attached

9. If written or oral informed consent is required, describe the manner in which consent and/or assent was obtained for each category).

(a) Adult Participants (18 years and older – written consent required). Participants will copy and paste an electronic copy of the informed consent with participants’ name typed in blank which stipulates the participant is in agreement with participation in the study. The informed consent is to be sent to the investigator by email or Postal Service to demonstrate agreement.

(b) Child Participants (under 18 – parent/guardian permission and participant assent required). There are no child participants in the study

a. Institutionalized participants (parent/guardian/conservator permission with appropriate participant assent). There are no Institutionalized participants in the study

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10. Describe any possible physical, psychological, social, legal, economic or other risks to participants (Attach another page if needed).

a. Describe the precautions taken to minimize risk to participants. The investigator will ensure there is no risk to participants, as the participants will only be asked their opinions to open-ended questions and rating their responses to the questions.

b. Describe procedures implemented for correcting harm caused by participating in the study (e.g., follow up calls, referral to appropriate agencies). The investigator will publish contact information for should participants have any questions regarding the study and if any participant feels the study has caused harm the investigator will do follow-up calls to the participant affected to make appropriate referrals to any resources necessary to address the issues.

11. Potential benefit of the study:

a. Assess the potential benefit(s) of the study for the participants: The study is constructed such there are moo individual benefits for participation.

b. Assess the potential benefits(s) to the professional audience in the study: The results of the study will eliminate areas of Counselor Supervision which have limited exploration and therefore promote healthy discussion of the subject matter.

As the principal investigator, I attest that all of the information on this form is accurate, and that every effort has been made to provide the reviewers with complete information related to the nature and procedures to be followed in the research project. Additional forms will be immediately filed with the IRB to report any change in participant(s), selection process, principal investigator, or faculty dissertation chair, as well as notification of any adverse incidents and final completion date of project. I also attest to treat human participants ethically and in compliance with all applicable state and federal rules and regulations that apply to this study, particularly as they apply to research work conducted in countries other than the United States.

Signature Principal Investigator Date

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Signature of Research Supervisor/Committee Chair Date

Attach any other forms, tests, institutional permission slips, etc., relative to this study. Failure to do so will result in delayed processing of the certification form.

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Conflict of Interest (Disclosure) Statement

To the Institutional Review Board:

I have reviewed the EDMC Code of Business Ethics and Conduct Statement found in SECTION 5.0 of the Argosy University Intuitional Review Board Handbook and wish to disclose the following potential conflict of interest related to my research study:

________________________________________________________________________

________________________________________________________________________

___________________________________________________________

or

I have reviewed the EDMC Code of Business Ethics and Conduct Statement found in SECTION 5.0 of the Argosy University Intuitional Review Board Handbook and state that I have no potential conflicting interests that might influence or be perceived to influence how I professionally conduct my research study.

Signed and Dated (under printed name).

Alice Crawford Date

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APPENDIX G

Round One Response

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Round One Response

Responses to question one

Panelist 1 The supervisee should have had post grad training in a focused area – it

helps is the supervisor and supervisee share the same model, but not

crucial.

Panelist 2 The ability to have a theoretical knowledge base that is broad enough to

support many different areas of learning.

The ability to have strong boundaries and to have the ability to provide

input and feedback to the supervisee to assure that the case is progressing.

Panelist 3 1 A clear understanding of the boundaries, expectations and roles of the

supervisor and counselor

2 Mutual trust and respect

3 A willingness to collaborate.

Panelist 4 I believe it is critical for the supervisor to be available and intentional

about supervision, to be receptive to working with the supervisee's style,

and to be able to provide both supportive and challenging feedback at

well-timed moments in supervision.

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I also believe the supervisee's openness, ability to initiate and collaborate,

and values regarding high standards of client care are critical.

Panelist 5 Critical elements are:

capacity to put oneself in the place of the counselor

ability to assess and act upon risk

ability to teach so the counselor develops professionally

ability to hold the best interest of the client

capacity to allow the counselor to develop their own way of working

Panelist 6 The most critical elements necessary to conduct effective supervision is

training in supervision and a clear understanding of what is expected,

required and the ethical guidelines to practice as a clinician and to educate

and guide the supervisee within these parameters.

Panelist 7 1 The ability to look beyond the counselor's report of their work with their

clients and catch any countertransference that may be impacting their

clinical relationships

2 A personal comfort and sense of competence, knowledge of a variety of

theories and methods, and a personality that means that experienced

counselors respect your opinion

3 A supportive environment to enable clinicians to do their best work

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4 Ongoing training and updates on research and effective methodologies

Panelist 8 1 The ability to accurately assess the degree of professional development

of the experienced counselor

2 The ability to engage an experienced counselor in tailoring supervision

of his/her self-identified professional goals and areas of interest.

3 The ability to remain flexible in setting the supervision agenda and

focus.

4 The ability to allow for the experienced counselor to advance beyond the

supervisor's expertise.

5 The ability to treat the experienced counselor as a colleague.

6 The ability to make supervision more of a collaboration, and less

teaching/oversight/directives.

7 The ability to provide less technical expertise and instruction, and more

eliciting the experienced counselor's self-determination and self-

directedness.

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Responses to question 2

Panelist 1 Similar to question above the supervisee should have had post grad

training in a focused area – it helps is the supervisor and supervisee share

the same model, but not crucial. Novice could sit in on others’ sessions

and/or video tape their own sessions for best practice.

Panelist 2 The ability to assess strengths and areas for growth for the trainee to

assure that learning is tailored to the trainee's needs

Making sure that client's are matched to an area where the trainee will feel

confident while still working on growing edges.

The ability to provide support and guidance to the trainee during this

initiatory phase of their development as a therapist

Panelist 3 1 Clear understanding of the boundaries, expectations and roles of the

supervisor and counselor

2 Structure for the counselor

3 Education

4 Freedom for the counselor to process countertransference and fears

Panelist 4 I think it is critical for the supervisor to be aware of when supervisees

need concrete direction and when they need time to find their own way. I

think it is very important for supervisors to be able to give lots of

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encouragement and when needed to provide corrective feedback. Early on

in supervision, it is even more important to be sure to cover safety and

ethical issues, workplace concerns, supervisee professional development,

diagnosis, documentation, and to be a stable connection for the supervisee.

As the supervisee develops his or her style, it is important for the

supervisor to be able to allow the supervisee to challenge the supervisor

and to experiment with new ideas. Later in supervision, the efforts become

more collaborative and there is greater emphasis on abstract thinking

including transference and countertransference concerns.

Panelist 5 teaching basic principles of treatment

letting them talk about the case and helping them to think though the

meaning of the material

supporting their sense of themselves professionally

Panelist 6 An open and trusting relationship with the supervisor, ability to self reflect

and observe- with the supervisee, and a clear understanding of boundaries

within relationships.

Panelist 7 1 Patience

2 Ability to review basic counseling techniques and assist new counselors

in developing their own style and theories of change

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3 Knowledge of the levels of counselor development and ability to utilize

to assess counselor level and guide to greater levels of competence

Panelist 8 1 The ability to accurately assess the novice counselor's development

level.

2 The ability to be directive when needed.

3 The ability to teach and instruct, and to provide technical

assistance/expertise.

4 The ability to nurture passion for the work.

5 The ability to effectively and appropriately role model.

6 The ability to be patient as the novice counselor learns.

7 The ability to be available outside of formal supervision appointments

for questions, brainstorming, checking in, and crisis management.

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Responses to question 3

Panelist 1 Truthfully I have found there are “novices” that have the post grad training

who outshine the experiences counselors without the post grad training.

Panelist 2 An experienced counselor will have an idea of case progression and

intervention strategies that are more sophisticated than the trainee.

Areas of clinical development will be greater with regard to diagnosing

and assessing clients.

Panelist 3 The relationship between novice and supervisor is more "teacher/pupil",

whereas the supervisor/experienced counselor relationship is more

collegial.

With a novice there is a more tangible focus on practical issues, theoretical

issues, legal issues.

An experienced counselor has had prior supervision and is intuitively

more aware of what they might need from their supervisor.

More "hand holding" with a novice

Panelist 4 I answered this in # 2.

For the novice counselor, provide direction, structure, and lots of support.

For the counselor who has been in supervision for a moderate amount of

time, be ready t be challenged, allow for questioning and experimentation.

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For the experienced counselor, support discussion of abstract concepts,

meaning in one's professional development, transference and

countertransference.

Panelist 5 for the novice, you are teaching them things they do not already know, or

know solidly.

for the experienced counselor, they know things intellectually, but have

not yet made clinical thinking part of who they are. The knowledge is

assumed and referred to, but as something they already know about.

Panelist 6 With a very novice counselor, there is more need to review counseling

theory and methodologies, how the counselor is conceptualizing the case,

and hearing more detail about sessions and interactions. As a counselor

progresses, discussions more to more of an overview of the case,

discussions about dynamic and system issues, and countertransference

issues.

Panelist 7 Experienced counselors are able to integrate more quickly and are more

open to bringing issues to supervision, a novice counselor often has this

feeling of needing to prove themselves and aren't as open to sharing their

insecurities, vulnerabilities or transference issues.

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Panelist 8 1 Cannot assume the same degrees of competency, confidence, skill

implementation, critical thinking, ability to think on one's feet,

intervention creativity, attention to details.

2 The role of a supervisor is significantly different between the two,

coaching vs. teaching, collaboration vs. direction, developing therapy

skills vs. refining existing skills, emphasis on becoming a therapist vs.

becoming an expert.

3 Degree of responsibility for the supervisee's decisions, and

ability/willingness/necessity to override the supervisee's decisions

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Responses to question 4

Panelist 1 Benefits are that they GET IT more quickly without the need for repeating

oneself. Drawbacks are the know-it-all attitude that sometimes pervades,

or they are stuck in a certain modality and have difficult time adapting to

new ideas.

Panelist 2 Benefits are that the experienced counselor will have a working

knowledge of what it's like to be with clients, where to potentially start

with a client and how to build rapport.

Drawbacks may be that the counselor had limited exposure to certain areas

in their traineeship and may actually be at a very beginning stage.

Some experienced counselors also enter supervision as if they are fully

trained and don't need case consultation.

Panelist 3 Supervising experienced counselors allows the supervisor to work on a

deeper level with the counselor; to look at nuance, to be freer in the

direction they go with their work.

A drawback might be remembering your role as the supervisor. It feels

great to have experienced counselors to speak with about cases and if the

boundaries aren't clear it could become merely peer supervision.

Panelist 4 The major benefits of supervising an experienced counselor are the more

mutual collaboration, the exchange of exciting ideas, and the discussion of

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transference and countertransference. One downfall to supervising an

experienced counselor is that there can be moments when both the

supervisor and supervisee wonder whether the service is fully needed in

the context of a challenging work schedule. However, typically both see

the overall value in that it is such a rewarding experience.

Panelist 5 benefits are that you have the opportunity to put your own knowledge into

words and see how much you know.

you can help people get to the next level in their work

potential drawback is that they think they know things, which they do, but

have not yet made it a part of who they are.

Panelist 6 Major benefits include being able to discuss cases at a deeper clinical level

and a greater trust for the clinicians abilities in handling a variety of

situations. Major drawbacks include the possibility of overlooking a major

issue due to trusting the clinician more, a greater tendency for clinicians to

become "set" in their style and methods, and some experienced counselor's

struggle with supervision, especially if from a less experienced counselor.

Panelist 7 Benefits- quicker integration and understanding of concepts- a thirst for

understanding of self and patient relationships

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Drawbacks- may feel that they have mastered certain areas that still need

improvement, not as open to feedback

Panelist 8 Benefits: more intellectual and professional challenge, more personal

challenge to set aside one's expertise, ability to learn more from an

experienced counselor, less responsibility and more collaboration.

Drawbacks: at times can become more administrative than clinical,

possible clinical and professional impasses due to differences in

philosophy/approach

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APPENDIX H

Additional Comments Round 2

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Additional Comments Round 2

Round 2

Additional comments Supervisor Characteristics

Panelist 1 1 Be comfortable with discomfort (be able to handle intense moments and

differences in supervision)

2.Understand personality differences (i.e. supervisor is extroverted vs.

introverted supervisee)

Panelist 4 ability to provide structure

ability to accept diverse thinking

Additional comments Supervisee Characteristics

Panelist 4 follows up immediately with recommendations regarding safety and

ethical issues

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APPENDIX I

Additional Comments Round 3

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Additional Comments Round 3

Additional comments on Supervisor Characteristics

Promotes Trust

Panelist 5 Your definition seems to be about confidence, but trust is interpersonal,

about the supervisor's concern for supervisee and trustworthiness as well.

Credible

Panelist 5 Although there should be room for differing opinions or points of view

Comfortable in Supervisor Role

Panelist 5 Yes, but the ones above are more important. You have to become a new

supervisor at some point, and you would not be fully comfortable at that

point.

Competent

Panelist 5 Yes, but as above, newer supervisors would differ from seasoned ones.

Supportive

Panelist 8 I would add that "Supportive" also includes the supervisor's ability to

encourage the supervisee's ability to make sound clinical decisions.

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Additional comments on Supervisee Characteristics

Self-Reflective

Panelist 2 More than just with behaviors; self-reflective should include, by

definition, how one is affected on a cognitive, affective and somatic level.

Corrective Feedback

Panelist 5 But it would be expected that there are obstacles/resistance as well, to be

understood in the supervision.

Yes, but this may be a lot to expect for newer supervisees. Another quality

to develop over time

High Standards Client Care

Panelist 7 The Supervisee is invested and values the importance of high standards of

client care. Knowledge and use of best practices can be taught.

Additional comments on Supervision Process

Protect the client

Panelist 5 Although the supervisee really is the primary focus of supervision, and the

supervisor develops the supervisee's capacity to put client first.

Setting Boundaries

Panelist 4 This also includes boundaries regarding protecting one's time and the level

of self-disclosure each person is expected to provide

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Panelist 8 More that the formal supervision structure role models interpersonal limits

and respect, to be reflected in the counseling provided by the supervisee

Panelist 7 I would not focus so much on formal structure in this arena, but more on

the roles of supervisor and supervisee demonstrating appropriate

boundaries.

Adherence to Ethical Issues

Panelist 8 I would add that this encourages the supervisee's use of professional ethics

as an integral part of clinical decision-making.

Addressing Safety Concerns

Panelist 2 And also with the safety of the supervisee, i.e., some are in communities

and schools that have safety concerns for the counselor themselves

Panelist 4 Especially related to suicide, homicide, self-harm behavior, substance

Tailoring Supervision

Panelist 5 Also, transference and ct would also arise in the supervision itself, not just

the treatment with the patient.

Additional Comments on Supervision Relationship Characteristics

Empower

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Panelist 2 Or to encourage supervisee to think of 'next steps' or interventions in the

counseling process

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