Clinical Supervision of Counselors-in-Training: A Nationwide Survey of Ideal Delivery, Goals, and Theoretical Influences

m a supervision

C I i n ical Supervision of Counselors-i n-Traini ng :

A Nationwide Survey of Ideal Delivery, Goals,

and Theoretical Influences

BRENDA FREEMAN SHERENE MCHENRY

The study reports opinions of counselor educators regarding the ideal delivery, goals, and methods of clinical supervision, and the supervision models and theories influencing practice.

The last decade has experienced a marked increase in attention to research on goals, functions, and methods in clinical supervision, evidenced by research such as the work of Borders (1986, 1989a, 1989b) and Borders and Leddick (1987, 1988). Related specifically to methods of delivery is the research on effective use of live supervision (Bubenzer, Mahrle, &West, 1987: Bubenzer, West, & Gold, 1991; Costa, 1994: Kaplan, 1987; Neukrug, 1991), self-report conference (Bigs, 1988). the advantages of videotaping (Broder & Sloman, 1982; Ward, Kagan, & Krathwohl, 19721, and the use of counseling laboratories (Myers & Smith, 1995). Litera- ture and research on the goals and functions of supervision includes the work of Bernard ( 19791, Bernard and Goodyear ( 1992),

Brenda Freeman is an assistant professor in the Educational Psychology and Coun- seling Program at the University of Wyoming, Laramie, and Sherene McHenry is an assistant professor in the Counseling and Special Education Department at the Central Michigan University, Mt. Pleasant, Michigan. Correspondence regarding this article should be sent to Brenda Freeman, Educational Psychology and Coun- seling, PO. Box 3374, University of Wyoming, Lararnie, WY 82071.

144 COUNSELOR EDUCATION AND SUPERVISION / DECEMBER 1996 / VOL. 36

Borders and Usher (19921, Bradley (19891, Hart (1982), Hess (19801, and Holloway (1984). In the 1980s there was a surge of interest in models of clinical supervision, particularly developmental approaches. Kell and Mueller (1966) and Boyd (1978) were at one time among the few authors of clinical supervision models or theories. Most early theoretical models of clinical supervision were embedded within the major schools of counseling theory. Examples of psychotherapy-based approaches to supervision include the work of Eckstein and Wallerstein (1959) who defined the stages of the supervision process from a dynamic theory perspective, and Truax and Carkhuff (1967) who advocated an experiential and didactic training approach to clinical supervision based on facilitating the growth of the counselor in a manner that empha- sized Rogerian therapeutic conditions. The 1980s have seen the emergence of at least 16 (Hardy, 1989) nonpsychotherapy based, developmental conceptualizations of clinical supervision, such as Littrell, Lee-Borden, and Loren, (1979), Loganbill, Hardy, and Delworth (1982), Stoltenberg (1981), and Stoltenberg and Delworth (1987). Bernard’s (1979) atheoretical Discrimination Model has also received considerable attention.

In addition to increased attention in research, the delivery of clinical supervision is central to the standards of the Council for Ac- creditation of Counseling and Related Educational Programs (CACREP, 1994). CACREP standards require 1 hour per week of individual clinical supervision and 1 Yi hours per week of group supervision.

Although the field of clinical supervision is still evolving, the criti- cism that clinical supervision literature is sketchy is much less valid today than it was a decade ago. One might wonder how the field has been affected by the research and models? I s there a consensus today about the amount, goals, and functions of supervision? To what extent are the research studies, atheoretical supervision models, and theoretical supervision models developed during the 1980s, driving the practice of clinical supervision today?

The purpose of this study was to assess counselor supervisor opinions regarding the ideal functions, methods, goals, and supervisor roles, as well as influences of theory and research, rela- tive to the practice of clinical supervision. The research questions that guided the inquiry were: (a) What are the opinions of clinical supervisors regarding the ideal functions, methods, goals, and supervisor roles? and (b) What styles and theoretical/research influences are most influential in the practice of clinical supervision?

METHOD

The population selected for this study was counselor educators from CACREP-accredited programs. The rationale for choosing

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CACREP programs was that because CACREP standards require individual and small group clinical supervision, it would increase the likelihood that participants would be experienced clinical supervisors. The mailing list was developed by calling all CACREP- accredited programs from a published list provided by the CACREP office, and asking each program for the names of current faculty members employed full-time or as adjuncts who were currently involved in providing clinical supervision to counselors-in-training. This procedure resulted in a mailing list of 554 counselor educators. Given the relatively small size of the population, a sample was not drawn. For the purpose of ensuring that the mailing list was errorless, one question asking participants to indicate their involvement in clinical supervision was included on the ques- tionnaire, allowing for the removal of counselor educators who were not current supervisors.

The first mailing, including a survey, a stamped return envelope, and a cover letter, was sent to 554 counselor educators. The surveys were numbered in order to allow for a second mailing. One hundred ninety-nine were returned and 12 were omitted from the study because of incomplete data or because of lack of involvement in clinical supervision. Four weeks later, a second mailing (a survey, cover letter, and stamped return envelope) was sent to the 355 nonrespondents. One hundred fifty-two surveys were returned. Of the returned surveys, 10 were removed because of missing data or because of lack of current involvement in clinical supervision. The total usable surveys for the study was 329, a 59% return rate after removals.

The survey used in the study was designed by the researchers and included demographic items, ideal clinical supervision items, and two open-ended questions regarding supervisory approach and theoretical influences. The demographics section directed respondents to indicate gender, ethnicity, rank, years of experience as a counselor educator, and years of experience as a clinical supervisor for master's-level students in counseling.

The ideal clinical supervision section asked participants to imagine the ideal counselor training program in four areas: (a) functions of supervision, (b) methods of delivery, (c) goals of supervision, and (d) preferred supervisor roles. On the functions of supervision item, respondents were asked to "please rate the importance of the eight supervision functions listed below." A 1- 3 rating system was used, with 1 representing very important function of clinical supervision, 2 representing somewhat important function of clinical supervision, and 3 representing not an im- portantfunction of clinical supervision. The selection of the eight functions items was influenced by the literature. They included


instruction in specific counseling skills (Bernard, 1979; Bernard & Goodyear, 1992; Biggs, 1988; Borders, 1989b; Lanning, 1986), consulting with counselor to provide a different view of counseling (Biggs, 1988; Littrell, Lee-Borden, & Lorenz, 1979), evaluation of counselor-in-training (Bernard & Goodyear, 1992; Dochrman, 1976; Eckstein & Wallerstein, 1959; Kadushin, 1976; Kadushin, 1985). discussing philosophical issues related to helping (Stenack & Dye, 1982; Stoltenberg, 1981), teaching the supervisee to conceptualize client themes (Bernard, 1979; Bernard & Goodyear, 1992; Lannine, 1986). working on issues of personalization (Bernard, 1979; Bernard & Goodyear, 1992; Lanning, 1986; Mueller & Kell, 1972; Russell, Crimmings, & Lent, 1984). and teaching professionalism and ethics (Bernard & Goodyear, 1992; Lanning, 1986).

The methods of delivery of supervision item stated “for the ideal counseling training program, rate the following eight methods of providing supervision.” A 1-3 scale was used, with 1 representing of more than nominal value as a supervision tool, 2 representing of nominal value as a supervision toot, and 3 representing ofless than nominal value as a supervision tool. The selection of the eight methods was influenced by supervision literature. The items included videotape (Bernard & Goodyear, 1992; Broder & Sloman, 1982; Dowling, 1984; Goldberg, 1985; Stoltenberg & Delworth, 1987; Ward, Kagan, & Krathwohl, 1972), audiotape (Bernard & Goodyear, 1992; Bowman, 1979; Goldberg, 1985; Kruger, Cherniss, Maher, & Leichtman, 1988; Ward, Kagan, & Krathwohl, 1972). live supervision (Berger & Dammann, 1982; Bernard & Goodyear, 1992; Kickert & Turner, 1978; Schroll & Walton, 199 1). bug-in-the-ear/phone (Ber- nard & Goodyear, 1992; Gallant & Thyer, 1989). co-counseling (Lothstein, 1980; Munson, 1983; Reynolds & McWhirter, 1984; Siddall & Bosma. 1976; Thompson & Blocher, 1979), verbal reports of sessions with clients (Bernard & Goodyear, 1992; Eckstein & Wallerstein, 1959; Hess, 1980; Hess & Hess, 1983; Kadushin, 1985), written reports of sessions with clients (Goldberg, 1985; Schwartz, 198 l), and anticipatory role play (Mann & Mann, 1966).

The goals of supervision item directed participants to rank order the ideal goals of supervision, with 1 being the most important goal and 5 being the least important goat. The five-goal items to be ranked were: to (a) assist supervisee to have greater self- awareness (Bernard, 1979; Bernard & Goodyear, 1992; Lanning, 1986), (b) assist supervisee to conceptualize client themes (Ber- nard, 1979; Bernard & Goodyear, 1992; Lanning, 1986). (c) assist supervisee to develop clinical skills (Bernard, 1979; Bernard & Goodyear, 1992; Boyd, 1978; Bradley, 1989; Lanning, 1986), (d) provide supervisee with a supportive learning environment (Ber - nard & Goodyear, 1992; Blount, 1982; Hogan, 1964; Johnson &


Moses, 1988; Stoltenberg, 1981), and (e) model aspects of the counseling process for the supervisee (Blount, 1982; Flemming, 1953; Sansbury, 1982; Stenack & Dye, 1982; Wolpe, Knopp, & Garfield, 1966). Similarly, the role of supervision item was rank ordered with 1 representing the most important role and 5 representing the lowest rank or least preferred role for ideal master's- level supervision. The five items were: (a) teaching supervisees clinical skills (Bernard, 1979; Bernard & Goodyear, 1992; Biggs, 1988; Borders, 1989b; Boyd, 1978; Lanning, 1986); (b) giving supervisees advice about appropriate responses to client situations (Flemming, 1953; Stoltenberg, 1981); (c) listening to supervisees; (d) coaching supervisees, giving feedback on strengths and weaknesses (Freeman, 1985; Hess; 1980; Loganbill, Hardy, & Delworth, 1982; Worthington & Rochlke, 1979); and (e) supporting supervisees by providing encouragement (Blount, 1982; Grotjahn, 1955; Hess, 1980; Hogan, 1964; Sansbury, 1982).

The two open-ended questions at the end of the survey were: "Describe your supervisory approach/style" and "What theories and/or research have influenced your approach?" The survey al- lowed one half page of blank space to respond to these questions.

The survey was critiqued by three experienced counselor educators, all of whom were experienced clinical supervisors. Using the information from the critiques, the instrument was exten- sively revised and edited prior to the first mailing.

RESULTS

Of the 329 surveys returned, 204 were returned from counselor educators working in master's only CACREP-accredited programs and 125 were returned from those working in master's and doctoral CACREP programs. The gender item revealed that 1 16 (35.3%) of the participants were women and 208 (63.2%) were men. Five participants did not respond to the gender item. Participants were primarily Caucasian (289 or 87.8%) with 12 (3.6%) indicating Af- rican American ethnicity, 9 (2.7%) indicating Hispanic, and 4 (1.2%) indicating Asian American. Of these 25 ethnic minorities, 15 were female counselor educators and 10 were male. One participant indicated "other ethnicity" without specification, and 14 participants did not respond to this item. Results of the demographics on rank indicated 140 (42.6%) were professors, 95 (28.9%) were associate professors, 76 (23.1%) were assistant professors, 6 (1.8%) were adjunct faculty, and 4 (1.2%) were emeritus faculty. In viewing the rank by gender, women dominated the assistant professor rank (45 women, 30 men), and men dominated the associate (39 women, 54 men) and professor (25 women, 114 men) ranks. The

I48 COUNSELOR EDUCATION AND SUPERVISION / DECEMBER 1996 / VOL. 36

mean average years of experience as a counselor educator was 14.7 years with a median of 15.0 years, and a range of 1 to 42. More than 50% of the women in the study had 5 or fewer years of counselor education experience. Conversely, there was a heavy concentration of men with 20-42 years of counselor education experience. Mean average years of experience as a supervisor of master’s students was 13.3 years, with a median of 12.0 and a range of 1 to 42.

Table 1 reports the frequencies and means for the responses to the first supervision item, functions of supervision.

The functions viewed by the highest number of participants as very important for clinical supervision were teaching professionalism and ethics, and teaching the supervisee to conceptualize client themes, followed by personalization issues and instruction in specific counseling skills. The functions viewed by them as less important were providing therapy for the student and discussing relevant philosophical issues.

Also reported in Table 1 are the frequencies and means of the methods of providing supervision item, showing 90% (293 par-

TABLE 1

Ideal Functions and Methods of Master’s Supervision

Frequency

Item 1 2 3 M

Functions of Supervision Teaching the supervisee to conceptualize Teaching the professionalism and ethics Personalization issues Instruction in specific counseling skills Evaluation of student Consulting to provide different viewpoint Discussing relevant philosophical issues Providing therapy for student

263 263 261 255 256 162 139 27

56 4 60 3 59 5 66 6 61 8

137 18 159 27 63 232

1.20 1.20 1.21 1.24 1.24 1.55 1.66 2.64

Methods of Supervision Videotape 293 32 0 1.09

Audiotape 189 53 12 1.49 Live supervisor/mirror 257 53 12 1.30

Anticipatory role play 108 173 48 1.83 Verbal reports of sessions 117 144 64 1.84 Co-counseling 108 142 68 1.87 Written reports of sessions 79 166 78 2.00 Bug-in-the-ear/mirror 63 140 108 2.15

Note. For ideal functions, 1 = very important function of clinicalsupervision;2 = somewhat important function;3 = not an important function. For ideal methods, 1 = of more than nominal value as a superyision tool; 2 = of nominal value as a supervision tool; 3 = of less than nominal value as a supervision tool.


ticipants) found videotaping to be of more than nominal value as a supervisory tool, followed by live supervision (78% rated it of greater than nominal value) and audio tape (57% rated it of greater than nominal value). Bug-in-the-ear was rated as nominal or less than nominal value by 75% of the participants. Similarly, 74% of the participants indicated that written reports of sessions were of nominal or less than nominal value.

Table 2 shows the frequencies and percentages of the ranks, in mean rank order for the goals of supervision item. Of the five

TABLE 2

Rank Order Frequencies: Goals of Supervision and Supervisor’s Role

Rank Item 1 2 3 4 5 Goal of Supervision

Assist counselor to increase self-awareness Frequencies Percentages

Frequencies Percentages




Assist counselor to conceptualize themes

Assist counselor to develop clinical skills

Provide a supportive learning environment

Model aspects of the counseling process

Role of the Supervisor

Teach supervisee clinical skills Frequencies Percentages




Frequencies Percentaaes

Give advice about appropriate interventions

Listen to supervisees

Coach supervisees, giving feedback on strengths

Support and encourage

34 11.2

53 94 17.4 30.9

68 22.4

55 18.1

27 8.9

101 85 33.2 28.0

70 23.0

21 6.9

167 50.9

71 28 23.4 9.2

18 5.9

20 6.6

66 21.7

48 52 15.8 17.1

86 28.3

52 17.1

12 3.9

32 44 10.5 14.5

61 20.1

155 51 .O

110 35.5

10 3.2

66 49 21.3 15.8

46 14.8

39 12.6

28 58 9.0 18.7

74 23.9

140 45.2

57 18.4

53 72 17.1 23.2

106 59 34.2 19.0

59 71 19.0 22.9

72 23.2

33 10.6

84 27.1

56 18.1

98 31.6

36 11.6

14 4.5

60 19.4

Note. 1 = most important; 5 = least important.


goals of supervision, the goal most frequently selected as the most important was assisting counselors-in-training to develop clinical skills (1.8 mean rank order). Of the participants, 51% ranked developing clinical skills as the highest goal (1) of supervision, followed by assisting counselors-in- training to conceptualize themes (2.8 mean rank order). Modeling aspects of the counseling process was ranked lowest, with a mean rank of 4.0 (51% ranked it 5).

Table 2 also reports the frequencies and percentages of rank order responses on the item, role of the supervisor. There was less consensus on the role of the supervisor than on the goals of supervision. The most preferred role was teaching clinical skills (2.4 rank order mean), with the least valued role a 3.9 rank order mean for offering advice about appropriate responses to client situations.

The results of the two essay format items, supervisory approach/ style and theoretical/research influences, were categorized and tallied. Because open-ended items typically yield a wide range of responses in terms of length, approach to responding to the question, and willingness to elaborate detail, the two items were viewed as exploratory. Some respondents wrote an entire page on the items, whereas others offered one sentence responses. Because of the variability of responses, the researchers tallied the frequency of times a style, approach, theory, or researcher/theorist was mentioned under general categorical headings. Tables 3 and 4 report frequency of response, rather than the number of participants.

In answer to the first open-ended item, "describe your supervision approach" 72.4% of the participants addressed the question by offering a description of the role of the supervisor, and 27.6% responded with a description of the content/process focus of supervision. Table 3 shows the frequency of responses using roles and focus subcategories.

The roles most frequently mentioned were teacher, challenger, and supporter. The teacher role ranged from the listing of the word to a defense of the supervisor-as-teacher position, such as this comment "any model of supervision, especially developmental models, are inferior to teaching students effective skills." The support role was indicated by comments such as "it is of utmost importance to me to establish a supportive supervisory relationship that focuses on growth of student as a counselor." Some of the respondents who indicated support also mentioned challenge/ feedback in the same sentence. Some of the participants who valued the counselor role in supervision were quick to note that the counselor role does not encompass therapy. Of the participants who responded to the question from a focus of supervision


TABLE 3

Frequencies and Percentages of Supervision Approach

Item Percentage of

Frequencies Responses

Role Responses Directorneacher Offer challenge/Direct feedback Provide support Design relationship/Environment Consultant Counselor Model Encourager Facilitator Coach Screening/Evaluator Mentor Resource person

Focus of Supervision Responses Enhance supervisee self-awarenesskelf-evaluation Teach counseling processlskills Focus on client conceptualizations/thernes Experiential Discuss philosophy and counseling theory Transferencekounter transference issues Focus on Intentionality Focus on congruence

52 18.2 41 14.3 39 13.6 26 9.1 26 9.1 23 8.0 19 6.6 19 6.6 18 6.3 10 3.5 8 2.8 3 1 .o 2 1 .o

29 26.6 24 22.0 19 17.4 12 11.0 11 10.1 9 8.3 3 2.8 2 1.8

viewpoint, the most frequently reported focus was assisting the supervisee to increase self-evaluation and self-awareness. Re- sponses included mention of transference, counter-transference, and personal issues as they affect counselors. An example was this comment, "I focus on the interactive nature of the personal issues of the student and his or her client, hoping the student will learn to deal appropriately with his or her blind spot and biases. If the student's personal issues are so potent that they inhibit the therapeutic process, I refer the student to a counselor." Not included on Table 3 are the responses that were mentioned by only one respondent.

Responses to the item, asking participants which theories, models, or research influenced their supervision approaches, were categorized into two broad groups: (a) models related to clinical supervision, and (b) counseling theories/school approaches. Comments not directly related to the question were categorized as "other." Because some participants indicated more than one influ- ence, the frequencies represent the number of times the approach was listed. Table 4 shows the breakdowns of theory/research influences.


TABLE 4

Frequencies of Supervision Influences

Percentage of ModelRheory Frequency Responses

Specific clinical supervision models/Research Developmental 53 14.5 Bernard’s discrimination model (Atheoretical) 19 5.2 Clinical supervision research 17 4.6

Psychodynamic supervision (Kell8 Mueller) 11 3.0 Boyd‘s behavioral supervision 3 0.8

Interpersonal process recall 12 3.3

Group supervision model 1 0.2 Counseling theory influences

Cognitive and R.E.T. 52 14.2 Person centered 50 13.7 Psychodynamic 19 5.2 Behavioral 17 4.6 Eclectic 17 4.6 Gestalt 15 4.1 Adlerian 13 3.6 Humanistic 12 3.3 Existential 10 2.7

Feminist theory 5 1.4 RealitylControl theory 8 2.2

Experience-as-teacher 12 3.3 Other Influences

Personal mentors 9 2.5 Unrelated 11 3.0

Only 19.5% (64) of the participants specifically mentioned research, models, or the names of researchers and writers in the clinical supervision field. Because some participants mentioned more than one researcher or model, the 19.5% of participants account for 31.6% of all the reponses on this item. In this cat- egory, the most frequently mentioned approach was developmental. Comments categorized as developmental included references to developmental models or writers such as Stoltenberg, Loganbill, Hardy, Delworth, Blocker, Goodyear, and Littrell. Bernard’s Dis- crimination Model was also frequently mentioned. Example of comments made by the 64 participants in the supervision- specific responses are, ‘I’m impressed by the Stoltenberg/Loganbill model. I also use theory/research by Bernard, and Holloway’s research in how trainees conceptualize clients,” and ‘My supervision follows Boyd, who says one supervises the same as they counsel.” None of the supervision-specific comments addressed counseling theories. Some of the comments addressed more than one supervision model or research study; others addressed a super-

COUNSELOR EDUCATION AND SUPERVISION j DECEMBER 1996 j VOL. 36 153

vision model in conjunction with a counseling skills model. Clini- cal supervision references included Leddick, Borders, Holloway, Heppner, Worthington, and Martin.

Comments from the 80.5% participants referencing counseling theories approaches (accounting for 68.4% of the frequencies) generally named one specific theorist or theory. A sample comment was, "I use family systems approaches-primarily struc- tural, strategic, and constructivist." The majority of the comments in this section supported person-centered and cognitive approaches. Carl Rogers and Albert Ellis were the two most frequently mentioned theorists.

Some of the comments were intriguing, but did not address the question directly and are thus not reflected in the frequencies in Table 4. A number of comments suggested learning supervision from experience. Examples of these comments include: "My approach to supervision has gradually evolved as a result of working with students and attending to what seems to work most effectively," and "I've never studied supervision theory, so I was taught by word-of-mouth to supervise."

DISCUSSION

Results related to the items regarding the ideal functions, roles, and goals of supervision provide support for some of the models and research in supervision. Teaching (or instruction) is included as a key role by many authors in supervision, including Holloway (1984), Hess (1980), and Littrell et al. (1979). Counseling as a supervisory role is also discussed in the literature, which may relate to supporting and creating a facilitative environment, items that received some support from participants in this study. Bernard's Discrimination Model, which is designed to be situation specific, includes process, personalization, and conceptualization focuses for supervision. This study supports the Bernard model in that assisting counselors to develop clinical skills (process), to increase self-awareness (personalization), and to conceptualize themes (conceptualization) were upheld by the participants as important goals of supervision. Lanning (1986) adjusted the Bernard model to add one focus, professionalism. In rating the functions of supervision, teaching professionalism and ethics was viewed as the second most important function of supervision. Although ethics and professionalism were seldom mentioned in the open-ended questions, they may be considered important background fac- tors in supervision.

The data gathered from the two open-ended response items is subject to scrutiny, because the process of categorizing the re-


sponses was to some degree subjective. Nonetheless, having only 19.5% of the respondents mention a supervision theory, model, or research study suggests the possibility that a majority of the participants have a lack of interest in reading or integrating into practice material from current counselor education and supervision journals, lack of preparation in clinical supervision, or a belief that counseling theories are more appropriate to supervision than supervision-specific models.

Note that the screening and evaluation elements of supervision were seldom mentioned by participants. Because supervision is frequently important in screening or remediating counselors- in-training who are inappropriate for the field, it might be ex- pected that this issue would have been raised more frequently by participants.

The general categories derived from the open-ended items could serve as the basis for further research on the approaches and theoretical influences on clinical supervision. The results of this study are limited in that it is possible that not all the preferred responses were indicated on the objective items. Also, non-CACREP supervisors may have differing opinions about the delivery of clinical supervision.

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Documents

Clinical Supervision of Counselors-in-Training: A Nationwide Survey of Ideal Delivery, Goals, and Theoretical Influences