[humanser] Clinical Supervision of Prelicensed Counselors: Recommendations for Consideration

[Mary Ann Robinson]

I read this article on another list and thought it might be of interest.

Mary Ann Robinson

Clinical Supervision of Prelicensed Counselors: Recommendations for Consideration
and Practice.
by Sandy Magnuson , Ken Norem , Allen Wilcoxon
Evidence of significant advances in expectations, theory, and practice of counselor
supervision is multifarious and replete (Bernard & Goodyear, 1998; Borders, Cashwell,
& Rotter, 1995; Magnuson & Wilcoxon, 1998a, 1998b). Whereas authors in the mid-1980s
asserted that the existing pool of knowledge related to counselor supervision processes
was deficient (Carifio & Hess, 1987; Goodyear & Bradley, 1983), contemporary supervisors
have an abundance of texts, in addition to journals such as Counselor Education and
Supervision and The Clinical Supervisor to guide their work. Refinement of supervision
theory and practice has been catalyzed by credentialing bodies. For example, the
National Board for Certified Counselors has authorized the Approved Clinical Supervisor
credential (Bernard, 1998) and state counseling licensure boards have specified requirements
for supervision of provisionally endorsed counselors.
Postacademic supervised experience is a requirement for counselor licensure in 45
states (Counselor licensure, 1999); however, the specification of guidelines for
skillfully providing the supervision is beyond the scope and purposes of such regulatory
boards. Instruction, models, and recommendations for supervising prelicensed counselors,
a discrete domain of practice, are sparse (Magnuson & Wilcoxon, 1998a). Consequently,
supervisors often proceed without knowledge of regulatory expectations and appropriate
procedures for supervising entry-level counselors (Hillman, McPherson, Swank, & Watkins,
1998; Nelson, Johnson, & Thorngren, in press). This article provides suggestions
for structuring and enacting clinical supervision of postacademic, prelicensed counselors.
Although the article is directed primarily to supervisors and prospective supervisors,
it may also help counselors-in-training become more astute consumers of supervision.
SUPERVISION: COUNSELORS-IN TRAINING VS. PRELICENSED COUNSELORS
Guidelines and strategies for supervision of master's- and doctoral-level students
are prevalent. However, supervision of prelicensed counselors differs from university-based
supervision of counselors-in-training in noteworthy ways. For example, students are
typically supervised by a team of university-based and field-based supervisors. In
contrast, supervisors of prelicensed counselors often assume sole responsibility
for overseeing supervisees' work without previous supervisors' assessments of supervisees'
skills and knowledge and without the clarity of evaluation criteria provided by course
syllabi and accreditation standards. General structures and proximity enable academic-based
supervisors to closely monitor the clinical work of counselors-in-training. Conversely,
supervisors of prelicensed counselors often have limited contact and opportunities
to directly observe clinical performance. These factors may become more salient when
supervisees apply for licensure, and the supervisors must independently ascertain
that the applicants have achieved appropriate levels of competency.
A significant contrast also emerges from the fee-for-service nature of post-academic
supervision. Although counselors-in-training pay tuition, there is no direct business
relationship between supervisors and supervisees. Another element of the postacademic
business relationship is that supervisees are free to select their supervisors. These
differences between supervision of counselors-in-training and supervision of prelicensed
counselors have implications for each phase of supervision practice, beginning with
preliminary preparation.
SUPERVISION OF PRELICENSED COUNSELORS: PRELIMINARY CONSIDERATIONS
Similar to supervision in academic settings, effective supervision of prelicensed
counselors is predicated upon preparation and consideration of pragmatic and theoretical
factors (Hillman et al., 1998). Skillful supervision requires specialized preparation
(Association for Counselor Education and Supervision [ACES], 1993; Bernard & Goodyear,
1998; Borders et al., 1991; Guest & Dooley, 1999; Hillman et al., 1998; Liddle, 1988;
Supervision Interest Network, 1990; Watkins, 1997). Endorsing the importance of such
preparation, professional associations have established minimum standards for training
and supervised experience for counseling supervisors (Borders et al., 1991). Professional
associations, university-based counselor education programs, certification agencies,
and supervisors in private practice provide a variety of training and supervision-of-supervision
opportunities for counselors who wish to become supervisors.
A few regulatory and certifying boards require applicants to be supervised by counselors
who hold specific credentials related to supervision. Thus, potential supervisors
should examine requirements and procedures for becoming credentialed for the jurisdictions
in which they wish to supervise prelicensed counselors (Todd, 1997).
Regulatory boards may ask supervisor credential applicants to provide written statements
of their fundamental beliefs about and orientation to supervision. These documents
typically include delineation of the following:
* The supervision model that informs the supervisor's practice
* Roles assumed by the supervisor
* General goals and objectives of supervision
* Modalities typically employed
* Beliefs and practices related to evaluation
Essentially, the process results in a "supervisor's epistemological declaration"
that becomes the "underlying rationale for a supervisor's every action" (Liddle,
1988, p. 157). This evolving, dynamic enterprise contributes to a supervisor's professional
identity and clarifies his or her fundamental beliefs about counseling and supervision.
(For additional information see Storm, 1997a.)
Statements of orientation to supervision segue to preparation of professional disclosure
statements, which communicate supervisors':
* Degrees, training specific to supervision, professional credentials, and licenses
* Areas of professional competence
* A general overview of the models and theories of supervision that inform their
practices of supervision
* Procedures for evaluation
* Expectations, parameters, and limits of confidentiality and privileged communication
* Procedures for documenting supervision activities and maintenance of records
* Fee arrangements
* Provisions for emergencies
* Ethical guidelines that govern their practice (Atkinson, 1997; McCarthy et al.,
1995; NBCC, 1998).
Professional disclosure statements communicate organizational and structural elements
within the supervision context. Thus, these documents provide a measure of accountability
for supervisors (Keel & Brown, 1999), and demonstrate "managerial competence" (Bernard
& Goodyear, 1998, p. 199). Self-disclosure statements also reflect deliberate attention
to pertinent ethical and legal factors.
ATTENDING TO RISK MANAGEMENT: ETHICAL AND LEGAL CONCERNS
An adequate discussion of ethical practice of supervision, implications of legislation
and court decisions, and strategies for risk management exceeds the scope of this
manuscript. However, we call attention to supervisory concerns of (a) vicarious liability,
(b) confidentiality, (c) dual relationships, and (d) the power differential that
is inherent within supervisory relationships.
Vicarious responsibility, or respondent superior, is a legal notion that assigns
ultimate responsibility for actions or nonactions of subordinates to the persons
in authority or control over others (Disney & Stephens, 1994; Tanenbaum & Barman,
1990). Thus, when supervisees inflict injury by negligence or malpractice, supervisors
may be legally liable, particularly when such actions are found to be within the
parameters of the supervision contract (Knapp & VandeCreek, 1997; Tanenbaum & Barman,
1990).
At another level, supervisors' negligence in providing adequate supervision can also
lead to litigation (Guest & Dooley, 1999); thus, supervisors are legally responsible
both for their own behavior and that of their supervisees. Indeed, responsibilities
attributed to supervisors for (a) the care and treatment of clients and (b) the professional
development of the supervisee are multiple and complex. Sagacious supervisors judiciously
examine and adhere to The Ethical Guidelines for Counseling Supervisors (ACES, 1993)
and Standards for Counseling Supervisors (Supervision Interest Network, 1990). Furthermore,
they assure that supervisees understand and follow appropriate codes of ethics and
standards of practice (ACES, 1993).
The principles of confidentiality and privileged communication pose additional complexities
within the context of supervision. Supervisors and supervisees share the responsibility
for protecting confidentiality of client material (Bernard & Goodyear, 1998; Disney
& Stephens, 1994). Supervisors further assume responsibility for assuring that clients
are fully informed and cognizant of the supervisory relationship, and the parameters
of confidentiality and privileged communication (ACES, 1993).
The importance of a viable working alliance within the supervisory relationship is
generally accepted and endorsed. However, when supervision is received in fulfillment
of credentialing and regulatory board requirements, an array of curious tensions
is inherent. For example, trust is believed to be an essential factor in supervisory
relationships (Bernard & Goodyear, 1998). Yet, supervisees function within the gatekeeper
responsibilities assigned to supervisors. To ignore the differential of power that
is intensified by a supervisor's having final and sole responsibility for recommending
licensure or certification would seem to be professionally inappropriate and ethically
unsound. Thus, we encourage supervisors to examine their own reactions to such diverse
roles, thereby preparing to facilitate dialogue about responsibilities for evaluation
and gatekeeping with supervisees.
Recognizing and maintaining appropriate boundaries within the context of a strong
working relationship warrants supervisors' scrupulous attention. Although sexual
relationships between supervisors and supervisees are clearly forbidden ([Sec. 2.10]
ACES, 1993), guidelines for other supervisory boundaries are sometimes ambiguous.
For example, supervisors are encouraged to mentor supervisees' participation in professional
associations ([VII.C] International Association of Marriage and Family Counselors,
1993); however, joint participation may result in blurred boundaries that obscure
objectivity, contribute to confusion, and lead to exploitation. As another example,
supervisors often invite supervisees to examine personal issues that may interfere
with their work with clients; yet, engaging supervisees in activities that approximate
personal counseling may be regarded as an unprofessional dual relationship. These
areas of ambiguity may be exacerbated when supervisors assume dual responsibilities
for administrative and clinical supervision. Thus, conscientious supervisors continuously
monitor the potential for (a) abusing the power that is inherent within supervisory
relationships, (b) exploiting supervisees, and (c) inflicting harm (ACES, 1993; Bernard
& Goodyear, 1998; Magnuson, 1999; Tanenbaum & Berman, 1990). They further model clarity
in articulating expectations and engage supervisees in discussions about issues of
power and boundaries.
This meager discussion of legal and ethical cautions underscores the importance of
formal training in supervision and risk-management practices. Such endeavors may
include maintaining consultative relationships with other supervisors, seeking legal
advice as appropriate, participating in risk-management continuing-education programs,
reading related professional literature, carrying liability insurance, and assuring
that supervisees adopt the same practices. Supervisors are also encouraged to monitor
their practices by reviewing videotapes of supervision sessions and sharing documentation
responsibilities with supervisees.
INITIATING SUPERVISORY RELATIONSHIPS: CONSIDERATIONS AND PROCESSES
Collaborative relationships characterized by mutual respect, authenticity, and trust
are as important for supervisory relationships as they are for counseling relationships
(Bordin, 1983; Emerson, 1999; Ladany & Friedlander, 1995; Lee, 1999). Although supervisory
relationships develop and evolve over time, the initial meeting to discuss possibilities
of engaging in a supervisory relationship is critically important (Prest & Schindler-Zimmerman,
1997; Prest, Schindler-Zimmerman, & Sporakowski, 1992). During this initial encounter,
lasting impressions develop that influence decisions to proceed with supervision,
dynamics of interpersonal relationships, and the nature of supervisory processes.
Preliminary encounters also provide a template for openly communicating about potential
ethical dilemmas mentioned in the previous section. Thus, astute supervisors remain
sensitive to implications and influences of culture (Fong & Lease, 1997; Kostelnik,
1999), gender (Carolan, 1999), sexual orientation (Waskerwitz, 1999), and other factors
that may affect the relationship (Brownell, Kloosterman, Kochka, & VanderWal, 1999).
Initial meetings between prospective supervisors and supervisees may be viewed as
reciprocal interviews, during which both parties examine the potential for a productive
working relationship to develop. Thus, supervisors should be prepared to discuss
the various topics included in their self-disclosure brochures. Business aspects,
such as fee arrangement, must be addressed as well.
Supervisors may ask supervisees to authorize consultation with former supervisors.
It is equally appropriate for supervisees to request supervisors' permission to contact
former and current supervisees. In this context, both parties have an opportunity
to further examine the potential for interpersonal and professional compatibility,
as well as the correspondence between supervisors' areas of expertise and supervisees'
primary professional needs and interests.
FORMALIZING THE SUPERVISORY RELATIONSHIP
Decisions to proceed with supervision should be based on mutual confidence in the
potential for a productive working relationship to evolve (Osborn & Davis, 1996).
Written agreements are generally recommended to assure explicit understanding of
the various facets of the supervisory relationship (Liddle, 1988; Storm, 1997b; Todd,
1997). However, effective contracts include mechanisms for modification and renegotiation
as needs of supervisees and their clientele change (Storm, 1997b).
Typical supervision contracts include:
* Supervisors' requirements
* Supervisees' initial goals
* Schedules to be followed
* Projected duration
* Modalities and interventions to be employed
* Mechanisms for documentation and maintenance of records
* Methods and purposes of evaluation
* Procedures for appropriately informing recipients of supervisees' services about
supervisory relationships and related limits of confidentiality
* Guidelines for responding to emergencies
* Provisions related to due process and filing complaints (Guest & Dooley, 1999;
Osborn & Davis, 1996; Storm, 1997b; Tanenbaum & Berman, 1990; Todd, 1997).
When supervisees are working toward certification or licensure, contracts should
also address those external requirements. As mentioned previously, business arrangements
should be clarified and included in the contract. Finally, consideration should be
given to supervisors' roles vis-a-vis responsibilities attributed to supervisees'
employing agencies.
More complex contractual agreements are required when supervisors' practices are
independent from the organization within which supervisees practice. In these situations,
policies and procedures of the organization warrant attention. Areas of administrative
and clinical supervision should be clearly delineated in the contract.
Unique complexities also emerge when supervisees engage in practice within supervisors'
agencies. Again, clarity in expectations and responsibilities of all parties are
recommended when such business relationships are superimposed over supervisory relationships.
ASSESSING PROFESSIONAL NEEDS AND FACILITATING PROFESSIONAL DEVELOPMENT
Supervisors employ a variety of strategies for assessing supervisees' professional
skills and needs (Magnuson & Wilcoxon, 1998a). In addition to inviting supervisees'
self-appraisal, supervisors may consult with previous supervisors, review tapes of
counseling sessions, and observe supervisees as they conduct sessions. Supervisors
may also employ assessment instruments and consider professional statements of competencies
(e.g., Association for Specialists in Group Work, 1991; Gladding & Pedersen, 1997;
Sue, Arredondo, & McDavis, 1992).
Identification of supervisees' professional goals and needs enables supervisors to
determine appropriate modalities and supervisory interventions (Nelson et al., in
press). Nichols and Lee (1999) identified live supervision, tape review, and case
consultation as major supervision modalities. Other formats include group supervision
(Borders, 1991; Keith, Connell, & Whitaker, 1992; Newman & Lovell, 1933), co-counseling
(Reynolds & McWhirter, 1984), and various modalities in combination. Within these
contexts a variety of supervisory approaches and interventions is appropriate for
working with prelicensed counselors.
While each supervee's level of professional development related to knowledge and
skills is unique, counseling supervisors have identified general areas that warrant
attention when supervising prelicensed counselors (Magnuson & Wilcoxon, 1998a). Entry-level
counselors may benefit from additional instruction in areas such as pharmacology,
diagnostic skills, ethical practices, therapeutic goals, and treatment planning.
They may also need guidance in case conceptualization strategies that are informed
by solid understanding of counseling theories.
A transcending purpose in supervising prelicensed counselors is to facilitate their
achieving appropriate levels of skill, knowledge, and acumen to practice autonomously.
Thus, continuous evaluation and feedback are integral and inherent elements of supervision
(Bernard & Goodyear, 1998; Borders, 1991; Fine & Turner, 1997; Freeman, 1985; Watkins,
1997). Ongoing, formative assessment mechanisms contribute to final or summative
appraisal of supervisees' professional development.
EVALUATION
A variety of assessment protocols are available to augment appraisal procedures (e.g.,
Baird, 1999; Bernard & Goodyear, 1998; Boylan, Malley, & Scott, 1995; Nelson & Johnson;
1999; Storm & Todd, 1997). Although these instruments are not standardized, they
offer a structure for documenting supervisees' progress. They also provide a framework
that can be adapted to reflect supervisors' style and expectations, as well as supervisees'
unique needs.
Competencies indicating that prelicensed counselors are appropriate recipients of
licenses to practice autonomously as professional counselors have not been clarified
(Magnuson & Wilcoxon, 1998b). Thus, supervisors and supervisees must rely on individually
defined criteria and procedures for formally and finally assessing progress and professional
development. Goals identified at the onset of supervision and modified through the
subsequent phases of supervision provide essential mechanisms for measuring progress
(Fox, 1983). Additionally, periodic formal assessments of supervisees' competency
levels provide indications of progress necessary for successful completion of the
supervisory experiences. However, summative evaluation may also include feedback
related to areas of growth that were observed, but not initially targeted.
CONCLUDING A SUPERVISORY RELATIONSHIP
Supervisory relationships often reflect progression through phases characterized
by diminishing levels of supervisor-directed leadership correlated with increasing
degrees of supervisees' autonomy. Final stages, which may comprise relationship completion
or redefinition, often evoke ambivalence for both supervisors and supervisees. Essentially,
supervisors of prelicensed counselors guide, instruct, monitor, and evaluate with
an ultimate goal of preparing a colleague (Bernard & Goodyear, 1998). Attention to
a variety of tasks contributes to successful conclusions of supervisory relationships
and may assuage tension resulting from ambivalence.
Completion of supervisory contracts invites participants to reflect on various experiences
and processes encountered (Bernard & Goodyear, 1998). Although the effectiveness
of supervision should be discussed and examined throughout the relationship, summative
evaluation includes retrospective consideration of the activities that were helpful,
as well as activities that were less effective (Bernard & Goodyear, 1998). Supervisees
and supervisors should jointly appraise their shared and individual experiences in
the context of the relationship. They should also formally assess supervisees' progress,
needs for continued professional development, and options for lifelong professional
growth (Littrell, Lee-Borden, & Lorenz, 1979; Nelson et al., in press). Finally supervisors
should endorse supervisees' progress toward professional autonomy (Liddle, 1988).
The multiple factors involved in clinical supervision of prelicensed counselors beckon
supervisors' continuous individual self-evaluation. Intentional, retrospective examination
of the supervision processes subsequent to the concluding session offer a unique
catalyst for enhanced effectiveness as a supervisor. This individualized endeavor
may be facilitated with formal instruments (e.g., Williams, 1994) or informal examination
of one's performance in comparison with effective supervision criteria (e.g., Supervision
Interest Network, 1990; White & Russell, 1995).
CLOSING COMMENTS
Many opportunities await supervisors of prelicensed counselors and researchers. Models
for supervising counselors during this crucial phase of professional development
are vacuous, as are systematic endeavors to evaluate the strategies that are employed.
Single-subject case studies and outcome-based inquiries can enhance our collective
knowledge of effective supervisory approaches, practices, and interventions for promoting
professional growth of prelicensed counselors. Additionally, documentation of successful
approaches and interventions for supervising prelicensed counselors can strengthen
designs for effectively and efficiently preparing their supervisors. Empirical support
for outcome measures to determine that licensure applicants have achieved levels
of professional maturity to competently practice autonomously can assist the regulatory
bodies who render critical decisions regarding licensure.
The magnitude of responsibilities attributed to supervisors of prelicensed counselors
is daunting. The information provided in this discussion is a preliminary step toward
fashioning models for supervising prelicensed counselors. The article is not intended
to serve as a substitute for didactic preparation and supervision-of-supervision;
nor is it intended to discourage persons from becoming supervisors. In fact, we hope
capable professional counselors will become supervisors, thereby contributing to
a professional legacy. In this regard, supervisors of prelicensed counselors have
unique opportunities to influence the evolution of the counseling profession as they
nurture the development of future clinicians, scholars, and leaders.
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Sandy Magnuson, Ed. D., is an assistant professor of Counselor Education and coordinator
of the School Counseling Program at Texas Tech University in Lubbock. Ken Norem,
Ph.D., is a visiting associate professor and coordinator of Counselor Education Programs
at Texas Tech University. Allen Wilcoxon, Ed.D., is a professor and chair of the
Counselor Education Programs at The University of Alabama in Tuscaloosa.
Correspondence concerning this article may be sent to Sandy Magnuson, Texas Tech
University, College of Education, Box 41071, Lubbock, TX 79409-1071. Email sandy,
magnuson at ttu, edu.
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Questia, a part of Gale, Cengage Learning. www.questia.com
Publication Information:
Article Title: Clinical Supervision of Prelicensed Counselors: Recommendations for
Consideration and Practice. Contributors: Sandy Magnuson - author, Ken Norem - author,
Allen Wilcoxon - author. Journal Title: Journal of Mental Health Counseling. Volume:
22. Issue: 2. Publication Year: 2000. Page Number: 176. COPYRIGHT 2000 American Mental
Health Counselors Association; COPYRIGHT 2002 Gale Group