Monday, January 13, 2014

Title: Two is Company, Three’s a Crowd: Issues and Answers in Triadic Supervision
Author: William B. McKibben, The University of North Carolina at Greensboro
Purpose: In this literature review, I explored the available literature on triadic supervision structure, processes, and outcomes and discussed implications for research and practice based on current findings. Triadic supervision refers to the pairing of one supervisor with two supervisees simultaneously.
Major Findings: Current CACREP (2009) standards list triadic supervision as an acceptable alternative to individual supervision for counseling students in practicum and internship, and this has remained unchanged in the most recent drafts of the proposed 2016 standard revisions. By establishing triadic supervision as an alternative to individual supervision, the assumption is made that the two modalities are comparable in effectiveness. Researchers have compared triadic to individual and group supervision and found that supervisees viewed triadic as comparable to individual supervision in areas of working alliance, supervisory leadership style, supervision satisfaction and relationship dynamics. However, triadic was rated lower than individual and higher than group on overall effectiveness and meeting supervisee needs. Essentially, supervisees tended to rate individual higher than triadic and triadic higher than group.
What is consistent in the research is what supervisors and supervisees see as important and challenging in triadic supervision. The pros and cons of feedback are a core feature. Having a second supervisee can enhance feedback for a supervisee, and it can also make giving constructive feedback more difficult for peers and supervisors (particularly if the feedback is personal in nature). Safety and trust are highly important to supervisors and supervisees in triadic settings. Vicarious learning (learning from one another through the supervision process) is a commonly noted theme of triadic as well. Finally, matching peers based on similar styles and developmental levels has been noted as a benefit to supervisees and as a challenge to supervisors. The rewards for the second supervisee may very well outweigh the logistical challenges to the supervisor if a triadic modality is possible.
What this means for practice: Although counselors need more conclusive evidence of the effectiveness of triadic supervision and what makes it effective, supervisors have a roadmap for structuring triadic in very helpful ways. First, as is the case in counseling sessions, the relationship consistently emerges as vital in triadic supervision. Supervisors who can attend to the multiple relationships (supervisor-supervisee, supervisee-supervisee) may get the best results. Supervisors should consider a triadic structure that emphasizes collaboration and reduces hierarchical relationships; this may best be accomplished by building trust, modeling how to give positive and constructive feedback, encouraging peer feedback, and linking supervisees’ experiences. Supervisors need to communicate clear expectations for structure, involvement, and feedback at the beginning of the supervisory process.
            Second, there is literature available on structuring triadic supervision in optimal ways; these references are provided below. One option is split-focused triadic supervision in which each supervisee is allotted 30 minutes to present a case or discuss pressing issues. An alternative is single-focused in which each supervisee is allotted a full hour on alternating weeks. These time structures can be helpful, but supervisors may still wonder what to do with two supervisees at once. Many approach triadic in the same way as individual as there is not much guidance in the literature. Stinchfield, Hill, and Kleist (2007) proposed a reflective model of triadic supervision which involved weekly supervision for an hour and a half. Supervisees engage in outer dialogue (engaging with one another in production of meaning) and inner dialogue (ideas constructed internally from listening to outer dialogues) from roles of supervisee, reflective, and observer-reflector. Reflecting from these various roles facilitates clinical learning and insight. This reflective model can be a helpful roadmap for supervisors seeking ways to structure triadic supervision.
Third, supervisors should match peers intentionally. Across several studies, researchers supported that congruent peer matches enhanced the supervision experience while mismatches hindered supervision. Specifically, supervisors should strive to match triadic peers based on developmental level (e.g., both interns, both experienced counselors). This may optimize richness of feedback and vicarious learning.
Finally, researchers have supported that triadic is a distinct modality from individual and group and that lack of supervisor training in this approach is a disadvantage. Thus, supervisors who use or plan to use triadic need to receive training in this modality. Counselor educators need to train future supervisors in triadic-specific supervision, and supervisors need to seek continuing education in triadic supervision. Such training will be limited until additional research is generated, but supervisors should seek out and/or provide training to enhance skills.
For further reading:
Borders, L. D., Welfare, L. E., Greason, P. G., Paladino, D. A., Mobley, A. K., Villalba, J. A., &
Wester, K. L. (2012). Individual and triadic and group: Supervisee and supervisor perceptions of each modality. Counselor Education and Supervision, 51, 281-295.
Council for Accreditation of Counseling and Related Educational Programs. (2009). 2009
standards. Retrieved from
Council for Accreditation of Counseling and Related Educational Programs. (2013). Draft #2
of the 2016 CACREP standards. Retrieved from
Goldberg, R., Dixon, A., & Wolf, C. P. (2012). Facilitating effective triadic counseling
supervision: An adapted model for an underutilized supervision approach. The Clinical Supervisor, 31, 42-60.
Hein, S. F., & Lawson, G. (2008). Triadic supervision and its impact on the role of the
            supervisor: A qualitative examination of supervisors' perspectives. Counselor Education
            and Supervision, 48, 16-31.
Hein, S. F., & Lawson, G. (2009). A qualitative examination of supervisors' experiences of the
            process of triadic supervision. The Clinical Supervisor, 28, 91-108.
Lawson, G., Hein, S. F., & Getz, H. (2009). A model for using triadic supervision in counselor
            preparation programs. Counselor Education and Supervision, 48, 257-270.
Lawson, G., Hein, S. F., & Stuart, C. L. (2009). A qualitative investigation of supervisees’
            experiences of triadic supervision. Journal of Counseling and Development, 87, 449-457.
Lawson, G., Hein, S. F., & Stuart, C. L. (2010). Supervisors’ experiences of the contributions of
the second supervisee in triadic supervision: A qualitative investigation. Journal for Specialists in Group Work, 35, 69-91.
Oliver, M., Nelson, K., & Ybañez, K. (2010). Systemic processes in triadic supervision. The
Clinical Supervisor, 29, 51-67.
Stinchfield, T. A., Hill, N. R., & Kleist, D. M. (2007). The reflective model of triadic
            supervision: Defining an emerging modality. Counselor Education and Supervision, 46,

Title: Rediscovering the Impact of Attachment Theory on Counseling Supervision
Author: Stephen P. Hebard, The University of North Carolina at Greensboro
What was the purpose of this literature review?
The purpose of this literature review was to analyze the existing conceptual and empirical research regarding the use of Attachment Theory as a way to conceptualize the supervisory relationship. Although there are few empirical studies on supervisor and supervisee attachment, attachment does appear to influence the supervisory working alliance, counselor professional development, compulsive avoidance of closeness to one’s supervisor, and counselor self-efficacy. Nevertheless, the research does not fully encompass appropriate definitions of attachment. Understanding attachment as a theory of emotion and emotion regulation may improve the existing literature and provide more impactful implications for practicing supervisors.
Major findings or points:
·      As conceptualized by the majority of supervision researchers working with attachment, supervision can be considered an attachment relationship.
·      By providing a secure base (grounding, holding, and freeing supervisees while stimulating their wonder and awe in becoming a therapist) and a safe haven (comfort and security in the face of danger), the supervisory relationship may function optimally.
·      Attachment styles between supervisor and supervisee interact to affect the supervisory relationship.
·      Supervisor attachment style carries a large amount of influence on the relationship. A secure supervisor attachment style is preferred.
·      Supervisee attachment avoidance and compulsive self-reliance are especially unfavorable in that they negatively impact important supervision outcomes.
Major caveats:
Current conceptualizations of attachment in supervision are operationally defined differently than how Bowlby and Ainsworth, the founders of Attachment Theory, described the concept. Further, the belief that the supervisor-supervisee relationship is indicative of an attachment bond, a very specific and emotionally critical affectional bond, is a major assumption of the current literature. Additionally, measurement of attachment has significant flaws (i.e., issues with self-report of one’s attachment style, using categorical vs. dimensional data) and many empirical studies have used unreliable or primarily clinically relevant instruments in research.  Thus, researchers of Attachment Theory in supervision must agree to an operational definition of the theory to bolster the literature and improve its clinical application.
What does this research mean for counseling practice, settings, and or training?
Supervisors must become accustomed to determining the extent to which supervisee behaviors are reflective of a desire to maintain safety. For instance, overly independent or hypervigilant supervisees may need to process the supervisory relationship with a supervisor. Additionally, it is very important for supervisors to determine how they can provide a safe haven and secure base for each individual supervisee. This may not look the same for every supervisee, depending on their specific ways of regulating their emotions in response to perceived threats. Research on attachment in supervision highlights the importance of monitoring self, other, and the interaction between both parties in hopes of providing the best services possible.
Labels: Attachment, Supervision, Working Alliance
For Further Reading:

Fitch, J. C., Pistole, M., & Gunn, J. E. (2010). The bonds of development: An attachment-caregiving model of supervision. The Clinical Supervisor, 29, 20-34.

Mikulincer, M., & Shaver, P. R. (2003). The attachment behavioral system in adulthood: Activation, psychodynamics and interpersonal processes. In M. P. Zanna (Ed.), Advances in experimental social psychology (vol. 35, pp. 53-152). San Diego, CA: Academic Press.
Mikulincer, M., & Shaver, P. R. (2008). Attachment theory and affect regulation. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research and clinical applications (2nd ed., pp. 503-531). New York: Guilford.
Pistole, M., & Watkins, C. (1995). Attachment theory, counseling process, and supervision. The Counseling Psychologist, 23, 457-478
Riggs, S., & Bretz, K. (2006). Attachment processes in the supervisory relationship: An exploratory investigation. Professional Psychology: Research and Practice, 37, 558–566.
Watkins, C. R., & Riggs, S. (2012). Psychotherapy supervision and attachment theory: Review, reflections, and recommendations. The Clinical Supervisor, 31, 256-289.

Wednesday, December 11, 2013

Rehabilitation Counseling Supervision:  Past, Present, and Future

Katie A. Wachtel, The University of North Carolina at Greensboro

What is the purpose of this literature review?
            There has been significant controversy regarding whether rehabilitation counseling (RC) should be considered a specialization of the counseling profession or its own unique profession.  Proponents of the belief in RC as a unique profession have argued that this should include specialized definitions, models, standards, and practices for supervision.  However, despite this belief, supervision has been largely ignored in both the research and practice of RC.  Recent revisions to RC ethical standards and research findings in the area of RC supervision, summarized below, may prove impactful on the way in which rehabilitation counselors conceptualize and practice supervision.

Major findings or points: 
A review of the literature indicated that prior to 1995 there was no distinct definition or model for supervision within the rehabilitation context, despite arguments that the nature of RC warrants distinctive supervision interventions.  Maki and Delworth (1995) proposed a definition and model unique to RC; however, ethical guidelines for RC supervision were not established until 2002.  Requirements of specialized training in supervision, use of a variety of evaluation methods, documentations of sessions, and multicultural competence were added in the 2010 revision of the ethical guidelines.
            Despite the adoption of ethical standards related to supervision in RC, minimal research has been conducted in this area, and the few researchers who have examined supervision have found that clinical practices in supervision may still be lacking.  Researchers have found that a majority of research on supervision in RC has been conducted using trainees so that little is known about supervision practices post graduation.  Supervision continues to be an important part of professional development and can protect against a decrease in counseling skills; however, many supervisees in professional settings report only receiving supervision on an as-needed basis.  Similarly, supervisees and supervisors alike consistently report confusion between administrative supervision and clinical supervision.  Supervisees overwhelmingly report only receiving supervision as part of team meetings and report slight to moderate satisfaction with administrative supervision, but less than satisfactory feelings regarding clinical supervision.  In addition, individuals who report lower satisfaction with supervision are often those reporting more frequent supervision.  A majority of supervisors report little to no formal training in supervision.  Based on these findings, it appears that clinical practice of supervision in RC is overall not perceived as effective and steps may need to be taken to improve supervision in professional RC settings.
What does this research mean for counseling practice, settings and/or training?
            Although ethical standards for RC supervision have been established and revised, a majority of supervisors and supervisees continue to report dissatisfaction with supervision practices.  It may be important to stress formal training of supervisors using the models developed specifically for RC to assist supervisors in better understanding and implementing supervision practices.  Supervisees may benefit from the adoption of ethical standards in that they will allow supervision to encompass specific expectations and goals.  This can help to add structure and understanding to the supervision process, which may assist both the supervisee and supervisor in feeling more positively about the experience.

Rehabilitation counseling, supervision

For Further Reading:
Blackwell, T. L., Strohmer, D. C., Belcas, E. M., & Burton, K. A.  (2002).  Ethics in rehabilitation counselor supervision.  Rehabilitation Counseling Bulletin, 45, 240-247.
Glosoff, H. L., & Matrone, K. F. (2010). Ethical issues in rehabilitation counselor supervision and the new 2010 Code of Ethics. Rehabilitation Counseling Bulletin, 53(4), 249-254. doi:10.1177/0034355210368729
Herbert, J. T., & Trusty, J. (2006). Clinical supervision practices and satisfaction within the public vocational rehabilitation program. Rehabilitation Counseling Bulletin, 49, 66-80.
Maki, D. R., & Delworth, U. (1995). Clinical supervision: A definition and model for the rehabilitation counseling profession. Rehabilitation Counseling Bulletin, 38, 282-294.
McCarthy, A. K. (2013). Relationship between supervisory working alliance and client outcomes in state vocational rehabilitation counseling. Rehabilitation Counseling Bulletin, 57, 23-30.
Schultz, J. C., Ososkie, J. N., Fried, J. H., Nelson, R. E., & Bardos, A. N. (2002). Clinical supervision in public rehabilitation counseling settings. Rehabilitation Counseling Bulletin, 45, 213-222.
Thielsen, V. A., & Leahy, M. J. (2001). Essential knowledge and skills for effective clinical supervision in rehabilitation counseling. Rehabilitation Counseling Bulletin, 44, 196-208.

Wilkinson, A. D., & Wagner, R. M. (1993). Supervisory leadership styles and state vocational rehabilitation counselor job satisfaction and productivity. Rehabilitation Counseling Bulletin, 37, 15-25.
Implications of Research on Metaphors in Supervision
Alwin E. Wagener
Facilitating the development of counselors in supervision is important and challenging. It requires awareness of supervisees’ developmental levels and challenges and supervisory approaches and interventions to assist them. One intervention that has been explored is the use of metaphors in supervision. Though empirical support is limited, there are findings relevant to supervision, summarized below.
Before describing implications of supervision research in counseling, a description of metaphors and brief defining of terminology is required. Metaphors in this context are not solely linguistic devices. Instead, they are recognized and supported by cognitive research as playing an important role in organizing thoughts and emotions, learning new information, and integrating new understandings. Two types of metaphors are described.  Conventional metaphors are the metaphors commonly used and easily understood (e.g. love is a journey), while unconventional metaphors are those not in common use and often requiring some explanation (e.g. love is an apple). Unconventional metaphors may involve combinations of conventional metaphors to create new links with what is being described, such as “love is a canoe journey and you don’t rock the boat”. With that foundation, the following implications can be understood.
·      The introduction of metaphors in supervision may increase both detail and depth of conversations about clients and experiences as a counselor.
·      Telling stories with strong metaphoric themes to supervision groups and initiating a discussion relating the metaphor to counseling may be useful for encouraging supervisee self-reflection.
·      Having the supervisee create a metaphoric drawing of the client and/or counseling experience he or she wants to process in supervision and then spending time processing that drawing has the potential to increase counselor development and bring out important client issues that might not otherwise be recognized or discussed.
·      When supervisees create unconventional metaphors, they often are working on emotional-cognitive integration or developing new perspectives.
·      If supervisees do not create unconventional metaphors, this may indicate that emotional-cognitive integration or developing new perspectives is not happening, which may or may not be appropriate for the situation or developmental level of the supervisee.
·      The co-creation of metaphors between supervisor and supervisee may help in the development of a working alliance by creating a shared language.
These implications are extrapolated from the articles attached to this manuscript. They have preliminary, qualitative, and theoretical support but lack generalizable, empirical support. Therefore, future research is needed to increase understanding of the use of metaphor in supervision. 

For Further Reading
Gelo, O. C. G., & Mergenthaler, E. (2012). Unconventional metaphors and emotional-cognitive regulation in a metacognitive interpersonal therapy. Psychotherapy Research, 22, 159–75. doi:10.1080/10503307.2011.629636
Guiffrida, D. A., Jordan, R., Saiz, S., & Barnes, K. L. (2007). The use of metaphor in clinical supervision. Journal of Counseling & Development, 85, 393–400. doi:10.1002/j.1556-6678.2007.tb00607.x
Long, P., & Lepper, G. (2008). Metaphor in psychoanalytic psychotherapy: A comparative study of four cases by a practitioner-researcher. British Journal of Psychotherapy, 24, 343–364. Retrieved from
Råbu, M., Haavind, H., & Binder, P.-E. (2013). We have travelled a long distance and sorted out the mess in the drawers: Metaphors for moving towards the end in psychotherapy. Counselling and Psychotherapy Research, 13, 71–80. doi:10.1080/14733145.2012.711339
Robert, T., & Kelly, V. (2010). Metaphor as an instrument for orchestrating change in counselor training and the counseling process. Journal of Counseling & Development, 88, 182–189. Retrieved from
Sommer, C., Ward, J., & Scofield, T. (2010). Metaphoric stories in supervision of internship: A qualitative study. Journal of Counseling & Development, 88, 500–508. Retrieved from
Stone, D., & Amundson, N. (1989). Counsellor supervision: An exploratory study of the metaphoric case drawing method of case presentation in a clinical setting. Canadian Journal of Counselling, 23, 360–371. Retrieved from
Tay, D. (2012). Applying the notion of metaphor types to enhance counseling protocols. Journal of Counseling & Development, 90, 142–150.
Young, J. S., & Borders, L. D. (1998). The impact of metaphor on clinical hypothesis formation and perceived supervisor characteristics. Counselor Education and Supervision, 37, 238–256. Retrieved from
Young, J. S., & Borders, L. D. (1999). The intentional use of metaphor in counseling supervision. The Clinical Supervisor, 18, 137–149. Retrieved from