Title:

The Relationship between Supervision and Clinical Counselors’ Outcome Efficacy

Author:

Nicole A. Adamson, The University of North Carolina at Greensboro

What was the purpose of this literature review?

This brief literature review explores ways in which the supervisory process is related to a counselor’s ability to help clients reach their goals.

Major findings or points:

Outcome efficacy refers to the act of clients reaching their goals.

The following points should be reviewed in order for supervisors to help counselors achieve higher levels of outcome efficacy.

·      Take care to be supportive of supervisees and ensure that they feel safe in supervision sessions.  This can be achieved through setting up clear boundaries and goals for the supervisory process.  Additionally, creative interventions such as bibliosupervision might help establish safety and openness in the supervisory relationship.

• Consistent and intentional supervision is an incredibly important addition to a counselor’s formal training program.  Supervisors should strive to provide systematic, long-term supervision beyond graduation.  The resources that will be required to offer a sufficient caliber of supervision should be accounted for in a mental health organization’s yearly planning.
• Supervision has a formative function (to help counselors develop professionally), a restorative function (to help counselors maintain a sufficient standard of care), and a normative function (to ensure that counselors who work with the public are competent).  The normative function of supervision can potentially cause discomfort and is often overlooked by supervisors.  Thus, it is recommended that supervisors discuss their dual role of mentor and evaluator with counselors, use systematic and objective evaluation criteria, and share the normative function with other qualified professionals (e.g., university supervisors or other colleagues).

Major caveats:

Although supervision is an accepted part of counselor training models, there is limited empirical literature that directly supports the relationship between supervision and counselor outcome efficacy.  The current research has identified some variables that might potentially contribute to outcome efficacy, but a modest amount of interventions has been concretely supported.

What does this research mean for counseling practice, settings, and/or training?

Researchers have considered several supervision variables that might contribute to counselor outcome efficacy.  The empirically-supported variables include the following: offering support; conducting consistent, long-term supervision; and having candid conversations about the functions of supervision.  Supervisors should strongly consider implementing these recommendations. 

Other variables that have not been empirically-supported include the timing of supervision sessions in relation to supervisees’ next counseling session, the possibility of training or modeling ways for counselors to improve therapeutic relationships, and supervision that focuses on specific intervention protocols.  Supervisors should consider their own hypotheses about the importance of such potential variables and develop an intentional supervisory process.

Labels:

supervisory relationship, outcome efficacy, clinical counseling, bibliosupervision, functions of supervision

For Further Reading:

Crits-Christoph, P., Gibbons, M. B. C., Crits-Christoph, K., Narducci, J., Schamberger, M., & Gallop, R. (2006). Can therapists be trained to improve their alliances? A preliminary study of alliance-fostering psychotherapy. Psychotherapy Research, 16, 268–281. doi:10.1080/10503300500268557

Graham, M., & Pehrsson, D. (2008). Bibliosupervision: A multiple-baseline study using literature in supervision settings. Journal of Creativity in Mental Health, 3, 428-440. doi:10.1080/15401380802531052

O’Donovan, A., Halford, W. K., & Walters, B. (2011). Towards best practice supervision of Clinical Psychology trainees. Australian Psychologist, 46, 101–112. doi:10.1111/j.1742-9544.2011.00033.x

Smith, J. L., Carpenter, K. M., Amrhein, P. C., Brooks, A. C., Levin, D., Schreiber, E. A., ... Nunes, E. V. (2012). Training substance abuse clinicians in motivational interviewing using live supervision via teleconferencing. Journal of Consulting & Clinical Psychology, 80, 450-464. doi:10.1037/a0028176

Wheeler, S., & Richards, K. (2007). The impact of clinical supervision on counsellors and therapists, their practice and their clients. A systematic review of the literature. Counselling & Psychotherapy Research, 7, 54-65. doi: 10.1080/14733140601185274