Dual Relationships in Counseling Supervision: Implications for Practice

(Note: Doctoral students in CED 781a Counseling Supervision during Fall 2010 completed abbreviated literature reviews on a topic of individual interest. They wrote both a research summary and a summary for practitioners. Here, we present the summaries for practitioners. Please let us know if you have questions or suggestions for future summaries. L. DiAnne Borders)

By Cristina Lima

The topic of dual relationships in supervision with counseling trainees has received the attention of the professional community for decades. Ability to determine potential for ethical problems is crucial, but the ethical codes of the helping professions do not always offer concrete guidelines. Supervisors often find themselves in dual role dilemmas. Some are easier to assess and determine a course of action, such as conflicts involving romantic relationships. However, there are ambiguous situations involving social interactions or multiple professional roles when supervisors face uncertainty.

Sexual Relationships

Historically, the first concern of helping professionals in regard to dual relationships in supervision was focused on sexual relationships. Pioneer studies were important to show the prevalence of such relationships and raise awareness among professionals (Pope, Levenson, & Schover, 1979). In 1981, the American Psychological Association (APA) revised its Ethical Standards and, for the first time, stated that sexual relationships with supervisees and students were unethical. A few years later, it was clear that romantic interactions in the supervisory relationship were harmful and that the main factor associated with the risk of exploitation was the power differential between supervisor and supervisee (Glaser & Thorpe, 1986).

Social Interactions

Once the issue of sexual intimacies was settled, interest turned to non-sexual relationships, especially social interactions. The main focus of attention was the potential of harm to the working supervisory relationship because of the risk of exploitation due to the power differential, and the potential of loss of objectivity consequent to the overlapping of roles. By that time, the framework used for dual relationship between clients and therapists was assumed to be equally valid for the supervisory relationship. However, this assumption was challenged by several researchers (e.g., Bowman & Hatley, 1995; Erwin, 2000), who suggested that not all dual-relationships are harmful. Furthermore, Burian and Slimp (2000) believed that not all types of dual relationships should be avoided because of possible benefits.

Multiple Professional Roles

Besides social interactions, supervisors also were concerned with multiple professional relationships (Lamb, Catanzaro, & Moorman, 2004). Multiple professional relationships in supervision occur when there is an overlap of roles such as teacher, advisor, clinical supervisor, and administrative supervisor. These type of dual relationship, according to studies (e.g.,Tromski-Klingshirn & Davis, 2007), seem to have the potential to bring more benefits than harm to the working relationship. The conclusion is that the quality of the relationship is more important than the dual relationship per se. Professional dual relationships carry the same potential risk for exploitation and loss of objectivity; however, the risk is minimized by the fact that the multiple professional roles often share the same evaluative nature.

Professional dual relationships are often difficult to avoid. Gottlieb, Robinson, and Younggren (2007) offered recommendations for administrators, supervisors, and supervisees when facing multiple relationships. The main recommendations were to focus on the best interest of the supervisees, acknowledge power differential and evaluative roles, maintain objectivity, assess potential for harm, keep clear boundaries, and discuss the issue openly with supervisees. It seems that awareness is an important component to avoid harm.

Conclusions

Considering the lack of more specific guidelines, the major implication of this review is to emphasize the relevance of awareness among supervisors. Furthermore, special attention should be given to training of supervisors, including a clear distinction among different types of dual roles and different strategies to determine and choose appropriate course of action. Also, it is important to foster opportunities for dialogue among supervisors to discuss the ethical implications of such relationships, what constitutes harm and benefit in non-sexual relationships, and what constitutes quality supervisory relationship.

For Further Reading

Burian, B. K., & Slimp, A. O. (2000). Social dual-relationships during internship: A decision- making model. Professional Psychology: Research and Practice, 31, 332-338.

Gottlieb, M. C., Robinson, K., & Younggren, J. N. (2007). Multiple relations in supervision: Guidance for administrators, supervisors, and students. Professional Psychology: Research and Practice, 38, 241-247.

Lamb, D. H., Catanzaro, S. J., & Moorman, A. S. (2004). A preliminary look at how psychologists identify, evaluate, and proceed when faced with possible multiple relationship dilemmas. Professional Psychology: Research and Practice, 35, 248-254.

Tromski-Klingshirn, D. M., & Davis, T. E. (2007). Supervisees’ perceptions of their clinical supervision: A study of the dual role of clinical and administrative supervisor. Counselor Education & Supervision, 46, 294-304.

Reflection in Supervision: A Literature Review and Implications for Practitioners

(Note: Doctoral students in CED 781a Counseling Supervision during Fall 2010 completed abbreviated literature reviews on a topic of individual interest. They wrote both a research summary and a summary for practitioners. Here, we present the summaries for practitioners. Please let us know if you have questions or suggestions for future summaries. L. DiAnne Borders)

By Evette Horton

Since the 1930’s, educators have been advocating for the use of reflection in training students to be insightful, critical thinkers (Dewey, 1933). Reflection, reflectivity, and self-reflection all refer to the cyclical process of evaluating one’s experiences to develop critical thinking skills and insightfulness (Orchowski, Evangelista, & Probst, 2010). Researchers in education have found that students who use reflectivity get the most out of their learning experiences (Lyon & Brew, 2003; McAlpine, Weston, Beauchamp, Wiseman, & Beauchamp, 1999).

In supervision specifically, the reflective process refers to the counselor-in-training thinking back critically on the counseling session with the client, and bringing these thoughts and ideas to supervision for discussion. It also entails the supervisor thinking back on sessions with the supervisee. Counselor educators and supervisors are charged with training competent, reflective counselors, who are able to think critically about their clients and their interactions with them, and the reflective process enables this critical competency to develop (ACA, 2005; Magnuson & Norem, 2002). Until recently, there was not much empirical research on effective ways to use reflection in supervision. However, researchers have now begun to validate the most effective reflection activities for supervisory counseling relationships.

Using Reflection in Supervision

Journaling. Asking students to write about their experiences in internship and practicum has been shown to improve student integration of learning and insightfulness. Several researchers found that specifically reflecting on a clinical dilemma enhanced supervisees’ conceptualization of the issue and improved their counseling competencies (Jen Der Pan, Deng, & Shiou-Ling, 2008; Neufeldt, Karno, & Nelson, 1996). Therefore, supervisors should ask supervisees to journal about a difficulty they are having with a client. Since some of our counseling students are international students, one study found that using reflective journaling helped international students manage their stress and improve their English and writing skills.

Supervisors modeling reflection. Several authors have found that supervisors who use reflection themselves are modeling critical thinking skills and promoting self awareness (Jen Der Pan, 2008; Orchowski et al., 2010). Neufeldt et al. (1996) reported that supervisors must teach the reflective process to supervisees and that the supervisory relationship is paramount for doing this. To model reflection, Stevens, Emil, and Yamashita (2010) suggested that supervisors can do journaling themselves, create a safe environment for reflection, and share dilemmas they have faced in their professional life.

Reflection in group supervision. Counselor educators and supervisors often use group supervision as a way to train counselors/supervisees. Reflectivity can be introduced in to the group relationship by asking group members to bring clinical dilemmas or troubling cases to the supervision group. The supervisor helps the counselors-in-training process these cases by looking for themes and hypotheses to explain client needs. Jen Der Pan et al. (2008) found that this type of group supervision significantly improved supervisees’ counseling competencies. It is important to note that a safe, supportive group supervision environment is imperative for reflective supervision.

Given that counselor educators and supervisors are ethically bound to promote competence in our supervisees (ACA, 2005), reflection is a useful tool for promoting these critical thinking competencies. Until we have more empirical validation of reflection, these techniques are all we have to go on. Future research may give us more information on what specific models of reflection and at what times using these reflective techniques are most helpful to supervisees. At the very least, it is important for counselor educators and supervisors to model and introduce reflectivity in the supervisory relationship.

For Further Reading

(*most recommended for practitioners)

American Counseling Association (2005). ACA code of ethics. Retrieved from http://www.counseling.org/Resources/CodeOfEthics/TP/Home/CT2.aspx.

Dewey, J. (1933). How we think: A restatement of the relation of reflective thinking to the educative process. Chicago, IL: Regnery.

*Heller, S. S., & Gilkerson, L. (Eds.) (2009). A practical guide to reflective supervision. Zero to Three: Washington, DC.

Jen Der Pan, P., Deng, L. F., & Shiou-Ling, T. (2008). Evaluating the use of reflective counseling group supervision for military counselors in Taiwan. Research on Social Work Practice, 18, 346-355.

Lyon, P., & Brew, A. (2003). Reflection on learning in the operating theatre. Reflective Practice, 4, 53-66.

Magnuson, S., & Norem, K. (2002). Reflective counselor education and supervision: An epistemological declaration. Reflective Practice, 3, 167-173.

McAlpine, L., Weston, C., Beauchamp, C., Wiseman, C., & Beauchamp, J. (1999). Building a metacognitive model of reflection. Higher Education, 37(2), 105-131.

Neufeldt, S. A., Karno, M. P., & Nelson, M. L. (1996). A qualitative study of experts' conceptualization of supervisee reflectivity. Journal of Counseling Psychology, 43, 3-9.

*Orchowski, L., Evangelista, N. M., & Probst, D. R. (2010). Enhancing supervisee reflectivity in clinical supervision: A case study illustration. Psychotherapy Theory, Research, Practice, Training, 47, 51-67.

Stevens, D. D., Emil, S., & Yamashita, M. (2010). Mentoring through reflective journal writing: a qualitative study by a mentor/professor and two international graduate students, Reflective Practice, 11, 347-367.

Parallel Process and Supervision

(Note: Doctoral students in CED 781a Counseling Supervision during Fall 2010 completed abbreviated literature reviews on a topic of individual interest. They wrote both a research summary and a summary for practitioners. Here, we present the summaries for practitioners. Please let us know if you have questions or suggestions for future summaries. L. DiAnne Borders)

By Amanda Giordano

Parallel process is a phenomenon that occurs within the supervisory relationship that impacts the supervisor, supervisee, and client. Below please find information related to the basics of parallel process, as well as further reading on this topic.

What: Parallel process is a construct that emerged from the psychoanalytic orientation. It occurs when supervisees unconsciously present to their supervisors in the same fashion that their clients presented to them. It is the unconscious “acting out” in supervision an issue in the supervisee’s relationship with his/her client. For example, a supervisee may be counseling a client who continuously challenges her or his assertions and attempts to undermine the therapeutic efforts. Similarly, the supervisee may begin to challenge the supervisor in subsequent supervision sessions and counter efforts to engage in supervisory work. In this way, the supervisee is unconsciously acting out the dynamics of the counseling relationship in supervision and “asking” the supervisor how to handle these challenges in working with the client.

Who: Parallel process has several participants. The supervisor, supervisee, and the supervisee’s client are all involved. First, the supervisee and client have an issue, reach an impasse, or experience a difficult dynamic in the therapeutic relationship. The supervisee may then act in supervision in the same way the client acted in the counseling session. Therefore, the supervisor becomes actively involved as he or she interacts with the supervisee presenting as the client. Each member of the triad (supervisor, supervisee, client) is affected by parallel process.

Why: The most commonly cited motivation for parallel process is to elicit help from the supervisor. The supervisee is “showing” the supervisor what he/she is experiencing in the counseling session by “acting out” the issue in supervision. The supervisee is seeking a demonstration from the supervisor about how to navigate the situation.

When: The most common signs that parallel process is occurring are atypical supervisee behaviors, changes in the supervisory relationship, or an impasse in counseling. The phenomenon may occur whenever the supervisee feels the need to elicit help from the supervisor.

Where: Researchers have suggested that parallel process can begin in either the counseling session or the supervision session. If it begins in the counseling session, the supervisee will present like the client in supervision. If it begins in the supervision session, the supervisee will present (act like) like the supervisor in counseling.

Implications for supervision

· It is important for supervisors to be aware of parallel process and notice if supervisees are demonstrating atypical behaviors or if there is a sudden change in the dynamics of the supervisory relationship.

· Since parallel process is often an unconscious presentation of client behaviors, it is important that supervisors consult other sources rather than rely solely on a supervisee’s self-report. By watching video recordings of counseling sessions or listening to audio recordings, the supervisor can better detect if parallel process is occurring.

· It is important to note that parallel process is neither good nor bad; instead, it is another form of information. Parallel process allows the supervisor to experience what the supervisee is experiencing in counseling and therefore develop empathy. In addition, by working through parallel process, the supervisee can learn how to navigate this impasse effectively and provide better service to his/her client.

· When parallel process occurs, supervisors can intervene in two ways: 1) by identifying it and bringing it to the supervisee’s awareness, or 2) by navigating through the situation and thus supplying the information that the supervisee is seeking. The developmental level of the supervisee and supervision environment must be considered when deciding how to manage parallel process. It has been suggested in that beginning counselors lack the insight and self-awareness to benefit from the supervisor directly labeling parallel process when it occurs. Only when a supervisee has advanced in the development of self awareness should parallel process be identified directly in supervision.

Future reading on parallel process

(* most recommended for supervision practitioners):

*Alpher, V. S. (1991). Interdependence and parallel process: A case study of structural analysis of social behavior in supervision and short term dynamic psychotherapy. Psychotherapy, 28, 218-231.

Deering, C. G. (1994). Parallel process in the supervision of child psychotherapy. American Journal of Psychotherapy, 48, 102-110.

*Grey, A., & Fiscalini, J. (1987). Parallel process as transference-countertransference interaction. Psychoanalytic Psychology, 4, 131-144.

*Martin, J. S., Goodyear, R. K., & Newton, F. B. (1987). Clinical supervision: An intensive case study. Professional Psychology: Research and Practice, 18, 225-235.

Power and Influence in Supervision

(Note: Doctoral students in CED 781a Counseling Supervision during Fall 2010 completed abbreviated literature reviews on a topic of individual interest. They wrote both a research summary and a summary for practitioners. Here, we present the summaries for practitioners. Please let us know if you have questions or suggestions for future summaries. L. DiAnne Borders)

By Cheryl L. Fulton

Overview

Social power is defined as an individual’s degree of personal influence. It is well recognized that power and influence exist in supervision and, therefore, it is an important topic for both researchers and practitioners. Social Influence Theory applied to supervision suggests that supervisees seek help because they believe the supervisor has resources needed to help them with client cases, often for difficulties supervisees perceive as beyond their control. Research supports that supervisees will accept the supervisors’ help (influence) if they perceive him/her as having three broad characteristics: expertness (credibility, training, knowledge, reputation), trustworthiness (openness, sincerity, supervisee’s best interest at heart), and attractiveness (similar and compatible). The supervisor uses this influence to affect supervisees’ attitudes and behaviors that cause them to be “stuck” with clients. The supervisor/supervisee relationship is similar to the counselor/client relationship, with the exception that the supervisory relationship is evaluative, which adds greater complexity related to power.

Researchers purport that there are five power bases used in influence. These are expert (good reputation, use of reflective statements, responsive non-verbal behavior, and well thought out and presented viewpoints that are discrepant with the supervisee's), referent (having similar attitudes and values and responsiveness), informational (familiarity with numerous helpful information sources), legitimate (a sanctioned authority position), and ecological (awareness of needed changes in supervisee’s environment, situation, or professional behavior).

There are several influence theories; however, three often seen in the counseling literature include: Dissonance Theory, Social Influence, and The Elaboration Likelihood Model. The respective methods of attitude/behavior change employed within these theories is dissonance (i.e., challenging attitudes); persuasion tactics (e.g., metaphors, noting negative consequences, pointing out benefits/rewards, and modeling); or messaging (i.e., communicate in an empathic, understanding manner). Although most studies support that supervisees value the supervisory experience and relationship, it has been a challenge to determine whether supervision positively affects client outcomes.

Practitioner Information and Tips:

Recognize that power and influence exist in supervisory relationships and therefore need the same care and attention you would give any relationship issue in any therapeutic relationship.

Supervisors will be able to influence the supervisee to accept attempts to change attitudes/behaviors best if the supervisee views the supervisor as expert, trustworthy, attractive.

When the supervisor challenges a supervisee’s perception and causes dissonance, recognize that the supervisee will attempt to resolve this in a number of ways (e.g., discredit, reject, minimize, revise, or accept). Responses other than “accept” are natural responses and need the same combination of empathy, support, and challenge that you would use in counseling.

Demonstrating professional attitudes and behaviors, continuing your own development as a counselor, building rapport, maintaining the supervisee’s welfare as paramount, attending to supervisee needs, and exhibiting warmth, empathy, respect, openness, sincerity, congruence, and expertise will enable influence and a positive supervisory experience.

Supervisory success also depends on sensitivity to other potential influence issues such as age, gender, and cultural factors. Some groups as well as some individuals may be more vulnerable to unproductive power dynamics. Being aware, genuine, and willing to seek consultation will help ensure success in dealing with these issues.

Although the supervisory relationship parallels the counseling relationship, supervision requires unique training, education, and experience to be successful.

For Further Reading

(*most recommended for supervision practitioners)

Benson, K. P., & Holloway, E. L. (2005). Achieving influence: A grounded theory of how clinical supervisors evaluate trainees. Qualitative Research in Psychology, 2, 117-140.

*Claiborn, C. D., Etringer, B. D., & Hillerbrand, E. T. (1995). Influence processes in supervision. Counselor Education and Supervision, 34, 43-53.

*Dodenhoff, J. T. (1981). Interpersonal attraction and direct-indirect supervisor influence as predictors of counselor trainee effectiveness. Journal of Counseling Psychology, 28, 47-52.

Dorn, F. J. (1985). The social influence model in clinical supervision. The Clinical Supervisor, 3, 77-84.

Granello, D. H., (2003). Influence strategies in the supervisory dyad: An investigation into the effects of gender and age. Counselor Education and Supervision, 42, 189-202.

*Heppner, P. P., & Handley, P. G. (1981). A study of the interpersonal influence process in supervision. Journal of Counseling Psychology, 28, 437-444.

Hernandez, P., & McDowell, T. (2010). Intersectionality, power, and relational safety in context: Key concepts in clinical supervision. Training and Education in Professional Psychology, 4, 29–35.

Holloway, E. L., Freund, R. D., Gardner, S. L., Nelson, M. L., & Walker, B. R. (1989). Relation of power and involvement to theoretical orientation in supervision: An analysis of discourse. Journal of Counseling Psychology, 36, 88-102.

*Houser, R., Feldman, M., Williams, K., & Fierstien, J. (1998). Persuasion and social influence tactics used by mental health counselors. Journal of Mental Health Counseling, 20, 238-249.

Stoltenberg, C. D. (1988). A test of the elaboration likelihood model for therapy. Cognitive Therapy and Research, 12, 69-80.

Latino Students in New Arrival States: Factors and Services to Prevent Youth from Dropping Out

Researchers: Andrew Behnke, North Carolina State University,

Laura Gonzalez, UNC Greensboro, & Ron Cox, Oklahoma State University

Source (Journal name, date of publication): Hispanic Journal of Behavioral Sciences, Aug 2010

What was the purpose of this research?

Latino youth are more likely than any other ethnic group to drop out of high school in the United States. Though some research has helped us understand the factors leading to dropout, very few studies have assessed Latino student’s opinions of services and factors that would help them stay in school.

If applicable, who were the participants, and what were they asked to do?

This study presents the results of an in-depth survey of 501 Latino students in North Carolina public schools.

Major findings or points:

Findings suggest that Latino youth drop out because of the difficulty of their school work (particularly if they are still acquiring English), personal problems (e.g., pregnancy or problems at home), the need to work to support their family economically, and peer pressure.

Major caveats:

The students surveyed were attending a leadership conference, so they represent a motivated subset of Latino students in North Carolina, but they were reflecting on their peers as well as their own concerns.

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

Students suggest improved academic and personal support in the form of tutoring, mentoring, after-school programs; improved English as a second language classes; and more Spanish-speaking staff/teachers.  Students pointed in particular to the importance of a caring attitude from school personnel (including counselors), which meant actively listening to their concerns or reaching out in a proactive manner.  The concerns reflected under reasons for drop out have many implications for counselors, both personal and academic.  As schools in North Carolina experience continued growth in the numbers of Latino students, administrators, teachers, and counselors who were previously unfamiliar with the culture will need to find ways to build bridges to these families.  Community and state-wide resources such as El Pueblo, the Center for New North Carolinians, and the NC Society of Hispanic Professionals have many resources to offer.  The value of personal relationships in Latino/Hispanic traditions cannot be overstated.

By: Laura Gonzalez

CED Students Create Sexuality Counseling Guidebook: Volume V (Special Theme: Sexuality Counseling Across the Lifespan)

Students in the Fall 2010 semester of the Sexuality Counseling course have written the fifth volume of the Sexuality Counseling Guidebook. The special theme for this volume was "Sexuality Counseling Across the Lifespan." The guidebook includes research-based information to assist counselors in working with clients about sexuality issues across the following stages of life: childhood, adolescence, young adulthood, middle adulthood, and older adulthood.

The Guidebook can be accessed here:

https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0Bx3L5tDfyhpRYzkxNDlhYzItMGVkYi00MzE2LWJiYTUtNmU1Yjg1YTcyNThh&hl=en

The students enrolled in this class were Whitney Akers, Abby Illig, Hannah Myung, Nicole Tate, and Emily Teague