Supervision in Career Counseling: Implications for Practice

by Melissa Wheeler

In practice, career counselors must balance addressing a client’s presenting concern with personal issues and considerations that may influence career choice. Due to the changing nature of the world of work, career counselors must stay abreast of workplace trends, unemployment numbers, and emerging career fields. Practicing career counselors must also continue to learn about emerging career theories and techniques that will influence their work with clients. How do practicing counselors receive this type of support when they may be far removed from educational settings?

Expressed Supervision Needs of Career Counselors

Ongoing supervision can be a tool for professional development and lifelong learning for career counselors in the field. Researchers have found that career counselors see the benefits of supervision, but they do not feel that they get enough supervision time (McMahon, 2005;Reid, 2010). Career counselors report wanting to receive the following from supervision (McMahon, 2005):

· Confirmation about their case conceptualizations

· Feedback on counseling techniques

· Affirmation of their counseling skills

· Suggestions for techniques to use with clients

· Additional perspectives on client conceptualizations and treatment plans

· Clarity regarding a difficult client’s presenting issues

· Support regarding issues that could lead to burnout

Special Considerations for Supervisors

Finding an appropriate supervisor can be difficult in professional settings. For career counselors in rural settings, supervisors may be in cities too far away to drive in regularly for face-to-face supervision sessions. In career counseling settings, supervisors may well be the superiors also in charge of performing performance evaluations. Furthermore, many counselors find it difficult to find a supervisor who has had training in supervision, much less training in supervision of career counselors. To ensure counselors and supervisors receive the most from supervision, supervisors of career counselors should keep the following in mind:

· Issues of power and possible dual relationships should be addressed at the beginning of the supervisory relationship so that counselors can be made to feel more comfortable discussing difficult cases with supervisors (Reid, 2010).

· Supervision time should be set aside as soon as possible and follow a set schedule. Supervision times must be protected, even when the work week becomes hectic (Reid, 2010).

· Expectations should be set in advance that both supervisor and counselor will prepare for the supervision session (Reid, 2010).

· Supervisors should be sure counselors not only are addressing a client’s presenting issues for career counseling, but also personal circumstances that may be affecting career decisions (Prieto & Betsworth, 1999).

· Supervisors should be attuned to a counselor’s beliefs surrounding career assessments and possible overreliance on assessment results for client conceptualizations (Prieto & Betsworth, 1999).

· Supervisors of career counselors should also receive supervision to enhance their skills (Reid, 2010).

· For supervisors who may not have expertise in career counseling, additional professional development opportunities should be sought (Reid, 2010).

For Further Reading:

McMahon, M. (2005) Clinical supervision in school counseling and career counseling: Is it time to develop a new story? Australian Journal of Guidance and Counselling, 15, 105-116.

Prieto, L. R., & Betsworth, D. G. (1999). Supervision of career counseling: Current knowledge and new directions. The Clinical Supervisor, 18, 173-189.

Reid, H. L. (2010). Supervision to enhance educational and vocational guidance practice: A review. International Journal of Educational and Vocational Guidance, 10, 191-205. doi: 10.1007/s10775-010-9184-x

Ending the Cycle of Trauma: Reducing Vicarious Trauma through Trauma-Sensitive Supervision

Laura K. Jones

Clinicians often report feeling underprepared to work with trauma survivors. Well over half of the clients being seen at community mental health clinics report having experienced at least one traumatic incident during their lifetime, however, so trauma work is nearly inevitable. Supervision affords a unique opportunity to help prepare and support counselors working with traumatized clients. The supervisory relationship as well as the structure and content of supervision can be used as tools to prepare and ensure the wellbeing of both the client and the counselor.

Hearing stories of abuse, neglect, violence, and loss can be exceedingly difficult for counselors, especially counselors who themselves have a history of personal trauma (Baird & Kracen, 2006). In fact, many counselors who work with survivors can experience symptoms analogous to the posttraumatic stress disorder (PTSD) faced by their clients, with nearly 20 percent of counselors developing clinically diagnosable PTSD as a result (Meldrum, King, & Spooner, 2002, as cited by Sommer, 2008). The potential for such vicarious trauma (VT) is one of the predominant considerations in tailoring supervision for trauma counselors. Supervisors can reduce the potential for VT by providing a collaborative, strengths-based supervisory relationship that integrates ongoing discussions about VT and provides time and space for supervisees to discuss personal feelings and reactions to their work. The use of stories and metaphors has also been suggested as a possible means of facilitating discussions of vicarious reactions and helping supervisees make meaning of their feelings and experiences (Sommer & Cox, 2006).

Trauma-sensitive supervisors should likewise continually monitor supervisees for signs of VT and promote self-care both in and out of the supervisory context. Use of guided imagery, progressive relaxation, and breath work can be used during supervision for supervisees who are expressing considerable stress (Sommer, 2008). Furthermore, given the predisposition for counselors with a personal history of trauma to develop VT, there is considerable debate as to whether supervisors should or ethically can inquire about the trauma history of supervisees (West, 2010). Supervisors are cautioned to weigh strongly the advantages and disadvantages of such an inquiry, taking into consideration the particular circumstances of the individual supervisee.

A second overriding concern in trauma-sensitive supervision is the specialized knowledge needed to effectively assist trauma clients (Etherington, 2000; Sommer, 2008; West, 2010). Information related to trauma assessment, trauma-induced changes in physiology and arousal, dissociation, treatment models, recovered memories, and countertransference are integral to efficacious and beneficent work with traumatized clients. The most prevalent misstep untrained trauma counselors make is pushing a survivor to work with traumatic memories before the client is emotionally and physiologically ready. As such, one of the roles of a trauma-sensitive supervisor is to assess for gaps in the supervisee’s knowledge within these six core areas and provide avenues for training in deficient areas (Etherington, 2000). An assessment of supervisees’ knowledge of trauma theory should occur prior to contracting for supervision so requisite training can be integrated into the supervisory agreement (West, 2010). Assigning regular readings and case presentations covering areas needing further development can facilitate continuing education. In order for supervisors to adequately assess and train trauma counselors, however, supervisors themselves also need to be literate in trauma theory and practice.

Organizational factors also influence the wellbeing of both the trauma counselor and client and thus should be addressed within the supervisory context (Sommer, 2008). Dual relationships whereby the supervisor is also a boss, inadequate time for supervision, supervision not being valued, and caseloads too heavily based in trauma clients can increase the potential for VT and negatively impact the client and counselor. Given the American Counseling Associations Code of Ethics (2005), counselors are obligated to take action when agency policies and practices are damaging to clients or influence the effectiveness of counselors. Therefore, discussions of organizational impediments should occur early in supervision and efforts should be made to mitigate the difficulties.

Ongoing supervision is integral to the wellbeing of trauma counselors and beneficent care of their clients and should be tailored to the particular pedagogical and emotional needs of this population. Balancing traditional supervisory goals with the core components of trauma-sensitive supervision and the individual supervisee’s needs and developmental level can be difficult, yet additional support systems outside of the supervisory relationship can help manage the more restorative, self-care needs of trauma supervisees. Supervisors can assist supervisees in finding and building such networks and in doing so better address the multifaceted demands of trauma-sensitive supervision.

For further reading:

American Counseling Association. (2005). ACA Code of Ethics. Alexandria, VA: American Counseling Association.

Baird, K., & Kracen, A. C. (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Counselling Psychology Quarterly, 19, 181-188. doi: 10.1080/09515070600811899

Etherington, K. (2000). Supervising counsellors who work with survivors of childhood sexual abuse. Counselling Psychology Quarterly, 13, 377-389.

Sommer, C. A. (2008). Vicarious traumatization, trauma-sensitive supervision, and counselor preparation. Counselor Education and Supervision, 48, 61-71.

Sommer, C. A., & Cox, J. A. (2006). Sexual violence counselors’ reflections on supervision: Using stories to mitigate vicarious traumatization. Journal of Poetry Therapy, 19(1), 3-16. doi: 10.1080/08893670600565587

West, A. (2010). Supervising counsellors and psychotherapists who work with trauma: A Delphi study. British Journal of Guidance & Counselling, 38, 409-430. doi: 10.1080/03069885.2010.503696

Use of Cognitive-Behavioral Techniques in Clinical Supervision

Edward Wahesh, MS, LPCA, NCC

Beginning counselors often struggle with self-defeating thoughts and negative emotions related to counseling. “I cannot make mistakes as counselor!” is a common example of a belief held by counselors that can contribute to anxiety or other negative emotions. If not addressed, such thoughts and emotions can negatively influence the counselor’s ability to establish robust therapeutic relationships with clients.

Clinical supervision provides an opportunity to assist counselors in identifying the underlying irrational beliefs that diminish their ability to conduct effective therapy. Cognitive-Behavioral Therapy (CBT) has demonstrated efficacy through numerous outcome studies to treat personal problems such as depression and anxiety. The focus of CBT on how beliefs influence mood and behavior can inform the supervision of counselors. Specifically, the philosophy and techniques of CBT can be adapted by clinical supervisors for use with supervisees to increase their self-awareness and to identify and modify beliefs that interfere with their role as counselors.

An example of a CBT technique that can be adapted for use in clinical supervision is the Thought Record. Developed by JS Beck (1995), the Thought Record (originally referred to as the Dysfunctional Thought Record) provides a set of prompts that allow clients to challenge unproductive thoughts as they occur. Clients are instructed to fill out the Thought Record when they notice their mood getting worse. They record the specific situation, related automatic thoughts, associated emotions, alternative responses, and outcomes. The purpose of this exercise is to teach clients how to recognize and dispute self-defeating thoughts. Following an introduction to CBT during supervision, this exercise can be assigned as homework for supervisees to monitor and modify their problematic thoughts related to counseling. The following is an example of how a Thought Record can be completed by a beginning counselor:

Thought Record (JS Beck, 1995)

Date/Time: 11.23.2011 at 2:30pm

Situation:

1. What actual event or stream of thoughts, or daydreams, or recollection led to the unpleasant emotion?

Preparing case presentation for supervision

2. What (if any) distressing physical sensations did you have?

Felt my heart beat faster, difficulty concentrating

Automatic Thought(s):

1. What thought(s) and/or image(s) went through your mind?

I am never going to become an effective counselor

2. How much did you believe each one at the time?

80% (scale of 0-100%)

Emotion(s):

1. What emotion(s) did you feel at the time?

Anxiety

2. How intense was the emotion?

80% (scale of 0-100%)

Alternative Response:

1. Use the following questions to compose a response to the automatic thought(s) and

2. How much do you believe each response?

a. What is the evidence that the automatic thought is true?

My client shows no sign of improvement (70%)

b. Is there an alternative explanation?

Change may take longer than I assume, the client may not be ready to change (50%)

c. What is the worst that could happen and how could I cope?

Over the course of counseling, the client not only does not change, but also gets worse (40%). I can cope by speaking with my supervisor (60%)

d. What is the effect of my believing the automatic thought? What could be the effect of changing my thinking?

My thoughts make me feel anxious whenever I think about the client. My anxiety can interfere with my counseling approach. Changing my thoughts can make me more responsive to the needs of the client (60%)

e. If (friend’s [colleagues] name) was in the situation and had this thought, what would I tell her/him? What should I do about it?

I would tell my colleague that counselors cannot make clients change (70%)

Outcome:

1. How much do you now believe each automatic thought?

50% (I am never going to become an effective counselor)

2. What emotion(s) do you feel now? How intense (0-100%) is the emotion?

60% (Anxiety)

3. What will you do? [Behavioral activation]

Consult with my supervisor

Continue to monitor the presence of this and related automatic thoughts

Cognitive-behavioral techniques used in supervision can aide counselors in developing self-awareness of self-defeating beliefs and negative emotions that can hinder their clinical skills. Prior to incorporating these strategies into supervision, it is critical that supervisors possess competence in the philosophy and techniques of Cognitive-Behavioral Therapy. The following recommended readings provide supervisors with resources regarding CBT and the appropriate use of CBT in clinical supervision.

Recommended Readings for Practitioners:

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). New York, NY: Guilford.

Fitch, T. J., & Marshall, J. L. (2002). Using cognitive interventions with counseling practicum students during group supervision. Counselor Education and Supervision, 41, 335-342.

Kindsvatter, A., Granello, D. H., & Duba, J. (2008). Cognitive techniques as a means for facilitating supervisee development. Counselor Education and Supervision, 47, 179-192.

Newman, C. F. (2010). Competency in conducting cognitive-behavioral therapy: Foundational,

functional, and supervisory aspects. Psychotherapy: Theory, Research, Practice, Training, 47, 12-19.

Rosenbaum, M., & Ronen, T. (1998). Clinical supervision from the standpoint of cognitive-behavior therapy. Psychotherapy: Theory, Research, Practice, Training, 35, 220-230. doi:10.1037/h0087705

Mentoring Promotion/Tenure-Seeking Faculty: Principles of Good Practice within a Counselor Education Program

Researchers: L. DiAnne Borders, J. Scott Young, Kelly L. Wester, Christine E. Murray, José A. Villalba, Todd F. Lewis, & A. Keith Mobley

The University of North Carolina at Greensboro

Source (Journal name, date of publication):

Counselor Education & Supervision, March 2011, volume 50, pages 171-188.

What was the purpose of this research?

The authors describe a successful program for mentoring junior faculty in one counselor education department.

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

Five promotion/tenure-seeking faculty members (PTSFs) employed in the department at the time the article was written reviewed lists of mentorship examples and provided written feedback about their mentorship experiences. The five PTSFs also provided feedback about what worked well and what could be improved.

Major findings or points:

The authors developed a model of mentoring PTSFs based upon 10 basic principles developed by Sorcinelli (2000): communicate expectations for performance, give feedback on performance, enhance collegial review processes, create flexible timelines for tenure, encourage mentoring by senior faculty, extend mentoring and feedback to graduate students who aspire to be faculty members, recognize the department chair as a career sponsor, support teaching, support scholarly development, and foster a balance between professional and personal life. The authors identified the most salient mentoring activities that occurred in the Department and used these examples to illustrate the 10 principles. The PTSFs’ reactions to the mentoring experiences and suggestions for improvement were also provided.

Major caveats:

This mentoring program was implemented at a single university; other universities will have different needs and should alter the model accordingly. The authors describe some informal aspects of mentorship that are difficult to quantify and might be difficult to replicate.

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

This model is a useful framework for mentoring PTSFs in counselor education departments and can be modified to fit the unique culture of a university. Mentorship activities generate positive consequences for senior faculty and PTSFs. The authors encourage other counseling departments to develop and implement a clear mentoring plan, have frequent conversations about senior faculty involvement with mentoring, be flexible, and emphasize open communication.

Labels:

counselor education, mentor, promotion, tenure

Latest volume of Sexuality Counseling Guidebook by CED 691 students is available

Students in the Fall 2011 Sexuality Counseling course are pleased to present Volume VI of the Sexuality Counseling Guidebook, which focuses on the topic of "Good Sex." Topics included in the guidebook include attraction, positive sexual communication, spirituality, and sexual self-esteem, among others. This volume, along with the previous five volumes, can be downloaded from Dr. Murray's faculty web-page: http://www.uncg.edu/ced/faculty/murray.html Students in CED 691 this semester were: Jenifer Aronson, Elizabeth Doom, Paulina Flasch, Callie Gordon, Susan Henkel, Kate Jessup, Adam Kim, Jenna McGown, Bill Molen, Tom Peake, and Lindy Snyder

Tarasoff and Duty to Warn in North Carolina

Title of Study:

Tarasoff and Duty to Protect in North Carolina

Researchers:

A. Keith Mobley & Eugene Naughton, University of North Carolina at Greensboro

Source (Journal name, date of publication):

North Carolina Counseling Association (2011)

What was the purpose of this research?

This conceptual article reviews the Tarasoff case and its implications for counselors practicing in the state of North Carolina. Implications for preventing and reacting to possible dangerous clients are discussed.

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

N/A

Major findings or points:

The Tarasoff Decision provided the basis for the “duty to warn” clause found in the ACA Code of Ethics and many state statutes. However, the state of North Carolina has not always held up the “duty to warn” ethic, as demonstrated by a number of court cases reported in this article. In particular, prior case law has required that mental health providers protect the health of the public when a client is under their control in a mental health facility. However, LPC’s lack the authority to involuntarily commit or release a client on the bases of his/her propensity for violence.

Major caveats:

Where a lack of legal guidance in NC supports a “duty to warn,” ACA clearly states this ethic’s importance. The authors provide several points that might assist clinicians in making proactive and reactive choices. However, the authors to not provide a one-size fits all answer to solving ethical issues. In the end, the practitioner’s ability to protect himself or herself is up to the discretion of the counselor and is subject to North Carolina law that does not have a cut and dry solution in regard to the counselor’s “duty to warn.”

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

Counselor educators and counselors alike can benefit from reading the proactive and reactive guidance provided by the authors. The authors explain the importance of informed consent, knowing your client, being able to detect violent clients, creating a plan for when violent clients arise, and for aligning appropriate professionals for consultation and supervision. In addition, steps for reactive services are also included which include reminding and including the client in situations where confidentiality may be broken, develop a safety plan for all parties involved, positioning key supervisors and legal consultants to aid in the decision-making process, and maintaining accurate and up-to-date paperwork to fully protect one’s clients and ability to practice counseling.

Labels:

Tarasoff; Ethics; ACA; North Carolina case law; Duty to Warn

Acculturation and Psychosocial Adjustment of African Adolescent Refugees in the United States: The Role of Social Support

By Bellah Kiteki, PhD, LPC

Purpose:

The purpose of this study was to examine the role of social support in psychosocial adjustment of African adolescent refugees during resettlement in a host country. Though a link has been established among acculturation attitudes, social support, and psychosocial adjustment with adolescent refugees in new environments, these aspects have not been examined with African adolescent refugees in the United States. In the Multicultural Acculturation Model proposed by Kovacev and Shute (2004), social support (defined as the positive regard received or perceived from others) from parents and peers were found to be key determinants of psychosocial adjustment of adolescent refugees. Therefore, this study was designed to investigate the roles of parents and peers in the adjustment of African adolescent refugees in the U.S.

Participants

Participants were African adolescent refugees resettled in Greensboro and High Point in Guilford County, North Carolina. The adolescents had to have lived in the U.S. for at least one year and no more than ten years, be enrolled in school grades seven through twelve, and have basic understanding of English.

Data Collection Procedures

Participants were informed about the study through a formal presentation by the researcher. Details about the reason they were the target group were explained, the need for parental consent before participation (for those under 18 years) and assent, and each participant receiving $5 Wal-Mart gift card upon completion of all study measures. Time was allocated for participants to ask questions during the presentation. Signed copies of consent forms were returned after two weeks and all participants signed assent forms before they took the measures.

Findings

1. Research Question 1. To investigate relationships among acculturation attitudes, social support, and psychosocial adjustment among African adolescent refugees. Relationships were found between social support and psychosocial adjustment. Parental support had a strong relationship with global self-worth and peer support had a strong relationship with peer social acceptance, respectively. Therefore, for African adolescent refugees in the sample, both parents and peers played an integral role in their adjustment in a new environment. With acculturation attitudes, a relationship was only found between peer support and integration but no relationship was found with assimilation (preference for mainstream/majority culture than original culture), separation (preference for original than mainstream/majority culture), and marginalization (no preference for mainstream/majority or original culture).
2. Research Question 2. To examine which one of the four acculturation attitudes (integration, assimilation, separation, and marginalization) is the best predictor of psychosocial adjustment. Findings indicated that acculturation attitudes failed to predict psychosocial adjustment, that is, none of the four predictors significantly predicted psychosocial adjustment.
3. Research Question 3. To examine which one between social support variables (parental and peer) is the best predictor of psychosocial adjustment. Results indicated that parental support was the best predictor of psychosocial adjustment followed by peer support.
4. Research Question 4. To examine mean differences in psychosocial adjustment by gender and duration of time lived in the U.S. Results showed that duration of time spent in the U.S. positively impacted adolescents’ adjustment; the longer they lived in the U.S., the higher their psychosocial adjustment.

Limitations

Findings in this study may not be generalized to African adolescent refugees in other parts of the U.S. due to the small sample size of participants. Participants in the study were selected from two mid-sized cities in the South East and may not be representative of adolescents resettled in other cities. Also, some countries of origin for participants were more highly represented than others, this difference in numbers also contributed to differences in some of the findings.

Implications

Community and school counselors working with African adolescent refugees need to be aware of the strong relationship between parental and peer support in the adjustment of adolescent refugees in a new environment. This knowledge will provide avenues of involvement and collaboratively working with parents either in schools or within the community to enhance positive adjustment of African adolescent refugees. Because of the importance of parents in their children’s adjustment from the study findings, counselors could involve parents as needed in the counseling sessions when working with African adolescent refugees.

Due to the integral role of peers in adolescents’ adjustment, school counselors and teachers could involve mainstream peers (as well as African adolescent refugees who have been in the U.S. for a longer period of time) by fostering peer relationships in helping those who may be relatively new arrivals during their adjustment. Adolescent refugees may be of great help to their peers who are new arrivals because they understand their backgrounds and some of the cultural issues they may have to deal with.

Additionally, community counselors need to be aware that differences in adjustment may arise between adolescents who are new arrivals and those who may have lived in the U.S. for a slightly longer period of time.

School personnel need to be aware of the important role of parents in passing on cultural values and heritage to their children. Therefore, they could involve parents in school activities that their children participate in during the school year. Setting aside days that are solely dedicated to cultural activities and events by students may be an avenue to involve parents in the activities of their children.