Counselors have been eligible for licensing beginning in 1973 in Virginia. Currently, all states with the exception of Nevada and California have licensing, and there is considerable variability as to required credits, course titles and topics, and pre- and postgraduate hours of supervision. Credit requirements range from a master’s degree (no credit hours specified) to 60 credits, with the majority being 45 to 48 credits. Supervision requirements vary from a low of 1,000 hours to a high of 4,500 hours, with the majority being 3,000 hours.
The purpose of this entry is to explore the purpose, definition, process, and ethics of the practice of prelicensure clinical supervision. While there are multiple definitions of supervision, the unifying theme is to assist the new counselors in applying their training with increasing effectiveness through careful observation, analysis, education, redirection, coaching, and mentoring by a seasoned, licensed professional. Some form of supervision occurs across all levels of applied social science and medicine.
Supervision Defined
The Council on the Accreditation of Counseling and Related Educational Programs (CACREP) specifies the hours and functions of supervision in counselor preparation. However, in non-CACREP accredited programs, the approach to supervision may or may not be made explicit. Either way, a brief overview of the purpose and definitions of supervision is presented as a starting point.
Supervision is an intervention provided by a more senior member of a profession to a more junior member or members of that same profession. This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior persons, monitoring the quality of the professional services offered to the clients they see, and serving as a gatekeeper for entry to the particular profession.
Supervision is a type of intervention that although distinct from the provision of counseling or psychotherapy, is a change agent in the development of a new professional. While supervision does include an educational component in the form of a predetermined curriculum for all students, supervision is tailored to meet the unique developmental needs of the individual or group of supervisees. Although there may be points in the supervisory process where a supervisee’s personal issues are addressed in relation to the clinical work, the supervisor does not engage in a therapeutic relationship with the supervisee to resolve these issues. Rather, the issues are addressed in a manner that heightens the supervisee’s awareness of how these factors may affect his or her work with clients. It is the supervisor’s responsibility to hold the supervisee accountable for effectively managing client issues and providing appropriate referrals. There is a distinction between consultation and supervision, where supervision is generally imposed by licensing requirements of the postgraduate/prelicensed counselor, while consultation is sought freely by the clinician, perhaps on a single occasion, and not necessarily from a member of his or her own discipline. Additionally, there is no evaluative component involved in a consultative relationship.
Postgraduate Supervision
Supervision, required by counselor licensing and regulatory bodies, is provided by a senior member of a profession (who, at a minimum, is licensed) for a junior member of the same profession working toward licensing. Although various disciplines can aptly address theoretical orientations, skill set development, and case management skills, socialization into the profession and fostering a sense of professional identity come from within a discipline. Supervision involves assisting the new professional in attending to matters of professional importance, e.g., changes in licensing laws, third-party reimbursement, modification or issuance of practice guidelines. Moreover, it includes not only bringing such matters to the supervisee’s attention but also developing the knowledge of how and what to attend to, finding sources of information pertinent to the profession, and participating in organizations relevant to the profession, i.e., the American Counseling Association and state branches.
Currently, supervision standards vary and may or may not require someone licensed from the same discipline, a licensee, or an approved supervisor credential such as the Approved Clinical Supervisor (ACS) credential from the Center for Credentialing Education (CCE) of the National Board for Certified Counselors (NBCC). Requirements about the length of time and hours of supervision required for licensing vary across states and territories. However, one common practice is that the postgraduate counselor must be under supervision until licensed in order to practice independently. The supervisor is required to provide ongoing evaluation of the postgraduate counselor and to submit or withhold a recommendation to license the supervisee.
Models of Clinical Supervision
Supervision is provided in various models and is often tied to a theoretical orientation, ranging across psycho-dynamic, developmental, narrative, cognitive-behavioral, person-centered, and eclectic/integrationist. Although supervisees often have little choice in the model of supervision they receive, new counselors should seek varying models and find supervision that best meets their theoretical orientation and needs and the needs of the clients with whom they work. Supervisors have an ethical obligation to encourage new counselors to explore several theoretical orientations rather than follow only the supervisor’s model.
Ethics and Competency to Practice
New counselors may have less day-to-day supervision during employment than in their internship and can benefit from the supervisor’s knowledge in areas that provide a potential ethical slippery slope. Because of the varying levels of preparation and professional orientation, constant reference to a code of ethics in clinical supervision is essential. Addressing such issues as insurance payments, boundaries, and multiple relationships can start the new counselor off in a healthy ethical direction.
Supervisors also have a responsibility to insure that supervisees are employing the most current and effective practices and should be thoroughly familiar with the research on empirically supported treatments. Most licensing laws and regulations include a caveat that counselors provide services in areas in which they are trained. Therefore, clinical supervision should focus on the competency of supervisees in providing services or addressing client issues consistent with their training. When practicing outside the boundaries of their competency, additional supervision, training, reading, and regular consultation or referral can ensure ethical practice and prevent licensing violations. Licensure candidates must be knowledgeable of the scope of practice in their state, because states with the broadest language include “diagnose and treat,” while other states have more restrictive language.
Multicultural, Gender, and Sexual Orientation Sensitivity
Supervision, like counseling, requires an awareness of, and competency in, multicultural, gender, and sexual orientation issues present in the process. Most supervisors are White, middle class, and of European origin, and studies about the impact of multicultural supervision are limited. Multiculturally based supervision offers a conceptual framework, and supervisees benefit from a variety of supervisors who provide a diversity of cultural, racial, gender, and sexual orientation backgrounds. Counselors graduating from a CACREP accredited program are required to study multicultural counseling and have field experiences in a range of multicultural settings. Most licensing boards use the CACREP course distribution, requiring social and cultural competency. Thus, supervisees should be encouraged to continually assess their multicultural competencies relative to CACREP’s multicultural counseling competencies and standards.
Recommendations to Licensure Candidates
Because standards vary and the portability of licenses is not assured, new graduates should familiarize themselves with the supervision requirements of the state in which they intend to seek licensure. With regulations frequently changing, candidates are advised to continually check for modifications in requirements. Because the supervisor’s role in licensing is critical, candidates should seek supervision from someone who is experienced and thoroughly versed in licensing requirements.
Finding a supervisor is often dependent on regulatory boards that provide a list of qualified supervisors. If there are no requirements, supervisees can find qualified counseling supervisors through their professional associations (ACA and state branches) or graduate programs. The American Association of State Counseling Boards (AASCB) is working to develop common standards among states by adopting a nationwide portability document and establishing the National Credentials Registry (NCR) to assist preli-cense counselors with supervision documentation.
Interviewing potential supervisors can provide insight into their theoretical orientation, counseling identity, supervision model, and availability. New counselors should look for personal qualities in the supervisor such as enthusiasm, a positive attitude, and openness to diversity as indicators of the potential for developing the working alliance between supervisor and supervisee. Ideally, seeking some, if not all, supervision from a licensed professional counselor will ensure a strong counseling identity and contribute toward future ethical practice.
References:
- American Counseling Association. (2005). Code of ethics. Alexandria, VA: Author.
- American Association of State Counseling Boards. (2005). AASCB national credentials registry: Portability policies and procedures. Retrieved from http://associationdatabase.com/aws/AASCB/asset_manager/get_file/37388
- Bernard, J. M., & Goodyear, R. K. (2004). Fundamentals of clinical supervision (3rd ed.) Boston: Allyn & Bacon.
- Council for Accreditation for Counseling and Related Education Programs. (2001). The 2001 standards. Alexandria, VA: Author.
- D’Andrea, M., & Daniels, J. (1997). Multicultural counseling supervision: Central issues, theoretical considerations, and practical strategies. In D. B. Pope-Davis & H. L. K. Coleman (Eds.), Multicultural counseling competencies: Assessment, education and training, and supervision (pp. 290-309). Thousand Oaks, CA: Sage.
- Kurpius, D. M., Gibson, G., Lewis, J., & Corbett, M. (1991). Ethical issues in supervising counselor practitioners. Counselor Education and Supervision, 39, 66-75.
- Leong, F. T. L., & Wagner, N. S. (1994). Cross-cultural counseling supervision: What do we know? What do we need to know? Counselor Education and Supervision, 34, 117-131.
- Mascari, J. B., & Webber, J. (2006). Salting the slippery slope: What licensing violations tell us about preventing dangerous ethical situations. In G. R. Walz, J. C. Bleuer, & R. K. Yep (Eds.), Vistas: Compelling perspectives on counseling 2006 (pp. 165-168). Alexandria, VA: American Counseling Association.
- Wing, D. S., Arrendondo, P., & McDavis, R. J. (1992). Multicultural counseling competencies and standards: A call to the profession. Journal of Counseling and Development, 70, 479-186.
See also:
- Counseling Psychology