National Survey of CACREPPrograms Supervision Practices

Mark Young, Gonzaga University Pit Kolodinsky, Northern Arizona University

Charles Lindsey, U. Wisconsin OshkoshMike Zlatev, NAU Community Counseling

StudentBennett Edgerly, NAU Community Coun.

Student

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Background• CACREP’s current (2001) standards for

Clinical Instruction allow for flexibility about supervision methods (2009 standards similar).– CACREP doesn’t differentiate between less

intrusive/more fluid methods (bug-in-the-ear) and other live supervision methods (phone-in, walk-in), or post-session review only.

• Impetus for study: which methods are we using, which are we most satisfied with?

• Goals for this exploratory study:– variability of supervision methods across

USA– satisfaction levels with current supervision

methods– supervision-related changes sought by

supervising instructors

Additional literatureFor background and context, please see our attached book chapter handout:

Young, M., Lindsey, C. & Kolodinsky, P. (2008-in press), “The Role of Live Supervision in Counselor Education Training Clinics”, in Mobley, A. K., & Myers, J. E. (Eds.). Developing and maintaining counselor education laboratories (2nd ed.). Alexandria, VA: Association of Counselor Education and Supervision.

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Differentiating types of Live Supervision:• Co-therapy • Watching behind a one-way mirror.• Listening to a session via audio connection.• Watching and listening via closed circuit television.

Supervisor Interventions during Live Supervision:• Sitting-in on the session and providing co-therapy or

feedback to the trainee. • Walking into the session on an as-needed basis to provide

guidance. • Phoning-in to the session at critical junctures. • Providing input via an earpiece (“bug-in-the-ear”). • Typing suggestions to the trainee who views the

interventions on a monitor placed strategically behind the client (“bug-in-the-eye”).

Supervision Modalities in Context

Scant Research about SV methods

• In one survey of CACREP program directors, live supervision was the third most frequently used supervision model behind videotape and audiotape review (Carlozzi, Romans, Boswell, Ferguson, & Whisenhunt, 1997).

• No distinction was made between live supervision models, but co-therapy was cited as an example of live supervision. An earlier study found 51% of master’s degree and 57% of doctoral counselor education programs using live supervision (Bubenzer, West, & Gold, 1991).

• The most popular live supervision formats reported in this earlier research were co-therapy (52.9% of respondents) and one-way mirror observation of the supervisee with telephone contact (45.5% of respondents)

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Brief review of Different types of live supervision

Bug-in-the ear: Counselor at left with earbug, & client

Bug-in-the ear: Monitoring Room

Bug-in-the eye: Counselor views monitor situated behind client’s head…

1-way mirror w/ walk-in or phone-in

Brief review of Different types of live supervision

Research QuestionsWhat supervision methods are CACREP programs using in their on-campus practicum labs?

How much live supervision vs. post-session feedback only (Post-only) is being used?

Among those using live supervision, which are the most common forms?

How satisfied are practicum supervisors with their current supervision methodologies?

If Practicum supervisors could change one thing in their current supervision methodology, what would it be?

Procedures

• CACREP directory obtained in 2007 • All CACREP Programs contacted –G.A.’s requested Practicum

instructors contact info–2 CESNET postings in 2007 and

2008.–Contacting ceased when 1 survey

completed from each program, or when no response was obtained by early 2009

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Participants• 184 participants responded– In several cases, more than one professor

responded completed survey from same program.

– Also, in several cases, the same professor responded twice from the same program (usually once in 2007 and again when contacted in 2008 via CESNET).

– Since we were aiming for one response from each CACREP program, we utilized only the most recent response from each program•N of 135 participants from 135 CACREP Programs• 63% of CACREP programs responded.

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Instrumentation• Survey developed after an extensive lit review (Young,

Lindsey and Kolodinsky, 2007, on Mobley & Myers), and was completed online by participants

• Participants were asked to “check off all methods of supervision used in your program's university-based (clinical instruction (practicum/internship) courses”.Live Supervision Options on the survey:– bug-in-the-ear, bug-in-the-eye, phone-in

consultation, walk-in consultation, in vivo (supervisor as co-therapist).

The post-session options on survey: – Post-session audio-review; post-session video-

review; supervisee post-session self-report (1 on 1); supervisee post-session self-report (group supervision); an “other” option offered for additional clarifications and comments.

• Challenges and concerns about live-SV or Delayed• Satisfaction rating with current system• “If you could change one thing about your current SV

modality…”

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RESULTS

• 63% of Programs using some form of LIVE, intrasession supervision (n=133)**• 53% have some form of walk-in

consultation available, • 33% have some type of in vivo method

available• 25% have phone-in capacity, • 16% utilize bug-in-the-ear• 6% offer bug-in-the-eye supervision.

** many programs use more than 1 method…

Challenges & Concerns with Live Supervision

LIVE SUPERVISION SITE COMMENTS

(ie: we use it, but we face these

challenges/concerns)• 33%: Maintenance &

costs• 33%: Time-consuming• 31%: Ongoing

concerns about client reactions

• 24%: Challenges with facilities were cited as a concern in almost one-fourth of the cases (24%).

DELAYED SV Site Comments

(ie, we don’t use it, and here’s why we don’t)

• 96% - $$$$• 73% - tech

implementation 73% - time to set up, maintain

• 39% - lack of training• 15% - Clinical

philosophy (ethics of live supervision, negative effects on clients, that live supervision is ineffective, fear of supervisee dependence on live supervision interventions, etc).

• only 8% cited lack of facilities as a reason 13

Are there Satisfaction differences between

LIVE vs. DELAYED sites?

There was no significant difference in satisfaction score between those using LS and those using delayed-only, t(125) = 1.268, p > .05, although those using LS did rank their satisfaction with their current system higher (5.45 vs. 5.13)

Comments re “desired changes” (n=184*)

2 Prominent Themes from LIVE SITES (77% of participants commented):

• Time-oriented (n-33 unique comments) themes were most prevalent, w/ comments such as “we simply need more time with students in live supervision”.

• More/better technology (n=27 unique comments), w/ several citing the desire to upgrade to digital recording and organization systems, such as the Landro system.

1 Prominent Theme from DELAYED-ONLY SITES

* 43% of participants from Delayed-Sites desire an on-campus practicum lab with some form of live supervision

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Conclusions• Almost 2/3 (63%) of CACREP Programs according

to this sample are using 1 or more forms of Live Supervision, up from 51-57% (Bubenzer et al, 1991)

• Prac Professors are roughly equally satisfied whether from Live Supervision (LS)programs or Delayed-Only (DO)

• Many LS Professors seek more TIME and better TECH

• Many Practicum Professors from programs using Delayed-Only Supervision wish for some form of Live Supervision and on-campus labs, and more $$$, training and technology to implement labs.

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Limitations• Unvalidated survey •Partial response set (63% of CACREP programs responded)•No data from satellite sites, data limited to one supervisor per site, unless reached by CESNET listserv•Having live supervision available doesn’t mean it’s being used:

• IE, frequency of direct, during-session intervention not known

•No accounting for qualitative differences in supervision approaches•Other plausible factors not looked at: •Satisfaction variable limited to single Likert-scale item

Future Research• Exploring:

–Which types of programs (School Counseling vs. Mental Health Counseling) use which types of supervision, & are their satisfaction differences among them?–Collect other indep. variable data (supervisors’ training as grad students; supervisory personality/professional variables)–How many are using digital coding systems for session review purposes (ie, Landro-type systems), and how satisfied are they?–How will supervision be affected by 2009 CACREP standards?–Analyze how Live SV is actually being used (do programs with Bug-in-the-Eye, etc., actually use it consistently?)

NOTE: We are currently collecting data from BITE sites vs. those using Delayed-Only Supervision (counselor efficacy, client ratings of counselor effectiveness, supervisory data, etc.). To be completed in 2010.