A Review of the Literature on Promoting Cultural Competence and Social Justice Agency Among Students and Counselor Trainees: Piecing the Evidence Together to Advance Pedagogy and Research

Amie A. Manis

There is a call for research on how to effectively foster cultural competence and a social justice advocacy orientation among counselor trainees. A multidisciplinary review of the literature reveals a body of anecdotal and empirical evidence in support of the use of pedagogical strategies grounded in critical theory to this end. Critical pedagogy regarding the development of a social justice origination is emphasized. Privilege, oppression, and experiential classroom activities are presented.

Keywords: critical theory, pedagogy, cultural competence, social justice, advocacy

The promotion of multicultural competence is an established professional training standard in industry and higher education (Musil, 1996). As a fourth force phenomenon within the counseling profession, multicultural education is intimately tied to advancing social justice (Arredondo & Perez, 2003) for trainees in the context of their studies (Ratts & Wood, 2011), and through populating our profession with culturally competent counselors. Its value in training has been empirically validated, yet much is left to discover about how to most effectively deliver multicultural education and ensure that counselors are able to engage in ethical and competent counseling and advocacy with diverse populations (Coleman, 2006; Manese, Wu, & Nepomuceno, 2001; Seto, Young, Becker, & Kiselica, 2006; Smith, Constantine, Dunn, Dinehart, & Montoya, 2006).

More recently advocacy competence has been recognized as a distinct professional standard for counselors with the American Counseling Association’s (ACA) endorsement of the Advocacy Competencies (Lewis, Arnold, House, & Toporek, 2002), the recognition of Counselors for Social Justice (CSJ) as a division of ACA, the 2005 ACA Code of Ethics, and the 2009 Council for Accreditation of Counseling and Related Educational Programs (CACREP) standards. As such, there is a growing body of literature with respect to the promotion of advocacy competence among counselor trainees grounded largely in critical theories (Bemak, Chi-Ying Chung, Talleyrand, Jones, & Daquin, 2011; Brubaker, Puig, Reese, & Young, 2010; Constantine, Hage, Kindaichi, & Bryant, 2007; Goodman, Liang, Helms, Latta, Sparks, & Weintraub, 2004; Green, McCollum, & Hays, 2008; Hof, Dinsmore, Barber, Suhr, & Scofield, 2009; Lewis, Arnold, House, & Toporek, 2002; Ratts & Wood, 2011; Steele, 2008; Toporek & Reza, 2001). Naturally, counseling research on the relationship between multicultural counseling competence and advocacy competence (Manis, 2008) and effective training methods for promoting advocacy competence (Hays, Dean, & Chang, 2007; Lewis, Davis, Lenski, Mukhopadhyay, & Taylor Cartwright, 2010; Murray, Pope, & Rowell, 2010; Odegard & Vereen, 2010) is early in its development.

Thus, while echoing the synergistic relationship between multicultural counseling competencies and social justice advocacy, Odegard and Vereen (2010) recently concluded “how counselor educators teach these constructs to students is a mystery” (p. 145). Their conclusion resonated with earlier expressions of this conundrum within and beyond the mental health professions. Palmer (2004) spoke to this challenge, indicating that the question of how to teach the constructs had been pondered and studied across disciplines.

In fact, a multidisciplinary review of the literature on multicultural education, social justice advocacy and critical pedagogy revealed not only a paucity of research on effective training practices in counselor education and supervision (Odegard & Vereen, 2010; Toporek, Lewis, & Crethar, 2009), but also a lack of attention and investment in training for social justice advocacy within counselor education programs (Hays et al., 2007; Nilsson & Schmidt, 2005; Ratts, 2006; Ratts & Wood, 2011). It further provided a pragmatic rationale for infusing attention to culture and social justice throughout program curricula (Brubaker, Puig, Reese, & Young, 2010; Dinsmore & England, 1996; Goodman et al., 2004: Green et al., 2008; Hays et al., 2007; Hill, 2003; Paylo, 2007; Ratts & Wood, 2011; Stadler, Suh, Cobia, Middleton, & Carney, 2006; Sue, Bingham, Porché-Burke, & Vasquez, 1999; Watts, 2004), and empirical evidence that suggested theoretically grounded pedagogies could be twice as effective as ungrounded approaches in delivering multicultural education (Smith et al., 2006). The literature also offered anecdotal and empirical evidence that critical pedagogical strategies are effective in raising the social consciousness of students and fostering social justice advocacy.

An analysis of the existing evidence, along with more recent findings specific to the field of counselor education and supervision offered a compelling case for further exploration of critical pedagogical strategies in training counselors and research on its efficacy. A brief overview of critical theory and pedagogy is presented, followed by a summary of key research findings. This is followed by a discussion of implications for counselor education and supervision practice, as well as future research.

Critical Pedagogy

Critical pedagogy is rooted in the work of Paolo Freire, who developed this approach with the explicit goal of empowering Brazilian peasants to advocate on their own behalf for social justice. Freire (1974) theorized that becoming aware of one’s sociopolitical reality and position through reflection and dialogue, or attaining critical consciousness, would serve as a catalyst for social justice advocacy.

The application of critical pedagogy in multicultural education has been described as “a deep examination, through dialogue with others, of the legitimacy of the social order in terms of access to socioeconomic resources and opportunities” (Sleeter, Torres, & Laughlin, 2004, p. 82), or in other words, social justice (Chang, Crethar, & Ratts, 2010; Fouad, Gerstein, &Toporek, 2006). Decoding is the term designated by Freire (1974) for this process whereby sociopolitical realities become transparent and a sense of empowerment as change agents is possible.

Freire (1974) used the term praxis to refer to social justice advocacy. He was deliberate in specifying that praxis is a manifestation, rather an outcome of critical consciousness. Thus, he emphasized the undeniably catalytic nature of developing critical consciousness, and the inherent charge which accompanies it regardless of one’s social positions of privilege or oppression. Freire also was explicit in observing the inherently value-laden nature of praxis, or social justice advocacy. He explained: “praxis (which can never be limited to mere activity of the consciousness) is never neutral; in the same way, education can never be neutral. Those who talk of neutrality are precisely those who are afraid of losing their right to use neutrality to their own advantage” (p. 132).

Sue, Bingham, Porché-Burke and Vasquez (1999) echoed Freire and elucidated the relationship between multiculturalism and social justice relative to mental health training and practice. They made it plain that multiculturalism, “…is not value neutral [and actually] … stands against beliefs and behaviors that oppress other groups and deny them equal access and opportunity” (p. 1064). Recognizing this valence is critical not only to advancing the practice standards of our profession (Ratts & Wood, 2011), but also to how we understand and frame our role as counselor educators and supervisors. “Our task as teachers is to clarify the complexity of the many overlapping economies of power and to work with our students to build the critical skills necessary to examine their own location in such a system and to find strategies of resistance to it” (Chan & Treacy, 1996, p. 214).

Enns and Forrest (2005) underscored the connection between the emergence of critical pedagogy from human rights movements and its regular use in multicultural education. They described the scope of multicultural education grounded in these theories as extending beyond the classroom and entailing: (a) a critical examination of the construction of knowledge, (b) an exploration of the relationships among diverse people, and (c) the recognition that cultural identities are dynamic and complex. The intuitive fit of critical pedagogy for raising the social consciousness of counselor trainees, as well as its regular employment in multicultural education lends the theory for investigation as an effective theoretical grounding for training culturally and advocacy competent counselors.

Cultivating Critical Consciousness: A Developmental Process

Critical pedagogical approaches reflect an appreciation of the socializing role of seasoned professionals and educators (Cornelius, 1998; Prilleltensky, 1989), the non-traditional and relational nature of the instructor–student relationship, and the developmental nature of the process of consciousness raising and becoming advocates (Ford & Dillard, 1996; Kathleen May, personal communications, 2006; Sleeter et al., 2004). Indeed, Ford and Dillard (1996) described multiculturalism in these terms: “… it is more than just a learning process, it is a socialization process that involves qualitative degrees of self-development” (p. 5). Sleeter et al. (2004) emphasized the importance of scaffolding students in this process of reflection on their own and others’ identities relative to social positions and experiences of privilege and oppression. The theoretical (Bemak et al., 2011; Green et al., 2008; Hof et al., 2009; Rasheed Ali, Ming Liu, Mahmood, & Arguello, 2008; Sleeter et al., 2004) and research literature (Hays et al., 2007; Murray et al., 2010; Nilsson & Schmidt, 2005; Paylo, 2007) has been consistent in the valuing of experiential learning as a means of cultivating social consciousness among students, and affording opportunities to practice and engage in advocacy.

Developing a Social Justice Orientation

Broido (2000) explored how college students from privileged positions actively engaged in advocacy for social justice understood their own development as advocates. Her findings initially suggested students’ willingness and ability to act as social justice allies developed through having increased information on social justice issues. She reported: “participants gained an overwhelming share of their knowledge of social justice issues from their experiences in the classroom” (p. 9).

The second critical factor in students’ willingness and ability to act as social justice allies was engagement in a dialectical meaning-making process. Broido (2000) concluded that it was “through reflection, discussion, and perspective taking, [that] the participants developed clarity regarding­­—and confidence in—their own position on social justice issues” (p. 10). The third finding pointed to the impact of self-confidence on the participants’ willingness to reflect on the role of privilege in their success.

These findings pointed to the potential importance of introducing material on social justice in counseling instruction. They also demonstrated the value of specific critical pedagogical practices, namely reflection, dialogue and decoding in the participants’ development of critical consciousness and change agency. Finally, they underscored self-confidence as a student quality that supported a critical examination of their own privileged positions.

Exploring Dynamics of Privilege and Oppression

Exploring dynamics of privilege and oppression is at the heart of critical pedagogy. A critical examination of one’s own social positions, as well as those of others, is considered integral to developing critical consciousness and social change agency. The findings of Chizhik and Chizhik (2002) highlighted the need for faculty to attend to student meaning with respect to dynamics of privilege and oppression.

Chizhik and Chizhik (2002) investigated middle class college students’ conceptions of privilege and oppression. They emphasized the importance for instructors of understanding students’ meaning-making with respect to those dynamics as a means of preparing to effectively guide them. They stated: “Knowing students’ preconceived notions about these terms should help instructors ‘scaffold students’ learning to a more multicultural and social justice orientation (if one does not already exist)” (p. 794).

Chizhik and Chizhik (2002) observed that both privileged and oppressed students as defined in terms of racial identity failed to understand these phenomena in systemic terms. They found that, “White students were more likely to blame oppression on internal factors [and believed that] the oppressed are and should be responsible for helping themselves” (p. 805). They also found that students of color were more likely to attribute privilege to factors external to the individual, but not to systemic factors. Furthermore, they found that students of color viewed “social change as a collective act rather than an individual act” (p. 805).

Chizhik and Chizhik (2002) identified the “lack of connection between privilege and oppression…[as] perhaps, the greatest challenge in multicultural discourse” (p. 806). They further suggested: “Understanding the compensatory relationship between privilege and oppression may be an important first step leading to an obligatory call for action through understanding one’s responsibility to act for social justice” (p. 806). Their findings underscored the need for exploration and collective meaning-making of the dynamics of privilege and oppression with students. They also suggested the relevance of this process for all students (Hays, 2008; Lark & Paul, 1998; Rooney, Flores, & Mercier, 1998). And finally, the findings have implications for helping students to resolve resistance to multicultural education and social justice advocacy.

Scaffolding the Development of Critical Consciousness

The challenging and potentially painful nature of decoding raises the importance of scaffolding students as they engage in reflection and dialogue. Broido’s (2000) findings pointed to the significance of confidence to the willingness and success of students of privileged social positions in decoding their experiences. The findings presented by Chizhik and Chizhik (2002) suggested the importance of attending to students’ preconceived ideas about privilege and oppression, and pointed to possible sources of resistance to engaging in open and active exploration of dynamics of privilege and oppression.

Clearly decoding requires unusual vulnerability within the classroom for both students and instructors (Garcia & Van Soest, 1997; Lark & Paul, 1998; Locke & Kiselica, 1999). Chan and Treacy (1996) captured the heart of the challenge more fully. They observed:
Any serious examination of a system of domination that usually cloaks its relationships of power makes many people uncomfortable; these are topics that are often skirted around. Moreover, this approach asks participants in the inquiry (students and teachers alike) to acknowledge [their] lack of knowledge, to examine what [they] do not know about [their] histories, [their] political and legal systems, [their] education, and the contexts in which [they] seek to understand [their] experiences. As we teach and learn about these power relationships, the world looks different and we take a different place in it; we are at least temporarily decentered from our usual normative self (p. 214).

Garcia and Van Soest (1997) conducted an exploratory study of master’s-level social work students engaged in a required course on diversity, particularly how their understanding of privilege and oppression changed over the course. Course objectives centered on familiarizing students with dynamics of social power, oppression, privilege and empowerment. A key pedagogical strategy was paying “considerable attention…to helping students assimilate information that challenged their world views, self-image, and professional self-concepts” (p. 122).

Their findings indicated that the majority of students’ in the course experienced increased social consciousness at the end of the course (Garcia & Van Soest, 1997). Changes reported by the White/non-Jewish students included increased awareness of privilege, increased understanding of the dynamics of oppression, increased hope and the identification of an action plan. Changes reported by the multiethnic students in the class also fell into the three areas of change reported by the White/non-Jewish students. Their changes were reported in terms of increased understanding “of their own oppression” (p. 125). One African-American student reflected: “This course has opened my eyes… It is easy for me to see how different rules can be racist, whereas in the past, I believed they were fair…I have become increasingly aware of how I am treated” (pp.125–126). In addition, among the reports of the students of color were increases in self-confidence, reflection and awareness of the oppression of other groups, as well as positive plans for change. These findings further supported the value and importance of scaffolding students in decoding dynamics of privilege and oppression for all students, and in this case for students in the mental health field.

The relevance of attending to dynamics of privilege and oppression in counselor education and supervision is further underscored by research within the field on social justice advocacy. Hays et al. (2007) conducted a qualitative study of counselors’ perceptions regarding how privilege and oppression were addressed in their training, and how these phenomena impacted counseling relationships. Their findings pointed to inadequate training in multicultural and advocacy competence, and a lack of attention to social justice advocacy specifically around the phenomena of privilege and oppression.

Experiential Activities: Moving Beyond the Classroom

Based on their findings Hays et al. (2007) proposed strategies to address the training deficits identified by counselors in practice. These resonated with critical pedagogy, and included: (a) addressing social justice advocacy in instruction, (b) attending to counselor self-efficacy as related to cultural and advocacy competence, (c) exploring the systemic nature of oppression in the context of case conceptualization, and (d) building from strategies used to enhance cultural competence such as guest speakers and experiential activities.

Nilsson and Schmidt (2005), among others (Ratts, 2006), also observed a deficiency in counselor training. They pointed out that while social justice advocacy has been emphasized in the literature, “this value appears not to have filtered through graduate training programs to its trainees” (p. 277). They further reported “little evidence that educators encourage students to act individually or in groups to produce social change” (p. 277).

Their findings pointed to a desire to advocate and political interest as two factors that may lead to advocacy and indicated a need for further research on differences in this regard between students of oppressed or privileged social statuses (Nilsson & Schmidt, 2005, p. 275). Nilsson and Schmidt (2005) arrived at conclusions with respect to counselor training that were similar to those of Hays et al. (2007). Specifically they noted: “counselors’ concern for others needs to be guided beyond the individual level and extended to societal and political levels” (p. 276). They also proposed incorporation of pedagogical strategies resonating with critical theory. These included engaging students in dialogue around political and social issues, exposing students to culturally diverse peers and individuals, providing opportunities for campus or community outreach, and teaching advocacy skills.

Paylo’s (2007) study of the characteristics of counselors who advocate also led to similar conclusions and recommendations. Paylo found that counselors who consider advocacy important are more likely to act as advocates. He stressed: “… it is imperative for counselor educators to infuse the importance of advocacy throughout the curriculum. They may not be able to directly affect counselors-in-training’s actual advocacy behaviors but by instilling the importance of advocacy, they may increase advocacy behaviors indirectly” (p. 134). He went on to suggest hands-on, relationally-oriented strategies such as bringing in guest speakers, infusing advocacy concepts within field and coursework, and service projects.

The literature provided both anecdotal and empirical support for service learning across disciplines as a strategy for promoting critical consciousness and social justice agency among students. McAllister and Irvine (2000) offered empirical support that “providing opportunities for students to interact with individuals from other ethnic backgrounds in authentic cultural settings” (p. 20) enhances the multicultural learning process. Beilke (2005) proposed community service as an effective intervention in facilitating the development of critical consciousness in pre-service teachers. She asserted that the “first task of developing a critical multicultural perspective is to see oneself more objectively by ‘unpacking’ power, privilege, and racial identity” (p. 3).

Research within counselor education also supported the practice of service learning as effective (Arthur & Achenbach, 2002), particularly immersion experiences or those involving direct contact with diverse individuals and communities (Burnett, Hamel, & Long, 2004; Coleman, 2006; Díaz-Lázaro & Cohen, 2001; Dickson & Jepsen, 2007).

Piecing the Evidence Together: Implications for Counselor Training and Research

Theory and research across the humanities addressing multicultural education, advocacy and social justice supported the developmental and process oriented nature of developing critical consciousness. It also provided compelling evidence to guide the use and further investigation of critical pedagogical strategies within the field of counselor education and supervision as a means of training counselors who are culturally competent and prepared to act as advocates for social justice. Key themes among the findings were the value of: (a) introducing social justice material in coursework, (b) incorporating examination, dialogue and reflection with respect to dynamics of privilege and oppression in society, (c) scaffolding all students in their meaning-making of the dynamics of privilege and oppression in their own experiences regardless of their identities and relative social positions, and (d) providing opportunities for experiential activities beyond the individual client level and classroom.


Consonant with the developmental nature of counselor training and the research findings discussed relative to critical pedagogy, the more recent literature in the fields of counseling and psychology promoted critical theoretical approaches (Brubaker et al., 2010), models (Green et al., 2008) and training strategies (Bemak et al., 2011; Hof et al., 2009; Rasheed Ali et al., 2008). These recommendations pointed to the value of pedagogies that: (a) incorporate a tone of equality, de-ideologize dominant paradigms and incorporate experiential training (Brubaker et al., 2010); (b) recognize the link between social justice advocacy and professional advocacy (Hof et al., 2009); and (c) address the domains of awareness, knowledge and skill in infusing social justice advocacy throughout curricula (Green et al., 2008). Green et al. (2008) proposed an advocacy counseling paradigm that builds from awareness of injustice, to knowledge to empowerment of self and others, up to skills to perform and teach to others. Their model is consistent with the guidance offered by Rasheed Ali, Ming Liu, Mahmood, and Arguello (2008), who advised: “Before the actual practical training of social justice begins, it is equally important for students to understand the meaning and implications of social justice as a theory as well as implementing theory to practice” (p. 3).

In their reflections on infusing social justice advocacy, Bemak et al. (2011) provided a number of suggestions. These included beginning with the faculty and engaging in collective meaning-making about social justice and how it applies across courses and content. They went on to address the relevance of personal experiences of students with respect to their worldview and their identities as counselors, and emphasized the need to explore the challenges of social justice work with students. They recommended utilizing real life situations and news in role plays and further suggested service learning as an important component of hands-on training.

Experiential learning, particularly in terms of service learning was a consistent recommendation in the most current literature. Murray et al. (2010) pointed out that experiential learning is already an essential component of counselor training through fieldwork. In addition to affording students the opportunity to apply gains in awareness, knowledge and skills, they asserted that service learning also encourages civic commitment. Rasheed Ali et al. (2008) described a homeless shelter practicum as an apt example of a practicum experience that reaches an underserved population and that could include attention to public policy initiatives. Ali emphasized the need for sensitivity and care in assessing community needs, placing students, and evaluating the impact of service learning projects when developing fieldwork opportunities for counselor trainees where they will have an opportunity to confront social injustices and engage in advocacy at the client, community and public policy levels.


Falender and Shafranske (2004) offered a clear description of diversity competent supervision as a process that not only promotes social justice, but also is in essence a social justice intervention. They asserted that diversity-competent supervision:
includes incorporation of self-awareness by both supervisor and supervisee and is an interactive process of the client or family, supervisee-therapist, and supervisor, using all of their diversity factors. It entails awareness, knowledge, and appreciation of the interaction among the client’s, supervisee-therapist’s, and supervisor’s assumptions, values, biases, expectations, and worldviews; integration and practice of appropriate, relevant, and sensitive assessment and intervention strategies and skills; and consideration of the larger milieu of history, society, and sociopolitical variables (p. 125).

Their conceptualization of the infusion of diversity and social justice within the supervisory relationship and the supervision process is in alignment with the critical pedagogical recommendations of Brubaker et al. (2010) for the infusion of advocacy in counselor training, as well as the recommendations of Glosoff and Durham (2010) for incorporating social justice advocacy in supervision. In short, their recommendations centered on calling supervisee attention to the continuum along which advocacy may occur, encouraging supervisee examination of their own place on the continuum, and scaffolding supervisee development of critical consciousness through reflective questioning, supervisor self-disclosure, and the incorporation of self-assessment and explicit examination of the counseling process in terms of dynamics of privilege and oppression.


Since research on social justice advocacy in counselor education and supervision is so young, the possibilities for investigation appear limitless. First, establishing a clear understanding of the state of social justice advocacy training in counselor education and supervision programs is needed. Surveying current practices would not only shed light on how the field has embraced the charge to train counselors who are competent advocates, but also would provide perspective on the range of practices currently in use. This would include investigation of (a) strategies for promoting advocacy competence currently employed in counselor education and supervision programs overall, (b) theoretical approaches to counselor training for social justice advocacy, (c) exploring the efficacy of standalone courses on cultural competence and/or advocacy as compared to infusion of training throughout a curriculum, and (d) the state and practice of social justice within counselor education and supervision programs.

Further qualitative inquiry into the training experiences of counselor trainees and counselors would lend an important perspective to the knowledge base. Immediate foci may include desires for training, reflections on the process of developing critical consciousness and committing to social justice advocacy, critical incidents in training, and social justice needs within counselor education. Similarly, qualitative investigation of the experiences of counselor educators and supervisors who are charged with implementing training initiatives would bring additional perspective to the challenges and opportunities inherent in this endeavor. In addition, qualitative investigations of the clients and communities with whom service-learning initiatives are planned or conducted could be useful in assessing not only needs but also the impact of such projects and advocacy initiatives (Murray et al., 2010; Rasheed Ali et al., 2008).

Examination of the relationship between multicultural counseling competence and advocacy competence also is indicated as an area in need of exploration. Understanding this relationship could lead to economies in programming and more effective facilitation of student development, as suggested by current practices and understanding of the synergistic relationship between the two competencies (Hays et al., 2007; Manis 2008). In addition, further investigation into how best to assess competence in both areas of practice would be useful (Smith et al., 2006).

Finally, experimental research that assesses the efficacy of critically grounded pedagogical strategies in short- and long-term approaches would be helpful in assessing its ongoing utility in counselor education and supervision curricula, and in considering the question of efficacy of stand alone versus infusion approaches (Manis, 2008). This could be limited to specific strategies such as examination of dynamics of privilege and oppression, or expanded to testing full models or approaches as presented in the literature. And while there is promising evidence of the efficacy of critically grounded approaches for counselor education and supervision, this does not rule out the potential utility of investigating the efficacy of approaches grounded in other theories (Smith et al., 2006).


A review of the literature pointed to an appreciation of critical theories in grounding training for competent social justice advocacy. These approaches call upon counselor educators to attend to social justice across the curriculum and remain alert to their role in socializing counselor trainees as advocates. They also emphasize the importance of attending to the individual meaning-making of counselor trainees with respect to culture and dynamics of privilege and oppression. Lastly, they underscore the developmental nature of developing critical consciousness and the need to incorporate strategies that both instruct counselor trainees, and allow them to apply concepts in the field.

Adopting a critical pedagogical approach demands a high degree of investment from faculty and trainees. Counselor education and supervision practices are inherently reflective and experiential, and thus consonant with critical pedagogies. Critical approaches offer tremendous potential for enhancing the process and content of existing counselor education and supervision curricula so as to better meet the training needs of diverse students and ultimately the clients and communities they will serve.

The time to delve more deeply into transformational practices in our field is now (Ratts & Wood, 2011). It has been five years since Smith et al. (2006) heralded the end of the debate on multicultural education, validated its value in training and called for research to examine the efficacy of theoretically grounded pedagogical interventions in multicultural education. A review of the literature points to the efficacy of critical theory in social justice pedagogy. This offers a sound basis for incorporating critical pedagogical strategies now, while collective efforts to fully investigate the effectiveness of critical pedagogy are undertaken to advance the most efficacious training within the field of counselor education and supervision.


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Amie A. Manis, NCC, is a Core Faculty member in Counselor Education and Supervision at Capella University. The author acknowledges the contributions of colleagues at the University of Virginia, including Dr. Kathleen May, Dr. Sandra Lopez-Baez and Dr. Matthew J. Paylo in the development of this paper. Correspondence can be addressed to Amie A. Manis, 255 Forge Road, Lexington, VA 24450, amie.manis@capella.edu.