Catherine Clifton - The Professional Counselor

Burnout and Implications for Professional School Counselors

Sep 1, 2018 | Volume 8 - Issue 3

Nayoung Kim, Glenn W. Lambie

To prevent school counselors from experiencing feelings of burnout, identifying relevant factors is important. The purpose of this article is to review studies investigating the constructs of burnout and occupational stress in school counseling samples. Eighteen published research articles fit the inclusion criteria for this review. The researchers identified external and internal variables relating to school counselor burnout, as well as protective and risk factors. The review identified that school counselors’ higher level of burnout correlated with having non-counseling duties, being assigned large caseloads, working in schools that did not meet adequate yearly progress (AYP) status, experiencing a lack of supervision, possessing greater emotion-oriented stress coping scores, providing fewer direct student services, and having greater perceived stress. In contrast, feelings of burnout among school counselors were mitigated when counselors received supervision, possessed higher task-oriented stress coping strategies, scored at higher levels of ego maturity, reported greater occupational support at their schools, had greater grit scores, and worked in schools that met AYP.

Keywords: burnout, occupational stress, school counselors, non-counseling duties, coping strategies

There are multiple definitions of burnout (e.g., Burke & Richardson, 2000; Stalker & Harvey, 2002); however, the primary consistent aspect of burnout is that it is a psychological phenomenon associated with job-related stress (Maslach, 2017). Burnout occurs when professionals are unable to meet their own needs, as well as their clients’ needs, in a high-pressure environment (Maslach, 2017). Freudenberger (1990) identified common symptoms of burnout, including negative changes in individuals’ (a) attitudes and decision making; (b) physiological states; (c) mental, emotional, and behavioral health; and (d) occupational motivation. Burnout has significant consequences, including compromised physical health, increased risk of mental health disorders (e.g., depression, substance abuse), poor job performance, absenteeism, occupational attrition, and low self-esteem (Maslach & Leiter, 2016). Burnout can also cause symptoms such as fatigue, exhaustion, and insomnia (Armon, Shirom, Shapira, & Melamed, 2008).

Burnout in School Counseling

Morse, Salyers, Rollins, Monroe-DeVita, and Pfahler (2012) identified that 21% to 67% of mental health professionals reported experiencing high levels of burnout, possibly because of dealing with high client caseloads (Ducharme, Knudsen, & Roman, 2007) or overall job effectiveness (Stalker & Harvey, 2002). In addition, Oddie and Ousley (2007) found that 21% to 48% of mental health workers reported experiencing high levels of emotional exhaustion. School counselors specifically are at risk for experiencing feelings of burnout because of their multiple job demands, including paperwork, parent conferences, school-wide testing, large caseloads, and requests from administrators (McCarthy & Lambert, 2008), and other factors such as role ambiguity and limited occupational support (Young & Lambie, 2007). The school counseling job environment, where “the demands of the work are high, but the resources to meet those demands are low” (Maslach & Goldberg, 1998, pp. 63–64), increases susceptibility to experiencing feelings of burnout (e.g., average student-to-counselor ratio being 491-to-1; National Center for Education Statistics, 2016). Stephan (2005) found that within a national sample of school counselors, 66% of middle school counselors scored at moderate to high levels of emotional exhaustion. Further, Wachter (2006) found that 20% of the school counselors in her investigation (N = 132) experienced feelings of burnout; 16% scored at moderate levels of burnout, and 4% scored at severe levels of burnout. Thus, many school counselors experience feelings of burnout that may influence their ability to provide ethical and effective counseling services to the students they serve.

School counselors may experience chronic fatigue, depersonalization, or feelings of hopelessness and leave their jobs because of the rigidity of school systems and limited support (Young & Lambie, 2007). In fact, counselors experiencing significant feelings of burnout provide reduced quality of service to their clientele because burnout relates to lower productivity, turnover intention, and a lowered level of job commitment (Maslach, Schaufeli, & Leiter, 2001). Because of the importance of preventing the burnout phenomenon, the American School Counselor Association’s (ASCA; 2016) ethical standards note that school counselors are responsible for maintaining their health, both physically and emotionally, and caring for their wellness to ensure their effective practice. The American Counseling Association’s (2014) ethical standards also state that school counselors have an ethical responsibility to monitor their feelings of burnout and remediate when their feelings potentially influence their ability to provide quality services to their stakeholders. To monitor burnout, counselors need to understand the symptoms of burnout and prevent it from happening, while maintaining their psychological well-being.

School counselors face challenges with their significant job demands (McCarthy, Van Horn Kerne, Calfa, Lambert, & Guzmán, 2010), such as large caseloads (Lambie, 2007) and extreme amounts of non-counseling duties (Moyer, 2011). In fact, school counselors report job stress and dissatisfaction when they are required to complete non-counseling duties, hindering their ability to work with their students (McCarthy et al., 2010). Examples of non-counseling duties include clerical tasks, such as scheduling students for classes; fair share, such as coordinating the standardized testing program; and administrative duties, such as substitute teaching (Scarborough, 2005). School counselors with large caseloads and high student-to-counselor ratios are more likely to experience increased feelings of burnout (Bardhoshi, Schweinle, & Duncan, 2014). Although ASCA (2015) recommends a student-to-counselor ratio of 250-to-1, the U.S. average student-to-counselor ratio is almost double the recommended proportion (491-to-1; National Center for Education Statistics, 2016).

Insufficient resources for school counselors and negative job perception increase their likelihood of experiencing feelings of burnout. Lower levels of principal support and lack of clinical supervision raise school counselors’ occupational stress (Bardhoshi et al., 2014; Moyer, 2011). For instance, school counselors with higher levels of role ambiguity are likely to experience burnout (Wilkerson & Bellini, 2006). School counselors experience role ambiguity when their responsibilities or the expected level of performance is not clearly identified (Coll & Freeman, 1997). As a result, school counselors report increased levels of stress (Culbreth, Scarborough, Banks-Johnson, & Solomon, 2005), leading to burnout and attrition from the profession (Wilkerson & Bellini, 2006). ASCA (2016) dictated that school counselors’ responsibilities include providing counseling services to students to support their development, which distinguishes them from other school personnel. With the importance of preventing burnout in school counseling, the purpose of this review is twofold: (a) to present identified factors influencing school counselors’ levels of burnout and (b) to offer strategies to assist school counselors in mitigating the feelings of burnout.

Research Examining Burnout in School Counseling

We began by conducting a formal search of electronic databases—PsycINFO, ERIC (EBSCOhost), and Academic Search Premiere—relating to school counselor burnout. The search term burnout was first used to analyze the research trend in the field. Both the search terms burnout and school counselors OR school counseling were used to collect any articles on the topic of school counselor burnout published between 2000 and 2018. An additional search was conducted with the terms occupational stress and school counselors OR school counseling to identify potential studies related to the topic in the same type of literature.

The following inclusion criteria were applied for our review: (a) investigations of school counselor burnout and occupational stress, (b) sample participants were school counselors in the United States, (c) the primary topic of the investigation was burnout and/or occupational stress, (d) articles were written in English, (e) articles were published in refereed journals, and (f) articles were published between 2000 and 2018. In addition, our review excluded literature reviews, editorials, and rejoinders. The abstracts of the articles meeting the criteria were examined and confirmed in order to be included in our review.

Our literature search based on the inclusion criteria produced 51 articles. As not all articles from the search satisfied the criteria, the articles were reviewed manually to evaluate whether they met the criteria, resulting in 35 articles not meeting criteria (e.g., conceptual articles, studies related to teachers) and 16 articles meeting all criteria. An additional literature search yielded two more studies meeting the inclusion criteria, identifying 18 studies in total. None of the identified research articles examined prevention or treatment interventions for burnout in school counselors. The 18 investigations had school counselor burnout or occupational stress as the constructs of interest. The research findings identified the positive relationships between school counselors’ burnout or occupational stress scores and the following factors: (a) non-counseling duties, (b) large caseloads, (c) not meeting adequate yearly progress (AYP) status (i.e., the expected amount of students’ academic growth per year based on the No Child Left Behind mandate [Minnesota House of Representatives, 2003]), (d) lack of supervision, (e) emotion-oriented stress coping scores, (f) grit, and (g) perceived stress.

Fourteen out of 18 articles provided information related to school counselor burnout (see Table 1 for quantitative studies and Table 2 for qualitative studies), and the other four studies investigated school counselors’ occupational stress (see Table 3). Occupational stress refers to the strain a person experiences when the perceived stress in a workplace outweighs their ability to cope (Decker & Borgen, 1993). Quantitative research methods were employed in 15 of the investigations, two used mixed-methods, and one study utilized a qualitative approach. For all 18 articles, the participants were current school counselors, and the number of participants ranged from 3 to 926. Effect sizes were categorized depending on the analysis into three groups (i.e., small, medium, and large) based on the effect size matrix from Sink and Stroh (2006), offering a better understanding of the results. Specifically, the effect size from independent samples t-test (2 groups; Cohen’s d) is interpreted as small for 0.2, medium for 0.5, and large for 0.8. For the effect size of other analyses listed in this review, including paired-samples t-tests (η²), multiple regression (R²), and analysis of variance (ANOVA; η²), 0.01 is considered as small, 0.06 as medium, and 0.14 as large.

Table 1

Summary of Quantitative/Mixed Studies Related to Professional School Counselor (PSC) Burnout

Study	Sample	Variables	Findings
Bain, Rueda, Mata-Villarreal, & Mundy (2011)	PSCs in rural districts of South Texas (N = 27) Convenient Sampling	Mental health awareness, the amount of time spent on academic advising	Feelings of burnout were reported by the majority of the PSCs (89%) in the study and many of them spent the greatest amount of time on administrative duties and the least on counseling.
Bardhoshi, Schweinle, & Duncan (2014)	PSCs (N = 212) Random Sampling	Non-counselor duties, school factors, five subscales of the CBI	Non-counseling duties and school factors were associated with PSC burnout. Non-counseling duties explained the variance of the three burnout subscales: Exhaustion (11%; medium effect size), NWE (6%; medium effect size), and DPL (8%; medium effect size). Non-counseling duties and other factors (e.g., caseload, principal support) explained the variance of the four burnout subscales: Exhaustion (21%; large effect size), Incompetence (9%; medium effect size), NWE (49%; large effect size), and DPL (17%; large effect size).
Butler & Constantine (2005)	PSCs (N = 533) Random Sampling	Collective self-esteem, burnout, demographics	Collective self-esteem explained 3% of the variance of PSC burnout (small effect size). In particular, PRCS (2%) and PUCS (1%) accounted for PA (both small effect sizes), and IICS explained 1% of feelings of DP and PA (both small effect sizes). Higher collective self-esteem was associated with lower PSC burnout. PSCs working in urban settings tended to have higher levels of burnout than the counterparts in other environmental settings. PSCs with experience of 20–29 years reported higher levels of burnout than the counterparts with 0–9 years of experience. PSCs with experience of 30 or more years reported higher levels of burnout than those with less experience.
Gnilka, Karpinski, & Smith (2015)	PSCs (N = 269) Convenient Sampling	Five subscales on the CBI	Effect size differences were found between PSCs and other professionals in the counseling fields (Exhaustion, d = .26, small effect size; DC, d = -.50, medium effect size). Effect size differences were noted between PSCs and sexual offender and sexual abuse therapists (Exhaustion, d = .27, small effect size; DPL, d = -.23, small effect size; DC, d = -.82, large effect size).
Lambie (2007)	PSCs (N = 218) Random Sampling	Ego maturity, three subscales on the MBI-HSS	PSCs with greater levels of ego maturity tended to have a higher level of PA than those with lower ego maturity. Ego maturity predicted PA (3.3%; small effect size). Occupational support and the subscales of burnout were correlated. Reported occupational support predicted EE (16%; large effect size), DP (12%; medium effect size), and PA (7.2%; medium effect size).
Limberg, Lambie, & Robinson (2016-2017)	PSCs (N = 437) Random Sampling/ Purposive Sampling	Altruistic motivation, altruistic behavior, burnout	PSCs with greater levels of altruism had lower levels of EE and higher feelings of PA. PSC altruism explained 31.36% of the variance in EE (large effect size), and 29.16% of the variance in PA (large effect size). Self-Efficacy accounted for 14.4% of the variance in EE (large effect size) and 9% of the variance in PA (medium effect size).
Moyer (2011)	PSCs (N = 382) Convenient Sampling	Non-guidance activities, supervision, student-to-counselor ratios, five subscales of the CBI	Non-guidance–related duties and clinical supervision were significant predictors of PSC burnout. Non-guidance duties (7.3%; medium effect size) and supervision (9%; medium effect size) predicted burnout.
Mullen, Blount, Lambie, & Chae (2017)	PSCs (N = 750) Random Sampling	Perceived stress, burnout, job satisfaction	Perceived stress predicted burnout positively (large effect size) and job satisfaction negatively (large effect size). Perceived stress and burnout predicted job satisfaction (large effect size). Burnout mediated the relationship between perceived stress and job satisfaction.
Mullen & Crowe (2018)	PSCs (N = 330) Convenient Sampling	Grit, stress, burnout	Grit was negatively related to burnout (small effect size) and stress (small to medium effect size).
Mullen & Gutierrez (2016)	PSCs (N = 926) Random Sampling	Burnout, perceived stress, direct student services	Burnout attributed to direct counseling activities (12%; medium effect size), direct curriculum activities (5%; small to medium effect size), and percentage of time at work providing direct services to students (6%; medium effect size).
Wachter, Clemens, & Lewis (2008)	PSCs (N = 249) Random Sampling	Demographics, stakeholder involvement, lifestyle themes, burnout	Burnout and lifestyle themes were associated. Perfectionism subscale was negatively related to burnout, and the Self-Esteem subscale was positively related to PSC burnout. About 15.1% of the variance in burnout was accounted for by the lifestyle themes of Self-Esteem and Perfectionism (large effect size).
Wilkerson & Bellini (2006)	PSCs in northeastern U.S. (N = 78) Systematic Random Sampling	Demographics, intrapersonal, and organizational factors; three subscales on the MBI-ES	Demographic (age, counseling experience, supervision, and student/counselor ratio), intrapersonal, and organizational factors significantly accounted for the amount of the variance in each subscale of burnout, including EE (45%; large effect size), DP (30%; large effect size), and PA (42%; large effect size).
Wilkerson (2009)	PSCs (N = 198) Random Sampling	Demographic and organizational stressors and individual coping strategies; three subscales on the MBI-ES	Demographic factors (years of experience and student/counselor ratio), organizational stress, and coping styles explained the variance of each subscale of burnout including EE (49%; large effect size), DP (27%; large effect size), and PA (36%; large effect size).

Table 2

Summary of Qualitative/Mixed Studies Related to Professional School Counselor Burnout

Study	Sample	Topic	Identified Themes
Bain, Rueda, Mata-Villarreal, & Mundy (2011)	PSCs in rural districts of South Texas (N = 27) Convenient Sampling	Helpful ways to better provide mental health services at school	Having access to additional staff and additional education and awareness in terms of helpful ways to provide mental health services at their school.
Bardhoshi, Schweinle, & Duncan (2014)	PSCs (N = 252) Random Sampling	a) Their experience of burnout b) The meaning of performing non-counseling duties	a) Lack of time, budgetary constraints, lack of resources, lack of organizational support, etc. b) Adverse personal/professional effects, a reality of the job, reframing the duties within the context of the job.
Sheffield & Baker (2005)	Female PSCs (N = 3) Purposive Sampling	Burnout experience	Important beliefs, burnout feelings, burnout attitude, (lack of) collegial support.

Table 3

Summary of Quantitative Studies Related to Professional School Counselor Occupational Stress

Study	Sample	Variables	Findings
Bryant & Constantine (2006)	Female PSCs (N = 133) Random Sampling	Role balance, job satisfaction, satisfaction with life, demographics	Multiple role balance ability and job satisfaction positively predicted overall life satisfaction. Role balance and job satisfaction explained the variance of life satisfaction (41%; large effect size).
Culbreth, Scarborough, Banks-Johnson, & Solomon (2005)	PSCs (N = 512)Stratified Random Sampling	Role conflict, role ambiguity, role incongruence, demographics	Perceived match between the job expectations and actual experiences predicted role-related job stress, including role conflict (7.6%; medium effect size); role incongruence (19.7%; large effect size); and role ambiguity (8.3%; medium effect size).
McCarthy, Van Horn Kerne, Calfa, Lambert, & Guzmán (2010)	PSCs in Texas (N = 227) Convenient Sampling	Demographics, job stress, resources and demands	Job stress was different between the resourced, balanced, and demand groups. The effect sizes were large in the differences between the demand group and the resourced group (1.62; large effect size) and the balanced group (0.70; large effect size).
Rayle (2006)	PSCs (N = 388)Convenient Sampling	Demographics, mattering, job-related stress	Thirty-five percent of the variance in overall job satisfaction was explained by mattering to others at work and job-related stress (large effect size). Mattering to others (19.36%; large effect size) and job-related stress (16.81%; large effect size) explained the variance in overall job satisfaction.

Three instruments were used to measure levels of school counselor burnout, including: (a) the Maslach Burnout Inventory (MBI; Maslach, Jackson, & Leiter, 1996), (b) the Counselor Burnout Inventory (CBI; S. M. Lee et al., 2007), and (c) the Burnout Measure Short Version (BMS; Malach-Pines, 2005). Maslach and Jackson (1981) defined burnout with three dimensions: Emotional Exhaustion (EE), Depersonalization (DP), and reduced Personal Accomplishment (PA). Emotional exhaustion is to exhaust one’s capacity to continuously involve with clients (R. T. Lee & Ashforth, 1996). Not being able to respond to clients’ needs may cause counselors to distance themselves from their job emotionally and cognitively, which is defined as depersonalization. Lastly, having a lower sense of effectiveness may reduce feelings of personal accomplishment (Maslach et al., 2001). Four studies used the MBI-Education Survey (MBI-ES), which was designed for the education population, and another study utilized the MBI-Human Services Survey (MBI-HSS), in which the word students from the MBI-ES is substituted with recipients in a third of the items (Sandoval, 1989).

Four studies used the CBI, which is a 20-item instrument with five subscales, including:
(a) Exhaustion, (b) Incompetence, (c) Negative Work Environment (NWE), (d) Devaluing Client (DC), and (e) Deterioration in Personal Life (DPL). Exhaustion is the condition of being physically and emotionally exhausted by the duties of a counselor, and incompetence focuses on counselors’ feelings of being incompetent. While negative work environment refers to the stress caused by the working environment, devaluing client is related to being unable to establish emotional connectedness with clients. Finally, deterioration in personal life assesses the level of deterioration in a counselor’s personal life. Sample items include “I feel exhausted due to my work as a counselor,” and “I feel I have poor boundaries between work and my personal life.” The internal consistency of the CBI ranged from .73 to .85 (S. M. Lee et al., 2007). In addition, three studies used the BMS (Malach-Pines, 2005), a 10-item scale in which participants rate their answers to the question “When you think about your work overall, how often do you feel the following?” in seven prompts, including: “Trapped,” “Hopeless,” and “Helpless.” The BMS is adapted from the original version of the Burnout Measure (Pines & Aronson, 1988). The internal consistency of the BMS ranged from .85 to .87 (Malach-Pines, 2005).

Researchers investigated different factors relating to school counselor burnout within the 18 published articles. One of the studies provided descriptive statistics of school counselor burnout, comparing school counselors to other mental health professionals and showing how burnout symptoms may emerge (N = 269; Gnilka, Karpinski, & Smith, 2015). School counselors had greater levels of Exhaustion (d = .26; small effect size) and lower levels of DC (d = -.50; medium effect size) than mental health professional participants. Furthermore, school counselors had greater levels of Exhaustion (d = .27; small effect size) and lower levels of DC (d = -.82; large effect size) compared to the mental health professional participants working with sex offenders and clients that have been sexually abused. Therefore, school counselors score higher in exhaustion as compared to other mental health professionals and score lower on devaluing their clients.

Individual Factors Related to Burnout

The two categories of individual factors relating to school counselor burnout were (a) psychological constructs and (b) demographic factors. The psychological constructs included ego maturity (Lambie, 2007), collective self-esteem (Butler & Constantine, 2005), altruism (Limberg, Lambie, & Robinson, 20162017), lifestyle themes (Wachter, Clemens, & Lewis, 2008), coping styles (Wilkerson, 2009), perceived stress (Mullen, Blount, Lambie, & Chae, 2017), and grit (Mullen & Crowe, 2018). The definitions of these psychological constructs related to school counselor burnout follow.

Ego maturity refers to the fundamental element of an individual’s personality, encompassing components of self, social, cognitive, character, and moral development (Loevinger, 1976). When individuals’ egos develop, they become more individualistic, autonomous, and highly aware of themselves (Loevinger, 1976). Collective self-esteem is individuals’ perception of their identification with the social group they belong to (Bettencourt & Dorr, 1997). Altruism is the behavior driven by values or goals individuals possess or their concerns for others, aside from external rewards (Eisenberg et al., 1999). A lifestyle is an individual’s way of perceiving self, others, and the world (Mosak & Maniacci, 2000), and lifestyle themes refer to common patterns people possess in relation to their lifestyles (Mosak, 1971). Coping is defined as cognitive and behavioral efforts to deal with specific demands that take up or exceed individuals’ resources (Lazarus & Folkman, 1984), and coping styles refer to individuals’ relatively stable patterns in handling stress (Heszen-Niejodek, 1997). Perceived stress represents the extent to which individuals evaluate their situations as stressful (Cohen, 1986). Grit is “perseverance and passion for long-term goals” (Duckworth, Peterson, Matthews, & Kelly, 2007, p. 1087). Specifically, grit refers to efforts to achieve a goal despite challenges. In addition to psychological constructs, the demographic factors category included years of experience in school counseling (Butler & Constantine, 2005; Wilkerson, 2009; Wilkerson & Bellini, 2006) and age (Wilkerson & Bellini, 2006).

Psychological constructs. Seven studies identified that psychological constructs relate to school counselors’ feelings of burnout. Five of seven factors had large effect sizes, including ego maturity, altruism, lifestyle themes, coping styles, and grit, and three of the factors with large effect sizes were associated with Emotional Exhaustion (EE) among the MBI (Maslach et al., 1996) subscale scores (i.e., ego maturity, altruism, and coping styles).

Specifically, Lambie (2007) examined the directional relationship between school counselors’
(N = 218) burnout and ego maturity, identifying that those counselors with higher levels of ego maturity were likely to have greater feelings of Personal Accomplishment (PA; R² = .033). The researcher also investigated the relationship between the school counselors’ reported occupational support and their MBI burnout subscales scores (Maslach & Jackson, 1996), identifying that each MBI subscale relates to the participants’ levels of reported occupational support; EE (large effect size; R² = .167); DP (medium effect size; R² = .120); and PA (medium effect size; R² = .072). The results indicated that school counselors scoring at higher ego maturity levels had lower feelings of burnout, and counselors experiencing high levels of occupational support had significantly lower burnout scores.

The relationship between burnout and collective self-esteem was investigated within a sample of school counselors (N = 533; Butler & Constantine, 2005). The Collective Self-Esteem Scale has four subscales (Luhtanen & Crocker, 1992), including (a) Private Collective Self-Esteem (PRCS), (b) Public Collective Self-Esteem (PUCS), (c) Membership Collective Self-Esteem (MCS), and (d) Importance to Identity Collective Self-Esteem (IICS). These subscales measure individuals’ perception of social groups they belong to, including how they feel about the group (PRCS), how they perceive others feel about the group (PUCS), how they perceive themselves being a good member of the group (MCS), and how important their social group is to their self-concept (IICS). These four Collective Self-Esteem Scale subscales explained 3% of the variance in the burnout subscales (Pillai’s trace = .08, F [12, 1584] = 3.48, p < .001, η²_M = .03; Maslach & Jackson, 1986).

In general, higher collective self-esteem relates to lower levels of burnout, and different dimensions of collective self-esteem relate to different components of burnout. Higher PRCS was associated with higher feelings of PA (η² = .02), and higher PUCS was related to lower levels of EE (η² = .01). The school counselors’ IICS subscale scores were related to their lower feelings of DP (η² = .01) and greater feelings of PA (η² = .01). Although a small amount of variance in burnout scores (.01–.02) was explained by the components of collective self-esteem, the positive relationship between higher PRCS and higher feelings of PA identified that positive perceptions of the group school counselors belong to might reduce their feelings of burnout. For instance, having a sense of pride as a school counselor by observing other school counselors’ hard work and good relationships with students may promote their sense of PRCS, which may lead to higher feelings of PA. Taken together, promoting school counselors’ collective self-esteem may decrease their feelings of burnout.

Limberg and colleagues (2016–2017) investigated the directional relationship between school counselors’ (N = 437) levels of altruism and burnout. The school counselors with greater levels of altruism had lower levels of EE and higher feelings of PA. Specifically, the altruism subscales of Positive Future Expectation (PFE) and Self-Efficacy from the Self-Report Altruism Scale (Rushton, Chrisjohn, & Fekken, 1981) and two subscales of burnout (MBI) correlated (χ² = 403.611, df = 216, χ² ratio = 1.869, p < .001). PFE and Self-Efficacy accounted for 31.36% of the variance in the EE subscale (large effect size), and 29.16% of the variance in the PA subscale (large effect size). The Self-Efficacy subscale, which involves individuals’ perceived competence in a certain skill, explained 14.4% of the variance in EE subscale scores (large effect size), and 9% of the variance in PA subscale scores (medium effect size). Therefore, the results identified that school counselors’ levels of altruism negatively contribute to their burnout scores.

Burnout was related to lifestyle themes among school counselors (N = 249; Wachter et al., 2008). Two subscales of lifestyle themes from the Kern Lifestyle Scale (Kern, 1996), Self-Esteem and Perfectionism, accounted for 15.1% of the variance in burnout (large effect size; R² = .151). Specifically, the Perfectionism subscale was negatively related to school counselor burnout scores (Burnout Measure: Short Version; BMS; Malach-Pines, 2005), and the Self-Esteem subscale was positively related to school counselor burnout. As a result, these findings identified school counselors’ personality factors relating to their risk of burnout, supporting that higher levels of perfectionism and lower levels of self-esteem may increase the likelihood of experiencing burnout.

Two studies employed hierarchical regression analyses to examine what factors may predict burnout subscale scores of the MBI, and one of the predicting variables was coping styles (Wilkerson, 2009; Wilkerson & Bellini, 2006). Wilkerson (2009) used four-step hierarchical regression models that included demographics, organizational stressors, and coping strategies, such as task-oriented, emotion-oriented, and avoidance-oriented coping (N = 198). The models with large effect sizes explained all three MBI burnout subscales. Specifically, 49% of the variance in the EE subscale was explained (large effect size; R² = .49); 27% of the variance in the DP subscale was accounted for (large effect size; R² = .27); and 36% of the variance of the PA subscale was explained (large effect size; R² = .36). The results identified school counselors’ stressor scores both at the individual and organizational levels; intrapersonal coping strategies contributed to feelings of burnout with large effect sizes in the final model. In other words, demographic factors (e.g., more school counseling experience), coping styles (e.g., more emotion-oriented and less task-oriented coping strategies), and organizational variables (e.g., lack of decision-making authority, role ambiguity, role incongruity, and role conflict) positively predicted the level of burnout among school counselors.

Wilkerson and Bellini (2006) used three-step hierarchical regression models including demographic, intrapersonal, and organizational factors to examine the relationship between the variables and burnout among school counselors (N = 78). The school counselors’ demographic data (e.g., age, counseling experience, supervision, and student/counselor ratio), and intrapersonal (i.e., coping strategies) and organizational factors (e.g., role conflict, role ambiguity, and counselor occupational stress) significantly accounted for the variance in their burnout subscale scores on the MBI. Specifically, 45% of the variance in the EE subscale was explained (large effect size; R² = .45), 30% of the variance in the DP subscale was accounted for (large effect size; R² = .30), and 42% of the variance in the PA subscale was explained (large effect size; R² = .42) by the final three-step model with the variables (i.e., counselor demographics, intrapersonal factors, and organizational factors). The findings indicated that school counselors’ emotion-oriented coping style predicted their three MBI subscale scores, supporting the importance of utilizing helpful strategies (i.e., task-oriented coping) to mitigate counselors’ feelings of burnout.

Another study examined how school counselors’ perceived stress and job satisfaction relate to burnout (Mullen et al., 2017). Specifically, perceived stress measured by the Perceived Stress Scale (Cohen, Kamarck, & Mermelstein, 1983) explained 52% of the variance in burnout (F (1, 749) = 808.55, p < .001; R² = .52) and 25% of the variance in job satisfaction (F (1, 749) = 243.36, p < .001; R² = .25). When both perceived stress and burnout were examined in order to test the relationship with job satisfaction, they explained 40% of the variance in job satisfaction (F (2, 747) = 246.48, p < .001; R² = .40). In addition, the results indicated that burnout mediated the relationship between perceived stress and job satisfaction (z = -21.47, p < .001), and burnout (r_s = .99) predicted job satisfaction better than perceived stress (r_s = .79). Overall, perceived stress predicted burnout positively (large effect size) and job satisfaction negatively (large effect size). Both perceived stress and burnout predicted job satisfaction (large effect size).

Finally, Mullen and Crowe (2018) investigated the relationship between grit, burnout, and stress among school counselors (N = 330). The researchers found that grit was negatively correlated with burnout (r = -.22, p < .001) and stress (r = -.28, p < .001). Specifically, perseverance of effort, one of the subscales from the Grit-S (Duckworth & Quinn, 2009), was negatively related with burnout (r = -.12,
p < .05) and stress (r = -.19, p < .001). Therefore, school counselors’ level of grit may be a protective factor for burnout and stress.

Demographic factors. School counselors’ individual factors, such as age (Wilkerson & Bellini, 2006) and years of experience (Butler & Constantine, 2005; Wilkerson, 2009), correlate with feelings of burnout. Age was negatively correlated to the DP subscale (r = -.19, p < .05); therefore, older school counselors were less likely to experience burnout as compared to younger counselors (Wilkerson & Bellini, 2006). Nevertheless, the correlation between school counselors’ years of experience and burnout was inconsistent. Wilkerson and Bellini (2006) indicated that years of experience negatively correlated with the EE (r = -.26, p < .01), and DP (r = -.24, p < .05) subscales, while Butler and Constantine (2005) identified that school counselors with more years of experience scored at higher levels of burnout (MBI scores). Specifically, school counselors with 20–29 years of experience had greater DP subscale scores than those with 0–9 years of experience (F (3, 529) = 3.38, p < .05); and counselors with 30 years or more of experience had lower PA subscale scores than those with less than 20 years of experience (F (3, 529) = 3.39, p < .05). Furthermore, Wilkerson (2009) also reported that the years of experience positively correlated with the EE (ß = .21, p < .01) and DP (ß = .26, p < .01) MBI subscales in the hierarchical regression models whose variables included counselor demographics and organizational and intrapersonal variables to explain the variance of the burnout scores. Possible reasons behind the incongruent results may relate to school counselors’ role ambiguity, as counselors with less experience may experience or perceive large workloads compared to more experienced counselors. The conflicting results also may be related to other school counselor factors, such as the level of social support counselors experience at their schools. The findings identified the need for more inquiry to increase our understanding of the relationship between school counselors’ years of experience and their feelings of burnout.

Organizational Factors Relating to School Counselors Levels of Burnout

Eight organizational factors appear to correlate with school counselors’ levels of burnout, including (a) workplace (Butler & Constantine, 2005), (b) non-counseling duties such as administrative and clerical tasks (Bardhoshi et al., 2014; Moyer, 2011), (c) caseloads (Bardhoshi et al., 2014), (d) AYP (Bardhoshi et al., 2014), (e) level of principal support (Bardhoshi et al., 2014), (f) clinical supervision (Moyer, 2011), (g) student-to-counselor ratio (Wilkerson, 2009; Wilkerson & Bellini, 2006), (h) perceived work environment (Wilkerson & Bellini, 2006), and (i) direct student services (Mullen & Gutierrez, 2016). We categorize these organizational factors into two domains: (a) job responsibilities and
(b) work environment factors.

Job responsibilities. Two studies examined the relationship between school counselors’ non-counseling duties and their burnout scores. First, Bardhoshi and colleagues (2014) examined school counselors’ (N = 212) non-counseling duties and identified a significant relationship between three of the CBI subscales: (a) 11% of the variance in Exhaustion was explained (medium effect size; R² = 0.11); (b) 6% of the variance in NWE was explained (medium effect size; R² = 0.06); and (c) 8% of the variance in DPL was explained (medium effect size; R² = 0.08). Taken together, the results identified that school counselors’ non-counseling duties positively predict their burnout scores.

Moyer (2011) examined how school counselors’ (N = 382) non-counseling duties (non-guidance duties) were correlated to their levels of burnout as measured by the CBI. School counselors’ non-counseling duties accounted for 7.3% of the variance in the burnout score (medium effect size; R² = .073, ß = .27, p < .01). Receiving supervision accounted for additional variance in school counselors’ burnout scores after controlling the variance explained by non-counseling activities (medium effect size; R² = .09, ß = -.14, p < .01). As a result, school counselors with more non-counseling duties and less clinical supervision had higher burnout scores. The findings identify the importance of clinical supervision to reduce burnout among school counselors, helping them improve their quality of counseling, which in turn may increase their sense of competence in the workplace.

Bain and colleagues (2011) investigated the mental health of school counselors in a rural setting and their percentage of workweek spent on counseling and administrative duties in South Texas (N = 27). Within this sample of school counselors, 89% had experienced feelings of burnout at least sometimes when trying to provide mental health services; specifically, 41% reported feelings of burnout, and 48% sometimes experienced burnout when providing mental health services to their students. School counselors also reported that they spent the greatest amount of time completing administrative duties and the least amount of time providing counseling services. About 48% of the counselors used more than 50% of their time completing administrative duties, such as organizing facts to report to administrators and preparing for assessments of knowledge and skills, and more than 70% of the participants spent less than 50% of their time providing counseling services. The sample size for this study was small; nevertheless, the results identified that approximately 90% of the school counselors experienced some levels of burnout and spent less time providing counseling services to their students and other stakeholders than completing administrative duties.

Finally, Mullen and Gutierrez (2016) investigated the relationship between burnout and direct student services of school counselors (N = 926). The results indicated that burnout negatively contributed to the frequency of direct counseling activities (ß = -.35, p < .001), direct curriculum activities (ß = -.22, p < .001), and percentage of time at work providing direct services to students (ß = -.24, p < .001). The findings suggest that school counselors experiencing feelings of burnout are likely to have lower numbers of direct counseling activities and curriculum activities, and spend less time offering direct services to students.

Work environment factors. School counselors’ levels of burnout may be different depending on the location of their workplace (Butler & Constantine, 2005). Specifically, school counselors working in urban settings scored higher on the EE subscale as compared to counselors in suburban, rural, and other settings (F (3, 529) = 24.66, p < .001). In addition, counselors in urban settings had higher DP subscale scores than those in other environmental settings (F (3, 529) = 13.67, p < .001). The results may relate to unique stressors school counselors in the urban settings face, including their expected proficiency in working with diverse students (Constantine et al., 2001). Overall, school counselors in urban settings were likely to experience greater feelings of burnout than those counselors in other settings, suggesting that more research is warranted to better understand possible contributors to these educators having higher MBI scores.

Factors relating to school counselors’ work correlating with their feelings of burnout include counselors’ caseloads, AYP status, principal support, and non-counseling duties. Specifically, school-related factors for counselors explained the variance of four burnout subscales of the CBI (Bardhoshi et al., 2014): (a) 21% of the variance in Exhaustion scores was explained (large effect size; R² = 0.21, p < .001); (b) 9% of the variance in Incompetence scores was explained (medium effect size; R² = 0.09, p < .01); (c) 49% of the variance in NWE scores was explained (large effect size; R² = 0.49, p < .001); and (d) 17% of the variance in DPL scores was explained (large effect size; R² = 0.17, p < .001). As a result, both school counselors’ work-related factors, such as caseloads and non-counseling duties, and their school environment (support from school staff and AYP status) correlate to their feelings of burnout. Therefore, providing sufficient support for school counselors, meeting the AYP, and reducing caseloads and non-counseling duties might mitigate feelings of burnout among school counselors.

Student-to-counselor ratio (Wilkerson, 2009) and perceived work environment (e.g., role conflict; Wilkerson & Bellini, 2006) were identified as predictive factors for school counselor burnout. Wilkerson (2009) found that the hierarchical regression models with variables of demographic data (e.g., years of experience), organizational stressors (e.g., counselor–teacher professional relationships), and coping strategies (e.g., task-oriented coping) explained all three subscale scores of the MBI in a sample of school counselors (N = 198): EE (R² = .49; large effect size), DP (R² = .27; large effect size), and PA (R² = 36; large effect size). Similarly, Wilkerson and Bellini (2006) identified that school counselors’ demographic, intrapersonal, and organizational factors accounted for variance in all three MBI subscale scores, including the EE, DP, and PA subscales (45%, 30%, and 42%, respectively; all large effect sizes). The findings from these studies support that environmental factors relate to school counselor burnout.

Identified Themes From Qualitative Studies

One qualitative study and two mixed-methods studies explored themes relating to school counselor burnout and ways to improve their service, which may offer ways to prevent burnout. Bardhoshi and colleagues (2014) examined how school counselors experienced burnout. Specifically, the emergent themes identified for school counselors’ feelings of burnout organized around four areas including (a) lack of time, (b) budgetary constraints, (c) lack of resources, and (d) lack of organizational support. When school counselors were asked about the meaning of performing non-counseling duties, they stated adverse personal and professional effects, the realities of practice, and reframing the duties within the context of the job. One participant described burnout stating, “It means that I am no longer helpful to my students. I feel like I’m extremely tired and overworked and consequently my effectiveness as a school counselor is negatively impacted” (p. 437).

These themes aligned with existing qualitative research examining school counselors’ feelings of burnout (N = 3; Sheffield & Baker, 2005), including (a) important beliefs, (b) burnout feelings, (c) burnout attitude, and (d) lack of collegial support. One of the participants stated, “I didn’t think I was doing any good for anybody . . . I just can’t go on this way” (p. 181). Another participant stated, “You get to the point where it is no longer fun coming to work or when you are just tired [and] don’t want to deal with anyone” (p. 182). Finally, Bain and colleagues (2011) explored helpful ways to better provide mental health services at school with 27 school counselors in rural districts of South Texas. The results identified that having access to more staff and additional education and awareness of mental health services at their school was needed. Overall, these studies identified common themes of school counselors’ need for collegial support and resources, such as a school climate encouraging collaboration, and identifying gaps in the needs and realities of school counselors (Bardhoshi et al., 2014), as well as reducing the amount of stressful, non-counseling–related work they perform.

Occupational Stress

Researchers examined which factors may influence school counselors’ job stress or job satisfaction, including (a) counselors’ perceived match between job expectations and their actual experiences (Culbreth et al., 2005), (b) the amount of resources in their work environment (McCarthy et al., 2010), (c) mattering to others (Rayle, 2006), and (d) role balance ability (Bryant & Constantine, 2006). Perceived match between initial expectations of the job and actual experiences as a school counselor was the most significant predictor of lower role stress demonstrated by each subscale score of the Role Questionnaire (N = 512; Culbreth et al., 2005): role conflict (medium effect size; R² = .076); role incongruence (large effect size; R² = .197); and role ambiguity (medium effect size; R² = .083). School counseling students reported not feeling trained enough because of the significant amount of non-counseling–related duties, which increased their sense of role conflict.

Graduating from a program accredited by the Council for Accreditation of Counseling and Related Educational Programs accounted for 1.2% of the variance in school counselors’ perceived readiness for the job (small effect size; r = .111, p < .05; Culbreth et al., 2005). School counselors’ balance between job demand and resources was another important factor for their job stress. Moreover, McCarthy and colleagues (2010) identified that perceived job stress and work environment in terms of demands and resources were correlated (N = 227; F (2, 206) = 44.77, p < .001). School counselors with resources, such as other counselors in general or as mentors, and support from administrators scored lower on levels of job stress. The effect size for the difference between the demand and the resourced groups was 1.62 (large effect size), and between the demand and balanced groups was 0.70 (large effect size). In other words, school counselors with more work-related resources were likely to experience lower levels of job stress.

Several factors are related to job satisfaction for school counselors. Rayle (2006) investigated the relationship between school counselors’ (N = 388) mattering to others at work scores and job-related stress scores, and their overall job satisfaction scores. The School Counselor Mattering Survey developed for this study included seven items asking participants to rate their perceived mattering to others, including their students, administrators, and the parents and teachers they worked with. School counselors’ mattering to others at work scores and job-related stress scores explained 35% of the variance in their overall job satisfaction (large effect size; ηp² = .62). Specifically, school counselors’ job satisfaction correlated with mattering to others at work scores (large effect size; r = .44, p < .001) and their job-related stress scores (large effect size; r = -.41, p < .001). In addition, school counselors’ mattering to others scores were negatively associated with their job-related stress scores (r = -.54, p < .001; large effect size). The findings suggest that school counselors’ perceived mattering to others at work and job-related stress predict their overall job satisfaction, and mattering to others at work relates to their job-related stress.

In addition, Bryant and Constantine (2006) investigated the relationship between female school counselors’ (N = 133) role balance, job satisfaction, and life satisfaction. After controlling for demographic information (age, years of school counseling experience, and location of school), role balance and job satisfaction scores correlated with their satisfaction with life scores (large effect size; R² = .41). As a result, school counselors’ multiple role balance ability and job satisfaction scores positively predicted their overall life satisfaction scores. In sum, these findings identified factors related to school counselors’ job satisfaction, including mattering to others at work, job-related stress, and life satisfaction.

Discussion

Because of the dearth of literature examining school counselor burnout or occupational stress, we reviewed 18 investigations based on the inclusion criteria and included articles focusing on the topic that were published between 2000 and 2018 in refereed journals and identified internal and external factors relating to the phenomena. Specific factors were identified relating to school counselor burnout or stress and their environment, including responsibilities not related to counseling, large caseloads, AYP status, and role confusion. The findings suggest the importance of school counselors asserting themselves to focus on mandated tasks (i.e., counseling) in order to experience less burnout. In addition, it is imperative to train school counseling students to understand the reality of practice, such as other job responsibilities and school climates, and inform them on the necessity of counselors advocating for themselves in order to overcome role confusion and avoid large caseloads. Furthermore, several resources were identified to mitigate burnout among school counselors. Clinical supervision from a competent supervisor is essential for school counselors to get support and learn how to intervene with their clients effectively. In addition, peer supervision or consultation from colleagues may benefit school counselors in sharing their difficulties and gaining other professionals’ perspectives (Butler & Constantine, 2005). Task-oriented coping skills which can be learned in the school counseling programs were also related to a reduced level of burnout among school counselors.

Limitations

Our review needs to be interpreted with some caution, as it is limited to the 18 published studies meeting the inclusion criteria. Therefore, additional research investigating school counselor burnout is needed to further our understanding of this significant construct that may influence the services school counselors provide to their stakeholders. In addition, the reviewed studies include methodological limitations (e.g., sample size, self-report data), further supporting the need for increased research examining the construct of burnout in school counseling. Moreover, no research was identified examining interventions to possibly reduce counselor feelings of burnout.

Implications for School Counseling

Although no studies were identified that investigated treatments for school counselor burnout, research from other similar professions may provide insight for developing coping strategies for school counselors addressing their feelings of burnout. Awa, Plaumann, and Walter (2010) reviewed 25 intervention studies for burnout prevention whose participants included employees from diverse occupations. Seventeen out of 25 studies employed person-directed interventions and indicated the positive effects of the interventions, including cognitive behavioral training (Gorter, Eijkman, & Hoogstraten, 2001), psychosocial skill training (Ewers, Bradshaw, McGovern, & Ewers, 2002), and recreational music making (Bittman, Bruhn, Stevens, Westengard, & Umbach, 2003). Two studies used organization-directed interventions, and one of the studies reduced burnout by using cognitive behavioral techniques, management skill training, and social support (Halbesleben, Osburn, & Mumford, 2006). The other six investigations explored the effects of combined (person- and organization-directed) interventions in reducing burnout. The examples of combined interventions to mitigate counselors’ feeling of burnout include professional supervision (Melchior et al., 1996); work schedule reorganization and lectures (Innstrand, Espnes, & Mykletun, 2004); and participatory action research, communication, social support, and coping skills (Le Blanc, Hox, Schaufeli, Taris, & Peeters, 2007). Overall, Awa and colleagues (2010) identified positive impacts of burnout intervention programs, suggesting potential benefits of these treatment programs for school counselors.

In addition, Krasner and colleagues (2009) reported the effectiveness of their continuing medical education program for physicians to reduce burnout, which involves mindfulness, self-awareness, and communication skills. Educating for mindfulness strategies, self-awareness, and communication skills also may be helpful for school counselors. Providing a supportive environment and acknowledging school counselors’ work may help them increase their sense of matter in their workplace. Lacking empirical studies identifying treatment outcomes for burnout in school counselors, research on decreasing the level of school counselor burnout should be examined both deeply and extensively. Furthermore, intervention programs to prevent and intervene with school counselors’ burnout and occupational stress at the individual and organizational levels are warranted. The efforts to prevent burnout may lead to school counselors providing better quality of services, benefitting the counselors and the students they serve.

Our review indicated that school counselors’ responsibilities, such as non-counseling duties and dealing with large caseloads, hindered counselors from maintaining their wellness. Additionally, experiencing role conflict and employing emotion-oriented coping skills increased their feelings of burnout. Therefore, school counselor preparation programs need to incorporate into their curriculum the characteristics of their future work environment that may involve potential risk factors for burnout. Furthermore, developing school counselors’ own strategies and practicing beneficial skills such as task-oriented coping skills may be helpful for them in decreasing their likelihood of experiencing burnout.

Conclusion

Preventing and reducing school counselors’ feelings of burnout is important to ensure counselors’ ability to provide ethical and effective services to their stakeholders. Failure to address work-related stress in school counselors may cause reduced quality of their service and increased counselor attrition from the profession. Although more investigations examining burnout in school counselors are warranted, this manuscript is the first systematic review of burnout in school counseling, offering increased insight into this significant job-related psychological phenomenon.

Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.

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Ageism and the Counseling Profession: Causes, Consequences, and Methods for Counteraction

Jun 28, 2018 | Volume 8 - Issue 2

Matthew C. Fullen

As the number of older adults increases, it is important to understand how attitudes toward aging influence society, the aging process, and the counseling profession. Ageism—defined as social stigma associated with old age or older people—has deleterious effects on older adults’ physical health, psychological well-being, and self-perception. In spite of research indicating that the pervasiveness of ageism is growing, there are few studies, whether conceptual or empirical, related to the impact of ageism within the practice of counseling. This article includes an overview of existing literature on the prevalence and impact of ageism, systemic and practitioner-level consequences of ageism, and specific implications for the counseling profession. Discussion of how members of the counseling profession can resist ageism within the contexts of counselor education, gerontological counseling, advocacy, and future research will be addressed.

Keywords: ageism, aging, older adults, gerontological counseling, advocacy

Currently, there are approximately 47.8 million adults age 65 and over living in the United States, and this number is expected to grow to 98 million—or more than one in five Americans—by 2060 (Administration on Aging, 2017). Much of this growth can be attributed to the aging of the boomer generation, the age cohort born between 1946 and 1964. Approximately 10,000 boomers turn 65 every day (Short, 2016). Increases to the average life span also have expanded the number of older Americans, with a person age 65 now living an average of 19.4 additional years, and many living well beyond that age (Administration on Aging, 2017). Nonetheless, many misconceptions remain about the aging process, and recent research demonstrates that the prevalence of ageism is growing (Ng, Allore, Trentalange, Monin, & Levy, 2015). Ageism—defined here as social stigma related to old age or older people (Widrick & Raskin, 2010)—is associated with the lack of mental health services available to older adults (Bartels & Naslund, 2013), and when negative attitudes toward aging are internalized by older adults, significant consequences to health and well-being may occur (Levy, 2009).

Within the counseling literature, there appears to be a lack of research on ageism and its impact on older adulthood. A keyword search of leading counseling journals dating back to 1992 results in a single publication on the topic of ageism within the American Counseling Association’s Journal of Counseling & Development (Saucier, 2004), as well as a single empirical study in Adultspan Journal (McBride & Hays, 2012). Therefore, to elucidate the effects of ageism, as well as its role within the field of professional counseling, this article will provide a review of existing literature on the prevalence of ageism, its consequences among mental health professionals, and the impact of internalized ageism on older adults. The article concludes with recommendations for how counselors, counselor educators, and counseling students can mitigate the effects of ageism and promote positive perceptions of aging.

Prevalence and Impact of Ageism

Prevalence of Ageism

The term “ageism” was first used in the late 1960s to describe discriminatory beliefs or practices that are predicated on the age of a person or group (Butler, 1969). Like racism or sexism, prejudice associated with age is both pernicious and challenging to quantify. Many myths about aging are assumed to be true without additional consideration, leading to a “commonsense reality” about old age or older people that is then perpetuated throughout a society (Angus & Reeve, 2006, p. 141). Moreover, scholars argue that ageism is currently met with less disapproval than racism or sexism (Cuddy & Fiske, 2002; Nelson, 2016; Palmore, 2005), although more recent empirical research is needed to substantiate this hypothesis. Nevertheless, research indicates that views about aging are becoming more negative (Ng et al., 2015). Dominant myths include the notion that older adults are: (a) lonely and depressed; (b) increasingly similar as they grow old; (c) sick, frail, and dependent; (d) cognitively and psychologically impaired; (e) sexless and boring; and (f) unable to learn or change (Thornton, 2002; Whitbourne & Sneed, 2002). These myths persist in spite of research that demonstrates that older adults are heterogeneous, possess many psychosocial resources, frequently have high levels of self-rated and objectively measured health, and mostly do not experience dementia or other forms of cognitive impairment (Whitbourne & Sneed, 2002).

Stereotypes about older adulthood are transmitted throughout society and may lead to detrimental consequences for the health and well-being of older people. For example, media representations of older adults are likely to reinforce negative views about older adulthood. Television shows, movies, and advertising depict older people according to stereotypes about aging—or omit them altogether (North & Fiske, 2012)—and older people who watch more television over the course of their lives tend to view aging in a more negative light (Donlon, Ashman, & Levy, 2005). Ageism is transmitted through social media as well. References to older adults on Facebook are commonly comprised of references to cognitive or physical debilitation, the infantilization of older people, or suggestions that older adults be banned from public activities like driving or shopping (Levy, Chung, Bedford, & Navrazhina, 2014).

Negative stereotypes may lead to age-based discrimination, a phenomenon that experts describe as both “understudied” and “surprisingly pervasive” (North & Fiske, 2012, p. 983). For example, Posthuma and Campion (2009) described several workplace-based stereotypes that exist, in spite of a lack of supporting evidence. These include the notion that older workers have lower levels of ability and motivation, lower productivity, and greater resistance to change. Within the realm of health care, physicians may be less likely to offer particular medical treatments to older patients because of a belief that certain ailments are the inevitable consequences of natural aging (Bowling, 2007). Ageism may result in elder abuse, both within care facilities and among family members; however, it is underreported because of a lack of awareness among health and social service providers (Nelson, 2005).

Negative stereotypes about aging develop in a manner that parallels stereotypes like racism or sexism. Levy’s (2009) stereotype embodiment theory suggests that ageist views may be transmitted culturally and internalized by older adults, leading to significant changes to health and functioning. Older adults are first exposed to negative stereotypes about aging when they are young. As individuals age into older adulthood, their negative beliefs about aging become increasingly salient and self-directed. On the other hand, if an individual is socialized to hold more positive views toward aging, these viewpoints may serve as a buffer against internalized ageism (Levy, 2009).

Furthermore, stereotype embodiment theory (Levy, 2009) suggests that when stereotypes are assimilated from the surrounding culture, they eventually become self-definitions that influence a person’s functioning and health. Stereotype embodiment theory concludes that: (a) stereotypes are internalized throughout the life span; (b) they are likely to operate unconsciously; (c) as views of older age become increasingly relevant to a person’s identity, the age stereotypes become more salient; and (d) self-referential views on aging are developed via pathways that may be both top-down (i.e., societal perspectives are passed on to the individual) and longitudinal (i.e., views on old age begin in childhood).

Cuddy, Norton, and Fiske (2005) argued that groups within a society are often categorized based on two traits—warmth and competence—and the authors found that most participants rated older adults as warm, but incompetent. Contrary to the belief that ageism is only a concern in Western countries, Cuddy et al. reviewed a large-scale international study that included college students in Belgium, Costa Rica, Hong Kong, Japan, and South Korea. Across samples, participants viewed older adults as significantly more warm than competent, non-competitive, and having lower social status. Within their study, this trend persisted even when looking at cultures and countries that are typically described as more collectivist (i.e., Hong Kong, Japan, and South Korea).

Research indicates that ageism is prevalent within environments where older adults receive housing and health care services. In an ethnographic study on the impact of age and illness within a residential care setting, Dobbs et al. (2008) found that some family members, staff, and residents held negative attitudes about aging that resulted in an environment affected by ageism. In their study, examples of negative age bias included neglecting to gather resident input prior to making decisions, using infantilizing speech with older people, and stigmatizing residents because of dementia or physical disability. In a similar study completed within a multi-level care setting, Zimmerman et al. (2016) found that the use of multi-level, stepped care (i.e., adults with differing independence levels residing within the same setting) reinforced stigma related to age and health, with older adults differentiating among themselves based on which levels of care were required.

Impact of Social Forces

Scholars posit a wide range of hypotheses to explain the prevalence of ageism, but two systemic processes—modernization and medicalization—are identified in the literature as the most likely catalysts of negative attitudes toward aging (Cuddy & Fiske, 2002; Ng et al., 2015). In regard to modernization theory, Cuddy and Fiske (2002) explained that views of older adulthood have changed as a result of the shift from an agrarian society to an industrial society. Technological advances, increased literacy rates among young people, and a trend toward urbanization resulted in greater competition between young and old generations, as well as weakened intergenerational social ties between young people and their families of origin. The sum of these social changes led to decreased status for older people, resulting in the “warm, but incompetent” stereotype that is now associated with them (Cuddy et al., 2005).

Relatedly, improvements in health care have extended the life span and increased the ratio of older to younger people. Previous research shows that as the ratio of older adults to younger adults increases, views about older adulthood become increasingly negative (Ng et al., 2015). Given that the number of older people will increase markedly in coming years, it is possible that negative attitudes toward older people will continue to grow unless intervention occurs.

The second major social force described in the literature is the medicalization of aging, which refers to associating old age with a person’s physical health or illness, to the detriment of other aspects of well-being (Ng et al., 2015). The dominance of medical conceptualizations of old age is described as one of the “master narratives” associated with the modern study of aging (Biggs & Powell, 2001, p. 97). Although the causes of medicalization are many and complex, they can be summarized by the shift from viewing old age as a natural part of the life span to the viewpoint that old age, and even death itself, are problems that modern medicine may be able to solve (Ng et al., 2015). Past research indicates that the medicalization of aging predicts negative attitudes toward aging and consequentially leads to “the objectification of older adults as patients rather than as individuals with interesting life experiences” (Ng et al., 2015, p. 2).

Consequences of Ageism

Impact on Older Adults’ Health and Well-Being

There is a substantial body of research indicating that age stereotypes influence older adults’ health and well-being. For instance, older adults’ perceptions of aging are associated with memory performance (Levy, Zonderman, Slade, & Ferrucci, 2011), hearing decline (Levy, Slade, & Gill, 2006), developing Alzheimer’s symptoms (Levy et al., 2016), and dying from respiratory or cardiovascular illnesses (Levy & Myers, 2005). In fact, Levy, Slade, Kunkel, and Kasl (2002) found that even after controlling for age, gender, socioeconomic status, loneliness, and functional health, older adults with more positive self-perceptions of aging lived 7.5 years longer than those with less positive self-perceptions of aging.

Conversely, research indicates that positive perceptions of aging may provide a salutatory effect on health and well-being. Older adults with positive age stereotypes are 44% more likely to fully recover from severe disability compared to those with negative age stereotypes (Levy, Slade, Murphy, & Gill, 2012), and older military veterans who resisted negative age stereotypes had significantly lower rates of mental illness compared to those who fully accepted them (Levy, Pilver, & Pietrzak, 2014). These positive differences were found for suicidal ideation (5.0% vs. 30.1%), anxiety (3.6% vs. 34.9%), and PTSD (2.0% vs. 18.5%), even after controlling for age, combat experience, personality, and physical health. In regard to variables that may influence older adults’ self-perceptions of aging, Fullen, Granello, Richardson, and Granello (in press) found that resilience—the ability to bounce back from adversity—and multidimensional wellness were significant predictors of positive age perception, whereas increased age and decreased physical wellness predicted internalized ageism. Furthermore, resilience appeared to buffer older adults from experiencing internalized ageism as they grew older. However, older adults may not be exposed to interventions to promote resilience and well-being because of ageism’s impact on the availability of mental health services among older adults.

Impact on Mental Health Professionals

The gap between the mental health needs of older adults and the number of mental health professionals with specific training in working with older adults is on the verge of a “crisis” (Institute of Medicine, 2012, p. ix). Scholars provide a variety of explanations to account for this, including systemic factors—such as inadequate funding and a lack of training opportunities within academic programs (Bartels & Naslund, 2013; Gross & Eshbaugh, 2011; Robb, Chen, & Haley, 2002)—and personal factors, including low interest in working with older adults (Tomko, 2008) and therapeutic pessimism (Danzinger & Welfel, 2000; Helmes & Gee, 2003).

Systemic ageism. Although older adults consistently report higher life satisfaction than younger or middle-aged adults (George, 2010), approximately 26% of all Medicare beneficiaries, or more than 13 million Americans, meet the criteria for a mental disorder (Center for Medicare Advocacy, 2013). Yet, mental health services currently account for only 1% of Medicare expenditures (Bartels & Naslund, 2013). Systemic barriers may be partially responsible for the lack of access to mental health services among older adults. For example, inadequate reimbursement rates is cited as one reason for the 19.5% decline in psychiatrists accepting Medicare between 2005–2006 and 2009–2010 (Bishop, Press, Keyhani, & Pincus, 2014). Similarly, Medicare payments to psychologists for psychotherapy decreased by 35% since 2001, after adjusting for inflation (American Psychological Association, 2014). Older adults are currently unable to use Medicare to access services provided by licensed professional counselors (LPCs) or marriage and family therapists (MFTs; Fullen, 2016b). This translates to an estimate of 175,000 mental health professionals who are unavailable to serve as Medicare-eligible providers (American Counseling Association, n.d.). Clients who age into Medicare coverage after working with these professionals face discontinuity of care caused by having to change providers.

Professional training barriers among the helping and health professions also may reflect systemic ageism. Half of the fellowship positions in geriatric medicine and geriatric psychiatry are unfilled each year, and only 4.2% of psychologists focus on geriatric care in clinical practice (Bartels & Naslund, 2013). Institutional barriers that inhibit student interest in careers related to work with older adults include a lack of visibility for multidisciplinary gerontology programs, the absence of gerontological content within textbooks, few faculty who are trained in gerontology, misconceptions about employment opportunities (i.e., the assumption that the only aging sector jobs available are in nursing homes), and a primary focus on the problems associated with old age when later life is discussed within the classroom (Gross & Eshbaugh, 2011).

Within the counseling profession, scholars describe a mixed commitment to gerontological counseling. Going back to 1975, Salisbury (1975) and Blake and Kaplan (1975) described counseling with older adults as an overlooked domain within professional counseling. Twenty years later, Myers (1995) argued that gerontological counseling had evolved from “forgotten and ignored” (p. 143) to a sub-discipline within the profession complete with standards and certification. However, the gerontological counseling specialization that existed between 1992 and 2008 was discontinued in 2009 when only two institutions had applied for accreditation (Bobby, 2013). Perhaps more telling, the 2016 Standards of the Council for Accreditation of Counseling & Related Educational Programs (CACREP) include zero references to the words old, older, older adults, or ageism; only one reference each to the words age and aging; and four references to the phrase life span (CACREP, 2015). Nonetheless, Foster, Kreider, and Waugh (2009) found that many counseling students have interest in topics related to gerontological counseling, including grief counseling (70%), retirement counseling (43%), family counseling with aging parents (64%), and counseling caregivers (55%). The same study found that many respondents were interested in working in a hospice setting (39%), a hospital geriatric unit (29%), a nursing home (25%), private practice with older adults (43%), and a community setting with older adults (45%). However, it is unclear whether students who are interested in working with older adults receive training and employment opportunities within these contexts.

Individual ageism. Research regarding the prevalence of ageism among individual mental health professionals is equivocal. When mental health professionals’ perceptions of clients based on age, gender, and health variables were studied, some researchers found health bias, but not age bias (Robb et al., 2002). Others reported that participants rated older clients as having a greater number of diagnostic problems (Helmes & Gee, 2003) and a worse prognosis than younger clients, in spite of all relevant information being matched across age groups (Danzinger & Welfel, 2000). Helmes and Gee (2003) found large differences in how older people were rated on key therapeutic variables. Older clients were viewed as less able to develop an adequate therapeutic relationship, less appropriate for therapy, and less likely to recover. Respondents in their study also felt less competent in treating older people, and they were less willing to accept older people as clients.

To counteract the potential influence of negative age bias on counseling treatment, McBride and Hays (2012) described the importance of linking work with older adults to multicultural competence. The authors surveyed 360 counselors and counselor trainees and found a significant, negative correlation (r = -.41) between multicultural competence and negative attitude toward aging. Tomko (2008) found that multicultural competence was associated with improved clinical judgment when working with older adults; however, it did not predict global attitudes toward aging. In sum, considerations of both the systemic and individual aspects of ageism have important implications for the counseling profession.

Implications for the Counseling Profession

The rapid growth of the older adult population will impact members of the counseling profession in a variety of ways. Shifting age demographics make it imperative that counselors understand how the pervasiveness of ageism impacts key professional values like diversity, social justice, and client advocacy. Four domains are outlined in which counselors may dedicate their attention to generating positive views of aging. These domains include counselor education, advocacy, research, and counseling practice.

Counteracting Ageism Within Counselor Education

Within counselor training programs, resistance to ageism begins with incorporating discussions about aging and older adulthood into the counselor education curriculum. Therefore, it is important that professional accreditation standards like CACREP adequately reflect the mental health needs of older adults and their families. In its current form, the omission of keywords like aging, older adulthood, and ageism from these standards may send a mixed signal to counselor training programs and their students about social justice and multicultural competencies as they relate to older adults.

Once ageism is identified by a counselor education program as a priority, counselor educators need to develop strategies for incorporating this focus in the existing curriculum. For instance, a life span development course provides ample opportunities to discuss issues such as shifting population demographics, multigenerational families, and how an aging population will impact the counseling profession. Assessing students’ current thoughts about the aging process, including both their own aging and that of family members, may create greater empathy for the needs of older adults. Similarly, when instructing social and cultural diversity courses, counselor educators should consider introducing topics such as ageism and age privilege and juxtaposing these constructs alongside dialogue about diversity and intersectionality (Black & Stone, 2005). Furthermore, when developing practicum or internship sites, counselor educators could make a point of developing placements in which older clients will be served. Identifying potential site supervisors who have experience in working with older adults is an important step, as it ensures that trainees are given adequate opportunities to reflect on their own perspectives on aging, disability, advocacy, and related issues.

Counteracting Ageism Through Advocacy

In regard to advocacy, counselors should resist ageism at national, state, and local levels. At the national level, the omission of counselors as approved Medicare providers limits the availability of mental health services for older adults and reflects the assumption that older adults’ needs are primarily physiological. This issue creates challenges for members of the counseling profession who are interested in providing services across the life span. Mental health advocacy on behalf of older adults includes educating lawmakers about the importance of Medicare reimbursement as a means of creating mental health service access (Fullen, 2016b). Professional organizations continue to support grassroots advocacy, as well as lobbying efforts, to influence Medicare policy on behalf of counselors. In fact, as of this writing there are bills in each chamber of the United States Congress (i.e., S. 1879; H.R. 3032), and a federal advisory group (i.e., the President’s Interdepartmental Serious Mental Illness Coordinating Committee; ISMICC) recently recommended inclusion of counselors within Medicare (National Board for Certified Counselors, n.d.).

At the state and local level, members of the counseling profession should forge partnerships with gerontology professionals. For example, advocacy occurs when professional counselors and counselor educators make connections with members of the local area agency on aging, directors of local assisted living or skilled nursing facilities, or state policymakers who are responsible for budgetary and policy decisions related to aging. These partnerships are mutually beneficial; they provide members of the counseling profession with increased exposure to the diverse needs of older adults in their communities, and they educate local gerontology professionals about the range of mental health services that counselors provide. Additionally, building interprofessional connections may lead to research opportunities that can improve the care received by older adults.

Counteracting Ageism Through Research

In spite of the numerous studies indicating that ageism has detrimental effects on older adults, there are currently very few studies that demonstrate the prevalence and impact of ageism within the counseling profession. For instance, research on in-session dynamics between counselors and much older clients could shed light on the ways in which age is broached in a counseling session. Additionally, research could focus on the benefits of professional counseling for older adult clients, as well as the effectiveness of novel interventions that are grounded in counseling theories or wellness (Fullen & Gorby, 2016; Fullen et al., in press). For instance, the development and validation of a wellness-based approach to counseling older adults might mitigate mental health issues or internalized ageism among older clients (Myers & Sweeney, 2005), and it would serve as additional evidence for the necessity of adding counselors as Medicare providers.

At the institutional level, more research is needed to understand the extent to which counselor training programs address ageism, and in which curricular contexts. It is important to understand which pedagogical strategies are most effective, whether these impacts persist over time, and how well training programs make inroads with local agencies that work with older adults. Research into advocacy efforts related to Medicare reimbursement may also advance the profession. Although Medicare reimbursement is described as a priority for the counseling profession, there is currently little research on counselors’ knowledge about Medicare or participation in Medicare advocacy.

Counteracting Ageism Through Counseling Practice

Finally, it is important to consider how counselors might resist ageism within their counseling practice. Because of the heterogeneity of older adults, counseling services should be tailored to the unique needs of each client. Given that ageism has the potential to influence how older clients are conceptualized by counselors, it is important for counselors to reflect on their own beliefs about aging as well as their assumptions about the ability of older clients to grow and change. Many counselors are not familiar with the wide range of mental health interventions that have been empirically validated with older adults (Myers & Harper, 2004). For example, the SAMHSA-HRSA Center for Integrated Health Solutions (n.d.) provides numerous resources related to providing behavioral health services to older adults. These resources address issues such as evidence-based treatments for late life depression, preventing suicide in older adults, screening for substance misuse, and assessing cognitive functioning.

Given the growing interest in wellness-oriented services for older adults, SAMHSA also provides evidence-based resources related to health promotion and integrated care. Programs that focus on cultivating holistic wellness or resilience are relatively new, but they also may be worth considering as a means of countering ageism within the practice of counseling. Because the wellness approach incorporates multiple dimensions of functioning, older clients who are experiencing deficits in a particular domain (e.g., limited mobility influencing ability to drive) may find that they can use alternative domains as a means of compensating (e.g., greater reliance on social network to carpool to events; Fullen, 2016a). Similarly, discussion of how older clients have used strengths to navigate loss, overcome adversity, and resist ageism in their own lives may prove to be key ingredients in the therapeutic process. Furthermore, incorporating resilience into an older client’s treatment plan may create a buffer against internalized ageism (Fullen et al., in press), as well as an opportunity to highlight older adults’ abilities to adapt in the face of adversity (Fullen & Gorby, 2016).

Conclusion

As the number of older adults grows, members of the counseling profession are increasingly likely to encounter older people who seek to benefit from counseling services. A review of existing research demonstrates that there are numerous causes of ageism, detrimental consequences associated with internalizing negative age stereotypes, and gaps in research related to how the counseling profession should respond. In light of the counseling profession’s commitment to diversity, social justice, and advocacy, it is important to better understand the broad impact of ageism. By combating ageism in the domains of public policy, research, teaching, and direct service with clients, members of the counseling profession have the opportunity to counteract ageism’s deleterious effects and promote more positive perceptions of growing older.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest or funding contributions for the development of this manuscript.

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Counselor-in-Training Intentional Nondisclosure in Onsite Supervision: A Content Analysis

Jun 28, 2018 | Volume 8 - Issue 2

Ryan M. Cook, Laura E. Welfare, Devon E. Romero

Studies from allied professions suggest that intentional nondisclosure in clinical supervision is common; however, the types of intentional nondisclosure and reasons for nondisclosure have yet to be examined in an adequate sample of counselors-in-training (CITs). The current study examined intentional nondisclosure by CITs during their onsite supervision experience. We utilized content analysis to examine examples of intentional nondisclosure. Sixty-six participants provided examples of intentionally withholding information from their supervisors they perceived as significant. The most common types of information withheld were negative reactions to supervisors, general client observations, and clinical mistakes. The most common reasons cited were impression management, perceived unimportance, negative feelings, and supervisor incompetence. We offer implications for both supervisees and supervisors on how they might mitigate intentional nondisclosure; for example, we present strategies to address ineffective or harmful supervision, discuss techniques to openly address intentional nondisclosure, and explore ways to integrate training on best practices in clinical supervision.

Keywords: intentional nondisclosure, counselors-in-training, supervision, content analysis, best practices in clinical supervision

Counselors-in-training (CITs) in programs accredited by the Council for Accreditation of Counseling & Related Educational Programs (CACREP) are required to complete two supervised onsite field experiences (i.e., practicum and internship) in their area of interest (e.g., clinical mental health, school, rehabilitation; CACREP, 2015). The purpose of this onsite field experience is for CITs to learn the roles and responsibilities of being a professional counselor by applying what they learn in their training programs to their work in a counseling setting (CACREP, 2015). Given CITs’ limited clinical experience, onsite supervisors provide weekly supervision to aid CITs in their professional development (Borders et al., 2011; Borders et al., 2014). Although supervision is a unique opportunity, CITs receive problematic mixed messages about the expectations of the supervisory process (Borders, 2009). CITs are encouraged to discuss the topics and concerns that are the most important to their professional growth (Bordin, 1983), but the information shared is then used by their supervisors to evaluate their clinical performance (Bernard & Goodyear, 2014). These evaluations have a definitive impact on CITs’ ability to pass a practicum or internship course or graduate (CACREP, 2015) and subsequently secure employment in the counseling field. Thus, it is not surprising that studies in allied professions (e.g., clinical psychology, counseling psychology, social work) have shown that trainees commonly withhold potentially unflattering information from their supervisors (Hess et al., 2008; Ladany, Hill, Corbett, & Nutt, 1996; Mehr, Ladany, & Caskie, 2010, 2015; Pisani, 2005). While CITs’ concern to maintain a favorable image in the eyes of their supervisor is understandable, withholding information can result in missed learning opportunities for CITs and negatively impact their clients (Hess et al., 2008).

To date, only two studies have examined supervisee intentional nondisclosure in a sample of counselor education students (Cook & Welfare, 2018; Lonn & Juhnke, 2017). However, neither study examined specific examples of the types and reasons of CIT nondisclosure during onsite supervision. Counselors submit to a unique training model, with specific requirements and goals for master’s-level counselors (e.g., CACREP, 2015). CITs enrolled in CACREP-accredited programs can specialize in one of seven tracks: (a) addictions counseling; (b) career counseling; (c) clinical mental health counseling; (d) clinical rehabilitation counseling; (e) college counseling and student affairs; (f) marriage, couple, and family counseling; (g) school counseling; and (h) rehabilitation counseling. As a result, CITs work in diverse settings with a wide variety of responsibilities that are unique to the counseling profession (CACREP, 2015; Lawson, 2016). Without a study focused on CITs’ experiences in onsite supervision, CITs and supervisors must rely on findings from allied professions that may or may not reflect the counseling training model. Thus, in the current study we aimed to examine the types of intentional nondisclosure and the reasons for the nondisclosure during CITs’ supervised onsite field experience.

Supervised Onsite Field Experience in CACREP-Accredited Programs

Given the growing importance of attending a CACREP-accredited program as an educational requirement for professional counselors (Lawson, 2016), we chose to specifically target intentional nondisclosure by CITs enrolled in CACREP-accredited training programs. State licensure boards are encouraging or mandating that those pursuing professional licensure as counselors must have a degree from a CACREP-accredited program (Lawson, 2016). Additionally, as of January 1, 2022, those applying to be National Certified Counselors (NCCs) will need to graduate from a CACREP-accredited program (National Board for Certified Counselors, 2014). Thus, the standards for onsite field experiences outlined in the 2016 CACREP Standards provide clear guidelines for counselor training. Furthermore, the activities during the onsite field experience are designed to mimic those of a professional counselor in the field (CACREP, 2015). Exploring CIT intentional nondisclosure within the CACREP educational structure can help to inform best practices in counselor training.

Intentional Nondisclosure in Clinical Supervision

The supervision process is reliant on CITs to self-identify important information to share with their supervisors (Ladany et al., 1996); however, identifying this important information is not always clear to CITs given the intricacies of the client–counselor relationship (Farber, 2006; Knox, 2015). Farber (2006) suggested that some nondisclosure “is normative and unavoidable in supervision” (p. 181). Yet, there are instances in which CITs purposefully withhold information they know is relevant because of concerns for what could happen if they shared the information with their supervisor (Hess et al., 2008; Yourman & Farber, 1996).

So why would CITs, who are held to the same ethical standards as practicing counselors (American Counseling Association [ACA], 2014), knowingly choose to withhold information that could be harmful to their professional development or their clients’ treatment? During an onsite field experience, CITs learn the day-to-day tasks of being a professional counselor (e.g., establishing rapport, planning treatment, managing paperwork), but they also must meet the demands of their graduate training programs. Most CITs want to perform counselor functions at a high level, if not perfectly (Rønnestad & Skovholt, 2003). Avoiding clinical mistakes is a dubious belief that CITs hold for themselves (Knox, 2015). These high expectations create a reasonable desire to present oneself favorably to their supervisors, even though supervisors know that perfection is impossible (Farber, 2006). Moreover, CITs are told to share information that is most salient to their personal and professional development with their supervisors, but disclosing information that may be potentially unflattering or embarrassing can then be used by supervisors to evaluate performance (Borders, 2009).

Types and Reasons for Intentional Nondisclosure

In a seminal study on intentional nondisclosure, Ladany et al. (1996) investigated the types and reasons for nondisclosure in a sample of clinical and counseling psychology trainees. Participants were asked to identify instances in which they withheld information from their supervisors and then provide a rationale for why they failed to share that information. The authors found that 97.2% of the participants withheld information from their supervisors.

Through categorizing the content of the nondisclosures, Ladany et al. identified 13 types of nondisclosure, providing definitions and examples of each type: (a) negative reactions to supervisor (e.g., unfavorable thoughts or feelings about supervisors or their actions); (b) personal issues (e.g., information about an individual’s personal life that may not be relevant); (c) clinical mistakes (e.g., an error made by a counselor); (d) evaluation concerns (e.g., worry about the supervisor’s evaluation);
(e) general client observations (e.g., reactions about the client or client treatment); (f) negative reactions to client (e.g., unfavorable thoughts or feelings about clients or clients’ actions); (g) countertransference (e.g., seeing oneself as similar to the client); (h) client–counselor attraction issues (e.g., sexual attraction between client and counselor); (i) positive reactions to supervisor (e.g., favorable thoughts or feelings about supervisors or their actions); (j) supervision setting concerns (e.g., concerns about the placement or tasks required at placement); (k) supervisor appearance (e.g., reactions to supervisor’s outward appearance); (l) supervisee–supervisor attraction issues (e.g., sexual attraction between supervisee and supervisor); and (m) positive reactions to client (e.g., favorable thoughts or feelings about clients or their actions).

They also identified 11 reasons for intentional nondisclosure: (a) perceived unimportance (e.g., information not worth discussing with supervisor); (b) too personal (e.g., information about one’s personal life that is private); (c) negative feelings (e.g., embarrassment, shame, anxiety); (d) poor alliance with supervisor (e.g., poor working relationship with supervisor); (e) deference (e.g., inappropriate for a counselor to bring up because of their role as intern or supervisee); (f) impression management (e.g., desire to be perceived favorably by supervisor); (g) supervisor agenda (e.g., supervisor’s views, roles, and beliefs that guide supervisor’s actions or reactions to supervisee); (h) political suicide (e.g., fear that the disclosure will be disruptive in the workplace and lead to the supervisee being unwelcome or unsupported); (i) pointlessness (e.g., addressing the issue would not influence change); (j) supervisor not competent (e.g., supervisor is inaccessible or unfit for supervisory role); and (k) unclear (e.g., researchers unable to read participants’ statements). The most common types of intentional nondisclosure in the study by Ladany et al. (1996) were negative reactions to supervisor, CITs’ personal issues, clinical mistakes, and evaluation concerns, while the most common reasons for the nondisclosures were perceived unimportance, too personal, negative feelings, and a poor alliance with the supervisor.

Subsequent studies, also from allied professions (e.g., social work, clinical psychology), have found similar results in regard to the types and reasons for intentional nondisclosure (Hess et al., 2008; Mehr et al., 2010; Pisani, 2005). Mehr and colleagues (2010) found 84.2% of psychology trainees reported withholding information from their supervisors, and the most common types of nondisclosures were negative perception of supervision, personal life concerns, and negative perception of the supervisor, while the most common reasons for nondisclosure were impression management, deference, and fear of negative consequences. Additionally, Pisani (2005) found the most commonly withheld information for social work trainees included supervisor–supervisee attraction issues, negative reactions to supervisor, and supervision setting concerns. Finally, in a qualitative study, Hess et al. (2008) explored the differences in a single example of intentional nondisclosure based on psychology trainees’ perceptions of the quality of the supervisory relationship—for example, good (i.e., only one instance of a problem in the supervisory relationship) versus problematic supervisory relationships (i.e., ongoing issues in the supervisory relationship). They found that supervisees in both good and problematic supervisory relationships withheld information about client-related issues. However, supervisees in problematic relationships more commonly withheld supervision-related concerns (e.g., negative reactions to supervisor) compared to supervisees in good relationships. The findings described above provide empirical evidence that nondisclosure in allied professions is common.

The Current Study

Although there is evidence that supervisees from allied professions withhold information, there is currently a dearth of literature regarding intentional nondisclosure by CITs in the field of counseling. Cook and Welfare (2018) found that the quality of the supervisory working alliance and supervisee avoidant attachment style predicted supervisee nondisclosure. In a qualitative study, Lonn and Juhnke (2017) examined supervisee nondisclosure in triadic supervision. They found that the supervisee’s perception of their relationships, the presence of a peer, and opportunity to share were important to whether supervisees withheld information. However, these studies failed to examine the types of information being withheld by CITs as well as their reason for withholding information. Considering that professional counselors have a unique training model (CACREP, 2015), professional identity (Lawson, 2016), and code of ethics (ACA, 2014), the purpose of the current study was to examine the types and reasons of intentional nondisclosure by CITs during their supervised onsite internship experience.

Method

We utilized content analysis (Hsieh & Shannon, 2005) to examine the examples of intentional nondisclosures provided by CITs that occurred in supervision with their onsite internship supervisors. Hsieh and Shannon (2005) defined qualitative content analysis as “a research method for the subjective interpretation of the content of text data through the systematic classification process of coding and identifying themes or patterns” (p. 1278). Our analysis was guided by the findings from Ladany et al. (1996), which allowed us to compare the findings from the current study with those from allied professions while also examining how the phenomenon of intentional nondisclosure might present uniquely in the counseling profession (Hsieh & Shannon, 2005). The current study was designed to answer two research questions: (a) What are the types of information that CITs intentionally withhold from their supervisors during their internship’s onsite supervision? and (b) What are the reasons for their nondisclosure?

Research Team

Our research team included three members. The first and third authors served as coders while the second author served as a peer reviewer. The first and second authors are counselor educators at different universities in the Southeast United States, and the third author was a doctoral student at the same institution as the first author. We all have experience as professional counselors, supervisees, supervisors, and researchers; consequently, we have experienced all parts of the nondisclosure cycle. Prior to the analysis process, we discussed how our previous experiences might impact the analysis. Likewise, we intentionally discussed and bracketed potential influences of bias throughout the project. We also employed triangulation (e.g., multiple coders), utilized frequent peer debriefs, and employed a peer reviewer (Creswell, 2013). Our items also were reviewed by four consultants with counseling, supervision, and research experience to minimize bias and maximize clarity.

Recruitment Procedure and Participants

After securing IRB approval, we recruited participants currently enrolled in internship for the current study through the assistance of counselor education faculty at CACREP-accredited institutions. Fifteen counselor educators at 14 institutions offered paper-and-pencil instrument packets to CITs during one of their class periods. As indicated by the key informants, 152 of the 173 CITs present in class on the day the packets were offered agreed to participate in the study. This resulted in an in-class response rate of 87.86%.

Participants were CITs currently enrolled in internship in a CACREP-accredited program and receiving supervision at their internship sites. The age of the participants ranged from 22 to 60 years old (M = 28.13, SD = 7.43, n = 107). Eighty-eight participants identified as female (80%), 17 participants identified as male (15.5%), three participants identified as nonbinary (gender identity not male and not female, 2.7%), and two participants indicated that they did not want to disclose their gender (1.8%). Regarding race, the majority of participants identified as White (non-Hispanic; n = 71, 64.5%), while 23 participants identified as African American (20.9%), four participants identified as Asian/Pacific Islander (3.6%), three participants identified as Hispanic/Latinx (2.7%), three participants identified as multiracial (2.7%), one participant identified as Native American (0.9%), one participant responded “none of the above categories” (0.9%), and four participants responded that they preferred not to disclose (3.6%). Regarding CACREP track, 64 participants were enrolled in a clinical mental health counseling track (58.2%), 32 participants were enrolled in a school counseling track (29.1%), nine were enrolled in a college counseling and students affairs track (8.2%), and five were enrolled in a marriage, couples, and family track (4.5%).

Instrument

The instrument was designed to gather information about participants’ experiences with their current onsite internship supervisors. Two items were the focus of this study: (a) “Describe a time when you decided not to share something you thought was significant with your current onsite internship supervisor” and (b) “What brought you to that decision to not share it with your current onsite internship supervisor?” In addition, the questionnaire included 15 items to collect demographic information about the participants and their current onsite internship supervisors. Of the 152 participants who began participation, 42 participants (27.6%) were removed from the analysis as they did not complete the open-ended questions, resulting in a final sample of 110 participants. We utilized the demographic variables to check for evidence of nonresponse bias using Chi-square tests of independence and independent t-tests. We did not find evidence of response bias when comparing those who answered the open-ended questions and those who did not.

Data Analysis

We analyzed participants’ responses to the open-ended questions utilizing content analysis. We categorized the types of intentional nondisclosure and the reasons for nondisclosure into categories as recommended by Hsieh and Shannon (2005). For our analysis, we utilized the types of nondisclosure and the reasons for nondisclosure originally identified by Ladany et al. (1996). To reiterate, Ladany et al. identified 13 types of intentional nondisclosure and 11 reasons for nondisclosure (1996). Also, as recommended by Hsieh and Shannon (2005), we allowed for new categories to emerge that did not fit within the categories from Ladany et al. The rationale for this approach was two-fold. First, we could best understand the phenomenon of intentional nondisclosure by comparing our findings to that of previous research from allied professions, while also generating new knowledge of how nondisclosure might uniquely manifest in the counseling profession (Lawson, 2016). Second, utilizing previous research provided structure to our coding procedures and informed the researchers’ interpretation of participant responses (Hsieh & Shannon, 2005).

Coding process. The first and third authors coded the responses of 110 participants for (a) whether or not the participant identified an incident of intentional nondisclosure and (b) to categorize the participant responses that indicated intentional nondisclosure by the type and reasons for the nondisclosure. Each response was coded into one category of type of nondisclosure and one category of reason for the nondisclosure. First, the two coders selected 10 participant responses and coded them as a team. Next, the two coders selected an additional 10 participant responses and coded them independently of each other. They then came together to reach a consensus on the categorization of participant responses. The remaining 90 participant responses were coded independently, and the two coders regularly engaged in peer debriefings throughout the process to ensure consistency (Creswell, 2013). After all 110 participant responses were analyzed, the first and third authors met to finalize the categorization of participant responses and to generate names for the new categories that emerged during the analysis (Hsieh & Shannon, 2005). Regarding the categorization of participant responses in terms of the participant-identified incident of intentional nondisclosure, the coders’ agreement was 100%. Regarding the types and reasons for the nondisclosure, the coders initially disagreed on 15 types of intentional nondisclosure and 23 reasons for the nondisclosure. The two coders established consensus through discussion, resulting in an agreement of 100% (Creswell, 2013). Finally, the second author, serving as a peer reviewer, evaluated the entire coding process. She was chosen based on her expertise with supervision delivery (e.g., protocol, practice) and the topic of intentional nondisclosure. She did not recommend any changes to the categorization of participant responses; however, she recommended renaming two of the new categories for the types of nondisclosures that emerged from the data to better reflect the content of participant responses. Eleven types of intentional nondisclosure and 13 reasons emerged from our analysis.

Results

Forty-four (40%) participants reported that they had never withheld something significant from their current onsite internship supervisors, while 66 (60%) reported that they had. Examples of responses coded as never having withheld something significant from their onsite supervisors include “N/A,” “At this time, I have not withheld any information that I felt was significant with my supervisor,” and “I don’t think there has been one.” For the responses that included an example of intentional nondisclosure (n = 66), 11 types of intentional nondisclosure and 13 reasons for withholding information emerged from the data. The types of intentional nondisclosure included eight types of nondisclosure that were from Ladany et al.’s (1996) research on nondisclosure and three new types of intentional nondisclosure that emerged in this data set: (a) CIT professional developmental needs, (b) a peer’s significant issue, and
(c) experiencing sexual harassment. Regarding the reasons for the intentional nondisclosures, 10 reasons mirrored the findings from Ladany et al. and three reasons were unique to the current study: (a) did not want to harm client or confidentiality concerns, (b) consulted with another supervisor, and (c) issue with other professional in supervision setting.

The Types and Reasons for Intentional Nondisclosures

The most common type of intentional nondisclosures identified by the researchers in the current study were negative reactions to supervisor (n = 18, 27.3%), general client observations (n = 16, 24.2%), and clinical mistakes (n = 15, 22.7%). The most common reasons for intentional nondisclosures were impression management (n = 12, 18.2%), perceived unimportant (n = 8, 12.1%), negative feelings, (n = 8, 12.1%), and supervisor not competent (n = 8, 12.1%). Complete results of the coding and category frequencies of the types of nondisclosures are presented in Table 1, and the final coding and category frequencies of the reasons for nondisclosure are presented in Table 2.

Table 1 Types of Intentional Nondisclosure
Type of Intentional Nondisclosure	n (%)	Examples
Negative Reactions to Supervisor	18 (27.3%)	When my supervisor asked if there is anything that is hindering our relationship, I lied and said that there wasn’t anything and the relationship is fine. I feel that I am not getting feedback about my counseling from my supervisor in the supervision meetings. Instead I am only getting suggestions of how the supervisor would have handled the client. Made a comment behind my back. My onsite supervisor is new and so I don’t share too much because he’s easily overwhelmed.
General Client Observations	16 (24.2%)	I gave [clients] more chances to skip/miss an appointment than [my supervisor] would allow so sometimes don’t let her know when people cancel or no show. When a client disclosed personal family issues; client’s past trauma.
Clinical Mistakes	15 (22.7%)	I put a client in danger by a lack of knowledge and being new in a position. Too much self-disclosure in a session; getting behind on case notes/paperwork. Having a chronically suicidal client and . . . not assessing for SI in a session and feeling as if when assessed it was not done so well.
Client–Counselor Attraction Issues	4 (6.1%)	I felt attracted to an assessment client. During a session, a client told me that he liked how I looked in my pants. He then told me that he got excited at the sound of my voice.
Countertransference	3 (4.5%)	A client reminded me of my late mother. Early in internship, I had strong countertransference with a client.
Supervision Setting Concerns	3 (4.5%)	I was concerned if I was going to have to find another site to finish hours. Frustration with internship duties.
Personal Issues	2 (3.0%)	I did not tell my supervisor that I chose to cut it off with a potential romantic partner.
CIT Developmental Need	2 (3.0%)	When I was first starting out I had a hard time letting my supervisor know when I needed something extra from them whether it be time or information.
Negative Reactions to Client	1 (1.5%)	Anger toward a student.
A Peer’s Significant Issue	1 (1.5%)	A client wrote a letter to my co-intern about his sexual desires and love for her.
Experiencing Sexual Harassment	1 (1.5%)	When I felt sexually harassed by a colleague.
Note. Not all types of intentional nondisclosure from Ladany et al. (1996) were present in this sample, and three new types emerged: (a) CIT developmental need, (b) a peer’s significant issue, and (c) experiencing sexual harassment.

Table 2 Reasons for Intentional Nondisclosure
Reasons	n (%)	Examples
Impression Management	13 (19.7%)	Concerned about evaluations by those who supervise my supervisors. Fear of looking bad or being perceived as not being a good counselor. [Supervisor] might pass judgment because I can’t possibly know what I’m talking about being only an intern. I worried she will think I’m unprofessional or not trust me with future clients.
Negative Feelings	8 (12.1%)	Poor self-confidence. Fear of rejection. Embarrassment, inferiority felt with supervisor.
Supervisor Not Competent	8 (12.1%)	I see the way she counsels clients and I know she thinks taking time to establish rapport and positive therapeutic relationships is not always necessary. Everyone in the office says she is burnt-out and I want to be more compassionate.
Perceived Unimportant	8 (12.1%)	I did not feel it was necessary. I was running late to class and I didn’t consult with her because she was in a session with a client so I figured I’d tell her the next day.
Deference	6 (9.1%)	I did not feel like it would be taken well, and that I am only an intern and should not correct her. Didn’t want to hurt/upset her or burn a professional relationship.
Poor Alliance with Supervisor	5 (7.6%)	The power differential. She berated me in supervision to the point of tears. I feel unsafe with her and our clinical styles contrast. I knew she would make me feel inferior.
Supervisor Agenda	4 (6.1%)	I thought he would immediately notify people in charge. Knowing my supervisor would want to tell [client’s] mother.
Political Suicide	4 (6.1%)	I want to get hired where I’m working and I don’t feel . . . safe during supervision. It’s a small practice and I have to share a wall with this offender every day.
Did Not Want to Harm Client or Confidentiality Concerns	4 (6.1%)	I didn’t want to put client in a bad situation. That student was not positive of her status and was not in any danger. Revealing her secret at that point would have damaged the relationship. Confidentiality issues.
Too Personal	3 (4.5%)	It was too personal. I didn’t want to talk about my grief.
Pointlessness	1 (1.5%)	Thought that was between student and personal physician.
Consulted with Another Supervisor	1 (1.5%)	Other supervisor suggestions.
Issues with Other Professionals in Supervision Setting	1 (1.5%)	The teacher expressed frustration. Hopes to prevent future conflict.
Note. Not all categories and reasons from Ladany et al. (1996) were present in this sample, and three new reasons emerged: (a) did not want to harm client or confidentiality concerns, (b) consulted with another supervisor, and (c) issues with other professionals in supervision setting.

Specific Examples of the Types and Reasons for Intentional Nondisclosure

To provide a more complete picture of the phenomenon of intentional nondisclosure (Hsieh & Shannon, 2005), this section is presented to highlight specific examples provided by participants for each type of nondisclosure and the reasons they withheld the information. Our coded reason for the type of intentional nondisclosure is included in parentheses below (e.g., deference, impression management, political suicide).

Negative reactions to supervisor. One participant stated that she did not disclose that her supervisor “was not helpful during a time that I needed her to be” because the participant “did not want to . . . upset her or burn a professional relationship” (deference). Another participant did not tell her supervisor at her school internship that she disapproved of the way the supervisor addressed a student: “I felt she was being too harsh on a student and not considering other factors.” This participant did not want her supervisor to perceive her as “being wrong” (impression management). A participant stated that even though her supervisor sits in on all of her sessions at her internship site, she still withheld that she is not satisfied with the quality of their relationship and did not share how she felt “in the relationship with her.” She added that she did not disclose this information because “I am afraid she’ll be angry and it will damage the relationship we do have” (negative feelings). Finally, for a clinical mental health CIT, even her supervisor directly asking if she had concerns about the supervisory relationship was not enough to encourage her disclosure: “When my supervisor asked if there is anything that is hindering our relationships I lied and said that there wasn’t anything and the relationship is fine.” The CIT stated she lied because “the power differential, being videotaped, and concerns with confidentiality . . . stopped me from being completely honest about my comfort with our relationship” (poor alliance with supervisor).

General client observations. General client observations differed from clinical mistakes because participants did not self-identify that they perceived the specific examples they provided to be mistakes. Rather, participants indicated that the examples they provided were relevant; however, they failed to disclose this significant information to their supervisors. One school counseling CIT stated that she did not share with her supervisor that she was having trouble “breaking the ice with a client” because she “knew my [supervisor] would make me feel inferior” (poor alliance with supervisor). Another school counseling CIT shared that she failed to disclose that one of her clients was “drinking alcohol on campus” because she thought her supervisor would “immediately notify people in charge of discipline rather than talking to the student first” (supervisor agenda). Finally, another school counseling CIT stated that a client told her she was pregnant, but she failed to notify her supervisor because “that student was not positive of her status and was not in any danger. Revealing her secret at that point would have damaged the relationship” (did not want to harm client; confidentiality concerns).

Clinical mistakes. Participants reported a range of clinical mistakes, from minor clerical errors to potentially more problematic mistakes such as failure to assess for client risk. One clinical mental health CIT did not share that she was “behind on my case notes” because she “did not feel it was necessary” and she “caught up quickly” (perceived unimportant). A student affairs CIT stated that he did not let his supervisor know that he “lacked confidence in theories” because he felt “inadequate” and “embarrassed” (negative feelings). A clinical mental health CIT shared that she failed to disclose something in supervision that her supervisor had previously told her not to do: “My supervisor had previously verbalized that she would be upset.” She withheld this information because “I didn’t want to seem . . . incompetent and I respected her and want her to think I’m doing my best” (impression management). Multiple participants provided specific examples of intentional nondisclosures related to failing to adequately assess for client risk or failing to notify their supervisors that a client was engaging in risk-related behavior. A school counseling CIT shared that she did not discuss with her supervisor that “a client (minor on a school campus) was engaging in [non-suicidal self-injury] again” because “we discussed before how she is obligated to pass that info to school principal who tells parents” (supervisor agenda). This participant added that she decided not to share this information with her supervisor because she perceived the self-injury to be non–life threatening and she wanted to “save rapport” with the client (did not want to harm client; confidentiality concerns). Finally, a school counseling CIT stated that she withheld from her supervisor that she “put a client in danger by my lack of knowledge and being new in my position.” This CIT did not discuss this with her supervisor because “my supervisor wasn’t available” (supervisor not competent).

Client–counselor attraction issues. One clinical mental health counseling CIT stated that her client “told me that he liked how I looked in my pants. He then told me that he got excited at the sound of my voice.” She stated that she did not disclose this information to her supervisor because “I told myself that I did not understand how he meant the comment and I thought he would stop the flirting if I ignored him” (perceived unimportant). Two participants indicated that they experienced sexual attraction to a client but failed to share it with their supervisor. One student affairs CIT stated that she felt “embarrassed” (negative feelings), while a clinical mental health counseling CIT shared that he “did not want anyone to find out and I felt like I handled it fine” (impression management).

Countertransference. One marriage, couples, and family CIT stated that she did not disclose to her supervisor that a client “reminded me of [my] late mother” because she “did not want to talk about [my] grief” (too personal). A clinical mental health counseling CIT echoed the previous participant’s thinking process. She stated she did not tell her supervisor she was experiencing “countertransference” with a client because “it was too personal” (too personal). Finally, another marriage, couples, and family CIT stated that early in her internship she had “strong countertransference with a client” as a result of a personal grieving process. She shared that she did not tell her supervisor because she wasn’t sure “how much I trusted her with this information as it was only several weeks into internship” (poor alliance with supervisor).

Supervision setting concerns. A clinical mental health counseling CIT stated that she did not express her “frustration with internship duties” to her supervisor because “he was unavailable” (supervisor not competent). Another clinical mental health counseling CIT was concerned that she “would need to find another site to finish [internship] hours,” but did not tell her supervisor because “I did not choose to add to stress [of my] site supervisor by posing my concern” (deference).

Personal issues. One participant enrolled in a clinical mental health counseling program withheld from the supervisor that “sad and depressed” feelings because of a “fear of rejection” (negative feelings) arose during supervision. A school counseling CIT did not disclose to her supervisor that she had recently ended a relationship “with a potential romantic partner” even though it was causing her to “feel drained and emotional during the day at her internship” because “I felt that it would be silly to and I thought I did a good enough job ignoring the feelings while with students” (too personal).

CIT developmental need. One clinical mental health counseling CIT shared that she had a difficult time “letting my supervisor know when I needed something extra from them whether it be time or information” because she “felt nervous about [her] position as ‘just an intern’” (negative feelings). Another clinical mental health counseling CIT stated that she failed to let her supervisor know that she is “concerned about being in an individual session with a male client” because she is fearful that her supervisor would think she is “unprofessional or not trust me with future clients” (impression management).

Negative reactions to client. Only one participant indicated that she failed to disclose a negative reaction to a client with her supervisor. This student affairs CIT stated that she did not disclose her “anger towards a client” because she “did not think it was important enough to share” (perceived unimportant).

A peer’s significant issue. One clinical mental health counseling CIT noted that there was a failure to disclose to the supervisor that “a client wrote a letter to my co-intern about his sexual desires and love for her.” This CIT stated that the co-intern did not want this information shared and that the participant “did not think it was my place” (deference).

Experiencing sexual harassment. A clinical mental health counseling CIT stated that she was “sexually harassed by a colleague,” but failed to disclose to her supervisor because “it’s a small practice and I have to share space with this offender every day” (political suicide).

Discussion

The current investigation was designed to examine the types of and reasons for intentional nondisclosure by CITs during their onsite supervision. Sixty percent of the participants provided an example of withholding something significant from their onsite internship supervisors, suggesting that, similar to allied professions, intentional nondisclosure by counseling CITs is common (Ladany et al., 1996; Pisani, 2005; Yourman & Farber, 1996). Participants also provided detailed examples of the types of intentional nondisclosures as well as the reasons they withheld the information. These findings provide insight into the experiences of CITs at their internship placement. In this section, we will connect our findings to those from previous research as well as offer implications for counselors, supervisors, and counselor training programs.

The Types of Intentional Nondisclosure and Reasons for Nondisclosure

Overall, the types of intentional nondisclosure and the reasons for these nondisclosures are comparable to the findings of previous studies in allied professions. There were four categories of the types of intentional nondisclosure that emerged in the study by Ladany et al. (1996) that were not present in the current study: (a) positive reactions to supervisor, (b) supervisor appearance, (c) supervisee–supervisor attraction issues, and (d) positive reactions to client. The category of “unclear” in regard to the reasons for nondisclosure also was not found in the current study, as all participant responses in the current study were legible. Participants of differing CACREP tracks all provided examples of intentional nondisclosure to their supervisors in regard to their field placement. These findings suggest that despite the differences in training models (CACREP, 2015) and professional identities (Lawson, 2016), CITs experience many of the same situations that result in intentional nondisclosure as those from allied professions. The most commonly withheld information in the current study was negative reactions to supervisor, which also was true for psychology trainees in the study by Ladany et al. Supervisees appear most hesitant to discuss their concerns about their supervisor or supervision experience (Hess et al., 2008; Mehr et al., 2010; Pisani, 2005). In addition, CITs also commonly withheld general observations about clients and clinical mistakes similar to allied professions (Hess et al., 2008; Ladany et al., 1996; Mehr et al., 2010; Pisani, 2005).

The CITs in the current study provided many reasons for their intentional nondisclosure, but some reasons were more commonly reported than others. Like the findings from Mehr et al. (2010), participants in the current study most commonly withheld information in order to make a favorable impression on their supervisors. Others reported they withheld because of negative feelings such as “shame” or “embarrassment.” Farber (2006) suggested that internalized negative feelings are often a reason for nondisclosure. Consistent with findings from allied professions (Hess et al., 2008; Ladany et al., 1996), CITs also withheld because (a) they believed a supervisor was not competent, (b) they believed information was not quite important enough to disclose, and (c) they wanted to perform perfectly in their new roles.

Novel Findings Regarding Types and Reasons for Intentional Nondisclosure

An important aspect of content analysis is discussing findings that may extend existing knowledge of a given phenomenon (Hsieh & Shannon, 2005). The current study is the first to examine the types of intentional nondisclosure and reasons for nondisclosure in a sample of CITs. As such, there are several novel findings that warrant discussion. For example, two participants indicated that they did not discuss their professional development needs with their onsite supervisor. This is particularly interesting, given a central function of clinical supervision is to facilitate CIT professional development (Bernard & Goodyear, 2014). CITs who internalize their professional developmental needs as a flaw or who desire to hide these needs for fear of their supervisors’ reactions also may desire to perform perfectly (Rønnestad & Skovholt, 2003). Discussing opportunities for growth as a CIT can be difficult (Mehr et al., 2010); thus, supervisors may need to prompt their supervisees to discuss their needs more directly.

Another novel finding is that one participant indicated that she withheld from her supervisor about her peer’s ethical dilemma (the client letter revealing romantic interest). This participant explained that she did not feel it was her place to share her peer’s information, but all counselors and CITs share some responsibility to address ethical concerns. Ladany et al. (1996) found that 53% of those who withheld information from their supervisors told a peer in the field about their concern. Therefore, it seems likely that other CITs may be placed in a similar position as the participant in the current study. Knowing one’s ethical responsibility to disclose unethical behavior, as in the situation germane to this study, could be prudent (ACA, 2014). Finally, one participant indicated that she was being sexually harassed by a colleague. This report of intentional nondisclosure is particularly concerning given the increased attention to Title IX and attempts to mitigate sexual harassment and sexual assault in university and workplace settings (Welfare, Wagstaff, & Haynes, 2017). This participant’s willingness to share her trauma through the data collection process in this study presents an opportunity for counselor educators and supervisors to explore strategies to prevent these experiences for future CITs.

Regarding the reasons for intentional nondisclosure, there also were novel findings because three new reasons emerged in the current study. First, five participants did not disclose information to their supervisor because they did not want to harm their clients or violate a client’s confidentiality. However, the sharing of information with a supervisor would never violate client confidentiality (ACA, 2014). Perhaps the supervisees’ confusion about the parameters of confidentiality or misdirected efforts to protect clients from the actions of a supervisor they perceived as incompetent led to this decision. A second novel reason for intentional nondisclosure was evidenced by one participant who reported consulting with a supervisor who was not her site supervisor. Ladany et al. (1996) found that 15% of psychology trainees consulted with “another supervisor” outside their primary supervisor (p. 16). Ladany et al. did not ask their participants to clarify the role of another supervisor; however, this finding is relevant to the current study and the training of CITs. Throughout a CIT’s internship experience, they have two supervisors: one onsite supervisor and one university supervisor (CACREP, 2015). It is unclear if the supervisor with whom the participant discussed their concern was another supervisor at the site or the university supervisor. However, this could be an inherent challenge for CITs to identify who to share information with, particularly if there are issues in one of the two relationships. Finally, one school counseling CIT indicated that she had an issue with a teacher and addressed this issue with the teacher directly. Counselors work in diverse settings (ACA, 2014; CACREP, 2015) and may often work with persons outside the counseling profession. Counseling programs and supervisors may need to better prepare students to work with other professionals in their specific setting.

Implications for CITs

The findings from the current study provide empirical evidence that, when faced with the decision to share in clinical supervision, CITs sometimes chose to withhold information from their supervisors despite knowing its relevance. CITs of all CACREP tracks will likely be faced with this difficult decision. We hope that these findings, which offer insights into the experience of intentional nondisclosure, help to normalize the challenges that CITs face and identify strategies to prevent nondisclosure.

Some of the participants described harmful supervision experiences in which they were berated by their supervisors, feared fallout if they were to disclose illegal sexual harassment by another site employee, were concerned about a supervisor’s clinical competence, or did not feel safe to share even blatantly inappropriate client behaviors. Harmful supervision such as this has also been described by Ellis et al. (2014) and is a major concern for counseling and related professions. CITs who find themselves in harmful supervision situations can consider seeking support from another professional, a peer, or a professional association ethics consultant who might help rectify these issues.

Even for those CITs who are not enduring harmful supervision, there are costs to nondisclosure such as stalled development, safety concerns, and ethical or legal violations. Ultimately, the decision to withhold information from one’s clinical supervisor rests with the CIT (Murphy & Wright, 2005). Advocating for a safe and productive supervisory experience may result in a change that serves as a catalyst for supervisee growth or prevents client harm. No supervisee needs to be concerned about burdening a supervisor with disclosures about training issues or ethics; it is the supervisor’s responsibility to address supervisee needs, no matter how burdensome. Relatedly, supervisees who are reluctant to discuss their observations of clients or clinical mistakes for fear of being evaluated poorly or perceived as unqualified should consider ways to demonstrate quality work in order to balance the areas for growth. Making mistakes is expected for all CITs, but it is important to use supervision to learn from these mistakes (Pearson, 2001). In fact, reflecting on previous experiences—and learning from those experiences—is key to becoming a skilled and seasoned counselor (Rønnestad & Skovholt, 2003). CITs also might find it helpful to pursue their own personal counseling as another strategy to facilitate personal and professional growth (Oden, Miner-Holden, & Balkin, 2009).

Several CITs shared their hesitancy in disclosing information to their supervisor for fear of violating their clients’ confidentiality or harming the therapeutic alliance. Although client confidentially is critical, disclosing information to one’s supervisor would not violate a client’s confidentiality (ACA, 2014). In fact, some of the concerns expressed seemed to be more about the limits of confidentiality in the setting more broadly (e.g., high school rules), rather than with the supervisor specifically. Counselors are encouraged to not tell a client that the information shared during the counseling process will remain absolutely confidential. Rather, counselors are encouraged to include a passage in their informed consent about the boundaries of client confidentiality and discuss this information with their clients (ACA, 2014). Finally, predicting when ethical or legal issues will occur may be impossible. Counselors should regularly consult with supervisors to discuss treatment options and legal and ethical issues (ACA, 2014).

Implications for Supervisors and Counselor Education Training Programs

Supervisors and counselor educators play a central role in reducing CIT intentional nondisclosures. The findings from the current study suggest there is a wide range of topics that CITs are reluctant to discuss with their supervisors and a wide range of reasons for withholding. The varying nature of intentional nondisclosures highlights the necessity of individualized interventions. Broadly speaking, supervisors are encouraged to facilitate an open and safe environment that invites disclosure (Bordin, 1983). This might also mean supervisors must be willing to purposefully solicit feedback from their supervisees (Murphy & Wright, 2005). Additionally, supervisors must be proactive in utilizing the knowledge gained from studies like this one to normalize the experiences of their supervisees. Perhaps by discussing each of the types of nondisclosure described above with CITs, supervisors can reduce the pressures associated with performing perfectly (Rønnestad & Skovholt, 2003) or diminish the negative emotions (e.g., shame, embarrassment) associated with making mistakes (Farber, 2006; Knox, 2015).

Finally, some of the experiences described by the participants in the current study are deeply troubling, as they shared specific examples of ineffective and harmful supervision. The burden of providing evidence and reporting instances of harmful supervision is often placed on the CIT (Ellis, Taylor, Corp, Hutman, & Kangos, 2017). We outlined some strategies for CITs in case they were to experience harmful supervision; however, the findings from the current study suggest that CITs are withholding this information for any number of reasons. The participants in this study are not unlike those from other allied professions who have similar supervision experiences (for specific examples of harmful supervision, see Ellis, 2017). Thus, supervisors and counselor education programs must work to prevent CITs from experiencing the damaging effects of ineffective or harmful supervision. We encourage counselor education programs to be proactive by reviewing the signs of ineffective and harmful supervision practices with students before they begin their internships and to regularly check in with students about the supervision experience. Counselor education programs may find it beneficial to solicit student feedback about their practicum/internship site at the end of each term—specifically targeting concerns related to ineffective and harmful supervision.

Encouraging students to disclose their experiences with ineffective or harmful supervision while they are in the process of graded program work might not be possible because of the reasons described above; however, preventing similar experiences for future students may be. Finally, CACREP (2015) requires that all site supervisors receive supervision training prior to serving in this capacity. Accidental instances of ineffective or harmful supervision may be prevented by adding training for site supervisors in this content area (Ellis et al., 2017).

Limitations and Future Research

The current study has limitations that create opportunities for future research. First, we utilized the categories originally identified in the study conducted by Ladany et al. (1996). Although we allowed for the creation of new categories, it is possible that selecting a different study to guide our investigation would have yielded different findings (Hsieh & Shannon, 2005). Also, prompting for a single example of significant intentional nondisclosure may have influenced the findings. Future studies should include the opportunity to provide multiple examples, which could result in different findings. Finally, participants were asked to provide examples of intentional nondisclosure with their onsite supervisors during their internship. These participants were receiving supervision from a university supervisor (CACREP, 2015), meaning the information withheld from the onsite supervisor may have been discussed with the university supervisor. It is also plausible that supervisees withheld the information from both the onsite and university supervisors. Site supervisors and university supervisors might have conflicting agendas, presenting a burden on supervisees to decide what to disclose to whom. Future studies should examine how supervisees decide what to disclose when they have multiple supervisors at one time. Finally, participants in the current study reported they were most hesitant to disclose their negative reactions about their supervisors. Future research should explore how supervisors can better monitor their supervisees’ reactions to them.

Conclusion

Although previous research from allied professions provides evidence of how nondisclosure manifests within those professions, the findings from this study provide empirical evidence of how CIT intentional nondisclosure presents during onsite supervision. These findings provide valuable insights into the types of information that CITs withhold as well as the reasons for their nondisclosure during their onsite supervision. Given that the counseling profession has a unique training model (CACREP, 2015) and professional identity (Lawson, 2016), these findings can be used by CITs, onsite supervisors, and counselor educators to generate targeted solutions to address this critical issue.

Conflict of Interest and Funding Disclosure

This research was supported by a grant from the Association for Counselor Education and Supervision.

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Ryan M. Cook is an assistant professor at The University of Alabama. Laura E. Welfare, NCC, is an associate professor at Virginia Tech. Devon E. Romero, NCC, is an assistant professor at The University of Texas at San Antonio. Correspondence can be addressed to Ryan Cook, 310A Graves Hall, The University of Alabama, Tuscaloosa, AL 35487, rmcook@ua.edu.

Current Practices in Online Counselor Education

Jun 28, 2018 | Volume 8 - Issue 2

William H. Snow, Margaret R. Lamar, J. Scott Hinkle, Megan Speciale

The Council for Accreditation of Counseling & Related Educational Programs (CACREP) database of institutions revealed that as of March 2018 there were 36 CACREP-accredited institutions offering 64 online degree programs. As the number of online programs with CACREP accreditation continues to grow, there is an expanding body of research supporting best practices in digital remote instruction that refutes the ongoing perception that online or remote instruction is inherently inferior to residential programming. The purpose of this article is to explore the current literature, outline the features of current online programs and report the survey results of 31 online counselor educators describing their distance education experience to include the challenges they face and the methods they use to ensure student success.

Keywords: online, distance education, remote instruction, counselor education, CACREP

Counselor education programs are being increasingly offered via distance education, or what is commonly referred to as distance learning or online education. Growth in online counselor education has followed a similar trend to that in higher education in general (Allen & Seaman, 2016). Adult learners prefer varied methods of obtaining education, which is especially important in counselor education among students who work full-time, have families, and prefer the flexibility of distance learning (Renfro-Michel, O’Halloran, & Delaney, 2010). Students choose online counselor education programs for many reasons, including geographic isolation, student immobility, time-intensive work commitments, childcare responsibilities, and physical limitations (The College Atlas, 2017). Others may choose online learning simply because it fits their learning style (Renfro-Michel, O’Halloran, & Delaney, 2010). Additionally, education and training for underserved and marginalized populations may benefit from the flexibility and accessibility of online counselor education.

The Council for Accreditation of Counseling & Related Educational Programs (CACREP; 2015) accredits online programs and has determined that these programs meet the same standards as residential programs. Consequently, counselor education needs a greater awareness of how online programs deliver instruction and actually meet CACREP standards. Specifically, existing online programs will benefit from the experience of other online programs by learning how to exceed and surpass minimum accreditation expectations by utilizing the newest technologies and pedagogical approaches (Furlonger & Gencic, 2014). The current study provides information regarding the current state of online counselor education in the United States by exploring faculty’s descriptions of their online programs, including their current technologies, student and program community building approaches, and challenges faced.

Distance Education Defined

Despite its common usage throughout higher education, the U.S. Department of Education (DOE) does not use the terms distance learning, online learning, or online education; rather, it has adopted the term distance education (DOE, 2012). However, in practice, the terms distance education, distance learning, online learning, and online education are used interchangeably. The DOE has defined distance education as the use of one or more technologies that deliver instruction to students who are separated from the instructor and that supports “regular and substantive interaction between the students and the instructor, either synchronously or asynchronously” (2012, p. 5). The DOE has specified that technologies may include the internet, one-way and two-way transmissions through open broadcast and other communications devices, audioconferencing, videocassettes, DVDs, and CD-ROMs. Programs are considered distance education programs if at least 50% or more of their instruction is via distance learning technologies. Additionally, residential programs may contain distance education elements and still characterize themselves as residential if less than 50% of their instruction is via distance education. Traditional on-ground universities are incorporating online components at increasing rates; in fact, 67% of students in public universities took at least one distance education course in 2014, further reflecting the growth in this teaching modality (Allen & Seaman, 2016).

Enrollment in online education continues to grow, with nearly 6 million students in the United States engaged in distance education courses (Allen & Seaman, 2016). Approximately 2.8 million students are taking online classes exclusively. In a conservative estimate, over 25% of students enrolled in CACREP programs are considered distance learning students. In a March 2018 review of the CACREP database of accredited institutions, there were 36 accredited institutions offering 64 degree programs. Although accurate numbers are not available from any official sources, it is a conservative estimate that over 12,000 students are enrolled in a CACREP-accredited online program. When comparing this estimate to the latest published 2016 CACREP enrollment figure of 45,820 (CACREP, 2017), online students now constitute over 25% of the total. This does not include many other residential counselor education students in hybrid programs who may take one or more classes through distance learning means.

At the time of this writing, an additional three institutions were currently listed as under CACREP review, and soon their students will likely be added to this growing online enrollment. As this trend continues, it is essential for counselor education programs to understand issues, trends, and best practices in online education in order to make informed choices regarding counselor education and training, as well as preparing graduates for employment. It also is important for hiring managers in mental health agencies to understand the nature and quality of the training graduates of these programs have received.

One important factor contributing to the increasing trends in online learning is the accessibility it can bring to diverse populations throughout the world (Sells, Tan, Brogan, Dahlen, & Stupart, 2012). For instance, populations without access to traditional residential, brick-and-mortar classroom experiences can benefit from the greater flexibility and ease of attendance that distance learning has to offer (Bennet-Levy, Cromarty, Hawkins, & Mills, 2012). Remote areas in the United States, including rural and frontier regions, often lack physical access to counselor education programs, which limits the numbers of service providers to remote and traditionally underserved areas of the country. Additionally, the online counselor education environment makes it possible for commuters to take some of their course work remotely, especially in winter when travel can become a safety issue, and in urban areas where travel is lengthy and stressful because of traffic.

The Online Counselor Education Environment

The Association for Counselor Education and Supervision (ACES) Technology Interest Network (2017) recently published guidelines for distance education within counselor education that offer useful suggestions to online counselor education programs or to those programs looking to establish online courses. Current research supports that successful distance education programs include active and engaged faculty–student collaboration, frequent communications, sound pedagogical frameworks, and interactive and technically uncomplicated support and resources (Benshoff & Gibbons, 2011; Murdock & Williams, 2011). Physical distance and the associated lack of student–faculty connection has been a concern in the development of online counselor education programs. In its infancy, videoconferencing was unreliable, unaffordable, and often a technological distraction to the learning process. The newest wave of technology—enhanced distance education—has improved interactions using email, e-learning platforms, and threaded discussion boards to make asynchronous messaging virtually instantaneous (Hall, Nielsen, Nelson, & Buchholz, 2010). Today, with the availability of affordable and reliable technical products such as GoToMeeting, Zoom, and Adobe Connect, online counselor educators are holding live, synchronous meetings with students on a regular basis. This includes individual advising, group supervision, and entire class sessions.

It is important to convey that online interactions are different than face-to-face, but they are not inferior to an in-person faculty–student learning relationship (Hickey, McAleer, & Khalili, 2015). Students and faculty prefer one method to the other, often contingent upon their personal belief in the effectiveness of the modality overall and their belief in their own personal fit for this style of teaching and learning (Watson, 2012). In the actual practice of distance education, professors and students are an email, phone call, or videoconference away; thus, communication with peers and instructors is readily accessible (Murdock & Williams, 2011; Trepal, Haberstroh, Duffey, & Evans, 2007). When communicating online, students may feel more relaxed and less inhibited, which may facilitate more self-disclosure, reflexivity, and rapport via increased dialogue (Cummings, Foels, & Chaffin, 2013; Watson, 2012). Subsequently, faculty who are well-organized, technologically proficient, and more responsive to students’ requests may prefer online teaching opportunities and find their online student connections more engaging and satisfying (Meyer, 2015). Upon Institutional Research Board approval, an exploratory survey of online counselor educators was conducted in 2016 and 2017 to better understand the current state of distance counselor education in the United States.

Method

Participants

Recruitment of participants was conducted via the ACES Listserv (CESNET). No financial incentive or other reward was offered for participation. The 31 participants comprised a sample of convenience, a common first step in preliminary research efforts (Kerlinger & Lee, 1999). Participants of the study categorized themselves as full-time faculty members (55.6%), part-time faculty members (11.1%), academic chairs and department heads (22.2%), academic administrators (3.7%), and serving in other roles (7.4%).

Study Design and Procedure

The survey was written and administered using Qualtrics, a commercial web-based product. The survey contained questions aimed at exploring online counselor education programs, including current technologies utilized, approaches to reducing social distance, development of community among students, major challenges in conducting online counselor education, and current practices in meeting these challenges. The survey was composed of one demographic question, 15 multiple-response questions, and two open-ended survey questions. The demographic question asked about the respondent’s role in the university. The 15 multiple-response questions included items such as: (a) How does online counselor education fit into your department’s educational mission? (b) Do you provide a residential program in which to compare your students? (c) How successful are your online graduates in gaining postgraduate clinical placements and licensure? (d) What is the average size of an online class with one instructor? and (e) How do online students engage with faculty and staff at your university? Two open-ended questions were asked: “What are the top 3 to 5 best practices you believe are most important for the successful online education of counselors?” and “What are the top 3 to 5 lessons learned from your engagement in the online education of counselors?”

Additional questions focused on type of department and its organization, graduates’ acceptance to doctoral programs, amount of time required on the physical campus, e-learning platforms and technologies, online challenges, and best practices for online education and lessons learned. The 18 survey questions were designed for completion in no more than 20 minutes and the survey was active for 10 months, during which time there were three appeals for responses yielding 31 respondents.

Procedure

An initial recruiting email and three follow-ups were sent via CESNET. Potential participants were invited to visit a web page that first led to an introductory paragraph and informed consent page. An embedded skip logic system required consent before allowing access to the actual survey questions.

The results were exported from the Qualtrics web-based survey product, and the analysis of the 15 fixed-response questions produced descriptive statistics. Cross tabulations and chi square statistics further compared the perceptions of faculty and those identifying themselves as departmental chairs and administrators.

The two open-ended questions—“What are the top 3 to 5 best practices you believe are most important for the successful online education of counselors?” and “What are the top 3 to 5 lessons learned from your engagement in the online education of counselors?”—yielded 78 statements about lessons learned and 80 statements about best practices for a total of 158 statements. The analysis of the 158 narrative comments initially consisted of individually analyzing each response by identifying and extracting the common words and phrases. It is noted that many responses contained more than one suggestion or comment. Some responses were a paragraph in length and thus more than one key word or phrase could come from a single narrative response. This first step yielded a master list of 18 common words and phrases. The second step was to again review each comment, compare it to this master list, and place a check mark for each category. The third step was to look for similarities in the 18 common words and group them into a smaller number of meaningful categories. These steps were checked among the researchers for fidelity of reporting and trustworthiness.

Results

Thirty-one distance learning counselor education faculty, department chairs, and administrators responded to the survey. They reported their maximum class sizes ranged from 10 to 40 with a mean of 20.6 (SD = 6.5), and the average class size was 15.5 (SD = 3.7). When asked how online students are organized within their university, 26% reported that students choose classes on an individual basis, 38% said students are individually assigned classes using an organized schedule, and 32% indicated that students take assigned classes together as a cohort.

Additionally, respondents were asked how online students engage with faculty and staff at their university. Email was the most popular, used by all (100%), and second was phone calls (94%). Synchronous live group discussions using videoconferencing technologies were used by 87%, while individual video calls were reported by 77%. Asynchronous electronic discussion boards were utilized by 87% of the counselor education programs.

Ninety percent of respondents indicated that remote or distance counseling students were required to attend the residential campus at least once during their program, with 13% requiring students to come to campus only once, 52% requiring students to attend twice, and 26% requiring students to come to a physical campus location four or more times during their program.

All participants indicated using some form of online learning platform with Blackboard (65%), Canvas (23%), Pearson E-College (6%), and Moodle (3%) among the ones most often listed. Respondents indicated the satisfaction levels of their current online learning platform as: very dissatisfied (6.5%), dissatisfied (3.2%), somewhat dissatisfied (6.5%), neutral (9.7%), somewhat satisfied (16.1%), satisfied (41.9%), and very satisfied (9.7%). There was no significant relationship between the platform used and the level of satisfaction or dissatisfaction (X²(18,30) = 11.036, p > .05), with all platforms faring equally well. Ninety-seven percent of respondents indicated using videoconferencing for teaching and individual advising using such programs as Adobe Connect (45%), Zoom (26%), or GoToMeeting (11%), while 19% reported using an assortment of other related technologies.

Participants were asked about their university’s greatest challenges in providing quality online counselor education. They were given five pre-defined options and a sixth option of “other” with a text box for further elaboration, and were allowed to choose more than one category. Responses included making online students feel a sense of connection to the university (62%), changing faculty teaching styles from traditional classroom models to those better suited for online coursework (52%), providing experiential clinical training to online students (48%), supporting quality practicum and internship experiences for online students residing at a distance from the physical campus (38%), convincing faculty that quality outcomes are possible with online programs (31%), and other (10%).

Each participant was asked what their institution did to ensure students could succeed in online counselor education. They were given three pre-defined options and a fourth option of “other” with a text box for further elaboration, and were allowed to choose more than one option. The responses included specific screening through the admissions process (58%), technology and learning platform support for online students (48%), and assessment for online learning aptitude (26%). Twenty-three percent chose the category of other and mentioned small classes, individual meetings with students, providing student feedback, offering tutorials, and ensuring accessibility to faculty and institutional resources.

Two open-ended questions were asked and narrative comments were analyzed, sorted, and grouped into categories. The first open-ended question was: “What are the top 3 to 5 best practices that are the most important for the successful online education of counselors?” This yielded 78 narrative comments that fit into the categories of fostering student engagement (n = 19), building community and facilitating dialogue (n = 14), supporting clinical training and supervision (n = 11), ensuring courses are well planned and organized (n = 10), providing timely and robust feedback (n = 6), ensuring excellent student screening and advising (n = 6), investing in technology (n = 6), ensuring expectations are clear and set at a high standard (n = 5), investing in top-quality learning materials (n = 4), believing that online counselor education works (n = 3), and other miscellaneous comments (n = 4). Some narrative responses contained more than one suggestion or comment that fit multiple categories.

The second open-ended question—“What are the top 3 to 5 lessons learned from the online education of counselors?”—yielded 80 narrative comments that fit into the categories of fostering student engagement (n = 11), ensuring excellent student screening and advising (n = 11), recognizing that online learning has its own unique workload challenges for students and faculty (n = 11), providing timely and robust feedback (n = 8), building community and facilitating dialogue (n = 7), ensuring courses are well planned and organized (n = 7), investing in technology (n = 6), believing that online counselor education works (n = 6), ensuring expectations are clear and set at a high standard (n = 5), investing in top-quality learning materials (n = 3), supporting clinical training and supervision (n = 2), and other miscellaneous comments (n = 8).

Each participant was asked how online counselor education fit into their department’s educational mission and was given three categorical choices. Nineteen percent stated it was a minor focus of their department’s educational mission, 48% stated it was a major focus, and 32% stated it was the primary focus of their department’s educational mission.

The 55% of participants indicating they had both residential and online programs were asked to respond to three follow-up multiple-choice questions gauging the success rates of their online graduates (versus residential graduates) in attaining: (1) postgraduate clinical placements, (2) postgraduate clinical licensure, and (3) acceptance into doctoral programs. Ninety-three percent stated that online graduates were as successful as residential students in gaining postgraduate clinical placements. Ninety-three percent stated online graduates were equally successful in obtaining state licensure. Eighty-five percent stated online graduates were equally successful in getting acceptance into doctoral programs.

There were some small differences in perception that were further analyzed. Upon using a chi square analysis, there were no statistically significant differences in the positive perceptions of online graduates in gaining postgraduate clinical placements (X² (2, 13) = .709, p > .05), the positive perceptions regarding the relative success of online versus residential graduates in gaining postgraduate clinical licensure (X² (2, 13) = .701, p > .05), or perceptions of the relative success of online graduates in becoming accepted in doctoral programs (X² (2, 12) = 1.33, p > .05).

Discussion

The respondents reported that their distance learning courses had a mean class size of 15.5. Students in these classes likely benefit from the small class sizes and the relatively low faculty–student ratio. These numbers are lower than many residential classes that can average 25 students or more. It is not clear what the optimal online class size should be, but there is evidence that the challenge of larger classes may introduce burdens difficult for some students to overcome (Chapman & Ludlow, 2010). Beattie and Thiele (2016) found first-generation students in larger classes were less likely to talk to their professor or teaching assistants about class-related ideas. In addition, Black and Latinx students in larger classes were less likely to talk with their professors about their careers and futures (Beattie & Thiele, 2016).

Programs appeared to have no consistent approach to organizing students and scheduling courses. The three dominant models present different balances of flexibility and predictability with advantages and disadvantages for both. Some counselor education programs provide students the utmost flexibility in selecting classes, others assign classes using a more controlled schedule, and others are more rigid and assign students to all classes.

The model for organizing students impacts the social connections students make with one another. In concept, models that provide students with more opportunities to engage each other in a consistent and effective pattern of positive interactions result in students more comfortable working with one another, and requesting and receiving constructive feedback from their peers and instructors.

Cohort models, in which students take all courses together over the life of a degree program, are the least flexible but most predictable and have the greatest potential for fostering strong connections. When effectively implemented, cohort models can foster a supportive learning environment and greater student collaboration and cohesion with higher rates of student retention and ultimately higher graduation rates (Barnett & Muse, 1993; Maher, 2005). Advising loads can decrease as cohort students support one another as informal peer mentors. However, cohorts are not without their disadvantages and can develop problematic interpersonal dynamics, splinter into sub-groups, and lead to students assuming negative roles (Hubbell & Hubbell, 2010; Pemberton & Akkary, 2010). An alternative model in which students make their own schedules and choose their own classes provides greater flexibility but fewer opportunities to build social cohesion with others in their program. At the same time, these students may not demonstrate the negative dynamics regarding interpersonal engagement that can occur with close cohort groups.

Faculty–Student Engagement

Remote students want to stay in touch with their faculty advisors, course instructors, and fellow students. Numerous social engagement opportunities exist through technological tools including email, cell phone texts, phone calls, and videoconference advising. These fast and efficient tools provide the same benefits of in-person meetings without the lag time and commute requirements. Faculty and staff obviously need to make this a priority to use these tools and respond to online students in a timely manner.

All technological tools referred to in the survey responses provide excellent connectivity and communication if used appropriately. Students want timely responses, but for a busy faculty or staff member it is easy to allow emails and voicemails to go unattended. Emails not responded to and unanswered voicemail messages can create anxiety for students whose only interaction is through electronic means. This also might reinforce a sense of isolation for students who are just “hanging out there” on their own and having to be resourceful to get their needs met. It is recommended that the term timely needs to be defined and communicated so faculty and students understand response expectations. It is less important that responses are expected in 24, 48, or even 72 hours; what students need to know is when to expect a response.

Survey responses indicated that remote counselor education students are dependent upon technology, including the internet and associated web-based e-learning platforms. When the internet is down, passwords do not work, or computers fail, the remote student’s learning is stalled. Counselor education programs offering online programming must provide administrative services, technology, and learning support for online students in order to quickly remediate technology issues when they occur. It is imperative that standard practice for institutions include the provision of robust technology support to reduce down-time and ensure continuity of operations and connection for remote students.

Fostering Program and Institutional Connections

Faculty were asked how often online students were required to come to a physical campus location as part of their program. Programs often refer to short-term campus visits as limited residencies to clarify that students will need to come to the campus. Limited residencies are standard, with 90% responding that students were required to come to campus at least once. Short-term intensive residencies are excellent opportunities for online students to make connections with their faculty and fellow students (Kops, 2014). Residential intensives also provide opportunities for the university student life office, alumni department, business office, financial aid office, registrar, and other university personnel to connect with students and link a human face to an email address.

Distance learning students want to engage with their university, as well as fellow students and faculty. They want to feel a sense of connection in a similar manner as residential students (Murdock & Williams, 2011). Institutions should think creatively about opportunities to include online learners in activities beyond the classroom. An example of promoting inclusiveness is when one university moved the traditional weekday residential town halls to a Sunday evening teleconference webinar. This allowed for greater access, boosted attendance, and served to make online counselor education students feel like a part of the larger institution.

As brick-and-mortar institutions consider how to better engage distance learning students, they need to understand that a majority of students (53%) taking exclusively distance education courses reside in the same state as the university they are attending (Allen & Seaman, 2016). Given that most are within driving distance of the physical campus, students are more open to coming to campus for special events, feel their presence is valued, and know that they are not just part of an electronic platform (Murdock & Williams, 2011).

E-Learning Platforms as Critical Online Infrastructure

All participants (100%) reported using an online learning platform. E-learning platforms are standard for sharing syllabi, course organization, schedules, announcements, assignments, discussion boards, homework submissions, tests, and grades. They are foundational in supporting faculty instruction and student success with numerous quality options available. Overall, online faculty were pleased with their technological platforms and there was no clear best platform.

Online learning platforms are rich in technological features. For example, threaded discussions allow for rich, thoughtful dialogue among students and faculty, and they are often valued by less verbally competitive students who might express reluctance to speak up in class but are willing to share their comments in writing. Course examinations and quizzes in a variety of formats can be produced and delivered online through e-learning platforms such as Blackboard, Canvas, and Moodle. Faculty have flexibility for when exams are offered and how much time students have to complete them. When used in conjunction with proctoring services such as Respondus, ProctorU, and B-Virtual, integrity in the examination process can be assured. Once students complete their exam, software can automatically score and grade objective questions, and provide immediate feedback to students.

Videoconferencing and Virtual Remote Classrooms

Videoconferencing for teaching and individual advising through Adobe Connect, Zoom, GoToMeeting, and related technologies is now standard practice and changing the nature of remote learning. Distance learning can now employ virtual classroom models with synchronous audio and video communication that closely parallels what occurs in a residential classroom. Videoconferencing platforms provide tools to share PowerPoints, graphics, and videos as might occur in a residential class. Class participants can write on virtual whiteboards with color markers, annotating almost anything on their screen. Group and private chat functionality can provide faculty with real-time feedback during a class session. Newer videoconferencing features now allow faculty to break students into smaller, private discussion groups and move around to each group virtually, just like what often occurs in a residential classroom. With preparation, faculty can execute integrated survey polls during a video class session. Essentially, videoconferencing tools reduce the distance in distance education.

Videoconference platforms allow faculty to teach clinical skills in nearly the same manner as in residential programs. Counselor education faculty can model skills such as active listening in real time to their online class. Faculty can then have students individually demonstrate those skills while being observed. Embedded features allow faculty to record the video and audio features of any conversation for playback and analysis. Videoconference platforms now offer “breakout” rooms to place students in sub-groups for skills practice and debriefing, similar to working in small groups in residential classrooms. Faculty members and teaching assistants can visit each breakout room to ensure students are on task and properly demonstrating counseling skills. Just as in a residential class, students can reconvene and share the challenges and lessons learned from their small group experience.

Challenges in Providing Remote Counselor Education

Participants were asked to select one or more of their top challenges in providing quality online counselor education. In order of frequency, they reported the greatest challenges as making online students feel a sense of connection to the university (62%), changing faculty teaching styles from brick-and-mortar classroom models to those better suited for online coursework (52%), providing experiential clinical training to online students (48%), supporting quality practicum and internship experiences for online students residing at a distance from the physical campus (38%), and convincing faculty members that quality outcomes are possible with online programs (31%).

Creating a sense of university connection. Counselor education faculty did not report having major concerns with faculty–student engagement. Faculty seemed confident with student learning outcomes using e-learning platforms and videoconferencing tools that serve to reduce social distance between faculty and students and facilitate quality learning experiences. This confidence could be the result of counselor educators’ focus on fostering relationships as a foundational counseling skill (Kaplan, Tarvydas, & Gladding, 2014).

However, faculty felt challenged to foster a student’s sense of connection with the larger university. For example, remote students not receiving emails and announcements about opportunities available only to residential students can feel left out. Remote students might find it difficult to navigate the university student life office, business department, financial aid office, registration system, and other university systems initially designed for residential students. Highly dependent on their smartphone and computer, remote students can feel neglected as they anxiously wait for responses to email and voicemail inquiries (Milman, Posey, Pintz, Wright, & Zhou, 2015).

In the online environment, there are extracurricular options for participating in town halls, special webinars, and open discussion forums with departmental and university leaders. Ninety percent of the programs require students to come to their physical campus one or more times. These short-term residencies are opportunities for students to meet the faculty, departmental chairs, and university leaders face-to-face and further build a sense of connection.

A majority of online students (53%) reside in the same state as the university they are attending (Allen & Seaman, 2016), with many within commuting distance of their brick-and- mortar campus. These students will appreciate hearing about the same opportunities afforded to residential students, and under the right circumstances and scheduling they will participate.

Changing faculty teaching styles. Not all residential teaching styles and methods, such as authority-based lecture formats, work well with all students (Donche, Maeyer, Coertjens, Van Daal, & Van Petegem, 2013). Distance learning students present their own challenges and preferences. Successful distance education programs require active and engaged faculty who frequently communicate with their students, use sound pedagogical frameworks, and maintain a collaborative and interactive style (Benshoff & Gibbons, 2011; Murdock & Williams, 2011). Discovery orientation, discussion, debriefing, action research, and flipped classrooms where content is delivered outside the classroom and the classroom is used to discuss the material are good examples of more collaborative styles (Brewer & Movahedazarhouligh, 2018; Donche et al., 2013).

Organization is critical for all students, but more so for remote students who often are working adults with busy schedules. They want to integrate their coursework into other life commitments and want a clear, well-organized, and thoughtfully planned course with all the requirements published in advance, including specific assignment due dates. Distance counselor education faculty will find their syllabi growing longer with more detail as they work to integrate traditional assignments with the e-learning and videoconferencing tools in order to create engaging, predictable, and enjoyable interactive learning experiences.

Providing experiential clinical training. Counselor educators ideally provide multimodal learning opportunities for counseling students to understand, internalize, and demonstrate clinical skills for a diverse clientele. In residential classrooms, the knowledge component is usually imparted through textbooks, supplemental readings, course assignments, video demonstration, and instructor-led lecture and discussions. All remote programs provide similar opportunities for students and replicate residential teaching models with their use of asynchronous e-learning platforms and synchronous videoconferencing technologies.

Asynchronous methods are not well suited for modeling, teaching, and assessing interpersonal skills. However, synchronous videoconferencing technologies provide the same opportunity as residential settings to conduct “fishbowl” class exercises, break students into groups to practice clinical skills, conduct role plays, apply procedural learning, and give students immediate, meaningful feedback about their skills development.

The majority of surveyed programs required remote students to come to campus at least once to assess students for clinical potential, impart critical skills, and monitor student progress in achieving prerequisite clinical competencies required to start practicum. Courses that teach and assess clinical interviewing skills are well suited for these intensive experiences and provide an important gatekeeping function. Faculty not only have the opportunity to see and hear students engage in role plays, but also to see them interact with other students.

Supporting quality practicum and internship experiences. Remote counselor educators report that their programs are challenged in supporting quality practicum and internship experiences. Residential students benefit from the relationships universities develop over time with local public and nonprofit mental health agencies in which practicum and internship students may cluster at one or more sites. Although online students living close enough to the residential campus may benefit from the same opportunities, remote students living at a distance typically do not experience this benefit. They often have to seek out, interview, and compete for a clinical position at a site unfamiliar to their academic program’s field placement coordinator. Thus, online counselor education students will need field placement coordination that can help with unique practicum and internship requirements. The placement coordinator will need to know how to review and approve distance sites without a physical assessment. Relationships with placement sites will need to rely upon email, phone, and teleconference meetings. Furthermore, online students can live in a state other than where the university is located, requiring the field placement coordinator to be aware of various state laws and regulations.

Convincing faculty that quality outcomes are possible. Approximately one-third of the surveyed counselor education faculty reported the need to convince other faculty that quality outcomes are possible with remote counselor education. Changing the minds of skeptical colleagues is challenging but naturally subject to improvement over time as online learning increases, matures, and becomes integrated into the fabric of counselor education. In the interim, programs would be wise to invest in assisting faculty skeptics to understand that online counselor education can be managed effectively (Sibley & Whitaker, 2015). First, rather than just telling faculty that online counselor education works, programs should demonstrate high levels of interactivity that are comparable to face-to-face engagement by using state-of-the-art videoconferencing platforms. Second, it is worth sharing positive research outcomes related to remote education. Third, it is best to start small by encouraging residential faculty to first try a hybrid course by holding only one or two of their total class sessions online. Fourth, it is important to provide robust support for reluctant but willing faculty who agree to integrate at least one or two online sessions into their residential coursework. Finally, institutions will find more willing faculty if they offer incentives for those who give online counselor education a chance.

Ensuring Online Student Success

Student success is defined by the DOE as related to student retention, graduation rates, time to completion, academic success, and gainful employment (Bailey et al., 2011). Counselor education programs would likely add clinical success in practicum and internship and post-master’s licensure to these critical success outcomes.

The survey respondents reported that student success begins with making sure that the students they accept have the aptitude to learn via online distance education. Students may have unrealistic perceptions that remote distance education is somehow less academically strenuous. Programs need to ensure students are prepared for the unique aspects of online versus residential learning. Fifty-eight percent of the programs engaged in student screening beginning with the admissions process. A quarter of the respondents used a formal assessment tool to assess students for success factors such as motivation, learning style, study habits, access to technology, and technological skills. A commonly used instrument was the Online Readiness Assessment developed by Williams (2017).

Lessons Learned and Best Practices

The 158 statements regarding best practices and lessons learned were further refined to yield the top six imperatives for success in online counselor education, namely: (1) fostering student–faculty–community engagement (57.4%); (2) providing high expectations, excellent screening, advising, and feedback (36%); (3) investing in quality instructional materials, course development, and technology support (30.5%); (4) providing excellent support for online clinical training and supervision (14.6%); (5) recognizing the workload requirements and time constraints of online students; (6) working to instill the belief in others that quality outcomes are possible with online counselor education programs (10.1%); and (7) other assorted responses (13.5%).

An indicator of success for many counselor education programs is the rate at which students graduate, obtain clinical placement, and become licensed. There is also an interest in how successful graduates are in becoming admitted into doctoral programs. For online programs, a further benchmark test is to compare online student graduation, licensure, and doctoral admissions rates to those in residential programs. Fifty-five percent of the respondents served in programs with residential as well as online students. These respondents were able to compare their online student outcomes to residential student outcomes. Their perception was that online graduates were as successful as residential students in gaining postgraduate clinical placements (93%), obtaining state licensure (93%), and acceptance into doctoral programs (85%). They generally believed online graduates were competitive with residential graduates.

Limitations, Recommendations, and Conclusion

Limitations of the Study

When this study began in 2016, there were 11 CACREP-accredited institutions offering online counselor education programs, and by March 2018, there were 36. This study represents a single snapshot of the online counselor education experience during a time of tremendous growth.

This study focused on the reported experience of faculty, departmental chairs, and administrators who have some commitment and investment in online learning. Some would point out the bias of those who advocate for remote counselor education in relaying their own experiences, anecdotal evidence, and personal comparisons of online and residential teaching.

The exploratory nature of this study was clearly not comprehensive in its inclusion of all the factors associated with online counselor education. Specific details of online counselor education programs were not emphasized and could have offered more information about university and departmental resources for remote education, faculty training for online educational formats, and student evaluations of online courses. The numerous technologies used were identified, but this says nothing about their differential effectiveness. Future studies should include these variables as well as other factors that will provide further information about the successes and challenges of online counselor education.

This survey assessed the informed opinions of counselor education faculty and administrators who responded that they were generally satisfied with the various aspects of their programs, including student outcomes. What was not assessed was the actual quality of the education itself. In order to change the mind of skeptics, more than opinions and testimonies will be needed. Future studies need to objectively compare learning outcomes, demonstrate quality, and delineate how remote counselor education programs are meeting the challenges of training counselors within distance learning modalities.

Recommendations

The dynamic nature of the field of online counselor education requires ongoing study. As more programs offer courses and full programs through distance learning modalities, they can contribute their own unique expertise and lessons learned to inform and enrich the broader field.

The challenge of faculty skepticism and possible mixed motives regarding online learning will continue to be problematic. There is a lingering perception by some faculty that online counselor education programs are not equivalent to residential training. An inherent faculty bias might exist in which residential means higher quality and online means lower quality. Some faculty may teach online courses only for additional compensation while privately having reservations. In contrast, departmental chairs and academic administrators might want the same high levels of quality, but may find themselves more driven by the responsibility for meeting enrollment numbers and budgets. In times of scarcity, these individuals may see online counselor education as the answer for new revenue sources (Jones, 2015). For others, online education may present concerns while providing an appeal for its innovative qualities or providing social justice through increasing access to higher education by underserved populations. The best way to clarify the issues and better inform the minds of skeptics is to present them with objective data regarding the nature and positive contributions of remote counselor education learning outcomes.

Aside from the modality of their instructional platform, it is important to understand if effective remote counselor educators are different from equally effective residential course instructors. Remote teaching effectiveness might be associated with some combination of attributes, interests, and motivations, and thus self-selection to teach remote students. Further studies will need to tease out what works, what does not work, and what type of faculty and faculty training make someone best suited for participation in remote counselor education.

Technology is critical to the advances in remote counselor education. Email, smartphones, texting, and e-learning platforms have helped faculty create engaging courses with extensive faculty–student interactions. Videoconferencing in particular has served to reduce the social distance between faculty and remote students. As aforementioned, innovative programs are taking the distance out of distance counselor education, where the virtual remote classroom modality provides similar experiences to those of residential classes. The nature of these technologically facilitated online relationships deserves further study to determine which technologies and related protocols enhance learning and which impede it.

A logical next step is to build on the work that has been accomplished and conduct more head-to-head comparisons of student outcomes among remote and residential programs. This is very feasible, as 34 of the 36 institutions currently offering online counselor education programs also have a residential program with which to make comparisons. These within-institution comparisons will be inherently quasi-experimental. Effective program comparisons of delivery models will require systematically implemented reliable and valid measures of student learning outcomes at strategic points in the counselor training program. The Counselor Competency Scale (Lambie, Mullen, Swank, & Blount, 2018) is a commonly used standardized assessment for graduate students engaged in clinical practicum and internship. The National Counseling Exam scores of current students and recent graduates can provide standardized measures to compare outcomes of graduates across programs.

Finally, although we can learn from institutional best practices and student success stories, we also could benefit from understanding why some programs, faculty, and students struggle. Challenges are certainly faced in remote counselor education and training, but it is likely that one or more programs have developed innovative concepts to surmount these obstacles. The 31 respondents were able to articulate many best practices to manage challenges and believed they were achieving the same learning objectives achieved by residential counseling students. Many faculty members, departmental chairs, and administrators believed that remote counselor education graduates are as successful as those attending residential programs, but this opinion is not universally shared. What is clear is that despite some reservations, a growing number of counselors are trained via a remote modality. It is time to embrace distance counselor education; learn from best practices, successes, and struggles; and continue to improve outcomes for the benefit of programs, the profession of counseling, and the consumers of the services our graduates provide.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest or funding contributions for the development of this manuscript.

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William H. Snow is an associate professor at Palo Alto University. Margaret R. Lamar is an assistant professor at Palo Alto University. J. Scott Hinkle, NCC, is Director of Professional Development at the National Board for Certified Counselors. Megan Speciale, NCC, is an assistant professor at Palo Alto University. Correspondence can be addressed to William Snow, 1791 Arastradero Road, Palo Alto, CA 94304, wsnow@paloaltou.edu.

Service Learning in Human Development: Promoting Social Justice Perspectives in Counseling

Jun 28, 2018 | Volume 8 - Issue 2

Kristi A. Lee, Daniel J. Kelley-Petersen

The focus on human development is foundational to the field of counseling, with its importance codified in guiding documents and frameworks, such as the American Counseling Association’s Code of Ethics (2014). Many developmental theories have been established using single-gender or single-culture groups, yet they claim universal application to all humans. Although counseling students must learn these theories because of accreditation standards and licensure requirements, counselor educators need to prepare students for practice in a multicultural world. Counselors are now called to act as social justice advocates, and teaching strategies are needed to prepare students for this role. This study’s focus is on the use of service learning with community counseling students in a human development course. Results from a content analysis demonstrate how service learning enhances learning and broadens students’ perceptions of themselves, others, and social justice in counseling. Findings indicate a shift in participants’ perception of social justice in counseling.

Keywords: service learning, social justice, human development, developmental theories, content analysis

Distinct from the medical model that underlies psychology, the field of counseling has historically focused on developmental processes as the foundation to understanding what makes human life function well (Brady-Amoon, 2011; Kraus, 2008; Lewis, 2011; Stennbarger & LeClair, 1995). These processes of development are explained through theories about learning, normal personality development, and individual and family development, among others (Council for the Accreditation of Counseling & Related Educational Programs [CACREP], 2015). The American Counseling Association (ACA) identified “enhancing human development throughout the lifespan” as the first core value of the counseling profession (2014, p. 3). Further, human development has been established as one of eight knowledge areas by CACREP (2015), the national accrediting body for counselor education programs. Additionally, standardized tests, such as the National Counselor Examination for Licensure and Certification, require students to demonstrate mastery of studies that provide an understanding of the nature and needs of individuals at all developmental levels (National Board for Certified Counselors [NBCC], 2015).

Although understanding and promoting healthy human development across the lifespan are central themes in counselor education, there are critiques of the study of human development (Brady-Amoon, 2011). Many theories and models of human development reflect middle-class, Caucasian-American value systems and culture (Brady-Amoon, 2011; Broderick & Blewitt, 2015; Dixon, 2001; Henrich, Heine, & Norenzayan, 2010), and thus lack utility in developing both a robust and a nuanced understanding of groups who are outside of this demographic. Broderick and Blewitt (2015) stated that there is a “growing concern that traditional theories are insufficient to explain development because they are biased in favor of single-culture or single-gender models” (p. 351). The role of culture in human development is crucial to consider (Rogoff, 2003), yet many theories consider culture an extraneous variable. Systematic misapplication of theories designed for the dominant population may not adequately account for the accepted indicators of development for diverse cultural and societal contexts (Broderick & Blewitt, 2015;
Dixon, 2001; Kraus, 2008). Recognizing challenges in applying developmental theories to diverse populations is critical for counselors who promote social justice in counseling and in society (Kiselica & Robinson, 2001; MacLeod, 2013).

The Movement Toward a Social Justice Perspective in Counseling

Counselors have a unique position as frontline witnesses to how social inequities impact clients. Individual, couples, family, and group counseling are critical in helping clients in non-dominant groups navigate and survive systems of oppression and opportunity. However, these modalities of counseling may not be sufficient to prevent or meaningfully address mental health issues that have systemic causes (Toporek, Gerstein, Fouad, Roysircar, & Israel, 2006). The recognition for the need to adjust counseling approaches to work with issues of healthy human development in a pluralistic society has contributed to the growth of the social justice movement within the field of counseling (Ratts & Wood, 2011). At times identified as the “fifth force” (Ratts, 2009) in counseling, the social justice perspective not only addresses the individual needs of clients, but also seeks to change systems that inhibit human development for oppressed groups. Counselors are challenged to determine how to balance individual counseling interventions with advocacy interventions on local, state, or national levels. A social justice approach to counseling emphasizes the importance of healthy human development for individuals and social groups and necessitates a broader array of skills, knowledge, and perspectives, including advocacy skills (Bemak & Chung, 2011; Brady-Amoon, 2011; Lewis, 2011; Ratts, 2009).

Acceptance of the social justice counseling perspective is evidenced by its codification in important documents that guide many practitioners and educators in the field of counseling. In the preamble to the 2014 Code of Ethics, ACA identified “promoting social justice” (p. 3) as a core principle. Ethical counselors are called to “advocate at individual, group, institutional, and societal levels to address potential barriers and obstacles that inhibit access and/or the growth and development of clients” (2014, p. 5). In 2003, ACA endorsed the Advocacy Competencies (Lewis, Arnold, House, & Toporek, 2002), a document that describes skills and activities for counselor advocacy. Additionally, the 2016 CACREP standards call for preparation of counselors in “advocacy processes needed to address institutional and social barriers that impede access, equity, and success for clients” (2015, p. 10). These documents provide evidence that segments of the profession of counseling, particularly some counselor education programs, are embracing a social justice perspective that can be enacted through counselor advocacy.

Although many counselors may want to advocate for marginalized populations, they may not be comfortable doing so or they may not know how (West-Olatunji, 2010). Further, it is unclear whether counselor educators are adequately preparing students with the skills necessary to practice from a social justice perspective upon graduation (Bemak & Chung, 2011; Constantine, Hage, Kindaichi, & Bryant, 2007). Preparing counselors with effective and culturally relevant advocacy skills for work in today’s pluralistic society requires that counselor educators rethink historically used teaching methods (Brady-Amoon, Makhija, Dixit, & Dator, 2012; Burnett, Long, & Horne, 2005; Herlihy & Watson, 2007; Hoover & Morrow, 2016; Manis, 2012). Rethinking traditional teaching methods and curricula is particularly important for courses such as human development, which have traditionally focused on universalist theories established using single-gender or single-culture groups (Broderick & Blewitt, 2015). However, for the foreseeable future students will be required to demonstrate their mastery of these traditional theories on licensing exams (NBCC, 2015). To meet the dual challenge of preparing students for licensure and preparing them for practice in a pluralistic society, new teaching approaches are needed. The role of social justice advocacy has been conceptualized as central for counselors (Chang, Crethar, & Ratts, 2010; Lewis, Lewis, Daniels, & D’Andrea, 1998), yet few studies have demonstrated how to prepare students for this role.

Service Learning: A Pedagogy for Counselor Education

Defining Service Learning

Teaching that is active, experiential, and addresses real-world problems is needed to meet the call to prepare students as social justice advocates in the context of rapidly changing and diversifying demographics (Bemak, Chung, Talleyrand, Jones, & Daquin, 2011; Constantine et al., 2007; Manis, 2012). As an experiential teaching strategy that combines academic content learned in the classroom with activities in the community that address “human and community needs” (Jacoby, 2015, p. 6), service learning provides a potential avenue for more adequately preparing counseling students for work in today’s pluralistic society.

Although similar to experiential learning, service learning has a set of characteristics that make it distinct from internships and volunteerism (Furco, 2002). With an emphasis on collaboration with community partners (CPs) who represent historically marginalized communities, all participants enter the service-learning experience as learners and as contributors. Community members and students benefit from a collaborative learning partnership through which a solution to a community-articulated problem is developed (Warter & Grossman, 2002).

Service learning can take two forms: placement-based and project-based. Placement-based service learning usually involves a requirement for students to spend a set number of hours at a community organization where a student completes agreed-upon tasks (Parker-Gwin & Mabry, 1998). In project-based service learning, small student groups work with CP organizations on specific projects that help to meet a need or solve a community-articulated problem (Hugg & Wurdinger, 2007).

Service Learning in Counselor Education

A growing number of counselor educators have called for the use of service learning within counselor education to provide students with an avenue for understanding complex systemic social inequities (Bemak & Chung, 2011; Bemak et al., 2011; Constantine et al., 2007; Manis, 2012). Additionally, the use of service learning within counselor education has been the focus of a limited number of studies. A qualitative study by Jett and Delgado-Romero (2009) focused on the impact of using service learning with pre-practicum counseling students. Results showed that service learning “was perceived to facilitate student counselors’ professional development” (p. 116) through promoting a deeper understanding of counselors’ roles and contexts. Exposure to counseling environments promoted student counselors’ understanding of what counseling is, as opposed to what they imagined it to be (Jett & Delgado-Romero, 2009).

Service learning also has been found to increase multicultural competencies in counseling students. In utilizing service learning in a multicultural counseling class, Burnett, Hamel, and Long (2004) found that it provided “an opportunity to build community learning and cultural sensitivity” (p. 190). They found that service learning had merit in multicultural counseling competency training and in reducing a “missionary ideology” (p. 191) in students. These results suggest that service learning can be a useful strategy for helping students understand how to advocate with and on behalf of marginalized communities. In addition, service learning may give students the opportunity to practice advocacy skills in real-world contexts.

In order to explore the relationship between service learning and students’ understanding of the role of social justice advocacy in counseling, the present study documented and analyzed community counseling students’ experiences in project-based service learning in a human development course in a CACREP-accredited program. The study’s research question has four foci: In what ways does the use of service learning in a human development course impact students’ (a) understanding of course content; (b) understanding of development of people in non-dominant populations; (c) perceptions of themselves; and (d) understanding of a social justice perspective in counseling?

Method

Description of Participants and Sampling Procedures

The study included data from 40 participants. Seventy-six percent of participants identified as female, 24% identified as male, and no participant identified as “other,” an option allowing for non-binary gender identities. Participants’ age range was 22 to 56 with an average age of 31, and they identified with the following race or ethnic categories: Black, 5%; Hispanic, 22%; Native American, 2%; Two or More Races, 10%; White, 49%; and No Response, 12%.

To gain a broad understanding of students’ experiences, data from nearly all community counseling students (hereafter called participants) who participated in the course over four academic terms were included in the study. The data for one student was left out of the study because of participation in the research process. Each participant was in the first of a three-year community counseling program while enrolled in the course with service learning. The program was in its final cycle of CACREP
re-accreditation as a community counseling program at the time the data were collected. This study was approved by its host institution’s Internal Review Board.

Class as Context

Service learning is grounded in a specific “academic house” (Lee & McAdams, 2017) that informs the type of service activities. The academic house for the current research project was a course designed to meet the CACREP human growth and development curriculum requirement. Entitled Counseling Across the Lifespan, it was positioned as the first course in a three-year community counseling program located in a private, urban, medium-sized university in the northwest region of the United States. Taught over a 10-week academic term, the course utilized a text that covered theories and models of human development across the lifespan (i.e., theories of learning, personality development, cognitive development, ecological models). Course elements included reading, class lectures, small and large group discussions, papers, and quizzes. Many theories of development included in the course to help students meet the requirements of licensure were developed using a single-gender, monocultural group. To incorporate a social justice perspective, the course instructor (first author) believed it was essential for students to understand how Euro-Western theories of development may or may not apply to populations for whom they were not developed. To provide context for critical analysis of class content, students engaged in a major class project, the Developmental Service-Learning Project (DSLP).

Developmental service-learning projects. In keeping with high-quality service-learning pedagogy with a social justice focus, the DSLPs were designed in collaboration with CP organizations working with marginalized populations. The primary instructor worked with a center on campus that supported faculty in developing service-learning courses to identify potential partners whose organizations serve people across the lifespan. Project examples included needs assessments, resource manual development, and socio-emotional lesson plan development. All project ideas were suggested by CPs and planned collaboratively with the course instructor. CPs visited class to introduce their organizations and projects to students during the second class session. Students then selected a project and met with their CPs during class time to launch the collaborative project work.

The DSLP had several requirements. For students to gain an understanding of the organization and the population with whom they were working, students visited the site under the supervision of the CP. Each project included the development of a product that could go into immediate use at the CP organizations and that would continue to benefit the site after the project ended. Students also were required to read, analyze, and report how relevant scholarly literature informed their project work. A project proposal detailing what would be accomplished during the DSLP was submitted for approval to the CP and the course instructor. Upon approval, students carried out their projects while remaining in contact with their CPs. During the study’s time period, there were a total of 24 completed DSLP projects. In collaboration with CPs, students completed projects on curriculum development, program evaluations, needs assessments through focus groups and interviews, and intake process development, among others. CP organizations served individuals across the lifespan and in historically marginalized communities ranging from a program on kindergarten readiness with refugee families, to developing resources for housing for an older African immigrant community.

CPs attended the final class session for DSLP group presentations. Partners asked questions, gave verbal feedback, and completed formal written evaluations of the projects. Project groups wrote a final report for their CP detailing their work and product. Digital and physical copies of all products were given to CPs for their continued use. The last class session served to celebrate partnerships and accomplishments. After the term ended, the course instructor met with each CP to discuss the experience, solicit feedback, and plan future collaborations; several CPs collaborated on projects over multiple academic terms.

Data Collection and Analysis

Data were collected from three sources, each a required class assignment. The first two sources were reflection papers—one written by participants at midterm, and one at the end of the term. The third assignment was a self-evaluation completed by participants at the end of the DSLP experience. Participants responded to specific prompts such as “Did your experience with the Developmental Service-Learning Project impact your comprehension of the material from the text and lectures? If so, how?” and “Through the Developmental Service-Learning Project, what did you learn about: Yourself? Your community? Working with people who may have had a different developmental trajectory than you?”

Content analysis is a qualitative methodology that can be used for analyzing and drawing meaning from large amounts of textual data. It allows for the “subjective interpretation of the content of text or data through the systematic classification process of coding and identifying themes or patterns” (Hsieh & Shannon, 2005, p. 1278). This methodology has been widely used in counselor education research (Avent, Wahesh, Purgason, Borders, & Mobley, 2015; Burkholder, Hall, & Burkholder, 2014; Cook, Hayden, Gracia, & Tyrrell, 2015).

Using content analysis of secondary data, researchers analyzed existing textual data collected from study participants enrolled in the course over four academic terms, for a total of 120 documents (N = 40 students with three documents each). To maintain participants’ confidentiality and to minimize possible researcher bias, all identifying information was removed from the data sources by the first author prior to analysis. Each participant was assigned a numerical identifier linking them to the course section in which they participated. These identifiers were kept in an Excel file that was password protected and was kept away from the rest of the data in order to reduce bias.

Data were analyzed in two phases to identify central themes associated with the participants’ experiences and perceptions with DSLP. First, data corresponding to each of the four foci of the research question were grouped into the following a priori categories: (a) understanding of course content,
(b) understanding of human development in non-dominant groups, (c) perception of self, and (d) a social justice perspective in counseling. During the second phase of analysis, data within each category were coded by meaning units, which was defined as a collection of words, sentences, or paragraphs that referred to a discrete idea. Closely related codes were collapsed into themes. Researchers used NVivo 10 (QSR International, 2012) for the coding process and to calculate interrater reliability statistics.

Trustworthiness

During the study, the researchers engaged in several strategies to ensure the study’s trustworthiness. The research team consisted of the course instructor and a graduate student research assistant who was trained in the research procedures. Prior to the study’s design and again before data analysis, researchers examined their potential biases. As recommended by Rossman and Rallis (2003), researchers engaged in reflexivity through writing, discussing, and revising researcher-as-instrument statements throughout the process. This process was done to bracket the researchers’ beliefs and opinions to ensure that the participants’ voices could be heard fairly and clearly.

Data were collected from documents that participants completed at two different points during the academic term (midterm and end of term), providing the basis of a longitudinal analysis. At the beginning of data analysis, researchers spent several hours coding data together to support shared meaning of codes and ensure credibility of the analysis. Additionally, researchers engaged in peer debriefing of codes and the coding process at weekly research meetings. Within each phase of coding, the researchers calculated interrater reliability statistics in NVivo 10 (QSR International, 2012) to determine the credibility of the analysis. After each coding session, researchers documented their reflections, questions, and ideas in a reflexive journal designed to document decision making related to the analysis. An audit trail was kept ensuring confirmability of the study’s findings.

Interrater Reliability

During each phase of coding, researchers conducted interrater reliability testing using NVivo 10 (QSR International, 2012) to ensure credibility of the coding process. In the first phase of grouping data into four a priori categories for further coding, an interrater reliability test resulted in a kappa coefficient of .68. This outcome is considered a “substantial” benchmark for kappa coefficients by Landis and Koch (1977). During the second phase of coding into emergent categories, the kappa coefficient for data that was coded by both researchers was .96. This is an “almost perfect” benchmark for kappa coefficients (Landis & Koch, 1977). These results demonstrated that raters consistently coded the data in a similar matter and increased the data’s credibility.

Results

The study’s results indicated the level of impact the DSLP experience had on participants’ understanding of course content, understanding of people in non-dominant groups, perceptions of themselves, and what social justice in a counseling context meant to them. For participants, the DSLP experience became a lens to look at the world in a different way and was a primary frame of reference for the course. In this section, results for each of the four a priori categories is reported, including qualitative results from the content analysis, as well as a narrative description of the data’s emergent themes.

Understanding of Course Content

The first a priori category focused on the impact of the DSLP on participants’ understanding of content in the human development course. Content analysis resulted in 374 meaning units that coalesced into two themes: connecting class material and reflections on learning.

Participants articulated coming away with a more complex and nuanced understanding of seemingly straightforward developmental theories because of the DSLP experience. The messiness of lived experience became real in a way participants did not believe the theories always described. For example, one participant stated that the DSLP experience “muddied the overly clear waters of the text’s simplistic approach to the behavior of complex systems. The service-learning project was a much more realistic approach, introducing us to complex systems and their interactions.” The hands-on nature of the DSLP, as well as the real-world context it provided, facilitated learning that participants described as broader, deeper, and more relevant to their professional futures. Participants reported that the class content was more accessible, more understandable, and easier to absorb because of the DSLP experience. One participant stated that the service-learning experience “required me to broaden my scope of what we were learning in the class. The focus can often be narrow in the classroom setting, but we were able to consider the ‘big picture’ in a realistic way because of this project.”

Further, the context provided by the service-learning experience offered the opportunity for critical analysis of class content. Consistencies and inconsistencies between class content and the lives of the people at their DSLP sites became apparent to participants. Many times, students came away realizing the gaps between theoretical models and lived experiences, particularly for people in non-dominant groups. One participant stated that the experience “made me more critical of the dominant views of development presented in our text. . . . While I understand there are certain fundamental human needs, I really believe in thinking about context as much as content.”

Human Development in Non-Dominant Groups

The next a priori category focused on how the experience with the DSLP impacted participants’ understanding of development of people in non-dominant groups. As CP agencies worked with populations outside the dominant culture, the DSLP provided an opportunity for participants to learn about these groups. Data analysis resulted in 291 meaning units in five themes: access to resources, creating community, cultural awareness, cultural differences, and systems of oppression.

Because of the DSLP experience, participants noted better understanding of the challenges a person in a non-dominant group faces when creating or maintaining their identity. Several participants reported seeing community members’ struggles by incorporating a social construct or standard that did not fit with their own cultural experiences. One participant stated, “As an immigrant parent, the stress is likely increased because the ‘outside influences’ are coming from a culture that is at the very least unfamiliar, and at worst, in conflict with cultural values important to the parents.”

Participants observed a strong sense of resiliency in community members as they overcame obstacles to seek out support. Participants identified that engaging in wellness activities and having a sense of purpose and pride in their lives contributed to resiliency for community members. These wellness activities included groups offered at mental health agencies and informal gatherings where stories and experiences were shared. A participant stated that at her DSLP site she witnessed “strength and resiliency with which people can create meaning and community that is not based on dominant cultural values.”

Furthermore, participants witnessed that when faced with conflicts or challenges, community members found support by referring to their own cultural values and norms. A participant stated, “For an immigrant in a new country, believing that there are others around who not only speak the same language, but have the same values and interests can be powerful in promoting feelings of efficacy instead of helplessness.”

Perceptions of Self

The third a priori category focused on how the DSLP experience impacted participants’ perceptions of themselves. Content analysis resulted in 227 meaning units with three themes that focused on working with new populations, their personal role in social justice, and specific work-related skills.

As CP organizations worked with marginalized communities, such as the East African immigrant community and the youth of the Asian and Pacific Islander community, most participants interfaced with communities with whom they had not previously worked. These interactions spurred participant reflection on the similarities and differences between themselves and those with whom they were working. Participants expressed surprise in what they learned about communities new to them, expecting to find more similarities or more differences. One participant stated, “As a first-generation person, I assumed that I could relate to the issues that the families face. However, I learned that their experience here in (location) is much different than the one I had growing up.” Another participant stated, “Although the students that were in the (CP program) may have a different developmental trajectory than me, there were still many similarities between us. Their values and work ethic reflected the same as mine.”

The interaction with CPs and clients through the DSLP provided a lens for participants to see how structural inequities in society impact the health and development of people in marginalized groups. Because of this, participants were better able to see and understand their own privilege, whether that privilege was related to race, gender, socioeconomic status, or educational attainment. One participant stated, “To be able to briefly see through the eyes of another individual who does not have the same background or privilege as I do, I am better able to understand my own privilege.” Another participant stated, “We all have our own biases and stereotypes and maybe even racist ideologies that we need to get rid of.”

Many participants articulated their perspectives on what social justice meant to them personally and how to move social justice goals in society forward. These were general definitions of social justice not specific to how social justice related to counseling. One participant said, “I believe that being an advocate for social justice involves understanding that many factors in people’s lives influence their development, and that not everyone has equal opportunity to environments conducive to healthy development.” Another participant stated, “To me, social justice means recognizing human dignity across social categories and engaging in some way to distribute power more equitably among people.”

A Social Justice Perspective in Counseling

The final a priori category was focused on how engagement in the DSLP experience impacted participants’ understanding of a social justice perspective in counseling. Data analysis resulted in 416 meaning units with three themes: definitions of social justice in counseling, counselor social justice knowledge, and counselor action through advocacy.

Participants articulated what social justice in the counseling sphere meant to them. One participant stated, “In order to successfully incorporate a social justice approach to counseling, socioeconomic status, culture, academic proficiencies and group membership must be considered.” Empowerment was identified by multiple participants as key to social justice approaches to counseling. According to one participant, “Empowering individuals is at the heart of social justice.” Additionally, participants pointed to understanding each client as a whole individual, including their unique social location, as important in counseling from a social justice perspective.

Participants shared new knowledge of recognizing systems that impacted people in non-dominant groups and acknowledging that the external factors of barriers and injustices may play a role in the need for mental health services. One participant said, “A counselor can promote social justice by helping clients identify the foundation of their behavior and understand that their feelings of insecurity are valid.”

Participants identified that a social justice perspective in counseling included a call to advocate for clients. One participant defined advocacy as, “Part of being a therapist who believes in social justice is advocating for and empowering those individuals who feel they have no voice or feel their voice has been extinguished through societal or institutional oppression.” Participants stated that the goal of social justice counseling was, in fact, to strengthen and support the resiliency of their clients who experience challenges brought on by external factors. One person said, “Social justice advocacy seeks not only to fight oppression but to empower individuals and communities that have been historically oppressed to be self-determinant to live lives of meaning and hope through equitable redistribution of resources, power, and opportunities.”

Discussion

The results of this study offer insight about how using service learning in a human development course impacted community counseling students. Because these findings document a shift in understanding the nature of human development in a pluralistic society, they may be useful for counselor educators who teach human development and who strive to prepare counseling students with a social justice perspective.

The Teaching and Learning of Human Development

As a core curricular area of accredited programs, coursework in human development is required for all counseling students (CACREP, 2015). Students who seek to become licensed counselors must demonstrate their mastery of this content area on national exams (NBCC, 2015). Therefore, counselor educators have an obligation to prepare students with this knowledge base. However, universalist theories of human development may not sufficiently explain development of all groups in a society (Broderick & Blewitt, 2015; Henrich et al., 2010). There is growing acknowledgement that often embedded in models are the worldviews of those who developed them (Rogoff, 2003). Counselor educators are called to teach human developmental theory in such a way that students will be able to responsibly apply (or not apply) theories to clients from whom and for whom they were not developed.

This study’s findings demonstrate that service learning provides participants with a deeper and more nuanced understanding of human development course content through its application in real settings. Participants witnessed how theories did not always match the lives of people at their service-learning sites. Further, participants articulated witnessing how systems of oppression negatively impacted the development of marginalized people. These results build on the evidence that the use of service learning can promote multicultural competence (Burnett et al., 2004) and help students be more prepared to move into the professional role of counselor with a more realistic perspective of what the role means (Jett & Delgado-Romero, 2009).

Preparing Counseling Students as Social Justice Advocates

According to the Code of Ethics (ACA, 2014), counselors should be ready to advocate for removing barriers to healthy growth and development, yet specific strategies for preparing students to do so are lacking. Participation in collaborative service learning focused on important issues for marginalized populations facilitates new awareness of what social justice counseling means. The need for counselors to be aware of their own privilege was stated clearly by participants. In addition, being a counselor for social justice also meant advocating for clients at multiple levels. Working with CPs provided opportunities to witness important work in the community and to practice enacting social justice advocacy. The results demonstrate that service learning can be used as a teaching strategy to meet CACREP requirements and to meet the call for using new “structures, requirements, and goals” (Constantine et al., 2007, p. 27) to prepare students as social justice advocates.

Limitations and Future Research

This study’s findings demonstrated that service learning can be used to teach academic content as well as promote students’ understanding of social justice and advocacy. However, limitations are important to note. First, the primary researcher was the course instructor and the co-researcher participated in the class as a student, although data for the co-researcher was not included in the analysis. Although steps were taken to ensure trustworthiness and authenticity, future studies should include an outside researcher to strengthen the methodology. Second, data for the study was drawn from written text. As such, there were no opportunities to ask participants follow-up or clarifying questions. Although content analysis was chosen to examine the participants’ experiences of the DSLP while they were occurring, future studies using interviews or focus groups could provide more sources of data. Third, the current study focused only on the student experience in the DSLP. Although CPs were involved in every aspect of project creation, execution, and evaluation, they were not included in the systematic study of outcomes. Future studies should examine the impact of service learning on CPs, clients, and communities.

Conclusion

The demographics of the United States are rapidly changing, and soon there will be no one majority group (Cárdenas, Ajinkya, & Gibbs Léger, 2011). Continuing to teach monocultural theories is no longer sufficient; it risks further marginalizing non-dominant groups in society. If we were to better understand how different groups and cultures experience development through their own lenses and a shared pluralistic lens, the problem of applying theories to those from whom and for whom they were not developed would be eliminated. Counselor educators should work with CPs and community members to develop, research, and apply culturally appropriate theories of human development. Until that time, counselor educators must use effective teaching strategies that prepare students to work responsibly and competently in a multicultural world. Service learning, as an educational tool for social justice in counselor education, can contribute to meeting this need.

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest or funding contributions for the development of this manuscript.

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Kristi A. Lee, NCC, is an associate professor at Seattle University. Daniel J. Kelley-Petersen, NCC, is an adjunct faculty member at Seattle University. Correspondence can be addressed to Kristi Lee, College of Education, 901 Twelfth Avenue, Seattle, WA 98122, leekrist@seattleu.edu.

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