Research Focused on Doctoral-Level Counselor Education: A Scoping Review

Gideon Litherland, Gretchen Schulthes

 

The aim of this study was to develop an understanding of the research scholarship focused on doctoral-level counselor education. Using the 2016 Council for Accreditation of Counseling and Related Educational Programs (CACREP) doctoral standards as a frame to understand coverage of the research, we employed a scoping review methodology across four databases: ERIC, GaleOneFile, PsycINFO, and PubMed. Research between 2005 and 2019 was examined which resulted in identification of 39 articles covering at least one of the 2016 CACREP doctoral core areas. Implications for counseling researchers and counselor educators are discussed. This scoping research demonstrates the limited corpus of research on doctoral-level counselor education and highlights the need for future, organized scholarship.  

Keywords: scoping review, doctoral-level counselor education, 2016 CACREP doctoral standards, counseling researchers, counselor educators

 

Counselor educators are positioned to be at the vanguard of research, teaching, and practice within the counseling profession (Okech & Rubel, 2018; Sears & Davis, 2003). The training of counselor educators is concentrated in the pursuit of doctoral degrees (e.g., PhD, EdD) in counselor education and supervision. Doctoral-level education of counselor educators is thus critical to the development of future leaders for the counseling profession (Goodrich et al., 2011). Counselor education doctoral students (CEDS) enrolled within programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) engage in advanced training in leadership, supervision, research, counseling, and teaching (CACREP, 2009, 2015; Del Rio & Mieling, 2012). CEDS complete academic coursework, participate in practicum and internship fieldwork, and deepen their professional counselor identity (Calley & Hawley, 2008; Limberg et al., 2013). Upon graduation, it is expected that CEDS are prepared to competently assume the responsibilities of a counselor educator. Counselor educators go on to work in any myriad of roles—professional and business leadership positions, academia, clinical and community settings, and consultation practices across the country (Bernard, 2006; Curtis & Sherlock, 2006; Gibson et al., 2015). It is imperative, then, for doctoral-level education to prepare and deliberately challenge these future counselor educators (Protivnak & Foss, 2009).

Historically, there have been concerns regarding the level of sustainability within the profession and the need for more qualified counselor educators (Isaacs & Sabella, 2013; Maples, 1989; Maples et al., 1993; Woo, Lu, Henfield, & Bang, 2017). Holding the terminal degree for the profession (Adkison-Bradley, 2013; CACREP, 2009; Goodrich et al., 2011), graduating CEDS meet the increasing demands across the country for trainers of a qualified workforce of school, college, rehabilitation, clinical mental health, addictions, and family counselors who can meet the psychosocial well-being needs of a diverse global population. There is an increasing need for counselors in all specialty areas, given recent projections of the next decade from the U.S. Bureau of Labor Statistics (2019). The needs of communities (e.g., criminalization of mental illness; Bernstein & Seltzer, 2003; Dvoskin et al., 2020), training programs (e.g., multicultural counseling preparedness; Celinska & Swazo, 2016; Zalaquett et al., 2008), and public mental health issues (e.g., suicide; Gordon et al., 2020) reflect the urgency for a qualified workforce that can serve clients, students, and a global economy (Lloyd et al., 2010; U.S. Bureau of Labor Statistics, n.d.-a, n.d.-b). Because of the demand for such a workforce, the counseling profession and its institutions must be prepared to educate counselor educators who, in turn, lead, teach, supervise, and mentor future generations of helping professionals. Given these market demands, it is important to consider: To what degree are CEDS being prepared to meet these demands in their post-graduation roles? How are CEDS being prepared to meet such demands? What evidence exists to guide the training and development of CEDS?

Based on available data from official CACREP annual reports, from 2012 to 2018, the number of CACREP-accredited counselor education doctoral programs increased from 60 to 85 (CACREP, 2013, 2019). In the same time period, the number of enrolled CEDS grew from 2,028 to 2,917. The number of doctoral program graduates similarly increased from 323 to 479. This interest and investment in accredited doctoral programs at universities across the country warrants greater research attention to better understand, focus on, and shape the doctoral-level education of future counselor educators. A great deal rests on preparation of future counselor educators as they maintain the primary responsibility for leading the profession as standard-bearers and gatekeepers.

Research on counselor education doctoral study is essential for improving and maintaining the efficacy of doctoral training because CEDS are the future leaders, faculty members, supervisors, and advocates of the profession. A critical step toward facilitating research on counselor education doctoral study is a scoping review (Tricco et al., 2018). Scoping review methodology has previously been used within counseling and mental health research (e.g., Harms et al., 2020; Meekums et al., 2016). Such a review can assist in constructing a snapshot of the breadth and focus of the extant research.

CACREP Core Areas as a Useful Framework for Analysis
     The 2016 CACREP Standards (CACREP, 2015) delineate core areas of doctoral education and provide a meaningful and accessible framework appropriate to assess the state of doctoral-level education and training of CEDS. CACREP develops accreditation standards through an iterative research process that capitalizes on counseling program survey feedback, professional conference feedback sessions, and research within the counseling profession (Bobby, 2013; Bobby & Urofsky, 2008; Leahy et al., 2019; Williams et al., 2012). CACREP publishes updated accreditation standards that are publicly available online, on average, every 7 years (Perkins, 2017). The 2016 CACREP Standards (2015) articulate core areas of doctoral-level education and training in counselor education that align with professional expectations of performance upon graduation. These areas include leadership/advocacy, counseling, professional identity, teaching, supervision, and research. These core areas aim to guide faculty in fostering the development of counselor educator identity and professional competence.

The 2016 CACREP (2015) doctoral-level core areas serve as a professionally relevant framework to examine the extant research addressing doctoral-level education and training of CEDS. Previous research has utilized CACREP master’s-level core areas for content analysis (Diambra et al., 2011). Although much research within the field of counseling and other helping professions addresses the experiences and training needs of master’s-level practitioners, there is seemingly scant published research addressing the education and training of CEDS. To arrive at a clearer understanding of this gap, a framework of analysis (e.g., the 2016 CACREP doctoral-level core domains) is necessary in order to furnish a status report of the current research addressing doctoral-level education and training of CEDS.

Employing the 2016 CACREP (2015) doctoral standards core areas as a frame through which to view the research emphasizes the importance of accreditation and professional counselor identity. Doctoral core areas directly relate to the domain-driven framework employed in this study. In order to achieve a focused understanding of coverage of the CACREP core areas, the framework employed within this study conceptualizes each core area as a domain with two distinct differences: (a) distinguishing between leadership and advocacy in separate domains and (b) inclusion of professional identity as its own domain. The domains of our framework included Professional Identity, Supervision, Counseling, Teaching, Research, Leadership, and Advocacy. By systematically mapping the research conducted in each area of counselor education, we aimed to identify existing gaps in knowledge as a means to focus future research efforts. In this scoping review, the primary research question was “What is the coverage of the 2016 CACREP doctoral standards within the research over the past 15 years?” Research subquestions included (a) How many studies “fit” into each of the doctoral standard domains? (b) What frequency trends were present within the data related to type of research (qualitative, quantitative, mixed-methods)? (c) What publication trends were present within the data related to (i) year of publication, (ii) profession-based affiliation of the publishing journal, and (iii) the publishing journal? and (d) What other foci emerged that were not addressed by the CACREP 2016 doctoral program standards?

Methods

In order to address the primary research question and related subquestions in a systematic way, the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P; Moher et al., 2015) was considered. The PRISMA-P articulates critical components of a systematic review and aims to “reduce arbitrariness in decision-making” (Moher et al., 2015, p. 1) by facilitating a priori guidelines—with a goal of replicability. However, given the general-focus nature of the research question, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR; Tricco et al., 2018) was more appropriate.

The PRISMA-ScR is an extension of the PRISMA-P with a broader focus on mapping “evidence on a topic and identify[ing] main concepts, theories, sources, and knowledge gaps” (Tricco et al., 2018, p. 467). The following steps, or items, of the PRISMA-ScR are described further in subsequent sections, including: primary and sub-research questions (Item 4), eligibility criteria (Item 5), exclusion criteria (Item 6), database sources (Item 7), search strategy (Item 8), data charting process (Item 10), data items (Item 11), and synthesis of results (Item 14). Items of the protocol not specifically listed here are satisfied by structural elements of this article (e.g., title [Item 1] and rationale [Item 3]).

Eligibility Criteria
     For the present study, articles were only considered eligible for inclusion if they had been published in a peer-reviewed journal between 2005–2019. To be included in the study, articles were required to be research-based with an identified methodology (i.e., quantitative, qualitative, mixed-methods), primarily focused on some aspect of counselor education doctoral study (e.g., program, student, faculty, outcomes, process), and published in the English language. Articles were considered primarily focused on counselor education doctoral study if their research questions, study design, and implications directly bore relevance to the scholarship of doctoral counselor education. Excluded from the study were published dissertation work, magazines, conference proceedings, and other non–peer-reviewed publications. Position, policy, or practice pieces; case studies; conceptual articles; and theoretical articles also were excluded. The primary focus of the study could not be outside of counselor education doctoral study.

Information Sources
     To identify articles for inclusion, the following databases were searched: PubMed, ERIC, GaleOneFile, and PsycINFO. We also utilized reference review (backward snowballing) as an additional information source (Jalali & Wohlin, 2012; Skoglund & Runeson, 2009).

Search
     Each database was searched with a specific keyword, “counselor education doc*,” followed by a topical search term. The asterisk (*) was deliberate in the search term to inclusively capture all permutations of “doc,” such as doctoral or doctorate. Search terms were derived from the rationale for the present study and CACREP doctoral core areas. The search terms were: “research,” “empirical,” “counseling,” “doctoral program standards,” “peer-reviewed research,” “CACREP,” “doctorate,” “quantitative,” “program,” “student,” “faculty,” “outcomes,” “process,” “professional identity,” “counseling,” “supervision,” “teaching,” “leadership,” and “advocacy.” Researchers divided the search terms, while maintaining the keyword “counselor education doc*,” and independently ran systematic searches using any eligibility criteria (e.g., inclusive years) that the database could sort. Inclusion criteria, including search terms and keyword, were entered into the search query tool and the results exported. Results from each database search were delineated on a yield list for later screening.

In order to increase methodological consistency among researchers, each utilized a search yield matrix (Goldman & Schmalz, 2004). Results from each researcher’s yield list were organized within the search yield matrix using three fields: article title, authors, and year of publication. This allowed for cleaner comparison of articles and continued identification of duplicates throughout the screening processes. Duplicate entries were collapsed to one citation so that only one entry per article remained, regardless of database origin. Each researcher conducted a preliminary screening of article titles with the inclusion criteria.

Selection of Sources of Evidence
     In order to systematically screen articles and produce a final list for data collection, three levels of screening were conducted for the entire yield. Level 1, 2, and 3 screenings are described in detail below.

Level 1 Screening
     Each researcher scanned their own yield list (duplicates removed). Every citation’s title was examined for preliminary eligibility. Researchers agreed to engage in an inclusive scan of titles and pass articles on to Level 2 screening if they seemed at all relevant to doctoral counselor education. Researchers indicated an article’s fitness for inclusion by a simple “yes” or “no” note on the Level 1 screening instrument. The yield from Level 1 screening was considered adequate for further review and moved on to Level 2 screening.

 Level 2 Screening
     Using the results from the Level 1 screening, each researcher scanned the other’s “for inclusion” list. Each citation’s abstract was examined for eligibility. Researchers indicated an article’s fitness for inclusion by a simple “yes” or “no” note on the Level 2 screening instrument. The yield from Level 2 screening was considered adequate for further review and moved on to Level 3 screening.

Level 3 Screening
     Using the results from the Level 2 screening, researchers combined their lists and consolidated duplicates. Each article’s full text was examined for eligibility by each researcher. Researchers indicated an article’s fitness for inclusion by a simple “yes” or “no” note on the Level 3 screening instrument. In order to avoid bias or influence, each researcher conducted their screening work on a separate document. In reviewing eligibility indicators, researchers sought resolution through discussion, review of eligibility criteria, and assessment of an article’s scholarly focus. This process of Level 1, 2, and 3 screening resulted in a unified list.

Reference Review
     In order to identify potential articles for inclusion that were missed or unintentionally excluded from the search process, researchers conducted a reference review strategy (Jalali & Wohlin, 2012; Skoglund & Runeson, 2009) on the unified list. The reference review consisted of examining the reference section of every article that was selected for inclusion in the unified list. Researchers examined the reference section for relevant titles (Level 1 screening) and endorsed each article according to “yes” or “no” for inclusion. If an article was determined possibly eligible for inclusion, a full-text examination (Level 3 screening) was conducted to determine further eligibility. Any articles determined to be eligible for inclusion were then added to the unified list.

Data Charting Process and Data Items
     In the data charting process, we employed a matrix strategy (Goldman & Schmalz, 2004). Data was collected and organized within a data collection matrix instrument. We created the data collection matrix instrument to organize and focus data collection.

Data items included: year of publication, publishing journal, professional affiliation of publishing journal, type of methodology (e.g., qualitative, quantitative), and domain fitness (i.e., Counseling, Supervision, Teaching, Professional Identity, Research, Leadership, or Advocacy). If other themes were identified that did not fit within the domains, those were noted for later review.

To collect data, we divided the unified list into two halves and then independently charted the data for each citation in the data collection matrix instrument. To determine the professional affiliation of the publishing journal, we reviewed the public-facing website of each journal and reviewed the information available. To determine domain coverage, we reviewed the aim, research question(s), and discussion section of each article and compared the focus of the article to the 2016 CACREP doctoral core area descriptions. For example, if a study focused on the experience of CEDS becoming supervisors, this was coded as “Supervision.” If, however, a study’s aim and research question focused on an area of counselor education doctoral study that was not covered by a domain, then it was coded as “Other Focus.” Researchers discussed articles coded as “Other Focus” and worked to collapse similar foci under broad categories for ease of reporting.

Of note, researchers did not consider articles that utilized CEDS within a sample or participant pool as automatically eligible for inclusion. Studies were only included if doctoral-level counselor education was a key component or focal point of the research inquiry. Every effort was made to ensure study appropriateness for review based on these criteria.

Synthesis of Results
     We analyzed the results after data collection through descriptive statistics and basic data visualization of trends (e.g., frequency, type). We discussed each research subquestion, considered what data best addressed the question, and reviewed data for any trends. Having described the process of the scoping review, the results of the study are presented next according to the preferred reporting items for scoping reviews (Tricco et al., 2018).

Results

Selection of Sources
     A total of 9,798 citations were initially retrieved from the ERIC (n = 1,012), GaleOneFile (n = 327), PsycINFO (n = 1,298) and PubMed (n = 7,161) databases. After an initial review of citation type (e.g., book, white paper) and removal of duplicates, 3,076 articles remained. The Level 1 screening captured 2,599 ineligible articles not meeting the inclusion criteria. Therefore, at the end of the Level 1 screening, 477 citations remained. The Level 2 screening captured 292 ineligible articles that did not meet inclusion criteria, resulting in 185 articles. As researchers combined lists for Level 3 screening and identified duplicates, 185 articles reduced to 123. The Level 3 screening captured 52 ineligible articles that did not meet inclusion criteria, resulting in 71 articles for the unified list. Articles from the reference review yield (n = 9) were screened and added to the unified list. The unified list initially consisted of 80 citations. However, three articles were removed as a result of data cleaning (e.g., text-based differences not previously captured by sorting tool) and/or not meeting inclusion criteria (e.g., inaccuracies in published article’s references). Therefore, 77 articles were selected for inclusion within the present scoping review.

Coverage of CACREP Doctoral Domains
     The results suggested that some trends exist within the literature focused on doctoral study within counselor education. Although there was coverage of each of the 2016 CACREP doctoral standards core areas within the last 15 years, it was quite minimal (see Table 1). Of our 77 identified studies, 39 studies (50.65%) mapped onto the seven-domain framework. This left 38 studies (49.35%) focusing on some other aspect of counselor education doctoral study, discussed further below.

 

Table 1

 

Domain Coverage as Addressed by Year

 

Identified Domain Advocacy Counseling Leadership Professional Identity Research Supervision Teaching Total
n n n n n n n n
Year
2006 0 0 0   0   1   1 0   2
2008 0 1 0   0   0   0 0   1
2009 0 1 0   0   0   0 0   1
2011 0 0 0   0   2   2 1   5
2012 0 2 0   0   0   0 0   2
2013 0 0 0   3   1   0 1   5
2014 0 0 1   0   1   2 0   4
2015 0 0 0   0   0   1 0   1
2016 0 1 0   1   0   2 1   5
2017 1 3 1   3   4   3 2 17
2018 0 1 0   2   1   0 1   5
2019 0 0 0   1   0   0 2   3
Total 1 9 2 10 10 11 8 51

Note. N = 51. Some articles met the criteria for more than one domain; therefore, the stated N is higher than the total number of articles identified. The years 2005, 2007, and 2010 are not included in the above table, as no articles that met the inclusion criteria and the established domains were published during those years.

 

Across the 15 years of literature examined in the current study, 39 studies covered the CACREP domains within our framework, but not necessarily with equal attention by scholars. To respond to the question “How many studies ‘fit’ into each of the doctoral standard domains?” we looked at the frequency of occurrence, per domain, across the 39 studies. Data indicated that Supervision was most frequently covered (n = 11), followed by Professional Identity (n = 10) and Research (n = 10). Domains with less than 10 studies over the 15-year time period included Counseling (n = 9), Teaching (n = 8), Leadership (n = 2), and Advocacy (n = 1). Of note, some articles mapped onto multiple domains during the coding process (see Appendix).

Methodological Trends
     In determining frequency trends related to methodology, researchers analyzed each article’s research questions, method, and results section. Within the 39 domain-covering articles, there was a nearly equal emphasis between quantitative and qualitative research on doctoral counselor education. Of the domain-covering articles, 21 identified a clear quantitative methodology and 17 identified a clear qualitative methodology. Only one study identified a mixed-methods methodology and mapped onto the Professional Identity domain.

Publication Trends
     The results did not indicate any identified trend within the year of publication. With regard to the professional affiliation of the publishing journal, 31 (79.49%) were published within counseling journals, and 8 (20.51%) were in interdisciplinary journals that were either topical (e.g., multicultural education) or methodologically (e.g., qualitative) focused.

Nearly half of the articles (n = 15) were published in Counselor Education and Supervision. The Professional Counselor was the second most frequent journal of publication (n = 5), followed by The Clinical Supervisor, Counseling Outcome Research and Evaluation, and the International Journal for the Advancement of Counselling, which each published two articles over the 15-year period (see Table 2).

The remaining journals—American Journal of Evaluation; Australian Journal of Rehabilitation Counselling; British Journal of Guidance & Counselling; Counseling and Values; Journal of Asia Pacific Counseling; Journal of College Counseling; Journal of Counseling & Development; Journal of Multicultural Counseling and Development; Journal of Rehabilitation, Mindfulness, Multicultural Learning and Teaching; The Practitioner Scholar: Journal of Counseling and Professional Psychology (now: The Practitioner Scholar: Journal of the International Trauma Training Institute); and The Qualitative Report—each only had one published article that covered a domain within the 15-year period.

Other Emergent Themes
     Several themes emerged across the 38 remaining articles that did not address a domain within our framework (see Table 3). These articles focused on some aspect of doctoral counselor education but considered some near-experience or program factor that did not directly link to CEDS’ learning, training, or skill acquisition. The most frequently occurring topics addressed by the scholarly literature were dissertations (n = 6), general student experience (n = 4), and persons of color (n = 4). Other identified themes include: admissions (n = 3), program culture (n = 3), attrition/persistence (n = 2), career planning (n = 2), comprehensive exams – student experience (n = 2), general wellness (n = 2), motherhood (n = 2), problematic behavior (n = 2), international students (n = 1), international students – student experience (n = 1), school counselor educators (n = 1), spirituality (n = 1), wellness in motherhood (n = 1), and workforce issues (n = 1).

 

Table 2

Number of Articles Addressing Domains by Journal

Journal Name n
Counselor Education and Supervision 15
The Professional Counselor   5
The Clinical Supervisor   2
Counseling Outcome Research and Evaluation   2
International Journal for the Advancement of Counselling   2
American Journal of Evaluation   1
Australian Journal of Rehabilitation Counselling   1
British Journal of Guidance & Counselling   1
Counseling and Values   1
Journal of Asia Pacific Counseling   1
Journal of College Counseling   1
Journal of Counseling & Development   1
Journal of Multicultural Counseling and Development   1
Journal of Rehabilitation   1
Mindfulness   1
Multicultural Learning and Teaching   1
The Practitioner Scholar: Journal of Counseling and Professional Psychology (now: The Practitioner Scholar: Journal of the International Trauma Training Institute)   1
The Qualitative Report   1
Total 39

Note. N = 39. Only articles that met the inclusion criteria and covered at least one doctoral
domain are included. 


Discussion

Given the importance of training doctoral-level counselor educators for the profession’s long-term growth and development, the results suggest minimal coverage of the CACREP doctoral standards core areas within the extant research. With little expectation of what we would find, this work is intentionally diagnostic of the current research scholarship focusing on doctoral counselor education. To date, no other scoping review research has focused on doctoral-level counselor education.

     Given that only 39 articles satisfied our criteria, it is important to note that the scope of this review was limited to only research-based published literature. There may be valuable grey literature and scholarship focused on doctoral-level counselor education, but it was not captured within our narrow, predetermined scope. Another possible reason for our results may simply be a function of the profession’s emphasis on master’s-level training within the broader counseling literature. As the entry-level degree for the counseling profession, it comports with expectations that master’s-level training would, therefore, be more represented within the literature. Further, it may be the early developmental stage of the counseling profession that, in part, explains the lack of attention to doctoral-level counselor education. Additionally, the research-to-practice gap within the counseling profession may also explain the minimum coverage of the CACREP core areas within our results. For a detailed discussion of the research-to-practice gap in the counseling profession, see Lee et al. (2014).

 

Table 3 

Number of Articles Addressing Other Foci Beyond Domains

Other Focus    n
Dissertations   6
Persons of Color   4
Admissions  3
Program Culture   3
Attrition/Persistence   2
Career Planning   2
Motherhood   2
Problematic Behavior   2
International Students   1
School Counselor Educators   1
Spirituality   1
Student Experience
    General   4
    Comprehensive Exams   2
    International Students   1
Wellness
    General   2
    Wellness in Motherhood   1
Workforce Issues   1
Total 38

Note. N = 38. Each article identified as having another focus
was only placed into one category.

Domain-Specific Discussion
     Across the domains, there was notably uneven coverage. With the highest occurrence (n = 11), Supervision may be more extensively covered because it is a skillset that is well-emphasized within counselor education and supervision doctoral programs. Supervision, as a professional skillset, also has significant interprofessional interest, relevance, and marketability. Professional Identity (n = 10) as a focus of doctoral-level research makes sense given the past two decades’ emphasis on unifying the profession and the resultant professional discourse around professional identity (Kaplan & Gladding, 2011). As CEDS experience a transition in their identity from practitioner to educator/researcher, professional identity is a natural topic of inquiry (Dollarhide et al., 2013). Similarly, as research skill and identity development have been an important part of the counselor education discourse (Lamar et al., 2019; Okech et al., 2006), it follows that Research (n = 10) would be tied for second in coverage of the CACREP core areas. Counseling (n = 9) was covered within the literature, somewhat surprisingly, more frequently than other domains that are considered foundational to the role of a counselor educator (Okech & Rubel, 2018), such as Teaching and Leadership.

The research covering Teaching (n = 8) and doctoral-level counselor education has received scant attention across the 15-year period. There are likely a few historical factors that have influenced this result. Most notably, doctoral training, specifically of PhDs, has not emphasized teaching, but rather the development of the subject expert (Kot & Hendel, 2012). And although counselor educators consider the training, teaching, and supervision of counselors-in-training to be a critical part of their work, the effectiveness of their teaching preparation remains a critical research topic (Association of Counselor Education and Supervision [ACES] Teaching Initiative Taskforce, 2016; Barrio Minton et al., 2018; Suddeath et al., 2020; Waalkes et al., 2018). Teaching also may not be as robustly covered of a domain in the research because of the historical reliance on other disciplines’ theories, andragogies, and practices or the absence of a collective, focused research agenda (ACES Teaching Initiative Taskforce, 2016).

Finally, although Leadership (n = 2) and Advocacy (n = 1) were covered within the research, the strikingly low occurrences of coverage stand in stark contrast to the profession’s stated values. Leadership is a robust area of scholarship outside of the profession of counseling and it is considered a critical part of doctoral counselor education (Chang et al., 2012). It may be that a significant amount of leadership-focused literature is primarily conceptual or theoretical in nature and thus did not meet the inclusion criteria. The absence in our results of research-driven discourse around doctoral-level leadership is noteworthy for those training the future leaders of the profession. Similarly, though advocacy has been discussed as a critical part of counselor practice (Toporek et al., 2010), it has also received little attention within the doctoral-level counselor education research. One possible reason for the minimal attention could be the seeming devaluation of advocacy within traditional conceptualizations of faculty scholarship (e.g., research, teaching; Ramsey et al., 2002). Perhaps, then, there is a “fitness” issue between professional advocacy skills and job responsibilities.

Other Foci
     These articles (n = 38) focused on some aspect of doctoral counselor education but also considered some element that did not directly link to CEDS’ learning, training, or skill acquisition. This may suggest a general interest in the experience and context of CEDS within the literature that simply did not map onto our scoping frame. The rationale for such non-domain, other-focused research likely lies in the counseling profession’s tacit understanding that education is a holistic endeavor and not solely driven by accreditation (Dickens et al., 2016).

There is value in this research that focuses on other aspects of the doctoral counselor education experience. If the profession is to value the role of accreditation in fostering quality education across the country, then it remains vital to build out a research base that bears relevance to both program accreditation and other variables related to the doctoral experience.

Limitations
     In selecting the methodology for this study, researchers aimed to reduce limitations and increase rigor through the adoption of a protocol. Despite using the scoping review protocol, limitations of this study are evident and worth considering for future replications, particularly related to the search strategy, inclusion criteria, and the stringent focus on counselor education.

In designing the search strategy, researchers limited search terms to the most proximal to the CACREP doctoral core areas. Because of the limited set of search terms used, the search strategy may not have captured an exhaustive list of all eligible citations for inclusion. A possible solution to address this in future studies is the addition of broader spectrum search terms and automated search engines, such as Publish or Perish (Harzing, 2010).

Citations were only included if they were peer-reviewed, research-based articles; no grey literature was included. However, future scoping reviews may consider including grey literature (research-based or not research-based) in order to get a broader understanding of the existing scholarship focusing on doctoral counselor education.

By design, this study focused solely on “counselor education,” to the deliberate exclusion of “counseling psychology,” the profession’s historical cousin within the field of psychology. Counselor education is, however, also a terminology used primarily within the United States, and many countries do not differentiate these fields as distinctly as the United States (Bedi, 2016). As such, the possibility exists that some international articles that may contribute to the conversation on doctoral counselor education have not been captured within this review. Including counseling psychology in future studies may result in a more comprehensive yield, but the education and accreditation differences between the two professions is worthy to note.

Implications for Research
     In the absence of clear parameters to assess our results, we may consider this study as an initial diagnostic baseline in a larger effort to identify knowledge gaps and set shared research agendas (Tricco et al., 2016). Notable in the results is the lack of a sustained scholarship addressing doctoral-level counselor education. As research excellence remains a priority for the counseling profession (Kaplan & Gladding, 2011; Kline, 2003; Wester & Borders, 2014), counseling scholars require strategies to construct a long-term research agenda exploring doctoral-level counselor education and directly informing training. Such strategies may include regular assessments of the scope of the research (such as this study), a community of collaborative researchers, and professional association support and showcasing. In developing a clear understanding of doctoral-level counselor education, researchers may then work toward defining effectiveness, evaluation, and excellence in doctoral preparation. Further, for researchers interested in publishing in this area of scholarship, it may be useful to consider the publishing journal results in order to compare editorial fitness for manuscript publication. All domains considered warrant further attention and scholarly investigation.

Implications for Counselor Educators
     In light of the 39 research-driven articles focusing on doctoral counselor education published from 2005–2019, it is critical to wonder if this is a robust enough evidence base to inform program-wide decision-making for doctoral training programs. For example, in a cursory review of the counseling literature, few published textbooks exist that specifically address doctoral-level counselor education domains, such as teaching (McAuliffe & Eriksen, 2011; West et al., 2013) or research (Balkin & Kleist, 2016) and at-large issues (Flamez et al., 2017; Homrich & Henderson, 2018; Okech & Rubel, 2018). To move beyond adapting master’s-level curriculum for more advanced practice, as may be appropriate for experienced professional counselors, counselor educators require a specific body of literature, tools, and strategies for developing doctoral counselor education programs that meet or exceed CACREP standards.

As doctoral-level preparation has previously been identified as vital for the long-term growth of the profession (Sears & Davis, 2003), doctoral program directors, faculty, and staff would benefit from the development of, for example, a specialized andragogy, professional identity, and best practices for implementation. Such a corpus of research evidence and praxis knowledge of doctoral-level counselor education could inform professional development workshops and resources focused on fostering doctoral student development. The results of the current study suggest an urgent need to address such gaps in our empirical body of evidence for application to counselor education doctoral programs.

Implications for the Counseling Profession
     CACREP, as the accrediting body for counseling programs across the country, assumes the responsibility for setting the standard of professional preparation for doctoral learners. By articulating clear and robust standards for doctoral programs, CACREP advances a framework that aims to produce competent counselor educators. It is essential to consider the extant conceptual, empirical, and experience base. Within this scoping review, findings indicate a seemingly impoverished empirical base covering the domains for doctoral-level counselor education. Other authors have called for further empirical inquiry of the CACREP standards, with particular respect to the evidence base for teaching preparation. In the ACES Teaching Initiative Taskforce (2016) Final Report, the authors wondered, “To what degree do current [2016] CACREP standards capture knowledge, skills, and dispositions needed for effective teaching practice in counselor education?” (p. 36). To extend this question, it may also be asked, “To what degree do the current CACREP standards capture the knowledge, skills, and dispositions necessary to be an effective counselor educator post-graduation?” Additionally, “What empirical base can we draw from to inform our training of future counselor educators?”

CACREP is actively engaged in promoting research on the impact of accreditation and is thus uniquely positioned to encourage focused scholarship to develop a research base for future iterations of the doctoral standards. In order to meaningfully shape and encourage scholarly research, counseling organizations should embrace opportunities for collaboration. Extending cooperative partnerships with professional associations, such as ACES, may prove especially fruitful for CACREP, and the larger counseling profession, in constructing a professional scholarly discourse around research of doctoral-level preparation. Such strategies that could stimulate research focused on doctoral-level preparation in counselor education may include: facilitating research-incubation initiatives; increasing the availability and amount of funding for such research; and the regular publication of briefs, syntheses, or memoranda that promote research-based or empirically driven preparation practices.

Conclusion

If doctoral preparation of counselor educators is to advance in a research-informed way, then the scholarship of doctoral-level training is valuable. Calling for more research is not the final conclusion of this study. Rather, if doctoral-level counselor education is to remain important to the profession, then the profession would benefit from an organized, focused, and high-quality scholarship of doctoral-level training. Doctoral programs, counselor educators, and the profession would benefit from a robust corpus of scholarship that directly impacts decision-making, andragogy, and professional identity development. With minimal research covering the identified doctoral-level domains, an opportunity exists to engage in critical reflection on the existing scholarship and evidence that form the foundational architecture of doctoral-level education within the counseling profession. This research seeks to assist in identifying the gaps in the current body of published research literature on doctoral-level counselor education and inform future research activity.

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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Appendix

Articles and Associated Domain Coverage 

Title Author Year Domains
An Exploration of the Perceived Impact of Post-Master’s Experience on Doctoral Study in Counselor Education and Supervision Farmer et al. 2017 Advocacy, Counseling, Leadership, Professional Identity, Research, Supervision, Teaching
Mindfulness and Counseling Self-Efficacy: The Mediating Role of Attention and Empathy Greason, P. B., & Cashwell, C. S. 2009 Counseling
Perceived Competency in Working with LGB Clients: Where Are We Now? Graham et al. 2012 Counseling
Faith as A Cultural Variable: Implications for Counselor Training Scott et al. 2016 Counseling
Collecting Multidimensional Client Data Using Repeated Measures: Experiences of Clients and Counselors Using The CCAPS-34 Martin et al. 2012 Counseling
Counselor Education Students’ Exposure to Trauma Cases Lu et al. 2017 Counseling
Multicultural Implications of the Influence of Ethnicity and Self-Efficacy for Students and Counselor Educators Maldonado, J. M. 2008 Counseling
Examining the Relationship Between Mindfulness and Multicultural Counseling Competencies in Counselor Trainees Campbell et al. 2018 Counseling, Professional Identity
Critical Readings for Doctoral Training in Rehabilitation Counseling: A Consensus-Building Approach Bishop et al. 2017 Counseling, Professional Identity, Research, Supervision, Teaching
Perceived Leadership Preparation in Counselor Education Doctoral Students Who Are Members of the American Counseling Association in CACREP-Accredited Programs Lockard et al. 2014 Leadership
Mexican American Women Pursuing Counselor Education Doctorates: A Narrative Inquiry Hinojosa, T. J., & Carney, J. V. 2016 Professional Identity
A “Chameleonic” Identity: Foreign-Born Doctoral Students in U.S. Counselor Education Interiano, C. G., & Lim, J. H. 2018 Professional Identity
Professional Identity Development in Counseling Professionals Woo, H., Lu, J.,
Harris, C., & Cauley, B.
2017 Professional Identity
Professional Identity Development of Counselor Education Doctoral Students: A Qualitative Investigation Limberg et al. 2013 Professional Identity
Professional Identity Development of Counselor Education Doctoral Students Dollarhide et al. 2013 Professional Identity
Title Author Year Domains
Fostering Connections Between Graduate Students and Strengthening Professional Identity Through Co-Mentoring Murdock et al. 2013 Professional Identity
Pedagogical Perspectives on Counselor Education: An Autoethnographic Experience of Doctoral Student Development Elliott et al. 2019 Professional Identity, Teaching
Evidence for the Mitigating Effects of a Support Group for Attitudes Toward Statistics Lenz et al. 2013 Research
The Authorship Determination Process in Student–Faculty Collaboration Research Welfare, L. E., & Sackett, C. R. 2011 Research
Understanding the Researcher Identity Development of Counselor Education and Supervision Doctoral Students Lamar, M. R., & Helm, H. M. 2017 Research
Doctoral Counselor Education Students’ Levels of Research Self-Efficacy, Perceptions of the Research Training Environment, and Interest in Research Lambie, G. W., & Vaccaro, N. 2011 Research
Doctoral Research Training of Counselor Education Faculty Okech et al. 2006 Research
Advisory Relationship as a Moderator Between Research Self-Efficacy, Motivation, and Productivity Among Counselor Education Doctoral Students Kuo et al. 2017 Research
Research Training in Doctoral Programs Accredited by the Council for Accreditation of Counseling and Related Educational Programs Borders et al. 2014 Research
Program Evaluation in Doctoral-Level Counselor Education Preparation: Concerns and Recommendations Sink, C. A., & Lemich, G. 2018 Research
International Doctoral Students in Counselor Education: Coping Strategies in Supervision Training Woo et al. 2015 Supervision
A Qualitative Study of Challenges Faced by International Doctoral Students in Counselor Education Supervision Courses Jang et al. 2014 Supervision
Becoming a Supervisor: Qualitative Findings on Self-Efficacy Beliefs of Doctoral Student Supervisors-in-Training Frick, M. H., & Glosoff, H. L. 2014 Supervision
Becoming a Supervisor: Doctoral Student Perceptions of the Training Experience Nelson et al. 2006 Supervision
New Supervisors’ Struggles and Successes With Corrective Feedback Borders et al. 2017 Supervision
A Delphi Study and Initial Validation of Counselor Supervision Competencies Neuer Colburn et al. 2016 Supervision
Supervisee Incompatibility and Its Influence on Triadic Supervision: An Examination of Doctoral Student Supervisor’s Perspectives Hein et al. 2011 Supervision
Examining the Status of Supervision Education in Rehabilitation Counsellor Training Pebdani et al. 2016 Supervision
Student Reflections on the Journey to Being a Supervisor Rapisarda et al. 2011 Supervision
Learning to Teach: Teaching Internships in Counselor Education and Supervision Hunt, B., & Gilmore, G. W. 2011 Teaching
Teaching Competencies in Counselor Education: A Delphi Study Swank, J. M. 2019 Teaching
Structure, Impact, and Deficiencies of Beginning Counselor Educators’ Doctoral Teaching Preparation Waalkes et al. 2018 Teaching
Coteaching in Counselor Education: Preparing Doctoral Students for Future Teaching Baltrinic et al. 2016 Teaching
Observing the Development of Constructivist Pedagogy in One Counselor Education Doctoral Cohort: A Single Case Design McCaughan et al. 2013 Teaching

 Note. N = 39. Only articles that met the inclusion criteria and covered at least one doctoral domain are included.

 

Inspiration for this research stemmed from the completion of a doctoral-level course assignment developed by Dr. Deborah Rubel, an associate professor at Oregon State University. Gideon Litherland, PhD, NCC, CCMHC, ACS, BC-TMH, LCPC, is a core faculty member in the Counseling@Northwestern site of the Counseling Program at the Family Institute at Northwestern University. Gretchen Schulthes, PhD, NCC, LAC, is the Associate Director of Advisement and Transfer at Hudson County Community College. Correspondence may be addressed to Gideon Litherland, 618 Library Place, Evanston, IL 60201, gideon.litherland@northwestern.edu.

 

“They Stay With You”: Counselor Educators’ Emotionally Intense Gatekeeping Experiences

Daniel A. DeCino, Phillip L. Waalkes, Amanda Dalbey

Emotionally intense gatekeeping experiences can require counselor educators to engage in a complicated, time- and energy-consuming, and draining series of events that can last years and involve legal proceedings. Research related to counselor educators’ experiences of intense emotions while gatekeeping remains limited. The aim of this transcendental phenomenological study was to investigate counselor educators’ (N = 11) emotionally intense gatekeeping experiences. Five themes emerged from the data: early warning signs, elevated student misconduct, dismissal, legal interactions, and change from experience. By being transparent about their feelings and challenges regarding emotionally intense gatekeeping experiences, counselor educators may compel other faculty, counselors in the field, and doctoral students to be better prepared for emotional gatekeeping experiences.   

Keywords: gatekeeping, counselor educators, transcendental phenomenological, emotionally intense, experiences

 

Gatekeeping is an important role for counselor educators in order to uphold ethical standards within the counseling profession and to protect clients, students, and faculty (Homrich & Henderson, 2018). Allowing unprepared individuals to become counselors can impede positive client outcomes in therapy and even harm clients (Homrich & Henderson, 2018). The American Counseling Association’s ACA Code of Ethics (2014) defined gatekeeping as “the initial and ongoing academic, skill, and dispositional assessment of students’ competency for professional practice, including remediation and termination as appropriate” (p. 20). In addition, the Council for Accreditation of Counseling and Related Educational Programs (CACREP; 2015) standards require counseling program faculty to follow gatekeeping procedures in line with university policy and the profession’s ethical codes.

Previous researchers have explored gatekeeping procedures (Swank & Smith-Adcock, 2014), gatekeeping policy (Rust et al., 2013), models for evaluating student counselor competence (Lumadue & Duffey, 1999), and problematic student behaviors (Henderson & Dufrene, 2013). Although research has focused on gatekeeping in counselor training, how counselor educators experience emotions tied to gatekeeping practices remains relatively unknown. Faculty who have engaged in some gatekeeping practices (e.g., remediation and dismissal) have reported experiencing strong emotions that may negatively impact the gatekeeping process (Wissel, 2014). Therefore, the purpose of this transcendental phenomenological study was to illuminate counselor educators’ emotionally intense gatekeeping experiences. We defined emotionally intense gatekeeping experiences as multilayered, complex, time-extended events that counselor educators identify as emotionally memorable.

Emotions and Gatekeeping
     In more serious cases, gatekeeping can be a multilayered series of interactions with administrators, university appeals boards, and lawyers (Homrich & Henderson, 2018). Ziomek-Daigle and Christensen (2010) framed counselor educators’ gatekeeping in terms of preadmission screening, postadmission screening, remediation plan, and remediation outcome phases. In many cases, students and educators often proceed through Ziomek-Daigle and Christensen’s linear gatekeeping phases, but in other cases, gatekeeping is non-linear. In these non-linear cases, a student may be dismissed from their program, file an appeal, and be granted re-admittance. In these intense gatekeeping scenarios, a considerable amount of attention, time, and energy are often required of counselor educators. Although Ziomek-Daigle and Christensen’s phases are aimed to promote more structured gatekeeping practices, little is known about what phases, specific topics, or dimensions of counselor educators’ experiences with intense gatekeeping may exist.

A fear of legal consequences as a result of gatekeeping practices can influence counselor educators’ decision making (Crawford & Gilroy, 2013). Homrich et al. (2014) found that gatekeepers experience negative emotions, including fear and apprehension, surrounding student dismissals. Recently, Schuermann et al. (2018) utilized consensual qualitative research to reaffirm counselor educators are fearful of some gatekeeping outcomes (e.g., threats of lawsuits or legal consequences). Despite this potential for negative feelings, little is known about how counselor educators’ emotions may be tied to gatekeeping-related lawsuits and how these experiences are processed and managed.

Gatekeepers can pay an emotional price for gatekeeping students (Gizara & Forrest, 2004). In a collective case study of 12 counseling psychologist site supervisors, participants unanimously expressed that student impairment issues (e.g., when students acted unprofessionally at clinical sites) were the most painful events to confront with supervisees (Gizara & Forrest, 2004). Similarly, participants interviewed in Wissel’s (2014) phenomenological study on counselor educators’ experiences of terminating students for non-academic reasons (e.g., students causing harm to clients during practicum) reported these experiences were uncomfortable because of role dissonance and responsibility. Kerl and Eichler (2005) claimed counselor educators may experience a “loss of innocence” as a consequence of emotionally taxing, isolating, and professionally challenging gatekeeping experiences (p. 83). Kerl and Eichler also stressed that counselor educators should emotionally explore the meaning of their gatekeeping experiences to uncover how these feelings interact with their gatekeeping practices. Unless emotions surrounding gatekeeping are addressed, counselor educators may “remain stuck in a place that holds on to us with powerful and overwhelming emotions” (Kerl & Eichler, 2005, p. 84).

Because gatekeeping can generate intense emotions, counselor educators’ failure to understand and bracket their emotions could result in flawed decision making that serves their needs instead of the ethical codes of the profession (Brear & Dorrian, 2010). Providing specific insights and strategies to help counselor educators become aware of their emotions during intense gatekeeping experiences may help them protect themselves, other faculty, peers, and future clients. Yet, there is currently a lack of depth in our understanding of counselor educators’ emotions related to gatekeeping. Therefore, guided by Moustakas’ (1994) notion that transcendental phenomenological studies should seek to uncover the essential structure of a particular phenomenon, our study sought to answer two research questions: First, what are the common elements of counselor educators’ emotionally intense gatekeeping experiences? Second, what, if any, important insights did counselor educators gain from emotionally intense gatekeeping experiences?

Method

Phenomenological research generates descriptions of experiences that “keep a phenomenon alive, illuminate its presence, accentuate its underlying meanings, enable the phenomenon to linger, and retain its spirit, as near to its actual nature as possible” (Moustakas, 1994, p. 59). Therefore, we chose to use a transcendental phenomenological approach for this study to capture and share the essence of counselor educators’ lived experiences with emotionally intense gatekeeping (Lopez & Willis, 2004). Transcendental phenomenology allowed us to (a) explore how emotionally intense gatekeeping experiences affect counselor educators personally and professionally, (b) bracket our own assumptions about emotionally intense gatekeeping, and (c) understand the common elements of participants’ gatekeeping experiences.

Participants
     Participants qualified for inclusion in this study if they self-reported at least one emotionally intense gatekeeping experience and were currently employed as a counselor educator at a CACREP-accredited institution. Eleven counselor educators participated in this study, representing years of experience between 2 and 37 years (M = 19.8, SD = 11.58). Table 1 provides a snapshot of participant demographics.

 

Table 1

Participant Demographics

Name Gender Race or Ethnicity Rank Degree Major Degree Type Yrs. Exp. CES
Sue Female White Assistant CES PhD     0–5
Rosie Female White, Caucasian Full CP PhD 20–25
Rose Female White, Caucasian Associate CES PhD 15–20
Mike Male Caucasian Full CEs EdD 25–30
Mark Male White Full CES PhD 35–40
Maria Female White, Caucasian Associate CES PhD   5–10
Lila Female Multicultural Full CP PhD 25–30
Frank Male Caucasian Full CES EdD 20–25
Rita Female Hispanic Associate CES PhD 20–25
Herbie Female Asian Assistant CES PhD   5–10
Dan Male White Adjunct CES EdD 30–35

Notes. All participant names are pseudonyms. For gender, race, or ethnicity, participants’ responses were recorded verbatim. CES = Counselor Education and Supervision. CP = Counseling Psychology. PhD = Doctor of Philosophy. EdD = Doctor of Education. Yrs. Exp. CES = Years Working as a Counselor Educator and Supervisor.

 

Recruitment Procedures
     To seek out counselor educators with emotionally intense gatekeeping experiences (Miller et al., 2018), we recruited participants through three purposeful sampling and screening procedures. First, participants were recruited based on their authorship of at least one gatekeeping article published in a journal or magazine that noted their professional experiences with gatekeeping. Four articles addressing the authors’ personal experiences with gatekeeping were identified. Those authors were sent an email inviting them to participate in this study. Second, we used a purposeful sample of accredited counselor education programs listed on CACREP’s official website. This search yielded a total of 880 potential counselor training programs. We generated a stratified sample three times that resulted in three separate batches of 23 programs. Program coordinators were sent emails asking them to share the study invitation with their faculty members who may identify as having one or more emotionally intense gatekeeping experiences. Third, snowball sampling was used by asking all participants to identify other potential participants who fit our criteria for participation. To meet the study’s eligibility requirements, participants were required to (a) be employed at a CACREP-accredited counselor training program; (b) be instructors or adjunct, full, associate, or assistant professors (Schuermann et al., 2018); and (c) have been involved in at least one emotionally intense gatekeeping experience as a counselor educator.

Data Collection Procedures
Semi-Structured Interviews
     After the lead researcher obtained IRB approval, we collected interview data through telephone and Skype interviews. We contacted potential participants with a description of the study, including our definition of emotionally intense gatekeeping, and a copy of the informed consent form. Interested participants responded to our requests via email and the lead researcher scheduled a time to interview them. Semi-structured interview questions were designed from a review of the relevant literature on gatekeeping and our own professional experiences with gatekeeping as counselor educators to gather rich and thick descriptions of the phenomenon (Creswell & Poth, 2018). Interview questions, including “What do you remember most vividly about your emotionally intense gatekeeping experiences?”, were emailed to all participants prior to their interviews. Before audio recording began, all participants created a pseudonym to protect their confidentiality. All interviews were audio-recorded using Garageband. Interviews were between 24 and 45 minutes and were transcribed by Rev.com. Once interviews were transcribed, audio files were deleted.

Letter-Writing Activity
     Once interviews were completed, participants also were invited to complete a letter-writing activity based on their emotionally intense gatekeeping experiences. Letter writing can provide a concrete and lasting record of one’s experiences as opposed to spoken words, which usually disappear after they are spoken (Goldberg, 2000). We used this letter-writing activity to help triangulate the data. The letter-writing instructions asked participants to revisit their emotionally intense gatekeeping experiences, if other prior life events may have influenced their perceptions of gatekeeping, and what, if anything, they learned from these experiences. We received three letters, ranging from 94 to 2,027 words (M = 786).

Data Analysis
     We used Moustakas’ (1994) five-step transcendental phenomenological process to analyze the data. First, prior to reading the transcribed interviews and letters, the research team (composed of all three authors of this article) met and existentially bracketed (Gearing, 2004) their experiences with emotionally intense gatekeeping, identifying biases or presuppositions. Next, we read the transcripts and letters twice independently and began familiarizing ourselves with participants’ experiences. We reconvened to discuss our initial impressions of the data and engaged in horizontalization (Moustakas, 1994), or highlighting and clustering significant statements into groups with similar meaning. Forty-six initial codes were created and grouped into clusters to generate textural descriptions of the phenomena. We met three more times to discuss our emerging themes, reconcile any discrepancies in our analysis, and reach consensus on the findings. In between each meeting, team members independently reflected on the codes and emerging phenomena. We reconvened a fifth time and developed nine larger themes that were organized as textural and structural clusters, or meaning units (Starks & Brown Trinidad, 2007). Through this process of phenomenological reduction (Moustakas, 1994), we refined our themes and identified the crucial elements of participants’ experiences. At this point, two themes were discarded because of inconsistent support and a lack of consensus among the research team. Next, an external auditor, who was a counselor educator with qualitative research experience and numerous publications in counseling journals, reviewed the initial coding and theme construction and provided feedback to the research team. The auditor suggested the removal of one theme and the consolidation of two others. The research team discussed the external auditor’s feedback and incorporated their theme reduction suggestions to help clarify the meaning and representation of the data. Finally, we met one more time to discuss our final five themes and confirmed that our findings accurately represented the essence of participants’ experiences of emotionally intense gatekeeping.

Trustworthiness
     In this study, we used several measures to achieve congruent trustworthiness within the phenomenological research tradition (Flynn & Korcuska, 2018). First, in order to uncover the essence of our experience without completely detaching from the world, we bracketed our prior theories, interpretations, and assumptions of the phenomena through multiple team discussions (Gearing, 2004). To track our discussions during the data collection and analysis phases, the lead author kept a reflexive journal to help us account for our presuppositions and interpret the data accurately. Second, we offered participants a member check of their interview transcripts. Each participant was asked to review their transcript for accuracy and was provided an opportunity to elaborate further on their initial statements. Five participants elaborated on their thoughts to clarify meaning. Third, the lead author kept an audit trail detailing the times and dates of participant interviews, sampling procedures, and member checks, and a summary of the discussions between the researchers (Creswell & Poth, 2018). Fourth, the letter-writing activity yielded another data source to triangulate our findings (Merriam & Tisdell, 2016). Finally, the auditor in this study challenged the research team to revisit our prior assumptions of emotionally intense gatekeeping experiences to ensure monitoring of potential bias.

Reflexivity Statement
     The research team included two counselor educators employed as full-time faculty at two different midsized universities in the Midwest United States, and one graduate student with knowledge of gatekeeping and research experience at the first author’s university. The first author identifies as a White, able-bodied, middle-aged male and pre-tenured counselor educator. The second author identifies as a White, able-bodied, middle-aged male and pre-tenured counselor educator, and the third author identifies as a White, able-bodied, young adult female counseling graduate student. Our main assumptions before starting this study were that (a) emotionally intense gatekeeping experiences elicit only negative emotions from faculty; and (b) discussion of emotionally intense gatekeeping experiences is considered taboo for fear of litigation or unwanted attention. These assumptions stemmed largely from our own experiences as students in counselor training programs. Each of us experienced times when we knew faculty were engaged in gatekeeping. These experiences modeled gatekeeping for us and demonstrated how faculty balance protecting students from peers who may be engaged in problematic behaviors.

Results

We identified five themes from counselor educators’ emotionally intense gatekeeping experiences: (a) early warning signs, (b) elevated student misconduct, (c) student dismissal, (d) legal interactions, and (e) change from experience.

Early Warning Signs
     Most participants (n = 10) discussed behavioral and academic issues with students that, at first, appeared to be fixable through remediation and interventions. During these experiences, participants reported feeling shock, frustration, irritation, and sadness. For example, Rose shared how faculty noticed that a student was making poor choices and how they tried to intervene quickly:

She really had tried to push herself too far, farther than she was ready to go. . . . I just knew the person, in spite of the faculty repeatedly saying don’t push yourself too hard to where you’re not even able to show up at your practicum internship site on a regular basis. They ignored our advice. And when somebody is simply not showing up on a regular basis, that’s behavior that can’t go on.

In other examples, participants shared stories of students exercising poor boundaries. In these experiences, students displayed behaviors that were symptomatic of larger issues that would reveal themselves later. Dan shared:

This student was chronically late, and when the student arrived, instead of just sliding in quietly, the student would make an entrance. . . . After this became a chronic problem, there seemed to be resistance. The next semester was similar, except by now, I could see that the student was being avoided by many of his classmates.

Like Dan, participants discussed a variety of outcomes after their early interventions with students regarding their problematic academic and professional behavior(s). Often counselor educators’ interventions helped students remediate and correct their behaviors. In other cases, students continued to act inappropriately or committed more serious infractions.

Elevated Student Misconduct
     All 11 participants described a more serious student violation after initial warning signs. These violations required a higher level of faculty intervention. In these interactions, participants felt anger, betrayal, and confusion. Sue discussed her emotions and process surrounding discovering her students had cheated:

I had one earlier this year that was very emotionally intense, that affected me personally and professionally, that was around academic honesty and integrity. During one of my classes, I discovered that a group of students cheated on an examination—a group of five out of a classroom of 12, so a very significant percentage. It was really shocking at first. I really did go through the stages of grief now looking back.

For several other participants, more serious violations occurred during students’ practicum or internship courses. Mike described hearing about one student’s ethical violation from their practicum site supervisor: “She has taken it upon herself to recruit individual clients from her group to see on her own, at home!” These events brought out anxiety, despair, and anger in faculty members and required more direct interventions, including direct meetings with students, discussions of students during faculty meetings, or removal of students from a class or courses.

Student Dismissal
     Participants (n = 9) reported feeling many intense emotions in their experiences when dismissing students. Most expressed extreme sadness and frustration with students. Students were usually dismissed after failing to comply with remediation plans (e.g., retaking an ethics course, attending personal counseling) within the time frame allotted. Some remediated students chose to leave the program on their own account. Some participants questioned if they were acting in the best interests of the profession, program, and university. For example, Rose reflected on her personal feelings and professional responsibilities with emotionally intense gatekeeping:

I would say that [gatekeeping experiences] took a lot out of me, emotionally. It was exhausting. Even today, I don’t feel the intensity that I felt at the time. But there’s still emotion. There’s still kind of a sadness and disappointment that we had to have conversations. And certainly, I’m very hopeful that . . . the people who were removed from the program have found something else to do where they can be successful.

Participants’ decisions to dismiss students also impacted them unexpectedly. Lila explained:

Once in a while it’s also very sad because you see people with a lot of potential, good people, that because of what’s happening in their lives might make poor choices. And the sad part is to see somebody with so much potential getting themselves into trouble because of personal issues. And then the investment they have made in their education and all this money they have put into it, it comes to an end because they made poor choices. It’s very sad to see something like this. It stays with you. Those are the things that sometimes will wake me up at three, four in the morning and think, “Ah, I wish things were different.”

Legal Interactions
     Among the most disruptive and emotionally intense phase of many participants’ (n = 7) gatekeeping experiences were legal proceedings. These moments were often physically and emotionally taxing, confusing, and disruptive on personal and professional levels. Participants frequently second-guessed their thoughts and behaviors. Usually this phase started with notification of a lawsuit that was filed on behalf of the student against the faculty, program, or university. Mark shared his feelings after discovering he was one of the primary people named in a lawsuit:

I was the department chair, and I had to deliver the news. I was named in the lawsuit along with the dean, and the Board of Trustees, and one other faculty member. . . . I questioned whether I had done things properly. I felt vulnerable. I felt like that my reputation might be compromised.

Legal proceedings involving participants (n = 6) were jury and judge trials in either civil or criminal court and sometimes generated publicity outside of their institutions. Several participants shared that legal proceedings came with an emotional cost to them and their respective programs. For example, Dan felt emotionally exhausted with his lengthy involvement with the legal system:

Along the way, there was tremendous amounts of angst, and time, and energy, and aggravation spent on this student, and on the trouble that he generated, and the accusations that he was making . . . 12 or 18 months later, we were notified that he had hired an attorney, and that he was going to sue the college. Depositions followed, hours of depositions. Because I was the faculty member that had the most time with him, I was deposed for about a day and a half, where his attorney asked me every imaginable question six different ways from Sunday. It was not a pleasant experience. Anyway, there would be many, many months that would go by without hearing anything, and then we’d be told that, “Okay, we’ve been scheduled for a trial.” Then we get up to the trial and there’d be some continuance, and the can would get kicked down the road again. From the time the student was expelled from the program to deposition, it was four years. From the time of the actual jury trial, it was 10 years.

Most participants were surprised and saddened by students’ efforts to win legal proceedings. Participants were aware of the importance of their legal encounters, yet also unsure how to balance them with multiple professional responsibilities. Lila expressed:

This was a student that was terminated and the student sued, started a lawsuit. . . . The student re-mortgaged their home so they could hire that attorney and take the university to court, take us to court. It was disruptive to our teaching because . . . the trial was happening about an hour and a half away. So we would have to find somebody to cover our class. We would get there, there would be delays, so we would be asked to go again the next day. . . . And we won the case because we had followed the policy and the student had refused to remediate . . . so the student lost their home. I mean it was a really sad situation.

Change From Experience
     All participants in this study shared what they learned from their emotionally intense gatekeeping experiences. In this theme, participants offered advice and wisdom for other counselor educators.

All participants shared that their emotionally intense gatekeeping experiences reinforced their commitment to ethics, program standards, transparency, and fairness. Despite their feelings of guilt and humility resulting from their experiences, participants wanted to be more proactive and clear with their gatekeeping processes. Dan shared:

It was a learning, not just for me, but for our entire faculty that we need to be really clear every step of the way, about who we are as a program, what do we stand for, what expectations do we have? And that when those expectations are in some way violated or are bent, we need to be very clear with the student about what’s going on. And when or if we ever arrive at a place where we see a student who is having this kind of a problem, we need to take action sooner.

Every participant expressed a commitment to engage in future gatekeeping practices more effectively. Several expressed feeling unsure about gatekeeping initially but eventually replaced vacillating feelings with more confidence and greater self-efficacy. Herbie noted:

I think initially there was much more apprehension and dread. Just a lot of uncertainty and a lot of ambiguity about like, okay, how is it going to go? What do I need to say? How can I be clear? How am I wrapping up this conversation and their understanding of the message I’m trying to communicate? Well, at the same time as, you know, like being a counselor, like how can I be like positive and supportive at the same time, which is a hard place to be in when you’re also being the disciplinarian. And I think now because I’ve had many more experiences with gatekeeping, and having those tough conversations, it’s much clearer to me. I go in and I have in my mind a plan that I need to follow.

Nine participants shared how bracketing their personal beliefs, emotions, and opinions of students helped them become more effective and ethical gatekeepers. Frank commented:

I was less aware of my emotional triggers years ago. And realizing that there are lots of different values, beliefs, knowledge, and skills that I bring in that I use to judge a situation. And in doing so I have to remember to bring it into the present. That I have to be able to separate what my values and beliefs, skills, and competencies are and what is expected of the profession, especially as delineated in the code of ethics.

Most participants also discussed how their programs and departments changed as a result of their intense gatekeeping experiences. Changes often occurred at multiple levels. For example, Sue shared, “I tightened my syllabi. I went back through the code. I actually advocated and we re-wrote all of the syllabi for my entire university in grad counseling.”

     All but one participant (n = 10) offered current and future counselor educators advice on emotionally intense gatekeeping experiences. Eight participants specifically mentioned that counselor educators should rely on trusted and supportive colleagues to help navigate emotionally intense gatekeeping. Dan said:

I want to say how critically important it is to make sure that you build a team of faculty, not just for the day when you’re going to have to engage in a gatekeeping process, but for all kinds of reasons. Building a team where there’s real trust, where there’s emotional vulnerability, and where differences about ideas . . . can be addressed is so very important.

In other examples, participants shared how each faculty member in their program developed a role. These roles helped faculty share responsibility with gatekeeping duties while also promoting due process and professionalism. Rosie commented:

We look at [gatekeeping] in a behavioral way, but certainly with a respect for the student’s interpersonal processes and personality style. . . . We’re always good at keeping each other (faculty) accountable. . . . We balance each other out. Then, when we do meet with the student as a faculty, if on one of those occasions we think that is necessary, we take different roles. We decide who’s going to be what person in that process.

Several participants offered tips for working with administrators (e.g., deans, human resource representatives, university lawyers, provosts, presidents), including how faculty may need to explain ethical codes, program policy, and gatekeeping philosophies to them. Lila shared, “Be prepared outside of the department, there are appeals committees. They may see it differently than you and your faculty see it.” Maria offered more proactive advice:

At the beginning of a semester, reach out to deans or upper administration, that, “we are looking to tweak or update our gatekeeping policy; we’d like to run it by you and get your feedback, and we’d also like to run it by legal counsel through university.” And that helps everybody be informed up front, and things tend to go much better when everybody knows what to expect and what our obligations are as gatekeepers.

Finally, all participants talked about ways in which counselor educators and counselor programs can better prepare doctoral students and support early career faculty for emotionally intense gatekeeping experiences. Herbie offered:

[The] messages I received and modeling that I saw were really helpful in me understanding the need for gatekeeping. Because the parameters that were set forth in both my master’s and my doctoral program, were just really clear on what’s okay and what’s not okay. And then having a cohort family . . . and having that support network and being able to talk about experiences that I was observing . . . within a safe container was really helpful.

Discussion

To ensure the counseling profession is composed of qualified, competent, and ethical counselors, counselor educators must gatekeep even if they may experience intense emotions. The emotions stemming from participants’ intense gatekeeping experiences included dissonance, discomfort, guilt, anger, and role confusion, as well as empathy, compassion, and sensitivity for students. These emotions were similar to those reported by participants in other studies (Gizara & Forrest, 2004; Wissel, 2014). Regardless of the type (i.e., professional or academic) and the level of severity of gatekeeping counselor educators experienced, participants’ experiences were persistent and draining. Counselor educators engaged in intense gatekeeping should prepare for exhausting, emotionally layered events that will impact them professionally and personally. In addition, the time-intensive nature of emotionally intense gatekeeping is noteworthy. Several counselor educators reported that numerous years (the longest being 10) were needed for due process (i.e., academic appeals and legal proceedings).

The findings from this study also extend the concept of gatekeeping beyond the boundaries of what happens within a counseling student’s program and institution. Ziomek-Daigle and Christensen (2010) noted that unsuccessful remediation efforts may yield either students leaving their program voluntarily or being dismissed. This study highlights that when students challenge dismissal decisions, the dismissal process can involve legal proceedings that can last for numerous years. Over half of the participants in this study discussed legal encounters of some kind related to intense gatekeeping, and this may indicate that legal encounters related to gatekeeping may be occurring more frequently among counselor educators (Homrich et al., 2014; Schuermann et al., 2018).

Most participants expressed that their gatekeeping experiences fostered their professional growth, but also came with personal emotional costs. Many participants said that their intense gatekeeping experiences unexpectedly affected them personally. Some participants indicated they felt trapped because they could not share details of their emotionally intense gatekeeping experiences with partners, family, or others outside their department because of student confidentiality constraints. This finding aligns with Kerl and Eichler’s (2005) assertion that unless faculty actively take steps to process emotionally intense gatekeeping experiences, the experiences themselves may hold power over faculty until they are properly addressed.

Finally, as a result of their intense gatekeeping experiences, many participants took more preventative and systematic approaches to protect the counseling profession, students, and future clients by preparing for future intense gatekeeping encounters. Participants reported processing their feelings about gatekeeping as well as reassessing individual responsibilities plus program and university polices to better align with the ACA Code of Ethics (2014). Homrich (2009) suggested that faculty, including adjunct instructors and clinical supervisors, should plan for challenges that may arise when gatekeeping students. Multiple faculty stressed that their admissions decision making and criteria for new students were improved as a result of their emotionally intense gatekeeping. For instance, faculty reported recognizing rigid beliefs and concerning behaviors more quickly during admissions interviews and when students were starting their graduate training (Swank & Smith-Adcock, 2014.) Participants also reported how changes in gatekeeping practices at the individual (e.g., confronting problematic behaviors quicker), institutional (e.g., discussions with provosts and deans about professional ethics and gatekeeping practices), and professional (e.g., publishing articles) levels often took time and focused effort to change perceptions among stakeholders and others connected to their programs.

Implications for Counselor Educators and Counselors
     Based on our findings, we noted several implications for counselors and counselor educators. First, counselor educators should consider how doctoral training programs can facilitate learning related to emotionally intense gatekeeping experiences that include discussion of students’ potential emotional reactions to gatekeeping. Doctoral students may benefit from more transparency among current counselor educators in discussing their emotionally intense gatekeeping experiences. Discussions may help normalize how maintaining professional relationships with students and navigating intense emotions can be useful learning experiences during their doctoral training. Doctoral student gatekeeping training may inadvertently create dual relationship conflicts between master’s students and doctoral students if there are pre-existing relationships. Although a faculty mentor’s sharing of a student’s gatekeeping context may help doctoral students learn, faculty should balance this with the need to maintain the student’s confidentiality (Rapp et al., 2018).

Furthermore, more mentorship for future and beginning counselor educators regarding emotionally intense gatekeeping experiences may help alleviate adverse feelings. Departmental discussions of gatekeeping policies, a culture of openness, and mentorship from senior faculty (Homrich, 2009) can help reduce feelings of isolation, anger, sadness, betrayal, and other negative emotions for future and inexperienced faculty. Over half of participants mentioned mentorship from experienced faculty as support that helped them manage feelings of stress, anxiety, and fatigue during emotionally intense gatekeeping experiences. In addition, several participants in this study, regardless of prior experience with emotionally intense gatekeeping, sought consultation and comfort from other faculty within their departments. Counselor education programs should have a designated mentor for faculty who may feel overwhelmed with an emotionally intense gatekeeping experience and keep open lines of communication for all faculty (Homrich & Henderson, 2018). Of note, two participants expressed that they were aware of colleagues at other institutions who were unable to find encouragement and mentorship while imbued in intense gatekeeping, and those faculty either found other jobs or left the profession entirely.

Third, participants in this study experienced challenging and intense emotions surrounding legal proceedings. Counselor educators and clinicians should consider that lawsuits related to gatekeeping, impairment, and professional competence are on the rise (Schuermann et al., 2018). Counselor educators and counselors in the field should be better prepared for lawsuits and retain legal counsel, consult with colleagues, utilize personal counseling, and take other protective and therapeutic measures (Gaubatz & Vera, 2002). In addition, counselor educators and counselors may want to utilize self-care strategies to help bracket and monitor their emotions to allow for clear thinking and more ethical and intentional decision making if confronted with a lawsuit (Dugger & Francis, 2014).

Limitations
     This study has three limitations. First, only three participants had less than 10 years of experience. Because perspectives, practices, and philosophies on gatekeeping can differ with experience (Schuermann et al., 2018), early counselor educators may have different experiences of emotionally intense gatekeeping. Second, only one participant in this study identified as an adjunct instructor. As institutions of higher education increase the number of their courses taught by non–tenure-track faculty, perspectives from adjuncts, lecturers, instructors, and other non–tenure-track training professionals, who are held to the same ethical standards and gatekeeping expectations, may be warranted. Likewise, site supervisors can play a vital role in the gatekeeping process and their perspectives on gatekeeping are important as well. Finally, given the complex and ongoing nature of emotionally intense gatekeeping experiences reported by participants, another data source (e.g., follow-up interviews) and more letters from participants might have provided a more thorough understanding of emotionally intense gatekeeping experiences.

Implications for Future Research
     This study was a first step in describing counselor educators’ emotionally intense gatekeeping experiences. Researchers of future studies might explore faculty groups’ collective emotionally intense gatekeeping experiences through focus groups. More understanding of how counselor education programs collect and document student information, make gatekeeping decisions, develop gatekeeping policies and procedures, and rely on gatekeeping-related ethical codes and standards are needed. Additionally, insights from adjunct instructors and clinical site supervisors who have experienced emotionally intense gatekeeping or students who have successfully completed remedial plans may provide unique perspectives on gatekeeping. Understanding how students navigate remediation plans and their emotional reactions to them may inform counselor educators and the profession as to what matters most to students and how to better reach them (Foster et al., 2014). Similarly, site supervisors often have more knowledge of students’ work with clients than counselor educators and may be an underutilized resource in gatekeeping practices. Finally, more research on counselor educators’ experiences with legal proceedings are warranted. Although several legal cases have generated considerable attention (see Plaintiff v. Rector and Board of Visitors of the College of William and Mary, 2005; Ward v. Wilbanks, 2009), this study seems to be the first that qualitatively explored counselor education faculty members’ experiences specifically with legal encounters. How counselor educators balance lawsuits and professional responsibilities, the prevalence of lawsuits against counselor education faculty for gatekeeping practices, and counselor educators’ levels of legal preparedness are rich topics for future study.

Conclusion

In conclusion, findings of this transcendental phenomenological study reveal the intense emotions counselor educators may experience when gatekeeping. In support of others’ research (Kerl & Eichler, 2005; Wissel, 2014), participants felt intense emotions such as anger, sadness, frustration, and vulnerability, as well as empathy for the affected students. Emotionally intense gatekeeping experiences seem time-consuming, usually involving multiple faculty members and administrators, as well as sometimes requiring legal counsel. The findings reveal how faculty should moderate their emotions and uphold ethical standards while engaging in emotionally intense gatekeeping. Finally, emotionally intense gatekeeping experiences can inspire counselor educators to revise their program policies, syllabi, and approaches to gatekeeping practices.

 

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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Daniel A. DeCino, PhD, NCC, LPC (Colorado), is an assistant professor at the University of South Dakota. Phillip L. Waalkes, PhD, NCC, ACS, is an assistant professor at the University of Missouri–St. Louis. Amanda Dalbey, MA, graduated from the University of South Dakota with a master’s degree in clinical mental health counseling. Correspondence may be addressed to Daniel DeCino, 414 E. Clark St., Vermillion, SD 57069, daniel.decino@usd.edu.

Gaining Administrative Support for Doctoral Programs in Counselor Education

Rebecca Scherer, Regina Moro, Tara Jungersen, Leslie Contos, Thomas A. Field

Initiating and sustaining a counselor education and supervision doctoral program requires navigating institutions of higher education, which are complex systems. Using qualitative analysis, we explored 15 counselor educators’ experiences collaborating with university administrators to gain support for beginning and sustaining counselor education and supervision doctoral programs. Results indicate the need to understand political elements, economical aspects, and the identity of the proposed program. Limitations and areas for future research are presented.  

Keywords: counselor education and supervision, doctoral, university administrators, counselor educators, support

 

The Council for Accreditation of Counseling and Related Educational Programs’ (CACREP) 2009 CACREP Standards (2008) included a new requirement for core faculty in both entry-level (i.e., master’s) and doctoral programs. This requirement endured in the 2016 CACREP Standards (2015). Although West et al. (1995) predicted the necessity of growth of CACREP-accredited doctoral-level counselor education programs in the mid-1990s, it was not until 2013 that core faculty in all CACREP-accredited programs were required to possess doctorates in counselor education and supervision (CES; or be grandfathered in from previous employment experience; CACREP, 2008). Master’s-level programs that are seeking new CACREP accreditation, as well as existing programs that are seeking to maintain accreditation, must therefore hire faculty with doctorates in CES. This requirement has created a need for greater numbers of doctoral graduates in counselor education, and institutions with master’s-level programs may be seeking to establish new doctoral-level programs to meet this need.

The creation of a doctoral program requires intricate navigation of complex systems of administration, accreditation, funding, laws, facilities, infrastructure, and politics. Additionally, universities have different requirements and levels of approval for new program development (S. Fernandez, personal communication, November 27, 2017). Counselor educators proposing a CES doctoral program must have an understanding of the complexity of the specific university (e.g., its organization, the history of university support for doctoral programs, the mission of the institution, the needs of the surrounding community, and the resources required for program development and implementation). Furthermore, counselor educators must have a firm grasp of accreditation standards for both the university’s regional accreditation bodies (e.g., Commission on Colleges of the Southern Association of Colleges and Schools), as well as specialty CES accreditation through CACREP.

Structure of Universities
     The hierarchical structure of universities varies from institution to institution. In this section, we provide a general outline of how universities are structured to help counselor educators who are interested in proposing a CES doctoral program. This information is very important when considering how to advocate for a doctoral program because of the many organizational layers and levels associated with an institution.

Typically, counseling programs are housed in a department, college, or school of the university (e.g., College of Education). The program is led by a program head, coordinator, or department chair. This person reports to the dean of the college. The dean reports to the provost or chancellor or chief executive officer. The president of the university then supersedes this level.

It is important for faculty members to assess the priorities of their institution for academic, student, and financial affairs. For example, a small private college in an urban area may have a mission to train adult learners and to provide access to education through lower admissions standards and flexible pathways to degree completion. In contrast, a large, public, research-intensive university may have a mission to support exceptional research and secure external grant contracts, and to raise college rankings through metrics such as low acceptance rates (The Carnegie Classification of Institutions of Higher Education, 2019). Based on administrative experience with doctoral program creation, structural information must be taken into consideration when advocating to administrators on behalf of CES doctoral program development.

Successful Initiation of Doctoral Programs
     In the higher education literature, there are a few publications on the creation of doctoral programs. Researchers have proposed that doctoral programs can be successfully initiated in the context of three circumstances: (a) top-down initiation, (b) filling a need in the local area, or (c) focusing on new delivery methods (Brooks et al., 2002; Haas et al., 2011; Slater & Martinez, 2000). In regard to top-down initiation, some authors have proposed that doctoral programs are likely to be launched if the initial idea comes from the provost or president of the university. Slater and Martinez (2000) described the process of successful initiation of a doctoral program in a small institution in Texas. They reported that the president suggested the idea to the dean, with later onboarding of faculty members.

Doctoral programs also seem to be initiated successfully if a need exists for such a program in the local area (Brooks et al., 2002; Haas et al., 2011). Haas and colleagues (2011) emphasized the importance of faculty members and administrators assessing program fit within the region. In both the Brooks et al. (2002) and Haas et al. (2011) studies, the importance of current delivery modalities in successfully recruiting support for a doctoral program, including the use of online delivery and interdisciplinary studies, was presented.

Rationale and Purpose
     At the time of writing, no studies could be identified in the CES literature regarding how to successfully gain administrative support for starting a doctoral program in CES. Another manuscript in this special issue (Field et al., 2020) illustrates a potential pipeline problem in counselor education, in particular the need for more CES doctoral programs in the North Atlantic and Western regions of the country. CES faculty members who are contemplating starting a CES doctoral program currently have little guidance on how to gain support for starting a program. In addition, no studies could be located regarding how to successfully sustain an existing doctoral program in CES. The purpose of this study was to collect and analyze qualitative data to address the research question guiding this study: Which strategies are helpful in gaining initial and ongoing support from administrators for a CES doctoral program, and how successful are those?

Method

This study was conducted as part of a larger basic qualitative study sampling counselor educators. The purpose of the larger qualitative study was to identify perceptions of doctoral-level counselor educators regarding four major issues pertinent to doctoral counselor education: (a) components of high-quality programs, (b) strategies to recruit and retain underrepresented students, (c) strategies for successful dissertation advising, and (d) strategies for working with administrators. In order to explore these four major issues, four research teams were assembled, one of which included the authors of this manuscript. All four coding teams worked together to select these four issues, as it was felt that these issues were most pressing for faculty who were seeking to establish new doctoral CES programs and that little information and guidance existed in these areas. In-depth interviews were then conducted with doctoral-level counselor educators in CACREP-accredited programs to answer a series of research questions that addressed the issues above. Faculty from CACREP-accredited programs were selected because the focus of the larger project was to support faculty who intended to seek CACREP accreditation for new doctoral CES programs.

In the basic qualitative tradition, qualitative data were collected, coded, and categorized using the constant comparative method from grounded theory methodology (Corbin & Strauss, 2015; Merriam & Tisdell, 2016). Basic qualitative designs involve the collection and analysis of qualitative data for the purpose of answering research questions outside of other specialized qualitative focus areas (e.g., developing theory, understanding essence of lived experience, describing environmental observations). Because we were not seeking to develop theory, understand lived experience, or research any other specialized qualitative focus area with this study, and because the research question did not require a specialized approach to data analysis, the large research team selected the basic qualitative approach described above.

Each coding team designed interview questions to directly answer their specific research question. The research questions explored in this study were as follows: Which strategies are helpful in gaining initial and ongoing support from administrators when seeking to start a new doctoral program in CES, and how successful are those? The interview questions that were developed and used as the basis for data collection for this study were: 1) What guidance might you provide to faculty who want to start a new doctoral program in counseling, with regard to working with administrators and gaining buy-in? and 2) What guidance might you provide to faculty who want to sustain an existing doctoral program in counseling with regard to working with administrators and gaining ongoing support?

Participants
     Participants met two inclusion criteria for entrance into the study: (a) current core faculty members in a doctoral CES program that was (b) accredited by CACREP. Email requests were sent to 85 CACREP-accredited programs; faculty from 34 programs responded (40% response rate). Interviews were conducted with 15 full-time faculty members at CACREP-accredited CES doctoral programs. Participants were each from separate and unique doctoral programs, with no program represented by more than one participant.

The 15 participants were selected one at a time, using a maximal variation sampling procedure to avoid premature saturation (Merriam & Tisdell, 2016). The authors used maximal variation to understand perspectives from faculty of diverse backgrounds who worked at different types of institutions. Participant selection was predicated on six criteria grounded in research data about factors that may impact perceptions about doctoral program delivery: (a) racial and ethnic self-identification (Cartwright et al., 2018); (b) gender self-identification (Hill et al., 2005); (c) length of time working in doctoral-level counselor education programs (Lambie et al., 2014; Magnuson et al., 2009); (d) Carnegie classification of university where the participant was currently working using The Carnegie Classification of Institutions of Higher Education database (Lambie et al., 2014); (e) region of the counselor education program where the participant was currently working (e.g., Field et al., 2020), using the regional classifications commonly applied in the counseling profession; and (f) delivery mode of the counselor education program where the participant was currently working, such as in-person or online (Smith et al., 2015). As an example of this procedure, the first two participants were selected because of variation in gender, years of experience, and Carnegie classification. The third and fourth participants were selected on the basis of differences from prior interviewees with regard to ethnicity and region. Interviews continued until data seemed to reach saturation and redundancy at 15 interviews.

Although unintended, participant characteristics closely approximated CACREP statistics for faculty characteristics. The demographics of counselor educators in the sample was 73.3% White (n = 11), with 73.3% (n = 11) of participants working at research-intensive (i.e., R1 and R2) institutions. The sample was highly experienced, with an average of 19.7 years (SD = 9.0 years) as a counseling faculty member, with a range of 4 to 34 years. More than half of the participants (n = 9) had spent their entire career in doctoral counselor education.

Procedure
     The last author of this manuscript sought IRB approval. Once we received IRB approval, potential participants were contacted from 85 CACREP-accredited programs with doctoral-level graduate studies in CES. Fifteen faculty were interviewed based on maximal variation sampling described above. All but one participant (n = 14) was interviewed via the Zoom video conference platform, chosen because of its privacy settings (i.e., end-to-end encryption). Interviews were recorded using the built-in Zoom recording feature. One participant was interviewed in person at a national counseling conference. This interview was recorded using a Sony digital audio recorder.

Interview Protocol
     Each videoconference interview was begun by collecting demographics and informed consent. Following the introductory phase, interviewees were asked eight questions that addressed the research questions of the larger study. Two of the questions were specific to this sub-research team. Interview questions were developed using Patton’s (2015) guidelines to inform question development. Specifically, the questions were open-ended, neutral, avoided “why” questioning, and asked one at a time. The questions were piloted with peer counselor educators prior to the start of the research project in order to get feedback on clarity and ease of answering. Participants received the questions by email before their scheduled interview. The participants were identified using alphabetical letters to blind participant identity to all members of the research team.

Each semi-structured interview lasted at least 60 minutes, during which participants responded to questions that were evenly distributed among the four research teams. Participants were therefore able to respond to interview questions with significant depth. Data did not appear saturated until 15 interviews had been conducted. Each research team was asked to review the transcripts developed from the 15 interviews to deduce whether adequate saturation had been achieved and until consensus was reached.

Transcription
     All interview recordings were transcribed by graduate students. These students had no familiarity with the interviewees and were trained in how to transcribe verbatim. Once completed, each transcript was sent back to the interviewees to ensure accuracy. After all interviewees checked their document, the sections of the transcripts with the questions related to each team were copied and pasted into a document organized by the participants’ alphabetical identifiers. Each team was responsible for coding and analyzing the responses to their respective questions from the interviews.

Coding and Analysis
     The first, second, third, and fourth authors served as coding team members. The fifth author conducted the interviews as part of the larger study and assisted with writing sections of the methodology only. The demographics of the coding team were as follows. Team member ages ranged from mid-30s to 40s. All four identified as White cisgender females. Two of the coding team members were employed as full-time counselor educators, one identified as an administrator and counselor educator, and one coding team member was completing doctoral training as a counselor educator. Two participants had worked in doctoral counselor education programs, and two had not. We have served on both sides of the faculty–administrator relationship. These differences in backgrounds allowed for both etic and emic positioning pertinent to the topic of working with administrators to start and sustain doctoral programs in CES.

Because of the nature of both insider (emic) and outsider (etic) perspectives, the authors used a memo system when coding the manuscripts. This memo system involved three components. First, we created a blank memo every time a transcript was coded. Second, each time an interviewee’s transcribed response provoked some response within one of us, we raised it to the group and reflected on our individual experience. This response was documented in a memo. Third, one of us took notes to bracket any biases that might have been present. Identified biases often stemmed from our own experiences as faculty members talking to administrators, our service in an administrative role, or our own personal experiences developing doctoral programs. This occurred during joint coding team meetings and individual coding meetings once the open coding had been solidified into a set of codes. The memos were kept in a shared, encrypted, electronic folder for later review.

The following steps were followed by the coding team in the current study to ensure trustworthiness of analysis. The four coding team members jointly coded the first three participant transcripts to gain consensus. Following this open coding process, the second author condensed the open codes for the next phase of analysis. The coding team members then reached consensus on the condensed codes. Following agreement, we used the condensed codes to continue the coding process for the next two transcripts in joint coding meetings. This process allowed for discussion to assist with consistent understanding of the codes across the team. Following the joint open coding of the fifth transcript, the remaining 10 transcripts were assigned to one of us for open coding to be completed independently. After the open coding process was completed, the fourth author proposed a framework of the emerging themes. She examined the open codes and considered discussions that emerged throughout the team process to identify the emergent themes from the data. Open codes were only included in the analysis if they emerged in at least four transcripts, which resulted in the removal of three codes from the final results. All team members reached consensus for the themes that were originally identified by the fourth author.

Results

The data analysis process resulted in three emergent themes regarding strategies for gaining initial and ongoing support from administrators for CES doctoral programs and the level of success of those strategies. The three themes were political landscape, economic landscape, and identity landscape. Each theme had five associated subthemes. Each theme and subtheme are discussed in more detail below, and brief participant quotes are inserted to highlight the experiences of the participants in their own words for the purpose of thick description (Merriam & Tisdell, 2016).

Political Landscape
     Considering the political landscape appeared to be a crucial strategy for recruiting administrative support when having conversations with administrators about CES doctoral programs. Participants described the importance of understanding the context of conversations with administrators within the larger political system of higher education institutions. The subthemes represented factors that influenced political decisions.

Political Endeavor: “Watching Your Politics”
     Participants reported that conversations with administrators were highly political in nature and having these conversations was a form of political endeavor. One example of political endeavor was to ensure that other academic units and programs were in support of a CES doctoral program. As one participant stated, “First make sure that you’ve got your politics in order, so social work agrees with you and psychology agrees with you. So, you’ve got support of any competitor on campus.” If other academic units or programs are opposed to a CES doctoral program, it may result in administrators being cautious about supporting the program because of fears that they may be caught in the middle of a turf battle.

Gaining administrative support seemed to be predicated on the ability to “strategically build relationships” with administrators, as one participant put it. One participant commented on the complexity of developing these relationships with administrators. This participant believed that faculty needed to strike a balance of being flexible and adaptive to the administrators’ agenda and “order of the day,” while also retaining one’s “own ideology and belief systems.” Building relationships with administrators also seemed to involve avoiding unnecessary conflict that may reduce administrator support for faculty ideas. One participant cautioned that “watching your politics” and “keeping your mouth shut when you know you shouldn’t be speaking up against key administrators” was important during conversations with administrators to avoid unnecessary conflict that could “hurt your own doc program.” Learning this form of engagement seemed to be a struggle for some participants. One participant stated that they “don’t know how to navigate those conversations effectively” and felt “saddened and frustrated” as a result.

Status, Prestige, and Recognition: “A Huge Feather in One’s Cap”
     Participants conveyed that CES faculty could gain administrative support through the strategy of arguing how a doctoral program could enhance status, prestige, and recognition for an institution. One participant commented that “all university presidents want doctoral programs. They want them because of the prestige.” This participant elaborated that faculty should therefore “show them how doctoral programs bring recognition, how it raises you in the rankings, and all of those kinds of things.” Some participants noted that the degree to which administrators cared about enhanced status, prestige, and recognition depended on the type of institution. For example, administrators who work at an institution that is less concerned with college rankings may be unpersuaded by the potential for enhanced status and recognition.

Participants also encouraged CES faculty to strategically engage in actions that increase recognition for the program and university. Some potential strategies that may appeal to administrators include being “identified as an expert, and to go out and do public radio broadcasts and be featured in the newspaper. Be featured in national publications.” This recognition helps with both program and university visibility, which participants believed was important to administrators. Participants also shared that visibility can help to protect the program from losing administrative support. As one participant stated, “If you’re invisible in the eyes of the administrators, they’re not going to think of you if some opportunities are coming to the fore.” This participant further commented that administrators needed to be reminded of the doctoral program through continual visibility efforts, as administrators often operate from an “out of sight, out of mind” position.

Demonstration: “Wanting Empirical Evidence”
     Participants identified the strategy of sharing evidence with administrators to support and sustain doctoral programs. As one participant stated, “Once you get to the doctoral level, then we’re talking about people wanting empirical evidence.” In the early stages of program formation, this evidence might be a comprehensive proposal that is supported by data. As one participant stated, faculty need to develop a “solid plan” and be “as prepared as possible” for conversations in which administrators will “ask a ton of questions.”

Once a program is formed, it seems crucial that programs continuously provide updates to administration about program successes to sustain administrative support. Participants identified several approaches to demonstrating the success of a program. Some participants indicated that it was important to keep administration informed about student successes that occurred during doctoral study. One participant reported that their program kept administration informed via email about “every little success of the doctoral program” and provided the following examples: “Every time somebody successfully defends a dissertation, every time somebody presents at a conference, every time somebody gets a job congratulated, the president knows about it.” Other participants believed that it was helpful to report program outcomes such as graduation rates and employment statistics, which requires faculty to maintain contact with alumni to understand where they are working after graduation. It therefore seems possible that administrators may differ in which types of evidence they value, requiring faculty to carefully consider which information their administration most values when sending them updates of program successes. As one participant stated, “I think the question is, what information do you need to feed to administration to be convincing?”

Scrutiny: “Internal Credibility Is Super Important”
     Participants reported that program faculty should understand the different ways that administration will scrutinize the credibility of a doctoral program. One participant defined credibility as, “Do what you’re doing well.” Administrators might withdraw support for a program that is perceived as not producing quality graduates or has problems such as not graduating students. Administrator scrutiny of the program’s financial situation also appears to be an important consideration. Administrators who are concerned about the financial viability of the program may withdraw their support.

Timeline and Trajectory: “It’s a Long Journey”
     Participants reported that political decisions, such as starting and sustaining academic programs, particularly doctoral programs, may be influenced by unique timelines and trajectories. Participants encouraged faculty to develop the strategy of thinking long-term about cultivating administrative support for a doctoral program. One participant emphasized the need to “work together” with administrators in a collaborative fashion and make compromises so that administrators will support the doctoral program throughout the “long haul” and “long journey” of the program.

The length of administrator tenure at the university is another factor that faculty are advised to consider. One participant stated that faculty tend to have longer tenure than administrators at their university. As a “lifer,” this participant saw “a lot of rotation in and out of leadership.” Administrator turnover can result in changes to administrative priorities and agendas, which can impact support for a CES doctoral program. This participant encouraged faculty to “be cognizant of the fact that winds change.” 

Economic Landscape
     Considering the economic landscape and economic realities of starting and sustaining a doctoral program was the second main overarching theme. Developing an understanding of the economic landscape is important context for faculty when preparing for discussions with administrators. Several subthemes comprise the economic landscape, each detailed below.

Financial Aspects: “It Takes a Lot of Money”
     Of utmost importance when discussing starting and sustaining CES doctoral programs with administrators is understanding the financial resources required. Many participants spoke about the cost of CES doctoral programs for universities. Participants believed that a crucial strategy to gaining administrator support was being able to explain how programs can be at least revenue-neutral or even generate revenue for the university, as administrators are less likely to support a CES doctoral program that is a drain on financial resources.

Participants varied in their perceptions of whether CES doctoral programs could generate revenue for the university. The key distinction between these participants seemed to be whether they believed doctoral programs should charge students tuition or fully fund them. Some participants believed that “high-quality doc programs do not make money for institutions” because they should be fully funding doctoral students rather than generating tuition revenue. These participants proposed that faculty should instead be “thinking creatively about funding sources” and seeking alternative methods of offsetting the financial burden on the institution. Examples of identified alternate funding sources included grants and undergraduate teaching opportunities for doctoral students.

Others were aware of this prevailing belief that doctoral programs do not generate revenue and argued the opposite: “Most faculty, when they want to start a doctoral program, they repeat this thing that they hear, which is ‘doctoral programs cost money, they don’t make money.’ And that’s not true.” These participants proposed that student tuition should be used to fund doctoral programs. One participant argued that if tuition exceeded the cost of faculty salaries, the program was likely to be generating revenue. This participant believed that counseling programs could generate money because they were relatively inexpensive. Unlike hard science disciplines, CES doctoral programs do not require expensive lab equipment, and CES faculty salaries are “lower compared to other programs.”

Tangible Benefits to Ecosystem: “How Do We Help?”
Participants discussed that administrator support for a doctoral program can be bolstered through demonstrations of how the program is supporting the local community. One participant shared that their program provides data to administrators about the number of hours of free counseling that the program provides to the community, which in turn helps the dean to gain the provost’s support for the program. Such data can help administrators when they conduct a cost–benefit analysis for whether to start a new program or sustain an existing program. Likewise, another participant encouraged faculty to take an “ecological view” and consider “how do we help . . . the surrounding communities?” 

Need for Resources: “Pit Bulls in a Fighting Ring”
     Participants discussed the need to address the competition for resources when attempting to gain administrator support. Participants mentioned the scarcity of resources that included faculty positions (i.e., lines) and physical building space. This scarcity resulted in programs needing to compete for resources. One participant stated, “I think we’re all going to be like pit bulls in a fighting ring over resources at this point.” Another participant shared a similar statement: “Once we get outside of our building, it is very territorial. So, we have to basically anticipate resistance from other pockets in the university if we want a new program at the doctoral level.” This participant elaborated that the provost needs to be aware of these dynamics and that faculty should attempt to make a strong case for needing resources if they are in competition with other programs.

Competition for resources seemed to occur not only within a university’s departments but also between CES programs at different universities. Doctoral applicants appear to be increasingly making enrollment decisions based on tuition costs and graduate assistantships, which increases the pressure for programs to provide financial support packages. One participant reported that it is becoming less feasible to operate a doctoral program without “some form of stipend or assistantship” because “if you don’t, there’s too many other programs that do.” This participant elaborated that administrators must support the program with assistantships and concluded, “I wouldn’t try to start a program without it.”

Some participants discussed strategies to maximize resources across the college or school in which the program exists, such as with college-wide methodology courses. Such strategies seemed particularly important when adapting to the pressure of accepting more students to make the program revenue-neutral. One participant suggested that such resource sharing was “of utmost importance… in the early beginnings of programs.”

Faculty and Program Responsibilities
     Faculty have more complex responsibilities when operating a doctoral program compared with a master’s program, such as attending conferences with students and engaging in the larger campus community. As one participant stated, “It’s also being at events, interacting with administrators, making sure when walking around campus or buildings that they know who you are and that they can connect with what you’re doing.” Participants explored the economic aspects of the responsibilities that individual faculty members and the larger program have when responsible for the doctoral education of counseling students: “At our institution, you don’t get a lot of credit per se, or release time or extra pay for all of the work it takes to mentor doctoral students.” This credit that is or is not allocated to doctoral education impacts faculty members’ well-being. Another participant cautioned faculty to be aware of “faculty burnout” that accompanies tensions around adequately funding faculty positions: “If you shrink, and you still maintain the same number of students, there is simply not enough time, not enough emotional capacity, to do the good work.” Another participant shared that their doctoral programs felt like “hell on wheels” because “we ended up with a program that had more than 100 students with two real tenured faculty running the program.”

Influence of University: “Know the Size and Culture”
     This subtheme represented faculty considerations of the larger university system context where the counseling program is situated. As one participant summarized, “part of it is looking at the context of the program in the university.” Participants particularly referenced size as an influencing factor. As one participant stated, “Know the size and culture of your institution.” University size influenced participants’ access to decision-makers: “We’re so small that I could literally walk out of my office and two minutes later I can be in the provost’s office. I can ask a question. They’re very approachable, and so I don’t feel intimidated.” Understanding the institution’s mission and its funding priorities is crucial to forging successful alliances with administrators regarding whether to start and sustain a CES doctoral program. Understanding where a CES doctoral program fits within the institution’s academic structure therefore helps faculty to effectively communicate with administrators, and consistently reviewing this can help inform ongoing dialogues with administrators.

Identity Landscape
     The overarching identity landscape theme represents how programs both understand their internal identity regarding doctoral education, as well as the external identity factors that contribute to the program. Each subtheme is detailed below with participant quotes.

Operationalize and Define Commitment: “Faculty Have to Buy In”
     Gaining faculty buy-in prior to conversations with administrators and gaining approval for a doctoral program was a consistent message relayed by participants. One participant reflected, “Everybody has to be on board and has to buy in to the concept that the mission can’t be the mission of one person.” Another participant recommended that faculty leadership (e.g., program directors) need to operationalize this commitment through intentional dialogues with faculty. This participant stated that “the evidence for faculty buy-in isn’t always there until you probe.” They elaborated that faculty leadership can facilitate discussions around the following questions: “Are you willing to do X, are you willing to do Y?” and “If we start a doctoral program, do you feel like you have the skills you’ll need or do you fear that you’re going to be left behind?” Such conversations appeared important to developing a unified collective commitment to the doctoral program, which was critically important when challenges arose. Other participants reflected on personal buy-in and encouraged self-reflection in this regard: “Things to consider including one’s own personal meaning making.” Participants reflected that doctoral education was significantly different than master’s-level education and required a different level of commitment. Administrators are unlikely to support a doctoral program if the faculty are divided in their commitment to the program.

Understanding Differences: “Know What Your Program Is Worth”
     Participants spoke about the need for faculty to possess knowledge about multiple aspects of doctoral education when conveying information to administrators. Faculty should be familiar with the differences between master’s and doctoral education, between doctorates in other disciplines within the university, and among doctoral programs at different universities in the state. This information assists faculty “to really know what your program is worth and to be able to explain it.” For example, faculty should make administrators aware of how doctoral education can enhance master’s-level training rather than result in master’s students being “ignored” and treated as “second class citizens.”

Participants indicated that administrators may not be familiar with the counseling profession and thus may need education. Participants reported the need for “educating your administrative colleagues about what counselor ed is, what they do, how we train.” Another participant stated that “even at the dean level, they don’t know what the heck a mental health counselor is. Not a clue.” Consistent with this, administrators may also need information about other aspects of the profession, such as the value of specialized accreditation. One participant reported, “I think that we can do a better job of telling our admin the pros of CACREP versus the cons.” Education about CACREP accreditation was important because of the costs associated with accreditation fees and hiring core faculty to meet the CACREP doctoral standards.

Quality in Programs: “High-Quality Output”
     Participants reflected on the importance of program quality as a reflection of the programs’ overall identity. Program outputs seemed to be a particularly important measure of program quality. Some participants, particularly those at research-intensive universities, emphasized the importance of research-related outputs such as “grants, high-quality output, and visibility.” Across participants, employment rates were a particularly important measure of program quality, especially employment in academic and administrative jobs post-graduation. Participants reported that such metrics were useful as a “selling point” to administrators, especially if needs existed for doctoral-level graduates in the local area. As one participant stated, “Some of those outcomes become really important to administrators, and I think that we need to be good at putting those outcomes in front of them.”

Participants also shared concerns with program quality. These concerns often centered on admitting more students than can be adequately mentored through the dissertation process. One participant was “concerned about doc programs that bring in cohorts of 20 and churn them out” because they feared that “big doc programs” are “just course-based models without a whole lot happening outside of that. . . . And, you know, I worry about dissertation mentoring.”

Program accreditation was explored as an influencing factor in program quality that ultimately influences the overall program identity through reputation. One participant stated, “We built the program around the accreditation standards and took those standards very seriously.” Another participant explored how the accreditation process can influence administrators’ opinions of the program: “If we had bombed that visit, from the president to the vice president on down, we would have looked really bad.”

Advancing the Institutional Mission: “It Has to Match”
     Study participants commented on the importance of the identity of the doctoral program connecting to the mission of the larger institution. One participant encouraged faculty to consider the institutional mission when communicating with administrators: “When we advocate for programs, we need to understand the mission of the institution.” This participant reported that administrators in a university that values community service may be in favor of doctoral programs that “create more service providers for the local community.” Another participant stated that “it has to match the university’s mission. I hear that more and more and more.” This participant acknowledged that a proposed doctoral program would only receive administrative support if it “fits with the strategic plan of the university.” Participants indicated that the program should align not only with the institutional mission but also with the mission of the college or school where the program is housed.

Stakeholder Dynamics: “Making the Administrators Happy”
     Participants discussed the variety of stakeholders that faculty should consider when developing a CES doctoral program. Such stakeholders include the students being educated, faculty in the program, administrators who make decisions about the program, and employers of future program graduates. Participants reflected that each stakeholder group can contribute meaningfully to the identity of the program.

At times, a stakeholder group’s contributions and agendas may be at odds with those of another stakeholder group. This is particularly problematic when tensions exist between a stakeholder group and administrators. For example, faculty may prefer a smaller program than administrators. One participant stated that “one of the things that I’ve fought with faculty about my whole life, has been that [faculty] want small classes and they want few students.” This participant added that administrators tend to close smaller programs when pressured to cull the number of doctoral programs at an institution, and thus smaller size represents a potential threat to the program: “Any time an administrator is going to cut a program or deny resources to a program, they do it with the program with the least number of students in it. It’s just the absolute way it’s done.” This participant proposed that faculty stakeholders must therefore understand the dynamics of higher education administration when advocating, as “making the administrators happy with the numbers” is an important priority.

Discussion

In this study, we conducted a qualitative analysis of interviews with 15 experts in the field to examine the research question. We identified participant-reported strategies for gaining initial and ongoing support from administrators for a CES doctoral program. The overarching themes of political, economic, and identity landscapes emerged from the data, alongside associated strategies necessary for gaining support. Navigation of complex university systems, including accreditation, finances, legal concerns, infrastructure, and politics, seem to be required for successful initial administrator approval of a CES doctoral program. Awareness of institutional mission and history, purpose, community needs, fiscal realities, and the university’s organizational chart also can facilitate approval and successful program sustenance.

Implications for CES Faculty
     The findings from this study may be utilized by existing master’s degree counseling program faculty who want to create a CES doctoral program. Faculty should embark on a data-driven process to inform administrators of tangible benefits across multiple systems and articulate the financial resources necessary for long-term success. As new CES doctoral programs are proposed, faculty should ensure that university administrators are aware of the relative worth of counselors and counselor educators, particularly in contrast to other mental health disciplines that may exist on campus. They may need to document the tangible benefits that CES programs bring to the university that are in alignment with the university’s mission and strategic plan. In 2013, Adkison-Bradley noted, “As universities change and grow, academic programs are often required to justify their request for resources or asked to explain how they uniquely contribute to the overall mission of the college and surrounding communities” (p. 48). Faculty could benefit from open dialogue with administrators and mentors about what it costs the institution to have a doctoral program compared to what revenue and resources a doctoral program can generate. CES faculty also can provide data to explain how accreditation requirements that may appear expensive to administrators (e.g., 1:6 faculty–student ratios in practica; 1:12 faculty–student ratios) do benefit students, clients, and communities, including protection of “broad public interests” (Urofsky, 2013, p. 13).

Faculty must engage in systemic thought that goes beyond the program and department. Bronfenbrenner’s (1979) ecological systems model provides a useful model for program faculty to understand. This model includes four main systems in which individuals exist—microsystem, mesosystem, exosystem, and macrosystem, with each system growing in size and complexity. Faculty without this perspective risk experiencing their department in a bubble and may not realize how their smaller microsystem (i.e., program, department) fits within the larger macrosystem of the university. The political landscape can become entangled in the developing exosystem where these systems overlap. This exosystem includes considerations for the college’s or school’s strategic priorities where the doctoral program is located. Faculty also should consider larger systemic interactions, such as the doctoral program’s relationship with the local community, with other master’s and doctoral programs in the state, and with other doctoral programs nationally.

The 2016 CACREP Standards (2015) require doctoral education to focus on leadership. However, the standards require this education to be in relation to counselor education programs and in professional organizations, not specifically in institutions of higher education as larger systems. It is unknown how or if students receive formal education about how to navigate university systems, as it is not typically included in CES doctoral program curricula. However, in our own personal experiences as faculty members and doctoral students, we have found that this knowledge seems to be acquired through observation, experience, and on-the-job mentoring. Unfortunately, this learning may occur when new and junior faculty are under pressure to establish themselves for tenure and promotion. Senior faculty, including those nearing retirement, are likely to possess this systemic knowledge and understanding. This knowledge could be conveyed via formal or informal mentoring programs; however, junior faculty in counselor education programs report a lack of mentoring experiences (Borders et al., 2011). The lack of mentoring could be from a variety of reasons, as junior faculty members may be intimidated by senior faculty (Savage et al., 2004), or senior faculty may lack the commitment to put forth the long-term effort to gain support for a new CES doctoral program.

Faculty must be willing to invest in learning about the processes involved in doctoral program creation—to listen, be respectful, and exercise patience for the time required for program approval, funding, and development. The results of this study indicate that program generation is a political process, and junior faculty must be aware of their environment. Faculty have different levels of input and leadership at different institutions, such as with different forms of shared governance (Crellin, 2010). Faculty who do not understand political savviness, the role of fiscal constraints, and the historical precedents for doctoral program initiation may struggle more than those who understand the lens by which individual institutional decisions are made.

Implications for University Administrators
     University administrators could utilize the results of this study to understand how to work with faculty who are requesting the initiation of a new doctoral program. Administrators could consider establishing dedicated time and orientation to new and junior faculty to assist them in conceptualizing how faculty requests are prioritized within the institution, perhaps via a formal mentoring program (Savage et al., 2004). For example, if the university’s current vision is to respond to the lack of STEM (science, technology, engineering, and mathematics) graduates in the local job market, counseling faculty could better manage their expectations about the estimated timeline of new degree program creation while aligning their new CES doctoral degree proposal to a more attainable target date. Communication about the timeline of decisions and the patience involved in systemic change (e.g., state legislature involvement) could also benefit the faculty perspective. Opportunities for learning about the organization are a crucial ingredient in organizational change (Boyce, 2003).

Although it is the responsibility of deans and department chairs to communicate the university’s vision and strategic plan, administrators should also trust the CES faculty’s distinct knowledge of the field and dynamic accreditation standards. Faculty are uniquely qualified to anticipate shifts in the profession that could impact their programs. From our experience, CES faculty who serve as internship clinical supervisors may also possess unique knowledge of the needs of the surrounding communities through their supervisees’ reports of client needs.

It is suggested that administrators include a university organizational chart in new faculty orientation or in the faculty handbook so that faculty can be aware of the hierarchy within the university. The orientation should include a clear explanation of how the particular institution prioritizes agendas and provide a history of the institution, with specific examples of prior program creation in the face of competing needs (e.g., missions, financial). Faculty can then understand how the university invests in its future.

Limitations and Suggestions for Future Research
     Several limitations exist with qualitative research in general, and with this unique project specifically. In general, qualitative research is limited by researcher bias, interviewer bias, interviewee bias, and participant demographics (Corbin & Strauss, 2015). To control for potential bias during the analysis process, the coding team used several strategies to enhance trustworthiness, including recruiting coding team members who had identities as both CES faculty and administrators, bracketing biases throughout coding, using consensus to resolve discrepancies in coding, and using memos to document decisions. Future studies could seek to triangulate the data from this study to determine whether the findings are transferable to the perspectives of other faculty in CES doctoral programs.

The focus of this particular research study was to explore faculty perspectives regarding how to gain administrative support for initiating and sustaining CES doctoral programs. As such, the perspectives of administrators were not surveyed regarding how to gain administrative support for CES doctoral programs (beyond those counselor educator faculty participants who have served in administrative roles). Future studies, perhaps in the form of quantitative research, could include these perspectives to determine whether the perspectives of CES doctoral faculty are consistent or divergent with administrator experiences regarding how to work effectively with administrators.

We sought to understand strategies for successfully gaining initial and ongoing administrative support for a CES doctoral program. This exploration included both participants who had recently started new programs and those who had long worked in CES doctoral programs. However, an analysis of thematic differences between participants who had and had not spearheaded the creation of a CES doctoral program was not conducted. Future research could explore whether strategies varied for those who had recently started a CES doctoral program versus those who had not. In addition, data were not organized and analyzed by differences in participants’ institution type (i.e., private or public), because it was outside the scope of the research question. Finally, the study focused solely on faculty at CACREP-accredited institutions. It is unknown whether the perspectives of participants in this study would be consistent with faculty at non–CACREP-accredited institutions.

Conclusion

The counseling profession continues its efforts to address the pipeline shortage of doctoral-level CES faculty to meet CACREP accreditation requirements. To meet this need, some master’s-level programs are seeking to start CES doctoral programs. The findings from this study may be useful to CES faculty when planning a strategic approach for collaboration with administrators regarding the initiation of new CES doctoral programs. This strategic approach will involve exploring political elements, economical components, and the identity of the proposed program. The findings of this study indicate these areas of knowledge promote a more comprehensive planning process to help prepare for working with administrators on the creation of a doctoral program.

 

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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Rebecca Scherer, PhD, NCC, ACS, CPC, is an assistant professor at St. Bonaventure University. Regina Moro, PhD, NCC, BC-TMH, LPC, LMHC, LCAS, is an associate professor at Boise State University. Tara Jungersen, PhD, NCC, CCMHC, LMHC, is an associate professor and department chair at Nova Southeastern University. Leslie Contos, NCC, CCMHC, LCPC, is a doctoral candidate at Governors State University. Thomas A. Field, PhD, NCC, CCMHC, ACS, LPC, LMHC, is an assistant professor at the Boston University School of Medicine. Correspondence may be addressed to Rebecca Scherer, B43 Plassman Hall, 3261 West State Road, St. Bonaventure, NY 14778, rscherer@sbu.edu.

Incidence of Intentional Nondisclosure in Clinical Supervision by Prelicensed Counselors

Ryan M. Cook, Laura E. Welfare, Connie T. Jones

 

This study examined the incidence of intentional nondisclosure by postgraduate, prelicensed counselors receiving supervision as they pursue licensure, which has not been previously examined. Examining the responses of 107 prelicensed counselors, we found that 95.3% reported withholding some degree of information from their supervisors, and 53.3% completely withheld a concern from their supervisors. Participants completely withheld supervision-related incidents (e.g., negative reactions to supervisor, questioning supervisor’s competency) more frequently than they withheld client-related incidents (e.g., clinical mistakes, personal issues). We offer strategies for prelicensed counselors, supervisors, counselor educators, and counselor credentialing bodies to reduce intentional nondisclosure. These strategies include creating a collaborative environment, developing supervision contracts, and attending to power differentials in supervision.

Keywords: intentional nondisclosure, clinical supervision, prelicensed counselors, supervisors, counselor educators

 

Counselors who desire licensure as full, independent professional counselors must complete a postgraduate supervised field experience (Henriksen et al., 2019). The primary purpose of postgraduate supervision is to ensure that prelicensed counselors provide counseling services that are in accordance with legal, ethical, and professional standards as they begin their professional careers (Borders et al., 2011; Magnuson et al., 2000). Unlike university-based supervision, to which prelicensed counselors are more accustomed (Magnuson et al., 2000), postgraduate supervision requires prelicensed counselors to regularly self-direct their supervision experience. That is, in postgraduate supervision, prelicensed counselors are called to more autonomously self-identify their clinical concerns and developmental needs, and to convey this information to their supervisors (Cook & Sackett, 2018).

 

Although supervisees’ self-reports can enrich the supervision process (Noelle, 2002), relying on prelicensed counselors to self-select information to share with their supervisor may be problematic (Ladany et al., 1996). While supervision is intended to facilitate supervisees’ professional development, there also is an evaluative component inherent in the supervisory relationship (Borders et al., 2011). The supervisor’s evaluations of the supervisee’s clinical performance are tied to their professional progress (i.e., obtaining full, independent licensure; Magnuson et al., 2000). As such, it benefits supervisees to present themselves in a manner that will yield positive evaluations from their supervisors and to withhold information that could result in their supervisors developing a negative perception of their clinical competencies (Cook, Welfare, & Romero, 2018; Ladany et al., 1996).

 

Supervisees withholding information from their supervisors is a well-established phenomenon in supervision literature (Cook, Welfare, & Romero, 2018; Gibson, et al., 2019; Hess et al., 2008; Ladany et al., 1996). Termed supervisee nondisclosure, researchers have shown that the frequency of supervisee nondisclosure in clinical supervision is high—ranging from 60% to 97.2% (Cook, Welfare, & Romero, 2018; Ladany et al., 1996; Mehr et al., 2010). But these studies were based on samples of counselors-in-training (CITs) or trainees in allied professions such as psychology. To date, only one qualitative study has examined the phenomenon of nondisclosure in a sample of postgraduate supervisees. Sweeney and Creaner (2014) found that counseling psychology graduates in Ireland (N = 6), like supervisees in mental health training programs (Cook, Welfare, & Romero, 2018; Ladany et al., 1996), commonly withhold information from their supervisors.

 

What seems most problematic are the instances in which a supervisee identifies a concern or perceives an issue and decides to withhold it from their supervisors anyway (Cook & Welfare, 2018; Yourman & Farber, 1996). These instances are known as supervisee intentional nondisclosure. Ladany and colleagues (1996) suggested that the information being intentionally withheld by supervisees is likely to be the most important information to their clinical and professional development. As such, supervisees who withhold information may inadvertently undermine their own professional growth.

 

Supervision scholars (Cook, Welfare, & Romero, 2018; Gibson et al., 2019; Hess et al., 2008; Ladany et al., 1996) have found that the types of information withheld by supervisees can be broadly categorized into supervision-related incidents (e.g., negative reactions to a supervisor, evaluation concerns, fears of correcting a supervisor, concerns about the process of supervision) and client-related incidents (e.g., clinical mistakes, general reactions to clients, concerns about lack of professional competencies). The reasons for these intentional nondisclosures most often point to issues in the supervisory relationship (e.g., supervisory working alliance; Cook & Welfare, 2018; Hess et al., 2008), supervisee personality traits (e.g., attachment styles; Cook & Welfare, 2018), and supervisor–supervisee power differentials (e.g., fear of negative evaluation concerns, desire to present oneself favorably to the supervisor; Hess et al., 2008; Ladany et al., 1996). In total, the types of information being intentionally withheld by supervisees, as well as the reasons for their nondisclosures, reflect issues that are inherent in a hierarchal and evaluative relationship such as the supervisory relationship (Hess et al., 2008; Mehr et al., 2010; Sweeney & Creaner, 2014).

 

Prelicensed counselors, like CITs and supervisees from allied professions, experience similarly high stakes in clinical supervision. However, as described in detail below, postgraduate supervision differs from university-based supervision (Magnuson et al., 2000), and prelicensed counselors are more advanced in their professional development as compared to CITs (Rønnestad & Skovholt, 2003). For these reasons, the salient issues that prelicensed counselors are hesitant or unwilling to discuss with their supervisors might differ from those of CITs. Relatedly, the degree to which they fail to disclose information might also differ. Thus, in our investigation we examined the types of information being withheld in postgraduate supervision by 107 prelicensed counselors and the degree to which they were unwilling to discuss their concerns with their supervisors.

 

Postgraduate Supervision for Licensure

 

Postgraduate supervision is required for counselors who desire licensure as full and independent professional counselors in all 50 states in the United States as well as Guam, Puerto Rico, and the District of Columbia. The specific requirements of postgraduate supervision differ in each licensing jurisdiction (e.g., frequency of supervision, hours of required supervision; Henriksen et al., 2019). Although prelicensed counselors often are more self-aware of their client needs and developmental concerns than CITs (Loganbill et al., 1982; Rønnestad & Skovholt, 2003; Stoltenberg & McNeill, 2010), prelicensed counselors also are facing new challenges as counselors such as managing more complex caseloads (Freadling & Foss-Kelly, 2014) and possibly questioning their own clinical competencies (Rønnestad & Skovholt, 2003). Thus, a supervised field experience is critical to helping prelicensed counselors transition from CITs to professional counselors (Henriksen et al., 2019).

 

As compared to university-based supervision, there are unique features of postgraduate supervision for prelicensed counselors (Magnuson et al., 2000). Namely, prelicensed counselors engaged in postgraduate supervision are tasked to self-direct their supervision experience (Cook & Sackett, 2018) more than they were during university-based supervision. For example, prelicensed counselors may have less access to their supervisors than they did during their graduate training. Henriksen et al. (2019) conducted a content analysis of supervision requirements for postgraduate supervision. Based on their findings, no jurisdiction required supervisors and supervisees engaging in postgraduate supervision to meet at a frequency that equaled the Council for Accreditation of Counseling and Related Educational Programs’ (CACREP) required averages of an hour of individual supervision or 1.5 hours of group supervision per week. It is important to note that it is certainly possible for prelicensed counselors to meet with their supervisors more than is required, but these standards provide a useful benchmark. Prelicensed counselors also may have fewer opportunities than CITs for their clinical work to be directly observed by their supervisors (Magnuson et al., 2000), which could perpetuate the supervisors’ reliance on supervisees’ self-report in supervision (Cook & Sackett, 2018) and unintentionally encourage supervisee nondisclosure (Ladany et al., 1996). For example, Fall and Sutton (2004) found that prelicensed counselors used self-report in their supervision sessions 80% of the time. Comparatively, other methods to monitor supervisees’ work, such as direct observation of a counseling session, audio and video recording, or live supervision, were used far less often (each used 10% of the time).

 

In addition, the interpersonal dynamics between supervisor and supervisee in postgraduate supervision may differ from those experienced during university-based supervision. Unlike the development-oriented process of university-based supervision, Magnuson et al. (2000) poignantly described postgraduate supervision as a “business relationship” (p. 177). Some prelicensed counselors pay for supervision from someone who does not work at their place of employment, while other prelicensed counselors work with a supervisor at their place of employment (Magnuson et al., 2000). In the latter situation, the supervisors providing clinical supervision also can be evaluating the prelicensed counselor as an administrative supervisor. Although the dual roles may be logistically advantageous for agencies, having combined clinical and administrative supervision could be problematic (Borders et al., 2011; Magnuson et al., 2000). In sum, as compared to university-based supervision, the businesslike nature of postgraduate supervision as well as the heavy reliance on prelicensed counselors to self-direct their supervision experience can change how these counselors utilize intentional nondisclosure in postgraduate supervision.

 

The degree to which prelicensed counselors are willing to disclose information to their supervisors has implications for clinical supervisors as well. Clinical supervisors assume legal responsibility for the quality of services rendered to their supervisees’ clients (Magnuson et al. 2000). With the dependence on prelicensed counselors to self-report information in clinical supervision (Fall & Sutton, 2004) and the potential absence of regular direct observation (Gray & Erickson, 2013; Magnuson et al., 2000), supervisors are reliant on prelicensed counselors to accurately recall details of their counseling work and to honestly discuss their developmental needs. If prelicensed counselors, like CITs, were to feel unsure about presenting themselves honestly to their supervisors, their decision could unintentionally undermine the work of their clinical supervisors, who have a legal duty to their supervisees and the supervisees’ clients (Magnuson et al., 2000).

 

No study has examined what prelicensed counselors perceive as salient in their clinical supervision experience and the degree to which they are willing to discuss concerns with their supervisors. Postgraduate supervision is critically important to a counselor’s developmental growth (Henriksen et al., 2019). Prelicensed counselors are mandated to receive clinical supervision (Henriksen et al., 2019), which means that supervisee intentional nondisclosure is a relevant issue. As such, an investigation of supervisee intentional nondisclosure in a sample of postgraduate, prelicensed counselors is needed. Therefore, the aim of our study was to examine prelicensed counselors’ self-reported incidents of intentional nondisclosure in clinical supervision. Specifically, our investigation was guided by two research questions: (a) What is the frequency of intentional nondisclosure in clinical supervision as reported by prelicensed counselors, and (b) Which concerns do prelicensed counselors find most difficult to discuss with clinical supervisors?

 

Method

 

Participants and Procedures

Participants in the current study were prelicensed counselors pursuing full, independent licensure as professional counselors. We aimed to recruit a nationally representative sample, so we obtained mailing addresses for persons pursuing licensure in two states in each of the five Association for Counselor Education and Supervision (ACES) regions. Specifically, we solicited participation from prelicensed counselors in Arkansas, Colorado, Idaho, Iowa, Oklahoma, Oregon, Rhode Island, Texas, Vermont, and Washington. We randomly selected up to 150 names from each state. After eliminating and replacing unverifiable mailing addresses, we identified 1,347 potential participants. We first received IRB approval and then solicited participation by mailing paper-and-pencil survey packets to the potential participants. We asked participants to anonymously respond about their current, licensed clinical supervisor. Participants returned the surveys to the authors using a prepaid envelope. Of the 1,347 mailed packets, 330 packets (24.5%) were “returned to sender” and never received by the potential participants. Of the remaining 1,017 packets distributed to potential participants, 109 survey packets were returned. However, two participants’ responses were incomplete and subsequently removed. The number of usable packets was 107, resulting in a response rate of 10.5%. This response rate, although low, is consistent with previous survey research employing a mailing recruitment strategy (Barden et al., 2017). Because data collection was anonymous, we are unable to identify the state of origin for participants included in our sample.

 

The age of participants ranged from 24 to 67 (M = 38.79, SD = 11.20). The majority of participants identified as White (83.2%), while eight participants identified as Hispanic (7.5%), five participants identified as African American/Black (4.7%), two participants identified as Asian (1.9%), two participants identified as Multiracial (1.9%), and one participant did not respond to this item (0.9%). Eighty-five participants identified as female (79.4%), 21 participants identified as male (19.6%), and one participant identified as non-binary (0.9%). The demographic characteristics of the participants in the current study are comparable to counseling professionals in general (CACREP, 2018). On average, the participants received 64.73 (SD = 29.79) minutes of clinical supervision per week. Finally, 56 participants were assigned a supervisor at their job (51.4%), 28 paid for supervision from someone who did not work at their employment site (26.4%), 17 chose a supervisor at their place of employment (15.9%), and six participants indicated other (5.6%; e.g., free supervision from someone outside their job).

 

Measures

Supervisee Nondisclosure Scale (SNDS)

     The SNDS is an instrument designed to capture the degree to which participants disclosed or withheld information to their supervisors (Ellis & Colvin, 2016; Siembor, 2012). Siembor (2012) developed a pool of 30 items, informed by prior research on nondisclosure (Hess et al., 2008; Ladany et al., 1996). Participants indicate their level of disclosure using a 7-point Likert scale with three defined levels: (1 = fully disclosed, 4 = sometimes disclosed, 7 = decided not to disclose). Higher scores indicate higher levels of nondisclosure. Participants are given the option to select not applicable for items describing incidents that have not occurred during their supervision experiences. The items include information related to the supervision experience (e.g., “Negative reactions that I had about my supervisor’s behavior or attitudes”) and items related to the supervisee’s clinical work (e.g., “Clinical mistakes that I did make”). Abbreviated item stems for all 30 SNDS items are presented in Table 1. The internal reliability of all 30 items was strong (α = .88, n = 107) and consistent with prior research (α = .84; McKibben et al., 2018).

 

Demographic Survey

     We created a survey to collect self-report demographic data for both the supervisee and supervisor (e.g., gender, race). We also asked participants to share about the details of their supervision experience (e.g., time in supervision, administrative versus clinical supervision, selecting a supervisor).

 

Results

 

Across all 30 SNDS items, 95.3% of the participants reported some degree of intentional nondisclosure (i.e., partially or fully withheld) for at least one item. The number of incidents of intentional nondisclosure endorsed by participants ranged from 0 to 26 (M = 10.68; SD = 6.62). Also, 53.3% indicated that they fully withheld information from their clinical supervisor for at least one item. The range of incidents completely withheld by participants was 0 to 14 (M = 1.73, SD = 2.6). This finding suggests that intentional nondisclosure by prelicensed counselors in clinical supervision is quite common.

 

The Frequency of Intentional Nondisclosure in Clinical Supervision

To address the first research question, we examined the frequency of participants who responded that they utilized intentional nondisclosure on each item (i.e., what percent withheld information?). To do so, we analyzed the self-reported responses on each item using the four groups: not applicable, fully disclosed, sometimes disclosed, and decided not to disclose (see Table 1). For each item, participant responses of not applicable were categorized in the not applicable group, responses of 1 were categorized in the fully disclosed group, responses of 2 to 6 were categorized in the sometimes disclosed group, and responses of 7 were categorized in the decided not to disclose group. The incidence of partial or complete nondisclosure per item ranged from 69.2% (“disagreement with one’s supervisor”) to 1.9% (“supervisor attraction issue”), and the average incidence across the items was 35.6% (SD = 15.8%). After “disagreement with one’s supervisor,” the items with the highest incidence rates were “negative reaction to supervisors’ behavior or attitudes” (66.3%), “perceived that my supervisor is wrong” (60.7%), “personal issue” (49.6%), and “personally identifying with a client” (e.g., countertransference; 48.6%). In addition to revealing what supervisees chose to withhold, the results indicated issues that did not emerge in supervision and those that emerged but were fully disclosed. For example, items frequently marked not applicable were “supervisor attraction issue” (97.2%), “client attraction issue” (86.9%), “unsafe in supervision” (86.0%), and “supervisors’ attire and/or appearance” (84.1%). In contrast, “client information” and “clinical mistake” came up often and were fully disclosed.

Table 1

Incidence of Intentional Nondisclosure by Prelicensed Counselors in Clinical Supervision for State Licensure as Professional Counselors

Incident of Potential Intentional Nondisclosure N M (SD) Not Applicable
n
(%)
Fully Disclosed

n (%)

Sometimes Disclosed

n (%)

Decided Not to Disclose

n (%)a

Negative reaction to supervisors’ behavior or attitudes SRI 106 3.49 (2.71) 29 (27.1%) 6 (5.6%) 47 (43.9%) 24 (22.4%)
Supervisors’ competence SRI 107 2.16 (2.87) 63 (58.9%) 2 (1.9%) 24 (22.4%) 18 (16.8%)
Needs not being met in supervision SRI 107 2.22 (2.83) 60 (56.1%) 4 (3.7%) 27 (25.2%) 16 (15.0%)
Supervisors’ display of stereotypes or bias SRI 106 1.85 (2.54) 63 (58.0%) 2 (1.9%) 30 (28.0%) 11 (10.3%)
Supervisors’ attire and/or appearance SRI 106 0.99 (2.37) 90 (84.1%) 0 (0.0%) 6 (5.6%) 10 (9.3%)
Consult with peer and/or another supervisor SRI 105 1.62 (2.19) 45 (42.1%) 26 (24.3%) 24 (22.4%) 10 (9.3%)
Supervision process concerns SRI 107 1.85 (2.42) 56 (52.3%) 9 (8.4%) 33 (30.8%) 9 (8.4%)
Power differentials SRI 106 1.25 (2.35) 76 (71.0%) 6 (5.6%) 15 (14.0%) 9 (8.4%)
Focus of supervision SRI 107 1.86 (2.50) 58 (54.2%) 9 (8.4%) 32 (29.9%) 8 (7.5%)
Unsafe in supervision SRI 106 0.78 (2.09) 92 (86.0%) 0 (0.0%) 6 (5.6%) 8 (7.5%)
Perceived that my supervisor
is wrong SRI
106 2.78 (2.42) 30 (28.0%) 11 (10.3%) 58 (54.2%) 7 (6.5%)
Disagreement with one’s supervisor SRI 106 2.92 (2.01) 13 (12.1%) 19 (17.8%) 68 (63.6%) 6 (5.6%)
Supervision format issues SRI 106 1.79 (2.36) 56 (52.3%) 10 (9.3%) 34 (31.8%) 6 (5.6%)
Personal issue CRI 107 2.22 (1.82) 9 (8.4%) 45 (42.1%) 48 (44.9%) 5 (4.7%)
Personally identify with client (e.g., countertransference) CRI 106 2.08 (1.74) 9 (8.4%) 45 (42.1%) 47 (43.9%) 5 (4.7%)
Evaluation concern SRI 106 1.75 (2.03) 38 (35.5%) 29 (27.1%) 35 (32.7%) 4 (3.7%)
Client attraction issue CRI 106 0.43 (1.48) 93 (86.9%) 5 (4.7%) 4 (3.7%) 4 (3.7%)
Client attracted to counselor CRI 107 0.70 (1.49) 74 (69.2%) 17 (15.9%) 13 (12.1%) 3 (2.8%)
Positive reaction to supervisor SRI 107 1.87 (1.50) 3 (2.8%) 63 (58.9%) 38 (35.5%) 3 (2.8%)
Issues with colleague SRI 107 1.68 (1.75) 27 (25.2%) 40 (37.4%) 37 (34.6%) 3 (2.8%)
Positive reaction to client CRI 106 1.62 (1.47) 11 (10.3%) 59 (55.1%) 33 (30.8%) 3 (2.8%)
Feeling inadequate CRI 105 2.09 (1.59) 6 (5.6%) 50 (46.7%) 47 (43.9%) 2 (1.9%)
Clinic setting concerns CRI 107 1.88 (1.62) 12 (11.2%) 51 (47.7%) 42 (39.3%) 2 (1.9%)
Supervisor attraction issue SRI 106 0.13 (0.96) 104 (97.2%) 0 (0.0%) 0 (0.0%) 2 (1.9%)
Unprofessional behavior with client CRI 107 1.13 (1.75) 62 (57.9%) 15 (14.0%) 27 (25.2%) 2 (1.9%)
Future clinical mistake CRI 107 1.89 (1.37) 63 (58.9%) 20 (18.7%) 43 (40.2%) 1 (0.9%)
Clinical mistake CRI 106 1.65 (1.31) 3 (2.8%) 71 (66.4%) 31 (29.0%) 1 (0.9%)
Unfavorable client–counselor
interaction CRI
107 1.78 (1.88) 41 (38.2%) 17 (15.9%) 48 (44.9%) 1 (0.9%)
Client information CRI 106 1.36 (1.15) 8 (7.5%) 77 (72.0%) 20 (18.7%) 1 (0.9%)
Negative reaction to client CRI 107 1.79 (1.35) 6 (5.6%) 58 (54.2%) 42 (39.3%) 1 (0.9%)

 

Note. Percentages may not equal 100% for each item because of rounding.

SRI = Supervision-Related Incident

CRI = Client-Related Incident
a = Items are ranked based on incidence of total nondisclosure (i.e., score of 7).

 

 

 

The Most Difficult to Discuss Items

In addition to the per-item incidence rates, we also calculated which concerns were most often totally withheld from supervisors. We hoped to understand what items participants might be completely unwilling to discuss in supervision. Interestingly, we ranked all 30 SNDS items by the number of participants who reported using total nondisclosure, and this revealed that the 13 items with the highest endorsement were all supervision-related incidents. There were 24 participants (22.4%) who reported completely withholding their negative reaction to their supervisors’ behavior or attitudes. Relatedly, 18 participants (16.8%) did not discuss their concerns about their supervisors’ competence, and 16 participants (15.0%) did not tell their supervisors that they believed they were not getting enough out of supervision. Regarding client-related incidents, the highest-rated total nondisclosure was personal issues related to work with clients, which was reported by five participants (4.7%). The full results regarding the most difficult to discuss items are presented in Table 1.

 

Discussion

 

     Our study examined the incidence of intentional nondisclosure by prelicensed counselors receiving postgraduate supervision for licensure as professional counselors. We found that 95.3% of prelicensed counselors in this study reported they withheld some degree of information from their clinical supervisors. This was comparable to the rates of intentional nondisclosure by trainees from allied professions (Ladany et al., 1996; Mehr et al., 2010). On average, participants reported 10.68 of 30 (SD = 6.62) intentional nondisclosures in clinical supervision, which also is comparable to the 8.06 nondisclosures reported by psychology trainees in the study by Ladany et al. (1996), although we should acknowledge that Ladany et al. used a different measure to capture incidents of nondisclosure in their study. Like allied professions, intentional nondisclosure by postgraduate, prelicensed counselors appears to be routine in clinical supervision. Further, we surmise that even though postgraduate, prelicensed counselors are more developmentally advanced than CITs (e.g., self-aware, motivated; Stoltenberg & McNeill, 2010), in a hierarchical and evaluative relationship such as clinical supervision, they too will withhold information. This suggests that prelicensed counselors, who are empowered to self-direct their postgraduate supervision experience, are doing just that—they are self-directing their supervision experience, including editing or concealing concerns about their clients and supervision experience from their supervisors. As such, supervisors who are reliant on supervisee self-report may not be getting a full picture of supervisee concerns or needs. This finding reveals implications for prelicensed counselors and supervisors alike. Delving further into the types of incidents being withheld in postgraduate supervision, as well as the frequency of these incidents, can help tell a more complete story of supervisee intentional nondisclosure by prelicensed counselors.

 

Overall, we found that participants were more willing to discuss commonly occurring client-related incidents than they were to disclose supervision-related incidents. However, the participants still reported hesitancy in disclosing many of their client-related concerns. This is evidenced by participants identifying client-related issues as salient issues to their supervision experience, and although they withheld some degree of this information from their clinical supervisors, they did not completely withhold the information. Although prior research has found that supervisees are less apprehensive to discuss client-related issues with their clinical supervisors (Ladany et al., 1996; Mehr et al., 2010; Yourman & Farber, 1996), there may be unique differences for prelicensed counselors that help to explain the findings from the current study. Notably, it is possible that as theorized (Loganbill et al., 1982; Stoltenberg & McNeill, 2010), prelicensed counselors are better able to self-monitor their own needs. As prelicensed counselors gain more clinical experience, they are able to autonomously address their client-related concerns (Rønnestad & Skovholt, 2003) and do not need to fully elaborate on their client-related concerns to their supervisors. However, when prompted by a survey such as this one, they recognize that there is more information to share about the incident (i.e., some degree of nondisclosure). Also, given the limited time in supervision for licensure, prelicensed counselors appear to need to prioritize specific information about their clinical work and seek guidance about their most pressing clinical needs (Cook & Sackett, 2018). Thus, at times they are unable to fully discuss the intricacies of their client caseloads.

 

We also found that prelicensed counselors are most hesitant and sometimes unwilling to discuss supervision-related concerns with their clinical supervisors. In the current study, the most common nondisclosures included disagreements with one’s supervisor, negative perceptions of one’s supervisor, and believing one’s supervisor was wrong, all directly pertaining to the supervisor. High levels of nondisclosure in relation to these types of incidents have been reported in prior research with psychology trainees (Mehr et al., 2010). Prelicensed counselors are likely to have started to develop their own counseling style (Rønnestad & Skovholt, 2003), which may or may not align with their supervisors’ approach to counseling. As such, it is likely that supervisees sometimes disagree with their supervisors or believe that their supervisor handled a situation poorly (Magnuson et al., 2002). It is possible that supervisees’ concerns about voicing dissent to their supervisors could reflect a weak or insecure supervisory relationship, which has been found to be a significant predictor of nondisclosure (Cook & Welfare, 2018; Mehr et al., 2010).

 

A little more than half of the participants (53.3%) reported that they completely withheld information from their supervisors. That is, these participants recognized something as being salient in their clinical supervision but refrained from disclosing any information about their concern with their supervisor. Perhaps most startling, the top 13 items (out of 30 items total) were all supervision-related incidents and some of these incidents occurred with staggering frequency. For example, a number of participants completely withheld their negative reactions to their supervisor’s behavior or attitudes (22.4%), never disclosed that they questioned their supervisor’s competence (16.8%), and declined to discuss that their needs were not being met in supervision (15.0%). These findings underscore the inherent power imbalance between supervisees and supervisors (Cook, McKibben, & Wind, 2018; De Stefano et al., 2017; Ladany et al., 1996). Although prelicensed counselors perceive concerns about their supervisor or their supervision experience, they are unwilling to broach these topics with their evaluative supervisors (Gibson et al., 2019).

 

It is difficult to say why the participants in the current study felt unfulfilled by their supervision experience or wondered about their supervisors’ competencies. We must exercise judgment before assuming that the supervisors of the participants in the current study were providing substandard supervision (Ellis et al., 2014). However, it also seems important that supervisees perceive their postgraduate supervision experience as a meaningful one, given the stakes associated with clinical supervision (Magnuson et al., 2000). For example, many prelicensed counselors pay for supervision, which can be a substantial financial investment for new prelicensed counselors. Relatedly, in situations in which prelicensed counselors’ clinical supervisors also are their administrative supervisors, sustained employment may depend on the supervisor’s favorable review. Regardless, these findings highlight the importance of outlining clear expectations of clinical supervision for supervisees (Magnuson et al., 2002) and developing a quality supervisory relationship in order to mitigate supervisee nondisclosure (Cook & Welfare, 2018; Mehr et al., 2010). In sum, these findings offer insight into the experiences of prelicensed counselors in postgraduate supervision, which can yield lessons for prelicensed counselors, supervisors, counselor educators, and counselor credentialing bodies in order to mitigate the occurrence of intentional nondisclosure in the future.

 

Implications for Prelicensed Counselors

Prelicensed counselors need to take an active role in their postgraduate supervision experience. Learning to navigate the nuances of supervision in addition to learning to be a practicing counselor early in one’s career is a daunting task (Freadling & Foss-Kelly, 2014). Prelicensed counselors who are contemplating withholding information from their clinical supervisors should consider their ethical and professional responsibilities to clients (American Counseling Association, 2014). Counselors who are starting postgraduate supervision may find it helpful to consult resources to help acculturate them to the specifics of postgraduate supervision and to explore strategies other than nondisclosure for addressing their concerns in supervision (Cook & Sackett, 2018; Magnuson et al., 2000; Pearson 2001, 2004).

 

Also, prelicensed counselors should consider which of the incidents described herein could be most relevant to their postgraduate supervision experience. Specifically, our prelicensed counselor participants were most apprehensive to discuss supervision-related concerns with their clinical supervisors. Unlike clients, who have the freedom to choose a different counselor if they are dissatisfied with their counseling services, supervisees likely have limited options when it comes to changing supervisors (De Stefano et al., 2017). Many of the concerns expressed by our participants reflect the inherent power differential between supervisors and supervisees. As such, prelicensed counselors who are dissatisfied with their supervision experience can find it helpful to broach some of these commonly reported issues with their clinical supervisors (Cook, McKibben, & Wind, 2018). The Power Dynamics in Supervision Scale was designed to operationalize supervisees’ perceptions of power and to aid in the discussion of power dynamics in clinical supervision (Cook, McKibben, & Wind, 2018). Prelicensed counselors may find such an instrument a helpful way to invite these discussions in an objective and nonthreatening manner with their supervisors. Such discussion between supervisors and supervisees can make it easier for supervisees to disclose more honestly if that issue arises (Knox, 2015).

 

Finally, some participants perceived their supervision experience as substandard, while a few more participants reported feeling unsafe in supervision or recognized power differentials between themselves and their supervisors. Although uncommon, our study is not the first one in which supervisees in the counseling profession report substandard or harmful experiences (Cook, Welfare, & Romero, 2018). Furthermore, no one should endure supervision that they perceive to be inadequate or harmful (Ellis et al., 2014). Supervisees can find it helpful to consult with a trusted colleague or another supervisor. For more egregious issues, prelicensed counselors may seek help from a professional association ethics consultant or a representative from their state licensing board (Cook, Welfare, & Romero, 2018). For those supervisees who are paying for supervision (26.4% in the current study), finding another supervisor may be the most viable solution.

 

Implications for Supervisors, Counselor Educators, and Counselor Credentialing Bodies

Addressing supervisee intentional nondisclosure must be a priority for clinical supervisors who are providing postgraduate supervision. If supervisors are to rely on supervisee self-report (Fall & Sutton, 2004), it will benefit supervisors to create a safe and open supervision environment that invites supervisee disclosure (Cook & Welfare, 2018; Gibson et al., 2019; Mehr et al., 2010). Encouragingly, prelicensed counselors appear more apt to discuss client-related incidents than supervision-related incidents; however, it also seems that clinical supervisors are not getting the full picture of their supervisees’ clinical work because there is some degree of nondisclosure. Notably, prelicensed counselors reported hesitancy in fully discussing their personal issues related to their work with clients, clinical mistakes, and reactions to clients. As prelicensed counselors continue their professional development, they can desire to try new interventions in their counseling work or have novel insights into how their personal experiences are impacting their clinical work (Rønnestad & Skovholt, 2003). Understandably, they might be apprehensive about discussing these issues with their evaluative supervisors. Supervisors will find it helpful to facilitate a discussion with their supervisees about the lifelong journey of being a professional counselor (Rønnestad & Skovholt, 2003) and the normality of sometimes feeling stuck in one’s clinical work with clients (Cook & Sackett, 2018) or going through stages of feeling stagnation, confusion, and integration, as discussed in the foundational model of Loganbill et al. (1982).

 

Prelicensed counselors’ unwillingness to discuss their supervision-related concerns, particularly those incidents that are commonly occurring such as negative impressions of one’s supervisor, negative reactions to a supervisor’s competence, and the belief that one’s needs are not being met in clinical supervision, seems to be most problematic. There are infrequently occurring issues that supervisees are completely unwilling to discuss (e.g., romantic attraction to one’s supervisor) that can lead to ruptures in the supervisory relationship (Nelson et al., 2008). Prior research suggests that supervisees who possess a favorable impression of their supervisory relationship are less likely to withhold information from their supervisors (Cook & Welfare, 2018; Gibson et al., 2019; Mehr et al., 2010). As such, supervisors need to take steps during formation of the supervisory relationship and throughout the supervision experience to create a safe and open environment that invites supervisee disclosure. Supervisors will find it helpful to specifically attend to the issues identified in our study such as how to professionally address disagreements between supervisors and supervisees, and to discuss supervisees’ personal expectations of clinical supervision.

 

Counselor educators can play a critical role in helping CITs learn strategies to navigate postgraduate supervision and understand the concept of intentional nondisclosure. For example, counselor educators can better prepare CITs for some of the nuanced differences of postgraduate supervision (Magnuson et al., 2002) versus the supervision they receive in their training programs. Counselor education programs can share resources (Cook & Sackett, 2018; Magnuson et al., 2002; Pearson, 2001, 2004) with CITs before they graduate to teach them about postgraduate supervision and help them learn about the experiences of prelicensed counselors. Further, counselor educators can teach CITs to be their own advocates in postgraduate supervision because they will be expected to self-direct their supervision experience (Magnuson et al., 2000). Advocacy in this context can include teaching soon-to-be graduates the importance of utilizing supervision contracts and training them to prepare their own supervision contracts to use with their postgraduate supervisors. These supervision contracts should outline key information to conducting adequate supervision (Ellis et al., 2014), including but not limited to (a) the frequency of clinical supervision (e.g., weekly individual or triadic supervision sessions), (b) the modalities to be utilized in supervision (e.g., self-report, audio or video recording), (c) the relevant ethical and professional guidelines that will guide the supervision experience, and (d) the roles and responsibilities for both the supervisor and supervisee. Preparing these documents prior to graduation can ensure that supervisees are well-informed of their rights as supervisees (Munson, 2002) and help easily identify signs of substandard postgraduate supervision (Ellis et al., 2014).

 

Counselor educators might also share the findings from this study with their CITs and facilitate a discussion about the concerns identified by the participants. Educating CITs on the concept of intentional nondisclosure is important, as it can aid CITs in identifying what influences their own intentional nondisclosure. With greater self-awareness, they may be able to identify the temptation if it ever presents itself. Counselor educators also can teach CITs about the potential harm to clients when supervisees choose to engage in intentional nondisclosure. For example, if supervisees purposefully withhold about the triggers they experience when working with a client, they run the risk of not providing effective counseling services and, even worse, harming the client (Hess et al., 2008; Ladany et al., 1996).

 

Finally, given that our study was the first study to examine supervisee intentional nondisclosure in a sample of prelicensed counselors, it is important to offer recommendations for state licensure boards and nationwide credentialing bodies that may improve the supervision experience for supervisees and supervisors. These prelicensed counselors withheld specific supervision-related concerns, including the belief that their expectations of clinical supervision were not being met and that they disapproved of their supervisors’ behaviors. Unlike university-based supervision in which supervision requirements and supervisors’ training and credentials (e.g., time in supervision, required supervision training, direct observation) are clearly outlined by accreditation bodies (CACREP, 2015), the supervision requirements for those pursuing state licensure vary from state to state (Field et al., 2019; Gray & Erickson, 2013; Henriksen et al., 2019). Some scholars have questioned if the supervision being provided is minimally adequate, or if supervisors are aware that they are providing inadequate or harmful supervision (Ellis et al., 2014). It is unclear how many supervisors in our study had received clinical supervision training or were providing supervision in accordance with professional standards (i.e., Borders et al., 2011). For example, only six of the 10 states that we sampled had licensure board requirements for clinical supervisors to have completed supervision training (Field et al., 2019), and none required a supervision credential such as the Approved Clinical Supervisor (issued by the National Board for Certified Counselors). It is important for all state licensure boards to require supervision training in order to best position supervisors to provide quality supervision. Relatedly, Field et al. (2019) found that only 47.1% of states require supervisors to complete a supervision contract or supervision philosophy prior to conducting postgraduate supervision. At a minimum, all licensure jurisdictions should require these documents as a part of the application packet for prelicensed counselors when they register their supervisor with their licensing board. By requiring these documents, state licensure boards and credentialing bodies can encourage a dialogue between supervisors and supervisees about some of the concerns identified in our study.

 

Limitations and Opportunities for Future Research

     Like in all studies, there are limitations that need discussion. We aimed to collect data from a nationally representative sample; however, our findings could have been impacted by the varying licensure regulations in each state. As such, future research could benefit from a retest of the incidence of nondisclosure by prelicensed counselors in other states. Relatedly, although our response rate was consistent with prior counseling research that collected data via mailings (Barden et al., 2017), future researchers could explore other data collection methods (e.g., electronic survey) to increase participants’ responsiveness. Also, it is possible that the topic of nondisclosure was acutely salient to the persons who chose to participate in the current study, which could have influenced our findings. Future scholars are urged to examine more demonstrable factors of the supervisory relationship that may help to explain intentional nondisclosure by prelicensed counselors such as the incidents of inadequate and harmful supervision, which appear to influence supervisees’ willingness to disclose in supervision. Finally, future researchers should explore if nondisclosure occurs less frequently in supervision dyads that regularly use one of a number of supervisory relationship inventories (Tangen & Borders, 2016) to assess the perceived quality of their supervisory relationship.

 

Conclusion

 

In sum, postgraduate supervision has important implications for prelicensed counselors and supervisors alike. Thus, it behooves both prelicensed counselors and clinical supervisors to mitigate supervisee intentional nondisclosure. The findings presented in this study provide insight into the type of information being withheld by supervisees and the degree to which they are hesitant to discuss certain concerns. Clinical supervisors who hope to create an environment that promotes supervisee disclosure will benefit from specifically targeting some of the issues identified herein.

 

Conflict of Interest and Funding Disclosure
This research was funded by the Southern
Association for Counselor Education and Supervision.

 

 

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Ryan M. Cook, PhD, ACS, LPC, is an assistant professor at the University of Alabama. Laura E. Welfare, PhD, NCC, ACS, LPC, is an associate professor at Virginia Tech. Connie T. Jones, PhD, NCC, ACS, LPCA, LCAS, is an assistant professor at the University of North Carolina at Greensboro. Correspondence can be addressed to Ryan Cook, 310 Graves Hall, Box 870231, Tuscaloosa, AL 35487, rmcook@ua.edu.

Practicing Counselors, Vicarious Trauma, and Subthreshold PTSD: Implications for Counselor Educators

Bethany A. Lanier, Jamie S. Carney

The purpose of this study was to gain an understanding of the relationship between vicarious trauma (VT) symptoms and subthreshold post-traumatic stress disorder (PTSD) symptoms among practicing counselors. The researchers determined the frequency of VT symptoms and subthreshold PTSD symptoms experienced among practicing counselors and common contributing factors that participants felt contributed to the development of VT symptoms. Implications are presented for counselor educators to determine how they best can prepare students.

 

Keywords: vicarious trauma, subthreshold post-traumatic stress disorder, PTSD, practicing counselors, counselor educators

 

 

Most counselors will likely work with clients addressing trauma (Sommer, 2008; Trippany, White Kress, & Wilcoxon, 2004). Thus, it is important for professional counselors to have an understanding of the dynamics of trauma and interventions to use with clients. Additionally, counselors should be educated on the impact that working with clients can potentially have on them, both personally and professionally. For instance, counselors who work with clients addressing trauma might themselves experience emotional and psychological symptoms, or vicarious trauma (VT). VT has been defined as a disruption in schemas and worldview because of chronic empathic engagement with clients. It is often accompanied by symptoms similar to those of post-traumatic stress disorder (PTSD), which occur as a result of secondary exposure to traumatic material that can result in a cognitive shift in the way the therapist experiences self, others, and the world (Jordan, 2010; Michalopoulos & Aparicio, 2012). Although estimates differ, it has been reported that as many as 50% of counselors are at risk of developing VT (National Child Traumatic Stress Network, 2011).

 

Counseling requires an immense amount of empathetic acceptance on the part of the counselor, which increases the counselor’s vulnerability to taking on their clients’ traumatic experiences (Finklestein, Stein, Greene, Bronstein, & Solomon, 2015). Empathic acceptance and increased vulnerability on the part of the counselor may increase the counselor’s likelihood of developing VT symptoms (Sommer, 2008). VT can have a detrimental effect on all aspects of the counseling process, including both the counselor’s professional and personal life. Practicing counselors experiencing VT have been found to leave the profession early and may also experience emotional and physical disorders, suicidal ideation, strained relationships, increased or continuous burnout, anger, and possible substance abuse (Bergman, Kline, Feeny, & Zoellner, 2015; Keim, Olguin, Marley, & Thieman, 2008). VT is highly detrimental to the counseling process and the care provided to clients. A counselor experiencing VT is more likely to make clinical errors, and VT can negatively impact the counseling relationship (Trippany et al., 2004). The negative implications associated with VT make it imperative that counselors and those who work with them (e.g., supervisors and counselor educators) understand all the factors that lead to the development of VT. This can include recognizing factors that decrease vulnerability, assessing VT, and intervening (Sommer, 2008). One of the initial components to this process is understanding how VT and related symptoms of subthreshold PTSD develop and the variables or experiences that can contribute to higher levels of vulnerability to VT symptoms. Subthreshold PTSD has been defined as the presence of clinically significant PTSD symptoms that fall short of the full Diagnostic and Statistical Manual of Mental Disorders PTSD diagnostic criteria (Bergman et al., 2015).

 

VT and Subthreshold PTSD

 

     As noted, VT can have a detrimental impact on all aspects of the counseling process. A counselor experiencing VT can report many of the symptoms associated with both VT and subthreshold PTSD. VT and subthreshold PTSD have been identified as closely related phenomena. Many counselors who experience VT also meet the criteria for subthreshold PTSD and share similar symptoms (Keim et al., 2008). Counselors who experience VT are in essence experiencing post-traumatic stress symptoms in response to hearing and processing the trauma experienced by their clients (Bercier & Maynard, 2015). Common similar symptoms of VT and subthreshold PTSD include experiencing recurring intrusive thoughts about clients or work, numbing of feelings, hypervigilance or increased anxiety, and a decrease in empathy (Howlett & Collins, 2014; Michalopoulos & Aparicio, 2012; Nelson, 2016).

 

Although there are limitations in the research on the variables that correspond to the development of VT and subthreshold PTSD among counselors, as well as the factors that address these vulnerabilities, the research has highlighted some areas of concern. Understanding these areas is a critical component of addressing the development, assessment, and intervention for VT and subthreshold PTSD, especially for supervisors and counselor educators who train and work with these counselors. One of these variables is years of experience. Although all practicing counselors are at risk for VT and subthreshold PTSD, novice counselors are at an especially elevated risk (Michalopoulos & Aparicio, 2012; Parker & Henfield, 2012). Novice counselors tend to have limited experience with trauma and often have limited training relevant to working with trauma (Newell & MacNeil, 2010; Parker & Henfield, 2012). Further, novice counselors might have trouble establishing boundaries during the early stages of professional identify development, which can contribute to an increase in vulnerability for developing VT and subthreshold PTSD (Howlett & Collins, 2014). Moreover, beginning counselors’ training and personal experiences may not have adequately prepared them for working with individuals dealing with trauma, so in turn they might not have received training on how to address trauma with their clients or identify the development of VT in themselves (Jordan, 2010; Mailloux, 2014; Trippany et al., 2004). It has been recommended that such training should include the key features of trauma, warning signs and symptoms, and strategies to prevent the development of VT and subthreshold PTSD (Newell & MacNeil, 2010).

 

     An essential element of training counselors on strategies to prevent or address the development of VT and subthreshold PTSD includes increasing awareness of the workplace dynamics that may increase vulnerability. Counselors spend a sizeable amount of their time ensuring that others take care of themselves while potentially neglecting their own personal self-care (Whitfield & Kanter, 2014). Neglecting self-care has been found to correspond to an increased rate for developing the negative effects of VT and subthreshold PTSD symptoms (Mailloux, 2014). In an effort to decrease VT and subthreshold PTSD practicing counselors must ensure they are incorporating various types of self-care on a regular basis. Counselors can incorporate self-care activities, such as adequate sleep, social interaction, exercise, a healthy diet, reading, and journaling, into their routine, but all too often practicing counselors let these activities slip (Jordan, 2010; Nelson, 2016).

 

Related to self-care is helping counselors to understand the importance of seeking support from peers and supervisors. Collaboration and consultation with peers and supervisors at the workplace are vital to minimize the adverse effects of VT and subthreshold PTSD (Jordan, 2010). To address possible VT and subthreshold PTSD, practicing counselors require support from colleagues in relation to case conceptualization and identification of impairment (Newell & MacNeil, 2010; Parker & Henfield, 2012; Whitfield & Kanter, 2014). Additionally, counselors should seek supervision specific to trauma to ensure they are not developing VT symptoms and subthreshold PTSD symptoms (Whitfield & Kanter, 2014). One of the concerns, however, is that for many counselors working at counseling sites with high caseloads related to trauma, there are often low levels of clinical supervision (O’Neill, 2010). These sites also can link to another variable that corresponds to higher levels of VT: the caseload of the counselor. For example, counselors with large caseloads are at increased risk of developing VT or subthreshold PTSD because the counselor may not be able to spend adequate amounts of time on each case and might overextend their time addressing case needs (Whitfield & Kanter, 2014). In addition, counselors with caseloads that deal primarily with trauma are at an increased risk of developing VT and subthreshold PTSD, especially if they have limited clinical experience (Bercier & Maynard, 2015; Newell & MacNeil, 2010; Trippany et al., 2004). Recognizing and understanding the contributors to VT and subthreshold PTSD are essential for counselor educators and supervisors to be aware of as they prepare new counselors to enter the field.

 

Counselor Educator and Supervisor Implications

 

When looking at the risk factors associated with VT and subthreshold PTSD, it is clear that a critical component to decrease risk is the training and support provided to counselors. Thus, it is imperative that counselor educators and supervisors be aware of the symptoms and factors that impact the development of VT and subthreshold PTSD. Keim et al. (2008) found that 12% of counselors-in-training (CITs) qualified for a PTSD diagnosis, highlighting the fact that counselor educators and supervisors need to be aware of and educate counselors to recognize the symptoms of VT and subthreshold PTSD. The Council for Accreditation of Counseling and Related Educational Programs (CACREP; 2015) reinforces the importance of this training by specifically requiring that programs educate CITs on trauma-related counseling skills and also engage students in methods to assess and address VT and subthreshold PTSD symptoms in themselves as practicing counselors. To meet this goal, counselor educators and supervisors must more fully understand the causes of VT and subthreshold PTSD (Keim et al., 2008).

 

This study was developed to assess the frequency of VT and subthreshold symptoms among practicing counselors. This included variables that correspond to the development of these symptoms. The data can contribute to our understanding of VT and subthreshold PTSD symptoms among counselors and provide a framework for working with counselors during supervision and in preparing CITs.

 

Method

 

Sample

Two hundred and twenty current practicing counselors completed the nationwide survey. Of the 220 participants, 219 participants reported gender; 23 (10.3%) respondents identified as male and 196 (87.9%) respondents identified as female. Of the participants, 217 (98.6%) reported they were over 19 years of age (range 23–65, M = 39). Two hundred and fifteen respondents indicated holding a master’s degree (97.8%). Thus, exclusion criteria removed five respondents from the data set for not meeting degree requirements—participants must have completed a master’s degree in counseling (i.e., school counseling, clinical mental health counseling, rehabilitation counseling, family and marriage counseling). Current work setting was reported by 207 of the respondents; 137 (62.3%) identified as school counselors, 24 (10.9%) reported working in a community mental health center, 17 (7.7%) reported working in a higher education center, 16 (7.35%) reported working in a private practice, and 13 (5.9%) reported “other,” which included settings such as employee assistance programs and crisis centers.

 

Six respondents (2.7%) reported less than one year of cumulative counseling experience, 50 (22.7%) reported 1–3 years of cumulative counseling experience, 31 (14.1%) reported 4–5 years of cumulative counseling experience, 47 (21.4%) reported 6–10 years of cumulative counseling experience, and 72 (32.7%) reported 10 years or more of cumulative counseling experience. Of the 220 respondents, 12 (5.5%) did not report how many years they have been in their current position, 8 (3.6%) reported being in their current position less than one year, 103 (10.9%) reported 1–3 years, 31 (14.1%) reported 4–5 years, 30 (13.6%) reported 6–10 years, and 36 (16.4%) reported being in their current position 10 or more years.

 

Instruments

Participants were asked to complete a brief demographic questionnaire and two surveys, the PTSD Checklist for the DSM-5 (PCL-5), developed by Blevins, Weathers, Davis, Witte, and Domino (2015), and the Secondary Trauma Stress Scale (STSS), developed by Bride, Robinson, Yegidis, and Figley (2004). The demographic questionnaire sought to understand the impact that years of experience, number of contributing factors, and preventive measures have on VT and subthreshold PTSD symptoms. Participants in this study also completed a series of measures assessing the rate of VT among practicing counselors, the number of participants who meet the criteria for subthreshold PTSD, and the impact of the types and number of professional supports on practicing counselors.

 

     Demographic measure. A basic demographic survey was developed and utilized to collect data on each respondent’s age, gender, current position, years of counseling experience, primary type of clientele served, and any licenses and credentials. Text entry was utilized to understand the type and number of professional supports respondents identified: supervision, peer support, years of experience, training specific to trauma, caseload size, and self-care implementation. The demographic survey collected basic information related to the participants’ counseling experience and background to gain an understanding of who chose to participate in the study. Further, the information gained was used to assist in developing implications for counselor educators and supervisors in preparing CITs to recognize VT symptoms and identify the types of professional supports needed.

 

     PTSD Checklist for the DSM-5 (PCL-5). The PCL-5 is a revision of the PTSD Checklist (PCL) that specifically assesses self-report measures of PTSD symptoms as outlined in the DSM-5 (Blevins et al., 2015). The PCL is one of the most widely used measures of PTSD symptoms, and the revised PCL-5 is the only instrument that specifically measures criteria defined in the DSM-5 (Blevins et al., 2015). The PCL-5 is a 20-item survey that corresponds to the 20 PTSD symptoms in the DSM-5 (Bovin et al., 2016). Respondents are asked to rank, from 0–4, how much they have been bothered by the presented symptom within the last month (Bovin et al., 2016). Sample topics include: having difficulty sleeping; feeling jumpy or easily startled; and avoiding memories, thoughts, or feelings related to the stressful event. In a validation study of the PCL-5, Blevins et al. (2015) found high internal consistency (.94), and the measure fell within the recommended range of inter-item correlation of .15 to .50. Test-retest reliability was r = .82 with a 95% confidence interval [.71, .89], and paired t-tests were significant (p < .01) for the PCL-5 between two test validations (Blevins et al., 2015). Cronbach’s alpha for this study indicated high internal consistency (.96) and test-retest reliability of r = .84.

 

     Secondary Trauma Stress Scale (STSS). The STSS, developed by Bride et al. (2004), was used to understand the number of VT symptoms among practicing counselors as well as to determine the relationship between VT symptoms and subthreshold PTSD symptoms among practicing counselors. The STSS is a 17-item self-report measure designed to assess helping professionals who may have experienced secondary traumatic stress and the frequency of intrusion, avoidance, and arousal symptoms (Bride et al., 2004; Ting, Jacobson, Sanders, Bride, & Harrington, 2005).

 

The STSS asks that respondents endorse how frequently an item was true for them in the past 7 days (Bride et al., 2004). Responses range from 1 to 5 in Likert form (1 = never and 5 = very often). Psychometric data for the STSS indicates very good internal consistency reliability with coefficient alpha levels of .93 for the total STSS scale, .80 for the Intrusion subscale, .87 for the Avoidance subscale, and .83 for the Arousal subscale (Bride et al., 2004). Ting et al. (2005) determined in their validation study of the STSS that internal consistency reliability for the 17 total STSS items was very high (.94) and was moderately high for the Intrusion subscale (.79), the Avoidance subscale (.85), and the Arousal subscale (.87), and all three factors were highly correlated with each other (intrusion–avoidance, r = .96; intrusion–arousal, r = .96; avoidance–arousal, r = 1.0), as indicated by a confirmatory factor analysis. Cronbach’s alpha for this study confirmed Ting et al.’s findings, as internal consistency reliability for the 17 total STSS items was very high (.94) and was moderately high for the Intrusion subscale (.80), the Avoidance subscale (.86), and the Arousal subscale (.89). Statements on the Intrusion subscale inquire about respondents’ intrusion symptomology on a Likert scale with statements such as “My heart started pounding when I thought about my work with clients” and “I had disturbing dreams about my work with clients.” The Avoidance subscale asks respondents to respond on a Likert scale to statements such as “I felt emotionally numb” and “I had little interest in being around others.” The final subscale, Arousal, asks respondents to respond on a Likert scale to statements such as “I had trouble sleeping” and “I expected something bad to happen.”

 

Procedures

Upon Institutional Review Board approval, participants were recruited via email through listserv solicitation that included the Alabama Counseling Association, the American School Counselor Association, the American Counseling Association, and CESNET. Participants were provided a link to an informed consent document and the research surveys in Qualtrics. Participation was restricted to practicing mental health or school counselors who had a master’s degree in counseling and had been a practicing counselor for at least 6 months at the time of the survey.

 

Design and Statistical Analyses

The purpose of this quantitative study was to investigate the frequency of VT symptoms and subthreshold PTSD symptoms experienced by practicing counselors. This included the relationship of VT symptoms and subthreshold PTSD symptoms with years of experience, work setting and type of clientele, and the number and type of professional supports utilized by practicing counselors. Descriptive analysis was used to determine what symptoms of VT and subthreshold PTSD practicing counselors experience. A linear regression was used to determine the relationship between VT symptoms and subthreshold PTSD symptoms. Linear regressions were utilized to determine the relationship years of experience, work setting and type of clientele, and professional supports have with VT symptoms and subthreshold PTSD symptoms among practicing counselors.

 

Results

 

Symptoms of VT and Subthreshold PTSD Experienced by Practicing Counselors

Descriptive statistics based on participants’ responses indicated symptoms of VT and subthreshold PTSD are being experienced by practicing counselors. On the STSS, all symptoms were experienced to some degree by 49.5% of the participants. Symptoms were rated significant if they scored higher than “never” on the STSS, meaning they had experienced the symptom to some degree within the past 7 days.

 

The most common symptom of VT experienced by participants was thinking about work with clients when not intending to do so (85.5%), as measured by the STSS. Additional symptoms of VT experienced commonly by participants included feeling emotionally numb (80.5%), becoming easily annoyed (79.1%), having difficulty concentrating (75.5%), and feeling discouraged about their future (75.5%). Experiencing disturbing dreams about their clients (49.5%) and feeling jumpy (56.4%) were the least common symptoms experienced by participants, but 49.5% of the participants experienced these symptoms. Table 1 outlines the VT symptoms of participants as measured by the STSS in descending order.

 

 

Table 1

 

STSS Symptom Distribution

Items in Descending Order n (%)
I thought about my work with clients when I didn’t intend to. 188 (85.5%)
I felt emotionally numb. 177 (80.5%)
I was easily annoyed. 174 (79.1%)
I felt discouraged about the future. 166 (75.5%)
I had trouble concentrating. 166 (75.5%)
I had trouble sleeping. 165 (75.0%)
I wanted to avoid working with some clients. 162 (73.6%)
I was less active than usual. 156 (70.9%)
Reminders of my work with clients upset me. 155 (70.5%)
My heart started pounding when I thought about my work with clients. 155 (70.5%)
I had little interest in being around others. 149 (67.6%)
It seemed as if I was reliving the trauma(s) experienced by my client(s). 133 (60.5%)
I expected something bad to happen. 132 (60.0%)
I avoided people, places, or things that reminded me of my work with clients. 126 (57.3%)
I noticed gaps in my memory about client sessions. 126 (57.3%)
I felt jumpy. 124 (56.4%)
I had disturbing dreams about my work with clients. 109 (49.5%)

 

 

 

 

Participant responses to the PCL-5, utilized to measure subthreshold PTSD symptoms, suggested practicing counselors are experiencing subthreshold PTSD symptoms. Symptoms were rated as significant if they scored higher than “not at all,” indicating they had experienced the symptom to some degree within the past month. The most common symptom reported to have been experienced by all participants (100%) was repeated, disturbing, or unwarranted memories of the stressful experience. Other symptoms that were reported to have been experienced commonly by practicing counselors included having trouble falling or staying asleep (71.4%), having difficulty concentrating (70.9%), feeling distant or cut off from other people (68.2%), and feeling very upset when something reminded them of the stressful experience (66.8%). Taking too many risks or doing things that could cause personal harm (36.8%); feeling or acting as if the stressful experience were actually happening again (42.7%); and experiencing repeated, disturbing dreams of the stressful experience (49.1%) were experienced least commonly by participants. Table 2 outlines the VT symptoms of participants as measured by the PCL-5 in descending order.

 

 

Table 2

 

PCL-5 Symptom Distribution

Items in Descending Order n (%)
Repeated, disturbing, and unwanted memories of the stressful experience? 220 (100%)
Trouble falling or staying asleep? 157 (71.4%)
Having difficulty concentrating? 156 (70.9%)
Feeling distant or cut off from other people? 150 (68.2%)
Feeling very upset when something reminded you of the stressful experience? 147 (66.8%)
Irritable behavior, angry outbursts, or acting aggressively? 139 (63.2%)
Avoiding memories, thoughts, or feelings related to the stressful experience? 139 (63.2%)
Having strong negative feelings such as fear, horror, anger, guilt, or shame? 134 (60.9%)
Having strong physical reactions when something reminded you of the stressful experience
(for example, heart pounding, trouble breathing, sweating)?
130 (59.1%)
Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)? 127 (57.7%)
Being “superalert” or watchful or on guard? 125 (56.8%)
Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)? 125 (56.8%)
Loss of interest in activities that you used to enjoy? 123 (55.9%)
Blaming yourself or someone else for the stressful experience or what happened after it? 121 (55.0%)
Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)? 119 (54.1%)
Feeling jumpy or easily startled? 116 (52.7%)
Trouble remembering important parts of the stressful experience? 113 (51.4%)
Repeated, disturbing dreams of the stressful experience? 108 (49.1%)
Suddenly feeling or acting as if the stressful experience were actually happening again
(as if you were actually back there reliving it)?
  94 (42.7%)
Taking too many risks or doing things that could cause you harm?   81 (36.8%)

 

 

 

 

Relationship Between VT Symptoms and Subthreshold PTSD Symptoms

     Linear regression models determined the relationship between VT symptoms and subthreshold PTSD symptoms among practicing counselors. In a backward regression, the PCL-5, measuring subthreshold PTSD symptoms, was entered as the dependent variable, and the subscales of the STSS, measuring VT symptoms, were entered as the independent variables. Results indicated that the more VT symptoms were experienced by practicing counselors, the more subthreshold PTSD symptoms were experienced. There was a significant relationship between results from the PCL-5 and all three STSS subscales. The relationship between subthreshold PTSD symptoms and the Intrusion subscale was significant (r = .676, p < .001). There also was a significant relationship between subthreshold PTSD symptoms and avoidance symptoms (r = .759, p < .001), and between subthreshold PTSD symptoms and arousal symptoms (r = .790, p < .001). Avoidance VT symptoms and arousal VT symptoms were the most predictive variables associated with developing subthreshold PTSD symptoms as evidenced in the restricted model regression summary. In the backward regression model, the Intrusion subscale of the STSS was eliminated as the least significant variable, which indicates the more arousal and avoidance symptoms were experienced as VT, the more subthreshold PTSD symptoms were experienced by the practicing counselors. In the full regression model (R2 Full = .656, F = 103.4, p < .001), results suggested a significant relationship, indicating that the more VT symptoms were experienced by practicing counselors, the more subthreshold PTSD symptoms were experienced. Through the restricted regression model (R2 Restricted = .655, F = 155.75, p < .001) and the F change test, results indicated that the restricted model is not worse than the full model because the observed F (.00000892; p = .647) does not exceed the critical F (df = 1,163), which is 3.94.

 

Relationship Among Demographics and Type of Professional Supports Among Practicing Counselors on VT

A backward linear regression model was utilized to determine the relationship between VT symptoms and years of experience, work setting and type of clientele, and type of professional supports among practicing counselors. There were two significant relationships within this regression in the restricted model of the regression. There was a significant negative correlation between VT symptoms and having a manageable caseload, indicating the more manageable caseload the counselor has, the fewer VT symptoms they have. In addition, there was a significant negative correlation between VT symptoms and having adequate supervision, indicating the more supervision received, the fewer VT symptoms experienced. Overall, the two variables (caseload and supervision) correlate with the dependent variable, VT symptoms (r = .273, R2 = .074). This overall correlation is unlikely due to chance (F = 8.159, p < .001). The F change test indicated the observed F (2.008; p = .158) does not exceed the critical F (df = 1, 202), which is 3.89. The semi-partial correlation between caseload and VT symptoms was -.173, while the semi-partial correlation between supervision and VT symptoms was -.150. The semi-partial correlation indicates the uniqueness of the relationship. The squared semi-partial correlation for supervision was (-.173)2 = .029, and the squared semi-partial correlation for caseload was (-.150)2 = .02., *p < .05.

 

Relationship Between Demographics and Type of Professional Supports Among Practicing Counselors on Subthreshold PTSD Symptoms

A backward linear regression model was utilized to determine the relationship between subthreshold PTSD symptoms and years of experience, work setting and type of clientele, and the number and type of professional supports among practicing counselors. With subthreshold PTSD symptoms as the dependent variable and years of experience, work setting and type of clientele, and type of professional supports as the independent variables, a backward linear regression was run to understand the relationship between the variables in the restricted model of the regression. Results indicated a significant relationship between subthreshold PTSD symptoms and those counselors who work primarily with adolescents or with sexual assault/domestic violence survivors. Overall, the two variables (adolescents and sexual assault/domestic violence) correlate with our dependent variable, subthreshold PTSD symptoms (r = .242, R2 = .059). This overall correlation is unlikely due to chance (F = 5.080, p = .007). The F change test indicated the observed F (2.255; p = .135) does not exceed the critical F (df = 1,162), which is 3.94. The semi-partial correlation between adolescents and subthreshold PTSD symptoms was .159, while the semi-partial correlation between sexual assault/domestic violence and subthreshold PTSD symptoms was .187. The semi-partial correlation indicates the uniqueness of the relationship. The squared semi-partial correlation for adolescents was (.159)2 = .025, and the squared semi-partial correlation for sexual assault/domestic violence was (.187)2 = .03. This data indicates that work setting and the type of clientele served by the counselor can influence risk for developing subthreshold PTSD symptoms.

 

Limitations

     One limitation for this study was the high percentage of participating school counselors (62.3%). This could have possibly skewed results as the type of clientele that the practicing counselors primarily worked with exhibited the most influence on symptoms of VT and subthreshold PTSD (i.e., adolescents). Additionally, this large percentage of school counselors could make the implications suggested in this study not as applicable for counselors in higher education settings.

 

An additional limitation of this study was the lack of demographics available to identify if counselors were in a rural setting or urban setting. Although the implications suggested are applicable to all counselors, demographic location could serve as an additional barrier to implementing the professional supports suggested.

 

Discussion

 

The purpose of this study was to develop an understanding of the frequency and characteristics of VT symptoms and subthreshold PTSD symptoms among practicing counselors, which was answered by the first research question. The most common VT symptom experienced by participants (85.5%) was thinking about their work with clients when they did not intend to outside of work. This finding is significant for counselor educators and supervisors as it indicates that VT symptoms are being experienced by the majority of the counselors in this study. All VT symptoms, as measured by the STSS, were experienced by 49.5% of the participants, indicating all 17 VT symptoms measured had been experienced to some degree by the counselors that participated in this study. This study adds to the current literature reported by Bride (2007) that 50% of child welfare counselors experience traumatic stress symptoms within the severe range. In addition, Cornille and Meyers (1999) reported 37% of their sample of child protection service workers reported clinical levels of emotional distress associated with secondary trauma, and Conrad and Kellar-Guenther (2006) reported 50% of child protection workers suffered “high” to “very high” levels of compassion fatigue.

 

In addition to measuring VT symptoms, the first research question was developed to acquire an understanding of the frequency of subthreshold PTSD symptoms experienced by counselors. Subthreshold PTSD symptoms were measured by the PCL-5 and results suggest practicing counselors are experiencing subthreshold PTSD symptoms. Of the 20 items in the PCL-5, all but three were experienced by at least 50% of the participants. All 220 (100%) of participants reported experiencing repeated, disturbing, and unwanted memories of the stressful experience. This finding is similar to that found by the STSS in that over 85% of participants had unwanted thoughts about experiences with clients outside of work. Furthermore, over 70% of participants reported having trouble sleeping and having difficulty concentrating in both the STSS and PCL-5 as symptoms of VT and subthreshold PTSD. Understanding the symptoms of VT and subthreshold PTSD experienced by participants was important, as previous studies have indicated that those who experience VT symptoms also experience subthreshold PTSD symptoms (Jordan, 2010). Additionally, the literature has reported VT symptoms and subthreshold PTSD symptoms as being one and the same (Finklestein et al., 2015).

 

The second research question was developed to gain an understanding of the relationship between VT symptoms and subthreshold PTSD symptoms. A linear backward regression with the PCL-5 measuring subthreshold PTSD symptoms was entered as the dependent variable, and the subscales of the STSS, measuring VT symptoms, were entered as the independent variables. Results from this regression model indicated that the more VT symptoms were experienced by practicing counselors, the more subthreshold PTSD symptoms were experienced. In the backward regression model, the Intrusion subscale of the STSS was eliminated as the least significant variable, which indicated that the more arousal and avoidance symptoms were experienced as VT, the more subthreshold PTSD symptoms were experienced by the practicing counselors, with the Intrusion scale not being significant. This finding is consistent with the extant literature that has reported VT symptoms being analogous to PTSD symptoms (Keim et al., 2008). Furthermore, this finding also is consistent with prior literature that reported counselors who experience VT symptoms also experience PTSD symptoms (Bercier & Maynard, 2015), as found in Bride’s (2007) study in which 34% of child welfare workers met the PTSD diagnostic criteria because of VT.

 

In an effort to answer the second research question, which was interested in the relationship between VT symptoms and subthreshold PTSD symptoms and years of experience, work setting and type of clientele, and the number and type of professional supports, two backward linear regression models were established. The first linear regression model was interested in the relationship between VT symptoms and years of experience, work setting and type of clientele, and the number and type of professional supports among practicing counselors. In this backward linear regression model, the STSS served as the dependent variable with years of experience, work setting and type of clientele, and the number and type of professional supports serving as the independent variables. Results indicate a significant relationship between VT symptoms and having a manageable caseload as well as between VT and utilizing supervision. A negative correlation between VT symptoms and having a manageable caseload indicates that the more manageable a counselor’s caseload, the less likely they were to experience VT symptoms. This finding is consistent with prior studies that indicate a manageable caseload as being a protective factor for counselors that can decrease their chance of developing both VT symptoms and subthreshold PTSD symptoms (Trippany et al., 2004). Additionally, there was a negative correlation between supervision as a professional support and the development of VT symptoms among counselors. Adequate supervision has been identified as a protective factor against the development of VT (Harrison & Westwood, 2009). Both of these findings are important implications for counselor educators and supervisors as they can be initiated in the classroom while CITs are preparing for a career in the counseling profession.

 

The second linear regression model focused on the relationship between subthreshold PTSD symptoms and years of experience, work setting and type of clientele, and the number and type of professional supports among practicing counselors. In this backward linear regression model, the PCL-5 served as the dependent variable with years of experience, work setting and type of clientele, and the number and type of professional supports serving as the independent variables. Results indicated a significant relationship between subthreshold PTSD symptoms and counselors who primarily work with adolescents and sexual assault/domestic violence survivors. These findings are consistent with prior literature that has indicated sexual assault counselors report more VT symptoms and subthreshold PTSD symptoms. For instance, Bride (2007) reported 65% of domestic violence and sexual assault social workers reported at least one symptom of VT, while Lobel (1997) reported over 20 years ago that 70% of sexual assault counselors experienced VT. Additionally, Schauben and Frazier (1995) reported that counselors who work with a higher percentage of sexual assault survivors report more disrupted beliefs about themselves and others, more subthreshold PTSD symptoms, and more VT than counselors who see fewer sexual assault survivors.

 

Implications for Counselor Educators and Supervisors

 

     The results of this study provide counselor educators and supervisors with information to prepare CITs to have an increased awareness of VT and subthreshold PTSD symptoms. This study established evidence that practicing counselors are experiencing numerous VT symptoms and subthreshold PTSD symptoms. In fact, this study found that all VT symptoms measured were experienced by 49.5% of the participants, and 17 of the 20 PTSD symptoms measured were experienced by all participants. Further, in an open-ended question in the brief demographic survey, participants provided the researcher with ideas they felt would increase awareness of VT and subthreshold PTSD and decrease VT and subthreshold PTSD symptoms. Over 40% of responses indicated a desire for more education on VT symptoms and subthreshold PTSD symptoms. With 49.5% of participants reporting VT symptoms and subthreshold PTSD symptoms, it is evident that additional education is needed related to these symptoms among practicing counselors. Keim et al. (2008) suggested educational trainings and workshops be provided to CITs proactively to increase awareness of VT and subthreshold PTSD and to decrease VT symptoms and subthreshold PTSD symptoms among practicing counselors. Counselor educators and supervisors can provide trainings on the signs and symptoms of VT and subthreshold PTSD experienced by counselors to raise awareness of these symptoms and ways to recognize and alleviate them before causing harm to the counselor or client.

 

This study denoted that counselors who work primarily with adolescents and sexual assault/domestic violence survivors are experiencing more subthreshold PTSD symptoms than counselors that do not work specifically with these populations. As counselor educators prepare CITs for practicum, internship, and employment as counselors, it is vital for counselor educators to acknowledge the unique challenges that may stem from working with adolescents and survivors of sexual assault/domestic violence. It is imperative that counselor educators and supervisors integrate specific educational material through coursework related to these populations to best prepare CITs. Evidence-based practices that are effective for counseling these populations should be implemented within counselor education programs, supervision, workshops, and trainings outside of the degree program (e.g., at conferences; Alpert & Paulson, 1990; Mailloux, 2014; Whitfield & Kanter, 2014).

 

Education on the significance of professional supports, such as adequate supervision and manageable caseloads, is fundamental for CITs to be prepared to lessen the hazard of developing VT symptoms and subthreshold PTSD symptoms. By providing sufficient supervision during practicum and internship, counselor educators and supervisors can prepare CITs for coping with VT symptoms and subthreshold PTSD symptoms should they develop. In addition, through modeling appropriate supervision, CITs will comprehend the supervisory process and seek post-degree supervision.

 

Directions for Future Research

     Future studies on VT symptoms and subthreshold PTSD symptoms need to focus solely on clinical mental health counselors or school counselors to develop implications specific to counseling sites. Further research devoted to the development of workshops and trainings to educate counselors on VT and subthreshold PTSD is needed.

 

A future study that compares counselors in rural settings and urban settings will be important to understand barriers to coping with and addressing VT symptoms and subthreshold PTSD symptoms. For example, in a rural setting, the counselor may not have adequate supervision and may be overloaded with cases, which can decrease the amount of self-care they are able to implement. It will be important for future research to explore what barriers to professional supports counselors face in these different demographic communities.

Because of this study’s finding that working primarily with adolescents and individuals who have experienced sexual assault or domestic violence increases counselors’ chances of experiencing VT symptoms and subthreshold PTSD symptoms, a qualitative or mixed-methods study focused on VT among counselors working with these populations is desirable. In an effort to best prepare students who will work with these populations, an understanding of exactly which aspects of working with these clients increase VT symptoms and subthreshold PTSD symptoms is essential.

 

 

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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Bethany A. Lanier, NCC, is an assistant professor at the University of West Georgia. Jamie S. Carney is a professor at Auburn University. Correspondence can be addressed to Bethany Lanier, 1601 Maple Street, Carrollton, GA 30116, blanier@westga.edu.