Counselor Educators and Students With Problems of Professional Competence: A Survey and Discussion

Kathleen Brown-Rice, Susan Furr

It has been found that 10% of counselors-in-training are ill-suited for the profession (Gaubatz & Vera, 2002). In that, they have problems of professional competence (PPC) that impede their ability to function as professional counselors (Elman & Forrest, 2007). These PPC include skill competencies, ethical behaviors and appropriate personal functioning (Kaslow et al., 2007). To evaluate students in terms of professional competence and prevent those with inadequate skills and dispositions from entering the profession, gatekeeping is utilized. Counselor educators are required to be transparent in their gatekeeping procedures with students. Students are to be informed of “the levels of competency expected, appraisal methods, and timing of evaluations for both didactic and clinical competencies” and be provided “ongoing feedback” (American Counseling Association [ACA], 2014, p. 15). There has been significant research to provide counselor educators with information to establish gatekeeping and remediation procedures (Gaubatz & Vera, 2002; Homrich, DeLorenzi, Bloom, & Godbee, 2014; Hutchens, Block, & Young, 2013; Kerl, Garcia, McCullough, & Maxwell, 2002; McAdams, Foster, & Ward, 2007; Pease-Carter & Barrio Minton, 2012; Vacha-Haase, Davenport, & Kerewsky, 2004; Zoimek-Daigle & Christensen, 2010). However, little research has been done to examine the impact on counselor educators when interacting with students who have PPC and the roadblocks that impede educators’ ability to gatekeep.

 

Gatekeeping Procedures

 

Gatekeeping is a mechanism for counselor educators to determine the fitness of students to enter the counseling profession (Vacha-Haase et al., 2004). Gatekeeping begins as part of the admission process of a counseling program (Kerl & Eichler, 2007). During the admission process, counselor educators do not allow entry to prospective students who show traits, qualities or behaviors that would result in them not being able to meet professional competencies or who lack the prescribed academic requirements (Lumadue & Duffey, 1999; Swank & Smith-Adcock, 2013). However, gatekeeping is not just part of the admission process. Ziomek-Daigle and Christensen (2010) found that gatekeeping is a progressive activity that includes four phases, including preadmission screening, postadmission screening, remediation plan and remediation outcome.

 

Informing Students of Program Expectations

The American Counseling Association Code of Ethics (2014) provides that counseling students be aware of what type and degree of skill and knowledge will be required of them to be successful in the program, specific training goals and objectives, what students’ evaluations are based on, and the policies and procedures for students’ evaluations. One of the most important methods of ensuring understanding of expectations is informing students of the program’s expectations at the beginning of the program. Once clearly defined behaviors are established, sharing these expectations with students can result in fewer problematic situations (Kerl et al., 2002; McAdams et al., 2007). Furthermore, not providing students with clear expectations for conduct may be viewed as unfair to those wanting to become counselors (Homrich et al., 2014).

 

It is recommended that professional standards be made clear to students and applied consistently (Hutchens et al., 2013). Using multiple methods of distributing information is desired by students who have stated they want information shared both orally and in written form, and want the information presented throughout the program (Pease-Carter & Barrio Minton, 2012). Pease-Carter and Barrio Minton (2012) found that students desired information not only about academic expectations but also wanted to know about self-disclosure, reflection, personal growth and student rights.

 

Assessing Students’ PPC Behaviors

Individual programs have developed standards for evaluating students on professional competencies and use these evaluations to provide formative feedback (Kerl et al., 2002). Historically, the most commonly cited problematic behaviors have been inadequate clinical skills, defensiveness in supervision and deficient interpersonal skills (Vacha-Haase et al., 2004). Efforts to identify criteria for evaluating students in terms of professional behaviors, interpersonal behaviors and intrapersonal behaviors have recently been undertaken (Homrich et al., 2014), and these criteria provide a platform for developing clear expectations for counseling trainees.

 

 

 

Roadblocks to Gatekeeping

 

There are a variety of reasons that counselor educators do not engage in the gatekeeping process. Gateslipping rates have been reported as higher in programs where faculty members reported that their colleagues were concerned about being sued or receiving less than favorable teaching evaluations (Gaubatz & Vera, 2002; Jacobs et al., 2011). In some settings, colleagues and administration provide support for engaging in gatekeeping; however, lack of clear evidence and bias toward leniency lead to gateslippage (Brear & Dorrian, 2010). Absence of well-defined program policies may make it difficult to initiate gatekeeping conversations with a student as well (Jacobs et al., 2011).

 

Gatekeeping demands a great amount of time and energy, and situations involving PPC often seem unending (Gizara & Forrest, 2004). Not only do PPC have to be identified and communicated to the student, remediation plans need to be developed. Such plans may include helping the counselor-in-training obtain remedial assistance, providing intensified supervision, documenting the activities of the plan and ensuring the student understands due process options (Ziomek-Daigle & Christensen, 2010). When remediation plans are not successful, decisions about dismissal must be made, and the actions taken must be transparent (Kaslow et al., 2007).

 

There may be occasions where the gatekeeping responsibility is diffused among different entities. In a review of ethical issues around professional competence problems (Johnson et al., 2008), Johnson labeled this issue as the “hot potato game” (p. 589), where the last entity engaged with the problematic student is stuck with the issue. If a student is allowed to gateslip through the graduate program, then the training facility and licensing board now become involved. Rather than address the issue when it is first recognized, the student may be allowed to move to the next stage of training with the hope that the problem disappears or that that it is addressed at the next level. Addressing issues early in the training may help avoid more serious issues, like the empathy veil, later when students go to clinical sites.

 

The Empathy Veil

This term was coined by Brown-Rice and Furr (2014) and refers to the counselor educator’s need to empathize with the counselor-in-training, which can result in reluctance to engage in gatekeeping activities. Role tension may be one factor in developing an empathy veil. This term evolved from work by Sue and Sue (2012) where a person’s worldview is seen as having an invisible veil that is created by cultural conditioning and is believed to operate outside of consciousness. Forrest et al. (2013) found that empathy may contribute to avoiding confronting student issues for fear of damaging the relationship. Because of the role that faculty play in fostering growth and development, which often involves compassion and support, it may become difficult to provide accurate summative evaluations of trainees’ behaviors (Johnson et al., 2008). Given that many faculty members also are professional counselors, they may view their role as assisting the student in behavior change and thus work with the student to address interpersonal issues that interfere with developing counseling skills (Kerl et al., 2002). This empathy can be both a support and a challenge when difficult conversations about problematic professional, interpersonal and intrapersonal behaviors need to take place (Jacobs et al., 2011). Although empathy can create a safe environment in which to discuss difficulties, an educator’s empathy also can lead to overprotective behaviors that may actually interfere with the student’s development (Gizara & Forrest, 2004).

 

Role of Diversity

Another important area of consideration is how cultural differences intersect with PPC. When there is a cross-cultural student PPC situation, a complex power differential arises that not only is associated with the faculty–student relationship, but also related to cultural differences (Goodrich & Shin, 2013). Kaslow et al. (2007) proposed that consideration should be given to the impact of beliefs, values and attitudes when assessing competence problems. Fear of appearing biased may complicate identifying trainees with PPC and how decisions are made regarding students (Shen-Miller, Forrest, & Elman, 2009). The counselor educator’s own cultural background may influence how counselors-in-training are evaluated, and it is recommended that cultural dynamics be assessed when addressing PPC (Rust, Raskin, & Hill, 2013). Shen-Miller, Forrest, and Burt (2012) identified two approaches that often are used by faculty in assessing students—culture-attentive (i.e., approaches that include attention to aspects of diversity) or colorblind (i.e., inattention or minimization of differences associated with diversity). These views represent two ends of a “continuum of conceptualizing intersections between diversity and professional standards” (Shen-Miller et al., 2012, p. 1207). In trying to find a place on this continuum to address PPC, do counselor educators underidentify PPC because of fear of being biased? Or, are counselor educators more prone to overidentify PPC because of not examining contextual factors that influence competence? In this study, an attempt is made to examine counselor educators’ views of what interferes with their ability to address issues of counselor education student PPC.

 

Other Barriers

Previous research has found that educators believe that they have not been provided with sufficient training related to gatekeeping and remediation procedures, and they do not feel supported by their agency and colleagues (Gizara & Forrest, 2004; Vacha-Haase et al., 2004). Additionally, counselor educators may be reluctant to dismiss a student for dread of potential litigation and personal recrimination (Crawford & Gilroy, 2012; Hutchens et al., 2013) and receiving poor teaching evaluations (Gaubatz & Vera, 2002). Recent court cases have increased awareness about the legal consequences of gatekeeping. The Ward and Keeton cases have highlighted the need for counseling programs to establish clear statements about student expectations (Herlihy, Hermann, & Greden, 2014). Other cases have taught faculty members the importance of providing regular process evaluations and thorough documentation (McAdams & Foster, 2007). Reflection on the results of facing a court challenge includes the significance of having a measure of performance that helps faculty retain objectivity and the importance of adhering to established procedures (McAdams et al., 2007).

 

The purpose of this study was to answer the following research questions: (a) What types of master’s students’ PPC do Council for Accreditation of Counseling and Related Educational Programs (CACREP) counselor educators perceive have the greatest impact on them as educators? (b) What do CACREP counselor educators perceive are roadblocks that interfere with their ability to engage in the gatekeeping of master’s students with PPC? and (c) What is CACREP counselor educators’ knowledge of their programs’ protocol for addressing a student with PPC? In this study, student refers to a master’s student enrolled in the participant’s counseling program, colleague is another counselor educator teaching in the participant’s counseling program, and impact means to have a strong effect. PPC refers to attitudes and behaviors that could interfere with the professional competence of a counselor-in-training, including: (a) a lack of ability or opposition to acquire and integrate professional standards into one’s professional counseling behavior; (b) a lack of ability to attain professional skills and reach an acceptable level of competency; (c) a lack of ability to manage one’s stress, psychological dysfunction or emotional responses that may impact professional performance; or (d) engagement in unethical behavior (Falender, Collins, & Shafranske, 2009).

 

Methods

 

Participants and Procedures

Prior to initiating the study, institutional review board approval was obtained. Recruitment of participants was conducted by an e-mail to all faculty employed at CACREP-accredited programs in the United States. The researchers of this study obtained a list of accredited programs from the official CACREP Web site and then visited each program’s Web site to obtain the e-mail addresses of the program’s counselor educators. Seven programs did not list faculty e-mails on their university Web sites. The exact number of educators teaching in CACREP-accredited programs is not known, as the programs’ Web sites might have imprecise or out-of-date information. Based upon the e-mail addresses gathered from the university Web sites, a list of 1,584 faculty members was created. Thereafter, one e-mail solicitation was sent to all identified faculty that directed participants to an online survey entitled, Problems of Professional Competency Survey – Counselor Educator Version (PPCS-CE), which was located on Psychdata.com. Of the 1,584 e-mails that were sent, 71 were undeliverable due to lacking a valid address or security issues, 15 were returned with automatic responses that the faculty member was absent (e.g., on sabbatical, no longer at university, ill, professor emeritus), and five responses indicated that the receiver of the e-mail was not a counselor educator. This left a total sample size of 1,493 CACREP counselor educators. For a population of 1,500, a sample size of 306 is adequate to generalize with a confidence interval of 95% (Gay, Mills, & Airasian, 2009). A total of 382 participants completed the survey; however, respondents with missing or invalid data (n = 12, less than 4%) were eliminated via listwise deletion, leaving a total number of 370 participants included in this study. This resulted in an adequate sample size of 370 participants and a final response rate of 25%. Frequencies and percentages of the demographic variables in this study are reported in Table 1.

 

 

Table 1  Numbers and Percentages of Demographic Variables
Variable  Number Percentage
Gender:
  Female

213

58

  Male

157

42

Background:
  Caucasian

310

84

  African American

24

6

  Hispanic/Latino

12

3

  Multi-Racial

15

4

  Asian/Pacific Islander

8

2

  Native American

1

1

Age:
  20 years to 29 years

7

2

  30 years to 39 years

77

21

  40 years to 49 years

97

26

  50 years to 59 years

76

21

  60 years or older

113

31

Sexual Orientation:
  Heterosexual

331

90

  Bisexual

9

2

  Gay or Lesbian

30

8

Description of Program:
  Predominantly on Campus

318

86

  Predominantly Online

7

2

  Hybrid of Online/on Campus

45

12

Location of Program:
  South

146

40

  Northeast

93

25

  Midwest

74

20

  West

57

15

Highest Degree:
  PhD – CACREP Program

201

54

  PhD – Non-CACREP Program

38

10

  EdS in Counseling

10

3

  PhD – Counseling Psychology

31

8

  PhD – Clinical Psychology

                                 4

1

  Other (doctoral in another discipline ormaster’s in counseling or related field)

86

23

Academic Rank:
  Assistant Professor

145

39

  Associate Professor

102

28

  Professor

92

25

  Clinical Instructor

8

2

  Adjunct Instructor

                                 6

.2

  Other

17

5

Years Teaching in a CACREP-Accredited Program:
  Less than 2 years

59

16

  2 to 5 years

84

23

  6 to 10 years

90

24

  11 to 15 years

66

18

  16 to 20 years

28

8

  Over 20 years

43

12

Licenses and Certifications Held:
  Licensed Professional Counselor

201

55

  Licensed Alcohol and Drug Counselor

21

6

  Provisionally Licensed Professional Counselor

14

4

  Licensed Marriage & Family Counselor

33

9

  Licensed Psychologist

37

10

  Licensed Social Worker

7

2

  Certified School Counselor

95

26

  National Certified Counselor

199

54

 

 

 

 

 

Instrument

The survey for this present study was designed based upon the Problems of Professional Competency Survey – Master Student Version (PPCS-MS) developed by Brown-Rice and Furr (2013), related to determining master’s students’ enrolled in CACREP-accredited programs knowledge of classmates with PPC. The PPCS-MS was constructed based upon the literature regarding PPC in psychology, counseling and social work. To establish content validity and reliability, the PPCS-MS underwent an expert review process and two pilot studies to provide clarity and conciseness of the survey questions. Additionally, a principal components analysis created components representative of what the review of the literature provided on these issues (Brown-Rice & Furr, 2013). The questions and format of the PPCS-MS were used and adjusted to create a self-report survey entitled the Problems of Professional Competency Survey – Counselor Educator Version (PPCS-CE). This instrument was divided into three parts: Part I – Demographic Information, Part II – Counselor Educators and Students with PPC, and Part III – Counselor Educators’ Knowledge of Colleagues’ PPC (removed from this analysis). Part II included three sections. Section I, Counselor Educators’ Knowledge of Students’ Problems of Professional Competency, included one question to determine whether participants have observed students with PPC and two questions to determine participants’ knowledge of the type of students’ PPC and the impact of the problematic behavior. Each PPC was rank ordered from 1 being the most common and 9 being the least common observed behavior, and the impact of having a student with PPC was ranked ordered with 1 having the most impact and 9 having the least impact. Chi square analyses of each of the rank ordered items led to a rejection of the null hypotheses of the categories of the item occurring with equal probabilities.

 

Section II of Part II of the survey investigated counselor educators’ reactions to students’ PPC and consisted of seven questions. The answers to all these questions were based on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Section III, Counselor Educators’ Knowledge of Counseling Program’s Protocol for Addressing Problems of Professional Competency, included questions relating to responsibility for being aware of students PPC and programs’ protocols for addressing PPC. The first nine questions were evaluated on a 5-point Likert scale. The tenth item was unstructured to provide a place for participants to provide additional information.

 

Results

 

Types and Impact of Students’ Problematic Behavior

Of the 370 participants, the majority (91%, n = 338) reported that they had observed students with PPC in their programs. Additionally, 2% (n = 8) of the respondents indicated they did not know if there were students with PPC in their programs, leaving 7% (n = 24) who had not observed any students with PPC. To answer the first research question regarding the types and impact of master’s students’ PPC observed by CACREP counselor educators, the responses for the 338 participants who reported observing a student with PPC were examined according to the rank order question regarding the types of PPC that participants most observed with counselors-in-training in their programs. The most frequently identified problematic behaviors included inadequate clinical skills (M = 2.90, SD = 1.88), inadequate interpersonal skills (M = 3.15, SD = 1.69), inadequate academic skills (M = 3.38, SD = 2.29), inability to regulate emotions (M = 4.16, SD = 1.88), and unprofessional behavior (M = 4.29, SD = 2.13). Those behaviors ranked as less impactful were unprofessional behavior (M = 4.29, SD = 2.13), unethical behavior (M = 5.63, SD = 2.03), psychological concern (M = 6.20, SD = 1.84), personality disorder (M = 7.60, SD = 1.61), and substance use disorder (M = 7.69, SD = 1.68).

 

The responses for the rank order question regarding the type of impact of having counselors-in-training in their program with PPC focused on the behaviors having the most impact on the faculty member. Included in this list were disrupted the classroom learning environment (M = 2.99, SD = 1.86), negatively affected other students (M = 3.26, SD = 1.52), increased participant’s workload (M = 3.29, SD = 2.05), and increased participant’s stress (M = 3.39, SD = 1.64). Additional items that were ranked as less impactful included negatively affected client care (M = 5.06, SD = 2.44), negatively affected relationship with students (M = 5.47, SD = .87), negatively affected relationship with colleagues (M = 6.59, SD = 1.42), negatively affected reputation of the program (M = 6.81, SD = 1.90), and a grievance or litigation occurred (M = 8.25, SD = 1.94).

 

Roadblocks to Gatekeeping

All participants (n = 370) completed Section II, Part II of the PPCS-CE, and these participants’ responses for strongly agree and agree were combined to report the subsequent findings. Each of the participants reported degree of agreement or disagreement regarding beliefs around the roadblocks that interfere with their ability to engage in the gatekeeping of master’s students with PPC. Fifty-three percent (n = 197) reporting struggling emotionally to balance being empathetic with a student demonstrating PPC and their gatekeeping duties. When looking at addressing PPC with a student who is culturally different from the participant, 38% (n = 141) stated they were reluctant to do so due to the fear they would appear culturally insensitive, and 36% (n = 137) were reluctant to do so due to the fear of allegations of discrimination. Regarding being supported by others, 13% (n = 47) provided they did not feel supported by their chair to address a student who demonstrated PPC, and 13% (n = 47) stated they did not feel supported by their colleagues to address a student who demonstrated PPC. Further, 92% (n = 339) were concerned about the counseling profession when a student with PPC was allowed to pass through the program. Additionally, 30% (n = 110) provided they were reluctant to address a student demonstrating PPC for fear of recrimination (e.g., negative teaching evaluations, legal action).

 

Protocol for Addressing Students with PPC

When the participants’ responses for strongly agree and agree were combined, 99% (n = 368) believed it was their responsibility to be aware of students with PPC, 91% (n = 335) believed that it was their chair’s responsibility, and 96% (n = 354) believed it was both their chair and respondents’ responsibility to be aware of students with PPC. Additionally, 94% (n = 347) were aware of their programs’ procedures regarding how to address problematic behavior, 71% (n = 263) reported their chair had discussed their programs’ procedures regarding addressing PPC with them, and 38% (n = 140) stated they had received training from their program regarding how to intervene with a student who they believe is demonstrating PPC. Further, 87% (n = 321) were aware of the appropriate intervention to take with students with PPC, 51% (n = 189) would like more information regarding how to identify students with PPC, and 61% (n = 226) of the participants would like more information on how to respond to a student with PPC.

 

Discussion and Implications

 

     The PPC identified in this study as being observed most frequently are consistent with those problematic behaviors identified in other studies. Vacha-Haase et al. (2004) also identified that inadequate clinical skills and deficient interpersonal skills were most commonly cited as problematic behaviors. In a study examining a proposed set of standards for clinical training, Homrich et al. (2014) identified three categories of behaviors needed by graduate students in clinical training, which included professional behaviors, interpersonal behaviors and intrapersonal behaviors. The types of PPC counselor educators observed in this study parallel the findings of Homrich et al. (2014) in that inadequate clinical skills and unprofessional behavior are similar to their theme of professional behaviors, and the category of inadequate interpersonal skills is comparable to their theme of interpersonal behaviors. Inability to regulate emotions is analogous to their theme of intrapersonal behaviors. Because they were examining clinical training standards, there was no mention of academic skills, yet this type of PPC was cited as a concern by many of the respondents in this study.

 

Examination of these data leads to questions about how counseling programs admit students. Both academic skills and interpersonal skills are areas that can be addressed through the admissions process. Smaby, Maddox, Richmond, Lepkowski, and Packman (2005) found that undergraduate GPA and GRE Verbal scores could be predictive of scores on the Counselor Preparation Comprehensive Examination (CPCE), which focus on knowledge, but were not highly predictive of personal development. Given the level of concern over academic skills, using these cognitive measures is important, but expanding the way of assessing academic ability also needs to be sensitive to issues around diversity and bias in standardized measures.

 

In a survey on admission screening measures, training directors indicated that the personal interview was the most effective screening measure (Leverett-Main, 2004). Using creative group strategies during the admission process has been advocated to help assess academic potential as well as dispositions (Swank & Smith-Adcock, 2013). Smith, Robinson, and Young (2007) found that an assessment of wellness might uncover issues around psychological distress that could affect performance in a counseling graduate education program.

 

Previous research has indicated that faculty members have concerns about addressing PPC because of their desire to be supportive of students (Johnson et al., 2008; Kerl et al., 2002), which would support the concept of the empathy veil (Brown-Rice & Furr, 2014). In this study, 53% of respondents reported struggling emotionally to balance empathy with their gatekeeping duties to intercede with a counselor-in-training with PPC. When the open-ended responses were reviewed, participants’ responses supported this empathetic struggle. For example, one respondent stated, “I have heard many times how a grade should be considered through compassion for student circumstances rather than demonstrated competency.” Another participant provided, “Our empathy wants to give them another chance, but our ethics don’t necessarily allow for it. It’s a struggle for me. It is not a part of the job that I anticipated. Although I remember learning the concept in my doctoral program, I wasn’t prepared to address it.” Therefore, it would appear that these counselor educators are struggling with empathy veils.

 

When looking at other roadblocks (e.g., lack of peer and institutional support, diversity in gatekeeping, threat of litigation or recrimination from a counselor-in-training), there were some interesting findings. Previous research has found a lack of support for counselor educators from administration and colleagues in dealing with problematic students (Gizara & Forrest, 2004; Vacha-Haase et al., 2004). This concern has been found to be especially true for field supervisors (Bogo, Regehr, Power, & Regehr, 2007; Homonoff, 2008). However, the results of the current study found that only 13% stated they did not feel supported by their chair or colleagues to address a student who demonstrated PPC. The open-ended responses supported these findings. For example, participants stated, “We have a culture and climate of supporting our gatekeeping role in the counseling profession”; “My colleagues and I work as a team in addressing student concerns”; and “I feel supported by my chair and department when dealing with such issues. We deal with these issues as a department. No one is alone in addressing such issues.” Therefore, for this study, lack of institutional and peer support do not seem to be roadblocks. This could be due to the fact that all the participants in this study worked at programs that were accredited by CACREP. CACREP (2016) requires a procedure for addressing student professional and personal development. Counselor educators at programs that are not CACREP-accredited may report different findings. A limitation of this study is that only faculty from CACREP-accredited programs were contacted. Future research focusing on non-CACREP programs and site supervisors regarding this issue may be beneficial. Those working in the field may not have a deep understanding of the role of gatekeeping and may need to develop clear guidelines for their role as supervisors for both counselors-in-training and for counselors seeking licensure.

 

When the counselor-in-training was from a different cultural background than the counselor educator, 38% of the respondents expressed concern about appearing culturally insensitive, and 36% were concerned about allegations of discrimination. Because this survey was a self-report measure, there is risk that some participants provided answers they considered to be socially desirable (which is a limitation of the study). The field of counseling is committed to multicultural competence in skills, knowledge and awareness, which could make it difficult for counselor educators to acknowledge problematic behaviors in students who are different from themselves. Research has indicated that White counselors tend to favor the colorblind approach in disposition cases (Neville, Lilly, Duran, Lee, & Browne, 2000). Yet fear of responding in a way that appears insensitive may have contributed to responding in socially desirable ways on this instrument. More exploration is needed in this area. While recent literature has addressed how to be culturally responsive when intervening with counseling students’ problematic behavior (Goodrich & Shin, 2013), there is a lack of research regarding culturally responsive performance standards. Until the counseling profession establishes clear performance expectations that are culturally sensitive, the tension between colorblind and culture-attentive expectations will continue to complicate responding to PPC. For example, class performance often has an evaluation component concerning class participation. If a student is from a culture where students do not contribute unless called upon by the professor, then this student may perform poorly because of not understanding expectations. The professor needs to be sensitive to this type of difference and work with the student to develop ways of being successful.

 

Few participants reported involvement in a legal action related to gatekeeping and remediation with a student demonstrating PPC; however, 30% stated they were reluctant to address a student for fear of retaliation from the student. Given that counselor educators who have been involved in such cases have disclosed the emotional toll these processes take on a program and its faculty members (Dugger & Francis, 2014; McAdams et al., 2007), it seems understandable that there is concern. Therefore, support from ACA, resources in the form of consultation with other campuses and endorsement of gatekeeping processes from one’s own campus are essential in navigating this demanding process. Although legal actions are not common, developing appropriate gatekeeping procedures will help prevent negative outcomes (Dugger & Francis, 2014).

 

In addition, Brown-Rice and Furr (2014) provided that counselor educators and supervisors should “maintain appropriate ethical boundaries and avoid dual relationships with counselors-in-training, inform and educate themselves regarding the proper gatekeeping protocols and limit their own hypocrisy regarding acting in a competent and ethical manner” (p. 5). There has been substantial research and discussion regarding ethical boundaries, dual relationships and establishing proper gatekeeping procedures (Brown, 2013; Kolbert, Morgan, & Brendel, 2002; Morrissette & Gadbois, 2006; Ziomek-Daigle & Christensen, 2010). However, there seems to be a lack of attention to the competence of counselor educators and how counselors-in-training perceive educators’ professional and personal competence. Do students see faculty members engaging in the same attitudes, skills, behaviors and self-awareness that they are required to adhere to? Are counselor educators modeling the behaviors they want to see in their students or do they hold students to different standards?

 

Almost all the participants (94%) provided they were aware of their programs’ procedures regarding how to address problematic behavior, and 87% were aware of the appropriate intervention to take with students with PPC. However, only 38% stated they had received training from their program regarding how to intervene with a problematic student. In the open-ended responses, participants stated that their programs had established procedures and all faculty members were aware of them; however, they also reported that PPC were minimized or not addressed. For example, one participant provided, “while there is often a policy in place . . . I find that colleagues fail to follow that policy in practice.” Another respondent stated, “It is also up to the adviser to address the issue with the student and create a plan of improvement. Not all faculty do this and this leads to students receiving different treatment.” Additionally, a participant shared that colleagues were resistant to “address inappropriate student attitudes, dispositions, personality characteristics, and behaviors unless they reach such a critical threshold that they pose a significant threat to clients or, in some cases, faculty egos.” It also appears that how a student is addressed may be related to faculty dynamics. For example, “Political alliances among faculty play a major role in determining which students are targeted for intervention.”

 

Participants overwhelmingly reported they were aware of their programs’ procedures and the appropriate interventions to take when they encounter counselors-in-training with PPC. However, they also reported that they struggle with their gatekeeping duties due to empathy, diversity issues and fear of recrimination; half of the participants (51%) stated they would like more information regarding how to identify students with PPC, and 61% would like more information on how to respond to these students. Apparently, counseling programs are doing a good job developing procedures and communicating these procedures to faculty members, as recommended by Gaubatz and Vera (2002). But there remains a disconnect between knowledge about procedures and the ability to implement a response to PPC that may be related to the roadblocks identified in this study.

 

Counselor educators and supervisors know what they are supposed to do if a PPC has been clearly delineated; however, they struggle with identifying problematic behavior that reaches a threshold of needing to be formally addressed and taking action related to problematic student behaviors. The gap between the recognition that a student is not meeting expectations and the point where formal action is initiated may be filled with the counselor educators’ own beliefs about how they can fix the problem as well as their own anxieties related to the barriers discovered in this study. The recognition of and intervention with students with PPC can be further complicated by counselor educators having to negotiate faculty politics. It would seem that more attention is needed on assisting counselor educators in negotiating these barriers to ensure students do not gateslip.

 

Conclusion

 

     The results of this current study provide insight that educators are aware of counseling students with problematic behaviors, and these behaviors are impacting the learning environment, other students in the program and personal stress. It also appears that the largest roadblock present and impacting counselor educators’ ability to engage in gatekeeping procedures relates to their empathy veils. The authors of this article perceive that there is a struggle for counselor educators between balancing compassion for students’ life circumstances and developmental level with holding them to an acceptable level of professional competence. Counselor educators know it is their responsibility to engage in ethical gatekeeping procedures; however, they do not want to be excessively critical of students. Having an understanding of the empathy veil will assist educators in finding the balance between challenging and supporting students. Counselor educators must not accept students with PPC into their programs or allow them to move on without confronting and remediating their problematic behaviors. Educators need to do their due diligence and be willing to lift their empathy veils and engage in their gatekeeping responsibilities.

 

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest

or funding contributions for the development

of this manuscript.

 

 

References

 

American Counseling Association. (2014). 2014 American Counseling Association Code of Ethics. Alexandria, VA:
Author.

Bogo, M., Regehr, C., Power, R., & Regehr, G. (2007). When values collide: Field instructors’ experiences of providing feedback and evaluating competence. Clinical Supervisor, 26, 99–117. doi: 10.1300/J001v26n01_08

Brear, P., & Dorrian, J. (2010). Gatekeeping or gate slippage? A national survey of counseling educators in Australian undergraduate and postgraduate academic training programs. Training and Education in Professional Psychology, 4, 264–273. doi:10.1037/a0020714

Brown, M. (2013). A content analysis of problematic behavior in counselor education programs. Counselor Education and Supervision, 52, 179–192. doi:10.1002/j.1556-6978.2013.00036.x

Brown-Rice, K. A., & Furr, S. (2013). Preservice counselors’ knowledge of classmates’ problems of professional competency. Journal of Counseling & Development, 91, 224–233. doi:10.1002/j.1556-6676.2013.00089.x

Brown-Rice, K. A., & Furr, S. (2014). Lifting the empathy veil: Engaging in competent supervision. In Ideas and research you can use: VISTAS 2014. Retrieved from http://www.counseling.org/knowledge-center/vistas

Council for Accreditation of Counseling and Related Educational Programs. (2016). 2016 CACREP

Standards. Retrieved from http://www.cacrep.org/wp-content/uploads/2012/10/2016-CACREP-Standards.pdf

Crawford, M., & Gilroy, P. (2012). Professional impairment and gatekeeping: A survey of master’s-level training programs. Journal of Counselor Preparation and Supervision, 5, 28–37.

Dugger, S. M., & Francis, P. C. (2014). Surviving a lawsuit against a counseling program: Lessons learned from Ward v. Wilbanks. Journal of Counseling & Development, 92, 135–141. doi:10.1002/j.1556-6676.2014.00139.x

Elman, N. S., & Forrest, L. (2007). From trainee impairment to professional competence problems: Seeking new terminology that facilitates effective action. Professional Psychology: Research and Practice, 38, 501–509. doi:10.1037/0735-7028.38.5.501

Falender, C. A., Collins, C. J., & Shafranske, E. P. (2009). “Impairment” and performance issues in clinical supervision: After the 2008 ADA Amendments Act. Training and Education in Professional Psychology, 3, 240–249. doi:10.1037/a0017153

Forrest, L., Elman, N. S., Huprich, S. K., Veilleux, J. C., Jacobs, S. C., & Kaslow, N. J. (2013). Training directors’ perceptions of faculty behaviors when dealing with trainee competence problems: A mixed method pilot study. Training and Education in Professional Psychology, 7, 23–32. doi:10.1037/a0032068

Gaubatz, M. D., & Vera, E. M. (2002). Do formalized gatekeeping procedures increase programs’    follow-up                     with deficient trainees? Counselor Education and Supervision, 41, 294–305.

Gay, L. R., Mills, G. E., & Airasian, P. (2009). Educational research: Competencies for analysis and applications (9th                         ed.). Upper Saddle River, NJ: Pearson Education.

Gizara, S. S., & Forrest, L. M. (2004). Supervisors’ experiences of trainee impairment and incompetence at APA-accredited internship sites. Professional Psychology: Research and Practice, 35, 131–140.
doi:10.1037/0735-7028.35.2.131

Goodrich, K. M., & Shin, R. Q. (2013). A culturally responsive intervention for addressing problematic behaviors in counseling students. Counselor Education and Supervision, 52, 43–55.
doi:10.1002/j.1556-6978.2013.00027.x

Herlihy, B. J., Hermann, M. A., & Greden, L. R. (2014). Legal and ethical implications of using religious beliefs as the basis for refusing to counsel certain clients. Journal of Counseling & Development, 92, 148–153. doi:10.1002/j.1556-6676.2014.00142.x

Homonoff, E. (2008). The heart of social work: Best practitioners rise to challenges in field instruction. Clinical Supervisor, 27, 135–169, doi:10.1080/07325 220802490828

Homrich, A. M., DeLorenzi, L. D., Bloom, Z. D., & Godbee, B. (2014). Making the case for standards of conduct in clinical training. Counselor Education and Supervision, 53, 126–144. doi:10.1002/j.1556-6978.2014.00053.x

Hutchens, N., Block, J., & Young, M. (2013). Counselor educators’ gatekeeping responsibilities and students’ First Amendment rights. Counselor Education and Supervision, 52, 82–95. doi:10.1002/j.1556-6978.2013.00030.x

Jacobs, S. C., Huprich, S. K., Grus, C. L., Cage, E. A., Elman, N. S., Forrest, L., . . . Kaslow, N. J. (2011). Trainees with professional competency problems: Preparing trainers for difficult but necessary conversations. Training and Education in Professional Psychology, 5, 175–184. doi:10.1037/a0024656

Johnson, W., Elman, N. S., Forrest, L., Robiner, W. N., Rodolfa, E., & Schaffer, J. B. (2008). Addressing professional competence problems in trainees: Some ethical considerations. Professional Psychology: Research and Practice, 39, 589–599. doi:10.1037/a0014264

Kaslow, N. J., Rubin, N. J., Forrest, L., Elman, N. S., Van Horne, B. A., Jacobs, S. C., . . . Thorn, B. E. (2007). Recognizing, assessing, and intervening with problems of professional competence. Professional Psychology: Research and Practice, 38, 479–492, doi:10.1037/0735-7028.38.5.479.

Kerl, S., & Eichler, M. (2007). The loss of innocence: Emotional costs to serving as gatekeepers to the counseling profession. Journal of Creativity in Mental Health, 1, 71–88.

Kerl, S. B., Garcia, J. L., McCullough, C. S., & Maxwell, M. E. (2002). Systematic evaluation of professional performance: Legally supported procedure and process. Counselor Education and Supervision, 41, 321–332.

Kolbert, J. B., Morgan, B., & Brendel, J. M. (2002). Faculty and student perceptions of dual relationships within counselor education: A qualitative analysis. Counselor Education and Supervision, 41, 193–206. doi:10.1002/j.1556-6978.2002.tb01283.x

Leverett-Main, S. (2004). Program directors’ perceptions of admission screening measures and indicators of student success. Counselor Education and Supervision, 43, 207–219.

Lumadue, C. A., & Duffey, T. H. (1999). The role of graduate programs as gatekeepers: A model for evaluating student counselor competence. Counselor Education and Supervision, 39, 101–109.
doi:10.1002/j.1556-6978.1999.tb01221.x

McAdams, C. R., III, & Foster, V. A. (2007). A guide to just and fair remediation of counseling students with professional performance deficiencies. Counselor Education and Supervision, 47, 2–13.

McAdams, C. R., III, Foster, V. A., & Ward, T. J. (2007). Remediation and dismissal policies in counselor education: Lessons learned from a challenge in federal court. Counselor Education and Supervision, 46, 212–229.

Morrissette, P. J., & Gadbois, S. (2006). Ethical consideration of counselor education teaching strategies. Counseling and Values, 50, 131–141. doi:10.1002/j.2161-007X.2006.tb00049.x

Neville, H. A., Lilly, R. L., Duran, G., Lee, R. M., & Browne, L. (2000). Construction and initial validation of the Color-Blind Racial Attitudes Scale (CoBRAS). Journal of Counseling Psychology, 47, 59–70.

Pease-Carter, C., & Barrio Minton, C. A. (2012). Counseling programs’ informed consent practices: A survey of student preferences. Counselor Education and Supervision, 51, 308–319. doi:10.1002/j.1556-6978.2012.00023.x

Rust, J. P., Raskin, J. D., & Hill, M. S. (2013). Problems of professional competence among counselor trainees: Programmatic issues and guidelines. Counselor Education and Supervision, 52, 30–42.
doi:10.1002/j.1556-6978.2013.00026.x

Shen-Miller, D. S., Forrest, L., & Burt, M. (2012). Contextual influences on faculty diversity conceptualizations when working with trainee competence problems. The Counseling Psychologist, 40, 1181–1219. doi:10.1177/0011000011431832

Shen-Miller, D. S., Forrest, L., & Elman, N. S. (2009). Training directors’ conceptualizations of the intersections of diversity and trainee competence problems: A preliminary analysis. The Counseling Psychologist, 37, 482–518. doi:10.1177/0011000008316656

Smaby, M. H., Maddux, C. D., Richmond, A. S., Lepkowski, W. J., & Packman, J. (2005). Academic admission requirements as predictors of counseling knowledge, personal development, and counseling skills. Counselor Education and Supervision, 45, 43–57.

Smith, H. L., Robinson, E. H. M., III, & Young, M. E. (2007). The relationship among wellness, psychological distress, and social desirability of entering master’s-level counselor trainees. Counselor Education and Supervision, 47, 96–109.

Sue, D. W., & Sue, D. (2012). Counseling the culturally diverse: Theory and practice (6th ed.). New York, NY: Wiley & Sons.

Swank, J. M., & Smith-Adcock, S. (2013). Creative group strategies for interviewing applicants for counselor education programs. The Journal of Counselor Preparation and Supervision, 5, 38–48.

Vacha-Haase, T., Davenport, D. S., & Kerewsky, S. D. (2004). Problematic students: Gatekeeping practices of                    academic professional psychology programs. Professional Psychology: Research and Practice, 35, 115–                122. doi:10.1037/0735-7028.35.2.115

Ziomek-Daigle, J., & Christensen, T. M. (2010). An emergent theory of gatekeeping practices in counselor education. Journal of Counseling & Development, 88, 407–415.

doi:10.1002/j.1556-6678.2010.tb00040.x

 

Kathleen Brown-Rice, NCC, is an Assistant Professor at the University of South Dakota. Susan Furr is a Professor at the University of North Carolina Charlotte. Correspondence can be addressed to Kathleen Brown-Rice, 114E Clark Street, Vermillion, SD 57069, kathleen.rice@usd.edu.

 

Examining the Practicum Experience to Increase Counseling Students’ Self-Efficacy

James Ikonomopoulos, Javier Cavazos Vela, Wayne D. Smith, Julia Dell’Aquila

Master’s level counseling programs accredited by the Council for Accreditation of Counseling and Related Education Programs (CACREP, 2016) require students to complete practicum and internship courses that involve group and individual or triadic supervision. Although clinical supervision provides students with effective skill development (Bernard & Goodyear, 2004), counseling students may begin practicum with low self-efficacy regarding their counseling abilities and skills. Given the importance of clinical supervision and counselor self-efficacy, it is surprising that there are limited studies that have examined the impact of supervision and practicum experience from the perspectives of supervisees. Almost all studies within this domain are qualitative and involve personal interviews with supervisees or supervisors (e.g., Hein & Lawson, 2008). In order to fill a gap in the literature and document the impact of the practicum experience, this study examined the effectiveness of the practicum experience encompassing direct counseling services, group supervision and triadic supervision to increase counseling students’ self-efficacy. First, we provide a literature review regarding group supervision, triadic supervision and counselor self-efficacy. Next, we present findings from a study with 11 counseling practicum students. Finally, we provide a discussion regarding the importance of these findings as well as implications for counseling practice and research.

 

Supervision in Counselor Education Coursework

CACREP requires an average of one and a half hours of weekly group supervision in practicum courses that involves an instructor with up to six counseling graduate students (Degges-White, Colon, & Borzumato-Gainey, 2012). Borders et al. (2012) identified that group supervisors use leadership skills, facilitate and monitor peer feedback, and encourage supervisees to take ownership of group process in group supervision. Borders and colleagues (2012) identified several benefits in group supervision, including exposure to multiple counselor styles and ability to learn about various educational issues. There also were challenges such as limited helpful feedback, brevity of case presentations, timing of group meetings and lack of educational opportunities. In another study, Conn, Roberts, and Powell (2009) compared hybrid and face-to-face supervision among school counseling interns. There were similarities in perceptions of quality of supervision, suggesting that distance learning can provide effective group supervision. CACREP counseling programs also require students to receive one hour of weekly supervision from a faculty member or doctoral student supervisor. Triadic is one form of supervision that involves a process whereby one supervisor meets and provides feedback with two supervisees (Hein & Lawson, 2008). Hein and Lawson (2008) explored supervisors’ perspectives on triadic supervision and found increased demands on the role of the supervisor. For example, supervisors felt additional pressure to support both supervisees in supervision. Additionally, Lawson, Hein, and Stuart (2009) investigated supervisees’ perspectives of triadic supervision. Noteworthy findings included: some students perceived less time and attention to their needs; importance of compatibility between supervisees; and careful attention must be given when communicating feedback, particularly if negative feedback must be given.

Finally, Borders et al. (2012) explored supervisors’ and supervisees’ perceptions of individual, triadic and group supervision. Benefits included vicarious learning experiences, peer-learning opportunities, and better supervisor feedback, while challenges included peer mismatch and difficulty keeping both supervisees involved.

 

Counselor Self-Efficacy

One of the most important outcome variables in counseling is self-efficacy. Bandura (1986) defined self-efficacy as individuals’ confidence in their ability to perform courses of action or achieve a desired outcome. Self-efficacy in counselor education settings might influence students’ thoughts, behaviors and feelings toward working with clients (Bandura, 1997). In the current study, counseling self-efficacy is defined as “one’s beliefs or judgments about his or her capabilities to effectively counsel a client in the near future” (Larson & Daniels, 1998, p. 1). Counselor self-efficacy also can refer to students’ confidence regarding handling the therapist role, managing counseling sessions and delivering helping skills (Lent et al., 2009). In higher education settings, researchers identified relationships between practicum students’ counseling self-efficacy and various client outcomes in counseling (Halverson, Miars, & Livneh, 2006). Self-efficacy also is positively related to performance attainment (Bandura, 1986), perseverance in counseling tasks, less anxiety (Larson & Daniels, 1998), positive client outcomes (Bakar, Zakaria, & Mohamed, 2011), and counseling skills development (Lent et al., 2009). Halverson et al. (2006) evaluated the impact of a CACREP program on counseling students’ conceptual level and self-efficacy. Longitudinal findings showed that counseling students’ perceptions of self-efficacy increased over the course of the program, primarily as a result of clinical experiences.

In another investigation, Greason and Cashwell (2009) examined mindfulness, empathy and self-efficacy among masters-level counseling interns and doctoral counseling students. Mindfulness, empathy and attention to meaning accounted for 34% of the variance in counseling students’ self-efficacy. Finally, Barbee, Scherer, and Combs (2003) investigated the relationship among prepracticum service learning, counselor self-efficacy and anxiety. Substantial counseling coursework and counseling-related work experiences were important influences on counseling students’ self-efficacy.

 

Purpose of Study

This study evaluated practicum experiences by using a single-case research design (SCRD) to measure the impact on students’ self-efficacy. In a recent special issue of the Journal of Counseling & Development, Lenz (2015) described how researchers and practitioners can use SCRDs to make inferences about the impact of treatment or experiences. SCRDs are appropriate for counselors or counselor educators for the following reasons: minimal sample size, self as control, flexibility and responsiveness, ease of data analysis, and type of data yielded from analyses. In the current study, the rationale for using an SCRD to examine the effectiveness of the practicum experience and triadic supervision was to provide counselor educators with insight regarding potential strategies that increase students’ self-efficacy. With this goal in mind, we implemented an SCRD (Lenz, Perepiczka, & Balkin, 2013; Lenz, Speciale, & Aguilar, 2012) to identify and explore trends of students’ changes in self-efficacy while completing their practicum experience. We addressed the following research question: to what extent does the practicum experience encompassing direct counseling services, group supervision and triadic supervision influence counseling graduate students’ self-efficacy?

 

Methodology

Instructors of record for three practicum courses formulated a plan to investigate the impact of the practicum experience on counseling students’ self-efficacy. We focused on providing students with a positive practicum experience with support, constructive feedback, wellness checks and learning experiences. With this goal in mind, we implemented a single case research design (Hinkle, 1992; Lenz et al., 2013; Lenz et al., 2012) to identify and explore trends of students’ changes in self-efficacy while completing their practicum experience. We selected this design to evaluate data that provides inferences regarding treatment effectiveness (Lenz et al., 2013). All practicum courses followed the same course requirements, and instructors shared the same level of teaching experience.

 

Participant Characteristics

We conducted this study with a sample of Mexican American counseling graduate students (N = 11) enrolled in a CACREP-accredited counseling program in the southwestern United States. This Hispanic Serving Institution had an enrollment of approximately 7,000 undergraduate and graduate students (approximately 93% of students at this institution are Latina/o) at the time of data collection. As a result, we were not surprised that all of the participants in the current study identified as Mexican American. Fifteen participants were solicited; four declined to participate. Participants (four men and seven women) ranged in age from 24 to 57 (M = 31; STD = 9.34). All participants were enrolled in practicum; we assigned participants with pseudonyms to protect their identity. Participants had diverse backgrounds in elementary education, secondary education, case management and behavioral intervention services. Participants also had aspirations of obtaining doctoral degrees or working in private practice, school settings, and community mental health agencies.

 

Instrumentation

     Counselor Activity Self-Efficacy Scale. The Counselor Activity Self-Efficacy Scale (CASES) is a self-report measure of counseling self-efficacy (Lent, Hill, & Hoffman, 2003). This scale consists of 31 items with a 10-point Likert-type scale in which respondents rate their level of confidence from 0 (i.e., having no confidence at all) to 9 (i.e., having complete confidence). Participants respond to items on exploration skills, session management and client distress (Lent et al., 2003), with higher scores reflective of higher levels of self-efficacy. The total score across these domains represents counseling self-efficacy. Reliability estimates range from .96 to .97 (Greason & Cashwell, 2009; Lent et al., 2003). We used the total score as the outcome variable in our study.

 

Treatment

Over the course of a 14-week semester, participants received 12 hours of triadic supervision and approximately 25 hours of group supervision. We followed Lawson, Hein, and Getz’s (2009) model through pre-session planning, in-session strategies, administrative considerations and evaluations of supervisees. During triadic supervision meetings with two practicum students, the instructor of record conducted wellness checks assessing students’ well-being and level of stress, listened to concerns about clients, observed recorded sessions, provided support and feedback, and encouraged supervisees to provide feedback. The instructor of record also facilitated group supervision discussions on clients’ presenting problems, treatment planning, note-writing, and wellness and self-care strategies. All practicum instructors collaborated and communicated bi-weekly to monitor students’ progress as well as students’ work with clients. All students obtained a minimum of 40 direct hours while working at their university counseling and training clinic, where services are provided to individuals with emotional, developmental, and interpersonal issues. Treatment for depression, anxiety and family issues are the most common issues. The population receiving services at this counseling and training clinic are mostly Mexican American and Spanish-speaking clients who are randomly assigned to a practicum student after an initial phone screening.

 

Procedure

We evaluated treatment effect using an AB SCRD (in our case, we referred to this more precisely as BT for baseline and treatment), using scores on the CASES as an outcome measure. During an orientation before the semester, practicum students were informed that their instructors were interested in evaluating changes in self-efficacy. Students who agreed to participate in the current study completed baseline measure one at this time. Following this, we selected a pseudonym to identify each participant when completing counselor self-efficacy activity (CSEA) scales throughout the study. The baseline phase consisted of data collection for 3 weeks before the practicum experience. The treatment phase began after the third baseline measure, when the first triadic supervision session was integrated into the practicum experience. Individual cases under investigation were practicum students who agreed to document their changes in self-efficacy while completing the practicum experience. Given that participants serve as their own control group in a single case design, the number of participants in the current study was considered sufficient to explore the research question (Lenz et al., 2013).

 

Data Collection and Analysis

We implemented an AB, SCRD (Lundervold & Belwood, 2000; Sharpley, 2007) by gathering weekly scores of the CASES. We did not use an ABA design with a withdrawal phase given that almost all students enrolled in internship immediately after the semester. As a result, we did not want to collect data that would have tapped into students’ internship experiences. After three weeks of data collection, the baseline phase of data collection was completed. The treatment phase began after the third baseline measure where the first triadic supervision session occurred. After the 13th week of data collection, the treatment phase of data collection was completed due to nearing completion of the semester, for a total of three baseline and ten treatment phase collections. We did not collect additional treatment data points given that students were scheduled to begin internship at the conclusion of the semester. We only wanted to measure the impact of the practicum experience.

Percentage of data points exceeding the median (PEM) procedure was implemented to analyze the quantitative data from the AB single case design (Ma, 2006). A visual trend analysis was reported as data points from each phase were graphically represented to provide visual representations of change over time (Ikonomopoulos, Smith, & Schmidt, 2015; Sharpley, 2007). An interpretation of effect sizes was conducted to determine the effectiveness of triadic supervision integrated into the practicum experience when comparing each phase of data collection (Sharpley, 2007). Interpreting effect sizes for the PEM procedure yields a proportion of data overlap between a baseline and treatment condition expressed in a decimal format that ranges from zero and one. Higher scores represent greater treatment effects while lower scores represent less effective treatments. This procedure is conceptualized as the analysis of treatment phase data that is contingent on the overlap with the median data point within the baseline phase. Ma (2006) suggested that PEM is based on the assumption that if the intervention is effective, data will be predominately on the therapeutic side of the median. If an intervention is ineffective, data points in the treatment phase will vacillate above and below the baseline median (Lenz, 2013). To calculate the PEM statistic, data points in the treatment phase on the therapeutic side of the baseline are counted and then divided by the total number of points in the treatment phase. Scruggs and Mastropieri (1998) suggested the following criteria for evaluation: effect sizes of .90 and greater are indicative of very effective treatments; those ranging from .70 to .89 represent moderate effectiveness; those between .50 to .69 are debatably effective; and scores less than .50 are regarded as not effective

 

Results

 

Figure 1 and Table 1 depict estimates of treatment effect using PEM across all participants. Detailed descriptions of participants’ experiences are provided below.

 

Participant 1

     Jorge’s ratings on the CASES illustrate that the practicum experience involving triadic supervision and group supervision was very effective for improving counselor self-efficacy. Before the treatment phase began, three of Jorge’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123, which considers an individual to have low counseling self-efficacy for the CASES. Evaluation of the PEM statistic for the CASES (1.00) indicated that 10 scores were on the therapeutic side above the baseline (total scale score of 217). Scores above the PEM line were within a 122-point range. Trend analysis depicted a consistent level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring exploration skills.

 

Participant 2

     Gina’s ratings on the CASES illustrate that the practicum experience involving triadic supervision and group supervision was moderately effective for improving counselor self-efficacy. Before the treatment phase began, three of Gina’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (0.77) indicated that seven scores were on the therapeutic side above the baseline (total scale score of 194). Scores above the PEM line were within a 99-point range. Trend analysis depicted a consistent level of improvement following the second treatment measure. The majority of improvement in confidence was found on items measuring exploration skills, session management and client distress.

 

Participant 3

     Cecilia’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving counselor self-efficacy. Before the treatment phase began, three of Cecilia’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (1.00) indicated that 10 scores were on the therapeutic side above the baseline (total scale score of 177). Scores above the PEM line were within a 162-point range. Trend analysis depicted a consistent level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring exploration skills and session management.

 

 

Figure 1.

 

Graphical Representation of Ratings for Counselor Activity Self-Efficacy by Participants

 

 

Table 1

Participants’ Sessions and Their CASES Total Scale Score for Counselor Activity Self-Efficacy

 

Participant 4

     Natalia’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving her counselor self-efficacy. Before the treatment phase began, two of Natalia’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (1.00) indicated that nine scores were on the therapeutic side above the baseline (total scale score of 138). Scores above the PEM line were within a 155-point range. Trend analysis depicted a consistent level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring exploration skills.

 

Participant 5

     Yolanda’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving counselor self-efficacy. Before the treatment phase began, three of Yolanda’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (0.90) indicated that nine scores were on the therapeutic side above the baseline (total scale score of 295). Scores above the PEM line were within a 27-point range. Trend analysis depicted a minimal level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring exploration skills.

 

Participant 6

     Leticia’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving her counselor self-efficacy. Before the treatment phase began, three of Leticia’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (1.00) indicated that 10 scores were on the therapeutic side above the baseline (total scale score of 293). Scores above the PEM line were within a 43-point range. Trend analysis depicted a consistent level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring client distress.

 

Participant 7

     Robert’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving counselor self-efficacy. Before the treatment phase began, three of Robert’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (1.00) indicated that 10 scores were on the therapeutic side above the baseline (total scale score of 197). Scores above the PEM line were within a 96-point range. Trend analysis depicted a consistent level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring client distress.

 

Participant 8

   George’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving his counselor self-efficacy. Before the treatment phase began, three of George’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the counselor activity self-efficacy measure (1.00) indicated that ten scores were on the therapeutic side above the baseline (total scale score of 300). Scores above the PEM line were within a 24-point range. Trend analysis depicted a consistent level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring exploration skills.

Participant 9

     Jeremy’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving his counselor self-efficacy. Before the treatment phase began, two of Jeremy’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (0.90) indicated that nine scores were on the therapeutic side above the baseline (total scale score of 142). Scores above the PEM line were within a 201-point range. Trend analysis depicted a consistent level of improvement following the second treatment measure. The majority of improvement in confidence was found on items measuring session management and client distress.

 

Participant 10

     Brittney’s ratings on the CASES illustrate that the practicum experience and triadic supervision were moderately effective for improving her counselor self-efficacy. Before the treatment phase began, three of Brittney’s baseline measurements were below the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (0.88) indicated that eight scores were on the therapeutic side above the baseline (total scale score of 94). Scores above the PEM line were within a 132-point range. Trend analysis depicted a consistent level of improvement following the fourth treatment measure. The majority of improvement in confidence was found on items measuring session management.

 

Participant 11

     Jessica’s ratings on the CASES illustrate that the practicum experience and triadic supervision were very effective for improving her counselor self-efficacy. Before the treatment phase began, three of Jessica’s baseline measurements were above the cut-score guideline on the CASES with a total scale score of 123. Evaluation of the PEM statistic for the CASES (1.00) indicated that 10 scores were on the therapeutic side above the baseline (total scale score of 186). Scores above the PEM line were within a 71-point range. Trend analysis depicted a consistent level of improvement following the first treatment measure. The majority of improvement in confidence was found on items measuring exploration skills.

 

Discussion

The results of this study found that in all 11 investigated cases, the practicum experience ranged from moderately effective (PEM = .77) to very effective (PEM = 1.00) for improving or maintaining counselor self-efficacy during practicum coursework. For most participants, counseling self-efficacy continued to improve throughout the practicum experience as evidenced by high scores on items such as “Helping your client understand his or her thoughts, feelings and actions,” “Work effectively with a client who shows signs of severely disturbed thinking,” and “Help your client set realistic counseling goals.” Participants shared that the most helpful experiences during practicum to improve their counselor self-efficacy came from direct experiences with clients. This finding is consistent with Bandura’s (1977) conceptualization of direct mastery experiences where participants gain confidence with successful experiences of a particular activity. Participants also shared how obtaining feedback from clients on their outcomes and seeing their clients’ progress was important for their development as counselors. Other helpful experiences included processing counseling sessions with a peer during triadic supervision, and case conceptualization and treatment planning during group supervision. Obtaining feedback during triadic supervision from peers and instructors after observing recorded counseling sessions also was beneficial.

Qualitative benefits of supervision included vicarious learning experiences, peer-learning opportunities and better supervisor feedback (Borders et al., 2012). Findings from this study extend qualitative findings regarding benefits of the practicum experience and triadic supervision. The results of this study yielded promising findings related to the integration of triadic supervision into counseling graduate students’ practicum experiences. First, the practicum experience appeared to be effective for increasing and maintaining participant scores on the CSEA scale. Inspection of participant scores within treatment targets revealed that the practicum experience was very effective for nine participants and within the moderately effective range for two participants.

Lastly, informal conversations with participants indicate that triadic supervision provided participants with an opportunity to receive peer feedback. Participants also commented that weekly wellness checks were important due to stress from the practicum experience. Trends were observed for the group as a majority of participants improved self-efficacy consistently after their fourth treatment measure. In summary, direct services with clients, triadic supervision with a peer and group supervision as part of the practicum experience may assist counseling graduate students to improve self-efficacy.

 

Implications for Counseling Practice

There are several implications for practice. First, triadic supervision has been helpful when there is compatibility between supervisor and supervisees (Hein & Lawson, 2008). Compatibility between supervisees is helpful, as participants shared how having similar knowledge and experience contributed to their development. While all participants in the current study selected their partner for supervision, Hein and Lawson (2008) commented that the responsibility to implement and maintain clear and achievable support to supervisees lies heavily on supervisors. As a result, additional trainings should be offered to supervisors regarding clear, concise and supportive feedback. Such trainings and discussions can focus on clarity of roles and expectations for both supervisor and supervisee before triadic supervision begins. More training in providing feedback to peers in group supervision also can be beneficial as students learn to provide feedback to promote awareness of different learning experiences. We suggest that additional trainings will help practicum instructors and students identify ways to provide clear, constructive and effective feedback.

Practicum instructors can administer weekly or bi-weekly wellness checks and discuss responses on individual items on the Mental Well-Being Scale to monitor progress (Tennant et al., 2007). Additionally, counselor education programs would benefit from bringing self-efficacy to the forefront in the practicum experience as well as prepracticum coursework. Findings from the current study could be presented to students in group counseling and practicum coursework to facilitate discussion regarding how the practicum experience can increase students’ self-efficacy. Part of this discussion should focus on assessing baseline self-efficacy in order to help students increase perceptions of self-efficacy. As such, counselor educators can administer and interpret the CSEA scale with practicum students. There are numerous scale items (e.g., silence, immediacy) that can be used to foster discussions on perceived confidence in dealing with counseling-related issues. Finally, CACREP-accredited programs require 1 hour of weekly supervision and allow triadic supervision to fulfill this requirement. We recommend that CACREP and non-CACREP-accredited programs consider incorporating triadic supervision into the practicum experience and suggest that triadic supervision as part of the practicum experience might help students’ increase self-efficacy.

 

Implications for Counseling Research

The practicum experience seemed helpful for improving counseling students’ self-efficacy. However, information regarding reasons for this effectiveness of the practicum experience and triadic supervision was not explored. Qualitative research regarding the impact of the practicum experience on counselors’ self-efficacy can provide incredible insight into specific aspects of group or triadic supervision that increase self-efficacy. Second, more outcome-based research with ethnic minority counseling students is necessary. There might be aspects of group or triadic supervision that are conducive when working with Mexican American students (Cavazos, Alvarado, Rodriguez, & Iruegas, 2009). Third, exploring different models of group or triadic supervision to increase counseling self-efficacy is important. As one example, researchers could explore the impact of the Wellness Model of Supervision (Lenz & Smith, 2010) on counseling graduate students’ self-efficacy. Finally, all participants in our study attended a CACREP counseling program with mandatory individual or triadic supervision. Comparing changes in self-efficacy between students in CACREP and non-CACREP programs where weekly individual or triadic supervision outside of class is not mandatory would be important.

 

Limitations

There are several limitations that must be taken into consideration. First, we did not use an ABA design with withdrawal measures that would have provided stronger internal validity to evaluate changes to counselor self-efficacy (Lenz et al., 2012). Most practicum students in our study began internship immediately after the conclusion of the semester. As a result, collecting withdrawal measures in an ABA design would have tapped into students’ internship experiences. Second, although three baseline measurements are considered sufficient in single-case research (Lenz et al., 2012), employing five baseline measures might have allowed self-efficacy scores to stabilize prior to their practicum experience (Ikonomopoulos et al., 2015).

 

Conclusion

Based on results from this study, the practicum experience shows promise as an effective strategy to increase counseling graduate students’ self-efficacy. Implementing triadic supervision as part of the practicum experience for counseling students is a strategy that counselor education programs might consider. Provided are guidelines for counselor educators to consider when integrating triadic supervision into the practicum experience. Researchers also can use different methodologies to address how different aspects of the practicum experience influence counseling students’ self-efficacy. In summary, we regard the practicum experience with triadic supervision as a promising approach for improving counseling graduate students’ self-efficacy.

 

Conflict of Interest and Funding Disclosure

The authors reported no conflict of interest

or funding contributions for the development

of this manuscript.

 

References

Bakar, A. R., Zakaria, N. S., & Mohamed, S. (2011). Malaysian counselors’ self-efficacy: Implication for career counseling. The International Journal of Business and Management, 6, 141–147. doi:10.5539/ijbm.v6n9p141

Bandura, A. (1977). Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: Freeman.

Barbee, P. W., Scherer, D., & Combs, D. C. (2003). Prepracticum service-learning: Examining the relationship with counselor self-efficacy and anxiety. Counselor Education and Supervision, 43, 108–120.

Bernard, J. M., & Goodyear, R. K. (2004). Fundamentals of clinical supervision (3rd ed.). Needham Heights, MA: Allyn & Bacon.

Borders, L. D. (2014). Best practices in clinical supervision: Another step in delineating effective supervision practice. American Journal of Psychotherapy, 68, 151–162.

Borders, L. D., Welfare, L. E., Greason P. B., Paladino, D. A., Mobley, A. K., Villalba, J. A., & Wester, K. L. (2012). Individual and triadic and group: Supervisee and supervisor perceptions of each modality. Counselor Education and Supervision, 51, 281–295.

Cavazos, J., Alvarado, V., Rodriguez, I., & Iruegas, J. R. (2009). Examining Hispanic counseling students’             worries: A qualitative approach. Journal of School Counseling, 7, 1–22.

Conn, S. R., Roberts, R. L., & Powell, B. M. (2009). Attitudes and satisfaction with a hybrid model of counseling supervision. Educational Technology and Society, 12, 298–306.

Council for Accreditation of Counseling and Related Educational Programs. (2016). 2016 CACREP standards. Retrieved from http://www.cacrep.org/wp-content/uploads/2016/02/2016-Standards-with-Glossary-rev-2.2016.pdf

Degges-White, S., Colon, B. R., & Borzumato-Gainey, C. (2013). Counseling supervision within a feminist framework: Guidelines for intervention. Journal of Humanistic Counseling, 52, 92–105.
doi:10.1002/j.2161-1939.2013.00035.x

Greason, P. B., & Cashwell, C. S. (2009). Mindfulness and counseling self-efficacy: The mediating role of attention and empathy. Counselor Education and Supervision, 49, 2–19.

Halverson, S. E., Miars, R. D., & Livneh, H. (2006). An exploratory study of counselor education students’ moral reasoning, conceptual level, and counselor self-efficacy. Counseling and Clinical Psychology Journal, 3, 17–30.

Hein, S., & Lawson, G. (2008). Triadic supervision and its impact on the role of the supervisor: A qualitative examination of supervisors’ perspectives. Counselor Education and Supervision, 48, 16–31.

Hinkle, J. S. (1992). Computer-assisted career guidance and single-subject research: A scientist-practitioner approach to accountability. Journal of Counseling & Development, 70, 391–395.

Ikonomopoulos, J., Smith, R. L., & Schmidt, C. (2015). Integrating narrative therapy within rehabilitative programming for incarcerated adolescents. Journal of Counseling & Development, 93, 460–470. doi:10.1002/j.1556-6676.2014.00000.x

Larson, L. M., & Daniels, J. A. (1998). Review of the counseling self-efficacy literature. The Counseling Psychologist, 26, 179–218.

Lawson, G., Hein, S. F., & Getz, H. (2009). A model for using triadic supervision in counselor education preparation programs. Counselor Education and Supervision, 48, 257–270.

Lawson, G., Hein, S. F., & Stuart, C. L. (2009). A qualitative investigation of supervisees’ experiences of triadic supervision. Journal of Counseling & Development, 87, 449–457.

Lent, R. W., Cinamon, R. G., Bryan, N. A., Jezzi, M. M., Martin, H. M., & Lim, R. (2009). Perceived sources of changes in trainees’ self-efficacy beliefs. Psychotherapy: Theory, Research, Practice, Training, 46, 317–327. doi:10.1037/a0017029

Lent, R. W., Hill, E., & Hoffman, M. A. (2003). Development and validation of the counselor activity self-efficacy scales. Journal of Counseling Psychology, 50, 97–108.

Lenz, A. S. (2013). Calculating effect size in single-case research: A comparison of nonoverlap methods. Measurement and Evaluation in Counseling and Development, 46, 64–73.

Lenz, A. S. (2015). Special issue editor’s introduction: Using single-case research designs to demonstrate evidence for counseling practices. Journal of Counseling & Development, 93, 387–393.
doi:10.1002/jcad.12036

Lenz, A. S., Perepiczka, M., & Balkin, R. S. (2013). Evidence of the mitigating effects of a support group for attitude toward statistics. Counseling Outcome Research & Evaluation, 4, 26–40. doi:10.1177/2150137812474000

Lenz, A. S., & Smith, R. L. (2010). Integrating wellness concepts within a clinical supervision model. The Clinical Supervisor, 29, 228–245. doi:10.1080/07325223.2020.518511

Lenz, A. S., Speciale, M., & Aguilar, J. V. (2012). Relational-cultural therapy intervention with incarcerated adolescents: A single-case effectiveness design. Counseling Outcome Research & Evaluation, 3, 17–29. doi:10.1177/2150137811435233

Lundervold, D. A., & Belwood, M. F. (2000). The best kept secret in counseling: Single-case (N = 1) experimental designs. Journal of Counseling & Development, 78, 92–102.

Ma, H. H. (2006). An alternative method for quantitative synthesis of single-subject researches: Percentage of                     data points exceeding the median. Behavior Modification, 30, 598–617.

Scruggs, T. E., & Mastropieri, M. A. (1998). Summarizing single-subject research: Issues and applications. Behavior Modification, 22, 221–242.

Sharpley, C. F. (2007). So why aren’t counselors reporting n = 1 research designs? Journal of Counseling & Development, 85, 349–356.

Tennant, R., Hiller, L., Fishwick, R., Platt, S., Joseph, S., Weich, S., . . . Stewart-Brown, S. (2007). The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): Development and UK validation. Health & Quality of Life

Outcomes, 5, 63. doi:10.1186/1477-7525-5-63

 

James Ikonomopoulos, NCC, is an Assistant Professor at the University of Texas Rio Grande Valley. Javier Cavazos Vela is an LPC-Intern at the University of Texas Rio Grande Valley. Wayne D. Smith is an Assistant Professor at the University of Houston–Victoria. Julia Dell’Aquila is a graduate student at the University of Texas Rio Grande Valley. Correspondence concerning this article can be addressed to James Ikonomopoulos, University of Texas Rio Grande Valley, Department of Counseling, Main 2.200F, One West Univ. Blvd., Brownsville, TX 78520, james.ikonomopoulos@utrgv.edu.