intentional nondisclosure | The Professional Counselor

Incidence of Intentional Nondisclosure in Clinical Supervision by Prelicensed Counselors

Mar 9, 2020 | Volume 10 - Issue 1

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.

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

Jun 28, 2018 | Volume 8 - Issue 2

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

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

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

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

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

Supervised Onsite Field Experience in CACREP-Accredited Programs

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

Intentional Nondisclosure in Clinical Supervision

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

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

Types and Reasons for Intentional Nondisclosure

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

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

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

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

The Current Study

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

Method

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

Research Team

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

Recruitment Procedure and Participants

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

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

Instrument

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

Data Analysis

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

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

Results

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

The Types and Reasons for Intentional Nondisclosures

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

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

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

Specific Examples of the Types and Reasons for Intentional Nondisclosure

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

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

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

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

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

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

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

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

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

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

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

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

Discussion

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

The Types of Intentional Nondisclosure and Reasons for Nondisclosure

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

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

Novel Findings Regarding Types and Reasons for Intentional Nondisclosure

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

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

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

Implications for CITs

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

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

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

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

Implications for Supervisors and Counselor Education Training Programs

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

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

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

Limitations and Future Research

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

Conclusion

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

Conflict of Interest and Funding Disclosure

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

References

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

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