Diane M. Coll, Chandra F. Johnson, Chinwé U. Williams, Michael J. Halloran
A defining moment experience is a pinnacle moment or critical incident that occurs within a therapeutic context and contributes significantly to the professional development and personal growth of counselors. The aim of this qualitative study was to investigate how experienced counselors make sense and meaning of their defining moment experiences in terms of developing their clinical attributes. Semi-structured interviews were conducted with nine experienced professional counselors to investigate how defining moment experiences influenced their professional development. Five main themes were derived from analysis via interpretative phenomenological analysis (IPA): acceptance reality, finding a balance, enhanced self-reflection and awareness, reciprocal transformation, and assimilation and integration. These themes provide perspectives on how facilitating conversations and reflection on defining moment experiences may enhance professional development and clinical attributes among counselors.
Keywords: defining moment experiences, professional development, clinical attributes, qualitative study, interpretative phenomenological analysis
The defining moment experience is a contemporary term to describe a pinnacle moment or critical incident that occurs within a therapeutic context and contributes to professional development and the personal growth of professional counselors (Prengel & Somerstein, 2013; Veach & LeRoy, 2012). The defining moment experience typically occurs in the early stages of counselor development and is considered a rite of passage, often serving as a catalyst for significant growth (Furr & Carroll, 2003; Lee, Eppler, Kendal, & Latty, 2001; Skovholt, 2012; Skovholt & McCarthy, 1988). A negative defining moment experience might entail initial exposure to a difficult client, which may have a negative influence on counselor perceptions of clinical competency. In contrast, a positive defining moment experience could involve a novice counselor’s first experience of effectiveness or making a therapeutic breakthrough with a client (Skovholt, 2012). Whether positive or negative, defining moment experiences provide great potential for counselor self-reflection and growth on professional and personal levels (Howard, Inman, & Altman, 2006).
Defining moment experiences are more likely to occur and have greatest influence among novice and early-career counselors from a counselor developmental perspective (Lee et al., 2001). In theory, novice counselors face several stressors, such as performance anxiety, rigid emotional boundaries, an incomplete practitioner-self, glamorized expectations, and inadequate conceptual maps (Skovholt & Rønnestad, 2003). Defining moment experiences are likely to intensify these stressors and existing growing pains in terms of confidence and perceptions of identity within the counseling profession (Patterson & Levitt, 2011). Novice counselors also may find themselves deeply questioning their personal beliefs, biases, and assumptions, which can lead to some level of personal transformation or significant growth (Skovholt, 2012). Nevertheless, Furr and Carroll (2003) argued that the first defining moment experience carries the potential to accelerate counselor development regarding their behaviors (e.g., performance-based skills), cognitions (e.g., simple to complex), and emotions (e.g., feelings of inferiority or self-efficacy).
Several research studies have confirmed these propositions. Indeed, Bischoff, Barton, Thober, and Hawley (2002) reported that the initial counseling session with a client was a defining moment experience among early-career counselors having both a positive and negative influence on their self-efficacy. Similarly, Furr and Carroll (2003) reported direct client experience to be a defining moment in the development of counseling students, leading them to increased self-understanding and confidence as well as recognition of personal deficiencies. A qualitative study by Howard et al. (2006) also investigated defining moment experiences among practicum counseling students as they pertained to their overall professional growth. The findings suggested defining moment experiences influenced their professional identity, personal reactions, competence, supervision processes, and counseling philosophy.
Defining moment experiences also have been found to be important in the ongoing development of professional counselors (Rønnestad & Skovholt, 2003). In their study over 30 years ago, Skovholt and McCarthy (1988) asked 58 mental health professionals with varying degrees of experience and credentials to submit narrative accounts of their own defining moment experiences. Common themes developed from the narratives included feelings of insecurity, learning to accept imperfections and limitations, transforming the experience into a specialty, the attitude of readiness to learn and grow from the experience, and dealing with unexpected events such as the suicide of a client. More recently, Veach and LeRoy (2012) reported several common themes in the defining moment essays of 37 professional counselors, including increased empathy, authenticity, honesty, self-awareness, resilience, compassion, connection, courage, and commitment. Two other publications (Prengel & Somerstein, 2013; Trotter-Mathison, Koch, Sanger, & Skovholt, 2010) have similarly used personal narratives of professional counselors to illustrate the significance of defining moment experiences in the ongoing development of counselors.
Theories of counselor development maintain that the process of growth and change continues throughout the career lifespan of counseling professionals, but may nonetheless entail different challenges at distinct stages of counselor development (Moss, Gibson, & Dollarhide, 2014; Skovholt & Rønnestad, 2003; Zahm, Veach, Martyr, & LeRoy, 2016). For novice counselors, defining moment experiences are likely to intensify pre-existing stressors and provide a significant opportunity for professional development (Skovholt & Rønnestad, 2003). In contrast, experienced counselors are more likely to be able to reflect and process the latent meanings of defining moment experiences for their own ongoing professional growth and development (Moss et al., 2014), making them a valuable resource for understanding the developmental effects of defining moment experiences. Yet there is little systematic research on how defining moment experiences contribute to the practice of experienced professional counselors. This study addressed this shortfall in the research literature by focusing on the following research question: How do experienced counselors make sense and meaning of their defining moment experiences with respect to their professional development and practice?
Method
A qualitative research design was employed in this study and incorporated interpretative phenomenological analysis (IPA) of the defining moment experiences of professional counselors (Smith, 2004; Smith & Osborn, 2008). The IPA approach was considered a suitable methodology to reveal the complex issues associated with the defining moment experiences of counseling professionals, as it enables a rich level of data collection and interpretation by studying people ideographically (Pietkiewicz & Smith, 2012). Semi-structured interviews were employed to collect data by providing participants the opportunity to discuss their defining moment experiences and give voice to their thoughts, beliefs, and attitudes formed as a result of the experience.
Research Team
The research team consisted of the first author, a research assistant, and an external auditor. None of the research team were in a dependent relationship or received monetary compensation for their work, and only the first author was significantly connected to the topic of defining moment experiences. The first author and principal investigator (PI) holds a doctorate in counselor education and supervision and is a licensed professional counselor with over 20 years’ experience. The external auditor is a doctorate-level clinician with over 20 years’ experience, significant knowledge of IPA methods, and no vested interest in the study. The research assistant (RA) is a retired English professor who has familiarity with and understanding of qualitative data analysis. The RA was intentionally selected to provide independent data analysis, as she had no counseling background.
Participants
The study consisted of a purposive sample of nine experienced professional counselors who met the following inclusion criteria: (a) have a minimum of 10 years’ professional counseling experience, (b) be an active licensed professional counselor, and (c) experienced a defining moment in the role of counselor and expressed willingness to share related thoughts, feelings, and attitudes. Participant demographics are displayed in Table 1 with respect to the pseudonym each counselor selected for the study, along with a description of their defining moment experience and their varied backgrounds in terms of gender, age, race, experience, and the nature of their reported defining moment experiences.
Procedure
University IRB approval to conduct the study was received. An invitation to participate in a semi-structured interview on the defining moment experiences of professional counselors was advertised on the state therapist listserv as well as other established mental health agencies and professional counseling listservs limited to the southeast region of the United States. Participants also were recruited via the snowball method by initial contacts for referrals or recommendations for potential interview subjects.
Participants received a paper copy of the informed consent for review and signature prior to the start of each scheduled interview wherein participants were provided with a definition of defining moment experiences. Each participant chose a pseudonym in order to maintain confidentiality and, in accordance with Standard G.2.f. of the American Counseling Association (ACA) Code of Ethics (2014), the location, time, and format (by phone or in-person) of the interview honored each participant’s schedule and preferences. Moreover, interviews were conducted in a private space to maintain confidentiality and be free from distractions. Each interview was audio-recorded using a digital voice recorder and lasted between 60 and 90 minutes. Two interviews were conducted in person, and seven interviews were conducted over the telephone.
Prior to their interview, participants completed a brief demographic questionnaire. Each interview consisted of 12 open-ended questions (see Table 2), with the five main questions being: (1) Tell me about a defining moment that occurred while working with a client(s). (2) How did this experience shape how you saw yourself as a professional counselor? (3) How did this experience shape your sense of clinical competency? (4) How did you regard the therapeutic relationship between client and counselor prior to your defining moment experience? (5) As you reflect on your defining moment experience, how has your perspective changed or not changed? Sub-questions also were asked to illicit the meaning and sense attributed to defining moment experiences. Each interview question was presented in the same order with each participant for consistency (Creswell, 2007). Follow-up impromptu questions were asked in between the established questions to obtain richer, more elaborate details or context, as needed. Each interview progressed at a pace that was set by the participant, allowing for the development of more elaborate data with each question (Hays & Singh, 2012).
Table 1
Participant Demographics and Defining Moment Experience
A range of procedural steps were taken to enhance the credibility, dependability, confirmability, and transferability of the data (Lincoln & Guba, 1985) and to counter any potential researcher biases (Morrow, 2005). To establish the credibility of the findings, descriptive field notes were taken during interviews to document observations and add context to the audio data. The field notes emphasized participant content, expressed meaning and PI observations (Creswell, 2007), and provided a means to confirm interpretations of interview data through data triangulation (Anney, 2014). Member checking was used to enhance the credibility of the findings (see Onwuegbuzie & Leech, 2005) by asking participants to check summaries of the interview content. Confirmability of findings entailed the use of analytic memos and a reflexivity journal to ensure objectivity in any interpretations made in the course of data analysis (Smith, Flowers, & Larkin, 2009). Analytic memos were written throughout data analysis to record thoughts about the meaning behind participants’ words (Saldaña, 2009). A reflexivity journal was employed to assist the PI with preparing to interview each participant and enter their subjective reality by writing about her own defining moment experiences as a counselor prior to interviews (Hays & Singh, 2012). Moreover, the PI maintained the reflexivity journal throughout the interviews and data analysis processes. The PI made a consistent effort to bracket assumptions and biases to not superimpose her own experiences or subjective interpretations as a professional counselor (Smith, 2004; Smith & Osborn, 2008). The transferability of research findings was met by purposive sampling of participants based on their capacity to provide relevant knowledge on defining moment experiences (Anney, 2014). The criteria of ensuring dependability was met by employing the Dedoose qualitative research software program (Moylan, Derr, & Lindhorst, 2015) to independently organize, archive, and code interview data and field notes, as well as validate codes and themes derived from interview data (Silver & Lewins, 2014). The dependability of the data was enhanced by having the external auditor confirm the accuracy of (1) interview transcripts, (2) descriptive field notes, (3) the reflexive journal, (4) the theme codebook, and (5) Dedoose summaries and output.
Table 2
Interview Questions for the Study
Question No.
Question content
1
Tell me about a defining moment that occurred while working with a client(s). This moment could have occurred in the early stages of counselor training or at a later time in your work as a counselor.
1a
• What made it a defining moment?
1b
• Do you have a takeaway from this moment?
1c
• Is there anything else you would like to share about this experience?
2
How did this experience shape how you saw yourself as a professional counselor? As a person?
2a
• What did this experience mean to you as a counselor?
2b
• What did this experience mean to you on a personal level?
2c
• What assisted you with making sense out of this experience?
3
How did this experience shape your sense of clinical competency?
3a
• What strengths did you become aware of?
3b
• What weaknesses or limitations did you become aware of?
4
How did you regard the therapeutic relationship between client and counselor prior to your defining moment experience?
4a
• How did your understanding of the therapeutic relationship change or not change after the
defining moment experience?
4b
• How would you describe the therapeutic relationship between client and counselor as if you
were describing this to a layperson/non-clinician?
5
As you reflect on your defining moment experience, how has your perspective changed or not changed?
5a
• How did you make sense of the experience then?
5b
• How do you make sense of the experience now?
Data Analysis
Data analysis followed a 3-stage process as outlined by Pietkiewicz and Smith (2012): immersion, transformation, and connection. The immersion process began with the PI listening to each interview after its conclusion in order to review the content and record any additional observations in the field notes (Smith & Osborn, 2008). Each interview was transcribed by an independent contractor and the PI reviewed each along with the digital recording to ensure accuracy and facilitate deeper immersion in the data (Pietkiewicz & Smith, 2012). The PI read the participant’s responses along with the recording during the review process to foster deeper immersion and understanding of the experience being shared (Bailey, 2008). The PI documented new observations and insights throughout the immersion process in field notes and via a reflexivity journal (Pietkiewicz & Smith, 2012). The RA also independently engaged in the immersion, transformation, and connection stages with the interview transcripts.
The PI and the RA worked together to review and interpret all their notes about the transcripts and transform them into emergent themes consistent with IPA methodology (Smith & Osborn, 2008). Emergent themes were then connected together according to conceptual similarities to develop a thematic hierarchy (Pietkiewicz & Smith, 2012). The final stage of analysis entailed a narrative account of each theme, including direct passages from the interviews. The PI and the RA also discussed and compared several levels of interpretation of interview content and of interpreted meanings to reach agreement on the final set of distinct themes. Moreover, the transcripts, notes, and themes were submitted to the external auditor, who conducted an independent cross-analysis to ensure their accuracy and clarity.
Results
Data analysis with IPA methods resulted in five themes being identified and labeled based on the meanings associated with professional counselors’ defining moment experiences (see Table 3). The first theme was labeled acceptance of reality and captures how defining moment experiences led professional counselors to the realization that counselors are not always a good match for a client and cannot fully resolve any clinical problem that comes their way. The second theme, finding a balance, addresses how defining moment experiences shaped perceptions of clinical boundaries and the balance between strengths and limitations and external and internal forces. The third theme to be derived from the analysis, enhanced self-reflection and awareness, captures professional counselors’ understanding that defining moment experiences facilitated their own reflection and questioning of their intrapersonal and interpersonal processes. The fourth theme, reciprocal transformation, illustrates how the experiences shaped professional counselors’ understanding of the therapeutic relationship and acted as a mutual change agent for both counselor and client. Lastly, the fifth theme, assimilation and integration, encapsulates how meanings attached to defining moment experiences changed and were incorporated over time.
Table 3
IPA Coding Scheme of the Meaning of Defining Moment Experiences of Professional Counselors
Theme
Description
Acceptance of reality
Coming to terms with the realistic, sometimes limiting, aspects of the counselor role
Finding a balance
Perceptions of clinical boundaries and the balance between strengths and limitations and external and internal forces
Enhanced self-reflection and awareness
Facilitated reflection and questioning of intrapersonal and interpersonal processes
Reciprocal transformation
Mutual change agent for both counselor and client
Assimilation and integration
How meanings attached to defining moment experiences changed and were incorporated over time
Theme 1: Acceptance of Reality
Experienced counselors made meaning of their defining moment experiences in the theme of acceptance of reality. This theme was derived to reflect participants’ thoughts about how their defining moment experience helped them come to terms with the realistic, sometimes limiting, aspects of the counselor role. Specifically, defining moment experiences were understood by counselors to help dispel the myth that counselors are a good match for any client and can “fix” and fully resolve any clinical problem that comes their way. According to Ellen, “some situations are beyond repair. If people wait too long to come to see us, we can’t help, and they can’t even make any changes for themselves.” For Jackie, the defining moment experience meant being comfortable with accepting the reality of the limiting aspects of the counselor role when a client didn’t want to change and wanted Jackie to do all the work. She reflected: “In that moment, I just remembered saying . . . you can’t help everybody. It just means I’m not a good fit (for everybody) and that’s okay.” Similarly, the defining moment experience of Alaina meant accepting the reality that “a client I cannot love is not right for me . . . I don’t agree celebrating [the fact of] working with someone you don’t have a connection with.” It also would appear from these defining moment reflections that the acceptance of reality was associated with deeper knowledge of counselor–client boundary conditions. Indeed, counselor–client boundary issues were a significant factor in the defining moments theme of finding a balance.
Theme 2: Finding a Balance
The theme of finding a balance was identified in participants’ understanding of their defining moment experiences as highlighting different therapeutic boundary conditions and balancing the fine line between internal or external limitations while gaining a sense of finesse and agility between opposing forces. Here, participants identified a dual connection between strengths and limitations, while expressing accountability for establishing a balance between the two factors for client benefit. By taking ownership of a specific personality trait as part of the defining moment experience, Lee came to understand the importance of balance and the potential for possible pitfalls if such a balance is not obtained: “It was my personal disposition to speak with conviction, which is both a strength and limitation. I am still this way of course, but I know when to scale it back—to strike that balance.”
Finding a balance through defining moment experiences was evident in participants sharing their experiences of entering uncharted or unfamiliar territories with some trepidation, only to find their own rhythm through setting boundaries. Alaina shared: “I understood I was really flying by the seat of my pants and the only thing I had that I really understood were my boundaries. It made my boundaries even stronger. They were very heart-wrenching limitations; it was very hard.” Moreover, Ellen conveyed how the defining moment experience highlighted the process of balancing between her own feelings of physical vulnerability and her inner strengths when she was working with a couple in an abusive relationship: “I needed to sit alone with him to keep her safe. It was like walking into the lion’s den; however, my use of self-intuition [and] wisdom was a strength. I was just going to tap dance with him when I saw him.”
Theme 3: Enhanced Self-Reflection and Awareness
Professional counselors understood their defining moment experiences as ones that especially facilitated self-reflection and awareness of intrapersonal and interpersonal processes. At the intrapersonal level, John highlighted how the defining moment experience “increased my awareness and clarity of my own internal processes.” At the interpersonal level, Lee shared: “I made a connection in my personal relationships where I’ve learned to create space for others.” The theme of self-reflection also was manifest in the level of self-questioning prompted by the defining moment experiences of professional counselors. Indeed, Jackie discussed how her defining moment experience led to “a lot of reflection; I started to question my passion and why I wanted to be a therapist.” Similarly, Gina reflected that “I was puzzled and confused; lots of self-doubt [and] reflection. I remember where I would question whether I was a good therapist.” Importantly, the self-reflection and awareness prompted by the defining moment experiences of professional counselors appeared to have confirmed their professional capacities, with Gretchen sharing: “I received affirmation of what I thought I knew—what my gut was telling me.”
Theme 4: Reciprocal Transformation
Professional counselors understood their defining moment experiences as entailing the theme of reciprocal transformation through shared vulnerability and trust. This theme was derived from counselors speaking to their awareness of the dynamic of change within the therapeutic relationship; defining moment experiences generated a broader understanding of the transformative power within the therapeutic bond. For example, Lee shared: “You know, it’s a two-way conversation. This guy came back, taught me a great lesson: just how sacred and fragile the bond can be. I think we both changed after that experience.” Reciprocal transformation was reflected in participants discussing how defining moment experiences were associated with shared feelings of vulnerability and healing. As stated by Ellen, “We work with vulnerable people and if we just pretend we’re not there’s no authentic connection. The relationship is the primary vehicle for healing. Vulnerability is a good thing as a therapist.”
Jackie discussed how her defining moment experience highlighted the importance of disclosure in transforming the therapeutic relationship into one of mutual trust: “You are both engaging in some sense of disclosure and that helps people to build trust. It’s ever-growing, it’s always changing. The relationship can change and grow as the two of you grow and change.” In a similar way, Jon’s understanding of his defining moment experience highlighted the importance of taking risks to transform the therapeutic relationship: “You are risking the possibility that something will happen so then emotionally they won’t go on with you. You need to be willing to clear the air and move forward. I think that’s the place where the relationship deepens.”
Theme 5: Assimilation and Integration
The final theme, assimilation and integration, represents the difference in meaning between how the defining moment experience was initially assimilated by professional counselors and how meanings gleaned from the experience continue to be integrated. Participants discussed the non-static nature of the meanings attached to their defining moment experiences. The meanings continue to be assimilated with time and experience and remain an integral part of their ongoing counselor development. For example, Jackie stated: “I needed to grow as a therapist. Now, I look at the experience differently. It really has evolved into knowing my limitations [and] my strengths.” For Alaina, “the meanings acquired more textures, they got better and continue with me today.” Similarly, Lee used the metaphor of winding a ball of yarn to explain the meaning associated with integrating her defining moment experience over time: “Then, it taught me more about the client. Now, it informs me more. It’s like a ball of yarn. As I acquired experience, there was more yarn to wind. It now informs me how to be with all clients.”
For John, processing the defining moment experience meant he went from a place of anxiety to becoming aware of the spiritual nature of counseling: “At first, the experience relieved some anxiety about whether I was able to do this work. What I appreciate now, that I was too anxious to be aware of at the time, is that this is spiritual work.” Finally, Ace integrated her defining experience of working with a victim of teenage sexual abuse by now conducting advocacy work: “What assisted me with making sense out of my experience was volunteering for child abuse agencies, serving on a board, [and] being an advocate.” Overall, each participant constructed meaningful interpretations of their defining moment experiences that continue to inform their work and passion as counseling professionals, whether as a source of inspiration or affirmation.
Discussion
From novice to seasoned professionals, challenges occur within the therapeutic relationship that can provide growth opportunities to counseling practitioners to develop their clinical attributes (Orlinsky & Rønnestad, 2005; Skovholt & Rønnestad, 2003). The findings from this study support and extend the idea that defining moment experiences represent one such challenge. Professional counselors in this study understood their defining moment experiences as growth opportunities associated with different meanings to their professional practice and clinical skills. The meanings of the defining moment experiences of professional counselors were interpreted to reflect five main themes relevant to counseling practice: acceptance of reality, finding a balance, enhanced self-reflection and awareness, reciprocal transformation, and assimilation and integration.
Professional counselors understood their defining moment experience as one that was a wake-up call to accept the reality that counselors are not ideal for all clients and all presenting problems. This finding supports theory and research that an idealistic and glamorized view of counseling is often a source of stress among developing counselors (Moss et al., 2014; Skovholt & Rønnestad, 2003), wherein supervisors play an important role in guiding novice counselors toward the realistic position that it is not always possible to have a positive impact with clients. Indeed, the findings of this study provide distinct evidence that defining moment experiences of professional counselors bring them to a point in their career when they come to accept that the counselor role may produce limited success with certain clients on different occasions. As suggested by Skovholt and Rønnestad (2003) and the findings of this study, acceptance of reality is paradoxical in a helping profession like counseling; growth as a counselor occurs with the realization that some people and problems cannot be helped. This change of view also meant that the acceptance of reality was associated with deeper knowledge of counselor–client boundary conditions.
The meanings of professional counselors’ defining moment experiences were reflected in the specific theme of finding a balance in terms of participants navigating the boundaries between their strengths and limitations. Previous counselor development research (e.g., Furr & Carroll, 2003; Moss et al., 2014; Trotter-Mathison et al., 2010) has shown that establishing client–counselor boundaries is an important challenge to novice counselors, usually meant in terms of establishing emotional boundaries. To the counselors in this study, establishing such boundaries was about finding the right balance. Nevertheless, the meanings associated with the defining moment experiences of professional counselors extended beyond client–counselor boundaries to include balance between one’s own strengths and weaknesses, internal and external limitations, and finding a rhythm in uncharted or unfamiliar territories. It also was apparent that the participants’ ability for self-reflection and awareness was important for facilitating balance.
Experienced counselors also understood their defining moment experiences to entail enhanced self-reflection and awareness. Indeed, their willingness to self-reflect and take ownership for finding an optimal balance between strengths and limitations that were revealed through defining moment experiences has been clarified elsewhere as an important developmental step toward increased counseling competency (e.g., Skovholt & Rønnestad, 2003; Thériault & Gazzola, 2010; Williams, Hayes, & Fauth, 2008). As identified by Moss et al. (2014), continuous reflection is required for optimal learning. Defining moment experiences for professional counselors meant self-reflection even to the point of questioning their suitability for the profession. Indeed, the best counselors are generally viewed as questioning what they do and why (Kottler, 2017). It would appear from the findings that defining moment experiences appear to bring that level of self-questioning into focus.
The findings also revealed the change-agent quality of defining moment experiences wherein the experiences of counselors led to the development of a broader understanding of the reciprocal and transformative power within the therapeutic bond. In line with previous research (e.g., Orlinsky, Botermans, & Rønnestad, 2001; Skovholt & Rønnestad, 2003), the findings clarified that learning within the counselor–client relationship was a significant influence on career development among experienced counselors. Moreover, reciprocal transformation was reflected in professional counselors acknowledging shared vulnerability within the counselor–client relationship. Other research (e.g., Trotter-Mathison et al., 2010) has similarly found the most powerful defining moments occurred when counselors took risks or a leap of faith and allowed themselves to be vulnerable. Indeed, the defining moment experiences of the professional counselors in this study were reported as opportunities to experience the transformative power of shared vulnerability to establish new learning and growth in both counselor and client alike.
Within the theme of assimilation and integration, professional counselors shared how meanings of their defining moments continue to be a solid foundation of inspiration for their purpose, passion, and advocacy work in the counseling profession. Siegel (2007) referred to this process as the power of recall and repetition, whereby as counselors self-reflect on definitive experiences, the repetition of each memory forges deeper, more meaningful connections in the brain. Whether counselors engage in self-reflection in present time or as retrospection, the repetition of recall begins to move newly acquired data from state to trait, thus furthering the integration of new information or insights (Siegel, 2007). This view is supported in Prengel and Somerstein’s (2013) study of defining moment experiences, which highlights the process of self-reflection as one that requires time and re-examination in order to deepen lessons learned. In kind, the findings of this study suggest it is beneficial for counselors to engage in self-reflective practices throughout their professional life; the practice of self-reflection appears to have facilitated deeper integration of originally assimilated meanings of defining moment experiences by professional counselors. Consistent with the view of Engels, Barrio Minton, and Ray (2009), assimilation and integration of significant meanings appeared to have a positive effect on the competencies of professional counselors in this study.
Altogether, interpretive analysis of the defining moment experiences of professional counselors suggested a set of interrelated meanings and themes that appear to facilitate the development of counselor capacities. Defining moment experiences appear to bring into sharp focus an important transition in counselor thinking—acceptance of the realistic nature of counseling in terms of the sometimes lack of counselor–client-problem fit. In a related way, defining moment experiences of professional counselors facilitated deeper thinking about finding balance in professional practice. Professional counselors reported deeper thinking in the form of heightened self-reflection and self-awareness as meanings they associated with defining moment experiences. One may posit that heightened self-reflection and awareness mediates the relationship between defining moment experiences and acceptance of reality and finding balance in professional counseling. Defining moment experiences of professional counselors also held significant meaning because they highlighted the reciprocal and transformative power within the therapeutic bond and because the meanings continue to be integrated. As shared by Jackie, “This was a great opportunity to reflect on where I was and who I’ve become . . . all with the same lesson from my first client . . . that thread continues to inform me.”
Implications for Counselor Practice
The significance of defining moment experiences to professional counselors raises implications for professional practice and the counselor development process. As suggested by themes identified in the findings of this study, experienced professional counselors appeared to find defining moment experiences helped them accept counseling realities, find balance within the counselor role, and understand the transformative power within the therapeutic bond. At the same time, defining moment experiences facilitated heightened self-awareness, providing professional counselors an opportunity to attune to their own internal processes. As such, the meanings associated with defining moment experiences tie in with standards set forth by the Council for Accreditation of Counseling and Related Educational Programs (2015), which aligns professional competence with counselor self-awareness via self-reflection. Facilitating conversations and reflecting on defining moment experiences may provide a focal point for continuing training of professional counselors consistent with the mission of ACA (2019). The findings of this study underline the potential benefits of practicing and modeling self-reflection throughout the careers of professional counselors, supervisors, and counselor mentors to enhance their ongoing development and clinical expertise.
At the same time, counselor training programs may incorporate the meanings of defining moment experiences into their courses. Indeed, some participants in this study reported on a defining moment experience that occurred as a counselor trainee, and previous research has revealed practicum and novice counselors find great benefit from reflecting on defining experiences when they worked with a challenging client or issue (e.g., Bischoff et al., 2002; Furr & Carroll, 2003; Howard et al., 2006). Providers of counselor education programs and supervisors could develop awareness of the potential for defining moment experiences to raise questions about the realities of counseling, finding a balance in the counselor role, and the transformative power of the therapeutic relationship. This may be facilitated by encouraging novice counselors to employ self-reflection techniques such as journaling, which has been shown in previous research to benefit counselor development (e.g., Burnett & Meacham, 2002). Novice counselors could be asked to self-reflect on a defining moment experience via journaling as a part of their practicum and internship programs and use supervision sessions to connect the meaning and significance of the experience to the development of clinical skills and attributes. The findings of this study provide some insights on what type of meanings may be discussed in such sessions, including how defining moment experiences may relate to acceptance of counseling realities, finding a balance within the counselor role, and understanding the transformative power within the therapeutic bond.
Limitations and Future Research
There are limitations inherent in this study that require acknowledgement. The sample of participants might have invoked a self-selection bias wherein participants who elected to take part in the study may have been more inclined to value and reflect on their defining moment experiences than those who did not elect to participate. The use of semi-structured interviews, whether conducted in person or by phone, could have increased the likelihood of response inhibition (Bischoff et al., 2002). The interview participants could have answered interview questions according to perceived socially desirable responses rather than provide a more accurate and honest account of thoughts and feelings associated with their defining moment experiences. Steps to ensure confidentiality, such as the use of pseudonyms for participants, may have minimized response bias; however, to what degree is uncertain. In addition, the sample of participants was limited to professional counselors who worked in private practice with an expertise in trauma. A final limitation of the study is the potential for researcher subjectivity to influence data collection (interviews) and interpretive analysis (thematic coding). Nevertheless, appropriate methodological steps were taken in this study, such as a reflexivity journal and independent coders, to enhance the objectivity and trustworthiness of the data collection and interpretation procedures and outcomes.
The research findings provide directions for future research on defining moment experiences of professional counselors. To date, there is very little empirical research on defining moment experiences and their significance to professional counselors. Whereas this study provides a unique contribution to the counselor literature, future research may broaden the sample criteria to include not only experienced professionals in other regions of the United States and in other countries, but also licensed clinical social workers, licensed marriage and family therapists, and clinical psychologists. Research with a range of professionals would broaden knowledge about the significance of defining moment experiences to their ongoing professional practice. Moreover, research that broadens the focus on counselors to include an investigation of the role of supervisors in defining moment experiences would be worthwhile. Finally, research may follow up on the revelation from two participants in this study that defining moment experiences led them to question their suitability for the counseling profession. Research on the defining moment experiences of individuals who chose to leave the field may shed light upon the goodness-of-counselor-fit within the counseling profession.
Conclusion
In conclusion, findings from this study support and contribute to the professional counseling literature by revealing the meanings associated with the defining moment experiences of professional counselors. Consistent with models of counselor development (e.g., Moss et al., 2014), experienced counselors showed a comparatively strong capacity to deeply reflect and process the latent meanings and implications of defining moment experiences for their ongoing professional growth and development. Defining moment experiences appear to help professional counselors accept the realities of counseling, find a balance within the counselor role, and understand the transformative power within the therapeutic bond. The findings contribute to existing literature by illustrating how meaningful interpretations of defining moment experiences continue to deepen over time and enhance counselor practice, especially when opportunities are taken for self-reflection. Application of knowledge on the significance, meaning, and implications of defining moment experiences in counselor training programs and supervision sessions provides an opportunity for enhancing the clinical attributes of professional counselors.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of interest
or funding contributions for the development
of this manuscript.
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Diane M. Coll is a professional counselor at Argosy University. Chandra F. Johnson is an associate professor at Argosy University. Chinwé U. Williams is an associate professor at Argosy University. Michael J. Halloran is an honorary associate professor at La Trobe University. Correspondence can be addressed to Michael Halloran, School of Psychology and Public Health, La Trobe University, Kingsbury Dr., Bundoora, Australia, 3086, m.halloran@latrobe.edu.au.
Varda Konstam, Amy Cook, Sara Tomek, Esmaeil Mahdavi, Robert Gracia, Alexander H. Bayne
This study examined work engagement and its role in mediating the relationship between organizational support of evidence-based practice (integrating research evidence to inform professional practice) and educational growth and perceived professional expertise. Participants included 78 currently employed counselors, graduates of a master’s program in mental health counseling located in an urban northeastern university. Results revealed that work engagement significantly mediates the relationship between organizational support of evidence-based practice and educational growth and perceived professional expertise. Implications for counseling practice and recommendations for future research are discussed.
Keywords: professional expertise, counselors, evidence-based practice, professional development, work engagement
Although ongoing efforts to maintain and improve clinical competence are intrinsic to ethical practice for counselors (Jennings, Sovereign, Bottorff, Mussell, & Vye, 2005), clinical experience does not appear to guarantee additional skill acquisition among counselors (Goodman & Amatea, 1994; Skovholt & Jennings, 2005). Notably, a meta-analysis conducted by Spengler et al. (2009) revealed that level of education, training and experience had a small effect on clinical judgment (d = .12). Skovholt and Jennings (2005) concluded that “experience alone is not enough” to ensure professional growth and increased professional expertise in counseling practice (p. 15).
Because years of experience only minimally inform professional expertise (defined as the ability to accurately diagnose and implement treatment plans that sensitively incorporate the contexts in which clients are embedded [Meier, 1999]), it is important to isolate both individual and organizational factors that improve professional expertise over time. Individual factors identified in the counseling literature include (a) the importance of self-reflection (Neufeldt, Karno, & Nelson, 1996), (b) exploration of unexamined assumptions about human nature (Auger, 2004), (c) empathy (McLeod, 1999; Pope & Kline, 1999), (d) self-awareness (Richards, Campenni, & Muse-Burke, 2010), (e) mindfulness (Campbell & Christopher, 2012) and (f) cultural competence (Goh, 2005). Organizational factors (defined as organizational systems and processes that are in place to support counselor professional growth linked to organizational and client outcomes) also have been identified (Aarons & Sawitzky, 2006a; Bultsma, 2012, Goh, 2005; Perera-Diltz & Mason, 2012; Truscott et al., 2012). The range of studies, however, has been limited in scope, and research has tended to focus on administrative practices associated with staff turnover, morale, efficiency and productivity (Aarons & Sawitzky, 2006a).
This research focused on how individual counselors and organizations providing counseling services can promote the continuing development and refinement of professional expertise among practicing counselors. Specifically, we focused on individual work engagement and organizational factors—that is, organizational support of evidence-based practice (EBP) and educational growth, and their relationships to perceived counselor professional expertise. Counselor use of EBP involves engaging in critical analysis of professional practice and integrating research evidence to inform interventions (Carey & Dimmitt, 2008). We propose that organizational support of EBP and educational growth are important job resources (Bakker & Demerouti, 2008), and that work engagement mediates the relationship between these resources and perceived counselor professional expertise. First, we present a review of the literature related to organizational support of EBP and work engagement, with a specific focus on linking individual and organizational factors to perceived professional expertise.
Evidence-Based Practice
Efforts put forth by the American Counseling Association (Morkides, 2009) and the American Counseling Association Practice Research Network (Bradley, Sexton, & Smith, 2005) have revealed that evidence-based interventions are critical to the optimal functioning of counselors. Implementation of EBP has been increasingly required across a variety of counseling settings, such as in schools (Carey & Dimmitt, 2008; Dimmitt, Carey, & Hatch, 2007; Forman et al., 2013) and nonprofit human services organizations (McLaughlin, Rothery, Babins-Wagner, & Schleifer, 2010). The Council for Accreditation of Counseling and Related Educational Program standards (2009) also have documented the importance of counselors being trained in using data to inform decision-making, although there are no specific guidelines informing counselors and counselor educators how to engage in EBP effectively. Consequently, implementation of EBP has required that practitioners work in new ways, develop and refine existing clinical skills, and at times reconcile philosophical differences between EBP and their respective disciplines (Tarvydas, Addy, & Fleming, 2010).
The requirement that counselors integrate research findings when working with clients serves to not only sharpen their conceptual understanding of treatment effects, but also aligns conceptual understanding with clinical practice. Such alignment affords the counselor a clearer sense of mastery and aids in developing professional confidence (Beidas & Kendall, 2010). At the organizational and individual practitioner levels, supervisors can work to promote the implementation of more efficacious interventions (Brown, Pryzwansky, & Schulte, 2006; Sears, Rudisill, & Mason-Sears, 2006; Truscott et al., 2012). Thus, understanding individual and organizational factors that influence the use of EBP could help inform counselor development and counseling expertise.
Aarons and Palinkas (2007) surveyed comprehensive home-based services case managers working in child welfare settings specifically with respect to their experiences with EBP. The authors reported that organizational support and willingness to adapt EBP to fit unique settings are the best predictors of successful EBP implementation, including positive attitudes toward EBP. When paired with consistent supportive consultations and supervision, implementation of EBP in child services settings has been associated with greater staff retention (Aarons, Sommerfeld, Hecht, Silovsky, & Chaffin, 2009). Researchers have not yet replicated these results with practitioners working across a range of counseling settings, nor have they expanded their analyses to examine the relationship of EBP training and implementation to professional expertise.
In a qualitative study, Rapp et al. (2008) identified barriers to implementing EBP in five Kansas-based community mental health centers participating in the National Implementing Evidence-Based Practice Project. Rapp et al. (2008) were able to identify critical strategies that produced successful outcomes and positive attitudes toward EBP on behalf of the staff. These strategies included the following: (a) managers setting expectations and front-line staff monitoring EBP use, (b) members of upper management serving as champions of EBP by proactively keeping organizational focus on EBP, (c) educating all staff on the importance of EBP rather than exclusively targeting the staff using EBP as part of their job responsibilities, and (d) creating leadership teams that included representatives from all levels of responsibility within the organization to monitor progress and identify obstacles to implementing EBP. Similarly, in a survey developed to assess EBP implementation in community mental health settings, Carlson, Rapp, and Eichler (2012) found that the key components of successful EBP implementation were team meetings, professional development and skill-building activities, and use of outcome measures to track progress.
Organizational and individual processes by which EBP contributes to optimal counselor functioning over time are relatively unexplored in the literature. One possible variable to consider when addressing issues related to EBP implementation and counselor effectiveness is work engagement, a work-related state of mind associated with feeling connected and fulfilled in relation to one’s work activities (Schaufeli & Bakker, 2004; Schaufeli, Bakker, & Salanova, 2006). Work engagement holds promise in furthering the understanding of how individuals and organizations that support these individuals can promote the continuing development and refinement of professional expertise (Bakker & Demerouti, 2008; Schaufeli et al., 2006).
Work Engagement and Professional Expertise
Schaufeli et al. (2006) defined work engagement as “a positive, fulfilling work-related state of mind that is characterized by vigor, dedication, and absorption” (p. 702). Contrary to those who suffer from burnout, engaged individuals have a sense of connection to their work activities and see themselves as capable of dealing with job responsibilities. It is important to note that the literature related to work engagement is represented by a wide array of contexts including those that are business related. The results of these studies, therefore, cannot be generalized to counselors working across a variety of mental health and school settings (Bakker & Demerouti, 2007, 2008; Salanova, Agut, & Pieró, 2005; Sonnentag, 2003). However, the findings in business-related contexts have revealed interesting associations that warrant further examination. For example, Langelaan, Bakker, van Doornen, and Schaufeli (2006) found that in participants working in diverse business settings (e.g., managers working for Dutch Telecom, blue-collar employees working in food processing companies), specific personality qualities associated with work engagement, such as low levels of neuroticism, high levels of extraversion and the ability to adapt to changing job conditions, were correlated with high levels of work engagement. A number of studies also identified a reciprocal relationship between personal resources (self-esteem and self-efficacy), job resources (effective supervision, social support, autonomy and variety in job tasks) and work engagement (Hakanen, Perhoniemi, & Toppinen-Tanner, 2008; Xanthopoulou, Bakker, Demerouti, & Schaufeli, 2009). The participants in the Hakanen et al. (2008) study were Finnish dentists, whereas the Xanthopoulou et al. (2009) study was based on the responses of employees working in three branches of a fast-food company.
Supportive Organizational Contexts, Work Engagement and Professional Expertise
Colquitt, LePine, and Noe (2000) emphasized the importance of providing organizational support in the workplace when considering job performance and work engagement. However, the focus on “situational characteristics such as support remains surprisingly rare” (p. 700). The authors defined organizational support of educational growth as the extent to which the organization supports ongoing professional learning and development. Research findings have suggested that work engagement is positively correlated with job characteristics identified as resources, such as social support from supervisors and colleagues, performance feedback, coaching, job autonomy, task variety, and training facilities (Bakker & Demerouti, 2007; Demerouti, Bakker, Nachreiner, & Schaufeli, 2001; Salanova et al., 2005; Salanova, Bakker, & Llorens, 2006; Salanova & Schaufeli, 2008; Schaufeli & Bakker, 2003; Schaufeli, Taris, & van Rhenen, 2008). According to Bakker, Giervels, and Van Rijswijk (as cited by Bakker & Demerouti, 2008), engaged employees have been successful in mobilizing their job resources and influencing others to perform better as a team.
In accordance with the model proposed by Bakker and Demerouti (2008), work engagement, in the context of perceived counselor professional expertise, mediates the relationship between job and personal resources and job-related performance. Job resources (e.g., organizational support of EBP, organizational support of educational growth) and personal resources inform work engagement, especially in jobs with high demands (Bakker & Demerouti, 2008; Bakker, Hakanen, Demerouti, & Xanthopoulou, 2007; Salanova et al., 2005). We propose that organizational support of educational growth and organizational support of EBP are important job resources as conceptualized by the Bakker and Demerouti model, and that work engagement mediates the relationship between these resources and counselor professional expertise.
This study addresses a gap in the literature by focusing on understanding the relationships among work engagement, organizational support of EBP and organizational support of educational growth with respect to perceived professional expertise in practicing counselors. To our knowledge, no research to date has linked the systematic organizational implementation of EBP and organizational support of educational growth with the proposed mediating role of work engagement in relationship to counselor perceived professional expertise. See Figure 1 for the proposed mediation model. In addition, the participants of this study function across a variety of counseling settings including schools, hospitals and mental health agencies.
It is important to determine whether a supportive professional context in general, rather than support specific to EBP, accounts for the relationship between EBP and work engagement. We assessed an alternative source of organizational support: support of educational growth, defined as the extent to which the organization supports ongoing professional learning and development. We hypothesized that organizational support of EBP uniquely contributes to work engagement, independent of support of educational growth. We hypothesized the following:
Organizational support of EBP, organizational support of educational growth and professional expertise will all be positively related to each other.
Work engagement will significantly mediate the relationship between organizational support of EBP and educational growth, and in turn will increase perceived professional expertise, as proposed by Bakker and Demerouti (2008).
Methods
Participants
The participants for this study included 78 graduates of a master’s program in mental health counseling located in an urban university in the northeastern part of the United States. The graduates of the counseling program were exposed to coursework that incorporated training and content specific to developing EBP (although they did not complete individual courses devoted specifically to the topic). For example, during the completion of internship coursework and courses foundational to the counseling profession, they were required to complete assignments focusing on using research and data to inform decision-making and practice. As such, prior to being employed in the field as professional counselors, the participants had prior exposure to the theory and practice of employing EBP.
Mailing addresses of 286 mental health counseling graduates were obtained from the alumni office, and a survey was sent to each graduate. A total of 91 mental health counselors located in a variety of settings, including mental health, school and hospital settings, completed the survey and returned it by mail; a response rate of 31.8% was obtained. Five of the questionnaires were excluded due to the participants not working in the field, and eight questionnaires were excluded due to missing data. An a priori power analysis was conducted to ascertain the number of participants required to achieve statistical significance using G*Power (Faul, Erdfelder, Buchner, & Lang, 2009). In using an alpha level of .05 and establishing a minimum power set of .80 and moderate effect size of .30, a minimum of 64 participants was needed to obtain a power of .80 in a hypothesis test using bivariate correlations. A minimum sample size of 58 was needed to achieve a power of .80 for our mediation model analysis (Fritz & MacKinnon, 2007).
The sample consisted of mostly female (n = 67, 86%) respondents. The participants were primarily White (n = 61, 78%), a small percentage Black (n = 4, 5%) and Hispanic (n = 3, 4%), and the rest identified as being “other” or “mixed-race” (n = 10, 13%). Participants averaged 37.4 years old (SD = 9.4), with a median age of 34.5 years. The participants were experienced, with over 90% having 2 or more years of work experience; 35% (n = 27) had 0–4 years of experience, 37% (n = 29) had 5–7 years of experience, while over 28% (n = 22) had 8 or more years of experience. A majority of participants (n = 65, 83%) reported involvement in a national committee within the mental health profession, indicating that the participants were involved within the counseling community and therefore more likely to be engaged at a professional level. Participants came primarily from mental health agencies (n = 33, 42%), followed by school settings (n = 15, 19%) and hospital settings (n = 7, 9%), with the remaining 27% (n = 20) indicating that they worked in more than one type of setting and approximately 4% (n = 3) not identifying their work setting. Data regarding licensure status was not collected.
Instruments
The Professional Expertise and Work Engagement Survey (PEWES) containing four subscales (Organizational Support of Educational Growth Measure [OSEGM], Organizational Support of Evidence-Based Practice [OSEBP], Utrecht Work Engagement Scale [Utrecht] and Mental Health Counseling Professional Expertise Questionnaire [PES]) was developed to measure professional expertise, organizational support of EBP and educational growth, and work engagement. The survey items were developed through incorporating key literature from counseling and related fields (e.g., business and psychology), since the constructs measured had not been assessed directly in the counseling literature. To ensure that the items were applicable to counseling practices, the survey was developed and piloted by two counselor educators. Items that the counselor educators identified as not applicable to counseling practices were excluded from analysis.
Organizational Support of Educational Growth. This assessment is a 5-item instrument using a 10-point Likert-type scale that evaluates characteristics of work settings. The instrument was designed based on the work of Colquitt et al. (2000) and focuses on attributes that predict motivation to learn and job performance. Cognitive abilities and age (identified as individual factors) along with work environment and trainee feedback from colleagues and supervisors (identified as situational factors) are represented in the model. The scale purports to assess support for educational growth present in the work environment. A few sample items used are the following: (a) To what extent does your work setting provide experiences for professional growth and development? (b) To what extent does your work setting provide time for learning activities to promote your professional growth? (c) To what extent does your organization have a climate that supports learning? A factor analysis was conducted on the items using a principal components extraction method. A single factor solution accounted for 52% of the variance in the items, with an eigenvalue of 2.6, indicating that a single summative scale could be utilized. The scale resulted in a range from 5 (low) to 50 (high). A Cronbach’s alpha of .81, 95% CI [.74, .87], was obtained for this instrument.
Organizational Support of Evidence-Based Practice. This 4-item survey using a 10-point Likert-type scale measures the organization’s culture in terms of supporting employee commitment to EBP. The items were created based on Colquitt and colleagues’ work (2000) and the work of Pfeffer and Sutton (2006). Examples of items used include the following: To what extent do the following statements represent your organizational culture? (a) Committed to evidence-based decision-making, which means being committed to getting the best evidence and using it to guide actions. (b) Looks for the risks and drawbacks in what people recommend—even the best interventions have side effects. A factor analysis with principal components extraction was conducted. Results indicated that a single factor accounted for 66% of the variance in the items, with an eigenvalue of 2.66. The scale resulted in a range of values from 4 (low) to 40 (high). A Cronbach’s alpha of .84, 95% CI [.78, .89], was obtained for this questionnaire.
Utrecht Work Engagement Scale. As originally developed, this is a 9-item assessment using a 10-point Likert-type scale that measures level of connection and enthusiasm related to one’s work (Schaufeli et al., 2006). Individuals are evaluated within three aspects of work engagement: vigor, dedication and absorption. The first five items of the scale are utilized to assess work engagement, as follows: (a) At my work, I feel bursting with energy. (b) At my job, I feel strong and vigorous. (c) When I get up in the morning, I feel like going to work. (d) I am enthusiastic about my job. (e) I am proud of the work that I do. These five items fall within the first two subscales of vigor and dedication. Given that absorption was not assessed due to clerical error, items were examined to determine whether a single summative scale could be utilized that would define both vigor and dedication at work. A factor analysis using a principal components extraction found a single factor to account for 81% of the variance in the items, with an eigenvalue of 4.06. This total sum scale created a range of values from 5 (low) to 50 (high). The Cronbach’s alpha for this subset of questions in our sample was .95, 95% CI [.93, .96], indicating high reliability. Schaufeli and colleagues (2006) found a reliability between .60 and .88 for the full 9-item scale.
Mental Health Counseling Professional Expertise Questionnaire. Professional expertise was measured by the PES. This self-assessment instrument was designed to measure perceived professional expertise and professional skills. It consists of 10-questions on a 10-point Likert-type scale. Those taking the survey are asked to determine how a strict but fair supervisor would rate their counseling and clinical abilities as related to their work setting. Questions focus on two areas of functioning: ability to select and employ appropriate diagnostic methods, including consideration of cultural data, and ability to implement a treatment plan, based on diagnostic considerations. A few sample items include the following: (a) I am able to select and employ appropriate diagnostic methods. (b) I am able to accurately interpret diagnostic material and make an accurate diagnosis. (c) I am able to develop a comprehensive treatment plan based on my diagnosis. A factor analysis with principal component extraction was conducted to determine whether a single summative scale could be utilized. Our results indicated that a single factor accounted for 63% of the variance in the items, with an eigenvalue of 6.3. A total sum scale was then created and had a range of 10 (low) to 100 (high) points. A Cronbach’s alpha of .92, 95% CI [.89, .94], was obtained for the scale.
Data Analysis
Analyses for hypothesis one were performed by calculating a full correlation matrix for the four variables. The second research question evaluated the hypothesized mediation effect proposed by Bakker and Demerouti (2008) using a path analysis. The alpha level was set to .05 for all statistical analyses. Analyses were conducted using SPSS Version 19.0 and SAS Version 9.2.
Results
Hypothesis One
Scores on the OSEGM were positively correlated with the OSEBP Measure, r(76) = .53, p < .001. This positive correlation indicated that high values of organizational support of educational growth were found with high values of organizational support of EBP. In addition, scores on the OSEGM were positively correlated with scores on the Utrecht, r(76) = .55, p < .001. This significant positive relationship indicated that high levels of organizational support of educational growth were found with high scores on the Utrecht. A significant positive correlation also was found between the OSEGM scores and the PES scores, r(76) = .25, p < .03. This positive directional effect indicated that high levels of organizational support of educational growth related to higher scores on professional expertise.
The Utrecht was positively correlated with the OSEBP Measure, r(76) = .58, p < .001. High levels of organizational support of EBP related to higher scores on the Utrecht. The Utrecht was positively correlated with the PES, r(76) = .46, p < .001. The positive relationship indicated that higher scores on the Utrecht found with higher scores on the PES.
Lastly, OSEBP was found to be positively correlated with the PES, r(76) = .33, p = .003. This positive relationship indicated that high levels of organizational support of EBP were found with high scores on the PES. Thus, as hypothesized, organizational support of EBP, organizational support of educational growth and perceived professional expertise were all positively related to each other (see Table 1 for correlations between all major variables.).
Table 1
Correlations Between Study Factors
Utrecht
OSEBP
OSEGM
PESOSEGM
.46***.55***
.33**.53***
.25*
OSEBP
.58***
*p < .05, **p < .01, ***p < .001
Hypothesis Two
Bakker and Demerouti (2008) proposed a model with a mediation effect of work engagement on the relationship between job and personal resources and performance. Our interpretation of the model placed the OSEGM and the OSEBP Measure into what Bakker and Demerouti (2008) identified as job and personal resources. Additionally, performance was measured by the PES. Work engagement, a mediating variable as suggested by the model, was measured by the Utrecht. Because we adapted the PEWES in accordance with Bakker and Demerouti’s (2008) model, we assessed the individual items and subscales for content validity and reliability as previously described. Given that preliminary findings suggested strong internal consistency, we hypothesized that the full survey could be utilized to ascertain a potential mediation effect of work engagement on the relationship between organizational support of EBP and educational growth, and consequently, greater perceived professional expertise.
The estimated model, along with the standardized estimates, is shown in Figure 2. The fit of the model was very good, with an RMSEA of 0.00, χ2(2, n = 78) = 0.66, p = .72, GFI = .99, CFI = 1.00. Additionally, 55% of the direct effect between the OSEBP Measure and the PES can be accounted for by the mediation of the Utrecht, and 70% of the direct effect between the OSEGM and the PES can be accounted for by the mediation of the Utrecht. Given the large bivariate relationships between professional expertise and both organizational support of EBP and organizational support of educational growth, it appears that work engagement itself is largely contributing to these positive relationships. This finding is shown by the large percentage of direct effects accounted for by the Utrecht.
Discussion
The purpose of this study was to gain an increased understanding of the relationships between organizational support of EBP and educational growth, work engagement, and perceived counselor professional expertise. In addition, we examined the mediational effect of work engagement on perceived counselor professional expertise. Results revealed a consistent and coherent picture with important implications for organizational support of continued development of counselor professional expertise across a variety of work settings, including mental health agencies, schools and hospital settings.
Significant positive relationships between all variables indicate that counselors who rated themselves higher in professional expertise and perceived their work settings as supportive of EBP and educational growth reported significantly higher work engagement scores. Results affirm the importance of organizational support of EBP and its unique contribution to nurturing and sustaining work engagement levels among counselors. Results also affirm the importance of organizational support of continued counselor educational growth. These findings help to substantiate the research efforts of Bakker and Demerouti (2007, 2008) and Schaufeli and Salanova (2007).
While organizational support of EBP and organizational support of educational growth both were shown to increase professional expertise, it was the amount of work engagement that accounted for a large proportion of the direct relationships between organizational support of EBP and educational growth with professional expertise. This finding suggests that employers can assist in creating environmental conditions that support and promote employee engagement. A commitment to supervision processes that promote the use of EBP and address issues related to the improvement of work engagement can contribute to improvement in counselors’ functioning across a variety of counselor work settings. Supervision that incorporates linkages between and among EBP implementation, work engagement and professional expertise is potentially empowering to respective supervisees.
It is important to note that relying on counselor individual factors exclusively is an insufficient and incomplete path to improving professional expertise outcomes. Results suggest that organizational assessment of work engagement, specifically how it is promoted within the organization, in concert with counselor self-assessments, has the potential to yield meaningful results in terms of creating work environments conducive to professional growth.
Further longitudinal research is needed to corroborate the pathways resulting in increased counselor work engagement and professional expertise. Linkages to client outcomes would have significant implications for the continued assessment and support of professional growth of counselors in the field. Another important contextual consideration, exploration of job demands (e.g., work pressure, emotional demands) and how they inform work engagement, would also be beneficial, with important implications for training, supervision and practice. Because work engagement appears to increase possibilities for influencing positive counselor outcomes across a variety of settings, a promising practice includes increased emphasis on assessment and continued monitoring of counselor work engagement.
Treatment approaches based on evidence-based principles are likely to increase counselors’ confidence levels and expectations for treatment (Beidas & Kendall, 2010). As suggested by the work of Bakker and Demerouti (2008), a positive feedback loop develops between level of work engagement and organizational support of EBP. Our data are incomplete in terms of understanding these critical and complex relationships that suggest mutually reinforcing feedback loops. Future research is needed urgently to understand these linkages, specifically how organizational support of EBP and counselor level of work engagement reinforce each other in the service of improving treatment outcomes. Conducting longitudinal studies would allow more complete understanding of the relationship between organizational support of EBP and counselor work engagement. Such studies would permit careful examination of how these feedback loops unfold and are sustained over time. Furthermore, supervision models that promote systematic understanding of feedback loops can empower supervisees and promote them monitoring and evaluating their professional growth.
In the current study, we did not assess individual attitudes about and commitment to EBP; rather, we assessed participants’ perceptions of organizational commitment to supporting EBP in their respective counseling work settings. We did not explore the unique contributions of supervision models across provider settings and their contributions to perceived professional growth. Consequently, future studies are needed to determine how organizational implementation of EBP, including the use of formal and informal supervision, combined with individual commitment to EBP, is implicated in terms of levels of work engagement and professional expertise.
Organizational support of EBP is likely to thrive in a context in which individuals, as well as the system in which they are embedded, embrace and respect the scientific inquiry process (Aarons & Sawitzky, 2006b). While preliminary factors have been identified (e.g., Rapp et al., 2008), further research is needed to investigate this potentially fruitful area of inquiry across culturally diverse work settings, including mental health agencies, schools and hospital settings.
Limitations
This study is characterized by several limitations, in particular, generalizability. All of the participants were graduates of a Master of Science degree program in mental health counseling at an urban northeastern university with a strong commitment to and focus on social justice and serving vulnerable populations. In addition, participants had completed coursework that incorporated assignments focusing on building knowledge and understanding of EBP. Further limiting the generalizability of our findings is that only a select number (31.8%) of graduates from the master’s degree program chose to respond to the questionnaire. The participants were a self-selected group committed to serving clients in urban contexts, and therefore the findings cannot be generalized to all practicing counselors.
Another limitation in our results is the use of a subset of questions designed to assess vigor and dedication on the Utrecht, but that did not assess absorption. However, the questions that were included to assess vigor and dedication yielded a Cronbach’s alpha of .95, indicating a very high reliability. A factor analysis revealed that a single factor accounted for 81% of the variance in the items.
The use of self-reports is an additional limitation of the study. Professional expertise and counselor work engagement were assessed by the participants themselves. The study would be enhanced if seasoned external evaluators, deemed experts in their fields, evaluated each of the participants’ level of work engagement and professional expertise. Multiple self-report measurements such as the EBP Attitude Scale (Aarons, 2004) would have provided additional useful information.
This study would be enhanced if variables such as provider demographics, job characteristics and in-depth analyses of supervision services provided were assessed. In addition, using a longitudinal design that incorporated client outcomes and linked them to mental health counselor professional expertise and work engagement would address the limitation of the cross-sectional nature of this design. Nevertheless, given the dearth of research in this unfolding area of study, our findings provide an important contribution in terms of building a foundation for developing a relatively unexplored section of literature as it relates to the counseling profession. Examining the impact of organizational support of EBP and educational growth and level of work engagement has the potential for significantly improving counselor professional expertise over time.
Professional Practice and Supervision Implications
The findings of this study suggest important directions for counselors, counseling supervisors and administrators. The mediation model indicates the strength of work engagement as a mediator of the large positive relationship between organizational support of EBP and counselor professional expertise, and provides a potential powerful lens for improving counselor outcomes. Given that work engagement accounts for a majority of the direct relationship between organizational support of EBP and professional expertise, the findings of this study suggest that assessment of work engagement can be a valuable avenue for increasing professional expertise.
Professionals in counseling and related work settings are struggling with how best to situate their organizations in terms of ensuring optimal counselor and client outcomes, particularly in a context of diminishing economic resources. Although, for example, research studies have provided a degree of clarity in terms of identifying strategies that promote positive attitudes on the part of counselors toward implementation of EBP (Rapp et al., 2008), the systematic study of counselor work engagement and its contribution to professional expertise has not received the attention and focus it merits. While traditional models of counselor training have focused on counselor deficiencies, our finding in support of the mediational role of work engagement expands the understanding of professional growth from a positive psychology perspective—the positive aspects of work.
The dynamic nature of the mediational model proposed in this study provides important opportunities for supervision and administrative practices. In accordance with the model proposed by Bakker and Demerouti (2008), relationships between resources, such as organizational support of EBP and continuing organizational support of education; work engagement; and counselor professional expertise are neither static nor unidirectional. These variables mutually reinforce and inform each other. Based on the model suggested by Salanova et al. (2005), organizational support of EBP and organizational support of educational growth serve as job resources that increase work engagement levels among counselors; they also inform counselor professional expertise. Sensitizing counselors and supervisors who function across a variety of settings, including schools, hospitals and mental health agencies, to the significance of work engagement, its linkage to EBP and the opportunities it provides for self-assessment can increase possibilities for improving counselor professional expertise (Crocket, 2007). To date, there is no study that suggests how these important linkages—organizational support of EBP and education, work engagement, and professional expertise—can best be harnessed and translated to a variety of settings and improved outcomes with respect to counselor professional expertise (as well as improved client counseling outcomes). Comparison studies are needed to determine optimal models and how they may be adapted and individualized across a variety of sociocultural settings in order to reinforce the dynamic interplay of these important constructs.
Supervisors of mental health counselors have an important role in helping counselors understand organizational contexts, and how they may influence and support their professional growth. Crocket (2007) found that a counselor’s workplace and professional culture, including what transpires during supervision discussions, influence the counselor’s development. Supervisors also play a role in deciphering organizational contexts and can be instrumental in supporting supervisees’ job satisfaction and work motivation (Sears et al., 2006). It is important to understand one’s work context and the potential impact of organizational and professional values on one’s own professional development, a stance that helps counselors to engage actively in the process of self-assessment (Crocket, 2007). Finally, the linkage of organizational commitment to EBP and counselor engagement to continuing professional expertise offers promising opportunities for reflection and professional growth. There is developing evidence that support for professional growth in general facilitates the successful implementation of EBP (Rapp et al., 2008). When there is consistent supportive supervision for using EBP, and when all staff members are included in the education on EBP and demonstration of its importance, even those personnel who are not targeted for EBP implementation, more successful outcomes of EBP implementation have been reported (Rapp et al., 2008). Further, Carlson et al. (2012) reported that successful implementation of EBP is supported by implementation of professional development and skill building as supervisory activities. Not only does our model provide support for the implementation of EBP in counseling settings, but it also provides support for implementation of interventions that enhance professional growth. In keeping with the findings of Colquitt et al. (2000), our model suggests that organizational support contributes to work engagement, independent of support of EBP. Furthermore, Witteman, Weiss, and Metzmacher (2012), based on the work of Gaines (1988), suggested that the development and refinement of professional expertise depend on consistent positive feedback processes. Organizational support of EBP provides counselors and administrators with data-driven feedback processes that encourage opportunities for focused collaboration with room for reflection, evaluation and refinement.
Conclusion
Our robust findings suggest a potentially fruitful area of inquiry that is relatively unexplored terrain. Given that implementation of EBP requires both well-conceived research and practitioners to interpret that research, it would be helpful to isolate and understand the variables that promote successful implementation of EBP in terms of counselor level of work engagement and counselor professional expertise. In the present study, a mediational model that considered systemic factors yielded fruitful findings that have significant implications for counselors, supervisors and administrators working in mental health, school and hospital settings.
Conflict of Interest and Funding Disclosure
The authors reported no conflict of
interest or funding contributions for
the development of this manuscript.
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Varda Konstam is a professor emerita at the University of Massachusetts-Boston. Sara Tomek is an assistant professor and the director of the Research Assistance Center at the University of Alabama. Amy L. Cook is an assistant professor at the University of Massachusetts-Boston. Esmaeil Mahdavi is a professor at the University of Massachusetts-Boston. Robert Gracia is an instructor at the University of Massachusetts-Boston. Alexander H. Bayne is a graduate student at the University of Massachusetts-Boston. Correspondence can be addressed to Varda Konstam, Department of Counseling and School Psychology, University of Massachusetts, Boston, 2 Avery Street, Boston, MA 02111, vkonstam@gmail.com.
