Academic journal article Journal of Mental Health Counseling

A Case in Clinical Supervision: A Framework for Putting Theory into Practice

Academic journal article Journal of Mental Health Counseling

A Case in Clinical Supervision: A Framework for Putting Theory into Practice

Article excerpt

A framework for applying supervision theory to clinical practice and an illustrative case study of a prelicensed counselor are presented. The framework integrates developmental and social role theories of supervision and consists of the following parts: (a) assessing the developmental level of the counselor; (b) deciding what topics will be discussed in supervision and who will initiate them; (c) choosing whether the role of teacher, counselor, or consultant is most appropriate in a given situation; and (d) recognizing unique opportunities that arise within the supervisory relationship.

In recent years, the counseling literature has attempted to reach out to mental health counselors who are supervising counseling interns (e.g., Nelson, Johnson, & Thorngren, 2000) and prelicensed counselors (e.g., Magnuson, Norem, & Wilcoxon, 2000). To further this end, a case for clinical supervision is presented across two scenarios with the same counselor. Before introducing the case and related supervision strategies, a brief explanation of the organizing framework used in choosing these strategies is described.


Practical application of supervision theories can provide supervisors with a useful guide for integrating their own theoretical approaches and clinical knowledge into the supervision process. The guiding framework applied in this case is derived from developmental and social role theories of supervision. While the Integrated Developmental Model (IDM; Stoltenberg, McNeill, & Delworth, 1998) and the Discrimination Model (Bernard, 1979, 1997) are the respective models drawn from most heavily, other approaches are cited where appropriate. As such, the framework for applying supervision theory to practice consists of the following steps:

Assessing the Developmental Level of the Counselor

Stoltenberg et al. (1998) proposed three levels of counselor development in which counselors display varying degrees of motivation, autonomy, and awareness. Knowing the developmental level of the counselor helps supervisors make decisions about the optimal supervision environment across several factors: (a) the balance of supportive versus challenging interventions needed; (b) the degree of structure provided; (c) the amount of teaching, skill development, and direct suggestions needed; and (d) the degree to which counselors' personal reactions are explored.

Determining the counselor's developmental level is the first step in choosing supervision strategies and forms the foundation from which the other steps follow. While counseling experience is certainly a critical factor, assessing whether counselors fit in level one, two, or three depends on the degree to which they exhibit a stable motivation for being a counselor, an awareness of self and clients, and dependence on the supervisor versus autonomous functioning (Stoltenberg et al., 1998). Stoltenberg et al. and Bernard and Goodyear (1998) provided self-report measures that can help to assess a counselor's developmental level.

According to Stoltenberg et al. (1998), level-one counselors, who are very uncertain about their counseling effectiveness, tend to be the following:

* Highly anxious and highly motivated to learn

* More focused on their own feelings and thoughts about what to do next in sessions and, subsequently, less aware of clients' needs and process dynamics

* Highly dependent on the supervisor for direction, instruction, and support

Because of the intense anxiety, heightened motivation, and lessened awareness, level-one counselors need an environment with large amounts of support, direct instruction, and structure, and minimal amounts of challenge and personal exploration.

Level-two counselors vacillate in their levels of confidence, anxiety, and motivation; struggle with feeling dependent and wanting autonomy; and improve in their awareness of clients' issues and relationship dynamics. …

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