|Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979|
Clinical Supervision: Models, Role, Legal & Ethical, & Transference
Question 1: How do cultural differences affect the dynamics of supervision relationships?
Understanding the implications of racial identity development within the supervision relationship may yield more clarity about cultural differences in the supervision process than simply considering race as a demographic variable (Ellis & Ladany, 1997). For example, Cook (Cook, 1994; Helms & Cook, 1999) provided a framework for considering how supervisors and supervisees may approach or avoid racial issues as a function of people of color and White racial identity statuses. One such avoidance of cultural issues is evidenced by the experience of one coauthor:
"Most supervisors that I have worked with tend to view clients from a limiting, dominant-culture perspective. Although my supervisors were, for the most part, experienced well intentioned, this approach never fully invited me or my clients into the discussion. I found this perspective to be much too dogmatic and imposed upon me a rigid framework for understanding the cultural and multiple contexts of my clients. As a result, I often found myself constantly checking the time to see when supervision would be over and telling my supervisors what they wanted to hear. That is, there was an insistence, however indirect, that I abandon my personal and cultural perspectives on how people interact with the world in favor of theirs."
Similarly, Ladany, Brittan-Powell, et al. (1997) found that racial identity interactions between supervisors and supervisees affected the supervisory working alliance and supervisee development of multicultural competence. In particular, supervision dyads were rated more poorly when the supervisees' racial identities were more advanced than their perceptions of their supervisors' racial identities.
No matter which cultural factors influence the supervisory relationship, an inherent power hierarchy results because of the supervisor's evaluative role, professional credentials, and responsibility for client welfare. In addition, White supervisors, who hold the power of White privilege (McIntosh, 1988), can control the supervision process by ignoring alternative cultural perspectives, unconditionally applying a Eurocentric approach, and pathologizing difference (Fong & Lease, 1997). The following example describes one supervisee's unique experiences with such issues:
Question 2: How might a supervisor or supervisee introduce cultural issues into the supervision relationship?
There is consistent agreement that conversations about multiculturalism should occur early in supervision, in particular to dispel any preconceptions and assumptions that might undermine the supervision process (Constantine, 1997; Cook, 1994; Daniels et al., 1999; Fong & Lease, 1997; Fukuyama, 1994; Leong & Wagner, 1994; Remington & DaCosta, 1989). For example, McRoy et al. (1986) found that those multicultural supervision dyads that discussed cultural concerns in supervision reported more favorable outcomes. Such action allows the supervisor and supervisee to establish rapport, emphasizes the importance of culture in the supervision and counseling process, and develops a working language concerning cultural issues.
Supervisee therapeutic competence is incomplete until multiculturalism is fully incorporated into the supervision process (Constantine, 1997). The development of supervisee cultural awareness is a supervisory responsibility (Cook, 1994; Fong & Lease, 1997); discussing multiculturalism helps supervisees identify and understand how culture influences their application of counseling (e.g., theoretical orientation, case conceptualization, treatment planning). Supervisees can also learn how culture influences their perceptions of culturally different clients and culturally different clients' perceptions of them. Finally, multicultural supervision can be a place for clients and supervisees to explore primary elements of their cultural identities. These skills and insights can only occur when multiculturalism is central to the supervision process. The following experience illustrates the impact of cultural understanding once it is introduced in the supervision process:
"Every one of my supervisees has been of the majority, and for some the discussion of multiculturalism has come without angst. However, when our conversations are framed within the context of the supervisee's understanding of self, the conversation becomes easier. That is, the discussion of culture becomes more salient to the supervisee as it revolves around his or her own culture and relates to his or her theory of counseling. Although there is a strong tendency in each of us to translate clients' stories into our understanding of the world, I have found that this conceptualization of self helps supervisees to appreciate their clients' worldview."
In a recent study of predoctoral psychology interns, supervisees indicated that their supervisors were reluctant to introduce and discuss cultural issues (Constantine, 1997). Although approximately 15% of supervision time was spent discussing or exploring cultural issues, both interns and their supervisors expressed a desire for more processing of cultural differences in the supervision relationship.
"Despite differences in culture that were present in my 10 years of supervised practice, culture had rarely been discussed directly. I had one supervisor, from a country other than the U.S., who occasionally shared anecdotal stories of his culture as metaphors. I feel that we missed a valuable learning experience by not bringing our differing worldviews more into focus."
Failing to discuss cultural issues in supervision may lead to miscommunications, misunderstandings, "hidden" agendas, assumptions, and disconnections between supervisors and supervisees (Constantine, 1997). Although conversations about multiculturalism may initially be awkward or uncomfortable, supervision that does not include a cultural context may be perceived as inadequate at best and incompetent at worst. Furthermore, supervisors who fail to integrate culture into the supervision process may develop reputations for being culturally insensitive and professionally inadequate (Helms & Cook, 1999).
Reflection Exercise #7
Others who bought this Course