Nicholas Ladany

Consensual Qualitative Research: An Update

The authors reviewed the application of consensual qualitative research (CQR) in 27 studies published since the methods introduction to the field in 1997 by C. E. Hill, B. J. Thompson, and E. N. Williams (1997). After first describing the core components and the philosophical underpinnings of CQR, the authors examined how it has been applied in terms of the consensus process, biases, research teams, data collection, data analysis, and writing up the results and discussion sections of articles. On the basis of problems that have arisen in each of these areas, the authors made recommendations for modifications of the method. The authors concluded that CQR is a viable qualitative method and suggest several ideas for research on the method itself.

Self-report multicultural counseling competence scales: Their relation to social desirability attitudes and multicultural case conceptualization ability.

This study examined the relationship between 4 self-report multicultural counseling competence measures and a general index of social desirability. The authors also investigated the association between these 4 multicultural scales and multicultural case conceptualization ability. Results revealed significant positive relationships between 3 of the 4 multicultural counseling competence inventories and a measure of social desirability attitudes. Additionally, after controlling for social desirability, none of the self-report multicultural counseling competence scales were significantly related to multicultural case conceptualization ability. Limitations of self-report multicultural counseling competence measures are discussed, and implications of the findings for counseling training, practice, and research are delineated.

Psychotherapy Supervisor Ethical Practices Adherence to Guidelines, the Supervisory Working Alliance, and Supervisee Satisfaction

The overall purpose of this article is to present a review of the literature that identifies the salient ethical guidelines related to the practice of supervision and to discuss the results of a study that examined supervisor ethical practices. In terms of our investigation, we examined supervisee perceptions of their supervisors’ adherence to ethical guidelines, supervisee reactions to ethical violations, and the relationships among supervisor ethical behaviors, the supervisory working alliance, and supervisee satisfaction. The results indicated that 51% of the 151 beginning to intern-level supervisees sampled reported at least one ethical violation by their supervisors. The most frequently violated guidelines involved adequate performance evaluation, confidentiality issues relevant to supervision, and ability to work with alternative perspectives. Greater nonadherence to ethical guidelines was significantly related to a weaker supervisory alliance and lower supervisee satisfaction. Limitations and implications for psychotherapy supervision theory, research, and practice are addressed.

Clinical Supervision Research From 1981 to 1993" A Methodological Critique

Michael V. Ellis University at Albany, State University of New York Nicholas Ladany Temple University Maxine Krengel Boston Veterans Affairs Medical Center and Boston University School of Medicine Deborah Schult University at Albany, State University of New York The empirical studies in clinical supervision published from 1981 through 1993 were investigated to assess scientific rigor and to test whether the quality of methodology had improved since the review by R. K. Russell, A. M. Crimmings, and R. W. Lent (1984). The 144 studies were evaluated according to 49 threats to validity (T. D. Cook & D. T. Campbell, 1979; R. K. Russell et al., 1984; B. E. Wampold, B. Davis, & R. H. Good III, 1990) and 8 statistical variables (e.g., effect size, statistical power, and Type I and Type II error rates). The data revealed a shift to realistic field studies, unchecked Type I and Type II error rates, medium effect sizes, and inattention to hypothesis validity. Recommendations for designing and conducting a feasible and well-designed supervision study are offered. It can be argued that a primary goal of research in clinical supervision is to test and improve theory and to guide the practice of supervision (Ellis, 1991b). A thorough under- standing of the strengths and weaknesses of supervision research would ostensibly expand supervision theory and provide practitioners with information on how to train ef- fective counselors who, in turn, will provide more effective therapy. Although there have been numerous calls for in- creasing the scientific rigor of research on counselor super- vision and training (e.g., Ellis, 1991b; Hansen & Warner, Michael V. Ellis and Deborah Schult, Department of Counseling Psychology, University at Albany, State University of New York; Nicholas Ladany, Department of Counseling Psychology, Temple University; Maxine Krengel, Psychology Section (1168), Boston Veterans Affairs Medical Center and Department of Psychology, Boston University School of Medicine. Earlier versions of this article were presented at the 96th Annual Convention of the American Psychological Association, Atlanta, Georgia, August 1988, and at the meeting of the North Atlantic Regional Association of Counselor Education and Supervision, Albany, New York, October 1991. Maxine Krengel completed some of this research while a doc- toral student in the Department of Counseling Psychology, Uni- versity at Albany, State University of New York. We are grateful to Micki Friedlander, Richard Haase, and Erica Robbins Ellis for their insightful comments on earlier versions of this article. We express our appreciation to Eric Adams, Mafoozal Ali, Elizabeth Bhargava, Virginia Flander, David Hahn, Gohpa Khan, Michelle Mautner, Deborah Melincoff, Michael Remshard, Greg Savage, Heidi Weiss, Donna Wilson, and Bradley Wolgast for their data coding and entry assistance. Correspondence concerning this article should be addressed to Michael V. Ellis, Department of Counseling Psychology, Educa- tion 220, University at Albany, State University of New York, 1400 Washington Avenue, Albany, New York 12222. Electronic mail may be sent via Internet to me464@cnsibm.albany.edu. 35 1971; Holloway & Hosford, 1983; Russell, Crimmings, & Lent, 1984), a comprehensive and in-depth investigation of the actual state of scientific rigor has yet to be conducted. If supervision research is going to meet the goal of informing theory and practice, then a thorough assessment of its meth- odological limitations and implications is warranted. At least 32 reviews of empirically based articles pertain- ing to clinical supervision and counselor training have ap- peared in the literature. Although these reviews have made substantial contributions to the field, many did not evaluate systematically the methodological or the scientific rigor of the examined studies (e.g., Harkness & Poertner, 1989; Holloway, 1984, 1992; Holloway & Neufeldt, 1995; Kaplan, 1983; Lambert & Arnold, 1987; Leddick & Ber- nard, 1980; Liddle & Halpin, 1978; Matarazzo, 1971, 1978; Matarazzo & Garner, 1992; Matarazzo & Patterson, 1986; Russell & Petrie, 1994; Stoltenberg, McNeill, & Crethar, 1994; Yutrzenka, 1995) or did so in a cursory fashion (i.e., Baker & Daniels, 1989; Baker, Daniels, & Greeley, 1990; Ford, 1979; Hansen, Pound, & Petro, 1976; Robins, & Grimes, 1982; Hansen & Warner, 1971; Holloway & Johnston, 1985; Holloway & Wampold, 1986; Kurtz, Mar- shall, & Banspach, 1985; Loganbill, Hardy, & Delworth, 1982; Stein & Lambert, 1995; Worthington, 1987). Only four reviewers presented details of the methodological flaws encountered in the studies reviewed (Alberts & Edelstein, 1990; Avis & Sprenkle, 1990; Holloway, 1987; Russell et al., 1984). The result of not systematically evaluating the methodological issues may have erroneously led to (a) equating (or even outweighing) the findings of excellent research with poor research (Hogarty, 1989; Kline, 1983), (b) exacerbating the theoretical ambiguity in the field (Meehl, 1990), and (c) drawing inaccurate inferences and conclusions (Cooper, 1989; Ellis, 1991a). The most recent review of research in individual clinical supervision that

Development and validation of the Evaluation Process Within Supervision Inventory

The purpose of this study was to develop the Evaluation Process Within Supervision Inventory (EPSI), a measure that examines evaluation practices in clinical supervision. Results based on 274 trainees with diverse training experiences indicated that the measure yields 2 theoretically consistent factors: goal setting (e.g., goals that are specific; feasible in regard to capacity, opportunity, and resources; and measurable) and feedback (e.g., feedback that is systematic, timely, clear, and balanced between positive and negative statements). Evidence of validity was based on theoretically consistent relationships between more effective goal-setting and feedback practices and (a) a stronger working alliance, (b) enhanced trainee perception of supervisor influence on self-efficacy, and (c) increased trainee satisfaction with supervision.

Trainee nondisclosure in supervision: What are they not telling you?

Aims: The purposes of this study were to examine: (1) the content of and reasons for trainee nondisclosure in supervision, and (2) the influence of trainee anxiety and perception of the supervisory working alliance on amount of nondisclosure and willingness to disclose. Method: As the focus of the study was a single supervision session, qualitative and quantitative data were collected from 204 trainees about their most recent supervision session. Results: Within the single supervision session on which they reported, 84.3% of trainees withheld information from their supervisors. Trainees reported an average of 2.68 nondisclosures occurring in the session, with the most common nondisclosure involving a negative supervision experience. Trainee perception of a better supervisory working alliance was related to less nondisclosure and greater overall willingness to disclose in supervision. Higher trainee anxiety was related to greater nondisclosure and lower overall willingness to disclose in supervision. Implications: The implications of the findings for the practice of supervision are discussed and areas for further research are suggested.

Psychotherapy supervision: What lies beneath

This article presents a discussion of the critical incidents involved in the authors development as a psychotherapy researcher with the aim of sharing his biases and expectations. The author then addresses how his research program attempts to answer 4 questions about psychotherapy supervision: If nothing else, what should a supervisor do? What are some of the worst things a supervisor can do? What secrets do supervisors and trainees keep from one another? What about sex? The article concludes with a series of propositions for psychotherapy supervision research.

Effective and Ineffective Supervision

Although supervision is recognized as a significant tenant of professional growth for counseling and psychotherapy students, the variability of the effectiveness, or ineffectiveness, of supervision has come under scrutiny in recent times. Our sample of 128 participants shed light on the most effective (e.g., encouraged autonomy, strengthened the supervisory relationship, and facilitated open discussion) and most ineffective (e.g., depreciated supervision, performed ineffective client conceptualization and treatment, and weakened the supervisory relationship) supervisor skills, techniques, and behaviors. Moreover, effective and ineffective behaviors, along with best and worst supervisors, were significantly differentiated based on the supervisory working alliance, supervisor style, supervisor self-disclosure, supervisee nondisclosure, and supervisee evaluation. Implications for supervision competencies and supervisor accountability are discussed.

The impact of psychotherapy training: Introduction to the special section

Does psychotherapy training positively, negatively, or negligibly impact process and outcome of clinical practice? This fundamental question touches a deep core of meaning not only for students of psychotherapy but for all of those engaged in the training of psychotherapists, including the clinical and academic staff of training institutions, clinical supervisors, and therapists’ personal therapists. The question is important not only to students and staff at training and treatment institutions but even more so to patients and to society, as was suggested by the tripartite outcome model of Strupp and Hadley (1977).

Sexual Attraction toward Clients, Use of Supervision, and Prior Training: A Qualitative Study of Predoctoral Psychology Interns.

Interviews were conducted with 13 predoctoral psychology interns about an experience of sexual attraction toward a client, use of supervision to address the sexual attraction, and prior training regarding sexual attraction. Results indicated that sexual attraction to clients consisted of physical and interpersonal aspects. Therapists believed they were more invested and attentive than usual to clients to whom they were sexually attracted, and they indicated that sexual attraction created distance, distraction, and loss of objectivity. In terms of supervision, only half of the participants disclosed their sexual attraction to supervisors, and supervisors seldom initiated the discussion. Furthermore, trainees found it helpful when supervisors normalized the sexual attraction and provided the opportunity to explore feelings in supervision. Finally, trainees believed their training programs did not adequately address therapist sexual attraction.