Computer-assisted live supervision in college counseling centers.
College counselors are frequently both providers and recipients of clinical supervision. Demands on limited time and resources necessitate the use of effective and efficient approaches for meeting supervision requirements. Advances in computer technologies during the past decade, along with declining costs of computer hardware, may now provide such opportunities.
Commonly referred to as "bug-in-the-eye" (BITE; Klitzke & Lombardo, 1991) technology (because of its ability to deliver visual information to only the counselor), computer equipment is used to provide instantaneous supervisory feedback during live counseling sessions. To achieve this goal, a supervisor's computer is connected both to her or his own monitor and to one located in a counseling room. The counseling room monitor is attached to a wall-mounted bracket or placed on a table within 2 to 3 feet of the counselor, positioned so that only the counselor can view the screen during a counseling session. Supervisors create text or iconographic messages on their monitor, while the counselor's monitor remains blank. Using a combination of keystrokes, the supervisor sends the message, causing it to "flash" onto the counselor's monitor and to capture her or his attention. The counselor reads and integrates the feedback into her or his delivery of services. After observing evidence that the counselor has received the feedback, the supervisor presses another combination of keys that causes the counselor's monitor to go blank as she or he continues supervision and prepares the next message. Use of BITE technology presumes remote audio and video access to live counseling sessions through a video feed or one-way mirror.
Supervisory feedback may take the form of text messages such as "Open your body posture," "Explore the client's anger in greater depth," or "Good work ... continue to reframe client's cognitions." Supervisors may also use computer-generated icons as shorthand for quickly and efficiently providing feedback or directives (Tracy et al., 1995). For example, a supervisor may activate the image of a beating heart to communicate her or his desire for the counselor to focus on client emotion. A downward pointing arrow can be used to signify a need to explore a particular issue in greater depth. Accurate interpretations of iconographic messages are assured through prior training and practice.
Hardware and Software Requirements
Budget constraints typically limit funds available for purchases of computer equipment, particularly for novel uses. Therefore, a bare-bones BITE system is described for a single supervision station and a single counseling room.
Required hardware for the supervision station includes a personal computer, monitor, keyboard, and/or mouse. The computer can be connected to two monitors by either of two options. The first option requires two video cards and Microsoft Windows98[R] or higher operating system. The second option requires only one video card with any operating system but also necessitates use of an amplified super video graphics adapter (SVGA) splitter. The current costs of these options are roughly equal. Regardless of brand name, older computers capable of supporting word processing and graphics software can be used for this application. Required software includes any compatible word processor. Commercially available graphics programs, such as Print Shop[R] ProPublisher by Broderbund[TM] or Gorel[TM] Draw Graphics Suite[R], may be used to generate iconographic messages.
Required hardware for the counseling room is a computer monitor. A shielded video graphics adapter (VGA) computer cable is recommended for connecting the supervisor's computer to the monitor in the counseling room. This type of cable provides greater resolution and reduces the likelihood of interference from other computers or electrical equipment. When cable lengths exceed 30 feet, use of a VGA distribution amplifier is also recommended to ensure adequate signal strength.
Comparisons With Other Forms of Supervision
The counseling literature is replete with studies that have examined the effectiveness of live supervision approaches (Klitzke & Lombardo, 1991; Mauzey & Erdman, 1997; Salvendy, 1984). These approaches include the "knock-on-the-door" method, which requires a supervisor to disrupt the counseling session to meet individually with the counselor or to join the session for the purpose of enhancing counseling effectiveness. The "telephone call-in" approach is similar to knock-on-the-door, with the exception that supervisory messages are communicated by telephone. "Bug-in-the-ear" supervision refers to the delivery of supervision feedback through "earbuds" worn by counselors during counseling sessions. The advantages and disadvantages of these approaches have been widely disseminated.
BITE supervision is a relatively recent and unique development in counseling and psychology. Consequently, few studies of its use have appeared in the professional literature. Those published have examined BITE in comparison with other forms of supervision. Klitzke & Lombardo (1991) reported that compared with knock-on-the-door and telephone call-in, BITE was relatively nonintrusive in the counseling process. Compared with the knock-on-the-door method or reviewing audiotapes or videotapes that had been recorded during the counseling sessions, BITE provided supervisors with greater flexibility in timing feedback delivery. Because communications were instantaneous, supervisors were free to focus on issues of immediate concern (e.g., "Determine if the client has a suicide plan, means, location, time") or on broader issues after observing session dynamics for a period of time (e.g., "Your client appears to be avoiding the issue of his alcohol use."). Compared with knock-on-the-door, telephone call-in, and bug-in -the-ear approaches, BITE was reported to be less distracting (Klitzke & Lombardo, 1991). In addition, BITE technology was reported to be less physically invasive than bug-in-the-ear supervision, which requires trainees to wear earbuds (Gallant, Thyer, & Bailey, 1991). Compared with knock-on-the-door interventions, BITE was reported to be time-efficient (Liddle, 1991; McCollum & Wetchler, 1995). Feedback and directives relayed through BITE technology reportedly enabled supervisors to communicate swiftly, meaningfully, and effectively (Smith, Mead, & Kinsella, 1998).
Support for BITE Supervision
Despite limited empirical evidence to support its effectiveness, anecdotal evidence suggests that BITE is a valuable supervision tool (Froehle, 1984; Klitzke & Lombardo, 1991; Liddle, 1991; McCollum & Wetchler, 1995; Neukrug, 1991; Smith et al., 1998). Trainees reported an overwhelming preference for BITE over both knock-on-the-door and telephone call-in approaches (Scherl & Haley, 2000).
Consistent with these reports, evaluative feedback from a convenience sample of four master's-level counseling students who received BITE, bug-in-the-ear, and telephone call-in supervision during a first counseling practicum at a midwestern university counseling center yielded support for BITE supervision. Using a qualitative design, researchers posed questions at the end of the practicum course that included the following: "Which of these three types of supervision did you find to be most helpful?" "In what ways did you find BITE supervision to be helpful?" "How did the use of BITE supervision affect your counseling?" "From your perspective, how did the use of BITE supervision affect your clients?" and "Is there anything that you would like to share with counselor educators regarding the use of BITE technology?"
Supervisees consistently reported that (a) they were comfortable using BITE; (b) BITE was helpful and effective as a learning tool; (c) BITE provided opportunities for immediate feedback, which helped them to correct mistakes and improve counseling effectiveness; (d) they preferred BITE over bug-in-The-ear supervision; (e) the use of BITE increased their confidence during sessions; (f) BITE did not negatively affect clients; and (g) the use of BITE benefited clients.
Limitations of BITE Supervision
Compared with low-tech supervision approaches such as reviewing audio- and videotapes or telephone call-in, BITE technology can be expensive. However, the pervasiveness of computer technology in college counseling centers, combined with opportunities to recycle older less powerful equipment, diminishes the expense.
Providing supervision through BITE technology requires a substantial degree of comfort and skill in using computer technology. Clinical supervisors who possess limited computer skills are not likely to embrace BITE technology. However, awareness of the need for technology-literate counselors (see Myers & Gibson, 1999; Van Horn & Myrick, 2001) may result in adapting counselor preparation curricula to increase the number of technology-literate clinicians.
BITE supervision may be inappropriate for visually challenged supervisors and counselors. The use of large screen monitors in concert with a large font size (i.e., 24 point or greater) may be useful in some, but not all, cases. However, supervisors and counselors with hearing impairments may greatly benefit from this supervision approach.
Like all live supervision interventions, BITE technology can be overused. Presenting too much feedback too frequently can be distracting and may diminish both supervision and counseling effectiveness. Therefore, it is important to develop a rationale for the use, sequencing, and timing of BITE interventions among all live supervision options (i.e., telephone call-in, bug-in-the-ear, knock-on-the-door). For example, supervisors may opt to use BITE for communicating brief messages that can be quickly read and interpreted but prefer to communicate longer messages through the telephone or bug-in-the-ear. Delivery of more comprehensive feedback may require use of a knock-on-the-door approach. Supervisors should determine before each counseling session the maximum number and type of interventions that will be made based on the length of the counseling session, the counselor's skill level, and other relevant considerations.
The efficacy of BITE supervision has not been established. Consequently, research is required to answer difficult questions such as "Is BITE an effective supervision approach?" "If so, under what conditions, in which clinical settings, with which clients?" and "What supervisor, counselor, and client variables have an impact on the effectiveness of this approach?"
Setting up a BITE system can be accomplished with older computer equipment for as little as $700-$800, excluding labor costs. Because university provosts and college deans typically have a vested interest in advancing the use of computer technologies, they are appropriate candidates to approach for funding. The rationale for such a request might include the capability of the technology to (a) improve counseling center services, (b) enhance supervision efficiency, (c) attract research on the efficacy of BITE technology, and (d) cut supervision costs.
To take full advantage of the opportunities provided by BITE technology, counseling center supervisors may consider using it for remote supervision. Assuming the availability of Internet connections, a digital camera and monitor may be installed in satellite campus counseling offices (e.g., residence halls, campus center) and networked with the computer in the supervisor's office. Such a configuration provides opportunities for high-quality supervision while eliminating supervisor travel time and reducing expenses.
BITE supervision is a one-way (supervisor-to-supervisee) communication process. Yet supervisees must be provided with opportunities to ask questions, obtain detailed feedback, and process their counseling experiences. Consequently, postsession debriefings are critical aspects of this supervision approach.
Supervisors and counselors must carefully consider professional ethical standards and state codes before using BITE technology for supervision purposes. Because the efficacy of BITE supervision has not been empirically established, clinicians should consider its use experimental. Consequently, counselors must provide clients with a rationale for its use, describe how it will be used in the counseling session, and correct any client misconceptions. In addition, they must identify who will have access to counseling content, assure client confidentiality, and obtain written, informed consent before implementing this approach.
As previously noted, the efficacy of BITE supervision has yet to be established. However, as computer technology permeates all areas of professional practice, BITE has the potential to transform the supervision process. Given this possibility, research must be conducted to determine the most effective ways to use BITE supervision in a wide range of clinical contexts with diverse groups of supervisors, counselors, and clients.
Froehle, T. C. (1984). Computer-assisted feedback in counseling supervision. Counselor Education and Supervision, 24, 168-175.
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Klitzke, M. J., & Lombardo, T. W. (1991). A "bug-in-the-eye" can be better than "bug-in-the-ear": A teleprompter technique for on-line therapy skills training. Behavior Modification, 15, 113-117.
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Scherl, C. R., & Haley, J. (2000). Computer monitor supervision: A clinical note. The American Journal of Family Therapy, 28, 275-282.
Smith, R. C., Mead, D. E., & Kinsella, J. A. (1998). Direct supervision: Adding computer-assisted feedback and data capture to live supervision. Journal of Marital and Family Therapy, 24, 113-125.
Tracy, M., Froehle, T., Kelbley, T., Chilton, T., Sandhofer, R., Woodward, D., et al. (1995, April). Data centric counseling: The development of a computer-assisted observation system for use in process studies in counseling, supervision, and counselor training. Paper presented at the annual meeting of the American Educational Research Association, San Francisco.
Van Horn, S. M., & Myrick, R. B. (2001, December). Computer technology and the 21st century school counselor. Professional School Counseling, 5, 124-130.
Kenneth L Miller, Department of Counseling and University Counseling Center/Community Counseling clinic, Youngstown State University; Susan M. Miller, Department of Psychological Studies in Education, Temple University; William J. Evans, Department of Education, Westminster College. Correspondence concerning this article should be addressed to Kenneth L Miller, Department of Counseling, Youngstown State University, One University Plaza, Youngstown, OH 44555 (e-mail: firstname.lastname@example.org).
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|Author:||Miller, Kenneth L.; Miller, Susan M.; Evans, William J.|
|Publication:||Journal of College Counseling|
|Date:||Sep 22, 2002|
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