Computer-based counselor-in-training supervision: ethical and practical implications for counselor educators and supervisors.
Clinical supervision is a crucial and necessary tool in the counseling profession. Bernard and Goodyear (2004) offered a definition of counselor supervision:
Supervision is an intervention provided by a senior member of a profession to a junior member or members of that same profession. This relationship is: evaluative, extends over time and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s), monitoring the quality of professional services offered to the clients that she, he or they see(s), and serving as a gatekeeper of those who are to enter a particular profession. (p. 8)
Counselor supervision is the main vehicle through which counselors-in-training gain the practical skills and knowledge that will assist them in becoming ethical and effective helping professionals (Vespia, Heckman-Stone, & Delworth, 2002). As Dollarhide and Miller (2006) noted, counselor supervision is "'the means by which skills are refined, theory and practice are integrated, and trainees explore their new professional identities in preparation for induction into their profession" (pp. 242-243). Many counseling professionals are involved in supervision, and it has been suggested that they devote much time and effort to this pursuit (Watkins, 1995). For the purposes of this article, a supervisor is a state-licensed mental health professional and/or counselor educator supervising counselors-in-training.
Layne and Hohenshil (2005) asserted that technology in counseling is a trend that is here to stay and believe that counselors and supervisors need to learn to use it effectively. To that end, computer-based supervision, although far from mainstream, is becoming more prevalent (Reisch & Jarman-Rohde, 2000). Harvey and Carlson (2003) indicated that the following technologies are being used for supervision: (a) e-mail, (b) computer-based teleconferencing, (c) electronic mailing lists, (d) chat rooms, and (e) computer-assisted live supervision. Thus, computer-based supervision is being used within multiple formats.
The full potential of computer-based counselor-in-training supervision has yet to be realized in counselor education programs, despite its potential benefits (Trolley & Silliker, 2005; Watson, 2003). Examples of possible contributions of computer-based supervision include (a) lower costs to supervisees (i.e., in time, travel cost, and course fees); (b) increased flexibility in scheduling; (c) greater cost-effectiveness for educational institutions because they can deliver services to a wider range of students, especially those living internationally and in remote locations; (d) provision of supervision opportunities for those who live in rural areas; and (e) increased diversity of counselor trainees based on increased accessibility (Bloom & Walz, 2000; Gainor & Constantine, 2002; Oravec, 2000; Watson, 2003). However, regardless of how supervision is being delivered, there are fundamental ethical issues that must be addressed in clinical supervision.
Ethical practice is a component of supervision for all students. Professional ethics are defined as "acceptable or good practice according to agreed-upon rules or standards of practice established by a profession, as in counseling or psychology" (Cottone & Tarvydas, 2003, p. 4). Supervisors have a responsibility to familiarize themselves with the existing standards of ethics for their respective fields. In addition, supervisors are expected to both model and educate their supervisees about professional ethics and ethical practice (Welfel, 2006). The American Counseling Association (ACA; 2005) ACA Code of Ethics states, "Supervisors have a responsibility to understand and follow the ACA Code of Ethics" (Standard F.1.a.). Emerging technologies in counseling and supervision present new ethical challenges for supervisors to consider.
Examples of the ethical considerations of computer-based supervision include (a) confidentiality, (b) emergency situations, (c) informed consent, and (d) jurisdiction and technical competence (Fenichel, 2000; Panos, Panos, Cox, Roby, & Matheson, 2002; Shaw & Shaw, 2006; Watson, 2003). Shaw and Shaw pointed to confidentiality issues that exist when using computer-based modalities such as e-mail, chat room, videoconferencing, and instant messaging (IM). In addition, supervisors need to have established protocol and process in managing emergencies and crises that may arise in the counselor-in-training's clinical fieldwork experiences. Shaw and Shaw noted the need for encrypted or secure transmissions of supervisory information to avoid interception by unauthorized parties. The counseling informed consent form must clearly state that computer-based supervision is a medium that is not 100% secure, and supervisees need to explain this to their clients (Fenichel. 2000). Shaw and Shaw further noted that there are jurisdiction issues involved in computer-based supervision and that all counselors are not covered under one uniform regulation. Supervisors need to adhere to the laws of both their state and their supervisee's state (or international laws, where applicable) when conducting computer-based supervision. Finally, technical competence is also an area that needs to be examined through an ethical lens. Watson indicated that the supervisor and supervisee must be trained to use this technology to ensure that supervision flows smoothly. In the case that there is a technological failure, the site needs to have a back-up plan in place to address such an issue.
A primary, role of clinical supervisors is to serve as a professional gatekeeper; that is, they continually monitor and evaluate their supervisees' practice to protect and safeguard the well-being of clients (Bernard & Goodyear, 2004). Supervisors have an ethical and legal responsibility to monitor the quality of care that is being delivered to their supervisees' clients. In order to enhance the professional functioning of the supervisee and ensure quality care, the supervisor constantly monitors and provides feedback regarding supervisee performance (Gladding, 2002).
Evaluation is the "nucleus of clinical supervision" (Bernard & Goodyear, 2004, p. 152). As important as evaluation is to supervision, both supervisors and supervisees may find the evaluation process anxiety provoking. Supervisors are charged to balance an understanding of individual differences in conducting counseling sessions with the notion of competent practice as ascribed by the profession through its ethical codes and standards of practice. The supervisor uses two general methods of evaluation: formative and summative (Cottone & Tarvydas, 2003). The supervisor is charged with evaluating his or her supervisees based on their counseling with clients and to assess supervisees' potential for working with future clients. As part of this role, supervisors formally evaluate supervisees. These summative evaluations occur after supervisees have developed a baseline of professional counseling competences. For example, during fieldwork experiences, summative evaluations typically occur in the middle and at the end of a term. It should be noted that the integrity of evaluation may be compromised without supervisors visually reviewing the counseling process (i.e., live supervision, videotaped case presentations).
Supervision is critical in the development of a counselor (Gladding, 2002). The benefits of supervision include (a) greater effectiveness and accountability; (b) enhanced counselor skill development and competencies; (c) increased feelings of support, confidence, job satisfaction, professional identity development, and self-efficacy; and (d) decreased feelings of isolation, role ambiguity, and burnout (Herlihy, Gray, & McCollum, 2002; Lambie & Sias, in press: McMahon & Patton, 2000). Computer-based supervision may be an approach to making supervision accessible to a wide range of trainees, especially trainees in situations in which face-to-face supervision opportunities are unavailable, for example, in between scheduled supervision appointments or when distances make face-to-face appointments difficult.
This article reviews ethical and legal issues regarding computer-based counselor-in-training supervision and the need for counselor education programs and supervisors to be educated in ethical practices pertaining to such technologies. More specifically, this article introduces specific types of computer-based supervisory tools and their potential strengths and limitations. In addition, ethical considerations from several authors are presented as suggestions for computer-based counselor-in-training supervision. Finally, practical implications for counselor educators and supervisors are offered.
Computer-Based Clinical Supervision
Computer-based supervision requires specific training and skill-based knowledge. Graf and Stebnicki (2002) suggested that computer-based clinical supervision requires (a) training on new supervision technology--both ongoing and frequent, (b) extra time to plan for supervision, (c) increased consistency and structured protocol for supervision (concrete guidelines, responsibilities, and expectations), and (d) more efficient communication procedures among all involved parties (e.g., supervisee, university supervisor, and on-site supervisor).
Logistical issues need to be considered when using technology to facilitate clinical supervision. Parker and Parker (1998) suggested that proponents of distance learning believe that using technology in education offers benefits to trainees such as flexibility, reduced expenses, and access to classes for those in remote locations. Although all of these advantages are positive, they pertain to an ideal setting--one in which there are no barriers to access for trainees and supervisors. One must consider that some trainees and schools do not have the necessary equipment available to execute computer-based supervision because of a lack of resources and/or remote locations (those without Internet capabilities). Furthermore, trainees and supervisors may also lack the skills and training in the technologies required for this endeavor (i.e., e-mail, chat room, teleconferencing, etc.; Panos et al., 2002).
There are several modalities of computer-based clinical supervision technologies being used. First, e-mail is a computer technology that allows users (supervisors and supervisees) to send electronic messages and documents to one another easily. According to Oravec (2000), e-mail appears to be the most widely used technology on college campuses in general.
E-mail technology has both strengths and limitations when applied to counselor-in-training supervision. An advantage is it allows supervisors both in the field and at the university to collaboratively work together in supporting supervisees to develop their counseling skills. In addition, Myrick and Sabella (1995) noted that e-mail allows supervisors and supervisees to have efficient contact with one another and supports more continuous flow of information between both parties. Thus, they viewed e-mail as a useful approach to present cases and discuss case-related information.
A significant disadvantage of e-mail counselor-in-training supervision is confidentiality (Watson, 2003). Watson noted that e-mail communication cannot be totally protected because messages may be accessed by other parties and confidentially thus breached. Watson suggested that messages not sent over a secure server or computer used by groups are vulnerable to security threats. Mallen, Vogel, and Rochlen (2005) stressed the importance of gaining trainee consent to save supervisory e-mails on their computer. Mallen et al. also suggested obtaining client consent. This is to ensure that the supervisee and client understand the potential risks of using e-mail as a means of communication. These threats may be mediated by using secure servers that encrypt messages and protect confidentiality, but there is no guarantee that unscrupulous people will not attempt to gain access to them. Furthermore, there may also be limitations in safeguarding strategies and technologies because these do not offer a complete guarantee of confidentiality (Spinello, 2000).
The literature consistently notes the importance of the supervisor-supervisee relationship (e.g., Bernard & Goodyear, 2004; Lambie & Sias, in press; Watkins, 1995). Barak (1999) concluded that, because of a lack of face-to-face communication during group supervision (i.e., when all participants are not in the same room together), computer-based supervision is potentially problematic because supervisors and their counselor trainees do not receive the full benefit of nonverbal communication (eye contact, facial expression, and body language). As a result, the lack of nonverbal cues may cause their interpersonal communications to be lacking in richness and depth (Helms & Cook, 1999). In addition, Case, Bauder, and Simmons (2001) noted that the absence of such nonverbal cues may lead to misinterpretation of supervisor feedback, loss of educational content, and lack of sensitivity to multicultural issues. Thus, the lack of supervisor-supervisee face-to-face communication often found in e-mail supervision may impede a counselor-in-training's professional development and ethical practice. In addition, it is difficult to translate feelings through written communication and to interpret tone, which is primarily conveyed through physical expression. For example, the statement "I'm doing fine, things are going okay" is not easily interpreted.
Videoconferencing is another form of computer-based counselor supervision. This method allows supervisors and counselor trainees to communicate in real time via video equipment installed in their computer stations. Using this technology allows them to see each others' faces and hear each others' voices. According to Watson (2003), supervisors are able to monitor for verbal and nonverbal cues, unlike other forms of computer-based supervision such as chat rooms and e-mail. They can also gain a better idea of the skills and abilities of their supervisees. A disadvantage is that supervisors must possess, and know how to use, videoconferencing technology, which is costly and often complicated to use. In addition, the relationship between the supervisor and supervisee may be hindered due to the lack of face-to-face communication (i.e., during group supervision when all participants are not in the same room together), which limits sensory and contextual cues that are keys to social interaction (Jerome & Zaylor, 2000).
A chat room is another form of technology through which counselor supervision may be conducted. Geraty (2002) defined chat room supervision as "a designated place in cyberspace where individuals gather to communicate around a specific topic, not unlike a room full of people anywhere" (p. 2). If a chat room format is used for counselor supervision, then supervisors can communicate with supervisees in real time (synchronous), and they have the ability to post messages. Chat rooms seem to be somewhat secure because they are intended to limit access only to those who are involved in supervision. Another benefit of chat room supervision is that supervisees can communicate with each other and gain support from one another (Watson, 2003). A potential disadvantage of this technology is that supervisees must have access to a personal computer and the Internet in order to participate in the chat room sessions. In addition, Jerome and Zaylor (2000) suggested that the lack of face-to-face interaction with the chat room supervisor reduces the strength of the supervisory relationship.
IM, such as Yahoo or AOL (America Online) messenger, is another form of synchronous communication that may be integrated into counselor-in-training supervision. This technology allows the supervisor and supervisee to communicate instantly, which is similar to a chat room except that it is a one-to-one conversation. Watson (2003) noted that the main advantage of IM is that it allows for instant communication between supervisor and supervisee. A disadvantage is that the supervisor may be overwhelmed by having several IM conversations happening simultaneously if they choose to work with more than one supervisee at a time. As with chat room technology, supervisees must have Internet access and a personal computer and must be able to download and operate an IM program. Again, the theme of a lack of personal connection between the supervisee and the supervisor pervades computer-based supervision technology (Omodei & McClennan, 1998).
The presented computer-based counselor-in-training supervision technologies have common strengths and limitations. The potential strengths are (a) allowing participants to share their communication with the supervisor (in a one-to-one session) or, in the case of videoconferencing, with a supervision group: (b) allowing supervisees to access supervision opportunities over considerable distances; and (c) allowing supervisors to have more consistent contact with supervisees and vice versa. On the other hand, computer-based counselor-in-training supervision also has limitations. Watson (2003) noted that a significant limitation is that many supervisors lack the professional competencies to provide such supervision. (Many supervisors are not trained to work with this technology as a means of supervision.) In addition, supervisors need to generate back-up plans in case of technological failure, and taking the extra time to do this may offset the benefits of using computer-based supervision approaches (McCarry & Clancey, 2002: Oravec, 2000; Watson, 2003). Furthermore, computer-based counselor-in-training supervision limits the supervisee-supervisor relationship, which has consistently been cited as a foundational component of counselor supervision (Bloom & Walz. 2000; Harvey & Carlson. 2003: Watson, 2003).
Ethics and Computer-Based Clinical Supervision
Perhaps the greatest clinical and ethical challenge of supervision is that supervisors must attend to the best interests of the client and supervisee simultaneously (Corey, Corey, & Callanan (2003). To do so successfully, supervisors must take into account issues of confidentiality (security), liability, and technological competence. Therefore, we review how computer-based counselor-in-training supervision affects each of these ethical domains and potential strategies to mediate their impact. Some professional counseling associations have established guidelines and best practices relating to Internet counseling. These include ACA (2005), the National Board for Certified Counselors (2005), and the International Society for Mental Health Online (2000). However, it is important to note that these professional associations have not established specific guidelines regarding computer-based counselor-in-training supervision. Therefore, it is incumbent upon supervisors using computer-based technology to ensure that they are ethical in their supervisory practices. The following is a discussion of some pertinent ethical issues that may assist in such an effort.
The first area to examine is that of security and how it affects confidentiality. Barak (1999) noted that supervisors must have methods to encrypt or protect confidential client information that is relayed through e-mail, chat rooms, and similar media. There is a possibility that dishonest persons could gain access to highly sensitive and private information if it is unprotected (Remley & Herlihy, 2001). One potential solution is to make sure that e-mail communications are as secure as possible, and this may be achieved through using encryption software. Having this software in place will assist in keeping records and communications confidential and unavailable to the general public. In addition, Panos et al. (2002) advocated that each institution have written protocols in place to minimize possible security breaches. The authors suggested that initials and codes be used in e-mail and chat room communications to minimize these concerns. Furthermore, Rice (1997) suggested that clients should be made aware of the chance of unauthorized access that may occur from counselors participating in computer-based supervision, and this should be included in the informed consent protocol. In addition, regarding videoconferencing, Panos et al. advocated that supervisors and other relevant university personnel need to ensure that the videoconferencing is conducted through a secure network and at a place and time to maintain privacy so that others may not inadvertently overhear sessions.
Counselor education programs using computer-based counselor-in-training supervision approaches also need to be cognizant of potential liability issues. Panos et al. (2002) suggested that because there are no specific standards in place for computer-based counselor supervision, counselor education programs need to be sure that they have the adequate liability coverage to support a computer-based supervision program. Because counseling trainees may be supervised over considerable distances, there needs to be a focus on making sure that appropriate liability insurance is in place. It is suggested that counselor education programs using computer-based supervision approaches seek legal counsel regarding their practices.
Both the supervisor's and supervisee's informed consent and professional disclosure statements should explicitly discuss the limits of confidentiality of computer-based supervision (Panos et al., 2002; Welfel, 1998). These authors suggest that all parties (supervisor, supervisee, and client) sign these documents, acknowledging their understanding of the potential limitation of confidentiality. By delineating the aforementioned limitations in the informed consent forms, this may help to address any potential liability issues that arise from using computer-based supervision (Bloom & Walz, 2000).
Supervisor technology competencies may also be related to counseling ethical practice. Barak (1999) noted the importance of supervisors and supervisees being specifically trained in using the technology needed for computer-based supervision. For example, with e-mail, one must know the limitations of such technology in order to compensate for them. E-mail restricts the ability of the supervisor to assess visual and physical cues from the supervisee. The supervisor must be aware of these limitations and be able to compensate for them in order to operate ethically through this technological medium (Barak, 1999). In addition, Oravec (2000) stressed the need for computer-based supervisors to be able to discern when there is a need to meet with a supervisee face-to-face rather than through a computer-based medium. This is important because sensitive issues may best be addressed in a format where visual and contextual clues are readily available to the supervisor.
There are benefits of computer-based supervision; however, it limits contextual clues and tends to deemphasize the supervisee-supervisor relationship, which is central to effective and ethical supervision. Computer-based counselor-in-training supervision might be best used as an adjunct and not as a replacement for traditional face-to-face supervision. The following are suggestions for counselor educators and supervisors in supporting the ethical practice of computer-based counselor-in-training snpervision.
In order to adhere to ethical practices regarding computer-based supervision, ethical guidelines specific to computer-based supervision need to be established. On a national level, it is suggested that ACA. the Association for Counselor Education and Supervision, and other counseling-related associations work to create such guidelines for their members. Similarly. to ensure best practice and ethical computer-based trainee supervision, it is suggested that counselor education training programs and the Council for Accreditation of Counseling and Related Education Programs adopt standards and guidelines for their preparation programs. Counselors, counselor educators, and supervisors need to advocate for such guidelines, not only to give this supervision modality increased credibility but also to ensure that guidelines and best practice standards are being met.
Counselor education programs, because of the lack of a current nationally established protocol, are encouraged to create their own standards to suit the needs of their respective curricula. The establishment of these standards should be used not only to operate in an ethical manner but also to assist supervisees and supervisors in understanding their roles and responsibilities in the computer-based supervision process. Furthermore, counselor education programs that offer computer-based supervision are advised to create specific protocol in managing crises that may occur in supervision. Again. this is for ethical purposes and the protection of client welfare. In addition, it is suggested that counselor education programs have a protocol in place for managing the ethical issues inherent in computer-based trainee supervision discussed earlier. Policies must be in place to address confidentiality (informed consent), jurisdictional and legal issues, and technological competence. Ethically, these standards should be in place prior to the utilization of computer-based trainee supervision.
If counselor education programs are to use computer-based supervision methods, they need to offer training to both their supervisors and supervisees, because both groups must be technically proficient. In addition, it is suggested that technical support staff should be available in the event of technological difficulties and/or failures. Therefore, counselor education programs using computer-based trainee supervision modalities need to allocate both time and financial resources to ethically implement this form of trainee supervision.
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Nicole Vaccaro and Glenn W. Lambie. College of Education, Department of Child. Family and Community Sciences. University of Central Florida. Correspondence concerning this article should be addressed to Nicole Vaccaro. Department of Child. Family, and Community Sciences. Counselor Education Program. University of Central Florida, PO Box 161250. Orlando. FL 32816-1250 (e-mail: firstname.lastname@example.org).
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|Title Annotation:||Current Issues|
|Author:||Vaccaro, Nicole; Lambie, Glenn W.|
|Publication:||Counselor Education and Supervision|
|Date:||Sep 1, 2007|
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