Genetic Counseling Supervisors’ Self-Efficacy for Select Clinical Supervision Competencies

Supervision is a primary instructional vehicle for genetic counseling student clinical training. Approximately two-thirds of genetic counselors report teaching and education roles, which include supervisory roles. Recently, Eubanks Higgins and colleagues published the first comprehensive list of empirically-derived genetic counseling supervisor competencies. Studies have yet to evaluate whether supervisors possess these competencies and whether their competencies differ as a function of experience. This study investigated three research questions: (1) What are genetic counselor supervisors’ perceptions of their capabilities (self-efficacy) for a select group of supervisor competencies?, (2) Are there differences in self-efficacy as a function of their supervision experience or their genetic counseling experience, and 3) What training methods do they use and prefer to develop supervision skills? One-hundred thirty-one genetic counselor supervisors completed an anonymous online survey assessing demographics, self-efficacy (self-perceived capability) for 12 goal setting and 16 feedback competencies (Scale: 0–100), competencies that are personally challenging, and supervision training experiences and preferences (open-ended). A MANOVA revealed significant positive effects of supervision experience but not genetic counseling experience on participants’ self-efficacy. Although mean self-efficacy ratings were high (>83.7), participant comments revealed several challenging competencies (e.g., incorporating student’s report of feedback from previous supervisors into goal setting, and providing feedback about student behavior rather than personal traits). Commonly preferred supervision training methods included consultation with colleagues, peer discussion, and workshops/seminars.     

Genetic Counseling Supervisor Competencies: Results of a Delphi Study

Clinical supervision is a critical component of genetic counseling student preparation, yet empirically-determined competencies for genetic counseling supervisors are lacking. In this study a modified, two-round Delphi method was used to gain consensus about important genetic counseling supervisor knowledge, characteristics, and skills. Program directors and assistant directors of American Board of Genetic Counseling accredited genetic counseling programs in North America (N?=?33) were invited to participate and to recruit three experienced supervisors. Seventy-four individuals completed Round 1 and, of these, 61 completed Round 2. Approximately two-thirds were clinical supervisors from prenatal, pediatrics, cancer, and adult clinics; one-third were program directors. Participants rated the importance for genetic counseling supervisors of 158 items derived from supervision literature in allied health professions. They rated 142 items (89.9 %) as highly important. Content analysis of these items yielded six supervisor competency domains: Personal traits and characteristics; relationship building and maintenance; student evaluation; student centered supervision; guidance and monitoring of patient care; and ethical and legal aspects of supervision. The results provide a basis for training genetic counseling supervisors and for further research to refine and validate supervisor competencies.     

Effects of Anxiety on Novice Genetic Counseling Students’ Experience of Supervised Clinical Rotations

Supervised clinical experiences with patients comprise a critical component of genetic counseling student education. Previous research has found genetic counseling students tend to be more anxiety prone than the general population, and anxiety related to supervision has been found in genetic counseling and related fields. The present study investigated how anxiety affects the experience of supervision for genetic counseling students. Second year genetic counseling students were invited to participate through email invitations distributed via training directors of the 33 programs accredited at the time of the study by the American Board of Genetic Counseling. An initial online survey contained the trait scale of the State-Trait Anxiety Inventory to estimate anxiety proneness in this population and an invitation to participate in a 45-minute semi-structured phone interview focusing on students’ experiences of supervision during their clinical rotations. High and low trait anxiety groups were created using STAI scores, and the groups’ interview responses were compared using consensual qualitative research methodology (CQR; Hill 2012). The high anxiety group was more likely to describe problematic supervisory relationships, appreciate the supervisor’s ability to help them when they get stuck in sessions, and feel their anxiety had a negative effect on their performance in general and in supervision. Common themes included supervisors’ balancing support and guidance, the importance of feedback, ego-centric responses, and supervisors as focal points. The results of the present study are largely consistent with current literature. Further research findings and research, practice, and training recommendations are provided.     

Effects of Second Language Usage on Genetic Counseling Training and Supervision

We conducted an exploratory study of the experiences of genetic counselors who have either trained or supervised in a second language to assess the relevance of this issue to genetic counseling training and supervision. Two hundred-thirty NSGC members, CAGC members and genetic counseling students completed the online questionnaire. Many of the respondents reported that training and supervision differed when another language was involved. Supervisors reported difficulty in assessing students’ counseling skills and discomfort with an incomplete understanding of session content. Students described a greater focus on vocabulary at the expense of psychosocial dimensions. Despite this, most felt that using another language enhanced their training experience. As such, training programs might consider increasing support to these learners and supervisors by explicitly acknowledging the challenges they face, providing students with language tools to aid in their acquisition of basic skills and providing supervisors with new methods for assessing student counseling skills when using other languages.     

Boundary Issues and Multiple Relationships in Genetic Counseling Supervision: Supervisor,Non-supervisor,and Student Perspectives

Boundary issues and multiple relationships potentially affect all supervision interactions. Boundary crossings are departures from the strictest professional role and may or may not benefit supervisees. Boundary violations are outside common practice and may place supervisees at significant risk. Multiple relationships occur when supervisors concurrently or consecutively hold two or more roles with supervisees. Studies in other fields indicate supervisors and supervisees may be uncertain about professional conduct regarding these issues. In this study, genetic counselor supervisors (n?=?126), non-supervisors (n?=?72), and genetic counseling students (n?=?129) completed an anonymous survey investigating four major questions: 1) Are various boundary issues and multiple relationships perceived as differentially appropriate? 2) Do supervisor, non-supervisor, and student perceptions differ? 3) What challenging situations have respondents experienced? and 4) What management strategies did they use? There was general agreement among groups in their appropriateness ratings of 56 hypothetical supervisor behaviors, although supervisor ratings tended to reflect stricter boundaries regarding the appropriateness of interactions than student ratings. A majority rated unavoidable boundary crossings and supervisor multiple relationships involving an academic relationship as most appropriate, and romantic/sexual multiple relationships and/or boundary violations as least appropriate. Analysis of respondents’ actual challenging situations revealed many involved boundary violations, placed students at risk of harm, and often resulted in student compliance.     

The use of self-efficacy scaling in training student clinicians: Implications for working with stutterers

A scaling technique developed by Bandura for determining an individual's personal performance expectations (self efficacy) was applied to student clinicians working with stutterers. The self-efficacy scores of clinicians conducting treatment increased significantly while the scores of clinicians without treatment experience showed no significant change. As the student clinicians gained clinical experience there appeared to be a corresponding reduction in fear and avoidance of the treatment situation. Clinician fear concerning stuttering treatment appeared to have little relation to performance in treatment as rated by supervisors. The results indicate that self-efficacy scaling may be used to indicate clinician avoidance of working with stuttering clients.     

Can boundary crossings in clinical supervision be beneficial?

Published studies have addressed boundary violations by clinical supervisors, but boundary crossings, particularly those deemed positive by supervisees, have not received much attention. Eleven trainees in APA-accredited doctoral programs in clinical and counseling psychology were interviewed regarding positive boundary crossings (PBCs) they experienced with clinical supervisors. Interview data were analyzed using Consensual Qualitative Research. Examples of PBCs included socializing with supervisors outside the office, sharing car rides, and supervisor self-disclosure. Typically, supervisees did not discuss the PBC with their supervisors because they were uncomfortable doing so, felt that the PBC was normal, or felt that processing such issues was not part of the supervisor’s style. Most supervisees viewed the PBCs as enhancing the supervisory relationship and their clinical training; however, some participants reported that the PBCs created role confusion. The results suggest that there are legitimate reasons for supervisors to be scrupulous about their boundaries with supervisees; however, supervisors who hold rigid boundaries can deprive supervisees of deeper mentoring relationships or a more authentic emotional relationship that can be valuable to supervisees learning how to provide psychotherapy.     

The Impact of Supervision Training on Genetic Counselor Supervisory Identity Development

Supervision is critical to the training of genetic counselors. Limited research exists on the influence of supervision training and experience on the development of genetic counseling supervisors. The purpose of this study was to investigate the impact of supervision training in addition to supervisory and clinical experience on supervisory identity development, and the perceived confidence and competence supervisors have in their own supervisory skills. In addition, we explored genetic counselors’ (N?=?291) interest in and barriers to training as well as perspectives on requirements for supervisors. Results indicated clinical experience, supervision experience, and formal supervision training are positively associated with genetic counselors’ supervisory identity development as measured by the Psychotherapy Supervisory Development Scale (PSDS) (p?ρ?=?0.42, p?p?相似文献   

The Science and Art of Integrating Psychodrama and Bernard’s Discrimination Model

This article presents the useful technique of Jacob L. Moreno’s psychodrama in counselor education supervision training. This article addresses how psychodrama can be used with student supervisors who are not sure which of Bernard’s discrimination model roles they are using in supervision. Bernard’s model uses three roles that help supervisors function successfully in their relationships with supervisees. Psychodrama may help student supervisors decide what action would be the most appropriate in a given supervision session. Student supervisors may also benefit from psychodrama in processing internal conflict they may experience in their supervisory role. Faculty members training new supervisors may use these techniques to help their student supervisors gain more awareness on how they view their relationships with supervisees.     

Games in Clinical Genetic Counseling Supervision

Games are defined as ongoing series of complementary ulterior transactions that are superficially plausible but have a concealed motivation to maximize pay-offs and minimize penalties for the initiator. While some games are harmless and part of socialization, others are destructive. Destructive game-playing in clinical supervision, in which game-playing (initiated by either supervisors or students) interferes with a student's realization of internship goals, has been documented in some allied healthcare professions but has not yet been studied in genetic counseling. Genetic counselors and clinical supervisors of genetic counseling students were anonymously surveyed regarding their experiences with destructive game-playing. Results show that such games do occur in genetic counseling clinical supervision. Some games are the same or similar to ones previously described in other health-care professions; others may be unique to genetic counseling. The purpose of this paper is to document these games as a first step to facilitating dialogue, understanding and awareness of them.     

The Incorporation of Predictive Genomic Testing into Genetic Counseling Programs

This study explored whether genetic counseling programs are incorporating instruction about the applications and techniques of predictive genomic testing (PGT) based on student recollection, and whether this is perceived as adequate by those students. For the purpose of this study, PGT was defined as the use of genome-based testing to assess a person’s risk, or susceptibility, of developing a disorder with either a known or suspected genetic component. Surveys from 114 graduates were analyzed. The majority of respondents indicated that PGT was covered in their curriculum including methodology, information generated, benefits, risks, limitations, and impact on the field of genetic counseling. A statistically significant increase in incorporating information about PGT as a whole from 2008 to 2011 was also reported. The majority of respondents reported that coverage of PGT prepared them for the American Board of Genetic Counseling (ABGC) board exam (80.6 %), to interpret PGT test results (60.2 %) and to identify clinical situations warranting testing (53.1 %). Although the majority of respondents indicated learning about a wide variety of aspects surrounding PGT, many recent graduates indicated their training was less likely to cover aspects essential for the clinical application of PGT. Therefore, genetic counseling programs should place a greater emphasis on these skills, and the development of continuing education opportunities aimed at increasing genetic counselors abilities to interpret and discuss PGT tests and identify clinical situations warranting such testing may be helpful.     

A Qualitative Investigation of Student and Supervisor Perceptions of Live Supervision in Genetic Counseling

Live supervision of genetic counseling students is critical for ensuring quality client care and student clinical skill development. However, no research has investigated students' and supervisors' experience of this primary supervision method. In this study, separate focus groups of students and supervisors discussed their perceptions of the nature and impact of live supervision. A modified Consensual Qualitative Research method (Hill et al. (1997) Couns Psychol 25:517–572) was used to analyze the data. Results suggest that live supervision is an essential and effective method that promotes student skill development and professional development for both students and supervisors. There is a lack of formal training regarding supervision; most learning is trial and error. Students worry about being evaluated, and supervisors wonder if they are providing supervision effectively. Both samples emphasized that client care should not be compromised. Participant recommendations for improving live supervision are described, and suggestions are made for future research.     

An Investigation of Relationships among Genetic Counselors’ Supervision Skills and Multicultural Counseling Competence

As racial and ethnic diversity increase in the U.S., genetic counselor multicultural competence is growing in importance. In mental health counseling, supervisor multicultural competence has been shown to promote supervisees’ multicultural competence. Moreover, developmentally-advanced supervisors tend to be more effective. This study was designed to investigate relationships among genetic counselor supervisors’ perceived multicultural counseling competence and development as supervisors, and their ability to evaluate a supervisee’s multicultural skills. One hundred twenty-two supervisors completed an online survey of demographics, the Multicultural Counseling Knowledge and Awareness Scale, the Supervisor Development Scale, and a hypothetical vignette in which they evaluated a supervisee’s multicultural skills and provided written feedback. Stepwise multiple regression yielded five significant predictors accounting for 31% of the variance in accuracy of supervisor evaluations of the student: multicultural awareness, multicultural knowledge, age, supervision experience, and supervisor development. Six feedback themes were identified from written responses. Practice and research suggestions are provided.     

心理弹性如何影响员工创造力：心理安全感与创造力自我效能感的作用

摘 要 通过对350名知识型员工及其领导的配对问卷调查,探讨心理弹性对知识型员工创造力的作用机制。结果表明,心理弹性对心理安全感有显著的正向影响;心理安全感完全中介了心理弹性对创造力的影响;创造力自我效能感调节了心理安全感对创造力的正向作用;创造力自我效能感调节了心理安全感在心理弹性与创造力之间的中介作用。     

Linking ethical leadership to employee performance: The roles of leader–member exchange,self-efficacy,and organizational identification

This research investigated the link between ethical leadership and performance using data from the People’s Republic of China. Consistent with social exchange, social learning, and social identity theories, we examined leader–member exchange (LMX), self-efficacy, and organizational identification as mediators of the ethical leadership to performance relationship. Results from 72 supervisors and 201 immediate direct reports revealed that ethical leadership was positively and significantly related to employee performance as rated by their immediate supervisors and that this relationship was fully mediated by LMX, self-efficacy, and organizational identification, controlling for procedural fairness. We discuss implications of our findings for theory and practice.     

Retail employees' self-efficacy and hope predicting their positive affect and creativity

The study shows how retail employees' self-efficacy and hope predict their creativity, both directly and through the mediating role of positive affect. Five hundred and seven retail employees reported their hope, self-efficacy, and positive affect, their supervisors reporting their creativity. Three main findings are: (1) hope and self-efficacy predict creativity; (2) positive affect also predicts creativity; (3) positive affect partially mediates the relationship between both dimensions of positive psychological capital (self-efficacy and hope), and creativity. The study suggests that retail organizations may foster employees' creativity by encouraging conditions that cultivate employees' hope and self-efficacy, as well as their positive affect.     

Ethics in Supervision: Consideration of the Supervisory Alliance and Countertransference Management of Psychology Doctoral Students

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference (CT) is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to the bond dimension of the relationship.     

Problematic Self-Efficacy Inferences in Beginning Psychotherapy Supervisees: Identification and Management

We contend that a particular form of self-efficacy beliefs — specifically referred to as relation-inferred self-efficacy beliefs — often gets activated in beginning supervisees, can potentially pose supervision problems from the outset and, consequently, is best addressed by supervisors early on. Relation-inferred self-efficacy beliefs refer to what supervisees think or infer that their supervisor is thinking about their therapeutic efficacy; because beginning supervisees often have doubts about their own therapeutic efficacy, they can make incorrect inferences about what their supervisor is thinking of them, and supervision can be accordingly affected. In this brief report, relation-inferred self-efficacy beliefs are elaborated upon, their significance for the trajectory of beginning supervisee development is considered, and some supervisor actions that can aid in alleviating the impact of those beliefs on beginning supervisees are identified. We view it as important that supervisors (a) hold supervisee problematic relation-inferred self-efficacy beliefs in mind as a likely supervision reality, (b) strive to proactively address their possible emergence through supervisee education at supervision’s onset and through including the topic in the body of the supervision agreement, (c) be sensitive to cues that may indicate the emergence of such problematic inferred beliefs during the course of supervision, (d) sensitively inquire about those cues and, if confirmed, be open to discussing their implications with beginning supervisees, (e) fully carry out discussion about those beliefs so as to allay supervisees’ inference concerns, and (f) because addressing those problematic beliefs is not a one-and-done affair, be ready to re-address them as need arises.

     

Genetic Counseling Graduate Student Debt: Impact on Program,Career and Life Choices

The cost of education is rising, increasing student financial aid and debt for students pursuing higher education. A few studies have assessed the impact of student debt in medicine, physical therapy and social work, but little is known about the impact of student debt on genetic counseling students and graduates. To address this gap in knowledge, a web-based study of 408 recent alumni of genetic counseling programs in North America was conducted to assess the impact of student debt on program, career and life choices. Over half (63 %; n?=?256/408) of the participants reported that loans were extremely important in their ability to attend their training program, with most using subsidized loans no longer available to current graduate students. While participants were generally satisfied with their genetic counseling education, 83 % (n?=?282/342) of participants with student debt reported feeling burdened by their debt, which had a median of $40,000–$50,000. This debt is relatively close to the median starting salary reported by survey participants ($45,000–$50,000), breaching the “20-10 rule” that states student debt should not exceed 20 % of annual net income. In response to this critical issue, we propose recommendations for the genetic counseling field that may help alleviate student debt impact and burden.     

Perceptions of Depression,Counseling and Referral Practices,and Self-Efficacy Reported by Minnesota Clergy

This study’s purpose was to measure clergy’s counseling, referral, and supportive activities for those with depression. Among a Minnesota sample (n?=?367), nearly 80 % (n?=?284) reported counseling their members (mean of 10.25 h/month), with 25 % providing mental health counseling (mean of 2.76 h/month). Ninety-one percent (n?=?336) reported ability to recognize depression, and 64 % (n?=?236) reported moderate to high ability in effectively counseling those with depression. Age, past academic counseling coursework/certification, hours of counseling, and number of individuals counseled were significant predictors of clergy’s self-efficacy in counseling for depression. A mean of 6.14 individuals approached clergy for depression-related help; clergy reported a mean of 3.86 referrals for mental health care. Nearly 90 % stated that one of the roles of the clergy is to provide mental health education.