To conceal or not to conceal: Supervisee and client identity processes in clinical supervision.

Abstract

Supervision is often conceived of as the "instructional strategy that most characterizes the preparation of mental health professionals" (Bernard & Goodyear, 2019; p. 2). Engaging in this process fully and authentically inevitably involves being vulnerable in front of and with one's supervisor in an effort to learn and grow. To more fully understand the supervisory relationship, researchers have focused on what supervisees do and do not share with their supervisors. This article sought to understand the extent to which supervisees engage in a process of concealment or nondisclosure about culture while in supervision. Cultural concealment (operationalized by Drinane, et al., 2018) was measured on 2 levels: one focused on if the supervisee concealed their own culture and one focused on if the supervisee concealed aspects of their clients' cultural identities. First, we found significant negative associations between each of these levels of cultural concealment and satisfaction with supervision and the supervisory working alliance. We then computed a residual score whereby supervisee cultural concealment about clients was predicted by supervisee cultural concealment about themselves. This residual variable was a significant predictor of satisfaction with supervision with supervision and with the supervisory working alliance, indicating that the relationship between these levels of concealment is important and related to the process of supervision. Implications and future directions will be discussed. Clinical Impact StatementQuestion: The present study sought to examine the impact of cultural concealment in supervision. Findings: The findings highlight that cultural concealment in supervision occurs at 2 distinct levels: about the supervisee's cultural self and about how supervisees understand their clients' cultural identities. Meaning: The interplay between these levels is meaningful and is related to how satisfied supervisees are with supervision and the work they feel is accomplished as a part of it. Next Steps: Future studies must look at this phenomenon in more depth and seek to access qualitative perspectives about what contributes to the need to conceal during the supervisory process.

A brief qualitative examination of multicultural orientation in clinical supervision.

“…The themes described by participants are consistent with the pillars of MCO, as well as some components (i.e., knowledge and skills) of the MCC model. Our qualitative results support and further expand upon the preliminary quantitative data (e.g., Cook et al, 2020;Drinane et al, 2021;King et al, 2020;Wilcox et al, 2022) that demonstrate the importance of cultural humility, cultural comfort, and attending to and creating cultural opportunities in the process of supervision. Participants explicitly described supervisors' cultural humility and cultural comfort (or lack thereof) and attending to or creating (or not) cultural opportunities.…”

“…To be eligible, participants needed to be currently enrolled in a master’s- or doctoral-level therapy training program and currently engaged in the provision of psychotherapy and receiving clinical supervision. Participants responded to measures as well as the open-ended questions described below (see Drinane et al, 2021; Wilcox et al, 2022, for more information on the measures and sample). The original sample consisted of 123 trainees (see Wilcox et al, 2022); however, not all participants responded to all questions.…”

“…For example, in a recent quantitative study, Wilcox et al (2022) found that supervisees who rated their supervisors higher in cultural humility and attending to cultural opportunities, specifically as it related to the supervisee’s own cultural identities, reported greater supervision satisfaction. Drinane et al (2021) observed cultural concealment, a facet of cultural opportunities, to be negatively related to the supervisory working alliance as well as satisfaction with supervision; and Wilcox and colleagues as well as King et al (2020) found both cultural humility and cultural missed opportunities were related to the supervisory working alliance (positively and negatively, respectively). Further, Cook et al (2020) found that 20% of the variance in intentional supervisee nondisclosure was accounted for by supervisors’ cultural humility.…”

“…A growing body of research demonstrates empirical support for the role of all three MCO pillars in advancing psychotherapy processes (e.g., working alliances) and outcomes (e.g., change in symptom functioning) in samples totaling over 7,000 clients (e.g., Davis et al, 2018; Hook et al, 2013; Kivlighan et al, 2019; Owen et al, 2014, 2016; Pérez-Rojas et al, 2019). Given the data supporting MCO in psychotherapy, scholars recently began to theorize and empirically study MCO in supervision (Cook et al, 2020; Drinane et al, 2021; Hook et al, 2016; King et al, 2020; Watkins, Hook, Mosher, & Callahan, 2019; Watkins, Hook, Owen, DeBlaere, Davis, & Callahan, 2019, Watkins, Hook, Owen, DeBlaere, Davis, & Van Tongeren, 2019; Wilcox et al, 2022).…”

“…There is evidence to suggest that such culturally focused supervision has a positive effect on supervision processes and outcomes (Gatmon et al, 2001; Inman, 2006; Toporek et al, 2004). Additionally, recent research (Cook et al, 2020; Drinane et al, 2021; King et al, 2020; Wilcox et al, 2022) has demonstrated preliminary support for the role of the MCO pillars of cultural humility and cultural opportunities in clinical supervision. For example, in a recent quantitative study, Wilcox et al (2022) found that supervisees who rated their supervisors higher in cultural humility and attending to cultural opportunities, specifically as it related to the supervisee’s own cultural identities, reported greater supervision satisfaction.…”