The Influence of Supervisor Multicultural Competence on the Supervisory Working Alliance, Supervisee Counseling Self-Efficacy, and Supervisee Satisfaction With Supervision: A Mediation Model

Discussions of personal identity in genetic counseling supervision

Fieldwork supervision is integral to genetic counseling students' training and has the potential to impact how included students feel in the genetic counseling field. For example, in related counseling fields, when supervisees and supervisors discuss their personal similarities or differences in ethnicity, supervisees report a stronger supervisory working alliance (SWA) (Journal of Multicultural Counseling and Development, 2001, 29, 102-113). However, the application of these studies on identity discussions to the genetic counseling field is currently unknown. The objective of this cross-sectional questionnaire-based study was to investigate (a) if genetic counseling students report having discussions of personal identity during fieldwork supervision, (b) who initiated any such discussions, (c) if there was a difference in the supervisory relationship between those who did and did not have discussions of personal identity, and (d) how students perceived the inclusivity of the genetic counseling profession and their genetic counseling programs. Discussions of personal identity were defined in this study as "discussions happening during supervision regarding how one or more aspects of personal identity impacts the provision of genetic counseling services and/or professional interactions" where personal identity included the student or supervisor's gender, sexual orientation, race, ethnicity, religion, disability status or other aspect of identity. Almost 40% of the participants (N = 190) reported discussing personal identity with their supervisor. For students identifying as white, discussions of personal identity were related to a stronger SWA (p = 0.014). However, for those with minoritized identities there was no relationship between the SWA and discussions of personal identity. Therefore, it is unclear from the current research whether discussions of personal identity can be an effective tool in improving inclusivity in the field of genetic counseling. Additional research is needed to explore the direct impact of identity discussions on the supervisory working alliance in genetic counseling supervision.

Supervisor Cultural Humility and Supervisee Nondisclosure: The Supervisory Working Alliance Matters

Given that half or more of supervisees (therapist trainees) never have their clinical work monitored or observed, supervisees who withhold salient information in clinical supervision compromise supervisors' ability to monitor client welfare and promote supervisees' professional development. Attempting to further understand the factors explaining supervisee nondisclosure, we tested the supervisory working alliance as a mediator of the hypothesized inverse relations of cultural humility and collaborative supervision with supervisee nondisclosure (supervision-related and clinically-related nondisclosure) among a diverse sample of 214 supervisees in applied psychology and allied mental health programs. Results supported the hypotheses that (1) descriptively, supervision-related nondisclosure was more prominent than clinically-related nondisclosure, (2) cultural humility substantially inversely predicted supervisee nondisclosure, and (3) the supervisory working alliance fully mediated the inverse relations of cultural humility and collaborative supervision with supervisee nondisclosure. Understanding the mechanisms underlying supervisee nondisclosure have broad implications for clinicians and researchers alike.