Counselor trainees' experience of analyzing their counseling sessions during a master's-level practicum
TABLE OF CONTENTS ACKNOWLEDGMENTS ii CHAPTER I. INTRODUCTION 1 Key Concepts 1 Focus of the Study 8 The problem 8 The purpose 9 The research questions 11 The methodological overview 11 Definition of terms 12 II. LITERATURE REVIEW 14 Counseling Skills and Counseling Skills Performance 14 Counseling skills training models 14 Application of counseling skills training models 22 Counselor Development 30 Developmental models for counselor training and supervision 31 Integrated developmental model 33 Level 1 counselor trainees 34 Level 2 counselor trainees 36 Level 3 counselor trainees 37 iii
Table of Contents—continued CHAPTER Level 3 integrated counselors 39 Applicability of the IDM 40 Counseling Self-Efficacy 46 Social cognitive theory and self-efficacy 46 Social cognitive model of counselor training 48 Research of self-efficacy 50 Feedback in Supervision 59 Elements of feedback 60 Supervisees' perspectives of feedback 60 Evaluation during clinical supervision 61 Trainees' responses to procedures of facilitating feedback 62 Recording Technology in Training and Supervision 65 Videotaping during counselor training and supervision 65 Advantages of videotaping 66 Video review protocols 67 Disadvantages of videotaping 71 Digital recording during counselor training and supervision 72 Landro Play Analyzer (Landro) 74 Summary of Presented Literature 76 III. METHOD 78 Research Paradigm and Philosophical Anchors 78 iv
Table of Contents—continued CHAPTER Research paradigm 78 Ontology 78 Epistemology 79 Axiology 80 Rhetorical structure 81 Methodology 81 Research Design 82 Researcher-as-Instrument 82 Researcher reflexivity 83 My experience with the phenomenon 83 My qualitative methods training 84 My approach to subjectivity 85 Participants, Access, and Setting 87 Participants 87 Access 89 Setting 91 Sources of Data 95 Informed consent document 95 Demographic questionnaire 95 Interviews 95 Data Analysis 97 v
Table of Contents—continued CHAPTER Data management 97 Analysis approach 98 Discrepant findings 101 Participants checks 102 Analytic journal 103 Trustworthiness and Rigor 104 IV. RESULTS 106 Researcher Textural-Structural Description 106 Composite Textural-Structural Description 112 V. DISCUSSION 134 Interpretation of Results 134 Central research question 134 Research subquestions 142 Limitations 166 Internal validity 166 External validity 166 Participant recruitment 167 Data collection 168 Implications of Findings 168 Implications for training and supervision 168 Implications for theory and future research 170 vi
Table of Contents—continued CHAPTER Personal Reflection and Conclusions 172 REFERENCES 174 APPENDICES A. Approval Letter From the Human Subjects Institutional Review Board 184 B. Script for Discussion with Direction of the Center for Counseling and Psychological Services—Kalamazoo 185 C. Script for Discussion with Instructors of Record 186 D. Script for Explanation of Study to Counselor Trainees 187 E. Informed Consent Document 188 F. Demographic Questionnaire 192 G. Interview One Questions and Prompts 193 H. Interview Two Questions and Prompts 195 vii
1 CHAPTERI INTRODUCTION One of the central goals of counselor training is to promote and ensure competence in novice counselors (Krasner, Howard, & Brown, 1998). The effective performance of counseling skills is a key source of competence for counselor trainees (Falender & Shafrankse, 2007). As such, skills-based training for beginning counselors is both valid and useful (Hill, Stahl, & Roffman, 2007). In the present study, I was interested in exploring the experience of counselor trainees who engage in a heretofore unstudied skills-based training practice. Within this skills-based training practice, counselor trainees use digital recording and playback software to review and analyze their counseling skills performance during video recorded counseling sessions. They identify and label segments in which they demonstrate specific counseling skills, and then they present these segments to their supervisors who provide feedback about their counseling skills performance. As a doctoral student providing supervision for master's-level counselor trainees while they engaged in this training practice, I wondered how the trainees would describe their experience and whether they noticed changes in their counseling skills performance, counselor self-efficacy, and counselor development as they took part in it. In addition to my personal interest in the study of this topic, there is evidence in the literature that my investigation could add to the body of knowledge regarding counselor training and supervision. Key Concepts In the preceding paragraph, I referred to the particular skills-based training approach of interest in this study, and I alluded to other concepts, including counseling skills performance, counselor development, and counseling self-efficacy. The purpose of
2 the current chapter is to briefly explain how these key concepts are relevant to the study. I begin by explaining skills-based training and some of the findings associated with it. Then I describe and provide a model of counselor development. After that, I present findings on counseling self-efficacy and feedback, which have a causal link. Finally, I connect all of these concepts in the context of counselor training and supervision that includes review and analysis of video recordings of trainees' counseling sessions. The developers of contemporary skills-based approaches derived them from the original models by Carkhuff (1969) and Ivey (1971). Some contemporary approaches include the helping skills model (Hill, 2004), the microcounseling training model (Daniels, Rigazio-Digilio, & Ivey, 1997), and the Skilled Counselor Training Model (SCTM; Smaby, Maddux, Torres-Rivera, & Zimmick, 1999). In skills-based training, the counseling process is reduced to moment-by-moment counselor interventions, and counselor trainees learn and practice these interventions (i.e., counseling skills) in different formats according to the particular training procedure until they reach competence (Urbani et al., 2002). Training based on counseling skills provides counselor trainees with a concrete framework to help them understand the counseling process and gives them confidence in their abilities (Hill, Stahl, et al., 2007). Skills-based training has been found to increase counselor trainees' counseling self-efficacy (Urbani et al.), level of complex thinking (Little, Packman, Smaby, & Maddux, 2005), and self- monitoring ability (Crews et al., 2005). Most important, skills-based training improves counseling skills performance (Buser, 2008). The contemporary skills-based approaches have in common their focus on discrete counseling skills, but are unique in their methods of instruction and evaluation. For example, microcounseling (Daniels et al., 1997) breaks down training to teach
3 counselor trainees counseling skills at a micro-level according to the Microskills Hierarchy (Ivey & Ivey, 2007). Another approach, the SCTM (Smaby et al., 1999), requires that trainees develop a 45-minute videotape featuring demonstrations of the model's 18 counseling skills to show their competency, and the helping skills model (Hill, 2004) incorporates counseling with volunteer undergraduate student clients as an experiential component to the skills training. What these skills-based approaches do not include is analyses of trainees' counseling skills performance through ongoing self- observation using video. Interpersonal process recall (Kagan & Kagan, 1997), on the other hand, does have counselor trainees analyze video of their counseling sessions, but their analysis is focused on the interpersonal interactions between therapist and client, not on counseling skills performance. Research findings have shown that these four models contribute to counselor training, but what remains unknown is how master's-level practicum trainees experience an approach that combines the unique features of these models. Exploring how they experience such an approach is important because of the emphasis on skills-based training for master's-level practicum trainees who are at a low level of counselor development (Bernard & Goodyear, 2004). To promote competency among novice counselors, it is important to understand and apply appropriate training and supervision according to their developmental level (Stoltenberg, 2005). Stoltenberg, McNeill, and Delworth (1998) designed the Integrated Developmental Model (IDM) to describe counselor development and to provide recommendations to supervisors about how to interact with trainees based on their developmental level (Bernard & Goodyear, 2004). The IDM provides a description of four levels of counselor development. Within each level, the counselors are considered to vary among "three overriding structures that provide markers in assessing professional
4 growth" (Stoltenberg et al., p. 16). The three structures are self and other awareness, motivation, and autonomy. Assessment of the self and other awareness structure provides information about the supervisees' levels of preoccupation with themselves, appreciation of the client's world, and open-mindedness. The motivation structure describes the counselors' fluctuating levels of interest in and commitment to their training. Finally, the autonomy structure is characterized by the supervisees' dependence on or independence from supervisors and the level of structure the supervisees' desire during their supervision sessions. Level 1 counselor trainees are inexperienced and have not yet received adequate training in the practice of counseling (Stoltenberg et al., 1998). According to the IDM, most master's-level supervisees enter their first practicum course as Level 1 trainees, and they likely exhibit the behaviors that characterize this level. In terms of their self and other awareness, these supervisees are highly focused on themselves. They tend to be preoccupied with their high levels of anxiety and low levels of skills competence. Perhaps because of interference from their anxiety and focus on skills acquisition, Level 1 trainees have low levels of other awareness. According to the IDM, Level 1 supervisees have high levels of motivation, although their motivation may be hindered by the anxiety described above. Level 1 counselors are excited to be challenged with learning new skills that are directly related to their chosen careers, meaning that a significant portion of their motivation is focused on acquiring counseling skills. Finally, Level 1 trainees are low on measures of autonomy. They typically depend on their supervisors as role models and sources of information, and they prefer structure, support, and positive feedback as central components of their supervision.
5 According to Stoltenberg and colleagues (1998), skills-based counselor training might help Level 1 trainees advance to Level 2 of counselor development, but researchers have not reported counselor trainees' perceptions of what aspects of skills-based training coincide with their movement from Level 1 to Level 2. In chapter 2,1 describe how Level 2, Level 3, and integrated Level 3 counselor trainees differ from those at Level 1 in the areas of self and other awareness, motivation, and autonomy. An additional notable difference between Level 1 and Level 2 counselor trainees is in the area of counseling self-efficacy. Leach, Stoltenberg, McNeill, and Eichenfield (1997) found that Level 2 counselors exhibited significantly greater perceptions of counseling self-efficacy than Level 1 counselors. Although this finding suggests the existence of differences in counseling self-efficacy according to counselor developmental level, information in the literature about the relationship among counselor trainees' changes in counselor development and counseling self-efficacy during skills-based training is inadequate. In the study of counselor training, counseling self-efficacy is a noteworthy concept due to its understudied relationship with counselor development and because research suggests that it improves with skills-based training (Urbani et al., 2002). Previous research has also established a causal relationship between counseling self-efficacy and counseling skills performance (Larson & Daniels, 1998; Levitt, 2001), such that increasing counseling self-efficacy enhances counselor performance. Given this latter relationship, it was important to understand what experiences affect counselor trainees' self-efficacy beliefs. According to Larson (1998), mastery or failure experiences influence counseling self-efficacy. For beginning counselors, mastery or failure experiences typically take the form of positive or negative feedback, respectively, about their counseling skills performance. Positive feedback should increase counseling self-
6 efficacy, and negative feedback should decrease it (Larson et al., 1992). Supervisors provide positive or negative feedback during supervision, and they base their feedback on trainees' performance of counseling skills as demonstrated in recordings of their counseling sessions (Daniels & Larson, 2001). Trainees who receive positive feedback about their demonstrated counseling skills are expected to have increased self-efficacy about their ability to effectively perform counseling skills. However, there is a dearth of literature describing the counselor trainees' perceptions of the feedback they receive and what types of changes in counseling self-efficacy they experience during different types of skills-based training. The potential influence of counseling self-efficacy beliefs on counseling skills performance and counselor development might be amplified for Level 1 counselor trainees, who tend to be highly self-focused. It is important for beginning counselors to focus on themselves, on their skills, and on their development to increase their competence (Hill, Stahl, et al., 2007). Falender and Shafranske (2007) recommended that counselor trainees develop metacompetence, one particular aspect of competence, as part of their training and supervision. Metacompetence is broadly defined as the ability to determine what one knows and does not know (Falender & Shafranske). In the area of counseling skills acquisition, metacompetence is counselor trainees' use of available skills to solve problems or tasks and their ability to determine which skills are missing, how to acquire them, and whether they are essential to success. According to Falender and Shafranske, counselor trainees can achieve metacompetence through ongoing and structured analysis of their counseling skills performance by reviewing video recordings of their counseling sessions. Although this claim could be accurate, it was uncertain what metacompetence looks like from the perspective of the counselor trainees who develop it in this manner.
7 In addition to acquiring metacompetence, counselor trainees may also experience growth in their counselor development through review of their counseling session recordings. How supervisors structure video review of counseling sessions during supervision could determine the effectiveness of the review process for supervisees. Pelling and Renard (1999) described how supervisors could approach videotape review based on each level of Stoltenberg and Delworth's (1987) developmental model. For the Level 1 practicum student counselors relevant to the present study, the authors recommended that supervisors make video review a consistent aspect of the supervisory process. Specifically, supervisors should focus on their supervisees' use and execution of counseling skills. The supervisor and supervisee should discuss improving skills and skills that still need improvement and how the supervisees could achieve more competence with those skills. According to Pelling and Renard, in order to advance their supervisees' counselor development, supervisors should provide supervisees feedback regarding counseling skills demonstrated on videotapes of counseling sessions. Any skills-based training at Level 1 of counselor development would take advantage of counselor trainees' focus on themselves by incorporating independent video review of counseling sessions (Stoltenberg et al., 1998). It is a powerful training experience to have counselor trainees watch videos of themselves in the counselor role (Hill, Stahl, et al., 2007). According to published scholarly material, most counselor training programs use videocassette recorders (VCRs) with videotapes to facilitate trainees' reviews of their counseling sessions (Borders & Brown, 2005). Despite their widespread use, there are disadvantages of using videotape playback systems (Welsh & Dickson, 2005). These systems take lots of available space for storage of videotapes and are apt to malfunction. In addition, it is challenging to incorporate any video editing
8 technology to the videotape/VCR combination because the technology is complicated and requires extensive training to use (Newman & Abney, 2005; Pretorius, 2006). Digital recording systems offer many advantages compared to analog videotaping (Borders & Brown). Digital recording and playback is fast, flexible, and efficient, making it more attractive for supervisors and counselors-in-training (Welsh & Dickson). The skills-based training approach of interest in the present study uses a digital playback system that allows supervisees to analyze their counseling skills performance by adding labels of the skills directly on the digital recordings. This type of training focuses beginning counselors on their moment-by-moment interactions in counseling sessions (Hill, Stahl, et al., 2007), which is developmentally appropriate (Stoltenberg et al., 1998) and should increase their counseling self-efficacy (Urbani et al., 2002); however, there is a lack of research on the counselor trainees' lived experience of engaging in this particular training. In addition, it seems likely that having the counselor trainees use the digital video playback system to prepare for supervision by identifying and labeling segments during which they demonstrated counseling skills would provide supervisors an avenue to structure feedback focused on the trainees' counseling skills performance, but what was unknown is how counselor trainees perceive this aspect of their skills-based training and supervision and how they would describe their experience engaging in it. Focus of the Study The problem. The existing research (e.g., Crews et al., 2005; Little et al., 2005; Smaby et al., 1999; Urbani et al., 2002) provides important information about skills-based counselor training, but the skills-based training procedure in the present study has unique aspects that have not been examined in previous studies. These unique aspects include
9 counselor trainees' ongoing analysis of counseling skills by viewing digital recordings of their counseling sessions and the ability of counselor trainees to identify and label video segments from a drop-down list of counseling skills during which they demonstrated counseling skills. Previous research has separately addressed the advantages of skills- based training, counseling self-efficacy, counselor development, and video review in counselor training. None of these studies has concurrently explored changes in these factors from the perspective of master's-level counselor trainees in their first practicum as they use digital recording and playback technology to analyze their counseling skills performance and receive feedback about their performance from their supervisors. Furthermore, there have been just two studies on the relationship between counselor development and counseling self-efficacy (Leach et al, 1997; Melchert et al., 1996), and this relationship was not described in the context of a skills-based training approach. The purpose. The purpose of this phenomenological qualitative study was to describe the lived experience of counselor trainees as they engaged in the central phenomenon. The central phenomenon includes a set of experiences that comprise the supervision and training model at the setting for this study. In this model, counselor trainees digitally record and store their counseling sessions. Later, they independently review video recordings of their sessions and analyze their counseling skills performance. As part of this analysis, they identify segments in which they demonstrate specified counseling skills, and the beginning and ending of each segment is displayed on the video so that it is noticeable during review. The counselor trainees might choose a particular segment because they believe they successfully enacted the counseling skill and want to show their supervisors how well they did or because they think that they struggled with
10 that counseling skill and are seeking guidance for improvement from their supervisors. In some cases, supervisors might instruct counselor trainees to identify a segment demonstrating a certain counseling skill that they discussed during the previous week's supervision sessions. After identifying the segment, counselor trainees locate the counseling skills listed in the dropdown list of the playback software that correspond to their identified segments and use the system to add the labels to the segments. The list of counseling skills available to trainees for tagging is programmed according to the practicum supervisor's specification. Finally, the counselor trainees show their supervisors the identified and labeled counseling skills during supervision sessions, which are noted on the screen as the video is playing, and the supervisors provide feedback about how well the counselor trainees performed the counseling skills given the circumstances of the session. This set of experiences is applicable to the specific context of master's-level counselor trainees in their counseling practicum course in which they see clients for the first time. From this point on in the document, I will refer to this set of experiences as the training phenomenon. As part of describing the lived experience of counselor trainees who take part in the training phenomenon, I was interested in exploring what changes they went through in areas central for beginning counselors. This study investigated counselor trainees' perspectives on changes in their counseling skills performance, counselor development, and counseling self-efficacy as they experienced the training phenomenon. Based on the previous research findings suggesting the importance of counseling skills acquisition for beginning counselors, I believed that finding effective and engaging ways of training beginning counselors in these skills would provide valuable information for counselor training programs and their training clinic directors. I decided to design this study
11 because I believed that its findings might be able to provide information about which aspects of engaging in the training phenomenon are the most beneficial from the perspectives of the counselor trainees. The research questions. The current qualitative study had one central exploratory research question: What is the lived experience of counselor trainees who engage in the training phenomenon? Again, this training phenomenon is described as counselor trainees' recording and reviewing counseling sessions; analyzing, identifying and labeling counseling skills; and presenting to and receiving feedback from their supervisors about the identified and labeled counseling skills. The study included three subquestions: (a) As the trainees engage in the training phenomenon, what do they say about their counseling skills performance, and what if anything about it changes? (b) As the trainees engage in the training phenomenon, what do they say about their level of counselor development, and what if anything about their level changes? and (c) As the trainees engage in the training phenomenon, what do they say about their counseling self- efficacy, and what if anything about it changes? The methodological overview. In this study, I used a phenomenological approach to collect and analyze the qualitative data (Creswell, 2007). The area of interest best fits the phenomenological approach because the focus was on a single phenomenon (Creswell, 2003), which was the counselor trainees' experience of engaging in the training phenomenon. Because all of the participants in this study experienced the phenomenon at the same time and for the same duration, a phenomenological approach was suitable to gain an understanding of their shared, lived experience.
12 Definition of terms. Description of this study includes the use of several terms related to counselor training and supervision. In this section, I provide definitions of these terms, in alphabetical order, which are referenced in the remainder of the document. 1. Counselor development is a way to describe how counselors evolve professionally as they gain training and supervised experience (Bernard & Goodyear, 2004). 2. Counseling self-efficacy (Larson & Daniels, 1998) is defined as one's beliefs about his or her abilities to successfully provide counseling to a client in the upcoming future. 3. Counseling skills are broadly considered as what counselors do during a counseling session (i.e., interventions), including basic and advanced helping skills, theory-based interventions, procedural skills, and issue-related tasks (e.g., suicide assessment) (Borders & Brown, 2005). In the present study, counseling skills were more narrowly defined as the counselor's moment-by-moment verbal and nonverbal expressions in a counseling session. In the first section of the literature review, I provide examples of counseling skills that comprise different skills-based training models. 4. Counseling skills performance is a term that I use in the present study to convey the effectiveness of the enacted counseling skills as defined above. 5. Counselor training is described as the specified instruction and acquisition of counseling skills (Bernard & Goodyear, 2004). 6. Feedback is described in terms of its use within supervision and counselor training and is defined as information that supervisors communicate to their supervisees about aspects of their skills, attitudes, behavior, and appearance that could influence their
13 performance with clients or affect the supervisory relationship (Hoffman, Hill, Homes, & Freitas, 2005). 7. Marking refers to the process of identifying a particular segment of a recorded counseling session during which a counseling skill was demonstrated using the digital recording and playback system. During video playback, the viewer is able to see exactly where the marked segment begins and ends. 8. Supervision is defined as an evaluative process over time that includes enhancing supervisee functioning, monitoring supervisee interactions with clients, and serving as a gatekeeper for the counseling and psychology professions (Bernard & Goodyear, 2004). 9. Tagging refers to assigning a label to the identified segment of a recorded session with the name of a counseling skill (e.g., reflection of feeling, challenge, self- disclosure, etc.) using the digital recording and playback system. These labels appear on the video as the recording progresses through each of the marked segments.
14 CHAPTER II LITERATURE REVIEW The purpose of this chapter is to review the existent literature to show how the present study seeks to contribute to the field of knowledge in counselor training. In the first section, I present the findings associated with counseling skills and counseling skills performance. I describe Stoltenberg and colleagues' (1998) IDM of counselor development and the findings supporting the model in the second section. In the third section, I review the research describing counseling self-efficacy and how it has evolved from its roots in Bandura's (1986) social cognitive theory. In the fourth section, I present the literature associated with feedback in the supervision process. Finally, in the last section, I examine the evolution of counselor supervision with a focus on the use of direct observation through analog and then digital recording and playback technologies. Counseling Skills and Counseling Skills Performance In this section, I present research findings related to counseling skills and counseling skills performance. First, I provide descriptions of training models developed to help counselor trainees acquire counseling skills. I then review research regarding the application of skills-based training for beginning counselors. Counseling skills training models. Previous research indicates that skills-based approaches to counselor training are very effective and useful (Hill, Stahl, et al., 2007). I review four counseling skills training models to illustrate skills-based approaches to counseling skills training for novice counselors. Some models present a broader approach to identifying counseling skills, and others have a much more specific focus on counseling skills as moment-by-moment verbal or nonverbal utterances. Although there
15 is no consensus among counselor trainers and practicum instructors about the most effective approach to teach counseling skills, there is agreement that the acquisition of counseling skills is a central task for novice counselors (Fitch, Gillam, & Baltimore, 2004). In each of these models, the responses of the counselors are divided into more manageable pieces of information to facilitate trainees' learning, although the type of responses (e.g., discrete counseling skills or affective behaviors) vary according to the purpose and theoretical underpinnings of the training approach. Additionally, each approach includes learning through the observation of others, either expert demonstrations on video or live observation of peers' counseling sessions. Finally, each approach includes ongoing supervision of counselor trainees' execution of the training objectives in their counseling sessions. I present the models in chronological order according to my references: interpersonal process recall (Kagan & Kagan; 1997), the microcounseling paradigm (Daniels et al., 1997), the SCTM (Smaby et al., 1999), and helping skills model (Hill, 2004). Interpersonal process recall. Interpersonal process recall (Kagan & Kagan, 1997) is an approach to counselor training that emphasizes human interaction at the core of its theoretical construct. The first basic element of the theory is that people need one another as part of our basic human nature. The second element, however, is that people learn to fear one another as our greatest source of pain. This fear manifests in a variety of behaviors during counseling sessions, but most of these behaviors reflect an approach- avoidance cycle of moving toward and away from others. The fears translate into anticipated reactions from others, which often produce self-fulfilling prophecies. The approach-avoidance cycle based on anticipated reactions is a hallmark of implicit