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Article Excerpt
It is likely that counselor trainees will be exposed to suicidal clients and subsequently face personal dilemmas, stress, and feelings of incompetence. Ethical guidelines mandate that supervisors have procedures to assist supervisees in such times. Currently, the literature does not provide a framework for providing such supervision. This article presents a theory-grounded model to assist the supervision of supervisees working with suicidal clients.
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The latest census reports reveal that suicide is the 11th leading cause of death overall and the 3rd leading cause of death for Americans ages 15 to 24. This means 1 American kills himself or herself every 17.2 minutes (Anderson, Kung, Murphy, & Kochanek, 2003).
Professional ethical standards of the American Counseling Association (1995, 2005), the Association for Counselor Education and Supervision (as cited in Bernard & Goodyear, 2004) and the National Board for Certified Counselors (2002) require supervisors to ensure that specific procedures are followed when dealing with crisis situations. Furthermore, studies in the 1990s reported that supervision is a necessity when dealing with suicide (Foster & McAdams, 1999; Kleespies, 1993; Kleespies, Penk, & Forsyth, 1993; Kleespies, Smith, & Becker, 1990).
Literature suggests that suicidal ideation is one of the most common forms of crisis found in counseling settings and produces the highest levels of stress and grief for clinicians (Bonger, 1993; Foster & McAdams, 1999; Jacobs, 1999; Juhnke, 1994; Kleespies, 1993). Given the high rate of suicide in the United States, the high likelihood of clinicians dealing with suicidal clients, and the ethical requirements of supervision, counseling supervisors need a model to provide appropriate supervision to counselor trainees working with suicidal clients. However, the literature does not provide a model for such supervision.
There is little scholarly literature in the area of the supervision needs of counselor trainees who are working with suicidal clients. However, Reeves and Seber (2004) contended that the role of supervision is "central" (p. 29) to working with suicidal clients. Vincent, Stanhope, and Taylor-Adams (2000) stated that there are deficits in supervisory practices in times of serious incidents in mental health, especially when working with suicidal clients. McAdams and Foster (2000) implied that supervision is necessary for the well-being of counselors who are working with suicidal clients, especially during their early years as counselor trainees. McAdams and Foster (2002) found that the supervisory relationship was one of the most beneficial aspects of supervision for counselors recovering from a client suicide. Finally, Tracey, Ellickson, and Sherry (1989) stated that beginning and even more advanced supervisees prefer highly structured supervision when working with suicidal clients.
Accordingly, the purpose of this article is to provide supervisors with the Cube Model of Supervision and Suicide to assist in the conceptualization and implementation of supervisory roles based on the developmental level of supervisees and the lethality level of suicidal clients. This model integrates the developmental level of supervisees, the needed role or intervention strategy of supervisors, and the current or potential suicide lethality of clients. This model incorporates the three levels of the Integrated Developmental Model (IDM; Stoltenberg, McNeill, & Delworth, 1998) of supervisee development, the Discrimination Model (Bernard, 1979) of counselor supervision, and a modified model of suicide lethality assessment (Bonger, 1992; Jacobs, 1999; Lester, 2001; Marls, Berman, & Silverman, 2000; Shea, 2002; Silverman & Maris, 1995; Simon, 2004; Yufit & Lester, 2005).
Overview of the Models
Developmental models of supervision address the supervisory needs and abilities of supervisees as they gain experience. Stoltenberg et al.'s (1998) IDM, perhaps one of the best known supervision models, described how supervisees change with experience across three levels. Furthermore, the IDM suggested specific supervision stances to accommodate supervisees' needs at each of three developmental levels related to self and other awareness, motivation, and autonomy (Stoltenberg et al., 1998).
According to Stoltenberg et al.'s (1998) IDM, Level-1 supervisees characteristically have little experience in the profession. They tend to focus primarily on their own performance, possibly disregarding the client's thoughts and feelings, and have a high need for supervisory direction, modeling, and structure.
Level-2 supervisees are those who have gained some experience in the field and function competently in some counseling domains. Level-2 supervisees are typically more aware of clients and may overly identify with clients as they become more aware of their stress or pain (Stoltenberg et al., 1998). They typically fluctuate between dependency on supervisors for direction and a desire for increased autonomy, leading them to overestimate their abilities.
Level-3 supervisees are characterized by the beginning of professional competence. They typically have extensive counseling experience, high self and other awareness, appropriate boundaries, high motivation to be a professional, and competency in many counseling domains. They typically function with a high degree of autonomy and are able to recognize...
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