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Article 55

The Intentional Use of the Parallel Process During Cross-Cultural Counseling Supervision

Rhonda L. Norman

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Paper based on a program presented at the 2013 ACES Conference, October 19, 2013, Denver, CO.

The development of cross-cultural counseling competencies in the helping professions has gained greater significance within the last 20 years, due in part to the tremendous increase in diverse populations in the United States (U. S. Census Bureau, 2009). There has been a demographic shift due to the increase of immigrants and refugees entering the United States, along with increasing birth rates of people of color. The definition of culture in the helping professions has broadened and become more inclusive within the past 20 years, encompassing not only race/ethnicity but also gender, spirituality, sexual orientation, age, and differing abilities (Sue & Sue, 2014). Additionally, the intersectionality of multiple identities adds complexity to the cultural dynamics that are salient in the counseling environment (Robinson & Howard-Hamilton, 2000). The Council for Accreditation of Counseling and Related Educational Programs (CACREP) has reported the demographics of enrolled counseling students to be 61.09% Caucasian/White and 20% African American/Black (Kimbel, 2013). Therefore, professional counselors and counselors-in-training are continually being called upon to serve clientele who are of a different culture.

One of the most important challenges of the profession is meeting the mental health needs of a diverse and multicultural society (Sue & Sue, 2014). Despite the American Counseling Association (ACA), American School Counseling Association (ASCA), and CACREP recommending and mandating the inclusion of cross-cultural counseling competencies, there remains a gap between academic knowledge and the application of cross-cultural counseling competencies among counselors-in-training (ACA, 2014; ASCA, 2010; CACREP, 2009; Sue & Sue, 2014). In the face of these mandates from the representing associations and the primary accrediting body, many master’s level programs in counseling continue to have one course that is identified as “the course” that encompasses the multicultural and diversity curriculum (Peters et al., 2011; Sue & Sue, 2014). The ACA Code of Ethics (F.2.c., 2014) recommends that counselor educators infuse multicultural material in all courses and workshops for the development of the counselor trainee (p. 14). Infusing multicultural material seems to be somewhat vague and ambiguous at best and may convey wavering levels of commitment by counselor educators (Arredondo & Arciniega, 2001).

Counselor educators are the primary gatekeepers for the counseling profession who determine through ongoing evaluations which students have mastered the competencies to gain access into the profession (ACA, 2014). It is my position that clinical supervision and the intentional use of the contemporary view of the parallel process will allow for more effective conceptualization and application of skills that promote cross-cultural counseling competencies. In addition, I believe that multiple opportunities exist within a strong supervision working alliance (SWA) that can impact the development of cross-cultural competency skill acquisition for counselor trainees (Ladany, 2004). Chief among the opportunities is the intentional use of the contemporary and bidirectional parallel process (Frawley-O’Dea & Sarnat, 2001; Ladany, 2004).

Parallel Process

The parallel process was first conceptualized in psychodynamic supervision by Henry Searles (1955), capturing the traditional view of the parallel process and being labeled the “reflection process.” Scholars agree that the parallel process is a phenomenon in which supervisees present to their supervisors as their clients have presented to them (Frawley-O’Dea & Sarnat, 2001; Friedlander, Siegel, & Brenock, 1989). For example, when a client presents with anxiety within a counseling session, the counselor trainee/supervisee then presents to the supervisor with anxiety about being able to help the client, which results in the supervisor experiencing anxiety about being able to help the supervisee. The more contemporary view of the parallel process being bidirectional, where the material presented in supervision influences the counseling relationship, was initially supported by Doehrman (1976) and later by Frawley-O’Dea & Sarnat, (2001), and is termed the “symmetrical parallel process.” For example, a supervisee is anxious about seeing a client that has a panic disorder and the supervisor intentionally facilitates a mindfulness relaxation activity with the supervisee to assist with managing his/her anxiety about serving the client. Subsequently, the supervisee is less anxious when meeting with the client and facilitates a mindfulness relaxation exercise to assist the client with managing his/her panic disorder. The bidirectional process has several components: a) processes that lead to parallels between treatment and supervision; b) transference and countertransference that is enacted in one dyad that impacts the other dyad; c) and parallels that highlight the similarities between counseling and counseling supervision (Doehrman, 1976; Frawley-O’Dea & Sarnat, 2001; Mothersole, 1999; Sigman, 1989). This contemporary view of the parallel process is the framework that is utilized throughout this paper.

Supervisors with differing therapeutic orientations report the existence of the parallel process as a “supervision and learning” intervention (Raichelson, Herron, Primavera, & Ramirez, 1997). A study by Raichelson et al. (1997), which included 150 supervisors and 150 supervisees with varying theoretical orientations in counseling, examined both the traditional and contemporary view of the parallel process by using the Parallel Process Survey and found that most participants confirmed the existence of the parallel process in supervision. By far, the psychoanalytic orientation acknowledged the parallel process greater than the non-psychoanalytic orientations, such as cognitive, rational emotive, or behavioral. The participants who endorsed the existence of the parallel process embraced several significant outcomes, which included supervisees who: a)became more comfortable inviting negative transference feelings; b) experienced deeper awareness of countertransference issues; c) developed an appreciation of the value of nonverbal, behavioral enactments; d) improved their ability to express negative feelings between the supervisor and supervisee directly and in a comfortable manner; and lastly, e) felt freer to act spontaneously, warmly, and interpersonally in the therapeutic process. Overall the supervisees reported a strengthening of the supervisory relationship and improved communication.

It is important for supervisors to attend to the parallel process to improve learning and promote the clinical development of the supervisee (Pearson, 2000). The literature illustrates that the parallel process can produce intense emotions that may also impact the care of the client if not addressed (Friedlander et al., 1989; Pearson, 2000).

Although the contemporary view of the parallel process has been highlighted in the literature, the intentional use of the parallel process has not been addressed. Giordano, Clarke, and Borders (2013) came close to the intentional use of the parallel process in their article “Using Motivational Interviewing Techniques to Address Parallel Process in Supervision.” At a minimum, the authors recommended that the supervisor address the supervisee’s presenting issue by modeling effective behaviors to attend to impasses in the therapeutic process. This paper will add a new perspective to the intentional use of the parallel process.

Supervision Working Alliance (SWA) and the Parallel Process

The parallel process does not occur effectively in isolation, but in the context of a strong supervision working alliance (Ladany, 2004). Bordin (1983) conceptualized the supervision working alliance (SWA) as having three primary components: a) mutual agreement on goals; b) mutual agreement on tasks; and c) development of emotional bonds. There are many benefits to developing a strong SWA, such as decreased likelihood of resistance and defensiveness by the supervisee in relation to implementing the parallel process, increased likelihood of trust, enhanced trainee self-disclosure, and most important for this discussion, enhanced multicultural competence (Ladany, Brittan- Powell, & Pannu, 1997). Ladany recognized that the SWA is usually developed within the first three to five supervisory sessions and consists of what he calls “ruptures and repairs” in the relationship (Bordin, 1983; Ladany, 2004). Having a strong SWA will assist with the process of repairing the ruptures when they occur, especially when the goal is the development of cross-cultural competencies.

In contrast, having a weak SWA results in role conflict and ambiguity, trainee nondisclosure, alleged unethical supervisor behavior, and counterproductive events in supervision (Ladany, 2004). Attending to the SWA seems paramount when implementing effective supervisory practices and influencing the learning and practice of the supervisee (Shulman, 2005). Shulman (2005) described supervision as interactional in nature, where the supervisor and supervisee play a part in the outcomes. In June of 2005, during a plenary presentation at the First International and Interdisciplinary Conference on Clinical Supervision, Shulman asserted that in supervision “more is caught, than taught, meaning that supervisees learn more from us by paying attention to how we treat them, than by what we say to them about their practice” (p. 24).

The parallel process has to be implemented within the appropriate context. The traditional view of the parallel process has been criticized for being used with supervisees who have not developed sufficiently to understand the parallel process, which yielded defensiveness as a response by the supervisee (Doehrman, 1976; Sumerel, 1994; Williams, 1987). Additional criticisms include the issue of “poor timing” with the use of the parallel process, especially when the result is defensiveness and the supervisee is not able to learn from the intervention (Williams, 1987). Several references have been made to utilizing the parallel process indirectly, not divulging to the supervisee that the parallel process is occurring or being implemented (Giordano et al., 2013; Sumerel, 1994). This approach seems somewhat disingenuous when counselor educators and supervisors are striving to communicate openly with the supervisee and work towards building a strong SWA.

Therefore, the best use of the parallel process is within a developmental model of supervision, encased within a strong SWA (Giordano et al., 2013). Having a strong SWA will assist with ascertaining the appropriate use of the parallel process with counselor trainees (Bernard & Goodyear, 2014). It is a necessary ingredient when operating within a cross-cultural supervision context (Ladany, 2004).

Cross-Cultural Supervision

The working alliance model serves to strengthen the quality of supervision, but supervisors must also be aware of cross-cultural dynamics within themselves and in the relationship. Cross-cultural supervision refers to content, process, and outcomes pertaining to the client-counselor-supervisor triad in which one of the members of the triad is culturally different from the others (Brown & Landrum-Brown, 1995; Estrada, Frame, & Williams, 2004). Embracing cross-cultural supervision captures the expanded definition of multiculturalism, which includes the following demographics: race/ethnicity, gender, sexual orientation, age, differing abilities, and spirituality (Estrada et al., 2004; Sue & Sue, 2014)

Cross-cultural supervision is embedded in the broad definition of clinical supervision, defined as an intervention provided by a more senior member of a profession to a more junior member or members who are typically of that same profession but not always (Bernard & Goodyear, 2014). Bernard and Goodyear (2014) also stated that the

relationship is evaluative, extends over time, has simultaneous purposes of enhancing the professional functioning of the more junior person(s), monitoring the quality of professional services offered to the clients that she, he, or they see, and serving as gatekeeper for those who are to enter the particular profession. (p. 9)

The ACA Code of Ethics (2014) emphasizes not only the gatekeeper function but Section F.2.b. also states that counseling supervisors must be aware of and address the role of multiculturalism/diversity in the supervisory relationship (p. 13). There is more attention in the literature spent defining cross-cultural counseling and its related competencies and less attention to cross-cultural counseling supervision and how it impacts and supports the development of cross-cultural counseling competencies of the supervisee. As the population demographics shift and change, counselor educators, supervisors, and supervisees have a responsibility to change to meet the needs of their increasingly diverse client population (Sue, Arredondo, & McDavis, 1992; Sue & Sue, 2014; U. S. Census Bureau, 2009). Thus, it becomes increasingly important for supervisors to become culturally competent and have the ability to facilitate discussions related to the cultural dynamics in the triad.

Ancis and Ladany (2001) proposed that counselor supervisors strive to build multicultural supervision competencies that consist of five domains, such as: a) Domain 1, Supervisor and Supervisee-Focused Personal Development—where supervisors challenge their own biases and explore the supervisees’ identity development; b) Domain 2, Conceptualization—supervisors facilitate supervisees’ understanding of the impact of oppression, racism, and discrimination on client’s lives; c) Domain 3, Skills/Interventions—where supervisors model and train supervisees in verbal and non- verbal helping responses; d) Domain 4, Process—supervisees are able to competently and effectively work with diverse supervisees, and e) Domain 5, Outcome/Evaluation— which includes a supervisor’s ability to identify supervisees’ personal and professional strengths and weaknesses in the area of multicultural/cross-cultural counseling.

Cross-Cultural Counseling Competencies

Cross-cultural counseling competencies are enhanced within a strong SWA by a supervisor who is able to give voice to the cross-cultural dynamics that are operative in the triad (Estrada et al., 2004; Ladany, 2004). The counseling profession has come a long way since Clement Vontress and Paul Pederson voiced their concerns and called the profession to action, to break free of “cultural encapsulation” and competently address the issues of difference for marginalized persons (Pedersen, 1978; Sue & Sue, 2014; Vontress, 1969). In 1991, the Association for Multicultural Counseling and Development first approved the Multicultural Counseling Competencies (Arredondo & Arciniega, 2001; Arredondo & Toporek, 2004). This document, termed “a living document,” has gone through several revisions and still guides the profession in curriculum development and training of counselors.

It is beyond the scope of this paper to elaborate on all of the 31 cross-cultural competencies, but acknowledgement of three significant areas is warranted for the support of cross-cultural counseling competencies within supervision. They include counselor: a) awareness of own cultural values and biases; b) awareness of client’s worldview; c) and development of culturally appropriate intervention strategies (Sue & Sue, 2014). As stated previously, the supervisor is guided by the five domains of multicultural supervision competencies that support and reinforce the cross-cultural counseling competencies of the supervisee.

Arredondo et al. (1996) led the profession by operationalizing the multicultural competencies for training and counseling purposes, while Day-Vines et al. (2007) emphasized broaching the subject of difference within the counseling process. The profession has now come full circle by examining the supervision relationship and the competencies that assist with counselor trainee development of cross-cultural competencies (Bernard & Goodyear, 2014; Estrada et al., 2004). The competencies can be acted upon when it is acknowledged that one or more cross-cultural interactions are occurring. Acknowledging the cross-cultural nature of supervision allows for interventions to be tailored appropriately to cross-cultural interactions (Arredondo & Toporek, 2004; Bernard & Goodyear, 2014).

The following vignette includes two parallel process situations, one with a weak SWA where cross-cultural issues pose concerns, and another with a strong SWA where the parallel process works well in acknowledging and supporting the three areas of cross- cultural competencies highlighted earlier. It is also a depiction of the supervisor’s competencies that support the cross-cultural learning of the counselor trainee.

Cross-Cultural Supervision Vignette

Tina Anderson is a 32-year-old African American female counselor trainee. Tina’s academic faculty supervisor is Jim Stenson, a 52-year-old European American male who has been in clinical practice for 35 years. Tina’s on-site supervisor is Pamela Jones, a 49-year-old European American female.

The initial meeting between Jim and Tina began with developing a strong working alliance that consisted of collaboratively reviewing the expectations of supervision (goals) for the university and for clinical practice (tasks). At the next meeting, Jim presented Tina with a supervision agreement that consisted of the previously discussed expectations, crisis management procedures, and communication strategies. Due to the differences between himself and his supervisee, Jim gave Tina a “cultural autobiography” (emotional bonds) to complete and bring back to the next supervision meeting. The cultural autobiography is a structured way to reveal dimensions of oneself, such as a) place of birth, b) school attended, c) languages spoken, d) places traveled, e) U.S. born friends, f) languages spoken, and g) other items as needed (Vontress, Johnson, & Epp, 1999).

Tina’s first clinical task was to co-facilitate a women’s substance abuse group with Pamela, the on-site clinical supervisor. Pamela identifies as being a recovering addict and has been with the agency for 15 years. One of the twelve diverse group members, an African American member, was struggling with homelessness as a consequence of her addiction and subsequently moved in with her sister and her sister’s three children in a two bedroom apartment. The client shared this information with the group and also asked the group to pray for her and for those who were familiar with the “laying of hands” to please touch her because her life was turning around, referring to the ability to find housing for her and her children. The group members did what was requested, while Pamela appeared visibly displeased. Pamela supported the acknowledgement of the higher power and prayer but verbally admonished the women for touching in the group. The group members became silent.

Tina left the group without talking with Pamela and because she did not feel comfortable discussing the issues with Pamela, she went straight to Jim’s office very anxious and tearful. Reflecting back on the events, she was fearful that it may have been harmful to the client who made the request and to other group members, who appeared uncomfortable. Tina was also aware that a cultural disconnect had happened between her and Pamela.

Jim listened intently and was supportive. Tina perceived a judgment was made by Pamela regarding the living arrangements of the client and the spiritual practices (her values and biases) and from what she researched about the African American community, it is not unusual for several families to have charismatic spiritual beliefs (culturally specific interventions) and to live with one another. Largely, the historical communal practices (client’s worldview) provided benefits such as safety, protection, and a pooling of resources for all involved. Pamela had not discussed cultural differences in their supervision meetings and Tina was not sure what Pamela’s position was on integrating culturally-specific interventions into the treatment. The initial meeting with Pamela consisted of organizational and clinical clarification such as making sure her mandatory trainings were complete (tasks) and learning how to facilitate the substance abuse group (goals).

When Jim identified the parallels within the supervision relationships with Tina, she agreed that she did not feel she could competently voice her concerns with Pamela but reflected on the reasons she felt competent in voicing her concerns with Jim. The primary reason was because he had broached the subject of cultural differences within their initial meetings and this allowed her to trust him enough to discuss cross-cultural issues in supervision and to also trust his cross-cultural competence as a supervisor. At the end of the supervision meeting, Tina devised a plan to repair the cultural disconnect and concerns. She will suggest to Pamela that a discussion of cultural differences could be beneficial in her supervision as well as within the group.

Parallel Process and Cross-Cultural Competencies

The vignette depicted two supervision processes, one that was effective and another process that was less than effective. Jim, as the faculty supervisor, focused on gaining agreement on goals and tasks and establishing an emotional bond with the supervisee. Pamela, as the on-site supervisor, gained agreement on goals and tasks but failed to focus on the supervision relationship (emotional bond) with her supervisee. The parallel process was enacted in both supervision experiences. The intentional use of the contemporary view of the parallel process with Jim and Tina was evident with Tina’s ability to discuss cross-cultural issues with Jim, primarily because he had initiated the subject by using the “cultural autobiography” as a starting point. In addition, the most visible parallel with Pamela and Tina was the “no discussion” of cross-cultural issues, and when an issue arose that called for communication about cross-culturally related issues, Tina felt less self-efficacious to initiate the conversation. Tina was aware of the cross-cultural disconnect between what was being taught in her academic environment and what was being practiced on-site. She learned more about herself from both supervision experiences. Benefiting from multiple supervisors, a strong SWA, the intentional use of the parallel process, and acknowledgement of cross-cultural supervision, Tina was able to appreciate the importance of discussing cross-cultural dynamics in supervision.

Below are seven best practices from the literature that can support cross-cultural counseling supervision and guide the development of cross-cultural counseling competencies for supervisees when utilizing the intentional, contemporary view of the parallel process. The intentional use of the parallel process within the SWA may assist with supporting the cross-cultural counseling competencies for supervisees. Again, they include supervisee: a) awareness of own cultural values and biases; b) awareness of client’s worldview; c) and development of culturally appropriate intervention strategies (Sue & Sue, 2014). It is important for supervisors to be aware of their own cultural values and biases, to understand the worldview of the supervisee and to develop culturally appropriate interventions to effectively facilitate cross-cultural dialogue as highlighted by the five domains.

Seven Best Practices in Cross-Cultural Counseling Supervision

1. Work to establish a strong working alliance by agreeing on the tasks and goals and by developing emotional bonds (Bordin, 1983; Ladany, 2004). A strong SWA has many benefits that impact the development of counselor trainees and can be implemented regardless of the specific supervision theory or model being utilized. Ladany (2004) highlighted two major benefits of a strong SWA: the propensity for the supervisee to disclose more readily in uncomfortable situations and the development of multicultural competencies.

2. Broach and initiate the discussion of cultural differences early on in the supervision relationship, preferably within the first three to five supervision meetings (Bordin, 1983; Estrada et al., 2004; Ladany, 2004). Establishing a strong SWA, as Ladany (2004) stated, usually happens within the first three to five supervision meetings. Therefore the first three to five supervision meetings will provide ample time to agree upon goals and tasks, to establish emotional bonds, and to also begin the conversation of addressing cultural differences.

3. Intentionally address any multicultural/cross-cultural dynamics that may hinder cross-cultural supervision or interactions (Estrada et al., 2004). Inherently there is a power differential in the supervision relationship, and therefore it is the supervisor’s responsibility to intentionally address the cross-cultural dynamics that are present within the supervision triad (supervisor, supervisee, and client; Bernard & Goodyear, 2014). This will allow the natural progression and discussion of cross- cultural material throughout the SWA.

4. Utilize a tangible and practical intervention to address cultural differences in supervision, such as the cultural autobiography or the cultural genogram (Estrada et al., 2004). The cultural autobiography is recommended for the counselor and client to use in the counseling relationship (Vontress et al., 1999). It is my recommendation that the intervention may also be used as a cross-cultural supervision intervention. This intervention may assist with the initial discussion of cross-cultural issues in supervision and also further enhance the establishment of emotional bonds between the supervisor and supervisee. The intervention may be used within the first three to five supervision meetings.

5. Review and discuss identity development models. An additional practical intervention to review and discuss could be racial/ethnic, feminist, gay, and lesbian identity models (Cook, 1994; Ladany et al., 1997; Sue & Sue, 2014). Racial identity models provide a non-threatening way to view cultural differences. They allow the dyad to begin to utilize a common language when addressing the different “ego statuses” for the supervisor, supervisee, or client.

6. Within the first three to five supervision meetings, lead a discussion related to the supervisor’s and supervisee’s cross-cultural counseling strengths and challenges (Bordin, 1983; Ladany, 2004). After utilizing and processing the cultural autobiography and identity development models, the conversation can naturally progress to a discussion of strengths and challenges related to cross-cultural competencies (self-awareness and biases, client’s worldview, cross-cultural interventions). This conversation may also lead to the establishment of additional goals and preparation needed in supervision.

7. Be mindful that cultural disconnects will happen; be open and ready to implement the repair process (Bordin, 1983; Doehrman, 1976; Ladany, 2004). Within any relationship, disconnects will happen. But when addressing cross-cultural issues, there may be a greater chance for disconnects and miscommunication. Being aware of nonverbal communication in the context of cross-cultural supervision may assist with opportunities to inquire about possible disconnects that the supervisee may have experienced. Building a strong SWA assists with decreasing trainee non- disclosure and improves the ability to discuss difficult content pertaining to the cross-cultural triad (Ladany, 2004).

Conclusion

The future of the counseling profession is only going to require supervisors and trainees to become more proficient in treating culturally diverse clientele (Sue & Sue, 2014). Counselor supervision is hailed as “the bridge” that connects the academy to site- based practice, and likewise I submit that it is “the bridge” that will assist counselor trainees with acquiring the needed competencies, awareness, and skills to provide effective treatment to diverse populations (Bernard & Goodyear, 2014).

Supervisors who are able to develop a strong SWA, by agreeing on goals and tasks and developing emotional bonds with supervisees, will ultimately create a safe environment where supervisees can focus on development of cross-cultural competencies (Bernard & Goodyear, 2014; Estrada et al., 2004). The intentional use of the contemporary view of the parallel process is one intervention that could prove beneficial in advancing cross-cultural competencies in the counseling profession. Not only is it important for supervisees to gain cross-cultural competencies through building awareness of one’s own cultural values and biases, awareness of client’s worldview, and development of culturally-specific interventions, it is equally important for supervisors to build competencies in the same areas to intentionally utilize the contemporary view of the parallel process. Leading and facilitating cross-cultural supervision means that the supervisor has the responsibility to “broach” the subject.

Best practices have been identified to help guide the supervisor in setting up a strong SWA. Developing a strong SWA is especially important to this process within the first three to five supervision meetings (Bordin, 1983). Capitalizing on the intentional use of the parallel process in the early supervision meetings, particularly to broach the issue of differences, can be helpful to the supervisee but also to the client. Utilizing the cultural autobiography or cultural genogram, assessing for racial/ethnic, feminist, gay, or lesbian identity, modeling self-disclosure of cross-cultural strengths and challenges, and establishing a process to repair cultural disconnects will advance not only the competencies in cross-cultural supervision but also cross-cultural counseling practice, which ultimately will assist in providing the best care for the client.