Cultural Awareness in Two UK Counselling Psychology Settings: Initial Training and Supervision

Peter Andrew Martin*a

Abstract

The issue of cultural awareness is inherent in every expression of social science. This paper addresses this topic in a Counselling Psychology context by presenting and discussing two separate questionnaires. Both were sent out to UK Counselling Psychologists between March and May 2013. The first on cultural awareness provision in training was sent to all 14 UK Counselling Psychology training institutions. The second questionnaire related to the experience of supervising or being supervised in the context of “cultural awareness”. This was sent to all 3000 BPS Division members. The purpose of the questionnaires was to find out about current practice, opinions, attitudes and perceived problems as they relate to cultural awareness. The questions in each case were usually multi-choice but responses that are outside of the categories offered were all included in the full results. The results of the training questionnaire indicated a varied coverage of the syllabi from being inherent in the philosophy of a training course, to being a specifically targeted area of teaching and learning. The chief problem in offering such teaching is lack of time on the syllabus. Experience of supervision was also very varied, and ranged from cultural issues being dealt with in great depth, to the experience of such issues being ignored. The discussion raises the key issues the responses pose and asks some of the questions that need answers from the whole psychological and wider community.

Keywords: supervision, multi-culturalism, difference, counselling psychology, BPS, discrimination, training

The European Journal of Counselling Psychology, 2015, Vol. 3(2), doi:10.5964/ejcop.v3i2.40

Received: 2013-10-14. Accepted: 2014-08-20. Published (VoR): 2015-03-31.

*Corresponding author at: 52 Ethelburt Avenue, Bassett Green, Southampton, SO16 3DD, United Kingdom. E-mail: petermartin834@gmail.com

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction [TOP]

Awareness of cultural issues is a central tenet of counselling psychology (CoP) (Martin, 2010). The responsibility to train new recruits to the profession in ways sympathetic to widening awareness is a clear imperative but is difficult to achieve: Eleftheriadou (2010, p. 198) paraphrases Bhui and Bhugra (2007) thus: “we need to understand the impact of culture in our client’s lives as well as the meaning that culture has in our own lives” (p. 198). Thus the understanding of what the notion of “cultural issues” consists is itself a moot and much argued construction. Pedersen (1997, p. 177) talks of “culture’s complexity” and of “hundreds or perhaps even thousands of culturally learned identities,” claiming that rather than a construction, culture is a “dynamic as each one of these alternative cultural identities replaces another in salience.” During training and throughout practice the counselling psychologist is challenged to widen and constantly evolve in the face of a plurality of meanings and the ever-changing zeitgeist that a cultural understanding of ourselves and of our clients involves.

It is the supervisor’s task to facilitate this maelstrom of multi-directional development. Indeed “The Division of Counselling Psychology was the first within the British Psychological Society to insist on supervision for its members” (Woolfe & Tholstrup, 2010, p. 591). This is not a condition that is replicated worldwide except for trainees. The responsibility of the supervisor, or in some other countries, the senior professional is huge in keeping the door open to the professional’s developing and evolving consciousness of whatever at a given moment constitutes “cultural issues”. This is the case, if only to maintain a degree of humility rather than a dangerously isolated arrogance in the tumultuous web that we call society.

This piece of research is groping in the dark, but is nevertheless an attempt to “encourage compassion and promote dialogue” (Ellis & Bochner, 2000, p. 748). I have worked from a phenomenological stance of semi-involvement with the material (Moustakas, 1990), as a member of the profession who has formed certain impressions about cultural awareness and its implications for training and for practice as seen in supervision. This research is an attempt to test those perceptions against those of the participants, and to hope that any ensuing discussion will help to light up the next twist in the path of complexity, and I would say, the immense richness of human experience.

The Present Study [TOP]

Counselling Psychology training in UK is accredited by the BPS but also compulsorily by the statutory Health and Care Professions Council (HCPC). Thirteen institutions currently offer courses leading to a Doctorate either within universities themselves, or are accredited by a university. The way that each institution interprets the BPS and HCPC requirements, known as Standards of Education and Training (SETS) and Standards of Proficiency (SoPs), varies enormously in terms of emphases. Individual programmes are of course subject to accreditation visits by both BPS and HCPC. The BPS has also an “Independent Route” that leads to Chartership but not to a doctorate. This qualification is recognised also by HCPP.

The British Psychological Society (BPS) is currently updating its international policy. Its former President, Richard Mellows quoted Marie Curie’s dictum, “After all science is essentially international” (Mellows, 2013). This renewed interest internationalism in my own professional society coincided with an invitation to take part in a symposium at the 2013 APA Convention organised by the international co-chair for APA Division 17 (Counseling Psychology), Dr D. C. Wang. The title all the speakers were to speak to was “Embrace Cultural Issues in Counselling Training & Supervision—Models in Multiple Countries”. I wanted to present something fresh and up to date so, with the cooperation of the BPS Division, I set up the two questionnaires referred to.

Method [TOP]

I constructed a questionnaire for each area, i.e. training (Training Questionnaire), and clinical supervision (Supervisor/Supervisee Questionnaire) with guidance from a respected colleague, Dr Sylvia Dillon. The questions were designed to enquire into the experience and views of trainers, trainees and supervisors and supervisees in the area of cultural awareness. My colleague and I brainstormed ideas of questions that might evoke an interesting and comprehensive response, then narrowed them down to exclude undue overlap and to allow for responses outside of the direct questions. 13 questions were evolved for the training item, and 9 for the supervision enquiry. The result was piloted using a small cohort of the BPS Division of Counselling Psychology (DCoP). The responses were based on ticking options with an opportunity to express an alternative response if needed. Some questions designed, for instance, to elicit how the respondents conceptualised “cultural issues” allowed as many applicable responses as required. In the case of the training questionnaire respondents asked how they are embraced in the applicable by the teaching and syllabi; they were also asked about statutory requirements for teaching and what the main barriers were to providing such services. Where supervision was concerned participants gave information experience of both giving supervision, and of having supervision from others.

The questionnaires were administered between March and May 2013.The Training Questionnaire on cultural awareness provision in training was sent to all 14 UK training institutions. There was 100% return. The Independent Route did not find the questions as I had constructed applicable to their particular circumstances, so a statement by their course leader was appended to the final report to DCoP instead of a response to each question. Most institution responses were from course leaders although a few were filled in by their colleagues.

The Supervisor/Supervisee Questionnaire relating to the experience of supervising or being supervisedi in terms of cultural issues was sent to all 3000 BPS Division member and had a return of 162, a 5.4% return. The “Questback” system was used (http://www.questback.co.uk). This system was readily available through BPS and has the advantage of analysing data as they are inputted.

Results and Discussion [TOP]

The Training Questionnaire [TOP]

Perceptions of how the sufficiency of SoPs to adequately express the nature of this learning; how much they are achieved or not by the course; where and how some institutions exceed the SoPs — Six of thirteen institutions believed that the SoPs did the job sufficiently, 4 were unsure, 3 said they were insufficient but could be supplemented, and no course said they are absolutely insufficient.

Two institutions thought they had evidence that their work exceeded the SoPs by far; 8 that they exceeded the SoPs, and three said that they just cover the SoPs.

Where it was claimed that a course exceeding the SoPs at least on some counts, reasons included, 7 who said this was done by exploring the philosophy underlying the term “culture,” 8 by underwriting all work with strong cultural awareness, and 8 by means of having a strong multicultural teaching and research team who privilege awareness of cultural issues (each of such institutions gave several reasons for their sense of success in this field).

Representation in staff and in trainees — Training courses were asked the proportion of teaching staff they estimated came from a “cultural background that is in some sense different” (from dominant UK culture). Bearing in mind that 8 courses are London based (where there is a high level of diversity of cultural origin) the results are not surprising: 4 institutions have staff within this description of 10-20%; 3 between 20-40%; and 6 above 40%.

It might therefore be concluded that there was often a good chance of many cultural issues being represented within the teaching staff. There is only a small discrepancy between staff representation and trainee representation. Two institutions estimated their trainees represented cultural difference by between 10-20%; in 3 the estimate was 20-40%, in 5 40-60%; and in 3 the estimate was more than 60%.

Definitions — All of the foregoing begs the question of how each course respondent may have conceptualised what may be considered “a cultural issue”. I generated alternatives on the basis of informal conversations I had engaged in within the Counselling Psychology Division. The alternatives were designed to allow for a wide range of conceptualisations of a “cultural issue.” There was an “other” response possible. As shown in Table 1 there was wider disagreement by supervisors/supervisees compared with the course providers but nevertheless the values in Table 1 are intriguing.

Table 1

Responses to Survey Question “How do you respond to the term “cultural issues” as they apply to you as a training provider?” (up to 3 options)

Alternatives n %
Diversity 13 100.0
Multi-Culturalism 7 53.8
A case for Person-Centred approach 2 15.4
Political education 5 38.5
Counselling Psychology as Social Psychology 4 30.8
An opportunity for personal growth 4 30.8
About changing attitudes 7 53.8
Other (not specified) 1 7.7

There are many useful issues raised by these responses, not least perhaps that at least three of the well represented choices (Diversity, Multi-Culturalism, and Political education) related to social change: a sense of mission well exemplified in Division 17 of the APA, and also a tangential preoccupation of a recent issue of UK’s Counselling Psychology Review (CPR) (Steffen & Hanley, 2013).

The quiet passion of an optional comment by one contributor is worth recording since it seems representative of a real intention often frustrated by lack of teaching time (see Table 2):

”it's an increasingly important area that needs to be covered well and explicitly in the training of counselling psychologists (and indeed all mental health professionals working in our culturally diverse society/world). In a recent re-design of our programme we created a new module in Year One which is dedicated to the topic of 'working with difference and diversity' which ensures that specific attention is given to the topic and can then be built upon in subsequent stages of the training. It is also an area that is specified in the competency evaluation forms that our practice placement supervisors complete on our trainees. There is probably scope for improving further”

Time directly spent teaching and learning about cultural issues; as a thread running through the course philosophy; in course-sponsored supervision — The minimum hours recorded for teaching and learning was 15-20 hours across the course (2 institutions). The same number used 25-30 hours and 35-40 hours respectively. One course offered 40-45 hours, and another 6 offered between 45-50 hours.

Claims that teaching and learning about cultural issues was “by infusion”, through the philosophy of the course, or as an aspect of more general modules varied enormously in terms of hours.ii Eight estimated that they spent between 5 and 30 hours, whereas 5 estimated 45-50 hours. Two comments are illustrative of beliefs about this work:

  • I feel strongly that training in this area should be written into/woven through all aspects of courses as a core belief/focus of attention.

  • Our current framework has a 'bolt on' module and this is not ideal.

The estimates given above would depend very much on the perceptions of the individuals who made them. It is very hard to know for instance how much a pervasive philosophy actually impacts on the trainees, or whether that intention by course providers is perceived and enacted by trainees. This is of course true of many areas of the curriculum.

Supervision sponsored directly by the institution — Responses represented a very even distribution between 0-5 hours and 45-50 hours. Much depends however on whether or not an institution chooses to engage in course sponsored supervision. Supervision can be a very potent form of learning, the absence of course clinical supervision does not mean that supervision anywhere else is necessarily any the less efficacious.

Assessment — Twelve institutions required a ”general assignment”, 11 required a targeted assignment, in 6 there were verbal assessment in seminars, in 8 assessments were by role-plays etc. Many institutions used several modes of assessment.

A whole debate on this matter would perhaps be centred on whether “cultural awareness” can be assessed, or indeed whether such awareness amounts to a competence.

Difficulties in delivering such teaching and learning — Teaching time is limited (see Table 2): UK universities operate with fairly short terms: it is not uncommon for the entire Doctoral Course to last for only perhaps 50-60 teaching weeks. Trainees often only attend the course on two days a week, so teaching time is often very compressed and therefore contact time between staff and trainees is often much pressurised. The following quotation is representative:

“[We deal with these issues] in everything that we do as practitioners, because they are in the middle of how we think, relate and 'be' as people. The dilemma I personally find here, as with anything in counselling psychology training, is simply how to support students gain the depth of critical understanding of these issues in a time-limited and pressured programme.”

Discussion: This would appear to be overall a fairly optimistic view of the state of training in terms of cultural issues in UK.The ideal thing now to do would be to conduct a similar review with trainees to see if their own views match those of their course leaders and course staff.

Table 2

Responses to Survey Question “We have difficulty in delivering such training because:” (all options could be chosen)

Alternativesa n %
1 Lack of cultural difference in amongst my trainees and their clients 1 16,7
2 Lack of space within the timetable 4 66,7
3 Fear of offence to some trainees or colleagues 0 0,0
4 Lack of experience 0 0,0
5 Lack of knowledge 0 0,0
6 Other (please specify) 2 33,3
Total (not including Independent Route) 5b

aAlternatives to this question were generated on the basis of informal conversations. There is an “other” response possible. bThere are only 5 replies to this because the “others” responding said that they did not have difficulty delivering this training.

The Supervisor/Supervisee Questionnaire [TOP]

Ethnic identity of the participants — The distribution of the ethnic identities of the participants is shown in Table 3.

Table 3

How participants identify in terms of ethnicity

Alternatives All
Supervisees only
Supervisora
n % n % n %
1 Black 9 5,7 9 7,8 1 1,6
2 Asian 13 8,2 12 10,4 2 3,3
3 Chinese 2 1,3 2 1,7 0 0,0
4 Mixed race 3 1,9 2 1,7 1 1,6
5 White 113 71,5 75 65,2 53 86,9
6 Other 16 10,1 14 12,2 3 4,9
7 I prefer not to say 2 1,3 1 0,9 1 1,6
Total 158 100 115 100 61 100

aMay also be supervisee.

Discussion: It may be that to ask about ethnicity in a survey about cultural issues is potentially sensitive simply because it is both easy and inaccurate to make cultural differences and ethnicity synonymous: they are not. One participant comment perhaps indicative of the nature of this debate: “Is it relevant? We are all people.”

What meaning do you give the term “cultural issues” as they apply to supervision? — The “leaders” were “Diversity” and “Multiculturalism” but participants pointed out that some important definitions had been missed out (see Table 4).

Table 4

Responses to Survey Question “What meaning do you give to the term “cultural issues” as they apply to your supervision?” (up to 5 options could be chosen)

Alternativesa All
Supervisees only
Supervisorb
n % n % n %
1 Diversity 139 85,8 98 83,1 58 92,1
2 Multiculturalism 124 76,5 87 73,7 50 79,4
3 Class 80 49,4 60 50,8 29 46,0
4 Gender 62 38,3 46 39,0 22 34,9
5 Ageism 46 28,4 33 28,0 16 25,4
6 Disability 51 31,5 38 32,2 21 33,3
7 Sexuality 64 39,5 48 40,7 22 34,9
8 A case for person-Centred approach 26 16,0 21 17,8 8 12,7
9 Political education 25 15,4 18 15,3 8 12,7
10 Counselling Psychology as Social Psychology 29 17,9 21 17,8 11 17,5
11 An opportunity for personal growth 55 34,0 39 33,1 21 33,3
12 About changing attitudes 47 29,0 35 29,7 17 27,0
13 A clinical situation which causes me anxiety 11 6,8 10 8,5 1 1,6
14 A situation I usually enjoy 23 14,2 19 16,1 5 7,9
15 Other 16 9,9 13 11,0 8 12,7
Total 162 118 63

aAlternatives to this question were generated on the basis of informal conversations. There is an “other” response possible. bMay also be supervisee.

“Multi-layered, not just skin colour, or ethnicity or geographic origins, it's about religion, community, gender roles, generations (first or second generation migrants) socio economic concerns, education or access to, values, mind-set, sense of self” and about Race, equality, skin colour, dress, eating customs.”

Discussion: It would seem that this is the area where a re-examination of where we are with “cultural issues” begins. The nature of what these issues are is “shifting sand”, so there needs to a frequent reappraisal of what it is we are seeking to address. It is probably not good enough to reduce the argument to extremes, such as “It is all about treating everyone as an individual”. People belong to groups as well as existing in themselves, so it important to be alert to how self-definition of both individual mutate as the zëitgeist changes. This task as possibly the hardest to achieve in the process of operationalizing cultural awareness, but it may also be the most important.

Experiences of working with cultural issues in supervision — The distribution of responses to the survey question “What is your general experience of working with cultural issues in supervision?” is given in Table 5.

Table 5

Responses to Survey Question “What is your general experience of working with cultural issues in supervision?” (one only choice)

Alternatives All
Supervisees only
Supervisora
n % n % n %
Very good 30 18,6 19 16,1 13 21,0
Good 76 47,2 54 45,8 34 54,8
Unremarkable 40 24,8 32 27,1 12 19,4
Poor 11 6,8 10 8,5 2 3,2
Very poor 4 2,5 3 2,5 1 1,6
Total 161 100,0 118 100,0 62 100,0

aMay also be supervisee.

It is noticeable here that the supervisors (who were probably also supervisees) were on the whole more positive. It would be interesting to conjecture whether power were a significant variable in this perception and judgement.

Some comments made by participants about this question shed light on the nature of the experience - some of them are saddening and indicate there is no room for complacency. They also indicate divergent perceptions. All of the following are from supervisees only:

  • I rarely work with people of different ethnicities - most of my clients are white British. What I find difficult is when I struggle to understand my client's accent.

  • Cultural issues' are not something that stands out alone when working with a client. Using a client centred approach I work with all aspects of the client's subjective experience which invariably includes their race, age, gender, sexuality etc. perhaps they become 'issues' when the practitioner is unaware of them, and not willing to be curious about difference in a transparent and congruent manner?

  • Unfortunately I have often been disappointed that cultural issues tend to defined in terms of skin colour when it comes to Multi-culturalism or diversity. Can we afford to continue training, working and supervising within such a narrow framework?

  • I have found shame in talking about cultural issues a problem in my supervision and a parallel process therefore in my work as I was so eager not to cause offence. It was a useful learning curve for me and I found that acknowledging my prejudice (both positive and negative) was necessary before I could move onto explore the issues further. My supervisor is a different ethnicity to me and I found myself to be treading on eggshell around our differences.

  • I do not expect my supervisor to address cultural issues. My experience of supervision over the years has been mostly positive but if I believe a supervisor does not want to explore cultural issues or is afraid of addressing it with me I often process this aspect myself.

  • I find that individuals who focus on 'cultural issues' are usually the individuals who are caught up with their own issues and not trying to work with the existential issue of being human.

Discussion: A narrative account of these comments would be characterised an often lonely journey, comments being made “sotto voce,” and beset with a kind of apologetic or defiant demeanour. This is a far cry from the robust and proclaimed debate, demand and delivery that those who care about navigating cultural issues would perhaps want.

What determines the helpful or unhelpful nature of supervision sessions that deal with cultural issues? — The ratings by supervisees only and of supervisors were usually similar. The level of skill of the supervisor was rated highest, followed by the general level of safety in the supervision, and then by level of willingness “not to know”. More supervisees than supervisors, however, thought the “political atmosphere of the supervision setting” mattered. Both groups (about 15% in each case) thought the perception of litigious threat was a salient factor.

Participants added their own determinants of the helpfulness of such supervision

  • The level of "cultural development", experience, training, general sophistication, personal awareness, strength of personal identity, comfort, etc. of all involved. Awareness, and so knowledge and training in this area have long been, and remain, abysmal, across institutions, in my (very wide) experience.

  • Supervisors’ ability to be open and curious without stereotyping or making assumptions.

  • Being open minded, reflexive of different meanings and willingness to embrace difference and uncertainty.

  • Has the supervisor 'done their work' on the issue and is s(h)e open to it being in the room?

  • Supervisors or supervisees being unwilling to or incapable of engaging with "difficult" or "uncomfortable" material”

Discussion: These observations indicate the need for a seismic shift in the way that cultural issues are encountered. There appears to be a clear need for more training, more honesty and an increased need to tolerate uncomfortable feelings in the service of greater understanding. Issues of how to make such supervision more helpful are clearly crucial and are at least partially addressed in Table 7.

Main areas of concern arising from cultural issues in supervision — There is very little difference in responses between supervisees only and supervisors only the combined results are reproduced in Table 6.

Table 6

Responses to Survey Question “Rank what you regard as the main issues arising from what might be called a cultural issue in supervision” (participants picked up to 3)

Alternativesa All
n %
1 Failure to notice cultural difference 111 69,4
2 Failure to understand cultural difference 101 63,1
3 Difficulty in feeling deskilled by cultural difference 40 25,0
4 Difficulty in making decisions predicated by clinical imperative, and cultural imperative 37 23,1
5 Supervision which seems to want to avoid cultural issues 71 44,4
6 Supervision which appears to emphasise cultural issues too much 29 18,1
7 Fear of failing the client 49 30,6
8 Feeling deskilled by difference 34 21,3
9 Other (please specify) 8 5,0
Total 160

aAlternatives to this question were generated on the basis of informal conversations. There is an “other” response possible.

Additions were as follows:

  • Lack of time in supervision to explore issue properly.

  • Failure to notice cultural difference or work with cultural difference can in my experience often lead to a reinforcement of historical power relations in the therapy room.

  • Fear of offending my supervisor.

  • Gender and recognition of countercultural aspects of facing up to gender.

  • Failure to notice how assumptions of similarity re culture impact as much as assumptions re difference.

Discussion: Again we appear to be dealing with awareness/avoidance as key factors. These comments unleash the power of a “fulcrum” which consideration of cultural issues bring about. When we as a profession consider culture gender, power, social imperatives, and social avoidance must come powerfully into play. Perhaps conflict is inevitable?

What training is necessary for better supervision involving cultural issues? — Training preferences are summarized in Table 7.

Table 7

Responses to Survey Question “If you believe that more training is necessary for better supervision involving cultural issues, please state your preferences for such training” (3 most important selected)

Alternativesa Allb
n %
1 Lectures by members of cultural traditions 78 50,6%
2 User-feedback 56 36,4%
3 Experiential groups 72 46,8%
4 Counselling Psychology cultural exchanges 53 34,4%
5 On-line or electronic awareness courses 31 20,1%
6 Conferences especially devoted to these themes 61 39,6%
7 Awareness raising of small “p” political awareness through the Division 57 37,0%
8 Other (please specify) 12 7,8%
Total 154

aAlternatives to this question were generated on the basis of informal conversations. There is an “other” response possible. bThere was no difference between the responses of the two groups (supervisees/supervisor) so only the table for all participants included.

Discussion: There seems to be a plea for the “experts to speak”: a problem if experts contribute to a particular and perhaps limited discourse perhaps. This is contrasted by the second choice which is to train through many voices in experiential groups.

Additions to this list were made by

  • Awareness and training re social diversity needs to be fully integrated across all aspects of training, not ghettoised to a single 'issues' module.

  • Supporting research on those topics

  • Cultural issues' being taught about in terms of subjectivity and individual differences, as well as in terms of inter-personal and group dynamics, and is largely present focussed.

  • More open discussions on racism without judgement

  • An explicit acknowledgement by the society that the issues of diversity are central to the practice issues. Especially power issues and psychology’s colonial history founded in racist theorising.

  • Ability to get consultation from particular ethnic groups.

  • Training that encourages participants to explore and acknowledge their own prejudices.

  • Training emphasising impacts of multiple identities and minoritisation within cultural groups, not just focusing on single identities and the voice of the most powerful within a group (e.g. lectures by disabled muslin women etc.).

Discussion: This discourse appears to make a plea for a holistic approach to culture. Within such a pluralistic and diverse enquiry the voices of individuals, of group identities, and of more traditional but well-founded quantitative research needs to be heard.

What did participants think was left out of the questionnaire? — Specific comments included

  • Some supervisors neglect this and solely look at the therapeutic relationship but ignore how cultural differences and perceived stereotypes from the client are impacting the relationship. They ignore the white elephant in the room.

  • I believe many cultural issues are dismissed / ignored with greater emphasis on technique and case management in supervision. The supervision culture itself is an important factor in how differences and similarities are incorporated into working within the client relationship and developing increased understanding to bridge differences.

  • I am struggling with certain ways in which my identity and sense of "what is a CoP" is at odds with where British CoPs situate themselves ideologically…There is a sense that in order to be an "authentic" CoP in Britain one has to be fundamentally based in the person-centred approach, deeply non-directive in style, suspicious of the so-called "threat" posed by CBT and its ilk; and so forth. These are cultural/political attitudes as much as therapeutic ones; and for me they are hard to adjust to…This "professional identity" issue is for me a "cultural issue".

  • Some supervisors give a structure to allow for cultural discussion, most do not. I will bring cultural issues to supervision if it has significance but do not expect it to be fully understood by the supervisor.

  • Please be aware that intelligent people from low income backgrounds are kept out of all the psychologies, which has a knock on effect in keeping non-White groups out of the psychologies too.

  • The very word supervision implies a power differential whereas collegiality implies something of collaboration. Could cultural issues also arise out of a clash between the task of the supervisor and attempts to create collaboration?

  • In my experience no amount of superficial training can alter the (often unwitting) homophobic, racist or sexist views of those who are simply unwilling to consider the possibility that they hold deep-seated and unpalatable prejudices.

Discussion: This was a very rich and informative response. The criticism that the questionnaire has too narrow a definition of culture and should include class, race, religion, education, sexuality, male difference is important to the concept of an ever-changing snapshot alluding to in the introduction above. This criticism is echoed by comments on what are perceived as bias in the “assumptions” in some of the questions; there are similar criticisms of the “linear” nature of some of the questions. The way I constructed the questionnaire raises the important issue of what one participant describes as “hegemonic therapeutic discourse” in any such discussion. I would contend that even initiating such a dialogue necessarily involves heighted sensitivities and “getting it wrong”: it is worth the risk in my opinion, unless we are willing to make cultural issues continue to be largely unspoken. One responder notes that such a debate needs to take place at macro levels such as at the top of organisations as well as between individual and smaller groups.

Part of the problem identified by another responder is the “lack a commonly `Recognized / standard language in counselling psychology in order to raise these issues.’ This must be a valid point so we need to consider if we can afford to wait for such a language, or if indeed it must be forged by the process itself. Language and power are inextricably enmeshed as Foucault has reminded us.

Conclusions [TOP]

The two questionnaires appear to support the following propositions, and give rise to the following questions:

The “shifting sand” of a definition of cultural issues is illustrated by the data again and again. It seems almost every question by its very formation marginalised some identities. How can the debate be handled so that it can be had, and its deliberations operationalized in some meaningful way without privileging a dominant group within the cultural mix?

Responses to cultural issues by trainers and by supervisors need to be universal in approach, and not pick and choose aspects of culture in isolation from others. They are all interlinked and there is a danger of reifying one aspect of culture if it is explored alone. Thus dealing with for instance, ethnicity, without seeing where this fits in with gender, race, sexuality etc. can be distorting. How, then, does one start?

These issues cannot be divorced from universal issues of power and authority. Social change can be considered to be an important outcome of increased cultural awareness – an issue which in UK Psychology at least is often treated very gingerly. If power and authority is the crucial prism, then why deal with the details, say of sexuality, if there is a “higher order” issue at stake?

The responses call for a more sophisticated sense of what culture may mean in individual lives. It is not enough, for instance, to understand better what it might be like to be lesbian. Our clinical experience teaches us that cultures do not come along in “ones”. How can we empathise collectively and individually with multiple identities e.g. a Muslim lesbian who is poor.

Standards of Proficiency (or their equivalent across Europe) can really only express guidelines for a training syllabus. How can counselling psychologists feed into to these structures when they are created so that they become living documents likely to increase better practice?

A huge problem in training is the lack of time and the breadth of the syllabus. How can the use the whole syllabus be used to promote wider cultural awareness, and how then can its success in terms of the individual trainee competence be assessed? How can the considerable resource of trainee cultural experience be better used in the teaching curriculum?

There is considerable anecdotal evidence that cultural issues are avoided in supervision to the detriment of both the supervisee and the unseen client. How can we create both for the supervisor/trainer and the supervisee/trainee an atmosphere that is safe enough to tackle issues of cultural difference courageously and effectively?

Opinions about effective training for such supervision vary. The UK and other European countries possess enormous resources for such training within their populations. How can such resources be used without this opportunity being hi- jacked by persuaders?

There is a need to develop a certain robustness. This involves everybody in the training/supervision room being ready “not to know” and to be uncertain. How do we find the way around fear of litigation, fear of being criticised for not being politically aware, or fear of making some unknown mistake, so that true and liberating dialogue is possible?

All of the points above could be summed up perhaps by acknowledging that moving forward in terms of cultural issues requires courage, mistakes, compassion, re-evaluation, pain and the willingness to be insecure. Thus we may increasingly widen a circle of trust in which we can all increase dialogue and increase compassion. No one promised this would be easy but we have no other sensible option than to take this thorny and often rewarding pathway. My goal at the beginning of this work was to test the assumptions of the questions I had set. Reading the responses was a mighty exercise in humility since almost everything my informed professional hunches had contributed was questioned or was contradicted. I am, however, not dismayed, for such is the nature of daring to engage in the crucial debate.

Notes [TOP]

i) In constructing the Supervisor/Supervisee Questionnaire I should have arranged three more refined categories but did not. The categories needed to be: supervisors only, supervisees only, both supervisors and supervisee. The questionnaire in fact used two categories: supervisee and supervisor. This has resulted in some respondents answering in both categories (i.e. supervisor and supervisee) without having the means to declare in which role they were answering a particular question.158 members responded of which 115 were supervisees only, whereas 61 participants identify as supervisors, but are likely, in the nature of the work to also be supervisees.

ii) I was aware from external examining experience that some courses aim to deal with important aspects of the syllabus such as diversity as a learning experience integrated with other areas of the curriculum. I designed this question to allow for a response from such institutions.

Funding [TOP]

The author has no funding to report.

Competing Interests [TOP]

The author has declared that no competing interests exist.

Acknowledgments [TOP]

Thanks are due to Dr Sylvia Dillon, and to the BPS Division of Counselling Psychology for support in this research.

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