Client-outcome model of supervision: a Delphi study of clinical supervisors' perception of practices contributing to client outcomes

The purpose of this study was to explore and identify constructs that signify competence in mental health and rehabilitation counselor supervision, glean information regarding specific clinical supervision practices endorsed in clinical supervisors' work with supervisees and their perceived relevance for promoting client outcomes, and to elicit specific supervision evaluation methods that are utilized to support these claims. A Delphi methodology was utilized to explore three research questions to identify these constructs as well as to identify the operating supervision practices and evaluation methods commissioned. A total of three survey rounds were conducted to seek expert consensus. Data were obtained from expert panelists who were randomly sampled from 2,159 identified Approved Clinical Supervisor (ACS) credential holders. A total of 10 expert participants completed all three rounds of the survey. Data were analyzed using qualitative analysis in the Round One survey. Surveys for Rounds Two and Three were developed based on the preceding survey data and were analyzed using statistical analysis of the Median (Mdn) and Interquartile Range (IQR). Results of each survey were provided to expert participants for re-evaluation and ranking of importance using a 7-point Likert scale. Items were retained with a Mdn of 6.00 or higher and with an IQR of 1.5 or less. The results identified seven total educational constructs perceived to deem competence, 12 supervision practice constructs perceived to enhance client outcomes, and seven total evaluation methods utilized to effectively evaluate the presence of improved client outcomes. The results were compared to the introduced Client-Outcome Model of Clinical Supervision. In conclusion, further research is needed to operationalize these constructs to further examine their empiricism and the effects on promoting client outcomes.