Psychological Services

Psychology Trainee and Supervisor Perspectives of Multicultural

Supervision
Lynette J. Adams, R. Ross MacLean, Galina A. Portnoy, John Beauvais, and Meaghan A. Stacy
Online First Publication, March 21, 2022. http://dx.doi.org/10.1037/ser0000643

CITATION
Adams, L. J., MacLean, R. R., Portnoy, G. A., Beauvais, J., & Stacy, M. A. (2022, March 21). Psychology Trainee and
Supervisor Perspectives of Multicultural Supervision. Psychological Services. Advance online publication.
http://dx.doi.org/10.1037/ser0000643
 Psychological Services
In the public domain
ISSN: 1541-1559 https://doi.org/10.1037/ser0000643

Psychology Trainee and Supervisor Perspectives

of Multicultural Supervision
Lynette J. Adams1, R. Ross MacLean1, Galina A. Portnoy1, John Beauvais1, and Meaghan A. Stacy1, 2
1
VA Connecticut Healthcare System, West Haven, Connecticut, United States
2
Department of Psychiatry, Yale University School of Medicine

The development and dissemination of multicultural competence in the field of clinical psychology is
garnering increased attention. Providing multicultural supervision enhances multicultural competence and
benefits the supervisor, supervisee, and client. However, there is little research on how multicultural
supervision is provided and how it could be improved. The purpose of this study was to evaluate
multicultural supervision and identity-related harassment within two cohorts of interns (N = 18) and 40
psychology supervisors from a large New England Veterans affairs (VA) Healthcare System. Response
rates were 72.2% for trainees and 42.5% for supervisors. Respondents indicated there is significant
variability across supervisors in the types and frequency of supervision techniques used. Trainees identified
behaviors they would like supervisors to offer more; the most common were “discussion of client’s cultural
or ethnic background as it relates to clinical presentation or client perspective of challenges” and “discuss
how aspects of diversity, power, privilege could influence the therapy relationship.” Supervisors also
indicated what behaviors they would like to offer more, with the most common being “provide examples of
conceptualization or theory that directly incorporate identity” and “provide time/opportunity in supervision
for my own self-reflection and examination.” A majority of trainees and supervisors (76.9% and 68.8%,
respectively) reported experiencing harassment based on an aspect of their identity, most commonly
originating from clients. We discuss recommendations for improving multicultural supervision and
addressing harassment.

Impact Statement
Multicultural supervision enhances multicultural competence and benefits the supervisor, supervisee,
and client. This study identified multicultural behaviors that both psychology interns and their
supervisors wanted to experience/offer. Recommendations are offered for improving multicultural
supervision.

Keywords: multiculturalism, supervision, diversity, harassment, cultural competence

Supplemental materials: https://doi.org/10.1037/ser0000643.supp

Cultural competence for psychologists is having an awareness
of one’s own cultural assumptions and biases, understanding the
worldviews of all clients, and developing skills to appropriately
work with diverse groups, including via less traditional roles, such
as that of an advocate (Ancis, 2004; Sue et al., 1992; Toporek et al.,
2010). It includes the knowledge and understanding of how
identity develops, how to incorporate the developmental and
contextual antecedents of identity, and how to recognize within-
group differences while also acknowledging the influences of self-
identity and the intersectionality of coexisting identities (American
Psychological Association [APA], 2017). Additionally, psychol-
ogists have been urged to consider how multicultural competence
Meaghan A. Stacy https://orcid.org/0000-0002-6907-8960
Correspondence concerning this article should be addressed to Meaghan A.
Stacy, VA Connecticut Healthcare System, 116B, 950 Campbell Avenue,
West Haven, CT 06516, United States. Email: meaghan.stacy@yale.edu
can be disseminated throughout professional psychological prac-
tice (APA, 2017). More recent social movements, such as #metoo
and the recent societal pushback against systemic racism, paired
with a greater emphasis within clinical training programs to
enhance training experiences on matters related to diversity,
have created an impetus for developing multicultural competence
within psychology.
Supervision (individual or group) is a means by which multi-
cultural competence and its facets, such as cultural humility
(Hook et al., 2016; Tervalon & Murray-García, 1998) and cultural
sensitivity (Ridley et al., 1994), can be fostered, developed, and
disseminated throughout the discipline. Supervision is a require-
ment of psychology training that fosters professional and personal
development, with the goal of promoting competence in multiple
domains, including individual and cultural diversity (American
Psychological Association, 2012; Kaslow et al., 2009). In supervi-
sion, trainees can discuss and process critical events such as those
related to multiculturalism, identity, diversity, harassment, and
discrimination (Bertsch et al., 2014). Multicultural supervision is

1
2 ADAMS, MACLEAN, PORTNOY, BEAUVAIS, AND STACY
the process by which supervisors and trainees examine a variety of
cultural issues relevant to the assessment and/or treatment of
diverse clients (Leong & Wagner, 1994). This approach to super-
vision may include fostering cultural awareness, discussing cultural
dynamics within the supervisory dyad, or reflecting on culturally
learned assumptions that exist within various theoretical orienta-
tions (Robinson et al., 2000). Supervision and the supervisory
relationship have the potential to foster multicultural competence
and translate a trainee’s theoretical knowledge into practice
(Martinez & Holloway, 1997). Notably, addressing multicultural
issues in supervision has been described as essential to helping
trainees conduct ethical and effective practice (Ancis &
Ladany, 2001).
Multicultural supervision can positively influence the entire
supervisory triad (i.e., supervisors, supervisees, and clients). For
example, discussion of culture in supervision is associated with
trainees’ perceptions of their supervisors’ cultural competence
(Mori et al., 2009), and greater supervisor multicultural competence
is associated with a stronger working alliance in supervision and
higher trainee supervision satisfaction (Gatmon et al., 2001; Green &
Dekkers, 2010; Inman, 2006; Ladany et al., 2013; Mori et al., 2009).
Culturally competent supervision can influence supervisees’ self-
awareness and recognition of limitations (Soheilian et al., 2014),
improve learning outcomes (Green & Dekkers, 2010; Toporek et al.,
2004), and enhance trainees’ therapeutic self-efficacy (Kissil et al.,
2015). Discussing aspects of culture during supervision can improve
client outcomes, including using advocacy to help clients’ make
desired changes, creating a safe environment for the client, and
increasing the client’s own awareness of their cultural identity and of
social issues and problems (Ancis & Marshall, 2010). Further, it can
help trainees modify the treatment approach and develop greater
empathy for their clients (Soheilian et al., 2014).
Given the benefits of multicultural supervision, it is important to
understand what constitutes strong multicultural supervision and
how effective supervisors attend to variables such as culture,
power, and privilege. Though multicultural supervision experi-
ences differ depending on the dyad (e.g., Constantine & Sue, 2007;
Constantine et al., 2005, Hird et al., 2004; Ladany et al., 1997;
Toporek et al., 2004), it is important to understand what supervisor
behaviors are perceived as components of effective multicultural
supervision. Yet little research has investigated psychology trai-
nees’ perceptions of behaviors that foster multicultural supervi-
sion, the process by which multicultural issues are addressed in
supervision, or trainees’ supervisory needs and preferences for
fostering cultural competence. The present study aimed to under-
stand what psychology trainees’ and supervisors’ perspectives of
behaviors that constitute effective multicultural supervision are
(i.e., behaviors that would increase trainees’ understanding of
multiculturalism and diversity), preferences for how to improve
their experiences during the internship year, and how they do or do
not overlap. Additionally, this study provides information on rates
of experiences of harassment based on identity reported by trainees
and supervisors to better understand the cultural climate in which
training occurs. Understanding experiences of harassment of
trainees is integral to providing a psychologically safe training
climate for all, and particularly for individuals who may be
at higher risk of experiencing harassment based on aspects
of identity.
Method
This project was conducted as part of a quality improvement
initiative within the Psychology Department at a large Veterans
affairs (VA) healthcare system in New England with input from
current supervisors serving on the current VA psychology training
committee, members of the current VA psychology diversity com-
mittee, current psychology interns, and department leadership. The
local VA’s Institutional Review Board designated and approved the
project as a quality improvement project.
Survey
The survey was developed using the existing literature of beha-
viors, strategies, and activities reported to be effective in developing
multicultural competence (e.g., APA, 2017; Ancis & Marshall,
2010). Input and feedback on the survey was also collected from
psychology supervisors and current interns at this training site. Items
included Likert-type questions that assessed perceptions of variabil-
ity between supervisors regarding types and frequency of utilization
of behaviors, competency of supervisors, perception of value of
diversity among supervisors, personal value of diversity, and
improvement of understanding or skill in diversity as a result of
individual supervision at this internship site. The survey also con-
tained questions about experiences of identity-related harassment and
reporting behaviors, given that experiences with harassment may
harm the training experience and may be addressed within the
context of multicultural supervision. Psychology supervisors and
trainees completed anonymous surveys via a hyperlink to an online
survey or via paper and pencil (see Supplemental Tables 1 and 2).
The trainee version of the survey consisted of 11 questions, each
with subitems, and Likert-type, yes/no, and free response questions
regarding multicultural supervision and harassment experiences.
We did not include an analysis of the free response questions as
part of this study as the items pertained directly to feedback meant
for the training site, and a majority were blank. The first set of
questions included a list of 26 multiculturally-focused supervisor
behaviors and asked trainees to indicate whether their supervisors
used these during individual supervision at the local site and/or at
previous external training sites. Trainees were also asked to select
items that they wanted their current individual supervisors to engage
in more frequently to enhance their multicultural supervision expe-
rience. Trainees responded to the following two questions (5-point
Likert from Strongly Disagree to Strongly Agree) about supervisor
behaviors: “There is significant variability between my individual
VA Connecticut (VACT) supervisors regarding the types of beha-
viors they have used (i.e., different individual VACT supervisors
use different behaviors)” and “There is significant variability
between my individual VACT supervisors regarding the frequency
of behaviors they have used (i.e., different individual VACT super-
visors use the behaviors above more frequently than others).” Using
the same scale, trainees were asked whether they have “increased
my understanding or skill in diversity and multiculturalism as a
result of my individual supervision at VACT.” Trainees were asked
to rate from 1 (not at all) to 10 (the best/most) the competency of
individual VACT supervisors and all VACT supervisors in multi-
cultural awareness and diversity as well as how much the depart-
ment and the respondent values multicultural awareness and
diversity. Trainees compared VACT supervisors to other non-VA
 PERSPECTIVES OF MULTICULTURAL SUPERVISION
supervisors with respect to “competence,” “frequency of discus-
sion,” and “importance” of multicultural awareness and diversity.
The supervisor survey consisted of 10 questions, each with sub-
items, and with the language adapted for the supervisor perspective.
For questions about “competence,” “frequency of discussion,” and
“importance” of multicultural awareness and diversity, supervisors
were asked to compare themselves to other VACT supervisors. The
survey included the same content as the trainee survey except that
trainees were asked about identity-related harassment at any point in
their training and at the current site, whereas supervisors were only
asked about identity-related harassment during their time at this VA.
In both the trainee and supervisor surveys, an initial screen asked
whether the respondent had ever experienced harassment (inappro-
priate remarks, behaviors, and interactions based on an aspect of
your identity, such as sex, race, gender identity sexual orientation,
religion, etc.,) at VACT. If yes, respondents could identify what
aspect of [their] identity had been the subject of harassment. Then
respondents could check where the harassment originated using the
following options: “client,” “client’s family member,” “supervisor,”
(or “trainee” for supervisor survey), “nonpsychology employee at
VACT,” or “stranger” (supervisor survey also included an option for
other psychologist).
Each survey was able to be completed in approximately 20–30
min. The study team, this VA’s Psychology Training Committee,
and the larger Psychology Department reviewed and adapted the
survey content. The psychology interns at the time of the survey
(2019–2020) provided feedback on the length of the survey which
included feedback that the length of the survey was acceptable.
Participants
Current and past psychology interns from the 2018–2019 and
2019–2020 cohorts (a total of 18 interns) were eligible to participate
in the trainee survey. The study team disseminated the supervisor
survey to 40 psychology supervisors, with the request that only
those who had provided individual supervision to interns for 2018–
2019 and/or 2019–2020 respond to the survey. To protect individual
identity and ensure the anonymity of respondents, we did not collect
identifying or demographic information in either survey.
Administration
Using email addresses on file with the Psychology Department,
the study team sent invitations to participate in the survey to trainees
and supervisors. The response period was open for 2.5 weeks for
both groups. Up to three automatic reminders were sent to those who
had not completed the survey by the deadline. Participation was
voluntary and no incentive was offered.
Survey data were collected and managed using Research Elec-
tronic Data Capture (REDCap) tools hosted at this VA Medical
Center (Harris et al., 2009, 2019). REDCap is a secure, web-based
software platform designed to support data capture for research
studies, providing (a) an intuitive interface for validated data
capture; (b) audit trails for tracking data manipulation and export
procedures; (c) automated export procedures for seamless data
downloads to common statistical packages; and (d) procedures
for data integration and interoperability with external sources.
Access to VA REDCap requires a valid VA email address; therefore,
interns from the previous cohort (2018–2019) who had since left VA
3
and lacked a valid VA email address were given the option to submit
an anonymous paper copy in-person to a department mailbox, via
email, or via postal mail. We received one anonymous paper copy of
the survey, which a member of the study team manually entered into
REDCap; all others were completed via REDCap.
Analysis
Data were exported from REDCap and analyzed using JASP
software (JASP Team, 2020). We calculated descriptive and fre-
quency data for primary analysis. To examine differences in survey
responses between trainees and supervisors, we calculated indepen-
dent samples t-tests, Mann-Whitney U tests (when the outcome was
not normally distributed), and chi-square tests. For 5-point agree-
ment scales, we were more interested in whether trainees and
supervisors agreed than in the level of agreement and therefore
dichotomized these variables into disagree (1–3) and agree (4–5).
Significance for all tests was evaluated at p < .05.
Results
The response rate for the trainee survey was higher than for the
supervisor survey (72.2%; n = 13 and 42.5%; n = 17, respectively).
Because invitations were sent to all supervisors taking part in the local
training committee, which also included supervisors who did not
provide individual clinical supervision to these cohorts, we expect the
true response rate of supervisors is higher than reported. Of the 26
multiculturally-focused behaviors in which supervisors could engage
(Supplemental Tables 1 and 2), trainees reported that local VA
supervisors engaged in an average of 9.6 (SD = 5.65; range =
0–17) behaviors, whereas supervisors reported personally engaging
in an average of 14.1 (SD = 4.67; range = 5–21) behaviors (Table 1).
There was a statistically significant difference between trainees’ and
supervisors’ report of supervisors’ engagement in multiculturally-
focused supervisory behaviors, t(28) = 2.36, p = .03, with supervisors
reporting higher engagement. All participants (trainees and super-
visors) were asked about the perceived consistency across supervisors
regarding the types and frequency of behaviors utilized in supervision
(Table 2). Trainees and supervisors both agreed that there is variability
between supervisors in both the types (n = 11, 84.6% and n = 16,
94.1%, respectively) and frequency (n = 10, 76.9% and n = 16,
94.1%, respectively) of multiculturally focused supervisory beha-
viors. Chi-square tests revealed no statistically significant differences
between trainees and supervisors with respect to types, χ2 (1, 30) =
0.06, p = .81) or frequency, χ2 (1, 30) = 0.69, p = .41, of behaviors
used by the supervisor. There were no differences in ratings of
supervisor competence between supervisors (Mdn = 6.00) and trai-
nees (Mdn = 5.5), U (Nsupervisors = 16, Ntrainees = 12) = 109, p = .5546.
Similarly, there were no differences in perceptions of how strongly the
department’s supervisors value multicultural awareness and diversity
between supervisors (M = 7.41, SD = 1.70) and trainees (M = 6.38,
SD = 1.45), t(28) = 1.75, p = .0914. The behaviors that both trainees
and supervisors would like to engage in more during supervision are
listed in Table 3. The top behaviors that trainees would like their
supervisors to engage in more frequently to increase trainees’ learning
about multiculturalism and diversity were (a) “Discussion of client’s
cultural or ethnic background as it relates to clinical presentation or
client perspective of challenges” (n = 9, 69.2%) and (b) “Discuss how
aspects of diversity, power, privilege could influence the therapy
4 ADAMS, MACLEAN, PORTNOY, BEAUVAIS, AND STACY
Table 1
Reported Use in Supervision of Multiculturally-Related Supervision Behaviors as Reported by Interns and Supervisors
Trainees
Behaviors most reported N (%)
Discussed how aspects of diversity, power, 10 (76.9)
privilege could influence the therapy
relationship
Discussion of client’s cultural or ethnic 9 (69.2)
background as it relates to clinical
presentation or client perspective of
challenges
Discussed their own limits in their (the 9 (69.2)
supervisor’s) knowledge of multiculturalism
Behaviors least reported N (%)
Discussed multicultural issues for every case 0 (0)
Shared that they had requested consultation 1 (7.7)
from another supervisor or clinician
Discussed trainings they (the supervisor) had/ 1 (7.7)
were taking to develop their own skills
Specifically discussed the Cultural Formulation 1 (7.7)
Interview from DSM-5 to understand the
client and the client’s experience
Note. DSM-5 = The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; ADDRESSING = Age, Developmental disabilities, acquired
Disabilities, Religion, Ethnicity, Sexual orientation, Socioeconomic status, Indigenous group membership, Nationality, and Gender.
relationship” (n = 7, 53.8%). There were four behaviors that no
trainees identified as wanting supervisors to engage in more fre-
quently: (a) “Assign readings or trainings,” (b) “Specifically discuss
the Cultural Formulation Interview from Diagnostic and Statistical
Manual of Mental Disorders 5th Edition (DSM-5; American
Psychiatric Association, 2013) to understand the client and their
experience,” (c) “Display ‘safe zone’ stickers or other visible signals
to convey environment of openness,” and (d) “Discussion of
harassment of clients.” The top behaviors that supervisors reported
wanting to engage more in during supervision to demonstrate and/or
increase supervisors’ expertise in multiculturalism and diversity were
(a) “Provide examples of conceptualization or theory that directly
incorporate identity (e.g., Minority Stress Model, ADDRESSING
Table 2
Consistency of Perceived Supervisor Behavior and Frequency
Trainees
Agreement (agree/strongly agree) N (%)
There is significant variability between my 11 (84.6)
individual supervisors regarding the types of
behaviors they have used (i.e., different
individual supervisors use different
behaviors)
There is significant variability between my 10 (76.9)
individual supervisors regarding the
frequency of behaviors they have used (i.e.,
different individual supervisors use the
techniques above more frequently than
others)
Note. VACT = VA Connecticut.
Supervisors
Behaviors most reported N (%)
Discussion of privilege and power dynamics 16 (94.1)
Made affirming comments regarding 16 (94.1)
inclusivity, acceptance, and equality
Disclosed some aspect of their (the 16 (94.1)
supervisor’s) own identity in supervision
Behaviors least reported N (%)
Specifically discussed the Cultural Formulation 2 (11.8)
Interview from DSM-5 to understand the
client and the client’s experience
Facilitated discussion about appropriate use of 3 (17.6)
assessment tools with diversity or minority
populations.
Discussed multicultural issues for every case 4 (23.5)
Provided examples of conceptualization or 4 (23.5)
theory that directly incorporates identity
(e.g., Minority Stress Model, ADDRESSING
model)
model)” (n = 6, 35.3%) and (b) “Provide time/opportunity in super-
vision for my own self-reflection and examination” (n = 5, 29.4%).
There were two behaviors that no supervisors identified as wanting to
engage in more frequently during supervision: (a) “Discussion of harass-
ment of clients” and (b) “Make affirming comments regarding inclusivity,
acceptance, and equality.”
As shown in Figure 1, a majority of trainees and supervisors
[76.9% (10/13) and 68.8% (11/16), respectively] reported
experiencing harassment, defined as inappropriate remarks, beha-
viors, and interactions based on an aspect of identity (e.g., sex, race,
gender identity, sexual orientation, religion) at this VA Medical
Center. Of the 10 trainees who reported experiencing harassment,
seven (70.0%) indicated they had discussed it with a supervisor.
Supervisors
Agreement (agree/strongly agree) N (%)
There is significant variability between 16 (94.1)
individual VACT supervisors regarding the
types of behaviors they have used (i.e.,
different individual VACT supervisors use
different techniques)
There is significant variability between 16 (94.1)
individual VACT supervisors regarding the
frequency of behaviors they have used (i.e.,
different individual VACT supervisors use
the techniques above more frequently than
others)
 PERSPECTIVES OF MULTICULTURAL SUPERVISION
Table 3
Behaviors That Trainees and Supervisors Would Like to Engage in to Increase Their Competence About Multiculturalism and Diversity
Trainees
Behavior most endorsed N (%)
Discussion of client’s cultural or ethnic 9 (69.2)
background as it relates to clinical
presentation or client perspective of
challenges
Discuss how aspects of diversity, power, 7 (53.9)
privilege could influence the therapy
relationship
Note. ADDRESSING = Age, Developmental disabilities, acquired Disabilities, Religion, Ethnicity, Sexual orientation, Socioeconomic status, Indigenous
group membership, Nationality, and Gender.
While most trainees indicated their experiences of harassment had
originated from their clients (n = 9, 90.0% of trainees reporting
harassment), strangers (n = 7, 70.0% of trainees reporting harass-
ment), or another employee (n = 4, 40.0% of trainees reporting
harassment), two trainees (20.0% of trainees reporting harassment)
identified that the harassment originated from a psychology super-
visor. Of the 11 supervisors who reported harassment, they reported
a slightly lower, but broadly similar, pattern of experienced harass-
ment at this site that originated from their clients (n = 10, 91.0% of
supervisors reporting harassment), strangers (n = 5, 45.0% of
supervisors reporting harassment), another employee (n = 5,
45.0% of supervisors reporting harassment) or from a trainee
Figure 1
Experience of Harassment Across Trainee and Supervisor Surveys
Note. See the online article for the color version of this figure.
5
Supervisors
Behavior most endorsed N (%)
Provide examples of conceptualization or 6 (35.3)
theory that directly incorporates identity
(e.g., Minority Stress Model, ADDRESSING
model).
Provide time/opportunity in supervision for the 5 (29.4)
trainee’s own self-reflection and examination
(9 other behaviors tied at 23.5%)
(n = 1, 9.0% of supervisors reporting harassment). There were no
significant differences between trainees and supervisors in the reported
frequency of experience of harassment, χ2 (1, 29) = 0.24, p = .62.
Discussion
Multicultural supervision has the potential to promote professional
and personal development, while focusing on cultural issues relevant to
the assessment or treatment of diverse clients. Multicultural supervision
can also be used as a mechanism to address incidents of harassment
experiences by trainees, which may be an indicator of diversity
resistance in organizations (Probst et al., 2008; Thomas, 2020).
6 ADAMS, MACLEAN, PORTNOY, BEAUVAIS, AND STACY
Because multicultural supervision benefits the supervisor, super-
visee, and client, it is important to understand what specific super-
visor behaviors trainees and supervisors perceive as aspects of
multicultural supervision that may increase learning. This article
addresses several gaps in the extant literature by identifying psy-
chology trainee experiences and perceptions of multicultural super-
vision, experiences and use of supervision to address harassment,
and these perceptions of supervisors.
Trainees and supervisors both reported that supervisors engage in
a range of multicultural supervision behaviors in terms of frequency
and types of techniques, consistent with literature demonstrating
that supervisors differ in which cultural issues they discuss and
consider applicable to supervision (Hird et al., 2004). However, 16
out of 17 supervisors in this study endorsed having utilized three
behaviors: (a) discussing privilege and power dynamics; (b) making
affirming comments regarding inclusivity, acceptance, and equality;
and (c) disclosing some aspect of their (the supervisor’s) own
identity in supervision. These behaviors are in line with behaviors
that have been identified in the literature as behaviors essential to
supervision in general. For example, discussion of power dynamics
is inherent to psychodynamic supervision (e.g., Frawley-O’Dea,
2003; Sarnat, 2016), and self-disclosure is often utilized in building
supervisory alliance (e.g., Knox et al., 2008; Ladany & Walker,
2003). These three behaviors may be useful starting points in
fostering conversations about how supervisors are already providing
or can enhance their provision of multicultural supervision, even for
those who may not personally prioritize it. We have included the full
survey in the Supplemental Materials so that readers can benefit
from using the survey if they wish to adapt/adopt a similar site
assessment.
Although supervisors can enhance their multicultural supervision
practice by including additional techniques, there was no consensus
among trainees or supervisors on which behaviors to incorporate.
This suggests that supervisors are not expected to offer the same
techniques and would likely benefit from tailoring their practice to fit
their own style, experience, and expertise. However, based on the
behaviors that trainees most commonly noted, we encourage super-
visors to consider including discussion of client’s cultural or ethnic
background as it relates to clinical presentation or client perspective
of challenges, and discussion of how aspects of diversity, power,
and privilege could influence the therapy relationship. Notably,
these two supervision behaviors closely align with recommenda-
tions in the American Psychological Association (APA) guidelines
(APA, 2017) and the literature (e.g., Butler, 2015; Hays, 2016;
Patallo, 2019), and these types of multiculturally responsive super-
vision techniques can positively influence the experiences of trai-
nees from minority backgrounds (Jendrusina & Martinez, 2019).
We also encourage supervisors to consider including behaviors that
supervisors reported wanting to engage more in during supervision,
such as discussing examples of conceptualization or theory that
directly incorporate identity such as the Minority Stress Model
(Meyer, 2003) or the ADDRESSING model (Hays, 2016).
Some behaviors were not requested by any trainee to enhance
their knowledge and skill in multicultural supervision (e.g., dis-
cussing the harassment of clients, displaying “safe zone” stickers, or
specifically discussing the Cultural Formulation Interview). It is of
note that about half of trainees reported they were already being
assigned readings and trainings, and already see visible signs to
convey a “safe zone” or environment of openness; as such, it is
unclear if these behaviors are not seen as useful or if they are being
done sufficiently and do not warrant additional efforts. More
research is needed to clarify whether trainees do not view these
specific behaviors as priorities for enhancing their multicultural
competency and understanding, do not have an awareness of how
these may be beneficial to their training, feel they are sufficiently
done, or view other behaviors as greater agents for learning.
In our sample, supervisors rated themselves as engaging in
significantly more multiculturally-focused supervisory behaviors
than trainees perceived the supervisors to be engaging in. This
finding reveals a potential blind spot among supervisors who may be
overstating their multicultural competence, at least from the per-
spective of trainees they supervise. Research that examines
multiculturally-focused supervisory behaviors directly (e.g., obser-
vation), rather than via self-report could shed light on the discrep-
ancy between supervisors’ and trainees’ perceptions of behavior.
A majority of trainees and supervisors reported experiences of
harassment, most commonly originating from clients. These rates of
harassment are consistent with the literature on harassment in other
healthcare education settings (e.g., Fnais et al., 2014), though higher
than what has previously been reported for psychology trainees
(Cencirulo et al., 2020; deMayo, 2000). This suggests that psychol-
ogy supervisors should expect trainee harassment to occur and
proactively discuss harassment in supervision early on, consistent
with literature on supporting trainees in broader healthcare settings
(e.g., Goldenberg et al., 2019). It is important to note that two
trainees identified a supervisor as the source of harassment based on
some aspect of identity and one supervisor reported harassment had
originated from a trainee at this training site. Proactively discussing
harassment in the context of multicultural supervision may not only
support and teach trainees to navigate these challenging trainee–
client dynamics, but also inhibit inappropriate comments or harass-
ment within the supervisory dyad as well.
This article has several limitations. First, this is a small sample
from a single healthcare system that may not be representative of all
psychology training sites. Some trainees completed this survey
electronically while others completed a hard copy due to limitations
of technology available to those no longer employed by VA; this
may have inhibited responses from those unable to complete an
electronic version. Further, the anonymous nature of the survey
limited the demographic data available, though we hope this mini-
mized socially desirable responses. We asked about supervisor
experiences in the past year and supervisors may have responded
differently if we asked them to consider behaviors they engaged in
over a longer timeframe. We also asked supervisors to opt in to
completing this survey if they had provided individual supervision
to interns during this timeframe, but it is possible that some
respondents may have provided responses regardless of type of
supervision they have engaged in. Additionally, although the list of
supervisory behaviors was compiled from the psychology supervi-
sion literature, it may not be exhaustive; multiculturalism may be
incorporated into supervision in ways that remain unidentified. We
also did not ask specifically which behaviors the participants felt
would reflect effective multicultural supervision; indeed, we asked
about what supervisors behaviors would increase their learning
 PERSPECTIVES OF MULTICULTURAL SUPERVISION
about multiculturalism and diversity. Finally, data was collected
amidst the coronavirus disease (COVID-19) pandemic and just prior
to a large-scale national acknowledgement of systemic racism, both
of which highlighted disparities in racial minority populations.
Perceptions and prioritization of multicultural awareness and advo-
cacy may have since shifted.
Despite these limitations, this article expands the larger psychol-
ogy education literature by providing insight on trainees’ and
supervisors’ experiences and perceptions of desired multicultural
supervision and how to improve it. Supervisors may consider
working to incorporate additional multicultural supervision techni-
ques and proactively discussing harassment in the workplace. Future
research is needed to assess the effectiveness of such techniques, and
explore which behaviors provide the greatest benefit for supervisors,
supervisees, and clients. This might be done through qualitative
analyses to better contextualize how these behaviors are conducted
and experienced. It would also be useful to have an understanding of
whether trainees also engage in any of these behaviors in supervi-
sion that might increase their understanding of multiculturalism and
diversity, as contributions around culture brought up by both
trainees and supervisions may increase learning.
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Received September 15, 2020
Revision received January 25, 2022
Accepted January 26, 2022 ▪