Abstract:In interviews with 14 counseling center predoctoral interns regarding a significant nondisclosure in supervision, eight interns reported good supervisory relationships and six indicated that they experienced problematic supervisory relationships. Nondisclosures for the interns in good supervisory relationships related to personal reactions to clients, whereas nondisclosures for interns in problematic supervisory relationships related to global dissatisfaction with the supervisory relationship. In both groups, interns mentioned concerns about evaluation and negative feelings as typical reasons for nondisclosure. Additional reasons for nondisclosure for interns in problematic supervision were power dynamics, inhibiting demographic or cultural variables, and the supervisor's theoretical orientation. Both groups described negative effects of nondisclosure on themselves and their relationships with clients. Interns in problematic supervision also reported that nondisclosures had negative effects on the supervisory relationship.Inherent in most models of supervision is the expectation that supervisees will disclose to their supervisors about themselves, their clients, and the therapeutic and supervisory relationships to facilitate the supervision process and therapist development (e.g., Bordin, 1983;Loganbill, Hardy, & Delworth, 1982;Stoltenberg & Delworth, 1987). When supervisees withhold important information from supervisors, opportunities for therapist development are missed and client welfare may be jeopardized (Ladany, Hill, Corbett, & Nutt, 1996;Yourman & Farber, 1996).Supervisee nondisclosure can occur in two ways. In unintentional withholding, lack of disclosure is the result of NOT THE PUBLISHED VERSION; this is the author's final, peer-reviewed manuscript. The published version may be accessed by following the link in the citation at the bottom of the page.Psychotherapy Research, Vol. 18, No. 4 (July 2008 (Farber, 2006;Wallace & Alonso, 1994). By contrast, willful or intentional withholding is the result of supervisees' conscious decisions to distort or not disclose significant information in supervision (Farber, 2006;Ladany et al., 1996). In this study, we focus on willful withholding. The three empirical studies on supervisee intentional nondisclosure in supervision (Ladany et al., 1996;Webb & Wheeler, 1998;Yourman & Farber, 1996) found that supervisees typically withhold important information from their supervisors. These studies surveyed supervisees with a range of training and experience; however, no studies have examined the phenomenon of nondisclosure from the perspective of trainees who are in the culminating internship year of their doctoral program (predoctoral interns). Therefore, our first purpose was to explore predoctoral interns' experience of nondisclosure.Our second goal was to explore reasons for intentional nondisclosure. From empirical data (Ladany et al., 1996), we know that supervisees sometimes do not disclose to their supervisors because the information is deemed irrelevant...

Lesbian, gay, and bisexual (LGB) supervisees were interviewed regarding their experiences of LGB affirmative and nonaffirmative supervision. Supervisees were asked to describe one of each type of event (i.e., affirmative, nonaffirmative) from their past supervision. In LGB-affirmative supervision, all supervisees felt supported in their LGB-affirmative work with NOT THE PUBLISHED VERSION; this is the author's final, peer-reviewed manuscript.

Purpose: To examine the rate of compliance with National Surgical Infection Prevention Project performance measures and compliance with American Society of Health-System Pharmacists guidelines for procedures not covered by these measures and to evaluate noncompliance for explanatory factors. Methods: A retrospective review of all patients receiving prophylactic antibiotics for Class I (clean) or Class II (clean-contaminated) surgical procedures. Information collected included antibiotic ordered, antibiotic given, dose of antibiotic, time of administration, time of incision, time of closure, duration of procedure, need for re-dosing during the procedure, documentation of re-dosing administered, and antibiotic discontinuation. Results: Choice of antibiotic for prophylaxis was appropriate in 99% of the 568 procedures. Antibiotic was administered too early in 94 of 527 (17.8%) patients. Prophylactic antibiotics were inappropriately continued for more than 24 hours in 43 of 216 (20%) patients undergoing noncardiothoracic procedures and for more than 48 hours in 4 of 10 (40%) in patients undergoing cardiothoracic surgery. Conclusion: Although improvements in key performance measures related to prophylactic antibiotic agent selection, timing of administration, and discontinuation have been made compared to data collected in a larger multicenter study conducted at the beginning of this century, there remains considerable room for improvement.