This collective case study examined the process by which experienced supervisors identified and intervened with impaired trainees. Twelve participants who worked at 3 university counseling center internships were identified for inclusion on the basis of the centers' reputations for being active in discussing and addressing intern competence problems. Participants completed a background questionnaire and were interviewed. Data were analyzed using the constant comparative method (Y. S. Lincoln & E. G. Guba, 1985). Participants identified key issues that affected their ability to intervene appropriately, including lack of preparation for the evaluative components of supervision, the degree of agency and collegial support for supervisors, and the emotional difficulty of intervening. SHARON S. GIZARA received her PhD in counseling psychology from Michigan State University. Currently at Direction Service Counseling Center, Eugene, Oregon, her research focuses on trainee impairment, consultation, and parenting. LINDA FORREST received her PhD in counseling from the University of Washington. She is currently a professor at the University of Oregon. Her area of research is trainees with competence problems/trainee impairment. WE THANK the supervisors, training directors, and directors who participated in this study for their willingness to be interviewed about these sensitive issues. We appreciate the thoughtful and careful answers they provided to the interview questions.

This article reviews the professional literature on the topic of evaluating the competence of trainees in professional psychology training programs including program policies, procedures, and actual practice for identifying, remediating, and, in extreme cases, dismissing trainees who are judged unable to provide competent, professional care. This review covers the literature on the following major issues related to trainee performance: (a) problems with definitions of impairment, (b) established professional standards for supervision and evaluation of trainees based on accreditation guidelines and ethical standards, (c) methodological critiques of empirical studies on trainee impairment, (d) issues related to evaluation and identification of trainees who are making inadequate progress toward professional competence, (e) issues related to remediation, (f) dismissal and due process, and (g) relevant legal cases and considerations. The review of these topics provides the platform for an extensive list of recommendations directed toward faculty and supervisors responsible for professional psychology training programs and internships.

Sixteen members of the Section for the Advancement of Women conference work group identified themes and issues relevant to a feminist multicultural perspective on supervision. Issues raised included feminist silence and White privilege, the importance of self-examination, the courage to be anxious, personal commitment to uncertainty, and isolation versus support. Specific risks for supervisors and supervisees participating in feminist multicultural supervision are identified.Dieciséis miembros de una Sección para el Adelantamiento de Mujeres conferencia de grupo del trabajo identificaron los temas y ausuntos pertinente de una perspectiva feminista multicultural en la supervisión. Los asuntos elevados incluyeron el silencio feminista y el privilegio Blanco, la importancia del autoexamen, el valor para estar ansioso, compromiso personal para la incertidumbre, y el aislamiento en oposicion de apoyo. Los riesgos específicos para supervisores y supervisa tomando parte en la supervisión feminista multicultural se identifica.

The three reactions written in response to our review article (Forrest, Elman, Gizara, & Vacha-Haase, 1999 [this issue]) are gratifying on a number of levels. First, we are pleased and appreciative of the thorough feedback we received from these three eminent psychologists whose work has informed our thinking on trainee impairment. As the lead author on early and seminal works on trainee impairment (Lamb, Cochran, & Jackson, 1991;Lamb et al., 1987), Douglas Lamb's (1999 [this issue]) comments clarify several points in our review, and the new work he presents extends the dialogue about this complex topic in exciting new directions. In "Practicing What We Preach," Gary Schoener (1999 [this issue]) brings to his reactions an extensive background and well-developed expertise in treating distressed and impaired practicing psychologists, as well as his long-time involvement with state and national professional associations. Melba Vasquez's (1999 [this issue]) multicultural, feminist perspective combines with her many years of experience as training director of an American Psychological Association (APA) accredited internship and as an author of a popular ethics textbook (Pope & Vasquez, 1991) to provide unique perspectives on trainee impairment.Second and more important, we believe that Lamb (1999), Schoener (1999), and Vasquez (1999) have extended the conversation that we hoped to facilitate about the extent of the unfinished work on the subject of impaired and incompetent trainees. Each of the reactants thoughtfully steps into the dialogue, extending our review by articulating new insights and proposing future directions for consideration.Together, the reactants' comments push our understanding of trainee impairment from an individual level focused on the trainee to a complex 712

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