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A Practical Guide to Clinical
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Patricia Mccarthy Veach
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A PRACTICAL GUIDE
TO CLINICAL SUPERVISION
IN GENETIC COUNSELING
Genetic Counseling in Practice
General Editors: Bonnie Jeanne Baty and Angela Trepanier
1. Genetic Counseling Research: A Practical Guide

I. MacFarlane, P. McCarthy Veach, and B. LeRoy
2. Foundations of Perinatal Genetic Counseling
A. Mathiesen and K. Roy
3. A Practical Guide to Clinical Supervision in Genetic Counseling
P. McCarthy Veach
A Practical Guide to
Clinical Supervision in
Genetic Counseling
Patricia McCarthy Veach

Distinguished Teaching Professor Emerita
Department of Educational Psychology
University of Minnesota
Minneapolis, MN, USA
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
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Published in the United States of America by Oxford University Press

198 Madison Avenue, New York, NY 10016, United States of America.
© Oxford University Press 2023
All rights reserved. No part of this publication may be reproduced, stored in

a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by license, or under terms agreed with the appropriate reproduction
rights organization. Inquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above.
You must not circulate this work in any other form

and you must impose this same condition on any acquirer.
Library of Congress Cataloging-in-Publication Data

Names: Veach, Patricia McCarthy, author.
Title: A practical guide to clinical supervision in genetic counseling /
Patricia McCarthy Veach.
Other titles: Genetic counseling in practice.
Description: New York, NY : Oxford University Press, [2023] |
Series: Genetic counseling in practice |
Includes bibliographical references and index.
Identifiers: LCCN 2022034961 (print) | LCCN 2022034962 (ebook) |
ISBN 9780197635438 (paperback) | ISBN 9780197635452 (epub) |
ISBN 9780197635469 (online)
Subjects: MESH: Genetic Counseling—organization & administration |
Personnel Management—standards | Staff Development—standards |
Administrative Personnel—standards | Administrative Personnel—ethics
Classification: LCC RB155.7 (print) | LCC RB155.7 (ebook) | NLM QZ 52 |
DDC 362.196/042—dc23/eng/20220902
LC record available at https://lccn.loc.gov/2022034961
LC ebook record available at https://lccn.loc.gov/2022034962
DOI: 10.1093/med/9780197635438.001.0001
This material is not intended to be, and should not be considered, a substitute for medical or other
professional advice. Treatment for the conditions described in this material is highly dependent on
the individual circumstances. And, while this material is designed to offer accurate information with
respect to the subject matter covered and to be current as of the time it was written, research and
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or incurred as a consequence of the use and/or application of any of the contents of this material.
9 8 7 6 5 4 3 2 1
Printed by Marquis, Canada

Contents
Preface | xix
About the Authors | xxi
Contributors | xxiii
1. Introduction to Supervision Theory and Practice | 1

Objectives | 1
What Is Clinical Supervision? | 1
Who Does Supervision Serve? | 3
Reciprocal Engagement Model of Supervision | 5
REM-S Tenets and Goals | 7
REM-S Supervisor Strategies | 8
Supervisor Competencies | 9
Supervision Is Hierarchical | 18
Why Serve as a Supervisor? | 19
Closing Thoughts | 20
Learning Activities | 20
Activity 1.1 Supervisor Self-A ssessment | 20
Activity 1.2 Reflecting on Supervision | 21
Activity 1.3 Wearing Different Supervisor Hats | 21
Activity 1.4 Genetic Counseling Supervisor
Competencies | 22
v
v i | Contents
Activity 1.5 REM-S Goals | 24

Appendix 1A: Genetic Counseling Supervisor
Competencies | 25
Appendix 1B: The Psychotherapy Supervisor Development
Scale | 36
2. Supervisory Styles | 39
Objectives | 39
Stylistic Differences | 39
Consultation Style | 41
Teaching Style | 42
Counseling Style | 43
Evaluation Style | 44
Style Limitations | 45
Additional Comments About Supervisory Styles | 47
Behaviors Common to Supervisory Styles | 49
Activity 2.1 Identifying Supervisory Styles | 51
Activity 2.2 Using Supervisory Styles | 52
Activity 2.3 Supervisory Focus and Style | 54
Activity 2.4 Supervision Metaphors | 57
Activity 2.5 The Counselor Supervisory Style | 57
Activity 2.6 Supervisory Styles: Triad Role Plays | 58
Appendix 2A: Learning Activities Answer Key | 60
3. Setting the Stage for Supervision | 61
Objectives | 61
Initiating the Supervisory Relationship | 61
Building a Supervision Working Alliance | 61
Prepping for Supervision: Anticipatory Guidance
Strategies | 63
Student and Supervisor Questions | 64
Contents | v i i
Supervision Information Statements and Agreements | 66

Additional Strategies to Set the Stage for Supervision | 67
Activity 3.1 Working Alliance Factors | 71
Activity 3.2 Prepping for Supervision—Getting
Started | 71
Activity 3.3 Prepping for Supervision—A nticipating
Student Questions | 72
Activity 3.4 Challenging Student Questions | 72
Activity 3.5 Supervision Information Statement/
Agreement | 72
Appendix 3A: Genetic Counseling Student Questions About
Supervision | 73
Appendix 3B: Genetic Counselor Supervisor Questions About
Students | 80
Appendix 3C: Sample Information Sheet | 82
Appendix 3D: Sample Information Agreement | 85
4. Culturally Engaged Supervision | 89
Ian M. MacFarlane and Krista Redlinger-Grosse
Objectives | 89
Introduction | 89
Important Terminology | 91
Culture | 91
Cultural Competence | 92
Cultural Humility | 93
Cultural Engagement | 94
Additional Terms | 94
Foundations in Theory and Research | 95
Culturally Engaged Supervision: Applications and
Strategies | 96
Starting Point: Cultural Self-Awareness | 98
Entry Points: Communication | 100
Challenging Issues: Microaggression/R acism | 109
Continuing the Work | 113
v i i i | Contents

Activity 4.1 Cultural Self-Awareness | 115
Activity 4.2 Communication Style Dimensions | 116
Activity 4.3 Culture Sharing in Supervision: Dyad Role
Plays | 116
Activity 4.4 Challenging Situations: Dyad Role Plays | 117
Activity 4.5 Culturally Engaged Supervision | 118
Appendix 4A: Cultural Identities and Their Intersection | 122
Appendix 4B: Communication Style Dimensions | 123
Appendix 4C: Culture Sharing Worksheet | 125
5. Models of Supervisor and Student Development | 129
Objectives | 129
Supervisor and Supervisee Developmental Models | 129
Supervisor Models | 130
Common Themes in Supervisor Models | 134
Supervisee Developmental Models | 135
Supervisor and Supervisee Developmental Challenges:
Parallel Processes | 136
Developmentally Based Interventions for Supervisors | 141
Developmentally Based Interventions for Students | 144
Engage in Assessment | 144
Match Interventions to Developmental Level | 144
Use Examples | 145
Assign Scaffolding Tasks/Experiences | 145
Counseling Independently | 148
Assess Student Readiness | 148
Prepare Students to Counsel Independently | 150
Prepare Yourself for Students to Counsel
Independently | 151
Activity 5.1 Supervisor Development Self-Reflection | 153
Activity 5.2 Supervisor Development Self-A ssessment | 153
Contents | i x
Activity 5.3 Experiential Evolutionary Scaffolding | 154

Activity 5.4 Addressing Student Developmental Issues:
Triad Role Plays | 154
Activity 5.5 Supervisor and Student Developmental
Stages | 156
6. Setting Goals in Supervision | 157
Objectives | 157
What Are Goals and Why Are They Useful? | 157
Types of Performance Goals | 158
Characteristics of Viable Goals | 159
Goal-Setting Processes | 159
Determining Goal Content | 160
Establishing Goal Levels: Bloom’s Taxonomy | 161
Goal-Setting Strategies | 163
Establish Long-and Short-Term Goals | 163
Regularly Review Long-and Short-Term Goals | 165
Make Goal Setting a Collaborative and Focused
Process | 165
Modify Goals as Appropriate | 167
Recognize and Manage Common Goal-Setting Pitfalls | 167
Evaluate Your Goal-Setting Skills | 169
Strategies for Promoting Goal Accomplishment | 170
Mind Mapping | 170
Activity 6.1 Writing Viable Goals | 173
Activity 6.2 Connecting Goals to Behaviors and Goal
Measurement | 174
Activity 6.3 Writing Goals Using the Discrimination Model
and Bloom’s Taxonomy | 175
Activity 6.4 Mind Mapping to Promote Goal/Strategy
Accomplishment | 176
Activity 6.5 Setting and Prioritizing Short-Term
Goals | 177
x | Contents
7. Giving and Receiving Feedback | 179

Objectives | 179
Types of Feedback | 180
Positive Feedback | 180
Corrective Feedback | 181
Characteristics of Helpful Feedback | 183
Strategies for Promoting Helpful Feedback
Interactions | 184
Create a Framework for Feedback | 185
Use Evocative Feedback Strategies When Feasible | 187
Shape Students’ Self-Critique Skills | 188
Provide Timely Feedback | 189
Be Honest and Direct | 189
Provide Sufficient, Balanced Feedback | 190
Be Strategic, Selective, and Sensitive to Student
Reactions | 193
Provide Specific Feedback and Place It in
a Context | 193
Recognize Corrective Feedback May Take Time to
“Land” | 194
Provide Oral and Written Feedback | 195
Feedback Regarding the Supervisor and Supervision
Relationship | 197
Supervisor Self-Feedback | 198
Student Feedback | 198
Activity 7.1 Reflecting on Feedback | 199
Activity 7.2 Feedback Challenges and Strategies | 200
Activity 7.3 Challenging Student Responses to
Feedback | 200
Activity 7.4 Challenging Supervisor Feedback
Statements | 201
Activity 7.5 Giving Feedback: Triad Role Plays | 202
Contents | x i
8. Evaluation in Supervision | 205

Carrie Atzinger
Objectives | 205
Evaluation Functions and Criteria | 206
Formative Versus Summative Evaluation | 207
Evaluation Criteria | 207
Approaches to Student Evaluation | 208
Likert-Style Evaluations | 208
Anchored Rubrics | 209
Qualitative Feedback | 214
Client Feedback | 214
Student Self-Evaluation | 215
Evaluation Challenges | 216
Subjectivity | 216
Power Dynamics | 217
Strategies for Promoting an Effective Evaluation Process | 217
Evaluating the Supervisor | 219
Activity 8.1 Summative Versus Formative Evaluation | 220
Activity 8.2 Skill-Specific Anchored Rubrics | 220
Activity 8.3 Evaluating Student Goals | 221
Activity 8.4 Qualitative Final Evaluation: Triad Role
Plays | 222
Activity 8.5 Client Feedback Forms | 223
Appendix 8A: Genetic Counseling Self-Efficacy Scale | 223
9. Supervision for Self-Reflective Practice | 227
Objectives | 227
What Is Self-Reflective Practice? | 227
Self-Reflection in Supervision | 229
Strategies for Promoting Student Self-Reflective
Practice | 229
Cultivate and Model Your Own Self-Reflection Skills | 230
x i i | Contents
Set the Stage with Directed Self-Reflection Protocols | 231

Work on Minimizing Barriers to Student Reflective
Practice | 234
Use Evocative Strategies | 238
Give Students Self-Reflection Assignments to Complete
Outside of Supervision Meetings | 239
Debrief Role Plays and Counseling Sessions Using
Interpersonal Process Recall | 240
Use Processes from Socratic Dialogue During
Supervision | 241
Activity 9.1 Creating a Self-Directed Protocol | 245
Activity 9.2 Engaging in Socratic Dialogue | 245
Activity 9.3 Supervision Self-Reflection | 246
Activity 9.4 Interpersonal Process Recall Debriefing: Role
Plays | 246
Activity 9.5 Using Evocative Strategies in Supervision:
Triad Role Plays | 247
10. Fostering Psychosocial Skill Development | 249
Objectives | 249
What Are Psychosocial Skills and Why Are They
Important? | 249
Types of Psychosocial Skills | 252
Strategies for Building Students’ Psychosocial Skills | 257
Discuss Definitions and Perspectives | 257
Recognize and Address Barriers to Using Psychosocial
Skills | 258
Assess Student Psychosocial Skills | 262
Set Developmentally Appropriate Goals | 262
Model Psychosocial Skills | 263
Use Directed Self-Reflection Protocols | 263
Assign Psychosocial Case Preparations | 263
Engage in Role Playing | 264
Contents | x i i i
Debrief with Interpersonal Process Recall Methods | 265

Use Mind Mapping Methods | 266
Connect Psychosocial Skills to Their Effects | 266
Activity 10.1 Addressing Student Misperceptions About
Psychosocial Skills | 268
Activity 10.2 Psychosocial Case Preparations | 269
Activity 10.3 Directed Self-Reflection Protocol | 270
Activity 10.4 Mind Mapping | 270
Activity 10.5 Addressing Students’ Use of Psychosocial
Skills: Triad Role Plays | 271
11. Ethics and Professionalism in Supervision | 273
Objectives | 273
Supervisor Responsibilities | 273
Ethical Considerations in Clinical Supervision | 274
Supervision Agreement | 274
Modeling | 276
Multiple Relationships | 277
Boundary Crossings and Boundary Violations | 278
Additional Issues | 280
Strategies to Promote Ethical and Professional Supervision
Practice | 281
Make a Lifelong Commitment to Ethical Awareness,
Sensitivity, and Behavior | 281
Set and Maintain Clear Boundaries Around the Supervision
Relationship | 282
Manage Multiple Relationships in an Ethical
Manner | 285
Delineate and Enforce Your Expectations
of Students | 287
Develop a Strong Supervisory Working Alliance | 288
x i v | Contents
Activity 11.1 Addressing Student Questions About Ethical

and Legal Aspects of Supervision | 289
Activity 11.2 Boundaries in Supervision
Discussion | 289
Activity 11.3 Strategies for Addressing Boundary Issues in
Supervision | 290
Activity 11.4 Addressing Ethical Situations: Triad Role
Plays | 291
Activity 11.5 Ethical Decision-Making | 292
12. Promoting Student Wellness | 293
Objectives | 293
What Is Wellness? | 293
Resilience | 294
Self-Care | 294
The Role of Supervision in Promoting Student Wellness and
Self-Care | 296
Stress and Distress | 296
Supervisor Responsibilities | 297
Wellness and Self-Care Strategies | 300
General Strategies | 300
Genetic Counselor Wellness Strategies | 302
Specific Strategies | 303
Tips for Promoting Student Self-Care Practices | 307
Activity 12.1 Self-Care Practices | 309
Activity 12.2 Assessing Student Wellness | 309
Activity 12.3 Setting Wellness Goals | 310
Activity 12.4 Sources of Stress and Stress
Management | 310
Activity 12.5 Self-Care Behavior | 311
Appendix 12A: Self-Care Behavior Inventory | 311
Contents | x v
13. Recognizing and Addressing Student Problematic

Performance | 313
Objectives | 313
What Is Problematic Performance? | 314
Problematic Performance Indicators | 315
Types of Problematic Performance | 316
Addressing Problematic Performance | 318
Identify Barriers to Addressing Student Behaviors | 319
Follow a Deliberate Process | 320
Prepare Yourself for Initial Conversations | 323
Be Planful and Deliberate During Conversations | 325
Additional Strategies to Support Remediation Efforts | 326
Activity 13.1 Remediation Conversations | 328
Activity 13.2 Problematic Performance | 328
Activity 13.3 Barriers to Supervision | 329
Activity 13.4 Addressing Student Problematic
Performance | 330
Activity 13.5 Developing an Intervention to Improve
Student Problematic Performance | 331
14. Common Clinical Supervision Challenges | 333
Objectives | 333
Supervisor–Student Conflict | 334
Types of Supervision Conflicts | 334
Conflict Management Strategies | 335
Example of Addressing a Conflict: Student Autonomy
Versus Imitation | 337
Supervisor Countertransference | 338
Sources of Supervisor Countertransference | 339
Types of Countertransference | 339
Behaviors That Suggest Countertransference | 341
x v i | Contents
Strategies to Manage Countertransference | 341

Example of Addressing Countertransference: Disliking a
Student | 344
Student Anxiety | 345
Types and Sources of Anxiety | 346
Behaviors Suggestive of Anxiety | 346
Anxiety Management Strategies | 349
Example of Addressing One Source of Student Anxiety:
Multiple Supervisors | 350
Activity 14.1 Conflict in Supervision | 352
Activity 14.2 Countertransference Self-Reflection | 353
Activity 14.3 Addressing Countertransference | 353
Activity 14.4 Student Anxiety | 355
Activity 14.5 Addressing Student Anxiety | 355
15. Supervision Delivery Methods | 357
Katie Wusik
Objectives | 357
Live Supervision | 358
Live Supervision Advantages | 359
Live Supervision Challenges | 360
Other Considerations Regarding Live Supervision | 362
Self-Report | 362
Self-Report Advantages | 362
Self-Report Challenges | 363
Integrating Self-Report into Genetic Counseling
Supervision | 364
Standardized Patients | 364
Standardized Patient Advantages | 365
Integrating Standardized Patients into Genetic Counseling
Supervision | 366
Peer Group Supervision | 367
Peer Groups for Professionals | 367
Peer Groups for Students | 368
Peer Observation and Feedback | 368
Contents | x v i i
Remote Supervision | 369

Activity 15.1 Reflections on Supervision Delivery
Methods | 373
Activity 15.2 Challenges in Live Supervision | 374
Activity 15.3 Client Reactions to Student Involvement | 374
Activity 15.4 Generating Questions for Self-Report | 375
Activity 15.5 Creating Guidelines for Peer Supervision
Groups | 375
Appendix: Instructional Tips for Building Supervision

Training Opportunities | 377
References | 383
Index | 407
Preface
Genetic counseling supervision is central to student profes-

sional development, and it is a prevalent activity among genetic
counselors. Genetic counselors without question are experts at
providing genetic counseling services. A good practitioner, how-
ever, is not automatically a good supervisor. Although there are
many parallels between genetic counseling practice and super-
vision, they are not the same activities. Genetic counseling liter-
ature supports formal training for supervisors to increase their
confidence and maximize their supervision skills. Furthermore,
the Accreditation Council for Genetic Counseling (ACGC; 2019a),
which endorses genetic counseling graduate programs in North
America, requires programs to prepare students to “understand
the methods, roles and responsibilities of the process of clinical su-
pervision of trainees” (p. 7).
This book is intended to serve as a practical resource to inform
educational efforts and to promote individual supervisors’ pro-
fessional development. Each chapter offers specific suggestions
and experiential activities for strengthening and maintaining
competencies that promote effective supervision processes and
outcomes. The content is pertinent for individual readers and for
workshop and classroom instruction. The Appendix, “Instructional
Tips for Building Supervision Training Opportunities,” contains
xix
x x | Preface
general suggestions to facilitate the learning experiences of current

and future genetic counseling supervisors.
There are four important considerations. First, the book
emphasizes student supervision, but basic concepts and skills
are relevant for individuals providing supervision to all types of
supervisees. Second, the content is applicable for individuals at
varying levels of supervision experience—students, novice and
experienced supervisors, and individuals interested in becoming
supervisors. Third, readers will see the terms “client” and “patient”
throughout the chapters. “Client” is consistent with revisions to
the ACGC standards and Practice-Based Competencies. This term
reflects the variety of settings in which genetic counseling practice
and supervision occur. “Patient” is consistent with terminology
used in cited publications. Fourth, it is possible that some readers
will expect supervisors to masterfully utilize every approach
described in this book. Perfectionistic expectations not only cause
undue stress but also impede supervision processes and outcomes.
This book is informed by firsthand experiences conducting
clinical supervision trainings and providing supervision, as well
as existing literature on clinical supervision. Several individuals
merit particular recognition: Carrie Atzinger, Ian M. MacFarlane,
Krista Redlinger-Grosse, and Katie Wusik shared their expertise
by serving as authors for three chapters. Carrie also provided val-
uable editorial suggestions for other chapters. Nancy Callanan,
Bonnie LeRoy, and Casey Reiser (advisors to the book) and Bonnie
Baty and Angie Trepanier (genetic counseling series co-editors) are
deeply experienced genetic counselors, supervisors, educators, and
researchers who reviewed chapter drafts and provided insightful
suggestions that enhanced the final product. Finally, I thank the
supervisors, practitioners, and students I have had the privilege
to work with throughout the years; their perspectives have greatly
enriched my understanding of clinical supervision.
Patricia McCarthy Veach, PhD, LP
About the Authors
Carrie Atzinger, MS, CGC, LGC, is an associate professor and co-

director of the University of Cincinnati Genetic Counseling Graduate
Program (GCGP). She has co-authored 15 peer-reviewed articles, the
majority of which are related to topics of supervision in the genetic
counseling field or development of genetic counseling self-efficacy.
In addition to her teaching, research, and administrative roles in
the Cincinnati GCGP, she has co-led workshops in supervision at
national meetings and outside universities and hospitals.
Ian M. MacFarlane, PhD, LP, is a licensed psychologist and
Research Assistant Professor at the University of Minnesota. He
is Director of Admissions and Associate Director of Research for
the Genetic Counseling Training Program, member of the Genetic
Counseling Workforce Working Group Task Force on Supervision
Training, and a founding member of the Advisory Board for the
international Clinical Supervision Research Collaborative. His
teaching and research include supervision, training, clinical
competency, and professional development of genetic counselors
and other human services professionals. He has authored 31
professional articles and a genetic counseling research book and has
conducted supervisor trainings at 13 genetic counseling programs.
Patricia McCarthy Veach, PhD, LP, is a licensed psychologist and
Emerita Professor at the University of Minnesota. She is a member
xxi
x x i i | About the Authors
of the Academy of Distinguished Teachers at the University

of Minnesota and recipient of the Minnesota Psychological
Association Outstanding Graduate Faculty in Psychology Award.
Her teaching and research involve supervision, training, and
professional development of genetic counselors and other human
services professionals. She has authored three books and more
than 150 professional articles, taught a graduate-level course on
clinical supervision for 30 years, and conducted more than 90
trainings on supervision.
Krista Redlinger-Grosse, PhD, LP, LGC, is a licensed genetic
counselor and psychologist who is on faculty with the University
of Minnesota Genetic Counseling Training Program as the
Director of Fieldwork and Supervisory Training. She also works
as a psychologist in private practice providing long-term support
to individuals and families impacted by genetic conditions. Her
interests center around the integration of the fields of genetic
counseling and psychology through clinical work, education,
supervision training, and research. She conducts regular
workshops to support supervisory development on topics that
include feedback and evaluation, boundaries, communication, and
cultural engagement.
Katie Wusik, MS, CGC, LGC, is a licensed genetic counselor at
Cincinnati Children’s Hospital Medical Center. In the past, she has
served as the Clinical Coordinator for the University of Cincinnati
Genetic Counseling Program. She continues to supervise genetic
counseling students in direct and nondirect patient care rotations.
Her research focuses on genetic counseling supervision and genetic
counselor professional development.
Contributors
Carrie Atzinger, MS, CGC

Co-Director and Associate Professor
Division of Human Genetics/Department of Pediatrics
Cincinnati Children’s Hospital Medical Center/University
of Cincinnati College of Medicine
Cincinnati, OH, USA
Ian M. MacFarlane, PhD, LP
Research Assistant Professor
Genetics, Cell Biology and Development
Patricia McCarthy Veach, PhD, LP
Distinguished Teaching Professor Emerita
Department of Educational Psychology
Krista Redlinger-Grosse, PhD, LP, LGC
Director of Fieldwork and Supervisory Training, Genetic
Counseling Training Program
Department of Genetics, Cell Biology, and Development,
Institute of Human Genetics
x xiii
x x i v | Contributors
Katie Wusik, MS
Genetic Counselor
Division of Human Genetics
Cincinnati Children’s Hospital Medical Center
Cincinnati, OH, USA
1
Introduction to Supervision Theory

and Practice
PAT R I C I A M C C A R T H Y V E A C H
Objectives
• Define supervision and its functions.

• Present the Reciprocal-Engagement Model of Supervision
(REM-S).
• Describe empirically derived genetic counseling supervisor
competencies.
• Explain the importance of genetic counselors taking on
the role of supervising students.

What Is Clinical Supervision?
When you hear the term supervision, what comes to mind? Maybe
you think of words such as guidance, support, advice, teaching,
consultation, feedback, and evaluation. Supervision can be any
of these things in different situations with different supervisees.
As such, supervision is a complex activity requiring deliberate
self-reflective practice. Furthermore, although there is a certain
amount of overlap, the skills of effective supervision are distinct
from the skills of genetic counseling practice.
1
2 | C l i n i ca l S u p e r v i s i o n i n G e n e t i c C o u n s e l i n g
Clinical supervision is the lynchpin of student preparation in

human services professions. Many descriptions of this essential ac-
tivity exist—for example:
[Supervision is] a highly significant activity of mentoring,

guiding, and shaping the next generation of competent [genetic
counselors].
—GRANT ET AL. (2012, P. 539)
Clinical supervision is an intervention provided by a more senior

member of a profession to a more junior colleague or colleagues
who typically (but not always) are members of the same profession.
This relationship is evaluative and hierarchical, extends over time,
and has the simultaneous purposes of enhancing the professional
functioning of the more junior person(s); monitoring the quality
of professional services offered to the clients, that she, he, or they
see; and serving as a gatekeeper for the particular profession the
supervisee seeks to enter.
—BERNARD AND GOODYEAR (2014, P. 9)
Clinical supervision is an essential component of genetic

counseling education, serving three primary purposes: (1)
promoting the professional development of student supervisees
who are the genetic counselors of the future, (2) ensuring
continued provision of quality professional services, and
(3) serving a gate keeper function regarding those individuals
who enter the profession.
—MCCARTHY VEACH AND LEROY (2009, P. 401)
Clinical supervision serves to teach, through reflective practice,

how to convey genetic information in an understandable,
informative and sensitive manner so patients can make informed
decisions about genetic testing and management for their
conditions.
—W HERLEY ET AL. (2015, P. 702)
Introduction to Supervision Theory and Practice | 3
These descriptions characterize clinical supervision functions and

processes as
• a means of transmitting skills, knowledge, and attitudes of a

particular profession through a focus on behavior (Bernard &
Goodyear, 2014; Grant et al., 2012; Wherley et al., 2015);
• a relationship in which one person’s skills/professional identity
are enhanced by interaction with another (Grant et al., 2012);
• an ongoing process in which one experienced person
helps another person acquire and maintain appropriate
professional/work behavior (Weil, 2000);
• an essential way of ensuring clients receive a standard of
care (Bernard & Goodyear, 2014; McCarthy Veach & LeRoy,
2009); and
• an activity that fosters professional development across
an individual’s career (see “Peer Group Supervision” in
Chapter 15).
Who Does Supervision Serve?
Supervision serves several constituents (McCarthy Veach &

LeRoy, 2009): students, the students’ current and future genetic
counseling clients, genetic counseling training programs, the ge-
netic counseling profession, and supervisors. The needs of these
various constituents require supervisors to wear several “hats”
(Bernard & Goodyear, 2014): Supervisors are skill builders, helping
students develop and maintain skills required of entry-level ge-
netic counselors. They are socializers, helping students learn and
adopt values, attitudes, and behaviors consistent with the genetic
counseling profession. Supervisors are monitors of services pro-
vided by students to ensure a standard of care for clients and other
consumers of genetic counseling services. They are gatekeepers,
contributing to decisions about who has the necessary characteris-
tics and skills to enter the profession.
A colleague of mine has said, “Genetic counseling is easy, it’s

genetic counseling student supervision that’s challenging.” Why
is that? I think it is partly because of those multiple hats. Every
action we engage in as supervisors should be to serve the needs
of our constituents, but sometimes those needs compete. I recom-
mend you inform students at the beginning of your relationship
about the nature of the various hats you wear (see the discussion of
information agreements in Chapter 3). Furthermore, to minimize
misunderstandings, it sometimes helps to tell a student when you
are switching hats. For example:
Scenario: The supervisor and student agreed the student

would present testing options to the client, but during
that part of the counseling session, the supervisor
stepped in. Later, when debriefing the session, the stu-
dent brought up the step-in.
Student: You told the client about whole exome sequencing,
and I was just getting to that.
Supervisor: I know you were well-prepared to present all of
the options, and you’re disappointed about not getting
to do that. Because we were running short on time, I put
on my “client care” hat and stepped in. Presenting infor-
mation within a set time frame is challenging. In retro-
spect, what do you think you might have done differently
to present options more concisely?
[Student offers some ideas, and the supervisor reinforces
feasible ones and adds their own thoughts.]
Supervisor: Why don’t we role play the part of the session
where you presented options, so you can try out some of
these ideas.
In this example, the supervisor acknowledges the student’s disap-

pointment/frustration, clarifies the step-in was not because the
student was unprepared, and identifies time management as the
reason for the step-in. They go on to normalize the challenging
nature of time management, elicit the student’s thoughts about
how to do things differently, and suggest a practice opportunity.

Of note, it is generally a good idea to discuss “step-ins” during
debriefings because students may have very different ideas about
why you stepped in and what it “says” about their performance.
Reciprocal Engagement Model

of Supervision
If I have a [model], I will have a method. I will know what to look

for, what to do, and when to do it. I will be able to justify my
intervention.
—JANSON (1998, P. 46)
A model of supervision practice provides a conceptual frame-

work for “initiation of the supervision relationship, identification
of goals and tasks, and evaluation of supervision processes and
outcomes . . . [and] can promote consistency in student training
and evaluation within and across genetic counseling programs”
(Wherley et al., 2015, p. 703). A model of supervision creates a
framework for a seemingly overwhelming endeavor (Kennedy,
2000a). A model also contributes to the “safety net” valued by
genetic counseling students to ensure quality client care while
allowing students to develop new skills (Hendrickson et al., 2002).
In 2007, McCarthy Veach et al. published an empirically derived
Reciprocal-Engagement Model (REM) of clinical genetic counseling
practice (shown in Figure 1.1). They based the model on a consensus
meeting of genetic counseling program directors or their represent-
atives, key informants, and a review of literature. The REM consists
of three key components, five tenets (fundamental assumptions or
beliefs), 17 goals specific to genetic counseling sessions, and three
broad outcomes.
In 2015, Wherley et al. proposed the Reciprocal-Engagement
Model of Supervision (REM- S) to provide a framework for
supervising genetic counseling students. Based on the belief that
REM: Genetic Counseling Process REM-S: Genetic Counseling Supervision Process
Education Individual Attributes Education Individual Attributes

Tenet: Genetic information Tenets: Patient autonomy must Tenet: Learning and applying Tenets: Student autonomy
is key be supported genetic information must be supported
Patients are resilient are key Students are capable
Patient emotions matter
Student emotions matter
Relationship Relationship
Tenet: Relationship is Tenet: Relationship is
integral to genetic integral to
counseling genetic counseling
supervision
Genetic Counseling Outcomes Supervision Outcomes

Patient understands and applies information to Student understands and applies information to
• Make decisions • Independently provide effective services
• Manage condition • Develop professionally
• Adapt to situation • Engage in self-reflective practice
Note. Each element interacts with every other element. None stands Note. Each element interacts with every other element. None stands
alone or works in isolation. alone or works in isolation.
F IG U R E 1 .1
Comparison of the Reciprocal-Engagement Model of genetic counseling

practice (McCarthy Veach et al., 2007) and the Reciprocal-Engagement
Model of Supervision.
Source: Wherley, C., McCarthy Veach, P., Martyr, M., & LeRoy, B. S. (2015).
Form follows function: A model for clinical supervision practice in genetic
counseling. Journal of Genetic Counseling, 24, 702–716 (Figure 1, p. 704).
Reprinted with permission from the Journal of Genetic Counseling.
“form follows function,” the REM-S is interconnected with and com-

plementary to the REM of genetic counseling practice. The REM-S
helps supervisors “deliberately direct genetic counseling through
supervision by structuring supervision to reflect the intended
structure of counseling and/or by modeling desired behaviors in
interactions with supervisees” (Wherley et al., 2015, p. 703). The
supervision structure allows supervisors to teach, model, and rein-
force each REM element.
Three REM-S components align with those of the REM (see
Figure 1.1): “(1) education to guide student skill development and
ensure they provide a standard of patient care, (2) relationship
development, and (3) individual student attributes. Each focus is

equally important and interacts with the others” (Wherley et al.,
2015, p. 704). These components are realized through five tenets
and 16 associated goals. The goals are informed by genetic coun-
seling supervisor competencies (Eubanks Higgins et al., 2013),
described later in this chapter, as well as by literature in medicine
and psychology. Three broad outcome goals involve the student
being able to understand and apply information to (1) independ-
ently provide effective services, (2) develop professionally, and
(3) engage in self-reflective practice.
REM-S Tenets and Goals

Tenet 1: Learning and applying genetic information are key.
Important activities include building and refining students’
case assessment skills, psychosocial skills, and teaching
skills. There are three goals: (1) supervisor knows what in-
formation to impart, (2) supervisor teaches genetic coun-
seling knowledge and skills, and (3) student acquires and/or
draws upon knowledge and skills to provide genetic coun-
seling services appropriately.
Tenet 2: Relationship is integral to genetic counseling supervision.
Supervision is a relationally based process. Good communi-
cation is essential to the process, and the supervisor is a pos-
itive part of the process. There are three goals: (1) supervisor
and student establish a bond, (2) good supervisor–student
communication occurs, and (3) supervisor and student
characteristics positively influence the supervision process.
Tenet 3: Student autonomy must be supported. This tenet assumes
students know themselves best and should be active
participants to the extent possible in exercising choice. Also,
the supervisor respects and values each student within their
personal, professional, and cultural contexts. There are
four goals: (1) establishment of a supervision agreement/
contract; (2) integrate personal, professional, and cultural
context into the supervision relationship and decisions;
(3) student feels empowered and more in control; and (4) fa-
cilitate collaborative decisions.
Tenet 4: Students are capable. This tenet reflects a belief that the
vast majority of students possess the abilities and qualities
necessary to become competent genetic counselors. They
have the capacity to learn and grow from supervised clin-
ical experiences tailored to their developmental level. There
are three goals: (1) recognize student stage of development,
(2) tailor supervision to student skill level, and (3) foster
student confidence.
Tenet 5: Student emotions make a difference. Students have emo-
tional reactions to the challenges of learning in supervision
and in response to patients’ emotions. The supervisor (and
student) must attend to the emotional impact of the supervi-
sion process. It is also critically important for supervisors and
students to connect in a human way. There are three goals:
(1) supervisor and student know student concerns, (2) both
supervisor and student understand supervisor–student and
student–patient dynamics, and (3) supervisor addresses student’s
feelings and responses to supervision and genetic counseling.
REM-S Supervisor Strategies

In a study of practicing genetic counselor supervisors, Suguitan
et al. (2019) identified 14 strategy domains (broad topic areas)
that align with REM-S tenets and goals. The strategy domains are
shown in Box 1.1.
The three most prevalent strategy domains across the REM-
S goals were assessment of student, practice self-reflection to in-
crease supervisor self-awareness, and establish student goals and
expectations. Table 1.1 contains a list of the most prevalent strategy
domains for each REM-S goal and examples of individual strategies.
Suguitan et al. (2019) concluded that due to the reciprocal nature
of the REM-S, any given strategy may help achieve multiple goals.
Furthermore, skill practice opportunities combined with feedback
are overarching strategies to help students achieve learning goals.
BOX 1.1 Genetic Counselor Strategy Domains That Align

with REM-S Tenets and Goals
Assessment of student
Assist students in collaborating with other health
professionals
Empower student
Establish student goals and expectations
Establish good communication with student
Establish working alliance with student
Facilitate patient care with student
Gather information from/with student
Give information to student
Practice self-reflection to increase supervisor self-awareness
Provide culturally competent supervision
Provide pre-and post-clinical sessions
Provide resources to student
Use psychosocial counseling skills/strategies in supervision
Source: Suguitan, M. D., Redlinger-Grosse, K., McCarthy Veach, P., &

LeRoy, B. S. (2019). Genetic counseling supervisor strategies: An elab-
oration of the Reciprocal-Engagement Model of Supervision. Journal of
Genetic Counseling, 28, 602–615.
Supervisor Competencies
Eubanks Higgins et al. (2013) conducted a modified Delphi study

to establish basic competencies (knowledge, skills, and qualities)
for genetic counseling clinical supervisors. Program directors and
assistant directors of accredited genetic counseling programs in
North America and clinical supervisors rated the importance of
competencies derived from supervision literature in allied health
professions. Participants rated 142 competencies as important for
supervisors. The researchers classified these competencies within
1 0 | C l i n i ca l S u p e r v i s i o n i n G e n e t i c C o u n s e l i n g
TA BL E 1 .1 Summary of the Most Prevalent Strategy Domains

and Examples of Specific Strategies Organized by REM-S Tenets
and Goals
REM-S Tenets Strategy Domain Specific Strategy Example

and Goals
Tenet 1: Learning and applying genetic information is key
Goal 1: Practice self-reflection Give feedback based on

Supervisor to increase supervisor patient needs
knows what self-awareness
information to
impart Assess student Assess student
development based
on previous student
rotation performance
Establish student Establish goals

goals and for session based on
expectations student feedback
Goal 2: Assess student Assess student

Supervisor performance of specific
teaches GC skill
knowledge and
skills Facilitate patient Model GC skills during
care with student session
Empower student Assign exercises to

build confidence
Give information to Provide possible

student patient perception to
student
Practice self- Gauge student

reflection to knowledge and
increase supervisor experience levels
self-awareness
Table 1 .1 (Continued)

and Goals
Goal 3: Student Assess student Evaluate student

acquires knowledge from activity
skills and/or
draws upon Provide pre-and Assign self-reflection
knowledge post-clinical sessions activity post-clinic
appropriately Practice self-reflection Use self-awareness on
to increase supervisor supervisor emotions
self-awareness
Tenet 2: Relationship is integral to genetic counseling supervision
Goal 1: Establish student Establish student goals

Supervisor goals and expectations for the rotation
and student
establish a Gather information Ask question about
bond from/w ith student student’s perceived
strengths
Collaborate with Introduce student to

health professionals professional health
team
Establish good Discuss communication

communication with styles with student
student
Goal 2: Good Establish good Facilitate bi-directional

supervisor– communication with communication with
student student student
communication
Collaborate with health Facilitate student
professionals with evaluation with other
student supervisors
Establish working Establish expectations

alliance with student to increase openness
and approachability
(continued)

and Goals
Goal Provide culturally Build rapport based on

3: Supervisor competent shared culture
and student supervision
characteristics
positively Give information to Share known patient
influence student background to student
process Use psychosocial Use primary empathy
counseling skills/ (affect)
strategies in
supervision
Tenet 3: Student autonomy must be supported
Goal Establish student Establish pre-session

1: Establish goals and expectations
supervision expectations
agreement/
contract Assess student Assess student skills
based on previous
rotation
Practice self- Use self-awareness of

reflection to own genetic counseling
increase supervisor style
self-awareness
Goal Provide culturally Establish session

2: Integrate competent expectations based on
personal, supervision cultural context
professional,
and cultural Give information to Provide anticipatory
context into student guidance on how
the supervision culture informs
relationship decision-making
and decisions Use psychosocial Use self-disclosing
counseling skills/ statement (e.g., I would
strategies in supervision do it this way)

and Goals
Goal Empower student Use positive

3: Student feels reinforcement
empowered and
more in control Use psychosocial Address student defense
counseling skills/ mechanisms
strategies in supervision
Facilitate patient care Intervene in student-

with student led session based on
student reaction
Goal Establish student Establish patient follow-

4: Facilitate goals and up with student
collaborative expectations
decisions
Gather information Check-in with student
from/w ith student post-session
Assess student Compare assessments

between other
supervisors
Practice self-reflection Draw insights from

to increase supervisor previous supervision
self-awareness experiences
Tenet 4: Students are capable
Goal Practice self- Use self-reflection about

1: Recognize reflection to student readiness
student stage increase supervisor
of development self-awareness
Assess student Quiz student knowledge
Gather information Ask questions about

from/w ith student student self-assessment
(continued)

and Goals
Goal 2: Tailor Practice self- Reference personal

supervision to reflection to experience as a student
student skill increase supervisor
level self-awareness
Assess student Evaluate student’s case

preparation
Gather information Assess quality of case

from/w ith student preparation/outline
Goal 3: Foster Empower student Respect student’s

student autonomy in session
confidence
Use psychosocial Use advanced empathy
counseling skills/
strategies in
supervision
Facilitate patient care Intervene in student-led

with student session upon student
request
Tenet 5: Student emotions make a difference
Goal Use psychosocial Ask questions about

1: Supervisor counseling skills/ student concerns
and student strategies in
know student supervision
concerns
Practice self- Recognize supervisor–
reflection to student boundaries
increase supervisor
self-awareness
Establish good Discuss student

communication with reaction post-session
student
Introduction to Supervision Theory and Practice | 1 5

and Goals
Goal 2: Both Establish good Discuss communication

supervisor communication with preferences with
and student student student
understand
supervisor– Collaborate with Utilize program
student and health professionals director
student– with student
patient Establish working Establish clinic
dynamics alliance with student expectations with
student and other
supervisors
Goal Use psychosocial Use primary empathy

3: Supervisor counseling skills/ (content)
addresses strategies in
student’s supervision
feelings and
responses to Practice self- Recognize limits of
supervision reflection to one’s supervisory role
and genetic increase supervisor
counseling self-awareness
Establish good Discuss

communication with countertransference
student post-sessions
Note: Every REM goal had at least three prevalent strategies. For some REM
goals, there were ties for the third most prevalent domain; in those cases, four
or five strategy domains are listed.
GC, genetic counseling.
Source: Suguitan, M. D., Redlinger-Grosse, K., McCarthy Veach, P., & LeRoy,
B. S. (2019). Genetic counseling supervisor strategies: An elaboration of the
Reciprocal-Engagement Model of Supervision. Journal of Genetic Counseling,
28, 602–615 (Table 4, pp. 611–612). Reprinted with permission from the
Journal of Genetic Counseling.
six domains (broad topic areas) and 15 categories (more specific

topics within domains):
Domain 1: Personal Traits and Characteristics. Domain 1 consists

of 23 competencies reflecting supervisor general quali-
ties and behaviors such as possessing demonstrated know-
ledge of the genetic counseling practice-based competencies
(Accreditation Council for Genetic Counseling [ACGC],
2019a), showing commitment to supervising, seeking
training opportunities in supervision methods, and en-
gaging in lifelong learning and professional development.
Domain 2: Relationship Building and Maintenance. Domain 2
reflects supervisor “qualities and behaviors that promote
a working alliance and a safe and positive learning envi-
ronment” (Eubanks Higgins et al., 2013, p. 44). There are
29 competencies across four categories: facilitative charac-
teristics (e.g., empathy, genuineness, and respect), initia-
tion of the supervisory relationship (e.g., orienting students
to supervision and clarifying supervisor expectations), su-
pervision dynamics (are sensitive to the evaluative nature of
supervision and inherent power differential, and expect,
recognize, and address student anxiety), and conflict resolu-
tion (e.g., recognize and address disagreements that inevi-
tably arise).
Domain 3: Student Evaluation. Domain 3 includes 26 competencies
within four categories reflecting supervisor effective en-
gagement in goal setting (e.g., setting realistic learning goals
through discussion with students, and identifying student
learning needs), evaluation (e.g., specifying and explaining
evaluation criteria, and using evaluation tools effectively),
feedback (e.g., providing timely, specific, honest feedback
and helping students process feedback), and remediation
(e.g., recognizing and documenting problematic perfor-
mance as needed, and interacting with program faculty to
discuss difficulties with students).
Domain 4: Student Centered Supervision. Domain 4 involves the

supervisor working effectively with student characteristics
such as learning style, developmental level, and cultural
background. There are 32 competencies divided into two
categories: use of appropriate methods and techniques (e.g.,
providing a balance of challenge and support appropriate to
a student’s developmental level and experience, and using
supervisory methods appropriate to a student’s level of con-
ceptual development) and facilitation of student development
(e.g., encouraging students to develop their own personal
genetic counseling styles, and encouraging multicultural
readings and educational opportunities).
Domain 5: Guidance and Monitoring of Patient Care. Domain 5
consists of competencies for fostering student learning
about how to provide a standard of care. There are 20
competencies across three categories: documentation
(e.g., provides guidance to students about effectively
documenting clinical encounters, and stresses the impor-
tance of accurate and timely medical documentation), case
preparation (e.g., assists students in developing a counseling
plan and prioritizing goals in the plan, and assists students
in incorporating patient psychological and behavioral char-
acteristics into the genetic counseling session), and coun-
seling interventions and post-counseling debriefing (e.g., assists
students in adjusting counseling goals for a patient based
on ongoing assessment and evaluation during the genetic
counseling session, and elicits students’ perceptions of pa-
tient psychosocial dynamics).
Domain 6: Ethical and Legal Aspects of Supervision. Domain
6 involves the supervisor modeling ethical and profes-
sional treatment of patients and students. There are 12
competencies across two categories: professional conduct (e.g.,
demonstrates ethical and professional standards of genetic
counseling practice, and seeks appropriate consultation in
ethically ambiguous situations) and nature and boundaries
of supervision (e.g., communicates knowledge of ethical

considerations pertinent to supervision relationships, and
maintains confidentiality with those outside the site about
student evaluation and feedback).
Appendix 1A contains the individual competencies within each do-

main and category.
Supervision Is Hierarchical
Both the REM-S (Wherley et al., 2015) and Eubanks Higgins

et al.’s (2013) supervisor competencies reflect the hierarchical
nature of the supervisor–student relationship. Within this hi-
erarchy, supervisors are in the more powerful seat because they
are the genetic counseling experts and ultimate evaluators
of student performance and readiness to move forward. As
supervisors, we should be ever mindful of the power differential
when approaching supervision and use this power in intentional
ways. One way to be intentional is to think about how you develop
working relationships with the individuals for whom you provide
genetic counseling services and consider ways you might apply
those behaviors with students:
• Cultivate an attitude of respect, openness, and sensitivity

to build and maintain a positive working alliance. A strong
working alliance has been shown to be related to stronger
supervisee self-efficacy regarding their genetic counseling
skills (Caldwell et al., 2018b).
• Expect that students are there for the “right” reasons, namely
learning and developing professionally.
• Believe in students’ ability and resilience. Most will have the
necessary capacity to become genetic counselors and will be
able to withstand the challenges that come with learning and
refining their skills.
Introduction to Supervision Theory and Practice | 1 9
• Recognize that supervision is a very emotional process. Both

your students and you will experience anticipation, hope,
anxiety, frustration, and joy at various times throughout
your relationship.
• Deliver “difficult news” (corrective feedback) with honesty,
clarity, and compassion.
Why Serve as a Supervisor?
The National Society of Genetic Counselors’ (NSGC, 2018) Code

of Ethics and the ACGC’s (2019a) practice-based competencies
“either explicitly state or imply genetic counselors have a duty to
supervise or work with genetic counseling students” (Reiser, 2019,
p. 727). These documents reflect that “only genetic counselors can
impart to students the art and skill of genetic counseling” (Reiser,
2019, p. 728).
Supervision is an essential training component of the genetic
counseling profession, and it is a prevalent activity among genetic
counselor practitioners. In 2021, the NSGC’s Professional Status
Survey found that 40% of 3,006 respondents provided supervision
to students. Moreover, student supervision was among the top
three significant roles of those in direct patient care positions.
Although there are potential challenges to supervision (e.g.,
it takes time and effort, and some genetic counselors may be-
lieve they are too busy with other tasks) (Berg et al., 2018;
Reiser, 2019), research supports numerous benefits from serving
as a supervisor (Berg et al., 2018). Benefits include playing a
role in shaping the profession’s evolution, reduced client case-
load, increased confidence about one’s genetic counseling skills
(Hendrickson et al., 2002), and the enjoyment of teaching and
contributing to the profession (Lindh et al., 2003). Serving as
a supervisor helps “keep you on your toes” (Lindh et al., 2003),
promotes your own professional development, and promotes the
vitality of the field by helping prepare future generations of ge-
netic counselors. Supervision may also help offset professional
risks such as compassion fatigue because it provides a break from

challenging clinical work (Udipi et al., 2008). Additional poten-
tial benefits include accruing professional activity credits for
recertification and recognition by some institutions through the
awarding of faculty status (Reiser et al., 2019).
Closing Thoughts
As this chapter suggests, much is expected of genetic counseling

supervisors. The following chapters contain practical suggestions
for strengthening and maintaining competencies that promote
effective supervision processes and outcomes.
Learning Activities
Most learning activities can be adapted for dyad or small group

discussions or for written exercises. Time estimates are provided
for discussions, but additional time should be allotted for large
group processing.
Activity 1.1 Supervisor Self-Assessment

The Psychotherapy Supervisor Development Scale (PSDS; Watkins
et al., 1995) provides a baseline of where you presently see yourself
with respect to your supervision competency/effectiveness and su-
pervisor identity/commitment or where you anticipate you will be
when you begin serving as a supervisor.
Complete the PSDS and use the Scoring Key contained in
Appendix 1B. Then share your responses with a partner.
Estimated time: 15 minutes
Note: Novices can retake this scale after undergoing further su-
pervision training/experience to gauge their development.
Experienced supervisors can note specific items for which they feel
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The Project Gutenberg eBook of Nat Wolfe; or,
The gold hunters: A romance of Pike's Peak and
New York
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Title: Nat Wolfe; or, The gold hunters: A romance of Pike's Peak
and New York
Author: Metta Victoria Fuller Victor
Release date: June 21, 2022 [eBook #68363]
Language: English
Original publication: United States: Beadle and Adams, 1872
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*** START OF THE PROJECT GUTENBERG EBOOK NAT WOLFE;

OR, THE GOLD HUNTERS: A ROMANCE OF PIKE'S PEAK AND
NEW YORK ***
NAT WOLFE;
OR,
THE GOLD HUNTERS.
A ROMANCE OF PIKE'S PEAK AND NEW YORK.
BY MRS. M.V. VICTOR.
NEW YORK:
BEADLE AND ADAMS, PUBLISHERS,

98 WILLIAM STREET.
Entered according to Act of Congress, in the year 1874, by

BEADLE AND ADAMS,
In the office of the Librarian of Congress, at Washington.
(P.N. No. 5.)
NAT WOLFE;
OR,
THE GOLD HUNTERS.
CHAPTER I.
THE RESCUE.
"Their black hair, thick and lowering,
Above their wild eyes hung,
And about their frowning foreheads
Like wreaths of night-shade clung.
'The bisons! ho, the bisons!'
They cried and answered back.
The frightened creatures stood aghast
To see them on their track."
With rifle on shoulder and knife in belt, Nat Wolfe rode along
carelessly, for it was midday, and the country was open. That caution
which ten years of uncivilized life had taught him never entirely
slumbered, and he gave a sharp glance ahead, when, upon turning a
low bluff rising out of the plain just here, he descried travelers in
advance of him. A moment assured him that they were a family of
emigrants making their toilsome way to Pike's Peak. He had seen
hundreds of such during the season; had sometimes aided them in
cases of sickness and famine; and had cursed in his heart the folly of
those men who had brought with them their women and children to
share in the hardships of the journey.
The party he now observed was only one of multitudes presenting
the same general features. There was a stout wagon, drawn by three
pairs of lean oxen at a slow and lumbering pace—probably the last
wagon of a train, as it was seldom that a family ventured upon
crossing the plains alone. If so, the train was out of sight along the
track, which here becomes less monotonous, winding among the
bluffs and along the shallow bed of a river, in which, at present, no
water was visible. The driver had attempted to lessen the difficult
task of his team while ascending a long swell of ground, the heavy
wheels of the wagon cutting deep in the sand, by dislodging the two
women and three children from their seats in the conveyance. The
sun was hot, the air languid, and there were no cool shadows of
trees to break the heat and glare of the way. The two elder children,
who were boys, ran on with spirit, but a four-year-old girl lagged
behind and cried, while the women toiled on with listless, dragging
steps. As Nat watched them, one of them stooped and took the poor
little child on her back.
"It's too bad!" muttered he, spurring his horse forward.
The whole family looked back anxiously when they heard the clatter
of horse's hoofs, the driver involuntarily reaching for his rifle, as the
route was one of frequent danger and dread.
"Halloo, madam, let me carry your cub for you," called Nat riding up
and lifting the child from the bent back to the neck of his strong
animal.
There was a kindness in his voice which dispelled fear, even that of
the shy little creature in his arm.
"Thank you, sir."
He looked down at the speaker curiously, for her tone and manner
were unexpected. She was a girl, of not more than seventeen,
slender, and with a face too quickly hidden again by the drooping
and uncomely sun-bonnet, for him to realize fully its peculiar and
melancholy beauty.
Nat Wolfe was a hater of Indians and hunter of bison, not a lady's
man; so he rode in advance of the slouched sun-bonnet to the side
of the wagon.
"Another fool!" was his curt, sarcastic greeting.
"I begin to think so myself," answered the emigrant, whose hollow
cheeks and emaciated frame gave force to his disconsolate words. It
was evident he had been sick on the way.
"Pike's Peak, I s'pose?"
"Yes."
"You're late in the season."
"Was down with the fever back to Pipe's Creek; kept us two weeks."
"Where's your company?"
"Just ahead. They're to stop at that little strip of cottonwoods we're
coming to, for dinner. I hope they've found water for the cattle."
"Not a drop. You'll have to press on smartly if you reach water this
evening. The nearest, on this trail, is fifteen miles beyond. I was over
the route yesterday."
"Sho! the teams'll have a tough pull through this sand; they'd be glad
of a drink now."
"What possessed you to bring this little thing along with you,
stranger? It's bad enough for men, let alone wives and babies."
"That's so. But fact is, Meranda's got tol'able used to follering me
about. When I fust went out to Indiana I left her to home in York, and
she won't never be left behind sence. She's emigrated to Missouri
with me, and two years ago to eastern Kansas, and now we're a-
marching for the mines."
"Marching for the poor-house," growled Nat. "I'm a 'rolling stone'
myself, but then I ain't a family man, and have a right to do as I
please."
"Well, the fact is, things hain't prospered with us as they seem to
with some people. We've had bad luck."
"And always will, I reckon," again muttered Nat, taking in at a shrewd
glance the whole air of the man.
They had now reached the summit of the bluff, and at its foot, on the
other side, along the edge of the stunted strip of wood which there
freshened the eye, was drawn up the emigrant-train for a brief rest.
The cattle were not unyoked, nor were there any fires kindled. The
men were eating their cold bacon and hard bread, some lounging on
the ground and some in their wagons. Only one woman was visible
among the party of thirty or forty men, besides the two now trudging
along by the last wagon. Nat did not resign the little girl until they
came to the halting-place, when her father came and lifted her down.
"Won't you take a bite with us?" he asked, in return for Nat's civility.
"Obliged to you, stranger; but I've got a bit of dried buffalo in my
pocket, and a biscuit."
Before dismounting and tying his horse to the low branches of a
cottonwood, the hunter rode along the line of wagons to see if he
knew any of the party. He had lived so long in that region that he was
widely known, having a fame of his own which just suited his peculiar
ambition, and which he would not have exchanged for that of
General or Senator. So, although he was acquainted with none of
the faces here, he was recognized by several, who greeted him
heartily, and passed his name from lip to lip. The emigrants could not
but feel braver and in better spirits when they heard that Nat Wolfe
was among them.
As he lounged under a tree, against which he had carefully rested
his rifle, cutting off bits of dried meat with the knife from his belt, he
was surrounded by eager inquiries, asking after the route—with
which they knew him to be familiar—about the water, the feed, the
Indians, the streams, the storms, etc. While he talked, his eyes were
constantly wandering to the little spot of shadow where the young girl
was sitting, patiently feeding the little one, but seeming to eat nothing
herself. She had thrown aside her bonnet to catch a breath of the
light breeze springing up on the plains; her eyes were fixed afar off,
on the heads of bison dotting the vast, monotonous desert, or the
horizon, which ringed it in—except for the care of the child, she
hardly took an interest in the scene more immediately about her.
Whether it was the beauty of her face or its sad patience which
touched him, Nat did not inquire of himself; he only wondered who
she was and what she was doing in such a place. He could trace no
resemblance between her and the thin, sun-burned, care-worn-
looking woman by her side, the mother of the children, but evidently
not of the young girl. They surely could not be sisters, for they were
too unlike.
Neither the fierce sun, nor the fiercer wind of the prairies had spoiled
the rich, dark hue of her skin, a clear olive on brow and temples,
melting into a glow on either cheek. The melancholy eyes were large
and dark, and floating in liquid fire—a fire that, however slumbering
and repressed, seemed made to flash forth laughter and love. Her
hair, instead of being neglected, as her present mode of life would
have excused, or "done up," frontier-fashion, in a rude knot, was
woven in glossy braids, wound tastefully about her head. The faded
calico dress, awkwardly fitted as it was, could not conceal the
rounded outlines of her form, any more than the coarse shoes and
the wearisome journey could deprive her movements of their natural
grace.
"See if he won't take a drink of this cold coffee, Elizabeth; it'll fresh
him up more than whisky," spoke the older woman, pouring out a
draught into a tin-cup, and giving it to the girl, who rose and
approached Nat with the simple offering which testified their
gratitude for the trifling kindness he had done them.
Too young and innocent to feel the full awkwardness of her position,
in the midst of so many rough men, yet with a demeanor of shrinking
modesty, she passed through the crowd surrounding the hunter, and
gave him the cup.
"Thank you, child. It's just what I wanted to top off this salt meat,"
and drinking the beverage, Nat returned the cup to her hand with a
smile which brought the flush to her cheeks.
"Pretty girl that," remarked one, as she retreated quickly.
"Yes," replied Nat, gravely, "and I wish she were where she ought to
be, instead of in such company as this."
"So do we all," said another, warmly. "There's none of us would harm
a hair of her head—and if we did, that uncle of hers would teach us
better manners. He sets more store by her than by his own children,
I do believe."
"Bosh! he hain't got spirit enough to take care of his own women-
folks," added a third.
"So she's his niece?" queried Nat.
As he threw another admiring glance toward the maiden, he met one
as admiring in return. Safe beside her aunt, she was regarding him
shyly, and with something of interest lighting up the apathy of her
expression.
There were not many who could first see Nat Wolfe without being
attracted to give him another look. He had an air of absolute self-
reliance, in which there was not a shadow of bravado; it was the
coolness of often-tested strength and courage; his piercing eyes
read every thing at a glance. Over six feet two in height, he was so
lithe and symmetrical that he did not appear as large as he really
was. His unshorn hair and beard, and his hunter's dress, gave a
roughness to his appearance which was at least both picturesque
and appropriate. Nat Wolfe would not have been himself, without the
long boots drawn over the doeskin pants, the blue shirt, the leather
belt, the brace of revolvers, the knife and the rifle which formed his
daily costume. Perhaps a rifle can not properly be called an article of
costume; but Nat's was to him like his good right arm—eating,
sleeping, on foot or in saddle, it never left his side.
The smile he had given the girl was enough to make her look back at
him kindly; it was a smile which he kept for children and helpless
things, and all the brighter for being rare.
"You'd better be pushing on, men; it's fifteen miles to the first drop of
water; it'll be ten o'clock to-night before your teams can reach it, if
you urge them to do their best."
"I'm thinkin' we had," responded the leader of the train. "Goin' to ride
our way, Wolfe?"
"Well, yes, I'm bound your way, at present. I'd thought to make forty
miles before midnight, but I don't know that it matters. Maybe I'll
keep 'long-side for a while."
The cold provisions were returned to their boxes, the women and
children climbed to their places, the drivers flourished their heavy
whips and shouted and swore at the patient oxen. As usual, Timothy
Wright was the last to get started; and his niece Elizabeth, as she sat
under the tent-like cover of the wagon, looked out forlornly on the
winding array, tired of every thing but of seeing the strange
horseman riding at the head of the company, and wishing he would
stay with them forever.
Yes, forever! that did not seem too long to say, for she was sure the
journey was endless—there was no limit to any thing more—the
earth was like the sky, the desert was illimitable; she should never
get away from that dreary caravan, never see trees or mountains
again; the cattle would never crawl over all that heavy sand, they
would never reach the far-distant Pike's Peak—never see the gold
glittering in heaps all over it—thus the sad thoughts drifted through
her mind as the sand drifted before the afternoon breeze.
Several times in the course of the afternoon, she crept out of the
slow-moving wagon and walked by its side. The prairie was cut up
by deep gullies worn by the spring freshets, and when the great
wheels went jolting down these, it was pleasanter to be out of the
wagon than in it. Although the track was sandy along which they
wound, there was still a scanty covering of short grass struggling up
through the arid soil, and occasional fringes of stunted cottonwood
along the banks of empty streams—mere brush—trees she would
not call them who remembered the magnificent forests of the home
of her youth.
"Blast it! I've broke an axle!" exclaimed Timothy Wright, as the
wheels went down a steep rut with a dangerous jerk, and stuck
there. "The whole lot's gone over safe but me. Of course if there's
trouble, it'll fall to me."
"It's our luck, Tim," said his wife, despondently.
"That's so. Every thing goes against us. Hello! hello there! They don't
hear me, they're so far ahead. You run on, Elizabeth, and holler as
loud as you can. It couldn't be worse than to happen just now," he
continued, in a complaining tone, as he went to work to unstrap the
extra pair of axletrees which each wagon carried in case of just such
accidents.
"It'll put us back so we won't get to camp before midnight. Blast it, it's
just my luck."
In the mean time Elizabeth ran on to attract the attention of the party
and obtain help in repairing the damage. She was fleeter of foot than
the lumbering oxen, and the train was not more than a quarter of a
mile in advance. She expected every moment when some one,
chancing to look back, would comprehend the state of affairs and
stop.
Suddenly she discovered that the train was thrown into confusion. At
first she could perceive no reason, but a sound as of rumbling
thunder drew her attention toward the south. A vast herd of bison
had come into view, rushing up from a valley which had concealed
them, and pouring down impetuously directly across the track of the
train. They had encountered many of these herds during the last few
days, had passed around and even close beside them; but this vast
army had been frightened by some real or suspected danger, and
the electric thrill of terror which flashed through their palpitating
breasts made them blind to the obstacles in front of them. On they
came by thousands, darkening the plain, shaking the earth,
threatening to annihilate cattle, goods and men. To attempt to
oppose their resistless numbers would have been like flinging
feathers in the face of a whirlwind. Forward they swept, near and
nearer, and for a few moments it seemed as if all were lost; the men
did the only thing they could do to save themselves—they fired their
rifles as rapidly as possible in the face of the enemy. The flash of
fire-arms, and perhaps some of the shots taking effect, saved the
train from destruction; the immense horde swerved slightly to one
side, and swept on more madly then ever, just grazing the last one of
the teams, bearing down the wagon and trampling the cattle
underfoot, but only stunning the driver, who was saved by the wagon
falling over him.
And now the path of the bison was toward the unprotected girl,
standing motionless with fright, her eyes fixed upon the mighty sea
of brutal life rushing down upon her, terrible and tumultuous. It was
as well for her to remain riveted by terror as to flee, for flight could be
of no avail—she could never outstrip that long wall darkening down
upon her. She felt, through all the cruel pangs of anticipation, their
hoofs trampling her young life into nothingness.
Then there came flying along in front of that rushing host a horse
and rider. While the horseman had to sweep almost the whole line of
the bison, they were galloping directly forward toward the girl, and it
was a question of fearful interest to the lookers on as to which would
reach her first—or whether he and his animal, as well as the hapless
maiden, would not be overwhelmed.
As for her, she did not see him, or if she did, terror had so paralyzed
her that she did not distinguish him from the multitude. Their hot
breath already blasted her, when she felt herself caught up, and
unable any longer to realize the truth, she gave a wild shriek and
became lost to further consciousness of her situation.
When they saw Nat Wolfe stoop and swing the girl lightly up across
the neck of his horse, the gazing emigrants in the distance gave an
irrepressible shout, and again became breathless and silent,
watching the further progress of events; for the herd had gained on
the steed during the momentary halt, and being doubly freighted, the
noble beast could not now run with his usual swiftness. A passion of
terror had taken possession of him also, as he felt himself
encumbered, and the bisons pressing upon him. He reared and
whirled about madly, threatening to run upon destruction, instead of
away from it. His owner bent and seemed to utter a word in his ear at
which he sprung forward, as if carrying no weight at all straight as an
arrow from the shaft, quite in advance of the bellowing monsters
throwing up the sand in clouds along their way.
Suddenly horse and riders went down into a ravine and were lost to
sight, and the next moment the whole excited herd poured over like
a torrent, and were seen thundering down the empty river-bed and
speeding over the valley. As soon as the bisons had passed, the
men started to ascertain the fate of the two human beings probably
crushed to death in the river-bed. As they reached the edge of the
ravine and looked eagerly over, Nat Wolfe crawled out from the
shelter of the shelving ledge on which they stood, shaking the dirt
and pebbles from his hair and garments.
"Hello," cried he, cheerfully. "All right. Hold on, till I hand up the girl,"
and he lifted her, just struggling back to consciousness, up to the
ready arms held out for her; then, finding a rift which afforded him a
foothold, he swung himself lightly after her.
"Well, I declare for't, Lizzie, you had a narrow escape—you're as
white as a sheet," cried her uncle, reaching the scene just as she
attempted to stand alone. "I don't wonder you're all in a tremble.
Miranda's so scart she hadn't strength to walk. We thought you was
gone for certain—and we didn't know but we was too. Them brutes
came nigh to giving us a brush—we just escaped by the skin of our
teeth. How on earth, stranger, did you manage to get out of the
way?"
"By the merest chance. You see when we went down, my horse
stumbled and fell—but I was too quick for him—I come down on my
feet with the girl under my arms. It occurred to me, quick as a flash,
that our only hope was to press close against the shelter of the bank
and let them go over us. And over us they went in a manner not the
pleasantest. I was afraid the shelving earth above would give way on
us, the gravel and dirt rattled down so furiously. But here we are,
safe and sound, aren't we?"
The light and color sprung to Elizabeth's face, as he turned to her
with a careless laugh; she essayed to say something, to thank him
for saving her, at the risk of his own life, from a terrible death, but her
lips trembled and the words would not come. Nat liked to do brave
deeds better than he liked to be embarrassed by thanks; he turned
quickly from the glowing face, and looked after the distant herd.
"Poor Kit," said he, "I hope he has escaped as well as his master. I'd
hate to lose that horse. He and I are one and inseparable. This isn't
the first danger he's carried me safely out of."
"What do you think has happened to him?"
"Well, he regained his feet before the buffalo came over. I think like
as not he held his own—just as the wise ones do—kept with the
crowd and said nothing."
"It's a chance, then, if you ever see him again."
"Don't you believe it—if he hadn't known more than common folks, I
wouldn't have named him Kit Carson. When he gets out of his
difficulty, he'll make his way back here. I'll stay here all night if he
don't get back before dark."
"And that puts me in mind that I'm like to be kept awhile too," said
Wright. "I was just sending my niece forward for help, when that
stampede of buffaloes took place. I've broke an axle."
"Let's set to work and repair damages then, if we don't want the
cattle to go thirsty to-night. By the time we're ready for a start, I hope
your horse will stray along, Wolfe."
"If he don't you needn't mind me. We'll overtake you soon enough if
he does get back. And if he don't, I've spent many a night in worse
places than this."
"P'raps part of us better go on," suggested one of the emigrants. "We
can choose the camp, build the fire, and be getting things
comfortable for the rest. It's like we'll kill a buffalo, and have a j'int
roasted by the time you come up."
"I'd advise you not to part your forces," said Nat, quietly. "There's
Indians about, and they're not particularly friendly. But don't be
frightened, child," he added, as he saw Elizabeth grow pale again. "I
don't think they'll venture upon any thing worse than begging.
They're a set of thieves and beggars."
"If there's any thing in the world I mortally dread, it's Indians," she
answered, in a low voice.
"These Indians are not the kind you read about—fierce warriors
hanging to their horses' sides and hurling their poisoned arrows—
they're a sneaking and dirty set of rascals who'd murder you if they
dared. But they won't dare. They're afraid of Uncle Sam—and your
party is too large and too well armed."
The men hastened away to see about the broken axle, while the
young girl lingered a moment, looking at Nat wistfully.
"But you," said she, "will not you be afraid to stay here alone all
night, waiting for your horse?"
"Afraid?"
A curious smile flashed over the hunter's face as he echoed the
word; she read its meaning, blushed, and continued:
"Ah! I know you are afraid of nothing. Yet harm might happen to you;
and I should not like you to suffer from an accident which comes
upon you by saving my life."
"Don't think of it then. I live out-of-doors. I've slept a hundred nights
on the open prairie as many miles from any white man. Good-by,
little girl. I'm off after them buffaloes. I'll have the satisfaction of killing
two or three of them in return for the fright they gave you; and I may
find my horse quicker by following 'em up. Tell your people I've
concluded to go after 'em. If I have good luck, I'll reach your camp
yet to-night." So saying, Nat Wolfe swung his rifle to his shoulder,
leaped down the bank, and started off with long strides across the
lower plain.
An hour's hurried labor sufficed to repair the damaged wagon and
replace the load; the emigrant train resumed its creeping pace, its
weary company finding something new to think and talk about in the
appearance of the hunter among them and the succeeding
adventure. As it grew dark, they kept a sharp look-out, having
examined their fire-arms and put them in order, the statement of Nat
as to Indians in the vicinity giving them some uneasiness.
A new moon, sinking in the western sky, threw a melancholy light
over the wide desert, enabling the drivers to keep the trail and push
on for the water which they were assured was not far away. The heat
of the day gave place to chilling winds, causing the wife and child of
Timothy Wright to shrink down to the bottom of the wagon and wrap
themselves in blankets. But Elizabeth sat by her uncle's side,
hugging her shawl close about her, and looking out at the moon with
a tired, home-sick face.
"I guess you wish you was back to Missoury," he said, looking
around at her, and speaking as if her looks were a reproach to
himself.
"I don't know, uncle. I didn't like Missouri very well, either."
"It was unlucky, our settling where the fever and ague was the
thickest. I'd a' done well there, if we hadn't been sick so much. And
then Kansas was a poorly country whar' we tried it—the drought just
discouraged me about that. It's mighty onpleasant for a young thing
like you to be jolting along away out to Pike's Peak. But if we once
get there, the worst'll be over; we'll see good times. You shall have a
silk frock this time next year, Lizzie."
"I hope the gold will come as easy as you think, uncle. Those people
whom we met, day before yesterday, coming back from the mines,
didn't tell us much to brighten up our spirits."
"Well, I will say I was rather set back by their story. 'Twon't do any
good to get discouraged now, though: we haven't provisions enough
to carry us back, nor money to buy 'em. We must go ahead and
make the best of it. Some folks may have better luck than others. I
expect we shall just pick up the biggest kind of nuggets."
"You say you're not one of the lucky kind," she answered, smiling
forlornly.
"'It's a long lane that has no turn'—maybe I'm coming to the turn
now. How's the young ones getting along, wife?"
"They're sound asleep, poor things, without supper."
"There's a fire ahead," spoke Elizabeth; "perhaps it's an Indian
camp."
"Nothin' of the kind, Miss," answered a person who had been
standing on the track, waiting for them to come up. "I run ahead and
took a squint, while the teams waited; it's our campin' ground, and
there's another lot of travelers in before us—a train most as large as
our own. They'll be glad of our company, and we'll be glad of theirs.
Hope you don't feel none the wuss from your scare to-day, Miss?"
"Oh no, not a bit the worse, thank you."
"I'd rather them blasted buffaloes had a' run down the hull train, than
to have knocked the breath out of your purty body. I never felt more
like a fool in my life, than I did when I saw the pickle you was in. I
swore and cussed myself awfully for being such a fool as not to be
able to do suthin'. You see I didn't have no hoss, and Nat Wolfe did
—else he wouldn't a' got the start of me."
"I believe you, Joe," replied the young girl, laughing.
"I was so mad about it I wouldn't come forward when I hearn you
were safe. I never was so put to my stumps before that I couldn't do
suthin'. But ye see I'd fired both barrels of my gun and the hull load
of my revolver to turn them pesky critters from the train, and when I
see'd 'em making tracks for you, I was jest used up."
"It's all right now, Joe."
"Yis, but it goes agin' the grit to think it was Nat Wolfe done it instid
of me. Ain't I the guide and purtector of the train? and it don't
become me to be letting strangers save the women-folks from
destruction. He did it in fust rate style, though; I'll say that much for
him. As long as Buckskin Joe couldn't have a hand in the fight, I'd
ruther it would be Nat Wolfe than anybody else."
"Do you know him?" asked Mr. Wright.
"Wal, I never sot eyes on him till to-day; but I knew him the minit he
rode up alongside. All us trappers and guides knows him, leastwise
by hearsay. I'd often hearn tell of that cut over his eye, and the queer
color of his ha'r. The Injuns call him Golden Arrow, both bekase his
hair is so yellow and bekase he's as swift and sure as a dart. They're
'so 'fraid of Golden Arrow they cl'ar out whenever they hear he's
about. I knew him by his hight, too. He's sent more buffaloes and
red-skins to their furren huntin'-grounds than any other ten men on
the plains. He fust sends an Injun to the spirit-land, and then, for fear
the dead rascal won't have nuthin' to do in the new country, he sends
a score of buffaloes after him to keep him in game. Years ago, when
this country wasn't quite so thickly settled as it is now and every
white man that tried to lay out a trail over the mountains had to fight
them devils, inch by inch, Nat Wolfe took a lastin' hate to the
sarpints, and he hain't got over it yet. He's a young-looking man now
—twenty year younger'n me—but he's been in sarvice as long as I. I
hope that train on ahead of us has got some fresh meat to spare, for
I ain't bagged a buffalo to-day, we've been in such a hurry. I promise
you a nice bit of antelope for your supper to-morrow, Miss."
The speaker was a small, wiry person, dressed in leather leggins
and woolen hunting-frock, whose profession had been that of a
guide for years; but the trail across the country being now so well
defined and defended as to render his services rather
supererogatory, he occasionally joined an emigrant train for the love
of it, when not off with exploring parties. He was on his way to Pike's
Peak with an idea of his own; his former experience led him to
believe that he could make discoveries for himself in a certain part of
the mountains as yet almost unvisited. Whatever the fond name
some proud mother may have bestowed upon him in the far-off days
of his babyhood, to whatever frontier family he may have belonged,
and to whose patronymic he would have done honor, all other titles
were obliterated in that of Buckskin Joe. Perhaps fifty years of age,
with iron-gray hair, sharp, weather-beaten features, as tough as he
was small, supple, quick, enduring as iron, and ready for all
emergencies, he had won considerable reputation as a guide, and
was a valuable acquisition to our western bound party.
He had taken a great fancy to the beautiful, modest young girl whose
face lighted up the rough company like a flower in a desert; and he
could not recover from the mortification of having, for once, been
caught in a situation where his wit was of no avail, and obliged to
see another achieve a rescue which he was powerless to attempt.
As he trotted along beside the wagon, he presently broke out again:
"It's all-fired mean to think I made sich a fool of myself. I've a mind to
take it up and fight it out with Wolfe; he'd no business to come

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A Practical Guide to Clinical

Supervision in Genetic Counseling

Foundations of perinatal genetic counseling : a guide

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Practical Guide to Clinical Data Management 3rd Edition

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A Practical Guide to Geriatric Neuropsychology Susan

1. Genetic Counseling Research: A Practical Guide

Patricia McCarthy Veach

Published in the United States of America by Oxford University Press

© Oxford University Press 2023

All rights reserved. No part of this publication may be reproduced, stored in

You must not circulate this work in any other form

Library of Congress Cataloging-in-Publication Data

Printed by Marquis, Canada

1. Introduction to Supervision Theory and Practice | 1

Activity 1.5 REM-​S Goals | 24

Supervision Information Statements and Agreements | 66

Closing Thoughts | 114

Activity 5.3 Experiential Evolutionary Scaffolding | 154

7. Giving and Receiving Feedback | 179

8. Evaluation in Supervision | 205

Set the Stage with Directed Self-​Reflection Protocols | 231

Debrief with Interpersonal Process Recall Methods | 265

Activity 11.1 Addressing Student Questions About Ethical

13. Recognizing and Addressing Student Problematic

Strategies to Manage Countertransference | 341

Remote Supervision | 369

Appendix: Instructional Tips for Building Supervision

Genetic counseling supervision is central to student profes-

general suggestions to facilitate the learning experiences of current

Carrie Atzinger, MS, CGC, LGC, is an associate professor and co-​

of the Academy of Distinguished Teachers at the University

Carrie Atzinger, MS, CGC

Introduction to Supervision Theory

• Define supervision and its functions.

What Is Clinical Supervision?

Clinical supervision is the lynchpin of student preparation in

[Supervision is] a highly significant activity of mentoring,

Clinical supervision is an intervention provided by a more senior

Clinical supervision is an essential component of genetic

Clinical supervision serves to teach, through reflective practice,

These descriptions characterize clinical supervision functions and

• a means of transmitting skills, knowledge, and attitudes of a

Who Does Supervision Serve?

Supervision serves several constituents (McCarthy Veach &

A colleague of mine has said, “Genetic counseling is easy, it’s

Scenario: The supervisor and student agreed the student

In this example, the supervisor acknowledges the student’s disap-

how to do things differently, and suggest a practice opportunity.

Reciprocal Engagement Model

If I have a [model], I will have a method. I will know what to look

A model of supervision practice provides a conceptual frame-

REM: Genetic Counseling Process REM-S: Genetic Counseling Supervision Process

Education Individual Attributes Education Individual Attributes

Activity 1.5 REM-S Goals | 24

Set the Stage with Directed Self-Reflection Protocols | 231

Carrie Atzinger, MS, CGC, LGC, is an associate professor and co-

Comparison of the Reciprocal-Engagement Model of genetic counseling

“form follows function,” the REM-S is interconnected with and com-

REM-S Tenets and Goals

REM-S Supervisor Strategies

Source: Suguitan, M. D., Redlinger-Grosse, K., McCarthy Veach, P., &

REM-S Tenets Strategy Domain Specific Strategy Example

Goal 1: Practice self-reflection Give feedback based on

Practice self- Gauge student

REM-S Tenets Strategy Domain Specific Strategy Example

Goal 2: Good Establish good Facilitate bi-directional

REM-S Tenets Strategy Domain Specific Strategy Example

Goal Establish student Establish pre-session

Practice self- Use self-awareness of

REM-S Tenets Strategy Domain Specific Strategy Example

Facilitate patient care Intervene in student-

Goal Establish student Establish patient follow-

Practice self-reflection Draw insights from

Goal Practice self- Use self-reflection about

REM-S Tenets Strategy Domain Specific Strategy Example

Goal 2: Tailor Practice self- Reference personal

Facilitate patient care Intervene in student-led

REM-S Tenets Strategy Domain Specific Strategy Example

Both the REM-S (Wherley et al., 2015) and Eubanks Higgins

Activity 1.1 Supervisor Self-Assessment