








































Emerging Perspectives 
ep.journalhosting.ucalgary.ca 

Corresponding author: tiffany.beks@ucalgary.ca 

 

The Role of Clinical Supervision in Supervisee Burnout: A Call to Action 

Tiffany Beks & Daniele Doucet 

University of Calgary 

Professional burnout is a well-documented issue in professional psychology and has 
been associated with multiple negative personal, professional, and institutional 
consequences. Interestingly, burnout in the context of psychologists-in-training has 
received very little attention. This article defines burnout in the context of professional 
psychology, outlines the factors leading to burnout, discusses burnout in the context 
of psychologists-in-training, and examines how clinical supervisors can play a 
preventative and/or remedial role in supervisee burnout. The article concludes by 
highlighting the need to integrate education and wellness plans into supervisory 
relationships and settings. 

Keywords: supervisees, burnout, burnout prevention, professional psychology, 
clinical supervision, clinical training 

Beks, T., & Doucet, D. (2020). The role of clinical supervision in supervisee burnout: A call to 
action. Emerging Perspectives, 4(2), 36-50. 

 
Decades of research have strongly suggested that the same qualities that make 

professional psychologists effective–such as empathy and compassion–also place them at risk for 
adverse psychological outcomes such as professional burnout (Lim, Kim, Kim, Yang, & Lee, 
2010). Psychologists-in-training (referred to herein as supervisees) are especially vulnerable to 
burnout given their pressures to manage the multiple demands associated with academia, clinical 
training, and their personal lives (Cieslak, 2016; Thompson, Frick, & Trice-Black, 2011). 
Importantly, the experience of burnout does not only negatively impact supervisee competence, 
morale, satisfaction, and self-concept (Pakenham & Stafford-Brown, 2012) but it may also 
compromise client welfare (Schwartz-Mette, 2009). While the literature in this area has focused 
extensively on the contributing factors and consequences of burnout among practicing 
psychologists and related professions such as licensed counsellors and psychotherapists 
(Thompson, Amatea, & Thompson, 2014), discussions regarding the impact of burnout on 
supervisee development are in their infancy (Pakenham & Stafford-Brown, 2012). Moreover, the 
role of clinical supervisors and, by extension, supervision models in preventing or remediating 
burnout has received only cursory mention in the literature (Cieslak, 2016). Hence, the purpose 
of this article is to explore the relationship between clinical supervision and supervisee burnout. 
This article begins with a brief review of the theory and research underpinning professional 
burnout and its consequences for clinical practice. Next, the potential of clinical supervision to 
serve a preventative and/or remedial role in supervisee burnout is examined. This article 



Beks & Doucet - Emerging Perspectives (2020)  37 

 
 

concludes with a discussion of the relative absence of research on supervision practices designed 
to address supervisee burnout, highlighting the need to integrate education and wellness plans 
into existing supervisory relationships and settings.  

Conceptualization and Prevalence of Burnout 

Burnout was first identified as a stress-related condition among counselling and 
psychotherapy professionals in the 1970s (Maslach & Leiter, 2016). Since this time, burnout has 
come to be defined as an extreme and enduring stress syndrome characterized by mental and 
emotional exhaustion, and in some cases, poor physical health (Volpe et al., 2014). A burgeoning 
body of literature has indicated that licensed psychologists, counsellors, and psychotherapists 
face a multitude of stressors that make them particularly vulnerable to burnout, such as the 
emotionally demanding nature of providing services, excessive administrative tasks and 
paperwork, and increasing organizational pressures to increase efficiency and persons served 
(Rupert, Miller, & Dorociak, 2015; Thompson et al., 2014).  

 While there is no consensus for defining the construct of burnout in professional 
psychology (Cieslak, 2016), a large proportion of the literature has conceptualized burnout more 
generally as an extreme stress syndrome (Volpe et al., 2014). Thompson et al. (2011) 
conceptualized this phenomenon specifically as it relates to graduate students in psychology, 
describing burnout as “a loss of enthusiasm and compassion, difficulty delineating and 
separating personal and professional boundaries” and “struggl[ing] to be assertive, set limits, 
maintain realistic expectations, and not assume personal responsibility for client outcomes” (p. 
156). Given the complexity of burnout illustrated in supervisee descriptions, arriving at a unitary 
conceptualization of this phenomenon has been challenging. For the purpose of constructing a 
meaningful, comprehensive discussion of burnout among supervisees in the clinical realm, this 
article aligns with the current, predominant definition espoused in the literature, which defines 
burnout as a work-related, stress-induced condition characterized by emotional exhaustion, 
cynicism (or depersonalization), and a diminished sense of efficacy or personal accomplishment 
(Maslach, Schaufeli, & Leiter, 2001). 

 Although several conceptualizations of burnout have arisen in the literature (Maslach et 
al., 2001), Maslach’s (1976) framework has been the most generative in terms of empirical 
research. According to this conceptualization, burnout is comprised of three elements: emotional 
exhaustion, depersonalization, and personal achievement (Maslach, 1976; Maslach et al., 2001). 
Emotional exhaustion refers to the feeling of being overwhelmed with emotions and void of 
energy (Maslach & Goldberg, 1998). Depersonalization refers to a negative, unsympathetic, or 
disinterested attitude toward one’s clients (Maslach & Goldberg, 1998). Personal achievement 
involves negative self-evaluation and dissatisfaction regarding one’s personal work and 
productivity (Maslach & Jackson, 1981). In addition, earlier research among healthcare 
professionals found a correlation between self-reported burnout and a range of mental and 
physical health symptoms, including depression, anxiety, sleep problems, memory impairments, 
neck and back pain, and alcohol consumption (Peterson et al., 2008). Beyond Maslach’s (1976) 
conception of burnout, research has demonstrated that physical symptoms such exhaustion and 
pain are strongly associated with supervisee burnout (Kaeding et al., 2017). Collectively, and in 



Beks & Doucet - Emerging Perspectives (2020)  38 

 
 

the context of professional psychology, these elements manifest in a diminished desire to engage 
in clinical work (Thompson et al., 2011). Moreover, the mental and physical symptoms 
associated with burnout may compromise supervisees’ personal and professional development, 
the therapeutic alliance with clients, and ethical and professional judgment in clinical work 
(Cieslak, 2016; Kaeding et al., 2017; Schwartz-Mette, 2009).   

Early research into the prevalence of burnout found that approximately 44% (n = 571) of 
practicing, licensed psychologists in the United States reported symptoms consistent with the 
emotional exhaustion element of burnout (Rupert & Morgan, 2005). In a later study that 
examined overall levels of burnout (i.e., composite levels of emotional exhaustion, 
depersonalization, and personal achievement), Kaeding et al. (2017) found that nearly half 
(49.2%) of a sample of 1,172 clinical and counselling psychology supervisees indicated severe 
levels of burnout, a rate slightly higher but comparable to their licensed counterparts. The 
prevalence of burnout in professional psychology, regardless of career stage, suggests that there 
may be factors inherent to clinical work that increase the risk of burnout. While more research is 
needed to establish the degree of burnout in professional psychology, these early studies suggest 
that licensed psychologists and supervisees may be at risk of burnout. In order to identify 
avenues for intervention, it is first necessary to have a fuller understanding of the factors 
contributing to burnout and their implications for supervisees and clinical practice. 

Factors Contributing to Burnout 

 According to Hardiman and Simmonds (2013), professional burnout may result from a 
combination of individual and environmental factors. Individual factors refer to the influence of 
personality characteristics, beliefs, and attitudes, whereas environmental factors refer to the 
influence of the setting on an individual’s work, its culture, and the inherent demands associated 
with one’s role (Hardiman & Simmonds, 2013). Empirical research offers compelling evidence 
to suggest that both sources influence burnout within the field of professional psychology (Lim 
et al., 2010). 

Individual Factors 

 Meta-analytic research has revealed that individual factors such as gender and age are 
associated with burnout among licensed psychologists (Lim et al., 2010). In an early study, age 
was negatively correlated with self-reported rates of burnout (Ackerley, Burnell, Holder, & 
Kurdek, 1988). More recently, Rupert and Kent (2007) found that those who identify as female 
were found to experience burnout at a higher rate than those who identify as male. While 
demographic factors such as gender and age are important considerations for understanding 
burnout in professional psychology, the majority of research on individual factors has focused on 
psychologists’ coping orientations, perceptions of control, expectations of client change and 
outcomes, and personal schemas pertaining to clinical practice (Ben Zur & Michael, 2007; 
Kaeding et al., 2017; Lee, Lim, Yang, & Lee, 2011).   

Ben Zur and Michael (2007) found that coping orientations play a role in the risk for 
burnout among counsellors and psychotherapists. Using the Burnout Scale (Maslach & Jackson, 
1981) to measure elements of depersonalization, emotional exhaustion, and personal 
achievement, Ben Zur and Michael (2007) found that emotion-focused coping (e.g., denial, 



Beks & Doucet - Emerging Perspectives (2020)  39 

 
 

“venting”) orientations were positively correlated with depersonalization and negatively 
correlated with personal achievement. In contrast, coping orientations characterized by problem-
solving strategies (e.g., planning, positive reframing, obtaining support) were negatively 
correlated with depersonalization and positively correlated with personal achievement (Ben Zur 
& Michael, 2007). While this research did not involve supervisees specifically, the findings 
suggest that coping orientations characterized by problem-solving may serve as a protective 
factor in the specific occupational contexts occupied by professional psychologists. 

Research has also revealed that professional helpers’ (e.g., psychologists, social workers, 
counsellors) level of involvement and perceptions of control with their clients is a strong 
predictor of burnout. According to Lee et al. (2011), over-involvement is a term used to describe 
professional helpers’ tendency to feel responsible for clients, frequently think about clients 
outside of sessions, and/or work harder than the client toward making change. Perceptions of 
control refers to professional helpers’ appraisal of the degree to which they control the activities 
that comprise their workday and when these activities take place (Lee et al., 2011). In a recent 
meta-analysis, Lee et al. (2011) found a strong positive relationship between over-involvement 
and the emotional exhaustion subtype of burnout. Furthermore, results revealed a strong negative 
correlation between perceptions of control and emotional exhaustion, in that low control 
correlated strongly with high emotional exhaustion (Lee et al., 2011). 

An additional body of literature has examined the relationship between idealistic and/or 
unrealistic expectations about the psychotherapy process and supervisee burnout (Pakenham & 
Stafford-Brown, 2012). Specifically, supervisees may exhibit an unrealistic optimism about their 
capacity to generate client change (Skovholt & Rønnestad, 2003). Supervisees who are new to 
clinical practice may also grapple with the realization that the same skillset that yielded mastery 
in their academic coursework does not transfer directly to the complexities of clinical practice 
(Skovholt & Rønnestad, 2003). For instance, Thompson et al. (2011) pointed out that idealistic 
and unrealistic expectations about client progress (e.g., high levels of supervisee effort will 
translate to positive client change; client progress will occur quickly and in a linear fashion) may 
inadvertently reduce personal feelings of self-efficacy and professional competence among 
supervisees. These expectations, ideals, and the potential for subsequent disillusionment, are 
further exacerbated by supervisees’ stress and uncertainty surrounding evaluation of their 
performance (Schwartz-Mette, 2009).  

Several authors have explored the role of supervisees’ schemas and belief patterns in 
increasing the risk for burnout. Kaeding et al. (2017) found that supervisees frequently self-
reported two maladaptive schemas: self-sacrifice (SS) and unrelenting standards (US). SS refers 
to a heightened sensitivity to the suffering of others, coupled with an inclination toward taking 
responsibility for others at the expense of personal health (Kaeding et al., 2017). US refers to the 
internalization of unrealistically high standards in order to eschew criticism from others 
(Kaeding et al., 2017). Interestingly, research has revealed a statistically significant positive 
correlation between the endorsement of SS and US schemas and self-reported burnout among 
supervisees (Kaeding et al., 2017). These findings suggest that supervisees with these schemas 
may be challenged to strike a balance between meeting the needs of their clients and meeting 
their own needs, thereby increasing the risk for emotional exhaustion and limited self-care 
(Kaeding et al., 2017).  



Beks & Doucet - Emerging Perspectives (2020)  40 

 
 

Collectively, this body of research highlights the importance of professional psychologists’ 
coping orientations, perceptions of control, expectations of client change and outcomes, and 
personal schemas pertaining to clinical practice. While it is important to address these individual 
factors as they pertain to supervisee development, it is equally important to understand the 
intersection of these individual factors with the organizational climate within which professional 
psychology and supervisee clinical training is taking place (El-Ghoroury, Galper, Sawaqdeh, & 
Bufka, 2012; Pakenham & Stafford-Brown, 2012). These organizational factors are discussed in 
greater detail in the following section. 

Environmental Factors  

 There are numerous environmental factors associated with burnout that have been 
highlighted in the literature. In general, characteristics such as number of hours worked, volume 
of paperwork, workload, and time pressure are positively correlated with risk for burnout across 
various occupational contexts and settings (Rupert et al., 2015). In research specific to 
professional psychology, factors such as level of control and autonomy over occupational 
demands and activities, complexity and severity of client presentations, emotional demands of 
therapeutic work, and practicing in public sector settings have been associated with burnout 
(Craig & Sprang, 2010; Rupert et al., 2015; Skovholt & Rønnestad, 2003). While a discussion of 
all these factors is beyond the scope of this article, the current section focuses on those factors 
unique to professional psychology that also place supervisees at an increased risk for burnout. 

 One of the foremost features of professional psychology that has been linked to burnout 
is the emotionally demanding nature of clinical work (Skovholt & Rønnestad, 2003). The 
emotionally demanding nature of clinical work may take several forms and the impact on 
professional psychologists may be profound. Exposure to clients’ painful, tragic, or traumatic 
narratives is a common dimension of professional psychology practice that can alter even 
seasoned psychologists’ worldview and understanding of humanity (Cieslak, 2016). Working 
with clients at high risk of harming themselves or others places tremendous demands on 
psychologists, in that they may experience apprehension about their clients’ safety as well as the 
threat of personal, professional, and legal implications associated with this level of risk (Webb, 
2011). Because the inherent demands of clinical work require the supervisee to be open, 
compassionate, and empathic, exposure to emotionally-charged content has the potential to 
“drain a counsellor’s reservoir of resilience” (Thompson et al., 2011, p. 152). The emotionally-
demanding nature of these relationships with clients, coupled with the stage of professional 
development for supervisees, where insecurity, anxiety, and uncertainty about one’s clinical 
skills and judgment is commonly experienced, may intensify conditions for burnout among 
supervisees (Testa & Sangganjanavanich, 2016; Thompson et al., 2011).  

 As noted earlier, supervisees may also be particularly vulnerable to burnout because they 
are often balancing the demands of academic, professional, and personal spheres of life because 
they are concurrently enrolled in graduate studies (Pakenham & Stafford-Brown, 2012). Ongoing 
demands/pressures to balance the expectations of the academic curriculum, accreditation bodies, 
the clinical training site, and their personal lives, can leave little time or space for self-care and 
reflection (Cieslak, 2016; Pakenham & Stafford-Brown, 2012). Graduate students in the field of 
professional psychology are expected to devote considerable time and effort to their work, which 



Beks & Doucet - Emerging Perspectives (2020)  41 

 
 

may become the source of additional stress and pressure (El-Ghoroury et al., 2012). Research 
suggests that graduate students in clinical and counselling streams of psychology report 
numerous stressors, including academic coursework, finances and debt, poor work/school-life 
balance, family issues, marital/relationship problems, and time-consuming research obligations 
(El-Ghoroury et al., 2012). The continuous need to balance these complementary—and at times 
competing—demands, may exceed supervisees’ coping resources and increase their 
susceptibility to burnout (Pakenham & Stafford-Brown, 2012). 

 Organizational climates and professional culture represent an additional factor that may 
contribute to supervisee burnout. Kaedling et al. (2017) maintained that supervisees may find 
themselves in settings that promote high or idealistic standards for client outcomes, which can 
lead to additional stress, evaluative pressure, and feelings of self-doubt. Thompson et al. (2011) 
interviewed supervisees about their experience of clinical supervision related to self-care and 
burnout. Interestingly, supervisees in this study reported that professional cultures that valued 
professional invulnerability and/or viewed being overwhelmed as both a rite of passage and a 
customary experience for entry into the psychology profession promoted supervisee burnout 
(Thompson et al., 2011). According to Kaeding et al. (2017), in these professional climates and 
cultures, supervisees may be reluctant to disclose overwhelming stress and/or distress out of fear 
of being labeled as incompetent or unfit for entry into the profession. In turn, the fear of 
disclosure in these settings limits opportunities for intervening with supervisee burnout. 

 An additional external factor, and of particular focus in this article, is the philosophical 
approach and characteristics of supervision. To date, there is a dearth of empirical literature on 
the role of clinical supervision practices in supervisee burnout. However, one qualitative study 
conducted by Thompson et al. (2011) revealed a considerable gap between faculty supervisors 
and field supervisors’ tendency to discuss and address burnout with supervisees. Specifically, 
supervisees reported that faculty supervisors were more likely to directly address issues such as 
burnout, self-care, personal wellness, time management, and the need to self-assess for these 
issues (Thompson et al., 2011). In contrast, supervisees indicated that field supervisors did not 
directly discuss personal wellness, and in extreme cases, put forth the attitude that burnout, as 
well as sacrificing personal time and family obligations, were unavoidable and necessary costs of 
clinical work (Thompson et al., 2011). This relative gap in supervisor perspectives, and the 
perception of distress in supervisees as a rite of passage into the profession, suggests that 
integrating education and awareness of burnout into supervisory models is warranted.  

Implications of Supervisee Burnout 

It is evident that burnout exerts a significant toll on the health and well-being of 
supervisees (Kaeding et al., 2017). While this is concerning for psychologists who have only just 
entered their careers in professional psychology, what is equally concerning is the impact of 
supervisee burnout on clinical practice and client care (Pakenham & Stafford-Brown, 2012). 
Specifically, when burnout goes unacknowledged and unaddressed, the capacity to conduct 
clinical work competently and ethically is compromised (Pakenham & Stafford-Brown, 2012; 
Thompson et al., 2011). Hence, the following section of this article describes the implications of 
supervisee burnout with respect to client care, professional and ethical practice, and challenges 



Beks & Doucet - Emerging Perspectives (2020)  42 

 
 

with terminology. While the majority of research on this topic was undertaken with licensed and 
practicing psychologists, it can be extrapolated that supervisee burnout would carry similar risks 
in terms of the therapeutic alliance. Notably, this is an area that clearly needs to be more 
explicitly addressed in the supervision literature. 

Client Care Issues 

In the absence of empirical research on supervisees, the current discussion borrows from 
literature on licensed professionals (e.g., psychologists, counsellors, psychotherapists) to provide 
an illustration of the potential effects of burnout on client care. In general, licensed professionals’ 
self-reports have illustrated a relationship between burnout and poor morale (Maslach & Leiter, 
2016). Interestingly, this body of literature has hypothesized that professional burnout also leads 
to diminished empathy, lower quality care, and poor communication with clients, despite the 
absence of research to support such assertions (Everall & Paulson, 2004; Hardiman & 
Simmonds, 2013; Maslach & Leiter, 2016; Smith & Moss, 2009). Smith and Moss (2009) 
pointed out that logistical and ethical issues with examining the experiences of clients in therapy 
have limited the extent to which the relationship between professional burnout and client care 
may be empirically studied. In the absence of actual data, the impact of professional burnout on 
clients and the therapeutic process appears to be more speculative and cautionary rather than 
evidence-based (Smith & Moss, 2009). However, the absence of data should not undermine or 
discredit the concerns espoused by professional Codes of Ethics and opinionated literature 
surrounding the potential hazards of burnout for clinical practice (CPA, 2017a; Schwartz-Mette, 
2009). Furthermore, several authors have postulated that because supervisees are normally at an 
earlier stage in their development than seasoned professionals, the effects of burnout may carry 
even greater risks to clients because supervisees may not have developed competence in 
identifying and repairing ruptures in the therapeutic alliance (Cieslak, 2016). Given that 
responsible caring is central to ethical psychological practice (CPA, 2017a), the potential harms 
associated with supervisee burnout warrants greater attention from field supervisors and the 
discipline of clinical supervision at large. Specifically, more empirical research should be 
devoted to better understand the link between supervisee burnout, therapeutic process, and client 
outcomes. 

Professional and Ethical Issues 

Previously, authors have speculated that burnout among clinical psychology professionals 
may lead to a number of ethical concerns, including professional-client boundary violations, 
harmful multiple relationships, and using treatment to serve the needs of the professional 
(Everall & Paulson, 2004; Schwartz-Mette, 2009). Hence, the potential for burnout to lead to 
professional and ethical violations cannot be overlooked. Ethical violations committed by 
licensed psychologists involve significant consequences, including compulsory rehabilitation, 
treatment, dismissal from professional regulatory bodies, and even criminal charges (Canadian 
Psychological Association [CPA], 2015). However, no studies to date to our awareness have 
revealed a direct relationship between supervisee burnout and ethical violations. Interestingly, 
the majority of the literature on ethical violations stemming from supervisee burnout emanates 
from opinionated literature or speculations (Collins, Falender, & Shafrankse, 2011; Schwartz-



Beks & Doucet - Emerging Perspectives (2020)  43 

 
 

Mette, 2009). This is not to suggest that supervisees experiencing burnout do not commit ethical 
infractions with their clients, but, rather, that empirical evidence as to the nature, course, and 
outcomes of such infractions is largely understudied. Hence, the picture of how supervisee 
burnout contributes to ethical violations remains incomplete and should be the focus of future 
research. As will be discussed in the following section, clinical supervisors are responsible for 
the care delivered to clients by their supervisees and, as such, play a critical role in preventing 
burnout among supervisees. 

Terminology 

 While the relationship between supervisee burnout and ethical violations has been 
described as a form of professional impairment (Schwartz-Mette, 2009), this lexis has sparked 
controversy over its ethical and legal implications (Collins et al., 2011). According to Collins et 
al. (2011), using the term impairment to describe a supervisee who is affected by burnout carries 
long-term implications for the supervisee. Firstly, the term impairment carries the legal 
connotation of disability, and hence may not be an accurate description of the supervisees’ 
professional and occupational status (Collins et al., 2011). Secondly, the term impairment 
connotes potentially irreparable issues that reside within the supervisee as a person (Collins et 
al., 2011). This places supervisors and agencies in a legal and ethical position to provide 
accommodations to the supervisee, whilst simultaneously overlooking the interplay of systemic 
and individual sources of burnout (Collins et al., 2011). Hence, the term impairment may be 
viewed as an intrapsychic issue despite the fact that the plethora of empirical research suggests 
that burnout is largely a product of systemic issues (El-Ghoroury et al., 2012; Pakenham & 
Stafford-Brown, 2012; Rupert et al., 2015; Thompson et al., 2011). Importantly, the vast and 
complex interplay between externally imposed, contextually-based stressors and individual 
factors may be mediated and alleviated with awareness, adequate supervision, and skill 
development (El-Ghoroury et al., 2012; Pakenham & Stafford-Brown, 2012; Rupert et al., 2015; 
Thompson et al., 2011). The historical use of the term impairment reinforces and maintains a 
long-standing intrapsychic tradition in the field of psychology that has the potential to 
pathologize supervisees who are experiencing tremendous and compounding pressures from 
multiple sources that may be beyond their control (Collins et al., 2011). More recently, Collins et 
al. (2011) have recommended replacing the term impairment with problems of professional 
competency (PPC). According to Collins et al. (2011), the nascent term PPC is considered more 
useful than its predecessor because it conceptualizes performance in relation to a professional 
standard while focusing on building competence (as opposed to focusing on impairment). PPC 
suggests that supervisee burnout remains a contentious issue in professional psychology and one 
which warrants attention from future researchers. Despite this shift in language, supervisee 
burnout remains a contentious issue in professional psychology and one that warrants attention 
from future researchers. 

The Role of Clinical Supervision 

 The potential implications of professional burnout on clinical practice provides 
compelling impetus to devise solutions to prevent and alleviate supervisee burnout. However, 
before one concludes that the solution is simply to cultivate supervisees’ individual coping 



Beks & Doucet - Emerging Perspectives (2020)  44 

 
 

strategies and personal resilience, research has emphasized the critical role of clinical 
supervision in preventing and alleviating supervisee burnout (Thompson et al., 2011). As 
stipulated in the Ethical Guidelines for Supervision in Psychology (CPA, 2017b), supervisors are 
not only influential in shaping the development of their supervisee, but they also hold an ethical 
and professional obligation to improve their supervisees’ professional skills, assure the quality of 
services provided to clients, and function as a gatekeeper for entry into the psychology 
profession at large. Moreover, supervisors hold a position of power in the supervisory 
relationship (CPA, 2017b) and may use this privilege to foster resilience and sustainable 
wellness practices in their supervisees (Collins et al., 2011). Finally, supervisors have an ethical 
responsibility to take up “opportunities and resources to continuously improve their ability as 
supervisors” (CPA, 2017b, p. 4), including developing an understanding of the complexity of 
burnout in supervisees and how supervision may alleviate associated risk factors.  

Although beyond the scope of this article, it is important to acknowledge that supervisors 
may also face pressure from systems (e.g., session limits, budget constraints) and administrative 
structures (e.g., policies, position) that counteract their own efforts to prevent burnout and 
maintain wellness. As such, the current section emphasizes the role of clinical supervision in 
preventing and remediating supervisee burnout, while acknowledging that supervision represents 
only a portion of the much larger systemic and cultural shift that is needed to address burnout in 
the broader context of professional psychology. Moreover, this section advances its focus on 
supervision with the understanding that the prevention and remediation of supervisee burnout is 
a responsibility shared by supervisees, supervisors, graduate training programs, and the broader 
profession of psychology (CPA, 2017b; Tyre, Griffin, & Simmons, 2016).  

The Ethical Imperative for the Monitoring of Self and Others 

 The Canadian Code of Ethics for Psychologists Fourth Edition (referred to herein as the 
Code) conveys the principles and values underlying the standards for professional conduct of 
psychologists in Canada (CPA, 2017a). Stated within these guidelines is the ethical imperative 
for all psychologists, including clinical supervisors, to demonstrate a level of awareness and 
reflectivity that enables them to monitor self and others with respect to their ability to deliver 
psychological services competently (CPA, 2017a). Specifically, standard II.11 of the Code calls 
upon psychologists to “seek appropriate help and/or discontinue scientific, teaching, supervision, 
or practice activity for an appropriate period of time, if a physical or psychological condition 
reduces their ability to benefit and not harm others” (CPA, 2017a, p. 20). Furthermore, standard 
II.12 states that psychologists should “engage in self-care activities that help to avoid conditions 
(e.g., burnout, addictions) that could result in impaired judgment and interfere with their ability 
to benefit and not harm others” (CPA, 2017a, p. 20). Although supervisees are not licensed 
psychologists, supervisees are expected to enter clinical training with knowledge of and the 
capacity to practice in adherence with the ethics and principles laid out within the Code. Hence, 
the aforementioned standards II.11 and II.12 reflect ideals that supervisees are expected to enact 
in their clinical training. With respect to the role of clinical supervisors, standards II.43 and II.44 
explicitly state that psychologists should “act to stop or offset the consequences of harmful 
activities carried out by another psychologist or member of another discipline” (CPA, 2017a, p. 



Beks & Doucet - Emerging Perspectives (2020)  45 

 
 

23) even when the harm appears to result from diminished sensitivity, knowledge, or experience. 
In the context of supervisee burnout, these guidelines suggest that the prevention and 
remediation of supervisee burnout is a shared responsibility between supervisee and supervisor 
(CPA, 2017b). Supervisees have an educational and ethical obligation to develop the capacity to 
self-monitor, whereas supervisors have an ethical duty to self-monitor and to intervene in 
situations in which the health and well-being of their supervisee is compromised. However, 
because of higher status and power and the supervisors’ ultimate responsibility for client welfare, 
the supervisor also has greater responsibility to maintain a level of awareness regarding 
supervisee limitations and their potential impact on clientele (CPA, 2017b). Importantly, the 
ethical imperative to intervene translates to a continuum of potential measures, including 
preventative responses in early stages, remedial actions, and gatekeeping (CPA, 2017b). While 
these ethical guidelines present ethical grounds for integrating awareness and remediation of 
burnout into clinical supervision models (CPA, 2017b), research is in its infancy as to precisely 
how clinical supervisors can effectively prevent and manage supervisee burnout. Nevertheless, 
the ethical standards of professional psychology imply that supervisee wellbeing should be a 
central concern addressed by supervisors (Thompson et al., 2011). 

Clinical Supervision and Supervisee Burnout/Wellness 

 Several authors have proposed viable avenues by which burnout among supervisees may 
be prevented or alleviated, including peer support, self-care, and personal counselling or 
psychotherapy (Cieslak, 2016). However, because clinical supervision facilitates the 
multidimensional development of the supervisee, and because burnout is directly related to the 
professional context of the supervisee, clinical supervisors are uniquely positioned to directly 
address supervisee burnout and monitor changes in the professional context. Despite the unique 
position of supervisors, the extant literature on clinical supervision suggests that the topic of 
burnout and wellness is frequently neglected in the supervisory relationship (Blount & Mullen, 
2015; Thompson et al., 2011).  

 As previously mentioned, earlier research suggests that professional burnout results from 
an overcommitment to client outcomes, elusive measures for success, and emotional exhaustion 
(Lee et al., 2011; Skovholt & Rønnestad, 2003). To our knowledge, one study has addressed 
supervisees’ perceptions of supervision practices related to self-care and burnout (Thompson et 
al., 2011). This study revealed that the aforementioned risk factors for burnout were not directly 
addressed by supervisors over the course of supervisee clinical training (Thompson et al., 2011). 
Moreover, supervisees in this study indicated that they believed supervisors can help prevent and 
remediate supervisee burnout by explicitly assessing supervisee expectations and beliefs 
surrounding psychotherapy and client outcomes, promoting supervisees’ development of a 
personal wellness plan, and being present and available for supervisees (Thompson et al., 2011). 
Additionally, supervisees expressed the need for supervisors to model behaviours and attitudes 
that engender self-care and appropriate personal and professional boundaries (Thompson et al., 
2011). Hence, supervisees viewed their supervisors as having the ability to play a preventative 
and remedial role in the degree of burnout they experienced during their training (Thompson et 
al., 2011). However, it is important to acknowledge that these findings are based on only a single 
study and may not be representative of the perceptions of all supervisees. Hence, our current 



Beks & Doucet - Emerging Perspectives (2020)  46 

 
 

understanding is limited as to clinical supervisors’ efforts and methods for intervening with 
supervisee burnout and additional research is required to extend this body of knowledge. 

 To date, empirical research in support of the effectiveness of clinical supervision in 
preventing and remediating supervisee burnout is lacking (Cieslak, 2016; Lenz & Smith, 2010). 
However, the lack of research has not deterred several authors from advancing the critical need 
for supervision to integrate education and training pertaining to supervisee burnout (Lenz & 
Smith, 2010). According to Tyre et al. (2016), advocates in the area of preventing burnout in 
professional psychology recommend integrating the following four pillars into education and 
training programs: a) education around the importance of self-care as a protective factor against 
burnout; b) ongoing self-assessment and reflection to increase awareness of resilience and 
burnout; c) programs and initiatives to cultivate resilience; and d) clinical supervision that 
directly addresses the propensity for burnout through education, coaching, and modeling 
wellness and resiliency. These four pillars illustrate the shared responsibility among supervisees, 
supervisors, graduate training programs, and the psychology profession to prevent supervisee 
burnout and simultaneously promote supervisee professional fitness, wellness, and resilience 
(Tyre et al., 2016). Tyre et al. (2016) emphasized the critical importance of clinical supervision 
as a learning environment by which supervisee-supervisor authenticity, reflection, and self-
awareness may be fostered. Furthermore, clinical supervision represents a climate in which 
unique skills and strength-building opportunities that foster professional fitness and wellness 
emerge for the supervisee (Tyre et al., 2016). Supervisors are in the position to approach the 
topic of burnout with intentionality and use their privileged status to help supervisees explore 
and cultivate a realistic, balanced, and culturally-relevant philosophy with respect to their beliefs, 
attitudes, boundaries, and roles as an emerging counsellor or psychotherapist (Thompson et al., 
2011; Tyre et al., 2016). Importantly, incorporating these dimensions into clinical supervision 
models may foster a level of professional fitness and wellness in supervisees that may be carried 
forward throughout their career (Lenz & Smith, 2010; Tyre et al., 2016). To this end, empirical 
evaluation of the implementation and efficacy of these four pillars is sorely needed to truly 
understand the benefits of strategies for burnout prevention. 

Implications, Conclusions and Recommendations 

 Although limited, the extant literature examined in this article indicates that clinical 
supervision has the potential to play a preventative and/or remedial role in supervisee burnout 
(Lenz & Smith, 2010; Thompson et al., 2011). According to advocates in this area, the primary 
mechanism by which clinical supervision may accomplish this aim is through directly addressing 
supervisees’ beliefs, attitudes, and perspectives that are likely to increase the risk for burnout, 
while simultaneously modeling and fostering appropriate self-care and wellness practices 
(Thompson et al., 2011; Tyre et al., 2016). While these recommendations are both encouraging 
and provoking, the dearth of research on the effectiveness of these practices in the context of 
supervision represents a significant barrier to widespread acknowledgment and integration 
among clinical supervisors (Lenz & Smith, 2010). Research that examines the execution, 
processes, and outcomes of integrating these practices into clinical supervision models is sorely 
needed.  



Beks & Doucet - Emerging Perspectives (2020)  47 

 
 

It is also important that the field of professional psychology, including graduate training 
programs, broadens the conceptualization of wellness beyond an individual and intrapsychic 
view of self-care. This widening stance on the meaning of wellness may include the cultivation 
of healthy and realistic measures of professional success, including beliefs and expectations 
about clinical work, client change, and therapeutic outcomes (Thompson et al., 2011; Tyre et al., 
2016), as well as an understanding that self-care and wellness involves an interaction between an 
individual and their environment, community, culture, and nature (Lenz & Smith, 2010). 
Moreover, education and awareness are needed to bring to light the complex interplay of 
individual and environmental factors that give way to professional burnout, and to dismantle the 
view that burnout is both an issue of professional impairment and an indicator of a lack of fitness 
for entering the field. The alarming prevalence of burnout in the field of professional psychology 
alone should provide sufficient cause to implore academic and professional communities to take 
up sorely needed research, education, and training that address individual factors with 
compassion and ameliorates environmental factors with systemic interventions for change.  

As prominent figures in professional development, training, and gatekeeping, clinical 
supervisors occupy a unique position of power to not only acknowledge the concerning 
prevalence of burnout in our field, but also to embolden a culture that upholds wellness as a 
domain of competency that deserves the same care, attention, and practice that has been 
traditionally afforded to other core competencies underpinning professional psychology. It is 
imperative that clinical supervisors and clinical training sites move beyond cursory awareness of 
the risks associated with supervisee burnout and move toward full recognition of the centrality of 
wellness in professional psychology, not only as a pillar of clinical supervision but also as an 
active stance against the traditions within the field of psychology that contribute to burnout 
among psychology professionals. This article calls upon the field to appreciate that, in order to 
accomplish the latter, wellness must be integrated into supervisory models as a domain of 
professional competence in and of itself (Lenz & Smith, 2010). To this end, future research may 
explore how professional wellness may be represented as a domain of clinical competence, and 
how this explicit emphasis may hold all relevant stakeholders in the field of professional 
psychology accountable to their collective responsibility to prevent burnout and promote 
wellness in those entering the field. It is the position of the authors that a sustainable future of 
ethical and effective psychologists depends on our advancing this critical and timely issue.  

References 

Ackerley, G. D., Burnell, J., Holder, D. C., & Kurdek, L. A. (1988). Burnout among licensed 
psychologists. Professional psychology: Research and Practice, 19(6), 624-631. 
doi:10.1037/0735-7028.19.6.624 

Ben-Zur, H., & Michael, K. (2007). Burnout, social support, and coping at work among social 
workers, psychologists, and nurses: The role of challenge/control appraisals. Social Work 
in Health Care, 45(4), 63-82. doi:10.1300/J010v45n04_04 

Blount, A. J., & Mullen, P. R. (2015). Development of an integrative wellness model: 
Supervising counselors-in-training. The Professional Counselor, 5(1), 100-113. 
doi:10.15241/ajb.5.1.100 



Beks & Doucet - Emerging Perspectives (2020)  48 

 
 

Canadian Psychological Association. (2015). Rules and procedures for dealing with ethical 
complaints. Retrieved from 
https://www.cpa.ca/aboutcpa/committees/ethics/Rulesandproceduresfordealingwithethicalc
omplaints 

Canadian Psychological Association. (2017a). Canadian code of ethics for psychologists (4th ed.). 
 Ottawa, Ontario, Canada: Author.  
Canadian Psychological Association. (2017b). Ethical guidelines for supervision in psychology: 

Teaching, research, practice, and administration. Ottawa, Ontario, Canada: Author. 
Cieslak, D. (2016). Recognizing the propensity for burnout during formative counsellor 

development. Canadian Journal of Counselling & Psychotherapy, 50(3), 193-213. 
Retrieved from https://cjc-rcc.ucalgary.ca/article/view/61103 

Collins, C., Falender, C. A., & Shafranske, E. P. (2011). Commentary on Rebecca Schwartz-
Mette's 2009 article “Challenges in addressing graduate student impairment in academic 
professional psychology programs”. Ethics & Behavior, 21(5), 428-430. 
doi:10.1080/10508422.2011.604547 

Craig, C. D., & Sprang, G. (2010). Compassion satisfaction, compassion fatigue, and burnout in 
a national sample of trauma treatment therapists. Anxiety, Stress, & Coping, 23(3), 319-
339. doi:10.1080/10615800903085818 

El-Ghoroury, N. H., Galper, D. I., Sawaqdeh, A., & Bufka, L. F. (2012). Stress, coping, and 
barriers to wellness among psychology graduate students. Training and Education in 
Professional Psychology, 6(2), 122-134. doi:10.1037/a0028768 

Everall, R., & Paulson, B. (2004). Burnout and secondary traumatic stress: Impact on ethical 
behaviour. Canadian Journal of Counselling and Psychotherapy, 38(1), 25-35. Retrieved 
from https://cjc-rcc.ucalgary.ca/ 

Hardiman, P., & Simmonds, J. G. (2013). Spiritual well-being, burnout and trauma in 
counsellors and psychotherapists. Mental Health, Religion & Culture, 16(10), 1044-1055. 
doi:10.1080/13674676.2012.732560 

Kaeding, A., Sougleris, C., Reid, C., van Vreeswijk, M. F., Hayes, C., Dorrian, J., & Simpson, S. 
(2017). Professional burnout, early maladaptive schemas, and physical health in clinical 
and counselling psychology trainees. Journal of Clinical Psychology, 73(12), 1782-1796. 
doi:10.1002/jclp.22485 

Lee, J., Lim, N., Yang, E., & Lee, S. M. (2011). Antecedents and consequences of three 
dimensions of burnout in psychotherapists: A meta-analysis. Professional Psychology: 
Research and Practice, 42(3), 252-258. doi:10.1037/a0023319 

Lenz, A. S., & Smith, R. L. (2010). Integrating wellness concepts within a clinical supervision 
model. The Clinical Supervisor, 29(2), 228-245. doi:10.1080/07325223.2010.518511 

Lim, N., Kim, E. K., Kim, H., Yang, E., & Lee, S. M. (2010). Individual and work‐related 
factors influencing burnout of mental health professionals: A meta‐analysis. Journal of 
Employment Counseling, 47(2), 86-96. doi:10.1002/j.2161-1920.2010.tb00093.x 

Maslach, C. (1976). Burned-out. Human Behavior, 5(9), 16-22. Retrieved from 
http://www.scirp.org 

Maslach, C., & Goldberg, J. (1998). Prevention of burnout: New perspectives. Applied and 
Preventive Psychology, 7(1), 63-74. doi:10.1016/S0962-1849(98)80022-X 



Beks & Doucet - Emerging Perspectives (2020)  49 

 
 

Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of 
Organizational Behavior, 2(2), 99-113. Retrieved from https://www.jstor.org 

Maslach, C., & Leiter, M. P. (2016). Understanding the burnout experience: Recent research and 
its implications for psychiatry. World Psychiatry, 15(2), 103-111. doi:10.1002/wps.20311 

Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of 
Psychology, 52(1), 397-422. doi:10.1146/annurev.psych.52.1.397 

Pakenham, K. I., & Stafford‐Brown, J. (2012). Stress in clinical psychology trainees: Current 
research status and future directions. Australian Psychologist, 47(3), 147-155. 
doi:10.1111/j.1742-9544.2012.00070.x 

Peterson, U., Demerouti, E., Bergström, G., Samuelsson, M., Åsberg, M., & Nygren, Å. (2008). 
Burnout and physical and mental health among Swedish healthcare workers. Journal of 
Advanced Nursing, 62(1), 84-95. doi:10.1111/j.1365-2648.2007.04580.x 

Rupert, P. A., & Kent, J. S. (2007). Gender and work setting differences in career-sustaining 
behaviors and burnout among professional psychologists. Professional Psychology: 
Research and Practice, 38(1), 88-96. doi:10.1037/0735-7028.38.1.88 

Rupert, P. A., Miller, A. O., & Dorociak, K. E. (2015). Preventing burnout: What does the 
research tell us? Professional Psychology: Research and Practice, 46(3), 168-174. 
doi:10.1037/a0039297 

Rupert, P. A., & Morgan, D. J. (2005). Work setting and burnout among professional 
psychologists. Professional Psychology: Research and Practice, 36(5), 544-550. 
doi:10.1037/0735-7028.36.5.544 

Schwartz-Mette, R. A. (2009). Challenges in addressing graduate student impairment in 
academic professional psychology programs. Ethics & Behavior, 19(2), 91-102. 
doi:10.1080/10508420902768973 

Skovholt, T. M., & Rønnestad, M. H. (2003). Struggles of the novice counselor and 
therapist. Journal of Career Development, 30(1), 45-58. 
doi:10.1177/089484530303000103 

Smith, P. L., & Moss, S. B. (2009). Psychologist impairment: What is it, how can it be 
prevented, and what can be done to address it? Clinical Psychology: Science and 
Practice, 16(1), 1-15. doi:10.1111/j.1468-2850.2009.01137.x 

Testa, D., & Sangganjanavanich, V. F. (2016). Contribution of mindfulness and emotional 
intelligence to burnout among counseling interns. Counselor Education and 
Supervision, 55(2), 95-108. doi:10.1002/ceas.12035 

Thompson, E. H., Frick, M. H., & Trice-Black, S. (2011). Counselor-in-training perceptions of 
supervision practices related to self-care and burnout. Professional Counselor, 1(3), 152-
162. doi:10.15241/eht.1.3.152 

Thompson, I., Amatea, E., & Thompson, E. (2014). Personal and contextual predictors of mental 
health counselors' compassion fatigue and burnout. Journal of Mental Health 
Counseling, 36(1), 58-77. doi:10.17744/mehc.36.1.p61m73373m4617r3 

Tyre, Y., Griffin, M., & Simmons, R. (2016). Building resiliency in counselors in training for 
counselor educators. The Alabama Counseling Association Journal, 41(1), 26-44. 
Retrieved from https://www.alabamacounseling.org/uploads/1/2/3/9/123960750/journal_-
_fall_2016.pdf  



Beks & Doucet - Emerging Perspectives (2020)  50 

 
 

Volpe, U., Luciano, M., Palumbo, C., Sampogna, G., Del Vecchio, V., & Fiorillo, A. (2014). 
Risk of burnout among early career mental health professionals. Journal of Psychiatric and 
Mental Health Nursing, 21(9), 774-781. doi:10.1111/jpm.12137 

Webb, K. B. (2011). Care of others and self: A suicidal patient’s impact on the psychologist. 
Professional Psychology: Research and Practice, 42(3), 215–221. doi:10.1037/a0022752 

 


	Conceptualization and Prevalence of Burnout
	Factors Contributing to Burnout
	Individual Factors
	Environmental Factors

	Implications of Supervisee Burnout
	Client Care Issues
	Professional and Ethical Issues
	Terminology

	The Role of Clinical Supervision
	The Ethical Imperative for the Monitoring of Self and Others
	Clinical Supervision and Supervisee Burnout/Wellness

	Implications, Conclusions and Recommendations
	References

