The practice of clinical supervision is common across most allied health professions, both in academic and practice settings (Bernard & Goodyear, 2019). While clinical supervision uses various similar techniques, it is a distinct intervention separate from the role of educator, administrative supervisor, counselor, or service provider. Clinical supervision, by definition, is provided by a more senior member of a profession to a more junior colleague in the same profession. According to Bernard and Goodyear (2019), supervisors evaluate the supervisee’s clinical work, monitor the quality of services, and serve as a gatekeeper for the profession. In an academic setting, clinical supervisors assist in skill development to bridge coursework and practice while providing the opportunity for supervisees to learn about themselves and their behaviors that affect their clinical work. With the definition of supervision in mind and the idea of the supervisor as a gatekeeper, supervisors are seen as responsible for the supervisee, the client the supervisee serves, the agency/educational program in which they work, and even the community at large. Serving as a gatekeeper to the profession, the supervisor protects the community by ensuring that supervisees are competent, ethical individuals capable of providing appropriate services. Along with protecting public health, modeling appropriate ethical behavior, and increasing the number of counseling professionals, supervisors focusing on social justice are tasked with advocating for community members.
The scope of clinical supervision is greater than what can be addressed in this article; for the purpose of this discussion, we will focus on the dynamics within the clinical supervision triad. Clinical supervision is often viewed from the triadic perspective, focusing on the relationships between the supervisor, the supervisee, and the client being served. As an intervention, supervision is hierarchical, with the supervisor having the most power in the triadic relationship and the client being the least powerful. The supervision research addresses various issues connected to the clinical supervision triad, including a need for shared goals and expectations or a strong working alliance between the supervisee and the supervisor. The research, however, also touches on individual differences and how a supervisee/counselor may have additional knowledge or personal experiences with an individual difference (e.g., disability) compared to the supervisor. From a multicultural counseling lens, Constantine (2003) addressed the instance where the counselor and the client share a similar background that is not shared by the supervisor, and how that might affect counseling services. Constantine also addressed issues that evolve in the supervision triad when there is a difference in both competency levels and perceived cultural power between the supervisor, the supervisee, and the client. While the Constantine article does not specifically address disability when discussing individual differences, the factors addressed are important in reviewing ways in which to infuse disability into clinical supervision when it comes to issues of competency, shared cultural differences, and perceived power. We will extend the concepts presented by Constantine (2003) in an examination of clinical supervision dynamics from the perspective of each member of the triad—the supervisor, supervisee, and the client—and relevant factors when at least one member experiences disability.
Author Positionality
The authors maintain a professional identity as counselors and counselor educators, all maintaining a Certified Rehabilitation Counselor (CRC) credential. Our team represents multiple social identities, including disabled scholars. Collectively, we have decades of experience as practitioners, supervisors, educators, and researchers. As an author team, we hold the position that disability represents an identity worth choosing and celebrating, and that addressing interpersonal and systemic barriers to access is a critical part of equity. As such, we dedicate significant time in this piece to shedding light on experiences of disabled supervisors, supervisees, and clients to start a conversation on making counseling more accessible- both to pursue as a career as well as access as a client. We intentionally use both identity-first and person-first language in this article to honor disabled people who may prefer one or the other. Finally, we submit these ideas as our own, and not as a way to speak for others or the disability community broadly.
Infusing Disability into Clinical Supervision: A Three-Pronged Anti-Ableist Approach
A discussion on infusing disability into clinical supervision starts with a common understanding of disability and a discussion of the framework used in this article. Disability, as an area of diversity, is a common human experience that cuts across all populations, regardless of gender, race, ethnicity, socioeconomic status, or other identity categories. Although commonly cited statistics estimate 15-20% of people worldwide have a disability (Centers for Disease Control, 2024; World Health Organization, 2023), the actual figure is likely much higher, given that individuals may not report their disabilities or may not perceive their conditions as disabilities. Despite the prevalence of disability, counselor education programs have historically overlooked disability-related content, either omitting it from the curriculum entirely or treating it as a secondary topic within broader diversity discussions (Deroche et al., 2020; Pierce, 2024; Smart, 2016).
Recent changes in the Council for Accreditation of Counseling and Related Educational Programs (CACREP) accreditation standards have prompted greater emphasis on infusing disability into counseling curricula. This shift calls for a model similar to comprehensive diversity education (Donnell et al., 2009); disability must be meaningfully integrated across all courses to ensure students fully understand the systemic barriers faced by disabled individuals in counseling and society. This article addresses the infusion of disability into clinical supervision and training, framed through an anti-oppression and anti-ableist lens. We advance a three-pronged approach that emphasizes the importance of centering disability when the client is disabled, the supervisee is disabled, and the supervisor is disabled. This model provides a comprehensive and practical framework for dismantling ableism within clinical training settings and fostering an inclusive, equity-driven supervisory environment.
Framing Disability Within an Anti-Ableist, Anti-Oppression Approach
Drawing on anti-oppression frameworks, this article adopts an anti-ableist stance as an active commitment to opposing and challenging ableism. Ableism is a pervasive system of discrimination and exclusion that oppresses individuals with mental, emotional, sensory, and physical disabilities (Rauscher & McClintock, 1996). It presupposes that non-disabled individuals represent the societal norm and marginalizes those who deviate from that standard (Robertson, 2020). Ableism manifests in counseling education in both overt and subtle ways: a professor refusing to provide accessible textbooks for visually impaired students, a clinical site denying placement opportunities to a student who uses a wheelchair, or colleagues maintaining outdated, deficit-based assumptions about disability. Importantly, ableism can also be internalized by individuals with disabilities, perpetuating negative attitudes absorbed before acquiring a disability.
In the context of counselor education, anti-oppression work demands that educators and supervisors critically examine how ableism—and other intersecting systems of privilege and oppression—shape client experiences, therapeutic processes, and training environments (Baines, 2011; Carey et al., 2023; Goodman et al., 2014). Anti-ableism reorients disability away from a purely medical model, emphasizing instead the societal and structural barriers that inhibit full participation and affirming diverse ways of being and knowing. Anti-oppressive approaches target the identification and neutralization of power dynamics, systemic oppression, and marginalization. Lack of awareness of interpersonal and intrapersonal dynamics inherent in marginalized identity status and layers of privilege has the potential to substantially hinder supervisory relationships (Levine et al., 2021).
Applying a Three-Pronged Approach to Clinical Supervision
To create an anti-oppressive and anti-ableist clinical supervision environment, it is critical to recognize that disability may be present in any participant within the supervisory triad: the client, the supervisee, or the supervisor. Our three-pronged approach ensures that disability is meaningfully considered across all supervisory relationships.
When the Client is Disabled
Supervisors must ensure supervisees are equipped to provide culturally responsive, disability-affirming services. This includes challenging internalized ableism, recognizing disability as a valid aspect of diversity, dismantling deficit-based frameworks, and understanding the social and systemic barriers faced by disabled clients. The work of preparing counselors (supervisees) to provide culturally responsive and disability-affirming services must start well before clinical skills classes, where counselors-in-training (CITs) learn how to develop relationships with future clients, effectively communicate with them, identify and eliminate barriers, and implement strategies for adapting and accommodating within the counseling process to honor clients’ culture, context, abilities, and preferences (CACREP, 2024). At a minimum, supervisees should be exposed to disability culture, recognize disability as an identity, and have considered and be able to articulate their own experiences with and beliefs about disability and ableism, including dynamics of power and privilege (Rivas, 2020). Unfortunately, previous research exposes disability information, disability-related discrimination as a form of oppression, ableism, and competence as a significant training gap in counselor education (Emir-Öksüz et al., 2024; Feather & Carlson, 2019; Rivas, 2020; Rivas & Hill, 2018).
Consistent with observations that coverage of disability in counseling curricula is limited and lacks inclusion in social justice aspects of training, it is common within counselor training to promote a medicalized and deficit-based conceptualization of disability, constraining how counselor trainees view disabled people (Olkin, 2002; Rivas & Hill, 2018). As a result, counselors may lead with the assumption that disabled people come to counseling because of their disability and problematize or overfocus on the role of disability in a client’s life without listening to the individual, their identities, and their needs and wants in the counseling process. This is evidenced in a historical study conducted by Kemp and Mallinckrodt (1996), where 36 therapists and 11 graduate students were asked to complete a case conceptualization task for one of two videotaped intake sessions of a client. The client videotapes provided identical presenting concerns, with the only difference being that one client was using a wheelchair while the other did not present with a disability. The study found that treatment themes and priorities were different for the client with the disability, focusing more on the disability than the presenting issue. Therapists who had training in working with individuals with disabilities were more likely, however, to focus on the presenting concerns rather than the disability.
Supervisees who lack appreciation for the ways that ableism influences our culture and systems may dismiss clients’ experiences and distress caused by disability-related discrimination, marginalization, and ableism and fail to see if and how their views are problematic and perpetuating harm to clients (Chapin et al., 2018; Rivas, 2020; Rivas & Hill, 2018). Counselors may lack awareness of ways their counseling spaces or communications styles may be inaccessible and need support in developing skills to modify sessions and incorporate alternative forms of communication as needed (e.g., adjusting interviewing styles, interpreters or augmentative communication devices, pacing of questions, length of sessions, ensuring an accessible space). Considering the accessibility of community resources shared with clients is also a must for supervisees, coupled with a need to learn about additional resources that provide specific disability-related supports (e.g, assistive technology, educational or vocational supports, disabled affinity spaces) to add to their repertoire (Chapin et al., 2018). An effective supervisor may need to employ multiple “hats” to teach specific information or techniques, give feedback on how supervisees show up in spaces and where ableism may be influencing their responses to clients, and provide support to supervisees as they learn (Bernard & Goodyear, 2019).
When the Supervisee is Disabled
Supervisors must foster an accessible and supportive supervisory environment. This involves proactive accommodations, affirming the strengths and unique insights of disabled counselors-in-training, addressing implicit biases, and advocating for equitable treatment within clinical sites and academic settings. Disabled supervisees have had to learn to navigate ableist educational systems and structures, including institutions of higher education and counselor education programs themselves (Roundtree, 2024). Please consider reading the student piece in this special issue for a better understanding of disabled student experiences (Roundtree & Andree, 2026). Given the nature of disability (in)visibility, a supervisor cannot assume they know whether a supervisee is disabled or not, nor can they assume anything about disability identity unless the topic is broached and the supervisee chooses to share their identities. Since disability intersects with other identities (e.g., culture, race, gender), supervisors can include it in their broaching conversations with supervisees to acknowledge the relevance of cultural identities and invite dialogue with supervisees (Jones et al., 2019). Clinical supervision literature suggests that supervisors are key to ensuring these conversations about cultural differences are addressed appropriately (Bernard & Goodyear, 2019). As part of this dialogue, supervisors have an opportunity to support supervisees in recognizing the strength and value of their lived experiences as it relates to effective counseling and explore supervisee preferences for finding additional mentors (perhaps) who share a disabled counselor identity.
Best practice for supervisors is to ask all supervisees if they require accommodations, whether or not a disability was disclosed. This practice removes the stigma of disability disclosure, shifts the burden from the supervisee with a disability, and creates an inclusive environment for those supervisees with hidden disabilities. (Andrews et al., 2013; Bernard & Goodyear, 2019; Olkin, 2009). Accommodation requests, for some students, are stressful experiences due to negative interactions and disability stigma experienced in academia. Disabled students report that faculty have denied accommodations and/or microaggressed against students following a request. For example, faculty suggested that students who need accommodations are taking advantage, asked invasive questions, or questioned their competence after learning of a request (Fleming et al., 2017; Herbert et al., 2020). Faculty can signal to students that they understand accommodations are a necessary aspect of equity by offering to work through accommodation requests, reaching out for assistance, and advocating for a supervisee if needed.
It is vital for supervisors and counseling agencies to understand that access is protected by laws and is not optional or a “favor” for a supervisee. For example, some counseling clinics use digital recording and case management systems that may or may not be compatible with screen magnifiers, screen readers, or voice-to-text software, which are common assistive technologies. Clinics may need to purchase software to allow supervisees access to necessary programs, which, if delayed, can cause lost work or training time. Spaces may also be structurally inaccessible, requiring modifications or solutions to bathrooms and other shared spaces supervisees need to use throughout a workday.
Finally, supervisors working with disabled supervisees must be ready to reflect on their own conceptions of disability and possible biases resulting from their own training in disability (likely from a medical model perspective; Roundtree, 2024) and lived experiences. Particularly when working with supervisees who are counselors-in-training at accredited counselor education programs, the concept of evaluating students for their professional dispositions becomes a critical aspect of counselor development and relates to the gatekeeping responsibilities of faculty and supervisors. The role of evaluating students and gatekeeping to the profession, when necessary, remains incredibly important to maintain high-quality counseling services available in community settings. However, the subjective nature of professional dispositions, as discussed by Levine et al. (2021), poses distinct challenges in practice. Particularly, supervisors risk perpetuating harm when they fail to recognize the role of systemic oppression and marginalization experienced by disabled people, intertwined with racism, sexism, and other “isms.” When supervisors are not aware of the interpersonal and intrapersonal dynamics inherent in marginalized identity status and their own layers of privilege, the supervisory relationship will be hindered (Levine et al., 2021).
A supervisor who has not reflected on their own lived experiences may send intentional or unintentional messages in their responses to supervisees during supervision sessions and their ratings of supervisee skills and dispositions. For example, labeling a supervisee who self-advocates by following up on an unaddressed accommodation request as “difficult,” or using disclosed disability status as a reason to question fitness to practice, reflects on how normed expectations of professionalism (i.e., eye contact or “sitting still”) require masking or create discomfort. The supervisor is then using these normed expectations, rather than data reflecting symptom decreases or client satisfaction. A climate where disability is seen from a deficit orientation creates the potential for a supervisee needing accommodations to not open up about their needs for fear of their supervisor’s judgment or questioning their competence, leading to breaches in the supervision relationship or working alliance (Roundtree, 2024).
Literature addressing disability and clinical supervision suggests that when the supervisee is disabled, there is a need for the supervisor to be a strong advocate for the supervisee’s supervision (Andrews et al., 2013; Olkin, 2009). As mentioned, this requires knowledge of disability identity, disability culture, personal biases, accommodation needs, and a willingness to both learn and teach others on best practices.
When the Supervisor is Disabled
Disabled supervisors offer invaluable expertise, mentorship, and representation. Supervisory relationships should recognize and honor the lived experiences of disabled supervisors while maintaining a strong anti-ableist, anti-oppression foundation that respects power dynamics and promotes mutual respect and equity. As discussed throughout this article, supervision is a hierarchical relationship with the supervisor holding the most power, based on their role. With a disabled supervisor, the power dynamic may be disrupted by the supervisee who sees disability as less than. Ryde (2000) points out that within supervision, there are three types of power: (a) personal power, drawn from personal characteristics; (b) positional power, based on the role as a supervisor; and (c) sociocultural power, based on historical-cultural relationships. Sociocultural power could help to examine how disability might factor into the supervision relationship. Referencing research on multicultural and social justice cultural competencies (MSJCC) and drawing on intersectionality research, Ratts and colleagues (2016) developed quadrants to illustrate the various ways in which power, privilege, and oppression might come into play. Although the MSJCC is developed for counseling, authors such as Fickling et al. (2019) and Mitchell and Butler (2021) addressed ways in which to formulate supervision models around the tenets of MSJCC. Supervision relations, like counseling relationships, may be affected by social and cultural power dynamics such as the supervisor’s and supervisee’s privileged and marginalized status. The marginalized supervisor (disabled) with the privileged supervisee (non-disabled) relationship recognizes that while the supervisor holds power based on their role, the supervisee may see themselves as having social power and privilege.
Disabled supervisors have also had to navigate ableist academic and professional settings, including relationships with supervisees. Supervisors are responsible for evaluating supervisee counseling, providing developmental support and training to build clinical skills and insight, and gatekeeping when necessary to protect the integrity of clinical services (Falender & Shafranske, 2004). Disabled faculty are significantly underrepresented in institutes of higher education at all levels (Friedensen et al., 2021) and are likely similarly underrepresented in supervisory roles in clinical and community counseling settings. Discourse surrounding disabled faculty and professional experiences is limited. What little is available is replete with narratives of discrimination, marginalization, and social exclusion (Friedensen et al., 2021; Lindsay & Fuentes, 2022). For a supervisor, ableism may be experienced structurally through their employment situation, as well as relationally, through microaggressions, discrimination, and even bullying and harassment coming from peers as well as supervisees. The literature regarding experiences of disabled faculty and staff in higher education suggests these experiences impacted willingness to disclose disability status and stunted career progressions, all of which can result in psychological harm (Lindsay & Fuentes, 2022).
Disabled supervisors’ lived experience positions them well to mentor more novice professionals, with or without disabilities. They likely have made decisions about disclosure and have established practices regarding broaching disability identity, along with their other identities, with disabled and non-disabled supervisees. They may be more aware of ways in which environments can be proactively designed for access and methods for implementing accommodations. Supervisees (disabled or non-disabled) may or may not have had previous experiences with a disabled supervisor and, if not prepared to discuss disability identity as part of the broaching and relationship-building process, may struggle to have these conversations. If a supervisee harbors ableist assumptions and sees disabled people as having less social power, they may dismiss or minimize the qualifications and expertise of their supervisor and fail to capitalize on the opportunity to learn during this important training experience. This impact on the perceived competence and power of the disabled supervisor may extend to the systems in which both the supervisee and supervisor are operating.
To support supervisor and supervisee awareness of ableism and self-reflection of biases, see the strategies proposed in the lead article of this issue (Saia et al., 2026). By explicitly integrating disability considerations into all supervisory pairings, this model moves beyond token inclusion and fosters truly equitable and accessible fieldwork experiences for all participants.
Practical Strategies for Implementation
Building from this three-pronged foundation, we offer strategies for the infusion of disability awareness and anti-ableism into clinical supervision and counselor education.
Design of Supervision Structures
Embed disability-related discussions into supervision contracts, evaluation rubrics, and feedback processes. Adopt a regular practice of meeting with new supervisees to discuss potential barriers to accessing counseling spaces, usability of software and other clinical tools, and individual goals for clinical development. Normalize multi-modal supervision options to increase accessibility and accessible tools for supervision tasks (e.g., tape review and closed captioning are frequent challenges). If accessibility issues are identified, bring suggestions to the software company or vendor responsible for correction so the barrier can be removed for future users. Determine responsibility for challenges within the field placement experience to prevent disproportionate labor falling on disabled supervisees.
Lecture Content in Clinical Skills Courses
Incorporate disability case examples, address systemic barriers in counseling interventions, and examine ethical considerations specific to disability in coursework such as pre-practicum and clinical supervision seminars. By examining real-life scenarios involving disability, students will develop a deeper understanding of the diverse needs and experiences of individuals with disabilities. This approach not only enhances their critical thinking and problem-solving skills but also prepares them to be more empathetic and effective practitioners. Furthermore, it fosters an inclusive mindset essential for creating equitable environments in their future workplaces. Overall, integrating disability cases into their education equips students to better advocate for and support individuals facing these challenges.
Practice-Based Placements
Proactively develop partnerships with clinical sites committed to accessibility and anti-ableism, and advocate for accommodations without stigma. Proactively evaluate sites based on accessibility and disability attitudes. This can inform partnerships and guide ongoing advocacy for equitable placements. Professional development sessions on anti-ableist supervision and attitudes can support this and should be led by disabled individuals when possible.
Classroom and Online Discussions
Integrate critical dialogue around disability, anti-ableism, systemic oppression, and clinical practice across all training modalities. Leverage models of disability culture, justice, and identity development to expand students’ understanding of disability from medically oriented to social and cultural. Integrate the Disability Counseling Competencies (Chapin et al., 2018) to directly address disability in counseling strategies. Discuss domains of ableist disability microaggressions (see, Aydemir-Doke, 2024), consider the harm in these interactions, and how to respond if you commit or observe an ableist microaggression.
Self-Reflection, Broaching, and Positionality
Integrate self-reflection of ableism and/or internalized ableism and an evaluation of personal exposure to and meaning attributed to disability into supervision. This reflection allows supervisors and supervisees to identify areas where they may have biases or require additional resources. The approach to this reflection should be both cross-disability and intersectional. Identifying positionality to disability and being able to communicate this identity and broach with a wide variety of cross-disability and even intra-disability populations is essential. Broaching the subject in the supervision relationship might include a discussion with the supervisee on how they feel about working with a disabled supervisor and then handling the conversation in a way to enhance the supervision relationship.
Summary
As mentioned, the current CACREP standards call for the infusion of disability in all areas of counseling. Our focus on infusing disability into clinical supervision reviews the competencies needed when any of the participants in the supervision relationship has a disability. Using a three-pronged anti-ableist approach, the article focuses on information that can be used to ensure the client, counselor, or supervisor who is disabled can be empowered within their role. We offer suggestions on how best to ensure accessibility for everyone in the relationship, as well as strategies on how to infuse information on disability into the classroom. While disability is rarely addressed in clinical supervision, practitioners and clinical supervisors can draw on clinical supervision research and their multicultural competency understanding to address issues of disability.
Bernard and Goodyear (2019) posited that all supervision is multicultural supervision. Supervisors and supervisees alike can enhance their skills by recognizing disability as a traditionally marginalized group, examining any personal biases, and developing disability identity competencies. When conceptualizing how disability competence interacts with clinical supervision, the focus is on recognizing intersecting identities and the impact of systems of oppression. To develop such competencies, readers are encouraged to review pivotal articles such as Ratts et al. (2016) on multicultural and social justice counseling. Readers are also encouraged to read multicultural supervision research, reviewing areas specific to power dynamics, broaching cultural differences within the triad relationship, and how the supervision relationship is enhanced through multicultural and anti-oppression supervision practices. Combining disability literature with clinical supervision and multicultural supervision puts the onus on the educator, supervisor, and/or practitioner to identify best practices. This article is therefore meant to provide individuals with a starting point in obtaining information on infusing disability into clinical supervision.