Examining Supervision Practices and Their Effects on Counsellor Professional Development and Client Outcomes in Nigerian Teaching Hospitals

Clinical supervision is a cornerstone of counsellor professional development in hospital settings, yet supervision practices in Nigerian teaching hospitals and their empirical relationships to counsellor development and client outcomes have not been systematically examined. This study examined supervision practices and their effects on counsellor professional development and client outcomes in Nigerian teaching hospitals. A mixed-methods explanatory sequential design was employed. In Phase 1, survey data were collected from 200 counsellors and counselling psychologists across twelve teaching hospitals in Lagos, Abuja, Kano, Enugu, and Ibadan. The Supervision Practices Inventory, the Counsellor Professional Development Scale, and the Client Outcome Satisfaction Index were administered. In Phase 2, follow-up case study interviews were conducted with 30 counsellors selected to represent diverse outcome profiles. Multilevel regression, structural equation modelling, and thematic analysis were used. Findings revealed that supervision frequency, supervisor competence, and the use of developmental supervision models were the strongest predictors of counsellor professional development. Counsellor professional development partially mediated the relationship between supervision quality and client outcomes. Most teaching hospitals lacked standardised supervision frameworks, with practices varying widely based on individual supervisors' preferences. The study contributes an original supervision-development-outcomes model for Nigerian hospital counselling and provides a framework for supervision policy development in Nigerian health institutions. Keywords: clinical supervision, counsellor professional development, client outcomes, teaching hospitals, Nigeria.