Ethical issues in supervision

1. 1. CARING COUNSELING CENTER Ethical Issues & Multiple Relationships in Supervision

Presented by Beth Ruff & Alex Huguelet P: 555.123.4568 Street P: 555.123.4568 123 West Main123
West Main StreetNew York, NY 10001 | | | F: 555.123.456710001 New York, NY
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2. 2. Focus Questions What are the most critical ethical issues in 1. supervision? What are the most
important ethical 2. responsibilities supervisors have toward supervisees and supervisee’s clients?
What kinds of training, coursework, and other 3. professional experiences are essential for competent
supervision? If you were a supervisee, how would you ideally like your supervisor to address multiple
roles 4. and relationships that might be a part of the supervisory process? As a supervisee, how have
your relationships with supervisors changed over time? What 5. lessons can you apply from these
experiences when you assume a supervisory role? What kinds of activities that extend beyond the
formal supervisory relationship do you think 6. might be appropriate for a supervisor to engage in with
a supervisee?123 West Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567 |
www.carecounseling.comEthical Issues in Supervision
3. 3. What are the most critical ethical issues in supervision? Balance • The rights of clients • The rights
& responsibilities of supervisees • The responsibilities of supervisors to supervisees and supervisee’s
clients Competence • Competence of supervisor • Competence of supervisee Multiple Roles and
Relationships • Role conflicts • Avoiding Dual relationships123 West Main Street P:
555.123.4568New York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
4. 4. What are the most important ethical responsibilities supervisors have toward supervisees and
supervisee’s clients? Before supervising, obtain training & education to ensure competence Limit
one’s clinical Assess supervisee’s practice & supervision competence and training to one’s area of
needs at beginning of competence relationship Promote ethical practice of supervisee by drawing
Treat supervisee with attention to ethical issues. respect and provide Model ethical practice & timely
and meaningful decision making feedback123 West Main Street P: 555.123.4568New York, NY
10001 | F: 555.123.4567 | www.carecounseling.com
5. 5. MODELING ETHICAL PRACTICE123 West Main Street P: 555.123.4568New York, NY 10001 |
F: 555.123.4567 | www.carecounseling.com
6. 6. MODELING ETHICAL PRACTICE Confidentiality • Model professional behavior by dealing
appropriately with confidentiality issues with supervisees. • Supervisors have responsibility of keeping
information obtained in supervisory relationship confidential. • Explain the limitations and parameters
of confidentiality. • Explain what will be shared with supervisors, faculty, for evaluation • Do not
share personal information shared in supervisory sessions • Maintain confidentiality of supervisee’s
clients123 West Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567 |
www.carecounseling.com
7. 7. ETHICAL DECISION MAKING • Supervisors have a responsibility to teach supervisees how to
think about ethical dilemmas. • Familiarize supervisee’s with ACA code of ethics • Teach ethical
decision making model123 West Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567
| www.carecounseling.com
8. 8. ETHICAL DECISION MAKING 1. Identify the Problem 2. Identify Potential Issues Involved 3.
Review Relevant Ethics Codes 4. Know Applicable Laws & Regulations 5. Obtain Consultation 6.
Consider Possible and Probable Courses of Action 7. Enumerate the Consequences of Various
Decisions 8. Decide the Best Course of Action123 West Main Street P: 555.123.4568New York, NY
10001 | F: 555.123.4567 | www.carecounseling.com
9. 9. ETHICAL DECISION MAKING RESOURCES FOR CODE OF ETHICS American Counseling
Association http://www.counseling.org/resources/cod eofethics/TP/home/ct2.aspx American School
Counselors Association http://www.schoolcounselor.org/content.a sp?contentid=136123 West Main
Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
10. 10. ETHICAL DECISION MAKING FULL HOUSE STYLE
http://www.youtube.com/watch?v=OxRpGMeJPs8123 West Main Street P: 555.123.4568New York,
NY 10001 | F: 555.123.4567 | www.carecounseling.com
11. 11. What kinds of training, coursework, and other professional experiences are essential for competent
supervision? Competent Supervisors… 1. Are trained in supervision and periodically update their
knowledge and skills on supervision topics through workshops, continuing education conferences, and
reading. 2. Must have the education, training, and experience necessary to be competent in the areas of
clinical expertise in which they are providing supervision 3. Must have effective interpersonal skills
and be able to work with a variety of group and individuals in supervision 4. Must be cognizant of the
fact that supervision is a situational process that is dependent on interaction between supervisor,
supervisee, the setting and the clients 5. Must be flexible and able to assume a variety of roles and
responsibilities123 West Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567 |
www.carecounseling.com
12. 12. What kinds of training, coursework, and other professional experiences are essential for competent
supervision? Competent Supervisors… 6. Must have a broad knowledge of laws, ethics, and
 professional regulations that may apply in a variety of situations that could arise in supervision 7. Stay
focused on the fact that a primary goal of supervision to monitor clinical services so that the welfare
of the client is protected 8. Are willing to serve an evaluative function with supervisees and provide
feedback about their performance on a regular basis 9. Document supervision activities in a timely and
accurate fashion 10. Empower supervisees. Supervisors assist supervisees at both problem solving
current situations and developing a problem solving approach that they can apply to nearly any
clinical situation long after the supervision has ended.123 West Main Street P: 555.123.4568New
York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
13. 13. Incompetent or Impaired Supervisors • Engages in exploitive or harmful dual relationships with
supervisees • Sexual contact with supervisees • Misuse of power • Extreme burnout • Makes poor
decisions due to inexperience • Creates a negative experience for supervisee123 West Main Street P:
555.123.4568New York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
14. 14. Incompetent and Impaired Supervisees • Skill deficits • Gaps in knowledge • Subject clients to
personal bias & stereotypes • Personality issues • Substance Abuse • Mental illness/Personality
Disorders • Interpersonal sensitivity • Need for control • Personal Problems affecting work • Using
one’s position to meet personal needs at the client’s expense.123 West Main Street P:
555.123.4568New York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
15. 15. Monitoring Trainee Competence SUPERVISORS have a responsibility to recognize, monitor, and
take action with incompetent or impaired supervisees. Dufrene & Henderson (2009) designed a
framework for remediation with counseling trainees. This table describes areas in which to monitor
supervisee’s competence Professionalism Counseling Skills DocumentationInterpersonal Demeanor 1.
Demonstrates basic counseling skills. 1. Completes and submits1. Receptive to feedback from
supervisor. 2. Consults with other professionals and application for clinical work.2. Open to self
examination. coordinates services related to clients. 2. Completes and submits logs on3. Exhibits
appropriate boundaries with 3. Demonstrates advanced counseling skills. time.clients, peers,
colleagues, 3. Completes and submitssupervisors, and faculty. evaluations on time.Procedural
Compliance 4. Demonstrates his or her theoretical 4. Completes and submits1. Knowledgeable of site
and university orientation. audio/video tapes of counselingrules and procedures. 5. Able to
conceptualize client cases sessions.2. Attends supervision on time weekly. 5. Takes notes during
supervision.3. Participates in required staffing and 6. Writes client case notes.meetings.Professional
Identity1. Identifies appropriate counselor roles inspecialty area.2. Demonstrates ethical behavior. 123
West Main Street P: 555.123.4568 New York, NY 10001 | F: 555.123.4567 |
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16. 16. Taking Action with Incompetent Supervisees As gatekeepers, it is of the utmost importance for
supervisees to hear from their supervisor about problems before it is too late for them to take
corrective measures. Supervisors have an obligation to provide their supervisees with regular, specific,
and ongoing feedback. Examples of corrective measures could include • Increased supervision • Leave
of absence • Personal therapy • Taking additional courses or workshops • Repeating practicum or
internship experiences123 West Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567
| www.carecounseling.com
17. 17. Multiple Roles and Relationships in the Supervisory Process • A multiple relationship occurs
when a supervisor is simultaneously in a professional role and at least one more role (professional or
nonprofessional) with the supervisee. • Supervision becomes more complicated when supervisors take
on two or more roles. • If a multiple relationship is neutral or beneficial, supervisors should explore
with the supervisee the pros and cons of the relationship. • Ethically, supervisors need to clarify their
roles and be aware of potential problems that can develop when boundaries become blurred. • This
will also help the supervisee practice and develop appropriate boundaries.123 West Main Street P:
555.123.4568New York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
18. 18. Managing Multiple Roles and Relationships • Multiple roles and relationships cannot always be
avoided. It is the responsibility of the supervisor to manage them in ethical and appropriate ways. •
The bottom line is to avoid multiple relationships that could impair the supervisor’s objectivity,
competence, effectiveness or will harm the supervisee. • Avoid multiple role relationships that involve
an abuse of power. • A boundary crossing is a departure from standard practice that could potentially
benefit the client or supervisee. A boundary violation is a serious breach that causes harm to the client
or supervisee. • It is during the practicum and internship experience that many students will actually
get to grapple with boundary issues for the first time. • Some writers have said that avoiding certain
multiple relationships could be harmful to some clients and that therapists need to use their
professional judgment.123 West Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567
| www.carecounseling.com
19. 19. Special Situations • MENTORING • If a supervisory relationship also takes on a mentor- mentee
relationship, the critical point is that the person with the greater power initiates a discussion about this
type of collaborative project. • To be a true mentor and allow a supervisee to know you outside of
your authority role may leave you feeling vulnerable.123 West Main Street P: 555.123.4568New
York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
 20. 20. Special Situations •DOCTORAL AND MASTER’S STUDENTS • In counselor education
programs, doctoral students often are in roles with master’s level students in which they hold a
position of authority. • These multiple relationships should not be discouraged, but there needs to be
an open discussion about keeping watch for boundary violations. • SOCIALIZING • However minor
the social situation may seem, supervisors still need to think about the potential issues that could
surface and how attending a social function might either enhance or inhibit the professional
relationship.123 West Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567 |
www.carecounseling.com
21. 21. More Special Situations • SEXUAL ATTRACTION • The attraction isn’t the problem. It is what
individuals do with the attraction that determines if it is appropriate or inappropriate. • It is the
supervisor’s responsibility to create a safe learning environment for supervisees. • If you find yourself
sexually attracted to a supervisee, you should examine your feelings and consider that sexual
harassment could be a real issue for you. You need to deal with this in your own therapy and
supervision. • Preoccupation with clients is problematic, while transient sexual feelings are normal. •
Sexual feelings for clients are common among students as well as professional practitioners. It is
crucial for trainees acknowledge these feelings to themselves and to their supervisors and take steps to
deal effectively with them. • It is important to normalize the feelings of attraction and distinguish them
from feelings of sexual misconduct.123 West Main Street P: 555.123.4568New York, NY 10001 | F:
555.123.4567 | www.carecounseling.com
22. 22. And More Special Situations • SEXUAL INTIMACIES • Although multiple relationships are
common in university settings, sex between students and their professors and supervisors is forbidden
by ethical standards. • It results in a loss of objectivity and an abuse of power. • Additionally, it is poor
modeling for supervisees and their relationships with clients. • If a problem does arise, the supervisor
has the responsibility to take steps to resolve them in an ethical manner. • Bottom line: If you want to
practice ethically, don’t do it. • Any form of sexual intimacy between supervisees and their clients is
inappropriate and unethical. • The supervisor has a legal and ethical obligation to do everything
possible to intervene immediately should sex between the supervisee and the client occurs.123 West
Main Street P: 555.123.4568New York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
23. 23. Combining Supervision and Counseling • There is a basic agreement that the supervision process
should concentrate on the professional development of the supervisee rather than personal concerns.
Supervision and counseling have different purposes. • Referrals should be made to a therapist when a
supervisee experiences a personal problem that interferes with their providing care to the client. •
Personal problems or limitations of supervisees should be challenged during supervision. • The
purpose of discussing supervisee’s personal issues in supervision is to help them work with clients
more successfully, not fix the problem.123 West Main Street P: 555.123.4568New York, NY 10001 |
F: 555.123.4567 | www.carecounseling.com
24. 24. Changing Roles and Relationships • Students and supervisees can become valued colleagues • It is
important to have open discussions to sort out any issues that may arise.123 West Main Street P:
555.123.4568New York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
25. 25. ReferencesCorey, G., Haynes, R., Moulton, P., & Muratori, M. (2010). Clinical Supervision in the
Helping Professions: A Practical Guide. Alexandria, VA: American Counseling Association.Dufrene,
R. L., & Henderson, K. L. (2009). A framework for remediation plans for counseling trainees in G.R.
Walz, J.C. Bleuer & R. K. Yep (Eds.), Compelling counseling interventions: VISTAS 2009 (pp 149-
159). Alexandria,VA: American Counseling Association.123 West Main Street P: 555.123.4568New
York, NY 10001 | F: 555.123.4567 | www.carecounseling.com
Recommended

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Both supervisors and supervisees can learn from this comprehensive review of social work supervision
issues.

Maintaining professional ethics in the supervisory process can pose unique challenges. The same ethical
violations that can occur in a therapeutic relationship can be paralleled in a supervisory relationship. From
performance evaluations to dual relationships, the supervisory relationship can be fraught with chances
for uncomfortable, inappropriate, and potentially litigious situations. This article will explore ethical
concerns in social work supervision, such as the following:

• “My supervisor uses me as a confidante and openly discusses another worker’s shortcomings with me,
yet she never approaches the worker about it.”

• “My supervisor degrades me and makes personal comments about me—usually negative—and
sometimes in front of other staff.”
• “My coworker reads all day long and doesn’t spend much time working with clients. My supervisor is
unwilling to address it and said to me, ‘Mind your own business. He gets his work done. That’s all that’s
important.’ It drives me crazy that I end up picking up his slack with clients.”

• “My supervisor passes work on to me even though I am overwhelmed with my own work. She dumps
administrative duties on me that she should be performing. If I do them, it’s credit in the bank for me to
get favors from her. I don’t like the game, but it does have benefits.”

• “I used to be best friends with a person I now supervise. Do we have to give up our friendship? I don’t
see why, as long as it is after work hours.”

• “I’m a supervisor of a domestic violence agency with a shelter program. A new employee reported she is
being abused by her live-in boyfriend. She feels she is in danger and would like to enter the shelter and
receive counseling with us. What do I do?”

These examples were actual supervisory situations presented in a supervision workshop. Supervisor-
employee relationships can potentially be ethical quagmires. Supervisors must be cognizant not only of
their employees’ ethical decisions but also of their own ethical behavior. Who supervises the supervisor?

Why is this topic important? The concept of respondeat superior, based on the idea of vicarious liability,
holds that a supervisor is responsible for a supervisee’s behavior. We like to think of graduate-level
people as professionals, but we all know colleagues or supervisees who may make us think twice about
this concept. A supervisor can be held liable for “not identifying inappropriate therapy, ignoring
inappropriate behavior, or supervising in a negligent or insufficient manner” (NASW Trust, 2000).

Some employees perceive the sole job of a supervisor as making employees uncomfortable. In an
educational sense, that perception is partially true. Supervisors should challenge, confront, and
encourage critical thinking. One of the supervisor’s tasks is to provide professional socialization, to not
only cultivate skills but also instill professional conscience. Certainly, modeling professional behavior is
one way of teaching it.

An ethical concern arises when there is uncertainty or conflict about values. Values are those strongly
held ideals, principles, and standards that inform decision making or actions. Generally, values relate
more to what we believe; ethics relate more to how we act.

In a therapeutic relationship, ethical concerns can be viewed as an integral part of the helping relationship
and can facilitate the therapeutic process. In the spirit of parallel process, ethical dilemmas can also
facilitate the supervisory process and can actually be a “teachable moment,” a golden opportunity for
personal insight and professional growth.

As social workers, we are fortunate to have the Code of Ethics to guide our practice. Most professional
decisions can be framed against that background. How often do workers and supervisors rely on the
code? A study (Munson, 2002) examined social work field instructors’ and students’ familiarity with
the Code of Ethics. Fifty-nine percent of supervisors could identify code items accurately. The mean
score for students was 71.1, demonstrating that the supervisees actually had more knowledge about the
code than supervisors.

There is no code of ethics specific to supervision. However, it could easily be argued that every standard
applies to the supervisory relationship in some way since a contemporary view in social work is that
supervision is actually a form of social work practice and mutual aid (Brashears, 1995).

In addition, social work supervisors have multiple professional resources available to them. The National
Association of Social Workers (NASW) has published standards for social work personnel practices and
guidelines for clinical supervision. The American Board of Examiners in Clinical Social Work has
published position papers on clinical supervision. Yet, there are times when these guidelines and
standards differ with agency policy or norm, resulting in an ethical dilemma for the supervisor.

Today’s complex practice settings cause increasing ethical conflicts. Ethical dangers in supervision can
occur in both the administrative and clinical aspects of practice. Productivity standards in a managed care
environment create ethical compromises for social workers and supervisors when marketing and profit
become the principles driving care—one agency gave an employee of the month award based on the
number of billable hours.

Supervisors are often in the unenviable position of making difficult decisions about how to do more with
less, perhaps even downsizing programs or staff, caused by reduced funding and increased costs.
Workers in such an environment are under increased stress, which can lead to poor judgment.
Supervisors are the important mitigating force in preventing stress-induced poor judgment.

Suing Social Workers

Historically, the social work profession has not been a major target for malpractice suits. However, the
NASW reports that the number of lawsuits, as well as ethics violations and unofficial complaints, brought
against social workers has recently increased.

According to the NASW Trust (2000), court awards against mental health practitioners have exceeded $1
million in a single suit. A malpractice suit or formal complaint filed by an injured party is for a wrongful or
negligent act or inaction on the part of a social work professional, which deviates from the standards of
professional care and results in an injury.

Being sued for malpractice is one of the most stressful events that a social worker can experience. The
average claim against a social worker takes at least one year—and typically more than three years—to
resolve, and supervisors are often included in suits filed against a worker or agency.

The most frequent classes of suits brought against individual social workers, according to data collected
from 1990 to 2005, are ranked below in order from most to least:

• incorrect treatment;

• sexual misconduct;

• suicide or attempted suicide;

• dual relationship (nonsexual); and

• reporting of abuse to authorities.

Typically, clients sue when the following occurs:

• They are disappointed with treatment.

• They blame a negative outcome on incompetence or neglect.

• They get a bill larger than expected.

• They believe they have been exploited (dual relationship).

The Supervisor Squeeze

Supervisors are usually middle managers. Not only do they get caught in the squeeze of trying to help
workers and consumers while satisfying agency demands, but they also have to balance legality,
fairness, and efficiency. Typically, human service professionals value relationships, so performing this
middle-manager balancing act while still trying to maintain relational approval is a recipe for mission
impossible.

Most ethical conflicts fall into one or more of the following ethical “D”angers of supervision:

• dual relationships;

• documentation;

• descriptions (position);

• duty to warn;
• dilemmas;

• disciplinary action; and

• discretion.

Dual Relationships
Dual relationships are at the core of many ethical issues. Boundary problems comprise most ethical
violations. The supervisor’s job is to manage his or her own attention to dual relationships with
supervisees and be on the lookout for potential boundary blurring with supervisees and clients.

A dual relationship exists when a relationship other than a professional one develops. This situation can
develop not only between employees and clients but also between supervisors and employees. (e.g., an
employee has a side service business that the supervisor would like to use). The supervisor can manage
this risk in several ways. Frederic G. Reamer, PhD, illuminates this conundrum in multiple writings (2001,
2003, 2006).

Paralleling the potential blurred boundaries between supervisor and employee are the potential boundary
violations that employees commit with clients. Yet most ethical violations are not maliciously intended.
Supervisors should be aware of cues to potential boundary violations, which are descriptively listed below
by Walker & Clark (1999):

• Strong feelings about clients or extended sessions with clients — a pattern justified by, “This client just
needs more time than others.” When personal and professional caring merge, the supervisor needs to
address the worker perception and redirect the focus.

• Inappropriate communication during transportation — conversations become less professional,

prompted by the informal and private atmosphere of riding in a car. The supervisor should clarify the
distinction between case management and therapy services and explore role confusion.

• Off-hours telephone calls — giving out cell or home phone numbers. The supervisor should explore the
goals of calls and clarify worker/client role.

• Gift giving — accepting from or giving to a particular client. The supervisor should explore the meaning
of the gift and perception of changed relationship.

• Boundary problems in home — Family-based services can create ambiguous situations, and the
supervisor needs to explore potentially changed relationships.

• Overdoing, overprotecting, and overidentifying — doing for a client and other signs of enmeshment. The
supervisor needs to clarify whether this behavior is for client or clinician need.

• Loans, barter, sale of goods (e.g., buying goods from a client or supervisee) — There should be clear
policies and procedures and unambiguous guidelines established.

• Clinician self-disclosure — sharing personal information that is not relevant to therapeutic exchange.
The supervisors should explore dynamics of disclosures and potential risks (Dewane, 2005).

• Touching — touch is risky; it can be interpreted as therapeutic or traumatic (Dewane, 2005).

Supervisors should confirm clear rules and ramifications regarding physical contact, explore ways of
establishing rapport that do not require touch, and provide literature about the topic.

In addition to these red flags, suspicion should be raised if a worker is hiding information from a
supervisor. Itzhaky (2000) advises that professional development requires unveiling of “the secret” in
supervision.

In some ways, the supervisory relationship is akin to a parent-child, with its concomitant need for approval
and avoidance of punishment. Transference/countertransference reactions that we pay attention to in
work with clients are just as potent in the supervisory relationship. Schamess (2006) says supervisees
can have “intrapsychically determined transference reactions to their supervisors... Because supervisors
typically represent surrogate parents, enactments not only reflect supervisees’ unconscious affective
responses to patients but also their unconscious affective responses to supervisors.”

Some supervisors can abuse this relationship by exerting undue power or condescendingly playing
“Father (Mother) Knows Best” (Kadushin, 1992) with supervisees. One of the most uncomfortable
violations is when supervisors, or even field instructors, try to “therapize” a supervisee (Jacobs, 1991). A
classic study by Rosenblatt & Mayer (1975) found that second-year MSW students identified four
objectionable styles of supervision in field instructors: constrictive (too close), amorphous (too loose),
aloof (disinterested), and therapeutic (personal), which was by far the most objectionable.

Peer Today, Boss Tomorrow

Conversely, newly promoted supervisors may find it lonely at the top when they find former colleagues
strangely distant. Often, supervisors are promoted from within, where they have had established
coworker relationships. Kadushin, in his characterization of the supervisory relationship as “Games
Supervisors Play” (1992), summarizes this reality as “they can’t party with the old gang anymore.” There
will always be a power differential, making a dual relationship impossible. Kadushin also talks about how
supervisors avoid exerting administrative power by pretending that all relationships are egalitarian with
the game “I Am Just Like You.”

Duty to Warn
A classic example used regarding duty to warn is that workers who disclose HIV status to third parties
violate confidentiality. But by observing that confidentiality, the worker may fail to prevent harm to another
party (Reamer, 1998). It is impossible to adhere to both ethics standards.

The following four elements are necessary to explore the mandate of duty to warn:

• a professional relationship exists;

• there is a specific identifiable threat;

• a person has been named as a victim; and

• the professional makes a determination that the patient indeed poses a risk.

The fourth element, a professional judgment, causes the most consternation. This issue of confidentiality
vs. duty to warn was aptly discussed by Heer (2006) in the context of domestic violence situations and
duty to warn.

Documentation
Documentation serves several functions that supervisors oversee. We have all heard, “If it isn’t written, it
didn’t happen.” But what are the consequences? Again, Reamer (2005) points the way: “Careful
documentation and record keeping protect practitioners against allegations of ethical misconduct and
professional negligence, guard clients’ privacy, and facilitate the delivery of high-quality services.” (p. 326)

Reamer provides guidelines for risk management related to documentation or charting categorized
according to content, language, credibility, and access. The Code of Ethics has standards relevant to
each. Although the primary reason for documentation should be for good clinical care, we also document
for litigious reasons. Social workers should be keenly aware that we are always writing “for an audience.”
(p. 331)

Since supervisors can be held liable for indiscretions of staff, if evidence of flawed supervision, perhaps
monitoring workers’ documentation is evidence of good supervision. In addition, supervisors should
document the date, time, and content of supervision sessions and meetings that address legal/ethical
issues.

Descriptions of Job and Disciplinary Actions

At the core of many workplace conflicts are differing expectations. Clear position descriptions provide the
opportunity for the supervisor to practice preemptive supervision. Recruitment efforts would be enhanced
if ethics discussions were part of the hiring process. Just as we establish contracts with clients, we may
 consider having employees sign a performance contract so all expectations are clear. Part of that contract
should be the employee’s right to routine supervision.

Even inadvertent ethical violations can result in client harm. Small acts of indiscretion are best not ignored
by supervisors because they can lead to big violations. Kadushin (1992) talks about workers’ attempts to
reduce the power differential inherent in a supervisory relationship when one of the games that
supervisees play goes along the lines of “Evaluation Is Not for Friends.”

Performance evaluations should be proactive, not reactive. An employee should never be surprised by an
annual summation of their work. Supervision should be presented and perceived as explorative, strength-
based (Cohen, 1999), and a tool of professional development, not a punitive mechanism.

Dilemmas, Decision Making, and Discretion

Every day of practice brings a continuous chance for ethical dilemmas confronting both supervisors and
supervisees. A supervisor has the responsibility to be well-acquainted with and have employees be
familiar with the Code of Ethics. A proactive preventative stance taken by the supervisor would include
being aware of not only the code but also the types of cases brought before sanctioning boards.

An educational stance that teaches and follows evidence-based decision-making models is a safeguard.
Several models are available in the literature (Reamer, 1998; Berman, 2001). Berman proposes that we
look at ethical dilemmas and decisions by examining the consequences of an action, the integrity (value
base) of the decision, the protection of the rights of all involved, and the practicality (feasibility) of an
action. Reamer suggests drafting and implementing an action plan after identifying the issue along with
prioritizing conflicting values and personal biases.

Probably the most important takeaway message from any model is the paramount importance to consult
and document. When deliberating a dilemma, consult with colleagues, counsel, and the literature. It is
unlikely that your particular dilemma has not been addressed before in some way. Then document your
consultations and decision. Regardless of the outcome of your decision, the ability to justify your actions
with sound principles and thinking reduces the likelihood of a negative outcome for you or your agency.
Sanctioning boards and courts look at the decision making that went into an action, not necessarily the
final outcome. The means do justify the end.

Supervisees look to supervisors to solve their ethical issues. Although this job may seem like one of the
onerous parts of being a supervisor, it is better than being blindsided by an ethical situation gone awry.
Visionary thinking by a supervisor may even consider performing an ethics audit on his or her department
or agency (Reamer, 2001). Ethics training should always be provided. And above all, remember that
among the games that supervisees play, all play “Follow the Leader.”

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ETHICAL AND LEGAL ISSUES IN SUPERVISION

Perhaps the greatest clinical and ethical challenge of supervision is that the supervisor must attend to the best
interests of the client and supervisee simultaneously. There are a number of ethical and legal issues that must be
considered by supervisors and their supervisees. The topics of direct and vicarious liability, duty to warn,
confidentiality, dual relationships, and informed consent will be discussed. See the following links for the ethical
standards related to supervision and training.

 Ethical Guidelines for Counseling Supervisors by the Association for Counselor Education and Supervision (ACES)
 The Approved Clinical Supervisor (ACS) Code of Ethics
 American Counseling Association (ACA) Code of Ethics – Teaching, Training and Supervision (SectionF)

Direct and Vicarious Liability

If a professional fails to follow acceptable standards of practice and harm to a client results, the professional can be
held liable for the harm caused.
Direct liability would be charged when the actions of a supervisor were themselves the cause of harm to a supervisee
or a client (for instance, if a supervisor suggested (and documented) an intervention that was determined to be the
cause of harm). The supervisor does not have to actually carry out the intervention, but if the supervisee follows the
suggestion of a supervisor and this results in harm – this is direct liability.

Vicarious liability is being held liable for the actions of the supervisee when these were not suggested, or even
known, by the supervisor. Therefore, if a supervisory relationship exists, the supervisor can potentially be held liable
for any negligent acts of the supervisee.

It should be obvious that the supervisor is very invested in the actions of his/her supervisee – and must take the
responsibility of supervision very seriously.

Duty to Warn
The duty to warn is as relevant for supervisors as counselors working directly with clients. In fact, in the Tarasoffcase
(the impetus for the duty to warn standard/law) the supervisor, in addition to the counselor, was implicated in the
case. The supervisor has a responsibility to advise the supervisee of conditions under which it is appropriate to warn
an intended victim.

Confidentiality
Supervision allows for third-party discussion of therapy situations. It is important to remember that the type and depth
of discussion allowed in supervision, is unethical in other situations. Supervisees must keep confidential all client
information except of the purposes of supervision. It is sound practice to keep explicit identifying information
confidential (for instance, use only first names and reveal few specific demographics).

Supervisees also have a right to privacy and it is the supervisor’s responsibility to keep information obtained in
supervision confidential except for the exceptions recognized by the profession and law.

Dual Relationships
There are two major categories of dual relationships: sexual and non-sexual.

Sexual Dual Relationships

There are four categories of sexual relationships:

Sexual Attraction

Sexual attraction is not an uncommon occurrence in supervision relationships. Unfortunately, however, there is little
attention to how to openly address and discuss the implications of the attraction – leading to successful resolve of the
issue. Because acting on an attraction poses serious ethical dilemmas, addressing the attraction in supervision or
through consultation with other professionals is vital.

Sexual Harassment

Unlike sexual attraction, sexual harassment is a clear abuse of power by the supervisor and is never acceptable.
Sexual harassment can leave the supervisee feeling violated, vulnerable and confused.

Consensual (but Hidden) Sexual Relationships

Results of studies indicate that the majority of sexual relationships between supervisor and supervisee fall in this
category. Because of the power differential inherent in supervision, it is suggested that no true “consensus” can be
freely given by the supervisee. Supervisors have a responsibility to own the “power” that is automatically attributed to
them by nature of their role.

Intimate Romantic Relationships

There is no distinction in the literature between relationships that occur within supervision, and those that begin there.
It is understood that intimate relationship may develop when adults work together in the world of therapy. The
important factor is to assure that a relationship that grew out of a supervision relationship poses no ethical
compromise for the supervisor or supervisee – and that there are no consequences for the supervisee’s clients.

The general consensus about sexual dual relationships is that there is much more potential for harm and negative
outcomes, than the potential for good or even acceptable outcomes. Supervisees and supervisors are encouraged to
seek discuss these issues and/or seek consultation. The secrecy that typically occurs in the development of dual
relationships is an important signal that there is a strong potential for unethical conduct and harm.

Nonsexual Dual Relationships

There is a general consensus that dual relationships between supervisors and supervisees (particularly in counselor
education programs) are inevitable. Unlike therapy relationships, persons who work together will share other
experiences with each other. In counselor education programs, faculty members may be instructors, supervisors,
academic advisors, personal confidants, and mentors.

The potential for negative outcomes, as a result of dual relationships, centers on the power differential between the
two parties. Dual relationships may be problematic in that they increase the potential for exploitation and for
impairment of the objectivity of both parties, and they can interfere with the professional’s primary obligation for
promoting the student’s welfare.

Some authors acknowledge that dual relationships are not tantamount to negative outcomes Indeed, with appropriate
attention to the power differentiation, there can be great flexibility in non-sexual dual relationships. While there is the
potential for harm, there are also training and personal benefits. These relationships tend to attract more confusion
than harm.

Supervisors have a responsibility to openly acknowledge and discuss the management of the multiple relationships
that may exist between supervisor and supervisee. Supervisees are encouraged to ask for clarifications regarding
any confusion resulting from dual relationships.

nformed Consent
The concept of informed consent is being addressed last, as it has the potential for impacting the ethical/legal issues
discussed to this point. Informed consent is the best defense against the difficult and confusing issues that arise in
supervision.

Supervisors have an obligation to determine that clients have been informed by the supervisee regarding the
parameters of therapy. Clients must not only be aware of therapeutic procedures, but also of supervision procedures.
The supervisor assures that clients are informed of the parameters of supervision that may affect them.

In addition, supervisors have a responsibility to inform supervisees about the supervision process, potential for dual
relationships, limits of confidentiality, and the conditions of their success or advancement (evaluation criteria and
process). Supervisors may use a Professional Disclosure Statement as a to facilitate the informed consent
discussion.

Ethical Decision Making

Ethical dilemmas are inevitable in counseling and supervision. To increase your ability to successfully manage
dilemmas, consider the following:

1. Successful management relies on the ability to recognize dilemmas – attend to feelings of confusion, concern,
anxiety and fear.
2. Incorporate experiential learning and case analysis into your work
3. Include questions regarding potential legal and ethical issues as part of case discussions
4. Familiarize yourself with ethical and legal codes and cases
5. Adopt and regularly implement an Ethical Decision Making Model