Ethical Issues

in the Practice of
Supervision

SYIFA MUSTIKA
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Presentation Goals

To present an overview of ethics as they

pertain to supervision.

To present key ethical guidelines regarding

Perry C. Francis, Ed.D., NCC, LPC

client rights, informed consent for the

supervisee, multicultural issues, and other
current issues.

To present information concerning the growing

practice of supervision in Indonesia
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Growing Complexity

The practice of supervision has grown more

complex in recent years. Issues of client rights,
informed consent for the supervisee, on-site
supervision by untrained supervisors, and
Perry C. Francis, Ed.D., NCC, LPC

multicultural issues (to name just a few issues) have all

served to enhance or detract from the practice
of supervision.

Ethical guidelines serve to help the supervisor

and the supervisee gain the most benefit from
the supervision experience and provide the best
care possible for the client.
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Supervision Defined

Supervision has been defined as a means

of transmitting the skills, knowledge, and
attitudes of a particular profession to the
next generation in that profession (Bernard &
Perry C. Francis, Ed.D., NCC, LPC

Goodyear, 1992, p. 2).

For those who are involved in the training of

mental health professionals, it also is a
means of ensuring that clients receive a
certain minimum quality of care while
trainees work with them to gain their skills
(Bernard & Goodyear, 1992, p. 2).
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What is an ethical consideration?

Refers to:
a) a non-legal or not solely legal norm,
duty, obligation or right; or b)
Perry C. Francis, Ed.D., NCC, LPC

consequences (well-being, happiness

etc.) for some specifiable person or
groups of persons; or c) what kind of
person one ought to be or what virtues
one ought to have.
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Ethics Defined

Ethics has been defined as the process of

making moral decisions about individuals and
their interactions in society while still
attempting to protect the rights and welfare of
Perry C. Francis, Ed.D., NCC, LPC

those same individuals (Kurpius et al., 1991, p. 48).

With this definition in mind, ethics used by

professional counselors focus on being sure
that one has the correct combination of
education, practice, and experience to help
people deal with the issues and problems they
bring to the counselors office.
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Ethics Defined 2

Supervisors who practice ethically make

sure they have the correct combination of
education, practice, and experience to
help supervisees develop their skills and
Perry C. Francis, Ed.D., NCC, LPC

talents so that they (the supervisees) can

help people deal with the issues and
problems they bring into the counselors
office.
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Administrative vs. Clinical

Administrative supervision can be understood

as those supervisory activities that increase
the efficiency of the delivery of counseling
services (ACES, 1995, p. 270).
Perry C. Francis, Ed.D., NCC, LPC

Clinical supervision includes the supportive

and educative activities of the supervisor
designed to improve the application of
counseling theory and technique directly to
clients (ACES, 1995, p. 270).
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Ethics & Supervision

The counseling supervisor:

should have sufficient knowledge, skill, and
judgment to use efficacious interventions with the
supervisee and the client the supervisee is working
Perry C. Francis, Ed.D., NCC, LPC

with
respects the human dignity and freedom of the
supervisee and client
uses the power of the supervisors role responsibly
for both the supervisee and client
act in ways that promote confidence in the
profession of supervision and public confidence in
the profession of counseling.
 Sudah baik . tinggal
perlu pengulangan
Tanganmu le.... biar lebih luwes
tanganmu !

DOSEN BADAL
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Ethical Issues in Supervision

Unique ethical issues can be separated

into three broad categories:
Issues dealing with client welfare and
Perry C. Francis, Ed.D., NCC, LPC

rights;
Issues
dealing with supervisor and
supervisee relationship;
Issues
dealing with administrative
supervision.
 Issues Dealing With Client Welfare and Rights

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Client Welfare & Rights

Triadic Relationship
Supervision appears to be a process that
involves two people: the supervisor and the
Perry C. Francis, Ed.D., NCC, LPC

supervisee. In actuality, there is a minimum of

three or more people involved in the
supervisory relationship: the supervisor, the
supervisee, and the client(s). This has been
referred to as a triadic relationship (Kurpius et
al., 1991; Upchurch, 1985).
 Issues Dealing With Client Welfare and Rights

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Making Ethical Decisions

The Supervisors Ethical Decision Tree:

Relevant legal and ethical standards
Client welfare
Perry C. Francis, Ed.D., NCC, LPC

Supervisee welfare
Supervisor welfare
Program and/or agency service and
administrative needs.
 Issues Dealing With Client Welfare and Rights

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Informed Consent for All

Client needs to be aware that the

counselor is under supervision so that the
client can give informed consent to their
Perry C. Francis, Ed.D., NCC, LPC

participation.
Supervisor need to review local laws
concerning confidentiality & privacy for
client. Generally privacy & confidentiality
are afforded under the supervisors
credentials.
 Issues Dealing With Supervisor and Supervisee Relationship

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Education & Training

The Supervisor needs:

Supervision & training in the process
of supervision.
Perry C. Francis, Ed.D., NCC, LPC

Education & training in the population

Knowledge of ones own strengths &
limitations as a supervior.
 Issues Dealing With Supervisor and Supervisee Relationship

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Dual Roles & Relationships

The Supervisor understands:

DualRelationships are inevitable and are to
be managed properly.
Perry C. Francis, Ed.D., NCC, LPC

Thata power differential exists between the

supervisor and the supervisee.
That a sexual relationship involves a power
differential that contaminates any perceived
intimacy.
 Issues Dealing With Supervisor and Supervisee Relationship

Informed Consent 17

The Supervisor can

Use an informed consent form to help educate
about the supervisory relationship, its limitations
and benefits, and the supervisory process.
Perry C. Francis, Ed.D., NCC, LPC

Informed Consent Form can include information

about:
Supervision Process, Evaluation & Due Process,
Ethical & Legal Issues, Professional Disclosure
(training, education, etcof supervisor),
Practical Issues (emergency procedures,
etc) Statement of Agreement
 Issues Dealing With Supervisor and Supervisee Relationship

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Informed Consent

Elements of the Informed Consent:

Purpose: A brief explanation about the
consent statement, its purpose and function.
Perry C. Francis, Ed.D., NCC, LPC

Professional Disclosure Statement: Includes the

supervisors credentials and qualifications.
Practical Issues: Practical information such as
phone numbers, crisis procedures, frequency,
length, and location of sessions, monetary
concerns, and professional development
requirements, if any.
 Issues Dealing With Supervisor and Supervisee Relationship

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Informed Consent

Elements of the Informed Consent:

Supervision Process: A description of the process,
expectations, and objectives of supervision is included
here.
Perry C. Francis, Ed.D., NCC, LPC

Evaluation and Due Process: The ethical guidelines

point out that the supervisor is responsible for reviewing
work samples of the supervisee, providing ongoing and
regular feedback in a variety of forms and formats, and
meeting regularly in face-to-face sessions with the
supervisee. Outlining these requirements and
responsibilities of both parties will prevent confusion
and promote clear communication.
 Issues Dealing With Supervisor and Supervisee Relationship

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Counseling the Supervisee

The Supervisor understands that:

Supervision is a complex task of educational,
professional, ethical, informational, & therapeutic
interactions.
Perry C. Francis, Ed.D., NCC, LPC

The power differential interferes with the counseling

relationship.
The supervisor can listen, empathize, & understand
the CITs personal issues, but limits this activity
because of the evaluative role he or she has with
the CIT.
 Issues Dealing With Supervisor and Supervisee Relationship

Electronic Supervision 21

The Supervisor seeks to insure that:

Allcommunication maintains a level of security
that allows only those who should be viewing it,
access to it.
Perry C. Francis, Ed.D., NCC, LPC

Emergency procedures are in place if there is a

crisis that requires the supervisors attention.
Timely care can take place for both the CIT &
Client.
 Issues Dealing With Supervisor and Supervisee Relationship

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Multicultural Issues

The Supervisor shall:

Take into account the effect individual
differences (gender, race, culture, etc) has
on the supervisory relationship. This includes:
Perry C. Francis, Ed.D., NCC, LPC

Appropriate training and experience in

cultural differences.
Working with the CIT to understand how
cultural differences effect
counseling/supervision process.
Issues of power surrounding differences.
 Issues Dealing With Administrative Supervision

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Educational Opportunities

The Supervisor seeks to:

Insure that the CIT is given the proper training
concerning their roles and responsibilities
Perry C. Francis, Ed.D., NCC, LPC

within the training organization.

Provide the CIT with training and clients that
are both commensurate with their skills and
challenging to their growth.
 A Typology Of Ethical Challenges

Type of ethical issue Specific examples

Telling the truth To patients and relatives about

diagnosis and prognosis
To patients about lack of
experience
To consultants about tasks
Perry C. Francis, Ed.D., NCC, LPC

performed
To colleagues about a patients
condition when seeking tests

Respecting patients autonomy Respecting patients wishes about

treatment, including at the end
of life
Maintaining confidentiality
Seeking informed consent
 A Typology Of Ethical Challenges
Preventing harm
Perry C. Francis, Ed.D., NCC, LPC
Managing the limits of ones
competence
2
Dealing with potential harm to
patients associated with their
treatment
Avoiding harm to patients
when involving them in the
educational Process
Coping with feeling
inadequately prepared for their
responsibilities
Negotiating lack of
supervision/role modelling by
superiors
Making mistakes
 A Typology Of Ethical Challenges 3

Addressing the inappropriate Dealing with peers mistakes/

behaviour of others incompetence
Conflicts between views of
junior doctors and superiors
subjugating own opinions and
values to superiors demands
Observing the unethical
behaviour of others
Perry C. Francis, Ed.D., NCC, LPC

Demeaning humour about

patients
Compromised superiors
Superiors handing risky tasks
down the hierarchy (passing
the buck)
Dealing with verbal or physical
abuse by patients or superiors,
including sexual harassment
 A Typology Of Ethical Challenges 4
Conflicts of interest
Setting interpersonal boundaries
with patients
Perry C. Francis, Ed.D., NCC, LPC
Impact of working conditions
Ability to treat family and friends
Offers of gifts or hospitality from
drug companies
Dealing with sexual advances or
romantic intentions
Treating disliked, difficult, or
dangerous patients
Controlling compassion
Dealing with transience
Working long hours
Feeling unsupported by hospital
administration
Working when unwell or
exhausted
Lack of cover for absent
colleagues
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How about Indonesia ?

1.Undang-undang Nomor 20 tahun 2003 tentang

Sistem Pendidikan nasional;
2. Undang-undang Nomor 36 Tahun 2009 tentang
Perry C. Francis, Ed.D., NCC, LPC

Kesehatan;
3. Peraturan Pemerintah Nomor 17 Tahun 2010
tentang Pengelolaan dan Penyelenggaraan
Pendidikan
4. UU no.20 th 2013 tentang Pendidikan Dokter
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Pendidikan Profesi

Pasal 18
(1) Untuk pembelajaran klinik dan pembelajaran
komunitas, Mahasiswa diberi kesempatan
terlibat dalam pelayanan kesehatan dengan
Perry C. Francis, Ed.D., NCC, LPC

bimbingan dan pengawasan Dosen.

(2) Mahasiswa sebagaimana dimaksud pada ayat
(1), tetap harus mematuhi kode etik Dokter atau
Dokter Gigi, dan/atau ketentuan Peraturan
Perundang-undangan yang mengatur
keprofesian
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Aplikasi Dalam Pendidikan Profesi

Langkah dan panduan praktis

akan tertuang pada tata tertib
baik tata tertib akademik, norma
Perry C. Francis, Ed.D., NCC, LPC

susila pergaulan dan lain lain

Jika melanggar tata tertib maka

berlaku sanksi
 Questions-Cases

What are your

thoughts?
Perry C. Francis, Ed.D., NCC, LPC

Your cases for

Discussion.
Perry C. Francis, Ed.D., NCC, LPC

2
3
Perry C. Francis, Ed.D., NCC, LPC

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