Ethical Issues in Supervision

Gerald P. Koocher, Ph.D., ABPP

Foci of Clinical Supervision

 Monitoring
 Teaching
 Ethical knowledge and behavior
 Clinical competence
 Personal functioning
 Attention to client welfare
Research Supervision

 Ethical knowledge and behavior

 Research competence
 Personal functioning
 Attention to participant welfare
 Attention to institutional review boards
and federal regulations
 Data integrity
Supervisory Roles

 Teacher
 Mentor
 Evaluator
 Facilitator of self-awareness and
personal exploration
Positive Supervisory Traits

 Competence
 Fairness
 Diligence
 Caution
 Recognition and respect for power
differential
Supervisor as Professional Parent

 Socialization
 Professional etiquette
 Wisdom
 Experience
Third Parties in Supervision

 Clients
 Research participants
 The agency
 The graduate program
 The payer
 The licensing board
 The subsequent employer
Significant Conflicts of Interest

 Self-paying for “supervision”

 Supervising relatives
 Sexual intimacies
 Other multiple-role conflicts
Hazards of Supervision

 Vicarious liability
 Supervision and personal
psychotherapy
– Oversight and teaching versus voyeuristic
gratification
 Vulnerabilities of trainees
– Devalued, criticized, humiliated, ignored,
exploited (sexual and otherwise)
Supervisory Feedback

 Timeliness
 Thoughtful presentation
 Adequacy
– Strengths and weaknesses
 Documentation
– Oral/written
– Acknowledgement of receipt by trainee
Points to Remember

 The person being evaluated is under

considerable personal stress
 Treat all with fairness and dignity
 Allow due process and discussion
 Clarify in advance
– Outcome goals
– Evaluation criteria
– Time lines
– Penalties/adverse consequences
What Do Trainees Want?

 Expertise
 Trustworthiness
 Assistance with personal growth
 Teaching technical skills
 Communication of expectations
 Timely feedback
What Frustrates Trainees

 Sexist, authoritarian, or demeaning

treatment
 Ambiguity in responsibilities and roles
 Lack of feedback
Contracting for Supervision

 When?
 Where?
 How often?
 Who pays?
 Who gets reports?
 What is covered?
 Back-up?
Issues in Group Supervision

 Helps with resource drain

 Reduces individual attention
 Inhibits some disclosures
 Privilege alterations and reduced
confidentiality
Risky Individuals

 Who are they?

– Emotionally unstable or labile
– Arrogant and narcissistic
– Have critical/hostile personality style
– Procrastinate
– Display impulsivity
 Best strategy: apply standard rules and
procedures; avoid emotional response
EEOC: Sexual Harassment

Sexual Harassment includes the following:

 Unwelcome sexual advances
 Requests for sexual favors or physical
conduct of a sexual nature that forces
submission as an explicit or implicit condition
of employment or academic standing
 Statements or conduct that create a hostile,
intimidating, or offensive learning or work
environment
Court Decisions on
Abuse Behavior
 Unwelcome = abusive
 Quid pro quo (implicit/explicit trading of
favors for job benefit or preventing job
detriment) = abusive
 Hostile work environment =abusive
Nature of the Problem

 25-90% of women victimized (Koen, 1989)

 Mostly unreported (Rubin & Borgers, 1990)
 Management tends to deny or minimize
– It never happened (denial)
– She misunderstood (minimized)
– It wasn’t intentional (minimized)
– She came on to me (blaming)
 Complex or difficult grievance process
Letters of Reference

 Never assume confidentiality.

 Be honest and direct.
 Focus on behavioral indicators and
objective evidence, not opinion or
innuendo.
 When in doubt regarding the value of
the letter, discuss it with the candidate.
 Just say “no.”