Ethical Issues in SupervisionEthical Issues in Supervision

Gerald P. Koocher, Ph.D., ABPP

Foci of Clinical SupervisionFoci of Clinical Supervision

Monitoring

Teaching

Ethical knowledge and behavior

Clinical competence

Personal functioning

Attention to client welfare

Research SupervisionResearch Supervision

Ethical knowledge and behavior Research competence Personal functioning Attention to participant welfare Attention to institutional review boards

and federal regulations Data integrity

Supervisory RolesSupervisory Roles

Teacher

Mentor

Evaluator

Facilitator of self-awareness and

personal exploration

Positive Supervisory TraitsPositive Supervisory Traits

Competence

Fairness

Diligence

Caution

Recognition and respect for power

differential

Supervisor as Professional ParentSupervisor as Professional Parent

Socialization

Professional etiquette

Wisdom

Experience

Third Parties in SupervisionThird Parties in Supervision

Clients Research participants The agency The graduate program The payer The licensing board The subsequent employer

Significant Conflicts of InterestSignificant Conflicts of Interest

Self-paying for “supervision”

Supervising relatives

Sexual intimacies

Other multiple-role conflicts

Hazards of SupervisionHazards 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 FeedbackSupervisory Feedback

Timeliness Thoughtful presentation Adequacy

– Strengths and weaknesses Documentation

– Oral/written– Acknowledgement of receipt by trainee

Points to RememberPoints 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?What Do Trainees Want?

Expertise Trustworthiness Assistance with personal growth Teaching technical skills Communication of expectations Timely feedback

What Frustrates TraineesWhat Frustrates Trainees

Sexist, authoritarian, or demeaning

treatment

Ambiguity in responsibilities and roles

Lack of feedback

Contracting for SupervisionContracting for Supervision

When? Where? How often? Who pays? Who gets reports? What is covered? Back-up?

Issues in Group SupervisionIssues in Group Supervision

Helps with resource drain

Reduces individual attention

Inhibits some disclosures

Privilege alterations and reduced

confidentiality

Risky IndividualsRisky 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 HarassmentEEOC: Sexual Harassment

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

Sexual Harassment includes the following:

Court Decisions on Abuse BehaviorCourt 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 ProblemNature 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 ReferenceLetters 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.”