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Clinical Supervision: Models, Role, Legal & Ethical, & Transference
Hi. My name is James Brennen. I will be the narrator for the remainder of this CD.
On the last track, we discussed the various types of supervisees that are resistant to improvement: the yeahbut supervisee; the silent supervisee; the "I'll try" supervisee; and the irrelevant supervisee. Also, we presented various techniques for overcoming difficult conversations with these types of supervisees.
On this track,
first we will discuss Four Ethical Cornerstone Questions to Consider. This will
be followed by a discussion of three key ethical considerations involved in the
supervision of the therapist. The three ethical issues are proper knowledge and
skill; avoiding dual relationships; and fair and balanced assessment evaluations.
# 1 - Possessing Proper Knowledge and Skill
A supervised therapist Steve had been treating Teresa who seriously injured herself during an unsuccessful suicide attempt. Teresa maintained that Steve had failed to properly assess her risk of attempting suicide. Under the doctrine of vicarious liability, Teresa also alleged that Steve's supervisor was negligent because the supervisor did not meet regularly with Steve for supervision or talk to him specifically about suicide assessment procedures. To avoid having to be the victim of vicarious liability, supervisors should have knowledge and skill in the following areas:
12 Supervisor Knowledge & Skill Areas
Also, I believe it's important to avoid misusing authority or manipulating a supervisee into an action that only reflects your own beliefs. Consider the case of Michael, a therapist in private practice provided clinical supervision to another, less experienced therapist Carmen. Carmen was employed at a community mental health. Michael was actively involved in his church, which opposed reproductive rights. During one supervision session, Carmen brought up a case involving a pregnant adolescent who was trying to decide whether to terminate the pregnancy.
Michael talked at length about "the immorality of abortion" and according to Carmen, pressured her to share these views with her client. Carmen also stated, "My supervisor also talked me into attending services at his church. I didn't really want to go, but I felt like I had to. After all, I can't afford to get on my supervisor's bad side." As you can see, the supervisor in this scenario misused his authority to project his personal beliefs onto his supervisee.
# 3 - Creating Fair and Balanced
For instance, consider this case. Robert, a therapist in private practice, agreed to provide supervision to Nick, who recently received his degree. Nick was employed at a small family services agency as the sole therapist in the agency's family reunification program. Robert found his supervisee to be pleasant and receptive. However, Robert became concerned about Nick's clinical skills, especially those related to assessment and relationship building. Several months later, Nick applied for a higher-level clinical position at the family services agency and asked Robert to write a reference letter commenting on his clinical skills.
Robert wrote the evaluation, but exaggerated Nick's strengths and glossed over his weaknesses. The promotion was granted, but before long, it became clear that Nick was not qualified to handle his new responsibilities. He was demoted and eventually left the agency.
As you can see, the supervisor in this case acted unethically, due to his positive feelings about his supervisee and would actually have benefited the supervisee had he been more honest about the supervisee's capabilities. Of course the question begs to be asked why he didn't mentor his supervisee in the skills he was lacking to better prepare him for advancement. One can only guess that too much of a peer relationship had developed for this form of criticism to take place.
On this track, we discussed three main ethical issues involved in the supervision of a therapist: proper knowledge and skill; avoiding dual relationships; and fair and balanced assessment evaluations.
the next track, we will examine methods to help improve your supervisee's therapist-client
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