The Supervisee's Checklist: Ethical, Legal, and Clinical Issues

Jeffrey E. Barnett, Psy.D.

The graduate school years are a time of rapid personal growth and professional development. It is an exciting period of one's professional development during which we assimilate knowledge and skills. Learning taken from the classroom and reading is applied in the clinical setting. During clinical training theory and technique are integrated into new understanding and effective clinical skills. This is also a time in our training during which our professional identity develops more rapidly and more fully than perhaps during any other period.

While didactic training in the classroom, readings, and research are of great importance, it is through supervised clinical experience that much of our professional growth and development occur. The clinical training we receive under supervision plays a vital role in how we progress from tentative neophyte to skilled clinician. Those professionals who supervise us play an important role in this aspect of our training and in the development of our professional identity.

But, not all supervisors and supervision experiences are created equal. It is in each graduate student's best interest to be an informed consumer about clinical supervision. It is important to know of the rights and responsibilities of both supervisee and supervisor. You should know what is reasonable to expect from the supervisory experience and should be a collaborator in the process of supervision. Clinical supervision is not done to you, it is a process of learning and discovery you and your supervisor share. By attending to the following important issues from the outset of the supervision relationship it is hoped that it will be a mutually satisfying and rewarding experience.

  1. Supervisee Competence: Supervisors should assess supervisee training needs and competence to determine the nature and extent of additional training and supervision needed. This should be reassessed over the course of supervision and responded to accordingly. You should not be receiving generic supervision; it should be responsive to your particular training needs.
  2. Supervisor Competence: Supervisors should only supervise in those areas of practice where they are competent. In other areas they should arrange for supervision by an appropriately trained colleague. Supervisors should have competence not only in the areas of clinical practice they will supervise, but in the theory and techniques of supervision itself. Having once been a supervisee oneself is not an adequate credential for providing clinical supervision.
  3. Informed Consent: Supervisors should utilize a comprehensive informed consent process at the beginning of the supervisory relationship. Be sure it includes: meeting time and location, how to reach the supervisor between supervisory sessions, emergency arrangements, fees and financial arrangements (if any), the nature and timing or evaluative procedures to be used and with whom they will be shared, and an agreement on all responsibilities for each individual. You have the right to know in advance what will be expected of you throughout the training experience as well as what you can expect of your supervisor. This agreement should be updated to include any changes that may occur during the course of supervision. IT IS also reasonable to include the role of discussing professional development issues such as how to balance work and family, career choice issues, and related topics.
  4. Supervision as a Safety Zone: The supervisory process should feel safe, not threatening or punitive. It should provide a forum for guided experimentation that offers enough security and safety so that you will not be afraid to try anything new or fear failure. If this safe environment does not develop discuss this with your supervisor or seek assistance from a trusted advisor.
  5. Paranoia vs. Trust: Ensure that both the level and intensity of supervision are adequate for your training needs. Remember that if you are unlicensed, the supervisor is responsible for all you do professionally. All treatment notes should be reviewed. A review of audio and/or videotapes of treatment sessions (with appropriate patient consent) will help to ensure better supervision for you. Merely having a supervisor asking how things are going with your patients is not adequate. While having tapes reviewed is anxiety arousing, it can help to provide the most beneficial training for you and therefore, the best treatment for your patients.
  6. Accurate Representation: Be sure you represent and advertise yourself in a manner that does not imply competence or licensure that you do not have. Make sure your patients know you are receiving supervision.
  7. Limits to Confidentiality: Ensure that informed consent agreements with patients address the limits to confidentiality to include your supervisor's involvement in the treatment process. Patients have the right to know what information will be shared with your supervisor and how this information will be utilized.
  8. Documentation: In addition to thorough documentation of clinical services provided, be sure both you and your supervisor each document the supervisory sessions to include any recommendations made or issues for you to follow-up on with patients. Maintain these records as you would other clinical records. This will help ensure greater accountability and resolve any differences about what transpired easily and effectively. It is also helpful for you to review notes of supervisory sessions over time to check for trends and patterns that may be important to discuss.
  9. Legal and Ethics Issues: Be sure that thorough attention is paid to legal and ethics issues in supervision in addition to patient treatment issues. Supervisors should expect you to be knowledgeable of, and adhere to, the APA Ethics Code and relevant state laws and regulations. If needed, they should ensure you are adequately trained in these areas and suggest readings as needed.
  10. Diversity Issues: Supervisors should be sensitive to diversity issues between themselves and you as well as with regard to each patient's treatment. Issues to consider include age, race, ethnicity, culture, gender, religion, and sexual orientation. These issues should be addressed in a manner that does not feel threatening or make you feel uncomfortable.
  11. Boundary Issues and Multiple Relationships: In addition to all issues typically considered in relationships with patients, supervisors and supervisees must be sensitive to the fine line that at times exists between supervision and psychotherapy. Supervisors should not cross that line and enter into the role of psychotherapist with you. Rather, they should make referrals when indicated. Supervisors hold more power than you in the supervisory relationship and should not take advantage of your trust or dependence on them. All their actions and behaviors should be consistent with the goals of your training and professional development.
  12. Consultation: When unsure on any of these or related issues, consult with an experienced colleague. Regarding legal matters, consult with an attorney before taking or recommending action. If uncomfortable with how the supervisory process or relationship are proceeding, try discussing this with your supervisor, but if this is not productive you should definitely consult with a professor or advisor. This is your professional training. It should meet your training needs in an ethical and appropriate manner.
  13. The Supervisee as Professional: Remember the serious professional obligation you have to your patients, to your supervisor, and to the profession. Take your training seriously and keep in mind the great impact you have on your patients' lives. If appropriate utilize your supervisor as a professional role model. If you feel the supervisory experience is not adequately meeting your training needs do not tacitly acquiesce. Be proactive and assertive. This is your professional training.

 Jeffrey E. Barnett, Psy. D. is a licensed psychologist in private practice in Annapolis, Maryland. He is also an Adjunct Associate Professor in the Psychology Department of Loyola College in Baltimore, Maryland. Dr. Barnett is a past president of the Maryland Psychological Association and holds several positions within APA to include being the Treasurer of the Division of State and Provincial Psychological Association Affairs and a co-chair of the Task Force on Managed Care of APA Divisions 29, 39, and 42.

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