maintaining professional ethics in the supervisory process can pose unique challenges

7/28/2019 Maintaining Professional Ethics in the Supervisory Process Can Pose Unique Challenges

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Maintaining professional ethics in the supervisory process can pose unique challenges. The same ethical violations

that can occur in a therapeutic relationship can be paralleled in a supervisory relationship. From performance

evaluations to dual relationships, the supervisory relationship can be fraught with chances for uncomfortable,

inappropriate, and potentially litigious situations. This article will explore ethical concerns in social work supervision,

such as the following:

My supervisor uses me as a confidante and openly discusses another workers shortcomings with me, yet she

never approaches the worker about it.

My supervisor degrades me and makes personal comments about meusually negativeand sometimes in front

of other staff.

My coworker reads all day long and doesnt spend much time working with clients. My supervisor is unwilling to

address it and said to me, Mind your own business. He gets his work done. Thats all thats important. It drives me

crazy that I end up picking up his slack with clients.

My supervisor passes work on to me even though I am overwhelmed with my own work. She dumps administrative

duties on me that she should be performing. If I do them, its credit in the bank for me to get favors from her. I dont

like the game, but it does have benefits.

I used to be best friends with a person I now supervise. Do we have to give up our friendship? I dont see why, as

long as it is after work hours.

Im a supervisor of a domestic violence agency with a shelter program. A new employee reported she is being

abused by her live-in boyfriend. She feels she is in danger and would like to enter the shelter and receive counseling

with us. What do I do?

These examples were actual supervisory situations presented in a supervision workshop. Supervisor-employee

relationships can potentially be ethical quagmires. Supervisors must be cognizant not only of their employees ethical

decisions but also of their own ethical behavior. Who supervises the supervisor?

Why is this topic important? The concept of respondeat superior, based on the idea of vicarious liability, holds that a

supervisor is responsible for a supervisees behavior. We like to think of graduate-level people as professionals, but

we all know colleagues or supervisees who may make us think twice about this concept. A supervisor can be held

liable for not identifying inappropriate therapy, ignoring inappropriate behavior, or supervising in a negligent or

insufficient manner (NASW Trust, 2000).

Some employees perceive the sole job of a supervisor as making employees uncomfortable. In an educational sense,

that perception is partially true. Supervisors should challenge, confront, and encourage critical thinking. One of the

supervisors tasks is to provide professional socialization, to not only cultivate skills but also instill professional

conscience. Certainly, modeling professional behavior is one way of teaching it.

An ethical concern arises when there is uncertainty or conflict about values. Values are those strongly held ideals,

principles, and standards that inform decision making or actions. Generally, values relate more to what we believe;

ethics relate more to how we act.

In a therapeutic relationship, ethical concerns can be viewed as an integral part of the helping relationship and can

facilitate the therapeutic process. In the spirit of parallel process, ethical dilemmas can also facilitate the supervisory

process and can actually be a teachable moment, a golden opportunity for personal insight and professional growth.

As social workers, we are fortunate to have the Code of Ethics to guide our practice. Most professional decisions

can be framed against that background. How often do workers and supervisors rely on the code? A study (Munson,

2002) examined social work field instructors and students familiarity with theCode of Ethics. Fifty-nine percent of


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supervisors could identify code items accurately. The mean score for students was 71.1, demonstrating that the

supervisees actually had more knowledge about the code than supervisors.

There is no code of ethics specific to supervision. However, it could easily be argued that every standard applies to

the supervisory relationship in some way since a contemporary view in social work is that supervision is actually a

form of social work practice and mutual aid (Brashears, 1995).

In addition, social work supervisors have multiple professional resources available to them. The National Association

of Social Workers (NASW) has published standards for social work personnel practices and guidelines for clinical

supervision. The American Board of Examiners in Clinical Social Work has published position papers on clinical

supervision. Yet, there are times when these guidelines and standards differ with agency policy or norm, resulting in

an ethical dilemma for the supervisor.

Todays complex practice settings cause increasing ethical conflicts. Ethical dangers in supervision can occur in both

the administrative and clinical aspects of practice. Productivity standards in a managed care environment create

ethical compromises for social workers and supervisors when marketing and profit become the principles driving

careone agency gave an employee of the month award based on the number of billable hours.

Supervisors are often in the unenviable position of making difficult decisions about how to do more with less, perhaps

even downsizing programs or staff, caused by reduced funding and increased costs. Workers in such an environment

are under increased stress, which can lead to poor judgment. Supervisors are the important mitigating force in

preventing stress-induced poor judgment.

Suing Social Workers

Historically, the social work profession has not been a major target for malpractice suits. However, the NASW reports

that the number of lawsuits, as well as ethics violations and unofficial complaints, brought against social workers has

recently increased.

According to the NASW Trust (2000), court awards against mental health practitioners have exceeded $1 million in a

single suit. A malpractice suit or formal complaint filed by an injured party is for a wrongful or negligent act or inaction

on the part of a social work professional, which deviates from the standards of professional care and results in an

injury.

Being sued for malpractice is one of the most stressful events that a social worker can experience. The average claim

against a social worker takes at least one yearand typically more than three yearsto resolve, and supervisors are

often included in suits filed against a worker or agency.

The most frequent classes of suits brought against individual social workers, according to data collected from 1990 to

2005, are ranked below in order from most to least:

incorrect treatment;

sexual misconduct;

suicide or attempted suicide;

dual relationship (nonsexual); and

reporting of abuse to authorities.

Typically, clients sue when the following occurs:

They are disappointed with treatment.

They blame a negative outcome on incompetence or neglect.


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They get a bill larger than expected.

They believe they have been exploited (dual relationship).

The Supervisor Squeeze

Supervisors are usually middle managers. Not only do they get caught in the squeeze of trying to help workers and

consumers while satisfying agency demands, but they also have to balance legality, fairness, and efficiency.Typically, human service professionals value relationships, so performing this middle-manager balancing act while

still trying to maintain relational approval is a recipe for mission impossible.

Most ethical conflicts fall into one or more of the following ethical Dangers of supervision:

dual relationships;

documentation;

descriptions (position);

duty to warn;

dilemmas;

disciplinary action; and

discretion.

Dual Relationships

Dual relationships are at the core of many ethical issues. Boundary problems comprise most ethical violations. The

supervisors job is to manage his or her own attention to dual relationships with supervisees and be on the lookout for

potential boundary blurring with supervisees and clients.

A dual relationship exists when a relationship other than a professional one develops. This situation can develop not

only between employees and clients but also between supervisors and employees. (e.g., an employee has a side

service business that the supervisor would like to use). The supervisor can manage this risk in several ways. FredericG. Reamer, PhD, illuminates this conundrum in multiple writings (2001, 2003, 2006).

Paralleling the potential blurred boundaries between supervisor and employee are the potential boundary violations

that employees commit with clients. Yet most ethical violations are not maliciously intended. Supervisors should be

aware of cues to potential boundary violations, which are descriptively listed below by Walker & Clark (1999):

Strong feelings about clients or extended sessions with clients a pattern justified by, This client just needs more

time than others. When personal and professional caring merge, the supervisor needs to address the worker

perception and redirect the focus.

Inappropriate communication during transportation conversations become less professional, prompted by the

informal and private atmosphere of riding in a car. The supervisor should clarify the distinction between case

management and therapy services and explore role confusion.

Off-hours telephone calls giving out cell or home phone numbers. The supervisor should explore the goals of

calls and clarify worker/client role.

Gift giving accepting from or giving to a particular client. The supervisor should explore the meaning of the gift

and perception of changed relationship.

Boundary problems in home Family-based services can create ambiguous situations, and the supervisor needs

to explore potentially changed relationships.


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Overdoing, overprotecting, and overidentifying doing for a client and other signs of enmeshment. The supervisor

needs to clarify whether this behavior is for client or clinician need.

Loans, barter, sale of goods (e.g., buying goods from a client or supervisee) There should be clear policies and

procedures and unambiguous guidelines established.

Clinician self-disclosure sharing personal information that is not relevant to therapeutic exchange. Thesupervisors should explore dynamics of disclosures and potential risks (Dewane, 2005).

Touching touch is risky; it can be interpreted as therapeutic or traumatic (Dewane, 2005). Supervisors should

confirm clear rules and ramifications regarding physical contact, explore ways of establishing rapport that do not

require touch, and provide literature about the topic.

In addition to these red flags, suspicion should be raised if a worker is hiding information from a supervisor. Itzhaky

(2000) advises that professional development requires unveiling of the secret in supervision.

In some ways, the supervisory relationship is akin to a parent-child, with its concomitant need for approval and

avoidance of punishment. Transference/countertransference reactions that we pay attention to in work with clients

are just as potent in the supervisory relationship. Schamess (2006) says supervisees can have intrapsychically

determined transference reactions to their supervisors... Because supervisors typically represent surrogate parents,enactments not only reflect supervisees unconscious affective responses to patients but also their unconscious

affective responses to supervisors.

Some supervisors can abuse this relationship by exerting undue power or condescendingly playing Father (Mother)

Knows Best (Kadushin, 1992) with supervisees. One of the most uncomfortable violations is when supervisors, or

even field instructors, try to therapize a supervisee (Jacobs, 1991). A classic study by Rosenblatt & Mayer (1975)

found that second-year MSW students identified four objectionable styles of supervision in field instructors:

constrictive (too close), amorphous (too loose), aloof (disinterested), and therapeutic (personal), which was by far the

most objectionable.

Peer Today, Boss Tomorrow

Conversely, newly promoted supervisors may find it lonely at the top when they find former colleagues strangelydistant. Often, supervisors are promoted from within, where they have had established coworker relationships.

Kadushin, in his characterization of the supervisory relationship as Games Supervisors Play (1992), summarizes

this reality as they cant party with the old gang anymore. There will always be a power differential, making a dual

relationship impossible. Kadushin also talks about how supervisors avoid exerting administrative power by pretending

that all relationships are egalitarian with the game I Am Just Like You.

Duty to Warn

A classic example used regarding duty to warn is that workers who disclose HIV status to third parties violate

confidentiality. But by observing that confidentiality, the worker may fail to prevent harm to another party (Reamer,

1998). It is impossible to adhere to both ethics standards.

The following four elements are necessary to explore the mandate of duty to warn:

a professional relationship exists;

there is a specific identifiable threat;

a person has been named as a victim; and

the professional makes a determination that the patient indeed poses a risk.


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The fourth element, a professional judgment, causes the most consternation. This issue of confidentiality vs. duty to

warn was aptly discussed by Heer (2006) in the context of domestic violence situations and duty to warn.

Documentation

Documentation serves several functions that supervisors oversee. We have all heard, If it isnt written, it didnt

happen. But what are the consequences? Again, Reamer (2005) points the way: Careful documentation and record

keeping protect practitioners against allegations of ethical misconduct and professional negligence, guard clients

privacy, and facilitate the delivery of high-quality services. (p. 326)

Reamer provides guidelines for risk management related to documentation or charting categorized according to

content, language, credibility, and access. The Code of Ethics has standards relevant to each. Although the primary

reason for documentation should be for good clinical care, we also document for litigious reasons. Social workers

should be keenly aware that we are always writing for an audience. (p. 331)

Since supervisors can be held liable for indiscretions of staff, if evidence of flawed supervision, perhaps monitoring

workers documentation is evidence of good supervision. In addition, supervisors should document the date, time,

and content of supervision sessions and meetings that address legal/ethical issues.

Descriptions of Job and Disciplinary Actions

At the core of many workplace conflicts are differing expectations. Clear position descriptions provide the opportunity

for the supervisor to practice preemptive supervision. Recruitment efforts would be enhanced if ethics discussions

were part of the hiring process. Just as we establish contracts with clients, we may consider having employees sign a

performance contract so all expectations are clear. Part of that contract should be the employees right to routine

supervision.

Even inadvertent ethical violations can result in client harm. Small acts of indiscretion are best not ignored by

supervisors because they can lead to big violations. Kadushin (1992) talks about workers attempts to reduce the

power differential inherent in a supervisory relationship when one of the games that supervisees play goes along the

lines of Evaluation Is Not for Friends.

Performance evaluations should be proactive, not reactive. An employee should never be surprised by an annual

summation of their work. Supervision should be presented and perceived as explorative, strength-based (Cohen,

1999), and a tool of professional development, not a punitive mechanism.

Dilemmas, Decision Making, and Discretion

Every day of practice brings a continuous chance for ethical dilemmas confronting both supervisors and supervisees.

A supervisor has the responsibility to be well-acquainted with and have employees be familiar with the Code of

Ethics. A proactive preventative stance taken by the supervisor would include being aware of not only the code but

also the types of cases brought before sanctioning boards.

An educational stance that teaches and follows evidence-based decision-making models is a safeguard. Several

models are available in the literature (Reamer, 1998; Berman, 2001). Berman proposes that we look at ethical

dilemmas and decisions by examining the consequences of an action, the integrity (value base) of the decision, the

protection of the rights of all involved, and the practicality (feasibility) of an action. Reamer suggests drafting and

implementing an action plan after identifying the issue along with prioritizing conflicting values and personal biases.

Probably the most important takeaway message from any model is the paramount importance to consult and

document. When deliberating a dilemma, consult with colleagues, counsel, and the literature. It is unlikely that your

particular dilemma has not been addressed before in some way. Then document your consultations and decision.

Regardless of the outcome of your decision, the ability to justify your actions with sound principles and thinking

reduces the likelihood of a negative outcome for you or your agency. Sanctioning boards and courts look at the

decision making that went into an action, not necessarily the final outcome. The means do justify the end.


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Supervisees look to supervisors to solve their ethical issues. Although this job may seem like one of the onerous

parts of being a supervisor, it is better than being blindsided by an ethical situation gone awry. Visionary thinking by a

supervisor may even consider performing an ethics audit on his or her department or agency (Reamer, 2001). Ethics

training should always be provided. And above all, remember that among the games that supervisees play, all play

Follow the Leader.

Personal and Interpersonal Issues

in Supervision

foundation for the work that will occur in supervision

Phases of the relationship


ual nature of the

relationship


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sees understand the linkage between theory and practice

more fully

meaning of termination, feelings, and thoughts

s are discussed

Personal and Interpersonal Issues in

Supervision

Copyright 2007 All About the Family, LLC

-supervisee relationship

Supervisor-supervisee relationship

is the supervisors responsibility to develop an atmosphere

conducive to learning

productive supervisor-supervisee relationship?


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Essential elements of the

supervisee-supervisor relationship

predictability

what both can do

to create a trusting supervisory relationship

about trust during supervision sessions

-disclosure: willingness of the supervisor and

supervisee to be open to and discuss all issues that may arise

in the supervisory relationship

alliance NOT to work on personal issues

maintaining professional ethics in the supervisory process can pose unique challenges

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