Counseling Supervision: Dynamics, Ethics, and Trainee Disclosure

Introduction to Supervisory Ethics and Disclosure

Worthington and Tan (2002) stated that, to maintain the integrity of the supervisory relationship and protect their supervisors from vicarious liability, trainees have an obligation to disclose all relevant and important case material. For example, the APA principles state that "psychologists are honest, fair, and respectful...[and]...do not make statements that are false, misleading, or deceptive" (APA, 1992, p. 1599), which could apply to intentional nondisclosure as well as to false statements — that is, to acts of omission as well as acts of commission. Under conditions in which a trainee knowingly withholds important case material from a supervisor, the trainee could be considered to be violating the principle of integrity through his or her dishonesty (Fly et al., 1997).

Gundrun (1991) stated that supervision means trainees are confronted with old patterns of relating to authority figures. In the trainees' unconscious minds, supervisors play the roles of parents, teachers, or other authority figures. Especially in the early supervisory process, supervisors may be identified with parental figures. We may assume that the supervisory situation is evocative of the supervisees' relationship with authority figures, independent of the role supervisors may play in reality.

The Supervisory Relationship and Authority Figure Dynamics

For example, supervisors can act more as teachers of psychotherapy with a patient-centered approach, giving didactic comments about patients and recommendations on technique. Alternatively, in a more supervisee-oriented approach, they can focus on the supervisees' experiences with their patients and supervisors by exploring attitudes rather than teaching techniques. A third approach supervisors could use would be to combine or alternate the patient-centered and supervisee-oriented approaches according to the demands of the situation.

One characteristic of supervision that Gundrun (1991) identified is that it is a helping process. The very position of needing help places supervisees in a subordinate, dependent position, for which the parent-child relationship serves as the universal prototype.

A second characteristic of the supervisory situation relates to the specific demands this situation poses on supervisees. In order to receive help, supervisees are asked to reveal to their supervisors their uncertain understanding of patients' dynamics, their technical errors, and their own emotional responses. Exposure of self in supervision is an absolute requirement for progress, as the self is used as an instrument in the psychotherapeutic process. Therefore, the learning process in supervision inevitably fosters concern with self-esteem regulation. The vulnerability that supervisees may feel in exposing themselves can activate conflicts around trust and mistrust in relation to authority figures (Gundrun, 1991).

Gundrun (1991) also identified a third characteristic: the supervisees' readiness to learn and accept new models requires an act of disloyalty or infidelity toward previous identification models, such as parents, teachers, and perhaps old theories. Thus, to be able to integrate new knowledge, supervisees must relinquish some degree of autonomy by accepting the authority of the supervisor.

Flexible Formats and Methods of Clinical Supervision

A fourth way to characterize the supervisory situation is to focus on the dual role supervisors must play. They are not only teachers who should promote learning, but also evaluators. Trainees know that their skills and psychological functioning are being judged, but they do not know against which standards. This is likely to create insecurity. Supervisees risk the possibility of criticism, shame, or perhaps rejection because of their admitted inadequacy. It is felt that not only the therapeutic work, but the whole self, is being judged.

Milne and Oliver (2000) offered their own perspective on what it means to be a supervisor and what supervision entails. They defined clinical supervision as "an intervention that is provided by a senior member of a profession to a junior member or members of that profession. This relationship is evaluative, extends over time, and has the simultaneous purposes of enhancing the professional functioning of the junior member(s), monitoring the quality of professional services offered to the clients she, he, or they see(s), and serving as a gatekeeper for those who are to enter the particular profession." In turn, flexible methods of supervision are those styles, roles, foci, formats, and techniques that improve efficiency.

Style refers to the supervisor's characteristic manner (e.g., experiential or didactic); roles refers to such functions as consultant or colleague; foci refers to the factors or processes that receive primary attention during supervision (e.g., professional or organizational issues); format refers to the supervisory arrangement (e.g., one-to-one or group); and techniques refers to the specific interventions used by supervisors, such as offering support or feedback. It is possible to introduce flexibility in relation to all of these variables, but for there to be efficiency there must be either greater output (i.e., better supervisee functioning) for the same input (i.e., supervisor time), or the same output for less input.

The following review of the literature adopts these definitions but concentrates on flexible formats, given the current professional interest in this aspect of supervision. It is acknowledged, however, that flexibility may usefully be introduced in relation to all of the above methods, as well as through other routes (e.g., enhanced competence and alternative arrangements for clinical experience placements). Some options for enhancing efficiency in these areas are noted in the discussion (Milne & Oliver, 2000).