One of the signs of a maturing profession is the development of a set of ethical guidelines. These guidelines serve to guide the practice of individual’s practice within a given profession. They also, however, reflect the values and, to some extent, the society in which the profession is positioned. The helping professions of counseling and human services are no different. While the practice of counseling and psychotherapy has been governed by ethical guidelines, the closely related activity of clinical supervision has only recently come under a set of ethical guidelines. The purpose of this module is to provide a brief overview of the theories that inform the development of ethics, ethical principles, codes of ethics in counseling and human services, and ethical issues that a student might encounter in clinical supervision.
Ethics is a branch of philosophy that, at its core, seeks to understand and to determine how human actions can be judged as right or wrong. We may make ethical judgments, for example, based upon our own experience or based upon the nature of or principles of reason. Those who study ethics believe that ethical decision making is based upon theory and that these theories can be classified. What follows is a very brief description of four classes of ethical theories (See Garrett, Baillie, & Garrett, 2001).
Ethical principles provide a generalized framework within which particular ethical dilemmas may be analyzed. As we will see later in this module, these principles can provide guidance in resolving ethical issues that codes of ethics may not necessarily provide. What follows are definitions of five ethical principles that have been applied within a number of professions (Beauchamp & Childress, 1979).
Ethical principles provide generalized frameworks that may be employed in the resolution of ethical dilemmas in our daily lives. These principles may be applied to our interpersonal relationships as well as to our professional lives. However, as members of a profession, we will encounter more specific codes of ethics that are designed to govern our professional behavior and to offer some guidance for the resolution of commonly faced ethical issues that occur in the practice of our chosen professions.
According to Neukrug (2000), codes of ethics are a fairly recent development in the mental health professions. He states that the APA formulated its first set of ethical standards in 1953; the ACA in 1961; and the NASW in 1960. Within this relatively short period of time, these ethical codes have undergone a number of revisions. This is due to the fact that they reflect ever changing societal and professional values. Those charged with the formulation of such codes struggle with how these issues should be dealt with. These guidelines, however, do serve a number of purposes that have remained constant. Neukrug (2000, pp. 48-49) delineated the general purposes of codes of ethics as highlighted in a number of works (see Ansell, 1984; Corey et al., 1998; Lowewenberg & Dolgoff, 1996; Mabe & Rollin, 1986; VanZandt, 1990). He goes on to point out that “ethical guidelines are moral, not legal, documents, and our professional associations expect us to be bound by them (p. 49).
Although codes of ethics provide an effective means of guiding professional practice and decision-making, they do pose certain limitations. Neukrug (2000, p.49) summarized these limitations, drawing especially on the work of Mabe and Rollin (1986).
Given the fact that ethical dilemmas may not always be readily resolved through the use of codes of ethics, it might be useful to have a framework in which to analyze and make ethical decisions. The following ethical decison-making model comes from the work of Corey et al. (1998).
It is extremely important that you keep your immediate supervisor and all involved parties informed during this process. After you have made your decision, take some time to reflect on the process and to review what you have learned with a trusted supervisor or colleague.
How do you think this model is helpful in the resolution of ethical dilemmas? How might the model be improved? Try applying this model to an ethical dilemma that you have experienced or try one of the cases included in this module.
Now that we have looked codes of ethics and how they apply to counseling and humans services, we will now look more specifically at how ethics apply to clinical supervision in counseling and human services. This is not meant to be an exhaustive treatment of the subject. For a more thorough treatment, see Chapter 9 in Bernard and Goodyear (1999).
If ethical guidelines for the helping professions are perceived as fairly recent developments (Neukrug, 2000), the development of guidelines for the professional practice of clinical supervision could be said to be in its infancy. According to Bernard and Goodyear (1999) the first code of ethics that specifically addressed clinical supervision was passed in 1993 (Supervision Interest Network, 1993). Because of its close relationship to the practice of counseling and psychotherapy, it may not come as a surprise that many of the same ethical issues that arise in these settings also arise in the practice of clinical supervision. What follows is a discussion of some of these common issues as well as some of the unique issues common to clinical supervision. This section is drawn heavily from the work of Bernard & Goodyear (in press; 1999).
Informed consent covers not only the relationship between a therapist and his or her client, but also the relationship between a supervisors and trainee. Trainees should be made aware of the fact that supervision is an evaluative process and upon what criteria they will be judged. Furthermore, the roles and responsibilities of both the supervisor and the trainee should be clearly delineated. More specifics should be presented in a clinical supervision disclosure statement. Elements of this disclosure statement would include, but not necessarily be limited to the following:
It should also be noted that trainees who are receiving clinical supervision should inform their clients of this fact. This provides clients with the opportunity to choose a more “experienced” therapist should they feel that they need one. A number of agencies will often have a form that you may present to your clients.
In the helping professions confidentiality is one of the key ethical principles. Helpers are relied upon to provide a safe environment for clients are free to disclose their problems. This principle becomes more complicated to enforce in the supervision process. Trainees must learn that all client information must be kept confidential except that used for supervision purposes. Cases should be presented with first names only. Tapes and videotapes must also be treated carefully. Once again, clients must be made aware of the fact that they are being seen by a counselor in training and furthermore, that content from his or her sessions will be shared with supervisors (class instructors, etc.) in an educational context. Trainees must also apply the principle of confidentiality to their own supervision.
Supervisors must also treat their interactions with their trainees as confidential to the extent possible due to the complexity of the relationship. Trainees should be made aware of the fact that information might be shared with persons who have some stake in their evaluation. Furthermore, trainees should be made aware of the limits of confidentiality at the beginning of the supervisory relationship so that he or she can make an informed decision about what might be appropriate to share in supervision.
Falvey (2002) listed some situations when a therapist or supervisor may break confidentiality:
Dual relationships in supervision are often tricky because of the fact that the clinical supervisor often has more than one professional relationship with the supervisee. For example, your clinical supervisor might be your teaching assistant or instructor in another class. In an agency, your agency supervisor might provide clinical and professional supervision. Hall (1988) described a dual relationship as unethical when the relationship impairs the supervisor’s judgment and the trainee faces the possibility of exploitation as a result of the relationship. Supervisors should be diligent in helping trainees understand the ramifications of dual relationships with their clients.
As mentioned previously in this module, supervision is an evaluative process. It is imperative that the trainee be made aware of the criteria by which he or she will be evaluated. Trainees should know what constitutes the successful mastering of the criteria. They should also be aware of the possible consequences and their rights should the criteria not be met. Evaluation should be an on-going process and the results of any formal evaluation should not come as a “surprise” to the supervisee.
While you are receiving clinical supervision, you have the right to due process. Due process is a legal concept. It describes a process that ensures that notice and hearing must be given before an important right can be removed (Disney & Stephens, 1994). There are two types of due process—substantive and procedural. In terms of clinical supervision, substantive due process addresses the fair and consistent application of the criteria that govern a training program. Procedural due process concerns itself with the rights that you have as a participant in a training program. They are delineated as follows:
As mentioned previously in this module, your supervisor should provide a clinical supervision disclosure statement that contains contact information for the appropriate person, licensing and or credentialing organizations, should you feel that a breach of ethics has occurred during your clinical supervision experience. There are usually procedures put in place by your academic department, agency, and/or professional organization to follow should you need to file a grievance. Try following your organization’s grievance procedures first.
You might want to read some codes of ethics that professional organizations use to guide professional practice in a number of counseling and human services practices. This will allow you to see how they address breaches of ethics and other ethical issues. Take note of the similarities and differences in the various codes. See, for example:
