For sure, the past 20 years have seen supervision evolve from an all-too-often casual process into something that is not only rather complex but is designed to take an individual with limited clinical experience and skills from a place that requires active oversight and management to a place where that individual can function independently.
It goes well beyond the old “just meet with me for an hour a week” model of training. And well beyond the adage, “If I was supervised, I can supervise.” Supervision is now widely viewed as a distinct professional competency, that like other functions of the psychologist, requires specific training and competence, focuses on organized goals and competencies that are required of an independent practitioner.
It requires the identification of specific training goals and the process by which those goals are to be achieved. It is active, involved and is not something that should be taken lightly.
From a risk management perspective, all supervisors need to be aware that by taking on the training responsibilities for another professional they are willing to assume responsibility for that supervisee, as that person will be functioning totally under the supervisor’s license. That is in fact the truth. By becoming a supervisor, the licensed psychologist is basically saying that they are responsible for the conduct of the supervisee – not only ethically responsible but legally responsible.
What that means is that the supervisor could be put in a position of criminal, civil and/or administrative responsibility by becoming a supervisor. With this in mind, we would like to make the following suggestions to those who are considering becoming supervisors in order to avoid a negative outcome:
- Obtain formal supervision training. Supervision is not something licensed psychologists “just do” because they have a license. It is a professional competence set. The suggested training is available throughout the country and many states now require that training prior to taking on the supervisor’s role.
- Be sure to check what your state laws and codes require of supervisors and operate in a fashion that is consistent with those requirements. Being casual in meeting this requirement can create difficulties not only for the supervisor but with the supervisee’s ability to use those hours to qualify for independent practice. That is, by not sticking to the “letter of the law,” if you will, required training hours may not qualify for licensure, a circumstance for which you might even be legally liable.
- Be aware of the latest developments in supervision. For example, the APA Guidelines for Clinical Supervision of Health Service Psychologists and ASPPB Guidelines for Supervision.
- Keep to your role. Being a supervisor is a professional relationship regulated by both law and ethics. While it might be tempting to expand your role with a supervisee beyond the professional one, such conduct is ill advised. Keeping the relationship formal avoids potentially dangerous conflicts of interest and multiple relationships.
- Be sure there is clarity about your role, the supervisee’s role and your expectations for their performance. Use of a supervision contract is ideal. (One will be available through ASPPB when they finalize the guidelines.)
- In addition to reviewing and signing off on your supervisee’s case notes, keep formal records of your supervision sessions. While these may not be requirements in your state, such conduct is protective of you and your supervisee. You should keep contemporaneous records of what happened during supervision and what recommendations you have made regarding a specific case. This includes a review of treatment records kept by your supervisee and signed approval of those notes, reflecting your agreement with what the records reflect. Remember the rule: “If it isn’t written down; it didn’t happen.”
- Make a requirement of your supervision monitoring of actual professional conduct of your supervisee. For example, listen to tape recordings of your supervisee’s treatment sessions or watch videos of them. Live observation or co-therapy also suffice. Conducting supervision sessions without ever monitoring their actual conduct is unwise.
- Remember that supervision is a form of life-long learning for the supervisor, invigorating your practice and competencies collaboratively as you work with the supervisee.
- Be sure you are aware of when a supervisee’s case becomes forensic. Carefully monitor forensic advocacy/ involvement on the part of your supervisee, conduct for which you are legally and professionally responsible.
Remember, until your supervisees are licensed, they cannot testify as experts and you will likely find yourself, as a supervisor, in that role dealing with the conduct of your supervisee. Simply put, be aware of potential legal advocacy on the part of your supervisee and make sure that your supervisee notifies you whenever the supervisee is contacted by an attorney dealing with a legal matter on behalf of a client.
Professional supervision is an important and key part of professional development. It makes the supervisor a gatekeeper to the profession, a job that is wrapped in professional obligation and ethical responsibility. While it can be, and usually is, a very rewarding experience, it also is a circumstance of risk and legal exposure. By adhering to the above suggestions and being familiar with the extensive literature that deals with supervision, psychologists can reduce the risks associated with it.
Carol A. Falender, Ph.D., has co-authored four books and numerous articles on clinical supervision includingClinical Supervision: A Competency-based Approach with Edward Shafranske, Ph.D. She was Chair of the APA Task Force on Supervision Guidelines.