Ethical Concerns and Practical Advice for Supervisors

Ethical Concerns and Practical Advice for Supervisors

In my role as a consultant for CPH, an insurance agency that provides professional negligence insurance for mental health professionals, I often consult with supervisors of licensure candidates from across the country when they have issues or concerns related to supervision. Supervisors can be held accountable for the mistakes and acts of their supervisees and held civilly liable for negligent supervision of supervisees if a client is harmed.  As a result of these consultations I have compiled the following list of suggestions for supervisors of candidates for licensure or certification.

  1. Know the rules promulgated by your board or certification body and review them with the supervisee. Make sure all documentation is timely completed and submitted at the front end and throughout the term of the supervision.  If you are an off-site supervisor be sure any changes in the supervision agreement or the supervisee’s practice sites are reported to the board if required.
  2. Keep your supervision credential current and monitor your continuing education compliance. Letting your credential lapse could jeopardize a supervisee’s approval of supervision hours and you could be compelled to refund fees paid to you by the supervisee.  Continually improve your knowledge of and competency for supervision through education and consultation with colleagues.
  3. Thoroughly vet your supervisees. Interview them carefully. Contact instructors, especially practicum and internship supervisors and instructors, for feedback and information. Ask for letters of recommendation. Trust your “gut”.
  4. Not all graduate programs are the same. Familiarize yourself with the programs your supervision applicants come from. You want strong applicants from strong programs.
  5. Review case files for every client your supervisee treats even if you are an off-site supervisor. I have had many consults with supervisors who learned after the supervision relationship terminated that deficiencies existed for a supervisee’s client records.
  6. Check in with the clients treated by the supervisee.Their perception of their therapy may be very different from the supervisee’s. Question them about their satisfaction with the supervisee and the services they have received.
  7. If you are an off-site supervisor, check in regularly with a supervisee’s employers and employment supervisors. Again, trust but verify.
  8. When you provide direction to your supervisee expect prompt follow through. Document compliance or the lack thereof in your supervision file.  When problems become evident quickly lay out a remediation plan orally and in writing. Monitor compliance and progress closely and document them.
  9. If a supervisee does not comply with the remediation plan or proves to be a poor provider terminate your supervision.
  10. Encourage communication from your supervisees when questions or problems arise for them.Make sure your supervisees have easy access to you when their need to communicate arises.  Consider setting a specific recurring time for supervision sessions so both you and the supervisee can more easily manage your calendars and availability.
  11. Make sure you have easy access to your supervisees when you need to communicate with them arises.
  12. Make sure your supervisees have professional liability insurance coverage and stay insured.Get proof of insurance.
  13. Make sure you maintain your own professional liability insurance.
  14. If applicable board rules or ethics codes require you to report violations by licensees or credential holders do not hesitate to do so. Your failure to do so could result in disciplinary action being brought against you.
  15. Be quick to intervene when you have concerns about a supervisee’s competence to effectively treat a client and if necessary help facilitate the referral to a mental health professional who has the needed competency.
  16. Make sure you charge adequate fees for your supervision. Fight the “you get what you pay for” mentality that could creep in otherwise. To provide good supervision and do the things I am suggesting is time consuming and a service for which you deserve to be appropriately compensated.
  17. Only supervise the number of supervisees for whom you can provide quality supervision.
  18. View supervisees like clients you treat, only hopefully, more stable and better adjusted.They deserve the same professionalism and courtesy as the people you treat. Remember you are a role model for your supervisees whether you like it or not
  19. To provide quality supervision you must maintain objectivity so consider maintaining the same strict boundaries as you would with a therapy client.
  20. Keep detailed records for each supervision session including time, date, what was covered and discussed. Don’t forget to cover ethics and document it.

Never forget your accountability and potential liability as a supervisor when things do not go well with a supervisee and the supervision. Being vigilant and active in your role as supervisor and thoroughly documenting your supervision is best practice.

For further information regarding supervision you can visit us here and like us on Facebook & Instagram to keep up with ATCB news and updates.

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Written by:

Tom Hartsel
Public Member Director

Defining Rights & Responsibilities in a Supervision Relationship

Defining Rights & Responsibilities in a Supervision Relationship

During school, supervision is provided and expectations for supervisor and supervisee roles are defined by the school or program. Newly graduated art therapists entering the work world may or may not have a supervisor available to them at their work site and will have to find and negotiate supervision services from a professional. Credentialed art therapists may also find themselves taking on the role of supervisor without formalized training in the role and responsibilities of supervisors. For both parties it is important to define the rights and responsibilities that are involved in the supervision relationship.

An excellent source of information regarding supervision rights and responsibilities may be found in Fundamentals of Supervision. Many forms for both supervisees and supervisors are provided to help support supervisor and supervisee dialogues about expectations and guidelines. A “Supervisee’s Bill of Rights” and a “Supervision Agreement” form, based on the Bill of Rights, are two such forms provided. Within the Supervisee’s Bill of Rights, the nature of the supervisory relationship is described. For example, the role of the supervisor is said to facilitate “professional growth of the supervisee through: monitoring client welfare, encouraging compliance with legal, ethical, and professional standards, teaching therapeutic skills, providing regular feedback and evaluation, [and] providing professional experiences and opportunities” (Giordana, Altekruse, & Kern, 2000, as cited in Bernard and Goodyear, 2014, p. 313).

Other components of the Bill of Rights address means to identify development of supervision goals and the processes that will be utilized. For example, the supervisee may identify the need to explore countertransference with a particular type of client, and the supervisor may identify that the supervisee will come prepared for supervision by bringing responsive art, or perhaps transcripts of sessions. Fundamentals of Clinical Supervision’s Bernard & Goodyear also assert that establishing defined learning objectives are essential in shaping the direction and content of supervision. Even before entering into a supervision agreement, Bernard & Goodyear recommend that the supervisor disclose essential information regarding credentials, licenses, academic background, and experience.

As a part of this initial introduction, it is important for supervisor and supervisee to discuss their theoretical orientations so that they may assess alignment or interest in the framework of instruction that may be utilized. For example, a supervisor may be trained in and practice art therapy from a psychodynamic framework, yet, the supervisee may want or expect art therapy supervision with a transpersonal or cognitive behavioral emphasis. Similar to the informed consent process in therapy and research, supervisors should clearly communicate their ways of working so that the supervisee understands what will be offered and expected.

Once informed, supervisees can determine if the supervisory relationship will meet their supervision needs. The Art Therapy Credentials Board also provides guidelines in the Code of Professional Practice regarding supervisory responsibilities. According to the Code of Professional Practice, art therapy supervisors foster professional growth through “the use of accurate, current, and scholarly information.”  Art therapists who serve as supervisors are also responsible for their supervisees and assure that supervisees do not perform and represent themselves “as competent to perform professional services beyond their education, training, experience, or competence.”

Supervisors are also responsible for the quality of the supervision they provide and the maintenance of their supervision skills. In his or her role as supervisor, a supervisor takes into consideration his or her own skill level and seeks supervision or consultation as needed in order to provide the supervisee with adequate feedback and evaluation. All supervisors need to be aware of the content of the Codes of Professional Practice in order to communicate and support ethical practice of art therapy.

Qualified ATR-BCs who are interested in demonstrating substantial supervision qualifications may apply for a supervisor credential through the ATCB. This credential, Art Therapy Certified Supervisor (ATCS), helps to inform prospective supervisees that their supervisor has met specific criteria for competency in the theories and practices of art therapy supervision. Additionally, ATCSs must apply for recertification during their ATR-BC renewal cycle every five years and meet requirements for continuing education in supervision.

Whether or not a supervisor holds the ATCS credential, he or she must be familiar with state regulations regarding his or her responsibility for supervisees’ client welfare. It is critical to understand that supervisors may be held responsible for a supervisee’s actions that have been identified as malpractice. The Bernard and Goodyear text provides general information and recommendations for preventing and addressing these challenges as well. Proactively, supervisors should alert their malpractice insurance carrier regarding their supervisory responsibilities to assure they have sufficient coverage for these potential occurrences.

Yes, supervisor responsibilities are significant, but, just as significant are the joys of sharing expertise, witnessing the development of new art therapists, and cultivating the growth of the art therapy profession. To all art therapists who mindfully take on the supervisor role, thank you. Keep up the good work! –

To learn more about art therapy supervision visit us here and like us on Facebook & Instagram to keep up with ATCB news and updates.

Written by:

Barbara-Parker Bell
PhD, ATR-BC
Past President-Art Therapy Credentials Board

Everything You Want to Know About Supervision

Everything You Want to Know About Supervision

Supervision is so important to our growth and development as art therapists, in our commitment to provide quality treatment to our clients and for self care. There can be many questions regarding supervision, I have highlighted the basics below.

What is supervision?

Supervision is a professional relationship that 2 people (or a seasoned art therapist and a group of supervisees) willingly enter into where one is deemed an expert. A supervisor has sufficient years of clinical experience, appropriate credentials, ongoing educational training (perhaps being involved in his or her own supervision process) and awareness of the responsibility of being a supervisor.

There are different aspects to supervision. Both parties are aware that the supervisor is a role model, one who guides and oversees the quality of client care and can provide support in managing and attending to administrative duties as well as support, encouragement and direction for professional development, enhancement of clinical skills and growth as an art therapist.

Who can provide supervision?

Anyone who provides supervision needs to demonstrate his or her knowledge, commitment to the field of art therapy and own ongoing growth and development as an art therapist. Supervisors need to have someone they can access for their own supervision and/or consultation, and have a minimum number of years of practice after they receive their credentials and their own supervision. (The ATR-BC and/or a license to practice in a particular state does not necessarily qualify someone to supervise another art therapist.) Completing the ATR, Board Certification, and state licensure is a huge accomplishment and requires many hours of direct service and supervision. While it is something of which to be proud, it does not automatically qualify an art therapist to able to provide adequate supervision to others.

So, who can provide supervision?

Malchiodi and Riley recommend a number of guidelines for art therapy supervision and for the responsibilities of a supervisor. They suggest that a supervisor have the following qualifications:

  1. Be credentialed in the field
  2. Have no pre-existing relationship with the potential supervisee
  3. Have two years of active practice following receiving his or her credentials
  4. Have supervised experience in serving a similar population to that of the supervisee
  5. Be aware of multicultural issues in both clinical work and supervision
  6. Be sensitive to the evaluative nature of supervision

Who needs supervision?

Supervision is important for on-going growth and development as art therapists, to enhance clinical skills, to receive support and guidance when working with challenging clients, for encouragement, for having a safe place to address countertransference concerns, and for self care.  Art therapists in training, new art therapists working towards their credentials and art therapists working with a new population all require supervision.

What about once art therapists have received their credentials? The mental health field, especially our chosen profession of art therapy, is constantly changing and growing. Reading, attending conferences, being aware of new ideas and approaches, attending advanced training programs, and yes, being involved in our own supervision can help us continue to grow. Supervision is especially imperative in one’s early years of clinical practice, but at any stage of development and experience, a supervisory relationship can be a satisfying and enriching experience for both parties.

While one may not necessarily choose to be in supervision weekly throughout one’s entire career, one does need to have someone to reach out to for supervision and/or feedback. “Supervision provides the distance that the therapist needs to look at cases objectively”- Klorer.

How do you know if you are ready to be a supervisor?

If you do want to be a supervisor, explore working towards your ATCS, an Art Therapy Certified Supervisor. Once you have your ATR-BC, be aware of the many important aspects of supervision, as well as things to think about prior to making a commitment to supervising other art therapists. Consider the following:

  • Do you feel you have adequate experience and clinical skills with the population with whom the supervisee is working?
  • Do you feel prepared to mentor, support, guide, and help another art therapist find his or her voice as an art therapist?
  • Are you prepared to address client – therapist interactions that may need to be looked at more carefully, whether it be related to counter transference, skill level, or treatment issues and goals?
  • How will you structure the supervision meetings?
  • How will art making be included?
  • Are you in supervision yourself?
  • Do you need to sign off on notes that the supervisee writes?
  • Will this take place on site, where you both work, off site, or in a private practice setting?
  • If on site, how will being the supervisor possibly alter your existing relationship with your supervisee?

Our own Code of Ethics, Conduct and Disciplinary Procedures, addresses the art therapist’s role as supervisor and should be consulted prior to making the decision to supervise someone. According to article 1.3.4, “Art therapists who act as supervisors are responsible for maintaining the quality of their supervision skills and obtaining consultation or supervision for their work as supervisors whenever appropriate.”

So, while you may be able to supervise someone once you have your ATR-BC, please be thoughtful in deciding if you should, if you feel adequately prepared to thoughtfully take on the roles and responsibilities of supervisor, including administrative, clinical and educational roles, and you are confident in your understanding of and ability to adhere to the ethics of the ATCB regarding supervision.

As Garlock stated in the Spring 2017 edition of The ATCB Review, “The helping professions are continually changing—hopefully growing and becoming better at serving clients and communities. Some allied fields already require supervisor certification in order to supervise; it may be just a matter of time before all licensed professions, including art therapy, require certification. And that is a good thing for therapists, supervisees, and clients.”

To learn more about art therapy supervision visit us here and like us on Facebook & Instagram to keep up with ATCB news and updates.

This article was originally published in the ATCB Review Summer 2017, Volume 24, Issue 2

 

Written by:

Caren Sacks
ATR-BC, ATCS, LCAT