emphasizing that this crosses a boundary. Although uncomfortable, discussion about attraction is warranted. Clinicians should normalize the realities of attraction but discuss that those feelings must be addressed in order to move on in therapy. 6. If a client sends a “like,” or mentions in session that they have seen the therapist’s profile on a dating app, the client’s reaction to this should be discussed: “Yes, I use a Email and Texting Email or text communication with clients allows the clinician to be more accessible and to answer simple questions between appointments. However, this risks replacing in-person sessions and, more importantly, risks misunderstanding in the communication due to lack of voice and body language and the ability to immediately clarify if needed. Clear guidelines about the use of electronic communication should be spelled out in the initial informed consent paperwork. Consider limiting the use of these communications to the more mundane administrative
dating app in my personal life like many others do. How do you feel about this? Does this change your view of my role as a therapist?” 7. After discussion with the client, consider if blocking may be appropriate. Blocking involves removing a user’s ability to view a profile; this may help to avoid potential problems in the therapy relationship. aspects of the therapy relationship and encourage in-person meetings for process-oriented issues. Self-Assessment Quiz Question #4 “Friending” or “following” a current client on social media: a. Is not addressed by most codes of ethics b. Does not have the potential for client harm c. May cause inappropriate therapist self-disclosure d. Is not a privacy issue for client and/or therapist
SUPERVISION AND BOUNDARIES
Entering into a supervisory relationship constitutes a unique dual relationship. Typically, the supervisor is providing clinical oversight to an unlicensed practitioner who is accruing the necessary hours required for independent licensure. This often occurs in an environment where supervisor and supervisee are also coworkers. This creates numerous opportunities for interactions outside of the supervision session. For example, attending the same administrative meetings, working on the same clinical team, or interacting during lunch in the breakroom or cafeteria can lead to a dual relationship. Professional ethics codes provide guidance on navigating these relationships. The ACA Code (2014) states that supervisors must clearly define and maintain ethical professional, personal, and social relationships with supervisees. (Section F). This is also outlined in the NASW Code (2021) which states that at the start of the relationship informed consent, policies and procedures, and mechanisms for due process are outlined. If boundaries are to be extended, precautions are taken to ensure that judgement is not impaired and no harm occurs. Sexual or romantic relationships with supervisees are prohibited (Section 2). The AAMFT Code (2015) additionally states that supervisors must remain aware of their influential position, and they avoid exploiting the trust and dependency of the supervisee (Section 4). The APA Code (2017) states that “Psychologists do not exploit persons over whom they have supervisory, evaluative, or other authority” and “They do not engage in sexual relationships with supervisees who are in their department, agency, or training center or over whom psychologists have or are likely to have evaluative authority” (Section 7). There is a clear power imbalance in the supervisory relationship. The supervisor is ultimately responsible for the quality of work performed by the supervisee and can be held accountable for the professional services provided by the supervisee. This places particular importance on the setting and maintaining of clear professional boundaries. Various states have regulations regarding supervision. For example, the New York Education Department (2023) lays out guidelines for maintaining appropriate boundaries in supervision. They state that the supervisory relationship is a form of practice and is governed by the same guidance that applies to client relationships with regard to ethical considerations, confidentiality, expectations and responsibilities, and appropriate boundaries.
The Education Department nicely outlines in a professional practice alert the specific areas that should be addressed when entering into a supervisory situation: 1. The nature and terms of the relationship should be spelled out in advance including: a. The limits of confidentiality including the mandate for reporting child abuse b. The information that the supervisor can report to the supervisee’s employer c. The limits of what the supervisor can do if there are questions about the nature or quality of the practice being supervised d. The supervisor’s ultimate responsibility to the person receiving supervision 2. Supervisors should be aware of the ramifications of their signature on forms, including insurance forms. 3. Supervisees should make clients aware of the supervisory relationship and get informed consent. 4. When a clinician is providing supervision for persons accruing experience for licensure, no direct payment should be made as this could be considered a conflict of interest and dual relationship. 5. Supervisors should recognize that they might be held accountable and/or charged with professional misconduct for the professional misconduct of a supervisee. 6. It is wise to keep records of each supervisory session. A written agreement that clarifies responsibilities can help to establish clear boundaries including: 1. Purpose and scope of supervision 2. Learning and development needs of the supervisee and plans to address those needs 3. Structure of supervision, including but not limited to a. Expected duration of the supervisory relationship b. Length and frequency of supervisory sessions c. Time and place of supervisory sessions d. Cost (if any) and payment arrangements e. Role expectations of supervisor and supervisee f. Accountability and reporting requirements g. Confidentiality protections Blalock and colleagues (2021) note that a common boundary issue faced by supervisors includes multiple relationships. Although a multiple relationship may be a boundary crossing, it may not necessarily be detrimental or harmful. The specific situation and intent needs to be considered.
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