Ethics Café: Clinical Supervision
19/11/2018ETHICS CAFÉ: CLINICAL SUPERVISIONBeth RobinsonDawn SchellLorna MartinOUR GOALThe Clinical Supervision Ethics Café has as its goalthe promotion of foundational awareness of ethicalconsiderations in clinical supervision for thecounselling and psychotherapy profession. CCPA 20181
19/11/2018SETTLE INSettle in with your favourite “cuppa” (literallyor figuratively) for some collegial connection,contemplation, and discourse.WHERE ARE WE HEADING?Updating Professional Supports‐Code of Ethics‐Standards of Practice‐Practice GuidelinesUses of Technology in Clinical SupervisionEthical Guidelines for Clinical Supervision ofCounselling and Psychotherapy CCPA 20182
19/11/2018CURRENT CONSIDERATIONS RELATED TOCLINICAL SUPERVISION IN THE CCPA CODE OF ETHICSCode of Ethics 2007EFFECTS OF MODERNIZATION ON PROFESSION OF COUNSELLING AND PSYCHOTHERAPY Increase in competency‐based foundations Increase in regulatory oversight Increase in requirements for clinical supervision Increase in evidence‐based research and service deliveryYour Coffee Shop5CURRENT CONSIDERATIONS RELATED TOCLINICAL SUPERVISION IN CCPA’S STANDARDS OF PRACTICEStandards of Practice 2015 Alignments to regulatory oversight Awaiting Code of Ethics updates to align to new Code indicators Increase in requirements for clinical supervision facilitates opportunity/potential forpractice guidelines Recognition of distinctions between clinical supervision during practicum/internship andduring professional lifespanYour Coffee Shop6 CCPA 20183
19/11/2018THE CURRENT SITUATIONSTANDARDS OF PRACTICE AND CODE OF ETHICS SUPERVISION SEGMENTATIONCODE OF ETHICS1/6 sections7.6%15.2%CoE 2007SoP 2015STANDARDS OFPRACTICE1/6 sectionsPERCENT OF TOTALSTANDARDS7.6%Section F15.2%TBD2019‐20 UPDATESTBDPERCENT OF TOTALCODESSection F2018‐19 UPDATESYour Coffee Shop7KEY GOALS31/05/1931/05/2030/09/2030/11/20Update Code of EthicsUpdate and align Standards of PracticeCreate Practice GuidelinesAlign Canadian Counselling andPsychotherapy Experience: Ethics‐BasedIssues and Cases to revised Code ofEthics and Standards of PracticeAlign Clinical Supervision of theCanadian Counselling andPsychotherapy Profession to revisedCode of Ethics and Standards of PracticeYour Coffee Shop8 CCPA 20184
19/11/2018MODERNIZATION AND RECOGNITION OFA CHANGING CANADAIncreasing Breadth and Depth of Focus Areas Modality diversity and service delivery varieties (within and across treatments) Client and provider diversity Vulnerable persons (changing dynamics) Indigenous ways of being, knowing, and doing Mindfulness High conflict Systems approachesYour Coffee Shop9USES OF TECHNOLOGY INCLINICAL SUPERVISION –ETHICAL CONSIDERATIONSDawn Schell CCPA 20185
19/11/2018GUIDELINES PROJECTTechnology and Innovative Solutions ChapterEmphasis on creating practical guidelines to inform and guide practitioner use of technology Literature review Reviewed Guidelines from other professional associations Conducted survey of members Hosted expert panel discussion Wrote CCPA guidelines (currently awaiting CCPA board approval)Your Coffee Shop11WHAT IS MEANT BY “TECHNOLOGY”IN CLINICAL SUPERVISIONAs an adjunct to .To communicate with Telephone (landline, cell, or Webcam/videoconferencingTo provide Telephone (landline, cell, orsmartphone)smartphone) Digital/video recording Webcam/videoconferencing Websites Email Apps Text or chat messaging Podcasts Webcam/videoconferencing Digital/video recording Via videoconference of face‐to‐face session or virtual reality Readingssession Email Text or chat messagingYour Coffee Shop12 CCPA 20186
19/11/2018EACH MODALITY Has unique features that may impact: Client‐supervisee relationship Supervisee‐supervisor relationship Privacy and security May require different competencies What might this mean for clinical supervision?Your Coffee Shop13ETHICAL GUIDELINES FOR CLINICAL SUPERVISION OFCOUNSELLING AND PSYCHOTHERAPYBeth Robinson CCPA 20187
19/11/2018TENETS OF BEST PRACTICE CLINICAL SUPERVISION Clinical supervisors of counsellors and psychotherapists conduct themselves in a manner that evinces clinical supervision competence and commitment engage in practices that are ethically and legally consonant exhibit cultural and other diversity responsiveness and competence prioritize the wellbeing of clients seek to cultivate supervisory relationships and processes that optimize opportunities for superviseeprofessional growth and development are aware that they represent the counselling and psychotherapy profession and take seriously their rolesas leaders, exemplars, and ambassadors for the professionYour Coffee Shop15ETHICAL MANDATE The primary mandate of clinical supervision is protection of the public, with emphasis on the wellbeing ofclients of supervisees This supervisory responsibility takes precedence over all others (Bernard & Goodyear, 2014) Consequently, clinical supervisors are held responsible for careful and comprehensive oversight ofsupervisees’ work with clients Clinical supervisors seek to ensure that client needs are assessed and addressed appropriately, adequately, effectively, and efficiently via soundcounselling practices accompanied by a clear rationale for approaches adopted supervisees consistently demonstrate adherence to ethical standards and compliance with legalimperatives Supervisees engage with clients in culturally responsive and competent manner Clinical supervisors also prioritize the continued professional growth and development of superviseesYour Coffee Shop16 CCPA 20188
19/11/2018ENTERING INTO A CLINICAL SUPERVISORYRELATIONSHIP AND PROCESS When counsellors and psychotherapists accept and assume the role of clinical supervisor, andenter into clinical supervisory relationships and processes, they carry with them all of theirexisting ethical commitments as helping professionals To these, they add ethical responsibilities that pertain to the multilayered relationshipsassociated with clinical supervision: counsellors/supervisees and clients (direct relationship); clinical supervisors and supervisees (direct relationship); and clinical supervisors and clients of supervisees (indirect relationship).Your Coffee Shop17ENTERING INTO A CLINICAL SUPERVISORYRELATIONSHIP AND PROCESS This increased ethical complexity might be compared to a three‐dimensional gameof checkers or chess in that clinical supervisors must be attentive to the impact ofall decisions and actions on clients of supervisees; client and counsellor/supervisee relationships; supervisees; supervisee and clinical supervisor relationships; supervisors; and indirect relationships between clinical supervisors and clients of supervisees.Your Coffee Shop18 CCPA 20189
19/11/2018COMPREHENSIVE ETHICAL GUIDELINESRATIONALE FOR DEVELOPMENT Clinical supervision identified as the third most frequent activity of professional helpers (Norcross,Hedges, & Castle, 2002) 85‐90% of practitioners with 15 or more years of experience reported undertaking clinicalsupervisory role (Rønnestad, Orlinsky, Parks, & Davis, 1997) Thus, virtually all counsellors and psychotherapists will engage in role of clinical supervisor at somepoint on their career path However, historically, a minority have received any formal training in clinical supervision Hence, Watkins’ (1997) now familiar quotation, “Something does not compute.”Your Coffee Shop19COMPREHENSIVE ETHICAL GUIDELINESRATIONALE FOR DEVELOPMENT Improper or inadequate clinical supervision identified as ninth most frequently citedcauseof disciplinary action by licensing boards (ASPPB, 2014) Appears likely that the emergent recognition in Canada of clinical supervision asspecialtyarea of practice in counselling and psychotherapy will be accompanied by increasedattunement to ethical comportment and professionalism expected of clinical supervisors In turn, heightened awareness may be reflected in concomitant increase in the number ofethics inquiries and complaints related to the practice of clinical supervisionYour Coffee Shop20 CCPA 201810
19/11/2018COMPREHENSIVE ETHICAL GUIDELINESRATIONALE FOR DEVELOPMENT Behooves clinical supervisors to refer regularly to CCPA’s Code of Ethics, Standards of Practice,and (anticipated) Ethical Guidelines for Clinical Supervision Reflect on how to align clinical supervision practices with these documents Attention to these professional guides will safeguard welfare of clients, supervisees, and clinicalsupervisors across clinical supervisory contexts and stages of supervisee and clinical supervisordevelopment Proposed Ethical Guidelines for Clinical Supervision framework will expand on ethical mattersthat pertain to counselling, addressed in CCPA’s Code of Ethics and Standards of Practice, andconsider these in light of the multilayered relational realities of clinical supervisionYour Coffee Shop21COMPREHENSIVE ETHICAL GUIDELINESRATIONALE FOR DEVELOPMENT Intent of proposed CCPA Ethical Guidelines for Clinical Supervision of Counselling and Psychotherapy is to establish guideposts for the ethical practice of clinical supervision cultivate a critically analytical ethical mindset that considers decisional impacts on all parties inclient‐counsellor/supervisee‐clinical supervisor relationships accord primacy to client wellbeing and protection of the public contribute to a reciprocally growth‐promoting supervision experience for supervisees and clinical supervisors provide parameters and predictability to clinical supervisory relationships, thus fostering mutual trust andrespect and a strong working alliance serve as the foundation for optimal clinical supervisory process and outcomesYour Coffee Shop22 CCPA 201811
19/11/2018FRAMEWORK FOR ETHICAL GUIDELINES1. Informed Consent2. Commitment to CCPA’s Codeof Ethics and Standards ofPractice3. Familiarity with OtherRelevant Ethics Codes andStandards4. Client Welfare5. Supervisee Welfare6. Confirmation of SupervisorSuitability7. Boundaries of Competence8. Confidentiality9. Technology10. Duties to Report, Warn, and/orProtect11. Multiple Relationships andProfessional Boundaries12. RecordkeepingRecordkeeping in CounsellingRecordkeeping in ClinicalSupervisionClinical Supervision Contract /Plan/Agreement13. Access to Records14. Care and Custody of Records15. Cultural and Other DiversityCompetence andResponsiveness16. Assessment, Feedback,Evaluation, and Reporting17. Due Process18. Remediation19. Gatekeeping20. Impairment21. Self‐Care22. Negligence and Malpractice23. Direct and Vicarious Liability24. Risk Management25. Supervision of Supervision26. ConsultationYour Coffee Shop23IMPLICATIONS AND DIRECTIONSWHAT DOES THIS MEAN?AS YOU CONTEMPLATE ETHICAL CONSIDERATIONS IN CLINICAL SUPERVISION, WHAT DO YOU PERCEIVE TO BE THEIMPLICATIONS FOR PRACTICE?WHAT HAVE YOU SEEN?WHAT ETHICAL CHALLENGES AND CONUNDRUMS HAVE YOU ENCOUNTERED IN CLINICAL SUPERVISION PRACTICE? WHATETHICAL CONFUSION OR CONCERNS HAVE EMERGED FOR YOU?ARE WE KEEPING UP?TO WHAT DEGREE HAS THE PROFESSION’S ATTENTION TO ETHICAL CONSIDERATIONS IN CLINICAL SUPERVISION KEPTPACE WITH THE ESTABLISHMENT OF CLINICAL SUPERVISION AS A SPECIALTY AREA OF PRACTICE?WHAT DO WE NEED TO DO?WHAT NEXT STEPS DO YOU FORESEE AND / OR RECOMMEND TO PROMOTE ETHICAL AWARENESS AND ADHERENCE INTHE PRACTICE OF CLINICAL SUPERVISION?Your Coffee Shop24 CCPA 201812
19/11/2018THANK YOU!CONTACT VIA:Beth RobinsonBeth.Robinson@acadiau.caYour Coffee Shop25REFERENCESAssociation of State and Provincial Psychology Boards. (2014). ASPPB disciplinary data system: Historical disciplinereport. Retrieved from http://www.asppb.net/?page DiscStatsBernard, J. M., & Goodyear, R. K. (2014). Fundamentals of clinical supervision (5th ed.).Upper Saddle River, NJ:Pearson Education, Inc.Canadian Counselling and Psychotherapy Association. (2007). Code of ethics. Ottawa, ON: Author.Canadian Counselling and Psychotherapy Association. (2015). Standards of practice (5th ed.). Ottawa, ON: Author.Martin, P., Kumar, S., & Lizarondo, L. (2017). Effective use of technology in clinical supervision. InternetInterventions, 8, 35 – 39.Norcross, J. C., Hedges, M., & Castle, P. H. (2002). Psychologists conducting psychotherapy in 2001: A study of theDivision 29 membership. Psychotherapy: Theory, Research, Practice, Training, 39, 97‐102.Your Coffee Shop26 CCPA 201813
19/11/2018REFERENCESRønnestad, M. H., Orlinsky, D. E., Parks, B. K., & Davis, J. D. (1997). Supervisors of psychotherapy: Mappingexperience level and supervisory confidence. European Psychologist, 2(3), 3.191Rousmanière, T., & Renfro‐Michel, E. (Eds.) (2016). Using technology to enhance clinical supervision. Alexandria, VA:American Counseling Association.Shepard, B., Martin, L., & Robinson, B. (Eds.). (2016). Clinical supervision of the Canadian counselling andpsychotherapy profession. Ottawa, ON: Canadian Counselling and Psychotherapy Association.Stretch, L. S., Nagel, D. M., & Anthony, K. (2012). Ethical framework for the use of technology insupervision. Therapeutic Innovations in Light of Technology, 3(2), 37‐45.Watkins, C.E., Jr. (Ed.). (1997). Handbook of psychotherapy supervision. New York, NY: Wiley.Your Coffee Shop27 CCPA 201814
Attention to these professional guides will safeguard welfare of clients, supervisees, and clinical supervisors across clinical supervisory contexts and stagesviseeof super and clinical supervisor development Proposed Ethical Guidelines for Clinical Supervision framework will expand on ethical matters
supervision). KEYWORDS. Clinical supervision, conceptual model, systematic review One of the major challenges hindering the further development of clinical supervision has been poor conceptualization in both theory and empirical studies: Clarifying what clinical supervision is and how it works. Supervision theories have historically been derived
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CAF World Giving Index 2018 This ninth edition of the CAF World Giving Index presents giving data from across the globe over a five year period (2013-2017). The CAF World Giving Index 2018 includes data from 146 countries that was collected throughout 2017. A full explanati
13.19 Voltage-Transformer Circuit Breaker 1032 13.20 Voltage-Balance Supervision 1033 13.21 Voltage-Sum Supervision 1034 13.22 Voltage Phase-Rotation Supervision 1035 13.23 Current-Balance Supervision 1036 13.24 Current-Sum Supervision 1037 13.25 Current Phase-Rotation Supervision 1038 13.26 Temperature Supervision 1039
Clinical Supervision assures that an appropriate safety and crisis management plans are in place at the onset of service delivery. Clinical Supervision addresses ethics and ethical dilemmas as aligned with the appropriate professional practice board. Clinical Supervisors will document date, duration, and the content of supervision
clinical supervision are to ensure (1) quality client care, and (2) clinical staff continue professional development in a systematic and planned manner. In substance abuse treatment, clinical supervision is the primary means of determining the quality of care provided. 2. Clinical supervision enhances staff retention and morale.
Sampling for the Ethics in Social Research study The Ethics in Social Research fieldwork 1.3 Structure of the report 2. TALKING ABOUT ETHICS 14 2.1 The approach taken in the study 2.2 Participants' early thoughts about ethics 2.2.1 Initial definitions of ethics 2.2.2 Ethics as applied to research 2.3 Mapping ethics through experiences of .
supervision and solution-focused supervision. Postmodernism is defined, key themes within the postmodern supervision literature are identified, a brief review and critique of the literature on both supervision approaches is provided, and implications for the practice of supervision and future
