Ethics in Clinical Supervision
Ethics is the foundation of professional practice as well as LPC licensure training and supervision. Ethics isn't a component of your practice: all aspects of your practice are based upon ethics. It is the cornerstone of the practice of psychotherapy.
Your practice can't survive if you don't have a solid grasp of what is right and wrong. Morally, clinically and legally. Without that foundation, even the most sophisticated counseling skills are of little value.
None of us are automatically 'ethical'. You must learn it from more experienced peers. Either through consultation or professional CEU workshops. In a broader sense, LPC licensure training and supervision involves getting a license, maintaining it, and receiving/giving help to our peers.
The state of the profession is determined by those it gives birth to.
In other words, experienced therapists have an obligation to nurture the growth of those new to the counseling profession. Good license hygiene requires a mastery of ethics.
This should start from the time we begin pursuing a license. It transcends professional identity or orientation: this guide applies to everyone licensed to practice psychotherapy including psychologists.
My decision to provide ethics training and supervision was based on my experience serving on the Composite Board of Professional Counselors, Social Workers and Marriage and Family Therapists. Board members are appointed by the governor. I served for 7 years. When I departed, I wanted to share my experiences with peers. I knew I could have a positive impact on the profession. I felt a duty to share how the board evaluates ethics complaints.
Why ethics should be your top priority
Some of the most common ethical violations are found to be boundary crossings.
For therapists, the greatest job hazard is managing human contact. When our helping turns into rescuing, we have engaged in a boundary crossing. This type of boundary crossing is a common blind spot for new or inadequately trained therapists.
Sometimes therapists lack a capacity to see they have crossed a boundary. This is very concerning and it is compounded when their clinical supervisor doesn't see it either.
Supervisors must be skilled not only in recognizing boundary crossings, but they must use those skills so together you can get your work back on track.
As you can see, you need a solid foundation in ethics in order to practice safely and fortify where you are most vulnerable. I explain this further in my approach to supervision.
What is good license hygiene
Hi-giene (ˈhīˌjēn) noun: conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness. synonyms: cleanliness, sanitation, sterility, purity.
First, hygiene is prevention. As you proceed towards licensure, you should be proactive in ensuring a clean and unblemished license history. You accomplish this by incorporating a system for addressing areas where you need to strengthen your license.
There are 7 essential elements to gaining a solid grasp of ethics and good license hygiene.
7 essential elements of ethics and good license hygiene
Read the Composite Board Code of Ethics
Review the Composite Board Code of Ethics. Georgia professional counselors, social workers and marriage and family therapists are all bound by this same code. I cover it with participants line-by-line in my ethics workshop, Understanding the Composite Board Complaints and Investigations Process.
Supervision by a Well-Trained Supervisor
Having a state practice license is a serious matter. Select your supervisor carefully. For example, if you are working with children, they need to have worked with children. They should state to you their approach to supervision.
Your supervisor should know the board rules and ethics. They need to stay on top of rule changes as well as board policies. They need to be competent in guiding you on ethical dilemmas.
There should be a 'click' between you. There is too much at stake to put your pursuit of licensure in the hands of someone you don't fully trust. You are paying them for your service. They should work on your behalf and in your best interests.
Nonetheless, they should be someone who will also kindly yet bluntly challenge your work. But, if you can't share challenging ethical situations with your supervisor, it will be difficult for you to develop as an ethical therapist.
Rethink Definitions of Boundary Crossings
We all know the obvious boundary violations. For example, we know not to engage in intimate relationships and barter with clients. However, there are subtle boundary crossings we tend to miss.
Consider how this can roll down hill very quickly. The client begins work. After several months they become disgruntled with their boss who is your friend who gave you the "hook-up" on the job. At this point a breach has occurred. The client further becomes upset with you for connecting them with a job where they have a legitimate harassment case. The client files a licensing board complaint against you for the breach and unprofessional conduct.
Do you want to avoid these types of complaints? Note the following best practices:
CEU Workshops on Boundary Management
From the above illustration it is easy to see why you can never get too much education in boundaries. Research the workshops and presenters thoroughly. It is important the information you learn is accurate and comprehensive.
Presenters/trainers should be in active clinical practice. The workshops should be empowering! You shouldn't leave with your head spinning feeling more confused and frightened.
Understand There is Always a Power Differential
Even though client relationships can be casual and relaxed, your client idealizes you. It may not be apparent, but clients hang on your every word and see you as the expert. Therefore, clients can be injured easily.
Choose your words carefully and check in with them to confirm that what you intended to convey is what they heard.
Peer Relationships That Are Friendships.
Perhaps the best way to achieve this is to carefully screen and select practice partners and office mates. Having a trusted peer on-site is invaluable.
Working through your ethical dilemmas often requires a non-judgmental third party.
It is very difficult to effectively practice psychotherapy if you have not been a client in therapy. Personal therapy compliments supervision. It also helps you recognize projections and transference/countertransference. Further, your supervisor will likely confront you when they believe that personal issues are impacting your work and you need to be able to respond to your supervisor.
Putting it all together
Now you can develop a personal system to ensure good license hygiene.
1) On even numbered years, you are required to complete 35 hours of continuing education. Take plenty of ethics courses especially boundaries. 10 hours is good. Choose topics that will help correct weak areas of your practice. Approved ethics courses can be used to fulfill all of your board CEU requirements. You can the round out our requirements with elective workshops.
2) As you encounter ethical dilemmas, you have at least two resources for help: your trusted supervisor and trusted peers. Through CE training you will have skills to interact in an educated manner with your trusted peers.
3) Incorporating and sharing your personal psychotherapy can be very helpful for your development. **More often than not, struggles with a client are related to personal issues and not sheer lack of clinical skills.**
I have tried to thoroughly cover ethics of LPC licensure training and supervision. If you have questions about this article, feel free to contact me by phone. If it is simple question, I am happy to offer a free phone consultation. Best wishes wherever you are in your career as a therapist!
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