A couple that you know from a mutual organization asks you to provide treatment to their child.  You offer referrals to other providers but they really press you to work with their child.  What are your ethical obligations? (paraphrased from NASW – Florida Chapter Newsletter (May/June 2010)

It may be ill-advised to work with the family members of people you know.  Marriage and Family therapists are cautioned by their code of ethics to

“1.3 Marriage and family therapists . . .[should] make every effort to avoid conditions and multiple relationships with clients that could impair professional judgment or increase the risk of exploitation. Such relationships include, but are not limited to, business or close personal relationships with a client or the client’s immediate family. . .”

It is up to the clinician to take specific steps to protect the client or potential client from any possible exploitation.  In the case above, the parents of the adult child are likely to want to be informed of the progress their child is making.  They may believe that their acquaintance with the therapist would entitle them to information that must be held in confidence.  When a therapist is put into a situation where he or she must refuse to provide information a conflict might arise.  No matter what the extent of the prior relationship between the parents and the therapist was, there is the possibility that the adult child may be concerned that his or her confidentiality could be breached.  Also, that individual might not even understand the strength of the mandate upon us as clincians to uphold their confidence.

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Great Seal of the State of  FloridaThe state of Florida requires that all mental health professional registered interns, Licensed Clinical Social Workers, Mental Health Counselors, Marriage & Family Therapists and  Psychologists must have several years of post-licensed practice and complete a 16-hour course on supervision in order to be determined a “Qualified Supervisor”.  The course as described in Florida State Chapter 491 is expected to be didactic, live and interactional, not a home-study or book and test based learning experience. In fact, there are very specific guidelines for the course one must take. Below, are the state’s basic requirements of content that must be included in supervision courses and my approach to these requirements to the course curriculum.

First, the course is expected to present information on major models of supervision. Interestingly, this trainer found little to no professional literature reviewing models of supervision to help the trainers to present a concise summary of supervisory theories has been found to date. So this trainer, with her colleague Mary Jo Klingel, LCSW has developed a method of helping the participants to use their knowledge of practice theories, values, performance expectations and other factors  to guide participants thoughts about supervisory interventions. As a result of the exploration of models of supervision, the participants of the training are able to develop their own personal model of supervision, another objective required by the state.

Another objective of the course is to help the participants explore the “co-evolving relationship dynamics between the therapist-client dyad, and the triad of supervisor-therapist-client relationships”. New therapists are helped to understand the dynamics of their relationship with their clients. This is often accomplished with the supervisor’s guidance and support while exploring the relationship between the supervisor and supervisee.

The training course also allows participants to explore distinctive issues that arise in supervision. Some examples of issues that our participants have explored include: strategies for resolving conflicts before they become complaints, documentation of supervisory sessions, contracting with the supervisee, transference and counter-transference.

The Qualified Supervisor’s courses incorporate either as a separate section or as thread weaving through the two days of study contextual variables such as culture, gender, ethnicity, power and economics. Potential Qualified Supervisors must also become familiar with ethical, legal and regulatory issues in supervision. We have explored at length the moral/ethical obligations related to “duty-to-warn” versus the absence of a legal obligation in Florida to make such a warning. Many discussions have revolved around potential liability as well as responsibility of the supervisor for the omission or commission of wrong acts by the supervisee.  While the Florida 491 Board has never disciplined a Qualified Supervisor as a result of vicarious liability, the possibility of that action does exist and should be

Finally, participants are helped to understand the role and necessity of evaluative practices during the time of supervision. The supervisory process is one step in the nurturing of new clinical professionals. Evaluation of performance and professionalism need not be harsh or overly critical. However, the supervisor has an obligation to his or her profession to ensure that individuals who become licensed are properly prepared and competent for the work they have chosen to do.

Supervision can be an exciting and mutually rewarding process when approached in the proper way. Keep in mind, that you are furthering your education for the betterment of you as a therapist and the betterment of the lives of your patients and colleagues. New theories and information are consistently becoming available, allowing these courses and your experience to remain fresh and stimulating.

If you are already a supervisor and feel like your work has become a bit stale or concerns about liability have arisen consider taking our Practice Friendly Supervision course as a refresher or attend one of our advanced supervision workshops.

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Group Psychotherapy

September 19, 2011

Mary Jo Klingel, ACSE, LCSW Human beings need one another in ways that influence us profoundly.  We grow and find our greatest joys and challenges in relationships. In group therapy, the relationships with the other group members become part of the healing process. When an individual is ready to make real changes in their life, [...]

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Dual Relationship Exemplars for Discussion

May 10, 2011

I am presenting some situations (from a variety of sources) that relate to Dual Relationships:

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What is a Dual Relationship?

December 18, 2010

. . .I gathered their questions, responses from a variety of knowledgeable people, and concerns into one file I realized that all of us would benefit from revisiting the concept “dual relationship”.

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New Workshops to be offered before 2011 licensure renewal

November 7, 2010

Two new workshops have been scheduled for Fort Lauderdale in February 2011, before Licensure Renewal deadline of March 31st.

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Florida Continuing Education Courses

January 15, 2010

Our 2010-2011 Training schedule has been posted. We want to know what topics you would like us to offer in the future. How do you think we could entice more people to open our Training Email Newsletters?

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Jacksonville social worker charged with having sex with teen patient

January 1, 2009

Ross McDonough from Jacksonville attended one of my courses which included a section on Ethics. He comments on knowing a colleague who violated therapist-client boundaries.

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Facilitator’s Resistance to New Interventions, and other matters

December 19, 2008

Frida responds (in red) to my questions and comments from our initial email conversation.

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