Balancing duty to client and therapist in supervision: Clinical, ethical and training issues

The clinical, ethical and training implications of supervision as a dual contract with supervisee as therapist and client as care recipient are considered. Particularly for the still unlicensed professional, the supervisor has a responsibility to ensure that treatment meets the standard of care which includes recognizing the existence and meaning of a dual contract with client and therapist. Careful selection of therapists does not fully ease the search for the proper balance of tolerance and oversight related to the supervisee's therapy work. In a field dedicated to accepting people in a very fundamental fashion, both supervisors and supervisees have difficulty with the evaluation and limit-setting sometimes involved in the training process. Two underlying aspects of the supervision process, modeling and relationship, modulate and shape supervisee learning. When the supervisor's responsibilities to the evolving supervisee/therapist and the client do not lend themselves to reconciliation, the clinical, ethical and training aspects of the supervisory process all fall on the side of client welfare. A number of supervisory vignettes illustrate the complexities of the supervisory process.