Supervisors' Advice vs. Therapist Autonomy: Ethical Considerations and Practical Tips

As a therapist, you might find yourself in a situation where you must decide whether to follow your supervisor's advice or make your own ethical decisions. This article explores the balance between these two approaches, providing insights based on ethical guidelines and practical experiences.

Introduction to the Debate

Therapists face the dilemma of whether to follow their supervisor's advice or make their own ethical choices. While some may argue that it is always necessary to follow the supervisor's guidance, others believe that a therapist should have the autonomy to make informed decisions.

Ethical Guidelines and Their Impact

United States: There is no specific ethical guideline in the US mandating that therapists in private practice need to follow their supervisor's advice. However, in some cases, such as when working for a clinic or practicing under another therapist's license, lack of adherence to supervisor's advice might result in termination based on clinic policies.

Other Countries: The rule varies across countries. In the UK, for instance, the British Association for Counselling and Psychotherapy (BACP) strongly recommends that therapists seek supervision, but it does not mandate it. Similar guidelines can be found in Canada with the Canadian Psychological Association (CPA).

Practical Considerations

Practicing therapists often bring their personal experiences and perspectives to therapy. Due to their close involvement, they might not be able to see certain situations objectively. This is where a supervisor plays a crucial role, offering an external, unbiased viewpoint to help therapists make better-informed decisions.

Case Study: A Supervisor's Influence on Therapy

Suppose a therapist, during a session, struggles with countertransference or is unable to provide the best care for their client. A supervisor might suggest changes or interventions that might help the therapist regain objectivity. In such cases, discussing these suggestions with the therapist could lead to a better understanding of the client's needs and more effective therapeutic strategies.

A therapist once shared a story where she disagreed vehemently with her supervisor's suggestion, feeling betrayed by the involvement of an outsider in her therapy sessions. This incident highlights the importance of transparency and the impact of such decisions on the therapeutic relationship.

Steps to Take When Questioning Supervisors' Advice

1. **Document the advice and your reasoning:** Record the supervisor's advice and your reasons for questioning it. This can be helpful for maintaining a clear record and understanding the reasoning behind decisions.

2. **Seek ethical guidance:** Consult the ethics committee of your professional association for advice on how to handle the situation. This can provide additional support and ensure that your actions align with ethical standards.

3. **Consider a change in supervisor:** If you consistently feel that a particular supervisor is not in your best interest, consider seeking a change. Full disclosure about your concerns is crucial for a new supervisor to understand your needs.

Conclusion

Therapists are often encouraged to seek guidance from supervisors but ultimately, they must make their own ethical decisions based on their client's best interest. By understanding the ethical guidelines, considering practical implications, and following structured steps, therapists can navigate these complex situations with confidence and integrity.

Key Takeaways:

Therapists have the autonomy to make ethical decisions. Supervisors can provide valuable, unbiased perspectives. Documenting and seeking ethical guidance is important. Transparency and full disclosure are key in maintaining trust.

Resources:

British Association for Counselling and Psychotherapy (BACP) Canadian Psychological Association (CPA) Psychology Today

Author Note: The author can be contacted for further discussions on this topic.