ACS Legal & Ethical Issues in Supervision 2 — Questions and Answers
Question 1: A supervisee discloses they have been in a romantic relationship with a former client who ended therapy 18 months ago. What is the supervisor's PRIMARY ethical concern?
- Report the supervisee to the licensing board immediately
- Explore whether the relationship violates the two-year prohibition in the supervisee's professional code (Correct answer)
- Terminate the supervisory relationship without further discussion
- Encourage the supervisee to resume the therapeutic relationship
Correct answer: Explore whether the relationship violates the two-year prohibition in the supervisee's professional code
Most professional codes prohibit romantic relationships with former clients for at least two years post-termination, so the supervisor must assess whether that standard was violated.
Question 2: Under HIPAA, which of the following best describes the supervisor's responsibility regarding a supervisee's client records?
- Supervisors have no legal access to client records without separate client consent
- Supervisors may access client records as part of their oversight role without additional client authorization (Correct answer)
- Supervisors must obtain a court order before reviewing any client documentation
- Supervisors may only review records after the client has been discharged
Correct answer: Supervisors may access client records as part of their oversight role without additional client authorization
HIPAA allows supervisors to access records as part of a treatment team's oversight function without requiring separate client authorization.
Question 3: A supervisee's client threatens to harm an identifiable third party. The supervisee is unsure how to proceed. What is the supervisor's legal duty?
- Advise the supervisee to increase session frequency with the client
- Ensure the supervisee fulfills their duty to warn the identifiable third party per Tarasoff standards (Correct answer)
- Instruct the supervisee to document the threat but take no further action
- Transfer the case to a more experienced clinician without warning the third party
Correct answer: Ensure the supervisee fulfills their duty to warn the identifiable third party per Tarasoff standards
Following Tarasoff v. Regents of the University of California, clinicians—and by extension supervisors—have a legal duty to protect identifiable potential victims from credible threats.
Question 4: Which scenario BEST illustrates a boundary crossing rather than a boundary violation in clinical supervision?
- A supervisor enters a sexual relationship with a current supervisee
- A supervisor attends a supervisee's graduation ceremony after obtaining consultation (Correct answer)
- A supervisor shares a client's confidential information with another agency without consent
- A supervisor falsifies a supervisee's licensure documentation
Correct answer: A supervisor attends a supervisee's graduation ceremony after obtaining consultation
Attending a supervisee's graduation is a minor departure from strict professional boundaries that, when handled thoughtfully, may not cause harm—this is a crossing, not a violation.
Question 5: A supervisee asks the supervisor to write a letter of recommendation that overstates the supervisee's competence. The ethical response is to:
- Write the letter as requested to support the supervisee's career
- Decline to write an inaccurate letter and explain the ethical rationale to the supervisee (Correct answer)
- Write the letter but add a disclaimer at the bottom
- Refer the supervisee to another supervisor for the letter
Correct answer: Decline to write an inaccurate letter and explain the ethical rationale to the supervisee
Supervisors have an ethical obligation to provide honest evaluations; falsifying a recommendation violates honesty and potentially harms future clients.
Question 6: When a supervisee is also a personal friend of the supervisor, this relationship creates which primary ethical risk?
- Vicarious liability for the supervisee's clinical errors
- Role confusion and potential inability to provide objective evaluations (Correct answer)
- Mandatory reporting obligation to the licensing board
- Automatic conflict of interest that requires immediate case transfer
Correct answer: Role confusion and potential inability to provide objective evaluations
Dual relationships between supervisors and supervisees compromise the objectivity needed for fair evaluation and may impair appropriate gatekeeping.
Question 7: A supervisee from a cultural background where hierarchy is strongly respected never questions the supervisor's clinical guidance, even when it conflicts with evidence-based practice. The supervisor's BEST response is to:
- Accept the supervisee's deference as a sign of high professional standards
- Explore how cultural dynamics may be affecting the supervisory relationship and encourage critical thinking (Correct answer)
- Report the supervisee for failing to practice independently
- Assign the supervisee only low-risk cases to minimize errors
Correct answer: Explore how cultural dynamics may be affecting the supervisory relationship and encourage critical thinking
Culturally-informed supervision requires exploring how cultural values affect the supervisory relationship and fostering the supervisee's independent clinical reasoning.
ACS Legal & Ethical Issues in Supervision 2
A supervisee discloses they have been in a romantic relationship with a former client who ended therapy 18 months ago.
What is the supervisor's PRIMARY ethical concern?