Ethical Supervisor Behavior?

[neuroal]

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I'm asking for feedback from those with more experience than I with supervisory situations. Let's just say this is hypothetical case example.

Situation - a hypothetical employee (HE) in inpatient psychiatric unit who is now supervised by a hypothetical licensed PhD (HS). The HS is not an employees of the facility as they only use LPCCs, LISWs and MFTs and psychiatrists. The HE will be under work supervision (instead of training supervision) as they are no longer in a graduate program. The HE called the State Board to ensure adherence to the code/regs (whether work or training) and was told if the HS is not on site at least once a week, then the HS is not in compliance with the direct supervision regs. HE then stops working until HS can report to the site weekly for supervision to review hypothetical charts etc. and get in compliance with the regs. HE sent Board's email directive to HS so he/she would would have it in writing and could contact the Board directly about compliance.

Secondary factor, HS is also supervising a hypothetical PhD student (HSt) employed at the facility who is completing an online PhD program (under grandfather laws of state - online degrees no longer acceptable in state). At this point both HS and HSt know they are out of compliance with State regs. HS has basically decided not to drive to the hosp for supervision as he/she does not want to. The HSt is knowingly still working without proper supervision per the Board and the HS is supervising.

HS told HE that if he/she had not contacted the Board to ensure adherence with code, he/she could have been working and making $ and HE should just work and not tell the Board HS is not going to the site. HE cannot do this as it is unethical and dishonest. HE plans to resign immediately and pursue other appropriate options. HE told HS that in order to protect HS's license, the patients, the facility and HE's development as a psychologist, HE just cannot do that.

The question: The hypothetical Clinical Director (HCD) has no experience with the Board of Psychology as they do not employ PhDs. The HE has to go in and resign HE's position and explain the reason - lack of proper supervision per Board. HE does not want to be involved in the situation that will go down for the HSt who will likely lose their job. HE would like to advise the HCD to call the Board directly and ask them about appropriate supervision (shouldn't this have been done anyway?). Then it would be up to the HCD to decide how to proceed as there are billing and other admin issues for HCD and the facility.

Is this an appropriate way to handle the situation? HE also wants to ensure that the hospital and patients are protected should there ever be an issue as this HSt is a FT employee and has seen many patients but is basically practicing psychology without proper supervision. There are many ethical considerations here. Also, HE is dumbfounded that a licensed PhD would advise HE to just work without proper supervision. HE needs the job and income but finds working like this is just not acceptable so will leave the position (pays $52K/yr -ouch!) as ethically it feels wrong to stay.

Or is HE making too much of this and it is common to work without proper supervision? Thanks so much for your help on this hypothetical situation!

 

[thewesternsky]

HE is absolutely not making too much of this. This is a huge ethical and professional violation. If I were HE, I would resign and report immediately. HSt should not be interacting with patients/clients without appropriate, regular, in-person supervision.

 

[DynamicDidactic]

HE needs the job and income but finds working like this is just not acceptable so will leave the position (pays $52K/yr -ouch!) as ethically it feels wrong to stay.

Or is HE making too much of this and it is common to work without proper supervision? Thanks so much for your help on this hypothetical situation!

I think HE is strong and much more ethical than a lot of other people involved. Its often difficult to make the ethical decision, I would applaud the person for doing so.

I would definitely just inform everyone what you plan on doing and that you are not looking to get anyone in trouble but are responding to the ethical code. If you could get this info onto the state's psych association listserv that would be helpful as well.

 

[Sanman]

The simple truth is that you have a choice to make here. You at the crossroads of an ethical decision that will affect your career. While people here on the internet may lecture you about ethics, it is a personal decision that you need to consider carefully. I ran into a similar issue with a rotation supervisor close to the the end of my doctoral training. It ended up in an extremely stressful time for me in which I was threatened and my career nearly came to an abrupt halt. Luckily, I had other clinicians and administrators stick up for me and see to it that I made it through alright. Still, being the ethical person still has an ongoing impact on my career. While others were saved from these issues, I still do not dare to ask for a letter of rec from this particular person who practices in the same area of the field as I do. While I have still been able to do well for myself, it puts me in a tough spot if some academic position/post-doc, etc needs a letter from me. So, do what you need to, but consider the consequences carefully.

 

[neuroal]

Thanks everyone. There is no question HE plans to resign. The reason will be given to the HCD as well. The question is what lengths should HE go to about reporting? HE has already done what the Board requested in advising the HS of the problem. Should not the HCD be takng over at this point to ensure the facility is in compliance with the Board and the HSt's supervision? The Board is aware of the situation as well. After resigning is the HE responsble for any other actions? BTW no ltrs of rec are needed from the facility or the new HS.

 

[neuroal]

The simple truth is that you have a choice to make here. You at the crossroads of an ethical decision that will affect your career. While people here on the internet may lecture you about ethics, it is a personal decision that you need to consider carefully. I ran into a similar issue with a rotation supervisor close to the the end of my doctoral training. It ended up in an extremely stressful time for me in which I was threatened and my career nearly came to an abrupt halt. Luckily, I had other clinicians and administrators stick up for me and see to it that I made it through alright. Still, being the ethical person still has an ongoing impact on my career. While others were saved from these issues, I still do not dare to ask for a letter of rec from this particular person who practices in the same area of the field as I do. While I have still been able to do well for myself, it puts me in a tough spot if some academic position/post-doc, etc needs a letter from me. So, do what you need to, but consider the consequences carefully.

I am so sorry to hear you had these struggles! I imagine you thought long and hard about what to do. Staying in the same area is challenging, not to mention risky, in some cases as you pointed out. I am glad you had other support from your peers and higher ups. That is very important in these types of situations. And you made it through successfully which speaks to your skills and determination! Thank you also for setting a good example.

Ethics, to me, has to be the foundation that my entire career will be built upon. Making it in a career on the back on deceit or the pursuit of the almighty dollar would be unacceptable. "To thine own self be true" comes to mind. As you said, talking about these hypothetical situations is quite different from actually being faced with one!