Legal and Ethics SupervisionBATESAWK8

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RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal Legal and Ethics Supervision Policy Update Proposal Andrea Bates Northcentral University 1

RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal Legal and Ethics Supervision Policy Update Proposal Within the standard IV of the AAMFT Code of Ethics, this paper will describe a policy update proposal about the responsibility to students and supervisors. One particular issue of the AAMFT Code of Ethics is the absence of hermeneutic solid references, i.e. in case of doubt, in case of rules and principles conflict before a messy dilemma, which ethical action direction(s) does AAMFT suggest for the rationale of due process decision making application of its code of ethics? Any preferred model(s) of ethical decision-making? (Kitchener, 1984, 1986; Zigmond & Boorhem, 1989) Or, a philosophical basis for ethical decision-making, like critical utilitarianism? Feminist theory? (Klein, 1976; Libow, Raskin, Caust, 1982) Hermeneutic approaches? Kohlberg's theory? Social constructivism? (Cottone & Claus, 2000). My idea is to start by referring briefly to the main ethical principles of decision making and professional behavior expected by a supervisor, a trainee supervisee or a MFT. According to the American Counseling Association (2021), those principles would be as follows; 1. Autonomy, the right to decide/choose on one's life orientation. 2. No maleficence, the obligation of avoiding actions that may cause someone harm. 3. Beneficence, the inclination to work for the good of the individuals, the couple, the families or the society by promoting wellness. 4. Justice, promoting fairness and equality. 2

RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal 5. Fidelity, staying loyal to professional expectations to maintain high levels of trust in these professional relationships. 6. Veracity, truthfully relating with the clients and all other individuals in a respectful professional manner. 4.1 Article "Marriage and family therapists do not exploit the trust and dependency of students and supervisees" comes as a most necessary overall intended interpretation principle of the following norms that will inform this standard IV of the AAMFT Code of Ethics. In the same exact breath, this standard opens with article 4.1 about the exploitation of trainees by their supervisors and it states as follows; "Marriage and family therapists who are in a supervisory role are aware of their influential positions with respect to students and supervisees, and they avoid exploiting the trust and dependency of such persons. Therapists, therefore, make every effort to avoid conditions and multiple relationships that could impair professional objectivity or increase the risk of exploitation. When the risk of impairment or exploitation exists due to conditions or multiple roles, therapists take appropriate precautions." This particular article is written in a way that isn’t safe towards the exploitation that it intends to stop. It is written in such a way that favors exploitation stating that "they make every effort to avoid exploiting" makes it seem that if a clear context of exploitation is exposed to the AAMFT the exploiter can get away with the just a simple justification of "but I made every effort to not exploit." The reason why exploitation is one of the worst common contexts of therapy supervision is because this ethical code does not work as a deterrent, and comes across as too delightful and favorable. This article 4.1 rule should define an exploitative context and 3

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RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal then establish direct consequences. An example for the proposal could be as follows; An AAMFT jury will be formed to forward due process in claims of abuse or exploitation of trainee’s supervisees by their supervisors in respect to the supervisory relationship. If the supervisee's abuse or exploitation claim is considered proved by the AAMFT jury commission, in that case, consequences start on a $2,500.00 fine to keep AAMFT membership going up till a possible recommendation to the adequate state board for a suspension of their supervisors and AAMFT licenses. Finally, the third proved claim of exploitation &/or abuse results in the loss of membership and a proper exposition to their state department of this person's ethical inadequacy to serve our profession. This approach could definitely make an abusive supervisor think before they act, in my opinion. Article 4.2 Within article 4.2 discussing therapy with students or supervisees, "marriage and family therapists do not provide therapy to current students or supervisees." I think that this article should also think about the supervisor's quality gatekeeper duty of recommending therapy, whether necessary, and thoroughly discuss the possible impact of mental health issues on clients, supervisory relationship, and on proper professional functioning (as in American Counseling Association, 2021). Article 4.3 Within article 4.3 which is about sexual intimacy with students or supervisees, “Marriage and family therapists do not engage in sexual intimacy with students or supervisees during the evaluative or training relationship between the therapist and student or supervisee." Inspired by the 2014 American Counseling Association Code of ethics, I would add, "This prohibition 4

RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal applies to both in-person and electronic interactions or relationships." Since we are now in the year of 2023, the electronic era is taking over and nude photos, sexual messages via social media or cell phone could definitely come into play, so we should look at that as professionals in a growing atmosphere of technology. Article 4.4 Within article 4.4 is Oversight of Supervisee Competence. "Marriage and family therapists do not permit students or supervisees to perform or to hold themselves out as competent to perform professional services beyond their training, level of experience, and competence." Towards this article, I would add some hermeneutic guidance with adding a statement as follows; we are to respect the highest standards expected from the guidance of the principles of veracity, non- maleficence, justice, fidelity, autonomy, and beneficence. Article 4.5 Within article 4.5 is Oversight of Supervisee Professionalism, & I would write it in a more specific mannerism. For example, MFT supervisors take rational standards to ensure that services provided by supervisees are performed, under the scope of their training and competence, at the highest professional level to ensure the client welfare and the respectable reputation of our profession is in motion. Upon the guarantee the client's welfare, this could include the appropriate delivery of supervision disclosures, informed consent, sharing the information about all the clients' rights, and the fair representations of their professional qualifications. Article 4.6 5

RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal Within article 4.6 is Existing Relationship with Students or Supervisees. "Marriage and family therapists are aware of their influential positions with respect to supervisees, and they avoid exploiting the trust and dependency of such persons. Supervisors, therefore, make every effort to avoid conditions and multiple relationships with supervisees that could impair professional judgment or increase the risk of exploitation. Examples of such relationships include, but are not limited to, business or close personal relationships with supervisees [e.g., social media interactions] or the supervisee's immediate family. When the risk of impairment or exploitation exists due to conditions or multiple roles, supervisors document the appropriate precautions taken." This article could be more specific and state something on the lines of as follows; A supervisor shall not supervise an individual with whom the supervisor has a relationship that may compromise the objectivity of the supervisor or impair the professional judgment of the supervisor. Also, within Missouri it states as follows; (6) “A supervisor shall not be a relative of the applicant. For the purpose of this rule a relative is defined as a parent, spouse, child, sibling of the whole or half blood, grandparent, grandchild, aunt, uncle, or cousin of the applicant, or one who is or has been related by marriage” (Missouri Secretary of State: Code of State Regulations, 2022). Article 4.7 Within article 4.7 is Confidentiality with Supervisees. "Marriage and family therapists [supervisors] do not disclose supervisee confidences except by written authorization or waiver, or when mandated or permitted by law. In educational or training settings where there are multiple supervisors, disclosures are permitted only to other professional colleagues, administrators, or employers who share responsibility for training of the supervisee. Verbal authorization will not be sufficient except in emergency situations, unless prohibited by law." 6

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RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal Article 4.7 seems to cover many aspects to me so I am not quite sure if anything needs to be added here. If so, it would be on the lines of adding another document/disclosure towards clients signing more confidentiality papers to put within their file so that the client feels secure. Article 4.8 Within article 4.8 is Payment for Supervision. "Marriage and family therapists providing clinical supervision shall not enter into financial arrangements with supervisees through deceptive or exploitative practices, nor shall marriage and family therapists providing clinical supervision exert undue influence over supervisees when establishing supervision fees. Marriage and family therapists shall also not engage in other exploitative practices of supervisees." I would try to regulate some consequences for the supervisor to avoid the current issues that clearly does not honor the profession and summons, in my opinion, ethical double standards which isn’t acceptable. An example could be as follows; if a supervisee's abuse or payment exploitation claim is considered proved by the AAMFT jury commission, in that case, the consequences start with a $3,500.00 fine to keep AAMFT membership going up till a possible recommendation to the state board for a suspension of their supervisor and AAMFT license. Additionally, the third proved claim of payment exploitation would result in the loss of membership and a proper exposition to the respective state department of this person's ethical inadequacy to serve the MFT profession. Relevant Supervision Laws & Statues in Missouri MFT Supervised Practice Requirements While fulfilling the practice requirement, the MFT must be under the guidance and oversight of an approved clinical supervisor. The supervisor is to be someone who has at least a master’s degree in mental health and has at least five years of experience providing marriage and family therapy. The supervisor may be licensed as a marriage and family therapist, professional counselor, social 7

RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal worker, psychologist, or psychiatrist. If the supervisor graduated any time from January of 1990 on, the supervisor must have training in supervision – this includes supervision-in-supervision. The supervising professional does not have to be someone who is employed at the same setting as the supervisee. However, a workplace representative will need to be in on the agreement and sign the contract. A candidate with master’s level education must accrue 3,000 total hours of experience. The candidate cannot meet requirements in a period of less than two years. The MFT has up to five years to meet them. If the candidate doesn’t put in at least 15 hours during a given month, though, the candidate is not allowed to count that month’s hours. At least 1,500 of the experience hours must be spent providing direct client services. Up to 1,500 may be in other areas related to MFT practice. (This can include activities like writing notes, developing client treatment plans, and even attending seminars.) The S-MFT/ PLMFT will need at least 200 total hours of supervision; it is permissible to do up to half of these hours in a small group setting with three to six supervisees in attendance. At least once every two weeks, the SMFT should meet individually with his supervisor (or with no more than one other supervisee in attendance). Volunteer work can be counted toward the experience requirement. If the supervised MFT adds a work setting or changes or adds a supervisor, the supervised MFT candidate must submit a change of status form. Within two months of the time the supervised MFT candidate completes the supervision requirements, the candidate must apply to the state committee for licensure. Supervisors will verify the experience in an official document submitted to the state committee. The document includes evaluation questions. A candidate who begins accruing supervision hours in another state and then moves to Missouri may count the hours they have already earned, provided that the conditions are determined to be sufficiently equivalent. Supervised Practice: Candidates with Advanced Coursework A candidate who has, at the time of registration, a doctoral or specialist degree in MFT or 30 semester hours of qualifying post-master coursework, will have a reduced requirement for post- degree supervised work experience and a reduced time frame in which to complete it. (MFT-LICENSE.COM, 2023) NOTE https://www.sos.mo.gov/cmsimages/adrules/csr/current/20csr/20c2233-2.pdf has more information for Supervision Laws & Statues in Missouri that connect towards these articles above. 8

RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal References American Association for Marriage and Family Therapy (2021, February 19). AAMFT diversity and inclusivity statement. Retrieved from https://www.aamft.org/About_AAMFT/DI_Statement.aspx\ American Counseling Association (2021, March 5). 2014 ACA code of ethics. Retrieved from https://www.counseling.org/docs/default-source/ethics/2014-code-of-ethics.pdf? sfvrsn=2d58522c_4 American Association of Marriage and Family. (2015). Code of Ethics. Retrieved from https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx Cottone, R. R., & Claus, E. R. (2000). Ethical decision-making models: A review of the literature. Journal of Counseling & Development, 78, 275-283 Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counseling psychology. Counseling Psychology, 12, 43-55. Kitchener, K. S. (1986). Teaching applied ethics in counselor education: An integration of philosophical processes and philosophical analysis. Journal of Counseling Development, 64, 306-310. Klein, M. H. (1976). Feminist concepts of therapy outcome. Psychotherapy: Theory, Research and Practice, 13, 89-95 9

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RUNNING HEAD: Generate a Legal and Ethics Supervision Policy Update Proposal Mft-license.com. (2023). Marriage and Family Therapist Requirements in Missouri. Retrieved from https://www.mft-license.com/states/missouri-mft-license/#supervision Missouri Secretary of State: Code of State Regulations. (2022). Retrieved from https://www.sos.mo.gov/cmsimages/adrules/csr/current/20csr/20c2233-2.pdf 10

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