American Psychological Association Guidelines for Clinical Supervision: Competency-Based Implications for Supervisees

Author Backgrounds

At the time of writing this manuscript, we were at various stages of professional development. Specifically, five of us were doctoral students: one was in the first year of the program, one in the second year, two in their third year, and one in the fourth year. Additionally, two authors were faculty members—a first year assistant professor and a full professor with over thirty years of experience. All of us were faculty or students at a 4-year college located in the Northeast United States. In addition, all of the authors had training backgrounds in counseling psychology. Six of the authors identify as non-Latino White; one identifies as African American. Six of the authors identify as heterosexual; one identifies as bisexual. All identify as cisgender; three of the authors are men and three are women. The authors had differing levels of clinical experience at the time of the writing of this manuscript, ranging from one of the authors entering into his first experience as a trainee, to one of the authors being a licensed psychologist with a private practice. Similarly, some of the authors had never served as supervisors, and others had already supervised multiple trainees at various stages of training. Furthermore, the authors ranged in their exposure to, and involvement in, supervision research. Finally, it is worth noting that the second author (M. V. E.) was a member of the task force that developed the unpublished Guidelines (APA, 2014).

Intentions

The impetus for putting forth the construct of SSC and focusing on the competency-based implications of the Guidelines for supervisees was largely informed by our personal experiences in supervision and our familiarity with the supervision literature. As a group, we were diverse both in terms of our identities and stages of professional development, yet we all had experienced, and had read about, a range of supervision experiences, both positive and negative. When we had experienced the latter, we often felt lost in terms of what to do, unaware of available resources, and overall, unclear about how to mobilize and advocate for ourselves. Even in cases where supervision had gone well, we had experienced a lack of orientation to, and training for, being a supervisee. Consequently, we wondered whether we had been adequately equipped with the tools needed to make the most of our supervision and training experiences. Furthermore, our familiarity with the research on harmful, inadequate, and exceptional supervision (Ellis, Ayala, Kotary, Berger, & Hanus, 2015; Ellis et al., 2014; Ellis, Creaner, et al., 2015) undergirded our assumption that our experiences were not so unique, with many supervisees finding themselves in a similar position: uninformed about what they could do to optimize their supervision experiences and unsure of how to respond when their training needs are not being met. As such, our intention in putting forth a companion document to the Guidelines from the perspective of SSC was to provide health service psychologists in training a resource and framework for understanding what they could do to enhance the likelihood of receiving high quality supervision. In addition, we wanted to highlight steps that supervisees could take to both prevent and respond to inadequate and harmful supervision, while also recognizing and remaining sensitive to the difficult and vulnerable position in which supervisees find themselves (Stringer, 2016).

Assumptions

We encourage readers to reference the unpublished Guidelines (APA, 2014) as a companion document; it offers definitions and content relevant for supervisees. The definitions delineated in the unpublished Guidelines (APA, 2014), as well as the Benchmarks (APA, 2011; Fouad et al., 2009), which underlie the Guidelines, provide a context for our discussion. In addition, our discussion is predicated on several assumptions: (a) supervision is developmental—as supervisees gain competencies, what they need from supervision changes (e.g., Aten, Strain, & Gillespie, 2008; Huhra, Yamokoski-Maynhart, & Prieto, 2008; Stoltenberg & McNeill, 2010); (b) supervision is a multicultural encounter wherein the supervisee and supervisor (and client) each bring multiple intersecting identities that are in constant interaction and are influenced by the training context (e.g., Gatmon et al., 2001; Inman, 2006; Inman et al., 2014; Nelson, Barnes, Evans, & Triggiano, 2008); and (c) supervision is an inherently power disproportionate relationship (e.g., Nelson et al., 2008). Thus, SSC may differ based on supervisees’ developmental and competency levels, the multiple identity statuses at play in supervision, and the extent to which supervisees can empower themselves in a hierarchical relationship.

Domain A: Supervisor Competence

Paralleling the guidelines for supervisor competence, supervisees are expected to strive to attain, and demonstrate professional competencies appropriate for, their level of development (APA, 2011; Fouad et al., 2009), and to consider how the Benchmarks apply to their supervisors. Supervisees tend to assume that supervisors are competent as HSP professionals and supervisors (e.g., Bernard & Goodyear, 2014). This assumption is warranted inasmuch as training programs are responsible for ensuring the competence of clinical supervisors (APA, 2017), and supervisors strive to be competent professionals. Nonetheless, supervisors’ competence should not be assumed. Some evidence suggests that many supervisors are not trained in clinical supervision, and supervisees are unaware of the extent of their supervisors’ training or competence in supervision (e.g., Ellis et al., 2014; Ellis, Hutman, & Chapin, 2015). Building on the Guidelines, supervisees can expect supervisors to be explicit about their areas of professional expertise, the limits of their competence, the rationale for their supervision approaches or methods, and the technology used in supervision (Bernard, 1999, 2000). Negotiating a supervision informed consent or contract at the beginning of supervision can facilitate these discussions (Ellis, 2017a). As appropriate, we encourage supervisees to ask questions or request more information respectfully (e.g, “Could you say more about what I can expect supervision to look like?”). Supervisees who are expected to use technology in supervision should be informed of the related security implications and confidentiality limitations, and be trained to use that technology.

Supervisees may believe that clinical responsibility and accountability rests solely on them, leading them to lose sight of their supervisors’ accountability (Mette, 2009). Supervisees, particularly novice trainees, tend to be self-focused and preoccupied with being evaluated by their supervisors (Rønnestad & Skovholt, 2003; Stoltenberg & McNeill, 2010), making them less likely to examine and consider their supervisors’ competence. Thus, to enhance accountability (APA, 2015) and build SSC, it may be appropriate to assess supervisors’ competence (Getz, 1999). Even if not shared with supervisors or others, written supervisor evaluations (see Bernard & Goodyear, 2014; Falender & Shafranske, 2011) empower supervisees to reflect upon their supervisors’ competencies and the quality of supervision. Thus, we encourage supervisees to routinely complete evaluations of their supervisors, even if no one else reviews them.

Domain B: Diversity

All supervision is multicultural supervision, as it is important to understand how diversity and context (a) inform self- and other-awareness, (b) are attended to in the supervisory relationship, and (c) influence supervision and client outcomes (Falender et al., 2014). As such, multicultural competence (MC) is a vital component of supervision (APA, 2015; Hatcher et al., 2013). Supervisors, supervisees, and clients each have multiple identities that uniquely and complexly intersect to shape their worldviews, experiences, and behaviors. Diversity factors encompass a range of intersecting identities including, but not limited to, age, sex, gender identity, race, ethnicity, culture, religion, sexual identity, disability, language, and socioeconomic status (APA, 2014). The Guidelines provide supervisees with information regarding the general expectations, standards, and responsibilities of supervisors concerning diversity issues, such as helping supervisees navigate conflicts that may interfere with their work with diverse client populations.

To promote SSC and MC development, supervisees are encouraged to discuss their limitations and developmental needs related to MC at the start of supervision (e.g., lack of familiarity working with different minority groups; Pearson, 2004). Research suggests that these discussions are alarmingly infrequent (Gatmon et al., 2001), and are seldom initiated by the supervisor (Gardner, 2002). Due to the fact that a focus on diversity education and training has increased in HSP doctoral programs in recent years, many supervisors may lag behind their supervisees in MC (e.g., Bernard & Goodyear, 2014; Constantine & Sue, 2007; Gardner, 2002). Supervisees, however, are well-positioned to proactively and respectfully clarify their needs and initiate diversity-related discussions. In fact, research suggests that supervisees are able to, and do, seize opportunities to integrate and address diversity issues in supervision (Chui, McGann, Ziemer, Hoffman, & Stahl, 2018; Greer, 2002), which may facilitate multicultural self-awareness and MC (Richardson & Molinaro, 1996), and help supervisees initiate cultural discussions with clients. On the other hand, supervisees, especially those from marginalized groups, may experience increased powerlessness within the hierarchical supervisory relationship and lack the requisite safety to initiate multicultural dialogues. In such cases, we encourage supervisees to consult with colleagues and trusted professionals about negotiating diversity-related challenges occurring in supervision, and to consult with staff, faculty, or training directors of their clinical site and doctoral program, who can advocate for their needs and push for systemic changes when needed (Greer, 2002).

Because becoming multiculturally competent is a process with no endpoint (e.g., Richardson & Molinaro, 1996), supervisees’ MC development should also occur outside of supervision. To develop the necessary knowledge, skills, and attitudes to work effectively with diverse supervisors and clients (APA, 2014), we urge supervisees to commit to lifelong learning. To further encourage MC development, supervisees can consult with peers and professionals; attend conferences, skills trainings, and workshops; review the relevant multicultural literature and guidelines (e.g., APA, 2018); enroll in relevant courses; engage in self-reflection; and seek to develop multicultural understanding through their work with clients. Being a self-advocate in supervision can be intimidating (Greer, 2002), yet continued learning can offer comfort with, and ownership of, one’s identities and MC. Moreover, being an self-advocate in supervision can help further develop SSC and may prepare supervisees to engage in difficult, yet critical, conversations regarding the dynamic influence of diversity factors in supervision and therapy (e.g., Chui et al., 2018).

Domain C: Supervisory Relationship

Research suggests that the relationship or alliance between supervisor and supervisee is critical to understanding conflict in clinical supervision as well as supervision outcomes (Ellis & Ladany, 1997; Nelson et al., 2008; Son & Ellis, 2013; Swords & Ellis, 2017). The supervisory relationship is complex, in part because “supervision is by definition a power disproportionate relationship that includes both evaluative and therapeutic components” (Nelson et al., 2008, p. 172). Although supervision is not, and should not be, personal psychotherapy (APA, 2002), supervisors are expected to not only promote the professional growth of supervisees, but also to uphold the integrity of the profession, model professional conduct, and protect clients (Falender & Shafranske, 2014). Given that the Guidelines in this domain are critical for the supervisory relationship to flourish, supervisees need to be cognizant of the knowledge, skills, and attitudes that are essential to ensure a productive relationship. Despite the challenge inherent in the hierarchical structure of the relationship, we encourage supervisees to be proactive in establishing a positive supervisory relationship by attending to it systematically, early, and often (Inskipp, 1999).

By educating themselves about clinical supervision and the supervisory relationship, supervisees may proactively develop and maintain a strong supervisory relationship (e.g., Bernard & Goodyear, 2014). Supervisors are an important resource in learning about the supervisory relationship, but should not be the sole source of knowledge. Supervisees can start by acquainting themselves with the Guidelines and the Benchmarks (APA, 2011), and work toward becoming active participants in supervision and in their own professional development (Bernard & Goodyear, 2014). The relationship between supervisor and supervisee ought to be discussed throughout the supervision experience given its role in successful supervision experiences (e.g., Ladany, Ellis, & Friedlander, 1999; Son & Ellis, 2013; Swords & Ellis, 2017). We encourage supervisees to initiate discussions about supervision and the supervisory relationship (e.g., expectations, professional competencies, responsibilities, performance standards) if supervisors do not do so. Supervisees may also benefit by learning effective supervision practices (Ladany, 2014; Ladany, Mori, & Mehr, 2013), and developing skills and strategies for advocating for themselves when their training needs are not being met (e.g., Greer, 2003; Inskipp, 1999).

Knowledge about the supervisory relationship also encompasses a commitment to self-awareness (i.e., having knowledge about self). We urge supervisees to engage in ongoing self-reflection and strive to be authentic in supervision. This entails being aware of their strengths, areas of growth, ability to communicate (e.g., listening, microskills), needs as a supervisee, and clinical competencies (Falender & Shafranske, 2014; Fouad et al., 2009). Supervisees’ needs, competencies, skills, developmental level, and cultural background shape the supervisory relationship; thus, we urge supervisees to consider the influence of these factors on the supervisory relationship. The way a supervisee reacts to supervision (positively or negatively) may reflect an important aspect of the supervisory relationship, and when possible, may be helpful for supervisees to discuss these reactions with their supervisors.

We urge supervisees to be forthcoming and take risks in conveying vulnerability in supervision. This can be difficult as supervision is an evaluative process. Due to feelings of disempowerment, doubt, fear, inadequacy, shame, and other negative beliefs about themselves, their work with clients, and the supervisory relationship overall, it may be difficult for supervisees to disclose to their supervisors (Markham & Chiu, 2011). Ideally, supervision is, at its heart, a collaborative process (Rousmaniere & Ellis, 2013). Although supervisees occupy a position of less power relative to their supervisors, supervision is an opportunity for professional growth. Being vulnerable and humble in supervision, owning one’s mistakes, and openly discussing problems are critical to fostering clinical learning and professional growth (Inskipp, 1999).

Although supervision is not personal therapy, supervisors are responsible for identifying any personal issues that may be influencing supervisees’ clinical work and professional development—supervisees are responsible for addressing the identified issues. Thus, supervisees should expect the work to be, at times, emotionally laden; this is possibly one of the most challenging aspects of supervision. By taking risks in supervision (e.g., presenting the cases they find most difficult or challenging), supervisees can maximize their professional growth and contribute to a positive supervisory relationship.

Domain D: Professionalism

We presume that supervisees are informed about, and will comply fully with, applicable ethical and legal standards—behaving unethically is inherently unprofessional. Professionalism is foundational to supervision and practice, and cuts across the roles in which supervisees engage (e.g., Bernard, 2000). Professionalism is not a “hat” one wears only in supervision or psychotherapy sessions, but an active and ongoing development of one’s character. Because professional behavior may depend on the clinical context (e.g., Fouad et al., 2009; Johnson, Barnett, Elman, Forrest, & Kaslow, 2012), we encourage supervisees to inquire about what professionalism means at each site and how client characteristics affect professional behavior. For example, supervisees working with young children may be urged to maintain a playful demeanor, whereas in other settings (e.g., medical, forensic) this behavior may be viewed as unprofessional. We encourage supervisees to seek clarification when the criteria for appropriate professional behavior may be uncertain, and to modify their behavior accordingly.

Professionalism extends beyond the clinical and academic settings—supervisees are representatives of psychology to the public. At best, supervisees are ambassadors-in-training with the potential to affect positively the public’s attitudes toward psychology. At worst, all interactions, such as interactions on social media, hold potential to damage the profession. It thus behooves supervisees to refrain from denigrating supervisors, sites, or peers in public forums, and to maintain professional, respectful attitudes in any interactions with or about supervision and clinical work (Fouad et al., 2009). As an essential part of professionalism, we also urge supervisees to monitor their areas of privilege (e.g., race, gender), remain sensitive to their positions of authority (e.g., as professionals), and be cognizant of their potential to perpetuate oppressive practices (Falender & Shafranske, 2014).

Domain E: Assessment/Evaluation/Feedback

Consistent with the Guidelines, supervisors should inform supervisees about the criteria and procedures for assessment, evaluation, and feedback (for definitions see APA, 2014). Assessment in supervision may entail the use of outcome measures and ratings to evaluate the extent to which supervisees’ performance meets or exceeds expected performance criteria. In those cases where the supervisors have not oriented supervisees regarding the evaluative process at the beginning of supervision, we encourage supervisees to ask about the expected, criterion-referenced goals for supervisees’ performance as well as about the evaluation process and procedures. If academic programs require specific evaluation forms, supervisees need to ensure that their supervisors are aware of, and have access to, such forms from the beginning of supervision. If no forms exist, supervisees have a few options. They could discuss the situation with the training director or practicum coordinator, consider bringing in a sample to discuss with their supervisors, or invite them to collaborate in developing an evaluation system that meets with the site’s and trainee’s needs concurrently.

We also encourage supervisees to engage in ongoing, systematic self-evaluation. This can be done individually or in conjunction with site supervisors, and can include providing self-ratings on the site’s evaluation form, or determine fidelity ratings of one of their own psychotherapy recordings, among other strategies. It is important for supervisees to have a sense of their strengths and weaknesses, to identify the issues they would like to work on in supervision, to build an awareness of their own competencies, and to work with supervisors to directly address any areas where supervisor and supervisee perspectives are discrepant. Coming to supervision prepared to discuss client issues and needs is imperative to client welfare. Also, if possible at their site, collecting routine outcome data on clients is another way to monitor progress and is an additional source of direct feedback on clinical performance that can be incorporated into supervision discussions (Duncan, 2014).

Feedback, ideally based on observations of clinical work, is a necessary component of the supervision process (Amerikaner & Rose, 2012; APA, 2017). Ongoing feedback, which entails the supervisor communicating specific, timely, and explicit information about supervisees’ performance, ideally serves as the basis for formative evaluations. In fact, observation and monitoring of clinical work (e.g., conducting live observation, listening to recorded sessions), and providing feedback, are critical components of competency-based supervision; supervisors (and supervisees) should not rely solely on supervisees’ self-report for evaluating supervisees’ clinical performance. If direct observational methods are not used at all or not routinely used, supervisees can request information from their training director about how supervisors are expected to monitor and provide feedback about clinical work (whether about parts of sessions or entire sessions), as conducting these observations is consistent with APA’s (2017) Standards of Accreditation for Health Service Psychology.

It also is important for supervisees to approach feedback and evaluation with humility and openness. Supervisees should assume a nondefensive, receptive, and responsive stance when receiving evaluative feedback, all while integrating the suggestions into their clinical work. We encourage supervisees to utilize basic therapy and microcounseling skills (e.g., active listening, restatement, reflection, clarifying questions) to ensure they are understanding supervisors’ feedback accurately. Supervisees have a right to prompt and clear feedback that is balanced, developmentally appropriate, and multiculturally sensitive, and to be given sufficient time and opportunity to improve their performance (APA, 2002, 2017). If feedback is insufficient, supervisees can initiate conversations regarding their progress and invite supervisors to answer the question: “How am I doing?” Should supervisees experience supervisor feedback as imbalanced or unjust (e.g., not developmentally appropriate), supervisees can ask for further elaboration, and seek clarification and supporting behavioral evidence—the key is to focus on specific changeable behaviors.

Evaluations are not final; supervisees can challenge an evaluation if they believe that it is unfair, biased, developmentally inappropriate, or culturally insensitive. If there is an unfavorable discrepancy between an earlier and current evaluation, supervisees can provide data, including previous feedback, that a competency was sufficiently performed. If there are conflicts and/or personality or value clashes, attempting to work through these in the supervisory relationship (Nelson et al., 2008), and alerting their clinical site or doctoral training director about them are appropriate steps to pursue (Pearson, 2004).

Domain F: Professional Competence Problems

Given the focus on supervisee competencies (Falender & Shafrankse, 2012), it is not surprising that guidelines, best practices, and recommendations exist to address supervisees’ professional competency problems (e.g., Kaslow et al., 2007; Shen-Miller, Forrest, & Burt, 2012). Supervisees are expected to have potential competency shortcomings, given that they are in training. Recall that supervisors are responsible for identifying problems of professional competence in an unbiased manner, and supervisees are responsible for remediating the problems. Most often, however, the problem is not the competency deficiency per se, but rather the supervisees’ inability to benefit from supervision, demonstrate progress in remediation, and/or maintain a professional attitude (e.g., Jacobs et al., 2011).

Formative written evaluations and feedback from supervisors are especially important when professional competence problems are raised. After supervisees receive detailed and clear evaluations delineating any areas of concern (Jacobs et al., 2011), we encourage supervisees to ask for an explanation and specific examples of the problems, and for steps they can take to remediate each problem successfully. Challenges to professional competence performance may pertain to broad competency areas (e.g., defensiveness when receiving feedback), as well as to a very specific, albeit important, area or issue (e.g., timeliness in documentation).

Supervisees need to know their rights (Ellis, 2017a) as well as the appropriate and available methods for addressing professional competence issues. Supervisees have the right to due process unless the behavior displayed was grievously unethical. To be dismissed from a training program, practicum, or internship requires for supervisees to (a) have received prior evaluation and feedback that their clinical performance failed to meet competency-based criteria, and (b) have been given reasonable opportunities and sufficient time to remediate professional competence problems. In essence, supervisees should not be surprised at summative feedback given at the conclusion of their practicum experience. If required, supervisors and supervisees can develop collaboratively a written remediation plan that takes into account multicultural factors, to be implemented within a reasonable timeframe (e.g., Bernard & Goodyear, 2014; Kaslow et al., 2007; Pearson, 2004; Shen-Miller et al., 2012). Ideally, remediation plans are discussed in the informed consent document and supervision contract that are reviewed at the beginning of the supervision experience, thus informing supervisees of the remediation procedures and process before problems arise (Ellis, 2017a; Forrest, Elman, & Shen-Miller, 2008; Jacobs et al., 2011). Being educated about these remediation processes and procedures may minimize supervisee defensiveness. As indicated in Domain D, we encourage supervisees to approach the remediation plan with vulnerability, humility, self-reflection, and an eagerness to learn, viewing it as an opportunity for professional development and growth. If supervisees feel harmed, the first step is to discuss the issue with their supervisor. However, if supervisees do not feel comfortable doing so, we recommend consulting with an advisor or mentor. Also, we encourage supervisees to seek out informal and/or formal support and advocates (e.g., training director, staff, faculty, former supervisors) when working through professional competence issues.

Domain G: Ethical, Legal, and Regulatory Considerations

Ideally, at the beginning of supervision, supervisors and supervisees negotiate a supervision informed consent and contract detailing the expectations for, and parameters of, supervision. Some areas included in the informed consent process are performance competencies, evaluation standards and procedures thereof, as well as grievance procedures, the limits of confidentiality, and information about supervisors’ credentials, licensure status, and any past ethical and legal concerns (e.g., via a professional disclosure statement; Ellis, 2017a; Thomas, 2007). Supervisees are encouraged to inquire about supervisors’ area(s) of clinical expertise, continuing education activities, consultation, and other workshops and training opportunities that the supervisor has sought to remain abreast of evolving current best practices in clinical practice and supervision. In the context of the Guidelines and a good supervisory relationship, these conversations should be feasible. If supervisees need supervision for clientele or concerns that are outside of their supervisors’ scope of practice, supervisees, in consultation with their supervisors, are encouraged to seek supplemental consultation from other professionals at their site who have the requisite competencies to oversee their clinical work. Doing so is consistent with the Guidelines and paramount to client welfare.

Client welfare is of utmost importance and should be the primary focus of supervision. Supervisees have an ethical responsibility for client care, which includes being forthright with information with their supervisors such as perceived clinical mistakes or ruptures. In instances where supervision has gone awry and the supervisory relationship is suffering, client welfare can be neglected due to mistrust and/or fear of the supervisor. However, the needs of clients must always come first, highlighting the importance of seeking support and help if supervision has gone awry.

There are some additional considerations within this domain. Before seeing clients, supervisees are encouraged to know the site policies and practices as well as state regulations specific to the site, including the duty to warn and mandated reporting. Supervisors are responsible for all legal and ethical decisions supervisees make; supervisees are expected to consult with their supervisors when facing difficult clinical decisions or any potential ethical dilemmas. Supervisees are encouraged to discuss with their supervisors client confidentiality, because limits of confidentiality can vary depending on the training site and the population being seen; as well as the limits of confidentiality specific to clinical supervision, such as identifying what information may be shared and with whom (e.g., staff, program and site training directors).

When Supervision Goes Awry

We based the recommendations presented in this article on the assumption that supervisors value and attempt to comply with the Guidelines (APA, 2014, 2015, 2017). What happens when supervisors (a) implement poor professional standards; (b) do not strive to adhere to the Guidelines; (c) provide inadequate supervision; (d) are blatantly unprofessional, unethical, or illegal; or (e) engage in harmful supervision (Ellis, 2017b; Ellis et al., 2014)? Given the inherent power differential and supervisees’ reliance on supervisors for letters of recommendation and attestations to advance professionally, supervisees are in a precarious position. Thus, supervisees need to know who they can approach when they believe that the supervisor is acting inappropriately or unethically. It is important for supervisees to keep in mind that training directors and training programs are tasked with assuring high quality training and are benevolent resources. Before taking any action, we recommend that supervisees consult with a trusted professional (e.g., advisor, training director, former supervisor) to decide how to approach the situation (Bernard & Goodyear, 2014). Problems with supervisors or sites are the responsibility of the training director and/or training program, not of the supervisee (APA, 2017; McNamara et al., 2017). However, supervisees do need to inform a trusted authority figure about potential problems. Supervisees may also consult anonymously with APA at any time by calling the APA Ethics Office at 202-336-5930 or 800-374-2721 x 5930.

Some evidence suggests that supervisees may not recognize or identify supervisors’ harmful or inadequate behavior (Ellis et al., 2014; Ellis, Creaner, et al., 2015). Thus, we urge supervisees to trust themselves—if something seems amiss, it may well be. We also urge supervisees to self-reflect (yet not assume the problem lies totally with themselves), and consult with a trusted professional (e.g., training director, advisor) before the situation worsens. This is a delicate balancing act—not wanting to jeopardize one’s professional advancement (e.g., being assigned to another supervisor or site), while also getting one’s professional development needs met, and in worst-case situations, surviving the situation (Ellis, 2017b).

When supervisors’ behavior is not egregiously unprofessional, supervisees may opt to hold themselves to a higher professional standard (e.g., being punctual even if the supervisor is not). Alternatively, after consultation with a trusted professional, supervisees may first attempt to advocate appropriately for themselves by respectfully expressing their concerns openly with their supervisors (e.g., seeking clarification about the issue), and subsequently documenting in writing their attempts and the associated outcomes (Greer, 2003). If supervisees do not feel safe talking with their supervisors about their concerns (and even if they do), at minimum they need to discuss their concerns with their training director (or person in authority). If supervisees cannot resolve their concerns with their supervisor sufficiently, the clinical training director or doctoral training program may need to intervene. Continuing to consult with trusted professionals, supervisees can also seek other sources of support and resources (e.g., via peer consultation, mentorship, additional supervision, literature, and/or requesting to change supervisors; Greer, 2003; McNamara et al., 2017).

In severe cases of unethical behavior or harmful supervision (e.g., sexual advances, physical assault, professional sabotage), supervisees are obligated to inform site and program administrators (e.g., training director) about the events, but not to attempt independently to redress the supervisors’ misconduct. Supervisors’ unethical behavior will need to be addressed at a systemic level by those with the authority to take protective action on supervisees’ behalves (e.g., training directors, practicum coordinator, other licensed HSPs). Only after extensive consultation with trusted colleagues and professionals and self-reflection, supervisees may choose to report the supervisor’s unethical behavior to APA (e.g., the APA Ethics Office, the APA Commission on Accreditation, or the American Psychological Association of Graduate Students) or to their state licensing boards.

In sum, assuming the misconduct is not egregious, supervisees should first follow the program and site-specific procedures. Due process procedures are state, program, and site-specific; we encourage supervisees to seek out and know the appropriate steps relative to their geographic location and training site, as these procedures are vital to follow. Second, supervisees should consult with a trusted professional, and if they feel safe enough and are advised to do so, they could attempt to resolve any concerns with their supervisors. Third, if their attempts to resolve any concerns directly with their supervisors are unsuccessful or unfeasible, supervisees should talk to the training director, academic program advisor, or a mentor. If the conflict remains unresolved, supervisees may consult anonymously with APA or their state licensing boards. Supervisees can consider pursuing formal procedures after extensive consultation with trusted professionals.

Disagreements in supervision are, to some extent, inevitable (Nelson et al., 2008). Tension can stem from conflict over clinical issues (e.g., course of treatment), as well as overarching site policies and procedures that supervisees cannot change. In short, supervisees need to develop the skills to fulfill their responsibilities, uphold professional standards, and maintain a professional demeanor even when they disagree with the supervisor or site. Although supervisees may not agree, they need to comply with supervisors’ directives and site policies, but that does not preclude them from advocating for themselves and their needs respectfully.

Implications for HSP Supervisors and Programs

It is essential that supervisors provide support for supervisees to take an active role in supervision and in their training (e.g., Chui et al., 2018). Supervisors should not assume that supervisees, even those who are advanced in their training, are equipped, prepared for, or have the knowledge, skills, and attitudes, to use supervision effectively. Thus, we invite supervisors to initiate ongoing and explicit conversations about (a) supervisees as active and collaborative partners in supervision and in their professional competency development (Nelson et al., 2008; Rousmaniere & Ellis, 2013), (b) the SSC, and (c) any SSC areas of growth. To promote SSC, doctoral programs and training sites could use a supervision role induction (e.g., Bahrick et al., 1991; Ellis, Hutman, & Chapin, 2015) tailored to supervisees’ level of training and the site prior to, or at the beginning of, a clinical training experience. Hence, we encourage administrators of HSP programs and pre and postdoctoral training sites to consider being more strategic about their focus on developing SSC.