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In substance abuse treatment contexts it has historically been reasonable and customary practice for clinicians to self-disclose their own status in recovery from addictions based on the idea that this self-disclosure might have a positive effect on the client and help him/her feel hopeful about the possibility of recovery. In mental health treatment contexts it has historically been reasonable and customary practice for clinicians to refrain from any disclosure of a personal nature with clients whether it be that the clinician is recovering from substance abuse or a mental health issue such as anxiety or depression.
In this exercise take the position of a clinical supervisor in a treatment program serving people with co-occurring substance abuse and mental health issues. Your treatment team is made up of mental health professionals and substance abuse counselors with different training and beliefs about self-disclosure. You have just taken this course on Supervision and Ethics and have a new understanding of the difference between boundary crossings and boundary violations and that in any discussion about preventing boundary violations with regard to clinician self-disclosure you need to be concerned about 1) reasonable and customary practice for your particular treatment context 2) intent of the clinician 3) harm (and potential of harm) to the client with co-occurring conditions when the clinician self-discloses or withholds self-disclosure.
A) What are some of the strategies you would employ to initiate and facilitate a discussion about the distinction between self-disclosure as a boundary crossing or boundary violation in your treatment team meeting?
I believe it is good practice to discuss openly the different lenses different professions use. I would bring the conversation back to the reason for a disclosure. Our treatment should focus on the clinical benefit for a disclosure and weigh it against any clinical harm that would occur from the disclosure.
B) Which of the supervisor roles (consultant, advisor, guide, mentor, professional colleague, educator) fits with your values and supervisory style? Which of these stances would you take in the conversation with the team and why?
I prefer the consultant role. I would help sort through reasons why or why not do disclose and help the clinician come to a resolution that feels comfortable and supported by best practices.
Describe 2–3 useful ideas and/or strategies about supervision and ethics that you have learned or been reminded of over the course of the past 5 weeks that you would like to bring back to your colleagues, supervisees, supervisor, administrators, etc. How do you envision integrating these ideas into your work.
Systematic method for working through ethical dilemmas’. I enjoyed the framework that we used in the earlier lessons of how to weigh out risks and benefits for different options.
I also appreciated the conversations about transference and counter transference. It is helpful for newer clinicians to be reminded that this occurs and how to notice when this is happening.
The last lesson on boundaries is also a good reminder that different professions have different norms and values. When you are supervising a multidisciplinary team, it is good to remember that not everyone on the team may act in the same way you would act in accordance with your license.