Robert M. Gordon,Ph.D., ABPP, LLC

Is it unethical to supervise a family member working in your practice? The answer is not as simple as some would believe. Unlike a toggle switch that goes from “ethical” to “unethical”, most situations require a series of steps to help determine the most ethical alternative in any given situation. APA has provided psychologists with a set of principles and standards to use in our ethical reasoning. Some standards are specific and unambiguous such as not having sex with a patient or client. But many other situations require an interpretation as to the intent and purpose of a standard and a need to reasonably apply the ethical standard in a judicious manner. Consider this vignette of a psychologist in a supervisory relationship with his wife.

Dr. D’s wife, a doctoral student in psychology, wanted to gain additional psychotherapy experience and work in her husbands private practice. His role as “supervisor” would be one of responsibly and overseeing and not one of evaluative authority. He would not be supervising his wife as part of a requirement to fulfill hours for licensing or certification or for the purposes of a course or fulfillment of a practicum or internship. The definition of “supervisor” can have more than one meaning. He would be taking legal and professional responsibility for his wife’s work with a few patients on Saturdays when he was the most consistently available psychologist if something went wrong.

Isn’t supervising a spouse or blood relative against State regulations?
This is a reference to § 41.32. Standards for supervisors paragraph 7, “The supervisor may not be a relative of the supervisee by blood or marriage, may not be involved in a dual relationship which obliges the supervisor to the supervisee and may not engage in treatment of the supervisee.” But this paragraph is preceded by the statement, “To ensure the quality of supervised experience, the Board requires that supervisors and those to whom supervisory responsibilities are delegated under § 41.31(c)(2)(iii)(A) (relating to qualifications for taking licensing examination) comply with the standards in paragraphs (1)—(19)…” There is no violation of our State regulation when the supervision is not for qualification for licensure.

Isn’t it unethical since the husband is presumably in a sexual relationship with his wife and at the same time he is her supervisor?
This is a reference to Standard 7.07 Sexual Relationships with Students and Supervisees. As long as the supervising psychologist does not have or is not likely to have evaluative authority over his or her spouse, there is no violation of this standard.

​

Isn’t it unethical because it is a conflict of interest?
This is a reference to Standard 3.06 Conflict of Interest. The role that Dr. D has with his wife would not reasonably be expected to cause impairment, harm or exploitation since Dr. D is not in an evaluative role.

​

Isn’t it unethical because it is a multiple relationship?

The standard is 3.05 Multiple Relationships. This standard provides a definition of multiple relationships, a test of the ethical appropriateness of the relationship, a statement that multiple relationships per se are not unethical, and a requirement to take reasonable steps to resolve any unforeseen problems “…with due regard for the best interests of the affected person and maximal compliance with the Ethics Code.”

​

Standard 3.05 provides a test that requires some judgment: “A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist's objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.”

​

This test requires a judgment of what a reasonable psychologist would think would be a likely outcome of the multiple relationship. If Dr. D were in an evaluative role as a supervisor, then bias would be a reasonable concern. But since Dr. D does not have evaluative authority in his role as a supervisor, it is not reasonable to assume that there will be an ethical problem.

The third paragraph of 3.05 makes it clear that multiple relationships per se are not presumed to be unethical.

​

“Multiple relationships that would not reasonably be expected to cause impairment or risk exploitation or harm are not unethical.”

​

The key factor in this particular situation is that Dr. D is not in an evaluative role with his wife. Dr. D is the most consistently available psychologist at the time his wife is working in his practice. This is a safe guard to patients as well as an aid to his wife. There are many benefits for the husband and wife to work together. The experience can be mutually rewarding, the wife could gain additional experience and skills and the practice could provide low cost therapy for patients. A reasonable psychologist would not expect impairment, exploitation or harm to come from this situation. A backup supervisor could be appointed. Although not as readily available, this backup supervisor could be a source to go to if there is a problem. Certainly if a multiple relationship is likely to be problematic (some family members do not work well together) it should be avoided from the start. If a multiple relationship later becomes dysfunctional or highly conflicted then it would then meet the test of an unethical arrangement. The psychologist must then take steps to make other arrangements that with regard for the best interests of the affected persons and maximal compliance with the Ethics Code. If the relationship is a normal one, it is cynical to expect a worse case scenario and assume that it is unethical. When in doubt, carefully reread the ethics code and consult with an ethics expert. Many situations may not be a matter of “ethical” verses “unethical” but require complex ethical reasoning.