Can boundary crossings in clinical supervision be beneficial?

Abstract

Published studies have addressed boundary violations by clinical supervisors, but boundary crossings, particularly those deemed positive by supervisees, have not received much attention. Eleven trainees in APA-accredited doctoral programs in clinical and counseling psychology were interviewed regarding positive boundary crossings (PBCs) they experienced with clinical supervisors. Interview data were analyzed using Consensual Qualitative Research. Examples of PBCs included socializing with supervisors outside the office, sharing car rides, and supervisor self-disclosure. Typically, supervisees did not discuss the PBC with their supervisors because they were uncomfortable doing so, felt that the PBC was normal, or felt that processing such issues was not part of the supervisor’s style. Most supervisees viewed the PBCs as enhancing the supervisory relationship and their clinical training; however, some participants reported that the PBCs created role confusion. The results suggest that there are legitimate reasons for supervisors to be scrupulous about their boundaries with supervisees; however, supervisors who hold rigid boundaries can deprive supervisees of deeper mentoring relationships or a more authentic emotional relationship that can be valuable to supervisees learning how to provide psychotherapy.

Keywords:

• supervision
• boundary crossing
• ethics, supervisees
• CQR
• positive
• training

Acknowledgements

No grant funding was used for this research. We thank Dr. Alan Burkard, Dr. Tim Melchert, and Dr. Pat Bradway for their comments on earlier drafts of this article. We thank the participants for volunteering for this research.

Appendix 1. Interview protocol

Thank you for agreeing to participate in this project. Your willingness to share your experiences is greatly appreciated.

Today we will be talking about boundary issues in supervision. Specifically, I will be asking you about your experiences with boundary crossings in supervision that you experienced as initially positive, or that in retrospect you now view as positively influencing your growth. For this study, we are defining a PBC as a supervision intervention that falls outside the expected supervision activities and is viewed by the supervisee as beneficial. We note however, that boundary crossings may first be viewed as distressing, but if a discussion ensues between supervisor and supervisee and the resolution of that discussion enhances the supervisory relationship or the supervisee’s professional development, such a boundary crossing is defined as positive. Several examples of boundary crossings that may deemed positive (either initially or later) are eating lunch with a supervisor, difficult discussion of sensitive clinical issues, (e.g. sexual attraction), and supervisor self-disclosure of a personal nature. Do you have any questions before we begin?

Opening questions:

1. People define boundaries in many ways … how do you define boundaries?

2. Please describe some of the boundary crossings that you have experienced in supervision.

3. What is your cultural background and your supervisor’s cultural background?

   1. How, if at all, did these similarities or differences influence boundaries in the supervisory relationship?

PBC questions:

1. Please tell me about a specific experience you had involving a supervisor’s boundary crossing that you experienced as initially positive, or that ended positively, in supervision.

1. What was the PBC?

2. How long had you been in supervision with this supervisor at the time of the event?

3. What level of rapport had been established between you and your supervisor at the time of the event?

4. What were the antecedent events leading up to the boundary crossing?

5. What made this event positive for you?

6. How, if at all, was the PBC addressed in supervision?

   1. What may have facilitated this discussion?

   2. What may have inhibited this discussion?

7. Why was not it discussed (if that is the case)?

8. How did the PBC affect your supervision? (e.g. you, the supervision process, the relationship)

9. What are your current thoughts about this event as you reflect back (i.e. would you do anything different, if so, what and why, if not, why not)?

Closing questions:

1. How has this interview affected you?

2. Why did you participate in this study?

3. Is there anything else you would like to add?