Clinical Supervision: Here and Now
Ethics, Presence, and Yalom’s Influence
CE Credit: 3 Hours
Format: Self-Study Article + Post-Test
Audience: LPCs, LMFTs, LCSWs, and related clinicians in supervisory roles
Course Description
Clinical supervision is an ethical cornerstone of effective mental health practice—yet often becomes a checkbox rather than a transformative, relational process. Drawing inspiration from Irvin Yalom’s work, particularly his emphasis on here-and-now exploration and existential themes, this 3-hour self-study CEU invites supervisors to reimagine supervision as a co-created space rooted in ethical presence, transparency, and depth…
This course challenges clinicians to examine ethical dimensions of the supervisory relationship—power, autonomy, cultural humility, and informed consent—through both traditional guidelines (e.g., ACA, AAMFT, NASW) and the lived moment-to-moment experience of supervision. Supervisors will gain tools for enhancing ethical decision-making, repairing ruptures, and practicing relational immediacy with supervisees.
Clinical supervision is not simply a process of gatekeeping or performance review; it is a sacred trust wherein both parties can explore vulnerability, bias, and clinical judgment. At its best, supervision becomes an ethical crucible—a space where difficult truths are surfaced and healing models are refined. Yalom’s existential approach encourages us to step away from protocols and into presence. What does it mean to sit in the moment with a supervisee? To name discomfort, explore power, or notice silence? This course will explore these questions, aiming to help supervisors develop both courage and clarity in their work.
This self-study course is designed for flexible, reflective engagement. You will read core content, reflect on guided journaling prompts, apply tools to your current supervision relationships, and take a post-test to assess your understanding. By blending theory, case examples, and practical exercises, this course creates space for supervisors to explore their ethical voice and refine their use of self as a relational instrument.
Learning Objectives
After completing this course, participants will be able to:
- Identify three core ethical responsibilities of clinical supervisors.
- Define the concept of “here-and-now” processing and how it applies in supervision.
- Describe how Yalom’s existential framework informs ethical supervisory presence.
- Recognize common ethical pitfalls in supervision (e.g., dual relationships, boundary blurring).
- Apply at least two techniques for fostering ethical immediacy and transparency with supervisees.
- Reflect on the impact of personal values and cultural dynamics in the supervisory relationship.
Instructions for Use
This course includes:
- Reading the article content
- Completing reflective journaling prompts
- Applying concepts to your own supervision experiences
- Finishing a brief post-test
We recommend printing the journaling prompts or keeping a digital supervision reflection log. You may complete the course at your own pace, with the expectation of spending 3 hours in total.
Course Outline and Content
I. Foundations of Ethical Supervision (45 minutes)
Ethical supervision is grounded in the core values of the profession: beneficence, autonomy, nonmaleficence, fidelity, and justice. These principles, common across codes such as those of the ACA, NASW, and AAMFT, guide supervisors in their dual role as mentor and evaluator.
Key Concepts:
- Legal vs. Ethical Responsibilities: Understanding how supervision differs from therapy and from administrative oversight. Ethical dilemmas may involve the need to navigate more than one code or board expectation.
- Documentation and Accountability: Supervisors must maintain accurate records, including supervision logs, feedback summaries, and critical incident reports. Failure to document feedback, concerns, or growth areas can expose both parties to legal risk.
- Evaluative Authority: Supervisors serve a gatekeeping role, determining whether a supervisee is ready for independent licensure. This introduces unavoidable power differentials. Ethical presence requires transparency about how evaluation is conducted.
Reflective Prompt:
“How do I experience my own power in the supervision room? What messages—spoken or unspoken—am I giving about that power?”
Activity:
List 3 ways you currently offer informed consent to your supervisees. Are these verbal, written, and revisited periodically?
II. Yalom’s Influence on Supervision (45 minutes)
Irvin D. Yalom, an existential psychiatrist and group therapist, emphasized themes that resonate deeply within supervision: mortality, meaning, freedom, responsibility, and isolation. His books, especially The Gift of Therapy and The Theory and Practice of Group Psychotherapy, illuminate a relational model grounded in presence.
Yalom’s Four Existential Concerns Applied to Supervision:
- Death/Mortality: Supervisees may confront existential themes such as grief, trauma, and the limits of therapy. Supervisors must hold space for their emotional labor, without rushing to rescue or rationalize.
- Freedom/Responsibility: Clinical work requires choice and consequence. Supervisors help supervisees explore not just what they “should” do, but what they are choosing—ethically, emotionally, relationally.
- Isolation/Connection: Supervision can counteract the profound loneliness of clinical work. Naming the relational support in supervision is an ethical act in itself.
- Meaning: Supervisors who explore “why does this matter to you?” help supervisees engage beyond symptom reduction.
Reflective Prompt:
Which of Yalom’s four concerns resonates most with your supervision style? How might that shape your approach?
Example Dialogue:
Supervisor: “I noticed when you described your client’s suicidal ideation, you shifted to a very clinical tone. That makes sense, but I also wondered—how did that land for you emotionally?”
III. The Here-and-Now in Supervision (60 minutes)
The here-and-now approach invites supervisors to comment on and explore what is happening in the room—live, relational content. Instead of only focusing on the supervisee’s work with clients, this model supports supervision as a second arena of growth.
Common Here-and-Now Moments:
- Discomfort when receiving feedback
- Withdrawing after discussing a mistake
- Uneasy silence when power is addressed
- Repetitive patterns that mirror therapy dynamics
Technique: Meta-Communication
Use statements such as:
- “Can we talk about what’s happening between us right now?”
- “I feel some distance here—are you sensing that too?”
Case Vignette:
Jorge, a supervisee, receives feedback about a boundary lapse. The supervisor notices Jorge’s jaw clench and his arms cross. Rather than pushing forward, the supervisor says: “Before we go further, I want to check in. What’s happening for you in this moment?”
This pause transforms the session into a relational process and invites repair. Ethical supervision includes space for rupture, acknowledgment, and reattunement.
Reflective Prompt:
Describe a time you avoided naming something happening between you and a supervisee. Why do you think you hesitated? What might you do differently next time?
IV. Ethical Challenges and Real-Life Dilemmas (45 minutes)
Supervisors often encounter moments when personal values, legal obligations, and relational ethics collide. Developing a consistent decision-making model supports clarity in these moments.
Cases and Applications:
Case 1: Values Clash
Taylor, a supervisee, expresses discomfort working with LGBTQ+ clients. The supervisor recognizes this as both a training need and an ethical issue involving non-discrimination. Rather than shaming, the supervisor explores Taylor’s values, unpacks bias, and refers to ethical codes.
Case 2: Feedback Avoidance
Fatima’s sessions are consistently over-focused on solutions, with little emotional process. Her supervisor fears discouraging her but realizes this pattern is impacting client depth. Together, they review tape and co-create a learning plan.
Case 3: Supervisee Burnout
Miguel discloses he is emotionally numb and dreading client sessions. The supervisor helps him examine vicarious trauma, refers to support services, and adjusts caseload expectations. This is both an ethical and clinical intervention.
Ethical Decision-Making Framework:
- Identify the issue
- Consult ethics codes
- Consider cultural/contextual factors
- Generate options
- Seek supervision/consultation
- Document decision and rationale
V. Tools for Ethical Presence (45 minutes)
Presence is more than being kind or professional—it is a full-bodied, relational engagement with your supervisee. Ethical presence allows both parties to be real while maintaining clarity of roles.
Practical Tools:
- Check-In Questions: “What’s one thing I did last week that helped—or hindered—you?”
- Role Play and Modeling: Show, don’t just tell. Model how to explore race, power, rupture, or emotion.
- Ethical Narratives: Share mistakes you’ve learned from in your career (within appropriate boundaries).
- Attachment Lens: Consider how each supervisee may attach to authority figures. Some may be eager to please, others defensive.
Reflective Prompt:
What does ethical presence mean to you—on your best days and your hardest days as a supervisor?
VI. Integration, Final Reflection, and Practice Commitment (30 minutes)
To close this self-study, supervisors are invited to reflect on how they will apply insights from the course.
Journaling Prompts:
- What is one supervisory behavior I want to change this month?
- What would it look like to lead with ethical courage?
- Who can support me in my own supervisory growth?
Final Exercise:
Draft a personal supervision philosophy. Include:
- Your core values as a supervisor
- How you manage power and presence
- How Yalom’s ideas influence your supervision
Practice Commitment:
Identify one change you will make in your supervision within the next two weeks. Write it down and revisit it after a month.
Course Materials
- PDF Handout: Ethical Guidelines Quick Reference
- Sample Supervision Contract Template
- Excerpt Handout: Selections from The Gift of Therapy by Irvin Yalom (fair use excerpt or paraphrase with citation)