The Clinical Supervision Power Differential

Dear Ryan,

I am a new clinician working toward licensure. The other day, I went into clinical supervision and my supervisor gave me a pound of coffee and said, “I thought of you when I saw this at the grocery store the other day,” and gave it to me. Ryan, I don’t drink coffee! I don’t like it, and I don’t do caffeine. I accepted it from them to be nice, but now I feel weird about it. I asked my colleagues, and none of them received anything from this person around the same time, which makes me feel even weirder about it. I’m thinking I might want to give it back, but I don’t want to appear mean. What should I do?


Confused Clinician

What a wise choice you’ve made to come to me, Confused, because my two favorite fighting words are “power differential”. Never is it more apparent in any counseling relationship than in the supervisor-supervisee relationship, particularly when you’re a new clinician working toward licensure with someone who will hold your ability to get said mental health license in their supervisory little hands. I can understand why, just based on the power differential alone, that you’d feel icky about it, but also, you don’t drink coffee, and your relationship with your supervisor is so new that they don’t know that! That just adds another layer of weird.

One of my old professors, also one of my favorite people on the whole planet, shared some wisdom with me once that sticks with me to this day – people at the top of the power differential are the least aware of its impact. What this supervisor has done is that they have abused the power differential. Does that sound a little like I’m being shrill? Maybe. But that doesn’t make it any less true. Supervisors have to be so careful about the power differential. We could make an off-hand comment that could be super offensive to someone over whom we have power and they would never tell us because of said power differential. We could also consciously and intentionally do something super egregious and the people over whom we have power would never say anything, also because of the power differential.

Still think I’m being shrill over something that seems inconsequential? Whenever I consult with other clinicians or counselors about something like this, my encouragement is consistently this: Play the tape to the end and play out worst case scenario. What if your supervisor gave you this pound of coffee that’s going to sit on your counter staring at you until you do something with it, and then later, because they didn’t know that you don’t drink coffee and you accepted it without saying anything (which they think gives them implied permission to keep abusing the power differential!), they ask you for a favor? Tell me about what’s going on with this coworker. Tell me about what you hear around the water cooler. Go to that group supervision to which clinical supervisors are not invited and tell me everything that goes on in that meeting. They washed your back by giving you a gift – now it’s your turn to wash theirs. And it all started with a pound of coffee.

What is also egregious about this is that your supervisor has tried to place some of the onus on you to state your discomfort and risk at least some kind of rupture to the relationship, and has potentially caused you to feel uncomfortable bringing it up due to this fear. This person holds your future licensure in their hands, and now you are the one responsible for fixing the problem and repairing the relationship. If you don’t say anything, it’s a slippery slope. If you do say something and give the coffee back, then you might be afraid that there’s going to be a weirdness between the two of you and you might feel like you caused it. (You didn’t. They did.) As the person at the top of the power differential, your supervisor is the one responsible for fixing the weirdness.

So, Confused, you have choices here. If it were me, I’d give the coffee back with a healthy dose of “please don’t do that again because it made me really uncomfortable” and let them repair the relationship from there. If you have a good supervisor, they’ll get it and respond accordingly. If you don’t and they don’t respond appropriately, you’ll know that too and you’ll have more choices from there.

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