Unsafe Supervision Is Real – and Likely Underreported
Clinical supervision is one of the profession’s most valued structures. At its best, it helps clinicians think, grow, reflect, and practise more safely.
But supervision is not automatically safe simply because we call it supervision and we assume it is.
One thing I keep coming back to is how easily we can confuse structure with safety.
We tend to assume that if someone has the right qualifications, enough years of experience, a senior role, and supervision of their own, that this should more or less equal safety.
And in a way, that assumption is understandable. As humans, we often rely on structures, titles, and formal processes as signals that things are probably okay.
But human relationships are more complex than that.
Formal structures, experience, seniority and organisational guardrails matter. But none of these, on their own, guarantee that supervision will actually be safe in practice.
The literature suggests that harmful and inadequate supervision are not rare fringe problems. In one comparative study, 25.2% of supervisees in a U.S. sample and 40.3% in an Irish sample were classified as currently receiving harmful supervision. Rates of inadequate supervision were even higher: 69.5% in the U.S. sample and 79.2% in the Irish sample. Lifetime rates were higher again.
I think that is confronting enough on its own.
But the problem may be even harder to see than those numbers suggest.
More recent qualitative work has shown that supervisees describe harmful supervision in different ways. Some spoke about supervisors being neglectful and callous. Inadequate supervision, by contrast, was more often described in terms such as inappropriate feedback, unavailability, and unresponsiveness. In that study, participants provided 156 supervision narratives: 63 inadequate, 30 harmful, and 63 exceptional.
Importantly, harmful supervision is not limited to the more obvious forms of mistreatment. It may also develop through quieter, harder-to-name dynamics: boundary blurring, emotional over-involvement, misuse of supervisory power, role confusion, or supervisory relationships that become too personally charged to remain safely held within the professional frame.
These are exactly the kinds of problems that can be easiest to miss.
And that brings us to underreporting.
Supervisees often do not feel fully free to say what is happening. Supervision is both supportive and evaluative, which makes silence understandable. In the Cook et al. study, 95.3% of participants reported withholding some degree of information from their supervisors, and 53.3% reported completely withholding at least one concern. The authors also noted that supervisees tended to withhold supervision-related concerns even more readily than some client-related concerns.
So when we ask, “Why wasn’t this raised?” or “Why didn’t someone say something sooner?”, the answer may be: because the structure itself can make saying something feel risky.
Other work suggests that nondisclosure is not simply a supervisee problem. It is also shaped by the quality of the supervisory relationship. Stronger supervisory alliance, collaboration, and cultural humility have been linked with lower nondisclosure, which suggests that supervisees speak more openly when supervision actually feels safer.
Also, it is not only the evaluative structure and quality of supervision that can make disclosure difficult. The dynamics can resemble what is seen more broadly in trauma and professional misconduct contexts, where people often delay, minimise, or avoid reporting because of shame, confusion, loyalty, fear of consequences, dependency, or difficulty naming what happened.
All of this matters because supervision is not a small side issue in professional life. When it becomes unsafe, it can affect:
- clinician development,
- confidence,
- reflective capacity,
- training progression,
- and, potentially, client care.
I recently wrote about unsafe supervision in a paper that is currently under review, and this article grows out of that broader reflection. The issue is larger than any one workplace, training program, or individual story. It is, I think, a professional issue that deserves more explicit attention than it currently receives.
If we want supervision to be genuinely protective, we may need to become more willing to ask uncomfortable questions:
- What actually makes supervision safe in practice?
- What are the limits of formal structure as protection?
- How do supervisees safely raise concerns?
- How do we recognise harmful supervision early, before it causes serious damage?
- And how do we make room for the quieter, more confusing forms of supervisory harm – not only the obvious ones?
I suspect many of us still place too much faith in the existence of structures themselves. But structure on paper and safety in practice are not always the same thing.
What seems to matter just as much is whether the people inside those structures have enough honesty, self-awareness, reflective capacity, and ethical steadiness to notice when something is starting to drift off course.
Without that, even good-looking systems can miss things.
References
Cook, R. M., Welfare, L. E., & Romero, D. H. (2020). Incidence of intentional nondisclosure in clinical supervision by prelicensed counselors. The Professional Counselor, 10(1), 25–38.
Ellis, M. V., Berger, L., Hanus, A. E., Siembor, M. J., & Swords, B. A. (2014). Inadequate and harmful clinical supervision: Testing a revised framework and assessing occurrence. The Counseling Psychologist, 42(4), 434–472.
Ellis, M. V., Creaner, M., Hutman, H., & Timulak, L. (2015). A comparative study of clinical supervision in the Republic of Ireland and the United States. Journal of Counseling Psychology, 62(4), 621–631.
Ertl, M. M., Ellis, M. V., & Peterson, L. P. (2023). Supervisor cultural humility and supervisee nondisclosure: The supervisory working alliance matters. The Counseling Psychologist, 51(4), 590–620.
Hutman, H., Ellis, M. V., Moore, J. A., Roberson, K. L., McNamara, M. L., Peterson, L. P., Taylor, E. J., & Zhou, S. (2023). Supervisees’ perspectives of inadequate, harmful, and exceptional clinical supervision: Are we listening? The Counseling Psychologist, 51(5), 719–755.
Aliz Ovlachi - Clinical Psychologist & Author 