Moral Distress Within the Supervisory Relationship: Implications for Practice and Research

A strong working alliance within the supervisory relationship is crucial to the success of the training experience and client welfare (Bernard & Goodyear, 2013; Falender & Shafranske, 2008; Gnilka, Chang, & Dew, 2012). Many threats exist in the alliance between a supervisor and intern, and these have already been documented (e.g., Bucky, Marques, Daly, Alley, & Karp, 2010; Ramos-Sánchez et al., 2002; Sterner, 2009). Role conflicts; skill deficits; multicultural challenges; sexual attraction; gender-based conflict; and problematic supervisee behaviors, emotions, and attitudes can all threaten the supervisory relationship (Ladany, Friedlander, & Nelson, 2005). In this article, we propose that moral distress is yet another threat that has remained absent within the counselor supervision literature. Furthermore, we argue that additional research is necessary to clarify the extent and severity of moral distress in counselor education. Moral distress is an ethical concern that is well documented in health care research, foremost within nursing literature. Although various definitions of moral distress have been proposed, all tend to address the same central ethical conundrum: knowing what one believes to be the correct ethical action, yet feeling constrained from pursuing it. Perhaps the most inclusive definition is as follows: