Original Research

Journal of Genetic Counseling

, Volume 20, Issue 1, pp 35-48

First online:

Boundary Issues and Multiple Relationships in Genetic Counseling Supervision: Supervisor, Non-supervisor, and Student Perspectives

  • Lidan GuAffiliated withDepartment of Educational Psychology, University of Minnesota
  • , Patricia McCarthy VeachAffiliated withDepartment of Educational Psychology, University of Minnesota Email author 
  • , Sonja EubanksAffiliated withUniversity of North Carolina at Greensboro
  • , Bonnie S. LeRoyAffiliated withDepartment of Genetics, Cell Biology, and Development, Institute of Human Genetics, University of Minnesota
  • , Nancy CallananAffiliated withUniversity of North Carolina at Greensboro

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Boundary issues and multiple relationships potentially affect all supervision interactions. Boundary crossings are departures from the strictest professional role and may or may not benefit supervisees. Boundary violations are outside common practice and may place supervisees at significant risk. Multiple relationships occur when supervisors concurrently or consecutively hold two or more roles with supervisees. Studies in other fields indicate supervisors and supervisees may be uncertain about professional conduct regarding these issues. In this study, genetic counselor supervisors (n = 126), non-supervisors (n = 72), and genetic counseling students (n = 129) completed an anonymous survey investigating four major questions: 1) Are various boundary issues and multiple relationships perceived as differentially appropriate? 2) Do supervisor, non-supervisor, and student perceptions differ? 3) What challenging situations have respondents experienced? and 4) What management strategies did they use? There was general agreement among groups in their appropriateness ratings of 56 hypothetical supervisor behaviors, although supervisor ratings tended to reflect stricter boundaries regarding the appropriateness of interactions than student ratings. A majority rated unavoidable boundary crossings and supervisor multiple relationships involving an academic relationship as most appropriate, and romantic/sexual multiple relationships and/or boundary violations as least appropriate. Analysis of respondents’ actual challenging situations revealed many involved boundary violations, placed students at risk of harm, and often resulted in student compliance.


Clinical supervision Genetic counseling Multiple relationships Boundary issues Boundary violations Ethics