CHHS17/247Clinical Supervision Agreement • October 4th, 2017
Contract for Clinical SupervisionClinical Supervision Agreement • May 14th, 2023
This document is intended to establish parameters of supervision and to provide clarity in supervisor and supervisee responsibilities.
Professional Diploma 2021-22 Therapeutic Life Story Work Clinical Supervision AgreementClinical Supervision Agreement • August 21st, 2021
Contract for Clinical SupervisionClinical Supervision Agreement • April 30th, 2022
The address and schedule of Clinical Supervision may be adjusted depending on the needs of Clinical Supervisor and Supervisee and should be communicated at least 24 hours in advance.
ContractClinical Supervision Agreement • September 15th, 2020
the clinical practice supervision of a Senior/Approved Psychosexual Evaluator and in accordance with the terms of a formal clinical supervision agreement to be approved in advance by the SOMB.
Contract for Clinical Supervision with Catherine ScholzClinical Supervision Agreement • November 17th, 2022
This document is intended to establish parameters of supervision and to provide clarity in supervisor and supervisee responsibilities.
CONTRACT FOR CLINICAL SUPERVISIONClinical Supervision Agreement • December 8th, 2008
During supervision, the supervisee provides information to the supervisor regarding the assessment, diagnosis, and treatment of each client. In a reciprocal dialogue, the supervisor provides oversight, guidance, and direction in assessing, diagnosing, and treating clients, and evaluates the supervisee’s performance. The supervisor balances the establishment of a safe place in which the supervisee can discuss mistakes with the need to intrude into the supervisee’s work to ensure quality service.
CLINICAL SUPERVISION AGREEMENTClinical Supervision Agreement • August 2nd, 2020
By signing this agreement, we agree to enter into a clinical supervision experience together and have discussed a number of issues that provide a context for the experience. The purpose of this agreement is to outline those issues and to serve as a resource for working together.
Your Company Name (Inc or LLC, etc.)Clinical Supervision Agreement • January 8th, 2021
The purpose of this agreement is to familiarize the Supervisee with the structure and process of Post-graduate clinical supervision as the Supervisee works toward licensure or maintaining the Supervisee license. Included is a description of the process, the Supervisee’s rights and responsibilities, which will ensure a common understanding about the supervision process, and provides the Supervisee an opportunity to ask questions for clarification and understanding.
ETHICS in CLINICAL SUPERVISION AGREEMENTClinical Supervision Agreement • March 10th, 2011
□ I hereby attest that I have read and understood the American Counseling Association’s Code of Ethics and Standards of Practice and will practice my counseling and clinical work in accordance with these standards.
AGREEMENT TO PROVIDE CLINICAL SUPERVISIONClinical Supervision Agreement • January 15th, 2019
Sample agreement for masters level non-independent practitioners seeking to work under direct supervision in their own practice in which they have ownership interest or manage pursuant to A.A.C. R4-6-211(B).
Clinical supervision agreementClinical Supervision Agreement • May 8th, 2015
CONTRACT FOR CLINICAL SUPERVISIONClinical Supervision Agreement • December 8th, 2008
During supervision, the supervisee provides information to the supervisor regarding the assessment, diagnosis, and treatment of each client. In a reciprocal dialogue, the supervisor provides oversight, guidance, and direction in assessing, diagnosing, and treating clients, and evaluates the supervisee’s performance. The supervisor balances the establishment of a safe place in which the supervisee can discuss mistakes with the need to intrude into the supervisee’s work to ensure quality service.
PURPOSE OF AGREEMENTClinical Supervision Agreement • September 15th, 2021
We agree to enter a clinical supervision experience together by signing this agreement along with signing the Contract for Supervision for the Kentucky Board of Social Work and have discussed the issues that provide a context for the supervisory experience. The purpose of this agreement is to outline those issues and to serve as a resource for working together. This agreement is an addendum to the Contract for Supervision approved by the KY Board of Social Work dated , but not part of that contract. This agreement may be updated as a need may arise.
Clinical Supervision AgreementClinical Supervision Agreement • February 21st, 2019
We have read and agree to our rights and responsibilities as outlined in the NHS GG&C AHP Clinical Supervision Policy and the ‘Clinical Supervision Guidance – supporting dietetic professional practice’ document.
ContractClinical Supervision Agreement • October 15th, 2020
Supervisee: Supervisor: Health Service/Team: Health Service/Team: Period of this Agreement:[start date] to [end date] The content/structure of this Clinical Supervision Agreement is adapted from Clinical Supervision Guidelines forMental Health Services (Queensland Health, October 2009, p. 22) & the sample agreements made available in the Queensland Centre of Mental Health Learning (QCMHL) Supervisor’s Toolkit (2009, pp. 14-20). Objectives Supervisee Restorative• To discuss clinical scenarios that I have faced, in a manner that is supportive and constructive.• To reflect on my responses to the challenges & issues I face in clinical practice.• To reflect on my responses to the challenges & issues I face in providing clinical supervision.• To identify counter-transference and prevent it from impairing my ability to work safely.Formative• To improve skills and knowledge in delivering clinical services.• To improve skills and knowledge in the practice of providing education.• To improve ski
Sample Contract with SuperviseeClinical Supervision Agreement • May 4th, 2022
The purpose of this agreement is to familiarize the ALC with the structure and process of licensure clinical supervision as the ALC works toward licensure or maintaining one’s ALC. Included is a description of the process, the ALC’s rights and responsibilities, which will ensure a common understanding about the supervision process and provides the ALC an opportunity to ask questions for clarification and understanding.
I ask you to read this supervision agreement prior to selecting me as your clinical supervisor *Clinical Supervision Agreement • February 2nd, 2024
⮚ To take necessary measures to develop both personally and professionally, striving for an ever-growing level of clinical expertise.
Agreement for Clinical Group SupervisionClinical Supervision Agreement • August 15th, 2022
The following is a letter of understanding between Jane Campbell, LCSW, supervisor, and Ann Robinson, LCSW, supervisor and , supervisee, concerning procedures for and conduct of clinical group supervision.
Agreement for Clinical SupervisionClinical Supervision Agreement • November 26th, 2018 • California
This agreement is made between Kathleen Phelps, LCSW, Clinical Supervisor – referred to in this agreement as “Supervisor” – and , supervisee requesting supervision for hours of licensure – referred to in this agreement as “Supervisee.” Supervisor agrees to provide Supervisee with clinical case supervision and other clinical skills consistent with the Board of Behavioral Science’s (BBS) standards toward the designation of licensed practitioner.
Calm Cabin Counselling Counselling, Psychotherapy and Clinical SupervisionClinical Supervision Agreement • January 12th, 2023
Calm Cabin Counselling is a therapeutic service offering one to one and group clinical supervision for counsellors, psychotherapists, teachers, youth workers and mental health professionals either in person at 23 School Hill, Ashcott TA7 9PN or online via zoom or teams. It important that supervisees feel safe and trust the supervisory relationship with their supervisor. This document sets out the structure of the Calm Cabin Counselling Clinical Supervision Agreement so that there is clarity and transparency about how Calm Cabin Counselling supports supervisees.
Clinical Supervision Agreement for Associate ProvidersClinical Supervision Agreement • February 26th, 2024
Your Company Name (Inc or LLC, etc.)Clinical Supervision Agreement • February 6th, 2021
The purpose of this agreement is to familiarize the Supervisee with the structure and process of Post-graduate clinical supervision as the Supervisee works toward licensure or maintaining the Supervisee license. Included is a description of the process, the Supervisee’s rights and responsibilities, which will ensure a common understanding about the supervision process, and provides the Supervisee an opportunity to ask questions for clarification and understanding.
If 1:1 or Group clinical supervision session please complete clinical supervision agreement and contract available in toolkit Action Learning Set Goals Sessions will be guided by an agenda and agreed to by both facilitator and group member’s but will...Clinical Supervision Agreement • April 7th, 2022
Reflect and review clinical practice linked to your role Structured conversation with a focus on improvement. For example, a case study or a specific area of practice or specific concerns or issues. Structured conversation leads to professional challenges, ideas, and solutions Facilitates CPD and can identify training needs for individuals and groups. Provides insight into your emotional responses Enhance morale and working relationships. Supports your self-care and well-being Supports delivery of a high standard of ethical, safe, and effective care Professional Accountability
VCU Counselor Education Clinical Supervision AgreementClinical Supervision Agreement • June 8th, 2016
Provide opportunities for candidate to meet required direct service hours as outlined in Practicum/Internship Plan (Appendix C of CH)
Sample Contract with SuperviseeClinical Supervision Agreement • May 4th, 2022
The purpose of this agreement is to familiarize the ALC with the structure and process of licensure clinical supervision as the ALC works toward licensure or maintaining one’s ALC. Included is a description of the process, the ALC’s rights and responsibilities, which will ensure a common understanding about the supervision process and provides the ALC an opportunity to ask questions for clarification and understanding.
ContractClinical Supervision Agreement • October 11th, 2020
Clinical Supervision Agreement We have read and agree to our rights and responsibilities as outlined in the NHS GG&C AHP Clinical Supervision Policy. Signature Date Supervisee: Supervisor: Supervisee’s Manager: T his is an agreement for: 1-1 supervision Group supervision Other T he choice of Clinical Supervisor has been mutually agreed: Yes No Frequency of sessions Min 6 per year Duration of session No less than 60 mins Ground Rules Code of Conduct We agree to abide by the HCPC and our individual professions Code of Conduct/Ethics Respect We agree to show respect to one another Punctuality We agree to be punctual Accountability The supervisee is accountable for their own practice and decides what to bring to supervision Responsibilities Agenda is set by the supervisee unless otherwise agreed Note-taking The supervisee will keep notes which can be shared with their supervisor. The supervisor will keep a record of the sessions. Cancellations We agree to give notice
Clinical Supervision AgreementClinical Supervision Agreement • December 13th, 2020
Clinical Supervision AgreementClinical Supervision Agreement • August 22nd, 2013
This template is an example of an agreement used between a supervisor and staff member in relation to the arrangements and processes for clinical supervision sessions. Specific organisations need to ensure agreements meet their specific needs. It is adapted from the NSW Drug and Alcohol Clinical Supervision Guidelines (2006)
Clinical Supervision AgreementClinical Supervision Agreement • September 10th, 2021
This document explains the details of our supervisory relationship. Please read it closely and be sure to ask me if you have questions or need further clarification.
AGREEMENT TO PROVIDE CLINICAL SUPERVISIONClinical Supervision Agreement • September 8th, 2021
Sample agreement for master’s level non-independent practitioners seeking to work under direct supervision in their own practice in which they have ownership interest or manage pursuant to A.A.C. R4-6-211(B). Supervisor will be responsible to monitor and oversee practice while providing direct and clinical supervision.
ContractClinical Supervision Agreement • December 4th, 2017
Centre for Health & Social Practice CITY CAMPUS Waikato Institute of Technology Private Bag 3036Waikato Mail Centre Hamilton 3240New Zealand Tel: + 64 7 834 8800 ext 7628Fax: + 64 7 858 0204Email : Info@wintec.ac.nzWebsite www.wintec.ac.nz
LCSW Clinical Supervision AgreementClinical Supervision Agreement • May 28th, 2024
Each practice location must encompass the primary role of social work. Additionally, at least one practice location must provide the below-referenced Supervisee a minimum of four (4) hours per week of direct clinical social work practice, gaining competency using specialized clinical knowledge and advanced skills to assess, form diagnostic impressions, and treat mental, emotional, and behavioral disorders, conditions, and addictions.
