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    Clinical Supervision Form

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    jirehcounseling
    This document summarizes a clinical supervision session between a staff member and their supervisor. The supervisor addressed topics like quality of service, assessment accuracy, cultural competency, treatment plans, documentation, and billing. They also discussed any topics or concerns raised by the supervisee, how the supervisee responded to supervision, and their compliance with scheduled sessions. The supervisor evaluated the supervisee's work ethics and identified any needed corrections or corrective actions.

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    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Clinical Supervision Form

    Uploaded by

    jirehcounseling
    2K views2 pages
    This document summarizes a clinical supervision session between a staff member and their supervisor. The supervisor addressed topics like quality of service, assessment accuracy, cultural competency, treatment plans, documentation, and billing. They also discussed any topics or concerns raised by the supervisee, how the supervisee responded to supervision, and their compliance with scheduled sessions. The supervisor evaluated the supervisee's work ethics and identified any needed corrections or corrective actions.

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    This document summarizes a clinical supervision session between a staff member and their supervisor. The supervisor addressed topics like quality of service, assessment accuracy, cultural competency, treatment plans, documentation, and billing. They also discussed any topics or concerns raised by the supervisee, how the supervisee responded to supervision, and their compliance with scheduled sessions. The supervisor evaluated the supervisee's work ethics and identified any needed corrections or corrective actions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    2K views2 pages

    Clinical Supervision Form

    Uploaded by

    jirehcounseling
    This document summarizes a clinical supervision session between a staff member and their supervisor. The supervisor addressed topics like quality of service, assessment accuracy, cultural competency, treatment plans, documentation, and billing. They also discussed any topics or concerns raised by the supervisee, how the supervisee responded to supervision, and their compliance with scheduled sessions. The supervisor evaluated the supervisee's work ethics and identified any needed corrections or corrective actions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    CLINICAL SUPERVISION

    Staff Name:
    Supervisor’s Name:

    Date:

    Start Time: End Time: Hours:

    (I). Name of clients/cases presented:

    (II). Topics/issues addressed by supervisor:


    Quality of service to clients Service effectiveness
    Accuracy of assessment/referral Service frequency with clients
    skills Cultural Competency
    Appropriateness of the service
    intervention
    Timeliness of initial contact with clients/family on caseload:
    Acceptable Shows Improvement
    Warrants Improvement Does Not Show Improvement

    Treatment Plan
    BIRP Notes (Goals/Objectives, Interventions, Follow-up/Plan)
    Quality of written documentation (clinical/non-clinical)
    Acceptable Shows Improvement
    Warrants Improvement Does Not Show Improvement
    Timeliness of submitting BIRP Notes in the system:
    Acceptable Needs Improvement
    Poor Unacceptable

    Invoice
    Communication w/Supervisor/ staff
    Ethics, legal requirements, and boundaries

    NOTES:

    BH1201(a)— Clinical Supervision Est Mar 2008


    (III). Topics/concerns presented by supervisee:

    (IV). Supervisee’s response to supervision:


    Appropriate Appears guarded Anxious Argumentative
    (V). Supervisee’s compliance to scheduled sessions:
    Good Fair Poor Often request to reschedule
    (VI). Work ethics:
    Appropriate Poor Liability Risk (High)

    Other Comments:

    (VII). Corrections Needed:

    (VIII). Corrective Action Plan:

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