Technical Field Advisor Supervision Contract Template

SUPERVISION CONTRACT (suggested template)
This is an agreement between ___________________ (Supervisee) and ________________ (Supervisor).

The purpose of supervision is to: (e.g., meet requirements for training supervision) __________________
Effective Dates: ____________; Frequency of Meetings: ____________; Duration of supervision session: ____
Type of Supervision: ___ Group; ___ Individual; ____ combination of both
Supervisor’s definition of supervision: ___ (clearly provide your definition to promote shared meaning) __
1. Purpose, Goals And Objectives Of Supervision:

a. To fulfil requirements for training supervision;
b. To promote development of supervisee’s professional identity and competence;
c. To (Other) AS AGREED UPON BY SUPERVISOR AND SUPERVISEE.
2. Context And Content Of Supervision:
1. The content of supervision will focus on the acquisition of knowledge, conceptualization, and skills
within the defined scope of practice.
2. The context will ensure understanding of ethics, codes, rules, regulations, standards, guidelines
(including consent, confidentiality/ privacy), and all relevant legislation.
3. A supervisory record form will be used to document impressions of each supervisory session. Feedback
will be provided at the close of each session. Supervision notes may be shared with supervisee.
4. Rights and Responsibilities of both parties
a. Supervisor Rights
1. To bring concerns/issues about Supervisee’s work.
2. To question Supervisee about his/her work and workload.
3. To give Supervisee constructive feedback on his/her work performance.
4. To observe Supervisee’s practice and to initiate supportive / corrective action as required.
b. Supervisor Responsibilities
1. To uphold ethical guidelines and professional standards.
2. To make sure supervision sessions happen as agreed and to keep a record of the meeting.
3. To create a supervision file containing supervision records and other documents relating to
development and training.
4. To ensure that Supervisee is clear about his/her role and responsibilities.
5. To record the supervision session and to store their copy in the supervision file.
6. To monitor Supervisee’s performance.
7. To set standards and assess the Supervisee against these.
8. To know what Supervisee is doing and how it is being done.
9. To deal with problems as they impact on the Supervisee’s performance.
10. To support supervisee and the agreed personal development plan.
11. To complete all forms as requested by the State of Ohio Counselor, Social Worker, and Marriage
and Family Therapist Board including a professional disclosure statement of supervisor and
supervision logs (http://cswmft.ohio.gov/pdfs/SupvLog.pdf).
c. Supervisee Rights:
1. To uninterrupted time in a private venue.
2. To Supervisor’s attention, ideas and guidance.
3. To receive feedback.
4. To set part of the agenda.
5. To ask questions.
6. To expect Supervisor to carry out agreed action or provide an appropriate explanation, within an
agreed time frame.
7. To have his/her development/training needs met.
8. To challenge ideas and guidance in a constructive way.
a. Supervisee Responsibilities:
1. To uphold ethical guidelines and professional standards;
2. To be prepared to discuss client cases with the aid of written case notes and / or video / audio
tapes;
3. To validate diagnoses, interventions, approaches and techniques used;
4. To be open to change and use alternate methods of practice if required;
5. To consult supervisor or designated contact person in cases of emergency;
6. Implement supervisor directives in subsequent sessions; and
7. Maintain a commitment to on-going counsellor education and the counselling profession.
3. Procedural considerations:
a. Supervisee’s written cases notes (plus diagnoses and treatment plans) and audio / video tapes may
be reviewed in each session;
b. Issues relating to supervisee’s professional development will be discussed;
c. Sessions will be used to discuss issues of conflict and failure of either party to abide by the guidelines
outlined in this contract. If concerns of either party are not resolved in supervision, (NAME OF
ALTERNATE PERSON TO WHOM TO MAKE GRIEVANCE TO) will be consulted; and
d. In event of an emergency, supervisee to contact supervisor. If not available, then contact (NAME /
CONTACT DETAILS OF APPROPRIATE PERSON).
4. Supervisor’s Scope Of Practice - Brief description of Supervisor’s work, qualifications and practice
5. Finances/ Insurance
Agreement as to hourly rate for supervision: ___________ to be paid by: ___________________
Malpractice/ liability insurance will be arranged by supervisee: Yes__________ No_________

(If yes, proof of such must be provided as soon as possible.)
Date proof provided, with copy to supervisor ____________________________
This contract is subject to revision at any time, upon the request of either the supervisee or the supervisor. A formal
review, however, will be conducted every six months and revisions to the contract will be made only with consent of
the supervisee and approval of supervisor.
We agree, to the best of our ability, to uphold the guidelines specified in this supervision contract and to manage
the supervisory relationship and supervisory process according to the ethical principles of the CCAA Inc.
___________________________ _____________________________
Supervisor Supervisee
This contract is in effect from DATE _______ Date of revision or termination: DATE _____

Technical Field Advisor Supervision Contract Template

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Technical Field Advisor Supervision Contract Template

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SUPERVISION CONTRACT (suggested template)

This is an agreement between ___ (Supervisee) and (Supervisor).

1. Purpose, Goals And Objectives Of Supervision:

Agreement as to hourly rate for supervision: _ to be paid by: _________

Malpractice/ liability insurance will be arranged by supervisee: Yes__ No_

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