The clinical supervisor
As mentioned above, clinical supervision refers to a contractual relationship between a clinical supervisor and a supervisee. The purpose of clinical supervision is: to discuss the direction of therapy and the therapeutic relationship; to promote the professional development of the supervisee; to enhance the supervisee’s safe and effective use of self in the therapeutic relationship; and to safeguard client well-being. The clinical supervisor must be competent in the area of practice/ modality that s/he has agreed to supervise. Clinical supervision may be individual (one supervisor per supervisee), dyadic (one supervisor to two supervisees) or group (generally, up to eight supervisees). College registration policies provide more detail regarding when these different formats are appropriate. (See Registration Guide)
Requirements of clinical supervisors
Prior to proclamation, a clinical supervisor is a practitioner who has extensive clinical experience, generally five years or more, in the practice of psychotherapy.
In the first three years following proclamation, a clinical supervisor is a regulated practitioner in psychotherapy in good standing with her or his College (includes College of Nurses of Ontario, College of Occupational Therapists of Ontario, College of Physicians and Surgeons of Ontario, College of Psychologists of Ontario, Ontario College of Social Workers and Social Service Workers), who has extensive clinical experience, generally five years or more, in the practice of psychotherapy and who is competent in providing clinical supervision. Upon proclamation of the Psychotherapy Act, practitioners who are receiving supervision from an unregulated practitioner will have a grace period of one year to transition their supervision to a regulated practitioner who meets the above requirements.
Three years after proclamation, a clinical supervisor is a regulated practitioner of psychotherapy in good standing with her or his College, who has extensive clinical experience, generally five years or more, in the practice of psychotherapy, and who has demonstrated competence in providing clinical supervision.
Outside Ontario, a clinical supervisor is an experienced practitioner of psychotherapy qualified to provide clinical supervision in his/her jurisdiction.
When clinical supervision is required
Fulfilling registration requirements
To qualify for registration as a Registered Psychotherapist, applicants are required to have completed 100 hours of clinical supervision in conjunction with 450 direct client contact hours. Typically, a portion of these hours will be completed as part of the applicant’s education and training program. Frequently, however, individuals will graduate without having completed the required 100 hours of clinical supervision. In that case, they may be eligible for registration in the Qualifying category, until they have completed the full 100 hours, and possibly, other outstanding registration requirements.
Qualifying members are required to practise with clinical supervision. In addition, all Registered Psychotherapists are required to practise with clinical supervision until such time as they have completed 1000 direct client contact hours and 150 hours of clinical supervision, i.e. until they have completed an additional 550 client hours and 50 clinical supervision hours beyond those required for registration as an RP.
Supervision may also be imposed by the College when a College committee directs that a member must practise with clinical supervision or some other form of supervision. This may occur when a member wishes to resume practice after a period of non-practice, or to address gaps in knowledge, skill or judgment identified through the Quality Assurance Program or discipline process. A member’s managed health issue could also result in a requirement to practise with supervision, thereby allowing the member to continue practising with monitoring and oversight.
In cases of College-directed supervision, supervisors need to know why supervision was imposed by the College, and must provide appropriate supervision as directed, particularly with respect to frequency of sessions, record-keeping and other conditions that may be stipulated.
Voluntary clinical supervision and consultation
Members may seek clinical supervision or consultation voluntarily, in order to discuss the direction of therapy regarding a particular client or clients, for reasons of professional growth, or to develop competence in a new area. This is strongly encouraged; indeed some psychotherapists engage in ongoing clinical supervision throughout their professional careers.
It is important to understand that the College does not regulate students. In fact, some psychotherapy students may plan to register with another regulatory college, or may already be registered with another college, e.g. Ontario College of Social Workers and Social Service Workers. However, practice standards set out in this section apply to members who provide clinical supervision to students. In addition, members may be responsible for other forms of student supervision related to their roles as teachers, professors, mentors, etc. In these situations, it is a regulatory requirement that members provide appropriate supervision to those whom they are responsible for supervising. The intensity of this oversight and level of direct involvement by the supervisor will depend on the experience and apparent competence of the student.
The clinical supervision agreement
Clinical supervision is characterized by a formal relationship between supervisor and supervisee(s). It is a requirement, therefore, that members providing and receiving clinical supervision have an agreement in place between or among the parties involved. Details of supervision agreements will depend on particular circumstances, including the therapeutic approach or model of supervision used. The agreement is to be documented in the
records of all parties, and ideally will be in writing and signed.
The agreement could include the following:
- the purpose of the supervision, plan for supervision and/or expectations of the relationship;
- contract details, e.g. duration, frequency, etc.;
- format (individual, dyadic, or group); modality (psychodynamic, cognitive behavioural, systemic, other); and method (self-report, videotape, live observation, thematic, other);
- location or medium of meeting (face-to-face; electronic medium, etc.);
- expectations of supervisor and supervisee(s);
- expectations regarding the sharing of client information and informing clients about supervision;
- provisions regarding the confidentiality of information shared between/among supervisor and supervisee(s);
- process for providing evaluation and/or feedback;
- process for resolving conflicts;
- remuneration, if any;
- process for renewing or terminating the agreement; and
- making explicit what, if any, responsibility the supervisor will take for the well-being of the client in the therapy.
Record of supervision provided
Supervisors should keep a detailed record of clinical supervision provided. In particular, records should include the name of supervisee(s), dates of attendance, number of hours provided, and fees paid. It may also include issues discussed and any directions given.
The Standard: Providing Clinical Supervision
A member appropriately supervises persons whom s/he is professionally obligated to supervise, or with whom s/he has entered into a clinical supervision agreement.
Demonstrating the Standard
A member demonstrates compliance with the standard by, for example:
- entering into a supervision agreement that sets out the responsibilities of the supervisor and supervisee(s), and the expectations of both parties;
- documenting the supervision agreement and, ideally, having the agreement in writing and signed;
- clearly defining what client information is to be shared between/among the supervisor and supervisee(s), and documenting both parties’ expectations with regard to informing clients about the supervision relationship;
- meeting regularly and documenting discussions between supervisor and supervisee(s), e.g. focus of the discussion, particular issues addressed, etc.;
- supporting the progress of the supervisee(s);
- undertaking supervisory responsibilities only when the member has the necessary knowledge, skill and judgment, i.e. competence, to provide the services to be supervised.
Note: College publications containing practice standards, guidelines or directives should be considered by all members in the care of their clients and in the practice of the profession. College publications are developed in consultation with the profession and describe current professional expectations. It is important to note that these College publications may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained.