Introduction

Clinical supervision means a contractual relationship in which a clinical supervisor engages with a supervisee to:

  • promote the professional growth of the supervisee;
  • enhance the supervisee’s safe and effective use of self in the therapeutic relationship;
  • discuss the direction of therapy; or
  • safeguard the welfare of the client.

Clinical supervision can be individual, dyadic or group. Group supervision may include structured peer group supervision if it is formal and structured, and includes at least one group member who meets CRPO’s definition of a clinical supervisor.

Structured peer group supervision differs from group clinical supervision in that the latter is led by a clinical supervisor, whereas the former includes at least one member who would qualify as a clinical supervisor but is an equal participant (not the leader). Structured peer group supervision often occurs in an institutional setting but may be formalized outside such settings.

Practitioners Providing Clinical Supervision

In order to be considered for registration purposes, the practitioner directly providing clinical supervision must meet the requirements to serve as a clinical supervisor, whether it is in an individual, dyadic or group format. For structured peer group supervision, there must always be at least one member of the group present who meets the requirements to serve as a clinical supervisor in order for the supervision provided to be considered for registration purposes.

The requirements for serving as a clinical supervisor will depend on when the supervision was provided, not when the supervisee submits their hours for review, either upon submitting their application or when updating their clinical experience to meet relevant registration requirements.

Clinical supervision is a key aspect in the establishment of competent professionals. If you are a member taking on the role as a clinical supervisor, you are identifying a willingness to support the development of other professionals who practise psychotherapy. As such, you have a responsibility to provide competent clinical supervision which includes assessing the knowledge, skill and judgment of supervisees, evaluating their needs and responding to those needs with appropriate and timely clinical supervision, which may include feedback and consultation, among other things, as negotiated between you and the supervisee.

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Qualifications to Serve as a Clinical Supervisor

Prior to proclamation of the Psychotherapy Act, 2007 (which took place on April 1, 2015), a clinical supervisor is a practitioner who has extensive clinical experience, generally five years or more, in the practise of psychotherapy.

In the first three years following proclamation of the Psychotherapy Act, 2007, a clinical supervisor is a regulated practitioner in psychotherapy in good standing with their college*, who has extensive clinical experience, generally five years or more, in the practise of psychotherapy and who is competent in providing clinical supervision.

Three years after proclamation of the Psychotherapy Act, 2007, a clinical supervisor must be a regulated practitioner in psychotherapy in good standing with their 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.

*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.

In the years following approval of this definition, the Registration Committee has undertaken a review of the criteria to demonstrate competence in providing clinical supervision that will take effect on April 1, 2018. The Registration Committee has approved the following criteria for demonstrating competence in providing clinical supervision:

  1. The supervisor must be a member in good standing of a regulatory college whose members may practise psychotherapy.
  2. The supervisor must have five years’ extensive clinical experience.
  3. The supervisor must meet CRPO’s “independent practice” requirement (completion of 1000 direct client contact hours and 150 hours of clinical supervision).
  4. The supervisor must have completed 30 hours of directed learning in providing clinical supervision. Directed learning can include course work, supervised practice as a clinical supervisor, individual/peer/group learning, and independent study that includes structured readings.
  5. The supervisor must provide a signed declaration that they understand CRPO’s definitions of clinical supervision, clinical supervisor, and the scope of practice of psychotherapy.

CRPO staff may request evidence of 30 hours of directed learning in providing clinical supervision and may also request a letter of verification and a statement describing the supervisor’s approach to providing supervision.

It is recommended that a clinical supervisor be able to provide their supervisee with a letter attesting to their competency, as set out in 1 through 5 above, that the supervisee would submit as evidence of supervision in the supervisee’s application to CRPO.

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Clinical Supervisors Outside Ontario

Outside Ontario, a clinical supervisor is an experienced practitioner of psychotherapy qualified to provide clinical supervision in their jurisdiction.

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Extensive Clinical Experience

CRPO believes that having at least five years of independent practice before undertaking the clinical supervision of a qualifying psychotherapist is a necessary foundation for this specific supervisory expertise.

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Directed Learning Activities in Providing Clinical Supervision

Members are encouraged to approach CRPO’s requirements with the intent of developing competence toward ensuring the richest possible experience for supervisees and cultivating their own practice as a supervisor. For instance, members should draw from the variety of activities that comprise directed learning (i.e. course work, supervised practice as a clinical supervisor, individual/peer/group learning, and independent study that includes structured readings) as a way of being exposed to and incorporating emerging best practices into the supervisory relationship.

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Practitioners Requiring Clinical Supervision

Clinical supervision is required for several categories of registration:

  • Applicants – Those applying to the Registered Psychotherapist (Qualifying) category must complete a minimum of 30 hours of clinical supervision for initial registration with CRPO to enter the Qualifying category.
  • RP (Qualifying) Members – Qualifying members, as a condition of their Certificate of Registration, must receive ongoing clinical supervision while they are a Qualifying member. These members will need to complete a total of 100 hours of clinical supervision as part of requirements to enter the Registered Psychotherapist category. Qualifying members must continue to receive ongoing clinical supervision once they have completed the 100 hours required to complete the Registered Psychotherapist category requirements.
  • Registered Psychotherapist Members – Members in the Registered Psychotherapist category must receive ongoing clinical supervision until they have completed a total of 1000 direct client contact hours and 150 hours of clinical supervision. Should a member acquire 150 clinical supervision hours prior to completing 1000 direct client contact hours, they are still required to receive ongoing clinical supervision until both requirements are met for “independent practice”. 

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Group Supervision

Grandparenting Applicants

At application, a grandparenting applicant may have submitted all of their clinical supervision hours that were completed in a group format. Once registered, a grandparented member requiring additional clinical supervision to meet the independent practice requirements must complete half of the outstanding clinical supervision hours in an individual or dyadic format.

Practitioners who applied through grandparenting could include group clinical supervision that included up to 12 supervisees. Supervision based on modalities that traditionally allow for larger group sizes will be considered on a case-by-case basis by Registration Committee.

Regular Route and Other Applicants

Applicants applying through other registration routes must complete at least 50 per cent of their clinical supervision hours in an individual or dyadic format. The remaining 50 per cent may be group supervision, including structured peer group supervision.

Regular route applicants can receive group clinical supervision that includes up to eight supervisees. Up to 20 per cent of the clinical supervision hours required for the Registered Psychotherapist category and independent practice requirements can be completed in groups of nine to 12 supervisees, provided the clinical supervisor attests that learning is promoted for all supervisees in the group for the hours submitted. 

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Frequency of Clinical Supervision

Professional Practice Standard 4.2: Practising with Clinical Supervision addresses the frequency that members should receive clinical supervision:

Members required to practise with clinical supervision participate meaningfully in such a way as to promote the purpose and effectiveness of clinical supervision.

Supervision hours should occur at regular intervals in relation to client contact hours. Determining “regular intervals” will depend on individual circumstances, as set out in the supervision agreement. It is not appropriate, however, to accumulate required clinical supervision hours over a short period of time, i.e. to clump them together; hours should be spaced out over time in relation to client contact hours. For example, unless clinical circumstances require more supervision, it is considered appropriate for Qualifying Members to obtain one clinical supervision hour per four or five direct client contact hours.[1]For RPs who are required to practise with clinical supervision, it is generally considered appropriate to obtain one clinical supervision hour per ten hours of direct client contact.[2]The suggested ratios are guidelines only.

When required clinical supervision hours have been completed, Members continue to meet with their supervisor on a regular basis, until such time as they have been notified by the College that they have met all of the requirements for ‘independent practice’, i.e. practice without clinical supervision.

[1] This ratio is based on the requirement of Qualifying Members to complete 450 direct client contact hours and 100 hours of clinical supervision in order to be registered as an RP.
[2] This ratio is based generally on the requirement of RPs to have completed a total of 1,000 direct client contact hours and 150 hours of clinical supervision, in order to be able to practise without clinical supervision, i.e. independently.

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