Creating an Optimal Clinical Supervision Agreement Template

All About Clinical Supervision Agreements

Clinical supervision agreements are a pivotal component in healthcare, particularly in nursing and counseling fields. Their primary purpose is to establish a formal relationship between the supervisor and the supervisee, clearly defining their roles, responsibilities, and expectations. These agreements play a vital role in protecting the interests of both parties, as well as the patients or clients they serve.
For supervisees, such as doctors, nurses, therapists, or other allied health professionals, these agreements outline the scope of their practice, responsibilities, and day-to-day tasks. They serve as an assurance that the supervisee will adhere to established guidelines and standards of care, all while under the supervision of a more experienced practitioner. It offers a level of protection against potential malpractice liability and assists in clearly delineating responsibilities.
In addition, clinical supervision agreements provide a clear framework for resolving conflicts and addressing grievances related to the supervision. They establish a protocol for how issues should be resolved, thereby minimizing misunderstanding or conflict between the supervisor and the supervisee.
For supervisors, these agreements help in filtering out unsuitable candidates , thus reducing the risk of undetected misconduct by the supervisee. These agreements allow supervisors to monitor the activities and performance of the supervisee. They provide a reference point to ensure that the supervisee fulfills their duties properly and according to the provisions of the agreement.
Lastly, clinical supervision agreements create an opportunity for both parties to adopt a solution-oriented approach to various issues that may arise during their professional relationship. They promote transparency and accountability, two important elements in maintaining a successful supervisory relationship.
These agreements have serious legal and ethical implications for both parties. Failing to enter into a clinical supervision agreement can have dire consequences for a supervisor. For example, without a proper agreement, a supervisor may find it difficult to manage the tasks of a supervisee appropriately. However, when there are rogue employees/contractors, supervisors may be held liable for their supervision duties.
For supervisees, failing to have a clinical supervision agreement can lead to unwanted conflicts with the supervisors. They may also lose their licenses due to negligence or misconduct. For this reason, clinical supervision agreements are essential to protecting the interests of both supervisors and supervisees.

The Elements of a Clinical Supervision Agreement

While every clinical supervision agreement should be tailored to the specific relationship between the supervisor and supervisee, there are several key components that get to the very heart of the agreement. First, the agreement should state the frequency and length of meetings and those meetings should occur at the frequency stated in the agreement. Second, the role of the supervisor and supervisee must be clearly defined. Will supervision unwind in a Socratic method? Or more of an apprenticeship model? Third, the agreement must address the confidentiality of the supervision sessions. While generally, supervision is considered confidential, state laws can vary (for example, supervisors may have a mandatory reporting responsibility for child abuse) and licensing boards can include supervision records in their investigative powers. Thus, the agreement should indicate whether or not a supervisee’s records may be protected from discovery by a court or licensing board. Fourth, the agreement should address the process that is used to report to the supervisee’s licensing board. In most cases, this is done by the supervisor on a quarterly basis. Finally, the agreement should discuss how conflicts in the relationship are to be resolved. Are conflicts to be mediated by a colleague? An attorney? A licensing board?

The Legal Aspects of Clinical Supervision Templates

One of the most important considerations in any clinical supervision agreement is whether it is compliant with the state law in which you are practicing. This relates to both how clinical supervision works and who is considered an acceptable clinical supervisor. Each state has their own licensing requirements for supervisors and those requirements vary substantially from state to state. When drafting a supervision template, a supervisor or a practice entity should never use a supervision template that was created in another state as that supervision template is bound to be noncompliant in the state under which the supervision template will be used.
The most common misunderstanding of participants in clinical supervision is that clinical supervision allows for independent practice under the law. In fact, that is almost never the case and each and every clinical supervision agreement must describe the supervision protocol being taken with a view toward how those standards meet the standards required by that state; the more specific the agreement is regarding the supervision practices employed, the stronger position the supervisor and supervisee would have with respect to complaints to the state board.
Next, there is the issue of whether the approval to give clinical supervision can be given by the respective state board that oversees the mental health care profession. This is a different process than the application process for licensure in that an applicant for acceptance for clinical supervision usually must be approved by the respective state licensing board. Each state has their own requirements for acceptance of clinical supervision and the process for approval is different in each state.
Finally, there is the issue of limiting liability to protect yourself and your supervisee from exposure. Clinical supervision agreements should not only specify the manner in which the supervision is to be undertaken, but should also contain protections against the acts and omissions of the supervisor and supervisee. These liability limitations may include indemnification, confidentiality, limitations and…

How to Write a Thorough Clinical Supervision Agreement

Crafting an effective clinical supervision agreement template is essential to ensure the rights and obligations of all parties are well defined and no stone is left unturned. When drafting an agreement, it is important to adhere to some key principles. A well-crafted clinical supervision agreement should be, above all else:

1. Clear

A comprehensive clinical supervision agreement should be drafted in clear and concise language so that the reader, irrespective of their background and education, should be able to understand what is covered under the agreement.

2. Contextual

It’s also critical that a clinical supervision agreement template be contextually appropriate, meaning that all potential applicable circumstances have been considered when drafting the document and the there’s sufficient scope that covers all foreseeable circumstances that the supervisor can share with the supervisee.

3. Consultative

When drafting a new supervision agreement template, it is useful to consult with all parties involved so that any concerns, suggestions, or requirements of each party can be addressed in the document.

4. Specific

A clinical supervision agreement template should be specific. Instead of using broad strokes, it is important to have enough detail in the actual wording of the agreement that makes it explicit what the duties, limitations, obligations, and expectations of every involved party are.

Sample Clinical Supervision Agreements

Within each discipline, there are also variations in the used template. One example representing the psychology field is presented here as an excerpt, "Supervision Agreement and Contract . . . The purpose of this contract is to clarify the responsibilities of Dr______________ and ______________________ in this supervisory relationship. It is expected that this agreement will be reviewed periodically in order to assess the progress of your work and to help us solve any problems that may arise. This contract is effective, dated ___/___/__ and remains in effect until modified by agreement of both parties. . .supervisee . . . agrees to: XXX. Supervisee further agrees to not utilize any electronic means of communicating confidential information (e.g., fax, e-mail, texting, etc.) unless approved in advance by supervisor, and then only in accordance with provisions of the HIPAA privacy rule, state statutes, Board rules, and relevant policies. . . .Supervisee further understands: XXX. . . .This agreement is not intended nor should it be construed as providing legal or ethical advice. It is also not intended to provide any guarantee or reassurance that board approval for licensure will be obtained. Supervisor and supervisee agree to assume equal responsibility for resolving any ethical problems related to supervision."
The American Association for Marriage and Family Therapy (AAMFT) provides a sample supervision agreement which incorporates many similar elements, "Purpose and Goals . . . The purpose of this contract is to clarify the responsibilities of ____________ and ______________ in this supervisory relationship. Both the supervisor and supervisee will review this agreement periodically in order to assess the progress of supervision and to help resolve any problems that may arise. This agreement is effective ________________ and will remain in effect until it is altered by mutual agreement or until ______________ replacement or termination of the contract. . . 3. Requirements of _____________ 1. The supervisee certifies that he/she has read this contract, has discussed this contract with his/her supervisor, and agrees with its contents. . . . . . .This contract is not intended nor should it be construed as providing legal or ethical advice. It is also not intended to provide any guarantee or reassurance that board approval for licensure will be obtained. _______________________________________________________(Supervisor) ________________________________(Date) ______________________________(Signature) ________________________________(Supervisee) ______________________________(Date) ______________________________(Signature)"
The most cited sample supervision agreement is a sample supervision contract provided by the National Board for Certified Counselors, Inc., "Preamble . . . . This agreement between the supervisor, ________, a professional counselor; and the supervisee, ________, a prospective professional counselor; is designed to make explicit the developmental nature of the supervisory relationship. . . . 2. Competencies of ___________’s State Licensing Board. __________ provides a listing of competencies for supervisors, including requirements for supervisor preparation and for supervision; guidelines for clinical supervision; and goals for clinical supervision. These must be considered by the supervisor and the supervisee to establish a supervision contract. . . . . . .This contract is not intended nor should it be construed as providing legal advice or supervision contract supervision. It is also not intended to provide any guarantee or reassurance that board approval for licensure will be obtained. . . ."
More specific to the social work field, the New York State Board for Social Work (NYBSW) provides a sample supervision agreement, titled Clinical Supervisory Agreement "The following Clinical Supervisory Agreement (the "Agreement") is made and entered into as of _______ between ________, LMSW (the "Supervisor"), and ________, LMSW (the "Candidate") for the purposes of complying with the requirements of Section 74.10[c] of the Rules and Regulations of the New York State Board for Social Work ("NYBSW"), which requires all licenses and certificate holders to register with the NYBSW and obtain a minimum of 36 clinical continuing education credits every three years whether or not they are and/or were engaged in the practice of social work during such three year period, and whether or not they are and/or were employed in the field of social work. . . . . . .A clinical supervision fee shall be mutually agreed upon by both parties and paid by Candidate to the Supervisor at the time of the clinical supervision session. Such supervisory fee shall be fixed annually and payable in advance of each supervisory session. . . ."
The NASW has a Supervision contract that is less formal, but covers basic agreement points that both the supervisor and the supervisee should be aware of in writing. "I. Agreement Uniqueness ________ and ________ acknowledge that this contract and ________’s unique needs dictate additional conditions. At any time, the supervision contract can be amended to meet the needs of _______. II. Supervisee Responsibilities 1. Clinical Supervisee will participate in clinical supervision sessions (at a minimum) _______ hours per month for _______ months for a total of _______ hours of supervision. 2. Clinical Supervisee will pay ________ at the rate of ________ per clinical supervision hour/session (with the exception of any preplanned absences of clinician or supervisee) at least _______ day in advance of each supervision meeting. To accommodate supervisee for the best possible supervision experience I will 1. _______ 2. _______ 3. _______ 4. _______ (If necessary, please add any other arrangements you would like to make.)…"

Issues and Answers for Clinical Supervision Templates

There are several common concerns when it comes to the implementation of clinical supervision agreements. Understanding these common challenges will help in understanding the importance of the agreement and how best to implement it within your clinical practice. The first challenge is setting expectations regarding overall familiarity with supervision as well as with the particular clinician being supervised and their specific clinical practice. It is important to clearly define what is expected of both parties to the agreement to avoid any possible misunderstandings about roles and responsibilities. Vague language can give rise to multiple interpretations, which can lead to miscommunication over time and can cause avoidable difficulties in the various stages of supervising a clinician. The second challenge involves various instances in which some may feel the supervision agreement has been breached. This may arise if a supervisor observes an issue on a case that needs to be addressed, but has not been specifically defined in the clinical supervision agreement as required. It is the responsibility of both parties to the agreement, as well as any other required supervisors, to come together at the beginning stages of this process to determine what issues and areas of concern require a more specific discussion. However, it is also the responsibility of the supervisor to ensure that the agreement explicitly lays out expectations and responsibilities to the greatest extent possible to avoid a breach of the contract. Finally, there is the concern about making sure that the agreement continues to function within the actual supervision process over time. For example, if the parties to the agreement do not share office space or rarely communicate, will this impact the effectiveness of the agreement? In some cases, sharing an office space may be necessary to ensure that the use of a qualified supervisor can monitor the outlined treatment plan to ensure compliance with national and state regulations. It is important to understand that monitoring the provider’s treatment plan is ultimately going to benefit the provider, the patient, and the health care facility. While there will always be occurrences in which disagreements may arise with regards to clinical supervision agreements, there are several ways to minimize their occurrence. Even if there are unforeseen issues, a clearly drafted supervision agreement will have the advantage of making it clear to both parties what they are responsible for under the terms of the agreement.

The Future of Clinical Supervision Agreements

The increasing use of technology, evidenced by the rise of telehealth services and the consolidation of paper files into comprehensive electronic clinical records, may also be paving the way for the digitalization of clinical supervision agreements. In the future, it is likely that clinical supervision agreements will be maintained in the clinical record and linked to the individual for whom supervision services are provided. Automated flagging will assist providers in tracking the expiry of supervision arrangements, and telehealth tools will provide easy access to the supervisor when questions arise. As with many other aspects of mental health delivery , the conversation surrounding the practice of clinical supervision is expanding. The expanding breadth and scope of both the regulatory profession standards and the subsequent health insurance requirements are expected to evolve to address these emerging developments in digital health care delivery. We may also expect to see more formalized safeguards, such as limiting the delegation of clinical supervision duties to only a single level or individual amongst the credentialed hierarchy. The future of clinical supervision agreements is likely to include new interpretations and applications concerning collaboration amongst professionals of diverse qualifications and specialties.