Supervision Session Summary

Handout #6 SUPERVISION SESSION SUMMARY

Date: ______Supervisee: ______

First names of clients/client systems discussed: ______

Updated Case Review: ______

Interventions and Client Progress: ______

Supervisee Concerns: ______

Discussion (theoretical bases, case conceptualization, clinical judgment, etc.): ______

Treatment Recommendations: ______

What student will work on over the next week: ______

Things I need to remember/Current Risk Management Issues

☐ Informed Consent ☐ Child Abuse/Neglect ☐ Supervisee Expertise ☐ Releases Needed ☐ Parental Consent ☐ Risk of Significant Harm ☐ Supervisor Expertise ☐ Vol./Invol. Hospitalization

rd ☐ Confidentiality ☐ Duty to Warn ☐ Institutional Conflict ☐ 3 Party/UR Review Handout #6

☐ Recordkeeping ☐ Substance Abuse ☐ Dual Relationship ☐ Discharge/Termination ☐ Records Security ☐ Medical Exam Needed ☐ Sexual Misconduct ☐ ______Action Taken: ______

Adapted from: Bernard, J.M. & Goodyear, R.K. (2004) Fundamentals of Clinical Supervision. New York, N.Y. Person Education, Inc.