This contract serves as verification and description of the counseling supervision provided by
(supervisor),to
(supervisee), Counselor Traineeenrolledin (course title and #)at Kent State Universityforthe semester.
PURPOSE, GOALS, & OBJECTIVES
- Monitor and ensure welfare of clients seen bysupervisee
- Promote developmentof supervisee’s professional counselor identity and competence
- Fulfill academic requirement for supervisee’s practicum orinternship
- Fulfillrequirementsinpreparationforsupervisee’spursuitofcounselorlicensure(whenapplicable)
CONTEXT OF SERVICE
- One (1) clock hour of individual supervisionweekly
- Supervision will revolve around counseling conducted with studentsseenat(name ofschool/agency)
- Individual supervision will beconductedon(day of theweek),fromto(time).
- Thesupervisorwillbeadheringtospecificmodelsofsupervisionalongwithusingprogressnotesandtapereview.
METHOD OF EVALUATION
- Feedbackwillbeprovidedbythesupervisorduringeachsession,andaformalevaluation,usingtheprogram’sstandardevaluationofstudentclientskills, will be conducted at mid-term and at the conclusion of the semester for practicum and at the conclusion of the semester for internship. A narrative evaluation may also be provided at mid-semester and at the conclusion ofthesemesterasanaddendumtotheobjectiveevaluationscompleted.
- Specificfeedbackprovidedbysupervisorwillfocusonsupervisee’sdemonstratedcounselingskills,professionalbehavior,anddocumentation.
- Supervisee will evaluate supervisor at the close of the semester, or upon changing sites using the program’s standard evaluation form for evaluating supervisors.Anarrativeevaluationmayalsoaccompanytheobjectiveevaluations.
DUTIES AND RESPONSIBILITIES OF SUPERVISOR
- Examinestudentspresentingcomplaintsandinterventionmethods
- Viewtapesofsupervisee’scounselingsessionsoutsideofregularlyscheduledsupervisionsessions
- Sign off on all studentdocumentation
- Challenge supervisee to justify approach and techniquesused
- Monitor supervisee’s basic attendingskills
- Support supervisee’s development as acounselor
- Present and model appropriatedirectives
- Intervene when student welfare is atrisk
- Ensure that ethical guidelines areupheld
- Maintain weekly supervision casenotes
DUTIES AND RESPONSIBILITIES OF SUPERVISEE
- Uphold ethicalguidelines
- Review counseling session tapes in preparation for weeklysupervision
- Be prepared to discuss all student cases; have student files, current and completed student case notes, and counseling session tapes ready to review in weekly supervisionsessions
- Justifycaseconceptualizationsmadeandapproachandtechniquesused
- Complete case notes and place in appropriate studentfiles
- Consult with field placement staff and supervisor in case ofemergency
- Implement supervisory directives in subsequentsessions
SUPERVISOR’S SCOPE OF COMPETENCE (IF APPLICABLE)
PROCEDURAL CONSIDERATIONS
- Supervisee’swrittencasenotes,treatmentplans,andvideotapeswillbereviewedandevaluatedineachsession
- Issues related to supervisee’s professional development will bediscussed
- Sessions will be used to discuss issues of conflict and failure of either party to abide by directives outlined here in contract. If concerns of either party are notresolvedinsupervision,thepracticuminstructorand/orDr. Steve Raineywillbeconsulted.
- In the event of emergency, supervisee is to contact supervisorat
SPECIFIC GOALS FOR THE SUPERVISEE
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We agree, to the best of our ability, to uphold the directives specified in this supervision contact and to conduct our professional behavior according to the ethical principles of our professional association.
Supervisee:Date:
Supervisor:Date:
Verification of Submission of Federal/State Background Checks (for School Counseling students only)
My signature serves as verification that the above named student (supervisee) has submitted a copy of their Federal/State Background Checks to our school.
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Signature of School Administrator (Principal, Vice-Principal, etc.)