Clinical Supervision Resources

Jacinto’s WORD.doc Templates

New Intern Competency Worksheets

I have added three worksheets to assess the level of competency an Intern has attained. I adapted the Competency Rubric from the NIH Proficiency Scale. I am uploading the three forms in WORD.doc so you can edit them to include the specific competencies you are using with your Intern. I will be updating these forms. The three files I have attached here are:

  1. The Supervisor Meeting with Intern Before beginning Supervision to Assess Intern’s Competencies form used in the first meeting with the Intern before starting supervision. It allows for you to get a sense of the Intern’s global competencies for practice based on a conversation about previous related experience.
  2. The Intern Feedback from Practice Observation or Video session that the Supervisor will use to observe the Intern at work and complete the form. This generic form can be used multiple times to provide feedback over the two years of supervision.
  3. The Diagnosis and Treatment Plan Worksheet has two parts: (a) the Intern completes the first two pages and, (b) the supervisor completes the third page.

Click the link below to open the templates. Feel free to open in WORD and edit the templates to suit your practice focus.

Outside Agency Qualified Superior Agreement for a Registered Intern Access at the Agency

Other Templates in PDF Format

The templates in this section are taken from the Internet as examples. Go to the link listed for additional information. Use them to inspire your construction of documentation you want to use.

RAI’s, Measurements for Practice

Selective Tools for Assessing Clients

Articles and Associated Content

4-Hour Supervision PowerPoint

Twelve Hour Qualified Supervisor Workshop PowerPoint

Summative Supervision Video with Fairy Supervisor

Four Hour Summative Evaluation Example

Alice Videos

Three Supervision and Two Therapy Vignettes

The three video clips address issues of Deliberate Practice, Feedback Informed Treatment, Trauma Informed Care, and provide examples of Therapeutic Synchronicity, and Administration of the ORS and SRS.

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