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:

Clinical Supervision Competency Rubric – The latest version was completed October 1, 2022.

  1. The Supervisor Meeting with Intern Before beginning Supervision to Assess Intern’s Competencies (Using the Clinical Supervision Competency Scale)form used in the first meeting with the Intern before starting supervision. It allows for you to get a sense of the Intern’s baseline competencies for practice based on a conversation about previous related experience.
  2. Further refine the Intern’s competencies by processing the first session with a client and a regular psychotherapy session. After the first session or a psychotherapy session that an intern has with a new client review the Session Rating Scale feedback from the client and have the intern complete the Clinical Session Notes or Initial Interview Process template notes. Then using the original Baseline from the Clinical Supervision Competency Scale adjust the baseline competency levels based on this additional data. This valuable information will assist in developing the Deliberate Practice Goals Tracking Form.

3. The Intern Feedback in which the intern completed the Session Notes from the initial session with a client or an ongoing psychotherapy session with client. It is important that the intern also complete the Session Rating Scale in order to incorporate feedback from the client about the session as well. This will assist in refining the Baseline Competencies and begin to focus on the Deliberate Practice Goals the intern will begin to work with to read the Competency Threshold.

Deliberate Practice Goals Tracking Form

The Deliberate Practice Goals Tracking Form lists the current deliberate practice goals that the Qualified Supervisor and Intern are practicing. Note the Baseline Competence number is located on the far left of the form. On the far left of the form are two columns: one to indicate the number 3 or higher and the date that the Intern had met the Competency Threshold.

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.

Template Resources

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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