Clinical Supervision Resources

Jacinto’s WORD.doc Templates

New Intern Competency Worksheets

I adapted the Clinical Supervision Intern Competencies (CSIC) from the NIH Proficiency Scale. I am uploading the form in PDF format. I will be updating the CSIC form from time to time. The SCIC is a helpful tool for the Supervisor to use when meeting with the Intern before beginning Clinical Supervision to assess the Intern’s Competencies. The Clinical Supervision Intern Competencies form is best used in 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.

0A Clinical Supervision Intern Competencies Click on link to Download 

  1. The Intern Case Discussion Notes (filled out by the Intern before the supervision session) for initial client interview and other sessions that the Supervisor will use to discuss cases and use observational methods of and client feedback from the Intern. This generic form can be used multiple times to provide feedback over the two years of supervision. After each session the Intern will complete the Clinical Supervision Notes form to document work with the Qualified Supervisor. Copy the templates here: Case Discussion Tool Template  and Clinical Supervision Session Notes Click/Download
  2. 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.   Diagnosis and Treatment Plan Worksheet   Click/Download

The Notebooks for the Four and Twelve Hour Courses are located here:

0A 4 Hour Handbook 10 18 22 FINAL  Click on file download and print.

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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