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<strong>Clinical</strong> <strong>Supervision</strong> <strong>Handbook</strong><br />
As a clinical supervisor I agree to<br />
• Keep all information you reveal in the clinical supervision sessions<br />
confidential, except for these exceptions:<br />
– You describe any unsafe, unethical, or illegal practice that you are<br />
unwilling to go through the appropriate procedures to address.<br />
– You repeatedly fail to attend sessions.<br />
• In the event of an exception arising, I will attempt to persuade and<br />
support you to deal appropriately with the issue directly yourself.<br />
If I remain concerned, I will reveal the information only after informing<br />
you that I am going to do so.<br />
• At all times work to protect your confidentiality.<br />
• Not allow procedural issues of the work to monopolize the clinical<br />
supervision session.<br />
• Offer you advice, support, and supportive challenge to enable you<br />
to reflect in depth on issues affecting your practice.<br />
• Be committed to continually developing myself as a practicing<br />
professional.<br />
• Keep a record of our clinical supervision sessions.<br />
• Ask for feedback for the purpose of evaluating the clinical supervision<br />
process.<br />
• Use my own clinical supervision to support and develop my own<br />
abilities as a clinical supervisor and clinician, without breaking<br />
confidentiality.<br />
Anything else?<br />
Frequency of Meetings<br />
Venue<br />
Duration of <strong>Clinical</strong> <strong>Supervision</strong> Relationship<br />
Next Review Date<br />
Signed<br />
(Clinician)<br />
Signed<br />
(<strong>Clinical</strong> Supervisor)<br />
Thank you for completing this questionnaire!<br />
Adapted from Bolton Primary Care Trust (2003). <strong>Clinical</strong> <strong>Supervision</strong> Guidance Document. Available at<br />
www.bolton.nhs.uk/foi_pubscheme/policy_store. Accessed January 15, 2008<br />
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