This page is a working list of clinical supervision topics, questions and activities for the supervision hour itself. It's written for licensed clinicians who supervise associates, residents and interns (LPCs, LCSWs, LMFTs and psychologists) and for supervisees who want to arrive with more than "things are going fine." You'll find topics grouped into eight areas, reflective supervision questions to copy one per line, ten activities with step-by-step instructions, an agenda a supervisee can send ahead, and a supervision note template with an invented example, built around one state board's documentation rule.
If you need the paperwork that comes before the first session (the contract, the hours log and state requirements for social workers), see our guide to clinical supervision in social work. This page is about what goes inside the sessions.
Every supervisee and client on this page is invented. Board rules change, and your board's current rules win over anything here.
How to choose what to bring to supervision
The topics to discuss in clinical supervision change from week to week, and no single hour uses more than a few items from the lists below. A fixed order keeps the important things from getting squeezed out by the interesting ones:
- Risk first. Any client with thoughts of suicide or of harming someone, abuse or neglect, a crisis since the last session, or a legal question. Put it first every time, even when the answer is "nothing new."
- The case you're stuck on. Not the most interesting case, the one where you don't know what to do next.
- One supervision goal. The ACES Best Practices in Clinical Supervision (2011), written by the Association for Counselor Education and Supervision, ask supervisors to give "attention to one or more of the agreed upon goal(s) during each supervision session" (2.c.ii). Choose the activity that serves that goal.
- A topic from the bank below, when the caseload is quiet, or as the month's theme for group supervision.
Two limits from the same document help with planning. Feedback should typically address "no more than three skills or issues" in a session (3.a.i), so plan for three things at most. And feedback should rest on direct observation, such as "live observation, audio or video recording," as well as the supervisee's own report (3.a.v). Supervision built only on the supervisee's account of sessions misses what actually happened in them, so build recordings or observation into the month (see the activities below).
Clinical supervision topics by area
Eight areas cover most of what supervision needs to reach over a licensure period. Rotate through them over a few months, and come back to risk and documentation more often than the others.
Case conceptualization
- Turning a list of symptoms into a working explanation: what started the problem, what keeps it going and what protects the client.
- Choosing a diagnosis and ruling out the alternatives, with the evidence for each.
- Matching interventions to the conceptualization rather than to habit or to the last training you attended.
- Writing goals the client agrees with and you can measure.
- Clients who aren't improving: when progress stalled and what changed around that time.
- Coordinating with a prescriber, school or primary care doctor, with the client's written consent.
- When to refer, and how to explain a referral so it doesn't feel like rejection.
A one-page case conceptualization and a current treatment plan make these discussions faster.
Risk and safety
- Asking about suicide directly, and recording the client's answers in their own words.
- Using a structured screener such as the C-SSRS, and what to do after a positive answer.
- Building a safety plan with the client, including a conversation about access to means.
- Risk of harm to others, and your state's duty-to-warn or duty-to-protect law.
- Mandated reporting of child, elder and dependent adult abuse.
- Intimate partner violence: screening, safety planning, and when couples work isn't safe.
- What happens between supervision sessions: when to call the supervisor, how, and who covers when they're away.
- The supervisee's own safety: threats, a client who shows up uninvited, home and community visits.
Ethics and boundaries
- Informed consent at intake, including telling clients that the clinician is under supervision. The ACA Code asks supervisees to "disclose their status as supervisees and explain how this status affects the limits of confidentiality" (F.5.c). An informed consent template is a good place to start.
- Confidentiality and its limits, especially with minors, couples and families.
- Dual relationships in small towns, faith communities and close cultural communities.
- Gifts, self-disclosure, touch, and running into clients in public.
- Social media: friend requests, online reviews, and searching for a client online.
- Fees, unpaid balances and what billing under supervision allows.
- Working at the edge of your competence, and when to get training before taking a case.
- A step-by-step way to work through an ethical dilemma under time pressure.
Our guides to the ACA Code of Ethics and the NASW Code of Ethics cover the standards counselors and social workers bring to supervision most often.
Documentation
- Progress notes that show the work: what you did, how the client responded and why care continues (DAP note examples).
- The difference between progress notes and psychotherapy notes, and what belongs in each (psychotherapy notes vs progress notes).
- Late entries and corrections, done the way your record system and your board expect.
- Writing every note so you'd be comfortable if the client read it.
- Documenting a risk assessment, a consultation and a decision not to act.
- Releases of information before you speak to anyone about a client.
- Records retention, and what to do when a subpoena or records request arrives.
ACES asks supervisors to require that supervisees "address ethical considerations as part of treatment planning and to document this in casenotes" (7.a.iv), so documentation and ethics often belong in the same conversation.
Cultural humility
ACES says "all supervision is multicultural supervision." It asks supervisors to raise culture, diversity, power and privilege in the first session (6.a.i) and to require "considerations of culture, power, and privilege in client case conceptualization" (6.b.i). Topics:
- Which parts of identity matter most to this client, in the client's words.
- Broaching: how and when to raise race, culture, religion, sexuality, disability or class with a client.
- How the supervisee's identity and the supervisor's identity shape the therapy room and the supervision room.
- Bias in diagnosis and assessment, including measures that weren't developed with the client's community.
- Working with interpreters.
- Language, immigration status, transportation and cost as barriers to attendance.
- Repairing a cultural misstep with a client.
The time is well spent. In a series of studies, Hook and colleagues found that clients' ratings of their therapist's cultural humility were linked to a stronger working alliance and to improvement in therapy (Hook et al., 2013).
Countertransference and self-care
- Clients the supervisee dreads seeing, and clients they look forward to.
- Reactions rooted in the supervisee's own history or values, and how they show up in session.
- Overfunctioning: working harder than the client, running sessions long, answering messages at night.
- Vicarious trauma, compassion fatigue and burnout (therapist burnout vs compassion fatigue).
- Caseload size and the mix of heavy and lighter cases (average caseload for a therapist).
- When personal therapy would help, and how to find a therapist.
Supervision isn't therapy for the supervisee. The ACA Code says supervisors "do not provide counseling services to supervisees" and instead address interpersonal issues "in terms of the impact of these issues on clients, the supervisory relationship, and professional functioning" (F.6.c). ACES describes the line in four steps: identify the issue, help the supervisee see its clinical effects, work to reduce those effects on the supervisee's clinical work, and contribute to a plan for resolution "that does not directly involve the supervisor" (7.d.iii).
Licensure and career
- Tracking hours, and checking the log against your board's categories every month.
- Preparing for the licensing exam.
- Liability coverage for associates (liability insurance for counseling students and associates).
- Choosing a specialty and the training it requires.
- What private practice involves, and what an associate may and may not do before full licensure.
- Joining or building a group practice (how to start a group practice).
- Practicing across state lines once licensed (Counseling Compact states).
- Becoming a supervisor one day: the training your board requires and what the role asks.
Telehealth practice
- The licensing rule. HHS says health professionals must "be licensed or legally permitted to practice in the state where the patient is located" (HHS, Licensure for behavioral health). Confirm where the client is at the start of each session.
- An emergency plan for each telehealth client: the address they're at for the session, a local emergency contact and the nearest crisis services. HHS says "all providers should establish and maintain an emergency plan."
- Telehealth informed consent (telehealth consent form).
- Choosing a platform that signs a business associate agreement (HIPAA compliant telehealth platforms).
- Privacy on the client's side: a parked car, a shared apartment, a workplace break room.
- What you lose on screen (posture, hands, the smell of alcohol) and how to ask about it.
- When telehealth isn't the right fit, and how to move a client to in-person care or refer.
- Supervision by video and telephone: what your board counts (Arizona's limits are below).
Topics that work well in group supervision
ACES says group supervision should be chosen "for multiple reasons; time efficiency is not a primary rationale" (4.d). Good group supervision topics are the ones where hearing several colleagues' views is the point:
- Ethics vignettes, where members reach different answers and have to defend them.
- Documentation standards, read together on invented notes.
- Cultural humility and broaching, practiced in pairs.
- A skill of the month, such as motivational interviewing, exposure planning or safety planning.
- Licensing exam preparation.
- Workload, self-care and how each member protects their time.
Agree on ground rules in the first group session, including how members keep each other's disclosures confidential, not only clients' information (ACES 10.b.ii).
Reflective supervision questions to copy
These questions work for a supervisor to ask, and for a supervisee to ask themselves before the session. Use two or three per case, not the whole list.
A note on terms: in infant and early childhood mental health, "reflective supervision" is its own practice with its own framework (for example, Zero to Three's RIOS framework). The questions below are general clinical supervision questions, and many fit both.
Before the session (for the supervisee)
About the client and the case
About the session and the relationship
About me: countertransference and self-awareness
Culture, identity and power
Risk, ethics and law
About supervision itself
To close the session
Supervision questions for supervisees to ask their supervisor
Supervisees often wait to be asked. These ten questions, most of them for the first session or two, prevent the misunderstandings that cause trouble later. ACES expects many of the answers to be in a written contract anyway (1.a and 1.b), so asking early is normal.
10 clinical supervision activities and how to run each
Each activity below lists what it's for, how long it takes, the steps and what to record. ACES asks supervisors to use "a variety of supervisory interventions," including direct observation, and to choose them on purpose, based on the supervisee's developmental level, confidence and learning style, the clinical context and the client's needs (4.c). SAMHSA's TIP 52 on clinical supervision lists the same core methods: case consultation, written work such as verbatims and process recordings, audio and video recording, live observation, modeling, skill demonstrations and role play (SAMHSA, TIP 52).
1Structured case presentation
Use it for: case conceptualization, a new case, or a case that has stalled.
Time: 15 to 20 minutes.
- The supervisee states the question first, in one sentence ("Is this panic disorder or something else?" rather than "I wanted to talk about C-14").
- The supervisee presents using the format below, in about five minutes.
- The supervisor asks clarifying questions only, for two or three minutes, with no advice yet.
- Both name two or three working hypotheses.
- The supervisee chooses the next step and says what they'll try at the next session.
This format is adapted from SAMHSA's sample case consultation format (TIP 52, Tool 16). Use client codes, never names.
Record: the question, the hypotheses and the agreed next step.
2Recording review, with the client's consent
Use it for: feedback on skills, based on what actually happened rather than what the supervisee remembers.
Time: 15 to 25 minutes.
Get consent first. The ACA Code says counselors "obtain permission from clients prior to recording sessions" (B.6.c) and before letting supervisors or others view recordings (B.6.d). The NASW Code says social workers "should obtain clients' informed consent before making audio or video recordings of clients or permitting observation of service provision by a third party" (1.03(h)). TIP 52's instructions for taping (Tool 17) add useful detail: explain the purpose at least one session ahead, tell the client the recording can be stopped at any point, and get a written release that covers the purpose, the limits of confidentiality, who will view it and when it will be erased.
- The supervisee picks a 5 to 10 minute segment and says why they chose it.
- Cue the segment before supervision starts.
- Play it, and stop at any point either person asks to.
- At each stop, ask the supervisee first: "What were you aiming for there?"
- Give feedback on no more than three skills, with one specific alternative for each.
- Every month or two, review a whole session. ACES recommends reviewing entire sessions "to ensure that all phases of a session are reviewed" (9.a.iv).
A recording holds the client's protected health information. Store it as securely as the record itself, keep it only as long as your written policy says, and delete it after review. TIP 52 warns that recordings can become part of the clinical record and can be subpoenaed. If recording isn't possible, live observation or co-facilitating a session gives the same direct view. In Arizona, a supervisor's review of audio or video recordings counts as observation toward the board's required observed hours (see the Arizona section below).
Record: the review method ("8-minute recorded segment"), the skills discussed and the feedback given.
3Stop-and-recall on a recorded segment
Use it for: anxious supervisees, and moments where the supervisee's inner experience matters more than technique.
Time: 15 minutes.
This activity draws on Interpersonal Process Recall, which Norman Kagan and colleagues developed using videotape replay to help people relive an interaction and examine their thoughts and feelings in it (Kagan et al., 1967).
- The supervisee controls the pause button.
- When they stop, the supervisor asks only open recall questions, with no teaching: "What were you thinking here?" "What were you feeling?" "What did you want to say?" "What did you think the client wanted from you?"
- Keep going for three or four stops.
- Only at the end, ask: "Is there anything you'd do differently now?"
Record: what the supervisee noticed about themselves and any link to the client's pattern.
4Process recording
Use it for: when recording isn't possible or allowed, and for building recall and reflection.
Time: 20 to 30 minutes of the supervisee's preparation, 15 minutes in supervision.
A process recording is a written reconstruction of a short stretch of a session, exchange by exchange. TIP 52 notes its limits: it misses nonverbal cues, carries self-report bias and "can be very tedious to write and to read." Keep it to 10 or 15 minutes of a session, and repeat the block below for each exchange.
- The supervisee writes it within a day of the session, leaving out names and identifying details.
- In supervision, read it aloud together.
- Pick the one exchange where the supervisee's intention and the client's response didn't match.
- Role-play that exchange with the alternative response (activity 5).
- Destroy or archive the written process recording according to your policy.
Record: "process recording reviewed," the exchange discussed and the alternative practiced.
5Role play and reverse role play
Use it for: practicing a conversation before it happens.
Time: 10 to 15 minutes.
- Set the scene in 30 seconds: who the client is, what just happened, what the supervisee wants to achieve.
- The supervisor plays the client. The supervisee practices for three to five minutes.
- Pause. The supervisee says what worked and what didn't, then the supervisor adds one or two points.
- Run it again with the change.
- Swap: the supervisee plays the client while the supervisor plays the clinician. Playing the client often shows the supervisee how the client experiences them, and what the client may be protecting.
Good conversations to practice: asking about suicide and access to means, raising a missed-payment pattern, explaining a referral, ending treatment, telling a client about a fee change, broaching culture, and responding to a client who is angry with you.
Record: the skill practiced and the supervisee's own assessment.
6Parallel process discussion
Use it for: when the supervision relationship starts to look like the therapy relationship.
Time: 10 minutes, when it comes up.
In 1955, Harold Searles described how something happening between a client and therapist can show up again between that therapist and their supervisor (Searles, 1955). It's now usually called parallel process. ACES asks supervisors to address "parallel process issues and transference and countertransference issues in ways that are developmentally appropriate" (5.b.x).
- The supervisor notices a pattern: for example, the supervisee keeps asking for "the right thing to say" about a client who keeps asking the supervisee for reassurance.
- Name it tentatively: "I notice I'm being pulled to give you a script, the way you described being pulled to reassure her. Does that fit?"
- If it fits, explore what the pull is about in the client's work, not the supervisee's personal life.
- Ask what the supervisee could do differently in the next session.
- If it doesn't fit, drop it. A parallel process offered as a fact rather than a hypothesis can feel like an accusation.
Record: the pattern noticed and the plan for the client's next session. Leave the supervisee's personal disclosures out of the note.
7Ethics vignette
Use it for: building an ethical decision-making habit before a real dilemma arrives.
Time: 15 minutes.
ACES asks supervisors to infuse "ethical discussions throughout supervision sessions" (7.a.iii). An invented vignette lets you practice without a client's welfare on the line.
- One person reads a short vignette aloud.
- Each person names the ethical issue and who is affected.
- Find the standards that apply: your profession's code, your board's rules and state law.
- List at least two options and the likely consequences of each.
- Decide who you'd consult (your supervisor, your association's ethics consultation service, an attorney).
- Choose an option, and say what you'd document and what you'd tell the client.
Six vignettes to start with, all invented:
- A client of eight months brings a gift card to the last session.
- A client is moving to another state for a semester and wants to keep meeting by video.
- A couple asks you to list a diagnosis for one partner so insurance will cover the sessions.
- You recognize a new intake client as your child's teacher.
- A client posts a review of your practice online that describes their treatment.
- A parent asks what their 15-year-old has been talking about in sessions.
Record: the vignette, the standards found and the decision process. If a real case prompted it, note the case code and the direction given.
8Documentation review
Use it for: keeping notes accurate, useful and defensible. Arizona's rule asks supervisors to conduct "on-going compliance review" of the supervisee's clinical documentation.
Time: 10 minutes.
- The supervisee picks one note, and the supervisor picks one at random.
- Read each against this checklist: date, time and format; what was done, named specifically; the client's own words; an assessment supported by the data; risk asked about and recorded; a plan someone could check next session; consents and releases on file; signed on time; no detail about other people that care didn't need.
- Rewrite one weak sentence together.
- Agree on one habit to change for the next two weeks.
Record: which notes were reviewed (by client code and date) and the feedback.
9Outcome measure review
Use it for: bringing the client's own view of progress into supervision. ACES encourages formal feedback methods such as "standardized assessments completed by clients on a regular basis" (3.c.i).
Time: 10 minutes.
- The supervisee brings score histories for two or three clients on the measures they use, such as the PHQ-9 or GAD-7 (our PHQ-9 scoring calculator and GAD-7 scoring calculator work in the browser).
- Look first for clients whose scores haven't moved in several sessions, or have moved the wrong way.
- Ask what the client makes of the change, and whether the supervisee has shared the scores with the client.
- Decide together: keep the plan, adjust it, add a measure, or consider a referral.
Record: the client codes, the trend in plain words and the decision.
10Peer feedback round
Use it for: group or triadic supervision.
Time: 25 to 40 minutes.
ACES gives three questions for structuring one peer's review of another's work: "What did the peer do well? What could the peer have done differently? What did you learn from reviewing your peer's counseling session?" (4.e.ix).
- The presenter states one question and plays a short recording or gives a structured case presentation (activity 1).
- Each member takes a lens: the client's view, the relationship, culture and identity, or risk and ethics.
- Members answer the three ACES questions through their lens while the presenter listens without responding.
- The presenter says what was useful and what they'll try.
- The supervisor summarizes and links the discussion to everyone's caseload.
Record: attendance, the topic and the teaching point for the group. Feedback about one person's performance goes in that person's individual record.
Lighter activities for group supervision
For the months when a group needs energy more than another case:
- The session I learned most from.Each member takes two minutes on a session that went badly and what it taught them. The supervisor goes first.
- Intervention swap.Each member brings one technique and teaches it in five minutes with a quick role play.
- Plain-words challenge.Explain a diagnosis, a treatment or the limits of confidentiality the way you'd explain it to a 14-year-old, in 60 seconds.
- Case in one sentence.Each member sums up one case's conceptualization in a sentence, and the group asks one question each.
A supervision session agenda
ACES asks that sessions be "structured, purposeful, and goal-oriented" (4.b.i). The simplest way to get there is an agenda the supervisee sends a day ahead. The supervisor reads it, cues any recording, and comes in ready.
A four-week rotation
Every session starts with risk and last session's action items. After that, rotate the main activity so a month covers the ground:
- Week 1:recording review (activity 2) on the supervisee's current skill goal.
- Week 2:structured case presentation (activity 1) on the case they're most stuck on.
- Week 3:ethics vignette (activity 7) and documentation review (activity 8).
- Week 4:outcome measure review (activity 9), then licensure, career and workload.
Add one topic area from the bank each month, in order, so eight months cover all eight areas.
A two-hour group agenda
- 10 minutes:check-in and attendance.
- 10 minutes:risk round: anyone with an urgent case speaks first.
- 40 minutes:one case presentation with a peer feedback round (activity 10).
- 5 minutes:break.
- 30 minutes:topic of the month, using an ethics vignette, role play or a lighter activity.
- 15 minutes:a second, shorter case.
- 10 minutes:wrap-up, teaching points and logging hours.
A supervision note template, with an example
The supervisor's note is the record of what supervision covered. ACES lists what it should hold: supervisee and client informed consent, what was discussed, the review method used, goals set for counseling sessions, and "recommendations and/or directives regarding counseling session and/or client care," plus decisions, problems and remediation when needed (8.a.ii). It should leave out "unprofessional remarks about the supervisee or client, sensitive supervisee personal history information, or unsupported opinions" (8.a.iii), and be kept separate from client files (8.a.v).
The template below adds separate lines for ethics, documentation, clinical themes and demonstrated skills, the four items Arizona's rule names from January 2027.
An invented example
Dana is an invented licensed associate counselor in Arizona, in month 14 of supervised work, at a small group practice. Her supervisor and all three clients are invented too, and the clients appear by code only.
- Supervisee and license type:Dana R., licensed associate counselor.
- Supervisor and license number:J. Ortiz, LPC, number on file.
- Date:10/20/2026.
- Start and end time:3:00 to 4:00 PM (1.0 hour).
- Individual or group:individual.
- In person, video or telephone:video, on the practice's video platform.
- Review method:8-minute recorded segment of C-14's session on 10/16, plus one progress note.
- Client consent to record on file:yes, C-14, signed 10/02.
- Clients discussed (codes only):C-14, C-09, C-22.
- Ethics discussed:C-09 sent a friend request on social media. Reviewed the practice's social media policy and the consent form's wording. Dana will not accept, and will raise it at the next session using the consent form's language.
- Documentation reviewed:progress note for C-14, 10/16. The assessment restated the data. Rewrote it together to state progress on goal 1 and why continued care is needed.
- Clinical themes:C-14, an invented adult with panic attacks and driving avoidance, session 7. Four sessions of education about panic so far, with no exposure work started. Dana said she worries the client will drop out if exposure starts. Discussed this hesitation and a parallel process: Dana asked for "the exact words" to use, the way C-14 asks her for reassurance.
- Skills demonstrated:in the recording, Dana gave a clear rationale for exposure and checked the client's understanding. She reflected feelings accurately twice and missed one chance to ask the client to predict what would happen. Role-played building a fear hierarchy with the client choosing the steps.
- Activity used:recording review, role play.
- Risk items and direction given:C-22, no new risk since the last session; Dana asked the suicide screening questions again per the safety plan and the client's answers were negative. Continue the standing plan; contact the supervisor the same day if anything changes.
- Recommendations for client care:C-14, begin a fear hierarchy at the next session, built with the client. Repeat the anxiety measure used at intake.
- Goals for the supervisee's next sessions:ask the client for predictions before each exposure task; keep sessions to time.
- Progress on supervision goals:goal 2 (CBT for anxiety), progressing. Goal 3 (documentation), one of two notes reviewed met the standard.
- Concerns or remediation:none.
- Next session:10/27, 3:00 PM. Dana to bring a recording of the exposure planning session, with consent.
- Signatures:both signed and dated 10/20/2026.
What the example leaves out matters as much as what it holds: no client names, no detail about C-14's family, and nothing about Dana's personal history beyond its effect on the work. When supervision changes a client's plan, record the change in the client's own record too, in the next progress note.
What one board requires: Arizona's supervision record
Arizona's Board of Behavioral Health Examiners spells out what each supervision record must contain, which makes its rule a useful model even if you practice elsewhere. Under Arizona Administrative Code R4-6-212, as amended effective November 2, 2025, the board accepts supervision hours through December 31, 2026 when the supervisor documented "contemporaneously and in writing" for each session (Ariz. Admin. Code R4-6-212):
- The date and duration of the session.
- "A detailed description of topics discussed to include themes and demonstrated skills."
- The supervisee's name and signature.
- The supervisor's name and signature, and the date signed.
- Whether the supervision was group or individual.
Through 2026, those records must be kept for at least seven years. From January 1, 2027, the topics line becomes a "detailed description of topics discussed including ethics, documentation, clinical themes, and demonstrated skills," and records must be kept for six years, or until the supervisee is independently licensed if that comes sooner. A note that says only "discussed cases" is unlikely to meet either version.
Other parts of the same rule shape what happens in the sessions:
- Supervision includes reviewing ethical and legal requirements, monitoring that the supervisee provides services safely and competently, ongoing review of the supervisee's documentation, and instruction in assessment, diagnosis, treatment plan development and treatment.
- The supervisor verifies in writing that the supervisee gives clients written notice of supervision, including a way to get the supervisor's name and phone number.
- At least 10 hours must involve the supervisor observing the supervisee with a client, in person, by videoconference, by teleconference or "by review of audio or video recordings."
- No more than 15 hours can be by telephone, and each session must be at least 30 minutes.
- At least 25 hours must be individual supervision, and the board accepts hours from at most six supervisors.
- For the professional counselor license, an applicant needs at least 100 hours of supervision that meet these rules (R4-6-504).
We read the rule in the Arizona Administrative Code, Title 4, Chapter 6 (Supp. 25-3). Check the board's site for anything newer before you rely on it. Other states set different rules: our social work supervision guide compares Texas, New York and California, where the documentation and video rules differ.
What an experienced supervisor should check
- The topic bank against your board's required content and your setting's population.
- The risk topics and questions against your state's duty-to-warn, duty-to-protect and mandated reporting laws.
- The recording review steps and release wording against your employer's policy, HIPAA, and how your practice stores and deletes recordings.
- The parallel process and countertransference activities, to confirm they stay on the supervision side of the line and don't become therapy.
- The ethics vignettes: whether each raises the issues you'd expect a supervisee to find.
- The outcome measure activity: which measures fit your clients and how often to give them.
- The note template and the invented example against Arizona's rule if you supervise there, and against your own board's forms if you don't.
- The group agenda and ground rules, especially confidentiality between group members.
- The telehealth topics against your state's current telehealth and licensure rules.
How this works in TranqBay
TranqBay is practice software for therapists in private practice: a practice website, online booking, video sessions and session notes in one place. Nothing on this page describes a TranqBay supervision feature. Keep supervision agendas, notes and logs where your board and your supervision contract say. Where TranqBay fits for a supervisor or associate is the client side of the work that supervision reviews:
- Video sessions with your clients are end-to-end encrypted, and TranqBay's Business Associate Agreement applies when you accept the Terms, with no separate document to sign (read the BAA). You can check camera, mic and speakers before joining, which helps with the telehealth topics above.
- Consent before the first session. The form library has ready-made templates you send to a client for a session, including consent to treat, telehealth consent and release of information. The client fills them in online and the answers wait with the session. Forms aren't scored automatically. If you practice under supervision, check that your consent wording tells clients about it, as Arizona and the ACA Code require.
- Notes that are easy to review together. Session notes come in BIRP, DAP, SOAP or GIRP format, or as a blank note. Structured formats are part of the advanced note templates, which some plans include. The documentation review activity goes faster when every note follows the same format.
- Booking. Clients book online. You confirm each booking or let clients book straight away, and returning clients book their next session themselves.
If you supervise from your own practice, or you're an associate planning one, practice.tranqbay.health shows a practice website template and the booking page your clients would use.
Frequently asked questions about clinical supervision topics
What topics should be discussed in clinical supervision?
Risk and safety at every session, then the cases where the supervisee is stuck, then the supervisee's goals. Over a licensure period, cover case conceptualization, ethics and boundaries, documentation, cultural humility, countertransference and self-care, licensure and career, and telehealth practice. Some boards set required content: Arizona's rule requires instruction in assessment, diagnosis, treatment plan development and treatment, plus a review of ethical and legal requirements.
What do I talk about in supervision when nothing is wrong?
Bring a recording, a note or a topic from the bank. "Nothing is wrong" weeks are the best time for skill practice, a documentation review, an ethics vignette or a client whose progress is slow but steady. Also try the hardest question on the list: which case would you least like to present?
What are examples of reflective supervision questions?
"What did I feel in the session, and when did it change?" "What am I assuming about this client that I haven't checked?" "Where am I working harder than the client?" "What would the client say is helping?" The full list above is grouped by when to use each question.
How should I prepare for clinical supervision?
Send an agenda the day before with your urgent items, one or two cases with a specific question for each, and any recording or note you want reviewed. Cue the recording segment. Bring your hours log. A specific question ("Is this enough to start exposure?") gets far more from the hour than a general update.
Can I record a therapy session for supervision?
Yes, with the client's informed consent, ideally written, and only on a method your employer's policy allows. The ACA and NASW codes both require client permission before recording or before anyone else views a session. Treat the recording as protected health information: store it securely, limit who sees it and delete it when your policy says.
What are good group supervision activities?
Peer feedback rounds using the three ACES questions, ethics vignettes, role plays in pairs, documentation reviews on invented notes, and the lighter activities above, such as an intervention swap or a plain-words challenge.
How long is a clinical supervision session?
Your board decides what counts. Arizona, for example, counts only sessions of at least 30 minutes. ACES gives weekly individual, triadic or group sessions as an example of meeting regularly (4.a.i). Check your board's rule on frequency, length and group size before you plan.
Do supervision notes go in the client's record?
No. ACES says supervision documentation should be kept separate from client files. When supervision changes a client's care, the clinician records that change in the client's own record, usually in the next progress note.
Can I talk about personal issues in supervision?
Yes, when they affect your work with clients, but supervision isn't therapy. The supervisor helps you see the effect on your clinical work and plan how to address it, and may suggest personal therapy. The ACA Code says supervisors don't provide counseling to supervisees.
Plan your next supervision hour
Pick one topic area, one activity and one goal. Send the agenda the day before, cue the recording or note, and leave the session with one thing to do differently. Repeat the rotation until every area has had its turn.
If you supervise associates from your own practice, or plan to open one after licensure, see how a practice website, online booking and encrypted video sessions fit together at practice.tranqbay.health, or read how TranqBay works for therapists on the join page.
Sources
acesonline.net 1Associations 2States 2Federal 1HHS 1Research 2zerotothree.org 1
Professional associations2
- 2ACA Code of Ethics (2014): B.6.c, B.6.d, F.5.c, F.6.ccounseling.orghttps://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf
- 3NASW Code of Ethics, Ethical Responsibilities to Clients, 1.03(h)socialworkers.orghttps://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English/Social-Workers-Ethical-Responsibilities-to-Clients
State boards and laws2
- 4Arizona Administrative Code, Title 4, Chapter 6, R4-6-212 and R4-6-504 (Supp. 25-3)apps.azsos.govhttps://apps.azsos.gov/public_services/Title_04/4-06.pdf
- 5Kagan N, et al. Studies in human interaction: interpersonal process recall stimulated by videotape. 1967. ERIC ED017946eric.ed.govhttps://eric.ed.gov/?id=ED017946
Other federal agencies1
U.S. Department of Health and Human Services1
Research2
- 8Searles HF. The informational value of the supervisor's emotional experiences. Psychiatry. 1955;18(2):135-146doi.orghttps://doi.org/10.1080/00332747.1955.11023001
- 9Hook JN, Davis DE, Owen J, Worthington EL, Utsey SO. Cultural humility: measuring openness to culturally diverse clients. J Couns Psychol. 2013;60(3):353-366doi.orghttps://doi.org/10.1037/a0032595