Supervision Disclosure Information
Pastoral Therapy Associates (PTA)
Dear Supervisee/Consultee;
Enclosed, please find a copy of my standard personal disclosure form I use with all clients and supevisees. This cover-letter provides you more detailed information about my perception of the context for the clinical supervision that I provide. These standards are an amalgam of requirements from the Commission of Supervision (COS) of the American Association of Family Therapy (AAMFT), the American Association of Pastoral Counselors (AAPC), the International Association for Analytical Psychology (IAAP), the North Pacific Institute for Analytical Psychology (NPIAP), and my own experience over the years. Full details and requirements of the AAMFT supervision program available at:
http://www.aamft.org/resources/Online_Directories/index_nm.asp
It is always the responsibility of the supervisee and or supervisor-candidate to track their compliance with state licensure or professional certifying requirements (such as the AAMFT Approved Supervisor designation). They must immediately inform me if there is any difficulty with meeting or responding to these requirements
We will work within a context of a learning contract which spells out the parameters and goals of our work together. For general practice supervision and, in required addition, to the above for AAMFT supervisory candidates:
1). I ask that you present an easily understandable clinical narrative, verbatim, audio, or video tape (on your own equipment) each session.* I generally wish that these tapes be accompanied by a one-to-two page case summary with an initial and occasionally updated case genogram. Early in our process, I would like to receive a complete sample of all the forms you use in your clinical practice. I also might request periodic review of your written case-tracking notes.
2).You must provide me, in advance of any supervision provided, a log of clients upon which you wish supervision. This log should included the client's name or security ID code and the type of therapy they have engaged with you. You should regularly provided me an updated copy of this log with both the dates of all sessions spent with the client while under my supervision and the dates and your summary of our supervisory reflection upon that client system.
3). I am ultimately responsible for the cases that I supervise and, therefore, must ask that, on those occasions when I require you to follow a certain course of action with a case, that you so comply. That does not mean that we cannot discuss and/or negotiate that directive but, in certain situations, my decision may be final. If you work for an agency, you must provide me a letter (from your administrative supervisor or appropriate Board officials) that grants me the full exercise of this clinical control and accountability.
4). Our first session or two is evaluative in nature, with you and I both assessing each other and the desirability/fruitfulness of our supervisory work together.
5) The current PTA fee for supervision is $100/ fifty-minute hour (to be paid at the end of each session by check or cash) and that figure is subject to the periodic review and alteration by the Board of Directors of PTA.** I will apply that same rate to all contact time directly required as a result of your supervision i.e. telephone consultations/costs, reports etc. though, subject to personal discretion, I may charge only half that fee per hour.
6). Unless an appropriate reason arises to move to another professionally appropriate space, all sessions will be conducted here in my office at PTA.
7). I am available to you for emergency clinical consultations (call and have me paged at 253-627-1550) but, otherwise, we will discuss all supervisory matters at our regularly scheduled sessions.
8). When I am called upon to make periodic review of your progress in supervision, I will base these reports on our mutually agreed to goals and will share and discuss these reports with you personally, where possible, before they are sent on to these other persons/organizations. If there are any grievances in our process together we will mutually discuss a holistic remedy that is congruent with any relevant organizational or state requirements.
9). I conduct this supervision in adherence with the professional codes of AAMFT, AAPC, IAAP, NPIAP and my clinical ministerial codes and cannons.
I look forward to our work together.
Cordially yours,
Terrill L. Gibson, Ph.D.
[Updated May 2008]
*Please notify me at least twenty-four hours in advance if you wish to use my video playback equipment.
**Analytic training supervision is $120/ hour.