A Guide to Supervision Contracts/Agreements

Introduction 

It is a requirement for Accreditation (Minimum Training Standards 7q) that you and your supervisor have a contract or agreement. This sets out agreed terms for how the supervisee’s needs will be met in supervision. 

We have developed a guide and contract template for qualified therapists within all forms of Cognitive and/or Behavioural Therapy (CBT) clinical supervision. Other supervision contracts should be used for trainee therapists in conjunction with their Higher Education Institution.

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We have provided a Supervision Contract Template. The format and content are optional, and you and your supervisor can amend this document, or create or use your own. 

You may prefer to use the term “Supervision Agreement” as it emphasises the collaborative nature of the clinical supervision process. However, “supervision contract” or “supervision agreement” can be used interchangeably to describe the systems, processes, models, and content of supervision. Despite the formality of the document, the supervision process itself ought to be relaxed but with a serious emphasis on individualised learning and high-quality practice. 

In the development of this guidance and the supervision contract template the literature has been reviewed to define the meaning of supervision, understand how it can improve quality and prevent harm. The important areas of interdisciplinary supervision and how we can make supervision effective have also been considered (Nelson et al. 2008; Tomlinson, 2015; Snowdon et al 2017; Lee and Kealy 2018; Rothwell et al. 2021). To address both the science and “art” of supervision expert professional opinion has also been used as well. 

Finally, but of equal importance we have also taken into account the views of people with personal experience of receiving CBT. Reviews that have found that many who have received psychological services did not know that professional staff were supervised. This has raised concerns by some that that decisions that might be being made in supervision without their knowledge (Lambley and Marrable 2013). 

Definition of Supervision within this Guide 

There are many definitions of supervision in the literature. We have used the following evidence-based definition - 

“The formal provision, by approved supervisors, of a relationship-based education and training that is work-focussed, and which manages, supports, develops and evaluates the work of colleagues. It therefore differs from related activities, such as mentoring and therapy, by incorporating an evaluative component and by being obligatory. 

The main methods that supervisors use are corrective feedback on the supervisee performance, teaching, and collaborative goal setting. The objectives of supervision are normative (e.g. encouraging emotional experience and processing) and formative (e.g. maintaining and facilitating the supervisees competence, capability and general effectiveness). These objectives could be measured by current instruments….” Milne (2009) pg 15-6.

Clinical supervision doesn’t include professional or caseload management.

Supervision Relationship and Practice

The cornerstone for the development of the supervisory relationship are the values that explicit in the supervision Contract.

The supervision contract can be a verbal agreement although we recommend a written document. It should record the discussions establishing how the supervisor and supervisee will work together and when reviews of the processes will take place. 

Important Considerations for the Supervision Contract

The use of supervision contracts has been recognised as an important approach within CBT Supervision (Townend 2005). There are believed to be several potential benefits. These include the establishment of clear expectations, explicit values, and goals at the outset of the supervisory relationship (Amaro et al. 2020). These are further detailed below: 

1. An opportunity to establish the meaning of the term “Supervision” and contextualise it within CBT.
2. Clarification of the roles and responsibilities within CBT supervision for both the supervisee and supervisor.
3. The establishment of the importance of the emotional impact and restorative function of CBT clinical supervision through support and the establishment of self-care practices. 
4. The establishment of the collaborative nature of CBT supervision and the importance of the supervisee (s) being an active participant in the process.
5. Clarification for the involvement of service users in the CBT supervision process. 
6. Clarification and definition of the boundaries of the supervisory relationship, including confidentiality, documentation and communication systems with others who may have some other responsibility for the supervisee’s work. 
7. A forum for the promotion anti-oppressive and anti-discriminatory practice through exploration of the factors that might impact on the supervisory relationship and the psychotherapeutic work of the supervisee. 
8. Clarification of the models and methods of supervision that will be favoured. 
9. The establishment of how the relationship and supervision agreement will be reviewed and what the supervisee should do if they have any concerns about the quality of the supervision they are receiving.
10. Clarification of the practical arrangements of CBT clinical supervision and any financial arrangements. 
11. Consideration of how the supervision arrangements will allow maintenance of accreditation eg. live supervision, marking of CTS-Rs etc, meeting Accreditation requirements, writing of Supervisor’s Reports.

Acknowledgements

Michael Townend, PhD (2023)

At the time of development Associate Professor, University of Derby.

References

Amaro, C. M. et al.(2020) ‘Clarifying supervision expectations: Construction of a clinical supervision contract as a didactic exercise for advanced graduate students’, Training and Education in Professional Psychology, 14(3), pp. 235–241. doi: 10.1037/tep0000273.

Armstrong, P. V., & Freeston, M. H. (2006). Conceptualising and formulating cognitive therapy supervision. In Tarrier, N. (ed), Case Formulation in Cognitive Behaviour Therapy: The Treatment of Challenging and Complex Cases (pp. 349–372). Hove, UK: Routledge.

Corrie, S and Lane, D. (2015). CBT Supervision. Sage. London. 

Ellis, M. V. (2017) ‘Clinical Supervision Contract & Consent Statement [ECPY 806]’, Clinical Supervisor, 36(1), pp. 145–159. doi: 10.1080/07325223.2017.1321885.

Lambley, S. and Marrable, T. (2013) ‘Practice enquiry into supervision in a variety of adult care settings where there are health and social care practitioners working together’, London: SCIE.

Lee, E. and Kealy, D. (2018) ‘Developing a Working Model of Cross-Cultural Supervision: A Competence- and Alliance-Based Framework’, Clinical Social Work Journal. Springer US, 46(4), pp. 310–320. doi: 10.1007/s10615-018-0683-4.

Michael V. Ellis (2017) Clinical Supervision Contract & Consent Statement and Supervisee Rights and Responsibilities, The Clinical Supervisor, 36:1, 145-159, DOI: 10.1080/07325223.2017.1321885

Milne, D. (2009). Evidence-based clinical supervision: Principles and practice. Blackwell Publishing; British Psychological Society. Oxford.

Nelson, M. L. et al.(2008) ‘Working With Conflict in Clinical Supervision: Wise Supervisors’ Perspectives’, Journal of Counseling Psychology, 55(2), pp. 172–184. doi: 10.1037/0022-0167.55.2.172.

Rothwell, C. et al. (2021) ‘Enablers and barriers to effective clinical supervision in the workplace: A rapid evidence review’, BMJ Open, 11(9), pp. 1–10. doi: 10.1136/bmjopen-2021-052929.

Snowdon, D. A., Leggat, S. G. and Taylor, N. F. (2017) ‘Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review’, BMC Health Services Research. BMC Health Services Research, 17(1), pp. 1–11. doi: 10.1186/s12913-017-2739-5.

Tomlinson, J. (2015) ‘Using clinical supervision to improve the quality and safety of patient care: A response to Berwick and Francis Career choice, professional education, and development the Many Meanings of “Quality” in Healthcare: Interdisciplinary Perspectives’, BMC Medical Education. 15(1), pp. 1–8. doi: 10.1186/s12909-015-0324-3.

Townend, M. (2005). Supervision Contracts in CBT. BABCP, Accrington.