Clinical Supervision
Personal DIsclosure & Informed consent for supervision
This serves to provide a thorough description of the counseling supervision provided by A Leap of Faith Counseling Services via Yoshica McCullough, LCPC. The intent is to familiarize you with the supervision approach and goals, highlight the expectations of the supervision process, and provide you with information that will ensure a successful supervisory relationship.
SUPERVISION OVERVIEW
A Leap of Faith Counseling Services offers a private practice of counseling supervision
services. We are dedicated to providing supervision services that improve the clinical
and administrative development of counselors in training. Your signature on the
“Supervision Contract” document indicates that you have consented to supervision at
A Leap of Faith, Counseling, Coaching, and Consulting, LLC, and have received and
understand the contents of the “Supervision Policies” document which includes the
Notice of Privacy Practices (HIPAA).
WHAT IS SUPERVISION AND HOW DOES IT WORK?
Supervision is a working relationship between a supervisor and a counselor in which the counselor can share, reflect, and get feedback to help increase her/his ethical competence and confidence to best serve clients over several sessions. Hence, supervision is the process employed to communicate the counseling experience with the goal of the supervisor facilitating the development of therapeutic competence in the supervisee within each 50-minute session.
The supervisor takes on specific roles with the supervisee based on the dynamic of the relationship and cases being processed. These roles include Teacher (Action) for didactic-oriented activities, evaluative functions, and transmitting knowledge; Counselor (Relationship) to help the counselor understand their own dynamics and resolve issue affecting counseling; and Consultant (Insight) to provide opportunity for the counselor to develop her/his own conceptualization and plan.
With these roles, the supervisor also embraces a development model of supervision where she/he aims to support you in the process of moving toward competence via stages. In the beginning stages, the supervisor will look for relationship building, goal setting, and contracting; soon after, will most likely vacillate between the role of counselor and teacher as the supervisee is faced with affective issues and any skill deficits. You will then see that the supervisor will adopt a more collegial role of consultant as the supervisee gains confidence and expertise. Finally, the supervisor may become more distant and serve as a consultant with the intent that the supervisee takes responsibility for her/his learning and development as a counselor. However, with these stages the supervisor may revert back to a previous stage when she/he finds that there is a need to lecture, instruct, and inform the supervisee of concepts or when there is a need to assist supervisees in identifying their own "blind spots" or intertransference process, etc. In addition to assuming various roles and proceeding through stages based on your needs, the supervisor may pull methods and strategies from their theoretical perspective, which includes a combination of cognitive behavioral and existential theories.
As the supervisee, “they” take on a role of disclosure as related to the client, therapeutic interaction, supervisory interaction, and personal information. Therefore, the supervisee should play an active role in the supervision process and be open to asking questions since the supervision relationship should be based on openness, acceptance, and trust. One of the most important roles in the provision of clinical supervision is to protect the welfare of the client and serve as a gate keeper for the field.
The process of clinical development, administrative finesse, and change will, in many ways, be unique to the supervisee’s particular situation. Who a supervisee is as a person will help to determine the ways in which she/he will go about developing into a counselor.
The most important factor in the success of supervision is good communication between supervisor and supervisee. In some instances, talking about your clinical development and your cases may trigger dynamics that impact your interpersonal relationships; however, over time you should see an improvement in your personal/professional boundaries and process your counseling/supervision experience with those in your support system. In addition, not all counselors benefit from working with a particular supervisor and you may decide to seek supervision elsewhere.
Supervision with A Leap of Faith Counseling Services will be consistent with the ethical standards set forth by the following organizations and the same will be expected of the supervisee: The Maryland Board of Professional Counseling https://health.maryland.gov/bopc/Pages/index.aspx), the American Counseling Association (http://www.counseling.org/resources/codeofethics/TP/home/ct2.aspx), and the National Board of Certified Counselors (http://www.nbcc.org/ethics).
If at any time during supervision you have questions about whether or not supervision is effective, feelings about something your supervisor have said or suggested or need clarification of our goals, do not hesitate to bring this up in your session. As the counselor/supervisee you have the right to ask your supervisor questions about her/his qualifications, background, and therapeutic/supervision orientation. You can learn more about Yoshica McCullough, LCPC background by visiting www.aleapoffaithcounselingservices.com.
MEETINGS AND FEES
The supervisor normally conducts an evaluation during the first session to ensure that the supervision requirements can be met and to identify two to three primary goals that the counselor would like to achieve in order to further grow and develop as a clinician. Please bring the signed Supervision Contract and a copy of your Photo ID to this session even if you have previously submitted it. During this time, the supervisor and you can both decide if the supervisor is the best person to provide the services you need in order to meet your supervision goals. If supervision is begun, we will usually schedule one 50-minute session (one appointment hour of 50 minutes duration) at a regular schedule at a time both parties agree on. Once an appointment hour is scheduled, you will be expected to pay for it unless you provide 48 hours advance notice of cancellation [unless both parties agree that you were unable to attend due to circumstances beyond your control, if it is possible, the supervisor will try to find another time to reschedule the appointment].
The hourly fee is $75 for office and/or online supervision. In addition to your regular appointments, the supervisor will charge this amount for other professional services you may need, though the supervisor will break down the hourly cost if the supervisor works for periods of less than one hour. Other services include report writing, telephone conversations lasting longer than 10 minutes, attendance at meetings with other professionals you have authorized, preparation of records or supervision summaries, and the time spent performing any other service you may request of the supervisor. If you become involved in legal proceedings that require A Leap of Faith Counseling Services participation, you will be expected to pay for A Leap of Faith Counseling Services professional time even if A Leap of Faith Counseling Services is called to testify by another party. Because of the difficulty of legal involvement, A Leap of Faith Counseling Services charge $600 per hour for preparation and attendance at any legal proceeding.
CONFIDENTIALITY POLICY
A Leap of Faith Counseling Services have an obligation to respect your right to confidentiality for the information you share within this clinical supervision setting. Confidentiality of client and counselor/supervisee information is governed by federal law (Health Information Portability and Accountability Act) and by state law. Maryland laws impose some limitations to your rights to confidentiality. The following is a list of some situations in which you may lose your right to confidentiality:
-We are obligated to report any maltreatment of minors or vulnerable adults. This includes physical abuse, sexual abuse or neglect. This applies to you and any clients you may be working with.
-We are obligated to report any prenatal exposure to controlled substances. This applies to you and any clients you may be working with.
-We are obligated to report any serious harm you intend to inflict on yourself or another. This applies to you and any clients you may be working with.
-We are obligated to share information if directed by Court Order to conform to state or federal law, rules or regulations. This applies to you and any clients you may be working with.
-We are obligated to share information with licensing boards, which is pertinent to a disciplinary proceeding involving a provider. This includes if the supervisee exhibit signs of impairment, exhibit behaviors that are unethical and/or dangerous to the client.
If you are working with minors, you should know that they have a limited right to privacy in that “their” parents may have access to their records. However, if the supervisor/counselor believes that sharing this information will be harmful to the client, confidentiality will be maintained to the limits of the law.
At the conclusion of each supervision session, the supervisee will submit notes of the session to the supervisor within one week, these records will be available to you to view at any time, and may include additional notes the supervisor has from each session. A Leap of Faith Counseling Services will maintain these notes for seven years. If you are submitting these hours of clinical supervision for your professional license, you are responsible to keep track of the number of hours. Be certain that A Leap of Faith Counseling Services can document every hour of supervision that you submit. You may request that A Leap of Faith Counseling Services provide information to others, and A Leap of Faith Counseling Services will do so after you have signed a release statement. All information regarding supervisees is considered strictly confidential and will not be given out to anyone without your written consent as bound by legal and professional ethics. In the event of request for transfer of records, the records will be forwarded upon completion of a consent form and a payment fee of $20.00 processing and copying fee.
BILLING
You are responsible to pay the full fee for each session 48 hours prior to the time of your session via PayPal/Venmo/Cash App only. If payment is not received in this timeframe, your session will be cancelled. Should you discontinue supervision for any reason any balances will become immediately due and payable in full by you. Because we are a “fee for service” provider, billing statements from A Leap of Faith Counseling Services will not automatically be sent - should you need a statement or payment itemization, please inform Yoshica McCullough, LCPC, and we will provide this for you upon request.
CASHAPP $ALOFCCC
PAYPAL paypal.me/ALOFCCC
VENMO @ALOFCCC
TECHNOLOGY POLICY
A Leap of Faith Counseling Services may require recordings of clinical sessions during your supervision and supervision may occur via technological devices such as with online supervision. The purpose of the recordings and use of technology for supervision is for supervision of the supervisee’s clinical practice. Supervisee’s will follow the policies and procedures of the site regarding recording procedures. Clients are informed that:
You give your written permission to be audio recorded prior to recording a session.
You will never be recorded without your permission.
The recording may be electronically or digitally recorded and electronically or digitally shared for the purpose of continued training and clinical development with relevant individuals such as other supervisors.
Identifying client and supervision information will be disguised/removed when turning in recordings and writing reports. Encryption or encoding will be used to limit access to authorized users.
Electronic recordings will be compliant with Health Insurance Portability and Accountability Act (HIPAA, see http://www.hhs.gov/ocr/privacy/) including “Technical Safeguards.”
When using digital recordings, confidentiality is limited by the secureness of the technology being used to record, transmit, and store them.
All efforts will be made to keep recordings and online supervision sessions confidential but the possibility of unforeseen events, including technological events, mean that confidentiality cannot be absolutely guaranteed.
Supervisees are mandated to abide by the American Counseling Association Code of Ethics: H.2. Informed Consent and Security, and H.5. Records and Web Maintenance.
Recordings will be stored and transported with utmost care and deleted after they are used.
When recordings are used for supervision review, the supervisee will be in possession of the recording at all times.
COURT & LEGAL PROCEEDINGS
A Leap of Faith Counseling Services does NOT provide disability determination, custody studies, or handle court issues.
A Leap of Faith Counseling Services does not perform court evaluations nor do they appear in court on behalf of counselors/supervisees, individuals, children or adults. A Leap of Faith Counseling Services is designed to assist in clinical supervision. A Leap of Faith Counseling Services is not trained for, nor do they maintain records with the intended purpose of court involvement.
In addition, the legal process is such that we may be compelled to reveal information about you/your clients that could affect you negatively or undermine your relationship with your supervisor. Because the supervisee/supervisor relationship is built on trust with the foundation of that trust being confidentiality, it is often damaging to the therapeutic relationship for the supervisor to be asked to present records to the court, testify whether factual or in an expert nature, in court or deposition.
If you wish forms for determination of mental illness, disability, court involvement with custody or assessments to be completed for you/your clients, we would be happy to assist you in finding practitioners in the area who offer this service.
In the event that it is necessary, by court order or by subpoena, for the supervisor or A Leap of Faith Counseling Services to testify before any court, arbitrator, or other hearing officer to testify at a deposition, whether the testimony is factual or expert, or to present any or all records pertaining to the supervision relationship to a court official, the client agrees to pay the supervisor/ A Leap of Faith Counseling Services “their” services, (including but not limited to: travel, necessary expenditures (copies, parking, meals, and the like), time spent speaking with attorneys, reviewing records and preparation of reports) @ the rate of $300.00 per hour, rounded to the nearest half hour.
A Leap of Faith Counseling Services does NOT provide disability determination, custody studies, or handle court issues.
-The client further agrees to pay a retainer fee of $1500.00 two weeks prior to the appearance, presentation of records, or testimony requested. Checks will not be considered an acceptable form of payment for these services.
Litigation Limitation: Due to the nature of the supervision process and the fact that it often involves making a full disclosure with regard to many matters which may be of a confidential nature, it is agreed that should there be legal proceedings (such as, but not limited to divorce and custody disputes, injuries, lawsuits, etc. for you/your clients), neither you (supervisee,) nor your attorney, nor anyone else acting on your behalf will call on your supervisor or A Leap of Faith, Counseling, Coaching, and Consulting, LLC to testify in court or at any other proceeding, nor will a disclosure of the supervision records be requested.
Initials of counselor/supervisee ______ showing that this litigation limitation is clearly understood and agreed to.
NOTICE OF PRIVACY PRACTICES (HIPAA)
This notice describes how your health/supervision information and your client’s health information may be used and disclosed and how you and they can access this information. Please review it carefully. Protecting our supervisee’s privacy and her/his clients has always been important to this practice. A state and federal law, the Health Insurance Portability and Accountability Act (HIPAA), went into effect on April 14, 2003 and requires us to inform you of our policy. At A Leap of Faith Counseling Services we are very careful to keep your supervision information and your client’s heath information secure and confidential. This law requires us to continue maintaining your/your client’s privacy, to give you this notice and to follow the terms of this notice.
The law permits us to use or disclose your supervision/your client’s health information to those involved in your supervision and your client caseload; for example, a review of your file by your site supervisor(s) whom we may be involved in your supervision as well. We may use or disclose your supervision/your client’s health information for payment of your services. For example, we may send a report of your supervision progress to your clinical site if requested. We may use or disclose your supervision/your client’s health information for our normal healthcare/supervision operations. For example, one of our staff may enter your information into our computer. We may share your supervision/your client’s medical information with our business associates, such as a billing service. We have a written contract with each business associate that requires them to protect your privacy. We may use your information to contact you or your clients. For example, we may send newsletters or other information to you. We may also want to call and remind you about your appointments. In rare cases, we may also deem it appropriate to contact your clients if a clinical situation arises. If you are not home, we may leave this information on your answering machine or with the person who answers the telephone. In an emergency, we may disclose your supervision information to a family member or another person responsible for your client caseload. We may release some or all of your supervision information when required by law.
If this practice is sold, your information will become the property of the new owner. Except as described above and by law, this practice will not use or disclose your supervision information without your prior written authorization. You may request in writing that we not use or disclose your supervision information as described above. We will let you know if we can fulfill your request. You have the right to know of any uses or disclosures we make with your supervision information beyond the above normal uses. As we will need to contact you from time to time, we will use whatever address or telephone number you prefer. You have the right to transfer copies of your supervision information to another practice. You have the right to see or receive a copy of any of your supervision information. You have the right to request an amendment or change to your supervision information.
Give us your request to make changes in writing. If you wish to include a statement in your file, please give it to us in writing. We may or may not make the changes you request, but will be happy to include your statement in your file. If we agree to an amendment or change, we will not remove or alter earlier documents, but will add new information. You have the right to receive a copy of this notice. You may also file a complaint with the MD Board of Professional Counseling.
COUNSELOR/SUPERVISOR BILL OF RIGHTS
A Leap of Faith Counseling Services does not discriminate on the basis of religion, race, gender, marital status, age, sexual orientation, national origin, previous incarceration, disability or public assistance status.
shall be informed prior to, or at the time of, the initial appointment of services available at A Leap of Faith Counseling Services and of any financial charges that are the supervisee’s responsibility to pay
can expect complete and current information concerning her/his supervision in terms “they” can understand.
shall have the right to know by name, and the competencies of, the licensed mental health professional supervisor responsible for coordination of her/his supervision.
shall have the freedom to place grievances to A Leap of Faith Counseling Services free from restraint, interference, coercion, discrimination, or reprisal.
has the right to be informed of and to refuse to participate in any experimental research.
may expect courteous treatment and to be free from verbal, physical, or sexual abuse by A Leap of Faith, Counseling, Coaching, and Consulting, LLC
has the right to a coordinated transfer of supervision care when there will be a change of providers.
may assert the supervisee’s right(s) without retaliation.
has the right to choose freely among available mental health professional supervisors and practitioners in the community and to change providers after mental health supervision services have begun by giving at least a two week notice.
communication
Supervisors are often not immediately available by telephone, email, or texts. While they are usually in the office between 9am and 5pm, they probably will not answer the phone or return emails/texts when with a client/supervisee. When unavailable, the telephone is answered by voice mail [that is monitored frequently] . A Leap of Faith Counseling Services will make every effort to return your call within 24-48 hours after you make it, with the exception of vacation and holidays. If you are difficult to reach, please inform A Leap of Faith Counseling Services of some times when you will be available. Please note that confidentiality of electronic/voice communications cannot be guaranteed so please keep this in mind when leaving or sending messages. If you are unable to reach A Leap of Faith Counseling Services and feel that you can’t wait for a return your call/email, contact your family physician or the nearest emergency room and ask for the therapist/supervisor on call. If A Leap of Faith Counseling Services will be unavailable for an extended time, you will be provided with the name of a colleague to contact, if necessary. We value your opinion and strive to provide the best service possible. If you would like to share your comments, questions, or concerns, please contact Yoshica McCullough, LCPC directly at 301-965-0159 or yoshica@aleapoffaithcounselingservices.com.
EXPECTATIONS OF SUPERVISION
Modalities that are used in clinical supervision include face-to-face case review (including treatment assessments, notes, etc.), live observation, transcription, and tape review. A Leap of Faith Counseling Services believes a healthy combination of these methods facilitates a comprehensive and holistic experience for the supervisee. It is also believed that both parties should continuously develop cultural competency via self-reflection, learning about other groups and developing effective cultural-specific interventions to help our clients and for A Leap of Faith Counseling Services to help supervisees.
A Leap of Faith Counseling Services is responsible to:
Prepare for and attend supervision sessions.
Provide regular feedback and a formal assessment periodically and at the conclusion of the supervisory relationship.
Review supervisee's case notes (follows D-SOAP format or another similar format) or other materials for quality control purposes.
Adhere to all applicable legal and ethical standards.
Maintain a healthy and professional relationship with the supervisee.
Practice only within the boundaries of competence, based on education,
training, supervised experience, and professional credentials.
Ensure that all cases you take on are within the limits of Company Name, competency and are appropriate for your level of skill.
You, the Supervisee, are responsible to:
Submit and maintain a list of current client’s names, contact information, active diagnosis for each supervision session.
Your Name will submit proof of professional liability insurance and the policy should be at least $1,000,000 / $3,000,000 which means you are covered for up to $1,000,000 for each professional liability coverage claim and up to $3,000,000 aggregate for professional liability coverage.
Prepare for and attend supervision sessions.
Complete any assigned task or learning exercises between sessions.
Keep supervisor informed regarding client issues and progress, including clients in crisis such as suicidal ideation.
Have knowledge of adhere to all applicable legal and ethical standards.
Provide each client with whom you work an appropriate Client Disclosure/Informed Consent Statement, Release of Information, Suicide At-Risk Contract, and other appropriate documentation with Empowering
Therapeutic Solutions, Inc. identifying contact information that informs your clients that you are obtaining clinical supervision from Company Name an how they can contact Company Name directly if needed.
Maintain ethical relationships and healthy boundaries with your clients.
Since you and A Leap of Faith Counseling Services share 100% of the responsibility for your client’s welfare, you are expected to inform A Leap of Faith Counseling Services immediately of any problems. Such problems include, but are not limited to, suspected child, elder or dependent abuse, domestic violence, if your client may be a danger to self or others, intentional spreading of infectious diseases defined by the Center for Disease Control, or if you use any non-traditional treatment methods.
Evaluation Information
In order to determine the effectiveness of supervision, there will be ongoing formative evaluations through direct feedback during each session. Also, periodically/quarterly Company Name will do summative evaluations in order to check-in on progress. A formal tool will be used in order to review your progress in several competencies. This will allow Company Name to evaluate your professional growth. In addition, a different instrument will be used to solicit your feedback about your relationship and the services you have received from A Leap of Faith Counseling Services.
Ethics Resources
Copies of the American Counseling Association (ACA) Code of Ethics, the National board of Certified Counselors (NBCC) Code of Ethics and the Code of Maryland Regulations (COMAR) Code of Ethics can be found in the following pages or by following the below hyperlinks.
Maryland Board of Professional Counselors and Therapists, Code of Ethics