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CONTRACT FOR SUPERVISION

IN THE PRACTICE OF CLINICAL PROFESSIONAL COUNSELING 1of 2

This contract for supervision is meant to formalize the professional relationship and

responsibilities between_______________________________________, Supervisor and

____________________________________, Supervisee, in which the supervisor directs,

guides, monitors, instructs, and evaluates the supervisee’s knowledge, skills, and abilities to

provide clinical professional counseling services in an ethical and competent manner in

compliance with Health Occupations, Title 17, Annotated Code of Maryland, and related

COMAR regulations.

Responsibilities of the Supervisor:

 Establish written contract items related to frequency of individual and/or group

supervision sessions, formal and informal evaluations, contact information, etc.;

 Ensure that the supervisee is practicing within the scope of the supervisee’s license;

 Determine the skill level at which the supervisee may practice;

 Focus on raw data from the supervisee’s practice;

 Maintain documentation of supervisory sessions for at least 7 years, including dates,

duration, and focus of the supervisory sessions;

 Ensure that the supervisee has read and is knowledgeable about Health Occupations

Article, Title 17, Annotated Code of Maryland, COMAR 10:58, and state and federal

laws related to reporting requirements and emergency procedures for high risk or abused

clients, as well as confidentiality and privileged communication;

 Within a reasonable period of time before termination of supervision, provide the

supervisee and employer with a notice of termination to avoid or minimize any harmful

effect on the supervisee’s clients or patients;

 Be responsible for the clinical professional practices of the supervisee;

 Provide for emergency supervision and direction to the supervisee by a Board-approved

supervisor;

 Provide a written evaluation of the supervisee’s progress to the supervisee every 3

months.

Responsibilities of the Supervisee:

 Verify that the supervisor has been approved by the Board;

 Establish and execute the written contract for supervision before beginning to practice

clinical professional counseling;

 Attend and participate in supervision as agreed in the written contract for supervision;

 Prepare for supervision using case materials related to the supervisee’s clinical

counseling practice;

 Maintain documentation of supervisory sessions for at least 7 years, including dates,

duration, and focus of the supervision, to be available for verification to the Board, on

request by the Board or it’s authorized agent;

 Refrain from engaging in the practice of clinical professional counseling independent of

supervision, (i.e., solo practice);

2 of 2

Responsibilities of the Supervisee – continued:

 Provide each client with a copy of a professional disclosure statement as described in

Health Occupations Article, 17-507, Annotated Code of Maryland and COMAR 10.57.12

clearly stating that counseling services are provided under clinical supervision, and

provides the name of the supervisor with address and contact information;

 Obtain a signed release of information and informed consent for treatment form from the

client which indicates that the client: 1) is aware that counseling services are being

provided under clinical supervision; 2) consents to the recording of counseling sessions

with the knowledge that the recording may be shared with and be limited to the

supervisor; and 3) consents to the sharing of client information between the licensed

graduate professional counselor and the named clinical supervisors.

In case of an emergency we have discussed and agreed upon the following procedure:

______________________________________________________________________________

Additional Provisions, Agreements and/or Clarifications:

______________________________________________________________________________

We agree to uphold the directives and provisions outlined in this contract to the best of our

abilities, and conduct our professional behavior according to Health Occupations Article, Title

17, Annotated Code of Maryland, COMAR 10:58, and relevant state and federal laws and

regulations.

Supervisor______________________________________________Date_________________

Supervisee______________________________________________Date_________________

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CONTRACT FOR SUPERVISION IN THE PRACTICE OF CLINICAL (State of Maryland)

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