Supervision Contract / Agreement Template
What Is a Supervision Contract?
A supervision contract — also called a supervision agreement — is a formal written document that establishes the terms, expectations, and structure of the clinical supervision relationship between a supervisor and supervisee. It functions as both a professional agreement and a regulatory document, defining the roles and responsibilities of each party before supervised clinical work begins.
The supervision contract is not merely an administrative formality. It is the foundational document of the supervisory relationship, serving three critical purposes. First, it protects the supervisee by clearly defining what they can expect from supervision — frequency, format, evaluation criteria, and the process for addressing disagreements. Second, it protects the supervisor by documenting the scope of the supervisory responsibility and the supervisee's obligations. Third, it satisfies licensing board requirements in states that mandate a written agreement as a precondition for counting supervised hours toward licensure.
The APA Guidelines for Clinical Supervision in Health Service Psychology recommend that supervisors establish a supervision contract that covers the parameters, expectations, and responsibilities of supervision. The ACES Best Practices in Clinical Supervision similarly emphasize the importance of a clear, written agreement that is reviewed periodically and updated as the supervisory relationship evolves. NAADAC provides a model supervision contract template that many addiction counseling supervisors use as a starting framework.
Multiple state licensing boards have codified these professional recommendations into regulation. The California Board of Psychology requires a Supervision Agreement pursuant to CCR section 1387(b)(10) that must be completed and signed before supervised experience begins. North Carolina's Psychology Board requires an up-to-date Supervision Contract Form on file at all times during the supervisory period. Minnesota's Board of Psychology provides a supervision agreement template as part of its licensure application materials.
When You Need It
- Before a supervisee begins seeing clients under your license or supervisory authority
- When beginning a new supervisory relationship with a pre-licensed clinician, intern, or trainee
- When a supervisee transitions to a new training site or clinical setting under the same supervisor
- When state licensing board regulations require a written agreement as a condition of hour accrual
- When the terms of an existing supervisory relationship change substantially (new contract or formal amendment)
- When beginning post-degree supervised experience for licensure
Key Components
1. Identifying Information
Include the full legal names, credentials, license numbers, and contact information for both the supervisor and supervisee. Specify the supervisee's current licensure status (e.g., psychological associate, associate marriage and family therapist, licensed professional counselor associate) and the license or registration number, if applicable.
2. Purpose and Goals of Supervision
State the purpose of the supervision — typically, to provide the supervisee with the supervised clinical experience required for independent licensure — and the specific goals for the supervisory period. Goals should be individualized to the supervisee's developmental level and may include competency in assessment, treatment planning, specific therapeutic modalities, ethical decision-making, multicultural competence, and professional identity development.
3. Supervision Format, Frequency, and Duration
Specify whether supervision will be individual, triadic, group, or a combination. State the frequency (e.g., weekly) and minimum duration of each session (most states require at least one hour of individual supervision per week). Indicate whether telehealth supervision is permitted and under what conditions. Include the expected start and end dates of the supervisory period.
4. Supervisor Responsibilities
Detail what the supervisor commits to providing: regular and timely supervision sessions, review of the supervisee's clinical work (including case notes, treatment plans, and recordings when applicable), formative and summative feedback, evaluation of competence, guidance on ethical and legal issues, and emergency availability. The supervisor should also commit to maintaining their own licensure and competence throughout the supervisory period.
5. Supervisee Responsibilities
Detail what the supervisee commits to: preparing for supervision sessions, presenting cases honestly and completely, maintaining accurate clinical documentation, adhering to ethical standards, implementing supervisor feedback and directives, tracking hours accurately, and disclosing their supervisee status to all clients. The supervisee should also commit to notifying the supervisor promptly of any client safety concerns, complaints, or ethical dilemmas.
6. Client Disclosure and Informed Consent
Specify that the supervisee must inform all clients that they are working under supervision, provide the supervisor's name and contact information, and obtain client consent for sharing clinical information in supervision. Many states require this disclosure in writing as part of the client's informed consent.
7. Confidentiality in Supervision
Address the limits of confidentiality within the supervisory relationship. The supervisee should understand that case material shared in supervision is confidential but not privileged in the same way as therapy. The supervisor may need to disclose information to licensing boards, training programs, or in legal proceedings. If group supervision is used, all group members should agree to maintain confidentiality about cases discussed.
8. Evaluation Process
Describe how and when the supervisee will be evaluated. Specify whether evaluations will be formal or informal, their frequency (e.g., quarterly, mid-year, and end-of-year), the competency domains assessed, and whether standardized evaluation instruments will be used. State that the supervisee will have the opportunity to review and respond to evaluations and that evaluations will be retained in the supervisory record.
9. Due Process and Grievance Procedures
Include a clear process for addressing disagreements, concerns, or complaints. Both the supervisor and supervisee should know how to raise a concern, what steps will follow (informal discussion, mediation, formal complaint), and what external resources are available (e.g., the licensing board complaint process, the training program's grievance procedure). This section protects both parties and demonstrates that the supervisory relationship includes accountability mechanisms.
10. Emergency Procedures
Describe the protocol for clinical emergencies involving the supervisee's clients. Specify how the supervisee should reach the supervisor in emergencies, who serves as the backup supervisor if the primary supervisor is unavailable, and the chain of command for high-risk situations. Include emergency contact numbers for the supervisor and the backup supervisor.
11. Termination of the Supervisory Relationship
Address the conditions under which the supervisory relationship may be terminated — by either party, for cause, or by mutual agreement. Include the notice period required, the documentation to be completed upon termination (including hour verification), and the supervisor's obligation to assist the supervisee in transitioning to a new supervisor if possible.
12. Signatures and Date
Both the supervisor and supervisee must sign and date the contract. If the supervisee's training program requires a copy, include a signature line for the training director. Retain signed copies for both parties and file with the licensing board if required.
Supervision Contract Example
Clinical Supervision Agreement
CLINICAL SUPERVISION AGREEMENT
Supervisor Information: Name: Maria Gonzalez, PsyD License: Licensed Clinical Psychologist, PSY 31204 (State of California) Practice: Westside Psychological Services, 4500 Ocean Avenue, Suite 220, Los Angeles, CA 90066 Phone: (310) 555-0187 | Email: mgonzalez@westsidepsych.com Theoretical Orientation: Integrative (CBT, ACT, psychodynamic) Areas of Specialization: Anxiety disorders, depressive disorders, trauma, adolescent psychology
Supervisee Information: Name: James Hartwell, MA Registration: Registered Psychological Associate, PSB 92017 (State of California) Practice Site: Westside Psychological Services (same address as above) Phone: (310) 555-0192 | Email: jhartwell@westsidepsych.com Degree: MA in Clinical Psychology, Pepperdine University (2024)
Effective Dates: January 6, 2026 through January 5, 2027 (subject to renewal)
1. PURPOSE OF SUPERVISION
The purpose of this supervision is to provide James Hartwell with the supervised professional experience required for licensure as a psychologist in the State of California, pursuant to California Business and Professions Code section 2913 and California Code of Regulations section 1387. The supervision will support the supervisee's development of clinical competencies in assessment, diagnosis, treatment planning, intervention, ethical and legal practice, multicultural competence, and professional identity.
2. SUPERVISION FORMAT AND SCHEDULE
- Individual supervision: Minimum of one (1) hour per week, every Wednesday from 2:00 PM to 3:00 PM
- Group supervision: Two (2) hours per month, first and third Fridays from 12:00 PM to 1:00 PM (with other supervisees in the practice)
- Format: Primarily in person; telehealth supervision permitted when either party is unable to attend in person, not to exceed 25% of total supervision hours per California regulations
- Cancellations: If either party must cancel, at least 24 hours' notice is required. Canceled sessions will be rescheduled within the same week whenever possible. No more than two consecutive supervision sessions may be missed.
3. SUPERVISOR RESPONSIBILITIES
The supervisor agrees to:
- Provide weekly individual supervision and twice-monthly group supervision as described above
- Review the supervisee's clinical documentation, including intake assessments, progress notes, treatment plans, and risk assessments, on an ongoing basis
- Provide formative feedback on the supervisee's clinical skills, professional development, and areas for growth
- Conduct formal written evaluations of the supervisee's competence at 6 months and 12 months
- Be available for emergency consultation during business hours (Monday-Friday, 9:00 AM to 5:00 PM) and by phone for urgent clinical matters outside business hours
- Maintain current licensure, malpractice insurance, and competence in supervision throughout the agreement period
- Co-sign all clinical documentation as required by California law
- Comply with all applicable California Board of Psychology supervision regulations
4. SUPERVISEE RESPONSIBILITIES
The supervisee agrees to:
- Attend all scheduled supervision sessions prepared to present cases, review documentation, and discuss clinical concerns
- Maintain accurate, timely clinical documentation for all clients and submit documentation for supervisor review within 48 hours of the session
- Inform all clients in writing that they are a Registered Psychological Associate working under the supervision of Dr. Maria Gonzalez, including the supervisor's name, license number, and contact information
- Disclose supervisee status in the informed consent provided to every client
- Implement supervisor directives and feedback in a timely manner, and raise any disagreements or concerns about directives in supervision
- Track all clinical and supervision hours accurately using the approved tracking system
- Notify the supervisor immediately (within 2 hours) of any client safety emergency, including suicidal ideation, homicidal ideation, child abuse disclosures, or other mandated reporting situations
- Adhere to the APA Ethics Code, California law, and all practice policies
- Not represent themselves as independently licensed or practice beyond the scope authorized by their registration
5. CLIENT DISCLOSURE AND INFORMED CONSENT
The supervisee will provide all clients with written disclosure of the supervisory arrangement at the first session, including:
- The supervisee's name, credentials, and registration number
- The supervisor's name, credentials, license number, and contact information
- A statement that the supervisor has access to clinical records and that case material will be discussed in supervision
- Client consent for the sharing of clinical information within the supervisory relationship
6. CONFIDENTIALITY
Information shared in supervision — including case material, supervisee self-disclosures, and evaluation data — will be treated as confidential, with the following exceptions:
- The supervisor may share information with the California Board of Psychology as required by law or upon request during an investigation
- The supervisor may be required to disclose information in response to a court order or subpoena
- If the supervisee's conduct poses a risk to client welfare, the supervisor may take appropriate action, including reporting to the licensing board
- In group supervision, all participants agree to maintain confidentiality regarding case material and peer feedback
7. EVALUATION
The supervisor will conduct formal written evaluations of the supervisee's competence at the following intervals:
- 6-month evaluation: Mid-year formative evaluation with written feedback on all competency domains
- 12-month evaluation: End-of-year summative evaluation with written feedback, competency ratings, and recommendation regarding continued supervised practice
Evaluations will assess the following competency domains: (1) Assessment and Diagnosis, (2) Intervention and Treatment Planning, (3) Ethical and Legal Practice, (4) Individual and Cultural Diversity, (5) Professional Values, Attitudes, and Behaviors, (6) Communication and Interpersonal Skills, (7) Clinical Documentation, and (8) Supervision Utilization.
The supervisee will have the opportunity to review evaluations, provide a written response, and discuss feedback during a dedicated evaluation session. Evaluations will be retained in the supervisory record for a minimum of seven years.
8. DUE PROCESS AND GRIEVANCE PROCEDURES
If either party has a concern about the supervisory relationship:
- Step 1: Raise the concern directly with the other party in a scheduled supervision session
- Step 2: If the concern is not resolved, either party may request mediation through a mutually agreed-upon third party (e.g., another licensed psychologist or the practice director)
- Step 3: If mediation is unsuccessful, either party may file a complaint with the California Board of Psychology
The supervisee has the right to seek consultation from other professionals or the licensing board at any time without retaliation.
9. EMERGENCY PROCEDURES
In the event of a client emergency:
- During business hours: Contact Dr. Gonzalez immediately at (310) 555-0187
- After hours: Contact Dr. Gonzalez by cell phone at (310) 555-0199
- If Dr. Gonzalez is unavailable: Contact the backup supervisor, Dr. Priya Sharma, PsyD (PSY 28903) at (310) 555-0234
- Imminent danger: If a client is in imminent danger, the supervisee should call 911 first, then contact the supervisor as soon as possible
- The supervisee should never delay emergency intervention to reach the supervisor
10. TERMINATION OF THIS AGREEMENT
This agreement may be terminated:
- By mutual written agreement of both parties
- By either party with 30 days' written notice
- Immediately by the supervisor if the supervisee engages in conduct that poses a risk to client welfare, violates ethical standards, or violates law
Upon termination, the supervisor will:
- Provide a written verification of all supervised hours completed
- Complete a final evaluation of the supervisee's competence
- Assist with transition to a new supervisor when possible
- Retain all supervisory records for a minimum of seven years
11. COMPENSATION
The supervisee will pay the supervisor a supervision fee of $150 per month, covering all individual and group supervision sessions. Payment is due on the first of each month. [Note: In some arrangements, the supervisee is employed by the practice and supervision is included as part of employment. Specify the applicable arrangement.]
SIGNATURES
By signing below, both parties agree to the terms of this Clinical Supervision Agreement.
Supervisor: Signature: ______________________________ Date: ______________ Maria Gonzalez, PsyD — Licensed Clinical Psychologist, PSY 31204
Supervisee: Signature: ______________________________ Date: ______________ James Hartwell, MA — Registered Psychological Associate, PSB 92017
This is a sample for educational purposes only — not real patient data.
How to Write a Supervision Contract
Step 1: Research your state's requirements. Before drafting a contract, review your state licensing board's specific supervision regulations. Some states provide mandatory forms (California, North Carolina, Minnesota); others set minimum requirements but allow flexibility in format. Use your board's required form as a starting point, supplementing with additional provisions as needed.
Step 2: Individualize the goals. Generic goals like "develop clinical competence" are insufficient. Tailor the contract to the supervisee's developmental level, training needs, and the clinical population they will serve. An early-career supervisee learning to conduct intakes needs different goals than a nearly-licensed clinician refining specialized skills.
Step 3: Be specific about logistics. Vague language like "supervision will occur regularly" invites problems. Specify the day, time, duration, and format of each supervision session. State how cancellations will be handled and what the maximum number of consecutive missed sessions is. Licensing boards count hours precisely, and ambiguity creates disputes.
Step 4: Address the difficult topics. Many supervision contracts are thorough on logistics but weak on due process, emergency procedures, and termination. These are the sections you need most when things go wrong. Write them carefully, imagining a scenario where either party needs to invoke them.
Step 5: Review together and sign before starting. Do not hand the supervisee a contract to sign without discussion. Review each section together, invite questions, and ensure genuine understanding and agreement. Both parties should sign before the first supervision session and before the supervisee begins clinical work.
Step 6: Schedule periodic reviews. Set a calendar reminder to review the contract at least every six months. Update goals, address any provisions that are not working, and document amendments with both signatures.
Common Mistakes
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Using a generic template without state-specific customization. A supervision contract from a national organization (NAADAC, ACES) is a starting point, not a finished document. Each state has different requirements for supervision format, ratio of individual to group hours, telehealth provisions, and documentation. A contract that does not reflect your state's regulations may result in the supervisee's hours being disqualified.
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Failing to sign the contract before supervision begins. If supervised hours begin before a valid contract is in place, many licensing boards will not count those hours. This can cost a supervisee months of progress toward licensure. Always sign and date the contract on or before the first day of supervised clinical work.
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Omitting a due process or grievance section. Without a written grievance procedure, disagreements between supervisor and supervisee have no structured path to resolution. This exposes both parties to risk and may lead to licensing board complaints that could have been resolved internally.
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Not specifying emergency protocols. If a supervisee's client is in crisis at 8:00 PM and the supervisee does not know how to reach the supervisor or who the backup supervisor is, client safety is compromised. Emergency contact information and a clear chain of command should be in the contract, not left to informal understanding.
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Neglecting to address termination. Supervisory relationships sometimes end unexpectedly. Without a termination clause, the supervisee may be left without documentation of hours completed, and the supervisor may remain legally responsible for the supervisee's clinical work beyond what was intended. Address early termination, hour verification, and transition planning in the contract.
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Setting goals that are never revisited. If the contract establishes supervision goals that are never referenced in supervision sessions or evaluations, the contract becomes a paper exercise rather than a meaningful framework. Align your supervision notes, evaluations, and contract goals so that they form a coherent, ongoing record of the supervisee's development.
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