Forms

Purpose of Supervision

As your supervisor, my role is to support you in developing your clinical knowledge, skills, and professional identity. Supervision is a collaborative process designed to facilitate reflection, ethical decision-making, and best practices in mental health care.

We will also work together to identify and progress towards your professional development goals. I encourage you to reflect on specific areas you would like to focus on, such as improving case formulation, developing skills in a particular therapeutic modality, or working with complex client presentations.

My aim is to assist your deeper learning by co-developing a tailored approach to your supervision. Feedback will be provided in a constructive and collaborative manner, and you are also encouraged to provide feedback on the supervision process.

Supervision Structure and Expectations

• Supervision sessions are held regularly, at agreed-upon times, and are typically 50 minutes in length. Our sessions will be conducted [In-person/Via telehealth/Combination].

• You are expected to come to each session prepared with relevant material for discussion. As a guide, it can be helpful to prepare a particular de-identified case you would like to work on.

• Active participation, self-reflection, and openness to feedback are essential components of effective supervision.

• As a registered health professional, you are responsible for adhering to the ethical guidelines and professional standards set by the Australian Health Practitioner Regulation Agency (AHPRA) and [mention other relevant professional organisations, e.g., APS].

• Supervision is not a crisis service; urgent matters should be directed to emergency services (000), Lifeline (13 11 14), or relevant professional assistance. It is also important to prioritise your own self-care, and you are welcome to discuss any concerns about burnout or vicarious trauma within supervision.

Confidentiality in Supervision

All discussions and materials shared during supervision are treated as confidential, except in the following situations:

• If disclosure is required by law, such as under mandatory reporting laws established by AHPRA.

• If I believe there is a serious and imminent risk to yourself or others.

• If information is required for court orders or legal processes.

• If prior approval has been obtained to share relevant information with other professionals or agencies (e.g., university supervisors, professional registration bodies).

Mandatory Reporting Obligations

As a supervisor, I am legally bound by mandatory reporting laws applicable to all registered health professionals in Australia under AHPRA. If concerns arise regarding professional misconduct, impairment affecting safe practice, or other reportable matters, I am required to notify AHPRA according to national health laws.

Cancellation and Fees

Please provide adequate notice if you need to cancel or postpone an appointment. Cancellations within 24 hours of the scheduled appointment will incur the full session fee of $260, unless it is an emergency or exceptional circumstances.

If you cancel between 24 and 48 hours before the appointment, a fee of $100 will apply. These fees are necessary to help me offer timely support to other clients and manage my practice effectively.

Record Keeping and Use of Digital Scribing

I maintain records of our supervision sessions using my own note-taking, and the following digital scribing platforms: NovoNote https://novopsych.com/novonote/

Use of Digital Scribing (Optional)

The digital scribing system employs artificial intelligence (AI) via PatientNotes or NovoNote to capture the audio of your consultation and produce an initial draft summary of the session with your supervisor.

This draft aids me in crafting a supervision note or document pertaining to the appointment, which is subsequently saved in your official supervision record. Once the content is stored in your official record, all information from the digital scribing system is permanently deleted.

My priority is to ensure that the supervisory environment is a trusted and safe space. The use of PatientNotes or NovoNote is 100% optional.

Access to Supervision Records

You may request access to supervision notes and records under reasonable circumstances. These records will be kept in accordance with AHPRA guidelines and relevant privacy legislation. Any discussions about these records should occur within supervision sessions to ensure clarity and professional integrity.

Termination of Supervision

Either party may initiate the termination of supervision. I encourage discussion of the termination process.

Agreement and Consent

By signing this form, I acknowledge that:

• I understand the purpose, structure, expectations, and Danielle Blanco’s approach to supervision.

• I understand the limitations of confidentiality and mandatory reporting requirements under AHPRA.

• I agree to actively engage in supervision, come prepared for sessions, and adhere to ethical and professional guidelines.

• I understand the fees and the cancellation policy for supervision sessions.