Improving Practice Through Supervision

Guideline 10: Improving Practice Through Supervision

Your Use of Supervision

If you are receiving supervision for the purpose of qualifying for licensure, you should ensure that the supervision is provided according to the requirements defined in the Education Law and Commissioner's Regulations. The regulations establish qualifications for a supervisor that include education, licensure in New York State to practice the profession being supervised, and at least three years of experience in the practice of the profession.

You should not accept employment unless the supervision you will receive meets the specific requirements for the frequency, duration, and location of supervision necessary to qualify for a professional license. You can review the definition of a qualified supervisor in the law and regulations.

After you are licensed and during your initial years of professional practice, you are encouraged to seek regular supervision focused primarily on improving skills and knowledge in patient care and professional development. You may wish to seek supervision from a more experienced practitioner in the same profession as you or from a licensed professional in another field with experience in that area of patient care.

Even as an independent and mature practitioner, you should seek consultation with experienced colleagues whenever you are minimally qualified in a specific practice modality, when you believe a patient could benefit from a collaborative approach to service, or when the practice raises personal issues that may affect or obstruct your ability to provide professional services.

Your Responsibility as a Supervisor

Your supervisory relationships are a form of professional practice and should be governed by the same guidelines that apply to patient relationships with regard to ethical considerations, defining needs, confidentiality, expectations and responsibilities and in establishing appropriate boundaries.

It is your responsibility as the supervisor to ensure that the supervisee is competent to practice, whether or not the supervisee is licensed. The supervisor who allows a supervisee to practice beyond the supervisee's level of competence, may be subject to charges of professional misconduct under the Education Law.

If you are providing supervision in a group setting, the size and duration of the group should be conducive to participation by all supervisees. Many agree that groups should be limited to no more than five supervisees with one supervisor. You may choose to supervise a group of less than five, based on factors such as your supervisory skills and the qualifications and needs of the supervisees.

In some instances, the Commissioner's Regulations may allow you to provide supervision by telephone or other technology. Before using such technology, you should determine the requirements established in regulation and assess the skills of the supervisee and the purpose of the supervision, including limitations that may be inherent in the use of supervision that is not conducted face-to-face.

You may find it helpful to conduct a regular progress report with your supervisee(s). This could include documentation of the supervisee's ability to:

• establish professional relationships;
• assess patient need and plan appropriate interventions;
• carry out appropriate interventions;
• be flexible and change interventions in response to changing needs or patient preferences;
• practice as a licensed professional;
• work effectively with patients at various levels and in relation to systems, including families, organizations and other groups.

When you provide supervision you should consider developing with the supervisee a written agreement that clarifies the responsibilities of each party, such as:

• purpose and scope of the supervision;
• learning and development needs of the supervisee and plans to address those needs in supervision;
• structure of the supervision, including but not limited to:
  • expected duration of the supervisory relationship;
  • if other than individual supervision, the number of participants;
  • duration/length of each supervisory session;
  • frequency of supervisory sessions;
  • time and place of supervisory sessions;
  • cost (if any) and payment arrangements;
  • responsibilities for case materials;
  • role expectations of supervisor and supervisee(s);
  • accountability and reporting requirements;
  • confidentiality protections.

You should not accept responsibility for supervising an individual if you are not licensed in the profession or have not met other appropriate qualifications. Supervising an individual when you are not competent could result in charges of unprofessional conduct against you and the supervisee.

An individual practicing under a limited permit is not qualified to practice independently. In most cases, the permit holder may not supervise other permit holders, students, interns, or licensees.

The supervisor must have access to information about the supervisee's patient in order to provide appropriate supervision. The supervisee and supervisor must place a premium on maintaining as confidential any patient-specific information. The supervisor has the same obligation as the supervisee to keep information confidential. You may not provide third party supervision to an individual employed in an agency, without the consent of the employing agency.

When you are supervising an individual under a limited permit, the supervisee must notify the patient in advance that information will be shared with a licensed supervisor for the purpose of improving the practitioner's skills. The patient must know that you are supervising the permit holder and how to contact the supervisor. Even when you are licensed and practicing independently, and you choose to consult with a supervisor to improve your skills, you should obtain the patient's consent if identifiable information may be shared with a third-party.

Citations of Pertinent Law, Rules or Regulations:

• Education Law, section 6509(2) - incompetence and negligence
• Education Law, section 6509(7) - permitting unlicensed practice
• Education Law, section 6509(9) - unprofessional conduct
• Regents Rules, part 29.1(b)(9) - practicing beyond competency and without adequate supervision
• Regents Rules, part 29.1(b)(10) - improper delegation of duties
• Regents Rules, part 29.2(a)(5) - failing to supervise appropriately
• Commissioner's Regulations, part 79-9.3 - experience requirement for mental health counselors
• Commissioner's Regulations, part 79-10.3 - experience requirement for marriage and family therapists
• Commissioner's Regulations, part 79-11.3 - experience requirement for creative arts therapists
• Commissioner's Regulations, part 79-12.3 - experience requirement for psychoanalysts