SOP 508.07-att-1: Record of Clinical Supervision

Division:
Mental Health Services
Effective Date:
August 15, 2022
Reference Code:
VG15-0001
Topic Area:
508 Policy-MH Administration/Staff/Certification
PowerDMS:
View on PowerDMS
Length:
77 words

Summary

This form documents clinical supervision sessions conducted with mental health staff members in the Georgia Department of Corrections. Supervisors use this record to document the offender cases discussed, clinical issues and concerns identified, and the supervisee's strengths and limitations during individual or group supervision sessions. The completed form is retained in the staff member's supervision file.

Key Topics

  • clinical supervision
  • mental health staff supervision
  • supervision documentation
  • supervisory record
  • offender case review
  • clinical issues
  • staff performance evaluation
  • mental health services
  • supervision session

Full Text

SOP 508.07
Attachment 1

8/15/22

GEORGIA DEPARTMENT OF CORRECTIONS – MENTAL HEALTH SERVICES
RECORD OF CLINICAL SUPERVISION

Institution: _______________________________ Date of Session: _______________________

Supervisee: ______________________________ Supervisor: ___________________________

Start time of Session: ______ End time of Session: _____ Modality: Group [ ] Individual [ ]

Offender/Cases Discussed:

|Name|ID#|Name|ID#|
|---|---|---|---|
|
||||
|
||||
|
||||

Clinical Issues/Concerns: ________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Supervisee’s Strengths and Limitations: ____________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________ ____________________________
Signature/Title of Supervisor Date

Form no. M15-01-01 Page 1 of 1

Retention Schedule: Upon completion, this form will be placed in the staff member’s supervision file.

Attachments (4)

  1. Record of Clinical Supervision (77 words)
  2. Semi-Annual Report of Clinical Supervision (161 words)
  3. Record of Individual Clinical Case Consultation (77 words)
  4. Clinical Group Case Conference Record (Attachment 4) (84 words)
Machine-readable: JSON Plain Text