Telesupervision is defined as clinical supervision that is provided via an electronic communication device, in real-time, via audio and/or video rather than in person.
In normal conditions, as per the APA Commission on Accreditation, telesupervision may not account for more than one hour (50%) of the minimum required two weekly hours of individual supervision, and two hours (50%) of the minimum required four total weekly hours of supervision for doctoral interns.
However, in the event of unprecedented global health crises such as the 2020-21 COVID-19 pandemic, expansion of the use of telesupervision has been allowed and may in some cases be the primary form of supervision.
Telesupervision is utilized as an alternative form of supervision when in-person supervision is not practical or safe. Our rationale is that telesupervision allows for continuation of high-quality training even in extenuating circumstances that might preclude in-person supervision.
Consistency with Training Aims and Outcomes:
Telesupervision allows our supervisors to be engaged and available to assigned trainees, to oversee client care, and to foster trainee development, even in circumstances that preclude in person interactions. In these ways, it is fully consistent with our training aims. Certainly, in-person supervision has unique benefits, including availability of non-verbal and affective cues that can assist in relationship formation and evaluation of competence. We work to ameliorate the drawbacks of telesupervision by discussing inherent challenges of the format with each trainee and collaboratively working to identify strategies for maximizing what can be done in this format. This can include discussion of potential for: miscommunication, environmental distractions, temptation to multitask, technology failures, lack of dedicated workspace, etc. We work to set clear expectations and learning objectives at supervision outset and regularly check in on these throughout the supervisory relationship. Trainees will continue to receive ongoing formative feedback as well as summative feedback to ensure they are progressing appropriately within core competency areas.
How and When Telesupervision is Used:
Telesupervision is used in place of in-person supervision when meeting physically is not possible or is not safe (such as extenuating schedule, travel, life event, or public health emergency situations). It is not used for the sole purpose of convenience. We implement telesupervision by using a videoconferencing platform, Zoom Healthcare. Supervisors and supervisees may access telesupervision either from their individual offices and in some cases from a secure and confidential space within a home.
All trainees will be afforded the opportunity to have telesupervision as an option for receiving supervision when telesupervision is indicated or reasonable.
Supervisory Relationship Development:
Ideally, in-person meetings between supervisor and supervisee are encouraged (if safety can be reasonably assured in the case of public health emergencies). This can be especially important early on in supervisory relationship development. We also encourage our supervisors to check in regularly on how supervisees are experiencing the telesupervision format. Our supervisors and other clinical staff are readily available via phone or Microsoft Teams between supervision sessions for consultation and for informal discussions. Such availability for consultation and socialization as well as our demonstrated interest in the learning and development of our trainees serves to foster development of strong supervisory relationships.
Professional Responsibility for Clinical Cases:
The supervisor conducting the telesupervision continues to have full oversight and professional responsibility for all clinical cases discussed. On-site and/or remotely-working clinical staff are also available to our trainees and maintain communication with the direct supervisor regarding any assistance they provide in responding to a trainee’s needs or client care.
Management of Non-scheduled Consultation and Crisis Coverage:
Supervisors are available by email, text, phone, or Microsoft Teams in the event of need for consultation between sessions. Other clinical staff are also available via such forms of communication if a direct supervisor is unavailable. If a trainee is working out of their office, we are maintaining our open-door policy and clinical staff can also be approached in this manner. Supervisors or other clinical staff can be invited to virtual client sessions to assist in cofacilitation in the event telehealth is being utilized and if there are any client emergencies that necessitate intervention of senior staff.
Privacy/Confidentiality of Clients and Trainees:
Supervisors and supervisees will only conduct supervision that pertains to discussion of confidential client information from settings in which privacy and confidentiality can be assured, whether this be in the office or in a home-based setting. Our videoconferencing platform, Zoom Healthcare, provides end-to-end encryption and meets HIPAA standards.
Technology Requirements and Education:
Telesupervision will occur via Zoom Healthcare. During their orientation weeks, trainees will receive telehealth training, specific training on utilizing Zoom Healthcare, and training on being prepared for supervision, be this in-person or via teleconference. Our staff receive continuing education and training on providing services in a teleconferencing environment. Individual supervisors will review the Telesupervision Supervision Agreement Addendum at the time the standard Supervision Agreement is reviewed.