How is supervision distributed among clinical/counseling faculty members? (Check all that apply.) How many on-campus faculty do you currently have supervising cases in your clinic? Do on-campus supervisors get course (teaching) credit for supervision? How many psychologists from the community (e.g. adjunct faculty) do you have supervising in your clinic? If these supervisors are compensated financially, what is the range of compensation per hour? If these supervisors are not compensated financially, is some other form of compensation provided? Do you have requirements for clinical supervisors? (Check all that apply.) What is the average number of trainees supervised by each supervisor per academic term? What is the minimum required ratio of supervision to therapy time? (Number of hours of therapy per hour of supervision) What is the average number of hours of supervision per week clinical supervisors provide?
Individual Does the supervisor see (observe?) the student trainee's clients? If Yes, is the supervisor present? (Check all that apply.) How are your trainees typically monitored in therapy? (Check all that apply.) Which of the following are your spervisors required to review and counter sign? (Check all that apply.) Are your clinic supervisors evaluated for supervisory skills? If Yes, please describe method: If Yes, are these evaluations made available to trainees? Please indicate your overall level of satisfaction with your clinic's existing procedures for the evaluation of supervisors: Do non-licensed psychologists (e.g. new Ph.D's) supervise? If Yes, do they receive supervision themselves for their supervision services? Who typically supervises graduate student supervisors? How many graduate trainees do you currently have supervising cases in your clinic? Do you provide your trainees with some type of training in supervision? If Yes, what is the nature of supervisory training? Please describe supervisory training as briefly, but specifically as possible. If Yes, in which of the following areas do you provide opportunites for trainees to gain experience providing supervision? (Check all that apply.) Please indicate if you have any individuals in each of the following categories who also provided consultation and/or supervision. How do you solicit feedback on clinic operations? Does your clinic charge a fee for services provided? If Yes, what are your fees for the services listed below?
What percentage of your clients pay fees? Who approves a fee reduction for clients? How do you charge for assessments? Does the clinic keep a proportion of clinic-generated fees? If not 100%, who gets the fees that your clinic doesn't keep? (Check all that apply.) When fees are collected, what is the policy? Does your clinic enter into contractual arrangements with external/community agencies to provide services? If Yes, indicate type of community agencies. (Check all that apply.) If Yes, please indicate the nature of services provided to these agencies. (Check all that apply.) If Yes, what proportion of your clinic's fees are generated by contracts with external/community agencies? Do you charge clients if data on them is used in research? Do you feel your response to the previous itme affects: Does your clinic receive third party payments from insurance companies? If Yes, who signs the insurance forms? If Yes, who is listed as the provider of the service on the insurance forms? If Yes, what proportion of your clinic's fees are generated by third party payments from insurance companies? How do you handle clients who don't pay or fall behind in payments? (Check all that apply.) Do you bill for missed appointments? Who prepares the clinic budget? (Check all that apply.) To whom is the budget submitted? (Check all that apply.) By the affiliated university Training, research, or other grants Do clinic-generated fees provide: (Check all that apply.) Do you collect follow-up outcome measures on your clients? If Yes, how is this information collected? (Check all that apply.) Does your clinic conduct routine, systematic data collection for program evaluation? How many research projects were conducted with your clinic population during the academic year? Is outcome research conducted in your clinic? If Yes, which measures are used? (Check all that apply.) Do you use research data to form clinic research goals or policy? Do you have specific written guidelines governing the conduct of research activities in your clinic? How is informed consent for research obtained in your clinic? Do you believe there is any conflict between the research needs of the faculty and trainees and the clinical needs of your clinic clients? Please check the top three things listed below that you perceive to be the major obstacles to conducting research in your clinic? How are focus and propriety of research determined? Who oversees research conducted through the clinic? |
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