MFT Trainee Monthly Supervision Review Sheet D

Monthly Supervision Hours Log

Total Supervision Hours
Total Clinical Hours for this Month*
How many hours did you work at your placement for the month? E.g. 40 per week for 5 weeks= 200 hours for the month
In addition to you submitting your hours for the month, Please submit the following for review: (1 to 2 sentences each)

1. 1 typed de-identified progress note, including the client’s first and last initials, session date and what session number is this?,

2. The client's stated goals and/or hopes for therapy

2. Identify at lease one treatment plan goal you working on,

3. Identify at least one intervention you used in session,

4. Identification of any ethical, legal, safety, or mandated reporting concerns,

5. Any relevant social and cultural considerations,

6. A genogram

7. Trainee’s clinical conceptualization, how do you understand what is going on? Any patterns?

8. Any strengths and/weaknesses as you observe yourself while in session with the client
De-identified Progress Note*

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In the client's own words (quote), what is does the C say the presenting problem is? How do they hope therapy could be helpful?*
Treatment Plan Goal (S-specific, M-measurable, A-achievable, R-relevant, T-timeBound *
Intervention
Ethical, legal, safety, or mandated reporting concerns,*
Social/Cultural Considerations*
Genogram

You can draw, type or take a photo and send it in.
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Case conceptualization*
Strengths/Weakness of the therapist*
Supervisor Approval Status
Should be Empty:

AAMFT Monthly Supervision Review Sheet