Supervision Agreement Form - California Board of Psychology 2026

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  1. Click ‘Get Form’ to open the Supervision Agreement Form in the editor.
  2. Begin by filling in the primary supervisor's details, including their last name, first name, license number, and license type.
  3. Next, enter the delegated supervisor(s) information if applicable. Ensure all names and license numbers are accurate.
  4. Complete the trainee's section by providing their full name and registration number if applicable.
  5. Indicate the start and anticipated completion dates for the supervised professional experience (SPE).
  6. Select the appropriate category under which the trainee will be delivering psychological services by checking the relevant box.
  7. On a separate page, describe specific duties and summarize goals for the SPE plan as required.
  8. Review all supervision requirements carefully, ensuring both supervisors and trainees check 'yes' or 'no' where indicated.
  9. Finally, ensure all parties sign and date the agreement before submission to maintain compliance with regulations.

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A supervision agreement emerges from a discussion between you and those you supervise about what is important for you to know about each other if you are to work together effectively. Supervision agreements help to: set out the expectations you have of. one another in how you conduct the.
*The purpose of the Supervision Agreement is to ensure that both the supervisor and trainee understand and have a plan to comply with the laws and regulations related to the accrual of supervised professional experience (SPE).
16, 1387 - Supervised Professional Experience. This section applies to all trainees, pre- or post-doctoral, who intend for hours of supervised professional experience (SPE) to count toward meeting the licensing requirement stated in section 2914(c) of the Business and Professions Code .
Title 16, California Code of Regulations (16 CCR) Section 1833 1833.1 requires any qualified licensed mental health professional who assumes responsibility for providing supervision to those working toward a Marriage and Family Therapist license to complete and sign, under penalty of perjury, the following statement
SPE is defined as an organized program that consists of a planned, structured and administered sequence of professionally supervised comprehensive clinical training experiences.

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You might talk about: Legal issues and liability. Countertransference issues (feelings you have about your clients) Documentation and note taking. Clinical skills and interventions. Theoretical orientations and frameworks for change. Measuring outcome and asking for feedback (evaluation) Fees and finances.
► Supervisors must Possess a current and active California license that is not under suspension or probation as one of the following: Licensed Marriage and Family Therapist (LMFT) Licensed Clinical Social Worker (LCSW) Licensed Professional Clinical Counselor (LPCC) Licensed Educational Psychologist (LEP)

california board of psychology supervision requirements