Clinical Supervision Reflection Log
A clinician log for preparing and reflecting on supervision: cases, personal reactions, ethical and risk questions, development goals, learning and action points.
1-page fillable PDF · US Letter (prints on A4) · Clinical supervision
- Approach / concern
- Clinician Tools
- Technique
- Clinical supervision
- Format
- Fillable PDF, 1 page (US Letter / A4)
- Access
- Advanced plan
- For
- Licensed clinicians to use with clients
- Updated
- October 2026
Key facts
What is the Clinical Supervision Reflection Log?
Clinical supervision supports competence, ethical practice and professional development. Structured preparation and reflection help supervisees make the most of supervision and track their growth.
Why it works
Competency-based supervision emphasizes reflective practice, self-assessment and goal setting (Falender & Shafranske, 2004). Supervision frameworks highlight preparation and integration of learning as key to effective supervision (Bernard & Goodyear, 2019).
When to use it
- Clinicians in training and registration
- Peer supervision and consultation groups
- Experienced clinicians seeking consultation
- Documenting supervision hours
How to use it in session
- Complete the first four rows before supervision.
- Bring de-identified case material.
- Record learning during or after the session.
- Set action points.
- Review action points at the next session.
Clinician tips
- Protect client confidentiality; use initials or codes.
- Bring successes as well as struggles.
- Note supervision hours required by your regulatory college.
Worked example
Sharing with clients
Members can download the PDF to print or email, or copy a private client link from the download box. Your client opens the link and downloads the worksheet on any device. No client account is needed, and nothing your client writes is stored on TherapyAid.
Frequently asked questions
How much client information should I include?
Only what’s needed, de-identified, in line with privacy law and your college’s standards.
Can I use this for peer consultation?
Yes. It works for individual, group and peer consultation.
References
Bernard, J. M., & Goodyear, R. K. (2019). Fundamentals of clinical supervision (6th ed.). Pearson.
Falender, C. A., & Shafranske, E. P. (2004). Clinical supervision: A competency-based approach. American Psychological Association.
This worksheet is an educational tool for use by, or under the guidance of, a licensed or registered mental-health professional. It is not a diagnostic instrument or a substitute for clinical judgement. If a client is in crisis in Canada, call or text 9-8-8 or call 9-1-1.
