Do you possess at least five years of extensive post-graduate clinical counselling/psychotherapy practice ? *

Do you possess at least one year of post-graduate supervised counselling experience in one of the counselling professions, in addition to the post-graduate counselling experience required to become registered or licensed? *

Which regulatory college are you a registrant of? *

Have you completed 30 hours of directed learning in providing clinical supervision? *

I acknowledge that I will not agree to provide supervision to practicum students in circumstances that may form a dual relationship with the supervisee as outlined in the Supervisor Practicum guide (i.e., where I am the practicum student's direct employment supervisor, friend, therapist/counsellor, teacher, etc.) *

I am currently a Faculty Member in the Faculty of Behavioural Sciences at Yorkville University *

I am currently a Student in the Faculty of Behavioural Sciences at Yorkville University *

I agree to uphold the requirements and procedures outlined in the Supervisors Practicum Guide. *

I understand that in my role of Practicum Supervisor, I am required to provide 10 hours of direct observation as part of my supervision commitment. I understand that clinical work can be directly observed via direct observation of sessions, review of recorded video or audio sessions, co-counselling, or co-facilitating. *

I understand that all potential supervisors are required to provide a copy of (1) current CV or Resume and (2) registration/certification/licensure document to be reviewed and approved by the Department of Field Training, even if they have provided it previously. Please email these items to our Practicum Liaison [email protected] in order to complete the application process. *

Will you be providing Practicum Supervision in the province of Ontario? *

I am a Member in good standing of a regulatory college whose members may practice psychotherapy *

I meet the College of Registered Psychotherapists of Ontario (CRPO)'s "independent practice" requirement (completion of 1000 direct client contact hours and 150 hours of clinical supervision). *

I have completed 30 hours of directed learning in providing clinical supervision (I understand that directed learning can include course work, supervised practice as a clinical supervisor, individual/peer/group learning, and independent study that includes structured readings) *

I thoroughly understand CRPO's definitions of clinical supervision, clinical supervisor, and the scope of practice of psychotherapy *