Clinical supervision is now an integral part of the expert practice of all of the professions using psychotherapeutic or counselling frameworks, including psychotherapy, counselling, mental health nursing, social work, expressive therapies, organisational consultancy, psychology, occupational therapy, medical psychiatry, probation work and many others. Online supervision is a new way of accessing the guidance and support required by practitioners in these professions, using computer mediated communication tools.

The field of online supervision is hardly yet even in its infancy - at the time of writing there are no established professional guidelines to draw on to direct its practice. In this context, staff of GroupInterVisual Ltd. and members of The Online-supervision.net Research Team have put together the guidelines below, as a way of setting the tone for the culture and outlining what we consider 'best practice' usage of the service we are developing and researching, and to flag up issues that require thinking about by supervisors and supervisees in establishing supervisory relationships. We hope that these guidelines will be equally useful to those engaged in peer-group (i.e. leaderless) supervision.

The following guidelines are based on

• a review of all guidelines we have been able to locate for online therapy
• consultation amongst a range of those with expertise in clinical supervision, and
• engagement with the relevant issues and active debate within the Online-supervision.net Research Team and by members of a wider group of academics and professionals similarly interested in the development of online supervision practice.

These guidelines will be kept under review, as practitioners struggle with their own issues in the practice of online supervision, learn from the process and report back to us. They are set out below under the following five headings:

1. authentication of supervisor and supervisee
2. legal and professional regulatory constraints
3. supervision contract
4. security and confidentiality
5. keeping abreast of developments in field

1. authentication of supervisor and supervisee

2. legal and professional regulatory constraints

• Be mindful of the legal and professional regulations as they apply in the country, state and professional organisations of both supervisee and supervisor, in relation both to the supervisory relationship itself, and also in relation to the work supervised.
• Law and institutional policy is likely to govern the collection, transmission and storage of health related information, which might differ across jurisdictions. Practice in keeping with such law and policy.
• Both supervisee and supervisor should be aware of and abide by local custom and practice regarding such issues as boundaries of confidentiality and mandatory reporting of criminal activity, e.g. child abuse.

3. supervision contract

• As with face-to-face supervision it is advisable that supervisees and supervisors negotiate an explicit contract outlining roles, responsibilities, goals, fees, payment arrangements, frequency of contact and dates for review of the contract. A sample contract will be provided on the online-supervision.net site in due course, which all parties are free to adapt and use in this regard as they see fit.
• As with therapy, there are many different theories as to what supervision should comprise, and vastly different supervisory styles even within particular professional and theoretical schools. While these guidelines do not aim to prescribe how supervision should be conducted, it may be useful to consider this checklist of essential factors and foci for what is practiced to be considered clinical supervision by the Online-supervision.net Research Team, for the purposes of their evaluation study.
• There are a number of features of online relationships that require particular consideration and negotiation:

  a) Mode of communication
  The Internet provides a vast number of methods of communication, which are in a constant state of evolution. These may be divided into synchronous (or real time) methods (e.g. video or voice conferencing, internet telephony, real time chat, instant messaging or interaction in virtual environments), and asynchronous methods (e.g. email, voice mail, message/bulletin boards, e-mail groups or newsgroups). Agreement should be reached about the range and the preferred mode(s) of communication to be utilised.

  b) Security of communication
  Asynchronous methods may be better suited to people who live in different time zones but some of these may be more readily accessible to third parties than synchronous methods. Every care has been taken on the online-supervision.net site to ensure that bulletin boards, email list archives and other asynchronous modes of communication are password protected to prevent third party access, but responsibility for secure use of these rests with individual users and the contract between supervisor and supervisee should make explicit their expectations for usage in this regard.

  c) Breakdown of communication
  A back up system is required for when a person's computer crashes, or Internet connection is lost by one or both parties, or the online tool being used fails, during supervision. In such an eventuality, or if for any other reason either party to online supervision using synchronous communication tools loses their connection during the course of the meeting, there should be a pre-agreed procedure for re-connecting/rescheduling the meeting, for example the other party might wait five minutes for a reconnection to happen, and then use a telephone call in order to assess the problem and reschedule the meeting while any technology problems are addressed and rectified.
  

  d) Frequency of contact
  face-to-face supervision typically involves the scheduling of regular meetings (e.g. weekly, fortnightly etc.) with limited contact in between. Internet technologies enable people to be available or appear available twenty-four hours a day. Technologies such as videoconferencing and instant messaging may reveal whether or not a person is online, even though they may actually be engaged in leisure or other activities. A clear understanding needs to be reached regarding

  • when the supervisor or supervisee is willing to be contacted
  • how frequently the parties wish contact to take place
  • how quickly they will respond to email and other asynchronous communications
  • how they will notify the other of their being unavailable

  
  e) Record keeping
  Both supervisor and supervisee may wish to keep a record of communications. Computer mediated methods of communication enable the easy logging or storage of communications. Any supervision contract should state what records will be kept, by whom, what are the access arrangements and how such records will be disposed of.

  f) Communication difficulties and complaints
  Whilst many ways to convey emotion via text-only methods of communication have evolved, not everyone enjoys the same degree of sophistication in using Internet technologies and misunderstandings still easily occur. The contract should establish how misunderstandings will be negotiated, how one should express a wider grievance with the process of supervision and where to take such grievances where resolution between the parties is not achievable.

  g) Group Supervision
  There is compelling evidence that facilitation of online groups is every bit as difficult as face-to-face group facilitation. Should group supervision be part of the supervisory contract it is important to clearly establish the rules of the group, what counts as inappropriate behavior and what sanctions are available to the facilitator or administrator should there be a breach of the group rules. Participants need to be aware whether the group is open or closed, what are the terms of membership, what is the availability of archived dialogue and so on.
  

4. security and confidentiality

• Few forms of Internet mediated communication may be considered absolutely secure. Principles of confidentiality apply, subject to exceptions in the case of mandatory reporting of certain types of criminal activity, to:

  a) Client Information
  Names and details of clients, or any other information which may potentially render a client identifiable to third parties, should not be used in Internet communication. Communication from clients should not be forwarded to anyone, either in entirety or in part, without clients' explicit consent. Videostreaming of therapy sessions, or part thereof, either live or recorded, online or offline, either to the supervisor or anyone else, should not occur without the client's explicit and informed consent.

  b) Supervisee and supervisor communications
  Supervisors and supervisees should agree, as above, whether and how communications will be stored or logged. Video or voice communications should not be recorded without the other's consent and communications of any sort should not be forwarded to anyone, either in their entirety or in part, without the other party's explicit consent, subject to exceptions in the case of unresolvable grievances, according to procedures agreed in the contract as above.

• Security of communication may be compromised through system breakdown and unauthorised access to stored communications. Such security can be enhanced by the use of passwords and encryption, which should be used wherever possible. In the case of unauthorised access or other breach of confidentiality, the client and all other parties should be informed as soon as possible, unless doing so would in your clinical judgement lead to more harm than good.
• Refer to individuals' professional codes of conduct and ethics for guidance on when law may require disclosure of supervisee or client information. Clients, supervisors and supervisees should be aware, for example, that clear risk to self or others or current serious criminal offending may constitute instances in which the information may need to be shared with appropriate authorities.

5. keeping abreast of developments in field

• Online psychotherapy, counseling and supervision are new and evolving professional domains. Review latest policy statements and guidance documents on online counseling and supervision frequently.
• Visit http://www.online-supervision.net/ often to review links related to online supervision
• Ensure you have up-to-date awareness of the guidelines of your professional regulatory authority

Online-supervision.net Research Team
14 September 2003