Supervision Tool: Consultation Guide

This worksheet is from the Peer Professional Employer Toolkit.

Instructions: Print and use this guide to discuss and document the consultation during supervision. Consider completing the follow-up section at a later date.

1. Important service participant information (concerns and challenges, access to supports environmental factors, culture and diversity):
   
   
   
    
2. Presenting concerns and potential ethical dilemmas:
   
   
   
    
3. Conceptualization (forming, defining, and refining ideas):
   
   
   
    
4. What is the desired outcome? How to get there: Brainstorm support tasks. How might any OARS+I skills be integrated?
   
   
   
    
5. Action plan:
   
   
   
    

Follow-up date:

1. How did the support tasks go? Use of OARS+I skills?
   
   
   
    
2. What was the participant’s response? Was the desired outcome achieved?
   
   
   
    
3. What adjustments, if any, may be needed to the plan moving forward?
   
   
   
    

Consultation guide adapted from Center for Substance Abuse Treatment (2009, p. 132). Clinical Supervision and Professional Development of the Substance Abuse Counselor, Treatment Improvement Protocol Series No. 52.