ASE WEEKLY SUPERVISION LOG
The ASE Academy — intern-resources.html
================================================================================
Complete weekly; review with supervisor; compile monthly for university submission.

Intern: ____________________  Week of: ________  Site: ______________
Site Supervisor: ____________  University Supervisor: ______________________

================================================================================
DIRECT CONTACT HOURS THIS WEEK

Individual counseling sessions:    ___ sessions × ___ min avg = ___ hours
Group counseling sessions:         ___ sessions × ___ min avg = ___ hours
Classroom guidance lessons:        ___ sessions × ___ min avg = ___ hours
Crisis intervention contacts:      ___                           ___ hours
Assessment/consultation contacts:  ___                           ___ hours
                                                  TOTAL DIRECT: ___ hours

================================================================================
INDIRECT HOURS THIS WEEK

Individual supervision (site):       ___ hours
Group supervision (site):            ___ hours
Individual supervision (university): ___ hours
Group supervision/seminar (univ.):   ___ hours
Consultation with teachers:          ___ hours
Consultation with families:          ___ hours
Case notes / documentation:          ___ hours
MDT / team meetings:                 ___ hours
Program planning / admin:            ___ hours
Professional development:            ___ hours
                                   TOTAL INDIRECT: ___ hours

TOTAL HOURS THIS WEEK: ___     CUMULATIVE TOTAL: ___
Hours required for completion: ___

================================================================================
SUPERVISION SESSION NOTES

Date: ___________  Duration: _______  Format: [ ] Individual  [ ] Group

Topics addressed:
  [ ] Case conceptualization (EPM)   [ ] Cultural governor / cultural humility
  [ ] Co-regulation in session       [ ] Ethical/legal issue
  [ ] Crisis response                [ ] Group facilitation
  [ ] Documentation                  [ ] Program development
  [ ] Professional development       [ ] Intern's formation/wellbeing
  [ ] Other:

Cases discussed (first initial + grade only):


ASE framework applied in supervision:
  [ ] 3 Governors / EPM   [ ] 5Cs   [ ] Co-regulation   [ ] Advocating stance
  [ ] Emergent situated agency      [ ] Paideia / formation
Notes:


================================================================================
INTERN REFLECTION (complete BEFORE supervision)

This week's most important clinical learning:


A moment when I felt genuinely regulated and present with a student:


A moment when I felt under-regulated, reactive, or defended — and what I did:


One thing I want to bring to supervision this week:


Which of the 5Cs did I practice most clearly this week?


================================================================================
SUPERVISOR FEEDBACK

Strengths observed this week:


Areas for continued development:


Goals for next week:


Supervisor signature: _________________________  Date: ___________
Intern signature: _____________________________  Date: ___________

================================================================================
The ASE Academy | info@ASETheory.com | ASETheory.com