Pathway 3: Clinical Supervision - Awaken Inner Sense

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Welcome
About
Clinical Overview
Intake & Payment
Contact
Pathway 1: Single Specialisms
Pathway 2: Intertwined Specialisms
Pathway 3: Clinical Supervision
Pathway 4: Neuro-Somatic Energy Coaching
Pathway 5: Spiritual & Soul Healing
Pathway 6: Energy Healing & Guidance

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Pathway 3: Specialist Clinical Supervision
Price range: £150.00 through £480.00
Clinicial Supervision Intake Form
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Section 1:
Name
First
Last
Professional Title:
Professional Body & Registration Number: (e.g., UKCP, BACP, NCS, etc.)
Years in Practice:
Primary Modality: (e.g., Psychodynamic, Integrative, Hypno-Psychotherapy, etc
Email
Please enter your email, so I can follow up with you.
Telephone Number
Age
Location and Time Zone
Current Practice Status:
Senior/Established Practitioner
Emerging Specialist/Neurotherapist
Neuro Student / Trainee
Other
Section 2: Practice Context & Complexity
Average Weekly Caseload Volume:
Clinical Specialisms (Select all that apply):
Complex Trauma (C-PTSD)
Narcissistic Abuse & High-Conflict Dynamics
Neurodivergent (ADHD/Autism/AuDHD) Affirming Care
Somatic/Body-Based Therapy
Energy Psychotherapy / Energy Medicine
Hormonal/Menopausal Mental Health
Other
The Complexity Map:
Section 3: The Multidimensional & Neuro-Affirming Lens Identifying the "Neurospicy" and Energetic fit.
Neuro-Identity: Do you identify as a Neurodivergent (ND) or Highly Sensitive (HSP) practitioner?
Yes
No
Exploring/Unmasking
Energetic Integration: Do you currently integrate Energy Medicine (e.g., EFT, Biofield work) into your clinical practice?
Yes, it is a foundational part of my work.
I am beginning to integrate it and need clinical oversight.
No, but I am open to the "energy-informed" lens in supervision.
Somatic Tracking: On a scale of 1-10, how aware are you of your own somatic countertransference (body responses) during sessions?
Selected Value: 0
Section 4: Supervision Requirements
Desired Supervision Structure:
Complex Case Deep Dive (90 Mins): £350
Extended Clinical Review (120 Mins): £480
Student/Trainee Container (90 Mins): £150
Specialist Group Supervision (2 Hours): £160-£240
Supervision Goals:
Section 5: Safety & Professional Responsibility
Section 6: Practice Boundaries & Clinical Commitment
1. The Fixed Container Policy:
2. Financial Commitment:
3. Ending the Supervisory Relationship:
4. Communication Boundaries:
5. Professional Ethics:
Practice Boundaries & Clinical Commitment
Checkboxes
Financial Commitment & Policy: I acknowledge that all fees are paid in full to secure my placement in the diary. I understand that there is a strict no-refund, no-cancellation, and no-postponement policy. Once a diary slot is secured, it cannot be moved or refunded, and I am responsible for the full fee regardless of attendance.
Ethical Framework: I confirm that I am currently a member of a professional body (e.g., UKCP, BACP, or equivalent) and that I operate in accordance with its ethical guidelines and hold my own professional indemnity insurance.
Safety & Crisis Acknowledgement: I understand that my supervisor provides clinical oversight and is not an emergency service. I take full professional responsibility for the safety of my clients and will follow my own professional body’s safeguarding protocols in the event of a crisis.
Closing Phase Agreement: I agree to provide the required notice period (4 weeks or one full session) should I wish to end the supervisory relationship, to allow for an ethical closing process.
Confidentiality & GDPR: I understand that all client material presented in supervision will be anonymized to protect client identity, and I consent to my data being stored in accordance with UK GDPR.
Acknowledgment
Section 7: Final Submission
Date
GDPR Agreement
I consent to having this website store my submitted information so they can respond to my inquiry.
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Karyn Segers is a trading name of Awaken Inner Sense LTD, Registered in England and Wales. Company No: 12758826.

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Welcome
About
Clinical Overview
Intake & Payment
Contact
Pathway 1: Single Specialisms
Pathway 2: Intertwined Specialisms
Pathway 3: Clinical Supervision
Pathway 4: Neuro-Somatic Energy Coaching
Pathway 5: Spiritual & Soul Healing
Pathway 6: Energy Healing & Guidance