In addition, some case supervision activities are appropriate for small groups. However, telemedicine should be combined with in vivo supervision. Some case supervision activities occur in vivo others can occur remotely (for example, via secure telemedicine or virtual technologies). On average, direct supervision time accounts for 50% or more of case supervision. It should be noted that direct case supervision occurs concurrently with the delivery of direct treatment to the client. Both direct and indirect case supervision activities are critical to producing good treatment outcomes and should be included in service authorizations. Case supervision activities can be described as those that involve contact with the client or caregivers (direct supervision, also known as clinical direction) and those that do not (indirect supervision).
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