Career-Stage Supervision Model
Introduction
Occupational therapy supervision needs to change as professional responsibility, complexity and risk increase. The OT360 career-stage model provides a structured, ethical and professionally defensible approach to supervision across the full occupational therapy career span.
Why career-stage supervision matters
As occupational therapists progress, decision-making carries greater consequence and ethical dilemmas become more complex. Supervision that does not adapt risks becoming superficial or overly reassuring.
Overview of the model
The model begins with HCPC registration status and then matches supervision to one of four career stages, recognising that practitioners may move between stages depending on role and context.
Stage 1 — Early career and consolidation practice
Focus: Professional identity development, safe application of theory, boundary setting and confidence without over-reassurance.
- A calm, safe space to think clearly
- Practical next steps and professional reasoning you can trust
- Supportive challenge that builds independence
What occupational therapists say
Published with permission. Identifying details removed.
Stage 2 — Established and specialist practice
Focus: Complexity management, ethical reasoning, scope calibration and sustaining professional grounding across demanding caseloads.
- Space to step back and see patterns, not just problems
- Clear articulation of reasoning and defensible decisions
- Support that holds both challenge and compassion
What occupational therapists say
Stage 3 — Advanced, leadership and consultant practice
Focus: Governance-level thinking, high-stakes decisions, ethical complexity, leadership clarity, risk and accountability.
- A rigorous space to test judgement and hold complexity safely
- Confidence to lead with clarity, not overload
- Support for sustainable, defensible decision-making
What occupational therapists say
Stage 4 — Transition points and sustained senior practice
Focus: Professional re-grounding, confidence rebuilding, regulatory readiness and long-term professional consistency.
- Thoughtful, flexible space rooted in deep professional understanding
- Ongoing clarity and direction year-on-year
- A stable structure that supports longevity
What occupational therapists say
Working with OT360
OT360 uses this model to shape supervision structure, frequency and review — ensuring supervision remains tailored, ethical and professionally defensible. Practitioners may move between stages as roles shift, responsibility increases, or context changes.
Booking
You can book a professional supervision consultation here:
You can book a professional supervision consultation here
BOOK CONSULTATION
Margaret Spencer
MA, Dip COT, Cert Ed, HCPC reg
Consultant Occupational Therapy Practitioner
OT360 is led by Margaret Spencer MA DipCOT CertEd FRCOT, consultant occupational therapist, educator and professional supervisor. Her approach is calm, rigorous and deeply practical — so you leave sessions calm, clear and equipped for the realities of your role.
High standards, low pressure — supervision that’s rigorous, kind, and accessible at every career stage. You don’t need to be confident or “have it all together” to book. If you’re feeling unsure, stretched, or low in confidence, you’re exactly the kind of person I want to work with — we’ll start where you are and build clarity step by step.
If you’re a neurodiverse OT — especially ADHD — you’re in exactly the right place. Supervision is tailored to you, including Access to Work–funded sessions.





