Mentorship Sample Agreement

Nurse Healers-Professional Associates, Inc. (NH-PAI) The credentialing body of Therapeutic Touch International Association (TTIA)

Therapeutic Touch Practitioner Mentorship Sample Agreement In Preparation for Recognition as a Qualified Therapeutic Touch Practitioner (QTTP)

PURPOSE:

To provide a written sample agreement for the Therapeutic Touch (TT) Mentorship Process as required for recognition as a Qualified Therapeutic Touch Practitioner (QTTP).

The mentor and student may negotiate and make any adaptations as long as the changes remain consistent with the current NH-PAI/TTIA guidelines and policy & procedures.

Submit a copy of the signed Mentorship Agreement with the QTTP Application.

EDUCATION PREREQUISITES:

a) TT student has completed a minimum of a 12 contact hour Basic TT Program.
b) Basic TT Program must be taught by a Qualified Therapeutic Touch Teacher (QTTT).
c) The Mentor must be a QTTT or QTTP with 5 years’ experience.

PROCESS:

The eligible TT student will select a qualified mentor.  A mentor resource list is available through TTIA. The following NH-PAI/TTIA policies are available through TTIA as resources for the student and mentor. The documents listed are available at www.therapeutictouch.org:

a) Process and Application for QTTP.
b) TTIA One-Year Mentorship Process. An extension may be necessary to fulfill the requirements of competence, appropriate documentation and meetings.  Life circumstances beyond the control of mentor and student interactions may delay completion of some requirements and require extension of the QTTP Mentorship.
c) Therapeutic Touch Practitioner Mentorship Sample Agreement.
d) Guidelines for Recommended Standards & Scope of Practice for Therapeutic Touch.
e) Therapeutic Touch Policy & Procedure for Health Professionals.
f) Code of Ethics and Conduct for the Practice of Therapeutic Touch.

Nurse Healers-Professional Associates, Inc. (NH-PAI) The credentialing body of Therapeutic Touch International Association (TTIA)

Therapeutic Touch Practitioner Mentorship Sample Agreement

This Mentorship Agreement (Agreement) for the purpose of the Therapeutic Touch Qualified Therapeutic Practitioner (QTTP) Mentorship Process is by and between ______ (mentor) and _____ (student) who agree as follows:

1. The student and mentor will adhere to all NH-PAI/TTIA policy and procedures listed and available on the TTIA web site, www.therapeutictouch.org.

2. If not already a member, the student will join TTIA at the beginning of the Mentorship Process. Current TTIA full membership is required for ongoing recognition as QTTP.

3. The QTTP Mentorship Process will be for a minimum of one full year and may last longer as needed to meet all of the requirements and by mutual consent. This may be addressed either at the start of the Mentorship Process or at any time during the Mentorship Process.

4. Student will practice Therapeutic Touch (TT) on a regular basis, an average of 2 times per week or 8 times per month during the QTTP Mentorship Process.

5. Communication between the mentor and student throughout the QTTP Mentorship Process will be a minimum of once a month.  The communication may include, but is not limited to, discussion of experiences, clarifying questions and concerns, and problem solving.  In addition the student should seek out advice/suggestions on how to intervene for particular cues, health challenges/concerns/issues/diagnoses.

6. The QTTP Mentorship Process will consist of a minimum of 36 contact hours between mentor and student.  Activities recognized as appropriate may include 36 hours of:

a) follow-up TT practice sessions after a 12 contact hour Basic TT Program, supervised by the mentor.
b) email, phone or internet based conversations between mentor and student. c) donated community service if mentor is present to observe.
d) face to face meetings to discuss QTTP Mentorship Process.
e) a set number of hours from a formal mentorship program may be applied as determined by the mentor.
f) any other activities agreed upon by mentor and student.

7. The student’s evolving scope of practice will be agreed upon by the mentor and student.

8. It is the responsibility of the student to:

a) contact the mentor at least monthly for discussion, questions and feedback regarding TT sessions, documentation and journaling.
b) submit documentation in a timely manner as agreed upon with mentor.
c) read TT books and articles as assigned by mentor and prepare for discussion or report.
d) practice TT consistently, a minimum of 104 sessions during one year.  Determine creative opportunities to provide TT as a community service (e.g., TT clinic where TT is provided without a fee or at churches, health fairs, hospices or convalescent home).
e) provide TT to the mentor at least 3 times during the QTTP Mentorship Process. f) complete 75 TT session single case study documentation forms and required case studies as outlined in the QTTP application process.
g) repeat the Basic TT Program by a different QTTT.
h) take a 14 contact hour Intermediate TT Program by a QTTT approximately 6 months after a Basic TT program.
i)  complete the SETTS tool at start and completion of QTTP Mentorship Process (recommended).
j) keep an up-to-date accurate record of TT programs, teachers, case studies, etc.

9. It is the responsibility of the mentor to:

a) keep accurate records of the student’s Basic TT Program, including identity of QTTT.
b) record the date the QTTP Mentorship Process was initiated.
c) monitor the consistency TT Assessment and Evaluation Forms and Case Study Formats.
d) provide feedback on documentation in a timely manner and keep copies of documentation.
e) document the student’s progress (e.g., does the student ask appropriate questions, demonstrate a desire to learn and have the discipline to practice?).
f) receive at least 3 sessions of TT from the student over the period of the TTP Mentorship.
g) provide a Certificate of Completion upon successful completion of Mentorship Process.
h) provide a Letter of Recommendation for application.

10. If there are scheduling or unresolved issues/concerns by either student or mentor preventing completion of the QTTP Mentorship Process, the student or mentor will contact the TTIA Education Trustee.

11. The student will pay the mentor a fee of _______ on a ______ basis (select monthly, quarterly, etc.).       If no fee, then delete this paragraph; if in-kind, and then state the details at the ______ (beginning, end) of each (month, quarter, etc.)

12. This QTTP Mentorship Agreement is agreed to by the mentor and student by their signatures as of the date last written below.   The mentor and student may amend this Agreement at any time by written mutual agreement signed by both parties.

_______________________________________________________________ Signature of Student                                                         Date
Printed Name:
Phone:
Email:

________________________________________________________________ Signature of Mentor                                                         Date
Printed Name:
Phone:
Email:

[Note to mentor/student:  insert any additional agreed upon terms and conditions in the above Agreement and number accordingly, add any attachments as necessary and label them, then delete this note]