Counselor Education Program Department of Leadership and Counselor Education

Counselor Education Program Department of Leadership and Counselor Education Masters of Education School Counseling Clinical Mental Health Counseling...
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Counselor Education Program Department of Leadership and Counselor Education

Masters of Education School Counseling Clinical Mental Health Counseling Practicum and Internship Manual

The University of Mississippi School of Education P.O. Box 1848 University, Mississippi 38677-1848 (662) 915-7069

Revised January 2016

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T ab le of C on ten t s Introduction

………………………………………………………………………………………………2

Program Faculty ……………………………………………………………………………………….…3-4 Overview ………………………………………………………………………………………………….. 5 General Guidelines ………………………………………………………………………………….………5 Practicum/Internship Responsibilities ……………………………………………………………...…….….6 Practicum Hours Requirements …………………………………………………………...……………….. 6 Impairment in Practicum …………………………………………………………………………………... 6 Internship Hours Requirements ……………………………………………………………………………..7 Impairment in Practicum …………………………………………………………………………………....7 Practicum/Internship Forms and Documentation …………………………………………………………...8 Practicum Application Instructions ………………………………………..……………...………………...8 Practicum and Internship Forms ………..……...…………………………………………………. ........... .9 Practicum Student Filing Checklist .…………………………………..……………………...……….9 Internship Student Filing Checklist …………………………………………………………………..10 Practicum Application Form ………………………..………………………………….……..….………..11 Practicum Site and Supervisor Information Sheet…………….….……………………………..……….....12 Practicum/Internship Contract ……………………………………………………………….…..………...13 Practicum/Internship Contract Addendum …………………………………………………….…………. 16 Basic Counseling Skills Feedback Sheet-R…………………………………….…………….…. .............. 17 Professional Counseling Performance Evaluation-R ………………………………………………. …… 19 Weekly Counseling Log …………………..…………………….……………………………………….. 22 Multicultural Awareness, Knowledge, & Skills Survey –Couns. Ed.-Revised (MAKSS-CE-R)………… 24 Career Adapt-Abilities Inventory (CAAI) …………………………………………….……………….… 26 Evaluation of Site Supervisor. ………………………………………………………...……….............… 27 Evaluation of Site Form …………..………...……………………………………….………...………… 29 Site Visitation Form …………………….………………………………………………....…………….. 30

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COUNSELOR EDUCATION PROGRAM PRACTICUM and INTERNSHIP INTRODUCTION The Counselor Education Program at the University of Mississippi is accredited by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP) for the School Counseling, Community Counseling, and Counselor Education Ph.D. programs. All of the requirements for practicum and internship are based on CACREP standards. This manual contains critical information for students completing the clinical sequence (Practicum and Internship) and is the central information source for students, doctoral student supervisors, program faculty, and site supervisors regarding the clinical sequence. All forms to be used by students and their supervisors can be found in this handbook. The practicum and internship experiences are an important part of counselor training. These experiences are critical because they provide a means for students to apply their knowledge and counseling skills to the professional practice of counseling. Practicum is the first experience, where graduate students are placed in a school or community site with supervision and have an opportunity to continue development of counseling skills and learn other professional responsibilities and skills. Internship is the last phase of training and is a transitional phase leading to the professional world. These two field experiences provide students with an opportunity to work in an appropriate site as a counseling professional while being supervised. During the practicum and internship experiences, it is important that students select sites that are appropriate to their career goals. Students will work closely with the department practicum/internship coordinators to choose a site. The sites utilized by our program are chosen for the service they give to their consumers and for the learning opportunities they provide to our students. When sites agree to allow students to train with them, they do so realizing their responsibility to promote the educational and developmental process of counseling students. The program realizes that these training experiences have a dual role, and the program works diligently to insure that the needs of the agency and students are both met during the practicum and internship experiences.

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Program Faculty Practicum and internship students in The University of Mississippi Counselor Education Program are supervised by the following faculty. Faculty offices are located on the first floor of Guyton Hall. The telephone number for the department office is 662-915-7069. Each faculty member can also be reached by telephone directly. Their direct office numbers and email addresses are listed below:

Suzanne M. Dugger, Ed.D. Professor of Counselor Education and Program Coordinator Contact Information: Office Location: 139 Guyton Telephone: 662-915-8821 Email: [email protected]

Education: A. B., Harvard University M.A., Central Michigan University Ed.D., Western Michigan University

Dr. Dugger experience includes 5 years of experience as a school counselor, 3 years as a college counselor, 7 years in private practice, and 25 years as a counselor educator. Her teaching and research interests include career counseling, counseling children, school counseling, the counseling process, diagnosis and treatment planning, and doctoral education.

Alexandria K. Kerwin, Ph.D., LPC, NCC Assistant Professor of Counselor Education Contact Information: Office Location: 142 Guyton Telephone: 662-915-2342 Email: [email protected]

Education: B.A., The University of Southern Mississippi M.S., The University of Southern Mississippi Ph.D., Idaho State University

Dr. Kerwin has experience as a mental health counselor in a K-12 school-based setting, adolescent offenders program, and in university counseling centers. She also has worked as a community-based advocate for refugees. Courses you are likely to take from Dr. Kerwin are Introduction to Professional Counseling, Lifespan Development, and Addictions. Her research interests include professional identity, social justice, and counselor education.

Mandy L. Perryman, Ph.D. Assistant Professor of Counselor Education Contact Information: Office Location: 143 Guyton Telephone: 662-915-7816 Email: [email protected]

Education: B.A., Louisiana Tech University M.A., Nicholls State University Ph.D., University of New Mexico

Dr. Perryman has experience counseling children, adolescents and adults and providing play therapy. Courses you are likely to take from Dr. Perryman include Counseling Skills, Group Counseling, and Multicultural Counseling. Her research interests include eating disorders/disordered eating and compassion fatigue and wellness.

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Marc Showalter, Ph.D., LPC-S Assistant Clinical Professor of Counselor Education Contact Information: Office Location: 145 Guyton Telephone: 662-915-5376 Email: [email protected]

Education: B.S., Harding University M.S., University of Central Arkansas Ph.D., The University of Mississippi

Dr. Showalter’s teaching and research interests include counseling relationships, college counseling, and supervision. He also serves as the Clinical Coordinator at the Counselor Education Clinic for Outreach and Personal Enrichment.

Amanda M. Winburn, Ph.D. Assistant Professor of Counselor Education Contact Information: Office Location: 109 Guyton Telephone: 662-915-8823 Email: [email protected]

Education: B.S., Kentucky Wesleyan College M.Ed., Indiana University Ed.S., The University of Mississippi Ph.D., The University of Mississippi

Dr. Winburn’s teaching and research interests include school counseling, at-risk students, bullying and play therapy. She also serves as the Assessment Coordinator for the Counselor Education Program. Her professional experiences include working as a social worker, career counselor, school teacher, and school counselor. Potential courses include counseling skills, organization and administration of school counseling, practicum, and internship.

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Overview of the Practicum and Internship Manual This manual is designed to be the central source for information concerning the practicum and internship experiences in the counseling program at The University of Mississippi. All users of the manual are encouraged to read the entire manual so that each may possess a thorough understanding of the entire practicum and internship process.

General Guidelines 1. Selection of practicum and internship sites is coordinated by the Practicum/Internship Coordinators in collaboration with faculty advisors. 2. Practicum applications must be submitted to the Community Counseling or School Counseling Practicum Coordinator by mid-term of the semester prior to beginning practicum. The coordinators will advise applicants regarding their eligibility for Practicum. 3. After eligibility has been approved, practicum applicants will meet with the appropriate Practicum Coordinator to discuss placement availability and appropriateness for candidate, agency, and program needs. Faculty advisors may also provide input in this process. 4. Applicants will then schedule an interview with the recommended site and supervisor, and meet with the site supervisor and other appropriate individuals. During the interview, candidates will provide a resume and a copy of the Practicum/Internship contract. If the site supervisor, principal/director, and candidate are in agreement with the terms of the contract, the contract should be signed and returned to the appropriate Practicum Coordinator. 5. All contracts and placements should be secured and on file by the end of the semester. 6. All practicum and internship hours accrue only during The University of Mississippi academic calendar dates, unless prior written agreement has been made. 7. All practicum and internship students are required to obtain and provide proof of liability insurance prior to beginning practicum and/or internship. Insurance must remain active during the entire period of practicum and internship. Liability insurance is available free to students with paid membership to the American School Counselor Association as well as the American Counseling Association. In addition, teacher associations and other professional groups provide group liability insurance. A background check must be submitted prior to the beginning of the semester. 8. Candidates may change sites only after consultation and with approval of the appropriate Practicum/Internship Coordinator. 9. Successful completion of COUN 693 is required to enroll in COUN 695. Revised January 2016

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Practicum/Internship Student Professional Role and Responsibilities 1. Adhere to the ethical guidelines of the American Counseling Association, American Mental Health Counselors Association, and/or the American School Counselor Association at all times. 2. Follow all protocols, rules, and policies of the site. 3. Consult with site supervisor and/or university supervisors as needed. 4. Actively participate in weekly supervision with site supervisors, doctoral student supervisors, and the group supervision class. 5. Adhere to the hourly guidelines stated in the contract. 6. Complete necessary evaluations and weekly counseling logs. 7. Maintain active professional liability insurance. 8. A background check must be submitted.

Doctoral Student Supervisor Responsibilities 1. Meet all doctoral program requirements for eligibility to provide supervision to master’s students. 2. Provide weekly individual and/or triadic supervision with assigned students. 3. Participate in mid-term and final evaluations of students, completing appropriate evaluation forms for submission to the assigned Practicum/Internship instructor. 4. View video recordings of supervisee work. 5. Meet weekly with the appropriate Practicum/Internship instructor. 6. Follow through with supervisory recommendations and guidelines.

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Practicum Hours Requirements Practicum students are required to complete a minimum of 100 clock hours during the practicum experience, 40 direct service hours and 60 indirect service hours. Direct service hours may include individual, group, couples, and family counseling as well as presentation of classroom guidance lessons. Indirect service hours may include treatment planning and documentation, supervision, outreach, training, and administrative duties. The time commitment for practicum is approximately 12 to 16 hours per week, and time on site will be scheduled in collaboration with the site supervisor. From time to time, practicum students may be asked to provide additional hours on site for special events or situations.

Impairment in Practicum Some of your practicum experiences may trigger emotional and/or behavioral responses outside of your everyday experiences. At times you may feel some deeper emotional experiences that interfere with your ability to be an effective counselor and which may benefit from counseling or other therapeutic interventions. Practicum is not an appropriate forum to share these experiences. Should you have these types of emotional experiences you are expected to seek professional services (i.e., University Counseling Center or private services). In the event that your instructors believe that you are having these types of experiences during practicum in ways that interfere with your ability to be an effective counselor, we are ethically and legally bound to take steps to protect you and possibly make disclosures of your situation to faculty, site supervisors, and/or administration. In addition, we may initiate student retention and remediation procedures should we deem the experiences to be impeding your performance as a practicum student. Some professional definitions of impairment include: • Overholser and Fine (1993). Impairments may include a serious deficit(s) in any of the following: 1. 2. 3. 4. 5.

factual knowledge generic clinical skills orientation-specific technical skills clinical judgment interpersonal attributes

• Frame and Steven-Smith (1995). Impairment may include: 1. not being open, flexible, positive, and cooperative 2. not willing to accept and use feedback 3. not aware of impact on others not demonstrating an ability to deal with conflict, accept personal responsibility, and express feelings effectively and appropriately

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Internship Hours Requirements Internship students are required to complete a minimum of 600 clock hours during the internship experience, 240 direct service hours and 360 indirect service hours. Direct service hours may include individual, group, couples, and family counseling as well as presentation of classroom guidance lessons. Indirect service hours may include treatment planning and documentation, supervision, outreach, training, and administrative duties. The time commitment for Internship is approximately 32 to 40 hours per week and time on site will be scheduled in collaboration with the site supervisor. From time to time, internship students may be asked to provide additional hours on site for special events or situations.

Impairment in Internship Some of your internship experiences may trigger emotional and/or behavioral responses outside of your everyday experiences. At times you may feel some deeper emotional experiences that interfere with your ability to be an effective counselor and which may benefit from counseling or other therapeutic interventions. Internship is not an appropriate forum to share these experiences. Should you have these types of emotional experiences you are expected to seek professional services (i.e., University Counseling Center or private services). In the event that your instructors believe that you are having these types of experiences during internship in ways that interfere with your ability to be an effective counselor, we are ethically and legally bound to take steps to protect you and possibly make disclosures of your situation to faculty, site supervisors, and/or administration. In addition, we may initiate student retention and remediation procedures should we deem the experiences to be impeding your performance as an internship student. Some definitions of impairment: • Overholser and Fine (1993). Impairment may include a serious deficit(s) in any of the following: 1. 2. 3. 4. 5.

factual knowledge generic clinical skills orientation-specific technical skills clinical judgment interpersonal attributes

• Frame and Steven-Smith (1995). Impairment may include: 1. 2. 3. 4.

not being open, flexible, positive, and cooperative not willing to accept and use feedback not aware of impact on others not demonstrating an ability to deal with conflict, accept personal responsibility, and express feelings effectively and appropriately

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Practicum Application Instructions The Practicum Application Form is to be completed by the candidate and submitted to the Practicum Coordinator by mid-term of the semester prior to beginning practicum. The Practicum Site and Supervisor Sheet is to be completed by the candidate and submitted to the Practicum Coordinator by the end of the semester prior to beginning practicum. Professional liability insurance is required for all candidates. Proof of insurance must be submitted to the Practicum Coordinator before any candidate may begin practicum. A background check is required. Failure to complete and/or submit the forms on time will delay the candidate’s progress and may delay the candidate one (1) year in beginning practicum.

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Pr ac tic u m and Inter nshi p For m s The following is a checklist of required forms to be completed and submitted to your practicum/internship instructor. Practicum/internship instructors will forward the completed forms to the appropriate Practicum Coordinator for review and placement in your permanent student file. Practicum Filing Checklist Pre-Practicum: Practicum Application Form Practicum Site & Supervisor Information Sheet Professional Liability Insurance Declaration page Signed Practicum Contract (with site) Signed Practicum Contract Addendum (if applicable) Signed Supervision Agreement  Background Checks Mid-Semester (10th Week) Practicum: Mid-Semester Basic Counseling Skills Feedback Sheet (BCSFS-R) by Site Supervisor Mid-Semester Basic Counseling Skills Feedback Sheet (BCSFS-R) by Practicum Instructor Mid-Semester Basic Counseling Skills Feedback Sheet (BCSFS-R) by Doctoral Student Supervisor Mid-Semester PCPE-R by Site Supervisor Mid-Semester PCPE-R by Practicum Instructor Mid-Semester PCPE-R by Doctoral Student Supervisor Mid-Semester Weekly Counseling Log by Candidate

End of Semester Practicum: End of Semester Basic Counseling Skills Feedback Sheet (BCSFS-R) by Site Supervisor End of Semester Basic Counseling Skills Feedback Sheet (BCSFS-R) by Practicum Instructor End of Semester Basic Counseling Skills Feedback Sheet (BCSFS-R) by Doctoral Student Supervisor End of Semester PCPE-R by Site Supervisor End of Semester PCPE-R by Practicum Instructor End of Semester PCPE-R by Doctoral Student Supervisor Evaluation of Site by Candidate Evaluation of Site Supervisor by Candidate End of Semester Weekly Counseling Log by Candidate Site Visitation Form by Practicum Instructor Revised January 2016

10 Internship Filing Checklist

Mid-Semester Internship: Mid-Semester PCPE-R by Site Supervisor Mid-Semester PCPE-R by Internship Instructor Mid-Semester Weekly Counseling Log by Candidate

End of Semester Internship: End of Semester PCPE-R by Site Supervisor End of Semester PCPE-R by Internship Instructor Career Adapt-Abilities Inventory (CAAI) by Candidate Evaluation of Site by Candidate Evaluation of Site Supervisor by Candidate End of Semester Weekly Counseling Log by Candidate Site Visitation Form by Internship Instructor

Revised January 2016

11 School Counseling Practicum/Internship Application Form Candidate Information

Practicum Student’s Name:

Date: __________________

Address:

Phone: _________________

________________________________________________ University e-mail:

@go.olemiss.edu

__

Work: _________________ Cell:

Professional membership(s): _____________________________________________________ Professional Insurance Co. Name & Policy #: _______________________________________

Candidate Academic Program Status Completion of all listed coursework with a grade “B-” or higher is required to begin the Practicum Sequence Course Number

Course Name

COUN 639

Introduction to the Counseling Profession

COUN 643

Group Procedures (Taken w/Prac)

COUN 683

Counseling Theory I

COUN 688

O&A – School (Taken w/Prac)

COUN 690

Counseling Skills

COUN 670

Multicultural Counseling (Taken w/Prac)

Year

Semester Completed

Fall Spring Fall Spring Fall Spring

The candidate listed above must have successfully completed COUN 690 with a grade of “B-” or higher in order to enroll in Practicum COUN 693.

Revised January 2016

12 Mental Health Counseling Practicum/Internship Application Form Candidate Information

Practicum Student’s Name:

Date: __________________

Address:

Phone: _________________

____________________________________________________

Work: _________________

University e-mail:

Cell:

@go.olemiss.edu

Professional membership(s): _____________________________________________________ Professional Insurance Co. Name & Policy #: _______________________________________

Candidate Academic Program Status Completion of all listed coursework with a grade “B-” or higher is required to begin the Practicum Sequence Course Number

Course Name

COUN 639

Introduction to the Counseling Profession

COUN 670

Multicultural Counseling

COUN 643

Group Procedures

COUN 683

Counseling Theory I

COUN 685

O&A (Clinical Mental Health) (Taken w/Prac)

COUN 690

Counseling Skills

Year

Semester Completed

Fall Spring Spring Fall Spring Fall

The candidate listed above must have successfully completed COUN 690 with a grade of “B-” or higher in order to enroll in Practicum COUN 693.

Revised January 2016

13 Practicum Site & Supervisor Information Sheet Practicum Student’s Name: _________________________________ Site Name: _____________________ Site Mailing Address: City: ____

_ _

Date: _________________

______________

_____________________________________________________________

__ State: ____

Zip Code: _____________

Site Supervisor: __________________________________________ Title:

______________________

E-mail: _______________________________

Phone: _________________

Supervisor’s Education Degree: Years of Experience as a Counseling Professional: _______ Supervisor’s Licensure and/or Certification: (Check all that apply)  MS Licensed School Counselor

 MS Licensed Professional Counselor

 National Certified School Counselor

 National Certified Counselor

Other ______________________________ Type of Services at Site: (Check all that apply)  Individual Counseling

 Group Counseling

 Couples Counseling

 Classroom Guidance

 Family Counseling

Other: ____________________________________ Hours and Days Candidate will be working at Site: (Circle days you plan to be onsite) M T W Th F Hours on these days: ______________________________________________________________________________ ______________________________________________________________________________

Revised January 2016

14 The University of Mississippi Counselor Education Program Practicum/Internship Contract

This contract constitutes an agreement between the University of Mississippi Counselor Education Program and a school or community agency which will serve as a clinical training site for our students. Each member involved in this agreement, including a site supervisor, school principal or agency director, a counseling master’s or Ed.S. student, and a university faculty member will sign the contract after having read it in its entirety. Description of hours for practicum and internship: In accordance with the Council for the Accreditation of Counseling and Related Educational Programs’ (CACREP) standard that describes practicum and internship as a developmental sequence, students will begin their practicum at the start of the fall semester. During the first part of the fall semester, (approximately ten (10) weeks), practicum students may complete approximately 12 hours weekly at a site, with a maximum of 16 hours per week. Students will not be allowed to complete more than the maximum number of hours during this initial period in order to provide ample time for developing their initial clinical skills. At the ten (10) week point of the fall semester, students may request to be evaluated for their readiness to begin internship. If the site supervisor, the clinical professor, and a doctoral student supervisor-in-training concur (as evaluated using the PCPE) that the student demonstrates the appropriate level of skills, he or she may begin to move into internship. At this point, students will be allowed to complete additional weekly hours at their sites with approximately 32 but no more than 40 hours completed per week for the remainder of the fall semester and the spring semester. Under no conditions should students complete more than 16 hours per week during practicum or more than 40 hours per week during internship. Students may not begin to accrue internship hours until they have successfully completed the practicum final evaluation. For Ed.S. students, your internship hours will be congruent with the normal hours of employment at your school. Description of taping requirement for practicum and internship: The University of Mississippi Counselor Education Program requires students to video tape sessions with clients, after obtaining written consent to taping. Videotaping provides the highest level of supervision and assists students in their development as professional counselors. During the Site Supervisor Orientation held early each fall semester, the Basic Counseling Skills Feedback Sheet (BCSFS-R) and the Professional Counselor Performance Evaluation (PCPE-R) will be reviewed. Starting/Ending dates for practicum and internship: Per CACREP standards, students must receive weekly group supervision from a faculty member or a doctoral supervisor-in-training under the direct supervision of a faculty member. Therefore, practicum will begin on the first day of classes of the fall semester and end of the last day of classes of the fall semester. Students may begin to accrue internship hours at the ten (10) week point of the fall semester contingent upon a successful review of their developing counseling skills. Internship will continue on the first day of classes in the spring semester and end on the last day of classes in the spring semester. For the current years, these dates are:

Fall semester is from August 22 through December 2, 2016 Spring session is from January 23 through May 5, 2017 Summer semester is from May 30 through July 26, 2017 Should you wish to work at your site during times when Ole Miss is not in session, you will need to obtain written permission from your Principal/Agency Director and your site supervisor by having them sign the Contract Addendum.

Revised January 2016

15 During practicum/internship, the Counselor Education Program Faculty Liaison agrees to: 1. facilitate communication between university and site; 2. notify the student that he or she must adhere to the administrative policies, rules, standards, schedules, and practices of the site; 3. notify the student that he or she must adhere to the ethical codes of the American Counseling Association and/or the American School Counselor Association at all times; 4. be available for consultation with both site supervisor and student; 5. provide 1.5 hours of weekly group supervision during the course of the semester and to assign a grade for the course. During practicum and internship, the Practicum Site agrees to: 1. assign a site supervisor who (a) has a master’s degree in an appropriate mental health or school counseling area, has 2 years’ post-master’s degree experience, and who holds appropriate licensure and/or certification; (b) has time for and interest in the training of a counseling student; (c) will regularly review student tapes; (d) will provide one hour of weekly individual supervision; and (e) will attend Site Supervisor Orientation; 2. provide opportunities for the student to engage in a variety of counseling activities under supervision (suggested counseling-related experiences included in the “Activities” section below); 3. provide the student with adequate confidential work space, telephone, office supplies, and support to conduct professional activities; 4. complete the appropriate evaluation forms in accordance with guidelines provided during the Site Supervisor Orientation. 5. contact the counselor education program faculty liaison immediately if any problem should arise with the student’s performance; 6. provide the program faculty liaison with a current resume for the site supervisor. During practicum/internship, the site supervisor will be the primary supervisor. The site supervisor is the first person the student should contact in the event of an emergency regarding client well-being. Critique and feedback provided to the student during faculty-led group supervision should be utilized in consultation with the site supervisor. The training activities (checked below) will be provided for the student in sufficient amounts to allow an adequate evaluation of the student’s level of competence in each activity.

Revised January 2016

16 Activities ____

Individual Counseling

____

Staff Meetings

____

Group Counseling

____

Individual/Group Supervision

____

Couples/Family Counseling

____

Outreach Activities

____

Intake Interviewing

____

Parent/Teacher Conferences

____

Psychoeducational Activities

____

Data Driven MEASURE/SPARC

____

Case Documentation

____

Building/Grade Level Meetings

____

Consultation

____

Teacher Support Team Meetings

____

Assessment

____

Classroom Guidance Lessons

____

Case Staffings

____

Other (Please list)

After having read this contract, all involved parties demonstrate their agreement to adhere to this contract by signing below. Please keep a copy of this contract for your records. Site Supervisor

Printed name: _____________________________________________ Signature: ___ _ _ _ _ __ Date: ____________ Telephone: Email:

Agency Director/ Principal

Printed name: _____________________________________________ Signature: Date: Telephone: Email:

Faculty Liaison

Printed name: _____________________________________________ Signature: ___ _ _ _ _ __ Date: ____________ Telephone: Email:

Candidate

Printed name: _____________________________________________ Signature: ___ _ _ _ _ __ Date: ____________ Telephone: Email:

Revised January 2016

17 Practicum/Internship Contract Addendum During time periods in the academic year when The University of Mississippi is not in session (i.e., August May), students may work at their sites and accrue hours if the following conditions are agreed upon: 1. The site agrees to provide sole supervision during these times. 2. The university agrees to provide back-up consultation as needed. 3. The site understands that, during these times, students are not under the jurisdiction of The University of Mississippi and the university assumes no responsibility to students including supervision, liability, and so forth, except as outlined above. 4. Students may accrue practicum/internship hours only if the above criteria have been met and written agreement has been documented below. After having read this contract addendum, all involved parties demonstrate their agreement to adhere to this contract by signing below. Please keep a copy of this contract for your records. Site Supervisor

Printed name: _____________________________________________ Signature: ___ _ _ _ _ __ Date: ____________ Telephone: Email:

Agency Director/ Principal

Printed name: _____________________________________________ Signature: ___ _ _ _ _ __ Date: ____________ Telephone: Email:

Faculty Liaison

Printed name: _____________________________________________ Signature: ___ _ _ _ _ __ Date: ____________ Telephone: Email:

Candidate

Printed name: _____________________________________________ Signature: ___ _ _ _ _ __ Date: ____________ Telephone: Email: ________________________

Revised January 2016

18 Practicum Basic Counseling Skills Feedback Sheet – R Student Name: Rater’s Name: On Site Supervisor Mid Semester

Practicum Instructor End of Semester

Student ID: Date: Doctoral Student Supervisor

GUIDELINES Please rate student performance on N/O = Not observed but not required by the situation each skill listed using the following 1 = Not observed when required by the situation 2 = Demonstrated rarely ratings: 3 = Demonstrated inconsistently 4 = Demonstrated consistently 5 = Demonstrated consistently and to a level of expertise normally indicative of one beyond this level of training/expertise

When giving a rating of 1, please indicate the reason using the feedback section. Attending Score

Qualified Ratings

Attending Avg.

ATTENDING Specific Skill 1. Body Language & Appearance Maintains open, relaxed, confident posture. Leans forward when talking. Maintains professional dress. 2. Eye Contact Maintains appropriate eye contact. 3. Minimal Encouragers Uses prompts (uh huh, okay, right) to let the client know s/he is heard. Uses silence helpfully. Uses nods and body gestures to encourage client to talk. 4 Vocal Tone Matches the sense of the session and session goals. Vocal tone communicates caring and connection with the client. 5. Verbal Tracking Staying on topic that client presents. Repeats key words or phrases. Basic Listening Score

Qualified Ratings

Rating N/ O

1

2

3

4

5

N/ O

1

2

3

4

5

N/ O

1

2

3

4

5

N/ O

1

2

3

4

5

N/ O

1

2

3

4

5

Basic Listening Avg.

BASIC LISTENING Specific Skill 6. Selective Attending Selectively attend to key aspects of client communication. 7. Directions and Encouraging Client to Talk Uses “tell me more…about” or similar statements that encourage the client to talk about specific aspects of the client’s communication. 8. Paraphrasing (Reflections of Content) Engages in brief, accurate, and clear rephrasing of what the client has expressed. 9. Reflecting Feeling/Meaning States succinctly the feeling experienced by the client (You feel or You feel when Feeling/Meaning statements are personalized to the client in “you feel” statements. 10. Summarizing Makes statements at key moments in the session that capture the overall sense of what client has been expressing.

Rating N/ O

1

2 3

4

5

N/ O

1

2 3

4

5

N/ O

1

2 3

4

5

N/ O

1

2 3

4

5

N/ O

1

2 3

4

5

Revised January 2016

19 Rater’s Name:

Student Name: Deepening Session Score

Qualified Ratings

Date: Deepening Session Avg.

DEEPENING THE SESSION Specific Skill 11. Using Immediacy Recognizes here-and-now feelings, expressed verbally or nonverbally, of the client or the counselor. Can be related to the counselor-client relationship (“As we talk about ,I sense you are feeling . I’m feeling about how you are viewing the problem right now.”) 12. Challenging/Pointing Out Discrepancies Expresses observations of discrepancies (“You expect yourself to do when facing the problem of but you do instead. When this happens, you feel about yourself.”)

Total Score Tape Review

Rating N / O

1

2

3

4

5

N / O

1

2

3

4

5

Qualified Ratings Pass Approved to proceed to COUN 695

Feedback (only necessary if is given)

For more information regarding the validity and reliability of the items on this scale, the authors refer you to Eriksen, K & McAuliffe, G. (2003). A measure of counselor competency. Counselor Education and Supervision, 43, p. 120-133.

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20

Professional Counseling Performance Evaluation – R Student: Student ID: Semester/Year:

Mid-Sem

End-Sem

N/O = Not observed but not required by the situation 1 = Not observed when required by the situation 2 = Demonstrated rarely 3 = Demonstrated inconsistently 4 = Demonstrated consistently 5 = Demonstrated consistently and to a level of expertise normally indicative of one beyond this level of training/expertise

Course Number: Evaluator: Counseling Skills and Abilities

N

1

2

3

4

5

1. Demonstrates the ability to establish a therapeutic, working relationship 2. Demonstrates therapeutic communication skills including: A. Immediacy – recognizes the here and now B. Timing – responds at the optimal moment C. Intentionality – responds appropriately and with a clear therapeutic purpose D. Self-disclosure – skillful and carefully-considered for a specific therapeutic purpose 3. Demonstrates empathic responses A. Non-verbal communication – demonstrates effective use of head, eyes, hands, feet, posture, voice, attire, etc. B. Responding to content – reflects the primary elements of the client’s story C. Understands context – understands the uniqueness of the story elements and their underlying meanings D. Congruence – genuineness; external behavior consistent with internal affect E. Responds to feelings – acknowledges & responds to client affect therapeutically 4. Uses appropriate procedures for assessing risk of suicide or harm to self/others

5. Uses appropriate procedures for managing risk of suicide or harm to self/others 6. Uses appropriate procedures in screening for substance abuse/dependency 7. Collaborates with the client to establish clear therapeutic goals 8. Regularly check on client’s progress toward goals 9. Matches appropriate interventions to presenting clinical profiles in a theoretically consistent manner 10. Demonstrates multicultural competencies 11. Demonstrates analysis and resolution of ethical dilemmas 12. Keeps appropriate client records with accuracy and confidentiality 13. Maintains a current list of community resources and facilitates client access to those resources as appropriate

Revised January 2016

21 Student: Evaluator: Sem/Year: 14. Sets and maintains appropriate boundaries in the professional relationship (meeting time and place, session time limits, etc.)

MidTerm Final

15. Demonstrates skill in collecting and using the results of assessments for treatment planning or referral. (See Below) A. Intake interviews B. A mental status exam C. A biopsychosocial history D. A mental health history E. An education/work/career history 16. Properly assesses the traumatic effects of crises and disasters and treats or refers trauma clients as appropriate 17. Uses current research and program evaluation data to shape and improve her/his practice as a counselor 18. Selects assessment instruments that are appropriate for clients’ demographics and presenting profiles and the student’s training and experience

Professional Responsibility

N

1

2

3

4

5

N

1

2

3

4

5

N

1

2

3

4

5

19. Behaves ethically so as to promote confidence in the counseling profession 20. Promotes wellness and mental health through prevention, education, and/or advocacy activities 21. Relates to peers, professors, supervisors, and others according to professional standards 22. Advocates for services and resources appropriate for her/his client’s individual needs 23. Demonstrates sensitivity to real and ascribed power differences between themselves and clients, and does not exploit or mislead clients or others during or after professional relationships 24. Demonstrates application of legal requirements relevant to counseling training and practice

Competence 25. Demonstrates basic cognitive, affective, sensory, and motor capacities to respond therapeutically to clients 26. Recognizes the boundaries of her/his particular competencies and limits her/himself to providing only those services and applying those techniques for which she/he is qualified by education, training, and experience 27. Takes responsibility for compensating for her/his deficiencies 28. Assures client welfare when encountering the boundaries of her/his expertise

Maturity 29. Demonstrates appropriate self-control (such as anger control, impulse control) in interpersonal relationships with faculty, supervisors, peers, and clients 30. Demonstrates honesty, fairness, and respect for others 31. Demonstrates an awareness of his/her own belief systems, values, needs, and limitations and the effect of these on her/his work 32. Receives, integrates, and utilizes feedback from peers, teachers, and supervisors

Revised January 2016

22 33. Is appropriately self-assured, confident, and trusting in his/her abilities Student: Evaluator: Sem/Year: 34. Follows professionally recognized conflict resolution process, seeking to informally address the issue first with the individual(s) with whom the conflict exists

Integrity

MidTerm

N

1

2

3

4

Final

5

35. Refrains from making statements which are false, misleading or deceptive 36. Avoids improper and potentially harmful dual relationships 37. Demonstrates respect for the fundamental rights, dignity, and worth of all 38. Respects the rights of individuals to privacy, confidentiality, and choices regarding self-determination and autonomy 39. Respects cultural, individual, and role differences

Comments:

Revised January 2016

23 Multicultural Awareness, Knowledge, and Skills Survey – Counselor Edition-Revised (MAKSS-CE-R) Student Name: Student ID: Semester/Year: Please indicate one that best describes you

1 very limited

2 limited

3 good

4 excellent

1 very limited

2 limited

3 good

4 excellent

1. How would you rate your ability to effectively consult with another mental health professional concerning the mental health needs of a client whose cultural background is significantly different from your own? (C.D2; S.D1, F1) 2. How would you rate your ability to accurately assess the mental health needs of men? (C.D2; S.D1, F1) 3. How would you rate your ability to accurately assess the mental health needs of women? (C.D2; S.D1, F1) 4. How well would you rate your ability to accurately assess the mental health needs of lesbian women? (C.D2; S.D1, F1) 5. How well would you rate your ability to accurately assess the mental health needs of gay men? (C.D2; S.D1, F1) 6. How well would you rate your ability to accurately assess the mental health needs of older adults? (C.D2; S.D1, F1) 7. How well would you rate your ability to accurately assess the mental health needs of persons who come from very poor socioeconomic backgrounds? (C.D2; S.D1, F1) 8. How would you rate your ability to identify the strengths and weaknesses of psychological tests regarding their use w/persons from different cultural/racial/ethnic backgrounds? (C.H1) 9. How would you rate your ability to accurately assess the mental health needs of individuals with disabilities? (C.D2; S.D1, F1) 10. How well do you effectively secure information and resources to better serve culturally different clients? (C.D2; S.D1, F1) 11. At the present time, how would you rate your understanding of the following term? “ethnicity” (C.D2; S.D1, F1) 12. At the present time, how would you rate your understanding of the following term? “culture” (C.D2; S.D1, F1) 13. At the present time, how would you rate your understanding of the following term? “multicultural” (C.D2; S.D1, F1) 14. At the present time, how would you rate your understanding of the following term? “prejudice” (C.D2; S.D1, F1) 15. At the present time, how would you rate your understanding of the following term? “racism” (C.D2; S.D1, F1) Please indicate one that best describes you 16. At the present time, how would you rate your understanding of the following term? “transcultural” (C.D2; S.D1, F1) 17. At the present time, how would you rate your understanding of the following term? “pluralism” (C.D2; S.D1, F1) Student Name:

Student ID:

Sem/Yr: Revised January 2016

24 18. At the present time, how would you rate your understanding of the following term? “mainstreaming” (C.D2; S.D1, F1) 19. At the present time, how would you rate your understanding of the following term? “cultural encapsulation” (C.D2; S.D1, F1) 20. At the present time, how would you rate your understanding of the following term? “contact hypothesis” 21. At this time in your life, how would you rate yourself in terms of understanding how your cultural background has influenced the way you think and act? 22. At this point in your life, how would you rate your understanding of the impact of the way you think and act when interacting with persons of different cultural backgrounds? 23. How well do you think you could distinguish “intentional” from “accidental” communication signals in a multicultural counseling situation? Please indicate one that best describes your opinion

1 very limited

2 limited

3 good

4 excellent

24. Promoting a client’s sense of psychological independence is usually a safe goal to strive for in most counseling situations. 25. Even in multicultural counseling situations, basic implicit concepts such as “fairness” and “health” are not difficult to understand. (C.F3) 26. In general, counseling services should be directed toward assisting clients to adjust to stressful environmental situations. 27. While a person’s natural support system (i.e., family, friends, etc.) plays an important role during a period of personal crisis, formal counseling services tend to result in more constructive outcomes. 28. The human service professions, especially counseling and clinical psychology, have failed to meet the mental health needs of ethnic minorities. 29. The effectiveness and legitimacy of the counseling profession would be enhanced if counselors consciously supported universal definitions of normality. (C.F3) 30. Racial and ethnic persons are underrepresented in clinical and counseling psychology. 31. In counseling, clients from different ethnic/cultural backgrounds should be given the same treatment that White mainstream clients receive. (C.D5) 32. The criteria of self-awareness, self-fulfillment, and selfdiscovery are important measures in most counseling sessions. 33. The difficulty with the concept of “integration” is its implicit bias in favor of the dominant culture. (C.D5)

Revised January 2016

25 Career Adapt-Abilities Inventory USA Version

Student:

Student ID #

Course Completed:

Directions: Different people use different strength to build their careers. No one is good at everything, each of us emphasize some strengths more than others. Please circle your rating of how strongly you have developed each of the following abilities using the scale below.

Please indicate one that best describes you 1. Planning important things before I start

5

4

3

2

1

Strongest

Very Strong

Strong

Somewhat strong

Not strong

5 5

4 4

3 3

2 2

1 1

5 5 5 5

4 4 4 4

3 3 3 3

2 2 2 2

1 1 1 1

5 5 5 5

4 4 4 4

3 3 3 3

2 2 2 2

1 1 1 1

5 5

4 4

3 3

2 2

1 1

18. Directing my future

5 5 5 5 5 5

4 4 4 4 4 4

3 3 3 3 3 3

2 2 2 2 2 2

1 1 1 1 1 1

19. Learning how to make better decisions

5

4

3

2

1

20. Doing what’s right for me

5

4

3

2

1

21. Doing what’s best for my family 23. Taking charge of my future

5 5 5

4 4 4

3 3 3

2 2 2

1 1 1

24. Exploring my surroundings

5

4

3

2

1

25. Looking for opportunities to grow as a person

5 5 5 5

4 4 4 4

3 3 3 3

2 2 2 2

1 1 1 1

5 5 5

4 4 4

3 3 3

2 2 2

1 1 1

5 5 5

4 4 4

3 3 3

2 2 2

1 1 1

5 5

4 4

3 3

2 2

1 1

38. Feeling pride in a job well done

5 5

4 4

3 3

2 2

1 1

39. Having self-confidence

5

4

3

2

1

40. Being conscientious and doing things well 41. Learning new skills

5 5 5 5 5 5

4 4 4 4 4 4

3 3 3 3 3 3

2 2 2 2 2 2

1 1 1 1 1 1

2. Thinking about what my future will be like 3. Realizing that today’s choices shape my future 4. Expecting the future to be good 5. Preparing for the future 6. Becoming aware of the educational and vocational choices that I must make 7. Planning how to achieve my goals 8. Keeping upbeat 9. Considering the consequences of my decisions 10. Anticipating changes I must make 11. Concerned about my career 12. Making decisions by myself 13. Thinking before I act 14. Taking responsibility for my actions 15. Being persistent and patient 16. Sticking up for my beliefs 17. Counting on myself

22. Finding the strength to keep going

26. Imagining what my future will be like 27. Investigating options before making a choice 28. Observing different ways of doing things 29. Probing deeply into questions I have 30. Searching for information about choices that I must make 31. Becoming curious about new opportunities 32. Considering my alternatives 33. Seeking feedback about my plans 34. Questioning myself 35. Performing tasks efficiently 36. Learning from my mistakes 37. Being dependable—doing what I say I will do

42. Working up to my ability 43. Overcoming obstacles 44. Solving problems 45. Doing challenging things

Revised January 2016

26 Evaluation of Site Supervisor The University of Mississippi Counselor Education Candidate Name:

Student ID:

Site:

Evaluation Date:

Site Supervisor: Evaluation Period: From

To

Circle the number which best represents how you, the student counselor, feel about the supervision received. After the form is completed, the supervisor may suggest a meeting to discuss the supervision desired.

Poor

Ad equate

Good

Gives time and energy in observing, tape processing, and case conferences

1 2

3 4

5 6

Accepts and respects me as a person

1 2

3 4

5 6

Recognizes and encourages further development of my strengths and capabilities

1 2

3 4

5 6

Gives me useful feedback when I do something well

1 2

3 4

5 6

Provides me the freedom to develop flexible and effective counseling styles

1 2

3 4

5 6

Encourages and listens to my ideas and suggestions for developing my counseling skills

1 2

3 4

5 6

Provides suggestions for developing my counseling skills

1 2

3 4

5 6

Helps me to understand the implications and dynamics of the counseling approaches I use

1 2

3 4

5 6

Is spontaneous and flexible in the supervisory sessions

1 2

3 4

5 6

Helps me to define and achieve specific concrete goals for myself during the practicum experience

1 2

3 4

5 6

Gives me useful feedback when I do something wrong

1 2

3 4

5 6

Allows me to discuss problems I encounter in my practicum setting

1 2

3 4

5 6

Provides an adequate amount of attention to both me and my clients

1 2

3 4

5 6

Focuses on both verbal and nonverbal behavior in me and my clients

1 2

3 4

5 6

Helps me define and maintain ethical behavior in counseling and case management

1 2

3 4

5 6

Encourages me to engage in ethical behavior

1 2

3 4

5 6

Revised January 2016

27 Poor

Ad equate

Good

Maintains confidentiality in material discussed in supervisory sessions

1 2

3 4

5 6

Deals with both content and affect when supervising

1 2

3 4

5 6

Focuses on the implications, consequences, and contingencies of specific behaviors in counseling and supervision

1 2

3 4

5 6

Helps me organize relevant case data and in planning goals and strategies with my clients

1 2

3 4

5 6

Helps me to formulate a theoretically sound rationale of human behavior

1 2

3 4

5 6

Offers resource information when I request or need it

1 2

3 4

5 6

Helps me develop increased skill in critiquing and gaining insight from my counseling tapes

1 2

3 4

5 6

Allows and encourages me to evaluate myself

1 2

3 4

5 6

Explains his/her criteria for evaluation clearly and in behavioral terms

1 2

3 4

5 6

Applies his/her criteria fairly in evaluating my counseling

1 2

3 4

5 6

ADD I T I O NA L C O M M E N T S AND /O R S U G G E ST I O N S

Practicum/Internship Student

Date

My signature indicates that I have read the above report and have discussed the content with my supervisee. It does not necessarily indicate that I agree with the report in part or in whole.

Site Supervisor

Date Used with permission of Accelerated Development Press (1995)

Revised January 2016

28 Evaluation of Site The University of Mississippi Counselor Education Candidate Name:

Student ID:

Site:

Site Supervisor:

Evaluation Date: Evaluation Period: From

To

1 = Very Unsatisfied 2 = Moderately Unsatisfied

3 = Moderately Satisfied 4 = Very Satisfied

Rate the statements below concerning your site and experiences using the following rating scale: Amount of supervision Quality and usefulness of on-site supervision Usefulness and helpfulness of faculty liaison Relevance to career goals Exposure to and communication of school/agency goals Exposure to and communication of school/agency policies Exposure to information about community resources Rate all applicable experiences that you had at the site: Report writing Intake interviewing Administration and interpretation of tests Staff presentation/case conferences Individual counseling Group counseling Family/couples counseling Classroom guidance lessons Psychoeducational activities Consultation Career counseling Child/adolescent counseling Play therapy Other COMMENTS: Include any comments or suggestions for improvement in the experiences you have rated moderately to very unsatisfied. You may use the back of this form for additional space.

Revised January 2016

29 Practicum/Internship Site Visitation Form

Site Name:

Date:

Candidate Name:

Student ID:

Course: COUN 693

695

Semester: Fall

Spring

Site Supervisor: The supervisor: a. conducts supervision sessions with intern

yes

no

Comments:

b. conducts one-one weekly supervision

yes

no

Comments:

c. views video recordings of sessions

yes

no

Comments:

d. completes written evaluations

yes

no

Comments:

e. is able to provide adequate space for counseling

yes

no

Comments:

f. other

yes

no

Comments:

The supervisor recommends the following:

The supervisor assesses the counseling student as progressing on a 1-10 scale (progress rated as: 1-not at all, 10-very well, and 5-on schedule): 1 2 3 4 5 6 7 8 9 10

The supervisor would like assistance with:

Site Supervisor/Date

Practicum/Internship Instructor/Date

Revised January 2016

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