Clinical Training Manual Department of Psychology Suffolk University Fall, 2014

Transcription

Clinical Training Manual Department of Psychology Suffolk University Fall, 2014
Clinical Training Manual
Department of Psychology
Suffolk University
Fall, 2014
Contents
Introduction ......................................................................................................................... 4
Structure of Practicum Training ....................................................................................................... 4
Pre-Requisites to Practicum Training ................................................................................. 5
Standing in the Program ....................................................................................................................... 5
Completion of Clinical Psychology Lab (CPL) ............................................................................. 5
Professional Readiness .......................................................................................................................... 5
CORI Check .................................................................................................................................................. 6
HIPPA Training .......................................................................................................................................... 6
Liability Insurance ................................................................................................................................... 6
Practicum IA & IB .............................................................................................................. 7
Schedule ........................................................................................................................................................ 7
Sites ................................................................................................................................................................. 7
May Institute CrossRoads Day Treatment Program........................................................... 8
Newton Public Schools ..................................................................................................................... 8
Center for Anxiety Related Disorders (CARD) ...................................................................... 8
McLean Hospital- Obsessive Compulsive Disorders Institute ....................................... 8
Suffolk University Counseling Center ........................................................................................ 9
Practicum Class ......................................................................................................................................... 9
Practicum IIA & IIB ......................................................................................................... 10
Schedule ..................................................................................................................................................... 10
Sites .............................................................................................................................................................. 10
Beth Israel Deaconess Medical Hospital—Department of Neurology .................... 11
Bradley Hospital—Adolescent Unit......................................................................................... 11
Brigham and Women's Outpatient Psychiatry Department ........................................ 11
Center for Anxiety Related Disorders (CARD) ................................................................... 11
2
The Manville School at Judge Baker Children’s Center .................................................. 12
National Autism Center, May Institute, Randolph, MA................................................... 12
Neuropsychology Assessment Center, BIDMC—Department of
Psychiatry... 12
Brigham and Women's Outpatient Psychiatry Department ........................................ 12
The Walker School, Needham, MA ........................................................................................... 13
Practicum Class ...................................................................................................................................... 13
Advanced Practicum ......................................................................................................... 13
Pre-requisites to advanced practicum training ...................................................................... 14
Schedule ..................................................................................................................................................... 14
Tuition ........................................................................................................................................................ 14
Resources for finding practicum sites ......................................................................................... 15
Criteria for Advanced Practicum Sites ........................................................................................ 15
Applications and Interviews ............................................................................................................ 16
Clinical Affiliation Agreements ....................................................................................................... 16
Final Steps ................................................................................................................................................. 17
Registration .............................................................................................................................................. 17
Summer Advanced Practicum........................................................................................... 17
Tracking Clinical Hours.................................................................................................... 18
Evaluations ........................................................................................................................ 18
Program-Sanctioned Work Experiences ........................................................................... 20
Appendix A: Student Time Table for Practicum-Related Activities ................................ 21
3
Introduction
Structure of Practicum Training
Respecialization students please note: for timelines and pre-requisites you must refer to
the respecialization manual.
Students begin their official practicum training in the fall of their second year. All
students are required to complete at least two years of practicum training, though nearly
all elect to do an optional summer or third year prior to applying for pre-doctoral
internship.
In order to ensure the best clinical training possible, the two required years of practicum
training are almost exclusively with partner sites that have an ongoing relationship with
the Suffolk doctoral program. For the first year of practicum, the doctoral program
identifies positions for Suffolk students, and the students are then asked to rank order
their preferences before practicum recommendations are made by the Clinical Training
Coordinator (CTC). Sites interview students to ensure their appropriateness for their
setting. The benefits of this system are that students are assured of well-known quality
training sites in the early stages of their training, their supervisors are in regular contact
with the Director of Clinical Training (DCT) and the Clinical Training Coordinator
(CTC), and the content of practicum are aligned with the program mission and emphases.
For the second year of practicum, the program identifies training opportunities that will
continue to assure students of quality training appropriate to this stage of their training.
With guidance from the program, students then apply to, and are interviewed by, these
sites. Students who elect to do a third year of practicum training secure sites on their own
that fit their emerging areas of specific interest or best broaden their training prior to
internship. Practicum sites at all levels, including advanced, must meet program approval
standards. During the two years of required practicum training, students take two yearlong practicum classes which serve to 1) integrate the external practicum training
experience with other elements of our program and 2) provide knowledge regarding
professional standards and ethics, diversity, treatment and assessment process and
outcome, consultation and supervision.
Students have a variety of faculty resources at Suffolk to help guide them through the
decisions they will need to make about practicum training. Students are encouraged to
talk throughout their graduate training about training goals with their research mentors
and to discuss how these goals interact with other academic and research interests and
responsibilities. In addition, the DCT and CTC work closely with students throughout the
practicum sequence.
4
Pre-Requisites to Practicum Training
Standing in the Program
Students are required to be in good standing within the program, to have successfully
completed all required first year courses (for Prac I) and required second year courses
(for Prac II). Please see the program manual for a description of satisfactory progress:
http://www.suffolk.edu/college/departments/15388.php (under “General Program
Documents”).
Completion of Clinical Psychology Lab (CPL)
Students are required to successfully pass PSYCH L718 and L720. The goal of these lab
courses is to provide students with an introduction and orientation to the Suffolk doctoral
program, to provide early training support, and to orient students to the field of clinical
psychology. Students will also work on developing basic clinical interviewing skills and
risk assessment skills through their role play assignments and didactics in CPL.
Respecialization students receive a summer orientation to clinical psychology in lieu of
registering for CPL, as they start prac I their first month in the program, but are welcome
to audit the lab.
Professional Readiness
Students should be aware of the need to uphold and protect the welfare of others and
develop an on-going mastery of the APA Ethical Principles and Code of Conduct
(http://www.apa.org/ethics/code/index.aspx).
Additionally, there are a number of professional competencies that have been established
within the field as being important benchmarks for practicum readiness. Thus we expect
students to demonstrate sufficient: (a) interpersonal and professional competence (e.g.,
the ways in which student-trainees relate to clients, peers, faculty, allied professionals,
the public, and individuals from diverse backgrounds or histories); (b) self-awareness,
self-reflection, and self-evaluation (e.g., knowledge of the content and potential impact of
one's own beliefs and values on clients, peers, faculty, allied professionals, the public,
and individuals from diverse backgrounds or histories); (c) openness to processes of
supervision (e.g., the ability and willingness to explore issues that either interfere with the
appropriate provision of care or impede professional development or functioning); and
(d) resolution of issues or problems that interfere with professional development or
functioning in a satisfactory manner (e.g., by responding constructively to feedback from
supervisors or program faculty; by the successful completion of remediation plans; by
participating in personal therapy in order to resolve issues or problems by maintaining
proper self-care).
These expectations are in no way meant to discourage students from disclosing struggles
in these areas to faculty or from seeking assistance (from within the department or from
outside sources) to improve in these areas. In fact, we believe essential components of
professionalism are the abilities to self-reflect on areas of needed growth and to access
the needed resources to prevent their interference with professional activities and growth.
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More information on competency benchmarks can be found at
http://www.apa.org/ed/graduate/competency.aspx. More information on how we assess
these competencies can be found in the program manual at
http://www.suffolk.edu/college/departments/15388.php (under “General Program
Documents”).
CORI Check
Students should be aware that a practicum site may require that they submit a Criminal
Offender Record Information (CORI) check by the State of Massachusetts. A personal
copy of your CORI can be obtained by paying a $25.00 fee and completing the following
application available at http://www.massresources.org/cori.html#getcopy. Suffolk’s
Psychology Department does not conduct CORI checks.
Students should also be aware that the CORI process can take several weeks (especially
during summer and fall when many camps and schools are conducting CORIs) and many
sites will not let a student start until the CORI results are turned in.
HIPPA Training
Students must complete the online HIPPA training series, pass the online quiz and submit
documentation of completion to Jessica Festa by October 1, 2014, or before beginning
clinical training, whichever comes first. For respecialization students, the deadline for
completion is September, 1. 2014. The link to the required online HIPPA course is:
http://www.discoveringhipaa.com/login. Log-in information will be emailed directly to
first year students following orientation day.
Liability Insurance
Suffolk University carries liability insurance for students participating in practica and
internships. Although the Suffolk insurance policy is adequate for most liability needs,
clinical activities engaged in outside of Suffolk University’s direct supervision, yet part
of doctoral training, may not be covered under Suffolk’s blanket liability insurance
policy. Therefore, students are required to purchase personal malpractice insurance to
supplement this policy. Once obtained, this insurance policy should be sustained
throughout the student’s entire doctoral training.
We require that students take out personal liability insurance at $1,000,000 each incident/
$3,000,000 annual aggregate. The annual premium of this insurance is approximately
$35. The coverage will protect students for all internship and practicum work that is done
while under supervision of the school for the period of one year. Students are encouraged
to review all details of their specific policy. Professional liability insurance is offered via
APA by the Trust. An application and detailed information can be found at
http://www.apait.org/apait/products/studentliability/ . Students with additional questions
can contact Trust Risk Management Services at 1-877-637-9700, 8:00 AM – 7:00 PM
CST, Mon-Fri. or send an email to apait_info@nnng.com. In order to be eligible for
liability insurance coverage students must be an APA member. The APA Student
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Affiliate membership fee for graduate students is $55. For information, call APA
Membership at 800-374-2721, or visit
http://www.apa.org/membership/student/index.aspx to sign up directly.
Proof of Liability Insurance must be submitted to Department staff by August 15th prior
to the start of fall practicum. If a student will be starting practicum prior to the fall
semester, Proof of Liability Insurance must be submitted at least 15 days prior to the start
of practicum training. (If a student wishes to purchase insurance through APA, they first
need to become a student member as described above. Students should take this into
consideration when considering this due date).
Practicum IA & IB
Schedule
Students must be making satisfactory progress in the program and be in good standing to
be eligible for Practicum I. The Departments Standards and Ethics (S&E) Committee
typically determines student status in this regard as needed. The information provided in
the annual progress review meetings can also be applied by the DCT and CTC to
determine a student’s readiness for practicum. Thus a student might not be under review
by S&E, and still be deemed ‘un-ready’ for clinical practicum.
First year practicum training (second year of the program) usually runs for 9-10 months
and the hours for each placement can vary between 12-16 hours per week. Some
practicum may run longer. Details regarding specific start and end dates and weekly
schedules are agreed upon by the student and site supervisor at the time of official
placement and are then documented in Clinical Training Agreement, available on the
Doctoral Program Resources blackboard site (under the “Clinical Training Resources &
Forms” tab). Please note that the regular days and times you are scheduled to be at
practicum should not be rearranged to meet your outside work schedule, personal
preference or even site-related demands without permission from the Clinical Training
Coordinator. Our courses (graduate and undergraduate) are scheduled based on the
information we have about when students are on site at practicum and changes that
may seem to work on the surface often interfere with a student’s ability to fulfill
course, TA or other departmental responsibilities. With approval of the DCT and CTC,
a student may also extend their training at the site into the summer. The deadline for
submission of this document, and the deadlines for other practicum-related forms can be
found in the “Student Time Table for Practicum-Related Activities” (see Appendix A).
Sites
Each year we review our existing practicum training sites to ensure that the opportunities
available meet the needs of our existing students. Thus, the selection of sites may shift
somewhat from year to year. For the past several academic years, practicum I training
has taken place at one of five Practicum I sites (note that some sites are listed as both
Prac I and Prac II as these sites are appropriate for both.). Each practicum experience is
consistent with the training goals of the Suffolk University doctoral program. In order to
qualify as a practicum I site, we require that the site agree to provide face-to-face
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supervision at a ratio of 1 hour of supervision to every 4 hours of direct clinical work,
with a minimum of 2 hours per week of supervision. One of these supervision hours may
be group supervision. A licensed psychologist has supervisory responsibility for the
entire practicum experience, and must provide one of the hours of supervision, but other
supervision may be provided by other allied mental health professionals. We only use
sites that understand the supervisory responsibility in training novices and are willing to
work in a collaborative manner with Suffolk University. Most of our affiliated sites also
have didactic seminars that supplement the on-site training, but this is not required.
May Institute CrossRoads Day Treatment Program
Practicum students are placed at this day treatment program that provides a
continuum of care between outpatient and partial or full hospitalization. The
program serves adults with severe psychiatric and developmental disabilities.
Students are responsible for leading several therapy groups, and attend team
treatment planning and case management meetings. Students also meet with
clients individually providing on-going support for the program and case
management.
Newton Public Schools
Practicum students are placed at elementary or middle schools within the Newton
Public School System. Students provide services to school-aged children with
behavioral and emotional issues, issues related to academic performance, autismspectrum disorders as well as children in need of assessment for learning
disabilities. Depending on the site, students provide a mix of individual
assessment, individual psychotherapy and/or implement group/classroom
intervention and prevention programs aimed at topics such as relational and
physical aggression and acceptance of diversity.
Center for Anxiety Related Disorders (CARD)
Practicum students are an integrated part of this training clinic run by the doctoral
program at Boston University. Trainees conduct diagnostic interviews and
provide individual and group therapy. Trainees also attend didactic seminars and
case conferences. Individual supervision is provided by Suffolk or CARD
faculty.
McLean Hospital- Obsessive Compulsive Disorders Institute
Practicum students train in this residential treatment facility for individuals with
severe and refractory OCD. The primary clinical opportunity for students is to get
training and experience as a behavioral coach using Exposure and Response
Prevention (ERP) with OCD patients. In addition to individual supervision,
students have weekly group supervision and may attend clinical rounds and
didactic seminars. Opportunities for observing and co-leading groups are also
available.
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Suffolk University Counseling Center
Practicum students are an integrated part of the Counseling Center at Suffolk
University. Trainees conduct diagnostic interviews, and provide individual and
group therapy. Trainees also work with Center staff in responding to mental
health crises, and in providing consultation to other parts of the university
community.
Practicum Class
Students participating in Practicum I register for PSYCH 738 Clinical Practicum &
Ethics IA in the fall and PSYCH 739 Clinical Practicum & Ethics IB in the spring. These
courses are taught by Suffolk University faculty and they are designed to help students
apply their academic knowledge to their work in the field. These courses focus on
beginning clinical skills and provide an overview of the legal, ethical, and professional
issues currently facing psychologists in practice. Particular attention is paid to matters of
confidentiality/mandated reporting, informed consent, conflicts of interest, boundary
issues including sexual involvement, and limits of professional competence. Additionally,
the effective use of clinical supervision, the development of clinical writing skills and
beginning case conceptualization and treatment planning are covered in this seminar.
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Practicum IIA & IIB
Schedule
Students must be making satisfactory progress in the program and be in good academic
standing to be eligible for Practicum II. The Departments Standards and Ethics
Committee typically determines student status in this regard as needed, but as previously
stated, annual progress review data can be applied to this determination independently of
an S&E process.
Second year practicum training usually runs 9 months (late August through late May- and
in some cases into June), with up to 20 hours of placement per week. Details regarding
specific start and end dates and weekly schedules are agreed upon by the student and site
supervisor at the time of official placement and are then documented in the Clinical
Training Agreement. Please note that the regular days and times you are scheduled to
be at practicum should not be rearranged to meet your outside work schedule, personal
preference or even site-related demands without permission from the coordinator of
clinical training. Our courses (graduate and undergraduate) are scheduled based on
the information we have about when students are on site at practicum and changes
that may seem to work on the surface often interfere with a student’s ability to fulfill
course, TA or other departmental responsibilities. With the approval of the DCT and
CTC, a student may extend the training at their site into the summer. The deadline for
submission of this document, and the deadlines for other practicum-related forms can be
found in the “Student Time Table for Practicum-Related Activities” (see Appendix A).
Sites
Each year we review practicum training sites to ensure that the opportunities available
meet the needs of our existing students. Thus, the sites we recommend may shift
somewhat from year to year. For the past several academic years, practicum II training
has taken place at one of nine Practicum II sites. Although each student individually
applies to and interviews at practicum sites, each practicum experience must be
consistent with the training goals of the doctoral program and offer clinical experiences at
a more advanced level than Practicum I sites. In order to qualify as a practicum II site, we
require that the site agree to provide face-to-face supervision at a ratio of 1 hour of
supervision to every 4 hours of direct clinical work. One supervision hour may be
provided in the form of group supervision. A licensed psychologist has supervisory
responsibility for the entire practicum experience, and must provide one of the hours of
supervision, but other supervision may be provided by other allied mental health
professionals. We only approve sites that understand the supervisory responsibility in
training novices and are willing to work in a collaborative manner with Suffolk. Most of
these sites also have didactic seminars that supplement the on-site training, but this is not
required.
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Beth Israel Deaconess Medical Hospital—Department of
Neurology
Practicum students are placed in the Department of Neurology at this Boston
teaching hospital. Students are involved in the neuropsychological evaluation of
adult patients with a variety of neurological problems including learning and
attention disorders, head injury, stroke, multiple sclerosis, epilepsy, and
neurodegenerative disorders. The practicum students will gain skills in all areas of
neuropsychological evaluation, including interviewing, testing, scoring, report
writing, and feedback to patients. Additional experience may be obtained in
running cognitive remediation groups, presenting patients at weekly rounds, and
participation in didactic seminars. Students requesting additional intervention
experience have had the experience of providing individual cognitive
rehabilitation.
Bradley Hospital—Adolescent Unit
Second year practicum students will train as part of a multidisciplinary team on an
inpatient psychiatric unit that treats high-risk adolescents (ages 12-18). The
trainee will manage two groups a day: a skills-based group (i.e. anger
management, emotion regulation) and a process group, as well as providing
individual therapy with 1-2 patients a week. Trainees also attend a team meeting
with psychiatrists, nurses, psychologists, and social workers where we discuss
current treatment plans and the status of each patient on the unit are discussed.
There are opportunities to engage with a wide range of issues from substance
abuse and aggression to eating disorders, psychosis, and conversion disorder
providing a diverse experience in conceptualization and treatment.
Brigham and Women's Outpatient Psychiatry Department
Practicum students are placed in the outpatient division of this Department of
Psychiatry of this major Boston teaching hospital. The students are an integrated
part of the training clinics run by the psychiatry department at B & W's hospital.
Students are members of the diagnostic and interviewing team during morning
and afternoon clinics and are responsible for writing up intake evaluations.
Trainees also carry a caseload of individual clients most of whom present with
anxiety and depressive disorders and with whom they conduct cognitivebehavioral therapy. Trainees also attend case conferences and didactic seminars.
Center for Anxiety Related Disorders (CARD)
Practicum students are an integrated part of this training clinic run by the doctoral
program at Boston University. Trainees conduct diagnostic interviews and
provide individual and group therapy. Trainees also attend didactic seminars and
case conferences. Individual supervision is provided by Suffolk or CARD
faculty.
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The Manville School at Judge Baker Children’s Center
Practicum students are placed at this therapeutic day school that is part of a larger,
interdisciplinary, integrative Center that works with children and families.
Students work with children ages 5-16 with emotional, neurological or learning
difficulties that have impacted their ability to succeed in other school settings.
Trainees provide direct therapy interventions and are the case manager for each
student in their caseload. The case manager coordinates the service planning and
service delivery of a student’s interdisciplinary Manville team. The case manager
also facilitates communication between Manville staff and any outside providers
working with the child and family.
National Autism Center, May Institute, Randolph, MA
Trainees primarily perform comprehensive diagnostic evaluations to rule out
autism spectrum disorders. Practicum students work with a team of psychologists
and post-graduate trainees. Responsibilities include: conducting in-depth semistructured family interviews, administering and scoring intellectual and other
psychological tests, report preparation, and contribution to feedback sessions.
Students also have the opportunity to observe and receive training on the ADOS
(autism-specific diagnostic assessment).There may also be opportunities for
individual therapy cases as well as parent support groups.
Neuropsychology Assessment Center, BIDMC—Department of
Psychiatry
Trainees develop and refine skills in neuropsychological assessment of adult
outpatients. Trainees will get experience assessing a range of psychiatric and
neurological conditions, including dementia, degenerative disorders, ADHD,
learning disabilities, development disorders and traumatic brain injury. Trainees
receive supervised experience in diagnostic interviewing, planning test selection,
implementing, interpreting, writing up and communicating results of
neuropsychological evaluation using a broad range of tests and procedures. In
addition to individual case supervision, training will occur through didactic
seminars.
Brigham and Women's Outpatient Psychiatry Department
Practicum students are an integrated part of the training clinics run by the
psychiatry department at B & W's hospital. Students are members of the
diagnostic and interviewing team during morning and afternoon clinics and are
responsible for writing up intake evaluations. Trainees also carry a caseload of
individual clients most of whom present with anxiety and depressive disorders
and with whom they conduct cognitive-behavioral therapy. Trainees also attend
case conferences and didactic seminars.
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The Walker School, Needham, MA
Trainees participate in clinical work with children and families, including
individual and family therapy, clinical assessment, social skills and issue-oriented
group therapy, and milieu consultation. The Walker School is an academic
program for children between the ages of 5 and 13 with developmental difficulties
including learning disabilities, chronic mental illness, language disorders, highfunctioning autism spectrum disorders, and histories of high-risk behaviors.
Students at Walker School also may have suffered from severe trauma, histories
of sexual, physical, or emotional abuse, disrupted foster placements, failed
adoptions, or psychiatric hospitalizations. Several seminars are also held weekly
to expose trainees to the range of theoretical, multidisciplinary approaches offered
at Walker.
Practicum Class
Students participating in Practicum II register for PSYCH 740 Clinical Supervision and
Consultation IIA in the fall and PSYCH 741 Clinical Supervision and Consultation IIB in
the spring. The purpose of his course is to build on the information; skills and techniques
students have been developing in their practicum experiences that are required for
effective and ethical clinical work. The course focuses on building alliances and
engaging with clients, history-taking and diagnostic interviewing. Special emphasis is
also placed on case conceptualization and treatment planning as well as the development
of clinical writing skills and report preparation. In addition, this class provides a
framework for understanding supervision and consultation as these relate to clinical
practice. Discussions are rooted in assigned readings and current practicum experiences.
.
Advanced Practicum
Doctoral students may choose to complete one or more years of practicum placement
following the successful completion of Practicum I and II. Given the realities of
internship placement competition, an advanced practicum has become the rule for most
students, but it is not a program requirement. For students emphasizing a
research/teaching trajectory, there may be advantages to emphasizing time in the
laboratory over the advanced practicum. A student considering doing an advanced
practicum should first discuss this possibility with his/her research mentor. The decision
about whether or not to pursue an advanced practicum (and which type) should be
informed by a number of highly individualized factors such as previous clinical
experience, the need for specialized training, the longer-term career focus, and current
progress on research and other program requirements. Since approval for an advanced
practicum ultimately must be obtained from both your research mentor and the DCT, it is
critical that students begin the process of obtaining approval for an advanced practicum
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early and adequately prepare for the process. The Intent to Apply for Advanced Clinical
Training form (found on the “Doctoral Program Resources” blackboard site under the
Clinical Training & Resources tab) which must be signed by both the student and his or
her research mentor, is due by December 15th.
Pre-requisites to advanced practicum training
As with other practica, the Department S & E Committee can determine student advanced
practicum eligibility.
Advanced practicum is an elective course. Thus, it should not take priority over other
program requirements. Students are expected to have successfully completed all required
courses and to be making satisfactory progress in their research in order to participate in
advanced practicum training. If a student is not making satisfactory progress in either the
academic or research domain, they may be required to address these deficits before being
approved for practicum training.
Schedule
Students complete no more than 20 hours per week of placement service in order to
ensure adequate progress in other program domains (although fewer hours per week is
permissible). The specific number of hours is negotiated by each student with the site (or
sites, if a student is at more than one site) and documented in the Clinical Training
Agreement form that can be found on the Doctoral Program Resources blackboard site
(under the “Clinical Training Resources & Forms” tab). Students who wish to engage in
more than 20 hours per week of placement services must have specific approval from
their research mentor and the Clinical Training Coordinator.
Tuition
Students are required to register for both PSYCH 777 and PSYCH 000 for both the fall
and spring semesters of their first year of advanced practicum training. Students who seek
a second year of advanced practicum training after successfully completing two
semesters of this course are not required to register for PSYCH 777. However, students
must still:
•
Be in good standing and making satisfactory progress in all domains
•
Have current liability insurance on file with the department
•
Complete the Intent to Apply for Advanced Clinical Training form (found
on the Doctoral Program Resources blackboard site under “Clinical Training
Resources & Forms” tab) by December 15th.
•
Submit the Clinical Training Agreement by April 1st.
•
Have appropriate supervisor paperwork on file (we will contact your
supervisor to gather this information once the Clinical Training Agreement
is submitted).
•
Enter hours into MyPsychTrack
•
Submit signed evaluations at the end of each semester
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Resources for finding practicum sites
Students typically seek out advanced training sites that are consistent with their specific
interests and their internship training goals. Advanced practicum often includes more
advanced clinical training in selected areas of psychotherapy, evaluation, testing, clinical
research, crisis intervention, and consultation with a population of particular interest to
the student (e.g. children, adolescents, young adults, older adults).
There are several resources that students may use to identify potential practicum sites.
The Coordinator of Clinical Training holds two scheduled meetings in the fall for those
interested in advanced practicum (see the “Master List of Clinical Meetings” found on
the Doctoral Program Resources blackboard site under the “Clinical Training Resources
a& Forms” tab) to describe the process and application requirements and to go over
Suffolk criteria for advanced clinical training. Your research mentor and/or other
advanced students in your lab may have suggestions of sites that offer training in your
specific area of interest. In addition, both the Director of Clinical Training (DCT) and
the Clinical Training Coordinator (CTC) are available to meet with students to discuss
how to think about the options. The many Suffolk alumni practicing in the community
may also be a resource to the student.
Finally, the department maintains a listing of advanced practicum sites in the greater
Boston area with contact information and web addresses. This document and other
announcements regarding advanced practicum resources and opportunities are all housed
in Blackboard. All third year and beyond students will have access to the Blackboard
group “Advanced Practicum Resources”. To log into MySuffolk and Blackboard please
see here: http://www.suffolk.edu/offices/login.html. It is important to note that this list is
not exhaustive and other opportunities may exist. Also, students have found that first
identifying sites from this database, and then directly accessing the practicum sites’
websites has provided the most up-to-date information on practicum availability and
application deadlines.
Criteria for Advanced Practicum Sites
Students should be familiar with the criteria used by the DCT to determine whether or not
to approve a clinical training experience for advanced practicum training. These criteria,
informed by APA and APPIC training guidelines, are designed to ensure that students
receive high quality training and supervision. The below criteria are also listed on the
Clinical Training Agreement that students must complete to get approval for advanced
practicum.
For all advanced clinical training, the primary supervisor must be a clinical psychologist
(or doctoral level clinician who is supervised by a licensed psychologist). Students may
have additional supervisors who are licensed members of other professions (e.g. LICSW).
The supervisor must be on site at least part of the time the student is on site. When the
supervisor is not onsite, she or he must be available immediately by phone for clinical
emergencies or have a designated back-up supervisor.
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Comment [JF1]: Update link once uploaded
For all advanced clinical training, students must have at minimum 1 hour of individual
supervision and 1 hour of group supervision per 8 hours of direct contact with clients (an
additional .5 hour of individual supervision may substitute for 1 hour of group
supervision).
Students engaged in neuropsychological assessment or consultation must receive
supervision from an individual meeting the NAN criteria for neuropsychologists (criteria
are listed on the web at
http://www.nanonline.org/NAN/Files/PAIC/PDFs/NANPositionDefNeuro.pdf). For a
practicum experience that involves therapy and rehabilitation, a rehabilitation
psychologist with experience with cerebral disorders would be qualified. One hour of
individual supervision should be provided for every eight hours of advanced
neuropsychological clinical work.
Applications and Interviews
After students have discussed advanced practicum training with the appropriate faculty
and identified potential sites, students should follow the individual instructions provided
by each training site of interest as to how to apply to the practicum. Often sites require
letters of interest, resumes and letters of recommendations. Some sites, particularly those
emphasizing assessment, may also ask for samples of integrated reports.
Most sites also require an interview of those applicants that are selected for consideration.
Although there is no commitment at this point by either party that you will be training at
that site, it is important that you are familiar with the paperwork that Suffolk will require
if/when you take a position. Some sites have worked with Suffolk in the past, and know
the information we require, but it is advisable for you to be familiar with the Clinical
Training Agreement (found on the Doctoral Program Resources blackboard site, under
the “Clinical Training Resources & Forms” tab) so that you can get at least some of the
information you need during the interview
Upon accepting a position, complete the Clinical Training Agreement in conjunction with
your site supervisor. The Clinical Training Agreement must be submitted by April 1st.
Once you submit the agreement to the program administrator, an introduction email will
be sent from the DCT and the CTC your supervisor. It will contain a link to a Site
Information Sheet to be completed by your supervisor.,
Clinical Affiliation Agreements
As of the fall of 2010, Suffolk no longer requires that we hold a clinical affiliation
agreement with practicum training sites. However, some sites will still require such an
agreement.
If a site requires an affiliation agreement with Suffolk, you first need to establish whether
they will sign the standard Suffolk CAA agreement or whether they will require Suffolk
to sign their own institutional agreement. Please contact Jessica Festa in order to have a
copy of the standard Suffolk CAA sent directly to your site.
16
If a site requires an agreement, and is willing to sign the Suffolk agreement, please
inform Jessica Festa as soon as you learn that an agreement will be needed. It can
take several months for CAAs to be reviewed at the practicum training site and
sometimes they negotiate for changes to the agreement that must be reviewed by
attorneys. Thus it is in your best interest to start this process by February 1st with the
goal of coming to an agreement before the end of the spring semester. If an institution
refuses to sign the Suffolk CAA and requires that we sign their standard agreement, it is
critical that you get an electronic copy of the agreement as soon as possible. Any
external agreement must be reviewed in the psychology department, by our legal
representatives and by the Provost, a process that can take several months or more. Often
changes are proposed that need to be negotiated between the two sites and there is a
possibility that the institutions will not reach an agreement. Thus, students must allow at
least 3 months for such a review.
Final Steps
Students accept offers from advanced practicum sites understanding that the acceptance
is provisional and will need to be formally approved by the CTC (in consultation with the
DCT). The CTC will not review the clinical training experience until all the paperwork
has been submitted. Students will receive confirmation of CTC approval for advanced
practicum (this is required before student starts clinical training). If appropriate,
confirmation will result in being approved for Psych 777 Advanced Practicum.
Registration
As noted above, students who choose to do an Advanced Practicum are required to
register for PSYCH 777 for one credit for both semesters during the first year of
advanced practicum training. Registration for PSYCH 777 does not involve classroom
attendance but is required for evaluation oversight, monitoring, and administrative
purposes. In order to receive credit for Advanced Practicum, students must submit signed
evaluations to the Clinical Training Coordinator (CTC) each semester, and at the end of
the spring semester must complete the Evaluation of Supervisor. In addition, the CTC
maintains oversight of these clinical experiences by working with students and sites when
issues or questions arise.
Summer Advanced Practicum
Students are eligible to participate in a summer advanced practicum after having
completed Practicum IIA & IIB. Students must have their summer practicum site
approved in advance. Students who continue at their spring practicum or who begin their
fall practicum early are not required to have an additional evaluation completed. Students
are expected to continue to enter their hours in MyPsychTrack and, at the end of the
summer, submit the Addendum to Clinical Evaluation of Student form (found on the
Doctoral Program Resources blackboard site, under the “Clinical Training Resources &
Forms” tab) with supervisor’s signature.
17
All students doing summer practicum are required to check in with the CTC during the
summer to discuss the progress of their practicum. The purpose of these meetings is to
address any issues/concerns that come up during the practicum experience (though
students are encouraged to not let issues build up and to contact the CTC or DCT as soon
as issues arise). In addition, these meetings are an opportunity for students to articulate
their training goals and discuss how and to what extent these goals are being met. Those
continuing their practicum into the summer meet with the CTC once during the summer,
and those starting practicum early or only doing summer practicum meet with the CTC
two times. Students are responsible for arranging these individual meetings with the CTC
during the summer practicum period.
Tracking Clinical Hours
All students who engage in clinical activities as part of practicum are required by the
program and APPIC to engage in on-going, regular, and accurate tracking of their clinical
hours. Tracking allows us to oversee the activities of students at practicum sites in the
field and to verify hours for internship application. The department secures licenses for
students to use the online “MyPsychTrack” system. This system was developed
specifically to assist students in tracking their clinical hours in a way that is consistent
with the APPIC/internship application. It is updated yearly to conform with changes to
the application. Before starting practicum students will be given a coupon code, and will
then be expected sign up for MyPsychTrack (https://portal.mypsychtrack.com/) and to
log their hours on a regular and timely basis. The department has administrative access to
the data that students provide so that we can oversee practicum activities and confirm
hours for internship. All hours must be logged in MyPsychTrack by the end of each
grading period in order for students receive credit for ANY practicum class and for the
hours on the APPIC application to be approved by the department.
Evaluations
Practicum supervisors complete a formal student evaluation two times per academic year,
at the end of each semester of practicum service. These evaluations are designed to assess
each student’s progress in acquiring the clinical competencies expected at the appropriate
stage of clinical training.
A link to our on-line evaluation form is emailed to all practicum supervisors
approximately 3 weeks before the end of the semester. Supervisors provide an objective
rating of student progress in several key clinical domains as well as individualized
narrative text. The evaluation is completed by the primary supervisor (with input from
secondary supervisors).
The CTC attends the evaluation feedback sessions at the end of each semester for all
Practicum I and II students. This allows for clear communication amongst the site, the
student and Suffolk, about the practicum placement, student progress and student training
goals. In addition to this formal evaluation mechanism, the CTC is in regular contact
18
throughout the training year with the contracted sites for Practicum I and II and with the
Advanced Practicum sites on an as-needed basis.
Students are also asked to complete an evaluation of their supervisor and of the site at the
end of the training year. These evaluations, submitted online, provide the Clinical
Training Coordinator and the DCT with important practicum planning information.
Evaluations are kept confidential and student responses are not directly shared with the
site supervisor. Instead, responses are used by the CTC and DCT to evaluate sites and to
guide discussions between the site and the program aimed at improving the training
partnership between the site and the program. Students are invited to address any
concerns about the supervisor evaluation process to the CTC or DCT.
MyPsychTrack hours, the Evaluation of Student and the Evaluation of Supervisor (in
the spring semester) forms must be submitted by the end of the grading period in order
for the student to receive a passing grade. Students will receive a grade of “IP - in
process” if these forms are not submitted on time. Students are encouraged to keep
personal copies of all evaluations they receive from supervisors. Evaluations are collected
electronically via Survey Monkey however, copies of both forms can be found on the
Doctoral Program Resources blackboard site as well as Appendix B.
As indicated on the Evaluation of Student form, any skill rated 1 or 2 in the fall semester
needs to be addressed by the site in the narrative section of the evaluation, and discussed
with the Clinical Training Coordinator to ensure that a plan for intervention or
remediation has been developed where appropriate. If a student receives a 1 or 2 on their
evaluation, and the CTC is not present at the evaluation session, he or she is responsible
for immediately alerting the CTC and making an appointment to discuss the issue. If a
student is asked to leave a site because of numerous ratings of 1 or 2, the student may fail
or receive an incomplete in practicum for that semester. Being asked to leave a site will
result in a Standards and Ethics review for that student.
Students who receive a 1 on any item at the end of the placement will not receive a
passing grade and will be reviewed by Standards and Ethics and either required to repeat
the practicum or be dismissed from the program. Students who receive a 2 on two or
more skills at the end of the year may also not receive a passing grade, may be reviewed
by Standards and Ethics and are required to make appointments with their mentor, the
CTC and the Director of Clinical Training so that a plan to address the concerns of the
supervisor can be developed, and a decision about passing practicum can be made. The
plan for addressing the difficulties must be in place in order for the student to be
approved for another practicum.
If a second less than satisfactory evaluation is received, students will be reviewed by
Standards and Ethics which sends recommendations onto the Graduate Academic
Standing Committee, and may be asked to: 1) take a leave of absence to address issues
that may be interfering with practicum performance; 2) leave the program with a terminal
masters of science in psychology degree or 3) enter the following semester’s practicum
on probation and continued review by S&E
19
Program-Sanctioned Work Experiences
Given the significant demands of the doctoral program, we do not encourage students to
independently seek clinical work experiences unless they are in good standing in the
program and are making satisfactory progress in all domains. Students should be aware
that clinical hours obtained through employment are not reported on the APPIC/
internship application and thus do not “count” as program sanctioned pre-internship
clinical hours.
According to the APPIC application, the exception to this rule is that hours that are
obtained through program-sanctioned work experiences (e.g., VA summer traineeship,
clinical research positions, time spent in the same practicum setting after the official
practicum has ended, etc) may be counted. However, in order for these hours to count
they must be approved by the DCT in advance and meet all the same supervision
requirements as practicum training hours. In other words, they must be adequately
supervised by appropriate staff, using the appropriate ratio of supervision to direct
contact hours and the student must be formally evaluated using our practicum evaluation
form.
Students who seek program sanctioned work must:
•
Be in good academic standing and making satisfactory progress in all
training domains
•
Have current liability insurance on file with the department
•
Complete the Intent to Apply for Advanced Clinical Training form (found
on the Doctoral Program Resources blackboard site under the “Clinical
Training Resources & Forms” tab) by December 15th.
•
Submit the Clinical Training Agreement by April 1st.
•
Have appropriate supervisor paperwork on file (we will contact your
supervisor to gather this information once the Clinical Training Agreement
is submitted).
•
Enter hours into MyPsychTrack
•
Submit evaluations at the end of each semester
20
Appendix A: Student Time Table for Practicum-Related
Activities
21
Student Time Table of Practicum-Related Activities
Year 1
August 28, 2014
Orientation Day-Meeting with Coordinator of Clinical
Training to review Practicum Training Sequence
September 17, 2014
Initial meeting with first year students to explain practicum
placement process, forms, etc. (During Clinical Lab class)
October 1, 2014
Last day for students to submit to Jessica certificate of
completion of on-line HIPPA training course
November 18, 2014
Second meeting with first year students to present the
possible sites, hear from current Prac I students about the
sites, review any questions about placement process
December 17, 2014
Site preference ranking for Practicum I due
January 23, 2015
Final date for student placement assignments provided to
students (may be provided earlier)
February 19, 2015
Follow-up meeting on Practicum I placements—review
paperwork and interview requirements
March 6, 2015
Interview with Practicum I site completed (sites may want
this done sooner—their deadline trumps ours)
April 1, 2015
Deadline for paperwork turned in to administrative staff
Clinical Training Agreement (if Jessica does not already
have a copy)
April 25, 2015
Join APA as a student member (you must be a member to
purchase insurance
August 15, 2015
Purchase liability insurance and submit proof of insurance
to administrative staff
22
Summary of Practicum-Related Activities and Deadlines
Year 2
August 28, 2014
Orientation Day—Students are oriented to practicum
issues; training in electronic hours tracking system
November 18, 2014
Meeting with Year 2 students to describe practicum
options, hear from students currently at these sites, review
questions about the placement process
December 12, 2014
“Evaluation of Student” due (via Survey Monkey)/ give
Jessica a signed copy of final Survey Monkey page
December 17, 2014
Site preference ranking for Practicum II due
January 23, 2015
Final date for student placement assignments provided to
students (may happen earlier)
February 19, 2015
Follow-up meeting on Practicum II placements—review
paperwork and interview requirements
March 6, 2015
Interview with Practicum II site completed (sites may want
this sooner-their deadline trumps ours)
April 1, 2015
Deadline for paperwork turned in to administrative staff
Clinical Training Agreement (if Jessica does not already
have a copy)
May 1, 2015
“Evaluation of Student” due (via Survey Monkey)/ give
Jessica a signed copy of final Survey Monkey page
“Evaluation of Supervisor” due (via Survey Monkey)
May 31, 2015
If respecialization student planning to apply for internship
in the fall, review Internship guide and timeline on
Department’s Website
August 15, 2015
Renew Insurance and submit proof of insurance to
administrative staff (effective date no later than 8/15/2015)
23
Summary of Practicum-Related Activities and Deadlines
Years 3 and Year 4
August 28, 2014
Orientation Day—Students are oriented to practicum
issues; training in new hours tracking system
September 17, 2014
2nd Internship meeting -- Students applying for internship
meet to discuss applications process and interview
strategies.
October 8, 2014
Advanced practicum meeting for year 3 students and
beyond who are thinking about prac options
November 18, 2014
Advanced Practicum meeting for year 3 students and
beyond, focus on cover letters, applications & interviews
December 3, 2014
3rd Internship meeting—Students applying for internship
meet to discuss interviews
December 12, 2014
“Evaluation of Student Form” due (via Survey Monkey)/
hand in to Jessica a signed version of final page of Survey
Monkey
December 15th, 2014
Submit Intention to Apply for Advanced Clinical Training
form (if applicable)
January 14, 2015
Applications to Advanced Praticum sites completed &
mailed
April 1, 2015
Deadline to submit Clinical Training Agreement to
administrative staff. The submission of this material will
prompt us to contact your supervisor to get the remaining
required information from the site. Students who hand in
the agreement after this date may not be approved to
start the clinical training experience in the fall.
May 1, 2015
“Evaluation of Student” due (via Survey Monkey). Sign
and hand in final page of Survey Monkey; “Evaluation of
Current Supervisor” due (via Survey Monkey)
May 6, 2015
First internship meeting for students considering applying
to internship in Fall 2015—Overview and Summer Tasks
May 15, 2015
“Intention to Apply for Internship” form due to Jessica if
student is intending to apply for internship in the fall of
2015.
24
August 15, 2015
Renew Insurance and submit proof of insurance to administrative
staff (effective date no later than 8/15/2015)
25
Appendix B: Clinical Training Evaluations
26
Practicum Performance Evaluation of Student
Suffolk University
Department of Psychology
The following is an evaluation of our student’s progress at your practicum site to be completed by the supervisor. If you
have any questions or comments, we would be pleased to hear from you. Please send the completed evaluation to Sue
Orsillo, Suffolk University, Department of Psychology, 41 Temple St., Boston MA, 02114 or fax it to 617-367-2924.
Name of Supervisee: _____________________________________________________________________
Practicum Training site: __________________________________________________________________
Name of Supervisor: _____________________________________________________________________
Check One:
Practicum I
Practicum II
Advanced Practicum
Summer Practicum
Check One:
Fall
Spring
Summer
Year: _______________
PSWE
Instructions: Answer items according to the following scale, remembering to consider expectations relative to
the students’ year and level of training.
*** (Any skill rated 1 or 2 should be addressed in the narrative section along with a plan for intervention
or remediation where appropriate. Students who receive a 1 on any item at the end of the placement will
not receive a passing grade and will be required to repeat the clinical training). ***
1 = Far below expectations-needs much improvement, a concern
2 = Below expectations-needs some improvement to meet standards
3 = Acceptable-meets standards at average level for practicum student
4 = Above expectations-performs above average level for practicum student
5 = Far above expectations-a definite strength, performs well beyond average levels
N/A = Not applicable or not enough information to form a judgment
1. RELATIONSHIP WITH CLIENT/INTERPERSONAL SKILLS
____ Able to take a respectful, helpful, professional approach to patients/clients/families
____ Awareness of and sensitivity to clients’ verbal and nonverbal behavior
____ Able to establish an effective working relationship with client
____ Uses language and terms appropriate for client and client’s concerns
27
*** (Any skill rated 1 or 2 should be addressed in the narrative section along with a plan for intervention
or remediation where appropriate. Students who receive a 1 on any item at the end of the placement will
not receive a passing grade and will be required to repeat the clinical training.) ***
1 = Far below expectations-needs much improvement, a concern
2 = Below expectations-needs some improvement to meet standards
3 = Acceptable-meets standards at average level for practicum student
4 = Above expectations-performs above average level for practicum student
5 = Far above expectations-a definite strength, performs well beyond average levels
N/A = Not applicable or not enough information to form a judgment
2. CONCEPTUALIZATION AND INTERVENTION SKILLS
____ Appropriately synthesizes and integrates client information and generates hypotheses concerning client
behavior and dynamics
____ Writes conceptualizations which are clear and concise
____ Provides rationale for conceptualization based on available research and best practice
____ Formulates appropriate interventions and treatment plans based on conceptualization
____ Establishes and delineates short-term and long-term goals
____ Able to implement intervention skills appropriate to client needs and focus and scope of practicum site
____ Able to apply specific evidence-based treatment methods and activities
____ Able to utilize skills building and problem solving approaches in treatment
____ Effectively facilitates the client’s exploration, expression, and regulation of emotions in treatment
____ Attends to the assessment and monitoring of treatment progress and outcome
3. PSYCHOLOGICAL ASSESSMENT SKILLS
____ Able to effectively select and implement psychological assessment tools and diagnostic procedures
____ Able to effectively score, interpret and report assessment findings
____ Able to integrate assessment data from different sources for diagnostic purposes
____ Able to provide clear, concise, and informative feedback about assessment results
____ Able to write clear, concise and integrated assessment reports in a timely manner
28
*** (Any skill rated 1 or 2 should be addressed in the narrative section along with a plan for intervention
or remediation where appropriate. Students who receive a 1 on any item at the end of the placement will
not receive a passing grade and will be required to repeat the clinical training.) ***
1 = Far below expectations-needs much improvement, a concern
2 = Below expectations-needs some improvement to meet standards
3 = Acceptable-meets standards at average level for practicum student
4 = Above expectations-performs above average level for practicum student
5 = Far above expectations-a definite strength, performs well beyond average levels
N/A = Not applicable or not enough information to form a judgment
4. INTERPROFESSIONAL COLLABORATION/CONSULTATION SKILLS
____ Knowledge and awareness of the unique patient care roles of other professionals
____ Understands and observes agency functioning and procedures
____ Able to effectively relate with other agency personnel in accordance with their unique patient care roles
(a “team player”)
____ Understanding of consultant’s role as a provider of information
____ Able to choose an appropriate means of assessment to answer referral questions
____ Able to implement a systematic approach to data collection as part of a consultative process
____ Consultation reports are well organized, succinct and provide useful and relevant
recommendations to other professionals.
5. DIVERSITY/INDIVIDUAL AND CULTURAL DIFFERENCES
____ Aware of impact of own feelings, behavior and cultural values on client behavior
____ Knowledge about the nature and impact of diversity in different clinical situations
____ Able to work effectively with diverse others in assessment, treatment and consultation
____ Understands cultural background in client’s presentation and incorporates this understanding in
conceptualization and treatment plan
6. ETHICS
____ Demonstrates knowledge of ethical/professional codes, standards and guidelines
____ Recognizes and understands the ethical and legal issues across range of professional activities at
practicum site
____ Seeks appropriate information and consultation when faced with ethical issues
____ Keeps client information (written and verbal) confidential and secure
____ Able to understand and maintain appropriate professional boundaries
29
*** (Any skill rated 1 or 2 should be addressed in the narrative section along with a plan for intervention
or remediation where appropriate. Students who receive a 1 on any item at the end of the placement will
not receive a passing grade and will be required to repeat the practicum)
1 = Far below expectations-needs much improvement, a concern
2 = Below expectations-needs some improvement to meet standards
3 = Acceptable-meets standards at average level for practicum student
4 = Above expectations-performs above average level for practicum student
5 = Far above expectations-a definite strength, performs well beyond average levels
N/A = Not applicable or not enough information to form a judgment
7. SUPERVISION
____ Comes to supervision and other meetings prepared and with necessary materials
____ Able to work collaboratively with supervisor
____ Able to self-reflect and self-evaluate regarding clinical skills and role within practicum site, and willing
to admit mistakes
____ Able and willing to accept supervisory input and shows evidence of incorporating feedback and new
ideas
____ Knowledge of literature on supervision
____ Knowledge of how supervision responds appropriately to individual and cultural differences
____ Exhibits appropriately increased autonomy over the course of the year
8. PROFESSIONAL DEVELOPMENT
____ Behaves and presents him or her self in a professional and respectful manner
____ Keeps scheduled appointments and is on time for appointments and meetings
____ Writes notes, evaluations, reports for case file in a timely manner
____ Able to self-identify personal distress and to seek and use resources that support healthy functioning
____
Demonstrates effective time management skills
____
Seeks out and uses resources to promote effective practice
Narrative:
Please provide comments in the narrative to explain any skill rated 1 or 2. Students receiving a 1 or a 2 should
work with their supervisor, Clinical Training Coordinator and/or DCT to ensure that a plan is in placed for
intervention or remediation where appropriate. Students will not receive a passing grade for clinical training if
they receive a 1 on any skill during the final semester of a placement. Similarly, a student who receives several
ratings of 2 during the final semester of a placement and/or who fails to show adequate improvement on a skill
previously rated 1 or 2 may also receive a failing grade.
Student’s main strengths and assets:
30
Areas for continued focus and improvement:
Explicit recommendations for future training:
I have reviewed the information that the student entered in their Time2Track account OR in
MyPsychTrack, including student's Intervention & Assessment Experience, Supervision Received,
Support Activities, Diversity Experiences, Test Administration, and Integrated Report Writing, and certify
that this information is complete and accurate to the best of my knowledge. I have also reviewed this
evaluation with my student and agree that all information is complete and accurate.
Supervisor Name: ___________________________________________
Supervisor Signature:__________________________________
Date: ______________
Student Name: ______________________________________________
Student Signature:___________________________________
31
Date: ____________
Practicum Performance Evaluation of Supervisor/Site
Department of Psychology
Suffolk University
(Please note: Please fill out this evaluation for each supervisor you have met with at least one hour/week)
Name of Supervisee: __________________________________________________
Practicum Training Site: _______________________________________________
Name and Title of Supervisor: __________________________________________________
Academic Year: ___________ Circle One: Fall
Spring
TYPE OF PRACTICUM EXPERIENCE: PRAC I
PRAC II
Summer
ADVANCED PRAC
PSWE
1 = Far below expectations-poor, a concern
2 = Below expectations-marginal
3 = Met expectations-satisfactory
4 = Above expectations-good
5 = Far above expectations-excellent
N/A = Not applicable or not enough information to form a judgment
Defining and Supporting Supervision
Established clear training goals and expectations
1
2
3
4
5
n/a
Clearly defined the nature, structure, expectations and limitations of
1
2
3
4
5
n/a
Provided adequate time for supervision
1
2
3
4
5
n/a
Maintained regularly scheduled supervision and was on time for meetings
1
2
3
4
5
n/a
Established an atmosphere of acceptance and psychological safety
1
2
3
4
5
n/a
the supervisory relationship
32
Could be reached in emergencies
1
2
3
4
5
n/a
Maintained an appropriate focus in supervisory sessions
1
2
3
4
5
n/a
Was clear about the differences between supervision and psychotherapy
WAS AVAILABLE OUTSIDE REGULAR SUPERVISION TIME WHEN QUESTIONS/ISSUES EMERGED
HELPED NAVIGATE THE DYNAMICS/CULTURE OF THE SITE
Appropriate Guidance
Provided guidance appropriate to your level of competence
1
2
3
4
5
n/a
Was able to recognize and accommodate to your level of experience
1
2
3
4
5
n/a
Was flexible and responsive to your changing needs
1
2
3
4
5
n/a
Helped clarify and define the nature of problem(s) you are having in your work
1
2
3
4
5
n/a
Encouraged you to formulate your understanding of the case material
1
2
3
4
5
n/a
Encouraged you to explore the implications of your interventions
1
2
3
4
5
n/a
Supported your exploring how diversity affects conceptualization and intervention
1
2
3
4
5
n/a
Exposed you to relevant reading material/research
1
2
3
4
5
n/a
Provided you with general knowledge about the psychology profession.
1
2
3
4
5
n/a
Clearly informed you of legal and ethical issues relevant to clinical work at
1
2
3
4
5
n/a
1
2
3
4
5
n/a
and style of learning
your site
Addressed legal and ethical issues as they emerged
33
Feedback
Provided constructive, concrete and specific feedback about strengths.
1
2
3
4
5
n/a
Provided constructive, concrete and specific feedback about areas in which further
1
2
3
4
5
n/a
development was needed
USED OBSERVATION OF SESSIONS OR REVIEW OF VIDEOTAPES AS BASIS FOR SUPERVISION
Used role play, clinical case notes,
or other appropriate techniques to help you more effectively intervene with clients
1
2
3
4
5
n/a
Provided opportunities for you to question, challenge or doubt
1
2
3
4
5
n/a
Was open to feedback from you about the supervision
1
2
3
4
5
n/a
Was open to discussing any difficulties in the supervisor-supervisee relationship
1
2
3
4
5
n/a
that were hindering your learning
Narrative: Please elaborate on any of the above ratings. In particular, please provide more details on any ratings of “1” or “5” and provide any other
information that you believe would be helpful to the CTC or students thinking about this site as a possible training placement.
The Site
1=No Emphasis
34
2=Slight Emphasis
3=Moderate Emphasis
4=Strong Emphasis
5=Significant Emphasis
Opportunities for individual therapy experience
1
2
3
4
5
n/a
Opportunities for group therapy experience
1
2
3
4
5
n/a
Opportunities for assessment and diagnostic experience
1
2
3
4
5
n/a
Opportunities for research experience
1
2
3
4
5
n/a
On-site didactic training experience
1
2
3
4
5
n/a
Opportunities for working with underprivileged and/or underserved populations
1
2
3
4
5
n/a
Opportunities for working with range of client populations
1
2
3
4
5
n/a
Opportunities for gaining in-depth experience with a particular client diagnostic
1
2
3
4
5
n/a
1
2
3
4
5
n/a
presentation (please specify)
Opportunities for working with a range of client diagnostic presentations
OPPORTUNITIES TO INTERACT WITH AND LEARN FROM OTHER PRACTICUM STUDENTS
CREATING A WELCOMING ENVIRONMENT FOR PRACTICUM STUDENTS
ATTENTION TO APPROPRIATE MATCH OF CLINICAL CASELOAD FOR LEVEL OF TRAINING
MAINTAINING AGREEMENT ON NUMBER OF CLINICAL HOURS/NUMBER OF HOURS IN GENERAL AT THE SITE
FOCUS ON LEARNING ABOUT AND IMPROVING COMMUNICATION WITH AND AMONG SITE STAFF
35
Narrative: Please elaborate on any of the above ratings. In particular, please provide more details on any ratings of “1” or “5” and provide any other
information that you believe would be helpful to the CTC or students thinking about this site as a possible training placement.
36