PRACTICUM AND INTERNSHIP MANUAL

for

School Counseling Ed.S. Students

Counselor Education Program

Department of Educational Psychology

University of South Carolina

(803) 777-3053

NOTE: It is your responsibility to keep duplicate records of your Practicum and Internship activities and

supervision from both your on-site and university supervision. You may need these records in the future, to

support your application for certification and/or licensure. Records of your work are only maintained for three

years in the program office.

Updated August 2009

Practicum and Internship Manual

For School Counseling Ed. S. Students

Introduction

Purpose of this Handbook: This handbook is designed to introduce prospective student interns

to program expectations and requirements for satisfactory completion of EDCE 802 E & S (School Counseling

Practicum) and EDCE 805 E & S (School Counseling Internship). No handbook can ever completely prepare one

for the Practicum and Internship experience; the experiences and resultant learning can come only through the

exploration of the unknown, taking risks, making mistakes, and incorporating this learning into one’s counseling.

However, this handbook can provide information about much of the necessary paperwork, suggest ways to ensure

solid communication between student and supervisor, and share background data relative to professional standards

and ethics. The intent of this handbook is to concentrate on the mechanics, thereby freeing the student to focus on

and maximize the learning opportunities that the clinical experiences are intended to provide.

Prerequisites

Practicum: The following prerequisite courses must be completed with a grade of “B” or higher

before taking the Elementary (EDCE 802E) or Secondary (EDCE 802S) Practicum.

EDCE 510 Introduction to Counseling

EDCE 600 Communication Skills in Counseling

EDCE 700 Cross-Cultural Counseling

EDCE 702 Counselor as Consultant

EDCE 706 Assessment in Counseling

EDCE 707 Career Development

EDCE 708 Critical Issues in School Counseling

EDCE 710 Professional, Ethical, and Legal Issues in Counseling

EDCE 712 Comprehensive Developmental School Counseling

EDCE 720 Theories of Counseling

EDCE 721 Techniques of Counseling

EDCE 722 Group Procedures in Counseling

EDPY 705 Human Growth and Development

EDRM 700 Introduction to Research in Education

Internship: The following prerequisite course must be completed with a grade of “B” or higher

before taking the Elementary (EDCE 805E) or Secondary (EDCE 805S) Internship.

EDCE 802E Elementary School Practicum

or EDCE 802S Secondary School Practicum

Applications

Deadlines: There are two deadlines for submitting Practicum and Internship applications. These are:

Fall Practica/Internships - Applications must be received no later than January 15

Spring Practica/Internships - Applications must be received no later than September 1

Course Sections: All Ed.S. School Counseling students must complete at least nine credit hours of field

experience in schools with approved site supervisors. Three of these credit hours are earned in Practicum (EDCE

802 E or S) and the other six are earned in Internship (EDCE 805 E or S). The Internship must be completed in one

semester.

Of the required nine credit hours of field experience, students must complete experiences in elementary, middle and

secondary schools. Students need to register for their Practicum with the suffix applicable to the school they are

working in – for example, if working in an elementary school, students register for 802E. Students register for

802S if working in a secondary school. Whatever the suffix of a student’s Practicum, their Internship should have

the opposite suffix.

Students may choose to register for Practicum or Internship in any of the following ways.

1. Practicum in elementary school (802E)

Internship, half in middle school and half in high school (805S)

2. Practicum in high school (802S)

Internship, half in elementary school and half in middle school (805E)

3. Practicum in middle school (802E or S)

Internship, half in elementary school and half in high school (805E or S – select

the letter that was not used for 802)

Procedures: Complete a Counselor Education Practicum/Internship application and return it to the Counselor

Education Office. These application forms are available on the Counselor Education web page at

http://www.ed.sc.edu/edst/ce/practica_internship.asp. Do not contact a site-supervisor or other school personnel

to request your own placement!

Reminder: All students are required to have professional student liability insurance when enrolled in Practicum

and/or Internship courses. We have found that ACA or ASCA insurance adequately meets our program

requirements. Students should visit the web page of the above organizations to learn how liability insurance may

be obtained. Links to these organizations are located on our Resources page.

Mission Statement

The students and faculty of the Counselor Education Program in the Department of Educational Studies in the

College of Education at the University of South Carolina are a diverse community of learners collaboratively

engaged in scholarship, leadership, service, and advocacy for systemic change. The mission of the Counselor

Education Programs is to prepare multiculturally competent counselor educators, marriage and family counselors,

and K-12 school counselors. Graduates will demonstrate leadership, skill, knowledge, and character that are

reflective of the standards set forth by the counseling profession and their areas of specialization. Students and

faculty of the Counselor Education Program are expected to exemplify the highest ethical and professional

standards while engaged in accomplishing this mission.

Diversity Statement

The Counselor Education Program at The University of South Carolina is committed to multiculturalism by

actively promoting diversity within a social justice framework by building a community of learners that fosters a

climate of respect and values diverse racial, ethnic, and class backgrounds, national origins, native languages,

religious, spiritual, and political beliefs, physical abilities, health status, ages, genders, and sexual orientations.

Our program is committed to training counselors in becoming multiculturally competent scholars and practitioners

who can meet the diverse needs of diverse clients. We are equally committed to recruiting diverse students and

faculty to our program to enhance the richness of dialogue and experiences that will aid in the expansion of

multicultural and culture-specific awareness, knowledge, skills relevant to the client and student populations we

aim to serve.

Using the scholar-practitioner model, we are committed to training our students to be multiculturally conscious

change agents who actively engage in critical self-reflective scholarship and practice in an effort to effectively

transform communities, institutions, and systems.

Purposes of the Clinical Experiences

The Practicum and Internship are designed to satisfy requirements for professional training as stipulated by the

Council for Accreditation of Counseling and Related Educational Programs (CACREP) accreditation standards.

There is a fundamental difference in emphasis between the Practicum and the Internship. The Practicum stresses

counseling skills. Individual and small group counseling activities should be the student’s primary focus while on

site.

The Internship is intended to provide students with a broad-base practical experience in school settings. This

experience is designed to have interns relate academic and theoretical learning to field experience. Interns are

expected to assume a broad spectrum of counseling roles and functions. The intern is asked to participate in as

many activities as feasible in the settings that are similar to the responsibilities of an employed counselor. The

Internship also provides students with evaluative feedback on their knowledge, attitudes, and skills with specific

client populations. Since interns have previously received training in counseling, the staff and the clientele at the

placement site should benefit from the services.

Criteria for Approval of a Site Placement

Site supervisors will only be approved for settings that reflect culturally diverse populations. Typically, students

will do their Practicum and Internship in a variety of settings.

Facilities also play an important role in site selection. Certain minimum standards must be met. Suitably

equipped office space must be available to you to ensure counseling privacy and the ability to tape each session. A

major portion of a student’s evaluation is based upon videotapes of on-site counseling sessions. In addition, the

office should be located within the center of the institution for easy client access. Additional facilities and

equipment (such as videotape machines, observation rooms, computer availability) may also be site selection

considerations.

Site Supervisor Selection (Interns Only)

For Interns who desire sites outside greater Columbia:

In order to work with a school counselor who is not currently on the approved list, you will need to request that

he/she apply to become an approved site supervisor. Application forms are included in this handbook (see Form

B). This application needs to be submitted to the Office of Counselor Education for approval. If this application is

approved, a notification of acceptance will be sent directly to the school counselor.

You will be ultimately responsible for communicating Counselor Education expectations and requirements

(application procedures, assignments, taping of sessions, etc.) to the site supervisor. The steps suggested as a

means of assuring Practicum and Internship course expectations are included in this handbook beginning with Form

C. However, your job is to discuss fully all program expectations with the site supervisor to whom you are

assigned.

You should be prepared to work on a number of objectives during Internship. These should be communicated to

the site supervisor (preferably in writing). It is advisable to schedule a meeting with the site supervisor to discuss

these plans once you have been assigned.

As a professional courtesy, you should also provide the site supervisor with a schedule of the beginning and ending

dates of the Practicum/Internship as well as dates (holiday and the like) when you would not expect to be present at

the site. In addition, a schedule of your week should be submitted to the site supervisor and updated as necessary

(see Form C for a sample schedule).

During the semester, the university supervisor will meet with you and your site supervisor. During such

communications, the university supervisor will discuss your progress, course expectations, and may wish to observe

you conducting one or more counseling sessions.

You must meet a minimum of one hour per week with your site supervisor. The content of these sessions is

determined jointly by the student and the site supervisor. The format of supervision will vary; some site

supervisors will wish to review taped critiques in addition to the university supervisor’s review, while others will

wish simply to consult directly with the student counselor. In any case, you have the responsibility of making sure

that you receive the best possible supervision. If concerns arise, you should first talk with the site supervisor.

However, if problems persist, you should relate such concerns to your university supervisor.

Evaluations of student counselors should be completed by the site supervisor near the end of the

Practicum/Internship. These evaluation forms should be given to the site supervisor in the beginning

of the Internship so that the program expectations are clear (see Forms D, I, and N).

Activities and General Requirements

Practicum: The Practicum experience is supervised by the university instructor and the on-site Professional

School Counselor. Students enrolled in the Practicum are required to accumulate a minimum of 150 clock

hours. Of these 150 hours, a minimum of 60 hours must be in direct service work with clients

appropriate to one’s Program of Study. Emphasis is placed on developing individual and group

interaction skills. The Practicum student is to have a minimum of one hour per week in supervision

with the site supervisor, one hour of supervision per week with a program faculty member or doctoral student

supervisor working under the supervision of a program faculty member, and two hours per week in group

supervision. These supervision hours may count toward the total number of Practicum hours.

The student’s progress in the Counselor Education Program is reviewed by the faculty at the time of

Practicum completion. If the progress is judged as satisfactory, registration in Internship will be

permitted. If it is judged as unsatisfactory, registration will not be permitted and a conference with

the student will be arranged by the student’s adviser. The primary purpose of the conference is to

develop intervention strategies, which the student might complete prior to progressing further in the

degree program

Students should refer to the course syllabus for the specific requirements of their Practicum. Students

are also required to keep a log book (see Form E) describing their field experiences, the date of the

experience, the amount of time spent at it and the student’s reactions to the experience. It is required

that all students attend all Practicum individual and group supervisory meetings held during the

semester.

Internship: The Internship (EDCE 805E or EDCE 805S) is a required six-semester-hour

supervised opportunity for the student to perform all the expected activities that a regularly employed

counselor in a school setting would be expected to perform.

Students enrolled in the Internship are required to spend a minimum of 600 clock hours in a school where one can

perform all the activities that a regularly employed staff member in the setting would be expected to perform. Of

the 600 hours, 240 hours are to be spent in direct service work with clients appropriate to one’s Program of Study.

The Internship students are to have a minimum of one hour of supervision from the site supervisor, one hour of bi-

weekly individual supervision with a program faculty member or doctoral student supervisor working under the

supervision of a program faculty member, and one and one-half-hours per week in group supervision. These

supervision hours may count towards the total number of hours accrued in Internship.

Supervision

Practicum: The Practicum student is to have a minimum of one hour per week in supervision with

the site supervisor, one-hour supervision per week with a program faculty member or doctoral student

supervisor working under the supervision of a program faculty member, and two hours per week in group

supervision.

The Practicum experience is designed and supervised by the instructor of EDCE 802 E or S and by the site

supervisor in the field. Site supervisors are required to have a minimum of a master’s degree from a CACREP

approved program, or a master’s degree with a supervised field Practicum and Internship, and certification as a

school counselor in South Carolina. They must also be involved in at least one professional counseling association

such as ASCA or SCSCA, and have a minimum of two years of school counseling experience at the appropriate

grade level. The site supervisor is expected to acquaint the student with the site and its activities, policies, and

procedures; meet weekly with the student to discuss progress; participate in an evaluation of the student, and

consult with the university supervisor about the student’s progress.

The university supervisor is expected to provide weekly individual and group supervision with other students in

similar field experiences, consult with the site supervisor about the student’s progress, assure that all required field

experience forms are submitted, assure that all students complete all Practicum requirements, assess student

counselor competencies (see Form D), and submit grades for the students to the program secretary at the end of the

semester.

Internship: The Internship students are to have a minimum of one hour per week of supervision with the site

supervisor, one hour every other week of supervision with a program faculty member or student supervisor working

under the supervision of a program faculty member, and 90 minutes per week of group supervision.

The Internship site supervisor is expected to assist the student by acquainting him/her with the site and its

personnel, facilitate the student’s accomplishment of the course requirements, meet once a week with the student to

discuss progress, participate in a midterm and final evaluation of the student (see Forms I & N) and consult with the

university supervisor about the student’s progress.

The university supervisor is expected to provide individual supervision for each student, conduct group supervision

with students in similar field experiences, critique audio and video counseling tapes for each student, consult with

the site supervisor about the student’s progress, assure that all required Internship forms are submitted, attend all

university meetings of supervisors, assure that students complete all Internship requirements, assess student

counselor competencies (see Forms I & N), and submit grades for the students and the student logs documenting

their Internship experiences with the course instructor at the end of the semester.

Procedures and Steps (Summary)

Step 1: Submit application for Practicum or Internship to the Counselor Education Office in room 266, Wardlaw

Building, by the deadline.

Step 2: You will be assigned a site and supervisor. In the case of Internship, if there is not a designated site or

supervisor in your area, you may request that a school counselor may complete and send the Site

Supervisor Application Form.

Step 3: Obtain professional liability insurance and submit verification at the first University class meeting.

Step 4: Visit your site (after site supervisor approval) to plan with your site supervisor prior to the first week of

class.

Step 5: Become familiar with your responsibilities and assist your site supervisor in understanding her/his

responsibilities, as described in this handbook.

Step 6: If, after receiving your letter of approval, you have an emergency situation which makes it impossible to

proceed with the Practicum or Internship, notify the School Counseling Field Experiences Coordinator

immediately. You must reapply (by the deadline) for the semester you want to be readmitted to the

class.

SUMMARY OF COURSE EXPECTATIONS

EDCE 802: PRACTICUM

Student's responsibilities:

1. To commit 150 clock hours to a site, including 60 hours of direct student contact. Direct service hours are

those in which the student is offering either individual or group counseling to clients. The remaining 90

hours can be devoted to other relevant professional activities on site. Examples of appropriate activities are

in-service training, participation in staff meetings, educational activities at the Practicum site, preventive

interventions, consultation, observation, supervision, etc.

2. To videotape the client contact sessions for the purpose of supervision.

3. To attend weekly group supervision seminars with the University instructor.

4. To write case notes on all clients and complete all other paper work connected to Practicum.

5. To meet all other course requirements.

6. To meet any additional requirements as determined by the site supervisor.

Faculty supervisor's responsibilities:

1. To visit the Practicum site and meet with the site supervisor.

2. To conduct weekly group supervision seminars on campus.

3. To offer the student individual supervision of taped or live counseling sessions.

4. To communicate with the site supervisor regarding the clinical ability of the student as determined through

supervision.

5. To read all case notes turned in by student.

6. To keep records of all Practicum activity engaged in by the student.

7. To seek evaluation from the site supervisor.

8. To assign a grade at the end of the semester based on the student's performance.

Site supervisor's responsibilities:

1. To organize the Practicum experience at the site and assure that the student will have an opportunity to work

with appropriate clients.

2. To help orient the student to the site.

3. To provide appropriate space for the student to meet with clients.

4. To monitor the Practicum to determine that the student's needs and the client's needs are being met.

5. To provide the faculty supervisor with evaluation of the student's overall performance and professionalism

during the Practicum.

6. To be available to the student in case of emergency.

7. To provide any additional supervision for reasons of necessity or preference. (In other words, the

University faculty welcomes the site supervisor's involvement in supervision above and beyond the

minimum expectations listed above.)

Adapted from Fairfield University Practicum Manual with written permission of Program Faculty

SUMMARY OF COURSE EXPECTATIONS

EDCE 805: INTERNSHIP

Student's responsibilities:

1. To commit 600 hours to a site, including 240 hours spent in direct client contact. All other Internship hours will

involve relevant professional activity including in-service training, participation in staff meetings, individual

and group supervision, etc.

2. To meet all requirements of the site supervisor for the purpose of supervision, e.g., completing case notes,

audio-taping or videotaping, etc.

3. To attend the weekly group supervision seminars with the USC instructor.

4. To meet all course requirements.

5. To meet all additional requirements of the site.

Faculty supervisor's responsibilities:

1. To visit the Internship site and meet with the site supervisor.

2. To conduct weekly group supervision seminars on campus.

3. To conduct individual or triadic supervision at least every other wee.

4. To keep records of the student's Internship activity safely secured.

5. To seek evaluation of the student from the site supervisor.

6. To be available to the site supervisor should supervision difficulties arise.

7. To assign a final course grade for the student.

Site supervisor's responsibilities:

1. To organize the Internship experience and assure that the student will have an opportunity to engage in

individual and group counseling, as well as other appropriate professional activities.

2. To help orient the student to the site.

3. To provide appropriate space for the student to meet with clients and engage in other professional activities.

4. To meet with the student for a minimum of one hour per week for purposes of individual supervision.

5. To provide the faculty supervisor with evaluation of the student's overall performance during the Internship.

6. To be available to the student in case of emergency.

Adapted from Fairfield University Practicum Manual with written permission of Counselor Education Program Faculty

DIRECTIONS

1. For Practicum/Internship to be successful, the responsibilities stated in the Practicum and Internship Manual for

School Counseling Ed.S. students need to be implemented.

Student's Name:

Home Phone: Work Phone:

Mailing Address:

Street City State Zip

School Site:

Site Address:

Street City State Zip

School Site Phone Number:

Site Supervisor: SSN:

Site Supervisor’s Email Address:

I have reviewed the Roles and Responsibilities statements attached to this form, and I agree to accept them in my

work as a student counselor for the (Fall or Spring), semester.

________________________________________________ ____________________________

Student’s Signature Date

Return to: Counselor Education Office, Wardlaw 266, University of South Carolina, Columbia, SC 29208

FORM A: School Site Placement Form

UNIVERSITY OF SOUTH CAROLINA

COUNSELOR EDUCATION PROGRAM

Directions to the Applicant: The pages at the end of this document outline the benefits, qualifications, and

expectations for site supervisors, as well as the requirements for Practicum and Internship. After you read the

materials, fill out the information below, and send or fax to:

Counselor Education Program, University of South Carolina, Wardlaw 266, Columbia, SC 29208; fax: 803-777-

3045. You will then receive a letter with your approval status.

Name: Date:

SS#:

Home Address: Phone:

Street City State Zip E-Mail:

Home Phone: Email:

School: School Phone:

School Site Address:

Street City State Zip

School Email: Grade Levels:

Number of years as a counselor at these grade levels:

Number of years as a counselor in this building/school:

1. Formal Training Universities Attended Degrees Earned Majors

_____________________

_______________________

_______________________

2. Professional Certifications/Licenses Are you a certified school counselor? If yes, in what state(s)?

Do you have a professional license? If yes, which one(s)?

Do you have any supervision credentials? If yes, which one(s)?

FORM B: Application to Serve as

School Counseling Site Supervisor

Are you certified by the N.B.C.C.?

Do you hold any other professional credentials? ___ If yes, which one(s)?

3. Involvement in Professional Associations (Note: To be approved, you must have continuous involvement in one or more professional counseling

associations). List the counseling professional association(s) and divisions in which you currently hold

membership. Also, provide the dates of concurrent years you have been a member for each primary

professional association.

Counseling Associations/ Divisions Membership Years

In the following space, describe your level of involvement with these associations. For example, how often do

you attend conferences? How else have you been involved?

4. Developmental Counseling Focus In the following space, briefly describe how your program follows a comprehensive developmental school

counseling framework.

5. Supervision Background

Have you completed any coursework or had any other training in supervision? (Yes/No) If so, please provide a

description including the approximate date(s).

Have you previously served as a site supervisor for our school counseling program? (Yes/No)

If so, please (briefly) describe the experience, including the approximate date(s).

How many students have you supervised (approximate)?

Of those, how many have been USC students?

6. Site Suitability All students will be required to tape sessions and to provide individual and group counseling.

Will students be able to provide individual and group counseling at your school? (Yes/No)

Would our students be able to record audio and/or videotapes of their work with students at your school?

(Yes/No)

Does your school have a video camera and monitor that would be available for our students to tape some of

their sessions? (Yes/No)

What about your site would be most helpful for our students?

What (if anything) about your site would provide a limitation to the Practicum/Internship experience for our

students?

7. Personal Preferences

The following pages outline the Practicum and Internship experiences as defined by the University of South

Carolina and CACREP. Based on this information, would you rather supervise a Practicum ____ or

Internship ____ student (check all that apply)?

Would you prefer to supervise in Fall ___ or Spring ___? (check all that apply)

Would you prefer to interview the student before placement? Yes ___ No___

Approvals

Applicant Signature Date

Building Principal Signature Date

Student’s Name:

Student's Address:

Street City State Zip

Student's Home Phone:

Site Supervisor’s Name:

Site Supervisor’s SS#:

Site Address:

Street City State Zip

Site Phone:

Site Fax: Email Address:

__________________________________________________________________________________________

DAYS TIMES

Monday _______

Tuesday _______

Wednesday _______

Thursday _______

Friday _______

On-Site Supervision:

Day M: T: W: Th: F:

Times ________ ________ ________ ________ ________

FORM C: Student and Site Profile

Site Schedule

Students Name:

Supervisor’s Name:

Practicum Site:

Date: Circle One: Mid-term or Final

Directions: Please complete this evaluation of your Practicum student two times, once around mid-semester and

once again near the end of the semester.

NOT

OBSERVED WEAK AVERAGE STRONG

Process (Individual Counseling)

Rate the student’s ability to:

1. Begin counseling relationships effectively. N 1 2 3 4 5

Observations:

2. End counseling relationships effectively. N 1 2 3 4 5

Observations:

3. Use basic listening skills. N 1 2 3 4 5

Observations:

FORM D: Site Supervisor

Evaluation of Practicum Counselor Behaviors

4. Structure interviews appropriately N 1 2 3 4 5

(e.g., establish rapport, define problem, define

goals, explore and evaluate alternatives).

Observations:

5. Establish and communicate empathy. N 1 2 3 4 5

Observations:

6. Adapt counseling strategies so that responses N 1 2 3 4 5

to clients are culturally sensitive and effective.

Observations:

7. Provide a theoretical rationale for strategies N 1 2 3 4 5

employed in counseling.

Observations:

Other Comments:

Site Supervisor's Signature: _____________________________________

Practicum Student’s Signature: __________________________________

Student’s Name: Please Circle Course: Practicum / Internship

Semester: Week:

Activity Weekly Hours Cumulative Hours

I. Direct Service 802 Practicum*

805 Internship

1. Individual Counseling* _______ _______

2. Small Group Counseling* _______ _______

3. Classroom Guidance* _______ _______

4. Peer Facilitation _______ _______

5. Consultation* _______ _______

6. Student Intervention Team _______ _______

7. Individualized Education Plan _______ _______

8. Individual Graduation Plan*

9. Parent Education Class _______ _______

10. Teacher In-Service (not as participant) _______ _______

II. Indirect Service 1. Coordination _______ _______

2. Referral _______ _______

3. Program Planning _______ _______

4. Evaluation of Child/Class _______ _______

5. Observation of Child/Class _______ _______

6. Research into Student Information _______ _______

7. Research into Professional Issues _______ _______

III. Supervision 1. Individual Supervision (USC) _______ _______

2. On-site Supervision _______ _______

3. Group Supervision/Seminar _______ _______

IV. Other Hours 1. Counselor Staff Meeting _______ _______

2. District Counselor Meeting _______ _______

3. State-wide Counselor Conference _______ _______

4. Tape Critiques _______ _______

5. Progress Notes _______ _______

TOTAL HOURS _______ _______

Site Supervisor: Date:

USC Faculty: Date:

FORM E: Weekly Log of Field Experience Activities

Student’s Name: Course: Semester:

WEEK 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total

A. DIRECT SERVICE 802 Practicum 805 Internship

1. Individual Counseling 2. Small Group Counseling 3. Classroom Guidance 4. Peer Facilitation 5. Consultation 6. Student Intervention Team 7. Individualized Education Plan 8. Individual Graduation Plan 9. Parent Education Class 10. Teacher In-Service

B. INDIRECT SERVICE 1. Coordination 2. Referral 3. Program Planning 4. Evaluation of Child/Class 5. Observation of Child/Class 6.Research into Student Information 7. Research into Professional Issues

C. SUPERVISION 1. Individual Supervision (USC) 2. On-site Supervision 3. Group Supervision/Seminar

D. OTHER 1. Counselor Staff Meeting 2. District Counselor Meeting 3. State-wide Counselor Conference 4. Tape Critiques 5. Progress Notes

TOTAL

Direct Service Hours: Site Supervisor:

Indirect Service Hours:

Total Hours: USC Faculty:

FORM F: Field Experience Summary

Counselor Education

University of South Carolina

Site Supervisor: Semester/Year:

Site Placement:______________________________ Circle one: EDCE 802E/S or 805E/S

Please evaluate your supervisory experience in the following areas using the rating scale.

The rating scale is as follows:

5 = Almost always descriptive of my supervisor’s behavior

4 = Frequently descriptive of my supervisor’s behavior

3 = Generally descriptive of my supervisor’s behavior

2 = Infrequently descriptive of my supervisor’s behavior

1 = Almost never descriptive of my supervisor’s behavior

NA = Not applicable

Please circle your response.

1. My supervisor was genuinely interested in my growth as a professional counselor.

1 2 3 4 5 NA

2. My supervisor was very professional in his/her dealings with me.

1 2 3 4 5 NA

3. My supervisor made suggestions regarding my taped sessions that were beneficial.

1 2 3 4 5 NA

4. My supervisor created a setting of support.

1 2 3 4 5 NA

5. I was treated as a professional by my supervisor.

1 2 3 4 5 NA

6. My supervisor was dependable regarding his/her meetings with me and my colleagues.

1 2 3 4 5 NA

FORM G: SITE SUPERVISION

7. The supervisor offered me constructive criticism that assisted in improving my counseling skills.

1 2 3 4 5 NA

8. The requirements made of me by the supervisor were fair and challenging.

1 2 3 4 5 NA

Please comment on the following:

9. What do you feel you gained as a result of working with your supervisor?

10. What could have been done differently by your supervisor to make your experience more profitable?

11. If you were grading your site supervision experience, how would you grade it?

_____A _____B _____C _____D _____E

12. Were the physical facilities at your site appropriate? Please be specific regarding problems or strengths

like having your own space for counseling. If the site were to be graded, I would rate it:

_____A _____B _____C _____D _____E

Additional Comments: (Please include these)

UNIVERSITY SUPERVISOR'S NAME:

Circle One: EDCE 802E/S or 805E/S

DIRECTIONS: The following list of items provides descriptions of behaviors that contribute to effectiveness

in supervising counselor education students. Please rate your supervisor on the following items according to

how accurately each item describes the supervisor's actual behavior during the semester that has just ended.

Do not sign your name on this form; the ratings are to remain anonymous.

The rating scale is as follows:

5 = Almost always descriptive of my supervisor's behavior

4 = Frequently descriptive of my supervisor's behavior

3 = Generally descriptive of my supervisor's behavior

2 = Infrequently descriptive of my supervisor's behavior

1 = Almost never descriptive of my supervisor's behavior

N/A = Not applicable

DESCRIPTION OF MY SUPERVISOR’S BEHAVIOR SCALE RATINGS

This supervisor: 1 2 3 4 5 NA

1. Gives appropriate feedback to supervisees

about positive counseling behaviors. ____ ____ ____ ____ ____ ____

2. Gives appropriate feedback to supervisees

about ineffective counseling behaviors. ____ ____ ____ ____ ____ ____

3. Labels counselor behavior as effective or

ineffective rather than right or wrong. ____ ____ ____ ____ ____ ____

4. Gives us direct suggestions to supervisees

when appropriate. ____ ____ ____ ____ ____ ____

5. Confronts supervisees when appropriate. ____ ____ ____ ____ ____ ____

6. Helps supervisees assess their own strengths. ____ ____ ____ ____ ____ ____

FORM H: Practicum University Supervision Feedback

DESCRIPTION OF MY SUPERVISORY BEHAVIOR SCALE RATINGS

This supervisor: 1 2 3 4 5 NA

7. Helps supervisees assess their own weaknesses. ____ ____ ____ ____ ____ ____

8. Establishes clear goals conjointly with supervisees

against which progress in supervision can be measured. ____ ____ ____ ____ ____ ____

9. Evaluates supervisees at mid-semester. ____ ____ ____ ____ ____ ____

10. Helps supervisees in developing self-confidence

as emerging counselors. ____ ____ ____ ____ ____ ____

11. Shares his or her own experiences with clients

with supervisees. ____ ____ ____ ____ ____ ____

12. Establishes good rapport with supervisees. ____ ____ ____ ____ ____ ____

13. Demonstrates an openness to address professional

issues which arise from experiences in Practicum/

Internship setting. ____ ____ ____ ____ ____ ____

14. Models within the supervision session good

task-oriented skills. ____ ____ ____ ____ ____ ____

15. Provides more structure during the initial sessions

than during later sessions. ____ ____ ____ ____ ____ ____

16. Helps supervisees realize that trying new skills

usually seems awkward at first. ____ ____ ____ ____ ____ ____

17. Helps supervisees to conceptualize cases. Works

with supervisees to evolve a joint conceptualization. ____ ____ ____ ____ ____ ____

18. Helps supervisees define and maintain ethical

behavior in counseling and case management. ____ ____ ____ ____ ____ ____

19. Encourages supervisees to experiment with

different assessment and intervention techniques

to discover their own unique styles. ____ ____ ____ ____ ____ ____

20. Offers resource information when I request or

need it. ____ ____ ____ ____ ____ ____

ADDITIONAL COMMENTS:

Student’s Name:

Site Supervisor's Name:

Site Name:

Date: Circle One: Mid-term or Final

The rating is as follows:

5 = Almost always descriptive of the intern’s behavior

4 = Frequently descriptive of the intern’s behavior

3 = Generally descriptive of the intern’s behavior

2 = Infrequently descriptive of the intern’s behavior

1 = Almost never descriptive of the intern’s behavior

NA = Not applicable

Please circle your response.

Not Applicable Low High

The intern is able to:

(Consistently) demonstrate the high facilitative NA 1 2 3 4 5

responses in counseling and consulting relationships.

Establish and maintain a helpful counseling relationship. NA 1 2 3 4 5

Explore and identify counselee goals. NA 1 2 3 4 5

Help counselee through the stages of problem solving. NA 1 2 3 4 5

Evaluate and validate the changes in the counselor’s NA 1 2 3 4 5

behavior and/or attitude.

Recognize personal issues that affect counseling. NA 1 2 3 4 5

Develop a plan to deal with personal issues related to NA 1 2 3 4 5

counseling.

Gather and use assessment data in a counseling or NA 1 2 3 4 5

consulting relationship.

FORM I: Evaluation of Internship

Competencies

Organize, lead, and critique group counseling NA 1 2 3 4 5

experiences.

Organize, lead, and critique classroom guidance NA 1 2 3 4 5

experiences.

Develop a yearly plan for a comprehensive NA 1 2 3 4 5

developmental program

Consult with parents and teachers in order to promote NA 1 2 3 4 5

successful learning and adjustment for students.

Conduct parent/teacher workshops. NA 1 2 3 4 5

Assess environmental factors that negatively impact NA 1 2 3 4 5

on children and is able to plan strategies for appropriate

interventions.

Conduct a needs assessment. NA 1 2 3 4 5 Evaluate his/her guidance program. NA 1 2 3 4 5

Demonstrate professional commitment by active NA 1 2 3 4 5

participation in professional organizations for school

counselors.

Stay abreast of current issues through professional NA 1 2 3 4 5

journals.

Other Competencies: (please describe)

_____________________________________________ NA 1 2 3 4 5

_____________________________________________ NA 1 2 3 4 5

_____________________________________________ NA 1 2 3 4 5

_____________________________________________ NA 1 2 3 4 5

Comments:

Site Supervisor's Signature: _____________________________________

Student’s signature:

I (we) give permission for my (our) child to participate in counseling with

, a graduate student at the University of South Carolina, who is enrolled in the

course EDCE during the semester, 20 .

It is understood that the counseling sessions will be electronically recorded and played in class with both

the instructor and class members present. These recordings will be used for educational purposes and

erased at the end of the course.

It is understood that my (our) child is entitled to confidentiality and that information regarding

communications made in the counseling sessions will be limited only to those directly involved in

receiving, providing, or sharing the educational process and any professional consultants. I (we) do

also release and forever discharge the University of South Carolina, its officers, agents, employees, and

students from any and all suits, claims, damages, demands, liabilities, costs and expenses, including

reasonable counsel fees, which may result from participation in counseling.

Parent or Guardian/Date:

Witness/Date:

USC Student/Date:

USC Faculty Member/Date:

Note: The parent or guardian, USC Student, and USC Faculty Member are to be given copies of this

form after it is signed by all parties.

FORM J: Consent for Counseling of a Minor Child and Recording Release Form

I give permission for my participation in counseling with , a graduate student at

the University of South Carolina, who is enrolled in the course EDCE during the

semester, 20 .

I understand that the counseling sessions will be electronically recorded and played in class with both the

instructor and class members present. These recordings will be used for educational purposes and erased

at the end of the course.

It is understood that I am entitled to confidentiality and that information regarding communications made

in the counseling sessions will be limited only to those directly involved in receiving, providing, or sharing

the educational process and any professional consultants. I do also release and forever discharge the

University of South Carolina, its officers, agents, employees, and students from any and all suits, claims,

damages, demands, liabilities, costs and expenses, including reasonable counsel fees, which may result from

participation in counseling.

Signature/Date:

Witness/Date:

USC Student/Date:

USC Faculty Member/Date:

Note: The client, USC Student and USC Faculty Member are to be given copies of this form after it is signed by

all parties.

FORM K: Consent for Counseling and

Recording Release Form

Voluntary and required field experiences (i.e., Practicum and Internship courses) at the University of South

Carolina are not covered by professional liability or health insurance through USC or school districts. For

each semester of enrollment, all full time students (Full Time Student are those who are enrolled for

12 or More Hours of Credit) and those Who Pay the University Fee are automatically provided with health

insurance coverage for accidents occurring on campus or in University-related activities in accordance with the

specifications provided in the material below. Read all the information about health and liability insurance

provided in this form. Your Signature is Required on the Page Which Follows.

HEALTH INSURANCE

The following information is provided concerning health services and health insurance for students while

enrolled at the University of South Carolina, Columbia Campus.

Health Care Eligibility: All students enrolled in academic classes at the University of South Carolina,

Columbia Campus are eligible to use all facilities operated by the Student Health Services. This includes

Thomson Student Health Center, the Counseling and Human Development Center, and the Health and

Wellness Programs Office. Eligibility is verified using various student databases.

Charges for Student Health Services: All students enrolled in the Fall and Spring semester who have

paid the Health Fee (check with USC Student Health for current fee information) are entitled to provider

office services at no charge at all Student Health facilities. Students who have not paid the Fall or Spring

Health Fee is charged a fee-for-service for each visit with a provider. During Summer School sessions, all

enrolled students are entitled to free professional services. All students are charged at special student rates

for ancillary services (laboratory, x-ray, and pharmacy) and for various procedures, such as minor surgery,

during all academic sessions.

Fall and Spring Health Fee: The Health Fee is a component of the University Fee. All undergraduates

taking 12 or more hours are required to pay the university/health fee. Most graduate students taking 9 or

more hours and most graduate assistants are either required to pay the health fee, or it is included in their paying

the university/health fee. Health fee payment status will be verified when students present for care

at Student Health facilities.

Summer Health Fee: All students enrolled in Summer I and Summer II courses have a health fee

component included in their fee structure, and they are entitled to use Student Health Services facilities

without paying provider fees.

Health Insurance: Student Health Services cannot meet all potential health care needs. All students are

encouraged to have comprehensive health care insurance coverage.

a. No comprehensive health care coverage is provided by payment of the university fee or health

fee. Students currently covered under health plans, such as their parent's insurance plan, or through a

plan carried by their employer, should verify that these plans will continue to cover them while

FORM L: Insurance Responsibility

attending the University. Students who need comprehensive health insurance coverage should consider

purchase of coverage under an optional group health insurance plan sponsored by the University.

Information on the available plan can be obtained by calling the Student Health Center, 777-3174.

b. Students who pay the university fee or health fee are automatically covered under a limited

plan which provides reimbursement of up to $500 for out-of-pocket expenses associated with treatment

of an emergency illness or injury. This plan includes no coverage for non-emergency conditions or

routine care.

c. The current health care insurance contracts changed August, 1996. Students may check on status and

coverage under replacement plans by calling the Student Health Center (803-777-3174).

LIABILITY INSURANCE

Liability insurance is available through membership in the student NEA (777-6262), to student members in the

Palmetto State Teachers Association (256-2065), or through various professional development organizations.

Contact your advisor for more information.

Student counselors have other sources for insurance specifically for counseling liability. Information is

available on the insurance provided to student members of the American Counseling Association, and other

professional associations. Allow up to 60 days for confirmation of your liability insurance.

Detach and return the bottom section of this form to your instructor the first day of your Practicum or Internship

course along with evidence of liability coverage.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

I have read the Form L material on health insurance and services, and I understand my responsibility

for my own health care and insurance.

I understand and accept the condition that the College of Education, The University of South Carolina

and individual faculty members or other instructional staff are released from any liability related to

accidents or any other unexpected events which may occur in conjunction with my participation in

required or voluntary activities outside of the University of South Carolina, Columbia campus.

Student Signature Date

Witness Signature (College of Education Employee) Date

EDCE

Student Semester Semester

Signature of Signature of

University Supervisor/Date Site Supervisor/Date

Total Hours

FORM M: Supervision Log

The student will demonstrate ability to do some of the following activities at competency level judged adequate

by the supervising counselor and verified by the USC supervisor. Items with asterisks are required; other

selected activities will be negotiated on an individual basis.

DATE FIELD UNIVERSITY

COMPLETED SUPERVISOR SUPERVISOR

A. INDIVIDUAL PLANNING

1. Orient student groups to group appraisal

instruments and purposes.

2. Administer or proctor the administration

of appraisal instruments to student groups.

3. Score appraisal instruments and profile

and record appraisal data.

4. Interpret appraisal data to groups and/or

individuals.

5. Select appropriate appraisal instruments for

Individuals and groups.

6. Use appraisal data effectively in counseling

and/or conferences.

7. Use systematic observation instruments

to assess behavior.

8. Prepare and conduct programs for large

groups on orientation to guidance services

(or new services).

9. Collect and file personal-social, educational,

and career information.

10. Display and distribute personal-social,

educational, and career information.

11. Conduct small group activities to orient

students to and distribute personal-social,

educational, and career information.

FORM N: Internship Experiences

INDIVIDUAL PLANNING (continued) DATE FIELD UNIVERSITY

COMPLETED SUPERVISOR SUPERVISOR

12. Assist students with completing financial

assistance, school admission, and job

application forms.

13. Assist students with routine education and

career planning.*

14. Coordinate efforts to place students in

appropriate educational programs.

15. Coordinate efforts to place students in

appropriate setting for work experience

and/or part-time work.

B. RESPONSIVE SERVICES

1. Document individual counseling with a

student with a personal-social problem.*

2. Document individual counseling with

student with an educational problem.*

3. Document individual counseling with a student

with a problem concerning career choice.

4. Help students to learn how to collect and

evaluate information and use decision-making

processes. (May be documented with

individuals or groups).

5. Document with a case study the ongoing

counseling for at least one student with rather

serious concern for a minimum of six sessions.*

6. Document with an evaluation summary the

leadership of a counseling group that meets

for five or more sessions.*

7. Identify and select students for group guidance

and small group counseling activities.

8. Identify students for referral to other agencies.

RESPONSIVE SERVICE (continued) DATE FIELD UNIVERSITY

COMPLETED SUPERVISOR SUPERVISOR

9. Help students who need referral, and their

parents, to become aware of such needs and to

obtain referral services.

10. Maintain contacts with and make referrals to

referral agencies.

11. Provide consultation and information to teachers

which will aid in their effort to help students

achieve and adjust in the classroom

12. Provide consultation and information to

administrators and teachers to assist them in

program development and revision to meet

student needs.

13. Provide consultation and information to parents

to assist them with long range educational and

career planning for their children.*

14. Provide consultation and information to decision

makers to assist them in providing a physical

psychological environment conducive to

learning and adjustment.

15. Provide consultation to school personnel and

monitor activities in the school’s efforts toward

the maximum self-realization by all students.

16. Provide consultation and coordination to school

Personnel and parents in referring students

for special services.

C. SYSTEM SUPPORT

1. Work with other professional staff in developing

and maintaining contacts with employers and

placement agencies.

2. Work with other professional staff in

conducting student follow-up studies and

analyzing data.

SYSTEM SUPPORT (continued) DATE FIELD UNIVERSITY

COMPLETED SUPERVISOR SUPERVISOR

3. Work with other professional staff in

conducting student follow-up studies and

analyzing data.

4. Facilitate communication and exchange of

information between school and community

agencies.

5. Facilitate communication between students and

parents and between students and/or parents

and school faculty.

6. Cooperate and maintain communication with

other counselors at all levels.

D. STUDENT RESPONSIBILITIES

1. Maintain confidential files of pupil data on

students with whom you are working.*

2. Brief report in writing describing the process in

your school for preparing and sending individual

student transcripts, reports and recommendations

to appropriate agencies.

3. Collect and provide copies of counseling and

guidance records, forms and other professional

materials used by counselors in your building.

4. Prepare and present charts, summaries, and reports

of EDCE 802S experiences to counselors,

principals, and USC supervisors.

5. Describe the recommendation processes that are

appropriate to your setting (e.g., letters for

scholarships, honors, admissions, and

employment).

6. Attend one or more professional meetings

during the semester.*

STUDENT RESPONSIBILITIES (continued) DATE FIELD UNIVERSITY

COMPLETED SUPERVISOR SUPERVISOR

7. Professional readings; viewing professional films

or videotapes, listening to professional audiotapes;

list each by name and date on this sheet or an

attachment.

8. Develop proposal for professional program/

presentation to submit for consideration of

counseling related professional organization.

9. Complete the appropriate level of ASCA Audit

in Cooperation with site supervisor.*

Practicum Student Name University Supervisor Name (Printed)

Date of Evaluation Period Covered by Evaluation

Directions: Please complete this evaluation of your Practicum student two times, once around mid-

semester and once again near the end of the semester. Use a different colored pen or pencil for each of

these evaluations and indicate which color was used for each.

The Practicum student demonstrates an ability to form effective relationships with:

Superior Above Avg. Average Below Avg. Inadequate No Basis Clients Supervisor Other Staff Members Outside Agencies

The Practicum student:

Superior Above Avg. Average Below Avg. Inadequate No Basis Demonstrates knowledge

of principles and

processes

Begins counseling

session smoothly

Can explain counseling

processes and objectives

Is relaxed during the

counseling session

Expresses interest and

acceptance of the client

Facilitates expression of

concerns and feelings

Comments:

FORM O: Evaluation of Counseling

Performance University Supervisor

Evaluation (cont’d)

The Practicum student effectively uses:

Superior Above Avg. Average Below Avg. Inadequate No Basis Rapport Eye Contact Posture Encouragers Basic Empathy Probing Challenging Silence Exploration of Client

Concerns

Identification of Goals Summarizing

Comments:

The Practicum uses the following behaviors:

Usually Sometimes Infrequently No Basis Mechanistic Inaccurate Reflections /

Interpretations

Pat Answers Advice Giving Missing Non-Verbal

Cues from Clients

Inappropriate Counselor

Self-Disclosure

Comments:

Evaluation (cont’d)

The Practicum student effectively uses:

Superior Above Avg. Average Below Avg. Inadequate No Basis Terminates the

Counseling Session

Smoothly

Is Able to Make

Appropriate Referrals

Knows Community

Resources

Is Able to Make a

Treatment Plan

Can Explain, Administer

and Interpret Tests

Correctly

Completes Case Reports

Accurately and

Punctually

Operates from a Sound,

Rational Theoretical

Base

Demonstrates Ethical

Behavior

Committed to

Developing Professional

Competencies

Invests time and Energy

in Becoming a Counselor

Comments:

Student’s Signature: ________________________________________________________