Form: Site Supervisor's Evaluation of Counseling Intern's Performance

Owner: JSU Administration <jsuadmin>
Owner's Email: dherring@jsu.edu
Dataset: Site Supervisor's Evaluation of Counseling Intern's Performance
EDIT: Y, VIEW: N, REQR: N
1
Final Evaluation Due Date:
 (MM/DD/YYYY)
EDIT: Y, VIEW: N, REQR: N
2
Name of Intern:
EDIT: Y, VIEW: N, REQR: N
3
Evaluator:
EDIT: Y, VIEW: N, REQR: N
4
Placement / Site:
EDIT: Y, VIEW: N, REQR: N
5
Semester:
Fall
Spring
EDIT: Y, VIEW: N, REQR: N
6
Year:
2011
2012
2013
2014
2015
2016
EDIT: Y, VIEW: N, REQR: N
7
Provides counseling services for individual clients.
Individual Counseling
Reference: Learning Outcomes 1, 2 and 4
EDIT: Y, VIEW: N, REQR: N
8
Demonstrates understanding of counseling theories and proficiency in applying techniques to help individual clients (relative to intern's level of experience).
Individual Counseling
Reference: Learning Outcomes 1, 2 and 4
EDIT: Y, VIEW: N, REQR: N
9
Exhibits individual counseling strategies and techniques appropriate for clients of various ages and developmental levels (students P-12).
Individual Counseling
Reference: Learning Outcomes 1, 2 and 4
EDIT: Y, VIEW: N, REQR: N
10
Provides counseling / guidance services for groups.
Group Counseling and Guidance
Reference: Learning Outcomes 1, 2 and 4
EDIT: Y, VIEW: N, REQR: N
11
Demonstrates understanding of counseling theories and proficiency in applying techniques to help individual clients in groups (relative to intern's level of experience).
Group Counseling and Guidance
Reference: Learning Outcomes 1, 2 and 4
EDIT: Y, VIEW: N, REQR: N
12
Exhibits group counseling strategies and techniques that are appropriate for clients of various ages and developmental levels (P-12).
Group Counseling and Guidance
Reference: Learning Outcomes 1, 2 and 4
EDIT: Y, VIEW: N, REQR: N
13
Administers tests and/or conducts informal assessments.
Assessment and Treatment / Intervention Planning
Reference: Learning Outcome 8
EDIT: Y, VIEW: N, REQR: N
14
Uses appropriate procedures in selecting and scoring tests or other assessments.
Assessment and Treatment / Intervention Planning
Reference: Learning Outcome 8
EDIT: Y, VIEW: N, REQR: N
15
Interprets and communicates assessment data appropriately.
Assessment and Treatment / Intervention Planning
Reference: Learning Outcome 8
EDIT: Y, VIEW: N, REQR: N
16
Uses assessment data in making treatment / referral decisions.
Assessment and Treatment / Intervention Planning
Reference: Learning Outcome 8
EDIT: Y, VIEW: N, REQR: N
17
Delivers consultation services.
Consultation and Coordination
Reference: Learning Outcome 7
EDIT: Y, VIEW: N, REQR: N
18
Provides feedback about performance (treatment outcomes), as applicable.
Consultation and Coordination
Reference: Learning Outcome 7
EDIT: Y, VIEW: N, REQR: N
19
Plans or modifies interventions (treatments), when applicable.
Consultation and Coordination
Reference: Learning Outcome 7
EDIT: Y, VIEW: N, REQR: N
20
Works with others (e.g. with other agencies) to access services for clients (students).
Consultation and Coordination
Reference: Learning Outcome 7
EDIT: Y, VIEW: N, REQR: N
21
Uses technology to enhance the delivery of counseling services.
Consultation and Coordination
Reference: Learning Outcome 7
EDIT: Y, VIEW: N, REQR: N
22
Establishes appropriate goals and objectives.
Professional and Program Management Skills
Reference: Learning Outcome 4
EDIT: Y, VIEW: N, REQR: N
23
Plans for and schedules delivery of services.
Professional and Program Management Skills
Reference: Learning Outcome 4
EDIT: Y, VIEW: N, REQR: N
24
Manages service delivery and documents services.
Professional and Program Management Skills
Reference: Learning Outcome 4
EDIT: Y, VIEW: N, REQR: N
25
Completes and organizes files/materials in a timely manner.
Professional and Program Management Skills
Reference: Learning Outcome 4
EDIT: Y, VIEW: N, REQR: N
26
Responds appropriately to constructive feedback from supervisor.
Communication, Appreciation of Diversity and Professional Growth
Reference: Learning Outcome 5
EDIT: Y, VIEW: N, REQR: N
27
Uses effective strategies and interaction skills with clients / students, families and other professionals.
Communication, Appreciation of Diversity and Professional Growth
Reference: Learning Outcome 5
EDIT: Y, VIEW: N, REQR: N
28
Demonstrates proficiency in written and spoken language.
Communication, Appreciation of Diversity and Professional Growth
Reference: Learning Outcome 2
EDIT: Y, VIEW: N, REQR: N
29
Engages in professional growth activities.
Communication, Appreciation of Diversity and Professional Growth
Reference: Learning Outcome 5
EDIT: Y, VIEW: N, REQR: N
30
Adheres to legal mandates and ethical guidelines.
Communication, Appreciation of Diversity and Professional Growth
Reference: Learning Outcome 5
EDIT: Y, VIEW: N, REQR: N
31
Exhibits understanding of individual differences.
Communication, Appreciation of Diversity and Professional Growth
Reference: Learning Outcome 3
EDIT: Y, VIEW: N, REQR: N
32
Demonstrates sensitivity toward diverse populations in diverse settings.
Communication, Appreciation of Diversity and Professional Growth
Reference: Learning Outcome 3
EDIT: Y, VIEW: N, REQR: N
33
Comments: