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Counseling 6000: Practicum
Application & Contract Agreement

Lackland AFB and Brooks City Base
San Antonio, Texas

2006 - 2007

General Information and Procedures
The Counseling Practicum

  1. The Practicum is a experience in which the student provides counseling services to live clients in a mental health setting under the supervision of a licensed mental health counselor/practitioner.  A new student should begin immediately exploring the availability and type of practicum site desired for their long term professional goals:  agency setting, private practice setting, etc. 

  2. After preliminary contacts by the student, she/he should have narrowed the list of possible sites. The student should then arrange an interview at the agency in which she/he would like to do a practicum. The United Way of San Antonio maintains a searchable database of agencies.  In this interview, the student should discuss the practicum requirements with that agency.  (NOTE: These requirements/responsibilities are outlined in the document, COUN 6000 Counseling Learning Practicum, Application & Contract Agreement)  It is the students' responsibility to secure a Practicum site.

  3. Once a student and the Practicum Site Supervisor have agreed upon the specifics of a Practicum Proposal, the student must submit copies of the signed Practicum Proposal to the Webster Practicum Supervisor prior to the first class meeting.  (NOTE: A Practicum Proposal is not to be accepted unless both the student and the Practicum Site Supervisor sign it.)  The Practicum should NOT be the student?s ordinary employment.

  4. The Practicum Site Supervisor accepts the responsibility for providing a student with the individualized supervision consistent with the requirements/responsibilities that are outlined in the COUN 6000 Counseling Learning Practicum, Application & Contract Agreement.  As also outlined in that document, the student?s supervisor is responsible for reporting on the student?s performance to the Webster Practicum Supervisor.

  5. The Webster Practicum Supervisor is responsible for establishing evaluation procedures with the Practicum Site Supervisor. These procedures may include weekly or periodic updates on the student?s performance, site visits, etc.  Although the Webster Practicum Supervisor determines a final grade, the Practicum Site Supervisor is required to provide a formal letter of evaluation of the student at the completion of the practicum.  The student will also have liability insurance.  The  Practicum Site Supervisor, Webster Practicum Supervisor and agency will also have such coverage.

  6. Since the COUN 6000 Counseling Learning Practicum courses require many hours, the student may need to have the Practicum experience last for more than the normal nine-week term. The Webster Practicum Supervisor will work out an arrangement with the student for completing the course after the term ends.

  7. The direct supervision of a student?s Practicum must comply with state licensure requirements for the type of license that is sought.  More specifically, a Practicum Site Supervisor should possess  appropriate credentials such as: LPC, LMFT, LCSW, Licensed Psychologist, or Board Certified Psychiatrist.

COUN 6000: Counseling Learning Practicum

Responsibilities of the Webster Practicum Supervisor

  1. Approve students for registration and placement in the Practicum. 

  2. Endorse the student?s Practicum contract for the designated term.

  3. As far as practical, arrange seminars and conferences for students in the Practicum in order to provide feedback, to give support and direction, and to determine opportunities for professional growth, as well as other counseling experiences.

  4. Assign grades after consultation with the On-site Supervisor.  Grades to be assigned are CR for credit or I (I = Incomplete).  A CR means that the contract requirements have been completed.  Incompletes will be made up before nine weeks have passed during the subsequent semester and after a student and the Webster Practicum Supervisor have agreed on a written contract to fulfill the requirement, a contract that is to be placed in the student?s permanent file.

  5. Visit with the On-site Supervisor(s) at least one time during the semester.  Maintain regular contact with the On-site Supervisor(s) by telephone and/or additional visits.

Responsibilities of the Counseling Student

  1. Meet or talk with the Webster Practicum Supervisor in order to get permission to enter the practicum and to discuss possible sites.

  2. Complete the Practicum Application (APPENDIX A, Practicum Form 1) and return to the Webster Practicum Supervisor.   One copy will be placed in your permanent file. 

  3. Read and sign the CONTRACTUAL AGREEMENT BETWEEN PRACTICUM STUDENT AND WEBSTER UNIVERSITY (APPENDIX B, Practicum Form 2) and return to the Webster Practicum Supervisor.  This should be submitted with the INTERNSHIP APPLICATION and again, one copy will be placed in your permanent file.

  4. Reasonable effort will be made to honor student requests regarding Practicum placements.  The Webster Practicum Supervisor will make the final decision on placement.  Sites, which offer the greatest breadth of opportunity, most direct client, contact hour opportunities, and best-qualified supervision will take priority. The United Way of San Antonio maintains an up to date searchable database of agencies.

  5. After you have been notified that your placement has been approved, arrange an initial interview at the Practicum site with your On-site Supervisor.  At that time, give one copy of your resume to your On-site Supervisor and mutually decide on goals for your practicum.  Be sure to emphasize to your On-site Supervisor that you need a minimum of 150 hours of experience during the term.

  6. Submit a Practicum Schedule to your Webster Practicum Supervisor prior to the first week of the semester and plan to attend all orientations and seminars related to the Practicum course and site.

  7. On-site Supervisors are requested to meet with Practicum students a minimum of one hour for each ten clock-hours, but some may choose to meet more often.  At least half of these hours must involve individual supervision.

  8. The Webster Practicum Supervisor will meet a minimum of one individual supervision session during each semester with each student.  Depending upon the skill level demonstrated and other relevant factors, the student and the Webster Practicum Supervisor may decide to meet more frequently.

  9. Typically, your Webster Practicum Supervisor is the person with whom you should consult regularly.  Also, check carefully the course outline and/or syllabus for pertinent details.  It is your responsibility to complete all of the requirements that are listed in your Practicum syllabus.

  10. It is your responsibility to follow all of the instructions and to provide all of the information required in executing the steps outlined in this packet, including those intended for your designated On-site Supervisor.  Please be sure that you fully understand all of your responsibilities at the outset and if clarification is necessary, ask questions of a Counseling coordinator and/or your Webster Practicum Supervisor.

  11. Responsibilities of the On-Site Supervisor

    The following guidelines provide useful information to students and supervisors about the intended nature of the Practicum and about the responsibilities of the professional personnel, especially the On-site Supervisor, who are directly involved.

    1.  Regular supervision is essential to the success of the Practicum.

    a. The Webster Practicum Supervisor will contact each On-site Supervisor during the semester. Regular contact with the On-site Supervisor will be maintained by phone and/or additional visits

    b. The Webster Practicum Supervisor is available upon request at any time should the need arise..

    c. Each student will participate in an ongoing analysis or Practicum group seminar with the Webster Practicum Supervisor

    2.  The student is instructed to contact the agency, or institutional supervisor at least one week prior to the beginning of the semester to arrange hours, orientation sessions, deliver a resume, and to discuss and to decide on goals and a time plan for the semester.

    3.  During the semester, a student is expected to spend a minimum of 150 clock hours on site.

    4.  On-site Supervisors should arrange for students to take part in staff meetings and staff/in-service training.

    5.  The student should be given the opportunity to practice individual, group, and/or family counseling in order to demonstrate counseling skills and to receive feedback on his or her performance.

    6.  On-site supervisors are requested to suggest to the student readings relevant to that particular site.  These readings may be books, articles, manuals, or related materials the On-site Supervisor believes to be most helpful to the student in understanding better the site and/or the clients, which it serves. 

    7.   The student is expected to follow consistently the policies, professional activities and procedures, and legal responsibilities of the agency or institution.

    8.   On-site Supervisors are requested to complete a mid-semester and a final evaluation of a student?s performance.  See the ON-SITE SUPERVISOR EVALUATION (APPENDIX D, Practicum Form 4).

    9. The final evaluation and grading of a student?s performance is the responsibility of the Webster Practicum Supervisor, but only after receiving direct, written input from the On-site Supervisor.  It is the responsibility of the Webster Practicum Supervisor to initiate contact with the On-site Supervisor in order to establish specific criteria and procedures for evaluation of the student?s performance.

    10. The student is required to complete a STUDENT EVALUATION OF PRACTICUM SETTING (APPENDIX E, Practicum Form 5) of his or her Practicum which should include, but is not limited to, a discussion of learning outcomes; how to integrate these outcomes into practice; strength and limitations of the site; an analysis of the total field experience and seminar, as well as supervision; and learning from the On-site Supervisor?s assigned readings and on-site activities.  A copy of this review is to be shared and discussed with the On-site Supervisor; another copy goes to the Webster Practicum Supervisor; and the student retains one copy.

    11. The On-site Supervisor is requested to provide input to the Counseling degree program at Webster University.  Input may include, but is not limited to, feedback on the curriculum; competence or skill levels acquired as reflected in student performance; and skills or issues that could be added to the program.

  12. The Counseling degree program at Webster University greatly appreciates the professional input and participation of On-site Supervisors in the training of its students.  The ultimate success of that training is assured when the On-site Supervisor?s input and participation is maximized.  We thank you in advance for your cooperation and collaboration.


     

    APPENDIX A

    (Practicum Form 1)

    Student Practicum Application

    (A copy of this form will be returned to you after your site has been approved)

    This Application must be filled out completely and returned to a Counseling coordinator at least one term prior to the one in which the Practicum is to take place.  Indicate starting term and year:

                Spring I_____ Spring 2______ Fall I______ Fall 2 ______ Summer__________

    Student Name:_________________________________  Phone:___________________________

    Address:________________________________________________________________________

    Briefly describe your special areas of interest in the field of Counseling.  What would you like to accomplish in the Practicum experience?

    Is there a particular agency or setting in which you want to do your Practicum?  If so, where?

    Are you currently employed in the agency, school, institution, or setting mentioned above?

    Is there any other information (e.g., previous experience), which you believe may be beneficial to the On-site Supervisor?

    Student Signature: _________________________________________Date: _________________

    Webster Practicum Supervisor Signature: _____________________________ Date: ________________

    Practicum Site: __________________________________ Phone: _________________________

    Address: _______________________________________________________________________

    Site Supervisor: ________________________________ Contact Phone: ____________________


     

    APPENDIX B

    (Practicum Form 2)

    CONTRACTUAL AGREEMENT BETWEEN

    PRACTICUM STUDENT AND WEBSTER UNIVERSITY

    (A)  I hereby attest that I have read and understand the LPC and/or LMFT Codes of Ethics (http://www.dshs.state.tx.us/counselor/default.shtm  /  http://www.dshs.state.tx.us/mft/)

     I will practice my counseling in accordance with these standards.  I further understand that any breach of this code or any unethical behavior on my part will result in my receipt of a failing grade in the Practicum and written notification of such behavior will be placed in my permanent record

                                                                      

    (B)  I understand that all students must carry professional liability insurance. Attached is a photocopy of my insurance.

    (C) I understand that it is my responsibility to keep my Practicum supervisors (On-site Supervisor and Webster University Instructor of Record) fully informed regarding my Practicum experience.

    (D) I understand that I will not be awarded a passing grade until I have demonstrated in the Practicum a specific minimal level of Counseling knowledge, skills, and attitudes.

    (E) I further understand that it is my responsibility to attend all classes and supervisory sessions fully prepared as outlined in the Practicum course requirements.  If any sessions are not attended, or attended without my full preparation, they will not be counted toward the fulfillment of the minimal Practicum requirements.

    Student Name: __________________________________________

    Student Signature: _______________________________________     Date:________________


     

    APPENDIX C

    (Practicum Form 3)

    Webster University STUDENT ACCEPTANCE CONTRACT

    ________________________________________________________________ Agrees to accept

                (Agency, school, institution)

    ________________________________________________________________, A graduate

                (Print student name)

    Student in the Counseling degree program at Webster University, as a student counselor.  All parties have read the Counseling Practicum information packet and accept the responsibilities described therein.

    Practicum Beginning Date: _____________________ Ending Date:______________________

    Name of On-site Supervisor: ______________________________________________________

    Signature of On-site Supervisor: ___________________________________________________

    Contact Phone Numbers: _________________________________________________________

    Name of Student Counselor: ______________________________________________________

    Signature of Student Counselor: ___________________________________________________

    Contact Phone Numbers: _________________________________________________________

    Name of Webster Practicum Supervisor:_____________________________________

    Signature of Webster Practicum Supervisor:__________________________________

    Contact Phone Numbers: _________________________________________________________

    Date:________________________________


     

    APPENDIX D

    (Practicum Form 4)

    ON-SITE SUPERVISOR?S MIDTERM & FINAL EVALUATION FORM

    Webster University Counseling Program

    To the On-site Supervisor: Please have the student check the appropriate space below and sign and date before you complete your evaluation.

    I waive__________ do not waive__________ my right of access to this evaluation.

    Student Name:____________________________________     Date:______________________

    Student Signature:_________________________________

    Your Name:______________________________________     Date:______________________

    Your Signature:___________________________________

    Site Supervisor?s Evaluation of This Student (attach additional pages as necessary):


     

    APPENDIX E

    (Practicum Form 5)

    Webster University PRACTICUM STUDENT SITE EVALUATION

    NOTE: This form should be completed by the student and given to the Webster Practicum Supervisor at the conclusion of the Practicum experience at a given setting.

    Student Name:____________________________________  Term & Year:______________

    Practicum Setting:______________________________________________________________

    On-Site Supervisor's Name:_______________________________________________________

    In order to assist other students in choosing a Practicum setting, please comment briefly on your experience as a student in each of the following areas (attached additional pages if necessary).

    1. Describe the Practicum setting

    2. Describe the type of clients with whom you worked and the problems which they had.

    3. Describe the type of counseling/professional activities, which were available to you as a student.

    4. Describe the facilities and resources, which were at your disposal.

    5. Describe the type and level of communication among the counselors with whom you interacted.

    6. Describe the type and level of supervision you received.

    Please provide any additional comments (e.g., on the advantages and/or disadvantages of this particular setting) you think might be helpful to other students who might be considering this or a similar Practicum setting.






 

APPENDIX F

(Practicum Time Log)

Practicum Student:  _________________________________

            Facility:  _________________________________

            Site Supervisor: _______________________________

            Webster Practicum Supervisor: _______________________

Date

Brief Description of Counseling activity

Time In

Time Out

Total Time

Supervisor?s Signature


 

APPENDIX G

(Practicum Debriefing Log)

Intern:  __________________________________ Date: ________________

Facility:  _________________________________

Site Supervisor: _______________________________

Webster Practicum Supervisor: _______________________

Counseling Objective: ____________________________________________________________

Brief description of the day or counseling session:
       
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