1 1 Revised June 2011 University of North Florida Handbook for Mental Health Counseling Practicum and Internship REVISED June 2011 CLINICAL MENTAL HEALTH COUNSELING PROGRAM BROOKS COLLEGE OF HEALTH DEPARTMENT OF PUBLIC HEALTH 1 UNF DRIVE, Bldg. 39, Room 4033 Jacksonville, Florida (904) (904) FAX
2 2 Table of Contents Introduction..3 Time line.. 4 I. Practicum.. 5 II. Internship.. 6 III. Counting Hours...7 IV. The Application Process. 8 A. Selecting a Practicum or Internship Site 8 B. Multiple Sites..10 C. Completing Internship hours at your job site.10 D. Finalizing the Practicum or Internship Placement..10 V. Responsibilities of Site Supervisors..11 A. Qualifications 11 B. Supervision..12 C. Audio/Video Taping 12 D. Evaluation E. Site Supervisor Tuition Waiver. 12 VI. Responsibilities of UNF Supervisors. 12 A. Practicum Group Meetings. 12 B. Internship Meetings.. 13 C. Evaluation. 13 VII. The Practicum and Internship Experience 13 A. Liability Insurance B. Criminal Background Check.. 13 C. Immunization Requirement of some sites 14 D. Establishing a Schedule E. Maintaining a Log F. Individual Counseling. 14 G. Group or Family Counseling. 15 H. Related Responsibilities 15 I. Professional Associations & Memberships 15 J. Professional Development Opportunities 15 K. Evaluation of Practicum & Internship.. 16 L. Personal Counseling...16 VIII. Appendices A. Practicum or Internship Agreement Form. 17 B. Practicum or Internship Statement of Understanding. 18 C. Practicum or Internship Information Sheet 19 D. Practicum or Internship Learning Contract.. 20 E. Permission to Record & Consult 21 F. Mental Health Counseling Documented Supervision Form 22 G. Site Supervisor Evaluation of Mental Health Counseling Students 23 H. Report of Time Distribution. 25 I. Student Evaluation of UNF Practicum or Internship Supervisor J. Student Evaluation of Practicum or Internship Site Supervisor. 27 K. Site Supervisor Certificate of Participation L. Internship Remuneration M. Criminal Background Check Reference page.. 30 N. Specialized Learning Contract.31
3 3 HANDBOOK FOR MENTAL HEALTH COUNSELING PRACTICUM AND INTERNSHIP Introduction Your practicum and internship represent opportunities for you to put into practice the skills and knowledge that you have gained in the classroom. As such, it represents the real world of counseling more closely than any other aspect of your program. This is your chance to practice and hone your skills while under the protection of ample supervision, both on site and in the university. We hope you will take every advantage of this opportunity. This handbook is designed to provide you with the basic information you need to successfully complete your practicum (MHS 6800) and internship (MHS 6830). Please refer to the course descriptions listed below for a summary of practicum and internship requirements. MHS 6800: Mental Health Practicum. This course is designed to offer students in the mental health counseling track an opportunity to participate in a field experience within a mental health agency. Students will observe professional counselors and provide limited counseling services, under supervision, for a minimum of 100 clock hours. Of the 100 hours required in the practicum, at least 40 must be in direct client or student contact. Of the 40, at least 10 should include work with groups. MHS 6830: Mental Health Internship: Students in the mental health counseling track will complete, over a three semester period, a total of 900 clock hours working in a mental health counseling setting. The internship will be the culminating experience of the student s masters program. Of the 900 hours to be completed, at least 360 hours must be spent in direct individual, group, or family counseling with clients. Students are encouraged to devote 75 hours of the 360 hours to group and/or family counseling.
4 4 Timetable for Practicum or Internship Activities Time Frame Activity Semester prior to practicum Or internship Prior to beginning practicum Or Internship Beginning of Term Throughout term Middle of term End of term UNF Director of Clinical Field Experiences conducts P/I orientation for students Student meets with Faculty Mentor to discuss sites Student contacts potential site supervisors for interviews Student & site supervisor agree on placement Student and site supervisor sign Agreement form Student and site supervisor sign Statement of Understanding Student submits application for background check Student takes the CPCE the semester after Practicum, before Internship Student automatically obtains professional liability insurance Student submits above forms to UNF Faculty Supervisor for P/I Site supervisor conducts orientation for student at site Student and site supervisor establish individual objectives Student and site supervisor establish work schedule UNF supervisor reviews individual objectives Student begins work at site Student meets regularly with UNF supervisor for individual supervision Student meets with UNF supervisor for group supervision Student continues work at site Student maintains log of activities Site supervisor completes mid-term evaluation Student submits mid-term evaluation to UNF supervisor UNF supervisor confers with site supervisor regarding student progress Student completes Report of Time Distribution Site Supervisor signs Report of Time Distribution Site Supervisor completes evaluation of student and recommends grade Student completes evaluation of site supervisor Student submits Certificate Request to Site Supervisor Student completes evaluation of UNF supervisor Student completes Evaluation of site and submits to UNF Faculty Supervisor Student submits Report of Time Distribution and site supervisor s evaluation to UNF supervisor UNF supervisor assigns grade Site Supervisor submits to UNF completed Certificate Request (If applicable) UNF Faculty supervisor submits the Report of Time Distribution, Student s site evaluation, and Agreement form to Director Of Clinical Field Experiences Student makes copies of all forms submitted for P/I Note. An Internship/Practicum Fair is held in the Spring term of every year, in early February.
5 5 I. PRACTICUM Practicum is designed to provide you with practical experience in the counseling field. At this stage in your education, you will have had some experience in counseling through your courses as well as opportunities to learn about the work of counselors in different settings. During your practicum, you will focus primarily on the following: A. learning good counseling practices by observing and participating in joint experiences. B. developing your skills by counseling in groups and individually under close supervision C. becoming familiar with various types of educational and/or mental health agencies, services, referral sources, professional orientation, staff development, organizational development, etc. Prerequisites for practicum include the following: MHS 6404: Theories in Clinical Mental Health Counseling MHS 6941: Clinical Counseling Skills MHS 6700: Legal, Ethical & Professional Issues in Counseling MHS 6070: Psychopathology MHS 6510: Group Counseling During your practicum, you will be working in an agency for one semester, accumulating at least 100 hours of experience. Of the 100 hours required in your practicum, at least 40 must be conducted in direct client or student contact. This refers to individual, group, and family counseling; and/or intake and exit interviews with clients. Students are encouraged to obtain 10 of 40 hours of direct service in a group setting. You will attend weekly group supervision on campus for 2 hours and receive one additional hour of individual or triadic supervision from a faculty member. Although your responsibilities will vary according to the requirements of the site supervisor and the nature of the clientele served, you will probably spend the first part of your practicum observing, or shadowing your supervisor and/or other counseling professionals. Through observation, you will become familiar with the responsibilities of counselors and the organizational structure of the facility. You will begin working with clients, either in conjunction with your supervisor, other practicum students, or alone. Additionally, you will have opportunities to participate in ancillary responsibilities at your practicum site, such as staff meetings, in service training sessions, and record-keeping.
6 6 II. INTERNSHIP Internship must be scheduled over the last three (3) semesters of graduate study. Term 1: 300 hours (3 credit hours) 300 total, 120 hours of direct client contact, about 25 hours in a group setting Approximately 20 hours per week Term 2: Term 3: 300 hours (3 credit hours) 300 total, 120 hours of direct client contact, about 25 hours in a group setting Approximately 20 hours per week 300 hours (3 credit hours) 300 total, 120 hours of direct client contact, about 25 hours in a group setting Approximately 20 hours per week The following courses must have been completed prior to the beginning of internship: MHS 6404: Theories in Clinical Mental Health Counseling MHS 6486: Human Development Across the Lifespan MHS 6941: Clinical Counseling Skills MHS 6401: Advanced Counseling* MHS 6510: Group Counseling MHS 6070: Psychopathology MHS 6700: Legal and Ethical Issues in Counseling MHS 6428: Counseling Diverse Populations* MHS 6205: Assessment and Evaluation in Mental Health Counseling MHS 6305: Career Counseling MHS 6800: Practicum *MHS 6401 (Advanced Counseling) & MHS 6428 (Counseling Diverse Populations) may also be taken concurrently with the first semester of Internship. When you enter your internship, you will be close to the completion of your master s program. You will have had significant counseling experience in the classroom, as well as opportunities to counsel with others and on your own during your practicum. The internship is designed to be an experience where you can refine your skills in counseling others, while having the benefit of supervision by more experienced professionals. Your primary tasks in your internship will be to:
7 7 a. adopt a counseling theory to guide your clinical practice; b. counsel people with difficult issues while under supervision; c. explore areas of personal interest such as grief counseling, counseling children, or counseling people with eating disorders; and d. become involved in the professional community through membership in professional associations; attendance at workshops, conferences and other staff development activities; and by participation in informal networking groups. Of the 900 hours to be completed by mental health counseling interns, at least 360 hours must be spent in direct contact (individual counseling sessions, assessments, intakes, etc.). Students are strongly encouraged to devote 75 of those 360 hours to group and/or family counseling. Students enrolled in internship are required to attend weekly group supervision on campus for 2 hours. In your internship you will gain much experience working on your own or as a colleague with other counselors at your internship site. Although you may begin by observing and shadowing, by the middle of the first semester you should have your own clients and should be given responsibilities similar to those held by other staff members at the site. III. COUNTING YOUR HOURS IN PRACTICUM AND INTERNSHIP Students enrolled in both practicum and internship are responsible for maintaining a log of activities. The following guidelines have been created to assist you in the process of counting your hours. Direct client contact hours typically consist of the following: Providing face-to-face provision of therapeutic interventions in individual, group, and family counseling Observing your site supervisor as he or she provides individual, group and family counseling Conducting psychosocial or intake interviews with clients Conducting co-therapy with another counselor or supervisor Doing crisis intervention Providing phone consultations and home visits with underage clients parents or guardians. Nondirect hours typically consist of the following: Attending and participating in staffing meetings
8 8 Participating in individual site supervision and on-campus group supervision Attending professional workshops Completing all documentation including progress notes, case summaries, and written treatment plans Providing community outreach and programming BANKING HOURS DURING PRACTICUM While enrolled in practicum, students are NOT permitted to accumulate and bank clinical hours toward internship after they have accrued the 100 required hours. Students are also not permitted to begin accumulating hours prior to enrollment in practicum. BANKING HOURS DURING INTERNSHIP/CONTINUING INTERNSHIP AFTER THE TERM HAS ENDED. In the interests of establishing and maintaining self-care, students are encouraged to take time off after each term. In cases where students want to continue internship at their sites over interim breaks (i.e., before the start of the fall term, winter or spring break), they are permitted to do so, provided that they continue weekly one hour supervision on site throughout this period, and a UNF faculty must be willing and available to consult with the student during period. These hours may be "banked" and applied towards internship the following semester. Banked hours should not exceed 50 hours at any one interim break. It is strongly recommended that students keep personal copies of all weekly logs and other supportive documentation (i.e. time distribution forms). COUNTING UNF GROUP SUPERVISION HOURS Students are permitted to count the on-campus internship seminar (under the category "group supervision") in internship only. IV. THE APPLICATION PROCESS You must secure a Practicum or Internship site the semester before you enroll. Every spring term in early February, a Practicum/Internship Fair will be held. All students are required to attend the Fair. At the fair, representatives or supervisors from practicum/internship sites will be present to talk about their site, the counseling population with whom they work, the therapeutic approaches they use, the supervision they provide, the qualifications they look for in a practicum student or intern, and their application and interview process and timeline. A. SELECTING A PRACTICUM OR INTERNSHIP SITE There are many things to consider when choosing a practicum or internship site. These include:
9 9 Clientele: Locale: Service: What type of population do you want to work with? (e.g., young children, inner city students, hospitalized adults, people with specific issues such as addictions or eating disorders, families, etc.) What type of agency or work environment interests you most? (e.g., hospitals, private practice, university counseling centers, schools, community mental health agencies) Are you interested in crisis counseling, developmental counseling, working with families? Supervision: Do you want to do your practicum or internship in an agency with extensive supervision (10+ hours per week)? Or do you feel more comfortable with more freedom and less supervision? Students should make an appointment with their faculty mentor, to discuss possible sites. A directory of mental health agencies, which is updated annually, is available on the Mental Health Counseling Blackboard site. This directory provides information about various sites. After you have determined the type of agency and work that you want to pursue in your practicum or internship, your next step will be to apply to the sites and to interview with potential supervisors at several comparable agencies. When you interview, be sure to obtain information about the following: 1. Is an orientation to the agency provided? If so, when and how extensive is it? 2. Who will be your direct supervisor? What are the credentials of that person who will be supervising you? What type of supervision will you receive and how often? Is audio taping and/or videotaping allowed? What are your supervisor s expectations of you in terms of service, hours, and skills? 3. When will you be expected to work at the site? Are you expected to work weekends or nights? 4. Can the agency guarantee you enough contact hours to meet the University requirements? Can your supervisor help you obtain clients? 5. Regarding the general format of the counseling experience, will there be a period of observation or shadowing? Will you be able to co- lead groups or do individual counseling with a co-therapist prior to seeing clients on your own? 6. Will there be opportunities to participate in staff development activities?
10 10 7. What are the formal and informal rules of the organization pertaining to dress, lunch hours, holidays, etc? 8. Exactly what types of work will you be able to do during the practicum or internship? Will you be restricted to a particular type or mode of delivery (e.g., brief individual counseling)? Will you have opportunities to experience a variety of services such as testing and assessment, doing group work, etc.? 9. What are the agency s expectations of your skill level as you begin your practicum or internship? Will you need to be able to write treatment plans or to diagnose clients? Will you be required to have knowledge of particular disorders or problems such as addictions? 10. What are the agency s expectations of your work with them? Do they want you to commit to intern with them for at least 2 semesters? Or practicum and all 3 semesters of internship? B. MULTIPLE SITES Most students elect to complete their practicum and internship in one site. Students may complete their internship hours in more than one setting with the permission of their UNF faculty supervisor. If this is the case, students need to secure a site supervisor in each site who meets the necessary qualifications and can provide a minimum of one hour of documented supervision per week, per site. C. COMPLETING PRACTICUM/INTERNSHIP HOURS AT YOUR JOB SITE Practicum/internship students requesting permission to complete their field experience requirements at their place of employment must do the following: (a) receive approval from the Director of Clinical Field Experiences prior to commencing field hours (b) establish a specialized learning contract (See Appendix N) with the Director of Clinical Field Experiences which describes employment activities relevant to practicum/internship and specifies additional requirements if necessary (c) find a qualified supervisor other than the person who evaluates your job performance, who will provide an hour of weekly one-on-one supervision. D. FINALIZING THE PRACTICUM & INTERNSHIP PLACEMENT Students must schedule to meet with their site supervisor to finalize the details of their placement prior to the first week of the semester. Faculty reserve the right to de-register or administratively withdraw students who do not comply with this requirement. During your planning meeting with your site supervisor for practicum or internship placement, you will need to complete several forms to turn in to your UNF supervisor at the first meeting of the term. These forms, which are in the Appendix, include the
11 11 following: 1. Practicum or Internship Agreement Form. This form includes the name and address of the agency and requires the signatures of your site supervisor and your supervisor s director or head of the agency (See Appendix A). 2. Practicum or Internship Statement of Understanding. This form is a reminder that your supervisors are ultimately responsible for safeguarding your clients and therefore have the option of removing you from practicum or internship when necessary (See Appendix B). 3. Practicum/Internship Information Sheet. This form includes information which your UNF supervisor will use to reach you both at home, work, and at your practicum or internship site (See Appendix C). 4. Practicum/Internship Learning Contract. With assistance from your site supervisor, you should describe, in behavioral terms, specific objectives that you intend to accomplish during your practicum or internship. Your site supervisor should review these objectives with you since he or she will be responsible for evaluating your completion of them. Your UNF supervisor will review the objectives, as well, and return the form to you following the first or second meeting of the term (See Appendix D). V. RESPONSIBILITIES OF SITE SUPERVISORS Your site supervisor will be given guidelines for his or her responsibilities for supervising practicum and internship students. Most site supervisors have worked with many counseling students over the years and are comfortable with the process. It is important that you understand what is expected of your supervisor as well as what he or she will expect of you. A. QUALIFICATIONS Your supervisor must have a master s degree in counseling or a related profession with equivalent qualifications, including appropriate certifications and/or licenses. Your supervisor must have a minimum of two years of pertinent professional experience in the program area in which you are enrolled. Your supervisor must have completed relevant training in counseling supervision. (Supervisor qualifications in CACREP, Sec. III, C, 1, 2, & 4). B. SUPERVISION Your supervisor will be expected to provide at least one hour of individual supervision a week, throughout your experience. Additionally, you may participate in group supervision with 3 or more practicum students or interns. It will be important for your supervisor to review your counseling skills throughout the practicum or internship,
12 12 through video, audio, or direct observation. (See Appendix E for a sample Permission to Record and Consult form). Students are also required to document their site supervision each week by completing the Documented Supervision form (see Appendix F). C. AUDIO/VIDEO TAPING Your site supervisor must agree to provide you with appropriate training, and ensure that you are able to tape (audio or video) your sessions with clients, provided consent forms (see Appendix E) have been filled with clients and appropriate steps have been taken to ensure the client s confidentiality (e.g., removing any identifying information in the written case, using pseudonyms, etc.). D. EVALUATION Your supervisor will be responsible for evaluating your performance in writing to be submitted to your UNF practicum/internship supervisor at the mid term and at the end of the semester. A sample of the mental health evaluation form is provided in Appendix G. E. SITE SUPERVISOR TUITION WAIVER As a means of thanking supervisors for their service, UNF offers them opportunities to take courses tuition-free. For every 300 clock hours of student practicum or internship which they have supervised, your supervisor will be able to register for up to six semester hours of courses in a given semester. The number of practicum or internship hours is recorded on the Report of Time Distribution (see Appendix H). Your supervisor can request a fee waiver for the semester desired by submitting a Certificate of Participation Application (see Appendix K) to UNF s Director of Clinical Field Experiences. The Director of Clinical Field Experiences will forward this Certificate of Participation Application for necessary signatures and then submit this to the College of Education and Human Services (see Appendix L). VI. RESPONSIBILITIES OF UNF SUPERVISORS A. PRACTICUM MEETINGS During your practicum, you will meet individually and in small groups with your UNF practicum supervisor. The group meetings will be scheduled on a regular basis, much like a typical course. Additionally, your supervisor will either a) meet with you and/or your on- site supervisor at your practicum site or b) provide 1 hour of individual supervision for you. The primary supervision you will receive from your UNF supervisor will be conducted in groups of up to six students. The purpose of these meetings is as follows: 1. to share information among students regarding best practices and solutions to problems and issues;
13 13 2. to learn innovative ideas to deal with specific issues from the presentation of case studies; 3. to review legal and ethical issues that may arise at the site; 4. to review relevant literature and /or current topics that would impact all members of the group; 5. to learn to conduct an assessment, formulate a diagnosis and appropriate treatment plans, and provide professional counseling to facilitate treatment goals. 6. to discuss information regarding licensure, certification, continuing education, professional organizations, and other practical considerations. B. INTERNSHIP MEETINGS During your internship you will meet individually and in groups of no more than twelve with your UNF internship supervisor. During these sessions, the focus will be on individual and group supervision of your counseling skills, discussion of current topics in counseling, and in developing your skills in counseling-related areas. You are required to bring your recorded client sessions (audio-tape or video-tape) for your case presentations in group supervision. You will have opportunities to work with your supervisor or another faculty member on special activities such as supervision, research, training, writing, or making presentations at conferences and workshops. C. EVALUATION Your UNF supervisor will evaluate your performance as shown in your participation in group supervision and the seminar. Additionally, with recommendations from your site supervisor, your UNF supervisor will assign your final grade in practicum and internship. You will receive a letter grade in practicum, and a grade of Pass/Fail in internship. VII. THE PRACTICUM AND INTERNSHIP EXPERIENCE A. LIABILITY INSURANCE Students are not required to purchase professional liability insurance while they are enrolled in the program. The Brooks College of Health provides umbrella coverage for all students involved in clinical training, with a professional liability insurance of a minimum of $1,000,000 personal/$3,000,000 professional limits. B. CRIMINAL BACKGROUND CHECK Students are required to apply for and pass a criminal background check and finger printing before beginning clinical work in the community. The
14 14 background check must be completed once a year once you have started doing your clinical work. You cannot begin practicum or internship client contact until you have cleared the University sanctioned background check. Please refer to Appendix M for additional information regarding background checks. C. IMMUNIZATION REQUIREMENT FOR SOME SITES Please be aware that some sites, mostly hospitals, require their practicum students and interns to be immunized for select diseases before beginning work at their site. Although this will be at your own expense, the Student Health Services at UNF can typically provide these immunizations at a lower cost than you would incur out in the community. The website address for Student Health Services is They are located in Bldg. 39A, Room The telephone number is (904) You can also contact regarding questions or concerns about Student Health Services. D. ESTABLISHING A SCHEDULE Whether in your practicum or internship, it is important that you work closely with your site supervisor to establish a reliable schedule. It is recommended that you plan to work at your site at least one full day and several part time days per week. Be sure to keep track of agency meeting times and events that your supervisor thinks are important for you to attend and make a special effort to participate, even if they occur on a non- practicum/internship day. Stay with your schedule as closely as possible, and always give advance notice if you have to rearrange it E. MAINTAINING A LOG/MAKING COPIES OF ALL FORMS It is important that you keep a daily record of your activities and the time spent on each, throughout your practicum or internship experiences. Most students find that a small notebook is convenient to carry and use for this purpose to later transfer to computer format. The daily log will be helpful when you meet with your site or university supervisor to discuss your counseling cases and related activities. Additionally, at the conclusion of your practicum or internship, you will use the log to summarize the various activities on the Report of Time Distribution. Please be responsible and make copies of all the forms you have submitted for Practicum and Internship. This way, you have personal copies of all your forms, when you need them for registered internship application, licensure application, or if you transfer to another state. F. INDIVIDUAL COUNSELING In most agency settings, counseling with individuals is the backbone of the work. Do what you can to ensure you have clients you see over a period of time, rather than concentrating on crisis intervention. You will find that counseling experiences are more challenging when you see the same individual a number of times. Ask your supervisor for advice on how the site deals with issues such as scheduling appointments, intake
15 15 interviews, consent forms, reminder calls to clients, etc. When you are counseling individuals, concentrate on following a theory, or theories, or a model that you have learned and has been found to be empirically effective. Understand that your practicum and internship experiences are meant to be for learning and practice as you assimilate information and develop your professional identity as a counselor. Your site supervisor is there to help you as you try out different counseling theories and styles by providing you with helpful feedback. G. GROUP OR FAMILY COUNSELING You should plan to spend a portion of your direct contact hours working with groups and/or families. It is important that you spend time observing and co- leading groups before working on your own, since different agencies may follow specific formats when working with multiple clients or families. H. RELATED RESPONSIBILITIES You will undoubtedly find that your practicum or internship will consist of much more than individual and group counseling. You may find that much time is spent on tasks such as developing treatment plans, writing comprehensive case notes, and consulting with counselors in other agencies. Additionally, you may be expected to make case presentations, join on-going discussion groups, or do outside reading in specific areas. I. PROFESSIONAL ASSOCIATION AND MEMBERSHIPS If you have not done so already, you should plan to join local, state and national professional associations now. While you are in your practicum and internship you will have many opportunities to practice some of the suggestions offered by experienced professionals through newsletters, journals, workshops, and conferences. You will also notice that professional articles on serious topics take on new meaning when you are counseling people who have the same issues being addressed in the literature. Local counseling organizations are an excellent way to meet professional counselors, learn about job opportunities, and form lasting professional bonds. At the state and national level, you will have opportunities to become involved in issues that are important to the welfare of counselors and their clients. Relevant organizations include the following: Florida Mental Health Counseling Association National Board for Certified Counselors American Counseling Association American Mental Health Counselors Association J. PROFESSIONAL DEVELOPMENT OPPORTUNITIES As you become more involved in your practicum or internship, you will become increasingly aware that your professional education is just
16 16 beginning, and that it is likely to continue. Luckily, every year, dozens of interesting and helpful workshops are presented in Jacksonville or the surrounding area. Your supervisors will probably be familiar with many of the workshops and can advise you on training that will be particularly helpful in your present experience. You can usually get significant discounts on registration fees while still on student status. Participation in professional development activities can be included in your non-contact practicum or internship hours. K. EVALUATION OF PRACTICUM OR INTERNSHIP Your site supervisor and your UNF supervisor are responsible for evaluating your performance, as discussed earlier. At the end of each semester, you will have an opportunity to evaluate your supervisors, as well. The Student Evaluation of UNF Practicum or Internship Supervisor is shown in Appendix I; The Student Evaluation of Practicum/Internship Site appears in Appendix J. L. PERSONAL COUNSELING FOR STUDENTS While individual counseling for each student is not required, students are strongly encouraged to participate in their own personal therapy, especially while immersing in clinical field experiences, such as Practicum and Internship. To most students, being in the program is the best time to explore and possibly resolve one s personal concerns. The UNF Counseling Center, located in Founders Hall, Building 2, provides individual counseling at no additional cost to students. The University of North Florida is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools (1866 Southern Lane, Decatur, Georgia ; Telephone number ) to award baccalaureate, masters, and doctoral degrees and by the Council for Accreditation of Counseling and other Related Counseling Programs, 1001 North Fairfax Street, Suite 510, Alexandria
17 17 UNIVERSITY OF NORTH FLORIDA 1 UNF Drive, Bldg. 39, Rm. 4033, Jacksonville, Florida (904) Mental Health Counseling Program, Department of Public Health, Brooks College of Health, University of North Florida Appendix A COUNSELING PRACTICUM OR INTERNSHIP AGREEMENT FORM Semester Student Name (typed or printed) Social Security Number Home Address City State Zip code Phone Practicum Setting Phone Location (mailing address) Dates of Practicum (beginning & ending dates) Signature of Student Site Supervisor (typed or printed) Degree/Licensure/Certification# Site Supervisor (signature) Social Security Number Director of Agency (if applicable) (signature) Date NOTE TO STUDENT: AT THIS POINT, PLEASE RETURN AGREEMENT FORM TO FACULTY SUPERVISOR. FOR UNIVERSITY USE ONLY - DO NOT WRITE BELOW THIS LINE University Supervisor (signature) Date Program Director, Mental Health Counseling (signature) Date
18 18 Appendix B Practicum or Internship Statement of Understanding I acknowledge that my primary obligation, as a practicum or internship student, is to do no harm to my clients or students. I therefore agree to maintain ethical behavior at all times during this field experience. I further acknowledge that my UNF and site supervisors are legally and ethically obligated to protect my clients from potential harm as much as possible through their supervision and review of my performance. In the event that any of my supervisors have reason to believe that I may harm my client through unethical or incompetent behavior, they have the right and responsibility to take immediate action. Such action may include removing me, temporarily or permanently, from the practicum or internship. Student/Date Site Supervisor/Date UNF Supervisor/Date
19 19 Appendix C PRACTICUM/INTERNSHIP INFORMATION SHEET Name: Date: Address: Home Phone: Work Phone: Practicum/Internship Information: Name of Agency: Address: Phone: Supervisor: Anticipated days and times at Practicum/Internship site: Monday Tuesday Wednesday Thursday Friday Weekend 21
20 20 Appendix D Practicum or Internship Learning Contract Directions: Students, in consultation with site and/or UNF supervisors, will choose projects or activities to complete during practicum or internship. Describe the projects or activities in terms of measurable objectives below. The UNF supervisor will review and approve the objectives at the beginning of the semester. The site supervisor will describe the degree of accomplishment of the objective, will sign below, and return this form to the UNF supervisor at the conclusion of practicum or internship with the student s final evaluation. Student Objectives Site Supervisor Evaluation Student Signature Date Site Supervisor Signature Date 22
21 21 Appendix E Permission to Record and Consult I, the client (or parent or guardian), consent to the recording of my counseling sessions for purposes of professional consultation with the goal of helping improve the counselor s effectiveness. This recording may be done by video and/or audio taping. This consent is being given in regard to the professional services provided by the counselor named below. I understand that I will be given counseling even if I choose not to sign this authorization. I understand that even if I sign this authorization, I may ask for the recording to be turned off or erased at any time during my sessions. All audio and videotapes will be kept in a safe location and will be destroyed at the end of the semester. I further understand that to improve counseling techniques, my counselor may be consulting with the supervisor of this agency as well as my UNF faculty supervisor. She/he may also select a portion of the tape to be viewed by other counselor graduate trainees during group supervision. I therefore authorize any of the supervisors and graduate trainees to observe or have access to information relating to my treatment. It is understood that these professionals and their students are bound by state laws and by professional rules about client s privacy. Signature Date (Client or parent/guardian) Printed name I, the counselor, have discussed the issues above with the client (and/or his or her parent or guardian). My observations of this person s behavior and responses give me reason to believe that this person is fully competent to give informed and willing consent. Signature copy accepted by client (Counselor) Date copy accepted by counselor 2
22 22 Appendix F MHS 6800 / MHS 6830 PRACTICUM OR INTERNSHIP IN MENTAL HEALTH COUNSELING DOCUMENTED SUPERVISION Student Name Date / / Beginning Time Ending Time Functions Reviewed: client screening client intake client assessment treatment planning client orientation evaluation individual counseling crisis intervention outreach reports/record keeping group counseling referral client follow-up case management family counseling consultation client education case review written communication community education other Specific Issues Discussed and/or Reviewed Specific Suggestions for Student Date / / Student Signature Date / / Supervisor Signature
23 23 Appendix G Site Supervisor s Evaluation of Mental Health Practicum/Internship Student Name of Student: Name of Supervisor Practicum/Internship Site: Title Period of Evaluation Mid - Term or Final Evaluation Directions: This evaluation will be used by the faculty of the Mental Health Counseling Program to provide an indication of the student=s performance during her/his practicum/internship experience. Please circle the number to the right of each item which best describes your assessment of your supervisee. Please note: 0 = Not observed; 1 = Unsatisfactory; 2= Adequate; 3 = Does well, 4 = Outstanding I. INTERPERSONAL SKILLS: Χ Displays sensitivity toward others Χ Accepts differences (i.e. racial, ethnic, sexual orientation, etc.) Χ Self-aware (strengths, personal issues, limitations, etc.) Χ Open to personal and professional growth Χ Recognizes her/his personal and profession impact upon others Χ Professional demeanor II. COUNSELING SKILLS: Χ Behaves ethically and responsibly Χ Is appropriately respectful and sincere in relation to clients Χ Displays effective attending and active listening skills Χ Able to respond appropriately at the client s level Χ Able to formulate accurate diagnostic impressions Χ Able to formulate appropriate treatment goals/plans Χ Demonstrates awareness of physical, psychological, spiritual, and social factors impinging on the client Χ Able to implement proposed treatment plans Χ Applies general knowledge appropriately to specific client needs Χ Recognizes his/her own competencies and the limitations of techniques Χ Displays effective group leadership skills Χ Displays confidence in his/her skills Χ Able to appropriately terminate a counseling relationship.
24 24 III. CONSULTATION SKILLS: Χ Able to elicit and utilize feedback from others Χ Able to consult with others while maintaining confidentiality Χ Able to follow through with assigned tasks/responsibilities Χ Able to interact effectively with agency personnel/staff Χ Displays effective oral communication skills Χ Able to make appropriate referrals IV. GLOBAL ASSESSMENT: Χ Overall assessment of his/her effectiveness as a Mental Health Counselor Χ Potential for becoming an effective Counselor V. SUMMARY NOTES: Student s strong points: Student s needs for improvement: Have you discussed this evaluation with the student? Yes No (If no, please note the this evaluation may be seen by the student upon request as required by the Buckley Amendment). Based upon the preceding information, I would recommend a grade of for the student. Supervisor s Signature Date If this is the Final Evaluation, please attach the student s Learning Contract to this form.
25 25 Revised Appendix H UNIVERSITY OF NORTH FLORIDA 1 UNF Drive, Bldg. 39, Rm Jacksonville, Florida (904) Mental Health Counseling, Department of Public Health, Brooks College of Health, University of North Florida REPORT OF TIME DISTRIBUTION Practicum Internship An exact report of the number of hours the student spent in his or her Counseling Practicum or Internship experience is required for the student s record as well as for the site supervisor s record. Site supervisors receive free tuition for every 300 hours of student practicum or internship. Students are to return the original of this report at the close of the Practicum or Internship to the UNF Supervisor. Name of Student Site Number of hours spent by the student in: Observation: Individual Counseling: Family Counseling: Research: Supervision: Individual (Site): Individual (Campus): Intake Interviews: *Group Counseling: Case Staffings: Professional Development: Group (Site): Group (Campus): Documentation/Record Keeping: Outreach/Advocacy: Other (specify): Total Hours: From To Typed or Printed Name of Site Supervisor Signature of Site Supervisor Degree, License, or Certification Social Security Number Date Signed *1 hour credit is assigned for group sessions consisting of 6 or fewer members; an additional 15 minutes credit is assigned for each additional client group member.
26 26 Appendix I Student Evaluation of UNF Practicum or Internship Supervisor 0=not helpful 1=somewhat helpful 2=helpful 3=very helpful 4=not applicable 1. Assisted me in evaluating my readiness for practicum or internship. 2. Assisted me in selecting a practicum or internship site. 3. Provided me with information regarding expectations and requirements of practicum or internship. 4. Provided me with opportunities to consult, on an individual basis, regarding problems or issues concerning practicum or internship. 5. Allowed students to contribute input regarding the emphasis and direction of class discussion. 6. Led small group discussions of issues relevant to all practicum or internship students. 7. Provided structure for student - led case presentations. 8. Provided relevant literature and/or other resources relative to current topics of interest to all practicum or internship students. 9. Provided information related to licensure, certification, exams, continuing education, graduation, and professional organizations. 10. Provided information about opportunities to participate in community, agency, or school professional development activities.
27 27 Appendix J Student Evaluation of Practicum or Internship Site Note to Student: The information you provide may be shared in general terms with the site supervisor. Site/Agency/School Name: Address: Date: Phone: Student completing this evaluation: Practicum Internship Directions: On the rating scale to the right of each item please circle the number which best describes your practicum/internship experience. Please note: 1 = poor; 2 = adequate; 3 = good; 4 = very good, and 5 = superior. I. Orientation: Time provided for orientation Comprehensiveness of orientation Overall quality of orientation II. Supervision: Supervision was regularly scheduled Supervision was appropriate for my needs Feedback from my supervisor was helpful Supervisor was accessible (beyond regularly scheduled times) Supportiveness of supervisor Overall quality of supervision III. Learning Experiences: Availability of clients Appropriateness of clients Suitability of tasks/duties Number of tasks/duties Overall quality of learning experiences IV. Professionalism Treatment as a professional Opportunities for input Inclusion/reception by staff persons Overall sense of professionalism V. Global Assessment of Practicum/Internship VI. Would you recommend this site to others? yes no Why? Why not? Please explain on back.
28 28 Appendix K Certificate of Participation Application Mental Health Counseling Program Department of Public Health, Brooks College of Health University of North Florida This certificate allows the Site Preceptor to exempt the tuition fee for up to six hours during one term of instruction at any State University in Florida. The holder will be required to pay all current fees applicable at the time of registration except tuition fees. Admission to the University is not guaranteed by the certificate. The certificate application must be typed. The Certificate of Participation will not be issued without the site preceptor s social security number and home address. Only an original certificate application will be accepted. A scanned or faxed copy is NOT acceptable. Given the confidential information that is included on this application, it can be put in a sealed envelope and mailed directly to the Faculty Internship Coordinator at the address below. Tes Tuason University of North Florida Department of Public Health 1 UNF Drive Jacksonville, FL The certificate application will be routed for signatures and reported to the Office of Educational Field Experiences at the end of the semester of supervision. Allow a minimum of 4-6 weeks for processing. The official Certificate of Participation will be mailed to the home address reported on the certificate application. Do not contact the Office of Educational Field Experiences with questions. All correspondence should be directed to the Director of Clinical Field Experiences, Tes Tuason, or (904) I certify that I served as a field site preceptor and supervised an intern as follows: Date: Name of Student: Course Number/Program: Term/Dates of Supervision: Total Number of Internship Hours: Agency: Agency Address: City: State: Zip Code: Business Phone: Fax: Site Preceptor s Name: Site Preceptor s Social Security Number: Site Preceptor s Home Address: City: State: Zip Code: Site Supervisor s Home Phone: Fax: Field Site Preceptor Date Faculty Internship Coordinator Date Department Chairperson Date 1 UNF Drive, J Brooks Brown Hall, Bldg. 39, Jacksonville Florida 32224
29 29 Appendix L Internship Remuneration Guidelines for obtaining a certificate entitling the bearer to register for 2 courses (6 credit hours) at UNF, tuition free. The certificate is awarded on a one time basis, for completion of 300 hours of supervision of student-interns in the Brooks College of Health: 1. Documentation of the 300 hours must accompany the request. If more than one student and/or more than one term are involved, documentation must include student s name, term and year during which the supervision took place, and the number of hours for each student. 2. Documentation must be verified by Program Leader or his/her designee (the documentation should carry a signature from both the supervisor requesting the certificate and the Program Leader. 3. The certificate request and the accompanying documentation should be forwarded to Dr. Cathy O Farrell in the College of Education and Human Services, who will issue the certificate. 4. A certificate to be used in exchange for tuition for two college credit courses may only be awarded to an individual supervisor one time.
30 30 Appendix M UNIVERSITY OF NORTH FLORIDA 1 UNF Drive, Bldg. 39, Rm Jacksonville, Florida (904) Department of Mental Health Counseling, Brooks College of Health, University of North Florida Background Check Information A background check will be required of all students who will be participating in field experiences as part of their educational program. The background check will be required prior to the practicum and internship experience. These field experiences include, but are not necessarily limited to: practicum, internships, clinical experiences, or other types of experiential learning either directly involving or in agencies serving children, the elderly, patients, or other vulnerable populations. The background check shall be completed: 1. annually for students enrolled in the Mental Health Counseling Program the semester prior to their practicum and every year thereafter while enrolled in an Internship course. 2. in the semester immediately preceding the experience for students in those programs including these experiences as a final or capstone experience. 3. must be done through the vendor sanctioned by the College. NOTE: To meet Brooks College s contractual obligation to the agencies in which students are placed, the background check must be done through the vendor sanctioned by the Brooks College of Health which is Certified Background Checks at CertifiedBackgound.com which is the only vendor accepted by the Brooks College of Health. In order to complete your background check, 1. Go to 2. You will be asked to give your full name, social security number, current address, phone number, and address 3. Click on students and enter the Package Code. 4. Our package code is UA Full background check package + Fingerprint 5. The cost is $91.00 plus possible additional charges for each county where you have lived. NOTE. You can order your Background Check securely on the site for a fee. However, please be informed that you will be charged for every additional county you have lived in within the past 7 years. Since this Background Check is at your personal expense, this fee may then be between $91+, depending on the number of counties you have lived. Since this check needs to be current while you are involved in field experiences, you would need to order this before Practicum, and then order another one before the previous background check expires, which is before your last Internship class (assuming you are doing your Internship courses consecutively per semester). Please prepare then to order this Background Check twice. The detailed mechanism for obtaining the background check is explained in the pdf document located in the P/I tab in the Blackboard site, entitled, UA39-Mental Health Counseling.pdf. Students with questions regarding what may appear on their background check, should contact the Director of Clinical Field Experiences of the Mental Health Counseling Program. Information revealed by a background check may: 1. prohibit participation in required practicum and/or internship. Inability to participate in required field experience will jeopardize successful completion of the program. 2. prohibit sitting for required post-graduate national examinations for licensure and/or certification and/or post-graduate internships.
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