School Psychology Program. Internship Handbook. Ed.S. School Psychology

Transcription

1 School Psychology Program Internship Handbook Ed.S. School Psychology College of Education Department of School Psychology, Literacy, and Special Education Chung-Hau (Howard) Fan, Ph.D. Faculty and Program Director (208) Spring

2 Contents Purpose of Internship. 3 Responsibilities of Internship Student 4 Responsibilities of Field Supervisor.. 5 Responsibilities of Faculty Supervisor... 6 Internship Evaluation. 7 Guidelines and Documentation Required Hours and Setting. 8 Field Supervisors and Supervision.. 9 Required Experiences Professional Identity and Behavior 10 Assessment and Evaluation 11 Consultation and Collaboration.. 12 Social Emotional Intervention- Counseling 13 Preventive Services.. 14 Crisis Management.. 14 Program Evaluation and Applied Research 14 Culture and Diversity 14 Appendix A Internship Contract Appendix B Internship Training Plan Appendix C Intern Evaluation Form Appendix D Malpractice Insurance. 35 Guidelines for Distance Communication. 36 Spring

3 A. Purpose of this Handbook Internship Handbook SCPY 6759 Internship in School Psychology 1200 Clock Hours This handbook is a guide for the internship experience and is designed to ensure the quality and professionalism of the school psychology internship. The goal of this manual is to facilitate the planning, organization, and implementation of the internship experience for the student, the field supervisor, and the university supervisor. B. Purpose of the School Psychology Internship Consistent with the Training and Field Placement Programs as defined by the National Association of School Psychologists (NASP), the internship is the culmination of graduate preparation, which requires the Candidate to integrate and demonstrate, under supervision, their acquired knowledge and applied skills of school psychology principles. The internship provides an opportunity for the Candidate to apply their skills learned through coursework and practicum experiences, to acquire new skills in addressing the needs of children, families, and school personnel, and to demonstrate their professionalism in meeting the mental health and educational needs of children with whom they work. The internship is provided at the end of the formal training period and occurs on a full-time basis over a period of one academic year (or for two years on a part-time basis). In addition to evaluation and consultation experiences, the school psychology internship is designed to provide a broad array of counseling, behavior management, and program development opportunities. C. The Internship Experience: Definitions The internship experience follows a formal written contract (See Appendix A), which is agreed to by all persons involved, and is provided in a setting consistent with the training objectives of Idaho State University. Field supervision is provided by an appropriately credentialed school psychologist for at least two hours per week of direct supervision. University internship supervisors provide at least one field visit with the intern and field supervisor each academic semester. The internship contract is an agreement among the internship student, the field supervisor, and the University supervisor regarding the goals, guidelines, and expectations of the experience. The evaluation of the Candidate s performance is primarily based upon the internship Candidate s plan (Appendix B), which includes a list of responsibilities, objectives, and activities required to fulfill those objectives, and which is to be completed early in the internship. Lastly, the internship experience is recognized through the awarding of graduate academic credit. Final evaluations will be determined by the University supervisor with input from the field supervisor. The field supervisor is responsible for providing the appropriate and necessary supervision while in the Candidate is in the field. The University supervisor is responsible for Spring

4 the evaluation of the Candidate during internship as well as the approval of the internship site. In order to effectively monitor the Candidate s progress, the University supervisor will communicate with the field supervisor at the beginning, and end of each academic semester while the Candidate is enrolled in the internship. D. Responsibilities of the Internship Student 1. Orientation and Planning a. The Candidate is responsible for making arrangements necessary to insure appropriate placement. b. Prior to the beginning of the internship the Candidate should become familiar with this Handbook and NASP Standards for Training and Field Placement Programs. Prior to or at the commencement of the internship the Candidate should become familiar with the relevant agency materials and procedures (e.g., referral process, report format, pertinent documentation of exceptionalities, etc.). c. The faculty supervisor and the internship Candidate will meet with the field supervisor prior to or at the beginning of the internship and formally sign internship agreements. If necessary, the formal agreement may be accomplished through the use of facsimile. With assistance of the faculty supervisor, the Candidate should prepare a tentative plan for the semester s experience prior to or at the beginning of the internship. This working document includes the Candidate s internship goals, the methods to achieve those goals, and a plan for assessing the experience. This plan must be completed and submitted to the faculty supervisor within the first month of the internship. d. The Candidate is expected to arrange for reliable and regular transportation to and from the assigned school/agency. e. The Candidate must make arrangements to schedule two hour weekly meetings for supervision with the field supervisor and to discuss accomplishing the goals established in the internship plan and to progress toward those goals. 3. The intern is expected to obtain practitioners insurance through APA, NASP, ACA, or similar professional organizations. 4. Evaluation/Documentation Spring

5 a. The Candidate must carefully document each week s activities using the necessary form and signed by the field supervisor monthly. This documentation form provides documentation regarding the extent to which the intern Candidate is meeting the goals established in their plan, is acquiring a broad spectrum of professional experiences, and is meeting the required number of supervision hours. b. The internship Candidate must submit a portfolio of work samples and a written summary of their experiences, including supervision, by the end of the first semester, which clearly states the extent to which they are meeting the expectations outlined in their plan. E. Responsibilities of the Field Supervisor Note: The field supervisor must be approved by the University and be well versed in current theory and practice in the field of school psychology. 1. Orientation a. The field supervisor is expected to communicate with the faculty supervisor and the intern to: a) discuss the internship and b) sign the formal agreement to provide supervision. b. The field supervisor will orient the Candidate to the assigned school/agency. This includes the identification of the various components and pertinent persons of the school, organization of the school, and procedures for acquiring materials and reimbursement for travel. c. The field supervisor is expected to meet with the Candidate at the beginning of the internship to provide assistance in the development of the internship Candidate s plan. 2. Professionalism/Supervision a. The field supervisor is expected to provide the intern with at least two hours per week of direct supervision. Supervision should be designed to facilitate and guide their professional growth and to refine and implement their internship plan. b. The field supervisor will facilitate opportunities for professional growth within the immediate placement(s) or at ancillary district programs/buildings, such as supervised experiences with low incidence exceptional children, interventions with families, experience in preparing and delivering oral and written reports, consultation with teachers and other professionals, and attendance at workshops. Spring

6 c. The field supervisor is expected to help facilitate a positive environment in the internship school/agency so that the Candidate can function as a school psychologist-in-training. d. The field supervisor is expected to facilitate the Candidate s professional growth and transition into the role of a professional school psychologist, and should provide frequent guidance and opportunities for feedback regarding their skill development. 3. Evaluation/Documentation a. The field supervisor will complete two (mid-term and end-of-term) Intern Evaluation Form appraisals of the intern s performance in each academic semester (i.e., Fall, Spring). These documents, along with recommendations, will be included in the intern Candidate s portfolio. The evaluation form is provided in the Appendix C. b. The field supervisor will review the Candidate s internship log (documented hours) and sign the documents at least monthly. c. Lastly, the field supervisor will be expected to maintain regular contact with the faculty supervisor to discuss the internship Candidate s performance and progress. This may be done through phone, , face-to-face communication. F. Responsibilities of the Faculty Supervisor 1. Orientation a. The faculty supervisor will coordinate Candidate placement with the school/agency setting b. The faculty supervisor will communicate with the internship Candidate and field supervisor at the beginning and end of each academic semester. Additional visits will be arranged as needed. c. The faculty supervisor will assist the internship Candidate in preparing the internship plan. 2. Professionalism/Supervision a. The faculty supervisor will endorse and continually evaluate the internship Candidate s plan for the semester. b. The faculty supervisor will arrange regular communication with the field supervisor to share expectations for the Candidate and the internship experiences. Spring

7 3. Documentation/Evaluation G. Internship evaluation a. At the end of each semester the faculty supervisor will review the evaluation materials, progress in meeting the guidelines established in the internship Candidate s plan, and the Candidate s documentation log book. b. With consultation and input from the field supervisor, the faculty supervisor will assign course grades at the end of each semester. Detailed evaluation of the internship is an important part of the Candidate s learning experiences. The general criterion for evaluation are: (1) quality of on-job performance, including evidence of need for less supervision as the internship progresses; (2) estimate of the Candidate s ability to carry out increasingly complex responsibilities; (3) the Candidate s demonstrated awareness of his/her effect on others; and (4) scope and depth of professional insights gained through the internship. Field supervisors are requested to conduct an evaluation with each Candidate halfway through each semester of internship and at the end of each semester of internship. The Candidate s internship contract, including the goals, objectives, and an expected list of activities to be completed, should serve as the basis for discussion. The specific evaluation components and criteria are provided (page 10-15). The Intern Evaluation Form completed by the field supervisor and the internship log completed by the Candidate is to be reviewed by the Candidate and field supervisor together. Both persons must sign the forms before they are forwarded to the faculty supervisor. Spring

8 Guidelines/Documentation This section provides guidelines and portfolio documentation for the internship requirements. Required Hours and Internship Setting Hours Candidates typically complete their internship on a full-time basis by completing the required 1200 hours during the course of one school year. However, with written approval from the Program Director, Candidates may complete the internship on a half-time basis by completing the 1200 hours during two consecutive years. Candidates are expected to follow the school calendar of the school district where they are doing their internship. All Candidates are expected to remain in their internship placement until the end of their district s academic year. Setting A minimum of 600 of the 1200 internship hours must be completed in a public school setting, under the field supervision of a department of education, state certified / licensed school psychologist. Full-time Internship Candidates will not be approved for placement in a school district that expects interns to cover more than three schools at a time during each semester of their internship. Part time Internship Candidates will be limited to 1 ½ schools. With prior approval of the Program Director, the other 600 hours may be completed in a non-public school setting provided all of the following conditions are met: 1) The Candidate is under the supervision of a psychologist holding the appropriate state psychology credential for practice and is a full-time employee of the non-public school setting. 2) The non-public school setting houses a child or adolescent state-accredited educational program. 3) The non-public school setting is able to meet the requirements of internship experience as outlined below. Out of State Placement Spring

9 With prior approval of the Program Director, the internship hours may be completed outside the state of Idaho as long as the setting meets all the requirements for an ISU internship placement. Field Supervisors and Supervision 1) All field supervisors must possess a current state certification or license. 2) All field supervisors must have at least three years of experience working as a psychologist within the past 5 years. 3) Field supervisors must provide a minimum of two hours of face-to-face supervision each week. Phone consultations between the Candidate and the field supervisor will not satisfy the supervision requirement. 4) All field supervisor contact will be documented in the Internship Log and signed by the field supervisor. Expectations The expectation is that internship Candidates will have attained sufficient knowledge and skill from their practica so that they can begin their internship with direct experiences in assessment, intervention, and consultation. They are expected to increase their competency to levels of independent functioning in these and other areas related to NASP s domains of practice throughout the academic year of the internship experience. The internship supervisor in consultation with the Candidate (and if necessary the university supervisor) will determine the candidate s readiness for more advanced experiences. Required Experiences In order for Candidates to attain a satisfactory grade in the internship course, they must demonstrate competency in the following areas: a) professional identity and professional behavior (including ethics) b) assessment and evaluation c) consultation and collaboration d) social emotional intervention- counseling e) preventive services f) crisis management g) program evaluation and applied research h) culture and diversity These areas and required documentations are described below. Documentation will be complied and placed into the Internship Portfolio. The relationship between these specific training domains and NASP standards ( ) is provided in the Intern Evaluation Form. Spring

10 A) Professional Identity and Behavior Internship Candidates are expected to demonstrate commitment to the profession of school psychology. This includes but is not limited to: Seeking out professional development opportunities Joining professional associations Attending state association conferences Minimum Required Internship Portfolio Documentation: Documentation may include, but is not limited to: 1) conference and workshop registration documentation confirming attendance 2) a list of professional association membership status in the current vitae Professionally related interpersonal/professional skills Internship Candidates are expected to conduct themselves in a professional manner. This includes maintaining a professional disposition and skills set that are consistent with the profession of school psychology as noted: Ethics Demonstration of knowledge/application of APA/NASP Ethical Guidelines Demonstration of knowledge/application of other statutes regulating professional practice Demonstration of concern for client welfare Demonstration of appropriate client-school psychologist relationships Professional Deportment Appropriate manifestation of professional identity, as demonstrated by attire and behavior judged by practica, internship, and other field-based partners to be appropriate for educational settings Appropriate involvement in professional development activities (e.g., professional associations) Appropriate interaction with peers, colleagues, staff, trainees, etc. Awareness of impact on colleagues (faculty and students) Completion of assigned tasks in a timely fashion and in an acceptable format Sensitivity to Client Issues. Acknowledgment and effective interactions with: Spring

11 children parents teachers school administrators other school staff (e.g., social workers, counselors, therapists, etc.) sensitivity to the needs, resources and priorities for individuals from different cultural backgrounds (including differences in SES, gender, age, disability, sexual orientation, race, etc.) Use of Supervision Appropriate preparation Acceptance of responsibility for learning Openness to feedback/suggestions Application of learning to practice Willingness to self-disclose and/or explore a personal issue which affects professional functioning Appropriately self-reliance Appropriately self-critical Other Training Issues Effective management of personal stress Lack of professional interference because of own adjustment problems and/or emotional responses, as reflected by ability to maintain appropriate level of concentration, focus, and commitment to graduate study and professional demeanor in academic, social, and field-based settings Formulation of realistic professional goals for self Appropriate self-initiated professional development (e.g., self-initiated study) B) Assessment and Evaluation The Candidate will engage in the administration and interpretation of a wide range of diagnostic instruments and apply diagnostically derived data for decision-making and problem-solving at the individual and school levels. Minimum Required Internship Portfolio Documentation: Candidates will complete at least 6 full evaluations and select one into the Internship Portfolio, which represents the Candidate s best work. At least one of the six evaluations must reflect an assessment with a Candidate from a culturally diverse background and must demonstrate awareness of cultural factors. Spring

12 Although no single report will include all the assessment methods listed below, it is expected that the Candidate will attain competency with all the methods by the end of the internship experience. The assessments are expected to reflect a scientific-problem-solving approach to assessment. The assessment results are expected to lead to data-based decision making and/or intervention. Assessments and assessment reports shall include the following methods: 1. Interview teachers, parents, children/adolescents, and other relevant parties. 2. Administer, score, and interpret intelligence tests (e.g., Woodcock-Johnson III, WISC-IV, WPPSI-III, DAS, UNIT, CAS, SB-V). 3. Conduct direct observations of the referred student in the classroom and/or other relevant settings. 4. Evaluate candidates behavior functioning using functional behavior assessment (FBA) methods, if relevant to the referral question(s). Based on the results of the FBA, develop a behavior intervention plan (BIP). 5. Evaluate candidates behavioral, social and adaptive functioning by means of rating scales (e.g., BASC, CBCL, Vineland), if relevant to the referral question(s). 6. Evaluate candidates academic progress, if relevant to the referral question(s). i. individually-administered norm referenced achievement tests ii. curriculum-based assessment probes 7. Review relevant permanent products and records about the referred student (e.g. attendance, handwriting samples, group achievement test scores). In addition, internship Candidates are expected to: 1. Develop data-based and practical recommendations as a result of the assessment. 2. Write comprehensive case reports from an ecological perspective. C) Educational Intervention: Consultation and Collaboration Internship Candidates are expected to provide consultative assistance to at least four school staff and two parents during the school year. Interns should demonstrate good understanding of family-school relationships, respect for parents, and effective communication skills when working with parents. At least one consultation case report should include a family- Spring

13 school collaboration component (Standard 2.7 Family-School Collaboration Services). Consultation shall involve: 1. Helping the consultee clearly identify problems and factors that might be contributing to the problems. 2. Developing consultation goals in collaboration with the consultee. 3. Developing and implementing a theoretically sound and practical intervention plan. 4. Evaluating the outcomes of and the consultee's satisfaction with consultation, and if necessary adapting the intervention plan. Minimum Required Internship Portfolio Documentation: Reports of two of these cases shall be placed in the Internship Portfolio. One consultation case should focus on an academic target and one should focus on a behavioral target. D) Intervention: Counseling Internship Candidates are expected to counsel at least six students during the school year, either individually or in groups. Counseling will be school-based and educational in nature with goals focused on school-based interventions. For example, an intern counseling a depressed student might focus the counseling interventions on school-based situations/conditions/triggers that cause the student to feel depressed while at school and/or how those school-based situations/conditions/triggers effect the student s educational experience. The counseling process shall include: 1. Assessing the student s problems and the relevant context of the problems, and identifying student s strengths. 2. Developing counseling goals for the student in collaboration with student and relevant others. 3. Developing and implementing a theoretically sound and practical counseling plan for the student(s) that is based upon empirical research and is data-driven. 4. Evaluating the outcomes of counseling, and, if necessary, revising the plan. Minimum Required Internship Portfolio Documentation: Spring

14 1) Candidates are expected to keep a written record of the case, which includes progress notes of counseling sessions. This may be accomplished as a student log with dates/entries and a short two or three sentence summarization of each date/entry. 2) A report on at least one case shall be included in the Internship Portfolio. E) Preventive Services Internship Candidates are expected to be involved with the planning (or improvement) and evaluation of at least one preventive program (e.g., suicidal prevention) and at least one professional development program (i.e., in-service training). Planning and evaluating activities shall encompass: 1. Identifying a service delivery need 2. Setting or modifying program goals 3. Designing or redesigning a prevention program 4. Evaluating the program s implementation and outcomes Minimum Required Internship Portfolio Documentation: 1) One development or improvement of program relating to academic or psychosocial problem shall be included in the Internship Portfolio. 2) One in-service professional development presentation shall be given to personnel in the internship site and receive feedback (evaluation) from the participants. F) Crisis Management Internship Candidates are expected to be involved with at least one crisis assessment and/or intervention, if possible. These opportunities may increase the Candidates competencies in the areas of conducting risk assessments and effective risk responses (at individual and/or group level). G) Program Evaluation and Applied Research At a minimum, Internship Candidates shall: Be involved in developing, improving, as well as evaluating the implementation and outcomes of at least one Prevention Program (as described in E) Preventive Services). Minimum Required Internship Portfolio Documentation: 1) One development or improvement of preventive program relating to academic or psychosocial problem shall be included in the Internship Portfolio. Spring

15 H) Culture and Diversity Internship Candidates are expected to demonstrate multicultural competencies in all aspects of their internship experiences, including assessment, counseling, prevention and consultation. The culturally competent school psychologist is able to sensitively deliver services to students and parents from diverse cultural, racial, and linguistic backgrounds. The three broad-based areas of multicultural competencies include: a) attitudes and beliefs b) knowledge c) skills Minimum Required Internship Portfolio Documentation: Knowledge and skills pertaining to multicultural issues must be reflected in materials submitted as part of the comprehensive case reports placed in the Internship Portfolio. Spring

16 Appendix A THE IDAHO STATE UNIVERSITY SCHOOL PSYCHOLOGY PROGRAM INTERNSHIP OR PRACTICUM AGREEMENT (Revised Fall 2011) This document is an Agreement Between (School/Agency), and (Intern or Practicum Student), and the Idaho State University School Psychology Program, Pocatello, Idaho, on (Date of Agreement) for the Provision of: Select the appropriate experience from list below: 1 st Year M.Ed. Field Experiences 2 nd Semester (Spring) SCPY 668 Practicum: Intro to School Psych, SPED, & LD (3 credit/150 clock hrs) 2 nd Year Ed.S. Field Experiences 1 st Semester (Fall) SCPY 669 Advanced Practicum in School Psychology (3 credit/150 clock hrs) 2 nd Semester (Spring) SCPY 669 Advanced Practicum in School Psychology (3 credit/150 clock hrs) 3 rd Year Ed.S. Field Experience 3 rd Year SCPY 759 Ed.S. Internship (3 hrs each semester credit/1200 clock hours minimum) General Agreement Between Parties and Requirements This agreement is between the ("the Internship or Practicum Site"), the School Psychology Program at Idaho State University, ("the Program"), and. ("the Intern or Practicum Student"). At the outset, it is understood that the participating parties will cooperate in the conduct of professional activities relating to the field experience as described below. This Agreement will be in effect from through ; the student will work at the Internship or Practicum site for the appropriate number of clock hours as mutually agreed upon by the Site and as required to meet the requirements for the internship or practicum experience by the Program. In the case of the SCPY 7759 Ed.S. Internship, the Intern shall work on the same work hours as do the Internship Site's regular 10 month employees, with total number of hours at the Internship Site will be at least In the case of other practicum or intern experiences, 50 hours of on-site contact will be required per each graduate hour of credit received, i.e. 50 hours = 1 graduate credit. The Spring

17 intern or practicum student will also be required to participate and complete other activities as specified below as part of their grade and contact hours requirement. Please Go to Next Page General Agreements for Program, Internship Site, Intern A. The Program agrees: 1. To recommend for placement at this Internship Site only those prospective interns who have satisfactorily completed all of the pre-internship coursework and practicum requirements as specified by the Program's curriculum. 2. To appoint an Internship Coordinator who shall serve as the primary liaison between the Program and the Internship Site. 3. To meet with the Internship Site's designee(s) prior to the beginning of the Internship in order to secure agreement on the Intern's experiences, expectations, supervision, and other such matters. In the case of internships occurring geographically outside of the ISU area, this provision may be met by phone contact with the agreement of all parties. 4. To physically visit the Field Experience Site at least twice during the course of the Internship to consult with the Internship Site's designee(s) regarding the Intern's activities and progress, and to meet with the Intern and others as appropriate. In the case of internships occurring geographically outside of the ISU area, this provision may be met by phone contact with the agreement of all parties. 5. To actively solicit from both the Internship Site and the Intern their respective written evaluations of progress and developing skills, knowledge and dispositions relative to the field experience. 6. To be available on reasonable notice for consultation to the Field Experience Site and/or the Field Experience Student regarding any problems or issues that may arise during the Internship. 7. To furnish the Field Experience Site with information about the Program, as the Internship Site may require. 8. To perform other duties or functions that may be necessary to insure the Internship experience meets the requirements as specified by applicable professional standards and relevant certifying bodies. 9. To provide a regularly scheduled university based internship training experience for Interns and/or Practica students so as to keep current on their needs and to address any concerns they may have. The training experience will meet at a minimum of every other week at the University training site, and/or may be coordinated via phone or other online media process that may address the same issues with student unable to attend the University site. B. The Field Experience Site agrees: 1. To provide a School Psychology Internship which emphasizes the training needs of the Intern, and which includes such experiences as are necessary to gain initial competence as a School Psychologist. 2. To negotiate with the Program and the Intern a specific set of experiences which will be included in the Internship, and to monitor the Intern's activities to insure that the agreed-upon experiences are occurring. 3. To assure that all aspects of the Intern's work are conducted within the prevailing standards of practice. 4. To designate a supervisor(s) who is primarily responsible for coordinating the experience of the Intern. Additional involvement by the Intern with other psychological staff is expected and encouraged. Collaborative work with representatives from other disciplines is desirable. 5. To provide a minimum of two hours a week of regularly scheduled, face-to-face individual supervision with the supervising psychologist(s). 6. To keep the University informed regarding the Intern's progress, including at least two written evaluations (Mid-term and Final), and to immediately notify the Program if problems arise or are anticipated. 7. To participate in a minimum of 1 site visit per semester, or in the case of the SCPY 759 Internship, two site visits over the internship year. 8. To designate the trainee status of the Intern by the title "school psychology intern." or in the case of a Practicum student school psychology practicum student. 9. To assure that reports by the Intern are approved and cosigned by the psychologist responsible for the Intern. Spring

18 10. To provide the Intern with training opportunities to assist in increasing awareness, sensitivity, knowledge, and practice about issues impacting the psychological development and social development of racial, ethnic, linguistic, and/or economic minorities. C. The Intern/Practicum Student agrees: 1. To provide the Internship Site with any material that it may request regarding the prospective Intern's progress in the Program, previous work, or other relevant credentials. 2. To negotiate a specific set of expectancies for the Internship, as described above. 3. To perform all internship functions and duties within the ethical guidelines and professional standards applicable to professional school psychologists, as delineated by NASP. 4. To abide by all regulations and guidelines that apply to professional school psychologists working at the Internship Site. 5. To engage in the supervision process in a manner that maximizes the Intern's learning, and to affirmatively seek out additional supervision from the Internship Site when needed. 6. To authorize the Program and the Internship Site to exchange any and all information regarding the Intern which the Program and/or Internship Site shall deem necessary to conduct the Internship. 7. To provide at least two written evaluations of the internship experience to the Program. 8. To affirmatively inform the Program if problems arise or are anticipated, and to do so at the earliest possible time. 9. To maintain a monthly internship log detailing the Intern's activities, signed by the primary supervisor, and filed with the Program's internship coordinator on a monthly basis. 10. To participate in regularly scheduled university based internship seminar and successfully complete all assignments related to the seminar. 11. Complete the required log of activities and present to ISU Coordinator each month. 12. Incur all costs including meals, transportation, lodging related to internships/practicums. 13. Secure and checkout and in all materials and tests necessary to complete intern/practica requirements. 14. Keep all appointments with Site, ISU staff to complete requirements. 15. Be aware of and sensitive to the schedules of Site and ISU University staff. Additional Elements Specific to this Agreement: Please complete this section as it relates to any additional expectations, responsibilities, and/or requirements on the part of the Intern/Practicum Student, Site, or University. Spring

19 Please Continue to the Next Page Spring

20 Please provide signatures below. Note that signatures represent agreement with all representations made in this document. Parties of this agreement should mutually review this document and clarify any of the stipulations. In the section above, clarification of any conditions or other qualifications regarding this agreement should be noted. Signatures Below: University Program Representative: Signature Date Site Representative: Signature Date Intern/Practicum Student: Signature Date Please file 1 copy each of this document with: Intern/Practicum Student Personal Copy ISU Program Student File ISU Practicum/Internship Coordinator ISU Program Director Field Experience Site Supervisor or Representative Spring

21 Appendix B Internship Training Plan: School Psychology Program Student's Name: Date: School/Placement: Location: Supervisor: Training Areas to Address: a) professional identity and professional behavior (including ethics) b) assessment and evaluation c) consultation and collaboration d) social emotional intervention- counseling e) preventive services f) risk assessment and crisis management g) program evaluation and applied research h) culture and diversity Go to next page Spring

22 Internship Training Form Training Area: a) Professional Identity / Professional Behavior General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

23 Training Area: b) Assessment and Evaluation General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

24 Training Area: c) consultation and collaboration General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

25 Training Area: d) social emotional intervention- counseling General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

26 Training Area: e) preventive services General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

27 Training Area: f) crisis management General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

28 Training Area: g) Program Evaluation and Applied Research General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

29 Training Area: h) Culture and Diversity General Statement of Goal(s): Specific Objectives in Measurable Terms: Plan for Implementation of Objectives in Measurable Terms: Evaluation of Plan (assess outcomes in measurable terms): Spring

30 Appendix C THE IDAHO STATE UNIVERSITY SCHOOL PSYCHOLOGY PROGRAM Student Evaluation Form, SCPY 6759 Internship Student: Site Supervisor: Semester: Fall Spring Internship Site: University Supervisor: Evaluation: mid-term final Directions: The ratings of the intern should be based upon actual observation and/or reports from staff, students, parents, etc. Circle the description that best describes the intern s competence. A description of each classification is provided below: 0 = Don t Know Not having the opportunity to observe the student in this area 1 = Weak Competence is considered to be in need of further training. Intern seems to lack adequate professional maturation in this area. Close supervision is required. 2 = Adequate Competence is at an average level for functioning with moderate supervision. 3 = Excellent Competence is very well developed and reflects a capacity for independent functioning with little supervision required. A. Prevention/Intervention Skills (NASP Domain 2.3, 2.4, 2.5, 2.6, 2.7, 2.8 & 2.10) 1. Establishes effective therapeutic relationships/rapport (2.10) 2. Knows and applies appropriate research-based counseling strategies (2.3) 3. Behavioral Interventions (2.4) 4. Academic Interventions (2.3) Spring

31 5. Provides/Promotes preventive services (2.5) 6. Supports home-school collaboration services (2.7) 7. Demonstrates sensitivity to cultural and ethnic diversity in interventions (2.8) 8. Demonstrates effective crisis response (2.6) B. Assessment Techniques (NASP Domain 2.1 & 2.8) 1. Diagnostic Interview (2.1) 2. Intelligence Testing (2.1) 3. Academic Achievement Testing (2.1) 4. Behavioral/Emotional Assessment (2.1) 5. Projective Testing and Personality Assessment (2.1) 6. Observation Skills (2.1) 7. Integration of historical information (e.g., document review) (2.1) Spring

32 8. Awareness of strength and limitations of testing instruments (2.1) 9. Demonstrate awareness of and sensitivity to the needs of diverse populations, in test selection, administration, and interpretation (2.8) 10. Overall case conceptualization and assessment planning (2.1) C. Report Writing (NASP Domain 2.1, 2.2, 2.8, & 2.10) 1. Integrates assessment data (2.1) 2. Formulates accurate diagnosis (2.1) 3. Makes appropriate and relevant recommendations which are related to the diagnoses and are appropriate for specific individuals and families) (2.1 & 2.8) 4. Communicates information professionally (proper grammar, explanation of results and terms) (2.2) 5. Completes assessments in a timely manner without compromising the integrity of the assessment process (2.10) D. Consultation (NASP Domain 2.2) 1. With parent (2.2) Spring

33 2. With teacher (2.2) 3. With other support staff/professionals (2.2) 4. Overall Communication skills (i.e., participation in IEP meetings, in-service presentations, etc.) (2.2) E. Research and Program Evaluation (NASP Domain 2.9) 1. Skills in designing, conducting, or evaluating research (2.9) 2. Design and/or conduct program evaluation (2.9) F. Professionalism (NASP Domain 2.8 & 2.10) 1. Able to work cooperatively and collaboratively with staff and school personnel (2.10) 2. Understands the impact of one's role and behaviors on the rest of the school or agency system (2.10) 3. Demonstrates knowledge of community resources and makes appropriate referrals (2.10) 4. Understands and follows ethical and professional standards of practice (2.10) Spring

34 5. Demonstrates sensitivity to cultural, ethnic, racial, family, environmental and individual issues (2.8) 6. Organizes and completes tasks (2.10) 7. Demonstrates self-motivation and interest in professional growth. Actively seeks opportunities to grow clinically through readings, observation of other professionals, attending seminars, and consultation with other professionals (2.10) 8. Demonstrates theoretical understanding of psychopathology and child development (2.10) 9. Completes paperwork in a timely, self-directed and careful manner (2.10) 10. Punctuality and attendance 11. Responds positively to supervision suggestions and feedback 12. Independently consults with supervisor and staff (awareness of own competence 13. Comes prepared for supervision F. Please summarize intern's performance during the evaluation period. Spring

35 I certify that I have read this evaluation: Intern: Date: Site Supervisor: Date: University Supervisor: Date: Spring

36 STUDENT MALPRACTICE COVERAGE Appendix D Idaho State University has mandatory professional liability (malpractice insurance) coverage for students. The carrier for the policy is the Chicago Insurance Company. The policy provides $1,000,000 per claim and $3,000,000 in the aggregate. Students registered for field instruction are required to purchase this coverage for the entire period they are in the field. Students should verify that they have been billed for this coverage; the billing should happen automatically whenever a student is registered for the field instruction. The coverage is restricted to school-related, for-credit activities involving field instruction. Malpractice is a specialized form of negligence requiring certain characteristics in order for there to be a legal basis for action. These are as follows: A duty or obligation, recognized by law, requiring a certain standard or conduct. A failure on his/her part to conform to the standards required. A reasonably close causal connection between the conduct and the resulting injury. Actual loss or damage. Even though malpractice claims against students are relatively uncommon, it s important to be aware of some student-client situations that could lead to claims. They include the following: Failure to inform the client of student status; Providing treatment without obtaining proper consent; Keeping inaccurate or inadequate records; Administering inappropriate or radical treatment; Failing to consult with or refer to a specialist; Failing to provide proper supervision; Failing to take action to prevent a client s suicide. Policy Information: Idaho State University is covered through Chicago Insurance Company ( Company ). Coverage policy period runs from August to August of each year for all programs. The limit of liability is $1,000,000 per incident, $3,000,000 Aggregate. Persons insured under this policy include students of the programs specified on file and approved by the Company, while participating in activities which are part of and a requirement of the students curriculum at Idaho State University, as well as Faculty Member Spring

37 Guidelines for Distance Communication The university supervisor, field supervisor, and student are all responsible for appropriately using the telephone, postal mail, and to communicate with one another, as well as transmitting information in a timely manner about the internship. At minimum, three-way (i.e., student, field supervisor, university supervisor) conference calls must occur near the beginning, middle, and end of the internship. Leave important decisions to telephone contacts or face-to-face meetings. Use for generating possible alternatives. Sometimes, it is easier to clarify an issue with a brief telephone conversation or an in-person meeting than . Use , telephone, and in-person meetings as needed. Remember that many social cues are absent when using electronic mail. Therefore, don t use phrases that might be misconstrued as being critical, insulting or dismissive. When you are unsure of the intent or meaning of a message, ask the sender to clarify the point. If the matter is urgent and you are unsure of when the person will read your message, don t hesitate to use the telephone. Do not include information in that will lead to the possible identification of a client or colleague. For example, use a pseudonym in replace of the actual name. Be careful to protect the identity of the others. Do not include anything in an message that you couldn t publicly defend. can be subpoenaed as evidence in court cases. Indicate when you want the person to respond to you. If your need is urgent, clearly communicate the urgency. If you won t be available for an extended period of time (e.g., vacation), inform people of your timetable so that they can plan ahead and appropriately budget their time. Spring