Competencies for Canada s Substance Abuse Workforce SECTION VI PERFORMANCE MANAGEMENT TOOLS FOR COMMON JOB CLUSTERS FOR THE BEHAVIOURAL COMPETENCIES

Competencies for Canada s Substance Abuse Workforce SECTION VI PERFORMANCE MANAGEMENT TOOLS FOR COMMON JOB CLUSTERS FOR THE BEHAVIOURAL COMPETENCIES

This package was published by the Canadian Centre on Substance Abuse (CCSA). Suggested citation: Canadian Centre on Substance Abuse. (2014). Competencies for Canada s substance abuse workforce. Ottawa, ON: Canadian Centre on Substance Abuse. This is a living document, which CCSA may revise and update to reflect the latest evidence and research. Canadian Centre on Substance Abuse, 2014 For additional copies, contact CCSA, 75 Albert St., Suite 500 Ottawa, ON K1P 5E7 Tel.: 613-235-4048 Email: competencies@ccsa.ca ISBN 978-1-77178-192-3

SECTION VI PERFORMANCE MANAGEMENT TOOLS FOR COMMON JOB CLUSTERS FOR THE BEHAVIOURAL COMPETENCIES TABLE OF CONTENTS ADMINISTRATIVE SUPPORT IV 1 COUNSELLING IV 9 HEALTH PROMOTION IV 17 SENIOR MANAGEMENT IV 25 SUPERVISION IV 33 SUPPORT AND OUTREACH IV 41 WITHDRAWAL MANAGEMENT IV 49

ACKNOWLEDGEMENTS The Canadian Centre on Substance Abuse (CCSA) gratefully acknowledges the significant contributions and support received from people working in the field who participated in focus groups across Canada. CCSA especially thanks all its partners who so graciously allowed and encouraged staff to participate in the focus groups. The research means nothing if the end result is not meaningful to the people for whom it is intended and CCSA could not produce a meaningful report without the input from the focus groups. CCSA also thanks members of the National Advisory Group on Workforce Development (comprised of representatives from key national organizations and provincial/territorial governments) and other experienced directors and managers who participated in reviews of both sets of competencies. These documents can also be downloaded as a PDF at www.ccsa.ca Ce document est également disponible en français sous le titre : Compétences pour les intervenants canadiens en toxicomanie

Competencies for Canada s Substance Abuse Workforce PERFORMANCE MANAGEMENT TOOLS FOR COMMON JOB CLUSTERS FOR THE BEHAVIOURAL COMPETENCIES VI 1 ADMINISTRATIVE SUPPORT This performance management tool provides you with a process and template for conducting employee performance reviews within the Administration Support occupational cluster. It includes a selection of sample performance objectives for the Behavioural Competencies and proficiency levels relevant to the suggested competency profile. This tool is useful as a template or starter guide, but it might not accurately represent the competencies required for the position you are evaluating. To assess and revise the tool so it is well-suited to your organization: 1. Review the tool to determine if the suggested competency profile is relevant. 2. Adjust, as necessary, to suit the job description and your organization. 3. Review the Behavioural Competencies to determine what competencies or proficiency levels you need to change to give a more accurate representation. A brief overview of the steps involved in identifying the relevant competencies for a profile has been provided in the Behavioural Competencies Report. It may be that the profile competencies related to the performance objectives are not all identified in the planning stage. Others can be added as needed. Typically, each performance objective has one related competency or more. To assist you in planning the initial review, sample performance objectives have been provided. They relate to the Behavioural Competencies in each job profile. Ensure that all performance evaluations are conducted in accordance with existing organizational policies and procedures. A job competency profile includes only the critical competencies required for the job (not those that are nice to have i.e., not essential to performing the job successfully). Preferably, there are no more than 12 competencies per profile.

Performance Management Tools for Common Job Clusters for the Behavioural Competencies ADMINISTRATIVE SUPPORT VI 2 **CONFIDENTIAL WHEN COMPLETED** Performance Management Tool for Positions Related to Administrative Support Position Title: Employee Name: Manager s Name and Title: Review Period from (Month/Year) to (Month/Year): Date of Review (Day/Month/Year): Preparation Checklist Review job description to identify the target position requirements and competencies. Review previous performance evaluation, if available. Suggested Competency Profile Job Cluster Administrative Support Example Job Titles Administrative Assistant, Administrator, Regional Administrator, Clinic Technician Competency Required Proficiency Levels Adaptability/Flexibility 1 Analytical Thinking and Decision Making 1 Client Service Orientation 1 Continuous Learning 2 Diversity and Cultural Responsiveness 1 Effective Communication 2 Ethical Conduct and Professionalism 1 Interpersonal Rapport/Savvy 2 Planning and Organizing 2 Self Care 2 Self Management 2 Teamwork and Cooperation 2

Performance Management Tools for Common Job Clusters for the Behavioural Competencies ADMINISTRATIVE SUPPORT VI 3 How to Use this Form INITIAL PLANNING: At the beginning of the performance cycle (e.g., on or immediately following the anniversary date of the employee) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. The performance objectives can be task- or activity-based, or can be competency-based objectives (see Part A: Performance Planning and Review). In almost all cases, performance objectives identified (the what of the job) can be related to particular competencies required to achieve them (the how of the job). If this is the first year a performance review has been conducted, the manager and the employee might not yet be able to identify any learning and development needs. They can have an initial discussion about what these might be, based on the employee s own performance development concerns. If this is not the first year, the manager and the employee confirm the learning and development needs identified at the end of the previous cycle. INTERIM REVIEW: During the cycle (e.g., 6-month review) The manager and employee meet to review progress in achieving performance objectives and begin to identify areas for development. Formal reviews might also be conducted throughout the period; for example, when the manager or employee changes jobs, when there is significant change in the existing job, or at the end of a key milestone. Performance objectives might need adjusting if work or priorities have changed since the beginning of the cycle (see Part A: Performance Planning and Review). If this is the first year a performance review has been conducted, the manager and the employee can begin to identify learning and development needs (see Part B: Learning and Development). If this is not the first year a performance review has been conducted, the manager and employee review the employee s accomplishment of the action plan so far and adjust as necessary (see Part B: Learning and Development).

Performance Management Tools for Common Job Clusters for the Behavioural Competencies ADMINISTRATIVE SUPPORT VI 4 FINAL REVIEW: At the end of the cycle (on or near the anniversary date of the employee s hiring) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. Record the employee s performance for each of the required competencies (see Part A: Performance Planning and Review). For each objective, the manager and employee discuss the extent to which objectives were achieved. This is recorded in the Results section. In the Rating section, employee and manager use the rating scale provided on the last page to evaluate results. If this is the first year a performance review has been conducted, the manager and the employee work together to identify the learning and development needs and the required action plan for the following review cycle (see Part B: Learning and Development). Focus is on the most pressing learning needs (e.g., up to five areas for development). If this is not the first year, the manager and employee review the employee s accomplishment of the action plan throughout the previous year (see Part B: Learning and Development). SIGN OFF: At the end of the cycle (on the anniversary date of the employee s hiring) The manager prepares the final summary review and evaluation and reviews the results with the employee (see Part C: Final Evaluation). The manager and employee jointly determine and agree to an action plan to enhance performance and results. This includes action to be taken by both the manager and the employee (see Part C: Final Evaluation). The employee comments on his or her own performance over the review cycle and the results (see Part C: Final Evaluation). The original of the completed form is placed in the employee s Human Resource file and the manager gives a copy to the employee.

Performance Management Tools for Common Job Clusters for the Behavioural Competencies ADMINISTRATIVE SUPPORT VI 5 PART A: Performance Planning and Review Related Competencies Sample Performance Objectives Adaptability/Flexibility Teamwork and Cooperation 1. Provide administrative coverage/support for other sections during periods of absence of other administrative staff and when necessary. Analytical Thinking and Decision Making 2. Provide timely information on user activity based on an analysis of available data. Client Service Orientation Interpersonal Savvy/Rapport Ethical Conduct and Professionalism 3. Provide necessary information to clients within the boundaries of confidentiality policies and/or contact appropriate staff to pass information as appropriate. Continuous Learning Self Care 4. Undertake training as identified by supervisor and learning plan. Results Achieved Rating Self Mgr

Performance Management Tools for Common Job Clusters for the Behavioural Competencies ADMINISTRATIVE SUPPORT VI 6 Related Competencies Effective Communication Self Management Diversity and Cultural Responsiveness Planning and Organizing Ethical Conduct and Professionalism Self Care Teamwork and Cooperation Adaptability/Flexibility Sample Performance Objectives 5. Ensure effective communication is maintained between service users and colleagues at all levels, both verbally and in writing. 6. Maintain and create efficient filing systems (electronic and hard-copy) to facilitate data retrieval and ensure that confidentiality is preserved. 7. Seek assistance from others to resolve issues or meet demands of the workload, as appropriate. Results Achieved Rating Self Mgr

Performance Management Tools for Common Job Clusters for the Behavioural Competencies ADMINISTRATIVE SUPPORT VI 7 PART B: Learning and Development Areas for Development Action Plan/ Development Options Target Completion Dates Results

Performance Management Tools for Common Job Clusters for the Behavioural Competencies ADMINISTRATIVE SUPPORT VI 8 PART C: Summary Review and Overall Evaluation After discussion on Parts A and B, the manager prepares summary comments on the employee s overall performance during the review period and rates the employee s performance. The employee and manager agree on a mutual action plan recording the actions to be taken by the manager and employee to achieve desired results (includes making funds, time and resources available as necessary). The employee records summary comments on own performance and/or the review process, as desired. Both the manager and employee sign the evaluation. 4 3 2 1 Exceeds Expectations Exceeded requirements on most of all important elements of the objective(s). Meets Expectations Fulfilled requirements and met performance objective(s) within the standards for the position assessed. Progressing Fulfilled some of the requirements of the objective(s). Progress is being observed for the majority of objective requirements. Needs Improvement Fulfillment of objective(s) was less than adequate in all or most respects. Performance is below satisfactory level and must improve. Overall Evaluation Needs Improvement Progressing Meets Expectations Exceeds Expectations Manager Comments/ Summary Mutual Action Plan Employee Comments Employee Signature Manager Signature Date (dd/mm/yy) NOTE: By signing here, the employee acknowledges reading the results and discussing them with the manager.

COUNSELLING VI 9 COUNSELLING This performance management tool provides you with a process and template for conducting employee performance reviews within the Counselling occupational cluster. It includes a selection of sample performance objectives for the Behavioural Competencies and proficiency levels relevant to the suggested competency profile. This tool is useful as a template or starter guide, but it might not accurately represent the competencies required for the position you are evaluating. To assess and revise the tool so it is well-suited to your organization: 1. Review the tool to determine if the suggested competency profile is relevant. 2. Adjust, as necessary, to suit the job description and your organization. 3. Review the Behavioural Competencies to determine what competencies or proficiency levels you need to change to give a more accurate representation. A brief overview of the steps involved in identifying the relevant competencies for a profile has been provided in the Behavioural Competencies Report. A job competency profile includes only the critical competencies required for the job (not those that are nice to have i.e., not essential to performing the job successfully). Preferably, there are no more than 12 competencies per profile. It may be that the profile competencies related to the performance objectives are not all identified in the planning stage. Others can be added as needed. Typically, each performance objective has one related competency or more. To assist you in planning the initial review, sample performance objectives have been provided. They relate to the Behavioural Competencies in each job profile. Ensure that all performance evaluations are conducted in accordance with existing organizational policies and procedures.

COUNSELLING VI 10 **CONFIDENTIAL WHEN COMPLETED** Performance Management Tool for Positions Related to Counselling Position Title: Employee Name: Manager s Name and Title: Review Period from (Month/Year) to (Month/Year): Date of Review (Day/Month/Year): Preparation Checklist Review job description to identify the target position requirements and competencies. Review previous performance evaluation, if available. Suggested Competency Profile Job Cluster Counselling Example Job Titles Addictions Counsellor, Alcohol & Drug Counsellor, Substance Abuse Counsellor, Intake Counsellor Competency Required Proficiency Level Adaptability/Flexibility 3 Analytical Thinking and Decision Making 3 Client-centred Change 3 Client Service Orientation 2 Continuous Learning 2 Diversity and Cultural Responsiveness 3 Effective Communication 3 Ethical Conduct and Professionalism 2 Interpersonal Rapport/Savvy 3 Self Care 2 Self Management 2 Teamwork and Cooperation 2

COUNSELLING VI 11 How to Use this Form INITIAL PLANNING: At the beginning of the performance cycle (e.g., on or immediately following the anniversary date of the employee) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. The performance objectives can be task- or activity-based, or can be competency-based objectives (see Part A: Performance Planning and Review). In almost all cases, performance objectives identified (the what of the job) can be related to particular competencies required to achieve them (the how of the job). If this is the first year a performance review has been conducted, the manager and the employee might not yet be able to identify any learning and development needs. They can have an initial discussion about what these might be, based on the employee s own performance development concerns. If this is not the first year, the manager and the employee confirm the learning and development needs identified at the end of the previous cycle. INTERIM REVIEW: During the cycle (e.g., 6-month review) The manager and employee meet to review progress in achieving performance objectives and begin to identify areas for development. Formal reviews might also be conducted throughout the period; for example, when the manager or employee changes jobs, when there is significant change in the existing job, or at the end of a key milestone. Performance objectives might need adjusting if work or priorities have changed since the beginning of the cycle (see Part A: Performance Planning and Review). If this is the first year a performance review has been conducted, the manager and the employee can begin to identify learning and development needs (see Part B: Learning and Development). If this is not the first year a performance review has been conducted, the manager and employee review the employee s accomplishment of the action plan so far and adjust as necessary (see Part B: Learning and Development).

COUNSELLING VI 12 FINAL REVIEW: At the end of the cycle (on or near the anniversary date of the employee s hiring) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. Record the employee s performance for each of the required competencies (see Part A: Performance Planning and Review). For each objective, the manager and employee discuss the extent to which objectives were achieved. This is recorded in the Results section. In the Rating section, employee and manager use the rating scale provided on the last page to evaluate results. If this is the first year a performance review has been conducted, the manager and the employee work together to identify the learning and development needs and the required action plan for the following review cycle (see Part B: Learning and Development). Focus is on the most pressing learning needs (e.g., up to five areas for development). If this is not the first year, the manager and employee review the employee s accomplishment of the action plan throughout the previous year (see Part B: Learning and Development). SIGN OFF: At the end of the cycle (on the anniversary date of the employee s hiring) The manager prepares the final summary review and evaluation and reviews the results with the employee (see Part C: Final Evaluation). The manager and employee jointly determine and agree to an action plan to enhance performance and results. This includes action to be taken by both the manager and the employee (see Part C: Final Evaluation). The employee comments on his or her own performance over the review cycle and the results (see Part C: Final Evaluation). The original of the completed form is placed in the employee s Human Resource file and the manager gives a copy to the employee.

COUNSELLING VI 13 PART A: Performance Planning and Review Related Competencies Sample Performance Objectives Interpersonal Savvy/Rapport Effective Communication 1. Provide individual and group counselling sessions to clients in a safe environment. Client Service Orientation Diversity and Cultural Responsiveness 2. Negotiate and sustain goaldirected counselling relationships that honour individual, cultural and situational diversity. Effective Communication Interpersonal Savvy/Rapport Self Management 3. Demonstrate appropriate awareness of self through recognition of impact on others, managing bias, and the identification of strengths and limitations. Client Service Orientation 4. Assist individuals, groups and the community to attain knowledge and skills in addressing substance use issues. Results Achieved Rating Self Mgr

COUNSELLING VI 14 Related Competencies Teamwork and Cooperation Continuous Learning Ethical Conduct and Professionalism Client-centered Change Client Service Orientation Adaptability and Flexibility Effective Communication Diversity and Cultural Responsiveness Self Management Self Care Continuous Learning Ethical Conduct and Professionalism Sample Performance Objectives 5. Engage in reciprocal relationships of learning with colleagues. 6. Collaborate with clients to identify appropriate treatment options and/or supports. 7. Develop personal and professional resilience and promote health through the development and implementation of a personal wellness plan. Results Achieved Rating Self Mgr

COUNSELLING VI 15 PART B: Learning and Development Areas for Development Action Plan/ Development Options Target Completion Dates Results

COUNSELLING VI 16 PART C: Summary Review and Overall Evaluation After discussion on Parts A and B, the manager prepares summary comments on the employee s overall performance during the review period and rates the employee s performance. The employee and manager agree on a mutual action plan recording the actions to be taken by the manager and employee to achieve desired results (includes making funds, time and resources available as necessary). The employee records summary comments on own performance and/or the review process, as desired. Both the manager and employee sign the evaluation. 4 3 2 1 Exceeds Expectations Exceeded requirements on most of all important elements of the objective(s). Meets Expectations Fulfilled requirements and met performance objective(s) within the standards for the position assessed. Progressing Fulfilled some of the requirements of the objective(s). Progress is being observed for the majority of objective requirements. Needs Improvement Fulfillment of objective(s) was less than adequate in all or most respects. Performance is below satisfactory level and must improve. Overall Evaluation Needs Improvement Progressing Meets Expectations Exceeds Expectations Manager Comments/ Summary Mutual Action Plan Employee Comments Employee Signature Manager Signature Date (dd/mm/yy) NOTE: By signing here, the employee acknowledges reading the results and discussing them with the manager.

HEALTH PROMOTION VI 17 HEALTH PROMOTION This performance management tool provides you with a process and template for conducting employee performance reviews within the Health Promotion occupational cluster. It includes a selection of sample performance objectives for the Behavioural Competencies and proficiency levels relevant to the suggested competency profile. This tool is useful as a template or starter guide, but it might not accurately represent the competencies required for the position you are evaluating. To assess and revise the tool so it is well-suited to your organization: 1. Review the tool to determine if the suggested competency profile is relevant. 2. Adjust, as necessary, to suit the job description and your organization. 3. Review the Behavioural Competencies to determine what competencies or proficiency levels you need to change to give a more accurate representation. A brief overview of the steps involved in identifying the relevant competencies for a profile has been provided in the Behavioural Competencies Report. A job competency profile includes only the critical competencies required for the job (not those that are nice to have i.e., not essential to performing the job successfully). Preferably, there are no more than 12 competencies per profile. It may be that the profile competencies related to the performance objectives are not all identified in the planning stage. Others can be added as needed. Typically, each performance objective has one related competency or more. To assist you in planning the initial review, sample performance objectives have been provided. They relate to the Behavioural Competencies in each job profile. Ensure that all performance evaluations are conducted in accordance with existing organizational policies and procedures.

HEALTH PROMOTION VI 18 **CONFIDENTIAL WHEN COMPLETED** Performance Management Tool for Positions Related to Health Promotion Position Title: Employee Name: Manager s Name and Title: Review Period from (Month/Year) to (Month/Year): Date of Review (Day/Month/Year): Preparation Checklist Review job description to identify the target position requirements and competencies. Review previous performance evaluation, if available. Suggested Competency Profile Job Cluster Health Promotion Example Job Titles Health Promotion Specialist, Health Education Specialist, Prevention Coordinator, Health Educator, Health Promotion & Protection Specialist/Worker Competency Required Proficiency Level Adaptability/Flexibility 3 Analytical Thinking and Decision Making 2 Collaboration and Network Building 3 Continuous Learning 3 Creativity and Innovation 3 Developing Others 3 Diversity and Cultural Responsiveness 3 Effective Communication 3 Ethical Conduct and Professionalism 2 Interpersonal Rapport/Savvy 3 Planning and Organizing 3 Self Care 2 Self Motivation and Drive 2 Teamwork and Cooperation 2

HEALTH PROMOTION VI 19 How to Use this Form INITIAL PLANNING: At the beginning of the performance cycle (e.g., on or immediately following the anniversary date of the employee) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. The performance objectives can be task- or activity-based, or can be competency-based objectives (see Part A: Performance Planning and Review). In almost all cases, performance objectives identified (the what of the job) can be related to particular competencies required to achieve them (the how of the job). If this is the first year a performance review has been conducted, the manager and the employee might not yet be able to identify any learning and development needs. They can have an initial discussion about what these might be, based on the employee s own performance development concerns. If this is not the first year, the manager and the employee confirm the learning and development needs identified at the end of the previous cycle. INTERIM REVIEW: During the cycle (e.g., 6-month review) The manager and employee meet to review progress in achieving performance objectives and begin to identify areas for development. Formal reviews might also be conducted throughout the period; for example, when the manager or employee changes jobs, when there is significant change in the existing job, or at the end of a key milestone. Performance objectives might need adjusting if work or priorities have changed since the beginning of the cycle (see Part A: Performance Planning and Review). If this is the first year a performance review has been conducted, the manager and the employee can begin to identify learning and development needs (see Part B: Learning and Development). If this is not the first year a performance review has been conducted, the manager and employee review the employee s accomplishment of the action plan so far and adjust as necessary (see Part B: Learning and Development).

HEALTH PROMOTION VI 20 FINAL REVIEW: At the end of the cycle (on or near the anniversary date of the employee s hiring) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. Record the employee s performance for each of the required competencies (see Part A: Performance Planning and Review). For each objective, the manager and employee discuss the extent to which objectives were achieved. This is recorded in the Results section. In the Rating section, employee and manager use the rating scale provided on the last page to evaluate results. If this is the first year a performance review has been conducted, the manager and the employee work together to identify the learning and development needs and the required action plan for the following review cycle (see Part B: Learning and Development). Focus is on the most pressing learning needs (e.g., up to five areas for development). If this is not the first year, the manager and employee review the employee s accomplishment of the action plan throughout the previous year (see Part B: Learning and Development). SIGN OFF: At the end of the cycle (on the anniversary date of the employee s hiring) The manager prepares the final summary review and evaluation and reviews the results with the employee (see Part C: Final Evaluation). The manager and employee jointly determine and agree to an action plan to enhance performance and results. This includes action to be taken by both the manager and the employee (see Part C: Final Evaluation). The employee comments on his or her own performance over the review cycle and the results (see Part C: Final Evaluation). The original of the completed form is placed in the employee s Human Resource file and the manager gives a copy to the employee.

HEALTH PROMOTION VI 21 PART A: Performance Planning and Review Related Competencies Sample Performance Objectives Adaptability/Flexibility Continuous Learning Creativity and Innovation Collaboration and Network Building 1. Assist the school district in implementing a comprehensive school health approach by providing access to up-to-date information on health promotion theory and evidence-based practice. Collaboration and Network Building Effective Communication 2. Establish and maintain links with community leaders and other key health promotion stakeholders (e.g., schools, businesses, churches, community associations, labour unions). Effective Communication Interpersonal Savvy/Rapport Creativity and Innovation Collaboration and Network Building 3. Facilitate a health education program to address binge drinking among young adults. Creativity and Innovation Effective Communication Collaboration and Network Building 4. Develop a social marketing campaign including multiple channels (leaflets, posters, brochures, PSAs, etc.) to raise awareness of low-risk drinking. Results Achieved Rating Self Mgr

HEALTH PROMOTION VI 22 Related Competencies Diversity and Cultural Responsiveness Ethical Conduct and Professionalism Interpersonal Savvy/Rapport Adaptability/Flexibility Sample Performance Objectives 5. Facilitate development of a communication coalition to advocate for addressing health inequities impacting socio-ethnic minorities in the community. Results Achieved Rating Self Mgr

HEALTH PROMOTION VI 23 PART B: Learning and Development Areas for Development Action Plan/ Development Options Target Completion Dates Results

HEALTH PROMOTION VI 24 PART C: Summary Review and Overall Evaluation After discussion on Parts A and B, the manager prepares summary comments on the employee s overall performance during the review period and rates the employee s performance. The employee and manager agree on a mutual action plan recording the actions to be taken by the manager and employee to achieve desired results (includes making funds, time and resources available as necessary). The employee records summary comments on own performance and/or the review process, as desired. Both the manager and employee sign the evaluation. 4 3 2 1 Exceeds Expectations Exceeded requirements on most of all important elements of the objective(s). Meets Expectations Fulfilled requirements and met performance objective(s) within the standards for the position assessed. Progressing Fulfilled some of the requirements of the objective(s). Progress is being observed for the majority of objective requirements. Needs Improvement Fulfillment of objective(s) was less than adequate in all or most respects. Performance is below satisfactory level and must improve. Overall Evaluation Needs Improvement Progressing Meets Expectations Exceeds Expectations Manager Comments/ Summary Mutual Action Plan Employee Comments Employee Signature Manager Signature Date (dd/mm/yy) NOTE: By signing here, the employee acknowledges reading the results and discussing them with the manager.

SENIOR MANAGEMENT VI 25 SENIOR MANAGEMENT This performance management tool provides you with a process and template for conducting employee performance reviews within the Senior Management occupational cluster. It includes a selection of sample performance objectives for the Behavioural Competencies and proficiency levels relevant to the suggested competency profile. This tool is useful as a template or starter guide, but it might not accurately represent the competencies required for the position you are evaluating. To assess and revise the tool so it is well-suited to your organization: 1. Review the tool to determine if the suggested competency profile is relevant. 2. Adjust, as necessary, to suit the job description and your organization. 3. Review the Behavioural Competencies to determine what competencies or proficiency levels you need to change to give a more accurate representation. A brief overview of the steps involved in identifying the relevant competencies for a profile has been provided in the Behavioural Competencies Report. A job competency profile includes only the critical competencies required for the job (not those that are nice to have i.e., not essential to performing the job successfully). Preferably, there are no more than 12 competencies per profile. It may be that the profile competencies related to the performance objectives are not all identified in the planning stage. Others can be added as needed. Typically, each performance objective has one related competency or more. To assist you in planning the initial review, sample performance objectives have been provided. They relate to the Behavioural Competencies in each job profile. Ensure that all performance evaluations are conducted in accordance with existing organizational policies and procedures.

SENIOR MANAGEMENT VI 26 **CONFIDENTIAL WHEN COMPLETED** Performance Management Tool for Positions Related to Senior Management Position Title: Employee Name: Manager s Name and Title: Review Period from (Month/Year) to (Month/Year): Date of Review (Day/Month/Year): Preparation Checklist Review job description to identify the target position requirements and competencies. Review previous performance evaluation, if available. Suggested Competency Profile Job Cluster Senior Management Example Job Titles Executive Director, Clinical Director, Program Director, Program Manager, Controller, Office Manager Competency Required Proficiency Level Adaptability/Flexibility 4 Analytical Thinking and Decision Making 4 Collaboration and Network Building 4 Continuous Learning 4 Creativity and Innovation 4 Developing Others 4 Diversity and Cultural Responsiveness 4 Effective Communication 4 Ethical Conduct and Professionalism 4 Leadership 4 Planning and Organizing 4 Self Care 4 Teamwork and Cooperation 4

SENIOR MANAGEMENT VI 27 How to Use this Form INITIAL PLANNING: At the beginning of the performance cycle (e.g., on or immediately following the anniversary date of the employee) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. The performance objectives can be task- or activity-based, or can be competency-based objectives (see Part A: Performance Planning and Review). In almost all cases, performance objectives identified (the what of the job) can be related to particular competencies required to achieve them (the how of the job). If this is the first year a performance review has been conducted, the manager and the employee might not yet be able to identify any learning and development needs. They can have an initial discussion about what these might be, based on the employee s own performance development concerns. If this is not the first year, the manager and the employee confirm the learning and development needs identified at the end of the previous cycle. INTERIM REVIEW: During the cycle (e.g., 6-month review) The manager and employee meet to review progress in achieving performance objectives and begin to identify areas for development. Formal reviews might also be conducted throughout the period; for example, when the manager or employee changes jobs, when there is significant change in the existing job, or at the end of a key milestone. Performance objectives might need adjusting if work or priorities have changed since the beginning of the cycle (see Part A: Performance Planning and Review). If this is the first year a performance review has been conducted, the manager and the employee can begin to identify learning and development needs (see Part B: Learning and Development). If this is not the first year a performance review has been conducted, the manager and employee review the employee s accomplishment of the action plan so far and adjust as necessary (see Part B: Learning and Development).

SENIOR MANAGEMENT VI 28 FINAL REVIEW: At the end of the cycle (on or near the anniversary date of the employee s hiring) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. Record the employee s performance for each of the required competencies (see Part A: Performance Planning and Review). For each objective, the manager and employee discuss the extent to which objectives were achieved. This is recorded in the Results section. In the Rating section, employee and manager use the rating scale provided on the last page to evaluate results. If this is the first year a performance review has been conducted, the manager and the employee work together to identify the learning and development needs and the required action plan for the following review cycle (see Part B: Learning and Development). Focus is on the most pressing learning needs (e.g., up to five areas for development). If this is not the first year, the manager and employee review the employee s accomplishment of the action plan throughout the previous year (see Part B: Learning and Development). SIGN OFF: At the end of the cycle (on the anniversary date of the employee s hiring) The manager prepares the final summary review and evaluation and reviews the results with the employee (see Part C: Final Evaluation). The manager and employee jointly determine and agree to an action plan to enhance performance and results. This includes action to be taken by both the manager and the employee (see Part C: Final Evaluation). The employee comments on his or her own performance over the review cycle and the results (see Part C: Final Evaluation). The original of the completed form is placed in the employee s Human Resource file and the manager gives a copy to the employee.

SENIOR MANAGEMENT VI 29 PART A: Performance Planning and Review Related Competencies Sample Performance Objectives Planning and Organizing Analytical Thinking and Decision Making Leadership 1. Develop and administer the region s comprehensive substance abuse program involving the allocation of federal, provincial and municipal resources to agencies that provide substance abuse prevention, on or before all submission dates and within 1% of budget (or with approval explanations for overage). Collaboration and Network Building Developing Others Creativity and Innovation Effective Communication Diversity and Cultural Responsiveness 2. Promote community use of substance abuse and other public service programs through enhancing and developing community needs-based education and resources. Ethical Conduct and Professionalism Teamwork and Cooperation Effective Communication 3. Develop a policy for conflicts of interest for the organization. Leadership Creativity and Innovation Analytical Thinking and Decision Making 4. Identify a new or enhanced mission statement, goals, values and vision through a collaborative process, positively evaluated and supported by the board and other stakeholders, which establishes Results Achieved Rating Self Mgr

SENIOR MANAGEMENT VI 30 Related Competencies Teamwork and Cooperation Developing Others Continuous Learning Creativity and Innovation Adaptability/Flexibility Planning and Organizing Sample Performance Objectives 5. Facilitate collaboration and development within the senior management team by providing: One-to-one coaching Mentoring Teaching consensusbased decision making 6. Conduct a review of best practices in substance abuse prevention and/or treatment and develop a strategy on how to implement those practices into existing programs to gain measurable enhancements. Results Achieved Rating Self Mgr

SENIOR MANAGEMENT VI 31 PART B: Learning and Development Areas for Development Action Plan/ Development Options Target Completion Dates Results

SENIOR MANAGEMENT VI 32 PART C: Summary Review and Overall Evaluation After discussion on Parts A and B, the manager prepares summary comments on the employee s overall performance during the review period and rates the employee s performance. The employee and manager agree on a mutual action plan recording the actions to be taken by the manager and employee to achieve desired results (includes making funds, time and resources available as necessary). The employee records summary comments on own performance and/or the review process, as desired. Both the manager and employee sign the evaluation. 4 3 2 1 Exceeds Expectations Exceeded requirements on most of all important elements of the objective(s). Meets Expectations Fulfilled requirements and met performance objective(s) within the standards for the position assessed. Progressing Fulfilled some of the requirements of the objective(s). Progress is being observed for the majority of objective requirements. Needs Improvement Fulfillment of objective(s) was less than adequate in all or most respects. Performance is below satisfactory level and must improve. Overall Evaluation Needs Improvement Progressing Meets Expectations Exceeds Expectations Manager Comments/ Summary Mutual Action Plan Employee Comments Employee Signature Manager Signature Date (dd/mm/yy) NOTE: By signing here, the employee acknowledges reading the results and discussing them with the manager.

SUPERVISION VI 33 SUPERVISION This performance management tool provides you with a process and template for conducting employee performance reviews within the Supervision occupational cluster. It includes a selection of sample performance objectives for the Behavioural Competencies and proficiency levels relevant to the suggested competency profile. This tool is useful as a template or starter guide, but it might not accurately represent the competencies required for the position you are evaluating. To assess and revise the tool so it is well-suited to your organization: 1. Review the tool to determine if the suggested competency profile is relevant. 2. Adjust, as necessary, to suit the job description and your organization. 3. Review the Behavioural Competencies to determine what competencies or proficiency levels you need to change to give a more accurate representation. A brief overview of the steps involved in identifying the relevant competencies for a profile has been provided in the Behavioural Competencies Report. A job competency profile includes only the critical competencies required for the job (not those that are nice to have i.e., not essential to performing the job successfully). Preferably, there are no more than 12 competencies per profile. It may be that the profile competencies related to the performance objectives are not all identified in the planning stage. Others can be added as needed. Typically, each performance objective has one related competency or more. To assist you in planning the initial review, sample performance objectives have been provided. They relate to the Behavioural Competencies in each job profile. Ensure that all performance evaluations are conducted in accordance with existing organizational policies and procedures.

SUPERVISION VI 34 **CONFIDENTIAL WHEN COMPLETED** Performance Management Tool for Positions Related to Supervision Position Title: Employee Name: Manager s Name and Title: Review Period from (Month/Year) to (Month/Year): Date of Review (Day/Month/Year): Preparation Checklist Review job description to identify the target position requirements and competencies. Review previous performance evaluation, if available. Suggested Competency Profile Job Cluster Supervision Example Job Titles Clinical Supervisor, Non-Clinical Supervisor, Senior Counsellor, Lead Clinician, Manager, Coordinator Competency Required Proficiency Level Adaptability/Flexibility 3 Analytical Thinking and Decision Making 3 Client Service Orientation 3 Continuous Learning 3 Creativity and Innovation 3 Developing Others 3 Diversity and Cultural Responsiveness 3 Effective Communication 3 Ethical Conduct and Professionalism 3 Interpersonal Rapport/Savvy 3 Leadership 3 Planning and Organizing 3 Self Care 3 Teamwork and Cooperation 3

SUPERVISION VI 35 How to Use this Form INITIAL PLANNING: At the beginning of the performance cycle (e.g., on or immediately following the anniversary date of the employee) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. The performance objectives can be task- or activity-based, or can be competency-based objectives (see Part A: Performance Planning and Review). In almost all cases, performance objectives identified (the what of the job) can be related to particular competencies required to achieve them (the how of the job). If this is the first year a performance review has been conducted, the manager and the employee might not yet be able to identify any learning and development needs. They can have an initial discussion about what these might be, based on the employee s own performance development concerns. If this is not the first year, the manager and the employee confirm the learning and development needs identified at the end of the previous cycle. INTERIM REVIEW: During the cycle (e.g., 6-month review) The manager and employee meet to review progress in achieving performance objectives and begin to identify areas for development. Formal reviews might also be conducted throughout the period; for example, when the manager or employee changes jobs, when there is significant change in the existing job, or at the end of a key milestone. Performance objectives might need adjusting if work or priorities have changed since the beginning of the cycle (see Part A: Performance Planning and Review). If this is the first year a performance review has been conducted, the manager and the employee can begin to identify learning and development needs (see Part B: Learning and Development). If this is not the first year a performance review has been conducted, the manager and employee review the employee s accomplishment of the action plan so far and adjust as necessary (see Part B: Learning and Development).

SUPERVISION VI 36 FINAL REVIEW: At the end of the cycle (on or near the anniversary date of the employee s hiring) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. Record the employee s performance for each of the required competencies (see Part A: Performance Planning and Review). For each objective, the manager and employee discuss the extent to which objectives were achieved. This is recorded in the Results section. In the Rating section, employee and manager use the rating scale provided on the last page to evaluate results. If this is the first year a performance review has been conducted, the manager and the employee work together to identify the learning and development needs and the required action plan for the following review cycle (see Part B: Learning and Development). Focus is on the most pressing learning needs (e.g., up to five areas for development). If this is not the first year, the manager and employee review the employee s accomplishment of the action plan throughout the previous year (see Part B: Learning and Development). SIGN OFF: At the end of the cycle (on the anniversary date of the employee s hiring) The manager prepares the final summary review and evaluation and reviews the results with the employee (see Part C: Final Evaluation). The manager and employee jointly determine and agree to an action plan to enhance performance and results. This includes action to be taken by both the manager and the employee (see Part C: Final Evaluation). The employee comments on his or her own performance over the review cycle and the results (see Part C: Final Evaluation). The original of the completed form is placed in the employee s Human Resource file and the manager gives a copy to the employee.

SUPERVISION VI 37 PART A: Performance Planning and Review Related Competencies Sample Performance Objectives Planning and Organizing Interpersonal Rapport/Savvy 1. Manage an agreed-upon caseload and provide specialist assessment and intervention services to address the substance abuse treatment needs of youth ages 14 18 years. Submit caseload report monthly. Developing Others Continuous Learning Self Care 2. Identify, organize and participate in the development of methadone treatment training programs within next 12 months. Client Service Orientation Analytical Thinking and Decision Making Ethical Conduct and Professionalism 3. Monitor, evaluate and improve the standard of service delivery of the alcohol and drug treatment program to meet agreed-upon standards of care, as stated in policy manual. Submit evaluations to supervisor at end of each course. Analytical Thinking and Decision Making 4. Review client satisfaction surveys monthly. Incorporate and consider recommendations for improving program after reviewing with the team. Results Achieved Rating Self Mgr

SUPERVISION VI 38 Related Competencies Leadership Teamwork and Cooperation Interpersonal Rapport/Savvy Effective Communication Diversity and Cultural Responsiveness Effective Communication Effective Communication Planning and Organizing Developing Others Continuous Learning Adaptability/Flexibility Client Service Orientation Creativity and Innovation Effective Communication Sample Performance Objectives 5. Hold monthly clinical supervision meetings with individual staff and review caseloads. Facilitate monthly team meetings. 6. Organize quarterly meetings between staff and Aboriginal healer/elder to enhance cultural sensitivity and service delivery. 7. Develop a lunch-and-learn session on managing e-mail by end of May to learn effective e-mail and file management. 8. Manage shift schedule to ensure continuous client service delivery throughout the year. Results Achieved Rating Self Mgr

SUPERVISION VI 39 Related Competencies Ethical Conduct and Professionalism Developing Others Planning and Organizing Creativity and Innovation Developing Others Effective Communication Interpersonal Rapport/Savvy Self Care Developing Others Creativity and Innovation Adaptability/Flexibility Interpersonal Rapport/Savvy Sample Performance Objectives 9. Organize team workshop on dual relationships by June 30. 10. Identify issues that concern the team and effectively facilitate brainstorming, rotating facilitator role to develop staff. 11. Ensure that all staff manage overtime and take vacation time before end of year. Results Achieved Rating Self Mgr

SUPERVISION VI 40 PART B: Learning and Development Areas for Development Action Plan/ Development Options Target Completion Dates Results

SUPERVISION VI 41 PART C: Summary Review and Overall Evaluation After discussion on Parts A and B, the manager prepares summary comments on the employee s overall performance during the review period and rates the employee s performance. The employee and manager agree on a mutual action plan recording the actions to be taken by the manager and employee to achieve desired results (includes making funds, time and resources available as necessary). The employee records summary comments on own performance and/or the review process, as desired. Both the manager and employee sign the evaluation. 4 3 2 1 Exceeds Expectations Exceeded requirements on most of all important elements of the objective(s). Meets Expectations Fulfilled requirements and met performance objective(s) within the standards for the position assessed. Progressing Fulfilled some of the requirements of the objective(s). Progress is being observed for the majority of objective requirements. Needs Improvement Fulfillment of objective(s) was less than adequate in all or most respects. Performance is below satisfactory level and must improve. Overall Evaluation Needs Improvement Progressing Meets Expectations Exceeds Expectations Manager Comments/ Summary Mutual Action Plan Employee Comments Employee Signature Manager Signature Date (dd/mm/yy) NOTE: By signing here, the employee acknowledges reading the results and discussing them with the manager.

SUPPORT AND OUTREACH VI 42 SUPPORT AND OUTREACH This performance management tool provides you with a process and template for conducting employee performance reviews within the Support and Outreach occupational cluster. It includes a selection of sample performance objectives for the Behavioural Competencies and proficiency levels relevant to the suggested competency profile. This tool is useful as a template or starter guide, but it might not accurately represent the competencies required for the position you are evaluating. To assess and revise the tool so it is well-suited to your organization: 1. Review the tool to determine if the suggested competency profile is relevant. 2. Adjust, as necessary, to suit the job description and your organization. 3. Review the Behavioural Competencies to determine what competencies or proficiency levels you need to change to give a more accurate representation. A brief overview of the steps involved in identifying the relevant competencies for a profile has been provided in the Behavioural Competencies Report. A job competency profile includes only the critical competencies required for the job (not those that are nice to have i.e., not essential to performing the job successfully). Preferably, there are no more than 12 competencies per profile. It may be that the profile competencies related to the performance objectives are not all identified in the planning stage. Others can be added as needed. Typically, each performance objective has one related competency or more. To assist you in planning the initial review, sample performance objectives have been provided. They relate to the Behavioural Competencies in each job profile. Ensure that all performance evaluations are conducted in accordance with existing organizational policies and procedures.

SUPPORT AND OUTREACH VI 43 **CONFIDENTIAL WHEN COMPLETED** Performance Management Tool for Positions Related to Support and Outreach Position Title: Employee Name: Manager s Name and Title: Review Period from (Month/Year) to (Month/Year): Date of Review (Day/Month/Year): Preparation Checklist Review job description to identify the target position requirements and competencies. Review previous performance evaluation, if available. Suggested Competency Profile Job Cluster Support and Outreach Example Job Titles Support Worker, Outreach Worker, Alcohol Worker, Drug Worker, Substance Abuse Worker, Drug Outreach Worker, Substance Abuse Practitioner, Community Outreach Worker, Community Liaison Worker, Attendant Competency Required Proficiency Level Adaptability/Flexibility 3 Analytical Thinking and Decision Making 2 Client-centred Change 3 Collaboration and Network Building 2 Continuous Learning 2 Creativity and Innovation 2 Diversity and Cultural Responsiveness 3 Effective Communication 3 Ethical Conduct and Professionalism 2 Interpersonal Rapport/Savvy 3 Planning and Organizing 2 Self Care 3 Self Management 2

SUPPORT AND OUTREACH VI 44 How to Use this Form INITIAL PLANNING: At the beginning of the performance cycle (e.g., on or immediately following the anniversary date of the employee) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. The performance objectives can be task- or activity-based, or can be competency-based objectives (see Part A: Performance Planning and Review). In almost all cases, performance objectives identified (the what of the job) can be related to particular competencies required to achieve them (the how of the job). If this is the first year a performance review has been conducted, the manager and the employee might not yet be able to identify any learning and development needs. They can have an initial discussion about what these might be, based on the employee s own performance development concerns. If this is not the first year, the manager and the employee confirm the learning and development needs identified at the end of the previous cycle. INTERIM REVIEW: During the cycle (e.g., 6-month review) The manager and employee meet to review progress in achieving performance objectives and begin to identify areas for development. Formal reviews might also be conducted throughout the period; for example, when the manager or employee changes jobs, when there is significant change in the existing job, or at the end of a key milestone. Performance objectives might need adjusting if work or priorities have changed since the beginning of the cycle (see Part A: Performance Planning and Review). If this is the first year a performance review has been conducted, the manager and the employee can begin to identify learning and development needs (see Part B: Learning and Development). If this is not the first year a performance review has been conducted, the manager and employee review the employee s accomplishment of the action plan so far and adjust as necessary (see Part B: Learning and Development).

SUPPORT AND OUTREACH VI 45 FINAL REVIEW: At the end of the cycle (on or near the anniversary date of the employee s hiring) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. Record the employee s performance for each of the required competencies (see Part A: Performance Planning and Review). For each objective, the manager and employee discuss the extent to which objectives were achieved. This is recorded in the Results section. In the Rating section, employee and manager use the rating scale provided on the last page to evaluate results. If this is the first year a performance review has been conducted, the manager and the employee work together to identify the learning and development needs and the required action plan for the following review cycle (see Part B: Learning and Development). Focus is on the most pressing learning needs (e.g., up to five areas for development). If this is not the first year, the manager and employee review the employee s accomplishment of the action plan throughout the previous year (see Part B: Learning and Development). SIGN OFF: At the end of the cycle (on the anniversary date of the employee s hiring) The manager prepares the final summary review and evaluation and reviews the results with the employee (see Part C: Final Evaluation). The manager and employee jointly determine and agree to an action plan to enhance performance and results. This includes action to be taken by both the manager and the employee (see Part C: Final Evaluation). The employee comments on his or her own performance over the review cycle and the results (see Part C: Final Evaluation). The original of the completed form is placed in the employee s Human Resource file and the manager gives a copy to the employee.

SUPPORT AND OUTREACH VI 46 PART A: Performance Planning and Review Related Competencies Sample Performance Objectives Client-centred Change Analytical Thinking and Decision Making 1. Develop client-centred service delivery plans including bio-psycho-social (needs/risk) assessment, treatment plan, and discharge strategy, with high levels of input and ownership from clients when possible. Effective Communication Collaboration and Network Building 2. Provide information and support to assist clients with their housing needs and maintaining their residence. Analytical Thinking and Decision Making 3. Screen and assess clients referred into the prevention/ treatment service and make recommendations for appropriate treatment while maintaining professional integrity. Adaptability/Flexibility Planning and Organizing 4. Develop and review short-term care plans for multiple clients, including identifying needed resources and establishing timelines. Results Achieved Rating Self Mgr

SUPPORT AND OUTREACH VI 47 Related Competencies Ethical Conduct and Professionalism Self Management Diversity and Cultural Responsiveness Sample Performance Objectives 5. Meet with supervisor monthly to review ethical conduct and self management competencies as part of the supervision plan. 6. Ensure that substance abuse education/prevention/treatment program content and delivery are reflective and responsive to diversity e.g., socio-political and cultural issues. Results Achieved Rating Self Mgr

SUPPORT AND OUTREACH VI 48 PART B: Learning and Development Areas for Development Action Plan/ Development Options Target Completion Dates Results

SUPPORT AND OUTREACH VI 49 PART C: Summary Review and Overall Evaluation After discussion on Parts A and B, the manager prepares summary comments on the employee s overall performance during the review period and rates the employee s performance. The employee and manager agree on a mutual action plan recording the actions to be taken by the manager and employee to achieve desired results (includes making funds, time and resources available as necessary). The employee records summary comments on own performance and/or the review process, as desired. Both the manager and employee sign the evaluation. 4 3 2 1 Exceeds Expectations Exceeded requirements on most of all important elements of the objective(s). Meets Expectations Fulfilled requirements and met performance objective(s) within the standards for the position assessed. Progressing Fulfilled some of the requirements of the objective(s). Progress is being observed for the majority of objective requirements. Needs Improvement Fulfillment of objective(s) was less than adequate in all or most respects. Performance is below satisfactory level and must improve. Overall Evaluation Needs Improvement Progressing Meets Expectations Exceeds Expectations Manager Comments/ Summary Mutual Action Plan Employee Comments Employee Signature Manager Signature Date (dd/mm/yy) NOTE: By signing here, the employee acknowledges reading the results and discussing them with the manager.

WITHDRAWAL MANAGEMENT VI 50 WITHDRAWAL MANAGEMENT This performance management tool provides you with a process and template for conducting employee performance reviews within the Withdrawal Management occupational cluster. It includes a selection of sample performance objectives for the Behavioural Competencies and proficiency levels relevant to the suggested competency profile. This tool is useful as a template or starter guide, but it might not accurately represent the competencies required for the position you are evaluating. To assess and revise the tool so it is well-suited to your organization: 1. Review the tool to determine if the suggested competency profile is relevant. 2. Adjust, as necessary, to suit the job description and your organization. 3. Review the Behavioural Competencies to determine what competencies or proficiency levels you need to change to give a more accurate representation. A brief overview of the steps involved in identifying the relevant competencies for a profile has been provided in the Behavioural Competencies Report. A job competency profile includes only the critical competencies required for the job (not those that are nice to have i.e., not essential to performing the job successfully). Preferably, there are no more than 12 competencies per profile. It may be that the profile competencies related to the performance objectives are not all identified in the planning stage. Others can be added as needed. Typically, each performance objective has one related competency or more. To assist you in planning the initial review, sample performance objectives have been provided. They relate to the Behavioural Competencies in each job profile. Ensure that all performance evaluations are conducted in accordance with existing organizational policies and procedures.

WITHDRAWAL MANAGEMENT VI 51 **CONFIDENTIAL WHEN COMPLETED** Performance Management Tool for Positions Related to Withdrawal Management Position Title: Employee Name: Manager s Name and Title: Review Period from (Month/Year) to (Month/Year): Date of Review (Day/Month/Year): Preparation Checklist Review job description to identify the target position requirements and competencies. Review previous performance evaluation, if available. Suggested Competency Profile Job Cluster Withdrawal Management Example Job Titles Withdrawal Management (Detox) Worker, Detox Nurse, Specialty Nurse, Withdrawal Management (Detox) Counsellor, Attendant Competency Required Proficiency Level Adaptability/Flexibility 3 Analytical Thinking and Decision Making 2 Client-centred Change 3 Continuous Learning 2 Diversity and Cultural Responsiveness 3 Effective Communication 3 Ethical Conduct and Professionalism 2 Interpersonal Rapport/Savvy 3 Planning and Organizing 3 Self Care 2 Self Management 3 Self Motivation and Drive 3 Teamwork and Cooperation 2

WITHDRAWAL MANAGEMENT VI 52 How to Use this Form INITIAL PLANNING: At the beginning of the performance cycle (e.g., on or immediately following the anniversary date of the employee) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. The performance objectives can be task- or activity-based, or can be competency-based objectives (see Part A: Performance Planning and Review). In almost all cases, performance objectives identified (the what of the job) can be related to particular competencies required to achieve them (the how of the job). If this is the first year a performance review has been conducted, the manager and the employee might not yet be able to identify any learning and development needs. They can have an initial discussion about what these might be, based on the employee s own performance development concerns. If this is not the first year, the manager and the employee confirm the learning and development needs identified at the end of the previous cycle. INTERIM REVIEW: During the cycle (e.g., 6-month review) The manager and employee meet to review progress in achieving performance objectives and begin to identify areas for development. Formal reviews might also be conducted throughout the period; for example, when the manager or employee changes jobs, when there is significant change in the existing job, or at the end of a key milestone. Performance objectives might need adjusting if work or priorities have changed since the beginning of the cycle (see Part A: Performance Planning and Review). If this is the first year a performance review has been conducted, the manager and the employee can begin to identify learning and development needs (see Part B: Learning and Development). If this is not the first year a performance review has been conducted, the manager and employee review the employee s accomplishment of the action plan so far and adjust as necessary (see Part B: Learning and Development).

WITHDRAWAL MANAGEMENT VI 53 FINAL REVIEW: At the end of the cycle (on or near the anniversary date of the employee s hiring) The manager and employee meet to discuss and agree on the key performance objectives and related competencies for the review period. Record the employee s performance for each of the required competencies (see Part A: Performance Planning and Review). For each objective, the manager and employee discuss the extent to which objectives were achieved. This is recorded in the Results section. In the Rating section, employee and manager use the rating scale provided on the last page to evaluate results. If this is the first year a performance review has been conducted, the manager and the employee work together to identify the learning and development needs and the required action plan for the following review cycle (see Part B: Learning and Development). Focus is on the most pressing learning needs (e.g., up to five areas for development). If this is not the first year, the manager and employee review the employee s accomplishment of the action plan throughout the previous year (see Part B: Learning and Development). SIGN OFF: At the end of the cycle (on the anniversary date of the employee s hiring) The manager prepares the final summary review and evaluation and reviews the results with the employee (see Part C: Final Evaluation). The manager and employee jointly determine and agree to an action plan to enhance performance and results. This includes action to be taken by both the manager and the employee (see Part C: Final Evaluation). The employee comments on his or her own performance over the review cycle and the results (see Part C: Final Evaluation). The original of the completed form is placed in the employee s Human Resource file and the manager gives a copy to the employee.

WITHDRAWAL MANAGEMENT VI 54 PART A: Performance Planning and Review Related Competencies Sample Performance Objectives Planning and Organizing Analytical Thinking and Decision Making Adaptability/Flexibility Teamwork and Collaboration Effective Communication Diversity and Cultural Responsiveness 1. Coordinate withdrawal management and/or treatment plan with clients, clients families, hospital(s), related services and colleagues. Effective Communication Client-centred Change Diversity and Cultural Responsiveness 2. Deliver education sessions to small groups of clients and their family members on withdrawal/ detoxification process, stress management, wellness, problem solving and coping skills. Teamwork and Cooperation Continuous Learning Interpersonal Rapport/Savvy Diversity and Cultural Responsiveness 3. Consult and collaborate with interdisciplinary team members and other health professionals and providers in the identification and resolution of a variety of client and family issues by participating in client care conferences and staff meetings. Self Care Ethical Conduct and Professionalism Teamwork and Cooperation 4. Develop personal resilience and emotional health by participating in weekly team support sessions. Results Achieved Rating Self Mgr

WITHDRAWAL MANAGEMENT VI 55 Related Competencies Client-centred Change Ethical Conduct and Professionalism Interpersonal Rapport/Savvy Analytical Thinking and Decision Making Adaptability/Flexibility Teamwork and Cooperation Effective Communication Self Management Analytical Thinking and Decision Making Adaptability/Flexibility Interpersonal Rapport/Savvy Diversity and Cultural Responsiveness Effective Communication Interpersonal Rapport/Savvy Adaptability/Flexibility Planning and Organizing Sample Performance Objectives 5. Monitor clients progress and effectiveness of interventions by meeting with clients one-onone to assess their progress, identify problems and implement established protocol for high-risk clients in crisis. 6. Adjust client treatment plans based on consultation with multidisciplinary team. 7. Monitor clients interactions and behaviours and provide crisis intervention, such as first response to suicide threats and medical emergencies, managing the situations as required. 8. Facilitate group and individual sessions and discussions, providing supportive counselling and education in areas such as guided meditation/relaxation techniques, relapse prevention, harm reduction and nutrition. Results Achieved Rating Self Mgr

WITHDRAWAL MANAGEMENT VI 56 PART B: Learning and Development Areas for Development Action Plan/ Development Options Target Completion Dates Results

WITHDRAWAL MANAGEMENT VI 57 PART C: Summary Review and Overall Evaluation After discussion on Parts A and B, the manager prepares summary comments on the employee s overall performance during the review period and rates the employee s performance. The employee and manager agree on a mutual action plan recording the actions to be taken by the manager and employee to achieve desired results (includes making funds, time and resources available as necessary). The employee records summary comments on own performance and/or the review process, as desired. Both the manager and employee sign the evaluation. 4 3 2 1 Exceeds Expectations Exceeded requirements on most of all important elements of the objective(s). Meets Expectations Fulfilled requirements and met performance objective(s) within the standards for the position assessed. Progressing Fulfilled some of the requirements of the objective(s). Progress is being observed for the majority of objective requirements. Needs Improvement Fulfillment of objective(s) was less than adequate in all or most respects. Performance is below satisfactory level and must improve. Overall Evaluation Needs Improvement Progressing Meets Expectations Exceeds Expectations Manager Comments/ Summary Mutual Action Plan Employee Comments Employee Signature Manager Signature Date (dd/mm/yy) NOTE: By signing here, the employee acknowledges reading the results and discussing them with the manager.