REHABILITATION COUNSELING CLINICAL FIELDWORK MANUAL FOR STUDENTS

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REHABILITATION COUNSELING

 

 

CLINICAL FIELDWORK MANUAL FOR STUDENTS

                     

CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO

REHABILITATION COUNSELING PROGRAM D

EPARTMENT OF EDUCATIONAL PSYCHOLOGY & COUNSELING

COLLEGE OF EDUCATION

 

 

Dr. Margaret Cooney, Ph.D., CRC, CIRS, LPCC

Dr. Connie McReynolds, Ph.D., CRC, PVE, Licensed Psychologist Dr. Dwight Sweeney, Ph.D.

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TABLE OF CONTENTS

CORE Fieldwork Standards ……… 3

Rehabilitation Counseling Clinical Fieldwork Expectations……… 4

Rehabilitation Counseling Clinical Evaluation……….. 6

General Requirements for Clinical Fieldwork……… 8

Rehabilitation Counseling Case Study Outline………. 10

    Appendix A, Fieldwork Application………. 11

Appendix B, Fieldwork Contract……….. 13

Appendix C*, Student Counseling Skills Self-Evaluation……… 16

Appendix D*, Audio/Videotape Consent Form ………. 22

Appendix E*, Fieldwork Weekly Time Sheet………. 23

Appendix F*, Fieldwork Totals Time Sheet……… 24

Appendix G*, Site Supervisor Evaluation Form………. 25

  Appendix H*, On-Site Evaluation Form ………. 28

Appendix I, Corrective Action Plan Form ……….. 29

Appendix J, Corrective Action Plan ……… 30

Appendix K*, Fieldwork Mentor Agreement……….. 31

Appendix L*, Mentor Hours Log……….. 32

   

* Items designated with an * MUST be turned in at end of quarter. 

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CORE Fieldwork Standards

 

D.2 Students shall have supervised rehabilitation counseling internship activities that include a minimum of 600 hours of applied experience in an agency/program, with at least 240 hours of direct service to individuals with disabilities.

D.2.1 The internship activities shall include the following:

D.2.1.a. orientation to program components, policies and procedures, introduction to staff and their role and function, identification of the expectations for interns, confidentiality and due process procedures, risk assessment, and the Code of Professional Ethics for

Rehabilitation Counselors;

D.2.1.b. observation of all aspects of the delivery of rehabilitation counseling services, as practiced by the agency or organization, including diverse populations;

D.2.1.c. work assignments, performing the tasks required of an employed rehabilitation counselor at the agency or organization; and

D.2.1.d. reporting, including all required academic reports as well as logs, weekly progress reviews, and summaries of activities.

D.2.2 Written expectations, procedures, and policies for the internship activities shall be contained in a manual or other appropriate document(s) and distributed to students and supervisors.

D.2.3 For the internship, an on-site supervisor must be assigned to provide weekly supervision throughout the internship experience.

D.2.4 The internship shall include an evaluation of student performance, including self-evaluation by the student, the field site supervisor, and the faculty supervisor.

D.2.5 The RCE Program shall use internship experience sites that provide rehabilitation counseling services to individuals with disabilities appropriate to the mission of the program.

D.2.6 Internship students shall have experiences that increase their awareness and understanding of differences in values, beliefs and behaviors of persons who are different from themselves. Internship shall promote cultural competence, foster personal growth, and assist students in recognizing the myriad of counseling approaches and rehabilitation issues that affect service delivery.

D.3 Internship experiences shall include an average of one (1) hour per week of

individual or 1½ hours per week of group (with no more than ten students/group)

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cooperation with a program faculty member who is a CRC.

D.3.1 When using distance education modalities, supervision may be provided using a variety of methods such as video conferencing, teleconferencing, real time video contact, or others as appropriate.

D.3.2 In states that have specific supervision requirements for counselor licensure, the program shall make the required supervision experiences consistent with the state licensure requirements and available to those students desiring to qualify for licensure. D.3.3 There shall be a progress review of all students enrolled in an internship.

D.3.4 There shall be a written procedure for responding to students who do not demonstrate satisfactory internship knowledge or clinical skills.

D.3.5 The individual supervision of five students shall be considered equivalent to the

teaching of one course due to the intensive, one-on-one instruction and the ongoing evaluation necessary in internship.

REHABILITATION COUNSELING CLINICAL FIELDWORK EXPECTATIONS

 

The Council on Rehabilitation Education (CORE) requires that each student complete a minimum of 600 hours in rehabilitation counseling (240 hours of one-on-one individual counseling) at an agency site. The additional activities shall include, but not be limited to, the following components:

 

1. Orientation to the agency’s program components, policies and procedures,

introduction to staff and their role and function; identification of the expectations for the interns. (See Contract, Appendix A)

2. Observation of rehabilitation service delivery in all stages of development – in the

office/facility, in conferences and in the field;

3. Work Assignments – performing the tasks required of an employed rehabilitation

counselor in the agency from intake to discharge and/or placement;

4. Reporting – includes all required academic reports as well as longs, weekly

progress reviews and summaries of client activities;

5. Evaluation – includes self-evaluation by the student, site supervisor evaluation,

and academic evaluation by the university supervisor.

 

Students will complete their fieldwork in clinical sites which provide services to individuals with disabilities. According to the CORE Manual, suggested sites where the student may complete their clinical fieldwork/internship are as follows:

 

1. State offices of rehabilitation, commission for the blind or developmental

disabilities;

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3. State training schools and rehabilitation centers;

4. Medical hospitals- medical rehabilitation;

5. Psychiatric hospitals;

6. Community mental health clinics;

7. Correctional institutions;

8. Drug and alcohol settings;

9. Agencies for the culturally (economically) disadvantaged;

10. Consumer organizations;

11. Institutions for the aging;

12. Independent living centers and/or agencies;

13. Private, for profit agencies;

14. University and college offices for individuals with disabilities and Affirmative

Action; Special Services for students with disabilities;

15. Rehabilitation units of larger entities, (e.g., Workers Compensation, Railroads,

Public Utilities, Veterans Administration Hospitals, Dept. of Labor, etc.)

 

Clinical Fieldwork/Internship is a culminating process in which students are encouraged to complete their clinical experience near the end of their program of study. Further, students are encouraged to have as wide a variety of experiences as possible within this clinical area.

 

Fieldwork experiences shall include an average of one (1) hour per week of individual or 1½ hours per week of group (with no more than 10 students/group) supervision by a program faculty member or qualified individual working in cooperation with a program faculty member.

 

Students who have returned to school and who are currently working on a full-time basis

in the rehabilitation field will be allowed to use their work-based experiences for one of

the three required quarters, as long as the student is engaging in new learning activities for this fieldwork experience. For the additional two quarters, the fieldwork experience must include a minimum of 100 hours each quarter completed in a rehabilitation setting that is not their place of employment. Fieldwork students are to complete 80 hours of one-on-one direct client counseling experience each quarter.

For students who are not working in the rehabilitation field, they will need to complete all three fieldwork experiences in a rehabilitation service setting that includes 80 hours of one-on-one direct client counseling experience each quarter.

NOTE: For students who are a Training Award Recipient on the RSA Long Term Training Grant in Rehabilitation Counseling, the student must complete a

minimum of two fieldwork experiences (EREH 679) with the California Department

of Rehabilitation effective fall, 2014. Students who have concerns about this

commitment need to meet with the Project Director of the RSA grant in the quarter prior

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REHABILITATION COUNSELING CLINICAL EVALUATION

 

The supervision and evaluation of the student during clinical fieldwork is the responsibility of the university supervisor in consultation with the on-site supervisor and the student’s CRC mentor. The on-site supervisor has an important role in the evaluation process and subsequently there is close cooperation between the university and on-site supervisor. All on-site supervisors participate in a continual evaluation process of the student’s activities. The CRC mentor meets with the student for approximately one hour per week to discuss general issues and professional and ethical dilemmas.

 

A student who experiences difficulties during the clinical fieldwork experience will meet with both the on-site and university supervisors. This discussion is designed to help resolve the problem. A student may be removed from a fieldwork site if the student is demonstrating unethical or unsound rehabilitation counseling practices or if the student is not conducting him/herself in an appropriate manner within the agency setting. This may include, but not be limited to, questions of tardiness, absenteeism, and general behaviors that would be reasons for dismissal as a probationary employee.

Serious violations of rehabilitation counseling ethics and practices may result in the student being terminated from the CSUSB rehabilitation counseling program.

 

When a student is deemed to be proceeding in an unsatisfactory manner in a Fieldwork course, a Corrective Action Plan (see Appendices I & J) will be prepared by the

University Supervisor summarizing both the points of concern and a specific action plan for remediation, including specific recommendations, behavioral outcomes, and

deadlines for review that offer a realistic opportunity for the student to experience an ultimately successful Fieldwork experience. Successful completion of the Corrective Action Plan is required in order for the student to receive a passing grade in the Fieldwork course.

 

The student’s evaluation in Clinical Fieldwork is a Credit/No Credit assessment. This allows the student the opportunity to try new ideas and concepts without fear of it

negatively affecting the student’s grade. If a student does not submit all required course work, does not attend the mandatory class meetings, and/or fails to complete required hours within the quarter, the student will receive a No Credit standing for the course. If the student receives a No Credit mark for any fieldwork experience, the student is required to retake the clinical fieldwork course. Clinical Fieldwork hours completed during a quarter when a No Credit mark is assigned are not carried into the next

fieldwork experience. A student with a No Credit mark is required to repeat all 200 hours except in exceptional cases.

 

A student’s grade in Clinical Fieldwork will be based on an evaluation of the following three areas: *

1. Rehabilitation Counseling skills and practices (50% of evaluation process)

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3. Functioning and understanding of community rehabilitation organizations (25% of

evaluation process)

Please note conditions in prior paragraph regarding when a No Credit grade will be

assigned.

 

The following is a listing of the competencies to be demonstrated in the stated areas of fieldwork evaluation. These competencies are expected of all students. The evaluation method may vary with university supervisors, but the specific requirements will be

included in the syllabus for the Clinical Fieldwork/Internship course.

 

1. Evaluation of Rehabilitation Counseling Skills and Practices.

a. Student will demonstrate rehabilitation counseling ethics and an understanding of the rehabilitation counseling process.

b. Student will demonstrate an understanding of the vocational implications and handicaps of different diseases and disabilities.

c. Student will demonstrate an understanding of vocational planning. d. Student will demonstrate an understanding of organized casework

management.

e. Student will demonstrate an understanding of effective vocational evaluation. i. Selection of appropriate evaluation measures for client.

ii. Ethical administration of evaluation procedures.

iii. Competent scoring (where feasible) and interpretation of evaluation results to the client.

f. Student will demonstrate effective job placement skills.

g. Student will demonstrate an understanding of rehabilitation organizational development activities.

h. Student will demonstrate effective interviewing skills.

i. Student will demonstrate sound rehabilitation counseling with clients.

Counseling development (as appropriate) will reflect the following counseling understandings and strategies.

i. The process skills of warmth, respect, empathy, and genuineness; and nonverbal physical attending skills.

ii. Primary accurate empathy skills including paraphrasing content, accurate reflection of feelings, summarizing content and feelings, minimal encouragers, open leads and questions when appropriate, toleration of silences, suspension of own frame of reference.

iii. Advanced accurate empathy skills including identification of themes and patterns, pulling together masses of materials, providing alternative frames of reference, recognizing polarities and discrepancies,

responding to nonverbal communication, self-disclosure, immediacy, and confrontation.

iv. Skills including mutual goal setting, development and elaboration of behavioral change intervention plans, monitoring of change, and assessment of planned intervention.

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vi. Identification of some resistance and evidence of change.

vii. Ability to critique and accurately identify strengths and weaknesses in own counseling.

viii. Ability to describe counseling sessions in process terminology. ix. Use of three distinctly different intervention strategies.

x. Ability to initiate and terminate counseling sessions in an effective and appropriate way.

 

These skills will be evaluated via on-site visits by the university supervisor, course work activities, the feedback of on-site supervisor, and other related assignments that may be required dependent on the student’s skill level.

 

2. Participation in Course Work Activities 

Students are expected to attend all clinical fieldwork/internship classes. Students who miss two or more seminars will receive a No Credit mark for the course.

A. Student will evaluate counseling development within her/himself and submit

a written evaluation by the end of the quarter.

B. Student will develop his/her own individual rehabilitation counseling identity.

 

3. Community Rehabilitation Organizational Structures Understanding and

Functioning

A. The student will demonstrate knowledge of the purpose, structure,

procedures, and resources of the clinical setting (case management, audio/videotape presentations)

B. The student will demonstrate the ability to relate effectively to relevant

segments of the population including students/clients, staff and administration based on on-site observations and site supervisor assessment.

C. The student will demonstrate an understanding of the role of the

rehabilitation counselor as a change agent.

D. The student will demonstrate an understanding of agency’s relationship to

other agencies in the community.

 

GENERAL REQUIREMENTS FOR CLINICAL FIELDWORK Course Requirements:

1. A contract (see Appendix B) will be developed indicating the way in which the

student will utilize their time in the Clinical Fieldwork experience. The contract will include:

a. The student counselor’s functions in that particular setting b. The hours to be spent in each activity

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c. Methods of implementation

d. Dates by which various activities will be completed

 

2. Prior to working with clients, the student will provide verification of professional

liability insurance. The student will provide a copy of the face sheet of the

professional liability insurance coverage that includes policy number and dates of coverage. Professional liability insurance must be in place at the beginning of each quarter of fieldwork class.

 

3. A Fieldwork Weekly Time Sheet and Fieldwork Total Time Sheet will be

completed by the student, signed by the on-site supervisor and given to the CSUSB supervisor. (See Appendices E & F)

 

4. The student will keep a Weekly Record of his/her activities. This journal will

include the dates and times of counseling activities and a brief notation of the nature of the activity and progress reviews for each client.

 

5. The student will submit two (2) audio/video recordings demonstrating rehabilitation

counseling skills with two clients. The student will play and discuss the

counseling skills demonstrated on tape during the student / university supervisor review session.

 

6. Student will prepare two (2) case studies on two separate clients (see page 10).

The case study will reflect: a. Reason for referral b. Social vocational history c. Vocational planning

d. Services needed to complete the plan

e. Overall evaluation of client’s progress toward successful completion of the rehabilitation plan.

 

7. The student will complete a self-evaluation of their rehabilitation counseling

development at the end of the quarter, which they will discuss with the on-site supervisor. (See Fieldwork Competencies).

8. The student will attend and actively participate in all fieldwork/internship classes.

 

9. The student will demonstrate sound rehabilitation counseling ethics and practices

during the Clinical Fieldwork/Internship experience.

 

10. Each student will submit an evaluation from the on-site supervisor at the end of

the quarter. (See fieldwork competencies and dispositions in Supervisor’s Manual)

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REHABILITATION COUNSELING CASE STUDY OUTLINE  

 

Identifying Data: Name (pseudonym), general address, age, date of birth, gender, etc.

 

Reason for Referral:

Disability: Nature, onset, seriousness, duration, treatment, medication, mobility,

stability, hospitalization. Feelings and attitudes of subject to work “disability,” etc.

Family Constellation: Brothers, sisters, stability, supportiveness, relationships between

members, etc.

 

Social Background: General appearance of subject and impression made upon others,

relationships with friends and community agencies, leisure time activities, living arrangements, etc.

 

Educational Background: Highest level of schooling, interests, academic skills, other

training, attitude toward classroom education, etc.

 

Employment Background: Work experience, work stability, work skills, job continuation,

boy availability, skills, motivation for work, job seeking skills, etc.

 

Summary of Assets: Summary of Limitations:

Client’s Statement of Problem(s):  

Counselor’s Assessment: Perception of client’s problem(s) and their relationship to the

client’s potential vocational outcome, etc.

                           

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APPENDIX A

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

REHABILITATION COUNSELING PROGRAM FIELDWORK APPLICATION

Deadlines for Application: Fall - May 15, Winter - November 1, Spring - February 25

Name _______________________________________________________________ Address _____________________________________________________________ City ___________________________________ State ______ Zip ___________ Phone (home/cell) ___________________________ (work) ____________________ Email ________________________________________________________________

University ID Number ____________________

Application for: _____Winter _____ Spring ______Fall Year: ___________

Fieldwork Prerequisites: (please indicate grade received, successful completion required).

_______EREH 657 _________ EREH 667

Verification of liability insurance must be attached to this application.

Provide a copy of the face sheet of the professional liability insurance coverage that includes policy number and dates of coverage. Professional liability insurance must be in place at the time of the application for Fieldwork. No student will be permitted to enroll in Fieldwork without such documentation.

List previous experiences at human service agencies:

Name of Agency Dates Responsibilities

__________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

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List the fieldwork site for the quarter for which you are registering. You must have a site prior to being permitted to register for fieldwork class.

(Please enter the year)

Fall EREH 679 _______ Winter EREH 679 _______ Spring EREH 679 _______ Name of Site: __________________________________________________________ Site Address: __________________________________________________________ __________________________________________________________ City State Zip: _________________________________________________________ Phone: _______________________________________________________________ Name of the site Supervisor: ______________________________________________ Contact information for Supervisor:

Phone (if different from above): ____________________________________________ Email:_________________________________________________________________

Registration Commitment:

By signing:

1. I certify that I will have completed all prerequisite course work and that I am eligible to take the course.

2. I accept the responsibility for registering as indicated. I realize that failure to do so on my part deprives another student of the opportunity to register for the course that my slot may be given to another student.

3. If conditions arise so that registration is not possible, I will notify the Program Coordinator immediately.

____________________________________________________ ________________

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APPENDIX B

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

Rehabilitation Counseling Fieldwork Contract

Student's Name ________________________________________________________ Phone (home/cell) ___________________________ (work) ______________________ Quarter: _____ Fall ______ Spring Year: _________ Credit hours: ______ _____ Winter ______ Summer

Site Name: ____________________________________________________________ Site Address: ___________________________________________________________ City State Zip: __________________________________________________________ Phone: ________________________________________________________________ This contract is entered into between

______________________________________________, site supervisor for (Site Supervisor's Name)

______________________________________________, a fieldwork student from (Student's Name)

California State University San Bernardino, College of Education, Rehabilitation

Counseling Program as represented by: _____________________________________. (University Supervisor's Name)

The site supervisor agrees to assume responsibility for assisting the student in conducting activities related to his/her fieldwork experience. These activities are defined between the student and the College of Education and are agreed to by the site supervisor. The university supervisor agrees to be available for consultation with the site supervisor either personally or by phone and to make on-site visits.

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Fieldwork Learning Objectives

The student is to select five potential fieldwork objectives from the following list. Upon selection of the formal Fieldwork site, the student will initiate a meeting with the Site Supervisor to discuss the student’s prospective learning objectives. The student, in conjunction with the Site supervisor, will finalize at least three of the objectives that will best match the agency’s needs with the student’s desired objectives.

______ Observe/conduct intake interviews with clients.

______ Demonstrate effective listening/reflection skills.

______ Observe group sessions.

______ Demonstrate counseling abilities through direct counseling with actual

clients.

______ Observe one-on-one counseling sessions with various counselors.

______ Attend staff meetings.

______ Demonstrate an understanding of the practice of rehabilitation counseling.

______ Demonstrate an understanding of ethics in Rehabilitation Counseling

process.

______ Attend and participate in case staffing, as appropriate

______ Demonstrate an understanding of the components of the interviewing

process.

______ Become familiar and comply with the policies and procedures of the agency.

______ Observe and comply with the agency standards.

______ Student will gain new insights and understanding of rehabilitation counseling

ethics and strategies during counseling sessions through observation, participation, and discussion after the session with appropriate staff.

______ Other: _____________________________________________________

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Student Responsibilities:

1. Conduct oneself in accordance with the CRCC Code of Ethics and meet the standards for quality service as specified by the fieldwork site.

2. Be responsible for hours at the fieldwork site and maintain the mutually agreed upon time schedule.

3. Comply with the rules and regulations of the fieldwork site and support the philosophy and objectives of the Agency and the department in which the experience is being obtained. 4. Be responsible for audio taping and videotaping counseling sessions (not intake

interviews) as required in Fieldwork courses and following proper confidentiality procedures. 5. Be responsible for submitting daily/weekly log of fieldwork experiences as required by

course syllabi.

Site supervisor responsibilities:

1. Provide the student with an orientation to the agency, and establish goals and experiences for the student's fieldwork.

2. Provide the student with opportunities to engage in a variety of rehabilitation counseling activities under supervision such as (client contacts, attend staff meetings, make contacts with other cooperating agencies, record case notes, contact employers, and have involvement with all aspects of rehabilitation services).

3. Hold weekly conferences with the student to review progress, provide supervision, and establish continuing goals for the fieldwork experience.

4. Complete the Evaluation Form and review with the student as a final feedback on the progress of the student.

5. Provide the student with adequate physical facilities in which to work. 6. Be available for conferences with the University Supervisor as scheduled.

7. Consult with the University Supervisor if there is a problem with the student. The Agency Supervisor may refuse to continue the clinical experience when a student's practice and/or behavior does not meet the minimum standards of the Agency.

University Supervisor responsibilities:

1. Review progress of the fieldwork students on a regular basis. 2. Consult fieldwork Site Supervisor as needed.

3. Reserves the right of final evaluation of student competence in Fieldwork courses. 4. Agrees to withdraw the student from the fieldwork site when the student's practice and/or

behavior do not meet minimum standards of the Agency and such action is requested by the Agency Supervisor.

_____________________________________________ Student's signature Date

_____________________________________________

Site Supervisor's signature Date

_____________________________________________ University Supervisor’s signature Date

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APPENDIX C

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

 

Student Counseling Skills Self-Evaluation   Name: ___________________________________________________________________ First Session: ____________ Second Session: ____________ Third Session: ____________  

This competency checklist is designed to allow the student to rate his/her competencies. If a competency was not applicable in the particular setting of this Clinical Fieldwork/Internship, please rate your belief regarding that competency. If you have specific comments relating to a particular competency, please indicate under comments.

 

Section One competencies relate to Counseling Skills usedin Fieldwork placements.

Met Partially Met Not Met 1. Student demonstrates the ability to communicate

and apply relationship building skill ______ ______ ______ Comments:

2. Student demonstrates sensitivity to client’s needs and perceptions when dealing with counseling information

including testing

______ ______ ______

Comments:

3. Student demonstrates awareness of individuality of clients 

Comments: ______ ______ ______

4. Student demonstrates skill and knowledge in selecting and using effective intervention strategies appropriate to the

client’s needs and purposes ______ ______ ______

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5. Student demonstrates the ability to conceptualize, articulate

and defend a personally developed counseling process model ______ ______ ______ Comments:

6. Student demonstrates the ability to evaluate his/her own

Counseling interventions in terms of the model ______ ______ ______ Comments:

7. Student demonstrates the flexibility to modify their

conceptualizations of the counseling process as circumstances

and experience dictates ______ ______ ______

Comments:

8. Student demonstrates the knowledge and ability to help

client’s develop positive attitudes toward self and others ______ ______ ______ Comments:

9. Student demonstrates the knowledge and ability to assist

individuals and groups in their development ______ ______ ______ Comments:

 

10.  Student demonstrates the ability to interpret results from

group and individual assessments ______ ______ ______  

Comments:

   

11. Student demonstrates awareness of and sensitivity to sex biases ______ ______ ______  

Comments:

 

12.  Student demonstrates counseling skills utilizing tests,

career information, and personal data ______ ______ ______  

Comments:   

 

13.  Student demonstrates effectiveness in working with individuals and groups from diversity of backgrounds including persons who differ from one another in race, culture, varied lifestyles,

sex, and physical abilities ______ ______ ______  

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14.  Student demonstrates awareness of the counselor’s change-

agent function on behalf of clients ______ ______ ______  

Comments:

15. Student demonstrates skill in the following:

a. Group Orientation ______ ______ ______

b. Facilitating group movement and development ______ ______ ______ c. Maintaining stated group direction ______ ______ ______ d. Using appropriate verbal responses ______ ______ ______ e. Facilitating productive group interaction ______ ______ ______ f. Selecting and using a leadership model ______ ______ ______ g. Establishing and maintaining productive group norms ______ ______ ______ Comments:

16. Student demonstrates conscientiousness with regard to the

legal and ethical implications of client confidentiality. ______ ______ ______ Comments:

17. Student demonstrates the following personal capacities: a. The willingness and skill to join with others in effective self- evaluation and critiquing of each

other’s counseling ______ ______ ______

b. The openness to evaluate oneself in terms of

self-factors affecting person to person relationships

in counseling ______ ______ ______

c. The self-confidence and commitment needed for the

development of competence in counseling ______ ______ ______ Comments:

 

Section 2: Competencies involve the day-to-day activities of a rehabilitation counselor:  

The competencies that follow are designed for students to rate their perceived level of

competence. The competencies cover the broad range of activities of a rehabilitation counselor working in the field. Some of the activities may not be part of the clinical experiences that you were receiving this quarter. We are, however, interested in how you feel your skills in every area are developing and ask that you complete every area listed. Please add comments when you feel that is appropriate.

Met Partially Met Not Met 1. The student demonstrates knowledge of and behavior in

accordance with his/her professional role:

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c. Credentials, licenses, and training accreditations ______ ______ ______ d. Knowledge of and cooperation with comparable professionals ______ ______ ______ e. Knowledge of and working relationships with referring agencies ______ ______ ______ f. Participation in in-service and educational enhancing

opportunities ______ ______ ______

Comments:

2. Student demonstrates awareness of information, resources, and

social programs ______ ______ ______

Comments:

3. Student demonstrates the understanding of several strategies for consultation and skill developing constructive consulting

relationships with parents, paraprofessionals, and other persons

who are influential in the lives of their clients ______ ______ ______ Comments:

4. Student demonstrates knowledge of multiple career development theories and their relevance to various gender, age,

socioeconomic, and ethnic groups ______ ______ ______

 

Comments:

5. Student demonstrates the ability to write an interpretive profile of a tested person using a battery of tests relating to: a. the affective, cognitive and behavioral characteristics of

the tested person ______ ______ ______

b. the gender and cultural background of the tested person ______ ______ ______ c. the tested person’s career status and/or other implications ______ ______ ______ Comments:

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a. Intelligence ______ ______ ______ b. Aptitude ______ ______ ______ c. Vocational ______ ______ ______ d. Interest ______ ______ ______ e. Personality ______ ______ ______ f. Achievement ______ ______ ______ Comments:

7. Student demonstrates the ability to interpret the results of standardized tests (both group and individual) to the tested person, taking into account the individual needs and perceptions

of the tested person ______ ______ ______

Comments:

8. Student demonstrates the ability to perform the functions of a counselor within the community setting which includes: a. demonstrates a working knowledge of the types and

nature of services available in the community ______ ______ ______ b. assist individuals and groups in coping with basic life tasks ______ ______ ______ c. demonstrates knowledge of agency policy and practice

with regard to client costs, requirements for eligibility for services, waiting time for services, client rights, limits of

confidentiality, etc. ______ ______ ______

d. demonstrates at least entry level counseling skills for client services such as family, substance abuse, career and aging

including diagnosis and treatment where appropriate ______ ______ ______ Comments:

9. Rehabilitation counseling majors demonstrate the ability to perform the function of rehabilitation counselors including: a. Demonstrate at least entry level skills in developing,

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principles, problems, and goals ______ ______ ______ c. Demonstrates knowledge of the psychological and

medical aspects of rehabilitation ______ ______ ______ d. Demonstrate an awareness of appropriate use of occupational

and community resources ______ ______ ______

e. Demonstrates knowledge of the community employment market ______ ______ ______ f. Demonstrates a knowledge of employers in the community ______ ______ ______ g. Demonstrates a fundamental knowledge regarding job

placement ______ ______ ______

h. Demonstrates skill in job development within the community ______ ______ ______ Comments:

   

______________________________________________________________________________________

Student’s Signature Date

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APPENDIX D

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

REHABILITATION COUNSELING PROGRAM  

Audio/videotape Consent Form

 

 

Date: _____________________

I understand this counseling and/or assessment experience will be completed with a Rehabilitation Counseling student in the California State University San Bernardino

Rehabilitation Counseling Program. I understand this Rehabilitation Counseling student is working under the direct supervision of _______________________________ (University Supervisor) at CSUSB, who can be reached at (_____) _________________.

I understand all information I provide will be kept confidential and will be destroyed upon completion of the course. I understand I may withdraw from this educational experience at any time, without consequence to me for doing so and I understand that I may ask questions anytime during the experience.

_________________________________________ Client’s Signature

_________________________________________ Rehabilitation Counseling Student’s Signature

_________________________________________ Rehabilitation Counseling Student’s Printed Name

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APPENDIX E

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

REHABILITATION COUNSELING PROGRAM

FIELDWORK WEEKLY TIME SHEET (Insert New Form link Here)

See website:

http://coe.csusb.edu/programs/rehabCounseling/manuals.html

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APPENDIX F

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

REHABILITATION COUNSELING PROGRAM Fieldwork Total Time Sheet

(Insert New Form link here) See website:

http://coe.csusb.edu/programs/rehabCounseling/manuals.html

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APPENDIX G

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

REHABILITATION COUNSELING PROGRAM Site Supervisor Evaluation of Fieldwork Student

At the end of this course, please send the completed evaluation form to the class instructor via the mailing address that was provided by the student.

Quarter/Year _________________________________________________________ Name of Student ______________________________________________________ Fieldwork Site ________________________________________________________ Site Supervisor Phone __________________________________________________ University Supervisor ___________________________________________________

Directions: Please indicate the degree each competency has been demonstrated using the provided scale.

Definition of Rating Terms:

Excellent: Always performs above the minimum requirements and shows outstanding

aptitude and application of techniques and concepts of Rehabilitation Counseling

Average: Meets minimum requirements in a satisfactory manner; performs as might be

expected of a Rehabilitation Counseling graduate student.

Poor: Occasionally fails to meet minimum requirements in a satisfactory manner;

performs at a level below that expected of a Rehabilitation Counseling graduate student.

N/A: Not Applicable

1.Work Performance- Student demonstrates the ability to:

Excellent Average Poor N/A

1.1 Organize information for records or reports

1.2 Provide clarity and accuracy in records and reports 1.3 Carry out instructions or directions

1.4 Completes assigned tasks 1.5 Plan and organize work

1.6 Be flexible in adapting to work situations

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1.8 Work under pressure and use personal stress management strategies

1.9 Show skill in handling special assignments

1.10 recognizes the importance of individual differences and diverse cultures in counseling

1.11 Knows and consistently adheres to established professional codes of ethics

1.12 Students seeks out opportunities for observations and ways to participate in agency activities as appropriate

2. Response to Supervision - Student demonstrates the ability to:

Excellent Average Poor N/A

2.1 Develop a positive and respectful relationship with supervisor

2.2 Consults with supervision for assistance 2.3 Use supervisory help in performance of work 2.4 Appropriately express feelings in supervisory conferences

2.5 Be prompt and prepare for conferences with supervisor 2.6 Constructively accepts praise, criticism, and ideas for improvement

3. Acceptance of Professional Role – Student demonstrates the ability to:

Excellent Average Poor N/A

3.1 Accepts professional responsibility

3.2 Forms a positive relationship with other professionals in the agency/facility staff members

3.3 Forms a positive relationship with other professionals in the community

3.4 Respects and follows agency/ facility policies and procedures

3.5 Demonstrates potential to make a positive professional Contribution in the human services field.

3.6 Demonstrates professional identity through appropriate dress and demeanor.

4. Would you recommend this student for a fieldwork position in your agency? Please explain.

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5. Add any information that could clarify above responses or provide insight into this student's qualifications.

___________________________ ____________________________________

(Printed Name of Site Supervisor) (Site Supervisor's Signature & Date)

_____________________________ ____________________________________

(Printed Name of Student) (Student's Signature & Date)

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APPENDIX H

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

REHABILITATION COUNSELING PROGRAM ON-SITE EVALUATION FORM

  Visit Number   Name of Student_     Field Site    

Type of Activity Observed

 

 

On a scale of 1 to 5 (1 being low), would you please evaluate the student you observed. Rank your responses by circling one number from 1 to 5.

 

 

1. Ability to listen 1 2 3 4 5   2.  

Ability to demonstrate empathy 1 2 3 4

 

5

 

3.

 

Willingness to accept criticism 1 2 3 4

  5   4.   Demonstration of flexibility 1 2 3 4   5   5.  

Ability to work at the level of the clients at the agency   1   2   3   4     5   6.  

Ability to demonstrate rehabilitation counseling skills   1   2   3   4     5   7.  

Ability to meet the needs of the clients at the agency   1   2   3   4     5   Comments:        

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APPENDIX I

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407

REHABILITATION COUNSELING PROGRAM CORRECTIVE ACTION PLAN FOR

IMPROVEMENT OF FIELDWORK SKILLS/COMPETENCIES

Name of Student ______________________________________________________ Fieldwork Site ________________________________________________________ Site Supervisor Phone __________________________________________________ University Supervisor ___________________________________________________

When a student is deemed to be proceeding in an unsatisfactory manner in a Fieldwork course/experience, a report will be prepared by the University Supervisor summarizing both the points of concerns and a specific action plan for remediation, including specific recommendations, behavioral outcomes, and deadlines for review that offer a realistic opportunity for the student to experience an ultimately successful fieldwork experience. Successful completion of this Corrective Action Plan is required in order for the student to receive a passing grade in the Fieldwork course.

By signature below, the student is agreeing to the Corrective Action Plan as stipulated in

Appendix J and attached to this contract.

______________________________________________ ________________

Student’s Signature Date

______________________________________________ ________________

University Supervisor Signature Date

______________________________________________ ________________

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APPENDIX J

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407 (909) 537-5606

REHABILITATION COUNSELING PROGRAM Corrective Action Plan

Points of concern: 1.

2. 3.

Recommendations/steps the student must take for behavior outcomes: 1.

2. 3.

Plan will be reviewed every________________________________ (days, weeks, etc.)

Deadline for behavior changes: ________________________

Successful completion of this Corrective Action Plan is required in order for the student to receive a passing grade in EREH ____________ course. By signing below, the student is

agreeing to the Corrective Action Plan as stipulated. (Attach to Appendix I)

__________________________________________ _____________________

Student’s Signature Date

__________________________________________ _____________________

University Supervisor Signature Date

__________________________________________ _____________________

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APPENDIX K

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407 (909) 537-5606

REHABILITATION COUNSELING PROGRAM Fieldwork Mentor Agreement Form  

 

Student Name_

 

Clinical Fieldwork site:

  Agency Address_       Name of Mentor  

Address of Mentor (if different than Fieldwork site)

     

Mentor Phone Number

 

Mentor's Active CRC Number ________________________ 

   

My signature below attests to my commitment of one hour per week discussing topics related to rehabilitation counseling with the above listed student who is involved in a clinical fieldwork experience.

             

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APPENDIX L

California State University San Bernardino College of Education

Department of Educational Psychology & Counseling 5500 University Parkway

San Bernardino, CA 92407 (909) 537-5606

REHABILITATION COUNSELING PROGRAM Mentor Hours Log

Name of Student (print)____________________________________________________

Name of Mentor (print)_______________________________________________________

Initials of Mentor Initials of Student

Week 1 ____________ ______________ Week 2 ____________ ______________ Week 3 ____________ ______________ Week 4 ____________ ______________ Week 5 ____________ ______________ Week 6 ____________ ______________ Week 7 ____________ ______________ Week 8 ____________ ______________ Week 9 ____________ ______________ Week 10 ____________ ______________ Week 11 ____________ ______________

By signature below, I attest to providing/participating in at least one hour of contact specifically addressing rehabilitation counseling topics.

Mentor Signature CRC # Date

Figure

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References

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