PRACTICUM AND INTERNSHIP MANUAL
for
School Counseling Ed.S. Students
Counselor Education Program
Department of Educational Psychology
University of South Carolina
(803) 777-3053
NOTE: It is your responsibility to keep duplicate records of your Practicum and Internship activities and
supervision from both your on-site and university supervision. You may need these records in the future, to
support your application for certification and/or licensure. Records of your work are only maintained for three
years in the program office.
Updated August 2009
Practicum and Internship Manual
For School Counseling Ed. S. Students
Introduction
Purpose of this Handbook: This handbook is designed to introduce prospective student interns
to program expectations and requirements for satisfactory completion of EDCE 802 E & S (School Counseling
Practicum) and EDCE 805 E & S (School Counseling Internship). No handbook can ever completely prepare one
for the Practicum and Internship experience; the experiences and resultant learning can come only through the
exploration of the unknown, taking risks, making mistakes, and incorporating this learning into one’s counseling.
However, this handbook can provide information about much of the necessary paperwork, suggest ways to ensure
solid communication between student and supervisor, and share background data relative to professional standards
and ethics. The intent of this handbook is to concentrate on the mechanics, thereby freeing the student to focus on
and maximize the learning opportunities that the clinical experiences are intended to provide.
Prerequisites
Practicum: The following prerequisite courses must be completed with a grade of “B” or higher
before taking the Elementary (EDCE 802E) or Secondary (EDCE 802S) Practicum.
EDCE 510 Introduction to Counseling
EDCE 600 Communication Skills in Counseling
EDCE 700 Cross-Cultural Counseling
EDCE 702 Counselor as Consultant
EDCE 706 Assessment in Counseling
EDCE 707 Career Development
EDCE 708 Critical Issues in School Counseling
EDCE 710 Professional, Ethical, and Legal Issues in Counseling
EDCE 712 Comprehensive Developmental School Counseling
EDCE 720 Theories of Counseling
EDCE 721 Techniques of Counseling
EDCE 722 Group Procedures in Counseling
EDPY 705 Human Growth and Development
EDRM 700 Introduction to Research in Education
Internship: The following prerequisite course must be completed with a grade of “B” or higher
before taking the Elementary (EDCE 805E) or Secondary (EDCE 805S) Internship.
EDCE 802E Elementary School Practicum
or EDCE 802S Secondary School Practicum
Applications
Deadlines: There are two deadlines for submitting Practicum and Internship applications. These are:
Fall Practica/Internships - Applications must be received no later than January 15
Spring Practica/Internships - Applications must be received no later than September 1
Course Sections: All Ed.S. School Counseling students must complete at least nine credit hours of field
experience in schools with approved site supervisors. Three of these credit hours are earned in Practicum (EDCE
802 E or S) and the other six are earned in Internship (EDCE 805 E or S). The Internship must be completed in one
semester.
Of the required nine credit hours of field experience, students must complete experiences in elementary, middle and
secondary schools. Students need to register for their Practicum with the suffix applicable to the school they are
working in – for example, if working in an elementary school, students register for 802E. Students register for
802S if working in a secondary school. Whatever the suffix of a student’s Practicum, their Internship should have
the opposite suffix.
Students may choose to register for Practicum or Internship in any of the following ways.
1. Practicum in elementary school (802E)
Internship, half in middle school and half in high school (805S)
2. Practicum in high school (802S)
Internship, half in elementary school and half in middle school (805E)
3. Practicum in middle school (802E or S)
Internship, half in elementary school and half in high school (805E or S – select
the letter that was not used for 802)
Procedures: Complete a Counselor Education Practicum/Internship application and return it to the Counselor
Education Office. These application forms are available on the Counselor Education web page at
http://www.ed.sc.edu/edst/ce/practica_internship.asp. Do not contact a site-supervisor or other school personnel
to request your own placement!
Reminder: All students are required to have professional student liability insurance when enrolled in Practicum
and/or Internship courses. We have found that ACA or ASCA insurance adequately meets our program
requirements. Students should visit the web page of the above organizations to learn how liability insurance may
be obtained. Links to these organizations are located on our Resources page.
Mission Statement
The students and faculty of the Counselor Education Program in the Department of Educational Studies in the
College of Education at the University of South Carolina are a diverse community of learners collaboratively
engaged in scholarship, leadership, service, and advocacy for systemic change. The mission of the Counselor
Education Programs is to prepare multiculturally competent counselor educators, marriage and family counselors,
and K-12 school counselors. Graduates will demonstrate leadership, skill, knowledge, and character that are
reflective of the standards set forth by the counseling profession and their areas of specialization. Students and
faculty of the Counselor Education Program are expected to exemplify the highest ethical and professional
standards while engaged in accomplishing this mission.
Diversity Statement
The Counselor Education Program at The University of South Carolina is committed to multiculturalism by
actively promoting diversity within a social justice framework by building a community of learners that fosters a
climate of respect and values diverse racial, ethnic, and class backgrounds, national origins, native languages,
religious, spiritual, and political beliefs, physical abilities, health status, ages, genders, and sexual orientations.
Our program is committed to training counselors in becoming multiculturally competent scholars and practitioners
who can meet the diverse needs of diverse clients. We are equally committed to recruiting diverse students and
faculty to our program to enhance the richness of dialogue and experiences that will aid in the expansion of
multicultural and culture-specific awareness, knowledge, skills relevant to the client and student populations we
aim to serve.
Using the scholar-practitioner model, we are committed to training our students to be multiculturally conscious
change agents who actively engage in critical self-reflective scholarship and practice in an effort to effectively
transform communities, institutions, and systems.
Purposes of the Clinical Experiences
The Practicum and Internship are designed to satisfy requirements for professional training as stipulated by the
Council for Accreditation of Counseling and Related Educational Programs (CACREP) accreditation standards.
There is a fundamental difference in emphasis between the Practicum and the Internship. The Practicum stresses
counseling skills. Individual and small group counseling activities should be the student’s primary focus while on
site.
The Internship is intended to provide students with a broad-base practical experience in school settings. This
experience is designed to have interns relate academic and theoretical learning to field experience. Interns are
expected to assume a broad spectrum of counseling roles and functions. The intern is asked to participate in as
many activities as feasible in the settings that are similar to the responsibilities of an employed counselor. The
Internship also provides students with evaluative feedback on their knowledge, attitudes, and skills with specific
client populations. Since interns have previously received training in counseling, the staff and the clientele at the
placement site should benefit from the services.
Criteria for Approval of a Site Placement
Site supervisors will only be approved for settings that reflect culturally diverse populations. Typically, students
will do their Practicum and Internship in a variety of settings.
Facilities also play an important role in site selection. Certain minimum standards must be met. Suitably
equipped office space must be available to you to ensure counseling privacy and the ability to tape each session. A
major portion of a student’s evaluation is based upon videotapes of on-site counseling sessions. In addition, the
office should be located within the center of the institution for easy client access. Additional facilities and
equipment (such as videotape machines, observation rooms, computer availability) may also be site selection
considerations.
Site Supervisor Selection (Interns Only)
For Interns who desire sites outside greater Columbia:
In order to work with a school counselor who is not currently on the approved list, you will need to request that
he/she apply to become an approved site supervisor. Application forms are included in this handbook (see Form
B). This application needs to be submitted to the Office of Counselor Education for approval. If this application is
approved, a notification of acceptance will be sent directly to the school counselor.
You will be ultimately responsible for communicating Counselor Education expectations and requirements
(application procedures, assignments, taping of sessions, etc.) to the site supervisor. The steps suggested as a
means of assuring Practicum and Internship course expectations are included in this handbook beginning with Form
C. However, your job is to discuss fully all program expectations with the site supervisor to whom you are
assigned.
You should be prepared to work on a number of objectives during Internship. These should be communicated to
the site supervisor (preferably in writing). It is advisable to schedule a meeting with the site supervisor to discuss
these plans once you have been assigned.
As a professional courtesy, you should also provide the site supervisor with a schedule of the beginning and ending
dates of the Practicum/Internship as well as dates (holiday and the like) when you would not expect to be present at
the site. In addition, a schedule of your week should be submitted to the site supervisor and updated as necessary
(see Form C for a sample schedule).
During the semester, the university supervisor will meet with you and your site supervisor. During such
communications, the university supervisor will discuss your progress, course expectations, and may wish to observe
you conducting one or more counseling sessions.
You must meet a minimum of one hour per week with your site supervisor. The content of these sessions is
determined jointly by the student and the site supervisor. The format of supervision will vary; some site
supervisors will wish to review taped critiques in addition to the university supervisor’s review, while others will
wish simply to consult directly with the student counselor. In any case, you have the responsibility of making sure
that you receive the best possible supervision. If concerns arise, you should first talk with the site supervisor.
However, if problems persist, you should relate such concerns to your university supervisor.
Evaluations of student counselors should be completed by the site supervisor near the end of the
Practicum/Internship. These evaluation forms should be given to the site supervisor in the beginning
of the Internship so that the program expectations are clear (see Forms D, I, and N).
Activities and General Requirements
Practicum: The Practicum experience is supervised by the university instructor and the on-site Professional
School Counselor. Students enrolled in the Practicum are required to accumulate a minimum of 150 clock
hours. Of these 150 hours, a minimum of 60 hours must be in direct service work with clients
appropriate to one’s Program of Study. Emphasis is placed on developing individual and group
interaction skills. The Practicum student is to have a minimum of one hour per week in supervision
with the site supervisor, one hour of supervision per week with a program faculty member or doctoral student
supervisor working under the supervision of a program faculty member, and two hours per week in group
supervision. These supervision hours may count toward the total number of Practicum hours.
The student’s progress in the Counselor Education Program is reviewed by the faculty at the time of
Practicum completion. If the progress is judged as satisfactory, registration in Internship will be
permitted. If it is judged as unsatisfactory, registration will not be permitted and a conference with
the student will be arranged by the student’s adviser. The primary purpose of the conference is to
develop intervention strategies, which the student might complete prior to progressing further in the
degree program
Students should refer to the course syllabus for the specific requirements of their Practicum. Students
are also required to keep a log book (see Form E) describing their field experiences, the date of the
experience, the amount of time spent at it and the student’s reactions to the experience. It is required
that all students attend all Practicum individual and group supervisory meetings held during the
semester.
Internship: The Internship (EDCE 805E or EDCE 805S) is a required six-semester-hour
supervised opportunity for the student to perform all the expected activities that a regularly employed
counselor in a school setting would be expected to perform.
Students enrolled in the Internship are required to spend a minimum of 600 clock hours in a school where one can
perform all the activities that a regularly employed staff member in the setting would be expected to perform. Of
the 600 hours, 240 hours are to be spent in direct service work with clients appropriate to one’s Program of Study.
The Internship students are to have a minimum of one hour of supervision from the site supervisor, one hour of bi-
weekly individual supervision with a program faculty member or doctoral student supervisor working under the
supervision of a program faculty member, and one and one-half-hours per week in group supervision. These
supervision hours may count towards the total number of hours accrued in Internship.
Supervision
Practicum: The Practicum student is to have a minimum of one hour per week in supervision with
the site supervisor, one-hour supervision per week with a program faculty member or doctoral student
supervisor working under the supervision of a program faculty member, and two hours per week in group
supervision.
The Practicum experience is designed and supervised by the instructor of EDCE 802 E or S and by the site
supervisor in the field. Site supervisors are required to have a minimum of a master’s degree from a CACREP
approved program, or a master’s degree with a supervised field Practicum and Internship, and certification as a
school counselor in South Carolina. They must also be involved in at least one professional counseling association
such as ASCA or SCSCA, and have a minimum of two years of school counseling experience at the appropriate
grade level. The site supervisor is expected to acquaint the student with the site and its activities, policies, and
procedures; meet weekly with the student to discuss progress; participate in an evaluation of the student, and
consult with the university supervisor about the student’s progress.
The university supervisor is expected to provide weekly individual and group supervision with other students in
similar field experiences, consult with the site supervisor about the student’s progress, assure that all required field
experience forms are submitted, assure that all students complete all Practicum requirements, assess student
counselor competencies (see Form D), and submit grades for the students to the program secretary at the end of the
semester.
Internship: The Internship students are to have a minimum of one hour per week of supervision with the site
supervisor, one hour every other week of supervision with a program faculty member or student supervisor working
under the supervision of a program faculty member, and 90 minutes per week of group supervision.
The Internship site supervisor is expected to assist the student by acquainting him/her with the site and its
personnel, facilitate the student’s accomplishment of the course requirements, meet once a week with the student to
discuss progress, participate in a midterm and final evaluation of the student (see Forms I & N) and consult with the
university supervisor about the student’s progress.
The university supervisor is expected to provide individual supervision for each student, conduct group supervision
with students in similar field experiences, critique audio and video counseling tapes for each student, consult with
the site supervisor about the student’s progress, assure that all required Internship forms are submitted, attend all
university meetings of supervisors, assure that students complete all Internship requirements, assess student
counselor competencies (see Forms I & N), and submit grades for the students and the student logs documenting
their Internship experiences with the course instructor at the end of the semester.
Procedures and Steps (Summary)
Step 1: Submit application for Practicum or Internship to the Counselor Education Office in room 266, Wardlaw
Building, by the deadline.
Step 2: You will be assigned a site and supervisor. In the case of Internship, if there is not a designated site or
supervisor in your area, you may request that a school counselor may complete and send the Site
Supervisor Application Form.
Step 3: Obtain professional liability insurance and submit verification at the first University class meeting.
Step 4: Visit your site (after site supervisor approval) to plan with your site supervisor prior to the first week of
class.
Step 5: Become familiar with your responsibilities and assist your site supervisor in understanding her/his
responsibilities, as described in this handbook.
Step 6: If, after receiving your letter of approval, you have an emergency situation which makes it impossible to
proceed with the Practicum or Internship, notify the School Counseling Field Experiences Coordinator
immediately. You must reapply (by the deadline) for the semester you want to be readmitted to the
class.
SUMMARY OF COURSE EXPECTATIONS
EDCE 802: PRACTICUM
Student's responsibilities:
1. To commit 150 clock hours to a site, including 60 hours of direct student contact. Direct service hours are
those in which the student is offering either individual or group counseling to clients. The remaining 90
hours can be devoted to other relevant professional activities on site. Examples of appropriate activities are
in-service training, participation in staff meetings, educational activities at the Practicum site, preventive
interventions, consultation, observation, supervision, etc.
2. To videotape the client contact sessions for the purpose of supervision.
3. To attend weekly group supervision seminars with the University instructor.
4. To write case notes on all clients and complete all other paper work connected to Practicum.
5. To meet all other course requirements.
6. To meet any additional requirements as determined by the site supervisor.
Faculty supervisor's responsibilities:
1. To visit the Practicum site and meet with the site supervisor.
2. To conduct weekly group supervision seminars on campus.
3. To offer the student individual supervision of taped or live counseling sessions.
4. To communicate with the site supervisor regarding the clinical ability of the student as determined through
supervision.
5. To read all case notes turned in by student.
6. To keep records of all Practicum activity engaged in by the student.
7. To seek evaluation from the site supervisor.
8. To assign a grade at the end of the semester based on the student's performance.
Site supervisor's responsibilities:
1. To organize the Practicum experience at the site and assure that the student will have an opportunity to work
with appropriate clients.
2. To help orient the student to the site.
3. To provide appropriate space for the student to meet with clients.
4. To monitor the Practicum to determine that the student's needs and the client's needs are being met.
5. To provide the faculty supervisor with evaluation of the student's overall performance and professionalism
during the Practicum.
6. To be available to the student in case of emergency.
7. To provide any additional supervision for reasons of necessity or preference. (In other words, the
University faculty welcomes the site supervisor's involvement in supervision above and beyond the
minimum expectations listed above.)
Adapted from Fairfield University Practicum Manual with written permission of Program Faculty
SUMMARY OF COURSE EXPECTATIONS
EDCE 805: INTERNSHIP
Student's responsibilities:
1. To commit 600 hours to a site, including 240 hours spent in direct client contact. All other Internship hours will
involve relevant professional activity including in-service training, participation in staff meetings, individual
and group supervision, etc.
2. To meet all requirements of the site supervisor for the purpose of supervision, e.g., completing case notes,
audio-taping or videotaping, etc.
3. To attend the weekly group supervision seminars with the USC instructor.
4. To meet all course requirements.
5. To meet all additional requirements of the site.
Faculty supervisor's responsibilities:
1. To visit the Internship site and meet with the site supervisor.
2. To conduct weekly group supervision seminars on campus.
3. To conduct individual or triadic supervision at least every other wee.
4. To keep records of the student's Internship activity safely secured.
5. To seek evaluation of the student from the site supervisor.
6. To be available to the site supervisor should supervision difficulties arise.
7. To assign a final course grade for the student.
Site supervisor's responsibilities:
1. To organize the Internship experience and assure that the student will have an opportunity to engage in
individual and group counseling, as well as other appropriate professional activities.
2. To help orient the student to the site.
3. To provide appropriate space for the student to meet with clients and engage in other professional activities.
4. To meet with the student for a minimum of one hour per week for purposes of individual supervision.
5. To provide the faculty supervisor with evaluation of the student's overall performance during the Internship.
6. To be available to the student in case of emergency.
Adapted from Fairfield University Practicum Manual with written permission of Counselor Education Program Faculty
DIRECTIONS
1. For Practicum/Internship to be successful, the responsibilities stated in the Practicum and Internship Manual for
School Counseling Ed.S. students need to be implemented.
Student's Name:
Home Phone: Work Phone:
Mailing Address:
Street City State Zip
School Site:
Site Address:
Street City State Zip
School Site Phone Number:
Site Supervisor: SSN:
Site Supervisor’s Email Address:
I have reviewed the Roles and Responsibilities statements attached to this form, and I agree to accept them in my
work as a student counselor for the (Fall or Spring), semester.
________________________________________________ ____________________________
Student’s Signature Date
Return to: Counselor Education Office, Wardlaw 266, University of South Carolina, Columbia, SC 29208
FORM A: School Site Placement Form
UNIVERSITY OF SOUTH CAROLINA
COUNSELOR EDUCATION PROGRAM
Directions to the Applicant: The pages at the end of this document outline the benefits, qualifications, and
expectations for site supervisors, as well as the requirements for Practicum and Internship. After you read the
materials, fill out the information below, and send or fax to:
Counselor Education Program, University of South Carolina, Wardlaw 266, Columbia, SC 29208; fax: 803-777-
3045. You will then receive a letter with your approval status.
Name: Date:
SS#:
Home Address: Phone:
Street City State Zip E-Mail:
Home Phone: Email:
School: School Phone:
School Site Address:
Street City State Zip
School Email: Grade Levels:
Number of years as a counselor at these grade levels:
Number of years as a counselor in this building/school:
1. Formal Training Universities Attended Degrees Earned Majors
_____________________
_______________________
_______________________
2. Professional Certifications/Licenses Are you a certified school counselor? If yes, in what state(s)?
Do you have a professional license? If yes, which one(s)?
Do you have any supervision credentials? If yes, which one(s)?
FORM B: Application to Serve as
School Counseling Site Supervisor
Are you certified by the N.B.C.C.?
Do you hold any other professional credentials? ___ If yes, which one(s)?
3. Involvement in Professional Associations (Note: To be approved, you must have continuous involvement in one or more professional counseling
associations). List the counseling professional association(s) and divisions in which you currently hold
membership. Also, provide the dates of concurrent years you have been a member for each primary
professional association.
Counseling Associations/ Divisions Membership Years
In the following space, describe your level of involvement with these associations. For example, how often do
you attend conferences? How else have you been involved?
4. Developmental Counseling Focus In the following space, briefly describe how your program follows a comprehensive developmental school
counseling framework.
5. Supervision Background
Have you completed any coursework or had any other training in supervision? (Yes/No) If so, please provide a
description including the approximate date(s).
Have you previously served as a site supervisor for our school counseling program? (Yes/No)
If so, please (briefly) describe the experience, including the approximate date(s).
How many students have you supervised (approximate)?
Of those, how many have been USC students?
6. Site Suitability All students will be required to tape sessions and to provide individual and group counseling.
Will students be able to provide individual and group counseling at your school? (Yes/No)
Would our students be able to record audio and/or videotapes of their work with students at your school?
(Yes/No)
Does your school have a video camera and monitor that would be available for our students to tape some of
their sessions? (Yes/No)
What about your site would be most helpful for our students?
What (if anything) about your site would provide a limitation to the Practicum/Internship experience for our
students?
7. Personal Preferences
The following pages outline the Practicum and Internship experiences as defined by the University of South
Carolina and CACREP. Based on this information, would you rather supervise a Practicum ____ or
Internship ____ student (check all that apply)?
Would you prefer to supervise in Fall ___ or Spring ___? (check all that apply)
Would you prefer to interview the student before placement? Yes ___ No___
Approvals
Applicant Signature Date
Building Principal Signature Date
Student’s Name:
Student's Address:
Street City State Zip
Student's Home Phone:
Site Supervisor’s Name:
Site Supervisor’s SS#:
Site Address:
Street City State Zip
Site Phone:
Site Fax: Email Address:
__________________________________________________________________________________________
DAYS TIMES
Monday _______
Tuesday _______
Wednesday _______
Thursday _______
Friday _______
On-Site Supervision:
Day M: T: W: Th: F:
Times ________ ________ ________ ________ ________
FORM C: Student and Site Profile
Site Schedule
Students Name:
Supervisor’s Name:
Practicum Site:
Date: Circle One: Mid-term or Final
Directions: Please complete this evaluation of your Practicum student two times, once around mid-semester and
once again near the end of the semester.
NOT
OBSERVED WEAK AVERAGE STRONG
Process (Individual Counseling)
Rate the student’s ability to:
1. Begin counseling relationships effectively. N 1 2 3 4 5
Observations:
2. End counseling relationships effectively. N 1 2 3 4 5
Observations:
3. Use basic listening skills. N 1 2 3 4 5
Observations:
FORM D: Site Supervisor
Evaluation of Practicum Counselor Behaviors
4. Structure interviews appropriately N 1 2 3 4 5
(e.g., establish rapport, define problem, define
goals, explore and evaluate alternatives).
Observations:
5. Establish and communicate empathy. N 1 2 3 4 5
Observations:
6. Adapt counseling strategies so that responses N 1 2 3 4 5
to clients are culturally sensitive and effective.
Observations:
7. Provide a theoretical rationale for strategies N 1 2 3 4 5
employed in counseling.
Observations:
Other Comments:
Site Supervisor's Signature: _____________________________________
Practicum Student’s Signature: __________________________________
Student’s Name: Please Circle Course: Practicum / Internship
Semester: Week:
Activity Weekly Hours Cumulative Hours
I. Direct Service 802 Practicum*
805 Internship
1. Individual Counseling* _______ _______
2. Small Group Counseling* _______ _______
3. Classroom Guidance* _______ _______
4. Peer Facilitation _______ _______
5. Consultation* _______ _______
6. Student Intervention Team _______ _______
7. Individualized Education Plan _______ _______
8. Individual Graduation Plan*
9. Parent Education Class _______ _______
10. Teacher In-Service (not as participant) _______ _______
II. Indirect Service 1. Coordination _______ _______
2. Referral _______ _______
3. Program Planning _______ _______
4. Evaluation of Child/Class _______ _______
5. Observation of Child/Class _______ _______
6. Research into Student Information _______ _______
7. Research into Professional Issues _______ _______
III. Supervision 1. Individual Supervision (USC) _______ _______
2. On-site Supervision _______ _______
3. Group Supervision/Seminar _______ _______
IV. Other Hours 1. Counselor Staff Meeting _______ _______
2. District Counselor Meeting _______ _______
3. State-wide Counselor Conference _______ _______
4. Tape Critiques _______ _______
5. Progress Notes _______ _______
TOTAL HOURS _______ _______
Site Supervisor: Date:
USC Faculty: Date:
FORM E: Weekly Log of Field Experience Activities
Student’s Name: Course: Semester:
WEEK 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total
A. DIRECT SERVICE 802 Practicum 805 Internship
1. Individual Counseling 2. Small Group Counseling 3. Classroom Guidance 4. Peer Facilitation 5. Consultation 6. Student Intervention Team 7. Individualized Education Plan 8. Individual Graduation Plan 9. Parent Education Class 10. Teacher In-Service
B. INDIRECT SERVICE 1. Coordination 2. Referral 3. Program Planning 4. Evaluation of Child/Class 5. Observation of Child/Class 6.Research into Student Information 7. Research into Professional Issues
C. SUPERVISION 1. Individual Supervision (USC) 2. On-site Supervision 3. Group Supervision/Seminar
D. OTHER 1. Counselor Staff Meeting 2. District Counselor Meeting 3. State-wide Counselor Conference 4. Tape Critiques 5. Progress Notes
TOTAL
Direct Service Hours: Site Supervisor:
Indirect Service Hours:
Total Hours: USC Faculty:
FORM F: Field Experience Summary
Counselor Education
University of South Carolina
Site Supervisor: Semester/Year:
Site Placement:______________________________ Circle one: EDCE 802E/S or 805E/S
Please evaluate your supervisory experience in the following areas using the rating scale.
The rating scale is as follows:
5 = Almost always descriptive of my supervisor’s behavior
4 = Frequently descriptive of my supervisor’s behavior
3 = Generally descriptive of my supervisor’s behavior
2 = Infrequently descriptive of my supervisor’s behavior
1 = Almost never descriptive of my supervisor’s behavior
NA = Not applicable
Please circle your response.
1. My supervisor was genuinely interested in my growth as a professional counselor.
1 2 3 4 5 NA
2. My supervisor was very professional in his/her dealings with me.
1 2 3 4 5 NA
3. My supervisor made suggestions regarding my taped sessions that were beneficial.
1 2 3 4 5 NA
4. My supervisor created a setting of support.
1 2 3 4 5 NA
5. I was treated as a professional by my supervisor.
1 2 3 4 5 NA
6. My supervisor was dependable regarding his/her meetings with me and my colleagues.
1 2 3 4 5 NA
FORM G: SITE SUPERVISION
7. The supervisor offered me constructive criticism that assisted in improving my counseling skills.
1 2 3 4 5 NA
8. The requirements made of me by the supervisor were fair and challenging.
1 2 3 4 5 NA
Please comment on the following:
9. What do you feel you gained as a result of working with your supervisor?
10. What could have been done differently by your supervisor to make your experience more profitable?
11. If you were grading your site supervision experience, how would you grade it?
_____A _____B _____C _____D _____E
12. Were the physical facilities at your site appropriate? Please be specific regarding problems or strengths
like having your own space for counseling. If the site were to be graded, I would rate it:
_____A _____B _____C _____D _____E
Additional Comments: (Please include these)
UNIVERSITY SUPERVISOR'S NAME:
Circle One: EDCE 802E/S or 805E/S
DIRECTIONS: The following list of items provides descriptions of behaviors that contribute to effectiveness
in supervising counselor education students. Please rate your supervisor on the following items according to
how accurately each item describes the supervisor's actual behavior during the semester that has just ended.
Do not sign your name on this form; the ratings are to remain anonymous.
The rating scale is as follows:
5 = Almost always descriptive of my supervisor's behavior
4 = Frequently descriptive of my supervisor's behavior
3 = Generally descriptive of my supervisor's behavior
2 = Infrequently descriptive of my supervisor's behavior
1 = Almost never descriptive of my supervisor's behavior
N/A = Not applicable
DESCRIPTION OF MY SUPERVISOR’S BEHAVIOR SCALE RATINGS
This supervisor: 1 2 3 4 5 NA
1. Gives appropriate feedback to supervisees
about positive counseling behaviors. ____ ____ ____ ____ ____ ____
2. Gives appropriate feedback to supervisees
about ineffective counseling behaviors. ____ ____ ____ ____ ____ ____
3. Labels counselor behavior as effective or
ineffective rather than right or wrong. ____ ____ ____ ____ ____ ____
4. Gives us direct suggestions to supervisees
when appropriate. ____ ____ ____ ____ ____ ____
5. Confronts supervisees when appropriate. ____ ____ ____ ____ ____ ____
6. Helps supervisees assess their own strengths. ____ ____ ____ ____ ____ ____
FORM H: Practicum University Supervision Feedback
DESCRIPTION OF MY SUPERVISORY BEHAVIOR SCALE RATINGS
This supervisor: 1 2 3 4 5 NA
7. Helps supervisees assess their own weaknesses. ____ ____ ____ ____ ____ ____
8. Establishes clear goals conjointly with supervisees
against which progress in supervision can be measured. ____ ____ ____ ____ ____ ____
9. Evaluates supervisees at mid-semester. ____ ____ ____ ____ ____ ____
10. Helps supervisees in developing self-confidence
as emerging counselors. ____ ____ ____ ____ ____ ____
11. Shares his or her own experiences with clients
with supervisees. ____ ____ ____ ____ ____ ____
12. Establishes good rapport with supervisees. ____ ____ ____ ____ ____ ____
13. Demonstrates an openness to address professional
issues which arise from experiences in Practicum/
Internship setting. ____ ____ ____ ____ ____ ____
14. Models within the supervision session good
task-oriented skills. ____ ____ ____ ____ ____ ____
15. Provides more structure during the initial sessions
than during later sessions. ____ ____ ____ ____ ____ ____
16. Helps supervisees realize that trying new skills
usually seems awkward at first. ____ ____ ____ ____ ____ ____
17. Helps supervisees to conceptualize cases. Works
with supervisees to evolve a joint conceptualization. ____ ____ ____ ____ ____ ____
18. Helps supervisees define and maintain ethical
behavior in counseling and case management. ____ ____ ____ ____ ____ ____
19. Encourages supervisees to experiment with
different assessment and intervention techniques
to discover their own unique styles. ____ ____ ____ ____ ____ ____
20. Offers resource information when I request or
need it. ____ ____ ____ ____ ____ ____
ADDITIONAL COMMENTS:
Student’s Name:
Site Supervisor's Name:
Site Name:
Date: Circle One: Mid-term or Final
The rating is as follows:
5 = Almost always descriptive of the intern’s behavior
4 = Frequently descriptive of the intern’s behavior
3 = Generally descriptive of the intern’s behavior
2 = Infrequently descriptive of the intern’s behavior
1 = Almost never descriptive of the intern’s behavior
NA = Not applicable
Please circle your response.
Not Applicable Low High
The intern is able to:
(Consistently) demonstrate the high facilitative NA 1 2 3 4 5
responses in counseling and consulting relationships.
Establish and maintain a helpful counseling relationship. NA 1 2 3 4 5
Explore and identify counselee goals. NA 1 2 3 4 5
Help counselee through the stages of problem solving. NA 1 2 3 4 5
Evaluate and validate the changes in the counselor’s NA 1 2 3 4 5
behavior and/or attitude.
Recognize personal issues that affect counseling. NA 1 2 3 4 5
Develop a plan to deal with personal issues related to NA 1 2 3 4 5
counseling.
Gather and use assessment data in a counseling or NA 1 2 3 4 5
consulting relationship.
FORM I: Evaluation of Internship
Competencies
Organize, lead, and critique group counseling NA 1 2 3 4 5
experiences.
Organize, lead, and critique classroom guidance NA 1 2 3 4 5
experiences.
Develop a yearly plan for a comprehensive NA 1 2 3 4 5
developmental program
Consult with parents and teachers in order to promote NA 1 2 3 4 5
successful learning and adjustment for students.
Conduct parent/teacher workshops. NA 1 2 3 4 5
Assess environmental factors that negatively impact NA 1 2 3 4 5
on children and is able to plan strategies for appropriate
interventions.
Conduct a needs assessment. NA 1 2 3 4 5 Evaluate his/her guidance program. NA 1 2 3 4 5
Demonstrate professional commitment by active NA 1 2 3 4 5
participation in professional organizations for school
counselors.
Stay abreast of current issues through professional NA 1 2 3 4 5
journals.
Other Competencies: (please describe)
_____________________________________________ NA 1 2 3 4 5
_____________________________________________ NA 1 2 3 4 5
_____________________________________________ NA 1 2 3 4 5
_____________________________________________ NA 1 2 3 4 5
Comments:
Site Supervisor's Signature: _____________________________________
Student’s signature:
I (we) give permission for my (our) child to participate in counseling with
, a graduate student at the University of South Carolina, who is enrolled in the
course EDCE during the semester, 20 .
It is understood that the counseling sessions will be electronically recorded and played in class with both
the instructor and class members present. These recordings will be used for educational purposes and
erased at the end of the course.
It is understood that my (our) child is entitled to confidentiality and that information regarding
communications made in the counseling sessions will be limited only to those directly involved in
receiving, providing, or sharing the educational process and any professional consultants. I (we) do
also release and forever discharge the University of South Carolina, its officers, agents, employees, and
students from any and all suits, claims, damages, demands, liabilities, costs and expenses, including
reasonable counsel fees, which may result from participation in counseling.
Parent or Guardian/Date:
Witness/Date:
USC Student/Date:
USC Faculty Member/Date:
Note: The parent or guardian, USC Student, and USC Faculty Member are to be given copies of this
form after it is signed by all parties.
FORM J: Consent for Counseling of a Minor Child and Recording Release Form
I give permission for my participation in counseling with , a graduate student at
the University of South Carolina, who is enrolled in the course EDCE during the
semester, 20 .
I understand that the counseling sessions will be electronically recorded and played in class with both the
instructor and class members present. These recordings will be used for educational purposes and erased
at the end of the course.
It is understood that I am entitled to confidentiality and that information regarding communications made
in the counseling sessions will be limited only to those directly involved in receiving, providing, or sharing
the educational process and any professional consultants. I do also release and forever discharge the
University of South Carolina, its officers, agents, employees, and students from any and all suits, claims,
damages, demands, liabilities, costs and expenses, including reasonable counsel fees, which may result from
participation in counseling.
Signature/Date:
Witness/Date:
USC Student/Date:
USC Faculty Member/Date:
Note: The client, USC Student and USC Faculty Member are to be given copies of this form after it is signed by
all parties.
FORM K: Consent for Counseling and
Recording Release Form
Voluntary and required field experiences (i.e., Practicum and Internship courses) at the University of South
Carolina are not covered by professional liability or health insurance through USC or school districts. For
each semester of enrollment, all full time students (Full Time Student are those who are enrolled for
12 or More Hours of Credit) and those Who Pay the University Fee are automatically provided with health
insurance coverage for accidents occurring on campus or in University-related activities in accordance with the
specifications provided in the material below. Read all the information about health and liability insurance
provided in this form. Your Signature is Required on the Page Which Follows.
HEALTH INSURANCE
The following information is provided concerning health services and health insurance for students while
enrolled at the University of South Carolina, Columbia Campus.
Health Care Eligibility: All students enrolled in academic classes at the University of South Carolina,
Columbia Campus are eligible to use all facilities operated by the Student Health Services. This includes
Thomson Student Health Center, the Counseling and Human Development Center, and the Health and
Wellness Programs Office. Eligibility is verified using various student databases.
Charges for Student Health Services: All students enrolled in the Fall and Spring semester who have
paid the Health Fee (check with USC Student Health for current fee information) are entitled to provider
office services at no charge at all Student Health facilities. Students who have not paid the Fall or Spring
Health Fee is charged a fee-for-service for each visit with a provider. During Summer School sessions, all
enrolled students are entitled to free professional services. All students are charged at special student rates
for ancillary services (laboratory, x-ray, and pharmacy) and for various procedures, such as minor surgery,
during all academic sessions.
Fall and Spring Health Fee: The Health Fee is a component of the University Fee. All undergraduates
taking 12 or more hours are required to pay the university/health fee. Most graduate students taking 9 or
more hours and most graduate assistants are either required to pay the health fee, or it is included in their paying
the university/health fee. Health fee payment status will be verified when students present for care
at Student Health facilities.
Summer Health Fee: All students enrolled in Summer I and Summer II courses have a health fee
component included in their fee structure, and they are entitled to use Student Health Services facilities
without paying provider fees.
Health Insurance: Student Health Services cannot meet all potential health care needs. All students are
encouraged to have comprehensive health care insurance coverage.
a. No comprehensive health care coverage is provided by payment of the university fee or health
fee. Students currently covered under health plans, such as their parent's insurance plan, or through a
plan carried by their employer, should verify that these plans will continue to cover them while
FORM L: Insurance Responsibility
attending the University. Students who need comprehensive health insurance coverage should consider
purchase of coverage under an optional group health insurance plan sponsored by the University.
Information on the available plan can be obtained by calling the Student Health Center, 777-3174.
b. Students who pay the university fee or health fee are automatically covered under a limited
plan which provides reimbursement of up to $500 for out-of-pocket expenses associated with treatment
of an emergency illness or injury. This plan includes no coverage for non-emergency conditions or
routine care.
c. The current health care insurance contracts changed August, 1996. Students may check on status and
coverage under replacement plans by calling the Student Health Center (803-777-3174).
LIABILITY INSURANCE
Liability insurance is available through membership in the student NEA (777-6262), to student members in the
Palmetto State Teachers Association (256-2065), or through various professional development organizations.
Contact your advisor for more information.
Student counselors have other sources for insurance specifically for counseling liability. Information is
available on the insurance provided to student members of the American Counseling Association, and other
professional associations. Allow up to 60 days for confirmation of your liability insurance.
Detach and return the bottom section of this form to your instructor the first day of your Practicum or Internship
course along with evidence of liability coverage.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I have read the Form L material on health insurance and services, and I understand my responsibility
for my own health care and insurance.
I understand and accept the condition that the College of Education, The University of South Carolina
and individual faculty members or other instructional staff are released from any liability related to
accidents or any other unexpected events which may occur in conjunction with my participation in
required or voluntary activities outside of the University of South Carolina, Columbia campus.
Student Signature Date
Witness Signature (College of Education Employee) Date
EDCE
Student Semester Semester
Signature of Signature of
University Supervisor/Date Site Supervisor/Date
Total Hours
FORM M: Supervision Log
The student will demonstrate ability to do some of the following activities at competency level judged adequate
by the supervising counselor and verified by the USC supervisor. Items with asterisks are required; other
selected activities will be negotiated on an individual basis.
DATE FIELD UNIVERSITY
COMPLETED SUPERVISOR SUPERVISOR
A. INDIVIDUAL PLANNING
1. Orient student groups to group appraisal
instruments and purposes.
2. Administer or proctor the administration
of appraisal instruments to student groups.
3. Score appraisal instruments and profile
and record appraisal data.
4. Interpret appraisal data to groups and/or
individuals.
5. Select appropriate appraisal instruments for
Individuals and groups.
6. Use appraisal data effectively in counseling
and/or conferences.
7. Use systematic observation instruments
to assess behavior.
8. Prepare and conduct programs for large
groups on orientation to guidance services
(or new services).
9. Collect and file personal-social, educational,
and career information.
10. Display and distribute personal-social,
educational, and career information.
11. Conduct small group activities to orient
students to and distribute personal-social,
educational, and career information.
FORM N: Internship Experiences
INDIVIDUAL PLANNING (continued) DATE FIELD UNIVERSITY
COMPLETED SUPERVISOR SUPERVISOR
12. Assist students with completing financial
assistance, school admission, and job
application forms.
13. Assist students with routine education and
career planning.*
14. Coordinate efforts to place students in
appropriate educational programs.
15. Coordinate efforts to place students in
appropriate setting for work experience
and/or part-time work.
B. RESPONSIVE SERVICES
1. Document individual counseling with a
student with a personal-social problem.*
2. Document individual counseling with
student with an educational problem.*
3. Document individual counseling with a student
with a problem concerning career choice.
4. Help students to learn how to collect and
evaluate information and use decision-making
processes. (May be documented with
individuals or groups).
5. Document with a case study the ongoing
counseling for at least one student with rather
serious concern for a minimum of six sessions.*
6. Document with an evaluation summary the
leadership of a counseling group that meets
for five or more sessions.*
7. Identify and select students for group guidance
and small group counseling activities.
8. Identify students for referral to other agencies.
RESPONSIVE SERVICE (continued) DATE FIELD UNIVERSITY
COMPLETED SUPERVISOR SUPERVISOR
9. Help students who need referral, and their
parents, to become aware of such needs and to
obtain referral services.
10. Maintain contacts with and make referrals to
referral agencies.
11. Provide consultation and information to teachers
which will aid in their effort to help students
achieve and adjust in the classroom
12. Provide consultation and information to
administrators and teachers to assist them in
program development and revision to meet
student needs.
13. Provide consultation and information to parents
to assist them with long range educational and
career planning for their children.*
14. Provide consultation and information to decision
makers to assist them in providing a physical
psychological environment conducive to
learning and adjustment.
15. Provide consultation to school personnel and
monitor activities in the school’s efforts toward
the maximum self-realization by all students.
16. Provide consultation and coordination to school
Personnel and parents in referring students
for special services.
C. SYSTEM SUPPORT
1. Work with other professional staff in developing
and maintaining contacts with employers and
placement agencies.
2. Work with other professional staff in
conducting student follow-up studies and
analyzing data.
SYSTEM SUPPORT (continued) DATE FIELD UNIVERSITY
COMPLETED SUPERVISOR SUPERVISOR
3. Work with other professional staff in
conducting student follow-up studies and
analyzing data.
4. Facilitate communication and exchange of
information between school and community
agencies.
5. Facilitate communication between students and
parents and between students and/or parents
and school faculty.
6. Cooperate and maintain communication with
other counselors at all levels.
D. STUDENT RESPONSIBILITIES
1. Maintain confidential files of pupil data on
students with whom you are working.*
2. Brief report in writing describing the process in
your school for preparing and sending individual
student transcripts, reports and recommendations
to appropriate agencies.
3. Collect and provide copies of counseling and
guidance records, forms and other professional
materials used by counselors in your building.
4. Prepare and present charts, summaries, and reports
of EDCE 802S experiences to counselors,
principals, and USC supervisors.
5. Describe the recommendation processes that are
appropriate to your setting (e.g., letters for
scholarships, honors, admissions, and
employment).
6. Attend one or more professional meetings
during the semester.*
STUDENT RESPONSIBILITIES (continued) DATE FIELD UNIVERSITY
COMPLETED SUPERVISOR SUPERVISOR
7. Professional readings; viewing professional films
or videotapes, listening to professional audiotapes;
list each by name and date on this sheet or an
attachment.
8. Develop proposal for professional program/
presentation to submit for consideration of
counseling related professional organization.
9. Complete the appropriate level of ASCA Audit
in Cooperation with site supervisor.*
Practicum Student Name University Supervisor Name (Printed)
Date of Evaluation Period Covered by Evaluation
Directions: Please complete this evaluation of your Practicum student two times, once around mid-
semester and once again near the end of the semester. Use a different colored pen or pencil for each of
these evaluations and indicate which color was used for each.
The Practicum student demonstrates an ability to form effective relationships with:
Superior Above Avg. Average Below Avg. Inadequate No Basis Clients Supervisor Other Staff Members Outside Agencies
The Practicum student:
Superior Above Avg. Average Below Avg. Inadequate No Basis Demonstrates knowledge
of principles and
processes
Begins counseling
session smoothly
Can explain counseling
processes and objectives
Is relaxed during the
counseling session
Expresses interest and
acceptance of the client
Facilitates expression of
concerns and feelings
Comments:
FORM O: Evaluation of Counseling
Performance University Supervisor
Evaluation (cont’d)
The Practicum student effectively uses:
Superior Above Avg. Average Below Avg. Inadequate No Basis Rapport Eye Contact Posture Encouragers Basic Empathy Probing Challenging Silence Exploration of Client
Concerns
Identification of Goals Summarizing
Comments:
The Practicum uses the following behaviors:
Usually Sometimes Infrequently No Basis Mechanistic Inaccurate Reflections /
Interpretations
Pat Answers Advice Giving Missing Non-Verbal
Cues from Clients
Inappropriate Counselor
Self-Disclosure
Comments:
Evaluation (cont’d)
The Practicum student effectively uses:
Superior Above Avg. Average Below Avg. Inadequate No Basis Terminates the
Counseling Session
Smoothly
Is Able to Make
Appropriate Referrals
Knows Community
Resources
Is Able to Make a
Treatment Plan
Can Explain, Administer
and Interpret Tests
Correctly
Completes Case Reports
Accurately and
Punctually
Operates from a Sound,
Rational Theoretical
Base
Demonstrates Ethical
Behavior
Committed to
Developing Professional
Competencies
Invests time and Energy
in Becoming a Counselor
Comments:
Student’s Signature: ________________________________________________________
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