Site Evaluation of School Counselor Candidate
Internship Midterm/Final
The University of Dayton
Dept. of Counselor Education and Human Services
School Counseling Internship
Counselor Candidate: ________________________________________
Date: ______/_______/_______
Site Supervisor: ___________________________________________________
School Site: _____________________________________________________
Midterm/Final: ____________________________________________________
Competency Assessment Levels: (It is expected that students will begin in the “Novice/Beginning” area. By the end
of an internship, the expected level in all areas should at least be “Competent.”)
1. Unsatisfactory – Student has not shown initiative in developing this skill.
2. Novice / Beginning – Student is in the initial stages of development and has demonstrated beginning
knowledge/skill under supervision.
3. Progressing – Student is developing this skill, and is beginning work in this area independently, as well as with
supervision. Student is beginning to show initiative in developing this skill further.
4. Competent - Student understands and has used the skill. Works Independently and shows initiative in this area.
5. Proficient – Student has attained mastery of the skill and independently performs the skill. Student shows
initiative and is ready for employment in the field of school counseling. I am willing to verify this skill when
writing a letter of recommendation.
6. Exceptional – Student demonstrates skill levels and initiative above and beyond expectation.
7. Not Applicable, Not Observed, or No Opportunity, as yet
Counseling and Coordination
Level
1. Utilizes referral process for counseling in the school.
_________________________
2. Demonstrates understanding of a standard procedural counseling process
(e.g. establishing the helping relationship, explaining confidentiality and
other informed consent issues).
__________________________
3. Utilizes brief, solution-focused counseling techniques appropriate to school setting.
_________________________
4. Develops counseling goals & action plans for students' problems related to behavior,
career, academic achievement, and/or social/relationship issues.
_________________________
5. Utilizes record-keeping procedures and referrals for off-site services.
_________________________
6. Coordinates and consults with community referral sources.
_________________________
7. Responds appropriately in a crisis.
_________________________
8. Uses appropriate guidance techniques in the classroom.
_________________________
9. Skillfully facilitates small and large groups .
_________________________
10. Demonstrates proficiency in at least one internship experience with students from
(a) different ethnic groups than the intern’s
__________________________
(b) ESL students
__________________________
(c) students with exceptionalities
__________________________
(d) students from different SES groups than the interns
__________________________
11. Practices according to professional and ethical standards and school
board policy.
Collaborating and Consulting
_______________________
Level
1. Communicates effectively with co-workers.
_______________________
2. Works effectively with faculty and staff to address student behavior and learning
needs.
_______________________
3. Works effectively with faculty to develop strategies to enhance learning in the
classroom.
_______________________
4. Performs in the counselor's role as a consultant when serving on school intervention teams. ______________________
Program Administration/Assessment and Use of Data
Level
1. Has demonstrated how guidance programs are integrated with the school
curriculum and overall mission.
_________________________
2. Promotes methods for determining school wide needs to be addressed by classroom
guidance or small group curricula.
__________________________
3. Is actively involved in designing procedures for planning and initiating additions to
the guidance program such as classroom guidance or group curricula.
__________________________
4. Discusses and how data is collected and compiled (e.g., grades,
enrollment, attendance, retention, disciplinary actions, and placement)
at school site.
__________________________
Leadership & Advocacy
1. Has assisted the counselor in developing and implementing school-wide
programs that enhance student success in school.
2. Utilizes outcome data to advocate for program viability.
3. Demonstrates the belief that all children can learn
4. Treats all children with fairness (positive regard, equality, concern and respect)
Level
__________________________
___________________________
__________________________
___________________________
Professionalism
1. Consult with supervisor for assistance and feedback.
Level
________________________
2. Accepts and incorporates feedback and suggestions.
________________________
3. Demonstrates appropriate organizational and time management skills.
_______________________
4. Demonstrates appropriate oral and written communications skills.
________________________
5. Self presentation is consistently professional regarding manner of attire and
interpersonal interactions.
________________________
6. Is prepared for upcoming activities and shares prepared materials with
the site-supervisor.
________________________
7. Is always on time and treats the clinical experience as a job.
_______________________
Comments:
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___________________________________________ Date _____/_____/________
Supervisor’s Signature
___________________________________________ Date ____/_____/_________
Counselor Candidate’s Signature