Placement Forms - Griffith University

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FORMS
Field Placement Contract
This is a field placement contract between (insert student’s name) and (insert field
supervisor’s name or, where applicable, insert external field supervisor’s name). As
parties to this contract we agree to the following:
1. (Insert Student’s name) will be a student worker in (insert name of organisation)
for the period (insert date to date) and will complete the required field placement
days.
2. (Insert Student’s name) will keep a time sheet of the days/hours completed on
field placement. Social Work students can have up to 3 days sick leave without
the need to make these days up. Any days off from the placement (due to ill
health/personal reasons) that exceed the sick leave provision will be advised
and/or negotiated with the field supervisor and will make up at the end of the
placement.
3. It is expected that (insert student’s name) will commence work at (insert time)
and will finish at (insert time). The student will have (add number and duration of
breaks) each work day. Any changes to work times or attendance at after hours
events will be negotiated between the parties.
4. Supervision will occur weekly and will average 1.5 hours each week, which
includes both formal and informal supervision.
The structure for formal
supervision is as follows: (insert details ie time, location, content (including
method of setting agendas), record keeping responsibilities).
5. The policy for rescheduling supervision sessions is (insert details)
6. The roles and responsibilities of the student include:

be willing to learn, be enthusiastic and flexible in their approach to practice

approach all tasks responsibly and in a professional manner

be prepared to monitor their own experiences and development

set appropriate learning objectives and develop strategies to meet these

attend all supervision meetings, and complete the required assessment

advise the field supervisor and/or university field placement liaison staff of
any conflicts of interest

advise the field supervisor and university field placement liaison staff of any
personal information that may affect their ability to function in the placement

accept support and constructive criticism and ask for help when needed.
7. The roles and responsibilities of the field supervisor include (adjust as necessary
and include arrangements for on-site, external or co-supervision arrangements):

orientation, monitoring, supervision and evaluation of the student.

preparing the organisation for the student’s arrival

assisting the student to develop their learning contract and facilitating access
to appropriate tasks to meet the learning needs of the student

introducing the student to the broader contexts of practice including other
organisations, key sector stakeholders, relevant policies and legislation etc

mentoring, supporting, challenging and debriefing the student

regular weekly supervisory meetings with the student and provision of
guidance and support as required

liaising with the University field placement liaison staff and reporting any
issues regarding the student

completion of the mid placement and end of placement evaluation reports.
8.
Organisation requirements include: (insert details e.g. police check, compliance
with code of conduct, maintenance of records, oaths of confidentiality).
9.
Either party should contact the University field placement liaison staff and/or the
Field Placement Convenor if issues regarding conduct or performance arise.
Signed (Onsite Field Supervisor) ………………………………………………………..
Date……………….
Signed (External Supervisor - if applicable) ………………………………………………
Date……………….
Signed (Student)…………………………………….…………......
Date……………..
Please complete and student to submit via Learning@Griffith Blackboard course site:
Time sheet for field placement
Student’s Name:
Student Number:
Course Code:
Must be submitted Friday of final placement week (with assessment items)
Week
Ending
Monday
Tuesday
Wednesday
Thursday
Friday
Field Supervisor confirmation of field placement days
Signature:_________________________________
YES
Student’s
Signature
NO
(Please
Date:__________________
Supervisor’s
Signature
circle)
Mid Placement Field Report
Field Supervisor’s Mid Placement Field Report
Social Work Field Placement
Course Code
(please tick one):  Bachelor of Social Work Field Placement 1 (3112HSV_Y2)
 Bachelor of Social Work Field Placement 2 (4112HSV_Y2)
 Master of Social Work Field Placement 1 (7134HSV_Y2)
 Master of Social Work Field Placement 2 (7144HSV_Y2)
STUDENT NAME
Student No.
Placement Start Date
End Date
SUPERVISORS
Field/Agency Supervisor
External Supervisor
(delete if not applicable)
ORGANISATION
Name
Position Title
Email
Phone Number
Name
Email
Phone Number
Name
Program/Team (if applicable)
Address
Phone and Fax
Briefly outline the experiences and tasks performed by the student
______________________________
______________________________
Field Supervisor’s Signature
External Supervisor’s Signature (if applicable)
________ / _________ / ________
________ / _________ / ________
Date
Date
End of Placement Field Report
Field Supervisor’s End of Placement Field Report
Social Work Field Placement
Course Code
(please tick one):  Bachelor of Social Work Field Placement 1 (3112HSV_Y2)
 Bachelor of Social Work Field Placement 2 (4112HSV_Y2)
 Master of Social Work Field Placement 1 (7134HSV_Y2)
 Master of Social Work Field Placement 2 (7144HSV_Y2)
STUDENT NAME
Student No.
Placement Start Date
End Date
SUPERVISORS
Field/Agency Supervisor
External Supervisor
(delete if not applicable)
ORGANISATION
Name
Position Title
Email
Phone Number
Name
Email
Phone Number
Name
Program/Team (if applicable)
Address
Phone and Fax
Briefly outline the experiences and tasks performed by the student
*** End of Placement Evaluation Report ***
Has the student completed their required minimum number placement days?
(1 day = 7 hours + breaks) (1st placement: 68 days, 2nd placement: 72 Days)
YES
______________________________
______________________________
Field Supervisor’s Signature
External Supervisor’s Signature (if applicable)
________ / _________ / ________
________ / _________ / ________
Date
Date
NO
Definition of Scale
We expect students to be assessed against all learning outcomes over the course of the
placement. Please use the following definition of scale to guide your assessment of the student.
Not
Competent
(NC)
Needs
Improvement
(NI)
Competent
(C)
Exceeds
Expectations
(EE)
Outstanding
(O)
Not Yet
Assessed
(NYA)
Not Competent (NC):
The student is unable to articulate and/or demonstrate the required learning outcome and lacks
capacity for improvement at this time.
Needs improvement (NI):
The student has some difficulty articulating and/or demonstrating the required learning outcome
but shows some capacity for improvement.
Competent (C):
The student is able to articulate and/or demonstrate the required learning outcome most of the
time.
Exceeds expectation (EE):
The student consistently articulates and/or demonstrates the required learning outcome.
Outstanding (O):
The student is exceptional at articulating and/or demonstrating the required learning outcome, is
self-motivated and takes initiative.
Not Yet Assessed (NYA):
The student has not had the opportunity at this time to complete tasks relating to the learning
outcome, therefore an assessment is pending. This scale item can only be used at midplacement.
Learning Category 1 : The social work role
The student's knowledge of the role and function of social work in their practice agency, community and
wider society is applied to identify inequalities and injustices, promote social change and enhance well
being.
Learning Outcome
1st Placement: The student is able to articulate the purpose of
social work in society, identifying underlying aims, objectives and
values that inform the social work role.
2nd Placement: The student is able to make links between the
purpose of the social work role in society, in the community and
within their practice agency
1st Placement: The student is able to demonstrate understanding of
the impact of socio-political, economic and environmental
factors on individuals, communities and groups in terms of access
to services, social justice and distribution of resources to meet
needs.
2nd Placement: The student is able to critically evaluate how social
work functions in the contemporary Australian welfare system,
providing examples of issues facing individuals and groups which
impact on well being.
1st Placement: The student is able to articulate their understanding
of organizational systems and processes in the placement
organization, with respect to power, disadvantage and socio-political
factors, that affect, or have potential to affect, the well being of
clients.
2nd Placement: The student is able to critically analyse
organisational systems to identify changes in social work processes
within their placement agency, with respect to power, disadvantage
and socio-political factors, that may improve client well being.
1st Placement: The student is able to describe the impact of
discrimination, disadvantage and oppression and identify how
appropriate change might be achieved.
2nd Placement: The student is able to challenge and address
identified discrimination, disadvantage and oppression by
participating in the change process where appropriate.
Supervisor Comments:
NC
NI
C
EE
O
NYA
Learning Category 2 : Ethics and values
The student's knowledge of social work ethics and values guides professional practice, ensuring they are
able to practice within the values, principles and ethical guidelines of contemporary social work practice.
Learning Outcome
1st Placement: The student is able to demonstrate knowledge of
their personal value system, identifying key values that influence
their professional decision making processes.
2nd Placement: The student is able to critically reflect on how their
value system relates to that of the social work value base, identifying
any potential conflicts between personal and professional values.
1st Placement: The student is able to demonstrate familiarity
with the AASW Code of Ethics, articulating and applying the core
values of the profession and key components of ethical social work
practice.
2nd Placement: The student is able to demonstrate application of
the AASW Code of Ethics within their placement organization, and
undertake ethical decision-making processes.
1st Placement: The student is able to identify and discuss value
positions of colleagues from other professional disciplines.
2nd Placement: The student is able to critically reflect on the
similarities and differences between the value positions of different
professional disciplines within the interprofessional context.
1st Placement: The student is able to demonstrate understanding
of culture, equity and diversity and their impact on clients in
their placement agency, demonstrating culturally competent social
work practice.
2nd Placement: The student is able to critically reflect on their
practice in relation to cultural competence within their placement
agency.
1st Placement: The student is able to identify and comply with
additional organizational documents that outline ethical
requirements for work within the organization.
2nd Placement: The student is able to critically analyse the
relationship between the social work Code of Ethics and ethical
documents of the placement agency, identifying any competing
requirements or areas of ethical risk.
Supervisor Comments:
NC
NI
C
EE
O
NYA
Learning Category 3 : Organizational Processes
Organizational goals of the service are met by the student, who undertakes work processes appropriately
using social work knowledge and skills.
Learning Outcome
1st Placement: The student works within the guidelines of agency
policies and procedures and demonstrates knowledge of relevant
legislative and social policy mandates that inform practice in the
agency.
2nd Placement: The student is able to critically analyze organizational
systems and processes and the extent to which these are responsive
to client need.
1st Placement: The student demonstrates accountability and
responsibility, takes initiative for workload, displays appropriate
time management skills, punctuality and a professional manner.
2nd Placement: The student demonstrates initiative in managing
workload and seeks out opportunities to participate and contribute to
all aspects of professional practice within the agency.
1st Placement: The student is able to utilize oral and written
communication skills and active listening skills that are in
accordance with agency requirements, for example report writing,
data collection and recording.
2nd Placement: The student is able to effectively advocate for clients
in oral and written communication within the agency, engaging the
client where possible.
1st Placement: The student demonstrates effective teamwork,
networking and collaboration with workers in the organisation and in
other agencies.
2nd Placement: The student effectively represents the social work
perspective in team collaborations, demonstrating conflict
management and problem solving skills.
Supervisor Comments:
NC
NI
C
EE
O
NYA
Learning Category 4 : Social work processes
Through effective use of the social work skills of engagement, assessment, planning, intervention and
review, the student develops the potential of clients, fostering client self-determination and seeking to
enhance client well-being.
Learning Outcome
1st Placement: The student is able to articulate and demonstrate
knowledge of relevant theories, perspectives and models
and how they apply to the stages of the social work process.
2nd Placement: The student is able to develop specialist knowledge
of social work theories, perspectives, models and the current
evidence base which are particularly relevant to the placement
agency.
1st Placement: The student is able to purposely and effectively
build rapport and engage with clients, in a professional and
contextually appropriate way.
2nd Placement: The student can articulate and demonstrate a range
of engagement strategies that are specifically tailored to effectively
build rapport, demonstrating skills in client centred practice.
1st Placement: The student is able to effectively understand the
service user perspective, and seeks to enhance client selfdetermination in a manner consistent with social work aims.
2nd Placement: The student is able to take action to promote the
service user’s perspective through the use of skills in advocacy,
mediation and conflict resolution.
1st Placement: With support, the student is able to gather, analyze,
evaluate and use information and knowledge during an
assessment process, seeking out client strengths, resources,
limitations and risks accurately.
2nd Placement: The student can independently gather, analyze,
evaluate and use information and knowledge during an
assessment process, seeking out client strengths, resources,
limitations and risks accurately.
1st Placement: With support, the student is able to make decisions
and recommendations regarding appropriate planning and
intervention, based on the assessment, professional knowledge
and judgement and seeks to advance client self determination
where possible during this process.
2nd Placement: The student is able to critically analyze the role of
power, disadvantage and socio-political factors that may impede
the planning and intervention process.
1st Placement: With support, the student can review the social
work process, in relation to the effectiveness of the engagement,
assessment and intervention process.
2nd Placement: The student is able to critically analyze factors that
may have impacted on the social work process, and uses this
analysis to inform their future social work process.
NC
NI
C
EE
O
NYA
Supervisor Comments:
Learning Category 5 : Student Learning and professional
development
Through a process of critical reflection, the student builds self awareness and is able to use this awareness
to inform professional development in such a way that a sustainable social work practice is developed.
Learning Outcome
1st Placement: The student is able to demonstrate their
development of an emerging practice framework, identifying
key components in their approach to social work practice and
underlying values that influence their framework for practice.
2nd Placement: The student is able to clearly articulate their
beginning practice framework, and critically analyse their own
practice approach through continued engagement with the broader
social work profession.
1st Placement: The student demonstrates use of self, combining
their professional knowledge, skills and values with aspects of their
personal self in a purposive manner.
2nd Placement: The student is able to critically reflect on their use of
self, identifying areas for improvement and taking action to enhance
purposive use of self.
1st Placement: The student is able to articulate the importance of
self-care, demonstrating an understanding of how their own health
and well being contributes to their professional practice.
2nd Placement: The student has developed strategies for attending to
their self-care, and is able to maintain their health and well being
through a range of activities.
1st Placement: The student demonstrates a commitment to
ongoing learning, using the supervisory process to develop their
skills and knowledge.
2nd Placement: The student keeps up to date with the latest research
and knowledge, demonstrating a commitment to a life long learning
process.
1st Placement: The student demonstrates continual reflection
on practice, utilising the supervisory relationship well to identify
areas for improvement and development and uses this knowledge to
expand their skills.
2nd Placement: The student practices reflectively and reflexively,
using the supervision process to develop insight and
recognizes and responds in a flexible way to changing practice
contexts and environments.
Supervisor Comments:
NC
NI
C
EE
O
NYA
Summary / Additional comments
Overall Performance
NC
NI
C
EE
O
How do you rate this student’s overall performance?
End of Placement Field Supervisor Recommendation
Pass
Fail
Do you recommend this student pass Social Work Field Placement?
*** Please attach the completed and signed timesheet to your Final Report ***
Practice Reflections
Students are expected to submit their Weekly Evaluation to their Field Supervisor each week for
use and review in supervision. Please confirm that you received and reviewed the evaluations
below:
WEEK
Practice Reflection 1
Practice Reflection 2
Practice Reflection 3
Practice Reflection 4
Practice Reflection 5
Practice Reflection 6
Practice Reflection 7
Practice Reflection 8
Practice Reflection 9
Weekly Evaluation 10
Practice Reflection 11
Practice Reflection 12
Practice Reflection 13
Practice Reflection 14
Practice Reflection 15
Practice Reflection 16
Practice Reflection 17
Practice Reflection 18
YES
NO
Student’s Personal Evaluation of Field Placement Learning
Field Supervisor Evaluation of the University
A. How would you rate the support from the University?
US
Please include any feedback:
B. Was the Field Placement Manual:
Helpful
Not helpful
No time to read it properly
Please include any feedback:
C. Were the University expectations for the placement within your organisation:
Reasonable
Unreasonable
D. Do you have any additional feedback?
S
HS
Glossary
Advocate
Advocating for a person ‘refers to the activities associated with negotiating or representing on
behalf of a person’ (Burke & Dalrymple, 2009, p. 265).
Articulate
The ability to express an idea or feeling fluently and coherently.
Client
Clients are individuals, families and other kinship arrangements, groups, communities,
organisations and societies (AASW, 2010).
Client centred practice
Practice informed by the belief that the client is ‘the expert and free to determine their chosen
path and the outcomes they encounter’ (Murphy, Duggan & Joseph, 2012, p. 3).
Client self determination
Self determination involves the social worker promoting the autonomy of clients and ‘actively
seeking to enable them to make informed decisions on their own behalf’ (AASW, 2010, p. 25).
Critically reflect, evaluate and analyse
‘Critical reflection is most simply understood as an approach to analyzing practice or experience,
based on the identification of the assumptions embedded in that practice or experience’ (Fook,
2004, p. 17).
Culturally competent practice
‘Cultural competence can be achieved through a commitment to achieving culturally appropriate
service delivery and a culturally appropriate workplace environment. This commitment would
require a focus on systemic, organisational, professional and individual levels’ (Farrelly & Lumby,
2009, p. 17).
Demonstrate
The ability to clearly show the existence of a skill or knowledge by giving an exhibition of how
the skill or knowledge is applied in practice.
Ethics
‘Ethics is a branch of philosophy which addresses questions about morality, such as what is the
fundamental nature of morality and the way in which moral values are determined’ (Gray &
Webb, 2010, p. 1).
Ethical decision making processes
‘Ethical decision making is the process by which social workers engage in an exploration of
values, that may be evident in the personal, professional, social and organisational fields, in order
to establish where an ethical dilemma might lie according to what competing principles, and what
factors take priority in weighing up the alternatives’ (McAuliffe, 2010, p. 41).
Initiative
The ability to initiate actions or plans independently and to act or make change before others do.
Interprofessional Practice
Health and community service professionals working together, using complementary knowledge
and skills, to provide care to patients, clients and communities, based on trust, respect and an
understanding of each other’s expertise. (Griffith University)
Practice framework
A practice framework is based on a range of knowledge, values and skills that provide a
foundation for practice. Frameworks guide practice and make it purposeful, helping the
practitioner to make judgements and decisions about how to undertake the work (Chenoweth &
McAuliffe, 2012).
Professional integrity
‘The social work profession values honesty, transparency, reliability, empathy, reflective selfawareness, discernment, competence and commitment (AASW, 2010, p. 13).
Reflective practice
‘Reflection is the process of learning from experience. It involves the process of questioning the
foundation of one’s beliefs with a preparedness to change them in the light of questioning’ (Fook,
2013, p. 3).
Reflexive practice
‘Reflexivity is an acknowledgement of how our self plays a role in the knowledge that we
recognise and develop; in short, how we see the world, others and our place in relation to it and
them. Being reflexive involves the ability to factor this knowledge into how professional decisions
are made and acted upon’ (Fook, 2013, p. 3).
Respect for persons
‘The social work profession holds that every human being has a unique and inherent equal worth
and that each person has a right to wellbeing, self-fulfulment and self-determination, consistent
with the rights and culture of others and a sustainable environment’ (AASW, 2010, p. 12).
Social justice
‘Social justice refers to the concept of a society in which justice is achieved in every aspect of
society, rather than merely through the administration of law. It is generally considered as a
social world that affords individuals and groups fair treatment, equality and an impartial share of
the benefits of membership of society (Ife, 2010, p. 148).
Theories, perspectives and Models
‘Theories are ways of viewing the world and explaining how objects, peoples and situations
work’ (Howe, 2009, p. 171).
‘A perspective is a particular way of looking at the world, a conceptual lens through which a
person views human behaviour and social structure’ (Chenoweth & McAuliffe, 2012, p. 115).
‘A model is a descriptive way of showing the relationship between numbers of elements. Models
are often used to outline practice approaches such as crisis intervention or task-centred
intervention’ (Chenoweth & McAuliffe, 2012, p. 114).
Use of Self
‘The use of self in social work practice is the combining of knowledge, values, and skills gained in
social work education with aspects of one’s personal self, including personality traits, belief
systems, life experiences, and cultural heritage’ (Walters, n.d.).
Values
‘Professional values are a particular grouping and ordering of values within a professional
context. In social work such values tend to focus on human functioning, capabilities and
development’ (Congress, 2010, p. 19).
University Liaison Feedback form
Social Work Field Placement University Liaison Feedback form
Course Code
(please tick one):  Bachelor of Social Work Field Placement 1 (3112HSV_Y2)
 Bachelor of Social Work Field Placement 2 (4112HSV_Y2)
 Master of Social Work Field Placement 1 (7134HSV_Y2)
 Master of Social Work Field Placement 2 (7144HSV_Y2)
DATE OF VISIT
VISIT NO.
PLACEMENT WEEK
Student
Field Supervisor/s
University Liaison
Organisation
Team/Program
LEARNING PLAN
VISIT 1
The University Liaison will have reviewed the Learning Plan and provided
constructive verbal or written feedback to the student during Liaison Visit
No. 1. Please provide general comments about the Learning Plan below.
VISIT 2
Is the Learning Plan being utilised as a working document? Please provide
general comments about any new learning goals set since the first visit and
any specific learning strategies set from the mid placement evaluation.
PRACTICE REFLECTIONS
VISIT
1&2
The Student should be submitting Practice Reflections to their Field
Supervisor for discussion in supervision each week. Please provide general
comments about the Practice Reflections.
SUPERVISION
VISIT
1&2
The Student should be engaged in 1.5 hours of supervision for every 5 days
of placement. Please provide general comments about the supervision
relationship frequency and type (e.g. individual and/or group).
GENERAL DISCUSSION ON THE PLACEMENT EXPERIENCE
VISIT 1
Feedback from Student and Field Supervisor regarding beginnings,
relationships, workload, key learning experiences and key challenges to
date.
VISIT 2
Feedback from Student and Field Supervisor regarding relationships,
workload, key learning experiences to date, strengths and challenges, and
the Mid Placement Evaluation experience.
ISSUES/CONCERNS
Please return to the Field Placement Convenor within 1 week of the visit.
Bachelor of Social Work: (3112HSV_Y2 and 4112HSV_Y2):
Dr Phyllis Chee
Bachelor of Social Work Field Placement Convenor, Logan campus
Email: p.chee@griffith.edu.au
T: (07) 3382 1484
F: (07) 3382 1210
Ms Janis Parrish
Bachelor of Social Work Field Placement Convenor, Gold Coast campus
Email: j.parrish@griffith.edu.au
T: (07) 5552 8090
F: (07) 5552 8562
Master of Social Work: (7134HSV_Y2 and 7144HSV_Y2):
Ms Melanie Hemy
Master of Social Work Field Placement Convenor, External
Email: m.hemy@griffith.edu.au
T: (07) 3382 1195
F: (07) 3382 1210
Dr Jeanette Neden
Director of Field Education and Field Placement Convenor, Gold Coast campus
Email: j.neden@griffith.edu.au
T: (07) 5552 7877
F: (07) 5552 8562
LEARNING PLAN: LEARNING CATEGORY 1 - THE SOCIAL WORK ROLE
Goals
Objectives
Tasks and Methods to
achieve the objectives
Evidence &
Evaluations
Time frame
LEARNING PLAN: LEARNING CATEGORY 2 - ETHICS AND VALUES
Goals
Objectives
Tasks and Methods to
achieve the objectives
Evidence &
Evaluations
Time frame
LEARNING PLAN: LEARNING CATEGORY 3 - ORGANISATIONAL PROCESSES
Goals
Objectives
Tasks and Methods to
achieve the objectives
Evidence &
Evaluations
Time frame
LEARNING PLAN: LEARNING CATEGORY 4 - SOCIAL WORK PROCESSES
Goals
Objectives
Tasks and Methods to
achieve the objectives
Evidence &
Evaluations
Time frame
LEARNING PLAN: LEARNING CATEGORY 5 - STUDENT LEARNING AND PROFESSIONAL DEVELOPMENT
Goals
Objectives
Tasks and Methods to
achieve the objectives
Evidence &
Evaluations
Time frame
PROCESS RECORDING
Process Recording Outline
The following paragraphs provide an explanation of each item that appears in section II of the process recoding outline.
INTERVIEW CONTENT: Record in this section, using a dialogue format, significant ongoing exchanges that you thought were important in your
interaction with the client(s).
DESCRIBE CLIENTS FEELINGS/AFFECT: Record how you perceived the client(s) was feeling moment-to-moment as the activity or verbal
interchange was taking place.
DESCRIBE YOUR GUT LEVEL FEELINGS: Record how you were feeling as the activity or verbal interchange was taking place. Do not use this
column to analyze the client’s reactions –use it to identify and look at your feelings. Be as open and honest as you can and don’t worry about having to
use any special professional language-tell it as you feel it.
WHAT INTERVIEWING SKILLS DID YOU USE DURING THIS INTERACTION: Label the interviewing skills you used in your interaction with the
client(s) (e.g. exploration, summarization, clarification, etc) Draw on skills learnt in counseling and interpersonal skills courses.
SUPERVISORY COMMENTS: The supervisor will use this section to provide written commentary and feedback on your interactions with the client(s)
in order to help you move towards greater proficiency in your knowledge, skills, and planning.
PROCESS RECORDING OUTLINE
Student's Name:_____________________________ Client's Initials:________________________________ Interview Date:___/___/____
Session#:_________
Clients Age:__________________________________ Date Submitted:___/___/___
Date Reviewed
Clients Ethnicity:______________________________ Date Supervision: ___/___/___
I.
PURPOSE OF THE SESSION: (Clearly state the goals and objectives you had in meeting with this client this session.)
II.
Interview Log:
INTERVIEW CONTENT
(may also include Client
Behavior - i.e. non-verbal
communication)
DESCRIBE CLIENTS
FEELINGS/AFFECT
DESCRIBE YOUR GUT
LEVEL FEELINGS
WHAT INTERVIEWING SKILLS DID
YOU USE DURING THIS
INTERACTION?
SUPERVISORY
COMMENTS
*Refer to first page for category instructions
35
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