University College London Doctoral Course in Clinical Psychology
Supervisor's feedback form for
a part- placement
PART A:
Name of Trainee:
Overall rating of placement progress
Name of Supervisor(s):
Placement:
Brief description of area of clinical work being supervised:
Evaluation of placement
Placement rating
PASS
REFER TO EXAMINATION BOARD
Signature of Supervisor:
Date:
Signature of Trainee:
General Comments of Supervisor
(use additional sheet if necessary)
General Comments of Trainee (use additional sheet if necessary)
PART B
Report of progress in specific areas of work
Supervisors should use this section to highlight any specific areas which would benefit
from detailed comment.
The section headings are taken from the supervisor’s feedback form for the ‘End of
Placement’ Review. Please refer to this form if more guidance is needed.
1) Capacity to engage clients and to form a working relationship
2) Capacity to undertake assessments
3) Capacity to formulate
4) Capacity to implement psychological interventions
5) Capacity to evaluate
6) Personal-professional skills
7) Capacity for communication
8) “Service-delivery” – working with the organisation and with service users
9) Capacity to use supervision
Skills in psychometric assessment
Supervisor’s comments (please use additional sheet if necessary)