Department of Counseling & Student Affairs
Clinical Mental Health / Marriage, Couple, & Family
Practicum Evaluation of Student Performance
Student’s Name
Term & Year
Site Supervisor
Dates of Evaluation
Faculty Supervisor
Directions: At mid-term and the conclusion of each semester, please rate the student on the following skills
and abilities according to the following scale:
(1) Unsatisfactory, did not meet expectations
(2) Below expectations for training level
(3) Satisfactory; meets expectations for training level
(4) Above expectations for training level
(5) Outstanding for training level
(NA) Insufficient contact to judge
Standards
and Skills
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2
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4
5
NA
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Uses vocal tone that communicates caring and connection
with the client.
Uses verbal (e.g., uh huh, okay, right, yes) and nonverbal
(e.g., nods and body gestures) to let the client know s/he is
heard. Uses silence helpfully to encourage client to talk
Stays on topic client presents. Repeats key words or phrases.
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Selectively attends to key aspects of client’s communication.
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Notices nonverbal language and gestures.
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Uses statements (e.g., describe… tell me more about…, say
more about…, etc.) that direct the client to talk about the
specific aspects of his/her communication.
Uses statements to selectively attend to expressed emotions.
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Uses statements to identify emotion implied in client’s
statements, demonstrates empathy to generate reflections
Engages in brief, accurate, & clear rephrasing of content
expressed by client.
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CMHC B.1
MCFC B.1
Demonstrates the ability to apply and adhere to ethical and
legal standards in clinical mental health counseling.
Openly receives and uses supervisory and peer feedback. Is
aware of when personal concerns and emotional responses
influence counseling.
CMHC D. 9 Demonstrates the ability to recognize his or her own
MCFC D.6 limitations as a counselor and seeks supervision or refers
clients when appropriate.
CACREP Core Uses self-care strategies appropriate to the counselor role
G. 1.
Maintains open, relaxed, attentive, confident posture. Leans
forward when talking as appropriate. Wears professional
attire.
Maintains appropriate eye contact.
Standards
and Skills
Makes statements at key moments in the session that capture
the overall sense of what the client has been expressing
(includes both content and affect discussed over time).
Makes statements describing here-and-now feeling and
experience of the client and/or the counselor.
Expresses observations of discrepancies between non verbals
and verbals, plans and behavior, desires and actions, etc.
Identifies more overarching patterns of client acting, thinking,
or behaving that may be related to the problem (“In ______
situations, you regularly do _____ [or think______ or feel
_____] which seems to lead to _____________ which causes
you problems.")
Uses questions to explore meanings; and uses
statements to highlight key meaning and value words of the
client.
Clearly demonstrates the application of a counseling theory
and uses skills and conceptualizations consistent with that
theory.
Identifies and directs exploration of client themes; remains
focused on important issues and sets effective counseling
goals.
Uses therapeutic confrontation effectively; recognizes and
resists manipulation by the client.
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NA
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Comments and suggestions about the student’s progress (i.e., strengths, areas for growth)
Recommended Grade
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B
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Site Supervisor Signature
Date
Faculty Supervisor Signature
Date
Incomplete
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My signature indicates that I have read the above report and have discussed the content with my site supervisor. It
does not necessarily indicate that I agree with the report in part or in whole.
Student Counselor Signature
Practicum Evaluation of Student Performance
Date
Revised 1/2015