University of Nevada, Reno │ School of Social Work, Field Education Program
“Encounter” Reflection Form
Date: ______________________________
Student: _______________________________________
Description of “encounter” (i.e. one-on-one meeting, facilitation of a group, attending a meeting):
Assessment of personal engagement during encounter (adapted from Jim Kiernan, LCSW):
Think about your own thoughts, physical and emotional presence. What percent of the time during your
encounter was spent in …
PRESENT = ___________%
 Completely engaged with
situation.
 Able to listen attentively.
 Not distracted.
PAST = ______________%
 Thinking about previous
moments (either personal or
related to encounter).
 Drawn back to something.
 Regretting a statement that
you made.
FUTURE = _____________%
 Thinking about future
moments (either personal or
related to encounter).
 Anxious about what to say
next.
 Thinking about resources to
refer a client to or what
strategies you will include in
a plan.
What factors and/or strategies did you employ to assist you with remaining
present?
What factors and/or “triggers” drew you back to the past? Did the client or a
person in the meeting say something that caused you to think to the past?
What factors and/or “triggers” caused you to think about something in the
future?
Thoughts:
Unaccounted =__________%
University of Nevada, Reno │ School of Social Work, Field Education Program
Describe something you said, did, or experienced that you are particularly proud of or excited about. This is
something that seemed to “just work” for you:
Describe something you said, did, or experienced that you found particularly challenging. This is something
that seemed to either throw you off track or left you feeling stumped:
Now that you have thought about this encounter, is there anything that you would do differently? Is there
anything that you would do again?
Did the encounter raise any questions that you would like to pursue?
Did the encounter raise any concerns for you?
Other thoughts: