SCHOOL OF PSYCHOLOGY & COUNSELING
SITE SUPERVISOR LIVE OBSERVATION EVALUATION
SCHOOL COUNSELING MAJOR
Name of Student:
Name of Supervisor:
_____________________________________________
_____________________________________________
Practicum/Internship Site:
_____________________________________________
Semester:
_____________________________________________
Day and Time of Observation:
___________________________________
How does the counseling student do the following therapy with children/students? Please be
thorough and specific with examples.
1.
Establish Rapport:
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
2.
Effectively manage the child/student’s discussion or contracted topics:
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
3.
How aware is the counseling student of the child/student’s problems/concerns?
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
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4.
How well can the counseling student track the child/student’s report of
problems/concerns and flow of information?
_________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
__________________________________________________________________________
5.
How does the counseling student manage the child/student’s presenting problems and
willingness/unwillingness to engage in the counseling contact?
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
6.
How well does the counseling student manage their own personal values and limits
within the counseling interaction?
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
7.
How does the counseling student problem solve with the child/student to effect
change?
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
8.
Is the counseling student able to conceptualize the child/student’s problems effectively?
________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
*Use extra paper wherever necessary.
Supervisor Signature: ______________________________
Date: _______________________________
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