SCHOOL OF PSYCHOLOGY & COUNSELING
STUDENT SELF-EVALUATION
Midterm OR
Final
Please select the appropriate degree level and mark the course below that best corresponds
with your Approved Degree Plan (ADP).
Doctoral Practicum
CES 770
CES 771
CES 772
Doctoral Internship
CES 801
CES 802
CES 803
The purpose of this evaluation is to help students evaluate their knowledge, values, and skills in a
practicum and/or internship experience to see how effective they are as mental health professionals.
This evaluation also enables students to define what constitutes quality work. From this assessment,
students can independently judge their own work by specific criterion and be more self-directed in
producing superior work. Please provide detailed comments on this form that you think would help to
improve your counseling abilities.
Practicum/Intern Student Name:
_____________________________________________
Practicum/Internship Site:
_____________________________________________
Site Address:
Practicum/Internship Site Supervisor:
_____________________________________________
_____________________________________________
____________________
Rating Scale:
1=
2=
3=
4=
5=
N/A =
Area of strength; continue to work on it
Potential for development; needs further training
Average performance; needs further training
Area of weakness; needs considerable improvement
Major weakness; lack of training and skill
Not applicable
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Date: _____
Please mark the number that you feel best evaluates your performance in practicum/internship.
1. Demonstrates a personal commitment in developing professional competencies.
1
2
3
4
5
N/A
2. Invests time and energy in becoming a counselor with advanced clinical skills.
1
2
3
4
5
N/A
3. Accepts and incorporates constructive criticism to enhance self-development and counseling
skills.
1
2
3
4
5
N/A
4. Engages in open, comfortable, and clear communication with peers and supervisors.
1
2
3
4
5
N/A
5. Recognizes own competencies and skills and shares this with peers and supervisors.
1
2
3
4
5
N/A
6. Recognizes own deficiencies and actively works to overcome them with help of peers and
supervisors.
1
2
3
4
5
N/A
7. Completes any case reports and records punctually and conscientiously.
1
2
3
4
5
N/A
8. Researches the referral prior to the first interview.
1
2
3
4
5
N/A
Counseling Skills:
9. Starts and ends group sessions on time.
1
2
3
4
5
N/A
10. Researches the referral prior to the first interview.
1
2
3
4
5
N/A
11. Begins the group sessions and/or interviews smoothly.
1
2
3
4
5
N/A
12. Keeps appointments on time.
1
2
3
4
5
N/A
13. Explains the nature and objectives of the counseling process to client, student, and/or group
members.
1
2
3
4
5
N/A
14. Communicates interest in and acceptance of the client, student, and/or group members.
1
2
3
4
5
N/A
15. Facilitates client, student, and/or group members’ expression of concerns and feelings.
1
2
3
4
5
N/A
16. Recognizes and resists manipulation by client, student, and/or group members.
1
2
3
4
5
N/A
17. Is spontaneous in the client interview and/or initial group sessions.
1
2
3
4
5
N/A
18. Uses silence effectively.
1
2
3
4
5
N/A
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19. Possesses awareness of own feelings in individual and/or group counseling sessions.
1
2
3
4
5
N/A
20. Self-discloses to client, student, and/or group members when appropriate.
1
2
3
4
5
N/A
21. Recognizes and skillfully interprets client and/or group members’ covert messages.
1
2
3
4
5
N/A
22. Facilitates realistic goal setting and appropriate action step planning with the client, student,
and/or group.
1
2
3
4
5
N/A
23. Employs judgment in the timing and use of different techniques.
1
2
3
4
5
N/A
24. Terminates the individual counseling and/or group sessions smoothly.
1
2
3
4
5
N/A
25. Competent knowledge of computer technology associated with counseling activities.
1
2
3
4
5
N/A
26. Initiates periodic evaluation of goals, action steps, and process during counseling.
1
2
3
4
5
N/A
The following section applies to School Counseling students only.
27. Comfortable in the school environment.
1
2
3
4
5
N/A
28. Effective in classroom/school guidance.
1
2
3
4
5
N/A
29. Communicates with parents in a facilitative manner.
1
2
3
4
5
N/A
ADDITIONAL COMMENTS:
__________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
(Practicum/Intern Student Signature)
(Date)
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