Concentration Learning Agreement - MSW Field Practicum II and III
6800
6850 [check one or both]
Advanced Social Work Practice with Individuals, Families and Groups
Semester:
Year:
Student Name:
ID#:
Student Address/ City/State/Zip:
Phone (home, cell, work):
E-mail:
Agency Name:
Address/City/State/Zip
Phone:
Fax:
E-mail:
MSW Field Instructor:
Job Title:
Degree:
Year received:
Address/City/State/Zip
Phone:
Fax:
E-mail:
In what department or section will you be based?
Task Supervisor (if different from MSW instructor):
Address/City/State/Zip
Phone:
Fax:
E-mail:
Student’s Faculty advisor:
Practicum Dates: (Begin)
(End)
Is this a 2 semester practicum at the same agency?
Yes
No
Is this practicum being completed in the agency in which the student works as a paid employee?
Yes
No
(If yes, please complete required form)
Signatures:
Student
Date
Faculty Liaison
Date
Practicum Instructor
Date
Office of Field Education
Date
Certificate Option Coordinator Date
(REQUIRED for CERTIFICATE option)
1
SECTION I
Summary of Practicum Experience: Complete the questions below to describe the agency
setting and population.
AGENCY:
What is the mission of the agency?
What services does the agency provide?
What population(s) does the agency serve?
SUMMARY OF STUDENT’S ROLE
What activities will you engage in during the course of your practicum?
A. List your primary responsibilities (e.g. conduct assessments, run groups, organize
community meeting, follow legislation impacting your client population).
B. List the products or deliverables you will create. (e.g., a program evaluation and report, a
grant proposal, organize a conference, develop a program)
SUPERVISION:
What is the day and time of the weekly supervision meetings?
How will you prepare for supervision?
2
SECTION II
Instructions for Completing the Competencies/Practice Behaviors
As part of the Educational Policy and Accreditation Standards (EPAS), the Council on Social Work
Education has identified 10 Core Competencies that social work students are required to meet. Each
EPAS has corresponding Practice Behaviors students must demonstrate as a measure of
competency.
Activity/Task Section
Please identify at least one (no more than three) tasks that demonstrate each Practice Behavior you
list. The tasks should be specific and appropriate to your agency. Ask yourself: What specific
knowledge and skill areas of social work practice will I apply in this setting? What specific
theoretical frameworks will I draw upon? What interventions will I engage in? What type of
recording or documentation will I learn? What product will I create? Because this is a practice
concentration, it is assumed that you will be working with clients or client groups either directly or
through supervising direct practitioners.
Evaluation Section
In the evaluation section select the evaluation method(s) that your field instructor will use to assess
whether or not you have demonstrated the practice behavior.
COMPETENCY 2.1.1 Identify as a professional social worker and conduct oneself
accordingly
Advanced family practice social workers recognize the importance of professional use of self in
relationships, the person-in-environment and strengths perspectives, and adherence to ethical
guidelines and social work values.
Practice Behavior 1:
Understands how own behavior and values affect relationships with clients
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
Able to use social work knowledge and skills in work with clients
Tasks:
3
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 3:
Uses person-in-environment and/or strengths perspectives to guide therapeutic relationships
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 4:
Understands challenges when using social work values and knowledge in multi-disciplinary setting
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 5:
Uses social work professional knowledge and skills to engage clients in problem solving that will
help to restore functioning
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
4
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.2 Apply social work ethical principles to guide professional practice
Advanced family practice social workers are knowledgeable about ethical issues, legal issues and
shifting mores that affect their relationships with clients.
Practice Behavior 1:
Apply ethical decision making skills and frameworks to issues specific to work with individuals,
families and groups
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
Can identify personal biases and understand how to manage these biases
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 3:
Understand ethical issues in the use of technology in clinical practice and use this knowledge to
manage technology to protect clients
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
5
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.3 Apply critical thinking to inform and communicate professional
judgments
Advanced family practice social workers understand and differentiate among multiple theories and
practice methods. They are able to evaluate how theories and methods relate to clients and client
systems within their environmental context. They regularly reflect on their own assumptions and
how those affect practice.
Practice Behavior 1:
Differentiates between several theoretical perspectives and determine which are most appropriate in
working with client/s
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
Keeps professional records
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 3:
Presents professional understanding of clients at team meetings and in other situations in which
social work knowledge is needed
Tasks:
Evaluation:
6
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.4 Engage diversity and difference in practice
Advanced family practice social workers are knowledgeable about many forms of diversity and difference
and how these affect professional relationships and client’s presenting problems. Advanced practitioners
understand how dimensions of diversity affect (a) explanations of illness, (b) help-seeking behaviors, and (c)
healing practices. They understand how clinical practice can be culture bound.
Practice Behavior 1:
Share with colleagues current information about best clinical practices for intervention with diverse
clients
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
Uses practitioner/client differences to identify client strengths
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 3:
Identify the diverse populations residing in the metropolitan region and share information about
how to respond appropriately to those who are experiencing poverty, marginalization, or alienation
Tasks:
7
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.5 Advance human rights and social and economic justice
Advanced family practice social workers understand how economic, social and cultural factors
challenge clients and client systems. They understand the stigma and shame that face many clients
who seek help. They also understand strategies for advancing human rights and social and
economic justice in many contexts.
Practice Behavior 1:
Develop approaches to treatment that take into account client’s difficulties created by social
injustice, particularly in terms of inability to access services
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.6 Engage in research-informed practice and practice-informed research
Advanced family practice social workers are knowledgeable about evidence-based practice
interventions, best practices and the evidence-based research process.
Practice Behavior 1:
Identifies and uses evidences based practices in work with clients
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
Evaluates own practice or that of agency
8
Tasks:

Conduct a research project in conjunction with SW6400.
Evaluation:
Completion of project SW6400; Professor reviews and evaluates project.
COMPETENCY 2.1.7 Apply knowledge of human behavior and the social environment
Advanced family practice social workers understand how to differentially apply theories of human
behavior and the social environment. They are familiar with diagnostic classification systems used
in a comprehensive assessment. They understand how sociocultural contexts influence diagnoses
and practice interventions.
Practice Behavior 1:
Is able to differentiate among theories and determine which are most appropriate for use with
targeted client group
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
Uses bio-psycho-social-spiritual theories and/or multi-axial diagnostic classification systems in
formulation of assessments
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 3:
Understand when to consult with others to confirm diagnoses and/or monitor interventions
Tasks:
9
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.8 Engage in policy practice to advance social and economic well-being
and to deliver effective social work services
Advanced family practice social workers understand the connection between clients, practice and
both public and organizational policy. They understand how legislation, policies, and program
services are developed and funded and are able to advocate for effective policies that promote
social well-being.
Practice Behavior 1:
Will communicate with stakeholders or others the implications of policy and/or policy changes for
clients
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.9 Respond to the contexts that shape practice
Advanced family practice social workers are knowledgeable about how relational, organizational,
and community systems may affect clients. They anticipate and react to evolving cultural,
technological, geographical, political, legal, economic and environmental contexts.
Practice Behavior 1:
Assess clients’ interactions with social contexts to understand how changes in the clients’
environments may affect their ability to engage in and/or use intervention
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
10
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
Work collaboratively with clients or others to plan and/or bring about systemic change
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 3:
Recognizes knowledge, skills and values needed to provide leadership in agency
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
COMPETENCY 2.1.10 Engage, assess, intervene, and evaluate with individuals, families,
groups, organizations and communities (with special emphasis on children, adolescents, and
transitional youth)
Advanced family practice involves the dynamic, interactive and reciprocal processes of
engagement, multidimensional assessment, intervention and practice evaluation at multiple levels.
Advanced practitioners have a theoretically informed knowledge base that allows them to practice
effectively with individuals, families and groups.
Practice Behavior 1:
2.1.10(a) Engagement-Develop a culturally responsive therapeutic relationship with a client within
the context of inter-professional and integrated teams.
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
11
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 2:
2.1.10(a) Engagement- Encourage clients to be equal partners in the establishment of treatment
goals and/or expected outcomes.
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 3:
2.1.10(b) Assessment- Use multi-dimensional assessment tools or approaches to plan interventions
that take into account clients’ coping strategies and willingness to change harmful behaviors,
including violence.
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 4:
2.1.10(b) Assessment- Select and, when appropriate, modify evidence-informed interventions that
are inclusive of families based on continuous assessment of client progress.
Tasks:
Evaluation:
direct observation by:
feedback from colleagues and/or clients
review of written work by:
discussion during supervisory sessions
review of audio/videotapes by:
results of tests/quizzes
other, please specify:
12
Practice Behavior 5:
2.1.10(c) Intervention- Critically evaluate, select and apply best practices and/or evidence-based
practice to children, adolescents, and transitional age youth (and their families) who are at-risk for
developing or who have developed a behavioral health disorder (e.g. mental illness, substance
abuse, or suicidal ideation).
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 6:
2.1.10(c) Intervention- Collaborate with other professionals to coordinate interventions that attempt
to resolve problems holistically (e.g., physical, medical, mental, and family-related) by integrating
behavioral health with primary care.
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
Practice Behavior 7:
2.1.10(d) Evaluation- Apply research skills to evaluate practice focused on children, adolescents,
and transitional age youth and their families that integrates behavioral health with primary care
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
13
Practice Behavior 8:
2.1.10(d) Evaluation- Use practice evaluation to determine best interventions for a range of
behavioral health conditions, specifically those related to children, adolescents, and transitional age
youth and their families.
Tasks:
Evaluation:
☐ direct observation by:
☐ feedback from colleagues and/or clients
☐ review of written work by:
☐ discussion during supervisory sessions
☐ review of audio/videotapes by:
☐ results of tests/quizzes
☐ other, please specify:
14