3.1d School Psychology Internship Agreement
INTERNSHIP AGREEMENT
School Year
Candidate Name, School Psychologist
School District
To be provided by School District; experiences with:
a. Children of early childhood through high school ages
b. Pupil support services functioning within a team framework
c. Full range of services to support children with handicapping conditions
d. Balanced exposure to regular and special ed support programs
e. Professional supervision and resources:
1) A minimum of one-half day per week of interaction with a supervising school
psychologist who will also be available for consultation by telephone during the week as
needed
2) Release time and for professional development
f. A written contract to specify salary, time requirements, and schedule
g. Participation in evaluation meetings once a semester to include the field supervisor, university
supervisor, and intern
h. Clerical support, mileage reimbursement etc, in accordance with agency procedure
To be provided by Pittsburg State University:
a. Visit the internship site once each semester in order to:
1) Directly observe the intern
2) Receive feedback from the field supervisor and district personnel
3) Relate feedback to the intern
4) Consultation with the University Supervisor as requested by the Intern
To be provided by the Intern in conjunction with the duties included in the employment contract:
1) The Intern will demonstrate knowledge of public school organization and operation by: reviewing
school policy and procedure documents; reviewing special education procedures and become
familiar with steps taken in referral and placement. The primary source for this information will
be the school personnel, the overview of local policy and procedure manuals, the State Plan and
Regulations.
Documentation: Paper documentation of interviews and verification of Field Supervisor.
2) The Intern will demonstrate knowledge of the role and function of the school psychologist
through interview and interaction with school personnel such as superintendent, principals, and
teachers, and review of current publications.
Documentation: Paper documentation of interview, and entries in the activity log.
3) The Intern will document awareness of community resources. The Intern will prepare a
community resource list of service providing agencies. The Intern will prepare a list of consultees
in a variety of education areas.
Documentation: Paper document to be filed with Internship activity log.
4) The Intern will develop communication skills, consultation skills, the ability to engage in
teamwork efforts, and organize and/or participate in the following:
1. Pre-referral meetings
2. Entry on non-qualification staffing
3. IEP annual goal setting
4. Exit from program staffing
5. Behavior consultation
6. Academic consultation
7. 504 meetings and accommodation plans
Documentation: Entries in the Internship activity log.
3.1d School Psychology Internship Agreement
5) The Intern will demonstrate skills in behavioral interventions, and conduct classroom
observations as requested. This is intended to include individualized curriculum adaptations.
Documentation: Paper samples of behavior plans, observations, and curriculum adaptations.
6) The Intern will demonstrate skills in strategies for remediation and intervention by participating
in consultation, pre-assessment, and case conferences.
Documentation: Paper examples in a folio (made anonymous), and activity log entries.
7) The Intern will demonstrate competence in applying research to professional practice.
Documentation: Verification of Field and University Supervisors.
8) The Intern will demonstrate professional growth continued in-service training; participate in inservice and professional development activities as made available by district; join state and
national School Psychology professional organizations; attend state, regional, and national
meetings and conventions as negotiated with the local employer.
Documentation: Paper documentation of activities.
9) The Intern will demonstrate ethical considerations and legal aspects of school psychology by:
reviewing current literature regarding ethical issues and reviewing existing and newly legislated
special education laws.
Documentation: Verification by Field and University Supervisors.
10) The Intern will demonstrate a value of multicultural, ethnic, and gender tolerance in all aspects of
consultation, assessment, and professional practice.
Documentation: Verification of Intern and Field Supervisor.
11) The Intern will maintain daily time log and provide other documentation as necessary to
demonstrate completion of the Internship objectives.
12) The Intern will demonstrate oral and written communication skills in working with Teachers,
Parents, and Administrators. This is to include both written reports and consultations.
Documentation: Examples of documents and verification by Field Supervisor.
13) The Intern will demonstrate skills in individual and group counseling.
Documentation: Entries in the Intern activity log, and verification by the Field Supervisor or cotherapist.
14) The Intern will constructively participate in the evaluation conducted by the University and Field
Supervisors once each semester.
Documentation: Completed evaluations in Internship file.
University Supervisor
Date
Field Supervisor
Date
Intern
Date