Gwinnett County Public Schools
School Counselor Intern Evaluation Form
Date introduced: __________
Interim Review: _________
Final Review: _________
Name of counseling practicum/intern student: _________________________________________________________
Name of Site Supervisor: ___________________________________________________________________________
Name of University Supervisor: ______________________________________________________________________
Scoring Rubric
Not assessed (NA):
Not Demonstrated (ND):
Novice, with support (NWS):
Novice, Independent (N- Indep):
The student has not been introduced to this
standard/disposition at this time in the program or
this standard/disposition has not been assessed.
The student does not demonstrate a basic level of
knowledge, performance or other professional skill on
this standard.
The student demonstrates the basic knowledge and
skill needed to achieve this standard only with
support from others.
The student demonstrates the basic knowledge and
skill needed to achieve this standard through
independent and autonomous planning and action.
Area 1: Professionalism, Advocacy and Leadership
Key: NA – Not assessed, ND – Not Demonstrated, NWS - Novice, with support, N-Indep – Novice, Independent
Guides professional behavior on knowledge, philosophy,
& current trends in school counseling.
Knows roles, functions, settings, and professional
identity of the school counselor in relation to the roles of other
professional and support personnel in the school.
Understands and applies ethical and legal principals in all aspects
of their role as a school counseling intern (i.e. confidentiality, abuse reporting)
Respects the privacy of students, teachers, and parents/guardians and the confidentiality of information.
Presents in a professional manner (i.e. attire, grooming, interactions, punctual)
Exhibits initiative, industry, and effort
Demonstrates organizational skills with priorities and documentation
Uses appropriate verbal/written communication skills.
Complies with system school mandates
Demonstrates use of good judgment
Promotes positive school climate
Interacts effectively with students
Interacts effectively with parents
Interacts effectively with colleagues (teachers, administrators, paraprofessionals)
Interacts effectively with supervisor by asking for supervision when needed and makes appropriate referrals to
school-based & non-school based resources
Accepts and learns from feedback
Demonstrates ability to articulate, model, and advocate for an appropriate school counselor identity and
program
Believes all students can, and supports all student to, learn at high levels
Appreciates and values human diversity
Respects students as individuals with differing personal & family backgrounds with different skills, talents, and
interests
Is sensitive to school, community, and cultural norms
Effectively makes students feel valued for the potential as people and helps them learn to value each other.
Makes students feel valued and helps them learn to value others
Understands the counselor’s role in social justice, advocacy, and conflict resolution
Is culturally self-aware and understands the impact of biases, prejudices, and discrimination on the student’s
academic, life skills and career development
Effectively uses knowledge of culture, advocacy, and social justice to create academic, Life skills, and career
development programs that meet the needs of the diverse population
Interim
Final
Comments
Area 2: Assessment, Program Development & Evaluation
Key: NA – Not assessed, ND – Not Demonstrated, NWS - Novice, with support, N-Indep – Novice, Independent
Assesses student needs to effectively plan, develop, implement, monitor, and evaluate the elements of a
comprehensive developmental counseling program
Understands the needs of individuals at various developmental levels
Uses knowledge of human growth and development to create counseling activities that are appropriate to the
developmental level of students
Understand career development and related life factors
Uses knowledge of career development and related life factors
Understands individual and group approaches to assessment and program evaluation
Effectively evaluates the impact of the school counseling program on student’s
Understands how to use student outcome data in order to facilitate academic, life skills, and career preparedness
success
Effectively uses student outcome data in order to facilitate academic, life skills, and career preparedness success.
Interim
Final
Comments
Area 3: Consultation and Collaboration
Key: NA – Not assessed, ND – Not Demonstrated, NWS - Novice, with support, N-Indep – Novice,
Independent
Understands strategies and methods for working collaboratively
with parents, guardians, families, communities, teachers, administrators,
and other school personnel
Establishes effective working relationship with student/parent/staff
Knows a general framework for understanding and practicing consultation
Effectively structures the discussion
Responds empathetically
Reflects content
Gives encouragement/support
Clearly identifies goals for consultation
Defines and focuses on problem areas
Develops a plan of action or treatment strategy with student/parent/staff
Helps student/parent/staff learn to advocate for self as appropriate
Redirects/refocuses discussion when necessary
Establishes a plan for follow-up
Uses appropriate closure techniques
Evaluates consultation outcome
Interim
Final
Comments
Area 4: Individual Counseling, Small Group and Classroom Guidance
Individual Counseling
Key: NA – Not assessed, ND – Not Demonstrated, NWS - Novice, with
support, N-Indep – Novice, Independent
Understands counseling theories that relate to the school setting
Uses a consistent model to conceptualize student concerns
and selects appropriate counseling interventions.
Effectively defines and structures the session
Establishes/maintains open and honest communication
and atmosphere
Responds empathetically
Uses appropriate questioning techniques
Invites and/or encourages participation during the session
Reflects content
Allows silence when appropriate
Summarizes
Uses appropriate closure techniques
Promotes school success through academic development
Promotes school success through career development
Promotes school success through life skills development
Uses age appropriate activities and materials
Session prepares and promotes the home-to -school,
school-to- school, and school-to-future connections
Uses a variety of activities to achieve session goal(s)
Effectively manages session time
Effectively manages session behavior
Paces the session according to student needs
Facilitates the establishment of norms/clear ground rules
and consequences
Interim
Final
Small Group
Interim
Classroom Guidance
Final
Interim
Final
Overall School Counselor Intern Evaluation
In need of remediation
Novice, with support
Novice, Independent
Please identify three (3) Strengths you believe will help this intern be a successful professional school counselor:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Please identify an area for growth or development which you believe will help this intern be a more successful professional school
counselor:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
________________________________________________
Would you recommend this person to work in Gwinnett County Public Schools?
___ Yes
___ Yes, with reservations
____ I prefer to discuss via phone or in person
Please give any other comments about this intern’s promise as a professional school counselor:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Interim Evaluation
Final Evaluation
_______________________________________ ____
______________________________________________
Interns Signature
Interns Signature
___________________________________________
______________________________________________
Supervisors Signature
Supervisors Signature