PRE-DOCTORAL INTERNSHIP
IN PSYCHOLOGY
HANDBOOK
SANTE CENTER FOR HEALING
&
THE UNIVERSITY OF TEXAS AT
ARLINGTON
PSYCHOLOGY CONSORTIUM
(SCUTAPC)
2010-2011
2
Introduction to SCUTAPC
The Santé Center – University of Texas at Arlington Psychology Consortium
(SCUTAPC) is a pre-doctoral internship program offering a variety of professional
training experiences to support doctoral students in their transition to professional
psychologists. The goal of training is to produce psychologists who possess the requisite
knowledge and skills to work in a variety of professional settings.
THE UNIVERSITY OF TEXAS AT ARLINGTON - COUNSELING SERVICES
The University of Texas at Arlington enrolls approximately 33,000 students, who pursue
more than 180 bachelors, masters, and doctoral degrees within 10 colleges and schools.
UT Arlington is a diverse campus, with 53% of students being of Hispanic, African
American, Asian American, Native American or International origin. U.S. News and
World Report recently named UT Arlington in the top 10 percent of the 200 national
universities listed in its 2008 report card on racial diversity.
UT Arlington Counseling Services falls within the purview of Academic Affairs. “The
mission of Counseling Services is to foster students' personal, academic, and career
development by providing counseling, outreach, and consultation services that facilitate
personal adjustment and growth, prevent distress, and help remediate problems.” Our
goal is to provide professional counseling services to help students maintain emotional
well-being necessary to achieve personal, academic and life goals. We work with
students who can benefit from short-term therapy, as well as those who require longerterm services. Some issues may require treatment and/or monitoring that is beyond the
scope of what our office can accommodate. In these cases, referrals to appropriate
campus and community resources are provided.
Counseling Services’ staff includes a multidisciplinary team of 7 mental health
professionals, including licensed psychologists, counselors, marriage and family
therapists and social workers. A variety of theoretical perspectives are represented
among the staff.
Services are available for students with a variety of concerns ranging from adjustment
issues to more serious mental health concerns. Students are seen by appointment or on
a walk-in basis. Counseling Services also provides crisis management on a walk-in
basis during business hours.
Some typical concerns for which students seek assistance include:
 dealing with stress and adjusting to college
 depression
 maintaining long-term relationships with friends and family
 anxiety
 understanding sexuality
 difficulty expressing feelings
 career planning
 balancing school, work and relationships
 improving self-esteem
 grief and loss
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trauma and abuse
eating disorders and body image
substance use/abuse
issues of cultural identity
international student concerns
SANTE CENTER FOR HEALING
Santé Center for Healing, a 46-bed inpatient facility, is situated on a hilltop on 14 acres
of rolling hills in Argyle, Texas, approximately 30 miles north of Dallas/Fort Worth. Santé
Center offers treatment and rehabilitation for those suffering from drug abuse and
addiction, eating disorders and complex behavioral health issues. Individuals who have
lost hope because of drug or alcohol addiction can find treatment and recovery at Santé.
Patients at Santé receive a spectrum of addiction treatment addressing the whole
person-- mind, body and emotions. Whether residential or outpatient rehabilitation, the
Santé staff are dedicated to the creation of a clinical treatment atmosphere needed to
work with all drug abuse and addiction issues.
The Mission of Santé Center for Healing is to address addictive behaviors and
associated conditions with an integrated addiction treatment model, drawing from
traditional and innovative approaches. Our services are open to individuals and families
who seek recovery from addictive behaviors, with a focus on treating the addicted
professional. We provide treatment with integrity, promoting wellness for the patient,
family and public in a safe and pleasant setting.
Santé Center provides an interdisciplinary approach to treatment, including psychiatry,
psychology, and counseling. Clients' treatment plans are individualized, and may include
individual psychotherapy, group therapy, and couple/family therapy. Additionally, the
following may be included in a patients’ treatment plan:
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Medical detox (as needed)
Treatment based on 12-step recovery principles
Focus on family of origin, trauma and co-occurring disorders
Therapist-led group sessions
Psycho educational lectures
Non-denominational spirituality groups
Psychodramas
Experiential therapies including:
 high and low ropes course
 equine assisted therapy
 art therapy
 music therapy
 Daily 12-step meetings
 Mirror imaging
 Yoga
 EMDR and neurobiofeedback
 Massage therapy
 Emphasis on relapse prevention
 Aftercare planning
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The basic drug abuse and addiction treatment design uses a traditional 12-step recovery
program as well as motivational enhancement therapeutic techniques, stress reduction
techniques, cognitive behavioral therapies, and spirituality components. For patients with
severe trauma and other difficulties, dialectical behavioral therapy and modified
assignments are designed to offer the patient a sense of success while they are learning
basic recovery skills.
Santé Center for Healing provides recovery support for a diverse population of adult
men and women who are struggling with addictive disorders. In addition, Santé Center
has earned a national reputation for treating the impaired professional since opening in
1996. The impaired professionals program specializes in treating health professionals,
executives, attorneys, physicians, nurses, dentists, pharmacists, and pilots.
Training Model and Philosophy
The training model for the pre-doctoral internship in psychology at SCUTAPC is a
Practitioner-Scholar model (Korman, 1973; McHolland, 1992). An important goal of this
model is to produce professional psychologists who value critical thinking and
incorporate theory and research into clinical practice. Psychologists are encouraged to
remain open to diverse ways of understanding, value the “practical application of
scholarly knowledge” (Rodolfa, Kaslow, Stewart, Keilin & Baker, 2005, p. 26), and
integrate individual, cultural and societal factors into clinical conceptualizations.
Practitioners are trained to become critical consumers of research, rather than
emphasizing the production of research and to value the knowledge gained from clinical
practice (Rodolfa, et al, 2005). In the practitioner-scholar model, science and practice
are seen as mutual and interactive.
Considering the Consortium training sites and goals, the internship training team has
identified the practitioner-scholar framework as an appropriate model of training.
Throughout the training year, interns will be encouraged to integrate self-awareness and
critical thinking skills into clinical practice. Interns will be encouraged to participate in
broadly-defined scholarly activities, such as participating in formal didactic trainings,
utilizing professional literature to supplement training and inform clinical work, integrating
research into case presentations, and actively seeking supervision and consultation
from a variety of professionals. Personal and professional growth during internship will
also be emphasized.
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Goals of the Program
The general objectives of SCUTAPC are:
 To provide pre-doctoral psychology students with an intensive, practice-oriented
year of training that will prepare them to function effectively and ethically within
an entry-level position in professional psychology.
 To expose interns to a wide variety of clients and modalities in which
psychologists can practice, and to enhance their ability to be self-directing with
respect to areas of interest, and to the selection of training experiences that will
further those interests.
 To produce new professionals who think like experienced psychologists, who are
problem solvers, and who can deliver psychological services in a flexible, selfaware, ethical, and culturally sensitive manner.
With these overall objectives in mind, SCUTAPC internship program has established the
following specific training goals:
1) Exposing interns to a broad range of clinical interventions as relevant to the
populations at each site. In particular, interns will gain knowledge and skills for
working with (a) dual-diagnosis and addictive disorders and (b) a highly diverse
university student population.
2) Producing graduates who are sensitive to multicultural issues including but not
limited to; race/ethnicity, age, gender, social class, sexual orientation, religious
preferences and physical and mental disabilities.
3) Instruct and supervise interns in a wide array of methods of assessment,
diagnosis and intervention procedures using several different theoretical models.
4) Preparing interns to work in multi-disciplinary settings.
5) Facilitate interns’ personal growth and foster their level of responsibility and
autonomy in providing psychological services.
6) Increase the interns’ knowledge and handling of legal, ethical, and professional
issues involved in the practice of professional psychology.
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Expectations of Interns
Interns are expected to give their full attention to this program while they are engaged in
it. Although fully supported by our professional staff in every aspect of treatment, interns
are expected to progressively learn to treat each client as if they had the sole
responsibility of an independent practitioner in clinical and counseling work. They are to
provide the thoughtful, considerate, polite, and ethical care necessary to help the clients
cope with the difficulties they are facing.
We expect interns to gain proficiency in the following competencies:
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intermediate to advanced skills in making accurate diagnosis
intermediate to advanced skills in providing counseling and psychotherapy
the development of treatment plans
advanced skills in clinical interviewing
the evaluation of suicidal lethality
the evaluation of malingering
the use and integration of psychological assessment as available
making recommendations that follow from clear evaluations of data
an understanding of the various roles of a psychologist within a multidisciplinary
setting
10) an understanding of the need to effectively collaborate with other professionals
whenever one is required to act at the boundaries of one’s competence
Leadership and Administration
Adria Villarreal, Ph.D. (Counseling Psychology, UTA)
Dr. Villarreal is the Consortium Internship Director and a supervising licensed
psychologist in Texas. Dr. Villarreal earned her degree in Counseling Psychology from
Texas Woman´s University and completed her pre-doctoral internship training at the
University of Missouri - Columbia Counseling Center. She has 7 years of experience in
college counseling and mental health settings and has served two years as Assistant
Director of Counseling Services at the University of Texas at Arlington. Her areas of
interest and expertise include providing individual and group therapy to college students
struggling with a variety of mental health and adjustment issues, including depression,
anxiety, grief and loss, and relationship issues. Areas of particular interest include
trauma recovery, supervision and training, and gender and diversity issues in mental
health.
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Sylva D. Frock, Ph.D. (Counseling Psychology, Santé Center)
Dr. Frock is licensed psychologist in Texas and will serve as the supervising
psychologist at Santé Center. Dr. Frock earned her degree in Counseling Psychology
from Texas Woman's University, and completed her pre-doctoral internship training at
the Texas Woman's University Counseling Center. Prior to joining Santé Center, Dr.
Frock worked at UT-Southwestern Medical Center at the North Texas VA Hospital, and
then spent several years providing psychology services for seniors in long-term care
along with maintaining a private practice. Dr. Frock has long-standing interests in the
treatment of addictions as well as GLBT issues. She joined Santé in 2009.
Vickie Goins, Ph.D. (Counseling Psychology, UTA)
Dr. Goins is a licensed psychologist in Texas and will serve as a supervising
psychologist at UTA Counseling Services. Dr. Goins earned her degree in Counseling
Psychology from Texas Woman’s University and completed her pre-doctoral internship
training at the Texas Woman’s University Counseling Center. She has been employed at
the University of Texas at Arlington Counseling Services for two years, currently serving
as Outreach Coordinator. Prior to joining UTA she was the Director of Victim Outreach
Services for a non-profit community agency that provided services for victims of
domestic violence and sexual assault. Dr. Goins also has several years of experience
working with domestic violence offenders. Her particular areas of interest include
relationship violence, gender socialization, eating disorders, and family of origin issues
Daniel Tomczyk, Ph.D. (Clinical Psychology, Santé Center)
Dr. Tomczyk is a licensed psychologist in the state of Texas. He earned his degree in
Clinical Psychology from the University of North Texas, and did his pre-doctoral
internship training at the Dwight D. Eisenhower Veteran’s Affairs Hospital in
Leavenworth, Kansas. There he helped in the development of the Psychiatric and
Addiction Recovery Treatment (PART) program, which is the only co-occurring disorder
treatment program offered in the Veteran’s Affairs Hospital system. He completed his
Postdoctoral Fellowship in neuropsychological assessment and Geriatric Psychology.
Dr. Tomczyk has specialized training in the treatment of survivors of traumatic
experiences, including childhood abuse/neglect, sexual assault, military combat,
domestic violence, natural disasters, and grief/bereavement. Other areas of
specialization include psychological and neuropsychological assessment, personality
disorders, substance abuse, anxiety-related disorders, and depression. Prior to joining
Santé Center, Dr. Tomczyk worked in private practice conducting psychotherapy,
neuropsychological assessment, and treating seniors in long-term care facilities
Dennis Wade, MS, FACHE (Chief Executive Officer, Santé Center)
Mr. Wade has been leading Santé Center for Healing since 1999. Wade came to Santé
Center for Healing with over twenty years experience in healthcare, eighteen of which
have been in healthcare administration. He has over 11 years experience at the Chief
Executive Officer level in psychiatric and addictions hospitals. Mr. Wade is a Fellow with
the American College of Healthcare Executives. He has a B.A. from Hanover College,
Hanover, Indiana, and a M.S. from George Williams College, Downers Grove, Illinois.
Mr. Wade began his career in healthcare at Mercy Center for Healthcare Services in
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Aurora, Illinois, where he was Program Coordinator of the Nelson Adolescent Program.
From there, he moved to South Bend, Indiana, where he helped open Charter Hospital
of South Bend. He was instrumental in designing, implementing, and administrating the
clinical programming. Mr. Wade eventually served as CEO of that hospital. After
leaving Charter Hospital, he moved to Dallas, Texas, where he became the
Administrator of Green Oaks Hospital at Medical City Dallas and served on the Senior
Management Team of Medical City Dallas Hospital.
Ronald Arrington, MS, LCDC (Clinical Director, Santé Center)
Mr. Arrington came to Santé from Tucson, Arizona, with 30 years of experience.
Licensed as a chemical dependency counselor and certified as a level II EMDR and
Equine Therapist. Ron holds a Bachelors Degree in Philosophy and Comparative
Theology and a Master’s of Science Degree in Addiction Studies from the University of
Arizona. Ron worked for Sierra Tucson for a number of years as a therapist and in
management. He also consulted with Sierra Tucson and Miraval and facilitated week
long intensives incorporating both equine and ropes course experiences. Ron had the
privilege of being past Executive Director of NCSAC (SASH), and hosted the “Addictions
and Answers” radio show. Ron moved from Tucson to head the Outpatient Services
Program and after Rip Corley’s retirement Ron became the Clinical Director. He helped
facilitate Santé Center Community Based Services and Intensive Outpatient program.
Cynthia Bing, LPC, NCC (Director of Counseling Services, UTA)
Cynthia Bing is the Director of Counseling Services at the University of Texas at
Arlington. She is a licensed professional counselor (LPC), LPC-supervisor and a
nationally certified counselor (NCC). She has 15 years experience in college counseling
and 7 years experience coordinating services to meet the developmental and
psychological needs of college students. Her areas of interest include a variety of mental
health and adjustment issues including anxiety, depression, self esteem and family of
origin issues. Cynthia received a Bachelor of Science degree in Psychology from Florida
State University and a Masters degree in Counselor Education from St. Louis University.
She also currently serves on the Executive Board for the American College Counseling
Association.
The Internship Training Program
The internship training year commences the Tuesday after Labor Day each year and
concludes on the last Friday of August each year. Full-time interns are paid a stipend of
$25,000 for the internship year. They are awarded 5 sick days per year and 10 days of
paid time off (vacation) following their 90-day probationary period. Interns have six
holidays (New Year’s Day, Memorial Day, Independence Day, Thanksgiving Day,
Christmas Eve Day, and Christmas Day). They receive health, dental, and life insurance
benefits as determined by the Santé Center’s Human Resources Department. As fulltime, salaried professional employees, interns are expected to work 40 hours per week.
Full-time interns are typically expected to spend at least 20 hours per week face to face
contact with clients across the two consortium sites, and the remaining hours in
internship related activities, including clinical paperwork, report writing, supervision, and
didactic seminars.
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The internship at SCUTAPC is a 2000 hour structured training program that allows
interns to function with increasing independence as the training year progresses, while
providing being provided intensive supervision and didactic experiences throughout.
A sample training week is displayed below as an example of what a typical week might
entail:
SANTÉ CENTER – THE UNIVERSITY OF TEXAS AT ARLINGTON
PSYCHOLOGY CONSORTIUM SAMPLE TRAINING WEEK
MONDAY
(SANTÉ)
TUESDAY
(UTA)
WEDNESDAY
(SANTÉ)
THURSDAY
(SANTÉ)
FRIDAY
(UTA)
8:00
CASE
MANAGEMENT
CASE
MANAGEMENT
DISSERTATION
GROUP
SUPERVISION
STAFF
DEVELOPMENT
9:00
DIRECT SERVICE
CASE
MANAGEMENT
DISSERTATION
CLINICAL
STAFFING
STAFF
DEVELOPMENT
10:00
DIRECT SERVICE
DIRECT SERVICE
DIRECT SERVICE
CLINICAL
STAFFING
SUPERVISION
11:00
DIRECT SERVICE
DIRECT SERVICE
DIRECT SERVICE
CLINICAL
STAFFING
DIRECT SERVICE
NOON
LUNCH
LUNCH
LUNCH
LUNCH
LUNCH
1:00
SUPERVISION
ADMINISTRATIVE
TIME
DIRECT SERVICE
DIRECT SERVICE
DIRECT SERVICE
2:00
DIRECT SERVICE
DIRECT SERVICE
DIRECT SERVICE
DIRECT SERVICE
ADMINISTRATIVE
TIME
3:00
DIRECT SERVICE
DISSERTATION
DIRECT SERVICE
DIRECT SERVICE
DIRECT SERVICE
4:00
ADMINISTRATIVE
TIME
DISSERTATION
DIRECT SERVICE
DIRECT SERVICE
DIRECT SERVICE
Supervision and Didactics
The consortium will provide one hour of face-to-face supervision per week on each of
the two sites, for a total of two hours per week of face-to-face individual supervision for
each intern by a psychologist licensed in Texas. Supervision by other mental health
professionals may also be a part of the intern’s training but interns will still receive two
hours per week of face-to-face supervision with a licensed psychologist.
Supervision includes clinical, professional, and scientific aspects. Clinical aspects of
supervision include a review of client progress, discussion of client status, discussion of
therapeutic techniques and interventions, diversity issues, review of case and
consultation notes and treatment plans, and any ethical or assessment issues.
Interns receive the equivalent of two hours of didactic training on site for every week
they are present in the internship. This training may occur via a 2-hour weekly seminar
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or via longer workshop formats. Training will cover crisis intervention, suicidality,
substance abuse, trauma, differential diagnosis, diversity issues, Axis II disorders,
motivational interviewing skills, group therapy, psychopharmacology, career counseling,
theoretical perspectives, and evidenced based practice and other issues.
It is expected that interns will audio/videotape client sessions, with appropriate
permission by the client. Supervision will include regular review and feedback from
supervisors on therapy sessions. Interns will also be expected to present cases, both
formally and informally, throughout the year.
Psychological Evaluation Experience
UT Arlington Counseling Services routinely provides experience using career
assessments, in particular the Strong Interest Inventory (SII) and the Myers-Briggs Type
Indicator (MBTI). Mental health screening measures such as the Beck Depression
Inventory, the Beck Anxiety Inventory, and the EAT-26 are also commonly used.
Santé Center routinely offers opportunities to administer assessments focused on
addiction, clinical diagnosis, intellectual functioning and personality. Assessments
include the Substance Abuse Subtle Screening Inventory – 3 (SASSI – 3), Beck
Depression Inventory, Beck Anxiety Inventory, Kalishman, Shipley 2, Rorschach, Millon
Clinical Multiaxial Inventory – II (MCMI – 2), Minnesota Multiphasic Personality Inventory
– II (MMPI – 2), and the Personality Assessment Inventory (PAI).
Intervention Experience
Interns will be primarily involved in individual psychotherapy, with some opportunities for
couples work. Crisis intervention and short-term counseling are typical, however, many
clients are seen longer-term when needed. There are not session limits imposed by UT
Arlington Counseling Services at this time. Psycho-educational groups and workshops
on topics related to assertiveness, healthy relationships, and grief and loss may be
available, as well as process groups focusing on developing interpersonal skills.
Supervisors work from a variety of theoretical perspectives (e.g. interpersonal/
psychodynamic, cognitive-behavioral, family systems, and feminist). Interns can expect
to work with a highly diverse population of students, given the demographic composition
of the university.
In-house and across campus, outreach activities will be a component of interns’ work.
UT Arlington Counseling Services routinely provides outreach to the campus community
on topics including suicide prevention, mental health and wellness, stress management,
career exploration, and LGBT awareness. Liaison responsibilities to Greek Life,
Athletics, International Office, Multicultural Affairs, the Relationship Violence & Sexual
Assault Office, and Residence Life are likely to occur in the context of outreach or
counseling.
At Santé Center, interns will provide individual and group therapy working with a variety
of patients with addictive disorders, both substances and process, such as gambling,
spending, sex, and food addictions. Interns will also provide on-call coverage, with
appropriate supervision, on a rotating schedule. Some common interventions used are
individual and group therapy, experiential therapies, family therapy,
psychopharmaceutical, EMDR, and motivational interviewing.
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Intern Resources
Interns at UT Arlington Counseling Services will be provided with individual offices, a
computer and email/internet access. The Counseling Services office also provides a
kitchen, conference/group room, fax, printers, and all basic office supplies. UT Arlington
Counseling Services operates a state-of-the-art scheduling system (Titanium). Audio
and video equipment are available for supervision of therapy work. In addition, interns
will have library privileges and access to the Maverick Activities Center, which is an onsite recreation center.
Santé will provide the interns with individual offices that are equipped with a telephone,
printer, personal computer with internet access, email, Microsoft Office software,
electronic medical records, and general office supplies needed to complete assigned
duties. In addition they will have access to various meeting rooms throughout the facility
used for group sessions. Audio and/or video equipment is available for supervision
purposes.
Feedback to Interns
The program has multiple methods for providing feedback to interns. At the beginning of
the training year, interns are given copies of all the relevant policies that address their
rights and the processes by which they will be evaluated. Interns will set goals in
conjunction with their training supervisors. Feedback is given in weekly supervision, in
both individual and group formats. In addition, during orientation interns are given copies
of the forms by which they will be evaluated at mid-year and at the end of the internship
year. Interns will also be introduced to the forms by which they give feedback to their
supervisors and the site overall.
Problem Performance and Intern Grievance Procedures
SCUTAPC will abide by progressive discipline policies established at Santé Center for
Healing and policies and procedures outlined by the Consortium specifically for
internship year.
Progressive Discipline
It is the policy of SCUTAPC to treat all interns equitably and to administer all policies and
procedures consistently. When an intern’s performance is unsatisfactory or the policies
or procedures are violated, corrective action to address the offense may be taken.
Generally corrective action is administered in a progressive disciplinary fashion which
normally would involve the following order: verbal warning, written warning (with
remediation), and dismissal from internship. Sometimes, misconduct by an intern may
be serious enough that steps in the disciplinary process may be dispensed with and the
intern would be immediately terminated. Misconduct will be investigated in each
instance, and the proper disciplinary step will be applied.
Below is a list of violations which includes the type of inappropriate behaviors and
conduct that may result in disciplinary action up to and including termination of an intern.
This list should not be viewed as all inclusive. Additionally, the training committee
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reserves the right to impose disciplinary action up to and including termination of the
intern for other inappropriate or dangerous actions.
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Excessive Absenteeism/Tardiness
Failure to report for work or failure to call in to report absences for 3
consecutive work days
Bringing prohibited contraband to work including but not limited to
weapons, alcohol, illegal drugs, or sexually explicit material
Failure to complete required training in a timely manner
Sleeping on the job
Misuse of company property
Failure to follow policies and procedures
Insubordination either intentionally or implied by actions or words spoken
Unsatisfactory performance on the job
Using tobacco products on the job or smelling of tobacco while at work
Working under the influence of drugs or alcohol
Positive Drug Test or failure to cooperate with drug testing procedures
Harassment
Endangering the lives of patients or other staff members
Fighting or threatening co-workers or patients
Falsifying records including but not limited to employment records,
timesheets, or patient records
Theft of company property
Breach of confidentiality
Identifying Problem Performance
Any staff member or peer who experiences concern about any aspect of an intern’s
behavior is expected to discuss that concern directly with the intern and to inform the
Consortium Internship Director about the discussion.
Any time that any significant concern about an intern’s progress or behavior is brought to
the attention of the Consortium Internship Director, the importance of this concern and
the need for related action will be assessed by the Internship training staff.
Definition of Problem Performance
Interns make significant developmental transitions during the internship placement
period. Part of the training process involves the identification of growth and/or problem
areas for the intern. A problem is defined as a behavior, attitude, or other characteristics
which, while of concern and requiring remediation, is not excessive or outside the
domain of behaviors for professionals in training. Problems are typically amenable to
management procedures or amelioration.
While it is a professional judgment as to when an intern’s behavior becomes problematic
rather than of concern, problematic behavior can be broadly defined as interference in
professional functioning that is reflected in one or more of the following ways:
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An inability and or unwillingness to acquire and integrate professional standards
into one’s repertoire of professional behaviors.
An inability to acquire professional skills in order to reach an acceptable level of
competency.
An inability to control personal stress, psychological dysfunction, and/or strong
emotional reactions.
More specifically, problems will typically become identified if they include one or more of
the following characteristics:
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The intern does not acknowledge, understand, or address the problem when it is
identified.
The problem is not merely a reflection of a skill deficit that can be rectified by
academic or didactic training.
The quality of services delivered by the intern is seriously impacted and not at an
acceptable level.
The problem is not restricted to one area of professional functioning.
A disproportionate amount of attention by training staff is required.
The intern’s behavior does not change as a function of feedback, remediation
efforts, and/or time.
Remediation
In the event that it is assessed that remedial action is necessary, the intern will be asked
to meet with the Internship training staff in order to discuss the concern and to reach an
agreement as to what action should be taken. The intern may invite a colleague to
attend this meeting in an advocacy role for the intern. The outcome will be a “Remedial
Action Plan,” which summarizes the concerns that exist and outlines the remedial steps
that the intern must take.
The purpose of the Remedial Action Plan is to provide the intern with a clear written
statement of what behaviors are deemed problematic and to facilitate the intern’s ability
to make the desired changes. The need to protect client and agency welfare will be
incorporated into this plan when these issues are relevant to the problematic behavior.
Examples of potential components of a Remedial Action Plan are:
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The intern is required to more responsibly attend to professional duties such
as completion of case notes, or attending scheduled client and supervision
sessions regularly and on time.
The intern is provided with additional supervision time, or the format and focus of
supervision is modified in order to facilitate the development of therapeutic skills.
The intern is required to complete additional readings, courses, or to attend
relevant workshops in order to supplement knowledge in deficient areas.
Increased monitoring of the intern’s performance is instituted by measures such
as additional review of case notes and therapy tapes by the primary supervisor
and/or other designated senior staff.
The intern is required to obtain therapy in order to address personal issues that
are seen as interfering with his/her professional development or behavior.
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If it is determined that the welfare of the intern and/or clients have been seriously
jeopardized, the intern’s ability to see clients may be significantly reduced or suspended
for a specified period. This will be documented in the Remediation Action Plan.
The Remedial Action Plan will be put into writing, signed by all parties to the Remedial
Action Plan, with copies going to (a) the intern, (b) the Consortium Internship Director,
(c) the TWU Director of Training of the Doctoral Program in Counseling Psychology, or
other home program doctoral director, and (d) any additional training staff member
directly involved in the remediation.
The internship training staff will meet with the intern and the primary supervisor at a
designated time after the development of the plan to assess compliance with the plan
and progress in the program. Failure to adhere to the plan or to make sufficient progress
in the designated behaviors of concern will be evaluated for appropriate consequences
and/or the need for modification of the plan.
Dismissal
In cases involving severe violations of the APA Code of Ethics, where imminent harm to
clients is a salient concern, where there is a preponderance of unprofessional behavior,
or lack of change in behaviors for which a trainee has been placed on remediation,
dismissal may be recommended. In such cases, this decision will be made by the entire
training staff and subject to approval by the Internship Consortium Director. The intern
will be notified immediately and will be provided with a copy of the documentation and
informed of grievance and appeal procedures. Dismissal means that the intern would be
terminated from employment payment and the training program. In the latter case, the
agency will make recommendations to the home program regarding further remediation
and/or a career shift.
If the intern is in disagreement with any aspect of the remedial action or dismissal
procedures, she/he may utilize designated intern grievance procedures. The intern may
grieve the validity of concerns that have been raised, the requirements of a Remedial
Action Plan, and/or the process used during the remediation procedure.
Grievance Procedures
SCUTAPC believes in promoting a work environment in which all interns are treated
fairly and with respect by co-workers and members of the management and training
committee. At any time during the year, an intern may take issue with a staff member
regarding a particular behavior or pattern of behaviors, or with entire staff regarding
policy or procedure. It is expected that the complainant will take the concern directly to
the persons(s) with whom they take issue and that the parties will work to resolve the
concern in a manner satisfactory to both. Any intern has the right to express her or his
opinions or concerns over the interpretation or application of policies and procedures.
The grievant shall be allowed access to any documentation pertaining to the grievance
plus any other documentation held by the agency as a part of the personnel or payroll
records.
SCUTAPC Psychology Internship Handbook 2010-2011
15
Every reasonable effort to respond to concerns in a timely fashion will be made. Should
extenuating circumstances such as vacation, illness, work related travel or other
unforeseen circumstances prevent this from happening the intern will be notified.
Steps for Filing a Grievance
Step 1 - The intern shall request a meeting with his/her immediate supervisor for the
purpose of resolving the grievance.
Step 2 - If the grievance is not resolved at Step 1 to the intern’s satisfaction, or the
grievance is against the intern’s supervisor and he/she is not comfortable in discussing
the issue with his/her supervisor, the Internship Consortium Director will meet with both
parties to provide mediation and resolution of the problem. The internship training
committee will also be notified of the situation. If the Internship Consortium Director is
the party with whom the intern has an issue, the Administrator of the other site will meet
with both parties to provide mediation and resolution. The intern may invite another staff
member to the meeting to serve in an advocacy role, or to present information
supporting the intern.
Step 3 - Should the grievance not be resolved in Step 2, the intern may request a
hearing by a “Grievance Committee,” composed of two internship training staff
members and one other colleague chosen by the intern be assembled, which is charged
with hearing the evidence and considering both sides of the issue. This committee will,
in a timely fashion (not to exceed 30 days), gather information regarding the grievance,
inform the intern of its findings, and offer recommendations to the Internship Consortium
Director and the internship training committee. The decision of the grievance committee
shall be binding.
Eligibility for Application
Two interns are offered positions at SCUTAPC each year. To be considered for the
internship program, applicants must have completed all coursework with the exception of
dissertation in a Clinical Psychology or Counseling Psychology doctoral program, with a
minimum of 800 practicum hours (at least 350 of which should be face-to-face
assessment and intervention hours). Applicants from the Texas Woman’s University
Counseling Psychology program are strongly preferred, though individuals from other
programs will be considered. Applicants from APA-accredited programs are strongly
preferred.
Each application is initially reviewed by the Consortium Internship Director. Applications
that meet the minimum requirements specified above are rank ordered by the internship
training team based on a number of factors. These factors include the breadth and
relevance of the candidate’s clinical training experiences; the perceived “fit” between the
candidate’s stated training goals and priorities and the experiences that SCUTAPC has
to offer; and the contributions that the applicant might make to the organization.
SCUTAPC Psychology Internship Handbook 2010-2011
16
Following the review and ranking of application materials as described above, the
candidates with the highest rankings are invited in for face-to-face interviews. Applicants
will be notified by e-mail on or before December 15, as to whether they have been
selected to come in for an interview. Interviews are held early in January.
The interview schedule includes a general overview presented to all applicants, and a
consistent set of questions that all intern applicants will be asked to address. Applicants
will meet and speak with all members of the training team. Opportunities for a question
and answer period will be provided. Interns will have separate interviews at UT Arlington
Counseling Services and at Santé Center for Healing. Following both sets of interviews,
the training team will convene a meeting either in-person or via teleconference to
determine final rankings and offers.
Application Procedures
All applicants will be using the APPIC On-Line application for all materials starting
July, 2009. The SCUTAPC requires all sections of the AAPI form (AAPI Part I, and AAPI
Part II – DCT Verification), including:
1. A cover letter indicating preferred training emphasis and goals
2. Curriculum vitae
3. Official graduate school transcripts from all graduate schools attended
4. Essays
5. Three letters of recommendation (only 3, do not include a 4th letter).
This internship site adheres to all APPIC Match policies and procedures, and agrees to
abide by the APPIC policy that no person at this training facility will solicit, accept, or use
any ranking-related information from any intern applicant. Please visit the APPIC web
site for additional information about policies and procedures: www.appic.org
SCUTAPC Psychology Internship Handbook 2010-2011
17
APPENDICES
1. Intern Evaluation Form
2. Site-Supervisor Evaluation Form
3. Internship Log Form
SCUTAPC Psychology Internship Handbook 2010-2011
18
SCUTAPC INTERNSHIP PROGRAM
INTERN EVALUATION FORM
Name of Intern:
__________________________________________
Name of Evaluator(s): __________________________________________
__________________________________________
__________________________________________
Evaluation Period:
__________________________________________
******************************************************************************
RATING INSTRUCTIONS
For Each Specific Competency:
Place one of the following marks on the line to the left of each task listed on the following
pages:
5
4
3
2
1
N/A
The intern consistently performs this task or demonstrates this skill in a
satisfactory manner.
The intern usually performs this task or demonstrates this skill in a satisfactory
manner.
The intern occasionally performs this task or demonstrates this skill in a
satisfactory manner.
The intern rarely performs this task or demonstrates this skill in a satisfactory
manner.
The intern has not performed this task or demonstrated this skill in a satisfactory
manner.
The evaluator has not observed the intern's performance of this task/skill.
For Overall Levels of Performance in Each Domain:
Average the ratings of independent performance in each MAJOR DOMAIN. Any domain or
sub-domain (indicated by capital letters) in which an overall rating of 3.5 or below occurs will
be cause for remedial action. Please note that this numerical criterion is not the sole
mechanism by which remediation may be needed or may occur.
Final Summary and Comments:
A final written summary and domain comments are to be filled out by the supervisor. These
will be reviewed with the intern on an individual basis, and the intern will have the
opportunity to respond.
SCUTAPC Psychology Internship Handbook 2010-2011
19
INDIVIDUAL THERAPY SKILLS
&
COUPLE/FAMILY THERAPY SKILLS
Ind
co/fa
A.
THEORY/CONCEPTUALIZATION
Basic Tasks in Theory/Conceptualization
___
___
1.
Draws upon several different theories in conceptualizations
___
___
2.
Develops relevant and useful hypotheses regarding cases
___
___
3.
Formulates appropriate plans for achieving goals
___
___
4.
Identifies culturally relevant client information as a component of case
conceptualizations.
___
___
5.
Recognizes when clients are not making progress
___
___
6.
Conceptualizes lack of client progress in useful manner
___
___
7.
Conceptualizes termination issues in a meaningful manner
Ability to independently perform
Basic Tasks in Theory/Conceptualization (Average)
___
____
ind
co/fa
Advanced Tasks in Theory/Conceptualization
___
___
1.
Demonstrates ability to consolidate and articulate own theoretical framework
___
___
2.
Demonstrates ability to integrate information from a variety of sources (e.g.,
theory, client-therapist process, client verbal content, client nonverbal
behavior, formal assessment, client history) into meaningful
conceptualizations
___
___
3.
Demonstrates ability to conceptualize long-range goals which are desirable,
but not appropriate for current therapeutic work
___
___
4.
Demonstrates flexibility in shifting to potentially more appropriate
conceptualizations
___
5.
Conceptualizes couple/family therapy in terms of interactive process
Ability to independently perform
Advanced Tasks in Theory/Conceptualization (Average)
SCUTAPC Psychology Internship Handbook 2010-2011
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____
ind
co/fa
20
B.
THERAPEUTIC PERSPECTIVE
Basic Tasks in Therapeutic Perspective
___
___
1.
Maintains appropriate interest, optimism, and enthusiasm
___
___
2.
Shows genuine concern for clients while retaining objectivity
___
___
3.
Demonstrates an awareness of one's own motivations, values and issues and
their potential impact on the therapy process
Ability to independently perform
Basic Tasks in Therapeutic Perspective (Average)
___
____
ind
co/fa
Advanced Tasks in Therapeutic Perspective
___
___
1.
Demonstrates an awareness of the overall process of therapy
___
___
2.
Demonstrates comfort with intense client affect
___
___
3.
Demonstrates an awareness of the realistic limits and possibilities of
psychological interventions
Ability to independently perform
Advanced Tasks in Therapeutic Perspective (Average)
C.
___
___
ind
co/fa
RELATIONSHIP AWARENESS
Basic Tasks in Relationship Awareness
___
___
1.
Establishes and maintains facilitative therapeutic relationships
___
___
2.
Communicates nonjudgmental acceptance of clients
___
___
3.
Listens carefully and communicates accurate empathy
___
___
4.
Maintains emotional presence with clients
___
___
5.
Attends to relationship issues within termination process
___
6.
Establishes and maintains effective relationships with co-therapists
Ability to independently perform
Basic Tasks in Relationship Awareness (Average)
___ ____
ind
SCUTAPC Psychology Internship Handbook 2010-2011
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21
Advanced Tasks in Relationship Awareness
___
___
1.
Demonstrates awareness of client-therapist dynamics
___
___
2.
Demonstrates awareness of and ability to utilize own emotional responses to
clients
___
___
3.
Demonstrates competence in addressing salient diversity issues in the
therapeutic relationship
___
___
4.
Understands and uses therapeutic power constructively
___
___
5.
Serves as an appropriate role model with clients
Ability to independently perform
Advanced Tasks in Relationship Awareness (Average)
___ ____
ind
D.
INTERVENTION SKILLS
Basic Tasks in Intervention Skills
___
___
1.
Employs basic interviewing skills including initiating and terminating the
session
___
___
2.
Demonstrates ability to work with both content and feelings from clients
___
___
3.
Demonstrates ability to assist clients in their decision-making processes
___
___
4.
Confronts clients in a direct, yet respectful manner when appropriate
___
___
5.
Appropriately provides support to clients
___
___
6.
Appropriately provides information to clients
___
___
7.
Appropriately provides interpretations to clients
___
___
8.
Uses silence effectively
___
___
9.
Encourages clients to be specific
___
___
10.
Uses language appropriate for clients, avoiding technical and belittling
language
SCUTAPC Psychology Internship Handbook 2010-2011
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22
___
___
11.
Demonstrates ability to use nonverbal and vocal behavior which facilitates the
therapeutic process
Ability to independently perform
Basic Tasks in Intervention Skills (Average)
___ ____
ind
co/fa
Advanced Tasks in Intervention Skills
___
___
1.
Integrates assessment, theory, and intervention
___
___
2.
Matches therapeutic techniques to client concerns and dynamics
___
___
3.
Demonstrates knowledge of when to focus cognitively, affectively, or
behaviorally with clients
___
___
4.
Incorporates culturally relevant client information into treatment
___
___
5.
Demonstrates ability to time interventions effectively
___
___
6.
Effectively uses client-therapist relationship in change process
___
___
7.
Demonstrates creativity in therapeutic work
___
___
8.
Discloses own experiences, feelings, and/or values in a therapeutic manner
___
___
9.
Intervenes constructively in response to lack of client progress
___
___
10.
Demonstrates flexibility in shifting to potentially more effective interventions
___
___
11.
Demonstrates ability to help clients access deep affect
___
___
12.
Uses immediacy appropriately in client interactions
___
___
13.
Uses humor appropriately
___
14.
Intervenes with couples/families at the interactive level
Ability to independently perform
Advanced Tasks in Intervention Skills (Average)
___ ____
ind
E.
MANAGEMENT OF THERAPY CONTRACT
Basic Tasks in Management of Therapy Contract
___
___
1.
Clarifies own and clients' expectations of therapy
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23
___
___
2.
Involves clients in developing short-range therapeutic goals
___
___
3.
Periodically reviews with clients the progress toward established goals
___
___
4.
Discusses therapy progress and clients' plans for future as part of termination
process
Ability to independently perform
Tasks in Management of Therapy Contract (Average)
F.
___
____
ind
co/fa
___
____
ind
co/fa
___
____
ind
co/fa
CASE MANAGEMENT
Basic Tasks in Case Management
___
___
1.
Recommends appropriate adjunct services to clients
___
___
2.
Demonstrates awareness of and appropriately utilizes resources
Ability to independently perform
Basic Tasks in Case Management (Average)
Advanced Tasks in Case Management
___
___
1.
Makes appropriate decisions regarding whether and when case
review/consultation is necessary and/or desirable
___
___
2.
Demonstrates working knowledge of psychotropic medication, makes
appropriate medication referrals
___
___
3.
Communicates with professionals outside of SCUTAPC in a timely and
appropriate manner
Ability to independently perform
Advanced Tasks in Case Management (Average)
SUMMARY FOR INDIVIDUAL THERAPY SKILLS
Theory/Conceptualization
BASIC TASKS
ADVANCED TASKS
_____
_____
SCUTAPC Psychology Internship Handbook 2010-2011
24
Therapeutic Perspective
_____
_____
Relationship Awareness
_____
_____
Intervention Skills
_____
_____
Management of Therapy Contract
_____
NA
Case Management
_____
_____
AVERAGE RATINGS
_____
_____
Comments on Individual Therapy Skills:
SUMMARY FOR COUPLE/FAMILY THERAPY SKILLS:
BASIC TASKS
ADVANCED TASKS
Theory/Conceptualization
_____
_____
Therapeutic Perspective
_____
_____
Relationship Awareness
_____
_____
Intervention Skills
_____
_____
Management of Therapy Contract
_____
_____
Case Management
_____
_____
AVERAGE RATINGS
_____
_____
Comments on Couple/Family Therapy Skills:
SCUTAPC Psychology Internship Handbook 2010-2011
25
CRISIS INTERVENTION SKILLS
Basic Tasks in Crisis Intervention
___
1.
Appropriately assesses magnitude of client crisis
___
2.
Appropriately assesses client suicidality
___
3.
Appropriately seeks consultation in crisis situations
___
4.
Provides effective crisis intervention to primary client
Ability to independently perform Basic Tasks in Crisis Intervention (Average)
_____
Advanced Tasks in Crisis Intervention
___
1.
Demonstrates understanding of the differences between crisis intervention and
individual therapy
___
2.
Demonstrates ability to handle own affect in crisis situations
___
3.
Provides effective crisis consultation to concerned others
___
4.
Provides appropriate follow-up after crisis contacts
Ability to independently perform Advanced Tasks in Crisis Intervention
(Average)
_____
OVERALL LEVEL OF PROGRESS on CRISIS INTERVENTION SKILLS
_____
Comments on Crisis Intervention Skills:
USE OF SUPERVISION
Basic Tasks in Use of Supervision
___
1.
Arrives promptly for supervision sessions
___
2.
Is prepared for supervision sessions with tapes and/or specific agenda items
SCUTAPC Psychology Internship Handbook 2010-2011
26
___
3.
Works cooperatively with supervisor to maintain weekly contact (i.e., reschedules as
necessary)
___
4.
Demonstrates a willingness to share her/his work with supervisors and other staff
(through tapes, observation, and case presentations)
___
5.
Is receptive to different perspectives and/or alternative conceptualizations
___
6.
Is receptive to experimenting with new or less familiar interventions
___
7.
Demonstrates an openness to feedback regarding clinical skills
___
8.
Demonstrates an openness to feedback regarding interpersonal behavior
___
9.
Demonstrates a willingness to explore and reflect upon personal issues (as raised by
supervisor) that may limit effectiveness in his/her professional work
Ability to independently perform Basic Tasks in Use of Supervision (Average)
_____
Advanced Tasks in Use of Supervision
___
1.
Recognizes and initiates discussion of personal issues as they impact clinical work
___
2.
Demonstrates ongoing attention to previously identified issues during the
supervisory process
___
3.
Recognizes and is willing to discuss diversity issues within the supervisory
relationship
___
4.
Identifies and attends constructively to supervisory relationship dynamics
Ability to independently perform Advanced Tasks in Use of Supervision
(Average)
_____
OVERALL LEVEL OF PROGRESS on USE OF SUPERVISION
_____
Comments on Use of Supervision:
SCUTAPC Psychology Internship Handbook 2010-2011
27
INTAKE ASSESSMENT SKILLS
Basic Tasks in Intake Assessment
___
1.
Appropriately labels intake information by source, e.g., counselor's hypotheses vs.
client's reports
___
2.
Provides behavioral observations on Intake Report or QCC
___
3.
Insures that other forms/information are obtained and/or provided, e.g., A/V release,
scheduling next appointment, wait list recommendation
___
4.
Obtains second opinion when necessary, e.g., brings another counselor into intake
session and/or discusses disposition decision with supervisor, Director, or Case
Review staff
___
5.
Makes appropriate referrals to outside agencies/service providers
Ability to independently perform Basic Tasks in Intake Assessment (Average)
_____
Advanced Tasks in Intake Assessment
___
1.
Completes majority of intakes in a timely fashion
___
2.
Judges appropriate length of time necessary for intake interview, when it deviates
from the norm
___
3.
Demonstrates ability to form preliminary case conceptualizations of intake clients
___
4.
Considers diagnostic factors other than psychological, e.g., organic, environmental,
sociopolitical
___
5.
Makes intake recommendations that are consistent with interview data
Ability to independently perform Advanced Tasks in Intake Assessment
(Average)
_____
OVERALL LEVEL OF PROGRESS on INTAKE ASSESSMENT
_____
Comments on Intake Assessment Skills:
SCUTAPC Psychology Internship Handbook 2010-2011
28
GROUP THERAPY SKILLS
___
1.
Conducts pre-group preparation that sets treatment expectations, defines group rules,
and instructs members in appropriate roles and skills needed for effective group
participation and group cohesion.
___
2.
If group composition is not pre-determined, balances intrapersonal and interpersonal
factors in making decisions regarding who is selected to participate.
___
3.
Is aware of the stages of group development and tailors/times interventions
accordingly.
___
4.
Plans, coordinates, and debriefs with co-leader (if co-leading the group).
___
5.
Facilitates group members' emotional expression, the responsiveness of others to
that expression, and the shared meaning derived from such expression.
___
6.
Monitors boundaries in the group so that members experience the group as a safe
place for their therapeutic work.
___
7.
Models caring, management of own emotional processes, and judicious selfdisclosure.
___
8.
Understands the unique confidentiality concerns raised by group therapy and
actively addresses these with group members as a matter of ongoing informed
consent.
___
9.
Understands and attends to the differing needs of psycho-educational,
process/therapy, open-ended, and time-limited groups.
OVERALL LEVEL OF PROGRESS on GROUP THERAPY SKILLS
Comments on Group Therapy Skills:
OUTREACH & CONSULTATION SKILLS
A. OUTREACH
_____ 1. Plans and coordinates outreach activities effectively
_____ 2. Clearly articulates concepts to be presented
_____ 3. Material presented has research/empirical support
SCUTAPC Psychology Internship Handbook 2010-2011
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29
_____ 4. Effectively communicates in the outreach environment
_____ 5. Demonstrates evaluation strategies to assess if learning objectives have been met
B. CONSULTATION & INTERDISCIPLINARY SYSTEMS
_____ 1. Ability to recognize situations in which consultation is appropriate
_____ 2. Demonstrates ability to gather information necessary to answer referral question
_____ 3. Ability to prepare useful consultation reports and communicate recommendations in a
clear and precise manner to all appropriate parties given the context of service provision
_____ 4. Demonstrates ability to work successfully on interdisciplinary team to incorporate
psychological information into overall team planning and implementation
_____ 5. Appreciates and integrates perspectives from multiple professions
OVERALL LEVEL OF PROGRESS on OUTREACH &
CONSULTATION SKILLS
______
Comments on Outreach/Consultation Skills:
ASSESSMENT
_____ 1. Collects accurate and relevant data from multiple sources
_____ 2. Uses assessment data to develop appropriate treatment plan
_____ 3. Selection of assessment tools reflects a flexible approach to answering the diagnostic questions
_____ 4. Independently selects assessment tools that reflect awareness of patient population
served at practice site
_____ 5. Awareness of and ability to use culturally sensitive instruments
_____ 6. Ability to write a comprehensive report
_____ 7. Limitations of assessment data clearly reflected in assessment reports
_____ 8. Ability to communicate results verbally to provide meaningful, understandable and
useful feedback to clients
OVERALL LEVEL OF PROGRESS on ASSESSMENT SKILLS
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30
Comments on Assessment Skills:
***************************
NUMERICAL SUMMARY OF ALL DOMAIN AVERAGES
INDIVIDUAL THERAPY
_____
COUPLE/FAMILY THERAPY
_____
CRISIS INTERVENTION
_____
INTAKE ASSESSMENT
_____
GROUP THERAPY
_____
OUTREACH/CONSULTATION
_____
ASSESSMENT
_____
USE OF SUPERVISION
_____
OVERALL COMMENTS BY SUPERVISOR(S):
SCUTAPC Psychology Internship Handbook 2010-2011
31
INTERN COMMENTS (OPTIONAL):
Supervisor Signature:
__________________________________
Date: ____________
__________________________________
Date: ____________
"I HAVE DISCUSSED THE CONTENTS OF THIS EVALUATION WITH MY
SUPERVISOR(S)."
Intern Signature: ___________________________________________ Date: ___________
(Attach Remediation Form as needed)
Adapted with permission from the Texas Woman’s University Counseling Center
SCUTAPC Psychology Internship Handbook 2010-2011
32
SCUTAPC INTERNSHIP SITE EVALUATION
Intern Name:
Current Date:
Placement Semester/Year:
Instructions: Use the following rating scale to rate SCUTAPC as an internship training site
1
________
unsatisfactory
_2
_
needs improvement
3_____________ 4
adequate
good
5
excellent
1. Agency orientation to administrative processes (e.g., agency’s mission &
policies, required paperwork, etc.)
2. Initial training regarding clinical processes (e.g., clinical populations to serve,
theoretical emphasis, therapeutic options, etc.)
3. Opportunity to work with diverse populations and a variety of client issues
4. Exposure to a variety of theoretical orientations to clinical practice
5. Allowed me to explore a variety of theoretical approaches & interventions
6. Meets individual supervision needs
7. Meets group supervision needs
8. Fosters professional growth (e.g., gain clinical knowledge and skills)
9. Fosters personal growth as counselor (e.g., self-confidence, autonomy, exploration of
personal biases, etc.)
10. Provides guidelines for professional conduct & adherence to ethical standards
11. Staff modeling of professional conduct and ethical standards
12. Treatment of internship students by professional staff
13. Physical work space provided for internship students
14. Emotional climate of agency as a whole
15. Emotional climate of specific workgroup (e.g., group supervision)
16. Equipment adequacy and availability (e.g., videotape recorder)
17. Access to extra consultation regarding client concerns
SCUTAPC Psychology Internship Handbook 2010-2011
33
18. Availability of in-service training throughout internship
Comments:
Adapted with permission from the TWU Department of Psychology and Philosophy
SCUTAPC Psychology Internship Handbook 2010-2011
34
SUPERVISOR EVALUATION
Supervisor Name:
________________________________
Intern Name:
_________________________________
Using the 5-point rating scale below, please rate your supervisor on each of the dimensions listed:
1
______
unsatisfactory
2
______
needs improvement
3
adequate
4 _ _______
5
good
excellent
_______1. Aids in establishing and maintaining the focus of supervision.
_______2. Aids in setting appropriate professional and training goals, tasks, and experiences for
this internship.
_______3. Is dependable (prompt for meeting, consultation).
_______4. Promotes productive use of our supervisory time.
_______5. Values supervision and expresses interest in the process.
_______6. Works at hearing and understanding my concerns; has respect for my opinion and
input.
_______7. Has respect for personal individual differences between supervisor and supervisee.
_______8. Is self-disclosing and shares his/her own experiences, feelings and values.
_______9. Works on establishing a climate of trust.
______10. Works toward conflict resolution between self and supervisee in constructive ways.
______11. Is willing to examine supervisor-supervisee relationship in a non-threatening manner.
______12. Gives continuous and relevant feedback about my strengths in a supportive and well
reasoned manner.
______13. Gives continuous and relevant feedback about my weakness in a supportive and well
reasoned manner.
______14. Gives continuous and relevant feedback about my semester goals.
______15. Interest in my professional and personal growth as a counselor.
______16. Demonstrates awareness of and sensitivity to my professional/developmental level;
fosters an appropriate level of autonomy (i.e. Was not too intrusive or too “handsoff”).
SCUTAPC Psychology Internship Handbook 2010-2011
35
______17. Willingness to allow experimentation with a variety of theoretical approaches and
counseling techniques.
______18. Articulates his/her own theoretical position in a clear, consistent fashion.
______19. Discusses theory and application; facilitates development of my own theoretical
position.
______20. Explores various therapeutic processes and their uses (i.e. Confrontation, support,
timing).
______21. Discusses and supports experimentation with a variety of theory based techniques.
______22. Has knowledge of, uses and recommends appropriate references that help in my
clinical work.
______23. Is knowledgeable about and promotes awareness of ethical issues.
______24. Knows community resources and helps me refer appropriately.
______25. Demonstrates an awareness of the potential impact of human biases (e.g., races, sexrole, class) in the counseling/therapy process and shows an ability to help me
recognize and deal with these biases.
______26. Was accessible for extra consultation and/or emergency supervision.
GLOBAL EVALUATION OF SUPERVISOR
Please summarize your perceptions of your supervisor in the following areas:
A.
Specific Strengths As A Supervisor
SCUTAPC Psychology Internship Handbook 2010-2011
36
B.
Specific Limitations As A Supervisor
C.
Recommendations For Growth As A Supervisor
Supervisor Comments:
______________________________
Supervisee’s Signature
_____________
Date
_______________________________
Supervisor’s Signature
____________
Date
Adapted with permission from the TWU Department of Psychology and Philosophy
SCUTAPC Psychology Internship Handbook 2010-2011
DATE
TOTALS:
SUPERVISOR
INTERN NAME: _____________________________
PLACE
SUPERVISION
ADMINISTRATION
TRAINING
DIRECT SERVICE:
CAREER
DIRECT SERVICE:
PSYCHOEDUCATION
DIRECT SERVICE:
GROUP
DIRECT SERVICE:
FAMILY
DIRECT SERVICE:
COUPLE
DIRECT SERVICE:
INDIVIDUAL
CLIENT’S
DISABILITY (IF ANY)
CLIENT’S SEXUAL
ORIENTATION
CLIENT’S
ETHNICITY
CLIENT’S GENDER
CLIENT’S AGE
CLIENT’S INITIALS
SCUTAPC INTERNSHIP: LOG OF INTERN HOURS
PAGE # ________
TIME SPENT IN ACTIVITY
REMARKS
(PROBLEM TYPE,
INTERVENTION)