GWYNEDD MERCY UNIVERSITY SCHOOL OF GRADUATE AND PROFESSIONAL STUDIES GRADUATE PROGRAM IN SCHOOL COUNSELING SITE SUPERVISOR EVALUATION OF STUDENT INTERN School Counseling Concentration : c Intern Name; Pee, Wer AK Internship Site: _e [Le Pfc a_S gq 2 Oeecacz Intemship Site Supervisor: Mnewn Baba’ Telephone #: 213TH 33 -y S527 Graduate Program Faculty Supervisor: Please rate the inte on the activities and skills listed below by circling the appropriate number. Please use the following scale: 1=Needs improvement and requires close supervision, inctions acceptably with close supervision, 3~Functions acceptable with little supervision, 4-Functions well with little supervision, 5=Functions extremely well and/or independently, NA=Not applicable. Area of Assessment Rating Professional Behavior . ‘© Dresses appropriately 1234G)NA © Comes to site on time 12345)NA © Keeps appointments 12348INA * Acts ina professional manner 12346NA * Has a professional demeanor 12345)NA Educational Setting * Has an adequate understanding of school structure 12346/NA and process . ‘Has an adequate understanding of the counselor role 12345NA and responsibilities + Adhetes to the ethical standards for school counselors. 123 4'NA + Applies the ASCA model in the school 12345/NA ‘* Displays the ASCA counselor competencies 12346)NA Counseling in General . ‘© Establishes rapport 12348NA + Shows empathy and understanding 12345)NA «Is aware of own values and how they relate to 12348)NA students/families counselor is working with Uses good listening skills 12348NA Discusses framework for counseling relationship 12343)NA with student/family (confidentiality, counselor's role, student/family responsibilities, informedconsent, ete.) Accurately reflects student concems Understands and follows professional ethical principles Uses appropriate therapeutic techniques Has worked successfully with students Facilitates appropriate termination Individual Counseling ‘© Understands, predicts behavior and intervenes with students using an appropriate theoretical model Has an adequate understanding of individual dynamics and process Has an adequate understanding and use of individual treatment interventions Interventions with School Children/Adolescents * Understands, predicts behavior and intervenes with students using an appropriate theoretical model © Has an adequate application of family dynamics and process © Has an adequate application of marital dynamics and process «Has an adequate application of appropriate counseling modalities for children/adolescents Has an adequate application of the Crisis Intervention process Group Counseling * Understands, predicts behavior and intervenes using a group counseling approach ‘* Has an adequate understanding of group dynamics and process © Has an adequate understanding and use of group counseling interventions Assessment and Evaluation Student © Adequately assess danger to self or others * Adequately assesses social/emotional/psychological factors in student’s educational achievement ‘Adequately uses assessment as part of the understanding student progress and process Adequately assesses student/family needs Adequately understands the results of assessments 12346NA 12345.NA 12345NA 123 45\NA 12345NA 12343NA 12345NA 1234\5NA 12345)NA 12345NA 12345NA 12345NA 12345NA 12346NA 12345NA 12346)NA 12345NA Adequately selects, administers and interprets master level 123 49 NA paper and pencil assessments‘© Uses classroom observation assessments appropriately © Adequately writes up reports Assessment and Evaluation ASCA Activities « Adequately uses assessment as part of evaluation of self and school counseling program components # Adequately designs, collects and interprets program evaluation assessments © Adequately designs, collects and interprets intervention evaluation assessments © Adequately applies such assessments to improve program and individual performance. Consultation ‘© Adequately consults and collaborates with teachers, administrators, and other school personnel # Adequately consults/works with student’s family © Adequately works with other treatment/educational providers involved with the student * Makes appropriate referrals when required Works well on educational teams (i.e. IEP/S04/IST/ SAPIR¢Lete,) Psycho-educational activi © Adequately develops guidance educational, social, psychological intervention programs # Adequately leads/co-leads guidance educational, social, psychological intervention programs Conduets career counseling activities Conducts college preparation activities Conducts prevention activities Conducts academic success activities Adequately encourages participation in guidance ‘educational, social, psychological intervention programs Case presentations © Adequately presents students/programming and their issues in supervision ‘© Has a good grasp of the students presented Responsiveness to supervision # Ability to assess strengths and weaknesses * Initiates discussion of own behavior and its impact 12343NA 12345NA 12343NA 12345NA 12349NA 12345NA 12345NA 12345NA 12346\NA y 12345NA 12349NA 123.45)NA 12345\NA 12349)NA 12346)NA 123 49NA 12345NA 1234GNA 1234 §)NA 12348NA 12346)NAon students © Can articulate own theory and style 12345)NA # Uses feedback and modifies behavior 12343NA © Recognizes limits of competency and functions 12345NA OVERALL RATING 12345) Pleas provide dina comments nthe following ares / | Intern strengths: he Stays) ny wr hae eer had | She ts [kes Gu An commlor nee Aepctrant Ebel confer Aub & | Gury er a apres Coe | | ‘Areas for growth and improvement: ———™rté—“C*~;™C™CUC—C—C*C™C™C— por elely gicl€ +f mie shin aid beable ty fleccsh I Irae nol enc 4 5,00 b- opne That Shemeds bhp f beget Suggestions for future development: Leadon cbealiy ber bink oF reseres oh th bomber wilt tuls that Ce avails i Whey she bers a Shall be cell uckly , cany tesleand haw bon / Signature ketal Date C Akimen Hs [x |