This document provides guidelines for referring learners to counseling. It outlines behaviors that may indicate a need for counseling like poor performance, lack of interest, isolation, or signs of depression. It instructs teachers to inform the learner and parents about observed behaviors and suggest counseling. The learner's consent is preferred but not required if their behavior endangers themselves or others. A referral form is included to track the status of the case like whether counseling sessions are ongoing or completed.
This document provides guidelines for referring learners to counseling. It outlines behaviors that may indicate a need for counseling like poor performance, lack of interest, isolation, or signs of depression. It instructs teachers to inform the learner and parents about observed behaviors and suggest counseling. The learner's consent is preferred but not required if their behavior endangers themselves or others. A referral form is included to track the status of the case like whether counseling sessions are ongoing or completed.
This document provides guidelines for referring learners to counseling. It outlines behaviors that may indicate a need for counseling like poor performance, lack of interest, isolation, or signs of depression. It instructs teachers to inform the learner and parents about observed behaviors and suggest counseling. The learner's consent is preferred but not required if their behavior endangers themselves or others. A referral form is included to track the status of the case like whether counseling sessions are ongoing or completed.
A. Name of Student: B. A. CHECK THE LEARNER’S BEHAVIORS THAT INDICATE THE Grade & Level : NEED FOR HELP Gender: A student who may need Date of Referral: counseling would likely manifest Reasons for Referral: the following behaviors: Talks aloud and distracts others in class Initial Actions Taken: Is often late or absent Performs very poorly in both oral and written exams Did the student agree to be referred to GCO: ____YES ____NO Shows lack of interest and Parent/Guardian’s Name: motivation in his or her studies Isolates himself or herself from the Parent/Guardian’s Contact Number: group Referred by: Seems to be perpetually tired, Designation: ANNEX F anxious, depressed, irritable, Contact Number: angry, etc. Fails to submit work on time Manifests deterioration in grooming or hygiene COUNSELING REFERRAL Shows signs of dramatic weight ACKNOWLEDGEMENT FORM loss or gain, etc. Talks about SUICIDE To: (Referring Person / Unit) Designation/Department: C. B. TALK TO THE LEARNER ABOUT THE NEED TO SEEK This is to confirm that PROFESSIONAL HELP ___________________________whom you referred to us If you observe any of the above on_________________________had started his/her session on behaviors, here's how to proceed: _____________________ and is being attended Inform the learner and/or the by________________________________________________. parent regarding the behavioral Kindly refer to the checklist below on the status of the case at hand. patterns that you have observed in □ Closed at Intake Interview a professional and confidential manner. □ For Counseling Listen to the person's situation. □ Counseling Sessions are on-going Suggest to the learner (and □ Parent/Guardian Conference Conducted parents) that they may consider □ Sessions Completed / Case Terminated availing of the counseling services □ Student did not show up provided by the GCO for free. □ Under Monitoring Respect the person being referred. □ Number of follow-ups made by the Counselor: ______ A learner has the option to refuse a □ Referred to ___________________________________________ referral. However, if his or her behavior Thank you. endangers one's well-being and Always for the welfare of students, those of others, it is our utmost ______________________________ responsibility to provide such help to the learner without necessarily Attending Guidance Counselor getting his or her consent. Date: