COUN 2761: Clinical Capstone Exam

Capstone Paper
Guidelines
The capstone paper is designed to help students and faculty prepare for the capstone oral
exam. Students should approach the case and the paper as the treating counselor and should
plan to provide the counseling intervention that they would use if they were operating as the
primary, independent therapist on this case. Students are encouraged to think comprehensively
across the CMHC curriculum and incorporate knowledge and skills from all counseling courses
into the capstone paper, as appropriate. In addition, students will draw from clinical
experiences and/or relevant literature.

Below is a detailed outline of the capstone paper components. It is important to recognize that
not all prompts are applicable or equally applicable in all cases. Students are expected to
provide more detail in areas that are especially pertinent to the case conceptualization, and less
detail in areas that are not as relevant. For example, if the client is a child, you would need to
expand more on family issues and dynamics, as opposed a case in which your client is an adult
living independently.

The capstone paper should be written as a narrative; do not use bullet points. The paper should
be no longer than 8-10 pages, not including cover page, treatment plan worksheet, and
references. (Faculty will not read past page 10.) It should be double spaced, 1” margins, 12-
point Times New Roman font. Use APA style. Use the provided capstone paper template.

Capstone paper writing should be professional. This may include some writing in first person,
e.g., “I propose a treatment plan that includes three long term goals: …”. However, it’s often
easy to eliminate first person. For example: “The treatment plan includes three long term goals:
…”. (We know you are the writer, it’s implied, so no need to insert yourself into every
sentence.) You want to be objective and professional in your writing, so you want to avoid
writing like: “After thinking about it for a while, I really feel like the best treatment plan would
include three long term goals: …”

Outline
1. Title page
a. Student Name
b. Advisor Name
c. Capstone Case Name
d. Capstone Defense Date
2. Background Information. In 1 page, summarize the client’s identifying information,
presenting issue, and relevant psychosocial and treatment history.
3. Assessment Data
a. Interpret the data as it pertains to developing a treatment plan.

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COUN 2761: Clinical Capstone Exam

b. In addition to the assessment data provided, what two measures or assessment

approaches would you use in this case? Provide a rationale for which measures
you selected.
i. Formal or informal (i.e., structured or unstructured) assessments are
appropriate.
ii. Assessments should be available for use by a practicing counselor.
iii. Assessments should not replicate data you already have; they should be
designed to elicit new data.
4. Case Conceptualization
a. Diagnosis
i. Discuss any potential differential diagnoses.
ii. Provide your provisional diagnosis and the appropriate DSM-5 TR code.
Explain how you reached your diagnosis, how the client's symptoms fit
the diagnostic criteria for the disorder(s), or any possible difficulties in
reaching a diagnosis.
b. Cultural Considerations. Consider the following:
i. What cultural factors does the client bring to the counseling
relationship?
ii. How are these factors significant (e.g., how are they impacting the
client’s mental health, how are they impacting you, how are they
impacting the counseling process, etc.)?
iii. Discuss the potential privileged and oppressed identities of your client
and how these may affect the client, you, the counseling process, etc.
c. Clinical Formulation. Conceptualize the case. Conceptualization should be
informed by one or more relevant theoretical models discussed in your
coursework and clinical experience. Please also be sure to include the identified
precipitant, maladaptive patterns, predisposition(s), protective factors, and
perpetuants.
5. Evidence-Based Practice.
a. Identify and summarize clinical practice guidelines, meta-analysis, or an
empirical review article identifying evidence-based counseling practices. Identify
a recent resource, ideally published within the last 10-15 years.
b. Identify an evidence-based treatment manual, book, or other reference that will
inform your treatment plan. Identify one alternative treatment that was
considered and provide a brief rationale for why one treatment was selected
over the other.
6. Additional Considerations. Identify at least one additional treatment element to
integrate into your treatment plan.
a. One additional treatment element should be something you can provide as the
treating counselor. Examples include case management and coordination of
care, family involvement in treatment, assistive technology, etc.
b. Consider whether any referrals are necessary.

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7. Ethical Issues. Consider ethical considerations including but not limited to roles and
relationships, boundaries, clients’ rights and welfare, honest and responsible conduct,
and confidentiality.
8. Treatment Plan Narrative. Include treatment goals, treatment focus, treatment
strategy, rationale for treatment timeline, and any possible treatment obstacles. (Follow
the format used in and reference materials from COUN 2747: Case Conceptualization.)
9. References
10. Treatment Plan Worksheet. Identify presenting problems and a minimum of two (2)
distal goals supported by at least six (6) appropriate proximal goals (written as
outcomes) that will likely attain the distal goal and resolve the problem(s), as well as
specific treatment methods (methods written as activities or tasks). Include target dates.