BEST PRACTICES IN PRACTICUM TRAININGCindy Juntunen & Mike Scheel

2012 CCPTP Midwinter Conference

Miami, FL

Practicum Planning

Identifying Readiness for Practicum Student issues Program issues

Developing Sequential Experiences Student needs Site needs

Documenting the Practicum Plan

Need for Practicum Plan

Licensure issues Students need to maintain and track Helps with AAPI

Demonstrating CoA expectations Broad and General with Specialty Unique Counseling Psychology

placements

Insert prac plan

Competency based assessment Use of the Competency Benchmarks Rating Form1) Three levels of rating: 1) Readiness for practicum 2)

Readiness for internship 3) Readiness for entry to practice

2) UNL practicum sequence: a) pre-prac (1 sem.); b) beginning on-campus clinic (one semester); advanced on-campus clinic (2 semesters); Field placement practicum (2 semesters); Second FP prac (optional; 1 or 2 semesters); supervision practicum (2 semesters)

3) We designate which level to rate. E.g., Readiness for practicum – post-bac doctoral students in on-campus clinic; Readiness for internship – 2nd and 3rd year field placement practicum

Competency Benchmark Rating Scale PROFESSIONALISM

Professional values and attitudesIntegrityDeportmentAccountabilityConcern for the welfare of othersProfessional identity

Individual and cultural diversitySelf as shaped by ind. and cultural diversityOthers as shaped by ind. and cultural diversityInteraction of self and othersApplications

Perceived advantages after two years using competency rating scale Broadens the scope of professional

practice that is evaluated Calls attention to the need to develop

professionalism Integrates science with practice Fosters more communication between

site and program about the professional role and the professional competencies of a psychologist in training.

Professionalism (cont.)

Ethical Legal Standards and PolicyKnowledge of ethical, legal, and professional standards and guidelinesAwareness and application of ethical decision makingEthical conduct

Reflective practice/Self assessment/Self careReflective practiceSelf-assessmentSelf-careParticipation in supervision process

Rate 0 to 4 (never to always)

Core clusters

Professionalism Relational Science Application Education Systems

Application core cluster

Traditionally the application cluster was the chief emphasis of practicum evaluation covering the functions of most traditional practica (e.g., counseling/intervention; assessment)

Application core cluster

APPLICATION Evidence-Based

Practice Knowledge and

Application of Evidence-Based Practice

Assessment Knowledge of

Measurement and Psychometrics

Knowledge of Assessment Methods

Application of Assessment Methods

Diagnosis Conceptualization and

Recommendations Communication of

Assessment Findings Intervention Intervention Planning Skills Intervention

Implementation Progress Evaluation

Strategies for Integrating EBP Supervision/ Class

Developmental change – exploring vs selecting orientation

Role plays with multiple theories

Student presentations on advanced techniques

Intentional site-specific demonstrations

Site Experience Clear

expectations with supervisor

Attending to models endorsed by sites

Outcome based training

Outcome management systems – consistent and continual monitoring of outcome

Patterns of treatment response can be identified

Treatment can be monitored and adjusted“involving the regular monitoring of client

progress in real time to positively influence treatment process and outcome” (p. 235; Lambert & Vermeersch, 2008).

OQ-45 used by Lambert and Vermeersch as an outcome management system

Use the Reliable Change Index (RCI; 14 points) and a normal functioning cutoff score (i.e., 63) derived from the OQ-45.

Use of feedback (a progress graph with a color coded message indicating the status of client progress) and clinical support tools – a signal alarm system

Five controlled studies (total N > 3000); NOT clients achieved significantly better results in the feedback condition

Clearly, outcome is positively influenced through this system.

PCOMS outcome management systems Partners for Change Outcome Management

Systems (PCOMS; Miller, Duncan, Sorrell, & Brown, 2005)

a very short measure that employs two, 4-item scales, one focusing on outcome and the other aimed at assessing the therapeutic alliance.

Very clinician friendly Facilitates discussion of assessment results

by client and therapist each session.

Outcome based practicum training The discussion each session of the two measures

strongly contributes positive training in practicum. ORS is completed at the beginning of the therapy hour,

and then discussed. This allows the counselor in training to gain an understanding of the client’s current state and discuss the session treatment plan with the client

SRS is completed at the conclusion of the therapy hour, allowing for discussion of the session and the relationship as it has manifested during therapy that day.

The SRS is my favorite, because of its utility in focuings on the client-counselor relationship each session

Training in processing SRS and ORS resultsUsually the practicum counselor initially doubts

whether the client will answer honestly each session. Students are trained in a method of discussing the ORS and SRS.

“You marked all items very high. That indicates to me that you like the direction we took in our session today.”

“Today, you rated each area very high, and I am wondering if that corresponds with the way you are feeling about how we are working together.”

“I see you marked the items very high, yet I sensed today that you were not very satisfied with how we worked together.”

Graphing PCOMS results

Practicum counselors graph results over time, session by session, to understand patterns of process and outcome.

Graphs are shared with clients periodically and at termination. Graphs facilitate discussions of patterns of change with clients.

Initiating multi-site research (UNL and UCSB) to gather evidence for the effectiveness of the PCOMS as a training method.