psychology service clinic internship...
TRANSCRIPT
Universidad del Turabo School of Social Sciences
Graduate Program in Counseling Psychology
Psychology Service Clinic
Internship Program INTERNSHIP MANUAL
2014
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Table of Contents Introduction .................................................................................................................................................. 4
Goals and Objectives ................................................................................................................................. 4
Philosophy of Training ............................................................................................................................... 6
Training Curriculum .................................................................................................................................... 6
Clinical Presentation Component ........................................................................................................ 7
Staff Meeting Experiences .................................................................................................................... 7
Psychological Services .............................................................................................................................. 7
Core Competencies ................................................................................................................................... 8
Locality ....................................................................................................................................................... 11
Internship Description .............................................................................................................................. 12
Intern’s Responsibilities ....................................................................................................................... 13
Clinical Area ...................................................................................................................................... 13
Teaching Area ................................................................................................................................... 13
Supervision Area .............................................................................................................................. 13
Application Procedure ............................................................................................................................. 13
Selection Procedures ............................................................................................................................... 14
Behavior Code .......................................................................................................................................... 15
Dress Code ............................................................................................................................................... 16
Supervisors ............................................................................................................................................... 16
Interns and Supervisors Evaluation ....................................................................................................... 17
Internship Clinical Activity Log................................................................................................................ 18
Due Process, Grievance Procedure and Dismissal from the Internship ......................................... 18
Due Process:......................................................................................................................................... 18
Grievance Procedure ........................................................................................................................... 19
Non-Discrimination Disclosure ............................................................................................................... 22
Appendix A: Application Form ................................................................................................................ 23
Appendix B: Goals and Objectives Assessment Plan ........................................................................ 25
Appendix C: Assessment of Intern Competencies .............................................................................. 28
Appendix D: Evaluation of Professor .................................................................................................... 36
Appendix E: Supervisor Evaluation Form ............................................................................................. 39
Appendix F: Evaluation of Internship Program .................................................................................... 44
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Appendix G: Case Presentation Evaluation Form .............................................................................. 47
Appendix H: Evaluation of Psychological Assessment Process Form and Evaluation of Case Conceptualization Process Form ........................................................................................................... 49
Appendix I: Evaluation of Didactic Presentation .................................................................................. 52
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Introduction This manual will serve to establish the administrative and clinical procedures for Interns
required by Universidad del Turabo Psychological Services Clinic (UTPSC). It also provides
general information about policies, the training process, procedures and responsibilities, and
requirements for staff and trainees in this program.
Universidad del Turabo Psychological Services Clinic (UTPSC) is part of the School of
Social Sciences Psychology Graduate Program. The UTPSC offers psychology assessment
and counseling services. It functions as a training site for master and doctoral counseling
psychology students. The UTPSC has been operating since 2003 and has continually been
expanding its services to provide excellent training and counseling services to the community.
The UTPSC provides its graduate students the opportunity to acquire the clinical skills
necessary for the counseling profession. The competencies that students need to become
counseling psychologists are multiple and complexed and can only be developed through
practical experience in a supervised context. The clinical practice required by the UT
Counseling Psychology Program emphasizes and pays special attention to the process through
which students develop the competencies of the profession. The training model focuses
primarily on the skills that graduate students must acquire to form effective therapeutic alliances
with their patients. Students will be able to use this relationship to comprehend the person’s
circumstances and his/her psychological functioning. Student-trainees will acquire the
professional competencies through the administration and interpretation of psychological tests.
They will also acquire skills and intervention capabilities such as psychotherapeutic
interventions, systemic and group counseling, and consultation skills, which are essential
elements of the clinical core competencies for professional counseling psychologists. These
experiences are necessary to develop core professional competencies for all social and human
sciences professions. The UTPSC is part of the School of Social Sciences, which encourages
academic excellence through social research and practice.
Goals and Objectives The fundamental goal of this training program is to provide all interns the opportunity to
attain the skills that will prepare them to become professional psychologists and to instill in them
values of commitment and the highest standards of practice in the profession and science of
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Psychology. This internship program provides trainees the opportunity to practice and
consolidate the skills and knowledge within the professional psychology competencies in the
context of a supervised clinical and academic professional setting. Its core mission is to provide
quality intensive supervised training by competent mentors. The goals and objectives of the
program are:
Goal 1: To develop in each intern advanced levels of competence in the psychological assessment, diagnostic process and counseling, and psychotherapy intervention.
Objective 1: The intern will develop advanced psychological evaluation skills in the selection, administration, interpretation, and report writing using data from various sources.
Objective 2: The intern will develop advanced skills in conducting psycho-diagnostic assessment by integrating data from various sources.
Objective 3: The intern will develop advanced levels of competence in conducting several evidence-based psychotherapeutic (individual, group, family, marital, etc.) interventions according to case conceptualization, formulated diagnosis, and the treatment plan designed to address the client’s difficulties.
Goal 2: Interns will consolidate their skills to effectively integrate research and practice as well as apply scholarly inquiry skills in their psychotherapeutic intervention.
Objective 1: Interns will develop an advanced level of competence in evaluating and applying current research to their clinical practice.
Goal 3: Interns will demonstrate an advanced awareness and sensitivity to issues of diversity.
Objective 1: The intern will develop advanced levels of diversity awareness, including attitudes of respect, and will acquire the skills needed to respond appropriately to all clinical and professional situations related to diversity issues.
Goal 4: Interns will integrate ethical standards in the practice of professional psychology following the Code of Ethics of the Puerto Rico Psychology Board, APA Code of Ethics, and all applicable laws and regulations.
Objective 1: Interns will consolidate their skills in managing complex ethical situations needing ethical reasoning and decision-making.
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Goal 5: Interns will develop consultation, teaching, and supervision competencies applicable to professional, academic, and clinical contexts.
Objective 1: Interns will develop the ability to utilize appropriate teaching and supervision models and strategies through their experiences supervising master’s level psychology students who are beginning their clinical training.
Objective 2: Interns will develop skills in consulting with other professionals and referral sources using contemporary consultation models and strategies.
Objective 3: Interns will develop a general sense of mental health administration philosophy, strategies and techniques by assuming responsibility for their caseload, participating in the clinic’s staff meetings, and attending conferences and workshops on supervision and administration.
NOTE: The assessment plan for these Goals and Objective is included in Appendix B.
Philosophy of Training The Psychology Service Clinic Internship Program is based on a practitioner/scholar
training approach which adheres to the philosophy that good clinical practice is based on an
empirical foundation coupled with an understanding of the individual and his/her broader context
(i.e., culture, socioeconomic status, etc.). Internship training includes supervised practice
experience, supervision in evidence based assessment and intervention methods.
Training Curriculum The internship training curriculum addresses five overarching areas based on the principles of Evidence-Based Practices in Psychology. These include:
1. training in individual, group, couples/family counseling and psychotherapy
2. assessment and psychological testing
3. diversity training and clinical practice with diverse populations
4. training in professional areas including consultation, teaching and supervision
5. mental health management and administration.
This curriculum emphasizes the core competencies of professional psychology and
builds upon the basic knowledge and skills already developed by interns.
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Clinical Presentation Component Interns will integrate science and practice and will acquire additional skills in using theory to
become familiar with clinical skills. To further develop the interns’ clinical and professional skills, they are required to present at least one case each semester to all interns and clinical faculty. Through these presentations, interns will:
1. demonstrate the clinical competencies they have developed and how these are applied
to the case being presented.
2. receive feedback on the presentation and on the work they have done with the client or
clients.
3. obtain recommendations for additional interventions and for addressing the case’s
clinical challenges.
A presentation guideline is provided to help interns organize the required information.
Staff Meeting Experiences As part of the mental health administration strategies, interns participate in biweekly staff
meetings where administrative issues are addressed. At these meetings interns learn about the
challenges confronted by mental health administrators. Some of the issues addressed through
these meeting are:
1. development of a referral base and dealing/cultivating with referral sources
2. assignment of cases to interns and practicum students
3. administration of the management information system and use of activities report to
monitor the clinic’s performance
4. administration of the clinic’s spaces and resources
5. personnel issues
6. the Clinic’s quality assessment and quality enhancement process including monitoring of
clinical records and gathering data on treatment outcomes and patient’s satisfaction.
Biweekly group supervision is also available to all program interns. Cases and clinical
situations are discussed at these meetings.
Psychological Services The psychological services offered at the Clinic are for community and university
members. These services are offered by graduate students of the Graduate Counseling
Psychology Program and interns from the program and other institutions. The interns are
supervised by licensed doctoral level psychologists in Puerto Rico. The services are regulated
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by the academic agencies, state and federal laws. The Clinic receives referrals from physicians,
teachers, social workers and concerned family members.
The people who request the UTPSC services come with a wide variety of problems, e.g.,
parents and/or teachers concerned about children and teenagers’ academic, emotional and
social problems; couples, marriage and family challenges; assistance for grief, anxiety,
psychosomatic, depress symptoms related situations, among others. In addition, UTPSC also
accepts referrals from governmental or business agencies. Additionally, faculty and staff offer
formal and informal consultations to community agencies and professional organizations to
expand our partnerships and community support. Some of these diverse groups include:
therapists, private and public schools, educators, parents, students, ministers, churches,
community leaders, among others. Services provided at the Clinic include individual, couple,
family, group and play therapy. It also offers psychological, cognitive, psycho-educational and
objective personality assessments and works closely with the university and community to
educate and provide support related to mental health.
Core Competencies Core competencies are those sets of skills that are essential to all practicing academic
psychologists. The interns are expected to develop expertise in the core competencies by the
end of the program. The core competencies address the professional psychological
competencies, skills, abilities, proficiencies and knowledge in the content areas outlined in the
APA Guidelines and Principles for Accreditation:
Psychological Assessment, Diagnosis, and Consultation:
o By the end of the internship, interns should be able to formulate a multi-axial
diagnosis by integrating data from a variety of sources, including clinical
interview, family history, medical history, mental status examination, and
psychological testing data. All students must demonstrate expertise in
psychological assessment.
o By the end of the training, interns should be able to develop a testing battery to
answers a specific referral question, administer and score a wide variety of
psychological tests, interpret test data, integrate test data with history and other
sources, write a report that clearly answers the referral question, and provide
clear, relevant, treatment recommendations. All interns must be able to assist
consumers and other providers in formulating treatments plans and setting
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attainable treatment goals, as well as linking the persons with needed resources
to achieve them.
o Specific competencies are taught or developed and evaluated to:
understand differential diagnosis and case conceptualization
select and administer appropriate tests
interpret and integrate test result
write clear, organized reports
facilitate development of specific, achievable therapeutic goals
develop action steps for goal achievement
match the assisted persons with required resources
recognize unique and shared skills and roles of other professions
General Principles of Evidenced-Based Interventions:
o students are expected to understand and demonstrate an advanced
understanding and application of psychotherapeutics techniques common to all
theoretical approaches including empathy, rapports, relationship building, and
history-taking, and must become proficient in the procedures involved in specific
individual and group evidence-based practices relevant to their training.
o students are required specific competencies to:
develop and maintain a positive working alliance (actively listen to
enhance understanding, instill hope, provide support, be directive, give
advice, set limits when appropriate, and be collaborative in goal settings
and treatment planning).
facilitate appropriate expression of emotion
enhance the person’s understanding of his/her problems and
psychological disorders (provide appropriate psycho-education and
stabilize emotional reactions when appropriate)
use empirically supported psychotherapeutic techniques to the maximum
possible extent (describe theoretical basis and goals of chosen treatment
approach, formulate goals/problems consistent with treatment approach,
structure therapy sessions consistent with treatment approach and modify
treatment plan based on ongoing evaluation
use homework effectively
conduct appropriate therapy termination including use of strategies to
minimize return of emotional instability
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develop group therapy skills and preparation (promote group interaction,
structure and manage time efficiently, develop and maintain a positive
working alliance, instill hope, provide support, set limit when appropriate,
instill emotional expression and interact with co-therapist in planning)
create awareness of self and effective use of emotional reactions
Law and Ethics:
o Students must demonstrate: (1) a sound professional clinical judgment and
behavior in the application of assessment and intervention procedures with
individuals; (2) familiarity with and understanding of professional and legal
standards in professional psychology, and (3) a thorough understanding of the
Puerto Rico Psychology Board of Examiners (PRPBE) and APA ethical principles
and standards.
o students are required specific competencies to:
work in an ethical manner in accordance with the PRPBE & APA ethics
code and all relevant laws
maintain appropriate professionalism and boundaries
recognize limits of one’s own expertise and seek appropriate consultation
assess persons at-risk (homicidal ideation, suicidal ideation, abuse) and
intervene appropriately, and
maintain confidentiality
Cultural Diversity:
o Students are expected to demonstrate expertise in cultural diversity. Cultural and
ethnic issues cut across all core competencies areas. Students develop
experience in cultural diversity through exposure to multiethnic students at
Universidad del Turabo. If students have this experience by the end of the
training, they are expected to:
identify cultural/ethnic issues relevant to the case
explain how these issues affect psychology test data, response to staff,
and treatment interventions, and
modify assessment/treatment approach based on supervisory and
consultant input
o students are required specific competencies to:
support the inclusion of all persons
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cultivate awareness of one’s own biases and limitations; seek
consultation as needed
assess cultural factors to ensure formulation of relevant treatment
conduct treatment in preferred communication style and language of the
consultant
remove institutional barriers to participation for all clients
teach persons the necessary skills to overcome cultural barriers
Supervision:
o Interns receive supervision and are provided with opportunities to supervise other
providers (master practicum students), under the guidance of their own
supervisor. They come to supervision prepared to discuss cases using a
theoretical framework to describe a case, assessment or treatment plan. Interns
seek supervision for complex cases, and communicate in a professional manner
with supervisors and supervisees. Open discussion and acceptance of
constructive feedback during supervision is essential to the learning process.
o students are required specific competencies to:
be aware of their own limitations; seek consultation or suggest alternative
supervision plans as appropriate
maintain an effective, professional supervisory relationship
recognized the precedence of the person’s well-being over your own (or
supervisee) wishes
be well prepared for supervision (prepare agenda, audio, participate in
one way mirror session, etc.)
integrate and implement supervisor feedback, and
be willing to discuss problem areas and accept constructive criticism.
Organization Management and Administration:
o Interns must use time management skills to maintain an efficient practice, comply
with program and local facility policy and procedures, complete administrative
tasks that support training in order to function as effective practitioners.
Locality The Psychology Services Clinic is housed on the first floor of a Universidad del Turabo
(UT) property in Gurabo, PR, adjacent to the UT main campus. A smaller structure located
behind the building houses the intern’s common room, a bathroom and storage closets. There
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are approximately 1,800 square feet of space between both buildings that are used for clinical
and training activities. Parking is readily available, and UT is conveniently situated on a city bus
line. The Clinic is accessible to those with physical disabilities and is barrier free. As an integral
part of an academic institution, the clinic enhances the credibility of the UTPSC in the
surrounding communities.
The Clinic has 16 separate spaces that are divided to accommodate a reception area
with security system (attended by an administrative assistant), a waiting room, and separate
offices for the clinic director and for the internship coordinator. A large office space with desks is
assigned to students where they wait for their clients and access the clinic’s computerized data
management system. Six of the offices are intervention rooms; three (3) are used for
interventions and three (3) for assessment/testing, and when needed, for interventions. A group
therapy/meeting room is available There are two bathrooms, a photocopying area and storage
areas (available for files, supplies and classified material). Consultation office number 6 has a
one-way mirror that can be used by clinical supervisors to monitor counseling or assessment
sessions. The main offices contain phones and all case records. The Clinic also has a small
library, eight computers, a fax machine and photo-copier. In an adjacent building, the Clinic has
a student center and a meeting room. The two structures are equipped with internet Wi-Fi
connection, telephones and with an additional bathroom.
The clinic has various electronic resources including a complete electronic record
system integrating client’s and interns’ scheduling program, productivity reports and billing
system. The software supporting these resources was specifically designed for internship and
practicum mental health clinics. There are testing software programs and word processing
capabilities.
Internship Description The UTPSC internship program is a well-organized supervised training experience that
includes a supervised clinical experience and a didactic experience. The minimum requirements
to complete the internship are:
o a minimum of 2000 hours in a year
o at least 25% of time will be for face-to-face psychological service to clients
o satisfactory evaluation from the supervisors
The UTPSC has five full time internship positions available to start in July 7th, 2014.
Interns will received a $1000.00 monthly stipend and have the following fringe benefits:
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two weeks of vacation leave
two weeks of sick leave
four hours per week for dissertation/ project time
Intern’s Responsibilities The responsibilities of the interns are divided into three main areas: clinical, teaching
and supervising.
Clinical Area During the program, it is required that the interns manage different evidence-based
interventions according to the client’s main concern and past history. Interns will also receive
training in several psychological batteries and how to administer these depending on the
participant’s needs.
Teaching Area Interns will teach a psychology course to UT undergraduate students. During the first
week of the internship program, interns will receive training in course planning, syllabus
preparation, and courses evaluation. Interns will also conduct community service
interventions/seminars according to the identified needs.
Supervision Area As stated in the goals and objectives of the internship program, it is fundamental that
interns be exposed to the supervision process. Interns will supervise practicum students at the
master and doctoral level who are completing their practicum at the UTPSC.
Application Procedure Students interested in applying for the internship program at UTPSC need to:
Be enrolled in the Universidad del Turabo Counseling Psychology Doctoral
Program. The UTPSC Internship is a captive program reserved for UT doctoral
students only.
o have completed all the academic courses before the beginning of the
internship program
o have the doctoral candidacy exam and dissertation/doctoral project
proposal approved before the beginning of the internship
complete the AAPI online application at www.appic.org
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submit three letters of recommendations (at least one from a professor and two
from clinical supervisors)**
provide their Curriculum Vitae**
submit an official school transcript**
submit a case conceptualization**
submit a psychological assessment integrated report**
**Required documents must be uploaded to AAPI online in pdf format following APPIC
guidelines.
Incomplete applications or applications received after December 5th will not be
considered. Applicants are welcomed to email or call the Internship Coordinator (IC) regarding
doubts, clarifications, or questions.
Attn: Jorge E. Berrios, PsyD Clínica de Servicios Psicológicos UT PO Box 3030
Gurabo, PR 00778 (787) 743‐7979 ext. 4466 [email protected]
Selection Procedures The internship application process will be as follows:
After all the documents listed above through AAPI are received, the UTPSC
internship faculty will review and rate applications. Each application is rated
independently by faculty members. Applicants with the highest rating scores will be
invited for an interview. Only those applicants who meet the program offerings and
settings will be invited to interview. Applicants will be notified via email about their
interview status by December 15th.
Most interviews are conducted during the month of January by two members of the
UTPSC Staff. On-site interviews are preferred. The interview is semi-structured,
conducted in Spanish, and seeks to obtain information about the candidate’s
professional development in the following areas:
o vocation
o clinical experience (psychotherapy and psychological assessments)
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o knowledge of theory and practice
o attitude toward work or work ethic
o correspondence between applicants expectations and program goals
o language proficiencies, spoken and written skills (Spanish & English)
o self-awareness
Once the interview is completed, the faculty will rank the candidates and submit the
results to APPIC for the match process.
The manual, policies and due process documents will be given to the intern when
he/she/signs the agreement.
Behavior Code The clinic director, internship coordinator, clinical supervisors, office assistant,
graduate/undergraduate assistants (work and study) and graduate students and interns of
UTPSC should always demonstrate a professional attitude and respect for all clinical processes.
Interns should wait in the student’s common rooms and verify if their cases have arrived. If they
don’t have any scheduled appointments, they will work on administrative tasks. Interns are not
allowed to stay in the waiting room, nor in the clinical director, internship coordinator, clinical
supervisors or the administrative areas. During the in service hours, the clinical director may
assign or request special tasks and office support. Students must demonstrate assertive and
professional attitude: hostile interactions are not accepted among/between students/interns or
staff.
Confidentiality is a critical issue and one that we make every effort to respect. No
unauthorized persons are allowed into the clinic’s offices or behind the one way mirror. Under
no circumstances are case files, video or audio recordings allowed outside the clinic. Cases
should never be discussed in the halls, or outside the clinic. Additionally, students should never
discuss clinical cases through electronic communications.
The consultation rooms are exclusively utilized for therapy or assessment. The reports
and academics tasks should be completed in the student’s common room. Students are not
allowed to eat, drink, or smoke in the consultation rooms. The use of social networks during
service hours is prohibited. It’s the Clinic’s policy to forbid interns’ family members or friends at
the Clinic’s facilities. All consultation rooms, clinical material, and supplies office should be
organized and cleaned after each use. The access to storage area is limited to the Clinic
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Director and administrative assistant or designate authority. The graduate students and staff
should always use a moderate voice level; avoid jokes or inappropriate laughter when
participants are present in any clinical area. Access to any clinical area outside service hours is
prohibited. Only the clinical director and authorized personnel may have access during these
periods. Failure to comply with the behavior code will result in: a first offense will be followed by
a verbal reprimand; a second offense by a memo to the intern’s file, and; a third offense by a
direct memo to the clinic director, internship coordinator and graduate psychology associate
dean.
Dress Code The way in which trainees dress to attend their clinical sites have particular significance
at different levels. Adequate clothing transmits a sense of professionalism and respect for
patients and for the professional staff at the training site. Attire should be consonant with the
settings of practice, weather, and time of day. Female and male basic dress attire should be
black in color and male students are encouraged to consider using long or short sleeves shirt
and a tie. Shorts, sneakers, jeans, skin-tight female pants that expose portions of the body are
unacceptable clothes to be worn at any of the clinical sites. However, when working with
children is predominant, less formal clothing are usually permitted as well as when the specific
situation requires it.
Supervisors The Intern’s Supervisors are doctoral level psychologists who are actively licensed as a
psychologist by the Board of Examiners in the jurisdiction of Puerto Rico. APPIC (2012)
believes supervisor expectations should be similar to intern expectations. It is expected that
during the year interns receive supervision from at least two different supervisors. Interns
primary clinical supervision and role modeling is provided by psychologists in the program who
are officially designated as psychology intern supervisors. They are significantly involved in the
operation of the training program. Regularly scheduled individual supervision is provided by one
or more doctoral level licensed psychologists, at a ratio of no less than one hour of supervision
for every 20 internship hours. Supervision is provided with the specific intent of dealing with
psychological services rendered directly by the intern.
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Intern supervisors are clearly designated by the Clinic as responsible for the cases (for
example, countersigning documentation or having their name on the treatment plan or case
summary). Depending on the needs increased hours of supervision are expected.
The primary responsibilities of all clinical supervisors are to:
provide guidance and advice to students throughout their training and serve as
professional mentors;
enable students to become familiar with the Clinic’s policies and procedures;
be responsible for gradually developing interns’ experiences that will prepare them to
assume entry levels responsibilities within the field of professional Counseling
Psychology;
discuss, and sign with each assigned intern the Intern Contract and provide the
expected amount of weekly individual supervision, and review on a regular basis the
cases assigned to each intern;
verify that interns complete all forms required by the Clinic. They should also address
through the supervision sessions scientific and evidence based practices in the
counseling psychology practice and any professional ethics issues that arise and
provide guidance and encouragement to the student to progressively assume an
independent clinical function and keep the students.
Interns and Supervisors Evaluation Besides being evaluated by clinical supervisors, interns are responsible for evaluating
each supervisor with whom they have worked each semester. Interns’ evaluations must be
turned in on the appropriate due date. For the intern’s evaluation form see appendix C and for
the clinical supervisor evaluation form see appendix E. The interns and supervisors evaluations
are based on APPIC criteria. APPIC (2012) includes a written evaluation process that provides
comprehensive evaluative feedback to graduate students.
The evaluation provides a summary of performance in all major competence areas that
are the focus of the internship training. Interns have the opportunity to review their evaluation
with supervisors to ensure the fullest possible communication between supervisors and interns.
Evaluation procedures provide feedback that validates trainees' achievements by noting areas
of unusual strength and excellence and facilitate trainees' further growth by identifying areas
that would benefit from additional training. The program provides the doctoral psychology
intern's graduate training director with feedback concerning the intern's progress in the
internship program.
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Internship Clinical Activity Log Interns are responsible for keeping a log of their own hours through the website
Uwww.mypsychtrack.comU . Interns must send the documentation to the supervisor for
verification. A report must be sent, via email, to the Internship Coordinator every three months.
Due Process, Grievance Procedure and Dismissal from the Internship The internship programs have documented due process procedures that describe
separately how programs deal with:
(1) concerns about intern performance, and
(2) interns' concerns about training.
These procedures include the steps of notice, hearing, and appeal, and are given to the
interns at the beginning of the training period.
The program has two written policies: (1) Due Process and (2) Grievance Process. The
procedures must be specific for the internship training program since reliance on a more general
Human Recourses (HR) policy is insufficient. Both procedures are provided to interns at the
commencement of their training. Due Process is a written procedure that comes into use when
an intern’s behavior is problematic.
Due Process: UT guarantees the rights of students to challenge and appeal to any conflicting situation
that may arise in the course of training. The UT Student Handbook includes the university’s due
process. However, a more specific due process is in place to address particular situations
pertaining to the internship program. The due process applicable to the UTPSC Internship
includes three main elements:
1. Notice
a. The intern is notified in writing that problematic behavior has been identified
and corrective action will be taken to address the problem.
2. Hearing
a. The program has a formal process where the intern with the identified
problematic behavior has an opportunity to listen and respond to the
concerns.
3. Appeal
a. The intern has the opportunity to appeal the actions taken by the program in
regards to the identified problematic behavior. The appeal should extend at
least one step beyond the Internship Coordinator.
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In the event that a supervisor or staff member suspects that a student is not achieving
the expected levels of development of critical competencies or is presenting problematic
behavior in the training site, the following steps will be taken:
1. The supervisor will meet with the student.
2. If the issue is not solved, the supervisor will bring the situation to the attention of the
Internship Coordinator and discuss the matter with him/her.
3. The Internship Coordinator will meet with the student and with the supervisor or staff
person who raised the concern to discuss the issue. The result of this meeting will be
documented and if applicable, a remedial plan will be drawn to address the situation.
The meeting proceeds or remedial plan will be presented in writing to the intern by
the internship coordinator.
4. The student will be allowed to respond to the proposed action and may request an
appeal hearing to the Psychology and Social Work Associate Dean. The Associate
Dean will appoint an appeal Committee.
Appeal Process 1. If the Intern is not satisfied with the process, and a mutual agreeable decision cannot be
reached the student may request an appeal to the Psychology and Social Work
Associate Dean.
2. The Associate Dean will appoint a Committee with two faculty members and the
Doctoral Program coordinator, who will chair the Committee.
3. The student may bring a witness or supporting documents to the appeal session.
4. The decision of the Committee will be formally provided to the intern in writing. The
trainee will sign the document that validates the decision. The committee courses of
action may include: return to the internship, written reprimand, referral to psychological
assessment/intervention, leave of absence or dismissal.
5. If it is determined necessary to refer the intern for psychological assessment or
intervention, the referral will be made to a qualified psychologist or mental health
professional that has no personal or professional connection with the Internship
program. A list of acceptable professionals will be made available to the student, who in
turn will be allowed to make the final selection of a professional. The student is
responsible for any cost incurred in the required assessment or intervention. Depending
on the result of the psychological assessment, the student may be asked to:
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a. take a leave of absence (the length of time will be determined by the internship
coordinator and primary supervisor in order to attempt to improve/resolve the
problem)
b. resign from the Internship, or
c. return to internship program
6. After the leave of absence has terminated and/or other specified progress evaluation
has been made, the internship coordinator and primary supervisor will meet again to
evaluate the outcome of the intervention, and to decide on further actions, including
allowing the student to continue in the internship program. To determine the student’s
fitness to remain in the program, the clinic director, internship coordinator and supervisor
may require the student to obtain a certificate from the treatment source authorizing a
return to the internship program.
7. If at any point during the process the intern fails to comply with any of the evaluation
requirements, rehabilitation, or remediation plan, the intern may be dismissed from the
program.
8. The student may opt to resign from the program without submitting to the psychological
assessment, the leave of absence, or the specified remediation/rehabilitation plan. In
such a case, the intern would be informed in writing that future re-admittance to the
internship or practicum time is not an option. A copy of the letter would be placed in the
intern’s file. The intern would be identified as having resigned from the program in poor
standing.
9. If the situation is not solved to the satisfaction of the intern at the appeal level, the due
process presented in the UT Student Handbook will be used.
Grievance Procedure Grievance procedure is a process by which an intern files a complaint against the
training program or one of its staff members. The grievance procedure includes specific steps /
reasons for grievance that include:
1. violation of professional ethical or legal standard
2. incompetence to perform typical services in this setting and inability to attain
competence during the internship and practicums, relative to the core competencies
and training goals specified in this manual
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3. failure to meet the minimum standards for clinical care, didactic training, or
maintenance of appropriate professional records
4. unsuitable behavior that hampers the intern or practicum student’s professional
performance.
There may be occasions when a student has a complaint against a supervisor, or a
complaint about some other aspect of the training experience. In such a case, the following
sequences of actions may be taken:
1. The student is encouraged to bring the issue to the attention of his/her supervisor or the
other party involved, in an effort to solve the problem. A previous meeting with the clinic
director and/or the internship coordinator is not required. If the student requests a
meeting, it would be planned to help the student think about how to articulate concerns
and define possible goals, facilitate skillful handling of conflicts, etc.
2. In most cases, if discussion with the supervisor or other party does not lead to a
satisfactory resolution of the problem, the student is encouraged to bring this concern to
the clinic director or internship coordinator. They will work in various ways to help
address the concern. Typically this would include meeting with the student and
supervisor or the other party involved to resolve the problem, but as deemed necessary,
other approaches might be selected. If the clinic director or the internship coordinator is
unable to solve the problem, the Psychology and Social Work Associate Dean will be
notified of the problem and offered an opportunity to resolve it.
3. There may be problems when the student does not want to directly address the clinic
director or internship coordinator (if the grievance directly involves an action of the clinic
director or internship coordinator). In such a case, the student is encouraged to select a
staff member whom he/she trusts could provide consultation and direction. If the student
chooses a staff member, that person will determine as quickly as possible whether the
student’s grievance may be potentially resolved without the intervention of the intern’s
supervisor or of the clinic director or internship coordinator. If such authority is required,
the staff member will assist the student in presenting the grievance to the Psychology
and Social Work Associate Dean, assuming that there is a reason for it not to be brought
directly to the clinic director. Interns can also decide to follow this procedure without the
assistance of a supervisor.
4. If the problem persists the next step will include the following: pursuing disciplinary
action against the supervisor or other party, or informing the intern that the grievance
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does not have the proper support and that he/she needs to approach the situation
differently. If the intern or other party is not satisfied with the decision, it may be
appealed to the Psychology and Social Work Associate Dean.
5. If the intern has sought guidance from another staff member, that person will act in lieu
of the clinic director by meeting conjointly with the student and party against whom the
grievance has been brought to achieve a mutual agreement. If an agreement cannot be
reached, the staff member will form a committee to help resolve the grievance. The
committee should involve at least three members deemed potentially helpful. The
committee will follow the actions described above in attempting to work an equitable
resolution for the student’s grievance. As stated previously, if the intern or other party is
not satisfied with the decision, it may be appealed to the Psychology and Social Work
Associate Dean.
6. If the intern has sought guidance from the alternative dispute resolution process, and a
mutually agreeable decision cannot be reached, the grievance will be brought directly to
the Psychology and Social Work Associate Dean for resolution.
7. If the situation is not solved to the satisfaction of the intern at the associate dean level,
the due process presented in the UT Student Handbook will be applied.
Non-Discrimination Disclosure Notice of Non-discrimination: The UTPSC Internship Program accepts applicants from
any race, color, sex, age, non-disqualifying disability, religion or creed, sexual orientation, or
national or ethnic origin to all the rights, privileges, programs, and activities generally accorded
or made available to students at the school, and does not discriminate in the administration of
its educational policies, admissions policies, scholarship and loan programs, and athletic and
other school-administered programs.
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Universidad del Turabo School of Social Science Psychology Service Clinic
INTERNSHIP APPLICATION INSTRUCTIONS
To apply to the UT Psychology Service Clinic Internship program you must fill out the APPI online application at www.appic.org before December 5. Documents Required for the AAPI Application
1. Psychology Practicum Hours 2. Curriculum Vitae 3. Three letters of recommendations (from professors, supervisors or professional) 4. Official School Transcript
Additional Documents Required
1. Case conceptualization 2. Psychological Assessment Integrated Report
This additional information must be uploaded to the AAPI application. Candidates must be aware to not provide information that can identify the client’s report or case conceptualization that could compromise confidentiality Note: No application will be processed until all documents are received.
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Universidad de l Turabo School of Social Science
Psychology Service Clinic
Internship Program
Assessment Plan
Goal 1: To develop in each intern advanced levels of competence in the psychological
assessment, diagnostic process and counseling, and psychotherapy intervention.
Objective 1: The intern will develop advanced psychological evaluation skills in the
selection, administration, interpretation, and report writing using data from various
sources.
Measure: Evaluation of Psychological Assessment Process
Measure: Assessment of Intern Competencies
Objective 2: The intern will develop advanced skills in conducting psycho-diagnostic
assessment by integrating data from various sources.
Measure: Evaluation of Psychological Assessment Process
Measure: Evaluation of Case Conceptualization Process
Measure: Case Presentation Evaluation Form
Measure: Assessment of Intern Competencies
Objective 3: The intern will develop advanced levels of competence in conducting
several Evidence-Based psychotherapeutic (individual, group, family, marital, etc.)
interventions according to case conceptualization, formulated diagnosis, and the
treatment plan designed to address the client’s difficulties.
Measure: Evaluation of Case Conceptualization Process
Measure: Case Presentation Evaluation Form
Measure: Assessment of Intern Competencies
Goal 2: Interns will consolidate their skills to effectively integrate research and practice as well
as apply scholarly inquiry skills in their psychotherapeutic intervention.
Objective 1: Interns will develop an advanced level of competence in evaluating and applying current research to their clinical practice.
Measure: Evaluation of Case Conceptualization Process
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Measure: Evaluation of Case Conceptualization Process
Measure: Case Presentation Evaluation Form
Measure: Assessment of Intern Competencies
Goal 3: Interns will demonstrate an advanced awareness and sensitivity to issues of diversity.
Objective 1: The intern will develop advanced levels of diversity awareness, including
attitudes of respect, and will acquire the skills needed to respond appropriately to all
clinical and professional situations related to diversity issues.
Measure: Evaluation of Case Conceptualization Process
Measure: Assessment of Intern Competencies
Goal 4: Interns will integrate ethical standards in the practice of professional psychology
following the Code of Ethics of the Puerto Rico Psychology Board, APA Code of Ethics and all
applicable laws and regulations.
Objective 1: Interns will consolidate their skills in managing complex ethical situations
needing ethical reasoning and decision-making.
Measure: Assessment of Intern Competencies
Goal 5: Interns will develop consultation, teaching, and supervision competencies applicable to
professional, academic, and clinical contexts.
Objective 1: Interns will develop the ability to utilize appropriate teaching and
supervision models and strategies through their experiences supervising master’s level
psychology students who are beginning their clinical training.
Measure: Assessment of Intern Competencies
Objective 2: Interns will develop skills in consulting with other professionals and referral
sources using contemporary consultation models and strategies.
Measure: Professor Evaluation
Objective 3: Interns will develop a general sense of mental health administration
philosophy, strategies and techniques by assuming responsibility for their caseload,
participating in the clinic’s staff meetings and by attending conferences and workshops
on supervision and administration.
Measure: Assessment of Intern Competencies
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Universidad del Turabo School of Social Science
Psychology Service Clinic Internship Program
ASSESSMENT OF INTERN’S COMPETENCIES
Student: ________________________________ _________
Supervisor: _______________________________________
Period of Supervision: ______ Mid Term _______Final
Instructions Please rate each item according to the scale provided and sign in the appropriate signature block and return this form to the Practicum Coordinator. Please discuss all of these ratings with the student, and compare the student’s self-assessment on these dimensions to your ratings. In your feedback, it is important to give specific examples if you have concerns about progress; it is also important to give clear examples of what you think the student does well. Please use the feedback sessions to plan what you and the student would like to emphasize in his/her continued training. If there are significant concerns about performance on any dimensions, you need to decide whether the student is passing at this point in the training (see target goals in each signature block). If not, please contact the Practicum Coordinator as soon as possible. Please indicate below what modalities/work samples you have used to obtain information for making your evaluations. __ Observation during team meetings __ Review of written work samples __ Consultation with other clinical supervisors __ Consultation with team members other staff __ Role Play __ Student’s self-report __ Audio record __ Video record __ One way mirror __ Direct, live observation __ Other: _____________________________________
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Supervisor: Use the scale below to make ratings from 1 to 10. Track-specific competencies may be added. To obtain that rating, within the past month, the student should consistently display the specific quality/skill in every clinical area and/or know when he/she needs to consult. Interns: Use these self-assessments to guide development of training plan. Scale 1-2 (Novice) = Inexperienced in this capacity and still developing basic skills; cannot identify problems but open to discussion in supervision 3-5 (Intermediate) = Developing some skills to function independently; can identify problems to discuss in supervision. 6-8 (Advance) = Functions independently most of the time requires supervision for difficult 9-10 (Proficient) = Student functions fully independently in this capacity at almost all times U (unsatisfactory) = Student is experiencing significant difficulties in developing skills to function independently in this capacity and is unable/unwilling to discuss problems in supervision or change practices according to suggestions.
Competencies Psychological Assessment, Diagnosis and Counseling
Middle Middle Final Final AREAS Student Supervisor Student Supervisor
1. Understand differential diagnosis and case conceptualization.
2. Select and administer appropriate test. 3. Interpret and integrate test result. 4. Write clear, organized reports. 5. Develop adequate conceptualizations. 6. Facilitate development of specific achievable therapeutic goals.
7. Develop action steps for the achievement of goals.
8. Match the person’s with resources as needed.
9. Recognize unique and shared skills and roles of other professions.
Comments
Mid Term
Total
Final Average
Total
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Evidence Based Interventions
Middle Middle Final Final AREAS Student Supervisor Student Supervisor
10. Develop and maintain a positive working alliance:
a. actively listen to enhance understanding
b. instill hope c. provide support d. be directive, give advice and set
limits when appropriate
e. be collaborative in goal setting and treatment planning.
11. Facilitate appropriate expression of emotions.
12. Enhance a person’s understanding / emotional instability:
a. provide appropriate psycho-education
b. normalize emotional reactions when appropriate.
13. Use empirically supported psychotherapeutic techniques:
a. describe theoretical basis and goals of chosen treatment approach
b. formulate goals/problems consistent with treatment approach
c. structure therapy sessions consistent with treatment approach
d. modify treatment plan based on ongoing evaluation.
14. Use homework effectively. 15. Conduct appropriate therapy termination.
16. Group therapy skills and preparation: a. promote group interaction b. structure and manage time
efficiently
c. develop and maintain a positive working alliance
d. instill hope, provide support, set limit when appropriate
e. instill emotional expression f. interact with co-therapist in
planning.
Comments:
Mid Term
Total Final Total
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Law and Ethics
Middle Middle Final Final AREAS Student Supervisor Student Supervisor17. Work in an ethical manner in accordance with the ethics code and all relevant laws.
18. Maintain appropriate professionalism and boundaries.
19. Recognize limits of one’s own expertise and seek appropriate consultation.
20. Assess person’s at- risk and intervene appropriately.
21. Maintain the person’s confidentiality.
Comments
Mid
Term Total
Final Total
Cultural Diversity Middle Middle Final Final
AREAS Student Supervisor Student Supervisor22. Support the inclusion of all persons 23. Cultivate awareness of one’s own biases and limitations; seek consultation as needed.
24. Assess cultural factors to ensure formulation of relevant treatment.
25. Conduct treatment in preferred communication style and language of the person.
26. Remove institutional barriers to participation by all persons.
27. Teach persons the necessary skills to overcome cultural barriers.
Comments
Mid Term Total
Final Total
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Supervision Middle Middle Final Final
AREAS Student Supervisor Student Supervisor28. Be aware of one’s limitations; seek consultation or suggest alternative supervision plans as appropriate.
29. Possess sufficient knowledge to provide guidance and legal/ethical issues to supervisee or other providers.
30. Maintain an effective, professional supervisory relationship.
31. Recognize the precedence of the person’s well-being over your own (or supervisee) wishes.
32. Be well prepared for supervision (e.g. prepares video, etc.).
33. Integrate and implement supervisor feedback.
34. Be willing to discuss problem areas and accept constructive criticism.
Comments
Mid Term Total
Final Total
Organization Management and Administration Middle Middle Final Final
AREAS Student Supervisor Student Supervisor35. Write timely, complete progress notes and reports.
36. Complete administrative tasks on time.
37. Use time management skills to prioritize.
38. Attend required meetings regularly.
39. Interact effectively with administrative staff and manage conflict.
40. Maintain caseload with appropriate number of attended persons and weekly visits.
Comments
Mid Term
Total
Final Total
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For the next table use the following rating scale Rating Explanation:
5 = Excellent: Student’s performance was at an exceptionally high level. 4 = Very Good: Student’s performance was solidly competent, clearly above average, and characterized by absence of difficulties. 3 = Good: Student’s performance was basically competent and fulfilled requirements. There were no major problems and the work was adequate. 2 = Satisfactory with Possible Concerns: Student’s performance was acceptable, but there were some weaknesses or concerns which, though minor, might require some remediation or corrective action, as noted in the comment section. 1 = Satisfactory with Concerns: Student’s performance was minimally acceptable; there was a major problem or some minor difficulties that identify a need for remediation/corrective action, as noted in the comment section. 0 = Unsatisfactory: Student’s performance was unacceptable; there were several major problems that identify a need for remediation/corrective action, as noted in the comment section.
Competency of Relations
Middle Middle Final Final Dimension Student Supervisor Student Supervisor41. Respectful Interpersonal Behavior Towards Supervisor(s) Peers
42. Punctuality/Attendance 43. Level of Participation/Preparedness 44. Use/Integration of Theory with Practice 45. Clinical Sensitivity 46. Sensitivity and Awareness 47. Insight and Use of Self 48. Appropriate Affect Modulation 49. Ethical Competence 50. Professional Values and Attitudes 51. Organizational and Systems Awareness
52. Openness to Feedback 53. Written and Communication Skills
Comments
Mid Term
Total
Final Total
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Summary of Assessment of Intern Clinical Competence
Competencies Mid Term Points
Mid Term Percentage
Final Points Final Percentage
Psychological Assessment, Diagnosis and Counseling (90 points)
Evidence Based Interventions (200 points)
Law and Ethics (50 points)
Cultural Diversity (60 points)
Supervision (70 points)
Organization Management and Administration (60 points)
Competency of Relations (65 points)
Overall Evaluation (595 points)
Approval of the Internship requires, at least, 80% in each competency and in the overall evaluation performed by the supervisor. Intern Name: ____________________________ __________________________________ ______________________ Intern Signature Date Primary Supervisor Name: ________________________________ __________________________________ ______________________ Primary Supervisor Date Received and filed by __________________________________ ______________________ Internship Coordinator Date
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Universidad del Turabo School of Social Science
Psychology Service Clinic Internship Program
Supervisor Evaluation Form
Supervisor: ________________________________ Date: _________________
Intern: ___________________________________
Please review each category and specific item on the following pages and rate according to the scale following each item. There are several examples under each item; these are provided to help you focus your assessment of skill level. However, they are not meant to be comprehensive list of skills or to imply that supervisors need to be effective in all areas at the same level. The final rating should represent an aggregate across several skills represented by the main statement of each item. Not every item will be relevant to your settings; you can check “not applicable” as needed. There are five categories: aspect of the supervisory relationship, facilitation of training experience, mentoring, treatment team interaction and functioning and cultural and individual diversity. After you rate the specific items for each category, there is space for general comments on that category. Please enter enough narrative to anchor your ratings. Attach the appropriate signature page. Please discuss your feedback with your supervisor(s), along with his or her feedback about you. In the feedback, it is helpful to give specific examples if you have concerns or suggestions for change. It is also helpful to give clear examples of what you think the supervisor does well.
Modalities: Please indicate below what modalities you have experienced in your work with this supervisor. Check of all that are applicable: ___ Supervisor listened to your reports of services ___ Supervisor reviewed audio recordings of service ___ Supervisor reviewed videotape of service ___ Supervisor did direct, live (one way mirror) observation of service ___ Direct observation of supervisor in services ___ Experience during group supervision sessions ___ Joint participation during team meetings ___ Co-intervention conducted by Intern and Supervisor ___ Reviewed of written material ___ Other_____________________________________________________________________
Instructions: Rate in a scale from 1 (poor) to 5 (excellent)
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Aspect of the Supervisory Relationship Rating 1. Supervisor facilitates establishment and maintenance of collaborative supervisory relationship:
a. clearly discusses expectations regarding the supervisory relationship.
b. invites comments about the quality of the supervisory relationship on an ongoing basis.
c. responds to your feedback in a non- defensive manner.
2. Supervisor demonstrates empathy, respect, and understanding of supervisees experience:
a. understands your stated needs in an open manner, despite the limitations of the settings.
b. respects your boundaries/privacy.
c. demonstrates emphatic understanding of personal and interpersonal struggles related to the demands of the training program.
d. demonstrates sensitivity and respect of supervisees’ cultural/individual background.
3. Supervisor is physically and emotionally available for supervision:
a. collaborates to schedule and adequate amount of time for supervision.
b. is available and accessible when needed including impromptu consultations and crisis.
c. helps you establish alternative source of consultation when unavailable or when specialty consultation is indicated.
d. participates actively during supervision sessions. e. communicates enthusiasm about and commitment to supervision.
4. Supervisor is amenable to working through conflicts, disagreements, or differences in opinions with supervisee:
a. supervisor openly addresses conflicts or problems in a constructive manner.
b. when conceptual disagreements arise, supervisor negotiates them in a nonjudgmental.
c. if an impasse occurs, supervisor arranges for mediation to facilitate conflict resolution.
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Facilitation of Training Experience Rating
1. Works with you to reach the training goals in your clinical setting: a. provides clear expectations for your role and performance. b. helps you to identify your own training needs and goals for rotation.
c. assists in meeting your training goals. d. helps you to understand intern exit competencies and training goals.
2. Provide Feedback on your performance that helps you to develop your clinical skills:
a. helps you identify your specific strengths and competencies. b. provides feedback on your performance and written work is constructive and specific.
c. provides opportunities for direct supervision of your clinical work (e.g., through live observation, review of audio recordings, co-treatment).
d. facilitates your accurate self-assessment (e.g., skill level, limits of competence, and need for consultation, interpersonal interactions, diversity issues, and other blind spots).
3. Provide supervision and guidance in all stages of the treatment process: a. helps prepare you for various types of persons, problems, and staff relationship.
b. helps with case conceptualizations, treatment planning, and working through impasses in treatment.
c. helps you to recognize your emotional responses to the clinical process and address personal issues that may interfere with effectiveness.
d. helps you to understand and address termination issues. e. discusses legal and ethical standards in clinical work and helps you to apply this knowledge in clinical situations.
Cultural and Individual Diversity Rating 1. The supervisor exhibits knowledge of and respect for cultural and individual diversity in clinical intervention and research:
a. has respect for diversity and at least basic awareness of providing culturally competent services.
b. is aware of his/her limitations of knowledge of cultural and individual diversity.
c. is helpful in seeking out additional information about diverse groups and effective therapeutic interventions with persons of different backgrounds.
d. models the process of consultations with colleagues about diversity issues when needed.
e. is aware of his/her own struggles with persons of different
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backgrounds. f. is aware of his/her own cultural identity, world view, and value system brought
Comments
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Signatures:
Intern___________________________________________ Date________________________
Supervisor_______________________________________ Date________________________
Internship Coordinator: _____________________________ Date________________________
Clinic Director________________________________ Date______________________
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Universidad del Turabo School of Social Science
Psychology Service Clinic Internship Program
Evaluation of Internship Program
Intern__________________________________________ Date_______________________
Primary Supervisor: ___________________________________ Training Year_____________
Please discuss all of these ratings with your supervisor and the Clinic Director. If you have
concerns about any aspect of the program, please give examples.
Scale
1 - Training needs not met 2 - Training needs somewhat met 3 - Training needs adequately met 4 - Training needs exceeded
Aspect Rating
1. Overall organization of training program.
2. Workload is challenging but not excessive.
3. Training plan is meeting goals, expectations, and training needs.
4. Expectations are clear.
5. Reactions, concerns, and problems are addresses adequately.
6. Adequate feedback regarding performance and progress.
7. Adequate opportunity for skills development.
8. Sufficient opportunity for input into training needs.
9. Environment is conducive to learning.
10. Environment is conducive to interrelationships among interns.
11. Resources are adequate (e.g., space, computers, and supplies).
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12. Treated in a professional manner.
13. Effective working relationships with support staff.
14. Amount of supervision support and availability.
15. Didactic experience and literature resources.
16. Opportunities training and support for clinical work.
17. Opportunities, training and support for teaching/supervision.
18. Opportunities training and support for research.
19. Incorporating and applying knowledge of culture and other diversity issues in training.
20. Training in professional, ethical and legal issues.
21. Overall satisfaction with program structure.
Comments
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Signatures
Intern_______________________________________ Date____________________________
Supervisor___________________________________ Date____________________________
Internship Coordinator__________________________ Date____________________________
Clinical Director_______________________________ Date_______________________
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Universidad del Turabo School of Social Science
Psychology Service Clinic Internship Program
Case Presentation Evaluation Form
Intern’s Name: ___________________________________
Date: ______________________
Examiner: _______________________________________
1 2 3 4 5r
Low Below
AverageAverage
Above Average
Superior
Adequately address the following domains:
Theory
Research
Assessment
Intervention
Integration of the above four domains
Communicates information in a clear, professional manner.
Demonstrates a thorough understanding of the information presented.
Is receptive to questions and comments from the audience, and responds to them in an informed manner.
Gives appropriate attention to ethical considerations (if applicable).
Comments: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Appendix H: Evaluation of Psychological Assessment Process Form and Evaluation of Case Conceptualization Process Form
Universidad del TuraboPsychology Service Clinic Internship Program
Intern: ________________________________ Case Record Number: _____________
Date: ___________________ Supervisor: _______________________________
Instruction: Rate the student's competence in the Psychological Assessment Process.
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
Total ScoreComments:
Evaluation of Psychological Assessment Process
_______ / 110
IV. Clinical Impressions(assess the integration between the referral, the examinee history and the diagnostic impression)
V. Grammar, Style, Communication (professional style, consistency, presented in an organized manner and without grammar errors)
I. Instrument Selection (the student selected the instruments relevant to the referral and with adequate standardization)
II. Administration of the Instruments(the student performed the assessment according to the standardization procedures)
Demographic Data(name, DOB, chronological age, etc.)
Referral Motive(it is clearly stated who, for what and why is referred )
Relevant History (relevant data of the examinee; developmental, health, academic, familiar/social, occupational; presented in chronological order in past tense)
Need Improvement
Clinical Observations(mental status, observation of the examinee during the assessment process, in past tense)
Test Results (test's results are presented in relevance order presenting a brief description of the test, areas measured and level. Table can be used with proper explanation)
Summary/Conclusion (begin stating the referral motive and presenting a brief summary of important data of the examinee history; assessment result integration with diagnostic impression. It should answer the referral motive.)
Recommendations(relevant and organized)
Exc.GoodReg
III. Report Writing
Universidad del TuraboPsychology Service Clinic Internship Program
Intern: ________________________________ Case Record Number: __________
Date: _______________ Supervisor: ________________________
Instruction: Rate the student's competence in the Case Conceptualization Process.
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
0 1 2 3 4 5 6 7 8 9 10
ScoreComments:
Goals (Long and Short Term)
Techniques (Relative to the model and client's needs)
Evaluation of Case Conceptualization Process
_______ / 120
Treatment Sessions (relative to client's need, diagnosis and treatment model)
Style, Grammar, Communication (professional, well written and organized)
Report Writing
Present Illnes & History of the Present Illness
Relevant History
Mental Status
Conceptualization Process
Need Improvement
Selected Theory/Model (Evidence Based Model)
Integration (Integration of Model with Client's HPI and History)
Diagnostic Impression
Treatment Plan
Exc.GoodReg
Demographics
Strengths, Weakness & Prognosis (relative to the client)
Diagnostic Impression (DSM-IV TR)
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Universidad del Turabo School of Social Science
Psychology Service Clinic Internship Program
Evaluation of Didactic Presentation
Please fill out in ink, fill out only one form per presenter/topic.
Date of Presentation ____________ Presenter _________________________________
Topic _____________________________________________________________________
On the basis of my overall impression of this presentation I would evaluate it as:
Excellent____ Good____ Undecided____ Bad____ Very Bad____ 1. The consultant was well prepared for the presentation. Strongly agree____ Agree ____ Undecided____ Disagree____ Strongly disagree____ 2. The material presented was interesting. Strongly agree____ Agree ____ Undecided____ Disagree____ Strongly disagree____ 3. The material presented was informative. Strongly agree____ Agree ____ Undecided____ Disagree____ Strongly disagree____ 4. The consultant’s method of presentation was: Excellent____ Good____ Undecided____ Bad____ Very Bad____ 5. The consultant addressed relevant diversity issues. Strongly agree____ Agree ____ Undecided____ Disagree____ Strongly disagree____ 6. What aspect of the presentation did you like most and why? 7. What aspect did you like the least and why? 9. Suggestions for improvements in the topic or the consultant’s presentation.