Health Counseling

and Mental Rehabilitation

Manual Internship

Student Handbook

TABLE OF CONTENTS Internship Manual

Introduction to Internship

• Purpose Time Commitment ....................................................................................... Int 2

Phases of Training......................................................................................... Int 2

Accommodations .......................................................................................... Int 3

• Student Intern Role ........................................................................................ Int 3

• Internship Site Supervisor Role ..................................................................... Int 4

• Faculty Supervisor Role ................................................................................. Int 5

• Phases of Training.......................................................................................... Int 6

• Guidelines for Using ASL Interpreters .......................................................... Int 10

• CORE/CACREP Standards – Clinical Experience ........................................ Int 10

Forms

• Internship Agreement..................................................................................... Int 14

• Learning Objectives

Mental Health Setting Sample ..................................................................... Int 19

Youth Transition Program Setting Sample .................................................. Int 20

VR Setting Sample ....................................................................................... Int 21

VAVR Setting Sample .................................................................................. Int 22

• Weekly Record of Internship Per Term ......................................................... Int 23

• Summary of Winter & Spring Internship Hours ............................................ Int 24

• Explanation of Columns on Weekly Record of Internship Hours Form ........ Int 25

• Check-off Sheet for Internship Documents

Faculty Site Visit............................................................................................. Int 26

End of Winter Term ........................................................................................ Int 27

End of Spring Term ........................................................................................ Int 28

• Internship Evaluation of Graduate Students in RMHC Program ................... Int 29

• Rating of RMHC Faculty Involvement.......................................................... Int 33

• Rating of Internship Site Supervisor .............................................................. Int 35

• Internship Log for CRC Supervision Credit .................................................. Int 37 Int 1

INTRODUCTION TO RMHC INTERNSHIP Purpose The Internship, which is 600-clock hours and includes 240-direct-client-contact hours (D.2), is the culminating experience of the two-year program leading to a Master of Science Degree in Rehabilitation and Mental Health Counseling. Prior to beginning the Internship, the student will have completed a basic core rehabilitation counseling course and a required number of practicum hours (100 clock hours). For the graduate student, the principle objective of the Internship is to provide an opportunity to integrate knowledge and skills in a rehabilitation counseling setting. Testing theory and practice under competent supervision enables students to make the necessary transition from the University to the actual work setting. If the transition is made with adequate supervision, the graduate student will gain competence and confidence in the delivery of rehabilitation counseling services. The Internship experience is one that must provide rehabilitation counseling services to individuals with disabilities and must be appropriate to the mission of the RMHC program. In addition to preparing the graduate student for transition into the world of work, the Internship program will be of benefit to the agency involved. The graduate student brings to the staff an enthusiasm and willingness to learn as well as basic knowledge and skills already acquired. It is expected that the student will have work responsibilities comparable to a regular staff member, thereby contributing substantially to the functioning of the host organization. Time Commitment The two-year counseling program requires a minimum of 18 credits of RC 610 Internship over two terms. Time equivalents for credit hours are as follows: 9 credits equal 32-35 hours per week on-site (300-hours per term; 600-hours total required with at least 240 of those hours providing direct services to persons with disabilities). The Internship will begin the student’s second winter term (early January) and continue through to the end of Spring term (early June). It is ideal if a student can arrange the final practicum hours to be completed at his/her Internship site. Phases of Training It is suggested that supervised fieldwork be divided into three phases: Orientation, Observation, and Participation. These, no doubt, will overlap. It is expected that the time devoted to participation is relatively longer than that devoted to orientation and observation. It is expected that each student will work under the close supervision of one of the agencies' staff members. This person should have a desire to aid in the preparation of new professional personnel and be willing to become part of the total training program. He or she must be willing to devote the necessary time for proper training and have the ability to supervise the student in fieldwork as demonstrated by successful experience and professional training at the graduate level, as well as appropriate professional certification (CRC for Rehabilitation Counselors).

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The climate of the fieldwork is best set when the agency accepts the intern as a professional colleague, even though it is understood that s/he is neither expected nor required to carry the same responsibilities as fully qualified staff members. It helps the student to develop a sense of professional responsibility if allowed to attend and participate in various staff meetings and be accepted as a member of the professional team. Interns are responsible for their expenses in connection with the Internship. In some cases, to help defray expenses, students receive a traineeship stipend during fieldwork. These arrangements are made specifically with the training agency. The intern assumes responsibility for regular attendance, conformity to agency rules, regulations and standards, adherence to the CRC Code of Ethics (available in the Student Handbook), following through with staff assignments which are given by the agency supervisor. Interns are not covered by accident or Worker's Compensation by the University or the Oregon University System of Higher Education. It is the intern’s responsibility to purchase student liability insurance coverage throughout their Internship experience. Accommodations An access plan will be developed to address the accessibility need for any graduate student who is Deaf or has a disability prior to beginning their Internship. The access plan will be developed collaboratively with the student, the RMHC program, the supervisor from the training site and the director of Western’s Office of Disability Services. Please refer to the Office of Disability Services, Accommodating Students in the Classroom, Faculty and Staff Handbook for additional information. You may contact the Office of Disability Services at 503-838-8250.

STUDENT INTERN ROLE Given the Rehabilitation and Mental Health Counseling (RMHC) Program Clinical Coordinator’s approval of the agency as an appropriate Internship site and mutual acceptance by both student and agency of the Internship experience, the student intern will follow the procedures listed below:

1. Develop a written agreement with the agency or institution in which the Internship is to take place. The agreement will describe the objectives, duties and responsibilities related to the Internship experience, as well as the weekly schedule. All Internship Agreements are to be completed and signed one term prior to Internship.

2. Maintain an ongoing time log of activities and hours, including the hours of direct services to persons with disabilities, to be discussed weekly with and initialed by the agency supervisor. A total of 600 or more clock hours, including at least 240-hours of direct services to clients must be accumulated during the Internship experiences.

3. Maintain an ongoing personal journal to include personal reactions to situations and experiences throughout the Internship. These will be emailed to the faculty supervisor weekly and an option to share this with site supervisor as part of supervision.

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4. Consult with the Internship site supervisor (must be a CRC or LPC) at least one hour per week. During this consultation the intern and site supervisor may discuss specific caseload issues and general progress on Internship objectives.

5. At mid-term and at the end of the academic quarter, the intern and site supervisor will complete a required RC 610 Internship Evaluation (pages 19 through 21 of this manual). These evaluations must be completed and signed and submitted to the faculty supervisor by Monday of mid-term and then again Monday of dead week each quarter.

6. Student interns MUST attend all mandatory Internship campus meetings. Failure to attend mandatory meetings will affect student’s successful completion of RC 610. Distance participation is available for students with out-of-state Internship sites.

INTERNSHIP SITE SUPERVISOR ROLE

The Internship site supervisor must be an experienced professional in rehabilitation-related human services who has been assigned by the agency or institution to oversee and evaluate the intern. Internship experiences shall be carried out under the weekly scheduled supervision of a Certified Rehabilitation Counselor (CRC) or Licensed Professional Counselor (LPC). The site supervisor assists the intern, with input from the RMHC Clinical Coordinator and Faculty Supervisor, in establishing Internship goals, assessing professional development, and in helping the intern become an integral part of the staff and counseling setting. The site supervisor will assist the intern in:

1. Developing a list of objectives, responsibilities, and tasks specific to the agency or institution involved. Sign and accept a copy of this document by October 15 (Fall term prior to Winter term Internship start-up).

2. Acquisition of specific skills and knowledge related to direct delivery of services to persons with

disabilities.

3. Planning for efficient use of time and resources.

4. Maximizing client potential and self-determination skills.

5. Fostering positive working relationships with supervisors, peers, and related agencies.

6. Provide the intern with counseling situations in which s/he can gain experience in practical application of methods and techniques.

7. Model and discuss appropriate ethical behavior and procedures as outlined in either the Code of

Professional Ethics for Rehabilitation Counselors (CRCC) or the Ethical Standards by the American Association for Counseling & Development (AACD).

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8. Directly observe at least a portion of the intern’s counseling sessions whether live or via appropriate technology.

9. Meet with the intern at least one hour each week to provide supervision. The on-site site supervisor

will sign off on document noting the week and time spent in supervision which will be submitted per term to faculty supervisor (page 17 of this manual).

10. Verify the supervision and client contact hours recorded in student log. Verification should be

done on a regular base (e.g., at minimum, weekly, with supervisor initials) (page 17 of this manual).

11. Communicate with the faculty supervisor regarding progress of the intern, at minimum, twice per

term. One contact most commonly occurs with faculty supervision visiting internship site.

FACULTY INTERNSHIP SUPERVISOR ROLE

The Clinical Coordinator and student will establish contact with the site supervisor and discuss agency requirements and standards for Internship placement. Supervision of student skill development and acquisition of knowledge has been the primary responsibility of faculty during the three terms of practicum. The faculty supervisor will function as a liaison between Western Oregon University and the Internship placement agency. Primary responsibility of actual supervision of counseling rests with the on-site supervisor. During the course of the Internship, the faculty supervisor will perform the following tasks:

1. Maintain ongoing contact with the Internship site supervisor and intern. The goal is to make at least five (5) contacts during the term with at least one of them as an on-site visit. An out-of-state placement may necessitate phone/video conferencing verses actual site visitations. The other communication throughout the term between the site supervisor and the faculty supervisor may be accomplished via site visits, conference calls, video conferencing, or other electronic communications.

2. Review the Intern's Record of Internship Hours at mid-term and then again at the end of the term to make sure the intern will complete the required hours.

3. Review the mid-term and final for “RC 620 Internship Evaluation” submitted by the student and signed by both the site supervisor and intern. Review all student documents and submit a grade for the RC 610 Internship.

4. Evaluate the entire Internship experience for both student and agency and work toward continued improvement of learning opportunities for the student.

5. Provide ongoing support and any intervention needed, if problems arise with the student intern or placement agency.

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PHASES OF TRAINING

Orientation, Observation and Participation

INTERN ORIENTATION:

Physical Facilities - Tour of Physical Plant *

Files: charts, case folders, records, etc.

* Supply room: supplies, equipment, forms, etc.

* Reference material: library, manuals, technical dictionaries, occupational information, vocational testing materials, etc.

Agency Functions and Services

* History of agency

* Support of income structure

* Overview of services

* Administrative organization

* Acceptance or admission policy

* Referral sources

* Client population

* Reporting and statistical procedures

* Policy regarding confidentiality

Agency Routines and Office Regulations

* Hours of work

* Lunch times

* "Breaks" * Holidays

* Use of telephones, computers, and other office equipment

* Clerical personnel protocol * Travel expenses (if allowable)

* Signing in and out

* Agency report schedules and their significance in agency administration

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* Dress codes

Staff Role and Function

* Managerial

* Professional

* Clerical

* Personal interviews with administrators and department heads: social service, occupational therapy, physical therapy, nursing, medicine, psychology, speech, etc.

Client

* Select several typical cases (current or closed) for study or analysis, which illustrate agency function, clients served, and the specialist's role.

* Risk assessment (such as health safety issues)

INTERN OBSERVATION:

In order for the student to feel secure in the new setting, it is essential to provide an initial period of observation prior to the direct management of the cases. Suggested areas for student observations:

Interviewing

* Intake or screening interviews

* Counseling interviews

* Social work interviews

* Interviewing with clients who differ as to type and severity of disability, background, etc.

Procedures Involved in Diagnostic Work-Up

* Medical

* Psychological

* Vocational * Social

* Assessment

Case or Team Conference

* Intra-agency

* Inter-agency

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Staff Meetings

* Administrative

* In-service training

Medical and Psychiatric Consultation Case Recording Counselor "Field" Rounds (Provision of Services)

* Home visits

* Employer visits (job promotion, follow-up) * Community resources:

State and county cooperating agencies

Schools

Training facilities

Hospitals

Rehabilitation centers, etc.

INTERN PARTICIPATION:

Students should be permitted to engage in as many activities as individual readiness and time availability will allow (see suggested activities below). The student should progress to a point, where s/he will be able to complete a few less complicated cases or at least carry them far enough along to have a sense of accomplishment in seeing the client's progress toward appropriate goals.

With Clients

* Screening interviews, intake interviews, reviewing assessment results, counseling, planning interview, follow-up on training or placement.

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With Facilitating Personnel and Agencies

* Individual or team consultation with staff and community partners concerning an assigned case. Examples include mental health departments, sheltered workshops, training agencies, state employment services, private health, job developers, and family-service agencies

Suggested Criteria for Case Selection

* The case should be typical or representative of those carried or served by the agency.

* There should not be too many reality limitations (transportation problems, limited time available for appointments, reluctance on the part of the client to come, etc.).

* Cases should represent the different types of services rendered by the agency.

* There might be a balance of new and old cases which would give the intern experience with the various stages of the rehabilitation process.

* The case situations should present an opportunity for some collateral contacts whenever possible.

* There should be some prospect of change or movement, allowing the intern to experience success.

* Client should be prepared to receive assistance and have little degree of personality disturbance.

* The nature of the case problem should be such as to allow the intern and client to work through to problem solution and plan of action without undue pressure or need for precipitate action.

* The case selected should have potential usefulness in the instruction of interns by the agency supervisor.

* The cases selected should be a challenge to the professional development of the intern.

As student growth and capacity increase, cases of increasing complexity can be assigned, including a variety of problems that require multiple services outside the agency. Students have the opportunity to become involved, to test their impressions, and to develop awareness of their own abilities and limitations from initial interview to final contact with the client. Fieldwork experience is most useful when it provides opportunity to practice and test out techniques, and when it leads to self-understanding, as well as client understanding.

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Guidelines for Using ASL Interpreters

What is the role of the RCD counselor-in-training:

• The RCD counselor-in-training cannot take on the additional role of interpreter when working as a Practicum student with a site mentor and/or volunteer client. Doing so would create a dual relationship which places the counselor-in-training in an unethical situation.

o EXAMPLE: If the site mentor does not know sign language and is meeting with a RCD counselor-in-training and a volunteer client who both sign, the RCD student will not be able to provide interpreting for the mentor. A professional interpreter will need to be hired.

Who is responsible to schedule an interpreter:

• The RCD counselor-in-training will schedule an interpreter through WOU if one is needed to communicate with a site mentor or with a volunteer client.

o EXAMPLE: If the RCD student is Deaf and the site mentor does not know sign language, then the student will be responsible to secure an interpreter.

• The site mentor will schedule an interpreter if one is needed for the mentor to communicate with a volunteer client.

o EXAMPLE: If a non-signing mentor chooses to join a counseling session with a RCD student and volunteer client who both sign, the mentor will be responsible to secure an interpreter.

• Staff meetings vary depending on who is attending and the accommodation needs. o EXAMPLE: Both the site mentor and RCD student are attending a staff meeting where the

site has historically been providing an interpreter. The site would continue to be responsible for securing an interpreter. o EXAMPLE: On the RCD student is in need of ASL interpreting. The student would be responsible for securing an interpreter.

Western Oregon University’s Office of Disability Services is the contact for students seeking accommodation in the form of ASL interpreting. Students are encouraged to get a recommended list of interpreters in the area of the clinical site. When meetings will be occurring on a regular basis a schedule is encouraged to be created and forwarded to disability services as soon as it is know. In the case of Internship that may even be 3 to 4 months in advanced.

Concise Data ODS Needs for an Interpreter Accommodation:

• DATE & TIME FRAME – example, 1/1/11 9am-11am • WHERE – includes location and address • JOB TYPE – intake, client 1 on 1, staff meeting

APPLICABLE CORE and CACREP STANDARDS

C.1.4 Ethics C.1.4 a. practice rehabilitation counseling in a legal and ethical manner, adhering to the Code of Professional Ethics and Scope of Practice for the profession.

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C.2.3 Implications of cultural and individual diversity including cultural, disability, gender, sexual orientation, and aging issues C.2.3.a. provide rehabilitation counseling services in a manner that reflects an understanding of psychosocial influences, cultural beliefs and values, and diversity issues that may affect the rehabilitation process. C.5.3 Counseling skills and techniques development C.5.3.a. develop and maintain confidential counseling relationships with individuals with a disability using established skills and techniques. C.5.3.b. establish, in collaboration with the consumer, individual counseling goals and objectives. C.5.3.c. apply basic counseling and interviewing skills. C.5.7. Termination of counseling relationships C.5.7.a.facilitate counseling relationships with individuals with a disability in a manner that is constructive to their independence. C.5.7.b.develop a plan of action in collaboration with the consumer for strategies and actions anticipating the termination of the counseling process. C.5.9 Boundaries of confidentiality C.5.9.b. identify established rehabilitation counseling ethical standards for confidentiality and apply them to actual case situations. SECTION D: Clinical Experience D.1 Students shall have a minimum of 100 hours of supervised rehabilitation counseling Practicum experience with at least 40 hours of direct service to people with disabilities (not role-playing clients). Practicum students shall have experiences that increase their awareness and understanding of the differences in values, beliefs, and behaviors of individuals who are different from themselves. D.1.1 The practicum shall include instructional experiences (audio-video tapes and individual and group interaction) dealing with rehabilitation counseling concerns, and clinical experiences (on or off-campus) that facilitate the development of basic rehabilitation counseling skills. During the practicum, students will conduct interviews that will be reviewed by a supervisor. If practicum experiences are provided off-campus, there will be direct and periodic communication throughout the semester between the site supervisor and the faculty (e.g., site visits, conference calls, video-conferencing, electronic communication). Practicum activities shall be documented in logs, progress reviews, and summaries. The program faculty member responsible for practicum supervision must be a CRC. D.1.2 Written expectations, procedures, and policies for practicum will be distributed to students and supervisors. This will include the policy that the practicum is a prerequisite to the supervised rehabilitation counseling clinical Internship experience.

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D.1.3 Practicum experiences shall include an average of one (1) hour per week of individual and 1½ hours per week of group (with no more than ten students/group) supervision by a program faculty member or qualified individual working in cooperation with a program faculty member. D.1.5 In states that have specific practicum supervision requirements for counselor licensure, the program shall make the required supervision experiences consistent with the licensure requirements available to those students desiring to qualify for licensure. D.1.6 There shall be a written progress review of the performance/counseling skills of all students enrolled in a practicum. D.1.7 There shall be a written procedure for responding to students who do not demonstrate satisfactory practicum knowledge or clinical skills. D.1.8 The individual supervision of five students shall be considered to be equivalent to the teaching of one course. Clinical Rehabilitation Counseling Standards

Students are expected to know, understand, and apply relevant research findings, models of program evaluations, and evidence-based treatments in rehabilitation counseling. (IIG.K and L) Specifically, students are expected to:

1. Understands ethical and legal considerations specifically related to the practice of rehabilitation counseling. (A.2.)

2. Understands the roles and functions of rehabilitation counselors in various practice settings and the importance of relationships between counselors and other professionals (e.g., medical and allied health professionals), including interdisciplinary treatment teams. (A.3.)

3. Understands methods, models, and principles of clinical supervision. (A.7.)

4. Applies knowledge of disability policy, financing, and regulatory processes to improve service delivery opportunities in rehabilitation counseling. (B.2.)

5. Understands how disability affects the human body, including relevant medical terminology. (C.1.)

6. Understands the onset, progression, expected duration, and functional limitations specific to the client’s disability from a holistic perspective (i.e., physical, spiritual, sexual, vocational, social, relational, and recreational). (C.2.)

7. Applies the principles and practices of rehabilitation counseling concerning issues such as etiology, diagnosis, treatment, and referral for clients with disabilities, including clients with co-occurring disabilities. (D.1.)

8. Knows the principles, models, and documentation formats of biopsychosocial case conceptualization and treatment planning. (E.5)

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9. Recognizes the importance of family, social networks, and community in the provision of services for and treatment of people with disabilities. (E.6.)

10. Understands professional issues relevant to the practice of rehabilitation counseling. (E.7.)

11. Applies multicultural competencies to rehabilitation counseling. (F.2.)

12. Applies current record-keeping standards related to rehabilitation counseling. (F.5.)

13. Demonstrates the ability to recognize his or her own limitations as a rehabilitation counselor and to seek supervision or refer clients when appropriate. (F.6.)

14. Understands how living in a multicultural society affects clients seeking rehabilitation counseling services. (G.1.)

15. Understands the effects of discrimination—such as handicapism, ableism, racism, sexism—and power, privilege, and oppression on one’s own life and career and those of clients. (G.3.)

16. Understands current literature that outlines approaches, strategies, and techniques shown to be effective when working with specific populations of clients with disabilities. (G.4.)

17. Maintains information regarding community resources to make appropriate referrals for clients with disabilities. (H.1.)

18. Understands how to critically evaluate research relevant to the practice of rehabilitation counseling. (K.1.)

19. Knows evidence-based treatments and basic strategies for evaluating counseling outcomes in rehabilitation counseling. (K.3.)

20. Applies relevant research findings to inform the practice of rehabilitation counseling. (L.1.)

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CLINICAL SITE AGREEMENTWestern Oregon University

Rehabilitation and Mental Health Counseling (RMHC)

Graduate Student ________________________________ Phone _____________V/VP

Address___________________________________________________________________Street City State Zip

WOU Email _______________________________ WOU V# ______________________

RMHC Clinical Coordinator: Kim Poage, MS, CRCPhone 503-838-8758 Video Phone 503-710-9686Email poagek@wou.edu Fax 503-838-8228 Address 345 North Monmouth Ave, RWEC Building, Monmouth Oregon 97361

Clinical Site/Cooperating Agency Name ________________________________________

___________________________________________________________________________Street City State Zip

Type of Clinical Coursework: PRACTICUM INTERNSHIP BOTH

Terms: _____ FALL (late September to early December)

_____ WINTER (early January to late March)

_____ SPRING (early April to middle of June)

_____ SUMMER

*note: Internship is traditionally done Winter and Spring terms

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SUPERVISION

Please list the primary clinical site supervisor and all other individuals who will provide supervision and evaluation of your clinical performance. All clinical supervisors need to sign the last page of this agreement. Sites are encouraged but not required to have two site supervisors assigned.

1. Primary Supervisor ____________________________________________________

CRC: YES NO LPC: YES NO Other: __________________ Highest Academic Degree_______ Degree Name ______________________________

Types of Experience (brief narrative; VR, mental health, academic, population types):_______________________________________________________________________

_______________________________________________________________________

Training in Counseling Supervision? YES NO

If yes: where/what?________________________________________________________

________________________________________________________________________

E-mail _____________________________________ Phone _____________V/VP

2. Secondary Supervisor ______________________________________ (not required)

CRC: YES NO LPC: YES NO Other: __________________ Highest Academic Degree_______ Degree Name ______________________________

Types of Experience (brief narrative; VR, mental health, academic, population types):_______________________________________________________________________

_______________________________________________________________________

Training in Counseling Supervision? YES NO

If yes: where/what?________________________________________________________

________________________________________________________________________

E-mail _____________________________________ Phone _____________V/VP

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LEARNING OBJECTIVES

Practicum Learning Objectives These are based on the course syllabus which can be provided if requested by the clinical site. Students in the second and third terms of Practicum will also be applying their chosen theory which student’s will also provideif requested to the clinical site.

Internship Learning Objectives Learning objectives are created in collaboration between the Graduate Student Counselor-In-Training, Clinical Site Supervisor(s), and RMHC Clinical Coordinator/Specialist. The use of measurable behavioral objectives is encouraged. Learning objectives will be reviewed and evaluated with the student and Site Supervisors at the end of each term. Please attach a copy of agreed upon learning objectives including duties, responsibilities, and/or projects to be performed by student interns during their counselor-in-training experience prior to Internship beginning. Often including portions of a positions job description is helpful.

Required duties and responsibilities for student intern:

To follow the time lines and required assignments found in the Internship syllabus.

Adhere to the rules and policies of the named cooperating agency.

Adhere to the CRC Code of Professional Ethics for Rehabilitation Counselors and/or the Ethical Standards by the American Association for Counseling & Development (AACD).

Maintain liability insurance coverage through HPSO.

The following section refers to Internship only requirements found in the RMHC Clinical Supervisor Handbook. Graduate Student Counselor-In-Training and site supervisor(s) are asked to initial eachsection once reviewed. The RMHC Clinical Supervisor is available to answer questions and provide clarification.

Handbook Section Student Site Supervisor Site SupervisorPurpose

Student Intern Role

Internship Site Supervisor Role

Faculty Supervisor Role

Phases of Training

Internship FormsHOURS

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Practicum Hours Schedule

Number of Clients Scheduled to Work With (circle a range if needed): 1 2 3 4 5+

Days and times will be worked out to be in alignment with site schedule, client schedule, and student schedule as they will still be taking graduate school courses during time of Practicum coursework.

Internship Hours Schedule

Internship hours must total a minimum of 600 hours including a minimum of 240 hours of direct service over the course of what is traditionally two terms. Students traditionally are on their internship site 30 to 32 hours per week. Students are encouraged to take Spring Break off (late March) but will depend on the needs and availability of the internship site.

If students complete their minimum internship hours and meet their learning objectives before the end of the scheduled Internship, they have the option to finish their internship at that time. For students who choose to end their scheduled Internship early, approval must be obtained from their Clinical Site Supervisor and Faculty Supervisor as well as completion of a formalized amendment to the internship agreement prior to leaving Internship site. Students are encouraged to continue with hours at their internship site to maximize possible hours for LPC internship as well as employment opportunities. Winter M T W Th F Hrs per week Term Total Term _____ _____ _____ _____ _____ ________ ________

DATES: January _____ through March _____ = 11 weeks

Working Over Spring Break? YES NO

Spring M T W Th F Hrs per week Term Total Term _____ _____ _____ _____ _____ ________ ________

DATES: April _____ through June _____ = 11 weeks

SIGNATURES

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________________________________________________________________ ______ Graduate Student Counselor-In-Training Date

__________________________________________________ _ ______ _________ RMHC Clinical Coordinator/Specialist Degree Date

Certification_____________ License _______________ Other: _________________

________________________________________________________________ ______Primary Clinical Site Supervisor Degree Date

Certification_____________ License _______________ Other: _________________

__________________________________________________________________ ____Secondary Clinical Site Supervisor Degree Date

Certification_____________ License _______________ Other: _________________

Attached: Learning ObjectivesCopy to: Graduate Student Counselor-In-Training, RMHC Clinical Coordinator/Specialist, Clinical Site Supervisor(s)

Mental Health Setting

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1. Orientation to physical facilities, files, supplies and equipment, forms, reference materials2. Orientation to agency functions and services; history of agency, overview of services,

administrative organization, acceptance policy, referral sources, client population, reporting and statistical procedures, confidentiality policy

3. Orientation to agency routines and office regulations: hours, lunch, breaks, holidays, use of equipment, dress codes, agency report schedules

4. Orientation to staff role and function: managerial, intern, professional, clerical5. Orientation to client files that illustrate agency function, clients served, specialist’s role

6. Observation: client interviewing, intake or screening, counseling7. Observation: Diagnostic Process8. Observation: Case or team conference, inter and intra-agency9. Observation: Staff meetings, In-Service training10. Observation: medical and psychiatric consultation11. Observation: Case recording

12. Participation: With clients in screening interviews, intake interviews, regarding assessment results, counseling, planning interview, counseling

13. participation: With other professionals concerning case in team staffing weekly, in weekly hour long individual supervision sessions with CRC and LPC supervisors

14. Continue to develop and practice skill in solution-focused counseling interventions and techniques15. Review current research regarding solution-focused counseling, stress management skill

development, and applications of Integral Theory to developmental challenges for young adults16. Review research and incorporate Motivational Interviewing and Stage of Change theory in

interventions with mandated clients

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Youth Transition Program Setting

1. Identify potential participants from students projected to graduate in June 2010 and June 2011 who are currently receiving special education services from high school and who have the greatest potential for success in YTP.

2. Coordinate with special education teachers to identify and refer students to VR.3. Attend all high school student IEP meetings to better understand each student’s learning and

performing needs and barriers.4. Observe potential YTP students in special education classes to assess the student’s readiness

to participate.5. Use Career Information System (CIS) when beginning to work with students interested in

participating in the YTP program.6. Coordinate the IEP with the IPE collaboratively with the VR counselor as well as district

counseling and special education staff. During joint IEP/IPE in-take meetings, make sure the appropriate school eligibility documentation (testing, psychological evaluations, WAIS/WISC test scores, medical diagnoses, and any other school information used to determine eligibility) will be presented and discussed.

7. Carefully consider each student’s career goals and parameters affecting their academic success, help to ensure that the IPE is developed to direct them to the most appropriate path to develop their career plan and meet program performance benchmarks.

8. Assess student’s interests and abilities and help students focus their interests on career-related goals.

9. Develop vocational goals with each student that reflects the student’s present level of performance and the specific interests of the student expressed in their IEP and IPE.

10. Meet with students to develop and focus their work-related interests. This will be done with students individually on a pull-out basis in addition to coordinating and facilitating a bi-weekly job club (during the lunch break), teaching career exploration classes for vocational credit (a vocational elective) and aiding students that are seniors in their career-based senior project (a requirement for graduation). In addition, students will attend career exploration events at local community colleges and travel to a variety of vocational training opportunities, (Job Corps, International brotherhood of Electrical Workers (IBEW), heavy equipment operation, beauty schools, culinary schools).

11. Ensure that all students participating in the YTP program will at least attend one supervised, on-campus or off-site work experience. On-campus experiences may include childcare, cadet teaching, janitorial, office assistants, pool staffing, or sports assistant that will be supervised. Off-site experiences, mostly paid, some volunteer, include grocery clerk, childcare, retail sales, gas station attendant, food service, clerical, stock room attendant, health care support.

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VR Setting

1. Gain a working knowledge of referral sources, referral process, orientation to services, conduct initial interviews, enter new case file into case management system.

2. Be able to accurately determine eligibility for vocational rehabilitation services by obtaining, analyzing, and evaluating all pertinent medical, psychological, social, vocational and additional applicable data.

3. Understand Order of Selection and make priority designation as part of the eligibility determination process. Meet with clients to provide information and referral while they are on the wait list.

4. Form a collaborative working relationship with eligible clients of the vocational rehabilitation program in order to remove barriers that exist to suitable employment posed by the individual’s functional impairments. Assess client’s state of change. Refer to motivational interviewing workshop and/or conduct one-on-one with client. Explore client concerns about working until client behaviors demonstrate preparation to write the IPE.

5. Write the IPE after demonstrating client informed consent to the vocational goal and services. Provide follow-up of plans with reports and appropriate documentation

6. Be able to provide a range of placement services; knowledge of vendor services and coordination of the referral to a vendor, direct employer contact to develop job leads and client referral for job interview.

7. Develop and maintain documentation of client progress, monitoring time limits and training schedules agreed to in the IPE, all while monitoring for service cost within the approved VR budget.

8. Monitor and evaluate client progress and make appropriate modifications of the rehabilitation plan as necessary. Also provide post-employment services as needed.

9. Demonstrate proficiency in entering case documentation into case management system.10. Serve as a professional representative of VR with advocates, employers and other public

agencies and vendors.11. Participate as a team member with counselors and clerical staff of the VR office.12. Gain a strong working knowledge of the VR system, guidelines, policies and mission

statement.13. Maintain a working client caseload of at least fifteen clients by the end of the internship

period.14. Feel comfortable and ready to ask questions of the support staff and supervisors that the

office will provide.

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VAVR Setting

1. Obtain, analyze and evaluate pertinent medical, psychological, social, vocational and other data to determine eligibility and entitlement for services; the existence of a vocational handicap, the severity of the employment handicap, the feasibility for reaching a vocational goal and the need for independent living services.

2. Form a partnership with eligible persons with disabilities to develop a plan to remove barriers to suitable employment and that leads to employment (rehabilitation plan) and provides follow-up on active plans with reports and adequate documentation.

3. Administer and interpret vocational assessment, testing, and records; complete transferable work skills analysis, and employability assessment potential after initial interview.

4. Utilize information from assessment, knowledge of DVA regulations, assessment of data from medical, psychological sources, vocational assessments and labor market data.

5. Consider complete personal, vocational and educational history, data on limitations related to disability. Evaluate abilities, aptitudes and interests. Guide career exploration and assist in selecting rehabilitation resources.

6. Develop and maintain case documentation, timetables and training schedules; monitor service costs (where applicable) within standards for budget management; Document procurement of service.

7. Evaluate client progress and make changes to rehabilitation or treatment plan as needed. Provide problem-solving counseling, adjustment counseling.

8. Provide individual and group counseling to provide information and assistance with the program.

9. Participate as team member and representative of VBA and VHA with other providers.10. Maintain log of activities and hours, including hours of direct services to be discussed weekly

with and to be initialed by supervisor for a total of 600 or more clock hours, including at least 240 documented hours of direct service to persons with disabilities.

11. Maintain personal log to include personal reactions to situations and experiences throughout the internship.

12. Consult with on-site internship supervisor (CRC) at least one hour per week.13. At mid-term and end of academic quarter, intern and site supervisor will complete evaluation

and submit to faculty supervisor by Monday of mid-term and again Monday of dead-week each quarter.

14. Intern will attend mandatory internship seminars and on-campus meetings.

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WEEKLY RECORD OF TERM INTERNSHIP HOURS

Student: Instructor: Site/Agency: Site Supervisor:

WeekInternship

Site Supervisor

Initials

Direct Client

Contact

Indirect Client

Contact / Case

Activity

Supervision by mentor, peers, or faculty

Individual Supervision with CRC

Group Supervision with CRC

Other usual and

customary duties

Total Internship

hours worked

Week 1

Week 2

Week 3

Week 4

Week 5

Week 6

Week 7

Week 8

Week 9

Week 10

Week 11

Totals

Total Direction Client Contact + Indirect Client Contact/Case Activity = ____________

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END OF TERM SUMMARY OF INTERNSHIP HOURS

Student: Faculty Supervisor: Site/Agency: Site Supervisor:

Direct Client Contact

Direct Service Hours (Direct + Indirect Client Contact)

Supervision by mentor, peers, and faculty

Individual Supervision with CRC

Group Supervision with CRC

Other usual and customary duties

Total Internship hours worked

Total Winter Internship Hours

Total x 1.5 =

TotalSpring Internship Hours

Total x 1.5 =

Total Internship Hours

Winter Term Spring Term

Student Signature Date Student Signature Date

Internship Site Supervisor Signature Date Internship Site Supervisor Signature Date

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Faculty Supervisor Signature Date Faculty Supervisor Signature Date

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EXPLANATION OF COLUMNS ON WEEKLY RECORD OF INTERNSHIP HOURS FORMPLEASE WRITE CLEARLY

1. Week – Time worked at internship site broken up by the week. Please write in the dates for the week worked. Example: 9/1-9/5

2. Internship Site Supervisor Initials – Initials of internship site supervisor providing a minimum of one-hour weekly supervision that includes weekly hours log check.

3. Direct Client Contact – Direct Client Contact in the form of counseling/therapy services performed directly with clients. Examples include family, individual, couple, or group counseling. Comprised of face-to-face and/or voice-to-voice communication.

4. Indirect Client Contact/Case Activity – all other case activity related to a specific client. Examples include agency visit, advocacy, case management, consultation, employer contacts, interdisciplinary meetings, and labor market research.

Direct Client Contact + Indirect Client Contact = Direct Service Hours Minimum 240 Direct Service Hours Need for Internship

5. Supervision by Mentors, Peers, or Faculty – includes faculty site visits and discussion with peers and mentors regarding specific client issues.

6. Individual Supervision with CRC – This will be your site supervisor if they are CRC or faculty supervisor if your site supervisor is not CRC.

7. Group Supervision with CRC – This will be your site supervisor if they are CRC or faculty supervisor if your site supervisor is not CRC. 3 hours on campus twice a term Internship class time.

8. Other Usual and Customary Duties – This is the “catch all” category. All other work performed that does not fit in one of the other categories. Keep a list of these activities such as trainings and meetings not directly related to working with the client.

9. Total Internship Hours Worked – Total internship hours worked for the week.

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Check-off Sheet for Internship DocumentsFaculty Site Visit

Student’s Name: _______________________________________________

Name of Internship Site: _________________________________________

Date of Site Visit: ______________________________________________

Participants in Meeting: _________________________________________

Please check off the documents ready for your faculty site visit. This will be occurring once winter term and once spring term.

Please have the following documents ready to review but not submit:

DOCUMENTS

Current Weekly Record of Internship Hours

Any changes in student or internship site contact information, supervisors or learning objectives.

Internship Learning Objectives

Int 27

Check-off Sheet for Internship DocumentsEnd of Winter Term

Student’s Name: _______________________________________________

Please check off the documents attached to this form. Please also place the documents in the same order as listed below. Where totals are required on documents (weekly and term totals for internship hours) please total all hours prior to submitting. Please be sure to keep a copy for yourself and your internship site supervisor of all documents submitted.

DOCUMENTS

Winter Term Weekly Record of Internship Hours ~ Signed by Student Intern (check addition of hours)

Summary of Winter & Spring Internship Hours ~ Complete Winter Term section only. Signed by Site Supervisor and Student Intern (check addition of hours)

Internship Journal – hand in hard copy of email thread of weekly submissions to your faculty supervisor

Internship Supervisor End of Term Evaluation ~ Signed and reviewed by Site Supervisor and Student Intern

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Check-off Sheet for Internship DocumentsEnd of Spring Term

Student’s Name: _______________________________________________

Please check off the documents attached to this form. Please also place the documents in the same order as listed below. Where totals are required on documents (weekly and term totals for internship hours) please total all hours prior to submitting. Please be sure to keep a copy for yourself and your internship site supervisor of all documents submitted.

DOCUMENTS

Spring Term Weekly Record of Internship Hours ~ Signed by Student Intern (check addition of hours)

Summary of Winter & Spring Internship Hours ~ Add Spring hours to already completed Winter hours. Signed by Site Supervisor and Student Intern (check addition of hours)

Internship Journal – hand in hard copy of email thread of weekly submissions to your faculty supervisor

Internship Supervisor End of Term Evaluation ~ Signed and reviewed by Site Supervisor and Student Intern

Student Internship Exit Survey~ Signed by Student Intern

Internship Supervisor Exit Survey~ Signed by Site Supervisor

Clinical Coordinator End of Program Evaluation (completed by student and placed in confidential envelop to be complied by a 3rd party)

Int 29

RC 610 Internship Evaluation of Graduate Students in Rehabilitation & Mental Health Counseling Program

Western Oregon University

Student Intern Internship Supervisor(s)

Internship site supervisor(s) must complete this evaluation at the end of each term. The completed evaluation must be reviewed and/or completed with the student intern. Completed evaluations are a required part of the Internship course. They are to be submitted to the faculty Internship supervisor the middle of March for winter term and early June for spring term.

Evaluation Criteria for Rating: A = Advanced Level of Performance E = Emerging Level of Performance S = Satisfactory Level of Performance N/A = Not Applicable to Rate Performance I = Improvement Needed

Case Management Rating Winter Comments Rating Spring Comments Sets up client file.

Maintains confidential client file with all required forms/documentation for each contact.

Adequately prepares and presents oral updates or questions for site supervisors.

Effectively utilizes community resources/partners in providing services for clients.

Demonstrates appropriate documentation and follow-up activities of client referrals to vendors.

Demonstrates competency with time management.

Demonstrates ability to prioritize case management tasks to effectively move cases along to meet and complete goals.

Counseling Skills Rating Winter Comments Rating Spring Comments Demonstrates application and an understanding of the counseling process.

Int 30

Demonstrates use of facilitative dimensions of counseling (e.g., empathy, positive regard, genuineness, and reflective listening).

Demonstrates increasing competency in disability and culture related counseling skills.

Demonstrates skill in identifying and clarifying client issues.

Demonstrates competency in self critique and peer critique.

Seeks clarification and feedback from supervisors.

Benefits and responds appropriately to peer and supervisory feedback.

Demonstrates understanding of counseling techniques/theories necessary for Internship site.

Effectively explains and applies chosen counseling theory and case management theory.

Professional Behavior Rating Winter Comments Rating Spring Comments

Reports to Internship site and counseling appointments on time and is regular in attendance.

Reports absences to Internship site supervisor before the absence and notifies clients appropriately.

Accepts and follows through with assigned responsibilities.

Meets timelines set by Internship site supervisor.

Follows rules and policies of Internship site, including confidentially.

Appropriate use of personal disclosure statement as mandated by CRC Code of Ethics and/or Ethical Standards by the AACD.

Schedules and attends weekly hour of supervision prepared.

Attends to personal hygiene and appearance as a professional counselor in training.

Communicates effectively with other professionals (e.g., site mentor counselor, assistants, manager, referring agencies, vendors).

Shows sensitivity to linguistic and cultural differences of clients.

Shows energy, initiative, and commitment to clients and the Int 31

counseling profession. Shows initiative in assuming responsibilities, finding materials and resources, and improving own counseling skills.

Reflects upon and evaluates effectiveness as a counselor, & seeks to improve skills.

Displays honesty and integrity, and maintains confidentiality.

Please see attached Internship objectives with progress note next to each objective.

Winter Term Spring Term Summary of student strengths

Describe any areas to continue working on

Plan for Success Contract required for all students where this evaluation has identified one or more areas that are marked I for Improvement Needed. Contract will be created with Internship site supervisor(s), student intern and WOU Internship instructor.

Plan for Success Needed? (circle one) YES NO Signature acknowledges that the student has had an opportunity to read and discuss this report with the Internship Site Supervisor(s).

Int 32

____________________________________________________

Signature of Student Date ____________________________________________________ CRC# __________ LPC# ____________ Other __________ Signature of Agency Site Supervisor Date ____________________________________________________ CRC# __________ LPC# ____________ Other __________ Signature of Faculty Supervisor Date

Int 33

RATING OF RMHC FACULTY INVOLVEMENT (Completed by Internship Site Supervisor)

Rehabilitation & Mental Health Counseling Program Western Oregon University

Name of Site Supervisor: ___________________________________________________ Agency: ________________________________________________________________ Name of RMHC Student Intern: _______________________________________________ Please rate the RMHC Program and Faculty Supervisor on the following components: The RMHC Faculty Supervisor worked collaboratively with me and the student intern during the Internship experience.

Strongly Agree Agree Disagree Strongly Disagree N/A

The RMHC Faculty Supervisor communicated effectively with me as well as with the student intern.

Strongly Agree Agree Disagree Strongly Disagree N/A The RMHC Faculty Supervisor conferred regularly with the student intern and me regarding the student’s progress and development.

Strongly Agree Agree Disagree Strongly Disagree N/A The RMHC Faculty Supervisor modeled professionalism during Internship meetings.

Strongly Agree Agree Disagree Strongly Disagree N/A The RMHC Faculty Supervisor demonstrated respect for the student intern as an individual.

Strongly Agree Agree Disagree Strongly Disagree N/A The RMHC Faculty Supervisor served as a positive link between my agency and the university.

Strongly Agree Agree Disagree Strongly Disagree N/A The RMHC Program adequately prepared the student intern for Internship at my agency.

Int 34

Strongly Agree Agree Disagree Strongly Disagree N/A I would consider accepting a RMHC student intern in the future.

Strongly Agree Agree Disagree Strongly Disagree N/A Your comments are encouraged as we continually make improvements to our program:

____________________________________________________________________ Internship Site Supervisor Signature Date

____________________________________________________________________ Faculty Supervisor Signature Date

(Please submit completed document to intern prior to end of Internship service)

Int 35

RATING OF INTERNSHIP SITE SUPERVISOR (Completed by RMHC Intern)

Rehabilitation & Mental Health Counseling Program Western Oregon University

Name of RMHC Student Intern: ___________________________________________ Name of Site Supervisor: _______________________________________________ Agency: ____________________________________________________________ Please rate our Internship site and Site Supervisor on the following components: The Internship Site Supervisor served as a mentor to the culture of the agency where you had our Internship experience: Strongly Agree Agree Disagree Strongly Disagree N/A The Internship Site Supervisor demonstrated knowledge of best rehabilitation counseling practice.

Strongly Agree Agree Disagree Strongly Disagree N/A The Internship Site Supervisor provided you with constructive feedback about case management with agency clients.

Strongly Agree Agree Disagree Strongly Disagree N/A The Internship Site Supervisor provided you with constructive suggestions and insight to the appropriate use of counseling skills with agency clients.

Strongly Agree Agree Disagree Strongly Disagree N/A The Internship Site Supervisor conferred regularly with me regarding m progress and development as a student intern.

Strongly Agree Agree Disagree Strongly Disagree N/A

The Internship Site Supervisor modeled professionalism at all times. Strongly Agree Agree Disagree Strongly Disagree N/A

Int 36

The Internship Site Supervisor applied appropriate expectations me across the Internship experience.

Strongly Agree Agree Disagree Strongly Disagree N/A I would recommend placing a future RMHC student intern at this Internship site.

Strongly Agree Agree Disagree Strongly Disagree N/A I would recommend placing a future RMHC student intern with this Internship Site Supervisor again. Strongly Agree Agree Disagree Strongly Disagree N/A I was satisfied with the overall experience at m Internship site.

Strongly Agree Agree Disagree Strongly Disagree N/A

Comments are encouraged as we consider this site and supervisor for future interns: ________________________________________________________________________________Student Signature Date

Faculty Supervisor Signature Date

(Please submit to faculty supervisor prior to last class of term.)

Int 37

Internship Log for CRC Supervision Credit Supervisor Name:______________________ Intern Name:

Meeting Date

Topics addressed (i.e., caseload management, counseling

techniques, eligibility determination, ethics, functional loss)

Length of meeting

Supervisor’s Initials

Intern’s Initials

TOTAL HOURS Complete this log form throughout the Internship supervision experience and submit a copy to RMHC Program Clinical Coordinator so that a letter can be generated to support the hours of supervision provided. To receive CRC credit you will then need to submit a copy of your log and letter from RMHC program to CRCC to add the credit to your file. Supervision of interns must be face-to-face; maximum of 50 hours allowed over five years.

Questions - Contact RMHC Clinical Coordinator Kim Poage poagek@wou.edu (503) 838-8758 V (503) 838-8228 Fax

Int 38