Practicum

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Please complete the following questions:

How many hours are required by your school for this experience?

If you are applying for a practicum, how many client contact hours are needed, and do they need to be particular types? (family, individual, group, etc.)

What are your supervision requirements? (i.e., degree requirements of your supervisor, number of hours of supervision per week needed)

How many days per week would you like to work?

What would you like your schedule to be? What dates would you propose for this experience?

 

-1-If applicable, list any past involvements/experiences within the eating disorders field. Why do you want to be involved with Melrose Center?

 

What kind of experiences would you hope to gain from an internship at Melrose?

 

What qualifications/skills do you possess that would make you an asset at Melrose?

 

 

 

TERMS

  1. The student is required to accumulate at least 880 total hours and at least 150 hours (though the student is highly encouraged to acquire closer to 280 hours) of client contact (face-to-face) and at least 10 hours of clinical work within each of the 12 Core Functions (see other side of this sheet). Also, the student is expected to work at their site approximately 27 hours per week (when completing the practicum course sequence – CPSY 608, 609, 610 – over about 8-9 months) OR a minimum of 20 hours per week (when completing the practicum course sequence – 608, 609, 610, 699 – over about 12 months). A student is required to attend the practicum class and work at the practicum site until the end of the final semester in the practicum course sequence or the “end date” shown on this document, whichever is later, even if they have acquired 880 total and 150 client-contact hours.
  2. The student will receive at least one continuous hour of individual (1:1) supervision per week from an employee (or employees) of the site who has (have) experience providing supervision to graduate students. The student will receive weekly site supervision according to one of the following scenarios: a) one supervisor who holds both the LPC/C and LADC licenses; or, b) two different supervisors – one who has received a master’s degree or higher and is licensed as a mental health professional (e.g., LPC/C, LICSW, LP, LMFT) and another supervisor who is licensed as an LADC.
  3. Each practicum site supervisor needs to submit a copy and renewal card of their Board-issued license(s) to the Director of the MA and Certificate Programs in the Graduate School of Professional Psychology at the University of St. Thomas.
  4. The practicum site will do all it can to ensure that a licensed clinician is on-site, if the student is seeing clients in-person at the practicum site. If the site is not able to have a licensed clinician on-site or if the student is meeting with clients via tele-health, the site agrees to have a licensed clinician available by phone at all times in case the student needs immediate consultation.
  5. The site supervisor(s) will submit written evaluations of the student’s work to the UST practicum instructor.
  6. The university will provide a practicum instructor who is considered a consultant and will facilitate the practicum seminar and make at least one visit to and keep in contact with the appropriate staff at the site over the course of the student’s practicum.
  7. The student will maintain professional liability insurance during the entire length of the practicum.
  8. The student will write a learning contract which will specify individual goals and objectives.
  9. The student will prepare a minimum of 4 audio and/or video recordings of sessions required for review by their practicum instructor. Release of information forms are REQUIRED for all recorded sessions.
  10. The student will act in accordance with the Appropriate Code of Ethics and Rules of Conduct and with all agency policies.
  11. This contract must be signed by the direct supervisor(s) and be resubmitted if the supervisor(s) change throughout the course of the student’s practicum.
  12. As necessary, the UST practicum instructor and practicum site supervisor(s) will exchange communication relevant to the student’s performance. By signing this form, the student is giving consent to allow any UST faculty or staff member (if necessary) and practicum site supervisor(s) to communicate with one another.

Student Signature Date Signature, Director of MA Programs, GSPP Date

Site Supervisor #1 Signature Date Site Supervisor #2 Signature Date

(If applicable)

Site Supervisor #1 printed name and email address Site Sup. #2 printed name and email address (If applicable)

12 Core Functions

  1. SCREENING:

The process by which the client is determined appropriate and eligible for admission to a particular program.

  1. INTAKE:

The administrative and initial assessment procedures for admission to a program.

III. ORIENTATION:

Describing to the client the following: general nature and goals of the program; rules governing client conduct and infractions that can lead to disciplinary action or discharge from the program; in a nonresidential program, the hours during which services are available; treatment costs to be borne by the client, if any; and client rights.

  1. ASSESSMENT

The procedures by which a counselor/program identifies and evaluates an individual’s strengths, weaknesses, problems and needs for the development of a treatment plan.

  1. TREATMENT PLANNING

Process by which the counselor and the client identify and rank problems needing resolution; establish agreed upon immediate and long-term goals; and decide upon a treatment process and the resources to be utilized.

  1. COUNSELING

(Individual, Group, and Significant Others): The utilization of special skills to assist individuals, families or groups in achieving objectives through exploration of a problem and its ramifications; examination of attitudes and feelings; consideration of alternative solutions; and decision-making.

VII. CASE MANAGEMENT

Activities which bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts.

VIII. CRISIS INTERVENTION

Those services which respond to an alcohol and/or other drug abuser’s needs during acute emotional and/or physical distress.

  1. CLIENT EDUCATION

Provision of information to individuals and groups concerning alcohol and other drug abuse and the available services and resources.

  1. REFERRAL

Identifying the needs of a client that cannot be met by the counselor or agency and assisting the client to utilize the support systems and community resources available.

  1. REPORT AND RECORD KEEPING

Charting the results of the assessment and treatment plan, writing reports, progress notes, discharge summaries and other client-related data.

XII. CONSULTATION WITH OTHER PROFESSIONALS IN REGARD TO TREATMENT

Relating with in-house staff or outside professionals to assure comprehensive, quality care for the clien