SUPERVISED INTERNSHIP IN COUNSELING Evaluation of Student Performance by Faculty Supervisor Student Name (Print): _____________________________________________ Date ______________ Name of Field-Site _________________________________________________ Please complete the following evaluation for the above named student’s Note to Supervisor: performance at the MIDWAY POINT and again upon COMPLETION (circle or highlight either midway or completion). Evaluation (Mark One) Performance Poor Satisfactory Excellent N/A Comments Category Diagnosing & Assessment (CACREP 5.C.3.a) Case Conceptualization (CACREP 2.F.5.g) Evidence Practices Identification & Integration (CACREP 2.F.8.b) Counseling/Clinical Activities (CACREP 2.F.5.g) Group Counseling/ Group Work (CACREP 2.F.6.c) Ethical Knowledge, Skills & Application Multicultural Competence Record Keeping Activities Responsiveness to Supervision Working Relationship with Staff/Coworkers Professionalism (attendance, dress, attitude, interactions) Enthusiasm – Creativity * 2016 CACREP Standards noted
SUPERVISED INTERNSHIP IN COUNSELING Evaluation of Student Performance by Faculty Supervisor Student Name (Print): _____________________________________________ Date ______________ Name of Field-Site _________________________________________________ Note to Supervisor: Please complete the following evaluation for the above named student’s performance at the MIDWAY POINT and again upon COMPLETION (circle or highlight either midway or completion). Performance Category Evaluation (Mark One) Poor Satisfactory Excellent N/A Comments Diagnosing & Assessment (CACREP 5.C.3.a) Case Conceptualization (CACREP 2.F.5.g) Evidence Practices Identification & Integration (CACREP 2.F.8.b) Counseling/Clinical Activities (CACREP 2.F.5.g) Group Counseling/ Group Work (CACREP 2.F.6.c) Ethical Knowledge, Skills & Application Multicultural Competence Record Keeping Activities Responsiveness to Supervision Working Relationship with Staff/Coworkers Professionalism (attendance, dress, attitude, interactions) Enthusiasm – Creativity * 2016 CACREP Standards noted