ࡱ>  a\pDaniel R. Huron Ba=* =[,8X@"1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial1Arial"$"#,##0_);\("$"#,##0\)!"$"#,##0_);[Red]\("$"#,##0\)""$"#,##0.00_);\("$"#,##0.00\)'""$"#,##0.00_);[Red]\("$"#,##0.00\)7*2_("$"* #,##0_);_("$"* \(#,##0\);_("$"* "-"_);_(@_).))_(* #,##0_);_(* \(#,##0\);_(* "-"_);_(@_)?,:_("$"* #,##0.00_);_("$"* \(#,##0.00\);_("$"* "-"??_);_(@_)6+1_(* #,##0.00_);_(* \(#,##0.00\);_(* "-"??_);_(@_)                + ) , *    #    (8@ @ *8@ @  (@ @  @ @  (@ @  (@ @ "0@ @  (8@ @  8@ @ (8@ @  (8@ @ (8""@ @ #8 "0   (@ @   (@ @   (@ @  (""@ @ (8" @  ( #8 "4@ @ "4@ @ "4""@ @ "0""@ @ "4" @ "4@ @ "4@ @ "4""@ @ "  (@ @  @  (@ @  (@   (     `  ( ` FINAL log [Settings and Client InfoZe Assessmentsq OrientationWeek 1=Week 2Week 3=Week 4Week 5=Week 6Week 7Week 8!Week 9/Week 10S<Week 11QWeek 12^Week 13tWeek 14Week 15Week 16Week 17n "+Doctoral Practicum WEEKLY LogNameWeek ofSemester __________________# face-to-face hrs. # individuals 2. Adults (18-64) 3. Adolescents (13-17) 4. Children school (6-12) 1. Older adults (65+) 5. Pre-school age (3-5) 6. Infants/toddlers (0-2) 1. Adults 2. AdolescentsOne unit 2. Adolescents 3. Childrenf. School Cng. Interventiong. Other Psych Interventiona. Individual Therapyb. Career Counseling 1. Sports Psychology 2. Medical Health 3. Intake Interview 4. Substance Abuse8 5. Other interventions with client present (describe)0h. Psych. Assessment Administration and Feedback:Psych., achievement, symptom assess., intelligence, careerNeuropsych assessmenti. Other Psych Experiences# 1. Supervision of other students 2. Prog. Development/Outreach$ 3. Outcome assessment of projects 4. Consultaton 5. Other (describe)'TOTAL INTERVENTION AND ASSESSMENT HOURSc. Group Therapy *d. Family Therapy *e. Couples Therapy *1. INTERVENTION AND ASSESSMENT2. SUPPORT ACTIVITIESa. Chart review b. Case notesc. Case consultationd. Tape reviewse. Video/audio tape reviewf. Planning interventions#g. Assessment interpretation/reporth. Training/didactic seminarsi. OtherTOTAL SUPPORT HOURS # of hours3. SUPERVISION OF CASESa. Individual face-to-faceb. Group supervisionc. Peer/Case conferenceTotal SUPERVISION Hours'Total INTERVENTION AND ASSESSMENT HoursTotal SUPPORT ACTIVITIES HoursTOTAL PRACTICUM HOURSDoctoral Practicum FINAL LogTOTAL PRACTICUM HOURS THIS WEEK& Site__________________________ q* In terms of # face-to-face hours, each hour of a group, family, or couple session counts as one practicum hour.L* In terms of # cases, each couple, family, or group counts as one (1) unit. Supervisor signatureSETTINGS.Indicate how many of the Total Practicum Hours,were spent in each of the following settingsChild Guidance ClinicCommunity Mental Health Center#Psychology Clinic run by DepartmentForensic/Justice setting Inpatient HospitalMilitary0Outpatient Medical/Psychiatric Clinic & HospitalUniversity Counseling CenterSchoolsOther2Indicate number of clients/patients seen for each of the following population%African American/Black/African OriginNumber,Asian American/Asian Origin/Pacific IslanderLatino-a/HispanicAmerican Indian/Alaskan NativeEuropean Origin/WhiteBi-racial/Multi-racial HeterosexualGayLesbian Bi-sexualPhysical/Orthopedic DisabilityBlind/visually ImpairedDeaf/Hard of HearingLearning/Cognitive DisabilitySerious Mental IllnessMaleFemale TransgenderedAssessment Administration Adult Tests Name of Test Total HoursTYPES OF CLIENTS SEEN*Self-report measures of symptoms/disordersBender GestaltTrial Making Test A & BWAIS-IIIWechsler Memory Scale IIIMMPI-II&Millon Clinical Multi-Axial Inv. (MCM) Personality Assessment InventoryRorschach (scoring system)TAT3Projective Sentences (e.g. Rotter Incomplete Sent.)5Self-report measures of symptoms/disorders (e.g. BDI)6Projective Drawings (Draw-A-Person and Kinetic Family)Myers-Briggs Type IndicatorStrong Interest Inventory1Structured Diagnostic Interview (e.g., SADS, DIS) Other TestsChild and Adolescent TestsConnors Scales (ADD Assessment)MMPI-ARorschach-scoring systemPeabody Picture Vocabulary TestParent Report MeasuresDiagnostic InterviewsWISC-IIIWPPSI-RWRATIntegrated Report WritingAdults Children# Administered and Scored # of ReportsWrittenTPlease indicate all instruments used by you in your assessment experience, excludingYinterpreted, and wrote a report for a test, coount in both columns. Please designate yourTthey are listed. Then, you may add as many additional lines as needed for any other "tests that you have administered. Xpractice administrations to fellow students. 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