ࡱ> =?< \bjbj33 .*Q_Q_<55555III8$I$G$I$I$I$I$I$I$$r&()m$5m$55$X55G$G$Vs"@7#]!s" 3$$0$"x))7#7#\)5#m$m$ $) : PHLS 8393 Practicum Contract Name of Practicum Student: ___________________________ ɫ Practicum Coordinator: Dr. Nicole Coleman 435 Farish Hall ɫ Houston, TX 77204 (713) 743-8392 ncoleman@central.uh.edu On-site Practicum Supervisor:___________________________ Address: ___________________________ ___________________________ Phone: ___________________________ Practicum Student Responsibilities Students are required to adhere to the following expectations: Work a minimum average of 16 hours per week Maintain at least 5 -7 client contact hours per week Follow all the requirements and procedures of the facility Conduct individual counseling sessions Keep notes Keep an accurate log of practicum work experiences Follow professional (APA) and agency ethical guidelines Adhere to all other responsibilities described in the PHLS 8393 syllabus When and where relevant, students are expected to adhere to the following expectations: Co-facilitate family or group sessions with agency staff Attend weekly staff meetings Conduct psychological assessments and provide written reports Supervisor Responsibilities: Provide ongoing individual supervision of at least one hour per week (see attached statement). Meet with the ɫ Practicum Coordinator when needed to discuss student progress Initial weekly and final logs of student work experiences Sign students final summary log sheet Complete and submit a standard evaluation form regarding students practicum work by the end of each semester of practicum. Directly observe (in person or via video) the students work at least once per semester. ________________________ ______________________ __________ Student signature On-site Supervisor signature Date A Program Statement Regarding Practicum Supervision Counseling Psychology Program ɫ The Counseling Psychology Program of the ɫ affirms that the practicum contract is a formal and binding relationship between the supervisor and the practicum student. A central feature of this contract is a shared understanding among the Program, external supervisors, and practicum students regarding the nature and quality of supervision that will be provided and obtained through the practicum experience. The Program requires that students receive a minimum of one hour of individual, single session, face-to-face supervision each week and at least one direct observation (in person or via video) per semester. It is also expected that, during the supervision hour, supervisors will promote discussions with their supervisees regarding case conceptualization, theoretical applications, interventions, therapeutic self-awareness, and other relevant professional development topics. Where appropriate, supervisors are also encouraged to provide the student with didactic material that can further her/his learning and development. It is further expected that supervisors and students will negotiate the regular scheduling of supervision sessions soon after the start of the practicum experience. The designation of an alternate supervisor is highly recommended for those occasions wherein the primary supervisor may be ill or otherwise unavailable. Beyond fulfilling their other on-site duties, practicum students are expected to attend and participate fully in scheduled meetings with their supervisors. Supervisors are further expected to initial students weekly logs and to complete final practicum documentation at the end of the semester, including a formal evaluation of the students performance. Students will similarly be expected to complete a formal evaluation of the quality of supervision and training they received as part of their practicum experience. Additionally, students will provide and retrieve from their supervisors all necessary practicum training documents and to submit this material to the ɫ Counseling Psychology Training Director in a timely fashion. Finally, supervisors will be expected to inform the ɫ Training Director immediately if they have significant concerns about a practicum students performance or professional conduct at any point during the practicum experience. Any questions regarding the above program statement should be addressed to the ɫ Counseling Psychology Training Director prior to signing this contract. By signing the attached practicum contract, supervisors and practicum students agree to abide by these expectations. 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