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Canisius College

1

EDC 576 (18)

SCHOOL COUNSELING PRACTICUM

COOPERATING COUNSELOR’S HANDBOOK

Department of Counseling and Human Services

Please note that additional information and SUPERVISORY TRAINING MATERIAL for cooperating counselors is provided through our Department web pages located at https://www.canisius.edu/academics/programs/school-counseling Use the link titled “Practicum and Internship Help for Cooperating Counselors”.

Conceptual Framework: The School of Education and Human Services builds its programs on the three interrelated dimensions of Knowledge, Professionalism /Leadership and Service to others.

Knowledge: The counseling program prepares students with the necessary historical, philosophical, theoretical, legal, and practical knowledge necessary for successful counseling practice.

Professionalism/Leadership: The counseling program is designed to promote attitudes and behaviors indicative of professionals who are able to practice effectively and assume leadership roles in counseling. There is a strong emphasis on collaboration and on reflective practice.

Service: Canisius College is committed to the education and care of the whole person. By its nature, counseling is a process that is in service of the client’s needs. Candidates are expected to work effectively with diverse populations and respect the dignity and worth of others.

CONTENTS:

Page 4 Letter of Introduction

Page 5 Candidate Information

Page 6 Goals and Objectives of Practicum

Page 8 Events to Monitor

Page 9 Methods to Monitor

Page 9 Reflections on Mentoring Graduate Students

Page 12 Guide for Live Supervision

Page 13 Evaluation of Graduate Student

Page 14 Competency Assessments

Page 21 Responsibilities of the College and the School

Page 23Agreement Made by the Student Counselor

Page 24Agreement Made Between Student Counselor

and Cooperating Counselor

Canisius College


School Counseling Practicum

Letter of Introduction

Dear Cooperating Counselor:

The degree candidate, who will be working in your school, is a registered graduate student at Canisius College in the counseling program. This practicum is the first field experience and is designed to develop the candidate’s professional counseling skills. The practicum student has had a pre-practicum course with extensive preparation for developing helping relationships.

The enclosed information is designed to give you an understanding of your role as the practicum field supervisor and an overview of the expectations for the practicum as we work with you in providing a field based experience that develops the necessary knowledge, skills and dispositions to be a competent school counselor.

Enclosed you will find:

a.Descriptive information regarding the student counselor.

b.Description of the course goals objectives.

c.A summary listing of events to be observed or monitored during the semester.

d.Suggestions for monitoring of objectives.

e.Cooperating counselor’s evaluation form (please complete the evaluation form and return it to Canisius College at the middle and at the end of the semester).

f.Agreement made by the student counselor.

g.An agreement between the supervising counselor and the student counselor.

We appreciate your interest in helping the candidate prepare for a career in counseling. Thank you in advance for your supervisory work with this candidate.

Sincerely,

Faculty and Staff of the Department of Counseling and Human Services

Canisius College

Candidate Descriptive Information

Date ______________

Name____________________________________________________________

Address__________________________________________________________

______________________________________________Zip________________

Cell No.____________________E-mail_________________________________

Counseling courses taken to date (title of course):

Title ofTitle of

Courses Completed Courses Completed

_______________________________ ______________________________

_______________________________ ______________________________

_______________________________ ______________________________

_______________________________ ______________________________

_______________________________ ______________________________

_______________________________ ______________________________

_______________________________ ______________________________

Educational Background:

Year

SchoolCompletedDegreeMajor field of study

H.S.______________________________________________________________

College___________________________________________________________

Other____________________________________________________________

A current resume is available to cooperating counselors directly from the student counselor.

Candidate’s Signature:

Canisius College


School Counseling Practicum Goals and Objectives

This course is designed to provide counselors with an in-depth experience of school counseling conceptualized through the ASCA National Model and focusing primarily on helping relationships. Practicum students are required to complete a minimum of 100 clock hours of field experience including 40 direct service hours. The major objectives of this class are organized using the Conceptual Framework of the School of Education and Human Services and utilize outcome based measures of CACREP School Counseling Standards.

KNOWLEDGE AND SKILL OUTCOMES:

Knowledge:

1. Student Counselors will utilize the pardigms of the ASCA national model, the ASCA standards for school counseling, and the use of Comprehensive Developmental School Counseling Plans to understand the practice of school counseling within the total education program.

2. Student counselors will explore policy and political issues related to community, environmental and institutional systems that enhance as well as impede student success and recognize issues that may affect the personal development of students including abuse, violence, and childhood psychiatirc disorders and other exceptional student characteristics.

3. Students will understand approaches to peer focused school based interventions such as peer mediation and peer helper programs.

4. Students will understand NYS SAVE legislation regarding Violence Prevention including background about the issue and school based intervention strategies.

Professionalism and Leadership:

5. Student counselors will engage in activities related to leadership, consultation, collaboration, teaming and the use of data when working with other professionals in a school setting and in the broader community of stakeholders.

6. Students will apply multi-cultural competencies when working with diverse

populations and explore the counselor’s role in confronting social justice issues, advocacy, prejudice, discrimination and other dynamics that block human growth and wellness in school counseling settings.

7. Students will embed ethical practice and ethical decision making into their role

as student counselor.

Service:

8. Student counselors will provide direct counseling services to clients developing skills related to the establishment of a therapeutic relationship, use of assessment procedures, development of counseling goals, individual, and group counseling interventions and evaluation of client outcome. Related to the counseling process, student counselors will demonstrate the ability to conceptualize client issues including identification of student competencies, and choosing interventions and modalities to enhance those competencies.

9. Student counselors will develop and lead an activity using a lesson plan as part of the Guidance Curriculum of a Comprehensive School Counseling.

10. Student counselors will deliver age appropriate academic interventions with students including educational planning including college admissions counseling when applicable.

11. Student counselors will identify and address career and vocation needs of clients using appropriate career, educational and labor market information.

SCHOOL COUNSELING PRACTICUM

LISTING OF EVENTS TO BE MONITORED

The following activities are suggested to help the candidate fulfill the requirements for the Practicum. We recognize that each school counseling program is unique and the list is provided only as a guide for providing the student counselor with the appropriate opportunity to develop his/her competencies.

MINIMUM QUOTA

EVENTS PER SEMESTER

1.Supervision with cooperating counselor......................... Weekly _____

2.Cooperating counselor completes evaluation of student's competencies at

midterm and course completion.....................…………. 2 Minimum _____

3.The student counselor delivers a minimum of 100 contact hours

including 40 direct service hours. Direct service hours are defined as

individual counseling, group counseling, guidance/education groups, test

administration or interpretations, phone contact or family

consultation......................................................................... 40 Minimum _____

4.Student counselor keeps & maintains student records... 5 Minimum _____

5.Student Counselor participants in one workshop or in-service session.........................................………………………….. 1 Minimum _____

6.Student counselor attends student conferences with staff......

5 Minimum _____

7.Student Counselor attends staff or team meetings....... 2 Minimum _____

8. Student counselor makes referrals ................................. 2 Minimum _____

9.Other activities that are developed by the cooperating counselor.

SUGGESTED GUIDELINES FOR CARRYING OUT

THE MONITORING OF WEEKLY SPECIFIC

BEHAVIORAL OBJECTIVES

A wide range of methods may be employed for monitoring or observing the events listed below. The methods employed are limited only by the cooperating counselor's ingenuity and environmental limitations. The methods suggested below are included merely as guidelines to the cooperating counselor.

1.Individual Counseling Sessions, Group Counseling, Group Curriculum/ Guidance Activities and Case Conferences: May be monitored in a variety of ways. Direct observation, video recording, dual counseling, audio recording, use of observation rooms, and interpersonal process recall are reasonable methods to use.

2.Making Referrals and Referral Follow-up: Referral processes as practiced by the school should be discussed and taught. This process will vary in different schools.

3.In-Service Sessions: The student counselor should have the opportunity to participate in an in-service or supervisory sessions with other counselors, teachers and related service providers.

4.Orientation of New Students: The student counselor should have the opportunity to engage in intake procedures for new students.

5.Staff Meetings: The student counselor should have the opportunity of attending staff meetings, committees and other collaborative activities.

6. Program Management: The student counselor should actively participate in program management processes such as review of the Comprehensive School Counseling Plan, data development, needs assessments and program evaluation.

7.Client Evaluations of Counselor: This activity is suggested to provide the student counselor with the opportunity to gain insight to client perceptions of his/her counseling. It is suggested that the coordinating counselor randomly select the evaluating clients from among the population assigned to the student counselor.

Reflections on Mentoring Practicum Experiences

Introduction:

This section provides a summary of ideas generated by professors, cooperating counselors, and graduate counseling students regarding various factors that contribute to a successful practicum experience.

From Professors:

Without professional counselors who are willing to be mentors to our students, Canisius would not be able to effectively train future counselors. Graduate students begin their practicum experiences with various levels of professional background and comfort. Graduate students need to be trained from a developmental perspective, meaning that each should be assessed individually and supported according to his or her needs. Some graduate students may be ready for more independent activity in the first practicum while others may need to be brought along more slowly.

It is important to touch base with students each week and talk with graduate students about the value of all of the activities that they experience at the site. Students need to process and understand these experiences. While there is considerable value in having students become involved in some of the behind the scenes paperwork and other organizational activity of the counselor, these kinds of activities should not preclude direct client contact.

Students should be expected to conduct themselves in a professional manner. In addition, the practicum student should feel part of a professional team. Their participation in team meetings or staffing activities is vital for developing their own professional identity. In addition, most students are as yet unaware of their own theoretical orientation and are just developing techniques to help people change. They need to be aware of the cooperating counselor’s theoretical and practical framework. This kind of discussion is an important step in helping graduate students make the transition from having theoretical ideas to developing successful practical skills. Although cooperating counselors can expect at least one contact from the practicum professor during the semester (either by phone or in person), they should feel free to call the student’s professor at any time. In those rare situations where there are issues with a graduate student, the quicker everyone is aware of the concern, the better chance there is to resolve the concern with a positive outcome. On a related topic, your evaluation of the student counselor should accurately reflect their performance; it is not expected that everyone does “A” work. While the cooperating counselor's suggested grade for the student is given considerable weight, the professor has the ultimate responsibility for the course grade.

From Cooperating Counselors:

The practicum experience should be a professional, developmental experience for the cooperating counselor as well as for the student counselor. Planning and organizing a "defined path" for the graduate student has benefits not only of efficiency, but also in considering one's own professional identity.

Students have different levels of professional background when they begin a practicum. For some students recognizing the need for professional dress cannot be taken for granted. For other students a whole set of professional skills and experiences are already in place. A hidden benefit for cooperating counselors comes when they are able to utilize the strengths of the graduate student to contribute to their counseling programs. Cooperating counselors recognize that students should not be considered "cheap labor", but at the same time, it is necessary to teach student-counselors practical tasks, which may involve some degree of tedium. When the purpose behind such activities is discussed, students are able to see the value of the work.

Experiences that allow students to be integrated and to network with regular staff members are important. Strategies toward this end include involving the student counselor in presentation projects, in team meetings, and in other consultation activities. In addition to providing the student counselor with opportunities to enhance counseling skills, cooperating counselors should offer experiences that give the student counselor practice in consultation, advocacy, coordination, and leading groups.

Proper supervision of students and good communication between student counselors and cooperating counselors is crucial. Student counselors should be allowed to make some mistakes and be taught that mistakes are acceptable. Regular communication with the graduate student will allow learning from mistakes as well as successes. Graduate students need to be told that being proactive, independent, and self-directed are expectations. Passive behavior on the part of the graduate student will generally lead to a less than satisfying experience for the student and for the cooperating counselor. When cooperating counselors contact the practicum professor they can expect support and assistance.

From Graduate Students:

Graduate students feel some anticipatory anxiety about starting the practicum. Establishing a set of goals during the initial meeting at the site can be a helpful procedure. Communication is a critical component of a successful practicum experience.

Practicum experiences are considered by students to be the most important experiences of their graduate training. Descriptive and balanced feedback provided in a timely manner by the cooperating counselor is essential. Student Counselors need a wide variety of counseling experiences in order to develop their own approach. Having a mentor to direct, support, and teach is an integral part of professional development.

Additional Factors:

1. It is acceptable for students to stay on at their sites after the college semester is over. Many students stay on at their sites after the close of a semester, and some must continue at their sites to complete service hours. In these cases a professor is “on call” from the College.

2. Cooperating counselors as well as graduate students in practica are free to negotiate more time at the site than the minimum requirements of practicum.

3. Some professional counselors have found that it is a good experience to take more than one student counselor at a time. The energy and collaboration of two or more student counselors can add another dimension to the practicum experience.

DEPARTMENT OF COUNSELING AND HUMAN SERVICES

GUIDE FOR LIVE SUPERVISION

Electronic recording of counseling sessions is preferred. This guide is only used when the graduate student is unable to make electronic recordings of counseling for review by the College supervisor. If the graduate student is able to make recordings from the site for review at the College you can disregard this form. In placements where recordings are not permitted you should use this form twice over the course of the semester to facilitate communication of live supervision of graduate students’ counseling skills with the professor at the College. You can use this form in one of two ways. You can scan a completed form and send to the professor via e-mail or you can use the form to facilitate telephone consultation with the professor. If you prefer, the professor can send you an electronic copy of the form in a Word document. It is essential that formal reviews are done two times during the semester and communicated to the course professor. Please complete the form in a concise manner. It is meant to aid communication and not to be a burden for the cooperating counselor.

Please rate each area on a scale of 1 – 6 6 = highest 1 = lowest

1. Over-all effectiveness of counseling _____

2. Over-all level of professional development of counselor

from perspective of your expectation at this point in time _____

3. Student awareness of areas needing growth _____

4. Focus of supervision (briefly describe):

_______________________________________________________________________________

_______________________________________________________________________________

5. Does the student show evidence of using feedback? _____

6. Additional Comments

CANISIUS COLLEGE

SCHOOL COUNSELING PRACTICUM: EVALUATION OF STUDENT COUNSELOR

Student Counselor (Candidate)_____________________________________________________

Cooperating Counselor _____________________________________________________________

Practicum Site_______________________________________________________________________

Phone ________________________

Midpoint Eval (use 6 pt. scale) ______ Final Eval (use 6 pt. scale) _______

Please rate the student counselor using the Field Placement Competency Assessment Form that follows on page 8 at the eighth (8th) and fifteenth (15th) week. Knowledge, Skills and Dispositions are assessed. Use pencil for the eighth week and pen for the fifteenth week. Please use the following system for assessment:

Scoring

6. Exceptional – Consistently exceeds performance standards. Currently has the potential to be an outstanding first-year counselor.

5. Advanced – Performance is consistently above the average performance standards. Demonstrates the likelihood of becoming an excellent counselor with more experience and mentoring.

4. Acceptable/adequate – Meets the average performance standards. Demonstrates acceptable level of performance.

3. Minimally Acceptable – Meets, but does not exceed the minimum performance standards. Demonstrates basic level of performance.

1. Needs Improvement – Is inconsistent in meeting minimum performance standards. Does not demonstrate sufficient depth on required competencies.

1. Unsatisfactory – Does not meet minimum performance standards. Does not perform at an acceptable level on required competencies.

Qualitative comments may also be made. At the 8th week evaluation, recommendations must be listed in any area where the candidate is rated unsatisfactory. On the 15th week evaluation, specific reasons must be given in any area where the candidate is rated unsatisfactory. During the final week of the semester, please forward this assessment form to the college supervisor.

FIELD PLACEMENT COMPETENCY ASSESSMENT FORM

RATING: 6=Exceptional, 5=Advanced, 4=Adequate, 3=minimally Acceptable, 2=Needs Improvement, 1=Unsatisfactory, NA=not applicable.

A. KNOWLEDGE OF COMPREHENSIVE SCHOOL COUNSELING

1. Demonstrates knowledge of national and state models for comprehensive developmental counseling programs.

Rating ____/_____

2. Demonstrates knowledge of child and adolescent developmental issues in counseling and how developmental awareness relates to a comprehensive developmental counseling program.

Rating ____/_____

3. Demonstrates knowledge of the program’s comprehensive developmental school counseling curriculum covering the domains of academic, career and social & emotional concerns.Rating ____/_____

4. Recognizes the importance of a Comprehensive School Counseling Plan in the organization and delivery an effective school counseling program.

Rating ____/_____

5. Can articulate how counselor activities are embedded in the ASCA Mindsets and Behaviors.

Rating ____/_____

6. Able to collect, analyze, and interpret data regarding how the school counseling program makes a difference.

Rating ____/_____

COMMENTS:

B. COUNSELING ATTIDUTES AND DISPOSITIONS


1. Treats all clients, colleagues and parents with respect and recognizes personal values and the impact of these values on a professional relationship.

Rating ____/____

2. Seeks to understand all persons and cultures. Never behaves in a prejudicial or discriminatory manner to any group of people. Able to be nonjudgmental and communicate that to clients.

Rating ____/_____

3. Demonstrates personal responsibility in academic and professional endeavors; personal and professional maturity; honesty and congruence.Rating____/_____

4. Recognizes and exhibits the ability to work with diversity issues of clients, as well as cultural factors that influence client issues.

Rating ____/_____

5. Engages in counselor supervision in a receptive and professional manner.

Rating ____/_____

6. Demonstrates ability to adhere to professional ethical standards as well as state and federal legal requirements.

Rating ____/_____

7. Displays willingness to take reasonable personal and professional risks.

Rating ____/_____

8. Exhibits willingness to participate in continuing education activities.

Rating ____/_____

COMMENTS:

C. ASSESSMENT AND REFERRAL


1. Able to formally and informally assess students’ strengths and needs while accounting for diverse backgrounds and abilities.

Rating ____/_____

2. Demonstrates the ability to form a valid conceptualization of students’ needs and develop an appropriate intervention based on the conceptualization.

Rating ____/_____

3. Exhibits understanding of referral criteria and techniques.

Rating ____/____

4. Exhibits knowledge of transmitting to referral sources appropriate data requested for the effective, efficient handling of referrals.

Rating ____/_____

5. Prepares and gathers appropriate data on the case being referred.

Rating ____/_____

6. Follows procedures for handling the referral, including any follow-up procedures inherent in the process.

Rating ____/_____

COMMENTS:

D. COUNSELING AND HELPING RELATIONSHIPS


1. Communicates genuine concern and respect for the client and the client’s welfare

Rating ____/_____

2. Communicates genuine empathy.

Rating ____/_____

3. Exhibits congruence and genuiness in verbal and nonverbal communication.

Rating ____/_____

4. Responds to client’s needs with clear therapeutic intention.

Rating ____/_____

5. Creates appropriate structure by setting and maintaining the boundaries of the helping relationship including appropriate application of confidentiality in the school setting.

Rating ____/_____

6. Reflects feelings expressed verbally or nonverbally by clients.

Rating ____/_____

7. Succinctly conveys an understanding of the theme or underlying meaning of client’s issues.

Rating ____/_____

8. Communicates in specific and concrete terms, including use of appropriate open-ended questions.

Rating ____/_____

9. Summarizes and reframes client communications when appropriate.

Rating ____/_____

10. Able to confront and clarify discrepancies in client communication.

Rating ____/_____

11. Exhibits immediacy by appropriate sharing and self-disclosure.

Rating _____/____

12. Collaborates with the client to develop counseling goals.

Rating ____/_____

13. Able to articulate his or her guiding theory or approach to counseling.

Rating ____/_____

14. Formulates hypotheses appropriate to the counselor’s theory and the client’s concerns.

Rating ____/____

15. Demonstrates the ability to use counseling theory and strategies to ameliorate client issues as well as to help students identify strengths, and cope with environmental and developmental problems.

Rating _____/____

16. Addresses termination issues in an appropriate manner.

Rating _____/____

17. Understands potential barriers to effective counseling with multicultural and specific populations including the following: historical events, client mistrust of authority figures, counselor cultural biases, client’s cultural orientation, developmental issues that include ethnic, sexual, and gender identities.

Rating _____/____

18. Effectively counsels with clients from diverse backgrounds.

Rating _____/____

19. Identifies and demonstrates the ability to use various advocacy strategies when appropriate.

Rating ____/_____

20. Able to effectively lead counseling groups by using appropriate selection procedures, choice of group model, establishment of “rules” and facilitation of group processes.

Rating ____/_____

COMMENTS:

E. CORE CURRICULUM AND EDUCATIONAL PLANNING


1. Effectively implements curriculum activities in the classroom and with small groups.

Rating ____/_____

2. Able to structure and facilitate positive and cooperative behavior with students.

Rating ____/_____

3. Facilitates the educational and career development of all students.

Rating ____/_____

4. Demonstrates the ability to appropriately assist students in planning for educational and career goals.

Rating ____/_____

5. Provides effective career counseling including the use of labor market information and college and other training opportunity admissions counseling.

Rating ____/_____

6. Selects age and culturally appropriate materials and activities designed to facilitate

goals of guidance activities.

Rating ____/_____

COMMENTS:

F. FOSTERS COLLABORATIVE AND COOPERATIVE RELATIONSHIPS


1. Conducts self in professional manner including professional dress and behavior

Rating ____/_____

2. Communicates effectively and demonstrates ability to maintain collaborative relationships.

Rating ____/_____

3. Consults with all stakeholders in education including teachers, administrators, staff, parents and other community members to meet student needs.

Rating ____/_____

4. Exhibits awareness of economic and political realities, as they exist in the school setting.

Rating ____/_____

COMMENTS:

G. USES TECHNOLOGY EFFECTIVELY AND COMMUNICATES CLEARLY


1. Prepares and maintains accurate and updated student records.

Rating ____/_____

2. Displays appropriate professional writing skills in all written documents.

Rating_____/_____

3. Displays ability to ensure confidentiality of all clinical records on the basis of pertinent legal and ethical guidelines.

Rating ____/_____

4. Can apply research and technology in the design, implementation and assessment of counseling to engage students, improve outcomes and administer the counseling program.

Rating ____/_____

COMMENTS:

SUMMARY NOTES:

Student Counselor’s strong points:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Student Counselor’s needs for improvement:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Would you hire this counselor to work for you? Yes ___No ____ Uncertain _____

__________________________________________________________________________________________________________________________________

Has this evaluation been discussed with the student? Yes ____ No ____

Additional Comments:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Based on the preceding information, I recommend a grade of _______ for the student.

Cooperating counselor signature: _________________________ Date__________

Print Name and Title_________________________________________________________

Practicum Site:

_________________________________________________________________________________________________

RESPONSIBILITIES OF THE COLLEGE AND OF THE SCHOOL

Canisius College will:

a. Select students, with the School’s approval, for the purpose of obtaining clinical learning experience and forward the names of the students to the School. At the School’s option, a preplacement interview may be required.

b. Select only such students who have completed the necessary academic prerequisites as determined by Canisius College.

c. Assign faculty member(s) to the course who will assume the responsibility for selecting and planning appropriate learning experience, for guiding students during the designated experience, and for evaluating the student’s learning through the course.

d. Retain direct responsibility for and the control of its student education through mutually agreed upon objectives and ongoing communication with the School.

e. Furnish to the School validation that all students participating in activities pursuant to this Agreement be covered by a policy of insurance for malpractice liability.

f. Provide on-going consultation and supervisory assistance to the cooperating counselor assigned to the practicum student.

g. Provide a tuition waiver to the cooperating counselor at the end of the practicum. Check with professor on current amount.

2. The SCHOOL agrees to:

a. Make available appropriate clinical learning experience (consistent with clients’ rights) enabling students to meet the objectives of the educational program. The School agrees that all students will be under the training and general supervision of an individual who has appropriate professional credentials (a master or doctorate degree in counseling, counselor education, clinical or counseling psychology, who is a NYS certified school counselor), and who is judged to be appropriate to the student’s level of training and the specific course goals and objectives.

b. Forward the final evaluation of the student’s performance and progress to the College in writing. The establishment of final grades for the experience shall be the direct responsibility of the faculty of the College.

c. With the exception of emergency care, the students will provide for their own medical care needs.

3. It is MUTUALLY agreed by the parties that the following student responsibilities shall be applicable to all students assigned to the School.

a. While at the School, the students’ program shall be structured within the working policies of the School.

b. Canisius College and the School shall maintain ongoing communication to integrate the academic and clinical fieldwork experience, which may include written correspondences, phone communication, and reciprocal on-site visits.

c. Canisius College shall advise students of their responsibility to conduct themselves in accordance with the School’s rules and regulations. The School will inform each student of all such rules and regulations, and the students will be responsible for this information.

d. The School reserves the right to dismiss at any time any student whose condition or conduct jeopardizes the well being of the clients or employees of the School. Unless unusual circumstances occur, such dismissal shall not occur without prior consultation with Canisius College.

e. The students and faculty shall respect the confidential nature of all information that they have access to, including but not limited to client’s personal health information provided to them orally, contained in a student’s records or maintained on the School ’s electronic information system. The College shall advise all students and faculty of the importance of complying with all relevant state and federal confidentiality laws.

f. Canisius College and the School acknowledge that students in conjunction with faculty may refer to clients for educational purposes at the School and at the College. Information used for such purposes shall be appropriately deidentified so as to remove all data that may be used to connect such information back to the student to whom it relates.

AGREEMENT MADE BY THE STUDENT COUNSELOR

DIRECTIONS: Please submit this sheet to the Practicum Professor.

A.I hereby attest that I have read and understand the ethics of the American Counseling Association and will practice my counseling in accordance with these standards. I further understand that any breach of this code or any unethical behavior on my part will result in my receiving a failing grade and notification of such behavior will be placed in my permanent record.

B.I understand that the practicum experience is critical to my development as a counselor and I must observe my responsibilities at the site with the same commitment and dedication that is necessary on any job. Weekly attendance is expected. Absences are permitted only for extreme circumstances. All absences must be immediately reported to the cooperating counselor. Should my cooperating counselor develop concerns about my performance, he or she has the capacity to discontinue my work at the site which will automatically result in a failing grade.

C.I understand that my responsibilities include keeping my practicum professor informed regarding my practicum experience. Should I experience any difficulty in starting at my site or completing the requirements of the practicum, I will inform my professor within 1 week of the becoming aware of the concern. Failure to do so may result in a failing grade or the condition of spending additional time to complete practicum requirements.

D.I understand that I will not be issued a passing grade until I have demonstrated a specific minimal level of counseling knowledge, skills, and attitudes.

E.I further understand that my responsibilities include attending classes and supervisory sessions fully prepared as outlined by the course requirements.

Candidate Signature Date__________

Print Name ___________________________________________ID#___________________________

e-mail ______________________________________________ cell phone #___________________

Professor ____________________________________________________________________________

AGREEMENT BETWEEN COOPERATING COUNSELOR & CANDIDATE

DIRECTIONS: The student counselor is to have the cooperating counselor sign this sheet at the start of the practicum.

Date _____________________

Student Counselor (name) _____________________________________________ has permission to begin counseling interviews under my supervision.

Cooperating Counselor Signature ______________________________________________________________

Name (print) _____________________________________________________________________________________

Title _______________________________________________________________________________________________

Please Check Applicable Credentials: _____ M.S. Degree _____ Doctorate

_____ NYS School Counseling Certification _____ N.C.C. _____ LMHC

_____ Other (Please List)__________________________________________________

_____Years of Professional Experience

Phone Number ______________________e-mail_____________________________

Name of School ________________________________________________________

Address _______________________________________________________

_______________________________________________________

_______________________________________________________

Principal _______________________________________________________

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