COUNSELING AND CAREER DEVELOPMENT MASTER S DEGREE PRACTICUM MANUAL

COUNSELING AND CAREER DEVELOPMENT MASTER S DEGREE PRACTICUM MANUAL Colorado State University College of Health and Human Sciences School of Education 209 Education 450 W. Pitkin 1588 Campus Delivery Fort Collins, CO 80523-1588 (970) 491-6317 phone (970) 491-1317 fax www.soe.chhs.colostate.edu

2 Contents OBJECTIVES AND REQUIREMENTS... 3 Practicum Objectives... 3 Practicum Requirements... 3 Evaluation and Grading... 4 CACREP Requirements for Entry-Level Professional Practice and Practicum... 5 POLICIES AND PROCEDURES... 6 Insurance... 6 Student Counselor Behavior... 7 Supervision... 8 Obtaining Clients... 8 Scheduling Client Appointments... 8 Group Counseling... 8 Client Records... 9 Titanium Schedule... 9 Termination... 10 Referrals... 10 Social Media... 11 Observation... 11 Class Assignments... 11 Suicide Assessment... 13 Crisis Intervention... 14 Suicide Evaluation and Procedures... 14 Title IX - Sexual Assault, Sexual Violence, Sexual Harassment... 16 Call Down List for Clients in Crisis... 16 Safety Plan... 16 Resource List... 17 Practicum Forms... 19

OBJECTIVES AND REQUIREMENTS 3 Practicum is one of the most important professional activities in which students engage during their degree program. Practicum students are given opportunities to synthesize and apply knowledge gained in their course of study and other academic pursuits. Through the sharing of experiences in both group and individual supervision, students refine previously learned skills and acquire new skills. Practicum Objectives The practicum is designed to facilitate refinement of counseling and interviewing skills and the development of new skills. Through closely supervised one-to-one and group counseling experiences, students can expand their repertoires of counseling theories, strategies, techniques, and interpersonal relationship skills as well as draw upon their diagnostic knowledge and skill. Through using the counseling lab, students are given opportunities to experience direct and specific feedback from their supervisors through the use of digital recordings, and occasionally, live supervision. On occasion, school-age clients may be seen at local schools under the supervision of your CSU CCD faculty supervisor and the school counselor at the school. These instances are kept to a minimum with typically only one to two off-site clients allowed per practicum student. Students are not to directly contact prospective sites, but to work in conjunction with their faculty supervisors to make arrangements. All practicum policies and procedures (e.g., paperwork, secured digital recordings, confidentiality, etc.) must be met. In practicum, students are expected to demonstrate a commitment to implement and expand the following skills and dispositions: Establish and maintain a helpful, supportive counseling relationship Development and application of appropriate counseling theories and techniques Maintain client records, schedule client appointments, learn about and use appropriate community resources Work effectively with supervisors and colleagues, include appropriate analysis and presentation of counseling sessions and case studies Offer supportive and collegial feedback in group supervision and on observation forms Continued development of professional ethical identity and ethical behavior Enthusiasm for and commitment to the counseling profession Foundational understanding and use of case conceptualization, diagnosis, and treatment planning Referral assessment and procedures A continued willingness to learn and openness to introspection about self as the counselor in the room Continued development of personal traits that are conducive to effective counseling, learning, and professional development Practicum Requirements Prior to enrolling in practicum, students are expected to have completed the following courses: EDCO 625 Foundations of Counseling EDCO 650 Individual Counseling EDCO 652 Ethics & Legal Issues (or concurrently) EDCO 651 Group Counseling (or concurrently)

During the course of the semester, students must be prepared to commit a minimum of 100 hours to required practicum experiences. Distribution of these hours is as follows: 4 Direct client contact (CACREP 3G) 40 hours o Up to 15 hours of this direct client contact can be in facilitating/cofacilitating a counseling group (3E). A minimum of 25 hours must be individual counseling. Students are required to facilitate or co-facilitate at least 10 hours of group counseling during their fieldwork experiences. If that is not completed in practicum, then it must be completed in internship (3E). Regardless of when it is completed, 40 hours of direct client contact must be completed in practicum (3G). Individual supervision (l hour per week for semester) (3H, 2.F.1m) 14-16 hours Group supervision (1.5 hours per week for semester) (3I) 20-24 hours Observation of another practicum student s recordings (3C, D) 5 hours Additional hours of activities approved by supervisor (e.g., documentation, attending conference programs, workshops, client preparation) (3D) 15-21 hours Students should be prepared to spend an average of 6.25 hours per week over a 16-week period in practicum activities. Due to the varied availability of clients, students should be prepared to spend more hours in one-to-one individual sessions as the semester progresses. It is expected that students will work up to a case load of 4 clients. Evaluation and Grading In addition to informal evaluations during individual supervisory sessions, practicum students will be formally evaluated by their supervisors on a variety of skills and activities at midterm and again at the end of the semester (CACREP 3C). The final grade is the result of a decision by your supervisor or a joint decision by all supervisors. Maintenance of documentation, will be included in the evaluation as well as attendance at both individual and group supervisory sessions (CACREP 3H, 3I). Additionally, a minimum of one digital recording (utilized in a case presentation) per semester will be required for viewing during class time (group supervision) (CACREP 3B). Case presentations and other assignments required by the practicum supervisor will also be included in the final grade (CACREP 3D). Clients are given an opportunity to evaluate their counselor at termination, as well as make comments on the services they have received through the lab. Client evaluations are not evaluated as part of the student s grade, but will be reviewed and discussed by the practicum student and faculty supervisor. Practicum students will complete a formal evaluation of their practicum supervisor at the end of the semester. Informal feedback is requested throughout the semester to facilitate a productive supervisorsupervisee relationship (CACREP 2.F.1m). Letter grades are based on the following course requirements: Attendance at class meetings Professional/ethical behavior and demonstration of personal/professional skills Completion of required number of clock hours

Evaluation of skills and performance on midterm and final evaluations Timely completion of documentation Accurate progress notes and record keeping Arranging and attending individual supervision on a weekly basis Following through with counseling lab policies and requirements 5 The letter grade of A indicates that in addition to completing all course requirements (identified previously) in a timely and professional manner, the student demonstrates a beginning mastery of counseling; high standards of ethical, professional and personal behavior; a continued willingness to learn; and a commitment to the counseling profession. Beginning mastery of counseling skills means that the student has a firm foundation and understanding of counseling theory, can demonstrate the basic counseling skills, can conceptualize the client issues from that theory or theories, can build appropriate/effective treatment plans, is willing to take appropriate risks, and has demonstrated some understanding and use of advanced counseling skills. The letter grade of B indicates that in addition to completing all course requirements in a timely and professional manner, the student demonstrates good counseling skills; with instructor assistance, can conceptualize the client s issues from a particular theory; with instructor assistance can develop appropriate/effective treatment plans; and demonstrates standards of professional and personal behavior, a continued willingness to learn, and a commitment to the counseling profession. The letter grade of C indicates that the student did not complete all course requirements in a timely and professional manner; needs to improve basic counseling skills as well as knowledge base of counseling theory; may need to examine personal and/or professional standards; and appears to be unwilling to learn or lacking in commitment to the profession. A letter grade of C will require that the student retake Practicum in the following semester and may lead to a re--- evaluation of the student s participation in the counseling program by his or her faculty advisor and the practicum supervisor. PRACTICUM CAN ONLY BE REPEATED ONE TIME. The instructor of your section will decide whether pluses or minuses will be earned (i.e., B+). In cases where the student has failed to meet the required number of clock hours due to acceptable extenuating circumstances, a grade of I (Incomplete) will be given. Failure to complete the requirements within one semester will result in re--- evaluation of the student s continued participation in the counseling program. CACREP Requirements for Entry-Level Professional Practice and Practicum The following are standards, as outline by the Council for Accreditation of Counseling and Related Educational Programs (CACREP), for Professional Practice. These can be found on page 15 in the 2016 CACREP Standards. SECTION 3: PROFESSIONAL PRACTICE A. Students are covered by individual professional counseling liability insurance policies while enrolled

in practicum and internship. B. Supervision of practicum and internship students includes program-appropriate audio/video recordings and/or live supervision of students interactions with clients. C. Formative and summative evaluations of the student s counseling performance and ability to integrate and apply knowledge are conducted as part of the student s practicum and internship. D. Students have the opportunity to become familiar with a variety of professional activities and resources, including technological resources, during their practicum and internship. E. In addition to the development of individual counseling skills, during either the practicum or internship, students must lead or co-lead a counseling or psychoeducational group. 6 SECTION 3: PROFESSIONAL PRACTICE F. Students complete supervised counseling practicum experiences that total a minimum of 100 clock hours over a full academic term that is a minimum of 10 weeks. G. Practicum students complete at least 40 clock hours of direct service with actual clients that contributes to the development of counseling skills. H. Practicum students have weekly interaction with supervisors that averages one hour per week of individual and/or triadic supervision throughout the practicum by (1) a counselor education program faculty member, (2) a student supervisor who is under the supervision of a counselor education program faculty member, or (3) a site supervisor who is working in consultation on a regular schedule with a counselor education program faculty member in accordance with the supervision agreement. I. Practicum students participate in an average of 1½ hours per week of group supervision on a regular schedule throughout the practicum. Group supervision must be provided by a counselor education program faculty member or a student supervisor who is under the supervision of a counselor education program faculty member. POLICIES AND PROCEDURES To increase the efficiency and professionalism of the counseling lab, the following guidelines have been established. Your participation in enforcing these guidelines will help make the counseling experience more ethical and productive for yourselves, your clients, and your colleagues. Insurance All practicum students are required to have some form of liability insurance (CACREP 3A). Students must complete the Confirmation of Pre-Practicum Requirements which includes a statement and signature regarding proof of liability insurance, and must upload this form and a copy of their liability insurance document to the secured electronic records system prior to seeing clients. Free insurance is available once a student becomes a student member of either the American Counseling Association (ACA; www.counseling.org), or American School Counselor Association (ASCA; www.schoolcounselor.org). It is recommended that students in the career counseling track join ACA and students in the school counseling track join ASCA. Students who are not currently ACA, ASCA, or NCDA members are expected to join at least one national association at this time, not only for the opportunity to be insured under their group program (please note NCDA does not provide student liability insurance), but also to begin

participation in a professional organization which serves the interests of the counseling profession. Memberships for all of these associations are available online. Other options are available for a student to secure liability insurance, but they can be costly. Liability insurance through a school district for a current teacher is not sufficient to cover the added liability of counseling during practicum. 7 Student Counselor Behavior All student counselors are responsible for reading, understanding, and abiding by the Ethical Guidelines of the American Counseling Association (ACA) as well as the ethical guidelines of the professional association closely related to their counseling track (e.g., American School Counselor Association (ASCA), National Career Development Association (NCDA), etc.). While facilitating a group, you will be expected to abide by the standards for best practice of the Association for Specialists in Group Work (ASGW). The counseling lab is a professional counseling training facility. Student counselors are expected to reflect that image in their dress (business casual), as well as personal and professional behavior. Use of the counseling lab is greatly facilitated by student counselors and staff following these guidelines: Confidentiality is critical. Students should discuss their cases ONLY in practicum class or supervision. If you must discuss a case with your supervisor outside of these times, please do so in a private area where no information can be overheard. All client information shared in practicum class or supervision is confidential. If you know a client of another student counselor whose information is being discussed (or a recording is being shared) during practicum class or triadic supervision, please let the faculty supervisor know and excuse yourself from the classroom immediately. The limits of confidentiality include harm to self and others, child abuse and neglect, elder abuse, and threats to national security. Please consult with your supervisor, or another CCD faculty member if you think you need to break confidentiality. In cases of emergency (e.g., client safety or your safety), and you cannot reach a CCD faculty practicum supervisor, please refer to the call down list provided in this manual. All information concerning hours spent in clinical contact, supervision, and other activities involved with Practicum are to be truthfully and accurately reported. When using counseling rooms, please be sure to place the Session in Progress sign on the outside of the door. Return this sign to its blank side and lock the door when you are finished. Doors to the observation room and the counseling student office need to be closed at all times Please avoid conversations in the hallways surrounding the counseling rooms to avoid being disruptive to sessions in progress. Remember that the counseling labs are busy, so avoid going over time with clients as the room may be in use directly after your session. You must schedule your room on the electronic calendar system provided. Do not assume a room will be available. No food or drink is allowed in the recording equipment room, and please be careful with food and drink in the office due to the computer equipment there. Digital recording equipment should not be moved. All digital recording equipment should be set up and operational before the client arrives. When using this equipment, follow the posted instructions exactly. If you have any difficulty with it, find a

Graduate Assistant or CCD Faculty to assist you. DO NOT CHANGE ANY SETTINGS ON THE EQUIPMENT unless instructed to do so on the posted instructions sheet. Please report any malfunction of equipment immediately to a CCD faculty member. Students are to work on completing case notes immediately following the session. 8 Supervision Supervision is a critical component of student counselor development. The supervisory relationship is a collaborative effort and the supervisor and supervisee work together to maintain client welfare. Attendance of group and individual/triadic supervision are a requirement during practicum (CACREP 3H, 3I). The supervisory relationship is not confidential. If you share personal information about yourself that seems to be impacting your efficacy and abilities as a counselor, your supervisor will discuss with you appropriate action to be taken. Remember, a supervisory relationship is not a counseling relationship. Numerous methods of supervision are available and will be employed for monitoring student counselor/client contact including, but not limited to, digital recordings of sessions, live supervision, and presentation and discussion of case studies. Students are expected to be prepared each week for supervision with completed assignments (e.g. reading journal articles), questions, concerns, digital recording clips, etc. In addition, please make sure your client notes are completed and your recordings uploaded before supervision, so that your supervisor can provide you with immediate feedback. Obtaining Clients While we hope to have many volunteer clients, it is imperative that student counselors be as flexible with their schedules as possible in order to reach the required client contact hours. It is expected that each student counselor will work up to, and maintain, a case load of 4 clients throughout the majority of the semester. Clients will be obtained through a variety of sources. The CCD program announces the availability of the counseling lab and its services to students who are enrolled at CSU, to faculty and staff at CSU, and to the local community through various electronic mailing lists, as well as through distribution of literature around campus. In addition, practicum students are provided with literature to distribute to prospective clients or organizations that may want to utilize these services. Please discuss your ideas for distribution with your faculty supervisor first. Scheduling Client Appointments First counseling sessions are scheduled by the Field Experience Coordinator and ALL session following are to be scheduled by the Practicum student with clients. Practicum students are responsible for maintaining their own appointments with their clients following the first session. Students should use the electronic practicum calendar to schedule a particular room. It is important that when scheduling to note the room number and practicum student initials on the calendar in the time slot reserved. Be sure to verify that counseling lab space is available before confirming the appointment with the client. Group Counseling As stated previously, it is required by the CCD program, and CACREP, that students facilitate,

or co-facilitate, at least 10 hours of a group experience (CACREP 3E). It is preferred that these hours be completed during the practicum experience. Students will complete the Group Facilitation Hours form at the end of the semester, and if 10 hours are not completed, that form is to be sent to the CCD internship coordinator. Regardless of the number of group hours completed, there must be a total of 40 direct contact hours completed. 9 While students will work with their faculty practicum supervisor to identify group counseling opportunities, students must take a great deal of initiative in obtaining this opportunity. Students are highly encouraged to work on this as early as possible in the semester. The faculty practicum supervisor must approve the group facilitation experience. Client Records Information and records about clients are an important part of the counseling lab. These records allow us to gather information about the number and type of clients seen, as well as provide documentation of intake sessions, client sessions, termination, and more. All information about clients, including digital recordings, must be kept in the secured electronic record system. All client forms and other documents are signed by clients electronically and stored in the secured electronic record system. No paper copies of forms or other documents are collected from clients and, therefore, no paper files are kept. If the student chooses to keep any paper copies of these files or client work completed in session, a client file must be created (consult with your Practicum Supervisor for assistance creating a file). These materials must remain in the counseling lab in a locked file drawer, and destroyed (shredded) at the end of the semester. (Make sure all necessary files are in the electronic system, first!) Again, all documentation related to clients is confidential and must remain on-site. Failure to comply with these practices will result in a meeting with the Practicum Supervisor and may result in the student s re-evaluation for continuation in the program. The Release to Record and age-appropriate Disclosure Statement forms must be completed by the client s first session. The client will be offered a paper copy for their records and the student counselor will keep the signed electronic copy in the client s secured electronic file. The appropriate intake form should also be completed in the first session. Practicum students who are counseling minors in a school setting should follow school district or agency policy regarding approval by a parent or legal guardian prior to the initiation of counseling sessions and must have an appropriate release to record and disclosure form on file. It is the student counselor s responsibility to ensure that all client records are up-to-date and signed in the secured electronic system. Immediately following each session, the student counselor should complete a progress/case note. These should be reviewed weekly by the student s supervisor. Please be sure to keep note of your task list in Titanium Schedule so you know when your supervisor has requested that you address possible issues with documentation. Documentation is completed for each session, even if a client does not attend. A notation of cancellation or no-show should be made for the file and what was done (e.g., client was called, or client called and indicated he/she will return next week). Check on your client s safety when dealing with cancellations and document it (e.g., client reported doing well, denies being suicidal). Any other contact with client should be noted in the Titanium system. Titanium Schedule The current secure electronic record keeping system used in Practicum is Titanium Schedule. Practicum students will have access to Titanium Schedule on computers in the clinic office and

on other approved computers. Practicum students will receive training related to record keeping procedures and Titanium Schedule prior to meeting with their first client (CACREP 3D). Information about Titanium and training videos can be found at: http://www.titaniumschedule.com/main/default.aspx and http://www.titaniumschedule.com/main/videos/training.aspx. Accurate progress notes and record keeping are included in student evaluations throughout the semester and in the final grade. All practicum student are expected to regularly check and update their records and task list in Titanium Schedule. 10 Termination Before terminating with your clients, you need to discuss the reason for termination and your closure process with your supervisor. In addition, the student counselor should have all clients complete the Client Evaluation of Practicum Student or Child Client Evaluation of Practicum Student and return the form in a sealed envelope to your practicum section supervisor. Please note that at least two client evaluations are required for each student counselor. Closure with the client also includes talking with the client about the counseling process. Areas to address might be: (a) highlights of the counseling time; (b) changes the client has made because of counseling; (c) what the client has learned about themselves, (d) concerns or interventions that the client would have liked to address or experience, and/or (e) how the client will know if a return to counseling would be beneficial. Following the final counseling session for each client, the student counselor should complete the Termination Summary and Client Referral at Termination documentation. Referrals It is helpful for student counselors to view their work with clients as ending at the end of the semester and plan their counseling accordingly. Therefore, it is inappropriate/unethical for student counselors to agree or suggest that they will continue to see clients personally or professionally after the practicum semester. Under no circumstances should student counselors solicit, invite, suggest, or hint to clients to initiate counseling at student counselors internship sites. CSU students may be referred to the CSU Health Network Counseling Center. Community members may be referred to Mental Health Connections (970-221-5551) which is located inside of Summit Stone Health Partners. CSU students in need of further career services may be referred to the CSU Career Center (970-491-7757). Community members may be eligible for services at the Larimer County Workforce Center (970-619-4650). Other referrals can be investigated for clients who live outside the Fort Collins area. A client may request to continue seeing another student counselor the following semester provided that they are completely aware they will be working with a new student counselor and there will be a lag time before seeing their new student counselor. (Please note, there is no practicum offered over the summer, so clients seen in the spring will need to wait until fall.) Please note this one and only exception to the parameter stated above. Should a former client autonomously pursue services at a student counselor s internship site and the former client is matched with the student counselor for services the following steps need to be taken. 1) The student counselor should notify the site and faculty supervisor about the situation. 2) The student counselor should discuss (in general terms) the previous work and counseling relationship with the supervisors prior to continuing the relationship at the internship site. 3) If approved to continue the counseling work and relationship with the former client, student

counselors can proceed to offer services to the client. Of course, the client may wish to not continue working with the counseling student which is their ethical right. The counseling student and the client should discuss the new counseling relationship as soon as services are initiated at the internship site to ascertain the client s decision. Violation of this ethical guideline will result in a review of the student by CCD faculty. 11 Social Media Student counselors should have no social media contact with clients under any circumstances. If a student counselor is contacted by a client via social media, student counselors should not reply and should notify their faculty supervisor. The student counselor will work with their faculty supervisor to decide how best to proceed. If a client contacts a student counselor via social media and the student counselor is concerned the client may be in danger of harming themselves or someone else, the student counselor should contact their faculty supervisor immediately via a phone call. If unable to contact their faculty supervisor, student counselors should immediately contact another faculty member via phone call. The faculty member will work with the student to engage in appropriate interventions. Faculty contact information is found in the resource list below. Observation Counseling sessions will be observed by faculty practicum supervisors and students on a periodic basis (CACREP 3B, 3D, 3H, 3I). Note: You are expected to complete 5 hours of observation of other student counselors (or a professional counselor or career counselor). After each observation, complete and file an Observation Record and plan to spend some time talking with your classmate about what you observed, and suggestions or questions that you might have for their next session. It is important that the client know of this possibility before they consent to participate as a client. This information is covered in the Recording Release and Disclosure forms and should be discussed with the client. Class Assignments The following are class assignments to be completed by Practicum students throughout the semester. See the course syllabus for more information about class assignments and other contributors to student s final grades. Note: The syllabus is to be used as the primary document for course requirements and this Practicum Manual is considered supplementary to the course. Professional Liability Insurance: All students are required to acquire professional liability insurance prior to meeting with clients. Professional liability insurance can be acquired with membership in the American Counseling Association (ACA) and the American School Counselor Association (ASCA). Students who wish to acquire professional liability insurance through an organization other than ACA or ASCA must receive prior approval from their practicum supervisor. Mandatory Reporters Training: Each student must complete the Mental Health Professionals Component of the Mandatory Reporters Training found at: http://coloradocwts.com/mandated-reporter-training. This training must be completed prior to meeting with clients. After completing the training, students will submit proof of completion to their practicum supervisor. Practicum Orientation: All students are required to participate in Practicum Orientation. During orientation you will

learn about technology in counseling, clinic record keeping system, clinic policies and procedures, and clinic research methods. The orientation will be held at the beginning of the semester in which practicum is held. Date, time, and location to be announced in the semester before the semester in which practicum is held. Students must complete Practicum Orientation prior to approval to meet with clients. 12 Case Conceptualizations: Each student must offer one case presentation each semester. Secure permission from the student s parents and include an audio or masked video recorded excerpt of a counseling session with this student. You must also provide a written case study and share it with your classmates during your case presentation. This can be in the form of either a formal report or a slide presentation. Please use pseudo-names for your client. You are responsible for appropriately disposing of any confidential material following your formal presentation. Please submit your document or presentation through the Canvas course site and I, as faculty supervisor, will retain a copy of your written material as record that you have successfully met this requirement. The following is a guide for you to use in developing your presentation: 1. Client pseudonym 2. Source of referral (if pertinent) 3. Presenting concern for client this usually 2 to 3 sentences that summarize the concerns and issues of the client. (Another way to think of it is, why are they here to see you and work with you?) School counseling students should include school-based data such as test scores, attendance data, and grade reports in addition to information that you gather from talking with the student. 4. Pertinent background information/history what is underlying the presenting concern or will help us understand it better (i.e., previous counseling, significant relationships, physical health, vocational/academic concerns, legal issues, divorces, history of mental disorders, religious background, cultural background, trauma history, or other information you or the client has identified as important) 5. Client s counseling goals and goal attainment measures that you are or will be using. 6. Tentative DSM diagnosis if you are interning at a site that uses diagnoses. Clarify/justify your decision. 7. Strategies and techniques to help client reach goal(s) how do you understand their goals/concerns/issues from a career development (required if in career track), human development, multicultural, or counseling theory? What interventions have you or will you implement with the client? 8. Integration of additional CACREP common core areas: a. See handout regarding oral final comprehensive examination and see if you can integrate another area besides career development theory or counseling theory into your case presentation). b. Reference Practicum Counseling Skills in the course syllabus. What skills are you utilizing and/or developing while working with this client? 9. In-session behavior and progress toward goals. 10. Your strengths and areas to work on (as a counselor) with this client. 11. Concerns you have/questions for group supervision. Submitting Recordings: Each student will submit 5 complete counseling session recordings throughout the semester (reference the course schedule below for specific dates). Students can choose which sessions to submit and are encouraged to choose sessions based on desired feedback. For example, students may choose a session during which they tried something for the first time, had a difficult time in

session, are proud of their counseling, etc. Students will receive feedback from peer observers and should review feedback as soon as it is received. 13 Recording Observations: Students will observe 5 counseling session recordings submitted by their peers throughout the semester. Students should review a different peer s recoding each of the 5 times, resulting in viewing 1 recording from 5 students by the conclusion of the semester (unless prohibited by practicum group size). Students are expected to view each session entirely and provide feedback throughout. The observation record form to be completed can be found in the course S:Drive folder (directions to be provided in class). The form is designed to encourage critical thinking and to assist you in applying your theoretical knowledge to a variety of clinical situations. When completing the form, please answer all of the questions as if you were the counselor in the session observed. It is expected that students will address each of the following areas on the feedback submitted: 1. Counselor (Actual counselor): 2. Date: 3. Observer # (you): 4. Time: 5. Presenting Problem (client s): 6. Theoretical Orientation (yours): 7. Focus of Session (as you would see it if you were working with this client): 8. Techniques (that you might use if you were working with this client): 9. Homework Assignment(s) (that you might use): 10. Ethical, safety, or other issues/concerns that you have regarding the session you observed: 11. What, specifically, did the counselor do that really worked for this particular client? What, specifically, would you have the counselor work on in the next session? Suicide Assessment (CACREP 2.F.7c) (From the American Counseling Association) Warning signs: Warning signs should be attended to and not be ignored or perceived as an attention getter. These warning signs are a way to reach out and ask for help. Common warning signs for suicide assessment include the following signs/symptoms: A. Verbal DIRECT:_ I am going to kill myself. INDIRECT: You are all going to be sorry, when I am no longer here. My life is not worth living anymore. B. Psychological _long term depression _feeling helpless _feeling hopeless _feeling overwhelmed _feeling sad C. Emotional _pre-occupation with death

_lack of appetite/overeating _sleep disturbances _poor concentration _isolation _crying 14 D. Behavioral _low self esteem _inability to perform daily tasks _previous suicide attempts _suicide note _engaging in risky or impulsive behavior _sudden poor school or job performance _giving away important things _lack of interest in things previously enjoyed _sudden refraining from activities with family and friends _sudden unexplained recovery from depression, sudden positive outlook- like the person is fine E. Situational _school or career problems _loss of job/career _death of a loved one or peer _suicide of a loved one or peer _relationship break-up/separation/divorce _multiple losses _terminal illness Crisis Intervention Suicide Evaluation and Procedures Ask the following questions: 1. Are you thinking about hurting yourself? If yes, ask How long have you been thinking about suicide? (Frequency, intensity, duration) and Have you ever tried to hurt yourself? (e.g., cut yourself, jumped out of car, taken too many pills)? 2. Has anyone else in your family ever tried to commit suicide? If yes, ask who, how, and when. 3. Have you made a plan? (Or ask what lethal things could you do on the spur of the moment to hurt or kill yourself.) 4. Is there anything or anyone to stop you (religious beliefs, children left behind, pets, etc.)? 5. If the answer to #3 is yes, ask about details. (Ask about availability to weapon or pills. Ask about availability of site - You say you plan to do this at home, how have you planned to be alone?) If the answer to questions 1 and 2 are YES and the answers to questions 3 and 4 are NO, your client has a moderate risk of suicide. At this point, please contact your supervisor and/or another CCD faculty member if you are unable to reach your supervisor. If unable to reach any CCD faculty member, then we suggest you walk your client over to the counseling center.

Below is the process, in general, the CCD faculty will go through with you and the client: 1. Express your concern and ask the person, How can we keep you safe? Can you guarantee me that you will not hurt yourself? 2. Make a safety plan with your client until they see you (or another counselor). a. If they agree, set up another appointment with them as soon as possible, but no later than the next 24 hours. b. If they are a CSU student give them the phone numbers of the University Counseling Center (491-6053) and counselors to call during the evening if they need immediate help - Mental Health Crisis Intervention (970-491-7111) and the National Suicide Prevention Lifeline: (800) 273-TALK (8255). They can also call 911 if they need immediate help. c. And/or, ask if there is someone they can stay with or who can stay with them until they come in to see the counselor. 3. INFORM YOUR SUPERVISOR OR ANOTHER FACULTY MEMBER IMMEDIATELY. DOCUMENT THE STEPS YOU TOOK ON CASE NOTES/PROGRESS NOTES. (Sometimes students have called their supervisor while the client is still in the room. This is a good strategy. The conversation with the supervisor will help you feel supported and demonstrate added support for the client.) 15 If the answers to questions 3 and 4 are YES, your client has a high suicide risk. Again, at this point, contact your supervisor and/or another CCD faculty member if you are unable to reach your supervisor. If unable to reach any CCD faculty member, then walk your client over to the counseling center. If the danger is HIGH, but NOT IMMEDIATE: Below is the process, in general, the CCD faculty will go through with you and the client: 1. Complete a safety plan with client. 2. Ask for the number of a family member or friend that you can call to support them. Make the call then and there to this family member or friend. 3. Refer them to the University Counseling Center for immediate on-call assistance. Emergency #s (from 5:00 p.m. to 8:00 a.m.) are 491-7111, or Helpline 491-5744, and National Suicide Prevention Lifeline: (800) 273-TALK (8255). 4. Before they leave you, tell them you will call back in 30 minutes to see if they have made an appointment. Call and evaluate status at that time. 5. INFORM YOUR SUPERVISOR OR ANOTHER FACULTY MEMBER IMMEDIATELY. DOCUMENT THE STEPS YOU TOOK ON THE TELEPHONE LOG SHEET. (Sometimes students have called their supervisor while the client is still in the room. This is a good strategy. The conversation with the supervisor will help you feel supported and demonstrated added support for the client.) If you feel there is an immediate danger if the client leaves, you are ethically responsible for preventing the client from leaving through all reasonable means. This may include: 1. Calling Campus Security to restrain the individual. 2. Calling a family member or friend to come and take the individual to a hospital. 3. INFORM YOUR SUPERVISOR OR ANOTHER FACULTY MEMBER IMMEDIATELY. DOCUMENT THE STEPS YOU TOOK IN YOUR PROGRESS NOTES. (Sometimes students have called their supervisor while the client is still in the room. This is good strategy. The conversation with the supervisor will help you feel supported and demonstrated added support for the client.)

Title IX - Sexual Assault, Sexual Violence, Sexual Harassment The Practicum clinic is exempt from mandated reporting of sexual assault, sexual violence, sexual harassment discussed by CSU student clients. Although Practicum students and Practicum Supervisors are not required to report, we encourage Practicum students to provide resources to CSU students who discuss experiences of sexual assault, sexual violence, and sexual harassment. See the Resource List below and CSU s Title IX website (https://oeo.colostate.edu/title-ixsexual-assault-sexual-violence-sexual-harassment/) for potential client resources. 16 Call Down List for Clients in Crisis IMPORTANT: Contact Persons or Agency in This Order Client is CSU Student Client is Community Person 1. Call CSU Counseling Center 491-6053. Schedule an appointment or walk person over to 123 Aylesworth NW. After hours call 491-7111 1. Immediate concern call 911. (If you are in a school setting, immediately consult with your site coordinator or school administrator.) 2. Call your practicum supervisor 2. Call your practicum supervisor 3. If you cannot reach your supervisor, call one of the other supervisors 4. Make sure to document in Progress Notes the people and agencies you ve contacted and the plan of action (e.g. safety plan) agreed upon between the client and yourself. 5. Contact client within 24 hours check to see whether they followed through on the action plan. During contact, assess for suicide potential and potential for harm to others. 6. If client did not follow through with action plan, contact your supervisor immediately. 3. If you can t reach your supervisor, call one of the other supervisors. 4. Make sure to document in progress notes the people and agencies you ve contacted and the plan of action agreed upon between the client and yourself. Make sure to complete the Safety Plan. 5. Contact client within 24 hours check to see whether they followed through on action plan. During contact, assess for suicide potential and potential for harm to others. 6. If client did not follow through with action plan, contact your supervisor immediately. Safety Plan 1. Recognize warning signs: What sorts of thoughts, images, moods, situations, and behaviors indicate to you that a crisis may be developing? Write these down in your own words.

17 2. Use your own coping strategies without contacting another person: What are some things that you can do on your own to help you not act on thoughts/urges to harm yourself? 3. Socialize with others who may offer support as well as distraction from the crisis: Make a list of people (with phone numbers) and social settings that may help take your mind off things. 4. Contact family members or friends who may help to resolve a crisis: Make a list of family members (with phone numbers) who are supportive and who you feel you can talk to when under stress. 5. Contact mental health professionals or agencies: List names, numbers and/or locations of clinicians, local emergency rooms, Call the National Suicide Prevention Lifeline: (800) 273-TALK (8255). This is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. 6. Ensure your environment is safe: Have you thought of ways in which you might harm yourself? Work with your counselor to develop a plan to limit your access to these means. From: http://www.suicidepreventionlifeline.org/learn/safety.aspx Resource List Dr. Sharon Anderson Office 970-491-6861 Mobile 970-217-4228 Home 970-377-1003 Dr. Jessica Gonzalez Office 970-491-6289 Mobile 305-318-6904 Dr. Laurie Carlson Office 970-491-6826 Home 970-454-9010 Mobile 970-405-0932 Dr. Jackie Peila-Shuster Office 970-491-7757

Mobile 970-222-8964 18 Bryan Lamb Office 970-491-5802 Mobile 972-921-8646 CSU Counseling Center 970-491-6053 (8am - 5pm) http://health.colostate.edu/services/counseling-services Mental Health Services 970-491-6053 Mental Health Crisis Intervention 970-491-7121 After Hours (CSU Emergency Dispatch) 970-491-7111 Crisis Assessment Center 970-495-8090 (Available 24 hours/7 days a week) Victim Assistance Team (sexual assault) 970-492-4242 (Available 24/7. 365 days a year) National Suicide Prevention Hotline 800-273-8255 (24/7, free and confidential support) National Hopeline Network (Available 2pm-2am Eastern Time 7 days/week) https://www.imalive.org/chat.php (Online suicide chat service) Colorado Crisis Services 1-844-493-TALK(8255) http://coloradocrisisservices.org Text TALK to 38255 (Available 24/7. 365 days a year) CSU Campus Police Non-Emergency 970-491-6425 CSU Student Case Management 970-491-8051 http://www.studentcasemanagement.colostate.edu Tell Someone 970-491-1350 (http://supportandsafety.colostate.edu/tellsomeone) Department of Human Services/ Larimer County: 970-498-6990 Child Protection Colorado: 1-844-264-5437 (Available 24/7. 365 days a year) Mental Health Connections 970-221-5551 (Located inside SummitStone) - For low income or no insurance Poudre Valley Hospital 970-495-7000 Mountain Crest Behavioral Health Center 970-207-4800 https://www.uchealth.org/pages/oham/orgunitdetails.aspx?organizationalunitid=264 SummitStone Health Partners 970-494-4200 Alliance for Suicide Prevention also lists numerous resources for Larimer County

http://allianceforsuicideprevention.org/about-suicide/where-to-get-help 19 CSU Career Center https://career.colostate.edu/ Larimer County Workforce Center http://larimerworkforce.org 970-491-5707 (Lory Student Center) 970-498-6600 (Fort Collins) 970-619-4650 (Loveland) You@CSU is a tool designed to help you manage stress, set goals, promote happiness and wellbeing, and connect to campus resources to thrive, succeed, and matter. http://health.colostate.edu/youcsu/ Practicum Forms All practicum forms are in the secured electronic records system. Here is a list of what you will find there. Supervision: Confirmation of Pre-Practicum Requirements & Proof of Liability Insurance Counseling Student Agreement Counseling Student Information Sheet Supervisory Memorandum of Agreement Practicum Time Log Student Evaluation-Midterm & Final Evaluation of Supervision Group Facilitation Hours Counseling Student Exit Requirements Client Forms: Adult Disclosure Statement Adolescent Disclosure Statement Child Disclosure Statement Release to Record and/or Observe Adult Intake Information Child/Adolescent Intake Information Progress/Case Note 3 rd Party Consultation Notes Authority to Release and/or Obtain Information Contact Log Client Evaluation of Practicum Student Child Client Evaluation of Practicum Student Termination Summary Client Referral at Termination Weekly Report for Conducting Groups Class Assignments: Observation Record Case Presentation Guidelines