Assignment:Clinical Training
Assignment:Clinical Training
Assignment:Clinical Training
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Level of Clinical Training:
FORMCHECKBOX Pre-clinical training; coursework only
FORMCHECKBOX 0-12 months FORMCHECKBOX 12-24 months FORMCHECKBOX 2+ years
Rating Scale
4=Outstanding: Strong mastery of skills and thorough understanding of concepts
3=Mastered Basic Skills at Developmental Level: Understanding of concepts/skills evident
2=Developing: Minor conceptual and skill errors; in process of developing
1=Deficits: Significant remediation needed; deficits in knowledge/skills
NA=Not Applicable: Unable to measure with given data (do not use to indicate deficit)
4: Outstanding 3: At Level 2: Developing 1: Deficits Comp Score
Introduction FORMCHECKBOX Detailed intro that identifies client, age, ethnicity, etc.
FORMCHECKBOX Descriptions useful for understanding problem
FORMCHECKBOX Identifies basic information: significant others, age, ethnicity, occupation, grade, etc. FORMCHECKBOXMissing 1-2 identifiers
FORMCHECKBOXDoes not identify any significant others
FORMCHECKBOXMissing, incorrect or significant problem with identifiers and/or significant involved parties 2.3.7 FORMDROPDOWN
FORMCHECKBOXNA
Presenting Concern
Presenting Concern
FORMCHECKBOX Descriptions provides detailed, fair description of all stakeholders views
FORMCHECKBOX Thoughtful identification of stakeholders
FORMCHECKBOX Word choice conveys empathy
FORMCHECKBOX Begins to build clear conceptualization
FORMCHECKBOX Clear description of problem for each person and key stakeholders
FORMCHECKBOX Sufficient description for case conceptualization
FORMCHECKBOXMinor problems or lack of clarity with problem descriptions
FORMCHECKBOX Missing stakeholders
FORMCHECKBOXSignificant problems with problem descriptions
FORMCHECKBOX Missing key perspectives; incorrect characterization
2.3.9 FORMDROPDOWN
FORMCHECKBOXNA
Background and History
Background Information FORMCHECKBOX Skillfully discusses trauma and substance issues
FORMCHECKBOX Includes detailed summary of recent and past events
FORMCHECKBOX Begins to build clear conceptualization
FORMCHECKBOX Identifies salient trauma and substance abuse issues
FORMCHECKBOXProvides clear overview of history
FORMCHECKBOXMisses trauma or substance use issues
FORMCHECKBOXInsufficient, vague, minimal or missing background information
FORMCHECKBOXSignificant information missing
FORMCHECKBOX Unable to identify significant events
2.3.7 FORMDROPDOWN
FORMCHECKBOXNA
Strengths and Diversity
Client/
Family Strengths and Diversity
FORMCHECKBOX Detailed and useful description of all forms of strengths
FORMCHECKBOX Meaningful discussion of diversity resources and limitations
FORMCHECKBOXIdentifies at least one of each form of strength
FORMCHECKBOX Identifies at least one diversity resource and limit
FORMCHECKBOXUnderdeveloped description of strengths
FORMCHECKBOXMisses diversity resources and limits
FORMCHECKBOXSignificant problems identifying clinically relevant strengths
FORMCHECKBOX Misses significant diversity resources and limits
2.3.8 FORMDROPDOWN
FORMCHECKBOX NA
Family Structure
Boundaries Detailed assessment of:
FORMCHECKBOX Family life cycle
FORMCHECKBOX Boundaries
FORMCHECKBOX Triangles/Coalition
FORMCHECKBOX Hierarchy
FORMCHECKBOX Complementary patterns
Clear assessment of:
FORMCHECKBOX Family life cycle
FORMCHECKBOX Boundaries
FORMCHECKBOX Triangles/Coalition
FORMCHECKBOX Hierarchy
FORMCHECKBOX Complementary patterns
Minor problems with:
FORMCHECKBOX Family life cycle
FORMCHECKBOX Boundaries
FORMCHECKBOX Triangles/Coalition
FORMCHECKBOX Hierarchy
FORMCHECKBOX Complementary patterns
Significant problems:
FORMCHECKBOX Family life cycle
FORMCHECKBOX Boundaries
FORMCHECKBOX Triangles/Coalition
FORMCHECKBOX Hierarchy
FORMCHECKBOX Complementary patterns
1.1.1
2.1.1
2.2.3
6.3.2
FORMDROPDOWN
FORMCHECKBOX NA
Interaction Patterns
Problem Interaction Pattern FORMCHECKBOX Detailed, insightful description of interaction sequence
FORMCHECKBOX Detailed, insightful systemic hypothesis
FORMCHECKBOX No member blamed
FORMCHECKBOX Clear, behavioral description of interaction behavioral sequence
FORMCHECKBOX Clear, useful systemic hypothesis
FORMCHECKBOX Vague, non-behavioral description of interaction pattern
FORMCHECKBOX Hypothesis vague or non-systemic
FORMCHECKBOX Unclear interaction pattern
FORMCHECKBOX Problems with hypothesis
FORMCHECKBOX One member blamed for problem
1.1.1
2.2.3
FORMDROPDOWN
FORMCHECKBOX N