Counselor-in-training Handbook

Professional School Counseling Program

Program Coordinator: Thurman Webb, Ed.D.

Psychology Department
Tennessee State University
3500 John A. Merritt Blvd.
Nashville, TN 37209
https://tsuschoolcounseling.weebly.com/

August 2018
 TABLE OF CONTENTS
CONTACT INFORMATION ............................................................................................................................3
PROGRAM INFORMATION ...........................................................................................................................4
Mission Statement.........................................................................................................................................4
Program Objectives ......................................................................................................................................4
Standard Alignment .....................................................................................................................................4
Professional Liability Coverage ...................................................................................................................4
Criminal Background Checks ......................................................................................................................4
Taped Counseling Sessions ...........................................................................................................................5
Comprehensive Exam ...................................................................................................................................5
Praxis Information .......................................................................................................................................5
Academic Expectations.................................................................................................................................5
Requirements for Full Licensure .................................................................................................................5
Professional Associations ..............................................................................................................................5
Ethical Standards .........................................................................................................................................5
Guidance Counselor vs. School Counselor ..................................................................................................6
CAEP STANDARDS* .......................................................................................................................................7
CACREP STANDARDS SECTION III - PROFESSIONAL PRACTICE* ......................................................8
DESIRED FIELD EXPERIENCE ACTIVITIES .............................................................................................9
APPENDICES ................................................................................................................................................ 10
Pre-Practicum Contract between ............................................................................................................... 11
PROPOSED PRE-PRACTICUM SCHEDULE ........................................................................................ 13
PRE-PRACTICUM TIME LOG ............................................................................................................... 14
PRE-PRACTICUM PLACEMENT SUMMARY ..................................................................................... 15
Practicum Contract between ...................................................................................................................... 16
Internship Contract between...................................................................................................................... 18
PROPOSED FIELDWORK SCHEDULE ................................................................................................. 20
FIELDWORK TIME LOG ........................................................................................................................ 21
Pre K-12 Professional School Counseling Student Self- Evaluation ......................................................... 23
Pre K-12 Professional School Counseling Student Fieldwork Evaluation ............................................... 26
SITE EVALUATION ................................................................................................................................. 30
TAPING CONSENT FORM ...................................................................................................................... 31

2
 CONTACT INFORMATION

Psychology Department Main Office

Clay Hall, Suite 303
(615) 963-5141

Department Chair
Dr. Kiesa Kelly
(615) 963-5157
kkelly5@tnstate.edu

Program Faculty
Dr. Thurman Webb
(615) 963-1593
Twebb8@tnstate.edu

Communication Resources
https://tsuschoolcounseling.weebly.com/
Facebook: TSU Psychology

3
 PROGRAM INFORMATION
Mission Statement
The mission of the Professional School Counseling program is to aid counselors-in-training along their journey
to foster scholarly research, continuous professional development, advocacy skills, and cultural competency.
The program will prepare counselor trainees to address the needs of students from diverse backgrounds in
relation to academic and career preparation, as well as personal growth and social development.
Program Objectives
The Professional School Counseling program will equip candidates with the skills to:
• Practice evidence-based counseling techniques
• Exercise goal-directed interviewing skills
• Implement meticulous record keeping techniques
• Demonstrate effective teaching
• Execute sound program evaluation research and reporting
Standard Alignment
The Professional School Counseling program is accredited by the Council for Accreditation of Educator
Preparation (CAEP). Additionally, it is designed to infuse the following common core areas of foundational
knowledge aligned with CACREP standards:
1. Professional Counseling Orientation and Ethical Practice
2. Social and Cultural Diversity
3. Human Growth and Development
4. Career Development
5. Counseling and Helping Relationships
6. Group Counseling and Group Work
7. Assessment and Testing
8. Research and Program Evaluation

Students are expected to display the following professional dispositions:

• Commitment
• Openness
• Respect
• Integrity
• Self-awareness

Professional Liability Coverage

Counselor trainees are required to obtain professional liability coverage (insurance) during internship. The
American School Counseling Association (ASCA) offers liability insurance as a benefit for members
(www.schoolcounselor.org).

Criminal Background Checks

Counselor trainees are required to successfully pass a background check for internship. Complete background
check in Fall (unless currently employed by school system, then present copy of school id to Ms. JoNatalyn
Mercer [Clay 112; (615) 963-5459; jmercer@tnstate.edu ]). Keep a copy of results (will need to submit for field
placement).

4
Taped Counseling Sessions
Counselor trainees are expected to video/audio tape several counseling activities during their internship
placement. Trainees will present portions of their taped sessions for review during supervision meetings with
faculty supervisors and/or during group supervision (class). Signed consent forms must be completed before
any taping is done and must accompany any tapes presented for review.
Comprehensive Exam
Students working toward degree completion must successfully pass the comprehensive exam to graduate from
the university. Students should register for the exam in the Fall semester prior to graduation. Application forms
can be found on the Graduate School website.
Praxis Information
Individuals entering the school counseling profession take the Praxis Subject test as part of the licensing
process required by the state. Students must pass Praxis test # 5421 (with a score of at least a 156) before
registering for internship. Official test dates and practice resources can be found on the following website:
https://www.ets.org/praxis/prepare/materials/5421 .
Academic Expectations
Graduate instruction assumes that the student has both the interest and the ability to do independent study and
research of outstanding quality. Thus, a graduate student must maintain a minimum average of “B” (3.0
quality/grade points on a 4.0 point system) in all graduate work. Course grades are: A, B, C, D, and F. In
master’s degree programs, grades less than “C” are counted in compiling the general average, but they may not
be included in the requirements for the degree.
Requirements for Full Licensure
Upon completion of program requirements, submit the following to the TSU Teacher Certification Office:
• Completed and signed Application for Tennessee Teaching License (form available from the Teacher
Certification Office);
• Official transcripts from all schools attended (schools must be accredited and your Master’s degree must
be listed on the transcript);
• Proof of passing PRAXIS;
• Current, updated Program of Study/Advancement to Candidacy with evidence of all courses completed
and form signed by Professional School Counseling Coordinator

Forms should be sent to the attention to:

Dr. Dianne Y. Bryant, Certification Officer
Teacher Education and Certification
Tennessee State University
3500 John Merritt Blvd., Box 9533
Nashville, TN 37209
Phone: (615) 963-5484
Professional Associations
The following associations are endorsed by the TSU Professional School Counselor Program:
American School Counselor Association (ASCA): www.schoolcounselor.org
Tennessee Counseling Association (TCA): www.tcacounselors.org/

Ethical Standards
Professional School Counselors (and trainees) are governed by the Ethical Standards for School Counselors.
This can be found on the ASCA website: https://www.schoolcounselor.org/school-counselors-members/legal-
ethical
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Guidance Counselor vs. School Counselor
Tennessee Bill # 302
Passed May 24, 1999:
An act to rededsignate guidance counselors as school counselors and to amend TCA (Tennessee Code
Annotated), Title 49, accordingly. Be it enacted by the general assembly of the State of Tennessee: Section 1.
TCA, Section 49-5-402(a), is amended by deleting the words "guidance counselor" wherever they appear and
substituting the words "school counselor".

This state law was passed to formally changing the name from “guidance” counselor to school counselor.
Professional school counselors, the American School Counseling Association, Tennessee School Counseling
Association, and the Tennessee Department of Education have been working diligently to reconfigure the
professional identity of PSCs from its historical guidance epistemology to a comprehensive developmental
model. The professional school counselor is a certified/licensed educator (must have a Master's or higher in
TN), is trained in school counseling with unique qualifications, and has skills to address all students’ academic,
career, and social/emotional development needs. Professional school counselors implement a comprehensive
school counseling program that promotes and enhances student achievement.

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 CAEP STANDARDS*
Standard 1. Content and Pedagogical Knowledge
The provider ensures that candidates develop a deep understanding of the critical concepts and principles of
their discipline and, by completion, are able to use discipline-specific practices flexibly to advance the learning
of all students toward attainment of college- and career-readiness standards.

Standard 2. Clinical Partnerships and Practice

The provider ensures that effective partnerships and high-quality clinical practice are central to preparation so
that candidates develop the knowledge, skills, and professional dispositions necessary to demonstrate positive
impact on all P-12 students’ learning and development.

Standard 3. Candidate Quality, Recruitment, and Selectivity

The provider demonstrates that the quality of candidates is a continuing and purposeful part of its responsibility
from recruitment, at admission, through the progression of courses and clinical experiences, and to decisions
that completers are prepared to teach effectively and are recommended for certification. The provider
demonstrates that development of candidate quality is the goal of educator preparation in all phases of the
program. This process is ultimately determined by a program’s meeting of Standard 4.

Standard 4. Program Impact

The provider demonstrates the impact of its completers on P-12 student learning and development, classroom
instruction, and schools, and the satisfaction of its completers with the relevance and effectiveness of their
preparation.

Standard 5. Provider Quality Assurance and Continuous Improvement

The provider maintains a quality assurance system comprised of valid data from multiple measures, including
evidence of candidates’ and completers’ positive impact on P-12 student learning and development. The
provider supports continuous improvement that is sustained and evidence-based, and that evaluates the
effectiveness of its completers. The provider uses the results of inquiry and data collection to establish
priorities, enhance program elements and capacity, and test innovations to improve completers’ impact on P-12
student learning and development.

* Taken from the Council for Accreditation of Educator Preparation (CAEP) 2013 Standards.

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 CACREP STANDARDS SECTION III - PROFESSIONAL PRACTICE*

Professional practice, which includes practicum and internship, provides for the application of
theory and the development of counseling skills under supervision. These experiences will provide opportunities for
students to counsel clients who represent the ethnic and demographic diversity of their community.

Supervisor Qualifications and Support

1. Counselor education program faculty members serving as individual/triadic or group practicum/internship
supervisors for students in entry-level programs have (1) relevant experience, (2) professional credentials, and (3)
counseling supervision training and experience.
2. Students serving as individual/triadic or group practicum/internship supervisors for students in entry-level
programs must (1) have completed CACREP entry-level counseling degree requirements, (2) have completed or
are receiving preparation in counseling supervision, and (3) be under supervision from counselor education
program faculty.
3. Site supervisors have (1) a minimum of a master’s degree, preferably in counseling, or a related profession; (2)
relevant certifications and/or licenses; (3) a minimum of two years of pertinent professional experience in the
specialty area in which the student is enrolled; (4) knowledge of the program’s expectations, requirements, and
evaluation procedures for students; and (5) relevant training in counseling supervision.
4. Orientation, consultation, and professional development opportunities are provided by counselor education
program faculty to site supervisors.
5. Written supervision agreements define the roles and responsibilities of the faculty supervisor, site supervisor, and
student during practicum and internship. When individual/triadic practicum supervision is conducted by a site
supervisor in consultation with counselor education program faculty, the supervision agreement must detail the
format and frequency of consultation to monitor student learning.
Practicum
1. 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
2. Practicum students complete at least 40 clock hours of direct service with actual clients that contributes to the
development of counseling skills.
3. 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.
4. Practicum students participate in an average of 11⁄2 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.

Internship
1. After successful completion of the practicum, students complete 600 clock hours of supervised counseling
internship in roles and settings with clients relevant to their specialty area.
2. Internship students complete at least 240 clock hours of direct service.
3. Internship students have weekly interaction with supervisors that averages one hour per week of individual and/or
triadic supervision throughout the internship, provided by (1) the site supervisor, (2) counselor education program
faculty, or (3) a student supervisor who is under the supervision of a counselor education program faculty
member.
4. Internship students participate in an average of 11⁄2 hours per week of group supervision on a regular schedule
throughout the internship. 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.

* Taken from the Council for Accreditation of Counseling and Related Education Programs (CACREP) 2016 Standards.

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 DESIRED FIELD EXPERIENCE ACTIVITIES

Activity Practicum Internship Time

Hours Hours
(100) (300)
Direct Student Services 80%
• Instruction
• Appraisal & Advisement >48 hrs. >120 hrs.
• Counseling

Indirect Student Services

• Referrals
• Consultation
• Collaboration
Program Management and School Support 20%
• Program Foundation, Management, and Accountability
• Fair-share responsibility
Site Supervision 1 hr. per 1 hr. per
week week

9
APPENDICES

10
 Pre-Practicum Contract between
Licensed School Counselor &
Department of Psychology

This contract serves as an agreement between the Licensed Professional School Counseling Program at
Tennessee State University and
_________________________________________________________________________________________.
(School/Agency/Organization)
This agreement between the Tennessee State University and

__________________________________________________________________________________________
(School/Agency/Organization)

will be effective for the period of one semester beginning___________________.

(Date)
This agreement indicates that both parties are willing to meet the responsibilities for Pre-Practicum and as set
forth by the Licensed Professional School Counseling Program at Tennessee State University.

Site Responsibilities:

1. Provide the student with 34 hours of shadowing Site Supervisor direct service with clients as defined by
face-to-face contact with clients in a therapeutic capacity.

2. Assign a site supervisor who has appropriate credentials, time, and interest in the student. TSU requires
that a site supervisor have a minimum of two (2) years experience in the field.

3. Provide the student with appropriate workspace and office supplies. The student should have the
opportunity to observe counseling in an environment comparable to that used by mental health staff or
school personnel, including ensuring the safety of the student and clients.

4. Provide opportunities for the student to observe a variety of counseling activities

implemented/conducted by a trained counselor. These activities may include but are not limited to: (a)
individual counseling, (b) career counseling, (c) co-counseling, (d) group counseling, (e) marriage and
family counseling, (f) intake interviews, (g) record keeping, (h) consultation and (i) referrals.

Site Supervisor(s) Responsibilities:

1. Regularly monitor, discuss and provide constructive feedback of activities provided by the pre-
practicum student throughout the course of the pre-practicum experience so as to facilitate the
professional development of the student and ensure the welfare of clients.

2. Be available to the student for regular consultation.

3. Review and sign the student's logs of activities completed at the site.

4. Ensure that the student is informed and follows site policies for working with minors and for handling
cases.

5. Provide an orientation for the student that includes policies for record keeping, introducing student to
relevant staff, and informing the student of the policies and procedures of the site.
11
 6. Provide both written and oral feedback to the student on a regular basis regarding development of
counseling skills.

7. Provide written evaluations at the mid-point and end of the semester. This evaluation should include oral
feedback regarding level of professionalism and competence in counseling skills. Student should sign
the evaluation.

8. Inform the university supervisor of any problems that the student is experiencing with an appropriate
amount of time for remediation.

The Licensed Professional School Counseling Program at Tennessee State University responsibilities:

1. Provide supervision for the student from a designated university supervisor, who will be responsible for
the assignment of a grade in the course.

2. Ensure to the greatest extent possible that the student is personally and professionally suitable to work
with clients.

3. Provide an opportunity for the student to conduct and participate in case presentations.

4. Provide group supervision experiences in which the student will provide feedback to peers and receive
feedback from peers.

5. Be available to site supervisor for consultation regarding placement and competence of student.

6. Inform student of the responsibilities to follow policies, rules, and procedures of site.

7. Be available to the student for additional clinical supervision should the site supervisor deem it
necessary.

8. Remove student from the placement should the site supervisor deem that the student is jeopardizing (or
at risk of jeopardizing) the welfare of clients and/or emotionally, psychologically, and/or interpersonally
unfit as a counselor-in-training at the time of the practicum placement.

_____________________________________________________________ ________________
Agency/organization Representative Date

____________________________________________________________ ________________
Practicum Instructor/University Supervisor Date

____________________________________________________________ ________________
Counseling Student Date

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 PROPOSED PRE-PRACTICUM SCHEDULE
*complete for each placement site

Counselor Trainee: Semester/Year:

Field Site Placement:

Proposed schedule for counselor trainee at field site placement:

Times trainee is expected to be at field site (e.g., 8am-3pm) # hours

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Total weekly hours =

______________________________________________________________________________
Counselor Trainee (print) Signature & date

______________________________________________________________________________
Field Site Supervisor (print) Signature & date

13
 PRE-PRACTICUM TIME LOG

Name: _______________________________________________School Site: _______________________________Week of: _____/_____/_____

DATE TIME TIME DIRECT INDIRECT TOTAL PROJECTS, REMARKS, DUTIES,
IN OUT HOURS HOURS HOURS THINGS LEARNED OR OBSERVED

Weekly Totals

Site Supervisor: _________________________________________ ___________________________________________________

Print Name Signature/Date

Student: ________________________________________ ___________________________________________________

Print Name Signature/Date

Faculty Supervisor: ________________________________________ ___________________________________________________

Print Name Signature/Date
 PRE-PRACTICUM PLACEMENT SUMMARY
Student Name: Year:

FIELD SITE

Elementary School Middle School High School

Direct Hours Indirect Hours Total Hours

Elementary

Direct Hours Indirect Hours Total Hours

Middle

Direct Hours Indirect Hours Total Hours

High

HOURS SUMMARY

Total direct: Total indirect: TOTAL CUMULATIVE HOURS: __________

_______________________________________________________ ___________________
Signature of Student Date
 Practicum Contract between
Licensed School Counselor &
Department of Psychology

This contract serves as an agreement between the Licensed Professional School Counseling Program at
Tennessee State University and
_________________________________________________________________________________________.
(School/Agency/Organization)
This agreement between the Tennessee State University and

__________________________________________________________________________________________
(School/Agency/Organization)

will be effective for the period of one semester beginning___________________.

(Date)
This agreement indicates that both parties are willing to meet the responsibilities for Practicum and as set forth
by the Licensed Professional School Counseling Program at Tennessee State University.

Site Responsibilities:

5. Provide the student with 100 clinical hours with a minimum of 40 direct service with clients as defined
by face-to-face contact with clients in a therapeutic capacity.

6. Assign a site supervisor who has appropriate credentials, time, and interest in the student. TSU requires
that a site supervisor have a minimum of two (2) years experience in the field.

7. Provide the student with appropriate workspace and office supplies. The student should have the
opportunity to provide counseling in an environment comparable to that used by mental health staff or
school personnel, including ensuring the safety of the student and clients.

8. Provide opportunities for the student to engage in a variety of counseling activities under the supervision
of a trained counselor. These activities may include but are not limited to: (a) individual counseling, (b)
career counseling, (c) co-counseling, (d) group counseling, (e) intake interviews, (f) record keeping, (g)
consultation and (h) referrals.

Site Supervisor(s) Responsibilities:

9. Regularly monitor, discuss and provide constructive feedback of activities provided by the practicum
student throughout the course of the practicum experience so as to facilitate the professional
development of the student and ensure the welfare of clients. Supervision should be approximately 1
hour per week.

10. Be available to the student for regular consultation.

11. Review and sign the student's logs of activities completed at the site.
 12. Ensure that the student is informed and follows site policies for working with minors and for handling
cases.

13. Provide an orientation for the student that includes policies for record keeping, introducing student to
relevant staff, and informing the student of the policies and procedures of the site.

14. Provide both written and oral feedback to the student on a regular basis regarding development of
counseling skills.

15. Provide written evaluations at the mid-point and end of the semester. This evaluation should include oral
feedback regarding level of professionalism and competence in counseling skills. Student should sign
the evaluation.

16. Assist the student in obtaining sufficient and appropriate client load considering the balance between
direct and indirect clients services provided by the student.

17. Inform the university supervisor of any problems that the student is experiencing with an appropriate
amount of time for remediation.

The Licensed Professional School Counseling Program at Tennessee State University responsibilities:

9. Provide supervision for the student from a designated university supervisor, who will be responsible for
the assignment of a grade in the course.

10. Ensure to the greatest extent possible that the student is personally and professionally suitable to work
with clients.

11. Provide an opportunity for the student to conduct and participate in case presentations.

12. Provide group supervision experiences in which the student will provide feedback to peers and receive
feedback from peers.

13. Be available to site supervisor for consultation regarding placement and competence of student.

14. Inform student of the responsibilities to follow policies, rules, and procedures of site.

15. Be available to the student for additional clinical supervision should the site supervisor deem it
necessary.

16. Remove student from the placement should the site supervisor deem that the student is jeopardizing (or
at risk of jeopardizing) the welfare of clients and/or emotionally, psychologically, and/or interpersonally
unfit as a counselor-in-training at the time of the practicum placement.

_____________________________________________________________ ________________
Agency/organization Representative Date
____________________________________________________________ ________________
Practicum Instructor/University Supervisor Date
____________________________________________________________ ________________
Counseling Student Date
17
 Internship Contract between
Licensed School Counselor &
Department of Psychology

This contract serves as an agreement between the Licensed Professional School Counseling Program at
Tennessee State University and
_________________________________________________________________________________________.
(School/Agency/Organization)
This agreement between the Tennessee State University and

__________________________________________________________________________________________
(School/Agency/Organization)

will be effective for the period of one semester beginning___________________.

(Date)
This agreement indicates that both parties are willing to meet the responsibilities for Internship and as set forth
by the Licensed Professional School Counseling Program at Tennessee State University

Site Responsibilities:
1. Provide an On- Site Supervisor/Licensed Professional School Counselor to oversee the Intern in completing
300 clinical hours with a minimum of 120 hours in direct service to clients (as defined by face-to-face contact
with clients in a therapeutic capacity).

2. Assign a site supervisor who has appropriate credentials, time, and interest in the Intern. TSU requires that a
site supervisor have a minimum of two (2) years experience in the field.

3. Provide the Intern with appropriate workspace and office supplies. The Intern should have the opportunity to
observe counseling in an environment comparable to that used by school personnel, including ensuring the
safety of the Intern and clients.

4. Provide opportunities for the Intern to engage in a variety of counseling activities under the supervision of a
Licensed Professional School Counselor. These activities may include but are not limited to: (a) individual
counseling, (b) career counseling, (c) co-counseling, (d) group counseling, (e) family counseling, (f) intake
interviewing, (g) record keeping, (h) consulting (i) educational counseling (j) educational presenting (k) test
administering and (l) referring.

Site Supervisor(s) Responsibilities:

1. Regularly monitor, discuss and provide constructive feedback of activities provided by the Intern throughout
the course of the Internship experience so as to facilitate the professional development of the Intern and ensure
the welfare of clients. Supervision should be approximately 1 hour per week.

2. Be available to the Intern for regular consultation.

3. Review and sign the Intern's logs of activities completed at the site.

4. Ensure that the Intern is informed and follows site policies for working with minors and for handling cases.

5. Provide an orientation for the Intern that includes policies for record keeping, introducing student to relevant
staff, and informing the student of the policies and procedures of the site.

18
6. Provide both written and oral feedback to the Intern on a regular basis regarding development of counseling
skills.

7. Provide written evaluations at the mid-point and end of the semester. This evaluation should include oral
feedback regarding level of professionalism and competence in counseling skills. The Intern should sign the
evaluation.

8. Inform the university supervisor of any problems that the Intern is experiencing with an appropriate amount
of time for remediation.

The Licensed Professional School Counseling Program at Tennessee State University responsibilities:
1. Provide supervision for the Intern from a designated university supervisor, who will be responsible for the
assignment of a grade in the course.

2. Ensure to the greatest extent possible that the Intern is personally and professionally suitable to work with
clients.

3. Provide an opportunity for the Intern to conduct and participate in case presentations.

4. Provide group supervision experiences in which the Intern will provide feedback to peers and receive
feedback from peers.

5. Be available to site supervisor for consultation regarding placement and competence of the Intern.

6. Inform the Intern of the responsibilities to follow policies, rules, and procedures of site.

7. Be available to the Intern for additional clinical supervision should the site supervisor deem it necessary.

8. Remove the Intern from the placement should the site supervisor deem that the Intern is jeopardizing (or at
risk of jeopardizing) the welfare of students and/or emotionally, psychologically, and/or interpersonally unfit as
a counselor-in-training at the time of the Internship placement.

____________________________________________________________ ________________
Intern’s On-Site Supervisor/School Representative Date

____________________________________________________________ ________________
Intern’s Instructor/University Supervisor Date

____________________________________________________________ ________________
Professional School Counseling Graduate Student/Intern Date

19
 PROPOSED FIELDWORK SCHEDULE

Practicum (100 hrs.) Internship I (300 hrs.)  Internship II (300 hrs.)

Counselor Trainee: Semester/Year:

Field Site Placement:

Proposed schedule for counselor trainee at field site placement:

Times trainee is expected to be at field site (e.g., 8am-3pm) # hours

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Total weekly hours =

Please specify & describe activities likely to be observed and/or undertaken by the counselor trainee
during this placement experience.

 Individual counseling
 Group counseling (leading or co-leading); please specify focus of planned groups:
 School Counseling Core Curriculum
 Career counseling
 Consultation (e.g., with parents, school officials)
 Psychoeducational activities relevant to the field site:
 Record keeping
 Receive individual site supervision
 Assessment (e.g., test interpretation). Please specify types:
 Other (describe):

______________________________________________________________________________
Counselor Trainee (print) Signature & date

______________________________________________________________________________
Field Site Supervisor (print) Signature & date

20
 FIELDWORK TIME LOG
Name: _______________________________________________School Site: _______________________________Week of: _____/_____/_____
DIRECT STUDENT SERVICES INDIRECT STUDENT SERVICES
Instruction Appraisal & Counseling Referrals Consultation Collaboration Site Supervision
Advisement

Monday
___/___/___
Tuesday
___/___/___
Wednesday
___/___/___
Thursday
___/___/___
Friday
___/___/___
Weekly
Totals:
*record time in quarter decimals (i.e. 1.0, 2.25, .50, 5.75, etc.)

Site Supervisor: _________________________________________ ___________________________________________________

Print Name Signature/Date

Student: ________________________________________ ___________________________________________________

Print Name Signature/Date

Faculty Supervisor: ________________________________________ ___________________________________________________

Print Name Signature/Date
 TSU SCHOOL COUNSELING FIELD PLACEMENT SUMMARY
Practicum Internship I Internship II

Student Name:

Field Site:
Name of site Phone Number

Street Address City/State/Zip

Site Supervisor of Record:

Highest Degree: License and/or Certification:

Dates of Placement: From: ______/______/______ To: ______/______/______

Hours summary:
Inst. A&A Counseling Referrals Consultation Collaboration Supervision

Wk 1
Wk 2
Wk 3
Wk 4
Wk 5
Wk 6
Wk 7
Wk 8
Wk 9
Wk 10
Wk 11
Wk 12
Wk 13
Wk 14
Wk 15
TOTAL

Total direct (Inst. + A&A + Counseling):

Total indirect (Referrals + Consultation + Collaboration + Supervision):

TOTAL CUMULATIVE HOURS:

This is to certify that the above-named student has satisfactorily completed fieldwork under my supervision.

_______________________________________________________ ___________________
Signature of Student Date

_______________________________________________________ ___________________
Signature of Site Supervisor Date

_______________________________________________________ ___________________
Signature of University Supervisor Date
 Pre K-12 Professional School Counseling
Student Self- Evaluation
Tennessee State University

Term: Choose an item. Date: Click here to enter a date. Field Experience: Choose an item.
Student Name
Please choose a number or NA (not applicable) for each of the following:

Evaluation Key
Excellent Good Acceptable Unacceptable
4 3 2 1

Delivery of Services Score

Standards & Objectives
• Professional objectives and state standards are regularly explicitly included in delivery plan.
• Objectives are regularly aligned and logically sequenced to the service delivery plan.
• Expectations for student outcomes are always clear.
• There is evidence that nearly all stakeholders understand
Motivating Students
• The educator consistently organizes services so that they are personally meaningful and relevant to
stakeholders.
• The educator consistently reinforces and rewards effort.
Delivery of Professional Services
*Services always include:
• Modeling by the educator to demonstrate his or her performance expectations.
• Logical sequencing and segmenting.
• All essential information
• No irrelevant, confusing or non-essential information.
Service Structure & Pacing
• All services are appropriately responsive.
• Pacing provides many opportunities for individual stakeholders needs.
• Routines for materials and/or information are seamless.
Activities & Materials
*Activities and Materials include most of the following as appropriate:
• Support the service and/or program.
• Challenging
• Sustain student/stakeholder’s attention
• Elicit a variety of thinking
• Provide time for reflection
• Are relevant to students’/stakeholders’ lives.
• Provide students/stakeholders with choices
• Incorporate multimedia and technology
• Incorporate resources beyond the school curriculum
• Encourage self-direction and self-monitoring
Communication
*Educator communications are consistently varied and high-quality, providing for a balanced mix of
communication methods including but not limited to written, oral, electronic, etc.
• Questions are consistently purposeful and coherent
• Communications methods often lead to further inquiry and self-directed learning.

Consultation
*Consultation is consistently focused, frequent and high quality.
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• Consultation is always appropriate to meet student/stakeholder needs
• Feedback is regularly used to monitor and adjust programs and services
Developing Educational Plans for Students
• Educator regularly contributes to short and long-term plans for individual students.
• Educator regularly analyzes data to make recommendations for students’ educational plan.
• Educator regularly consults with stakeholders to assist in development and refinement of students’
educational plans.
Professional Content Knowledge
Educator displays extensive content knowledge of all the programs/services he/she delivers.
• Educator regularly implements a variety of professional strategies to enhance program/service delivery.
Knowledge of Students
*Educator practices display a strong understanding of each student’s individual needs.
• Educator practices regularly incorporate student interests and cultural heritage.
Organization of Services
*The educator consistently provides a thoroughly developed, defined and comprehensive scope of services.
• Educator regularly utilizes school and/or student data to inform the organization of services.
• Educator regularly uses self-reflection and evaluation to refine organization of services.
Problem Solving
*The educator regularly implements activities that positively impact school data, including the following (as
applicable):
• Discipline referrals
• Attendance
• Student Achievement
• Graduation Rate
• Promotion Rate
• School Climate
• Course Enrollment Patterns
• CTE On-time completers

Planning of Services Score

Scope of Work
*Scopes of work include all of the following:
• Measurable and explicit goals
• Services, activities, materials, assessments, etc. are aligned to school improvement goals.
• Are appropriately scoped and sequenced based on the needs of the school and/or students.
• Evidence that scopes of work are chronologically and developmentally appropriate to meet school and/or
student needs.
• Evidence that services provide for regular opportunities to accommodate school, student, and stakeholder
needs.
Analysis of Work Products
*School and/or student data are regularly used to create work products.
• Work products are regularly analyzed and revised based on changing needs of school, student, and/or
stakeholders.
Evaluation of Services and/or Program
*Educator conducts an annual comprehensive evaluation of the services/programs delivered throughout the
year.
• Educator routinely collaborates with stakeholders to evaluate and improve services and programs.

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 Environment Score
Expectations
• Educator always sets high expectations for every student.
• Educator always creates opportunities where all students/stakeholders can successfully participate.
• Most students/stakeholders take initiative to benefit from the service delivery plan.
• Educator always optimizes service delivery time, provides appropriate materials, and encourages better
participation from every student/stakeholder.
Managing Student Behavior
• Students are consistently well-behaved, and on task.
• Educator and students establish clear rules for behavior.
• The educator uses a variety of effective techniques to maintain appropriate student behavior.
Environment
*The workspace:
• Welcomes all members and guests
• Is organized and understandable to all students/stakeholders.
• Supplies, equipment, and resources are easily and readily accessible.
• Is arranged to promote individual and group participation.
Respectful Culture
• Educator-student/stakeholder interactions demonstrate caring and respect for one another.
• Students/stakeholders exhibit caring and respect for one another.
• Educator seeks out, and is receptive to the interests and opinions of all students/stakeholders.

Area to be Strengthened (Area for Growth):

Professional Growth Goal(s) of this Plan: State your professional growth goal(s) in measurable or observable
terms.

Action Plan: Describe the actions you plan to take to accomplish this goal, including timelines for completion of
each action.

25
 Pre K-12 Professional School Counseling
Student Fieldwork Evaluation
Tennessee State University
Term: Choose an item. Date: Click here to enter a date. Field Experience: Choose an item.
Student Name
Site Supervisor
Please choose a number or NA (not applicable/no opportunity to observe) for each of the following:
Evaluation Key
Excellent Good Acceptable Unacceptable
4 3 2 1
PROFESSIONAL EDUCATION:
1. Standards & Objectives
a. Professional objectives and state standards are regularly explicitly included in Choose an item.
delivery plan.
b. Objectives are regularly aligned and logically sequenced to the service delivery Choose an item.
plan.
c. Expectations for student outcomes are always clear. Choose an item.
d. There is evidence that nearly all stakeholders understand Choose an item.
2. Motivating Students
a. The educator consistently organizes services so that they are personally Choose an item.
meaningful and relevant to stakeholders.
b. The educator consistently reinforces and rewards effort. Choose an item.
3. Delivery of Professional Services
a. Services always include: Modeling by the educator to demonstrate his or her Choose an item.
performance expectations.
b. Services always include: Logical sequencing and segmenting. Choose an item.
c. Services always include: All essential information Choose an item.
d. Services always include: No irrelevant, confusing or non-essential information. Choose an item.
4. Service Structure & Pacing
a. All services are appropriately responsive. Choose an item.
b. Pacing provides many opportunities for individual stakeholders needs. Choose an item.
c. Routines for materials and/or information are seamless. Choose an item.
5. Activities & Materials
a. Activities and Materials include most of the following as appropriate:
I. Support the service and/or program. Choose an item.
II. Challenging Choose an item.
III. Sustain student/stakeholder’s attention Choose an item.
IV. Elicit a variety of thinking Choose an item.
V. Provide time for reflection Choose an item.
VI. Are relevant to students’/stakeholders’ lives. Choose an item.
VII. Provide students/stakeholders with choices Choose an item.
VIII. Incorporate multimedia and technology Choose an item.
IX. Incorporate resources beyond the school curriculum Choose an item.
X. Encourage self-direction and self-monitoring Choose an item.
6. Communication

26
 a. Educator communications are consistently varied and high-quality, providing Choose an item.
for a balanced mix of communication methods including but not limited to
written, oral, electronic, etc.
b. Questions are consistently purposeful and coherent Choose an item.
c. Communications methods often lead to further inquiry and self-directed Choose an item.
learning.
7. Consultation
a. Feedback is regularly used to monitor and adjust programs and services Choose an item.
b. Consultation is consistently focused, frequent and high quality. Choose an item.
c. Consultation is always appropriate to meet student/stakeholder needs Choose an item.
8. Developing Educational Plans for Students
a. Educator regularly contributes to short and long-term plans for individual Choose an item.
students.
b. Educator regularly analyzes data to make recommendations for students’ Choose an item.
educational plan.
c. Educator regularly consults with stakeholders to assist in development and Choose an item.
refinement of students’ educational plans.
9. Professional Content Knowledge
a. Educator displays extensive content knowledge of all the programs/services Choose an item.
he/she delivers.
b. Educator regularly implements a variety of professional strategies to enhance Choose an item.
program/service delivery.
10. Knowledge of Students
a. Educator practices display a strong understanding of each student’s individual Choose an item.
needs.
b. Educator practices regularly incorporate student interests and cultural heritage. Choose an item.
11. Organization of Services
a. The educator consistently provides a thoroughly developed, defined and Choose an item.
comprehensive scope of services.
b. Educator regularly utilizes school and/or student data to inform the organization Choose an item.
of services.
c. Educator regularly uses self-reflection and evaluation to refine organization of Choose an item.
services.
12. Problem Solving
a. The educator regularly implements activities that positively impact school data,
including the following (as applicable):
I. Discipline referrals Choose an item.
II. Attendance Choose an item.
III. Student Achievement Choose an item.
IV. Graduation Rate Choose an item.
V. Promotion Rate Choose an item.
VI. School Climate Choose an item.
VII. Course Enrollment Patterns Choose an item.
VIII. CTE On-time completers Choose an item.
13. Scope of Work
a. Scopes of work include all of the following:
I. Measurable and explicit goals Choose an item.
II. Services, activities, materials, assessments, etc. are aligned to school Choose an item.
improvement goals.

27
 III. Are appropriately scoped and sequenced based on the needs of the Choose an item.
school and/or students.
IV. Evidence that scopes of work are chronologically and developmentally Choose an item.
appropriate to meet school and/or student needs.
V. Evidence that services provide for regular opportunities to Choose an item.
accommodate school, student, and stakeholder needs.
14. Analysis of Work Products
a. School and/or student data are regularly used to create work products. Choose an item.
b. Work products are regularly analyzed and revised based on changing needs of Choose an item.
school, student, and/or stakeholders.
15. Evaluation of Services and / or Program
a. Educator conducts an annual comprehensive evaluation of the Choose an item.
services/programs delivered throughout the year.
b. Educator routinely collaborates with stakeholders to evaluate and improve Choose an item.
services and programs.
16. Expectations
a. Educator always sets high expectations for every student. Choose an item.
b. Educator always creates opportunities where all students/stakeholders can Choose an item.
successfully participate.
c. Most students/stakeholders take initiative to benefit from the service delivery Choose an item.
plan.
d. Educator always optimizes service delivery time, provides appropriate Choose an item.
materials, and encourages better participation from every student/stakeholder.
17. Managing Student Behavior
a. Students are consistently well-behaved, and on task. Choose an item.
b. Educator and students establish clear rules for behavior. Choose an item.
c. The educator uses a variety of effective techniques to maintain appropriate Choose an item.
student behavior.

18. Environment
a. The Workspace: Choose an item.
I. Welcomes all members and guests Choose an item.
II. Is organized and understandable to all students/stakeholders. Choose an item.
III. Supplies, equipment, and resources are easily and readily accessible. Choose an item.
IV. Is arranged to promote individual and group participation. Choose an item.
19. Respectful Culture
a. Educator-student/stakeholder interactions demonstrate caring and respect for Choose an item.
one another.
b. Students/stakeholders exhibit caring and respect for one another. Choose an item.
c. Educator seeks out, and is receptive to the interests and opinions of all Choose an item.
students/stakeholders.

28
OVERALL EVALUATION:
Please provide summary comments concerning this student counselor as an aspiring Professional School
Counselor.

Do you have any reservations about recommending him/her for license as a school counselor? Choose an item.
If yes, please be candid in expressing your concern:

Additional comments, recommendations, etc.

Click here to enter a date.

Site Supervisor
Click here to enter a date.
Student

Site supervisor and supervisee should review evaluation together upon completion.

29
 SITE EVALUATION

Term: Choose an item. Date: Click here to enter a date. Field Experience: Choose an item.
Student Name
Site

Please choose a number or NA (not applicable/no opportunity to observe) for each of the following:
Evaluation Key
Excellent Good Acceptable Unacceptable
4 3 2 1

PROGRAM ASSESSMENT
1. Foundation
a. Standards are identified, visible, and shared with stakeholders Choose an item.
2. Program Management
a. Direct and indirect services account for 80 percent of time or more Choose an item.
b. Program management and school support activities account for 20 percent of Choose an item.
time or less
c. School counseling program data (process, perception, outcome) are collected Choose an item.
and reviewed and inform program decisions
d. Organizes and shares data/results in a user-friendly format (e.g., charts) Choose an item.
3. Delivery
a. Direct student services are provided (Strategies to include instruction, group Choose an item.
activities, appraisal, advisement, counseling and crisis response)
b. Deliver school counseling curriculum lessons to classroom and large groups Choose an item.
c. Provide appraisal and advisement to assist all students with academic, career Choose an item.
and personal/social planning
d. Provide individual and/or group counseling to identified students with Choose an item.
identified concerns or needs
e. Indirect student services are provided to identified students (Strategies to Choose an item.
include referrals, consultation, collaboration)
4. Accountability
a. School data profile is analyzed, and implications for results over time are Choose an item.
considered
b. Use-of-time assessment is analyzed and implications are considered Choose an item.

SUPERVISION ASSESSMENT
1. My supervisor gave me feedback about my role as a counselor. Choose an item.
2. My supervisor helped promote legal and ethical practice by discussing and by Choose an item.
modeling appropriate ethical behaviors.
3. My supervisor was genuine, congruent, empathetic, and honest. Choose an item.
4. My supervisor helped me focus on specific counseling strategies to assist clients. Choose an item.

30
 TAPING CONSENT FORM
Tennessee State University
Department of Psychology
School Counseling

Student: ____________________________________________ Student Age:

Counselor Trainee:

School Counselor: _______________________________ School:

TSU Instructor: Phone:

------------------------
By signing this form, you agree for your child to be counseled by a Tennessee State University Intern student
who is enrolled in a Professional School Counseling Program at Tennessee State University. The graduate student
will be supervised by both a TSU faculty member and site supervisor (school counselor).

Counseling interns are required to tape some of their sessions. The tapes are used for educational purposes only,
which provide feedback to the counseling student from other counseling professionals in order to become a more
effective counselor through improving their skills. TSU Counseling faculty oversee the use of the tapes and they
are then destroyed.

If you are willing to be taped, please indicate below by signing. Thank you for your willingness to participate in
the training of competent counselors. You may contact either supervisor for additional information.

Signatures:

Parent/Guardian (NA if student is over 18 years) Date

Student Date

Counselor Trainee Date

School Counselor Date

31