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School of Social Work Revised January 2012

Concentration Learning Agreement - MSW Field Practicum II and III 6800 6850 [check one or both]

Advanced Social Work Practice with Individuals, Families and Groups Semester:__________________ Year: ______________

Student Name: ________________________________ ID#:________________ Student Address/ City/State/Zip: _____________________________________________ Phone (home, cell, work): _____________________E-mail:__________________________

Agency Name: ______________________________________________________________ Address/City/State/Zip _____________________________________________________ Phone:__________________Fax:______________E-mail:_________________________

MSW Field Instructor: ________________________________________

Job Title: ________________________ Degree:__________ Year received:_______

Address/City/State/Zip ___________________________________________________

Phone:__________________Fax:______________E-mail:__________________

In what department or section will you be based: __________________________________

Task Supervisor (if different from MSW instructor):________________________________

Address/City/State/Zip ______________________________________________________

Phone:____________________Fax:_________________E-mail:_____________________

Student’s Faculty advisor: ____________________________________________________ _ Practicum Dates: (Begin)_______________________ (End)_________________________ Is this a 2 semester practicum at the same agency? _____ Yes _____No Is this practicum being completed in the agency in which the student works as a paid employee? Yes No (If yes, please complete required form)

Signatures: _______________________________ ___________________________ Student Date Faculty Liaison Date

_______________________________ ____________________________ Practicum Instructor Date Office of Field Education Date

____________________________________ Certificate Option Coordinator Date (REQUIRED for CERTIFICATE option)

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SECTION I Summary of Practicum Experience: Complete the questions below to describe the agency setting and population. AGENCY: What is the mission of the agency? What services does the agency provide? What population(s) does the agency serve? SUMMARY OF STUDENT’S ROLE What activities will you engage in during the course of your practicum?

A. List your primary responsibilities (e.g. conduct assessments, run groups, organize community meeting, follow legislation impacting your client population). [Students: List the major activities you will be doing this semester. Use these to fill in “tasks” under each of the competencies in the sections that follow.]

B. List the products or deliverables you will create. (e.g., a program evaluation and report, a grant proposal, organize a conference, develop a program)

[Students: List the things you will produce this semester. These can also be used to fill in “tasks” under each of the competences in the sections that follow.]

SUPERVISION: What is the day and time of the weekly supervision meetings? How will you prepare for supervision?

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SECTION II Instructions for Completing the Competencies/Practice Behaviors As part of the Educational Policy and Accreditation Standards (EPAS), the Council on Social Work Education has identified 10 Core Competencies that social work students are required to meet. Each EPAS has corresponding Practice Behaviors students must demonstrate as a measure of competency. Activity Section Please identify at least one (no more than three) tasks that demonstrate each Practice Behavior you list. The tasks should be specific and appropriate to your agency. Ask yourself: What specific knowledge and skill areas of social work practice will I apply in this setting? What specific theoretical frameworks will I draw upon? What interventions will I engage in? What type of recording or documentation will I learn? What product will I create? Because this is a practice concentration, it is assumed that you will be working with clients or client groups either directly or through supervising direct practitioners. Evaluation Section In the evaluation section select the evaluation method(s) that your field instructor will use to assess whether or not you have demonstrated the practice behavior. COMPETENCY 2.1.1 Identify as a professional social worker and conduct oneself accordingly Advanced family practice social workers recognize the importance of professional use of self in relationships, the person-in-environment and strengths perspectives, and adherence to ethical guidelines and social work values. Practice Behavior 1: Understands how own behavior and values affect relationships with clients Sample tasks: • Develop plan describing how to use behavior/interaction with client/s to bring about change in

client or client system. • Keep personal log documenting which behaviors or interactions are effective in developing

relationships with clients. • Keep log recording how values affect behaviors with clients and how these change over the semester. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify:

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Practice Behavior 2: Able to use social work knowledge and skills in work with clients Sample tasks: • Intervention plan identifies what social work knowledge and skills will be used in work with the client or

client system. Be specific about the knowledge and skills that will be utilized in your setting. • Track how social work values affect interactions with one or more clients or client groups. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 3: Uses person-in-environment and/or strengths perspectives to guide therapeutic relationships Sample tasks: • Develop intervention plan based on your person-in-environment assessment. Be specific about the

types of assessments/interventions that you will engage in and how PIE links to this. • Develop intervention plan based on client or group strengths. Be specific about the types of

assessments/interventions that you will engage in and how the strengths perspective is utilized. • Evaluates plan after initial intervention and corrects plan as necessary Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 4: Understands challenges when using social work values and knowledge in multi-disciplinary setting Sample tasks: • In team meetings, collaborates to develop best approach to resolving client/s’ problems. Be specific

about the types of multidisciplinary meetings that you will engage in and the potential challenges. • Researches several approaches to target problems and presents those ideas to colleagues. Be specific

about the types of problems targeted. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes

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____other, please specify: Practice Behavior 5: Uses social work professional knowledge and skills to engage clients in problem solving that will help to restore functioning Sample tasks: • Develop intervention plan that includes client ideas about problem solving. Describe how you will

involve clients in developing the intervention plan. • Actively consult with client/s regarding solutions to problems. Be specific about how this will occur in

your setting. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: COMPETENCY 2.1.2 Apply social work ethical principles to guide professional practice Advanced family practice social workers are knowledgeable about ethical issues, legal issues and shifting mores that affect their relationships with clients.

Practice Behavior 1: Apply ethical decision making skills and frameworks to issues specific to work with individuals, families and groups Sample tasks: • Uses ethical decision making skills in interactions with client/s or client groups. Describe the types of

interactions you will have with clients and the ethical decision making framework you will use. Will you use the ETHIC model presented in SW5100?

Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 2: Can identify personal biases and understand how to manage these biases Sample tasks: • Identifies how personal biases can affect interaction with clients and/or other.

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• Develops plan for managing biases. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 3: Understand ethical issues in the use of technology in clinical practice and use this knowledge to manage technology to protect clients Sample tasks: • Reviews with supervisor how social work ethics apply to social networking and use of office technology.

Be specific about technology used in your setting. • If appropriate, becomes familiar with HIPAA guidelines and how they affect practice. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: COMPETENCY 2.1.3 Apply critical thinking to inform and communicate professional judgments Advanced family practice social workers understand and differentiate among multiple theories and practice methods. They are able to evaluate how theories and methods relate to clients and client systems within their environmental context. They regularly reflect on their own assumptions and how those affect practice. Practice Behavior 1: Differentiates between several theoretical perspectives and determine which are most appropriate in working with client/s Sample tasks: • Uses critical thinking to determine most appropriate intervention or approach to working with a client

or client group. Give examples of the types of theoretical approaches that might be applied in your setting.

Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions

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____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 2: Keeps professional records Sample tasks: • Student records interactions with clients as required by agency. Describe what is required by your

practicum site. • If agency has no requirement for keeping records, student will keep own records documenting

interactions with clients, groups and/or communities, plans for intervention and results of intervention. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 3: Presents professional understanding of clients at team meetings and in other situations in which social work knowledge is needed Sample tasks: • Presents client information at team meetings or in other situations. Be specific about the types of team

meetings or other situations (describe them). • Presents information on interventions in meetings. Be specific about the kinds of meetings. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: COMPETENCY 2.1.4 Engage diversity and difference in practice Advanced family practice social workers are knowledgeable about many forms of diversity and difference and how these affect professional relationships and client’s presenting problems. Advanced practitioners understand how dimensions of diversity affect (a) explanations of illness, (b) help-seeking behaviors, and (c) healing practices. They understand how clinical practice can be culture bound.

Practice Behavior 1: Share with colleagues’ current information about best clinical practices for intervention with diverse clients

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Sample tasks: • Researches and prepares a summary of current information on best practices for interacting with

diverse client groups. Specify which aspects of diversity that you will focus on. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 2: Uses practitioner/client differences to identify client strengths Sample tasks: • Develops or includes in assessment plan strategies for using practitioner/client differences to identify

client strengths. • Uses client strengths in social work practice. Describe how this will occur in your setting. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 3: Identify the diverse populations residing in the metropolitan region and share information about how to respond appropriately to those who are experiencing poverty, marginalization, or alienation Sample tasks: • Uses knowledge about diversity in agency population to develop plan to respond to poverty,

marginalization, alienation or other similar problems facing clients. Will you focus on plans for specific clients or develop a plan to intervene at the organizational or policy level?

Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify:

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COMPETENCY 2.1.5 Advance human rights and social and economic justice Advanced family practice social workers understand how economic, social and cultural factors challenge clients and client systems. They understand the stigma and shame that face many clients who seek help. They also understand strategies for advancing human rights and social and economic justice in many contexts. Practice Behavior 1: Develop approaches to treatment that take into account client’s difficulties created by social injustice, particularly in terms of inability to access services Sample tasks: • Client assessments will include information about difficulties in accessing services and how these affect

intervention. • Promotes equitable access to services for all clients by recognizing when services are not equitable and

developing suggestions for changes. Be specific about area of focus. Will your suggestion for change be within the organization or on a more macro-level?

• Helps agency implement changes to provide equitable access to services. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: COMPETENCY 2.1.6 Engage in research-informed practice and practice-informed research Advanced family practice social workers are knowledgeable about evidence-based practice interventions, best practices and the evidence-based research process. Practice Behavior 1: Identifies and uses evidences based practices in work with clients Sample tasks: • Develops intervention plans supported by evidence- based practices. Give some examples of evidence

based practices used by your organization and/or identify areas in which you will investigate evidence based practices in the literature and apply them.

Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify:

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Practice Behavior 2: Evaluates own practice or that of agency Sample tasks: • Conduct a research project in conjunction with SW6400. Evaluation: Completion of project SW6400; Professor reviews and evaluates project. COMPETENCY 2.1.7 Apply knowledge of human behavior and the social environment Advanced family practice social workers understand how to differentially apply theories of human behavior and the social environment. They are familiar with diagnostic classification systems used in a comprehensive assessment. They understand how sociocultural contexts influence diagnoses and practice interventions. Practice Behavior 1: Is able to differentiate among theories and determine which are most appropriate for use with targeted client group Sample tasks: • Student describes theories used in social work practice at agency. Give some examples of the theories

that are most applicable in your setting. • Student describes which theory or theories are most appropriate for guiding practice. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 2: Uses bio-psycho-social-spiritual theories and/or multi-axial diagnostic classification systems in formulation of assessments Sample tasks: • When appropriate, student uses multi-axial diagnostic classification systems in formulation of

assessments • Students use bio-psycho-social-spiritual theories or multi-axial classification systems assessments to

guide practice Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify:

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Practice Behavior 3: Understand when to consult with others to confirm diagnoses and/or monitor interventions Sample tasks: • Student requests consultations and/or attends team meetings with other practitioners to share

information and monitor client progress. Be specific about the types of consultations that you might request or the types of team meetings you might attend.

• Student uses supervision to confirm diagnoses and monitor interventions Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: COMPETENCY 2.1.8 Engage in policy practice to advance social and economic well-being and to deliver effective social work services Advanced family practice social workers understand the connection between clients, practice and both public and organizational policy. They understand how legislation, policies, and program services are developed and funded and are able to advocate for effective policies that promote social well-being. Practice Behavior 1: Will communicate with stakeholders or others the implications of policy and/or policy changes for clients Sample tasks: • Reviews relevant governmental and agency policies on a regular basis and is able to inform clients and

others of implications of changes in policy. If you are reviewing governmental policies be specific about the areas you will review.

• Reviews policy and is able to describe to clients how policy affects services they are able to receive. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: COMPETENCY 2.1.9 Respond to the contexts that shape practice Advanced family practice social workers are knowledgeable about how relational, organizational, and community systems may affect clients. They anticipate and react to evolving cultural, technological, geographical, political, legal, economic and environmental contexts.

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Practice Behavior 1: Assess clients’ interactions with social contexts to understand how changes in the clients’ environments may affect their ability to engage in and/or use intervention Sample tasks: • Student includes information about client contexts in assessments. Mention the specific contexts that

are most applicable in your setting. • Client contexts are taken into account when planning interventions. Describe how. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 2: Work collaboratively with clients or others to plan and/or bring about systemic change Sample tasks: • When appropriate includes plan for systemic change in intervention plan. Describe the systems level

that will be included in your intervention plan. Are you looking at systemic changes in the family system, school system, etc. , or will you focus on working with clients to empower them to bring about policy changes at the local, state or national level?

• Collaborates with agency staff to plan and/or bring about systemic change. Again define the type of systemic change.

Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 3: Recognizes knowledge, skills and values needed to provide leadership in agency Sample tasks: • Describes leadership skills exhibited by agency director and how these contribute to the functioning of

the organization. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify:

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COMPETENCY 2.1.10 Engage, assess, intervene, and evaluate with individuals, families, groups, organizations and communities Advanced family practice involves the dynamic, interactive and reciprocal processes of engagement, multidimensional assessment, intervention and practice evaluation at multiple levels. Advanced practitioners have a theoretically informed knowledge base that allows them to practice effectively with individuals, families and groups. Practice Behavior 1: 2.1.10(a) Engagement-Develop a culturally responsive therapeutic relationship with a client Sample tasks: • Meets with clients and engages clients in relationship that is culturally responsive. • Is able to understand and use difference to engage clients or client systems. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 2: 2.1.10(a) Engagement- Encourage clients to be equal partners in the establishment of treatment goals and/or expected outcomes Sample tasks: • Develops treatment/intervention plan that incorporates client goals and/or expected outcomes Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 3: 2.1.10(b) Assessment- Use multi-dimensional assessment tools or approaches to plan interventions that take into account clients’ coping strategies and willingness to change Sample tasks: • Develops plan for intervention based on more than one type of assessment. Describe the assessment

process that you will engage in. Does your organization use interviewing, specific assessment forms, standardized assessment instruments, etc.?

• Plan includes assessment of clients’ coping strategies and willingness to change.

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Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 4: 2.1.10(b) Assessment- Select and, when appropriate, modify interventions based on continuous assessment of client progress Sample tasks: • Assessment of intervention occurs regularly. • Interventions are modified as indicated by on-going assessment Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 5: 2.1.10(c) Intervention - Critically evaluate, select and apply best practices and/or evidence-based practice Sample tasks: • Intervention is based on best practices or evidence-based practice for presenting problem. Give specific

examples of best practices or evidence based practices utilized in your organization.

Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 6: 2.1.10(c) Intervention- Collaborate with other professionals to coordinate interventions Sample tasks: • Student consults with colleagues and other professionals to determine how student’s participation fits

in with other interventions. Be specific about how this process occurs in your organization.

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• Student’s plan for intervention includes services provided by others. Describe the types of services that may be provided by others.

• With client permission, student shares information with other service providers Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 7: 2.1.10(d) Evaluation- Apply research skills to evaluate practice Sample tasks: • Student develops plan to evaluate practice. If you are using a single subject design it would be

appropriate to state that you will do this in conjunction with SW6400. • Student implements plan to evaluate practice. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: Practice Behavior 8: 2.1.10(d) Evaluation- Use practice evaluation to determine best interventions for a range of conditions Sample tasks: • Student compares results from work with clients with that of others to determine best intervention for

a problem. Evaluation: ____direct observation by:______________________ ____feedback from colleagues and/or clients ____review of written work by:__________________ ____discussion during supervisory sessions ____review of audio/videotapes by: _______________ ____results of tests/quizzes ____other, please specify: