Division of Social Work
Field Education Office / Employment-Based Field Internships
Description and Application

DESCRIPTION

The Division of Social Work recognizes that due to many personal factors students may want to explore field internship opportunities in their place of employment. While professional activity and learning are not incompatible, there is a difference between the goals of educational development and those of employment.The focus of the field placement must be on the student’s academic learning. With this in mind, the Field Education Office recognizes two types of employment-based internships:

Job Conversion Internship

“Job Conversation internships” arefor students who have been employed at their agency for at least one year and consider themselves “career employees.” These students plan to remain in their place of employment in the future, and the agency wishes to make an educational investment in the employee. The goal of the Job Conversion is to provide significantly different opportunities for students to gain social work experience with different populations, services, sites, etc.

New JobInternship

“New Job internships” are for students who are hired into a new agency within the last few months. If approved, the specific assignment of this internship can only be used one time in the course of student’s program.

REQUIREMENTS

  1. APPLICATION: The student must submit a completed application by the due date.

Note: If a student is already in a field internship, and there is an employment offer for that internship, the student should complete a different application --the “Offers of Employment by Internship Agency” application. See Division of Social Work website: Field Education, Field Forms.

  1. AGENCY’S OFFICIAL AGREEMENT THAT EMPLOYEE WILL BE TREATED AS A STUDENT DURING INTERNSHIP HOURS:The agency must agree that the employeewill be treated as a student and can complete the academic requirements of the internship. Internship requirements involve completing activities that might not otherwise be a part of the job description. Whereas employees may not have to go to city council meetings, read research articles, relate the NASW Code of Ethics to agency casesor write personally reflective journals for a professor, the intern will. Doing these activities may necessitate lighter caseloads, a longer probationary or orientation period, planned and varied assignments for educational purposes and additional hours above the normal workweek to achieve the internship requirements.
  1. FIELD INSTRUCTION: There must be an intern supervisor (“Field Instructor”) who has a degree in social work and at least two years of post-graduate experience. At a minimum, the Field Instructor must provide at least one hour of regularly scheduled “field instruction” per week.
  1. FIELD INSTRUCTOR TRAINING: There is a requirement that all Field Instructors complete introductory training on how to be an effective Field Instructor. This training is all day and is on campus. The training is available to all agency employees. Six free BBS CEU are available for all attendants. For info and registration:
  1. EMPLOYMENT SUPERVISION: The agency must provide an employment supervisor who is a different person than a Field Instructor. This is to ensure, in part, that the Field Instructor is free to focus on the educational aspects of the internship while the employment supervisor can focus on workload issues.
  1. FIELD ASSIGNMENTS: The field instruction tasks/assignments must be significantly new and different from the student’s current or past job duties and must be in accordance with the Division of Social Work’s field curriculum. The activities must occur during sustained periods of time during the week (minimum of 4 hours at a time) preferably at a different location than the site of employment.
  1. NO ROLE CONFUSION: The student must present evidence that role confusion (between student and employee) will not occur. A general rule is that role confusion will always exist in agencies with fewer than 25 employees unless you are physically located in separate places for the employment and the internship.
  1. WEEKEND/EVENING POLICY: Many students who request employment-based internships want to intern on the weekends and/or at night. The Field Education Office believes that interning during those hours would not provide the intern the opportunities and training necessary to fulfill the objectives/learning goals of their internship.Field hours must be held during the time when the agency is active so the student can participate in the “life of the agency,” e.g., staff meetings, case conferences, and in-service trainings. This is almost always during the day (8am to 5pm), Monday through Friday. If a student cannot be available during these daytime hours, it is probable they will not obtain a field placement.
  1. THE EDUCATIONAL REQUIREMENT FOR DIVERSITY:The Field Office requires that students get out of their comfort zone when in an internship. It is recommended that students use the internship experience to explore different agencies, populations, theoretical perspectives and supervision. An application will be rejected if the employment-based internshipkeep a student in the same kind of agency environment with the exact same population and the exact same kind of supervision.
  1. DEVELOPING CSWE CORE COMPETENCIES: The Division of Social Work is accredited by the Council on Social Work Education (CSWE). There is a strict requirement that the program ensure that a field internship help the student develop specific core competencies. These nine core competencies, listed below, must be a focus of any student’s internship experience and must be referred to in the student’s application.

1. Demonstrates ethical and professional behavior.

2. Engages in diversity and difference in practice.

3. Advance human rights and social, economic, and environmental justice.

4. Engages in practice-informed research and research-informed practice.

5. Engages in policy practice.

6. Engages with clients.

7. Assesses clients.

8. Provides intervention to clients.

9. Evaluate own work with clients.

  1. LIABILITY AND SEPARATION WAIVERS: As part of this application, the student needs to sign a special liability waiver. As well,the student must allow the agency/Field Instructor to release to the Field Education Office information regarding the student’s performance, if said performance results in separation from my field internship.
  1. FIELD OFFICE APPROVAL: BSW applicationsmust be approved by the Undergraduate Field Coordinator. MSW applications must be approved by the Field Director. All parties (student, field instructor, employment supervisor and agency director) will be notified about the final decision by email.

Employment-Based Field Internships

Application

Please complete this application and either place it in the “Drop Box” outside of the Social Work office(Mariposa Hall 4010) or mail to: Division of Social Work, ATTN: Field Education Office, 6000 J Street, MRP 4010, Sacramento, CA 95819-6090. The Field Education Office does not accept faxed or emailed copies of this document. Type or print legibly in blue or black ink only. Submitting this form does not guarantee approval of the request.

PART I.TYPE OF FIELD INTERNSHIP Job Conversion ☐ New Job ☐

PART II. STUDENT INFORMATION

Please check applicable level: ☐BASW ☐MSW I ☐MSW II
If a Title IV-E Stipend Program applicant, have you been accepted? ☐Yes ☐No ☐ On Waiting List
Student Last Name
/ Student First Name
/ CSUS ID# (required)

Address
City / State / Zip
Home Phone / Cell/Work/Msg. Phone (circle one)
Sac State E-mail Address (… ONLY)

PART III. AGENCY INFORMATION

Formal Agency Name
/ Program/Division

Agency Address

City
/ State
/ Zip

Executive Director Name
/ Executive Director’s Email

Agency Phone
/ Job Title for Internship Being Offered

Prospective Employment Supervisor Name
/ Employment Supervisor’s Email

Employment Supervisor’s Phone

Prospective Field Instructor’s Name
/ Field Instructor’s Email

Field Instructor’s Phone

For Division of Social Work Office Use Only

□ Approved □ Not Approved By: ______Date: ______

Reason if not approved: ______

PART IV. TASKS & SKILLS Please describe the following:

Current Employment Tasks & Skills
Note: This may not be applicable with a “New Job” Internship. / Proposed Internship Tasks & Skills

PART V.QUESTIONS

Complete the following questions after having a thorough discussion with your current employment supervisor, your prospective field instructor and anyone else in the agency who will be responsible for facilitating this employment-based internship.

  1. LIST REASONS: Why do you want a field placement at your place of employment?
  1. PREVIOUS AND FUTURE INTERNSHIPS
  • Have you already had an employment-based internship?YES☐ NO☐
  • If a MSW student, do you plan to request an employment-based placement for two different years of your master’s program? YES ☐ NO☐(See #9 -“Educational Requirement for Diversity”)
  1. DIVERSITY: List the many ways that the field internship will be new and different from your employment? Include information on new and different duties, client population, location, supervisors, and any other factors that will differentiate the employment from the internship.
  1. CSWE CORE COMPETENCIES: The CSUS Division of Social Workrequires that field internships help interns develop the nine CSWE social work core competencies. Describe how this employment-based internship allow you to develop these competencies?
  1. EMPLOYEE TREATED LIKE A STUDENT: Describe your understanding of how the agency will allow you to “be a student” for the 16 (BSW/MSWI) or 24 (MSWII) hours that you will be in the internship? Has the agency specifically agreed to reduce your caseload, provide you with extra training, agreed to allow you to engage in activities related to the CSWE competencies (that might not otherwise be a part of your employment), etc.? In addition, are you willing to spend any additional hours that might necessary to complete your internship or employment duties?
  1. ANTICIPATING PROBLEMS: What problems do you anticipate might come up with this internship arrangement (i.e.., role confusion, conflict between employment duties andfield placement duties, caseloads, etc.)? What are some ways you and your field instructor could reduce the impact of these problems
  1. TASK SUPERVISOR: In addition to an employment supervisor and a field instructor, some students will also have a “task supervisor” to assist with their academic learning. Will you have a “task supervisor” for the field internship who is NOT the same person as your field instructor or your employment supervisor? YES ☐ NO ☐If yes, name of Task Supervisor:
  1. DISTINCTION BETWEEN EMPLOYMENT SUPERVISION AND FIELD INSTRUCTION: Describe the distinction between your “employment supervision” and your “intern field instruction.”

PART VI. REQUIRED SIGNED INITIALS

The following items require the initials of the student, employment supervisor and field instructor as indicated.

  1. SALARY: Student and employment supervisor have discussed salary arrangements for the period of time that the student will be completing the student’s internship.

Student ____ Employment Supervisor ____

  1. HOURS: Student will be employed ______hours per week. The number of these paid hours that student will be allowed to participate in internship (vs. employment) activities ______. If no employment hours will be devoted to internship activities, attach a description of the agreed-upon work/internship schedule.

Student ____ Employment Supervisor ____ Field Instructor ______

  1. WEELY FIELD INSTRUCTION: Student will be able to meet with a qualified Field Instructor each week for at least one hour.

Student ____ Employment Supervisor ____ Field Instructor ___

  1. FIELD INSTRUCTOR TRAINING:Field Instructor has already completed the 6 hour Field Instructor Training YES _____ NO ______

If no, Field Instructor agrees to attend a prior to the start of student’s internship. YES _____ NO _____

Training Date: (registration ______

  1. ADEQUATE TIME FOR INTERNSHIP DUTIES: Student will have adequate time for internship-related responsibilities (such as Learning Agreement Task, extra learning tasks are not normally expected of employees, etc.).

Student ____ Employment Supervisor ____ Field Instructor ___

  1. TIME ALLOCATION

Days student will be completing INTERNSHIP HOURS

M T W ThF SaSu

Days student will be completing EMPLOYMENT HOURS

M T W ThF SaSu

Student ____ Employment Supervisor ____ Field Instructor ___

PART VII. REQUIRED WAIVERS

The final two pages of this application are two required waivers. Please review, sign and staple to the application.

PART VIII. REQUIRED SIGNATURES

“I have reviewed this document and agree with its contents.”

Agency Executive Director Signature ______Date ______

Employment Supervisor Signature ______Date ______

Field Instructor Signature ______Date ______

Student Signature ______Date ______

FIELD INTERNSHIP IN PLACE OF EMPLOYMENT:

LIABILITY WAIVER

Student Name:

Agency name:

This is to notify students participating in field education activities for credit in the Division of Social Work that field education has inherent risks, among them the risks of driving/riding in vehicles, working with clientele with various problems, and other factors known and unknown associated with the profession of Social Work. Sacramento State has no way of controlling the environment in which your Social Work practicum is done, hence, the University cannot be held liable for incidents or accidents that take place in the course of your field education experience. You are encouraged, however, to understand and abide by agency safety practices. Therefore …

In consideration for being allowed to participate in Social Work field experience (Activity), on behalf of myself and my next of kin, heirs and representatives, I release from all liability and promise not to sue the State of California, the Trustees of the California State University, California State University, Sacramento and their employees, officers, directors, volunteers and agents (collectively “University”) from any and all claims, including claims of the University’s negligence, resulting in any physical or psychological injury (including paralysis or death), illness, damages, or economic or emotional loss that I may suffer because of my participation in this Activity, including travel to, from and during the Activity.

I am voluntarily participating in this Activity. I am aware of the risks associated with traveling to/from and participating in this Activity, which include but are not limited to physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and/or death. I understand that these injuries or outcomes may arise from my own or other’s actions, inaction, or negligence; conditions related to travel; or the condition of the Activity locations(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this Activity, including travel to and from the Activity.

I agree to hold the University harmless from any and all claims, including attorney’s fees or damage to my personal property that may occur as a result of my participation in this Activity, including travel to, from and during the Activity. If the University incurs any of these types of expenses, I agree to reimburse the University. If I need medical treatment, I will be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

I am 18 years or older. I understand the legal consequences of signing this document, including (a) releasing the University from all liability, (b) promising not to sue the University, and (c) assuming all risks of participating in this Activity, including travel to, from and during the Activity.

I understand that this document is written to be as broad and inclusive as legally permitted by the State of California. I agree that if any portion is held invalid or unenforceable, I will continue to be bound by the remaining terms.

I have read this document, and I am signing it freely. No other representations concerning the legal effect of this document have been made to me.

Signature: ______Date: ______

FIELD INTERNSHIP IN PLACE OF EMPLOYMENT:

SEPARATION WAIVER

I, (student), understand that by signing this waiver I am authorizing my employer/placement agency to release to the Division of Social Work at California State University, Sacramento, information regarding my performance, if said performance results in separation from my field internship. The Division of Social Work may consider this information in rendering a decision about my continued participation in the field course.

I (student) do hereby agree to hold such employers/agencies, references, persons etc., harmless from liability for releasing said information.

Student Name Printed

Student Signature ______Date ______

Agency Executive Director Name
Agency Executive Director Signature ______Date ______

Employment Supervisor Name

Employment Supervisor Signature ______Date ______

Field Instructor Name

Field Instructor Signature ______Date ______