Dear Field Educator

BostonUniversitySchool of Social Work Department of Field Education

264 Bay State Road
Boston, Massachusetts 02215
T 617-353-3754F 617-353-8348

Dear Field Educator:

Thank you for your interest in an affiliation with the Boston University School of Social Work.

Below please find the following:

1)Agency Placement Form

2)Field Instructor Profile

3)Criteria for Field Instructors and Agencies

Please complete and return the Agency Placement Form and the Field Instructor Profiles as soon as possible. We welcome additional information such as brochures, annual reports, or descriptions of available learning opportunities, which provide a more indepth picture of your agency or program.

Assignments of students going into their advanced (second) year placements are made in the late Winter and throughout the Spring in collaboration with you. We then notify students to contact the agency to set up an interview. Students going into foundation (first year) placements will be assigned during the late spring and early summer and will contact the agency to set up an interview when the assignment is made. Throughout the process, the following Field Education staff members are available to answer your questions or concerns: Trudy Zimmerman, Judith Perlstein, and Sue White (Charles River campus), Deborah Sheehan (SEMA-FallRiver), Sue Landers(SEMA-Cape Cod) and Reeve Goldhaber (BU North at Chelmsford).We invite you to look at our web page, for further Field Education information.

We recognize and value the commitment and investment you make to the education of our students. We believe that our students will also make contributions to your agency, both by providing services and by bringing their curiosity, knowledge and vitality to the setting. Thank you in advance for your participation in our students’ education.

We look forward to hearing from you.

Sincerely,

Trudy Zimmerman

Assistant Dean for Field Education

P.S. Please note that you can now e-mail us at:

To complete this form please place cursor in each box rather than using the tab and directional keys to enter the information.

BostonUniversitySchool of Social Work
264 Bay State Road, Boston, MA 02215

Agency Placement Form ______Academic Year
Agency (if the name of your agency has changed, please indicate the former name):
Mailing Address:
Telephone: / Fax:
Agency Website:
Contact Person:
E-mail:
We will accept the following # of BUSSW students: / 1st yr: / 2nd yr: / either yr:
Indicate the following opportunities available for student assignments:
Clinical (Y/N): Macro (Y/N):
Individuals: / Community Organizing:
Couples: / Management:
Groups: / Planning:
Families: / Policy Advocacy:
Family Therapy: / Social Action:
Milieu: / Research:
Program Development:
Car needed to reach site? Car needed for assignment?
Describe student assignments as specifically as possible:
Suggestions regarding the type of learner who would do best in this setting:
We expect all agencies to orient students to the agency’s safety policies and procedures. Does your agency have written safely policies and procedures and how do you orient and train students about these?
Indicate the number and amount of STIPEND(S) available to student(s):
Special Site Requirements (please specify):
Required evening hours:
Different start/end date:
Required meetings (include which days):
Helpful Language(s):
Can up to 8 hours of student assignments be done evenings or weekends? (Agency open, supervision available - If YES, list preferred times):
Do you require interns to undergo any background check or other screenings (e.g., CORI, immunization, etc)? If so, please describe:
Please complete the following information about your Placement Site (put an X next to all that apply):
Type of SettingPopulation(s) Served
__ Aging__ Infants and Preschool
__ Child Welfare__ Latency Age
__ Coalitions__ Adolescents
__ Community Organizations __ Adults
__ Developmental Disabilities __ Community Residents
__ Family Service/Multi Service__ Elderly
__ Forensic/Corrections__ Families
__ Foundations__ GLBT
__ Health/Public Health__ Women
__ Housing__ Men
__ Industrial__ Newcomers & Refugees
__ Legislative/Government__ People of Color
__ Mental Health (specify):
__ Planning/Program Development__ Ethnic Groups
__ Policy Advocacy (specify):
__ Schools__ Sectarian Groups
__ Social Action (specify):
__ Substance Abuse__ People with disabilities
__ Other (specify):
Does agency have students from other Schools? Yes___ #____ No____
Schools of Social Work:
Other Disciplines:
Describe the educational opportunities in your agency:
Outside Consultants:
Inservice Training:
Other (describe):
Please list the name(s) of primary field instructor(s) available for this placement site. Please indicate who will be primary field instructors of M.S.W. students for the first time. Refer to Criteria for Field Instructors. Please have each field instructor complete a Field Instructor Profile.
Name:
E-Mail:
School & Year:
Major Method: / New Field Instructor?:
Name:
E-Mail:
School & Year:
Major Method: / New Field Instructor?:
Name:
E-Mail:
School & Year:
Major Method: / New Field Instructor?:
Please use this space to add any information about the student training program which you believe will be helpful to students and the Field Education Department in the placement process. Please comment on opportunities for students to learn about and work with culturally diverse clients and communities (e.g. racial, ethnic, sexual orientation, class, gender, religious, age, ability).
***For Office Use Only***
Entered by_____Date______Card by_____Date______Copied by___Date______

BOSTONUNIVERSITYSCHOOL OF SOCIAL WORK

264 Bay State Road, Boston, MA 02215

FIELD INSTRUCTOR PROFILE

(To be filled out by all field instructors – Please print or type)

Please fill in this sheet carefully, as it will be used in compiling data for our school bulletin and for Field Education Department records. Please attach a resume to this profile.

Date:

Name:Home #_

Name of Agency:Work #_

Address:E-mail:

Position in Agency:

Education:

School (Most Recent First)Degree Date Major

Social Work License (Kind and Number) Date

Professional Experience

AgencyDatesPositionFull or Part-Time

I wish to be identified as a member of an AHANA group* YES_____ NO_____

*If YES, which group?  African-American/Black Hispanic/Latino

 Asian Native American

 Other

I will be primary field instructor for an MSW student for the first time* YES_ NO_

*If YES, all new field instructors are required to take our seminar in supervision which is given in the Fall.

*If NO, prior field instructor experience of MSW students

School of Social WorkField AgencyYearNo. Supervisees

Other Supervisory Experience (Social Work)

AgencyDatesNo. SuperviseesEducational Level

Courses in Supervision Completed

Course TitleInstructorGiven WhereDate

Areas of Practice Specialization

Teaching Experience

PlaceCourse TitleDateStudents’ Level

Research Experience

Publication – Articles

Membership in Professional Organizations

I have read the criteria for Field Instructors, and I agree to abide by and represent these

standards. I agree to act as the student’s Field Instructor for the full academic year.

Signature

BOSTONUNIVERSITYSCHOOL OF SOCIAL WORK

264 Bay State Road, Boston, MA 02215

Field Education Department

CRITERIA FOR NEW FIELD INSTRUCTORS AND AGENCIES

Field Instructors are agency staff members selected by the agency who must meet the following criteria

of the BUSSW Field Education Department.

1.Master's degree from an accredited school of social work (not required for advanced level

macro students).

2.Minimum of two years, relevant full-time, supervised post-MSW experience.

3.LICSW (or equivalent for agencies outside Massachusetts) is preferred but not required for field instructors in advanced clinical placements.

4.Sufficient term of employment at the agency to ensure familiarity with agency policies and

procedures and availability to meet student's needs.

5.Agreement to act as field instructor on a continuing basis during the academic year or full placement period.

6.Commitment to:

a)provide two hours of supervision per week. A minimum of one hour of individual supervision per week must be provided by the primary MSW* field instructor. A second hour of supervision must be provided to the student and can be given by either the primary field instructor or another qualified professional either individually or in a small group (staff meetings do not qualify as supervision). It is the responsibility of the primary field instructor to ensure both the quality and quantity of all supervision.

b)provide time for reading student materials, holding informal conferences and meetings, and consulting with school representatives.

c)use recordings as a teaching tool in supervisory conferences.

d)develop a written educational contract with the student.

e)provide appropriate assignments for the student at the start of the placement.

7.Field instructors who are acting as primary supervisors to MSW students for the first time are required to participate in a 20-hour seminar in the fall that examines the content and process of field instruction. Prospective primary field instructors who are unable to participate in the seminar may not be considered even though they meet all the other criteria listed above. Social workers who have served as the primary field instructor for MSW students from another school are not required to take the course but may do so if they wish.

*MSW not required for advanced level macro students.

8.If the field instructor and the student have had a pre-existing professional or social relationship, this information should be shared with the Field Education Department so that the appropriateness of the placement can be determined.

9.The field instructor must be willing and able to evaluate the student's practice on a continuing basis and provide written evaluations consistent with the School's calendar and deadlines.

To ensure the student's learning in the field, the agency is expected to provide the student with the following:

1.A sufficient number and variety of assignments to support the progression of student learning. We expect students to become involved in practice activities within two weeks of the start of the placement.

2.An orientation to the agency's total program and its relevant communities.

3.An orientation to the agency's safety policies and procedures and ongoing support to ensure safety in the field.

4.An orientation to legal and ethical issues specific to the agency’s mission and programs.

5.Adequate work space and access to telephones, computers, records, etc., to fulfill

the requirements of the agency and School.

6.Reimbursement for expenses involved in rendering agency services, e.g., home visit travel

costs.

7.Adequate insurance coverage for students who are expected to use personal vehicles for agency purposes and who do not have their own insurance coverage for this type of activity.

8.Access to staff, committee, and seminar meetings when appropriate.

9.Use of selected agency records (appropriately disguised to ensure client and agency

confidentiality) for class assignments.

10.Use of agency consultation resources when appropriate.

11.Adequate time so that the field instructor can meet the School's criteria for working with a student. (See #6 under Criteria for Field Instructor.)

******************************************************************************