UMSL School of Social Work, MSW Program

UMSL School of Social Work, MSW Program

Advanced Social Work Practice with Individuals, Families and Groups

Agency Supervisor's Final Evaluation(Revised 12/2012)

Course 6800 Course 6850

Return formsby email attachment to: , by fax to: (314) 516-6416 or by mail to: UMSL School of Social Work, Field Education Office, One University Blvd., St. Louis, MO 63121. Electronic signatures in any format are considered legal and binding by Missouri law and are therefore acceptable for this practicum document.

Student's Name: Student ID#:

Semester: Year:

Agency Name:

Supervisor's Name:Phone:

Please complete the evaluation below by placing a check mark in the rating box that is appropriate for the student for each practice behavior identified. Please use the comment area to discuss ways in which the competency was met and to identify any areas in which you believe the student is particularly strong or those areas that need improvement.

*Practice behaviors in italics are specific to advanced practice with individuals, families and groups.

 Professional Identification: Identifies as a professional social worker and conducts oneself accordingly(EPAS 2.1.1)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Advocates for client access to the services of social work
Attends to professional roles and boundaries
Understands and follows agency policies and procedures
Demonstrates professional demeanor in behavior, appearance, and communication
Uses supervision and consultation
Establishes and maintains effective professional relations with clients, co-workers, representatives from other disciplines and other agencies
Organizes time and plans work accordingly
Demonstrates initiative and resourcefulness in practicum
Understands agency's mission, goals, function and role
Understands how own behavior and values affect relationships with clients
Able to use social work knowledge and skills in work with clients
Uses person-in-environment and/or strengths perspectives to guide therapeutic relationships
Understands challenges when using social work values and knowledge in multi-disciplinary setting
Uses social work professional knowledge and skills to engage clients in problem solving that will help restore functioning
Comments:

. Applies social work ethical principles to guide professional practice(EPAS 2.1.2)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Demonstrates knowledge of, and abides by, the NASW Code of Ethics in practice
Tolerates ambiguity in resolving ethical conflicts
Applies ethical decision making skills and frameworks to issues specific to work with individuals, families and groups
Identifies personal biases and understands how to manage these biases
Understands ethical issues in the use of technology in clinical practice and use this knowledge to manage technology to protect clients
Comments:
. Applies critical thinking to inform and communicate professional judgments(EPAS 2.1.3)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Demonstrates effective oral and written communication in working with individuals, families, groups, organizations, communities, and colleagues
Differentiates between several theoretical perspectives and determines which are most appropriate in working with client/s
Keeps professional records
Presents professional understanding of clients at team meetings and in other situations in which social work knowledge is needed
Comments:
IV.Engages diversity and difference in practice(EPAS 2.1.4)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Demonstrates awareness and sensitivity to racial, ethnic, cultural, religious, gender, disability, and sexual orientation factors in understanding clients
Has sufficient self-awareness to eliminate the influence of personal biases and values in working with diverse groups
Recognizes and communicates understanding of the importance of difference in shaping life experiences
Views self as a learner, and engages those with whom he/she works as informants
Shares with colleagues current information about best clinical practices for intervention with diverse clients
Uses practitioner/client differences to identify client strengths
Identifies the diverse population residing in the metropolitan region and shares information about how to respond appropriately to those who are experiencing poverty, marginalization or alienation
Comments:
V. Advances human rights and social and economic justice(EPAS 2.1.5)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Engages in practice that advances social and economic justice
Recognizes that each person, regardless of position in society, has basic human rights, such as freedom, safety, privacy, an adequate standard of living, health care and education
Develops approaches to treatment that take into account client's difficulties created by social injustice, particularly in terms of inability to access services
Comments:
VI. Engages in research-informed practice and practice-informed research(EPAS 2.1.6)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Identifies the research base for the work done at the agency
Identifies and uses evidence-based practices in work with clients
Evaluates own practice or that of agency
Comments:
VII. Applies knowledge of human behavior and the social environment(EPAS 2.1.7)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Utilizes conceptual frameworks to guide the processes of assessment, intervention, and evaluation
Demonstrates an understanding of how biological, psychological, and cultural factors influence human behavior
Demonstrates an understanding about the ways in which social systems promote or deter people in maintaining or achieving health and well-being
Differentiates among theories and determines which are most appropriate for use with targeted client group
Uses bio-psycho-social-spiritual theories and/or multi-axial diagnostic classification systems in formulation of assessments
Understands when to consult with others to confirm diagnoses and/or monitor interventions
Comments:
VIII. Engages in policy practice to advance social and economic well-being and to deliver effective social work services (EPAS 2.1.8)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Identifies the role of policy in service delivery
Collaborates with colleagues and clients for effective policy action
Communicates with stakeholders or others the implications of policy and/or policy changes for clients
Comments:
IX. Responds to the contexts that shape practice (EPAS 2.1.9)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Identifies and analyzes factors that impact the agency's mission and service delivery system (i.e., organizational structure, operation, policies, funding, scientific developments, economy, etc.)
Recognizes that the context of practice is dynamic and has the knowledge and skills to respond proactively
Assesses clients' interactions with social contexts to understand how changes in the clients' environments may affect their ability to engage in and/or use intervention
Works collaboratively with clients or others to plan/and or bring about systemic change
Recognizes knowledge, skills and values needed to provide leadership in agency
Comments:
X.Engages, assesses, intervenes, and evaluates with individuals, families, groups, organizations and communities(EPAS 2.1.10)
Unacceptable1 / Deficient 2 / Developing3 / Accomplished4 / Exemplary5
Performance is generally unacceptable; never meets competency / Rarely meets competency / Inconsistently meets competency / Consistently meets competency / Consistently exhibits mastery of competency
Engagement
Substantively and affectively prepares for action with individuals, families or groups
Embodies the concept of starting where the client is
Conveys respect for the client
Uses empathy and other interpersonal skills
Develops a culturally responsive therapeutic relationship with a client
Encourages clients to be equal partners in the establishment of treatment goals and/or expected outcomes
Assessment
Collects, organizes, and interprets client data
Assesses client strengths and limitations
Uses multi-dimensional assessment tools or approaches to plan interventions that take into account clients' coping strategies and willingness to change
Selects and, when appropriate, modifies interventions based on continuous assessment of client progress
Intervention
Utilizes agency services and community resources on behalf of client
Helps clients resolve problems
Facilitates transitions and endings
Critically evaluates, selects and applies best practices and/or evidence-based practice
Collaborates with other professionals to coordinate interventions
Evaluation
Applies research skills to evaluate practice
Uses practice evaluation to determine best interventions for a range of conditions

Comments:

Please describe the student’s primary strengths and areas for growth.

Strengths:

Growth Areas:

In what ways could the social work faculty have been more helpful to the agency or the student during the course of the practicum?

Is your organization planning any changes (such as in staffing, programming, etc.) of which the University should be aware? Please describe.

Please place a check mark next to the number that reflects your response to the following questions.

How would you rank this student’s effort in completing practicum tasks?

Consistent and outstanding

Consistent and above average

Consistent and average

Inconsistent and average

Inconsistent and below average

How would you rank this student’s level of knowledge and skill compared to a typical advanced-practice level MSW student?

Outstanding

Above average

Average

Below average

Poor

If this is the student’s final semester in field placement, please provide your assessment of this student’s readiness for entry level social work practice.

Surpasses expectations for entry level social work practice
Meets expectations for entry level social work practice
Meets expectations for entry level social work practice with the following exceptions:

Does not meet expectations for entry level social work practice. Please explain:

Does not apply. This student is not in his/her final semester of field placement

Please check to verify that the student has completed 300 practicum hours

Supervisor SignatureDate

Student SignatureDate