<p>1 UNIVERSITY OF SOUTH FLORIDA DEPARTMENT OF PSYCHOLOGY</p><p>Clinical Placement Chair 2016-2017 Jack Darkes, Ph.D.</p><p>JOB PLACEMENT INFORMATION FORM</p><p>Provide the following information about the position for which our graduate students would be applying if approved. This information is used by our Placement Committee to evaluate training opportunities and by our students to review/select placements in which they are interested.</p><p>Agency Name: ______</p><p>Title of Position: ______</p><p>Number of Positions Available ______</p><p>Location of Position: ______</p><p>Business Address: ______</p><p>Salary: ______</p><p>Fringe benefits (e.g. vacation, insurance, etc.) ______</p><p>Tuition Waiver (#of credits if any): ______</p><p>Expected Hours of work per week: ______</p><p>Minimum days per week expected to be on site: ______</p><p>How would you like students to apply? Please check choice.</p><p>Send letter and vitae via e-mail: _____ Make phone contact: _____</p><p>Contact person and information for the position:</p><p>Contact Person: ______Phone Number: ______E mail address: ______</p><p>Anticipated duration of employment:</p><p>Begin Date ______End Date:______</p><p>What is the policy of this placement regarding holidays and student scheduling issues (e.g. students interviewing for internship, other academic requirements)? ______</p><p>Job requirements (e.g. computer skills, assessment experience, Master’s degree; please also indicate if specific skills are necessary or desirable). Updated 2/9/2016 2 ______</p><p>Populations seen (child/adult, typical disorders, severity level, etc.): ______</p><p>Please describe typical duties of this position:</p><p>Clinical assessment (e.g. # and type of clients tests administered, emphasis on empirically based assessment, purpose of testing, interpretation, write-up, case presentation, will supervisor be present?): ______</p><p>Psychotherapy (e.g. # and type of clients, amount and type of client contact, group vs. individual, types of interventions, theoretical model, therapy techniques used, emphasis on empirically based intervention, will supervisor be present?): ______</p><p>Case conference/staffing meetings (e.g. format, frequency): ______</p><p>Research (e.g. scale administration/data collection; data reduction/scoring; data analysis; research meetings; involvement in formulation of design, write-up of results; involvement in presentation/publication of results, grant-writing experience): ______</p><p>Updated 2/9/2016 3 Supervision (Amount/nature of supervision, who provides it, what training background, where will it take place, encourages drawing upon psychological research to support clinical decisions?) Direct supervision (either live or video recorded) must occur during each evaluation period. ______</p><p>A. Briefly describe how research findings inform your practices with respect to: (a) clinical assessment, (b) clinical interventions, and/or (c) supervision of clinical staff. ______B. Please respond below to help applicants decide what opportunities are suitable for them.</p><p>This placement/externship would be ideal for students who want/need (circle all that apply):</p><p>1. Individual therapy experience</p><p>2. Group therapy experience</p><p>3. Testing/assessment experience</p><p>4. Report writing skills</p><p>5. Psychometric test scoring/interpretation experience</p><p>6. Conference presentations</p><p>7. Other: ______</p><p>C. Please indicate which student experience level is best suited for this position.</p><p> a. Junior clinical students (1st-2nd year)</p><p> b. Mid-level clinical students (3rd-4th year)</p><p> c. Advanced clinical students (5th year and up)</p><p> d. N/A, this position is well suited for any level of training</p><p>H. Additional information you feel is relevant: </p><p>Updated 2/9/2016 4</p><p>Updated 2/9/2016</p>