<p> 2/06 PRACTICUM EVALUATION SITE SUPERVISOR</p><p>Counselor-in-Training’s Name ______</p><p>Site Supervisor ______</p><p>Site ______</p><p>Date ______</p><p>Please evaluate the counselor-in-training on each of the characteristics listed below. Place an X in the space provided which best describes the trainee’s performance relative to the item.</p><p>The counselor-in-training demonstrates: Unsatis- Not Very Good Good Average factory Applicable</p><p>Promptness ( ) ( ) ( ) ( ) ( ) Dependability ( ) ( ) ( ) ( ) ( )</p><p>Prior preparation for sessions with clients ( ) ( ) ( ) ( ) ( )</p><p>Cooperativeness ( ) ( ) ( ) ( ) ( )</p><p>Openness to feedback ( ) ( ) ( ) ( ) ( )</p><p>Follow through with tasks ( ) ( ) ( ) ( ) ( )</p><p>Initiative ( ) ( ) ( ) ( ) ( )</p><p>Independence in the performance of tasks ( ) ( ) ( ) ( ) ( )</p><p>Flexibility ( ) ( ) ( ) ( ) ( )</p><p>Tolerance for ambiguity ( ) ( ) ( ) ( ) ( )</p><p>Self-control ( ) ( ) ( ) ( ) ( )</p><p>Self-confidence ( ) ( ) ( ) ( ) ( )</p><p>Clear and effective ( ) ( ) ( ) ( ) ( ) communication 2/06 Tactfulness ( ) ( ) ( ) ( ) ( ) Unsatis- Not Very Good Good Average factory Applicable</p><p>Respect for clients ( ) ( ) ( ) ( ) ( )</p><p>Ability to understand clients’ points of views ( ) ( ) ( ) ( ) ( )</p><p>Skill in securing cooperation of clients in individual counseling ( ) ( ) ( ) ( ) ( )</p><p>Skill in securing cooperation of clients in group work ( ) ( ) ( ) ( ) ( )</p><p>Maintenance of confidentiality ( ) ( ) ( ) ( ) ( )</p><p>Adherence to ethical standards ( ) ( ) ( ) ( ) ( )</p><p>Skill in relating to diverse types of clients ( ) ( ) ( ) ( ) ( )</p><p>Respect for the power of counseling and an awareness of its limits ( ) ( ) ( ) ( ) ( )</p><p>Ability to use/develop appropriate materials or activities for individual or group work ( ) ( ) ( ) ( ) ( )</p><p>Identification of self as a counselor in the setting ( ) ( ) ( ) ( ) ( )</p><p>Ability to function as a team member ( ) ( ) ( ) ( ) ( )</p><p>Productive interaction with other personnel in the setting ( ) ( ) ( ) ( ) ( )</p><p>Knowledge of “in-house” resources and referral sources ( ) ( ) ( ) ( ) ( )</p><p>Knowledge of community resources and referral sources ( ) ( ) ( ) ( ) ( ) 2/06</p><p>Please summarize what you consider to be the strengths of this counselor-in-training and provide specific examples when possible.</p><p>Please summarize areas for improvement or refinement that you can recommend for the continuing professional development of this counselor-in-training.</p><p>Please share any additional comments.</p><p>If you want to comment on the specific counseling skills of the counselor-in-training, please respond on the attached form. Thank you for your assistance and work with this trainee.</p><p>______Site Supervisor’s Signature 2/06</p>