REHB Form Supervisee Evaluation of Supervision Form Faculty E 8 31 09

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REHB Form Supervisee Evaluation of Supervision Form Faculty E 8 31 09 Powered By Docstoc
					               Supervisee Evaluation of Supervision Form
                         Faculty Supervisor –E
                                       Electronic (E) Version


Practicum ___ Internship ___ Semester/year _______


Directions: Supervisee/counseling student evaluates faculty supervisor by placing an X in box at
MID-TERM and END OF SEMESTER. Complete electronically on computer by placing
cursor on site and hit “insert” button on computer. Highlight inserted comments in electric blue.
Send completed form as a WORD attachment to the departmental secretary (moorec@ecu.edu).
Secretary will remove email name/address prior to sending to faculty. Place your name/
“supervision evaluation”/ practicum or internship/ semester & year in subject line of email.




 Supervisory Relationship                 Almost                                     Almost
 and Tasks                                Never                                      Always
                                            1              2            3     4         5
 1. My supervisor prepared me for
 clinical supervision by explaining
 our roles, his/her intentions,
 expectations and methods of
 evaluations at the beginning of our
 supervisory relationship.
 Comments:

 2. My supervisor spends an
 average of 1 hour/week in
 individual or group supervisory
 sessions.
 Comments:

 3. My supervisor listens to parts
 of my counseling tapes & gives
 feedback.
 Comments:

 4. I feel comfortable working
 with my supervisor.
 Comments:

 5. My supervisor treats me with
 respect.
 Comments:




LG    Department of Rehabilitation Studies - East Carolina University                  8-9-09
                                                                                         2


Supervisory Relationship                 Almost                                Almost
and Tasks                                Never                                 Always
                                           1              2            3   4      5
6. My supervisor listens to me
and my counseling rationales with
clients.
Comments:

7. I feel like I can share my
shortcomings, errors,
insecurities and vulnerabilities
with my supervisor.
Comments:

8. My supervisor gives me
helpful feedback for my
counselor development.
Comments:

9. I have learned many new
counseling approaches and
skills from my supervisor.
Comments:

10. My supervisor is open to
helping me learn a variety of
counseling styles/models and
techniques & doesn’t push only
one counseling model.
Comments:

11. My supervisor gives me
feedback on paperwork,
including case recording such
as progress notes, treatment
plans and assessment/discharge
summaries.
Comments:

12. I have disagreed with more
than one suggestion or mandate
from my supervisor as to how
to counsel a client.
Comments:




LG   Department of Rehabilitation Studies - East Carolina University            8-9-09
                                                                                              3


 13. I believe some of my
 supervisor’s actions in one or
 more situations were unethical
 or illegal and I was undecided
 whether to confront him/her.
 Comments:

 14. My supervisor gave me
 little to no helpful feedback & I
 feel lost.
 Comments:

 15. I feel like my supervision
 sessions are a waste of time.
 Comments:

 16. I received the most clinical
 help/benefit from my
 field/faculty/doctoral student
 clinical supervisor (highlight).
 Comments:



Supervisee Comments

How do you think the clinical supervision could be improved?




Notable strengths of clinical supervisor:




Would you recommend this supervisor to another counselor-in-training? Yes __ No __
Comments:




Would you recommend this field site to another counselor-in-training? Yes __ No __
Comments:




LG    Department of Rehabilitation Studies - East Carolina University                8-9-09

				
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