Counseling Supervision Review more

College of Mental Health Counselling Counselling Supervision Review (Please give a copy of the completed review to the counsellor and send a second copy to the College at: 113, 100 Saghalie Road, Victoria, BC V9A 0A1. Thank you for your valuable support of this counsellor.) Section A: Identification and Summary Counsellor Name: Organization Name: Supervisor Name: ____________________________ Review Date: Approximate number of client sessions during the period of review: _______ Supervision hours: _______ Summarize areas of counselling, such as issues and clients seen in counselling: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Overall evaluation of the counsellor’s counselling proficiency: poor good excellent Section B: Evaluation of Counselling Knowledge and Skills Evaluation Scale: Rate the level of proficiency in each of the following areas using a scale of 0 to 10, with 10 as the highest level of knowledge and skills. Counselling Knowledge Demonstrated: 1. Clinical/Psycho-Social Assessment, Crisis Intervention, and Suicide Prevention 2. Counselling Process and Therapeutic Interventions 3. Loss and Grief Counselling 4. Communication and Conflict Resolution 5. Initiating and Maintaining the Counselling Relationship 6. Assessment of Client Progress and Therapeutic Closure 1 ______ ______ ______ ______ ______ ______ 7. Professional Ethics and Legal Liability 8. Maintaining Professional Boundaries 9. Referral Procedures ______ ______ ______ Evaluation of Counselling Skills: 1. Maintains the client files 2. Possesses counsellor qualities: empathy, genuineness, unconditional positive regard 3. Utilizes and works with resistance and defences 4. Demonstrates empathic reflective listening 5. Able to use validating statements 6. Reaching for, drawing out, and supporting emotions 7. Generating client insight into life patterns connecting present and past 8. Recognizing and utilizing transference 9. Recognizing counter-transference 10. Self-awareness of the counsellor 11. Helping the client engage and withdraw from difficult content 12. Crisis intervention, problem –solving, instilling hope 13. Helping the client create new choices and ways of relating and coping 14. Identifying goals 15. Assessing achievement of goals 16. Opening, deepening, and closing the counselling session 17. Opening and closing the counselling relationship 18. Working with painful emotions: fear, anger, guilt, shame, sadness, emptiness, low self-worth, despair 19. Stating professional boundaries 20. Use of couple and family interviews 2 ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ ______ Additional comments on counselling knowledge and skills observed: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Overall Client Feedback on Benefit: poor good excellent Section C: Professional Development Recommended Professional Development: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Professional Development received during this review period (list training topics): __________________________________________________________________________________________ __________________________________________________________________________________________ Do you recommend the counsellor to continue or terminate supervision? Give reasons: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ I, ____________________________ (name), affirm that the above review is accurate to the best of my knowledge and in my professional opinion. Signed: ________________________________________ Date: _________________________________ ©2011, College of Mental Health Counseling. All rights reserved. http://www.collegemhc.com 3