Table of Contents
Table of Contents | ||||||||||||
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Policies and Procedures, and Educational Outcomes Review
Syracuse University Non-Discrimination and Equal Opportunity Policy Statement
Legal Disclaimer for M.F.T. Practicum and Supervision (Online Program)
Distance Learning Complaint Process for Out-of-State Students (Online Students)
Syracuse University Academic Resources and Student Support Services.
Department of Marriage & Family Therapy Student Support Services.
Appendix A: Master’s Project/Thesis Guidelines and Forms - 2025-2026
Program Description
The Marriage and Family Therapy program is housed in the Department of Human Development and Family Science, which is located in the College of Arts and Sciences.. The HDFS Department offers an M.A. and Ph.D. in Marriage and Family Therapy. Both programs are accredited by the Commission on Accreditation for Marriage and Family Therapy Education (C.O.A.M.F.T.E.).
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Date of meeting with mentor to discuss capstone presentation (must be before 4/18): add date
Mentor Signature: | Date: |
Student Signature: | Date: |
Master’s Thesis Proposal Form
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(must include introduction, brief literature review, research question and study design and be no more than 1000 words; references and instruments you are planning to use must be included as well, though not within the 1000 word limit; please use additional paper)
M.F.T. Advisor Signature: | Date: |
M.F.T. Faculty Member Signature: | Date: |
M.F.T. Faculty Member Signature: | Date: |
Chair of Research Committee Signature: | Date: |
Student Signature: | Date: |
Electronic Dissertation/Thesis Submittal Checklist
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Appendix B: Clinical Readiness Rubric
1. Self-Awareness
| Definition | 5 points | 4 points | 3 points | 2 points | 1 point |
A. Knowledge of self | Aware of thoughts, feelings, beliefs; Open to exploring self, family of origin as they relate to clinician development. | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
B. Awareness of reactivity | Observes and manages self in interaction with other; sustains response flexibility in emotionally charged interaction; Self-regulates affective arousal; reflects on self emotion during arousal & interactively following arousal; | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
C. Ability to use voice | Can articulate beliefs and position while recognizing contextual factors of those showing difference from self; responds to diversity with positive professional regard. | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development |
2. Interpersonal Skills
| Definition | 5 points | 4 points | 3 points | 2 points | 1 point |
A. Ability to stay present. | Uses self-presence and influence to promote strengths; balances effective listening and therapeutic system purpose; promotes process responsive to need. | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
B. Ability to convey empathy and respect. | Generates trust and confidence in relationships; notes and addresses relationship breeches with effective repair; Demonstrates ability to connect deeply with others. | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
C. Response to feedback. | Responds positively to feedback; open to learning and growth opportunities, integrates suggestions into work. | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays beginning recognition of target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
3. Academic Skills
3 Academic Skills | Definition | 5 points | 4 points | 3 points | 2 points | 1 point |
A. Understanding of M.F.T. theory and concepts. | Integrates concepts/theories into clear working model of therapy; engages and understands abstract concepts; accurate grasp of theoretical models and constructs; uses knowledge as resource for supervision and practice. | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
B. Writing skills | Writes clearly and produces quality graduate level work; | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
C. Organizational skills | Demonstrates ability to be organized, manage time and responsibilities; responsive to requests for action. | Student displays exceptional skill in multiple areas of target-level competencies. | Student displays advancing skill in multiple areas of target-level competencies. | Student displays target-level competencies with early skill development. | Student displays beginning recognition of target-level competencies with readiness for skill development. | Student displays difficulty engaging this area that may jeopardize future skill development. |
Appendix C: S.U. M.F.T. Masters Evaluation Timeline
Program Outcomes
Program Outcome | Variable | Benchmark | How often | Analyzed by: (Title) | Instrument |
#1. Student progress: Students will successfully complete the S.U.M.F.T. program requirements and graduate. | Graduation Rates |
| Yearly/ April Faculty Meet | Yearly/ April Faculty Meet | S.U.M.F.T. Student Tracking Sheet |
#2 Alumni Achievement: Graduated students will be successful in pursuing either a career in Marriage and Family Therapy or doctoral education. | National Exam Rates |
| Yearly/ April Faculty Meet | Evaluation Faculty | S.U.M.F.T. Alumni Survey/ S.U.M.F.T. Student Tracking Sheet |
#2 Alumni Achievement: Graduated students will be successful in pursuing either a career in Marriage and Family Therapy or doctoral education. | M.F.T. Licensure Rates |
| Yearly/ April Faculty Meet | Evaluation Faculty | S.U.M.F.T. Alumni Survey/ S.U.M.F.T. Student Tracking Sheet |
#2 Alumni Achievement: Graduated students will be successful in pursuing either a career in Marriage and Family Therapy or doctoral education. | M.F.T. Employment Rates |
| Yearly/ April Faculty Meet | Evaluation Faculty | S.U.M.F.T. Alumni Survey/ S.U.M.F.T. Student Tracking Sheet |
#3 Commitment to Diversity: The S.U. M.F.T. program will show clear commitment to diversity through curriculum content and student composition. | Curriculum Diversity Content |
| Yearly/ April Faculty Meet | P.D. | S.U.M.F.T. Diversity in Curriculum Tracking Sheet. |
#3 Commitment to Diversity: The S.U. M.F.T. program will show clear commitment to diversity through curriculum content and student composition. | Program Demographic Diversity | http://2.At least 40% of students and faculty in the department will self-identify with program-identified characteristics of a diverse population (gender, race, ethnicity, sexual orientation, age, culture, environment, health/ability, nationality, religion, spirituality, and socio economic status) as reported on the Demographic Questionnaire, assessed yearly. | Yearly/ Dec Faculty Meet | Eval Faculty | S.U.M.F.T. Demographic Survey |
Program Goals
Goal | Outcome | Variable | Benchmark | How often | Analyzed by: (Title) | Instrument |
Program Goal #1 (Self-in-Systems) To train family systems professionals who are informed by a Self in Systems perspective. | S.L.O.#1: Students will demonstrate awareness and regulation of self in system. | Self in context |
| Yearly/ April Faculty Meet | Evaluation Faculty | Clinical Readiness Interview Rubric |
Program Goal #1 (Self-in-Systems) To train family systems professionals who are informed by a Self in Systems perspective. | S.L.O.#1: Students will demonstrate awareness and regulation of self in system. | Self in context | http://2.At least 70% of students will receive a 3 or higher rating on the Competency Based Clinical Evaluation of Students (specifically 4a, 4b, 4g, 4i, 6a, 6b, 6c, and 6d), assessed at the end of each semester that the student is clinically active (Practicum course series). | Yearly/ April Faculty Meet | Evaluation Faculty | Competency Based Clinical Evaluation of Students |
Program Goal #2 (Diversity) To prepare family systems professionals who are sensitive to, and engaged with social justice issues. | S.L.O.#2: Students will demonstrate engagement with cultural and contextual differences. | Engagement with differences | 1: At least 70% of students will receive a B or better on the final project inM.F.T. 684. | Yearly/ April Faculty Meet | Evaluation Faculty | M.F.T. 684 Final Project Rubric |
Program Goal #2 (Diversity) To prepare family systems professionals who are sensitive to, and engaged with social justice issues. | S.L.O.#2: Students will demonstrate engagement with cultural and contextual differences. | Clinical Diversity Competency |
| Yearly/ April Faculty Meet | Evaluation Faculty | Competency Based Clinical Evaluation of Students |
Program Goal #3 (Practice) To prepare family systems professionals who are competent systems clinicians able to provide services across a variety of contexts. | S.L.O.#3: Students will demonstrate M.F.T. clinical competency skills across a variety of contexts. | Clinical Competency | http://1.At least 70% of students will receive a 3 or higher rating on the Competency Based Clinical Evaluation of Students (specifically 1a-f, 2a-e, 3a-d, 4c-f, and 4h), assessed at the end of each semester that the student is clinically active (Practicum course series). | Yearly/ April Faculty Meet | Evaluation Faculty | Competency Based Clinical Evaluation of Students |
Program Goal #4 (Ethics) To prepare family systems professionals with knowledge and skills for M.F.T. legal and ethical analysis and decision-making. | S.L.O.#4: Students will demonstrate an applied knowledge of M.F.T. legal and ethical guidelines and professional standards. | Ethical Competency |
| Yearly/ Dec Faculty Meet | Evaluation Faculty | Ethics Integration Rubric |
Program Goal #4 (Ethics) To prepare family systems professionals with knowledge and skills for M.F.T. legal and ethical analysis and decision-making. | S.L.O.#4: Students will demonstrate an applied knowledge of M.F.T. legal and ethical guidelines and professional standards. | Ethical Competency |
| Yearly/ April Faculty Meet | Evaluation Faculty | Competency Based Clinical Evaluation of Students |
Program Goal #5 (Knowledge and Research) To prepare family systems professionals with an educational foundation grounded in family systems theory and research informed practice. | S.L.O.#5: Students will demonstrate an applied knowledge of M.F.T. historical, current, and research-informed theoretical information. | M.F.T. Theory Knowledge |
| Yearly/ April Faculty Meet | Evaluation Faculty | Theory Exams |
Program Goal #5 (Knowledge and Research) To prepare family systems professionals with an educational foundation grounded in family systems theory and research informed practice. | S.L.O.#5: Students will demonstrate an applied knowledge of M.F.T. historical, current, and research-informed theoretical information. | M.F.T. Theory Application |
| Yearly/ April Faculty Meet | Evaluation Faculty | Competency Based Clinical Evaluation of Students |
Appendix D: S.U. M.F.T. Ph.D. Evaluation Timeline
Ph.D. Program Outcomes
Program Outcomes (PO) | Variable | Benchmark | When | Instrument |
P.O. #1. Student Achievement: Students will successfully complete the S.U. M.F.T. program requirements and graduate. | Graduation Rates |
| Summer | S.U. M.F.T. Student Tracking Sheet |
P.O. #2. Alumni Achievement: Graduated students will be successful in pursuing a career advancing Marriage and Family Therapy or related fields. | M.F.T. Employment Rates |
| Summer | S.U. M.F.T. Alumni Survey/ S.U. M.F.T. Student Tracking Sheet |
P.O. #3. Commitment to Diversity: The S.U. M.F.T. program will show clear commitment to diversity through curriculum content and student composition. | Curriculum Diversity Content |
| Summer | S.U. M.F.T. Diversity in Curriculum Tracking Sheet. |
P.O. #3. Commitment to Diversity: The S.U. M.F.T. program will show clear commitment to diversity through curriculum content and student composition. | Program Demographic Diversity |
| Fall | S.U. M.F.T. Demographic Survey |
P.O. #3. Commitment to Diversity: The S.U. M.F.T. program will show clear commitment to diversity through curriculum content and student composition. | Research on Diversity |
| Summer | S.U. M.F.T. Student Tracking Sheet |
Ph.D. Student Learning Outcomes
Student Learning Outcomes (S.L.O.) | Variable | Benchmark | When | Instrument |
S.L.O.#1: Students will demonstrate competence in advanced theory and theory building. | Theory Building |
| Summer | Assessed by Qual Theory component. Tracked on S.U. M.F.T. D Student Tracking Sheet |
S.L.O.#1: Students will demonstrate competence in advanced theory and theory building. | Philosophy of Supervision |
| Summer | M.F.T. 861 Phil of Sup Assignment Tracking Sheet |
S.L.O.#1: Students will demonstrate competence in advanced theory and theory building. | Theory Building |
| Fall | M.F.T. 865 Theory Dev Tracking Sheet |
S.L.O.#2: Students will demonstrate research competence. | Research Competence |
| Summer | Assessed by Qual Res component. Tracked on S.U. M.F.T.-D. Student Tracking Sheet |
S.L.O.#2: Students will demonstrate research competence. | Ethical Competence |
| Summer | C.I.T.I. Certificate. Tracked on S.U. M.F.T.-D. Student Tracking Sheet |
S.L.O.#2: Students will demonstrate research competence. | Research Dissemination |
| Summer | M.F.T. 882 Evaluative Assignment. Traced on S.U. M.F.T.-D. Student Tracking Sheet |
S.L.O.#2: Students will demonstrate research competence. | Research Competence |
| Summer | Attendance Confirmation. Tracked on S.U. M.F.T.-D. Student Tracking Sheet |
S.L.O.#3 Students will demonstrate supervisory competence. | Supervisor Competence |
| Fall | M.F.T. 861 Phil of Sup Course Tracking Sheet |
S.L.O.#3 Students will demonstrate supervisory competence. | Supervisor Competence |
| Summer | S.U. M.F.T. D Student Tracking Sheet |
S.L.O.#3 Students will demonstrate supervisory competence. | Supervisor Competence |
| Summer | S.U. M.F.T. D Student Tracking Sheet |
S.L.O.#4: Students will demonstrate professional teaching competence. | Teaching Effectiveness |
| Summer | Assessed by Qual Teach component. Tracked on S.U. M.F.T.-D. Student Tracking Sheet |
S.L.O.#4: Students will demonstrate professional teaching competence. | Teaching Effectiveness |
| Summer | S.U. M.F.T. D. Student Tracking Sheet |
S.L.O.#4: Students will demonstrate professional teaching competence. | Teaching Effectiveness |
| Summer | S.U. M.F.T. D. Student Tracking Sheet |
S.L.O.#5: Students will demonstrate clinical competence. | Clinical Competence |
| Summer | Clinical Hours Tracking Sheet |
S.L.O.#5: Students will demonstrate clinical competence. | Clinical Competence |
| Each Semester | Eval Form of Student |
S.L.O.#5: Students will demonstrate clinical competence. | Ethical Competence |
| Each Semester | Eval Form of Student (Ethics) |
S.L.O.#6: Students will demonstrate awareness and engagement with cultural and contextual differences. | Quals Cultural Engagement |
| Summer | Assessed by Qual Cultural component. Tracked on S.U. M.F.T.-D Student Tracking Sheet |
S.L.O.#6: Students will demonstrate awareness and engagement with cultural and contextual differences. | Cultural Competence |
| Summer | M.F.T. 875 Cultural Diversity Assignment Tracking Sheet |
Faculty Outcomes
Faculty Outcomes (F.O.) | Variables | Benchmarks | When | Instrument |
F.O.#1. Faculty will meet Syracuse University expectations for research, teaching, scholarship, and service. | S.U. Faculty Expectations |
| Spring | Curriculum Vitea Update Form |
F.O.#2. Faculty will contribute to students’ successful completion of program requirements through effective teaching, advising/mentoring and supervision. | Teaching Effectiveness |
| Summer | Evaluation Form of Instructor |
F.O.#2. Faculty will contribute to students’ successful completion of program requirements through effective teaching, advising/mentoring and supervision. | Supervisory Effectiveness | http://2.At least 80% of supervisors will receive an average score of 3 or higher on the Evaluation Form of Supervisor completed by Supervisee, assessed each semester. | Summer | Evaluation Form of Supervisor |
F.O.#2. Faculty will contribute to students’ successful completion of program requirements through effective teaching, advising/mentoring and supervision. | Mentoring Effectiveness | http://3.At least 80% of advisor mentors will advise dissertation research to completion. | Summer | S.U. M.F.T. Student Tracking Sheet |
Appendix E: Master’s Degree Plan Information
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Name: add name
Date: add date
Semester | Year 1 Class Information | Credits | Year 2 Class Information | Credits | Year 3 Class Information | Credits |
Fall | add classes here | add credits here | add classes here | add credits here | add classes here | add credits here |
Spring | add classes here | add credits here | add classes here | add credits here | add classes here | add credits here |
Summer MM | add classes here | add credits here | add classes here | add credits here | add classes here | add credits here |
Summer S-I | add classes here | add credits here | add classes here | add credits here | add classes here | add credits here |
Summer S- II | add classes here | add credits here | add classes here | add credits here | add classes here | add credits here |
Sub Total | - | add subtotal of credits here | - | add subtotal of credits here | - | add subtotal of credits here |
Total | - | add total credits here | - | add total credits for both years here | - | add total credits for all years here |
Sample Full-time Master's Degree Plan
Semester | First Year | Credits | Second Year | Credit |
Fall | M.F.T. 671 Theory (3 credits) M.F.T. 661 Practice I (3 credits) M.F.T. 681 Ethics (3 credits) M.F.T. 750 Practicum (3 credits) | 12 | M.F.T. 724 Psychopathology (3 credits) M.F.T. 663 Research Methods (3 credits) M.F.T. 762 Practicum 3 (3 credits) | 9 |
Spring | M.F.T. 682 Theory (3 credits) M.F.T. 662 Practice II (3 credits) M.F.T. 684 Diversity (3 credits) M.F.T. 760 Practicum 1 (3 credits) | 12 | M.F.T. 781 Alcohol and Drugs (AOD) (3 credits) M.F.T. 668 Family Life Cycle (3 credits) Master’s Project M.F.T. 763 Practicum 4 (3 credits) | 9 |
Summer MM | Elective 1 | 3 | no classes | no credits |
Summer S-I | M.F.T. 567 Sexual Issues (3 credits) Elective 2 (3 credits) M.F.T. 761 Practicum 2 (3 credits) | 9 | no classes | no credits |
Summer S- II | M.F.T. 672 Couples Therapy (3 credits) Elective 3 (3 credits) | 6 | no classes | no credits |
Sub Total | - | 42 | - | 18 |
Total | - | 42 | - | 60 |
Part-time Residential Master's Degree Plan (Sample)
Semester | Year 1 | Credits | Year 2 | Credits | Year 3 | Credits |
Fall | M.F.T. 671 Theory (3 Credits) M.F.T. 681 Ethics (3 credits) | 6 | M.F.T. 661 Practice 1 (3 credits) M.F.T. 724 Psychopathology (3 credits) M.F.T. 750 Practicum (3 credits) | 9 | M.F.T. 663 Research (3 credits) M.F.T. 762 Practicum 3 (3 credits) | 6 |
Spring | M.F.T. 682 Theory (3 credits) M.F.T. 684 Diversity (3 credits) | 6 | M.F.T. 662 Practice 2(3 credits) M.F.T. 781 Alcohol and Drugs (AOD) (3 credits) M.F.T. 760 Practicum 1 (3 credits) | 9 | M.F.T. 688 Family Life Cycle (3 credits) M.F.T. 763 Practicum 4 (3 credits) | 6 |
Summer MM | Elective 1 | 3 | Elective 2 | 3 | no classes | no credits |
Summer S-I | no classes | no credits | M.F.T. 567 Sexual Issues (3 credits) M.F.T. 761 2 Practicum (3 credits) | 6 | no classes | no credits |
Summer S- II | no classes | no credits | M.F.T. 672 Couples Therapy (3 credits) Elective 3 (3 credits) | 6 | no classes | no credits |
Sub Total | - | 15 | - | 33 | - | 12 |
Total | - | 15 | - | 48 | - | 60 |
Online (Part-time) Masters Degree Plan
COURSE | Semester | CREDITS |
MFT 661 Introduction to Family Therapy Practice | 1 | 3 |
MFT 671 Introduction to Family Systems | 1 | 3 |
MFT 675 Field Pre-Planning | 1 | 0 |
MFT 681 MFT Ethics and Issues | 2 | 3 |
MFT 682 MFT Theory and Techniques | 2 | 3 |
MFT 675 Field Pre-Planning | 2 | 0 |
MFT 724 Psychopathology | 3 | 3 |
MFT 662 Systems Dynamics in a Group Setting | 3 | 3 |
MFT 675 Field Pre-Planning | 3 | 0 |
MFT 684 Family Therapy Perspectives on Cultural Diversity | 4 | 3 |
MFT 750 Introduction to MFT Practicum | 4 | 3 |
MFT 688 Family Therapy Across the Life Cycle | 5 | 3 |
MFT 760 Practicum in MFT I | 5 | 3 |
PHP 609 Impact of Addictions on Families & Relationships | 6 | 3 |
MFT 761 Practicum in MFT II | 6 | 3 |
MFT 672 Couple Therapy: Theory and Techniques | 7 | 3 |
MFT 762 Practicum in MFT III | 7 | 3 |
MFT 763 Practicum in MFT IV | 8 | 3 |
MFT 567 Sexual Issues for the Helping Professional | 8 | 3 |
MFT 997 Master’s Thesis or Project | 8 | 0 |
Elective 3 (If hours are not complete take MFT 764) | 9 | 3 |
MFT 663 Applied Research | 9 | 3 |
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Elective 1 (after 3rd semester) | ? | 3 |
Elective 2 (after 4th semester) | ? | 3 |
| Total | 60 |
M.F.T. Master's Degree Plan Checklist
Record Semester Took | Required Courses | Credits |
add a semester here | M.F.T. 671 Theory | 3 |
add a semester here | M.F.T. 661 Practice I | 3 |
add a semester here | M.F.T. 681 Ethics | 3 |
add a semester here | M.F.T. 750 Intro to Clinical Practice | 3 |
add a semester here | M.F.T. 682 Theory | 3 |
add a semester here | M.F.T. 662 Practice II | 3 |
add a semester here | M.F.T. 684 Diversity | 3 |
add a semester here | M.F.T. 567 Sexual Issues | 3 |
add a semester here | M.F.T. 672 Couples Therapy | 3 |
add a semester here | M.F.T. 724 Psychopathology | 3 |
add a semester here | M.F.T. 663 Research Methods | 3 |
add a semester here | M.F.T. 781 Alcohol and Drugs | 3 |
add a semester here | M.F.T. 668 Family Life Cycle | 3 |
add a semester here | Master’s Project | 0 |
add a semester here | M.F.T. 760 – Practicum 1 | 3 |
add a semester here | M.F.T. 761 Practicum 2 | 3 |
add a semester here | M.F.T. 762 Practicum 3 | 3 |
add a semester here | M.F.T. 763 Practicum 4 | 3 |
add a semester here | Elective 1 * | 3 |
add a semester here | Elective 2 * | 3 |
add a semester here | Elective 3 * | 3 |
- | Total | 60 |
Electives you can take include M.F.T. 603 – Introduction to Trauma (3 credits), M.F.T. 686 – Play Therapy (3 credits), M.F.T. 642 – L.G.B.T. Issues in Therapy (3 credits), M.F.T. 643 – Trauma (3 credits), M.F.T. 773 – Family Violence (3 credits), Others by Petition
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Domain 1: Admission to Treatment
Domain Number | Competency | Criteria | Rating |
1.1.2 | Understand theories and techniques of individual, marital, couple, family, and group psychotherapy. | Can the student discuss theory, articulate which theory they might apply to a case? Do they use systemic questions? | add rating here |
1.3.5 | Obtain consent to treatment from all responsible persons. | Has all the Intake paperwork and appropriate consents been signed? Does the student ensure there is a release before talking with others? | add rating here |
1.3.6 | Establish and maintain appropriate and productive therapeutic alliances with the clients. | Has the therapist been able to engage with clients? Do they come back? | add rating here |
1.3.7 | Solicit and use client feedback throughout the therapeutic process. | Does the therapist ask the client about goals, session progress, specific feedback? | add rating here |
1.3.9 | Manage session interactions with individuals, couples, families, and groups. | Does the therapist start and end on time? Have clients talk with each other? Facilitate discussion, manage conflict? | add rating here |
1.5.2 | Complete case documentation in a timely manner and in accordance with relevant laws and policies. | Session notes done within 48 hours. Treatment plans within 4 sessions, updated as needed. | add rating here |
Comments:
add comments
Domain 2: Clinical Assessment and Diagnosis
Domain Number | Competency | Criteria | Rating |
2.3.3 | Apply effective and systemic interviewing techniques and strategies | Included all members attending? Use circular questions? Focus on systemic concerns & use systemic interventions? | add rating here |
2.3.5 | Screen and develop adequate safety plans for substance abuse, child and elder maltreatment, domestic violence, physical violence, suicide potential, and dangerousness to self and other. | Does the student recognize areas of risk? Do they seek assistance? Develop plan with the client? | add rating here |
2.3.6 | Assess family history and dynamics using a genogram or other assessment instruments. | Are they assessing the system/family/relationship? Do they use genogram, observation, tasks, other tools? Do they review the client assessment? | add rating here |
2.3.8 | Identify clients' strengths, resilience, and resources. | Do they include strengths when discussing case, build on them in session? | add rating here |
2.5.1 | Utilize consultation and supervision effectively. | Do they come to supervision regularly? Do they ask for assistance with cases? Show their work openly? | add rating here |
Comments:
add comments
Domain 3: Treatment Planning and Case Management
Domain Number | Competency | Criteria | Rating |
3.3.5 | Manage progression of therapy toward treatment goals. | Are they focused on goals? Can they articulate what they are working on? Do they note progress? | add rating here |
3.3.6 | Manage risks, crises, and emergencies. | Do they identify areas of risk? Are they calm when sessions are intense, client are in crises? Do they seek appropriate assistance in emergencies? | add rating here |
3.5.3 | Write plans and complete other case documentation in accordance with practice setting policies, professional standards, and state/provincial laws. | Have they completed a treatment plan? Are notes done on time? | add rating here |
3.5.4 | Utilize time management skills in therapy sessions and other professional meetings. | Are they on time for sessions? Do they end sessions on time? Are they on time for supervision? | add rating here |
Comments:
add comments
Domain 4: Therapeutic Interventions
Domain Number | Competency | Criteria | Rating |
4.1.1 | Comprehend a variety of individual and systemic therapeutic models and their application, including evidence-based therapies and culturally sensitive approaches. | Does theory inform their practice, conceptualization, interventions? Can they articulate what they do in session and why? | add rating here |
4.3.2 | Deliver interventions in a way that is sensitive to special needs of clients (e.g., gender, age, socioeconomic status, culture/race/ethnicity, sexual orientation, health/ ability, personal history, SES, larger systems issues of the client). | Do they tend to issues of diversity, account for it in the room, in the therapeutic relationship? | add rating here |
4.3.5 | Engage each family member in the treatment process as appropriate. | Do they utilize family members/ partners? Do they conduct relational sessions and develop systemic goals? | add rating here |
4.3.6 | Facilitate clients developing and integrating solutions to problems. | Do they ask clients about goals, what they want to see changed, what is working? | add rating here |
4.3.7 | Defuse intense and chaotic situations to enhance the safety of all participants. | Are they able to contain chaos & stay calm? Can they interrupt escalations effectively? | add rating here |
4.3.12 | Integrate supervisor/team communications into treatment. | Are suggestions and requests acted upon? | add rating here |
4.5.1 | Respect multiple perspectives (e.g., clients, team, supervisor, practitioners from other disciplines who are involved in the case). | Can they listen to other perspectives and be open to new ideas? Are such discussions productive? | add rating here |
4.5.2 | Set appropriate boundaries, manage issues of triangulation, and develop collaborative working relationships. | Does the therapist maintain professional boundaries (ex. refrain from using personal numbers, emails). Are they able to work with all members of the system (client and larger system) collaboratively and professionally? | add rating here |
4.5.3 | Articulate rationales for interventions related to treatment goals and plan, assessment information, and systemic understanding of clients’ context and dynamics. | Can they explain what they do and why? Does the therapist follow a plan? | add rating here |
Comments:
add comments
Domain 5: Legal Issues, Ethics, and Standards
Domain Number | Competency | Criteria | Rating |
5.3.1 | Monitor issues related to ethics, laws, regulations, and professional standards. | Do they follow policy of Center (ex. paperwork deadlines, response to messages, maintaining appointments)? Do they obtain consent? Seek consultation for cases that are challenging or beyond the scope of the Center? | add rating here |
5.3.3 | Inform clients and legal guardian of limitations to confidentiality and parameters of mandatory reporting. | Is this reviewed thoroughly at the beginning of the case? With all new members that join the therapy? | add rating here |
5.3.4 | Develop safety plans for clients who present with potential self-harm, suicide, abuse, or violence. | Does the student create a safety plan when risk is noted? | add rating here |
5.5.1 | Maintain client records with timely and accurate notes. | Are notes complete? On time? Accurately reflect the session? | add rating here |
Comments:
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Awareness of Self
Domain Number | Awareness of Self | Criteria | Rating |
3.4.5 | Monitor personal reactions to clients and treatment process, especially in terms of therapeutic behavior, relationship with clients, process for explaining procedures, and outcomes. | Does the student process reactions in supervision? Are they open to discussing the way the self impacts their therapeutic relationships & clinical work? | add rating here |
5.2.4 | Recognize when clinical supervision or consultation is necessary. | Does the student present cases that are challenging? Are they open to feedback? Are they able to ask for assistance? | add rating here |
5.4.2 | Monitor attitudes, personal well-being, personal issues, and personal problems to insure they do not impact the therapy process adversely or create vulnerability for misconduct. | Can the student discuss their personal issues, beliefs & attitudes as they relate to clinical work? Are they open to & incorporate feedback? | add rating here |
5.5.2 | Consult with peers and/or supervisors if personal issues, attitudes, or beliefs threaten to adversely impact clinical work. | Does the student share relevant issues in supervision? Are they open to getting assistance and working on areas of concern? | add rating here |
Comments:
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Areas of Strength:
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I expect this student to continue to work with me until__________.
Supervisor’s Signature: | Date: |
Student’s Signature: | Date: |