End of the Semester Evaluation of Supervisor

  • Rate the following statements based on the following 5 point scale. 1 = Poor 2 = Fair 3 = Good 4 = Very Good 5 = Excellent
  • Rate the following statements based on the following 5 point scale. 1 = Poor 2 = Fair 3 = Good 4 = Very Good 5 = Excellent
  • Rate the following statements based on the following 5 point scale. 1 = Poor 2 = Fair 3 = Good 4 = Very Good 5 = Excellent
  • Evaluation of Supervision Experience

  • Directions: Based on the rating scale, rate the level of competency that this supervisee has attained in each of the skill areas listed below. Enter the overall rating in the drop box. Write in comments that highlight key issues for this supervisee. Rating Scale 1 = Needs improvement – difficulty gaining competency in this skill area 2 = New skill area 3 = Beginner level – basic competency in this area of clinical practice 4 = Intermediate level – effective in this area of clinical practice 5 = Advanced level – very effective in this area of clinical practice NEI = Not enough information
  • I. CONCEPTUAL & PERCEPTUAL SKILLS (SLO 2.1)

  • System concepts, human development, family life cycle, normal family processes, human sexuality, gender roles.
  • knowledge of therapy models, integration of models.
  • gender; race; ethnicity, class, culture; religion, faith, spirituality; sexual orientation.
  • hierarchies, triangles, boundaries, intergenerational patterns and legacies, attachment styles, interactional patterns described in terms of cognitive, behavioral and affective sequences, differentiates content from process.
  • II. EXECUTIVE SKILLS (SLO 2.2)

  • engages clients in a balanced therapeutic alliance; demonstrates warmth, empathy and respect; conveys competence, authority, trustworthiness; inspires hope and trust; explores the clients’ frame of reference; paces therapy to match the readiness of the clients; adjusts language to match clients’ language.
  • actively listens, empathically attunes; elicits client sharing, reflects accurately, asks open ended questions, guides the communication process, explores clients’ expectations, clarifies goals, establishes boundaries, explores history of presenting problems, provides focus, identifies core themes.
  • conducts comprehensive history; completes a genogram; gathers history and context of presenting problems; assesses strengths; assesses significance of gender roles; assesses significance of diversity issues; assesses biological bases of behavior; assesses significance of SES, employment, school and developmental issues; explores previous solutions and prior treatment; makes appropriate referrals for psychiatric, medical and other issues; consults with other professionals connected to a case with appropriate releases; explores resources.
  • hypotheses based on clients’ frame of reference and assessment information; conceptualizes systemic hypotheses; frames presenting problems in systemic terms; hypotheses based on theories of change.
  • treatment plan based on assessment, hypotheses and theories of change; collaborative determination of treatment goals; short term treatment plan for attainment of immediate goals; long term treatment plan for sequential changes necessary for goal attainment; modifies treatment plan when appropriate; plans for termination; transfers cases when appropriate; refers to adjunct therapies for specific problem areas; seeks to coordinate treatment when multiple therapists are involved with family members.
  • interventions based on assessment, hypotheses and treatment plan; sustains focus on presenting problems; invites other family members into the tx; normalizes the problem; guides interactional and verbal dynamics; interrupts negative communication cycles; deflects scapegoating and blaming; facilitates expression of emotions; elicits affective schemas; elicits cognitive schemas; facilitates behavior modification; reframes; facilitates enactments; assigns homework; utilizes specific communication techniques; guides problem solving; utilizes sex therapy techniques; utilizes anxiety management techniques; explores outside resources. promotes engagement and experiential shifts; fosters arousal in order to highlight key issues;
  • incorporates depth oriented, psychodynamic, intergenerational approaches; incorporates structural, strategic approaches; incorporates affective approaches; incorporates cognitive-behavioral approaches; incorporates short term solution focused approaches; incorporates narrative, constructivist approaches; incorporates mind-body approaches.
  • III. PROFESSIONAL SKILLS (SLO 2.3)

  • introduces therapy; explains policies and procedures; manages time; manages scheduling; follows policies regarding fees.
  • attends supervision regularly; comes prepared; brings videotapes (audiotapes) for review; respectful of other supervisees; accepts and utilizes supervisory feedback.
  • knows the AAMFT code of ethics; knows state laws: privileged communication, mandatory reporting and duty-to-warn; avoids potentially exploitative relationships; seeks supervisory backup for emergency situations and adequately documents the events.
  • up to date with paperwork; follows clinic procedures.
  • presents as confident without arrogance; acts in a professional manner; treats staff with respect; can handle unexpected situations; seeks consultation from agency staff.
  • IV. EVALUATION SKILLS (SLO 2.4)

  • evaluates link between theory, assessment, hypotheses, treatment plan and interventions; evaluates intervention effectiveness; evaluates outcomes based on client goals; utilizes client feedback.
  • realistically evaluates self in terms of skill areas and effectiveness; recognizes how use of self contributes to an enhanced understanding of the case; articulates awareness of how personal issues impact the therapy; works with supervisor to improve therapeutic effectiveness and to expand skills; articulates strengths and weaknesses as a therapies.
  • V. PERSONAL SKILLS (SLO 2.5)

  • shares personal information appropriately; patient; caring, empathic, sensitive; flexible; accepting of others; warm; nondefensive attitude; takes responsibility for mistakes; introspective; curious; manages anxiety; uses humor; thinks critically and analytically; authentic; accepts feedback; boundaries personal material.
  • This evaluation has been adapted from: Nelson, T.S. & Johnson, L.N. (1999). The Basic Skills Evaluation Device. Journal of Marital and Family Therapy, 25, 1, 15-30.
  • When you hit submit, a copy of your completed form will be emailed to you and your supervisee to discuss together.