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Call 215-382-6680
Mid-Semester Evaluation of Supervisor
Semester
*
Please select
Fall
Spring
Academic Year
*
Your Name
*
Your Email
*
Supervision Format
*
Individual
Dydadic
Group
Areas of professional growth.
*
Goals for remainder of supervision semester.
*
Feedback about supervisory process.
*
Directions: Check off which skill areas you would like to focus on during the remainder of the semester. Please use this evaluation in supervision to discuss goals for the remainder of the semester.
I. CONCEPTUAL & PERCEPTUAL SKILLS (SLO 2.1)
*
A. Knowlegde Base
B. Familiarity with Therapy Models
C. Awareness of Diversity Issues
D. Recognition of Relational Patterns
II. EXECUTIVE SKILLS (SLO 2.2)
*
A. Joining
B. Basic Therapeutic Skills
C. Assessment
D. Hypothesizing
E. Treatment Planning
F. Intervention Strategies
G. Integration of Models
III. PROFESSIONAL SKILLS (SLO 2.3)
*
A. Session Management
B. Supervision Responsibilities
C. Ethical Issues
D. Paperwork
E. Professional Behaviors
IV. EVALUATION SKILLS (SLO 2.4)
*
A. Evaluation of Therapeutic Progress
B. Evaluation of Self as Therapist
V. PERSONAL SKILLS (SLO 2.5)
*
A. Personal Qualities of the Therapist
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.
Name of Supervisor
*
First
Last
Supervisor's Email
*
When you hit submit, a copy of your completed form will be emailed to you and your supervisor to discuss together.
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