ࡱ> !` bjbj\\ .>> 11111OB33333333AAAAAAA$ChmEnA43344A33 Bm5m5m54.33Am54Am5m57733 `n.1)5:7 8 B0OB7,Ec5E7E7(303"m534333AAc5 333OB4444-11 ̽Ƶ Supervisor Evaluation Form Counseling Psychology Practicum Site:_________________________________ Supervisor:____________________________________ Supervisee:____________________________________ Semester:______________________________________ Please complete the following evaluation form by circling the appropriate rating for each of the content area statements: Scale for Rating Competencies: Not Applicable Training needs not met Training needs somewhat met Training needs adequately met Training needs exceeded In the Comments section, please include any general information regarding any expectations of the supervisee. Content Area to ConsiderExceededAdequately MetSomewhat MetNot MetNot ApplicableExpectationsHad appropriate expectations of me: 43210The work load was manageable but challenging:43210Established clear goals and expectations: 43210Comments: Content Areas to ConsiderExceededAdequately MetSomewhat MetNot MetNot ApplicableSupervisory RelationshipTreated me with respect:43210Demonstrates involvement and commitment to supervision:43210Created a comfortable, "safe" atmosphere: 43210Was open to feedback from you about your needs:43210Served as a role model:43210Gave constructive feedback in a positive and supportive manner: 43210Comments:Supervision SkillsProvided helpful suggestions/guidance on clinical cases: 43210Used appropriate didactic material and can suggest additional readings and training:43210Helps define and clarify goals for counseling and/or assessment:43210Encouraged independent thought: 43210Provided an overall evaluation of supervisor's strengths and limitations:43210Comments:AvailabilityOffered regular, scheduled supervision meetings: 43210Was available outside of scheduled appointments: 43210Comments: Content Areas to ConsiderExceededAdequately MetSomewhat MetNot MetNot ApplicableMulticultural IssuesShowed awareness of diversity issues: 43210Discussed cultural issues relevant to therapeutic relationship: 43210Comments:Professional EthicsIntroduced and discussed professional and ethical issues as needed: 43210Modeled professional and ethical practices: 43210When necessary, supervisor served as a liaison in making referrals for the supervisee:43210Differentiates between therapy and supervision and aids supervisee in doing so as well:43210Comments:Overall Rating of Supervisor43210Comments: What do you consider to be the Strengths of this supervisor? 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