Best Practices in Practicum Training

1. Best Practices in Practicum Training Cindy Juntunen & Mike Scheel 2012 CCPTP Midwinter Conference Miami, FL

2. Practicum Planning • Identifying Readiness for Practicum • Student issues • Program issues • Developing Sequential Experiences • Student needs • Site needs • Documenting the Practicum Plan

3. Need for Practicum Plan • Licensure issues • Students need to maintain and track • Helps with AAPI • Demonstrating CoA expectations • Broad and General with Specialty • Unique Counseling Psychology placements

4. Insert prac plan

5. Competency based assessment • Use of the Competency Benchmarks Rating Form • Three levels of rating: 1) Readiness for practicum 2) Readiness for internship 3) Readiness for entry to practice • UNL practicum sequence: a) pre-prac (1 sem.); b) beginning on-campus clinic (one semester); advanced on-campus clinic (2 semesters); Field placement practicum (2 semesters); Second FP prac (optional; 1 or 2 semesters); supervision practicum (2 semesters) • We designate which level to rate. E.g., Readiness for practicum – post-bac doctoral students in on-campus clinic; Readiness for internship – 2nd and 3rd year field placement practicum

6. Competency Benchmark Rating Scale • PROFESSIONALISM Professional values and attitudes Integrity Deportment Accountability Concern for the welfare of others Professional identity Individual and cultural diversity Self as shaped by ind. and cultural diversity Others as shaped by ind. and cultural diversity Interaction of self and others Applications

7. Perceived advantages after two years using competency rating scale • Broadens the scope of professional practice that is evaluated • Calls attention to the need to develop professionalism • Integrates science with practice • Fosters more communication between site and program about the professional role and the professional competencies of a psychologist in training.

8. Professionalism (cont.) Ethical Legal Standards and Policy Knowledge of ethical, legal, and professional standards and guidelines Awareness and application of ethical decision making Ethical conduct Reflective practice/Self assessment/Self care Reflective practice Self-assessment Self-care Participation in supervision process • Rate 0 to 4 (never to always)

9. Core clusters • Professionalism • Relational • Science • Application • Education • Systems

10. Application core cluster • Traditionally the application cluster was the chief emphasis of practicum evaluation covering the functions of most traditional practica (e.g., counseling/intervention; assessment)

11. Application core cluster • APPLICATION • Evidence-Based Practice • Knowledge and Application of Evidence-Based Practice • Assessment • Knowledge of Measurement and Psychometrics • Knowledge of Assessment Methods • Application of Assessment Methods • Diagnosis • Conceptualization and Recommendations • Communication of Assessment Findings • Intervention • Intervention Planning • Skills • Intervention Implementation • Progress Evaluation

12. Strategies for Integrating EBP • Supervision/ Class • Developmental change – exploring vs selecting orientation • Role plays with multiple theories • Student presentations on advanced techniques • Intentional site-specific demonstrations • Site Experience • Clear expectations with supervisor • Attending to models endorsed by sites

13. Outcome based training Outcome management systems – consistent and continual monitoring of outcome Patterns of treatment response can be identified Treatment can be monitored and adjusted “involving the regular monitoring of client progress in real time to positively influence treatment process and outcome” (p. 235; Lambert & Vermeersch, 2008).

14. OQ-45 used by Lambert and Vermeersch as an outcome management system • Use the Reliable Change Index (RCI; 14 points) and a normal functioning cutoff score (i.e., 63) derived from the OQ-45. • Use of feedback (a progress graph with a color coded message indicating the status of client progress) and clinical support tools – a signal alarm system • Five controlled studies (total N > 3000); NOT clients achieved significantly better results in the feedback condition • Clearly, outcome is positively influenced through this system.

15. PCOMS outcome management systems • Partners for Change Outcome Management Systems (PCOMS; Miller, Duncan, Sorrell, & Brown, 2005) • a very short measure that employs two, 4-item scales, one focusing on outcome and the other aimed at assessing the therapeutic alliance. • Very clinician friendly • Facilitates discussion of assessment results by client and therapist each session.

16. Outcome based practicum training • The discussion each session of the two measures strongly contributes positive training in practicum. • ORS is completed at the beginning of the therapy hour, and then discussed. This allows the counselor in training to gain an understanding of the client’s current state and discuss the session treatment plan with the client • SRS is completed at the conclusion of the therapy hour, allowing for discussion of the session and the relationship as it has manifested during therapy that day. • The SRS is my favorite, because of its utility in focuings on the client-counselor relationship each session

17. Training in processing SRS and ORS results Usually the practicum counselor initially doubts whether the client will answer honestly each session. Students are trained in a method of discussing the ORS and SRS. “You marked all items very high. That indicates to me that you like the direction we took in our session today.” “Today, you rated each area very high, and I am wondering if that corresponds with the way you are feeling about how we are working together.” “I see you marked the items very high, yet I sensed today that you were not very satisfied with how we worked together.”

18. Graphing PCOMS results • Practicum counselors graph results over time, session by session, to understand patterns of process and outcome. • Graphs are shared with clients periodically and at termination. Graphs facilitate discussions of patterns of change with clients. • Initiating multi-site research (UNL and UCSB) to gather evidence for the effectiveness of the PCOMS as a training method.