681B Evaluation
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1. Default Section

 
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1. Supervisor's Name:

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2. Date Supervisor was first hired as a counselor or mental health professional:

3. Area of expertise (e.g., mental health counseling, social work, psychology, etc).

4. Mental Health (or related) License Number:

5. Internship Site:

6. Intern's Name:

7. FOUNDATIONS (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
A.1. Understands the history, philosophy, and trends in clinical mental health counseling.
A.2. Understands ethical and legal considerations specifically related to the practice of clinical mental health counseling.
A.3. Understands the roles and functions of clinical mental health counselors in various practice settings and the importance of relationships between counselors and other professionals, including interdisciplinary treatment teams.
A.4. Knows the professional organizations, preparation standards, and credentials relevant to the practice of clinical mental health counseling.
A.5. Understands a variety of models and theories related to clinical mental health counseling, including the methods, models, and principles of clinical supervision.
A.6. Recognizes the potential for substance use disorders to mimic and coexist with a variety of medical and psychological disorders.
A.7. Is aware of professional issues that affect clinical mental health counselors (e.g., core provider status, expert witness status, access to and practice privileges within managed care systems).
A.8. Understands the management of mental health services and programs, including areas such as administration, finance, and accountability.
A.9. Understands the impact of crises, disasters, and other trauma-causing events on people.
A.10. Understands the operation of an emergency management system within clinical mental health agencies and in the community.

8. FOUNDATIONS (Skills and Practice)

 NAFailNeeds ImprovementAdequateGoodExcellent
B.1. Demonstrates the ability to apply and adhere to ethical and legal standards in clinical mental health counseling.
B.2. Applies knowledge of public mental health policy, financing, and regulatory processes to improve service delivery opportunities in clinical mental health counseling.

9. COUNSELING, PREVENTION, AND INTERVENTION (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
C.1. Describes the principles of mental health, including prevention, intervention, consultation, education, and advocacy, as well as the operation of programs and networks that promote mental health in a multicultural society.
C.2. Knows the etiology, the diagnostic process and nomenclature, treatment, referral, and prevention of mental and emotional disorders.
C.3. Knows the models, methods, and principles of program development and service delivery (e.g., support groups, peer facilitation training, parent education, self-help).
C.4. Knows the disease concept and etiology of addiction and co-occurring disorders.
C.5. Understands the range of mental health service delivery—such as inpatient, outpatient, partial treatment and aftercare—and the clinical mental health counseling services network.
C.6. Understands the principles of crisis intervention for people during crises, disasters, and other trauma-causing events.
C.7. Knows the principles, models, and documentation formats of biopsychosocial case conceptualization and treatment planning.
C.8. Recognizes the importance of family, social networks, and community systems in the treatment of mental and emotional disorders.
C.9. Understands professional issues relevant to the practice of clinical mental health counseling.

10. COUNSELING, PREVENTION, AND INTERVENTION (Skills and Practices)

 NAFailNeeds ImprovementAdequateGoodExcellent
D.1. Uses the principles and practices of diagnosis, treatment, referral, and prevention of mental and emotional disorders to initiate, maintain, and terminate counseling.
D.2. Applies multicultural competencies to clinical mental health counseling involving case conceptualization, diagnosis, treatment, referral, and prevention of mental and emotional disorders.
D.3. Promotes optimal human development, wellness, and mental health through prevention, education, and advocacy activities.
D.4. Applies effective strategies to promote client understanding of and access to a variety of community resources.
D.5. Demonstrates appropriate use of culturally responsive individual, couple, family, group, and systems modalities for initiating, maintaining, and terminating counseling.
D.6. Demonstrates the ability to use procedures for assessing and managing suicide risk.
D.7. Applies current record-keeping standards related to clinical mental health counseling.
D.8. Provides appropriate counseling strategies when working with clients with addiction and co-occurring disorders.
D.9. Demonstrates the ability to recognize his or her own limitations as a clinical mental health counselor and to seek supervision or refer clients when appropriate.

11. COUNSELING, PREVENTION, AND INTERVENTION (Skills and Practice)

 NAFailNeeds ImprovementAdequateGoodExcellent
D.1. Uses the principles and practices of diagnosis, treatment, referral, and prevention of mental and emotional disorders to initiate, maintain, and terminate counseling.
D.2. Applies multicultural competencies to clinical mental health counseling involving case conceptualization, diagnosis, treatment, referral, and prevention of mental and emotional disorders.
D.3. Promotes optimal human development, wellness, and mental health through prevention, education, and advocacy activities.
D.4. Applies effective strategies to promote client understanding of and access to a variety of community resources.
D.5. Demonstrates appropriate use of culturally responsive individual, couple, family, group, and systems modalities for initiating, maintaining, and terminating counseling.
D.6. Demonstrates the ability to use procedures for assessing and managing suicide risk.
D.7. Applies current record-keeping standards related to clinical mental health counseling.
D.8. Provides appropriate counseling strategies when working with clients with addiction and co-occurring disorders.

12. DIVERSITY AND ADVOCACY (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
E.1. Understands how living in a multicultural society affects clients who are seeking clinical mental health counseling services.
E.2. Understands the effects of racism, discrimination, sexism, power, privilege, and oppression on one’s own life and career and those of the client.
E.3. Understands current literature that outlines theories, approaches, strategies, and techniques shown to be effective when working with specific populations of clients with mental and emotional disorders.
E.4. Understands effective strategies to support client advocacy and influence public policy and government relations on local, state, and national levels to enhance equity, increase funding, and promote programs that affect the practice of clinical mental health counseling.
E.5. Understands the implications of concepts such as internalized oppression and institutional racism, as well as the historical and current political climate regarding immigration, poverty, and welfare.
E.6. Knows public policies on the local, state, and national levels that affect the quality and accessibility of mental health services.

13. DIVERSITY AND ADVOCACY (Skills and Practices)

 NAFailNeeds ImprovementAdequateGoodExcellent
F.1. Maintains information regarding community resources to make appropriate referrals.
F.2. Advocates for policies, programs, and services that are equitable and responsive to the unique needs of clients.
F.3. Demonstrates the ability to modify counseling systems, theories, techniques, and interventions to make them culturally appropriate for diverse populations.

14. ASSESSMENT (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
G.1. Knows the principles and models of assessment, case conceptualization, theories of human development, and concepts of normalcy and psychopathology leading to diagnoses and appropriate counseling treatment plans.
G.2. Understands various models and approaches to clinical evaluation and their appropriate uses, including diagnostic interviews, mental status examinations, symptom inventories, and psychoeducational and personality assessments.
G.3. Understands basic classifications, indications, and contraindications of commonly prescribed psychopharmacological medications so that appropriate referrals can be made for medication evaluations and so that the side effects of such medications can be identified.
G.4. Identifies standard screening and assessment instruments for substance use disorders and process addictions.

15. ASSESSMENT (Skills and Practices)

 NAFailNeeds ImprovementAdequateGoodExcellent
H.1. Selects appropriate comprehensive assessment interventions to assist in diagnosis and treatment planning, with an awareness of cultural bias in the implementation and interpretation of assessment protocols.
H.2. Demonstrates skill in conducting an intake interview, a mental status evaluation, a biopsychosocial history, a mental health history, and a psychological assessment for treatment planning and caseload management.
H.3. Screens for addiction, aggression, and danger to self and/or others, as well as co-occurring mental disorders.
H.4. Applies the assessment of a client’s stage of dependence, change, or recovery to determine the appropriate treatment modality and placement criteria within the continuum of care.

16. RESEARCH AND EVALUATION (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
I.1. Understands how to critically evaluate research relevant to the practice of clinical mental health counseling.
I.2. Knows models of program evaluation for clinical mental health programs.
I.3. Knows evidence-based treatments and basic strategies for evaluating counseling outcomes in clinical mental health counseling.

17. RESEARCH AND EVALUATION (Skills and Practice)

 NAFailNeeds ImprovementAdequateGoodExcellent
J.1. Applies relevant research findings to inform the practice of clinical mental health counseling.
J.2. Develops measurable outcomes for clinical mental health counseling programs, interventions, and treatments.
J.3. Analyzes and uses data to increase the effectiveness of clinical mental health counseling interventions and programs.

18. DIAGNOSIS (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
K.1. Knows the principles of the diagnostic process, including differential diagnosis, and the use of current diagnostic tools, such as the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
K.2. Understands the established diagnostic criteria for mental and emotional disorders, and describes treatment modalities and placement criteria within the continuum of care.
K.3. Knows the impact of co-occurring substance use disorders on medical and psychological disorders.
K.4. Understands the relevance and potential biases of commonly used diagnostic tools with multicultural populations.
K.5. Understands appropriate use of diagnosis during a crisis, disaster, or other trauma-causing event.

19. DIVERSITY AND ADVOCACY (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
E.1. Understands how living in a multicultural society affects clients who are seeking clinical mental health counseling services.
E.2. Understands the effects of racism, discrimination, sexism, power, privilege, and oppression on one’s own life and career and those of the client.
E.3. Understands current literature that outlines theories, approaches, strategies, and techniques shown to be effective when working with specific populations of clients with mental and emotional disorders.
E.4. Understands effective strategies to support client advocacy and influence public policy and government relations on local, state, and national levels to enhance equity, increase funding, and promote programs that affect the practice of clinical mental health counseling.
E.5. Understands the implications of concepts such as internalized oppression and institutional racism, as well as the historical and current political climate regarding immigration, poverty, and welfare.
E.6. Knows public policies on the local, state, and national levels that affect the quality and accessibility of mental health services.

20. DIVERSITY AND ADVOCACY (Skills and Practices)

 NAFailNeeds ImprovementAdequateGoodExcellent
F.1. Maintains information regarding community resources to make appropriate referrals.
F.2. Advocates for policies, programs, and services that are equitable and responsive to the unique needs of clients.
F.3. Demonstrates the ability to modify counseling systems, theories, techniques, and interventions to make them culturally appropriate for diverse populations.

21. ASSESSMENT (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
G.1. Knows the principles and models of assessment, case conceptualization, theories of human development, and concepts of normalcy and psychopathology leading to diagnoses and appropriate counseling treatment plans.
G.2. Understands various models and approaches to clinical evaluation and their appropriate uses, including diagnostic interviews, mental status examinations, symptom inventories, and psychoeducational and personality assessments.
G.3. Understands basic classifications, indications, and contraindications of commonly prescribed psychopharmacological medications so that appropriate referrals can be made for medication evaluations and so that the side effects of such medications can be identified.
G.4. Identifies standard screening and assessment instruments for substance use disorders and process addictions.

22. ASSESSMENT (Skills and Practices)

 NAFailNeeds ImprovementAdequateGoodExcellent
H.1. Selects appropriate comprehensive assessment interventions to assist in diagnosis and treatment planning, with an awareness of cultural bias in the implementation and interpretation of assessment protocols.
H.2. Demonstrates skill in conducting an intake interview, a mental status evaluation, a biopsychosocial history, a mental health history, and a psychological assessment for treatment planning and caseload management.
H.3. Screens for addiction, aggression, and danger to self and/or others, as well as co-occurring mental disorders.
H.4. Applies the assessment of a client’s stage of dependence, change, or recovery to determine the appropriate treatment modality and placement criteria within the continuum of care.

23. RESEARCH AND EVALUATION (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
I.1. Understands how to critically evaluate research relevant to the practice of clinical mental health counseling.
I.2. Knows models of program evaluation for clinical mental health programs.
I.3. Knows evidence-based treatments and basic strategies for evaluating counseling outcomes in clinical mental health counseling.

24. RESEARCH AND EVALUATION (Skills and Practice)

 NAFailNeeds ImprovementAdequateGoodExcellent
J.1. Applies relevant research findings to inform the practice of clinical mental health counseling.
J.2. Develops measurable outcomes for clinical mental health counseling programs, interventions, and treatments.
J.3. Analyzes and uses data to increase the effectiveness of clinical mental health counseling interventions and programs.

25. DIAGNOSIS (Knowledge)

 NAFailNeeds ImprovementAdequateGoodExcellent
K.1. Knows the principles of the diagnostic process, including differential diagnosis, and the use of current diagnostic tools, such as the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).
K.2. Understands the established diagnostic criteria for mental and emotional disorders, and describes treatment modalities and placement criteria within the continuum of care.
K.3. Knows the impact of co-occurring substance use disorders on medical and psychological disorders.
K.4. Understands the relevance and potential biases of commonly used diagnostic tools with multicultural populations.
K.5. Understands appropriate use of diagnosis during a crisis, disaster, or other trauma-causing event.

26. DIAGNOSIS (Skills and Practices)

 NAFailNeeds ImprovementAdequateGoodExcellent
L.1. Demonstrates appropriate use of diagnostic tools, including the current edition of the DSM, to describe the symptoms and clinical presentation of clients with mental and emotional impairments.
L.2. Is able to conceptualize an accurate multi-axial diagnosis of disorders presented by a client and discuss the differential diagnosis with collaborating professionals.
L.3. Differentiates between diagnosis and developmentally appropriate reactions during crises, disasters, and other trauma-causing events.

27. Comments and suggestions regarding the above (e.g., omissions, additions, clarifications):