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 PRACTICUM AND INTERNSHIP

Textbook and Resource Guide for

Counseling and Psychotherapy

Fifth Edition

Judith Scott, John C. Boylan, and Christin M. Jungers

First published 2015
by Routledge
711 Third Avenue, New York, NY 10017

and by Routledge
27 Church Road, Hove, East Sussex BN3 2FA

Routledge is an imprint of the Taylor & Francis Group, an informa business

© 2015 Judith Scott, John C. Boylan, and Christin M. Jungers

The right of Judith Scott, John C. Boylan, and Christin M. Jungers to be identified as
authors of this work has been asserted by them in accordance with sections 77 and 78 of the
Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any
form or by any electronic, mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information storage or retrieval system,
without permission in writing from the publishers.

Trademark notice: Product or corporate names may be trademarks or registered trademarks,

and are used only for identification and explanation without intent to infringe.

Fourth edition published 2008 by Routledge

First edition published 1988 by Accelerated Development

Library of Congress Cataloging-in-Publication Data

â•… Scott, Judith, 1940–
Practicum and internship : textbook and resource guide for counseling and psychotherapy /
by Judith Scott, John C. Boylan, and Christin M. Jungers. — Fifth edition.
â•…â•…pages cm
Previous edition cataloged under John Charles Boylan.
â•… Includes bibliographical references and index.
╇ 1.╇ Psychotherapy—Study and teaching (Internship)—Outlines, syllabi, etc.â•…
2.╇ Psychotherapy—Study and teaching—Supervision—Outlines, syllabi, etc.â•…
3.╇ Psychotherapy—Study and teaching (Internship)—Forms.â•… 4.╇ Psychotherapy—Study and
teaching—Supervision—Forms.â•… I.╇ Boylan, John Charles.â•… II.╇ Jungers, Christin M.â•…
III.╇Title.
â•… RC459.B68 2015
â•…616.89'140076—dc23
â•…2014011115

ISBN: 978-1-138-80147-9 (hbk)

ISBN: 978-1-138-79651-5 (pbk)
ISBN: 978-1-315-75489-5 (ebk)

Typeset in Stone Serif

by Apex CoVantage, LLC
 To my children and their spouses: Kristin and Bill Pardini; Troy and Kristin Scott;
Megan and Adam Swift; and Neil and Shannon Scott for their loving support of
my life and work.

To my grandchildren: Brenna, Katrina, and Nate Scott; Josie and Mica Swift;
Riley, Aiden (AJ), and Ellie Scott; and Roman and Levi Pardini, who bring me constant
joy and hope for the future.

And to the memory of my dear friend and colleague, Jack Boylan.

Judith Scott

To Jean Boylan, Jack’s wife and constant support.

To his children and their spouses: John and Lisa Boylan; and Meghan and Ken Senisi,
who meant the world to him.

And to his grandchildren: Luke and Emily Boylan; and Molly and Caroline Senisi,
who were truly his blessings.

John C. Boylan

To my family, who have brought so much happiness to my life; and especially to

my niece, Natalie, and my nephews, Nicholas and Benjamin. May you grow up to know
how special each one of you is and how much you have to offer this world.

Christin M. Jungers
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 CONTENTS

About the Authors xvii

Prefacexix
Acknowledgmentsxxi
Overview of the Book xxiii

SECTION I PREPRACTICUM

CHAPTER 1 Preparing for Practicum and Internship 3

Becoming a Professional Counselor 3
Steps to Becoming a Professional Counselor 4
Accreditation Standards for Practicum and Internship 4
CACREP Standards for Practicum and Internship 5
CORE Standards for Practicum and Internship 6
CACEP Standards for Initial and Final Practicum 6
APA-CoA Standards for Practicum and Internship in Counseling Psychology 7
AAPC Standards for Practicum and Internship for Pastoral Counselors 7
Counselor Certification 7
National Certified Counselor (NCC) 7
NBCC Specialty Certifications 8
Certified Rehabilitation Counselor (CRC) 8
Canadian Certified Counsellor (CCC): CCPA 8
Registered Professional Counsellor (RPC): Canadian Professional
Counsellors Association 8
Other Specialty Counseling Certifications 9
State Licensure for Counselors and Psychologists 9
Prepracticum Considerations 10
Checklist of Questions to Be Researched and Answered Before
Practicum Site Selection 10
viiiâ•…Contents

Phases of Practicum and Internship 11

Development Reflected in the Program Structure 11
Development Reflected in the Learning Process 12
Development Reflected in Supervisor Interaction 12
Implications12
Summary12
References13

CHAPTER 2 Securing a Practicum/Internship Site 15

Guidelines for Choosing a Practicum/Internship Site 15
Criteria for Site Selection 16
Professional Staff and Supervisor 16
Professional Affiliations of the Site 16
Professional Practices of the Site 16
Site Administration 17
Training and Supervision Values 17
Theoretical Orientation of the Site and Supervisor 17
Client Population 17
Negotiating the Practicum/Internship Placement 19
Typical Questions Asked at the Interview 19
Getting Oriented to Your Field Site 20
Role and Function of the Practicum/Internship Student 21
Summary22
References22

SECTION II BEGINNING TO WORK WITH CLIENTS

CHAPTER 3 Starting the Practicum 25

Beginning the Practicum Experience 25
Getting Started: Where Do I Begin? 25
I’ve Taken the Classes, but Do I Really Know What to Do? 26
What if I Say Something Wrong? 26
How Do I Know When to Use the Right Techniques? 27
But I’m Just a Rookie! (Learning to Trust Yourself and Your Inner Voice) 27
When in Doubt, Consult! (Your Faculty and Site Supervisors Are There to Help You) 28
Preparing to Meet With Your First Client 28
The Health Insurance Portability and Accountability Act (HIPAA) 29
Informed Consent 30
 Contentsâ•… ix

Sample Informed Consent and Disclosure Statement 31

Establishing a Therapeutic Alliance 34
The Initial Session With the Client 35
Structured and Unstructured Interviews 35
Basic and Advanced Helping Skills 36
Procedural and Issue-Specific Skills 37
Structuring the Initial Session 38
Closing the Initial Session 39
Pretherapy Intake Information 39
Intake Summary 40
Client Record Keeping 40
Progress Notes 40
The DAP Format 41
The SOAP Notes Format 41
Record Keeping and the School Counselor 41
Documenting Practicum Hours 45
Summary45
Note45
References45

CHAPTER 4 Assessment and Case Conceptualization 47

Initial Assessment 48
Gathering Family History Data 49
Gathering Personal History Data 49
Obtaining Information From Others 50
Goals of Assessment 50
Processes and Categories for Assessing Client Problems 50
Assessing the Client’s Mental Status 52
Mental Status Categories of Assessment 52
Diagnosis in Counseling 53
DSM-554
Elimination of the Multiaxial Assessment System 55
Subtypes and Specifiers 55
Other Specified and Unspecified Designation 55
DSM-5 Codes and Classification 56
Sharing Assessment Information With the Client 56
Gathering Additional Data 57
Assessing the Client’s Progress 57
Reporting Therapeutic Progress 60
xâ•…Contents

Implications60
Case Conceptualization 60
Case Conceptualization Models 61
The “Linchpin” Model 61
The Inverted Pyramid Model 62
The Integrative Model 63
Summary63
References64

CHAPTER 5  oal Setting, Treatment Planning, and

G
Treatment Modalities 67
Goal Setting in Counseling 67
Goals and the Stages of Change Model 67
Types of Goals 68
Developing a Treatment Plan 69
A Review of Philosophy, Theories, and Theory-Based Techniques of Counseling 71
Identifying Your Theory and Technique Preferences 75
Extending the Counselor’s Theory-Based Techniques 80
Solution-Focused Brief Therapy 80
Strategic Solution-Focused Therapy 82
Cognitive Restructuring Brief Therapy 83
Rational Emotive Brief Therapy 83
Coping Skills Brief Therapy 83
Third-Wave Therapies 84
Mindfulness-Based Therapy (MBT) 84
Mindfulness-Based Stress Reduction (MBSR) 85
Mindfulness-Based Cognitive Therapy (MBCT) 85
Acceptance and Commitment Therapy (ACT) 86
Dialectical Behavior Therapy (DBT) 86
Summary87
References87

SECTION III SUPERVISION IN PRACTICUM AND INTERNSHIP

CHAPTER 6 Group Supervision in Practicum and Internship 93

Identifying Counseling Skill Areas 93
Skill Area One: Counseling Performance Skills 93
Basic and Advanced Counseling Skills 93
 Contentsâ•… xi

Theory-Based Techniques 94
Procedural Skills 94
Professional and Issue-Specific Skills 94
Skill Area Two: Cognitive Counseling Skills 94
Skill Area Three: Self-Awareness/Multicultural Awareness Skills 94
Self-Awareness Skills 94
Multicultural Awareness Skills 95
Skill Area Four: Developmental Level 95
Self-Assessment in the Skill Areas 96
Sample Supervisee Goal Statement 96
Concepts in Group Supervision 97
Group Supervision in Practicum 99
Sample of Course Objectives and Assignments in Group Practicum 101
Activities in Group Supervision 102
Peer Consultation 102
Evaluation of Practicum in Group Supervision 104
Formative Evaluation 104
Summative Evaluation 104
Transitioning Into Internship 105
Recommended Skill Levels for Transitioning Into Internship 105
Group Supervision in Internship 105
Group Supervision Models in Internship 107
The SPGS Model 107
The Structured Group Supervision (SGS) Model 108
Evaluation in Group Supervision of Internship 108
Summary109
References109

CHAPTER 7 Individual Supervision in Practicum and Internship 111

Role and Function of the Supervisor in Practicum and Internship 111
Administrative and Clinical Supervision 112
The Supervisor–Supervisee Relationship 112
What Is “Lousy” Supervision? 113
Overarching Principles 114
General Spheres 114
Approaches to Individual Supervision 114
Models Grounded in Psychotherapy Theory: The Psychodynamic Model 115
Developmental Models: The Integrated Developmental Model 115
Process Models: The Discrimination Model 116
xiiâ•…Contents

The Triadic Model of Supervision 117

The Clinical Supervision Process 119
Informed Consent in Supervision 119
Sample of a Supervisor Informed Consent and Disclosure Statement 119
Forming a Supervision Contract 121
Sample Supervision Contract 122
The Supervision Session Format 123
Supervising the Developing Counselor-in-Training 124
Evaluation of Individual Supervision in Practicum and Internship 126
Summative Evaluation in Practicum 126
Sample of a Midpoint Narrative Evaluation of a Practicum Student 126
Summative Evaluation in Internship 128
Documenting Internship Hours 129
Summary129
References129

SECTION IV PROFESSIONAL PRACTICE TOPICS

CHAPTER 8 Selected Topics on Ethical Issues in Counseling 135

Definitions: Ethics, Morality, and Law 135
Ethical Codes for Counselors 136
Websites for Ethical Codes and Related Standards for Professional Organizations 136
Codes of Ethics: Similarities 137
Ethical Decision Making 137
Principle-Based Ethics and Ethical Decision Making 137
Virtue-Based Ethics and Ethical Decision Making 140
Self-Tests After Resolving an Ethical Dilemma 142
The Use of Technology in Counseling 142
Summary145
References146

CHAPTER 9 Selected Topics on Legal Issues in Counseling 149

The Law 149
Classifications of the Law 149
Types of Laws 150
The Steps in a Lawsuit 150
Elements of Malpractice 151
 Contentsâ•… xiii

Why Clients Sue 152

Risk Management and the Counselor 153
Liability Insurance 154
Privacy, Confidentiality, and Privileged Communication 154
Release of Information 156
When the Counselor Must Breach Confidentiality 156
The Law and the Duty to Protect: The Suicidal Client 156
The Law and the Duty to Warn: The Potentially Dangerous Client 157
Mandatory Reporting: Suspected Child Abuse and Neglect 158
Mandatory Reporting: Suspected Harm to Vulnerable Adults 159
The Law and the Practice of Counsellor–Client Confidentiality in Canada 159
Managed Care and the Counselor 159
Client Records 161
Summary162
References162

CHAPTER 10 W
 orking With Clients in Crisis and Other
Special Populations 165
Understanding Crisis and Trauma 165
The Kanel Model of Crisis Intervention 166
The James and Gilliland Model of Crisis Intervention 167
Crisis Intervention in Schools 169
School Counselors as Prevention Consultants for Crises 170
Suggestions for a School-Based Training on Crisis Response 170
Post-Crisis: Understanding Children’s Responses 172
The High-Risk Client: Understanding and Assessing Harm to Self 173
Defining Suicide and Debunking Common Myths 173
Warning Signs for Suicide 175
Risk Assessment for Suicide 176
Assessment Point 1: Desire to Die 176
Assessment Point 2: Capacity to Commit Suicide 176
Assessment Point 3: Suicidal Intent 177
Assessment Point 4: Buffers Against Suicide 177
Evaluating Suicide Risk: Putting It All Together 178
Suicide Risk Assessment Instruments 178
Intervention and Planning 179
Ethical and Legal Mandates Relating to Danger to Self 180
Professional School Counselors 180
xivâ•…Contents

Professional Counselors 180

Suicide Risk Assessment and Prevention in Schools 181
Basics of Suicide Prevention Programs in Schools 181
Learning About and Responding to Potentially Suicidal Students 182
Suicide Risk Assessment for Students 183
The High-Risk Client: Potential Harm to Others 184
The Tarasoff Case: The Events 184
Implications of the Tarasoff Case 185
What Tarasoff Did Not Require 185
Post-Tarasoff185
Risk Assessment for Potentially Dangerous Clients 186
Task I: Risk Assessment 186
Task II: Selecting a Course of Action 188
Task III: Monitoring the Situation 188
Clients’ Past Criminal Acts 188
The Client Who Is Being Abused: Responding, Reporting, and Intervening 189
Legal Issues Related to Reporting Child Abuse 192
Making a Report Related to Child Abuse 192
Interviewing Children Who May Have Been Sexually Abused 193
Before the Interview 193
Interviewing the Child 193
Counseling the Sexually Abused 194
The Client Who Is Dealing With Addiction 196
Understanding Addiction 196
Diagnosing Alcohol and Drug Use 196
What Is Treatment? 197
What Is Recovery? 198
Stages of Recovery 198
Counseling Recommendations for Clients With Addiction 199
Preventing Relapse 200
Summary201
References201

CHAPTER 11 C
 onsultation in the Schools and
Mental Health Agencies: Models and Methods 207
Definition of Consultation 207
Types of Mental Health Consultation 208
 Contentsâ•… xv

Characteristics of Mental Health Consultation 209

Dimensions of Internal and External Consultation 210
Consultation or Collaboration? 210
Assumptions of and Metaphors for Consultation 211
The Purchase-of-Expertise Model 211
The Doctor–Patient Model 212
The Process Consultation Model 212
Cultural Issues in Consultation 212
School Consultation 213
Consultation Models and Practices in Schools 215
Sensorimotor216
Concrete216
Formal-Operational216
Dialectic/Systemic217
General Guidelines for Consultation 218
Preentry218
Entry Into the System 219
Orientation to Consultation 219
Problem Identification 220
Consultation Intervention 220
Assessing the Impact of Consultation 221
Resistance to Consultation 222
Contracting and the Forces of Change in the Organization 223
Summary224
References224

CHAPTER 12 Final Evaluations 227

Appendix I: The Supervisee Performance Assessment Instrument 231
Appendix II: Psychiatric Medications 237

FORMS
Form 2.1 Practicum Contract 247
Form 2.2 Internship Contract 249
Form 2.3 Student Profile Sheet 251
Form 2.4 Student Practicum/Internship Agreement 252
Form 3.1a Parental Release Form: Secondary School Counseling 253
Form 3.1b Elementary School Counseling Permission Form 254
Form 3.2 Client Permission to Record Counseling Session for Supervision Purposes 255
Form 3.3 Initial Intake Form 256
xviâ•…Contents

Form 3.4 Psychosocial History 258

Form 3.5 Case Notes 262
Form 3.6 Weekly Schedule/Practicum Log 264
Form 3.7 Monthly Practicum Log 265
Form 4.1 Elementary School Counseling Referral Form 266
Form 4.2 Secondary School Counseling Referral Form 267
Form 4.3 Mental Status Checklist 269
Form 4.4 Therapeutic Progress Report 272
Form 5.1 Counseling Techniques List 273
Form 6.1 Self-Assessment of Counseling Performance Skills 277
Form 6.2 Self-Awareness/Multicultural Awareness Rating Scale 279
Form 6.3 Directed Reflection Exercise on Supervision 280
Form 6.4 Supervisee Goal Statement 281
Form 6.5 Tape Critique Form 282
Form 6.6 Peer Rating Form 283
Form 6.7 Interviewer Rating Form 284
Form 7.1 Supervision Contract 286
Form 7.2 Supervisor Notes 288
Form 7.3 Supervisee Notes on Individual Supervision 289
Form 7.4 Supervisor’s Formative Evaluation of Supervisee’s Counseling Practice 290
Form 7.5 Supervisor’s Final Evaluation of Practicum Student 292
Form 7.6 Supervisor’s Final Evaluation of Intern 293
Form 10.1 Suicide Consultation Form 295
Form 10.2 Harm to Others Form 298
Form 10.3 Child Abuse Reporting Form 301
Form 10.4 Substance Abuse Assessment Form 302
Form 12.1 Weekly Internship Log 305
Form 12.2 Summary Internship Log 306
Form 12.3 Evaluation of Intern’s Practice in Site Activities 307
Form 12.4 Client’s Assessment of the Counseling Experience 308
Form 12.5 Supervisee Evaluation of Supervisor 309
Form 12.6 Site Evaluation Form 311

Index313