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PDPCOMPLETED2.pdf

Professional Development Plan – Clinical Supervision Foundations

Counselor Name: ___________________________________________ Supervisor: __________________________ Date: _________________

Foundation/Practice Dimension: _______________________________________________ Element: _____________________________________

Competency to be addressed and page number from TAP 21: ______________________________________________________________________

Strengths:

________________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________

Challenges/Concerns: _____________________________________________________________________________________________________

______________________________________________________________________________________________________

Present level of proficiency from rating forms

1 2 3 4

Level of proficiency to be achieved with this learning plan

1 2 3 4

Target date to complete the plan:

What is the

issue to be

addressed?

Goal

What is to be accomplished?

(measurable/behavioral)

Activities necessary

to achieve the goal…

What will be done?

Metrics

How will progress be

measured?

Target

Completion Date

Knowledge:

Skill:

Attitude:

- 2 -

Additional comments:

Supervisor Signature: ____________________________________________________________________ Date: _______________________

Counselor Signature: _____________________________________________________________________ Date: _______________________

Date Scheduled for "Re-Observation" to Assess Performance: ____________________________

Results (as noted by Supervisor):

NYS OASAS – Learning & Development October 25, 2016

  1. Counselor: Maria Rodrigues
  2. Supervisor: Luis Alamo
  3. Date1: 8/3/21
  4. Foundation: PD V. Counseling
  5. Element: Individual counseling
  6. Competency: Competency 75 page 101-97
  7. Strengths: Ms. Maria demonstrates knowledge and skills using open and ended questions from motivational interviewing. She is open to learning more evidence practices and is comfortable using cognitive approach to counseling.
  8. Challenges: Ms. Maria, has no experience working with the dual diagnosed population and addressing mental health issues. She tends to confront and hasn't developed the skills of reflective listening and rolling with resistance. Ms. Maria can benefit from trainings on evidence base practices, substance use disorders, methods of applying interventions and recovery knowledge to practice and professional readiness on issues related to self awareness, diversity, ethics, and continuing education.
  9. P1: Off
  10. P2: Yes
  11. P3: Off
  12. P4: Off
  13. L1: Off
  14. L2: Off
  15. L3: Yes
  16. L4: Off
  17. Date2: 1/27/17
  18. GK: To understand theories, conduct research on evidence- based literature. To learn approaches to counseling that are person centered and have demonstrated effectiveness with substance use disorders.
  19. AK: Read person centered therapy originated by Carl Rogers. Read stages of change model in order to understand the process of change. Participate in Motivational Interviewing training in order to understand the spirit of motivational interviewing and the principles.
  20. MK: Maria will discuss with supervisor findings on research and compare pros and cons of a person centered therapy approach and a confrontation approach, and provide feedback if allowed the reason why person centered approach is more effective than the confrontation approach.
  21. Date3: 10/2/21
  22. GS: To learn how to actively listen including paraphrasing, refecting, and summarizing. Demonstrating empathetic understanding. Using power and authority appropriately in support of treatment goals and rolling with resistance instead of confronting. Conveying warmth, respect, and genuineness in a culturally appropriate manner.
  23. AS: To role play with supervisor using motivational interviewing and person centered therapy the ability to roll with resistance.
  24. MS: Direct supervision and counselor competency assessment.
  25. Date4: 10/2/21
  26. GA: Recognition of the importance of cooperation and collaboration with the client. To demonstrate professional objectivity.
  27. AA: To illustrate the ability to orient staff with confidentiality rights, grievance procedure, rules regulations, policy, federal and state laws.
  28. MA: Group supervision initial application and group evaluation on Maria's awareness of policy, Federal and State Laws on confidentiality
  29. Date5: 10/27/21
  30. Comments: Ms, Maria will be evaluated on her professional developmental growth on 2/6/17. Feedback will be provided using the ORAL model.
  31. Results: Ms. Maria has illustrated growth in awareness, knowledge and skills as a counselor. She will continue to attend three trainings a year in order to develop a new set of skills addressing mental health issues and crisis interventions.
  32. Date6: 8/4/21
  33. Date7:
  34. Date8: 11/3/21