Forms and narrative

Process Recording

Intern: _____________________________________________________

Field Agency: ________________________________________________

Field Instructor: ______________________________________________

Date: __________________

IDENTIFYING INFORMATION: Identifying pertinent information (remember: always disguise client’s name to protect confidentiality)

PURPOSE OF THE SESSION: Briefly state whether there are any specific goals to be achieved, the nature of the referral, nature of the initial or presenting issues, the student's plans, and the client's agenda.

OBJECTIVES FOR THE INTERVIEW. Briefly state whether there are any specific goals to be achieved, the nature of the referral, nature of the initial or presenting issues

PROCESS RECORD: A word-for-word description of what happened as well as the student can recall. A description of any action or nonverbal activity that occurred.

Verbatim Content (Narrative)	Non-verbal behavior of the client	Process (Gut Level Feelings)	Student’s Use of Social Work Theories and Skills	Field Instructor’s Comments

ASSESSMENT OF THE CLIENT/ASSESSMENT OF YOUR OWN WORK A summary of the student's impressions of the client. This is a summary of the student's analytical thinking about the entire interview, including their role.

NEXT STEPS THAT YOU PLAN TO DO/QUESTIONS Future plans. Identification of unfinished business, identification of short and longer-term goals.

IDENTIFICATION OF QUESTIONS FOR FIELD INSTRUCTION. This provides the student with the opportunity to build upon their ability to become autonomous workers.

STUDENT’S SIGNATURE:__________________________________________________________

FIELD INSTRUCTOR’S SIGNATURE: _________________________________________________

Field Instructor’s input and signature required for maximum 5 points.