PRAC 6645 Clinical Skills Self-Assessment Form Nimi George Walden
University PRAC 6645: Psychotherapy with Multiple Modalities
Practicum Dr. Lavon Williams CLINICAL SKILLS 2023
PRAC 6645 CLINICAL SKILLS SELF-ASSESSMENT FORM
Student Name: Nimi George
Program: MS in Clinical Mental Health Counseling
University: Walden University
Course: PRAC 6645: Psychotherapy with Multiple Modalities Practicum
Instructor: Dr. Lavon Williams
Term: Clinical Skills 2023
Date: [Insert Date]
RATING SCALE
1 = Novice: Requires close supervision and direct instruction.
, 2 = Advanced Beginner: Requires frequent supervision and guidance.
3 = Competent: Requires occasional supervision and guidance.
4 = Proficient: Requires minimal supervision; demonstrates independent
skill.
5 = Expert: Demonstrates mastery; can teach others.
SECTION A: PROFESSIONALISM AND ETHICAL BEHAVIOR
1. Adheres to ACA Code of Ethics and legal standards. Rating: 4
2. Maintains confidentiality and informed consent. Rating: 4
3. Recognizes and addresses ethical dilemmas. Rating: 3
4. Demonstrates professional demeanor and boundaries. Rating: 4
5. Engages in reflective practice and self-care. Rating: 3
Comments: I consistently uphold ethical standards and maintain appropriate
boundaries. I am growing in my ability to identify and resolve ethical
dilemmas, particularly around dual relationships and mandated reporting. I
prioritize self-care but need to maintain consistent reflective journaling.
SECTION B: THERAPEUTIC RELATIONSHIP AND COMMUNICATION
6. Establishes rapport and trust. Rating: 4
7. Uses active listening, empathy, and unconditional positive regard.
Rating: 5
8. Demonstrates culturally responsive communication. Rating: 4
9. Manages silence, affect, and nonverbal cues. Rating: 3
10. Maintains appropriate boundaries. Rating: 4
Comments: I build strong therapeutic alliances quickly. Empathy and active
listening are strengths. I am working on becoming more comfortable with
silence and recognizing subtle nonverbal cues, especially with clients who
have trauma histories.
University PRAC 6645: Psychotherapy with Multiple Modalities
Practicum Dr. Lavon Williams CLINICAL SKILLS 2023
PRAC 6645 CLINICAL SKILLS SELF-ASSESSMENT FORM
Student Name: Nimi George
Program: MS in Clinical Mental Health Counseling
University: Walden University
Course: PRAC 6645: Psychotherapy with Multiple Modalities Practicum
Instructor: Dr. Lavon Williams
Term: Clinical Skills 2023
Date: [Insert Date]
RATING SCALE
1 = Novice: Requires close supervision and direct instruction.
, 2 = Advanced Beginner: Requires frequent supervision and guidance.
3 = Competent: Requires occasional supervision and guidance.
4 = Proficient: Requires minimal supervision; demonstrates independent
skill.
5 = Expert: Demonstrates mastery; can teach others.
SECTION A: PROFESSIONALISM AND ETHICAL BEHAVIOR
1. Adheres to ACA Code of Ethics and legal standards. Rating: 4
2. Maintains confidentiality and informed consent. Rating: 4
3. Recognizes and addresses ethical dilemmas. Rating: 3
4. Demonstrates professional demeanor and boundaries. Rating: 4
5. Engages in reflective practice and self-care. Rating: 3
Comments: I consistently uphold ethical standards and maintain appropriate
boundaries. I am growing in my ability to identify and resolve ethical
dilemmas, particularly around dual relationships and mandated reporting. I
prioritize self-care but need to maintain consistent reflective journaling.
SECTION B: THERAPEUTIC RELATIONSHIP AND COMMUNICATION
6. Establishes rapport and trust. Rating: 4
7. Uses active listening, empathy, and unconditional positive regard.
Rating: 5
8. Demonstrates culturally responsive communication. Rating: 4
9. Manages silence, affect, and nonverbal cues. Rating: 3
10. Maintains appropriate boundaries. Rating: 4
Comments: I build strong therapeutic alliances quickly. Empathy and active
listening are strengths. I am working on becoming more comfortable with
silence and recognizing subtle nonverbal cues, especially with clients who
have trauma histories.
