ࡱ>  YZabq` bjbjqPqP ::)0mKKK8KLNP(PPXQ^_7`H(******$?hN`#]^``NPXQ G e e e`^pPXQ( e`( e e.$X@XQN @K`đ@d]0<9a(9@9@$`` e`````NNd^```````+KK LOMA LINDA UNIVERSITY Department of Social Work LEARNING PLAN AGREEMENT FORM Clinical Concentration Year This form is due to your Field Faculty Liaison three weeks after field practicum begins. It may be modified quarterly as necessary.) Date: FORMTEXT      Student Name (print): FORMTEXT      Child Welfare Grant Recipient?Yes  FORMCHECKBOX  No  FORMCHECKBOX Full Time  FORMCHECKBOX Part Time  FORMCHECKBOX Date of Placement with Agency: FORMTEXT      Practicum Site: FORMTEXT      Address: FORMTEXT       FORMTEXT      Field Instructor & Phone: FORMTEXT       FORMTEXT      Preceptor & Phone: FORMTEXT       FORMTEXT      Field Faculty Liaison: FORMTEXT       I. General Conditions Days and Hours of Field Placement FORMTEXT      Day and Time of Individual Supervision FORMTEXT      Day and Time of Group Supervision FORMTEXT      Day and Time of Staff Meeting FORMTEXT      Other: FORMTEXT       II. Summary of General Assignment  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Student SignatureDateAgency Field Instructor SignatureDateField Faculty Liaison SignatureDateLearning Objective I: Understands, Respects, and Integrates the Ethics and Values of the Social Work ProfessionCompetencies: The minimum learning expectations for all students.Demonstrates respect for right of self-determination.Maintains appropriate guidelines for confidentiality.Maintains appropriate boundaries, distinguishing professional from personal relationships.Demonstrates the capacity to respect diverse issues of gender, race, religion, class, disability, and age.Identifies ethical dilemmas as these arise and takes to supervision for discussion.Demonstrates use of professional judgment and conduct consonant with the values, ethics, legal, and multidimensional responsibilities of clinical practice.Strategies: List a minimum of five strategies, tasks, assignments, or processes that will be used to assist the student in meeting the competencies. The "strategy" will be a series of successive steps that clearly lead to accomplishing both the competency and student outcomes within a specified time frame. FORMTEXT        Learning Objective II: Demonstrates Motivation in the Role of LearnerCompetencies: The minimum learning expectations for all students.Takes initiative to identify own learning needs.Demonstrates an ability to integrate new knowledge.Actively participates by asking questions and volunteering relevant information while in supervision or other training experiences.Demonstrates ability to learn from a variety of sources (peers, other agency staff, field instructor, preceptors, consultants, assigned reading.)Demonstrates the integration of complex theories and research findings in developing his/her practice proficiency.Evidences interest and takes advantage of opportunities for expanding his/her knowledge and skills for working with population groups and problem areaDemonstrates the capacity to evaluate his/her own practice in specific and meaningful ways.Accepts and utilizes constructive criticism.Acknowledges areas of strengthAcknowledges areas of needed growth and development.Demonstrates ability to identify own values and the potential impact on treatment objectives.Prepares for supervisory conferences.Participates in educational planning and evaluation of his/her performance.Demonstrates ability to assess need for direction from field instructor and is able to operate independently when appropriate.Strategies: List a minimum of five strategies, tasks, assignments, or processes that will be used to assist the student in meeting the competencies. The "strategy" will be a series of successive steps that clearly lead to accomplishing both the competency and student outcomes within a specified time frame. FORMTEXT        Learning Objective III: Demonstrates Knowledge of the Agency's Mission, Goals, Organizational Structure and Community Which is ServedCompetencies: The minimum learning expectations for all students.Demonstrates working knowledge of the practicum agency's mission, goals, policies, and procedures.Identifies and understands the intra-agency organizational relationships and activities.Demonstrates knowledge, respect, and ability to work cooperatively with support staff in the practicum setting.Collaborates appropriately with other professionals or as a member of a multi-disciplinary team to ensure integrated and comprehensive services to clients.Demonstrates the ability to access and utilize community resources that are appropriate for the population being served.Identifies social policies, laws, practices, etc. that impact the client system or delivery of service.Strategies: List a minimum of five strategies, tasks, assignments, or processes that will be used to assist the student in meeting the competencies. The "strategy" will be a series of successive steps that clearly lead to accomplishing both the competency and student outcomes within a specified time frame. FORMTEXT        Learning Objective IV: Demonstrates Responsible Work Management SkillsCompetencies: The minimum learning expectations for all students.Keeps accurate and up-to-date case records following agency policy.Completes and submits comprehensive process recordings (written, audio or video, minimum of one per week.)Writes in a well organized, comprehensive, and concise manner, using appropriate grammar, spelling, and professional vocabulary.Manages workload and prioritizes work assignments.Complies with agreed upon field practicum hours, including responsibilities to client and agency site.Writes legibly and thoroughly in all types of documentation.Strategies: List a minimum of five strategies, tasks, assignments, or processes that will be used to assist the student in meeting the competencies. The "strategy" will be a series of successive steps that clearly lead to accomplishing both the competency and student outcomes within a specified time frame. FORMTEXT        Learning Objective V: Demonstrates Skill in Developing an Appropriate Case/Treatment Plan Based on the Biopsychosocial Assessment and Diagnosis (When Applicable.)Competencies: The minimum learning expectations for all students.Demonstrates competence in completing a biopsychosocial history.Demonstrates basic knowledge of systems theory in work with clients.Demonstrates the critical thinking necessary to identify diagnostic criteria.Demonstrates awareness of self and responds objectively and purposefully rather than out of own needs and personal reactionsDemonstrates an ability to integrate and apply multiple theoretical frameworks in assessing client's presenting problem, assessment, and intervention.Student demonstrates a solid understanding of the multidimensional dynamics of physical and mental illness as these impact client systems (i.e., individuals, groups, households, families, and communities.)Demonstrates capacity to elicit information, including facts, feelings, and goals from client and significant othersDemonstrates ability to identify and clarify the presenting problem(s) and underlying dynamics and issues.Demonstrates ability to assess client and/or family member at risk for suicide, homicide, child abuse, elder abuse, spousal abuse, substance abuse, etcDemonstrates ability to identify the client's internal strengths and support systems.Demonstrates competence in formulating case/treatment plan based on the biopsychosocialStrategies: List a minimum of five strategies, tasks, assignments, or processes that will be used to assist the student in meeting the competencies. The "strategy" will be a series of successive steps that clearly lead to accomplishing both the competency and student outcomes within a specified time frame. FORMTEXT        Learning Objective VI: Demonstrates Awareness of Self and the Impact on the Helping Process.Competencies: The minimum learning expectations for all students.Shows ability to differentiate one's own feelings, values, attitudes, and behavior from those of the client.Demonstrates awareness of self and responds objectively and purposefully rather than out of own needs and personal reactions.Constructively deals with conflict and stress within the therapeutic process and agency context.Strategies: List a minimum of five strategies, tasks, assignments, or processes that will be used to assist the student in meeting the competencies. The "strategy" will be a series of successive steps that clearly lead to accomplishing both the competency and student outcomes within a specified time frame.  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positioning, eye contact, speech patterns, tone and volume of voice.Demonstrates an ability to use the following: open and closed questioning, encouraging, paraphrasing, reflecting, and summarizing.refraining, partializing, prioritization, and focusing.clarification, interpretation, and use of silence.Strategies: List a minimum of five strategies, tasks, assignments, or processes that will be used to assist the student in meeting the competencies. 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