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Freud, MSW, LCSW Field Instructor Email sfreud@whereverbehavioralhealthclinic.org University Field Liaison select Rousseau, Jerry Semester Fall Spring Summer Weekly Schedule @ Agency:

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PERFORMANCE-BASED LEARNING PLAN / DIRECT PRACTICE – CLINICAL / 721 & 722)

Field Course (please check): 421 422 423

Student Name: Ima S Worker Student ID 000 - 00 - 0000

Agency Wherever Behavioral Health Outpatient Clinic

Agency Address 0000 S Wherever Street - Milwaukee, WI Agency Phone 000 - 000 - 0000

Agency Fax 111-111-1111 Agency Field Instructor S Freud, MSW, LCSW Field Instructor Email sfreud@whereverbehavioralhealthclinic.org

University Field Liaison (select) Rousseau, Jerry

Semester Fall Spring Summer

Weekly Schedule @ Agency:

PM

Field Semester at this Agency: 1st 2nd 3rd 4th

Student will begin this semester on 09 - 01 - 0000 and end this semester on 12 - 22 - 0000

(date) (date) (*Please consult with assigned Field Liaison if dates vary from those designated on UWM Semester Calendar)

Weekly supervision day and time: Monday / 10 AM - 11 AM

(The school requires scheduling a minimum of one-hour of individual supervision per week.)

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Final Evaluation Due Date

(421/422/423 at 256 completed hours; 721/722 at 260 completed hours; 821/822 at 320 completed hours) 12 - 22 -0000 (fill in date due)

INSTRUCTIONS

The Learning Plan identifies the learning objectives mutually agreed upon between the student and Field Instructor at the beginning of each semester This plan should serve as a map for the student’s learning experiences and expected

performance for the semester You should be as specific as possible when developing the learning plan, and amend the plan as necessary throughout the semester The plan should be developed in conjunction with the field education course objectives located on the field website www.hbsswfield.uwm.edu

The following table identifies the primary learning objective categories for the field education course More detailed

information related to each objective is located on the Field Department website located at the above-referenced weblink

On the table below identify your learning activities for the semester The evaluation criteria utilized for the evaluation of student performance at mid-term and end of the semester are consistent with the social work objectives for this course

Learning Objective Categories Agency responsibilities, duties and

expectations that address the Learning Objectives

Written Assignments (assignments

totaling 5 points submitted to Field Instructor for discussion in supervision and submitted to the Field Liaison; ½ of field assignments due to Field Liaison by

mid-term)

Select from the Assignment List

www.hbsswfield.uwm.edu

Students do not have to have assignments listed for every objective category 1) Professional Development Student will utilize supervision to

discuss any issues / questions encountered in communication with

     

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Learning Objective Categories Agency responsibilities, duties and

expectations that address the Learning Objectives

Written Assignments (assignments

totaling 5 points submitted to Field Instructor for discussion in supervision and submitted to the Field Liaison; ½ of field assignments due to Field Liaison by

mid-term)

other professionals

Student will learn and use the clinic's system (SOAP) of recording progress notes

Student will establish and adhere to deadlines & timeframes for field work

Student will come to supervision pre-pared to initiate discussion of issues encountered in the practicum and how they related to field course objectives

Student will be open to incorporating the supervisory feedback from the Field Instructor & staff

2) Social Work Values and

Ethics

Student will learn and adhere to NASW Code of Ethics as it applies to this clinical social work setting

Student will establish ethical boundar- ies re: confidentiality, interaction with clients & staff, and personal disclosure

Student will inform clients of treatment options and rights / limitations of confi-dentiality including HIPAA provisions

Student will initiate discussion with

     

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Field Instructor / staff regarding any ethical concerns

3) Diversity Student will develop awareness of

per-sonal reactions / biases to clients &

staff who are different from student

Student will initiate discussion with Field Instructor regarding how these personal reactions / biases are affecting the student's relationship development with clients and staff

Written Paper on the Use of Self-Awareness in Social Work Practice / (6 - 9 pages for 2 points)

4) Populations at Risk and

Social and Economic Justice Student will identify the issues of poverty, racism, sexism, & ageism that

make clients of this clinic vulnerable to AODA & mental health problems

Student will initiate discussion with Field Instructor on appropriate ways to address these issues with clients in treatment & discharge planning

     

5) Human Behavior and the

Social Environment

Student will review client's history from records and interviews in order to understand how the client's social environment may have affected their AODA & behavioral health issues

     

6) Social Work Practice Skills Student will learn how to develop

rapport / relationships with clients through the use of Empathic / Reflective Listening and Motivational

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Learning Objective Categories Agency responsibilities, duties and

expectations that address the Learning Objectives

Written Assignments (assignments

totaling 5 points submitted to Field Instructor for discussion in supervision and submitted to the Field Liaison; ½ of field assignments due to Field Liaison by

mid-term)

Inter- viewing

Student will learn how to identify the strengths and needs of the client during the Initial Intake and On-going Assessment

Student will learn how to incorporate the strengths and needs of the client

in the Treatment Plan

Student will observe individual & group therapy

Written Social Assessment Report / Social History (2 points)

Recording For Learning of an observed individual therapy session (1 point)

7) Social Welfare Policy and

Services

Student will learn the requirements that must be met for a client to receive behavioral health treatment under Title

19 / Medicaid

Student will learn the benefits and potential negative consequences to having a behavioral health disability

     

8) Research Student will review and discuss in

supervision one published article providing research results on the use

of Motivational Interviewing

Student will discuss in supervision how these research results can be

incorporated in the student's

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relationship development with a client

Date:

Student’s Signature:

Field Instructor’s Signature:

Field Liaison Signature (for major assignment):

Revised 11/14/08

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