Practicum Program
2005 - 2006
Name:
Current
Doctoral Program:
Highest
Degree Earned:
Field:
Year:
Home
Address :
Telephone: (Home)
(Work)
(Cell)
Email
Address:
Previous Practicum and Counseling Experience
| Practicum
Course, Placement/Site, or Work Site |
Name, Telephone Number, and E-Mail of Supervisor | Number of Hours per Week |
Dates of Service at Site |
Direct Client Contact Hours | With
How Many Clients |
University of Washington
Counseling Center
Practicum Counselor Application
Please answer the following questions using the space provided. If needed, you may use a separate sheet of paper.
1. What
psychological theories do you use in your therapy with clients?
2. What feedback have you received in previous practicum about your strengths and target areas of improvement regarding:
A. Counseling Skills
Strengths:
Areas for Improvement:
B. Understanding Client Dynamics
Strengths:
Areas for Improvement:
C. Understanding of Process
Strengths:
Areas for Improvement:
4. How do you see this experience at our University Counseling Center fitting into your educational goals and into your career aspirations?
Chris
S.Grant, Ph.D.
Associate Director/Director
of Training
University of Washington
Counseling Center
401 Schmitz Hall, Box 355830
Seattle, WA 98195-5830
Phone: (206) 543-1240
FAX: (206) 616-6910
Email: csgrant@u.washington.edu
Center Director
M. Kathryn Hamilton, Ph.D.
University of Washington
Counseling Center
401 Schmitz Hall, Box 355830
Seattle, WA 98195-5830
Phone: (206) 543-1240
FAX: (206)
616-6910