Practicum and Internship

Clinical Mental Health Counseling &
Marriage, Couple, and Family Counseling
Practicum (CNS 591) and Internship (CNS 596)

Resources

• Practicum and Internship Manual (CMHC & MCFC)
• Approved Practicum & Internship Sites
• Internship & Job Fair
• Counseling Job Opportunities
• Professional liability insurance
  • ACA (HPSO) ~ free with ACA student membership ($99/yr)
  • NBCC (Lockton Affinity) ~ $18

Clinical Paperwork

Please follow the directions for completing and submitting the form in PDF.

Practicum

• Practicum Portfolio Checklist
• Practicum Application Form
• Practicum Site and Supervision Contract
• Practicum Hour Log
• Practicum Evaluation of Student Performance (Midterm and Final)
• Practicum Counseling Skills Scale
• Student Evaluation of Supervisor
• Student Evaluation of Site
• Sample LPCA Application
  The full LPCA application also requires official transcripts, a signed supervisory agreement, KY & FBI background checks, and payment (these are not required for the internship portfolio). Visit lpc.ky.gov (Resources > Applications and Forms) for more details.

Internship

• Internship Portfolio Checklist
• Internship Site and Supervision Contract
• Internship Hour Log
• Internship Evaluation of Student Performance (Midterm and Final)
• Student Evaluation of Supervisor
• Student Evaluation of Site
• Sample LPCA Application
  The full LPCA application also requires official transcripts, a signed supervisory agreement, KY & FBI background checks, and payment (these are not required for the internship portfolio). Visit lpc.ky.gov (Resources > Applications and Forms) for more details.

Additional

• Permission to Video
• Sample Client Intake Form & Case Notes (SOAP format)
• Plan of Action for Course Completion
• Petition for Change in Practicum or Internship Site
• Transcript

Establishing and Maintaining Clinical Sites

Review the Practicum & Internship Manual for instructions on establishing a  new site or maintaining a clinical site.  The following are forms used for reviewing and updating sites annually:

• Site Information Form (form should be saved first and then completed in Adobe Reader or Pro)
• Site Visit Checklist

Related Departmental Policies

• CSA Policy on Security of Media (Video and Audio)
• Practice Preparation Sequence and Departmental Approval for Practicum and Internship Placement Policies
• Internship Grading

Directions for working with the Forms

1. Right click on the link above and choose "save as," and save the file to your computer.
2. Open the file you want to print or edit and modify if desired. After editing the file, save it.
3. Attach it to email, print it, or save it for future editing.
4. To view PDFs, you can download Adobe Reader free by going to http://get.adobe.com/reader/.
5. To create PDF files, you can download CutePDF for free at http://www.cutepdf.com/.

Dates & Deadlines

2018-2019 Practicum & Internship

• Aug 27, 2018: Begin fall internship
• Oct 10, 2018: Submit mid-term evaluations to faculty supervisor for review and signature. Submit signed evaluations to Clinical Coordinator.
• Dec 7, 2018: Submit all final signed paperwork (see Internship Portfolio Checklist) to your Faculty Supervisor for review and signature. Submit signed evaluations to Clinical Coordinator. Contact CC in advance if an extension is required; portfolio must be submitted no later than 12/8/17.
• Jan 22, 2019: Begin spring internship
• Mar 13, 2019: Submit mid-term evaluations to faculty supervisor for review and signature. Submit signed evaluations to Clinical Coordinator.
• May 3, 2019: Submit all final signed paperwork (see Internship Portfolio Checklist) to your Faculty Supervisor for review and signature. Submit signed evaluations to Clinical Coordinator.

2019-2020 Practicum & Internship

• Jan 31, 2019, 3:00-5:00pm: Attend the mandatory practicum orientation.
• Feb 2019, 3:00-5:00pm: Attend the Internship & Job Fair to learn more about potential practicum sites. Sites can register online; students do not need to register.
• Mar 1, 2019: Submit the Practicum Application Form. You must get this form approved by the Clinical Coordinator BEFORE you apply for a practicum site to verify your eligibility to enroll in practicum.
• May 1, 2019: Submit the Practicum Site and Supervision Contract.
• May 13, 2019: Begin practicum.
• Jun 26, 2019: Submit mid-term evaluations to faculty supervisor for review and signature. Submit signed evaluations to Clinical Coordinator.
• Aug 7, 2019: Submit all final signed paperwork (see Practicum Portfolio Checklist) to your Faculty Supervisor for review and signature. Submit signed evaluations to Clinical Coordinator.
• Aug 9, 2019: Submit the Internship Site and Supervision Contract if changing sites.