Counseling and Student Affairs
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 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
Blank LPCA Application
Sample LPCA Application
Visit lpc.ky.gov (Resources > Applications and Forms) for more details. The full LPCA application is now online (but requires similar fields); it also requires official transcripts, a signed supervisory agreement, KY & FBI background checks, and payment (these are not required for the internship portfolio).Blank MFTA Application
Sample MFTA Application
Visit mft.ky.gov (Resources > Applications and Forms) for more details.
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
Blank LPCA Application
Sample LPCA Application
Visit lpc.ky.gov (Resources > Applications and Forms) for more details. The full LPCA application is now online (but requires similar fields); it also requires official transcripts, a signed supervisory agreement, KY & FBI background checks, and payment (these are not required for the internship portfolio).Blank MFTA Application
Sample MFTA Application
Visit mft.ky.gov (Resources > Applications and Forms) for more details.
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)
Related Departmental Policies
CSA Policy on Security of Media (Video and Audio)
Directions for working with the Forms
Right click on the link above and choose "save as," and save the file to your computer.
Open the file you want to print or edit and modify if desired. After editing the file, save it.
Attach it to email, print it, or save it for future editing.
To view PDFs, you can download Adobe Reader free by going to http://get.adobe.com/reader/.
To create PDF files, you can download CutePDF for free at http://www.cutepdf.com/.
Dates & Deadlines
2018-2019 Practicum & Internship
- 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. Contact CC in advance if an extension is required to complete hours during finals week; portfolio must be submitted no later than 5/8/19.
2019-2020 Practicum & Internship
- Feb 7, 2019, 3:00-5:00pm: Attend the mandatory practicum orientation.
- Feb 21, 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.
- Aug 26, 2019: Begin fall internship
- Oct 9, 2019: Submit mid-term evaluations to faculty supervisor for review and signature. Submit signed evaluations to Clinical Coordinator.
- Dec 6, 2019: 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 to complete hours during finals week; portfolio must be submitted no later than 12/13/19.
Some of the links on this page may require additional software to view.