2.17STEP 2 - SPE ADVANCED/CLINICAL PLACEMENT REPORT

Candidate Information

Legal Name:
Address:
Telephone - Home: Office:
Email address:Fax:
CASC Region:
SPE Units Completed: 1st Basic - / 2nd Basic - / 1st Advanced -

Check One of the Following:

- advanced Assessment processor

- clinical placement assessment process (equivalency)

Review Assessment:

Candidate demonstrated: Please check () as appropriate / Complete / Incomplete / Not Applicable
Familiarity with CASC/ACSS’ web site, including the information about:
  1. Our association’s Vision, Mission, & Goals,
  2. Details about Spiritual Care or Pastoral Counselling Eduation, including the Student Manual,
  3. Handbook standards for Basic and Advanced supervised spiritual care or pastoral
counselling education and certification,
d. The CASC/ACSS Code of Ethics
Familiarity with CASC/ACSS’ professional culture and emphasis on personal and professional integration, congruence, self-awareness, and professional collegiality by contacting 3 CASC/ACSS members and discussing these professional competence indicators at some relational depth.
Written materials provided by the candidate were:
Please check () as appropriate
Documentation of 1 year of graduate studies in theology and/or spiritual/religious theories at an ATS or CHEA accredited institution [See – Chapter 2, Section II (CPE) & Section III (PCE)]
Documentation of Completion of minimum of 1 CASC/ACSS SPE Unit within the last 5 years.
Professional Papers (See CASC/ACSS Manual, Chapter 2, Section II & III, B. for required papers for Advanced/Clinical Placement process)
Letter from a CASC/ACSS Associate or CertifiedSupervisor-Educator who is willing to supervise candidate at the Advanced level or Certified CASC/ACSS member willing to mentor candidate through Pre-Certification Mentor process.
Documentation of Previous Clinical Work/SPE Unit - (CPE - 200 hrs/unit; PCE – min. of 125 hrs clinical counselling & 50 hrs of supervision/ basic unit)

Reviewers’ Remarks & Recommendations of Each Paper:

4.1 / Autobiography, including a or b below:
i. Using your personal life story (i.e. personal, family, educational and vocational history, including SPE history) describe how you have integrated this into your personal and professional identity and your practice of spiritual care.
ii. Using yourself as the subject write your autobiography based on at least one of the personality theories/paradigms, highlighting how this impacts the way you provide spiritual care.
Remarks: / Recommendations:
4.2 / Paper highlighting beliefs as they pertain to the Work of Spiritual Care including:
i)Give examples of how the expression of your faith, beliefs, values, spirituality, etc. are expressed in your spiritual care work.
ii)Give examples of a deepening self-awareness of your internal belief systems.
iii)Include in your discussion appropriate competencies as they apply.
Remarks: / Recommendations:
4.3 / Paper highlighting how the experience of SPE has informed your Work of Spiritual Care including:
i)Give examples of how your clinical experience has impacted and informed how you provide Spiritual Care.
ii)Give examples of how the SPE educational process (i.e. supervision, group work, etc.) has influenced the development of your Spiritual Care work.
iii)Include a discussion of competencies as they apply
Remarks: / Recommendations:
4.4 / Paper demonstrating your readiness to function at the requested level of SPE including:
i) Give examples of how you utilized the evaluation process (i.e. written and group presentation) for a synthesis of learning and growth.
i.ii) Give examples of your ability and desire to utilize SPE education for the benefit of your work.
ii. iii) Give examples of how you have grown personally and professional growth and learning. What goals have you set for yourself that will demonstrate that you are able to work at the advanced level?
Remarks: / Recommendations:

Scoring Rating and Descriptions

Rating / Advanced/Clinical Placement Process
N/E / Not Expected / (Competency not expected/covered in this SPE Unit/Not Applicable)
1 / No Demonstrated Achievement / (competency not practiced)
2 / Beginning / (starting to engage)
3 / Developing / (frequently demonstrates)
4 / Consistent / (continually demonstrates)
5 / Proficient / (models this competency for others to learn within the defined role)

Assessment of Candidate’s Advanced/Clinical Placement Competencies

Prior to interview - Assessor(s) and Supervisor-Educator are encouraged to assess papers independently.

After the interview – Assessor(s) and Supervisor-Educator shall come to a consensus on the final scoring.

Scoring of
Advanced/Clinical Placement Competencies / Papers
Rating Score
(N/E, 1,2,3,4,5) / Interview
Rating Score
(1,2,3,4,5)
Spiritual Assessment and Care - (Competency 1)
Spiritual Assessment and Care are distinct but inter-related activities. Spiritual Assessment is an extensive, in-depth, ongoing process of actively listening to and summarizing a patient’s story, spiritual strengths, needs and coping strategies as they emerge over time.
Self-awareness –(Competency 2)
Assessment of the impact of one’s own spirituality, beliefs, values and assumptions on practice.
Spiritual and Personal Development –(Competency 3)
It is incumbent upon the professional Spiritual Care therapist to continue to develop and maintain personal and professional growth, awareness and self-understanding and making oneself appropriately accountable.
Multi-Dimensional Communication –(Competency 4)
Employ communication strategies that include active and accurate listening, awareness of the non-verbal, appropriateness, and relevant content.
Documentation and Charting –(Competency 5)
The Spiritual Care therapist documents clinical assessments, interventions and referrals in a way that is understood by members of the interdisciplinary healthcare team; keeps records and statistics in a timely manner; demonstrates clarity, skill and appropriate confidentiality in all paper/electronic correspondence.
Brokering Diversity –(Competency 6)
Understand, value and promote diversity and inclusion, and how to provide therapy that takes into account culture, bias, and the specific needs of clients.
Ethical Behaviour –(Competency 7)
Spiritual Care therapists function with ethical behaviour by ensuring that one’s personal and professional conduct shows respect for all. This behaviour is congruent with the values of the CASC Code of Ethics reflecting justice, compassion and healing for all.
Collaboration and Partnerships –(Competency 8)
Spiritual Care therapists are accountable to the public, faith communities, employers and professionals in all professional relationships.
Leadership –(Competency 9)
The Spiritual Care therapist exhibits leadership in numerous ways that provide support and allow the practitioner to operate as an integral member of multi-disciplinary teams.
Research –(Competency 10)
The Spiritual Care therapist sees research as integral to professional functioning and in keeping with degree work and/or as appropriate to one’s area of expertise.
Separate Scoring of Papers & Interview / /50 / /50
Overall Scoring of Competencies
Total of Papers & Interview / /100

Scoring Recommendations & Clinical Placement Assessment:

Candidate’s Score
(mark applicable score) / Score / Advanced/Clinical Placement Process
Score – (below) 40 / Basic Unit
Not Granted
Score – 40 - 55
All ratings – 2 or above / Basic Unit
Granted
Score – 55 - 70
All ratings –2 or above / Completed Basic SPE
Ready to Begin Advanced
Score – 70 - 85
All ratings – 3 or above / Completed 1st Advanced
Granted
Score – (above) 85
All ratings – 4or above / Completed 2nd Advanced
Granted
Ready to Apply forCertification(see below)

The Chair of the consultation (assessor appointed by RAC) forwards the scoring above onto the

Regional Step 3 Report form (2.23) Section I.

For those Scoring (Ready to Apply for Certification),

please note the following requirements to proceed.

EVIDENCE OF THE FOLLOWING IS REQUIRED IN ADDITION TO RECEIVING 2nd ADVANCED:

FOR CPE CANDIDATES – (Manual, Chapter 2, Section II) – requires an additional 1,000 hours of spiritual care practice.

FOR PCE CANDIDATES – (Manual, Chapter 2, Section III) – requires evidence of: 1) candidate’s own therapeutic process, 2) 500 hours of counselling, 3) receiving 200 hours of supervision (100 of which is individual supervision).

Assessor: ______Date: ______

Print Name Signature

Assessor: ______Date: ______

Print Name Signature

Supervisor: ______Date: ______

Print Name Signature

I confirm that I have received a copy of this completed Step 2 Report (Form 2.17)

Candidate: ______Date: ______

(Please sign)

Revised October 2016 Posted December 2016