Concentration/Advanced Standing Level MSW Student

Student’s Name (First, Middle, Last): / Name of Agency: / Date:
Address of Agency: / Field Supervisor Name and Title:
Student’s Phone Number (while enrolled in field placement):
Student’s Address (while enrolled in field placement):
Agency Phone Number: / Field Supervisor Phone Number:
Field Supervisor Email Address:
______Description of Field Assignment:______
______Practicum/Internship Schedule (Days and Times):______
______Supervisory Schedule (with Field Instructor):______
Competencies / Behaviors / Student Learning Activities/Strategies / Evidence of Accomplishment
Competency 1: Demonstrate Ethical and Professional behavior
. / 1. Demonstrate knowledge about ethical issues, legal parameters, and shifting societal mores that affect the professional relationship
2. Apply ethical decision-making models and theories to issues specific to direct social work practice with individuals, families, groups, and organizations
3. Employ strategies of ethical reasoning to address the use of technology in direct practice
4. Identify and integrate knowledge of relationship dynamics, including power differentials
5. Recognize and manage personal biases as they affect the professional relationship in the services of the profession / 1.
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Competency 2: Engage Diversity and Difference in Practice / 1 Engage in continuous exploration of diverse populations to enhance client well-being.
2. Apply knowledge of diverse populations to enhance client well-being
3. Identify practitioner/client differences, from a strengths perspective, to work effectively with diverse populations
4. Demonstrate a commitment to self-awareness when working with diverse populations as an integral part of on-going professional development / 1.
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Competency 3: Advance Human Rights and Social, Economic, and Environmental Justice / 1. Demonstrate an on-going commitment to promote human rights, and social, economic, and environmental justice
2. Integrate knowledge of human rights and social, economic, and environmental justice in practice with individuals, families, groups, and organizations
3. Demonstrate ability to advocate for equitable distribution of human rights without prejudice / 1.
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Competency 4: Engage in Practice-Informed Research and Research Informed Practice / 1 .Assess appropriateness of evidence-based practices to specific practice settings and populations
2. Interpret evaluation findings to improve program outcomes and delivery
3. Design formative and summative program evaluations / 1.
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Competency 5: Engage in Policy Practice / 1. Identify social policy at the local, state, and federal level that impacts well-being, service delivery, and access to social services
2. Assess how social welfare and economic policies impact the delivery of and access to social services
3. Apply critical thinking to analyze, formulate, and advocate for policies that advance human rights and social, economic, and environmental justice / 1.
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Competency 6: Engage with Individuals, Families, Groups, Organizations, and Communities / 1. Integrate and utilize theoretical frameworks to engage individuals, families, groups, and organizations
2. Utilize critical thinking to select appropriate engagement strategies for diverse individuals, families, groups, and organizations
3. Demonstrate on-going self-awareness in supporting client self-determination in establishing collaborative and culturally responsive relationships / 1.
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Competency 7: Assess Individuals, Families, Groups, Organizations, and Communities / 1. Demonstrate mastery of multidimensional bio-psycho-social-spiritual assessment with individuals, families, groups, and organizations
2. Select and modify appropriate intervention strategies based on continuous assessment
3. Integrate and utilize theoretical frameworks, research knowledge, and client preferences to inform assessment
4. Demonstrate on-going self-awareness of the impact of personal experiences on the assessment process / 1.
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Competency 8: Intervene with Individuals, Families, Groups, Organizations, and Communities / 1. Demonstrate mastery of evidence-based culturally sensitive interventions with individuals, families, groups, and organizations
2. Select and modify appropriate evidence-based intervention strategies based on continuous assessment and multi-disciplinary consultation
3. Integrate and utilize theoretical frameworks, research knowledge, and client preferences to inform intervention
4. Demonstrate on-going self-awareness of the impact of personal experiences on the intervention process / 1.
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Competency 9: Evaluate Practice with Individuals, Families, Groups, Organizations, and Communities / 1. Integrate theoretical knowledge in selecting evidence-based interventions in practice with individuals, families, groups, and organizations
2. Demonstrate ability to evaluate evidence-based interventions in practice with individuals, families, groups, and organizations
3. Select and implement research strategies for effective program evaluation / 1.
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Signatures:

Level of Practice / Definition of Level of Practice / Provide 3 examples of activities to be demonstrated in your placement. / Evidence of Accomplishment
Micro / “The term used by social workers to identify professional activities that are designed to help solve the problems faced primarily by individuals, families and small groups. Usually micro practice focuses on direct intervention on a case by case basis or in a clinical setting ”(Barker 2013, p. 269). / 1.
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Mezzo / “Social work practice primarily with families and small groups. Important activities at this level include facilitating communication, mediation and negotiation; educating; and bringing people together.” (Barker, 2013 p. 269) / 1.
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Macro / Social Work practice aimed at bringing about improvement and changes in the
general society. Such activities include some types of political action, community
organization, public education campaigning, and the administration of broad based social services agencies or public welfare departments” (Barker, 2013, p. 253) / 1.
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Barker, R.L.(2014). The Social Work Dictionary 6th edition. Washington, DC:NASW Press.

Signatures:

Student: ______Date: ______

Field Supervisor: ______Date: ______

Faculty Field Liaison: ______Date: ______