Clinical Activities Record Sheet Weekly Check-In

SAMPLE COUNSELLING ACTIVITIES RECORD SHEET

Note: This sample CARS will look different from what you will see in the Practicum Tool. However, it will provide you with an example of how to record your hours, and the type of information that is needed in your notes.

DATE
MM/DD/YY / TOTAL PRACTICUM HOURS / PRACTICUM ACTIVITIES
Direct practice / CASE MANAGEMENT / SUPERVISION / EDUCATION / Staff meetings / OTHER
Please specify
Intake / Screening / Testing / Assessment / Individual therapy / Family & couple therapy / Group therapy / Co-facilitated with other professional (not supervisor) / Reviewing case files / Session preparation / Case notes and maintaining counseling files / Formal report writing / Case consultation with other professionals related to the case / Direct observation by supervisor / Co-facilitation with supervisor / Supervision meetings with supervisor / Group Supervision / Observing other professionals / Attending workshops / seminars / Research / reading
60 hours required / Min.
1hr/
wk
About half of your time should involve dealing with clients directly, or doing activities that directly support your clients
WEEKLY CARS nOTES should include:
Provide brief daily notes in the space below the CARS table. Your notes should include:A brief summary of each client session you facilitate using the following format:
CLIENT NAME AND AGE: (ALWAYS use pseudonyms)
LENGTH OF SESSION: SUPERVISION: (Were you observed by your supervisor of another professional?)
TYPE OF SESSION: (Was it a solo session - you and client, or was it co-facilitated with your supervisor or another professional?)
PRESENTING ISSUES: FOCUS OF SESSION:
CONCERNS: (yours)
PERSONAL OBSERVATIONS:
PERSONAL LEARNING/SELF REFLECTION:
Also include a brief summary of your supervision meetings with your supervisor. Include information about whether any taped sessions or parts of sessions were reviewed and discussed, if files were reviewed, andcases on which you sought supervision .
Note: Below is an example of the type of information that should be included in your CARS notes. You will notice that the format for the session notes on the last two days below is very structured. Some students have altered this format to give their personal reflection at the end of each day or week, rather than at the end of each session. Please feel free to choose whichever works best for you. The important thing is that you provide all of this information in a format that works for you.
DATE
MM/DD/YY / TOTAL PRACTICUM HOURS / PRACTICUM ACTIVITIES
Direct practice / CASE MANAGEMENT / SUPERVISION / EDUCATION / Staff meetings / OTHER
Please specify
Intake / Screening / Testing / Assessment / Individual therapy / Family & couple therapy / Group therapy / Co-facilitated with other professional (not supervisor) / Reviewing case files / Session preparation / Case notes and maintaining counseling files / Formal report writing / Case consultation with other professionals related to the case / Direct observation by supervisor / Co-facilitation with supervisor / Supervision meetings with supervisor / Group Supervision / Observing other professionals / Attending workshops / seminars / Research / reading
09/02/10 / 7.00 / 1.00 / 2.00 / 2.00 / 2:00
OTHER / Other staff and read policy manuals
09/02/10:

Today was my first day of practicum. I met with my supervisor to review my practicum goals and review potential activities for the next few days.
Spent 2 hours reviewing clinic’s policy and procedures manual.
Observed supervisor for 2 individual counselling sessions.
Assigned my first two cases: 1. 65-yr-old married female - life transition, frustration/depression

2. 30-yr-old single female - Cultural adjustment, depression

Practicum site is very active. Other staff very pleasant and welcoming. Feeling a little overwhelmed at the moment but supervisor was reassuring that this is normal.

Spent the day observing supervisor in session, and reading and researching information for client sessions tomorrow.
Confirmed appointments for tomorrow’s sessions with 2 assigned clients. Will co-facilitate sessions with supervisor.
It was a good day. Enjoying supervisors counselling style, and learning a great deal about presentation; listening, empathy, mirroring, communicating difficult information, etc.
Very nervous about tomorrow.

Very busy day today. Attended first staff meeting. Everyone was quite helpful and conscious of the fact that I was new. I felt very included as they did a great deal to ensure that I knew what they were discussing.
Prepared for my first sessions; reviewed files again, prepared file documentation, did some background reading on depression.
Had my first co-facilitated sessions with both clients. My supervisor let me take the lead and was very helpful when there were questions about process and external services.
For both sessions:

-I explained the agency’s policy on confidentiality and its limitations, and my role as a student intern as well as my supervisors role;
-Had clients sign appropriate documentation;
-Had client describe the problem and why they were seeking help, confirmed and collected relevant background information;
-Explained what they may expect in future sessions; and
-Set appointment time for next session.

Next session I plan to work on goal setting.
The hour went very quickly. I felt a little scattered at times but supervisor was very helpful and gentle about getting me back on track.
Second session was better than the first.

Learned that clients can be very forgiving of student interns. I was grateful for their willingness to let me be involved in their treatment process
DATE
MM/DD/YY / TOTAL PRACTICUM HOURS / PRACTICUM ACTIVITIES
Direct practice / CASE MANAGEMENT / SUPERVISION / EDUCATION / Staff meetings / OTHER
Please specify
Intake / Screening / Testing / Assessment / Individual therapy / Family & couple therapy / Group therapy / Co-facilitated with other professional (not supervisor) / Reviewing case files / Session preparation / Case notes and maintaining counseling files / Formal report writing / Case consultation with other professionals related to the case / Direct observation by supervisor / Co-facilitation with supervisor / Supervision meetings with supervisor / Group Supervision / Observing other professionals / Attending workshops / seminars / Research / reading
09/05/10 / 4.00 / 1.00 / .50 / 1.00[A2] / .50 / 1.00 / 1.00
OTHER
09/05/10:

Had my first solo client today and was observed by my supervisor. Felt very nervous being observed, but it was very helpful because my supervisor was able to give me some good feedback.
Also had an opportunity to observe another session with a different counselor. Observing others continues to be very helpful, and has helped me identify some phrases that I would like to incorporate into my own sessions.

CLIENT: Alice (pseudonym) 65-yr-old married female
Type of Session: Individual therapy, directly observed by supervisor
PRESENTING ISSUES: life transition, frustration/depression
FOCUS OF SESSION: Goal setting,building rapport, reviewing current issues - physical health issues, boundaries with family members
CONCERNS (yours): It doesn't feel like I made a good connection with this client. I need to spend some time reflecting on why this is so. Is it me or her or both???
PERSONAL OBSERVATIONS: Client appeared very tired, had less to talk about
PERSONAL LEARNING/SELF REFLECTION: Helping her explore options without judgment is proving to be more challenging than I had expected. I must watch my body language as well as my choice of words and tone, as I may be reflecting judgment back to clients.
DATE
MM/DD/YY / TOTAL PRACTICUM HOURS / PRACTICUM ACTIVITIES
Direct practice / CASE MANAGEMENT / SUPERVISION / EDUCATION / Staff meetings / OTHER
Please specify
Intake / Screening / Testing / Assessment / Individual therapy / Family & couple therapy / Group therapy / Co-facilitated with other professional (not supervisor) / Reviewing case files / Session preparation / Case notes and maintaining counseling files / Formal report writing / Case consultation with other professionals related to the case / Direct observation by supervisor / Co-facilitation with supervisor / Supervision meetings with supervisor / Group Supervision / Observing other professionals / Attending workshops / seminars / Research / reading
09/06/10 / 3.00 / 1.00 / .50 / .50 / 1.00
OTHER
09/06/10:

Had my secondsolo session, I was not as nervous being on my own.

CLIENT: Millie(pseudonym) 30-yr-old married female
Type of Session: Individual therapy, solo
PRESENTING ISSUES: Cultural adjustment, depression, anxiety
FOCUS OF SESSION:Goal setting,building rapport, reviewing current issues - discussed difference between feeling/thinking and had client embody the feelings (where does she feel it?) and discussed strategies to relieve bodily feelings of anxiety in the moment before reacting.
CONCERNS: Felt very connected to this client, but not sure that she always understood what I was saying. I think I jumped into trying to do “therapy” too soon, but client seemed so eager to get right to work with all her smiles and nodding.
PERSONAL OBSERVATIONS: Client is very eager to learn how to modify her behaviour. She appears to be very task oriented and very eager to please.
PERSONAL LEARNING/SELF REFLECTION: I have to remember to slow down and keep checking to see if client is really keeping up with me or is just nodding and agreeing because she doesn’t want to disappoint me. I have to pay attention to the cultural differences and my own need to keep the session active. I talked too much and didn’t listen as well as I should have. I’m uncomfortable with long silences and I think this client needs extra time to process questions because English is her second language. I’m a work in progress!

Revised January 30, 2013

[A1]. If your supervisor has co-facilitated a session with you, record that time in the appropriate “Direct Practice” column and in the appropriate “Supervision” column. For example, if you have engaged in 2 hours of individual therapy that was co-facilitated with your supervisor; you would then record 2 hours under “Individual therapy” and 2 hours under “Co-facilitation with supervisor”. While you will be recording these hours twice, please note that the Practicum Tool system will only add them into your daily total once.

[A2]. If your supervisor has observed you during a session, record that time in the appropriate “Direct Practice” column and in the appropriate “Supervision” column. For example, if you have engaged in 1 hour of individual therapy that was observed by your supervisor; you would then record 1 hour under “Individual therapy” and 1 hour under “Direct observation by supervisor”. While you will be recording these hours twice, please note that the Practicum Tool system will only add them into your daily totalonce.

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