Brentwood Secondary College and Thriving Youth Australia

1.  Complete the Checklist for eligibility for student placement

2.  Read and agree to ACAP Placement Program Agreement

3.  Complete Questionnaire

4.  Attached Counselling Resume

5.  Return Application to by Wednesday 30th March 2016

Checklist for eligibility for student placement

Please complete the following Application Form carefully and truthfully. Only students who meet the following criteria can apply a placement at Brentwood Secondary College or Thriving Youth Australia.

ACAP Student Number :
First Name :
Surname:
E-mail Address:
Mobile Number:
Course Name:

By applying for a placement at Brentwood Secondary College and/or Thriving Youth Australia I confirm that I am a final year student and that:

Yes / No
I have received an email directly from Sonia Online informing me I am ready for placement
I have met the prerequisite units for student placement ( Refer to Sonia/Placement/Details Step 1)
Uploaded my Working with Children Check into Sonia Online
Uploaded my Police Check into Sonia Online

By applying for a placement at Brentwood Secondary College/Thriving Youth Australia I agree to the following:

Yes / No
Attend a group interview on Wednesday 20th April 2016
If my application is successful, to commence placement on the week of 2nd May 2016 and:
Attend this placement across two consecutive ACAP terms continuously (Approx. 8 months) with ACAP clinical supervision units 1 & 2
Have no holidays or other leave planned during my placement
Miss no more than 2 days on placement without a doctor’s certificate
Attend placement either as outlined in the agency brief and agreed upon by the Placement Supervisor

ACAP Placement Program Agreement

The ACAP Placement Program requires students to work in conjunction with other staff members across a broad range of programs.

For this reason the following requirements are essential in all applicants. Failure to demonstrate high levels of each attribute will result in the placement being cancelled:

·  Professionalism and clear adherence to boundaries - students are given clear instructions by staff as to what their role is with clients. This is purely the role of counsellor and as such students must not advocate on behalf of the client for referrals etc.

·  Strong attention to detail – students must be aware of safety practices such as locking doors behind them. This is for the safety of students/staff and clients

·  Professionalism and clear adherence to boundaries – Students are given clear instructions as to their role with clients. Therefore it is important to be mindful of professional boundaries in all interactions with clients.

·  Ability to work independently – Southwest Clinic is an extremely busy agency and students are expected to be able to work independently of their supervisor while following instructions precisely.

·  Punctuality – clients are scheduled with reference to available staff and rooms. Late arrivals by students are disruptive to this schedule.

·  Dress Code - Students are to comply with the dress code of their placement agency.

·  Workplace Health and Safety - Students are to comply with all health and safety practices of their placement agency. If the policy is not offered at orientation, please ask for a copy of all relevant policies.

I have read and will adhere to the above for the duration of my student placement. Failure to demonstrate high levels of each attribute may result in the placement being cancelled

Student Signature: / Date:

Day Availability :

Please indicate your preferred two placement days below. Placement days must include either a Monday, Wednesday or Friday for peer and group supervision.

Placement day / Available – Yes/No
Monday
Tuesday
Wednesday
Thursday
Friday

ACAP Placement Program Questionnaire

1.  Why would you like to complete a placement at Brentwood Secondary College and/or Thriving Youth Australia?

2.  What do you consider will be the key professional or personal challenges on a school student placement?

3.  What experience do you have which you think would be beneficial for a counselling school placement?

4.  Please add any further information which may be relevant to your selection for a school placement:

Student Signature / Date

Related Units:

I have or haven’t completed the following units (Delete as appropriate):

Bachelor of Counselling/Coaching Students Completed

COUN2951 Counselling Children and Young People YES / NO

COUN2051 Mental Health Policy and Practice YES / NO

BESC3071 Group Work YES / NO

Graduate Diploma of Counselling Students Completed

COUN5841 Family Counselling YES / NO

COUN5221 Mental Health Practice YES / NO

COUN5831 Groupwork Theory and Practice YES / NO

Master of Counselling and Psychotherapy Students Completed

COUN6341 Counselling Children and Young People YES / NO

COUN6131 Mental Health Counselling YES / NO

COUN6171 Group Therapy YES / NO

Additional Information

Is there any additional information or do you have other skills or experience that may be relevant?

5