The present level of each skill should be rated as follows:
/ Ability commensurate with level of training
? Insufficient data
n Needs improvement (must specify) na Not applicable Any rating of “needs improvement” must be accompanied by specific recommendations in the comments section. Supervisors are encouraged to provide narrative commentary as much as possible.
I. CONTRIBUTES TO CLINICAL TEAM
II. CAPACITY FOR PROFESSIONAL DEVELOPMENT
III. GENERAL PSYCHOTHERAPY SKILLS
A. CASE MANAGEMENT SKILLS
2. Data Gathering Skills:
3. Diagnostic-Analytic Skills:
1. Maintains Working Alliance:
3. Understands Interpersonal Process Issues:
4. Biopsychosocial Assessment:
EVALUATOR COMMENTS: Based on Hall-Marley (2000), an evaluation form used to give feedback to supervisees. Sections include contributions to clinical team, capacity for professional development, general psychotherapy skills (case management, assessment, intervention), and evaluator comments. Reprinted in Falender, C.A., & Shafranske, E.P. (2004). Clinical
Supervision: A Competency-based Approach. Washington, D.C.: APA.