Fillable Revised-Addendum Fall - SWrk 283 Learning Agreement 9-8-09

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Revised-Addendum Fall - SWrk 283 Learning Agreement 9-8-09

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Student Information:
Fall Semester/2
ND
Year Graduate Field Placement
MHSA Stipend Field Placement Addendum
FIRST NAME LAST NAME
STREET ADDRESS CITY ZIP CODE
HOME PHONE CELL PHONE WORK PHONE
CAMPUS E MAIL ADDRESS
ACADEMIC ADVISOR PHONE E MAIL ADDRESS
Agency Information:
AGENCY NAME
STREET ADDRESS CITY ZIP CODE
FIELD INSTRUCTOR (M.S.W.) PHONE E MAIL ADDRESS
AGENCY SUPERVISOR (non-M.S.W.) PHONE E MAIL ADDRESS
Identify as a professional social worker and conduct oneself accordingly
1. Student is knowledgeable about principles of wellness and recovery and the
Mental Health Services Act, and integrates this knowledge into his/her
professional practice both ethically and without bias , and advocates for access
to integrated service -delivery systems.
Date
Completed
a. Demonstrates respectful and effective relationships with colleagues, including
those with lived experience as consumers and/or family members; via field
instructor observation or student report in supervision.
2. Student is able to self-correct against personal bias in his/her professional
activities and attend to continuing professional growth.
Date
Completed
a. Demonstrates in supervision and practice an awareness of professional and
personal skills for social work practice and those required to manage workload
assignments, and develops self-care and organizational strategies to reduce work-
related stress.
3. Student is knowledgeable about ethical and boundary issues, utilizes this
knowledge in practice, and seeks supervision or consultation when needed.
Date
Completed
a. Demonstrates in supervision and in practice awareness of professional boundary
issues, including ambiguities often encountered in multiple roles (i.e., professional
and interpersonal) in recovery-oriented practice.
4. Student takes responsibility for professional development and growth, and is
able to utilize supervision, consultation and training effectively.
Date
Completed
a. Discussion in supervision demonstrates the development of objectives and
strategies for continued professional development and growth and utilizes ongoing
supervision, consultation and mentoring opportunities within the agency and in
cross- agency collaborations.
Apply social work ethical principles to guide professional practice
5. Student critically evaluates personal and cultural values and norms in all practice
situations, applying social work ethics and MHSA principles to make decisions and
resolve conflicts among different viewpoints.
Date
Completed
a. Practice and supervision discussion demonstrates adherence to legal and ethical
standards in practice to ensure consumer/client and family member engagement in
decision-making in relation to the NASW Code of Ethics.
b. Practice and discussion in supervision demonstrates student ensures
confidentiality of protected behavioral health information in accordance with all
state and Federal regulations.
c. Student’s performance demonstrates use of social work knowledge, supervision
and learning opportunities that arise in a diverse contextual framework (e.g.
individual, family, community, and/or organizational factors), to resolve or
acknowledge ambiguities and conflicts in making principled decisions.
Apply critical thinking to inform and communicate professional judgments
6. Student demonstrates sound critical thinking and professional judgments in all oral
and written communications.
Date
Completed
a. Demonstrates skillful written and oral communication that is clear, focused and relevant
to meet behavioral health record and funding stream documentation requirements (e.g., .
supervision, case presentation, Medi-cal, agency software)
Advance human rights and social and economic justice. Engage in policy practice to
advance social and economic well-being and to deliver effective social services.
7. Student advocates for social justice and demonstrates ability to proactively
identify and implement interventions addressing the causes as well as impacts of
discrimination, stigma and injustice.
Date
Completed
a. Supervision discussion demonstrates that student articulates the effects of stigma,
discrimination and oppression on individuals, families, groups and communities.
b. Supervision discussion demonstrates student identifies and confronts stigma and
disparities that exist between diverse cultural and disability groups, such as persons
living with mental illness and addictions, through advocacy and outreach.
1. Student can formulate and advocate for actual or proposed policies that effectively
advance recovery principles and practices, and apply strength based concepts to engage
stakeholders in wellness/recovery policy development and implementation.
Date
Completed
a. Applies research and practice experience to assess public policies and agency practice
for their impacts on recovery-oriented service delivery.
2.
Student demonstrates capacity to
take a leadership role in policy action/development
activities.
Date
Completed
Apply knowledge of human behavior and the social environment
8. Student demonstrates skill in applying a strengths based and systems approaches to
assessment and interventions to address the effects of interactions between the client
and the social environment (e.g. trauma, poverty, oppression).
Date
Completed
a. Student demonstrates skill in incorporating an understanding and knowledge of human
development across life span (children, adolescents, adults, older adults) in practice with
individuals and families.
b. Student demonstrates skill and understanding in applying knowledge of gender/sexual
orientation (heterosexual male or female, gay, lesbian, bisexual, gender non- conforming)
in practice with individuals and families
c. Student demonstrates skill in applying understanding and knowledge of unique
behavioral health needs of special populations ( e.g. people living with severe/prolonged
mental illness, have co- occurring substance use, and are homeless, incarcerated or have al
challenges (acute or chronic) in practice with individuals and families,
d. Student demonstrates awareness of their own perceptions regarding individuals with
mental illness and understands how their perceptions may affect help- seeking behaviors
and generate stigma and discrimination
e. Student demonstrates an understanding of the role of natural community supports and
community based resources in their practice and/or discussion in supervision.
Engage, assess, intervene, and evaluate with individuals, families, groups, organizations,
and communities
10. Student demonstrates skilled use of self in engaging individuals, families, groups,
and communities in collaborative working relationships.
Date
Completed
a. Discussion in supervision reflects establishment of effective and collaborative working
relationships with individuals, families, groups and communities.
b. Discussion in supervision demonstrates conscious utilization of empathy, respect,
understanding and
other interpersonal skills
in establishing effective working
relationships grounded in recovery, resilience and wellness.
c. Student demonstrates adherence to the principles of consumer and family directed
services in the development of mutually agreed upon service goals.
Assessment
10. Student is able to a) use relevant skills in gathering and interpreting data from a
variety of sources to develop a consumer driven assessment and plan. b utilize a
strength based perspective & recovery model, c) utilize multiple resources, including
community-based resources and natural supports, in developing consumer and family
driven assessment and plans. d) utilize knowledge of major theories, models and
treatment interventions relating to behavioral health conditions in developing
strategic and client driven assessments and plans.
Completed
a. Completes critical analysis of assessment data and consumer capacities in developing a
multidimensional behavioral health assessment, diagnosis and plan which reflects a
consumer-driven perspective (i.e., mutually agreed upon service goals) and principles of
recovery, including the impacts on individuals, families, and communities of trauma.
b. Completes critical analysis of assessment data and consumer capacities in developing a
multidimensional behavioral health assessment, diagnosis and plan which reflects a
consumer-driven perspective (i.e., mutually agreed upon service goals) and principles of
recovery, including the impacts on individuals, families, and communities of co-occurring
(mental disorder and substance abuse) behavioral health conditions.
c. Completes critical analysis of assessment data and consumer capacities in developing a
multidimensional behavioral health assessment, diagnosis and plan which reflects a
consumer-driven perspective (i.e., mutually agreed upon service goals) and principles of
recovery, including the impacts on individuals, families, and communities of adverse
health conditions.
d. Able to diagnose the major mental health disorders using the DSM IV or other currently
accepted diagnostic tools, and can identify the challenges and limitations of diagnosis in
relationship to diverse racial, ethnic, sexual orientation, cultural and lifestyle factors.
a. Student engages the individual and his/her family in the development of a consumer-
driven assessment, treatment and discharge plan, and revises treatment plans as needed.
a. Demonstrates understanding of issues related to the use of medication, and psychiatric
consultation in social work practice and in supervision.
b. Supervision discussion demonstrates student applies knowledge of efficacy of treatment
models (i.e., evidence-based, practice wisdom) in development of multidimensional
treatment plans
a. Demonstrates understanding of the roles of consumers, family members, practitioners,
the agency and the community, in shaping policy and in the development and
implementation of relevant behavioral health services.
b. Recognizes the variety of client strengths and applies interactions and interventions that
promote wellness and resilience in relation to the client’s unique strengths
c. Demonstrates the ability to apply interventions with consumers, families and groups
based on recovery principles including prevention, early intervention, and crisis
intervention.
d. Demonstrates the ability to partner with consumers and families to identify and utilize
natural community supports.
e. Utilizes clinical care coordination principles (case management) in assisting consumers
and family members by linking and coordinating needed services and resources to achieve
mutually identified goals.
F. Applies advanced social work practice skills to engage client in transition to the
termination process.
Signatures:
_____________________________________________________________________________________________
STUDENT SIGNATURE DATE
_____________________________________________________________________________________________
M.S.W. FIELD INSTRUCTOR SIGNATURE DATE
_____________________________________________________________________________________________
FACULTY LIAISON SIGNATURE DATE
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Revised-Addendum Fall - SWrk 283 Learning Agreement 9-8-09

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Completed 31 May 2020

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