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Field Education Program(510) 642-1306

Second Year Learning AgreementAdvanced DIRECT PRACTICE Practicum

NOTE: This document is confidential communication intended for review only by the field instructor, student, and the School of Social Welfare.

StudentName:

Contact Email: Contact Phone Number:

Concentration Area (check one):☐ Child and Family ☐ Community Mental Health ☐ Gerontology ☐HealthApplicable Specialties:☐ IV-E/Child Welfare ☐ PPSC ☐ Public Mental Health ☐ MSW/MPH ☐MSW/MPP ☐ MSW/PhD

Agency PlacementAgency Name:

Agency Address:

Program Address (if different):

Internship ScheduleStart Date: End Date: Minimum Hours for Completion: 720

☐ Standard days: Wednesday & Thursday & Friday Start Time: End Time:

☐ Other Schedule – Specify:

Designated Supervision Time (include days, times, and with whom):

InstructorsBerkeley Social Welfare Field Consultant: Contact Email: Contact Phone Number:

Primary Field Instructor: Contact Email: Contact Phone Number:

Secondary Field Instructor (if applicable): Contact Email: Contact Phone Number:

Berkeley Social Welfare Advanced Direct Practice Practicum Learning Agreement

Signature Page

Required AgreementsThe Agency and Field instructor agree to provide the following to the intern (please read and check box to indicate assent):

☐ One month orientation to the agency mission, program operation, roles, and expectations☐ Orientation to safety and risk reduction policies and procedures☐ Adequate work space☐ Access to computer, telecommunications, and all equipment needed to perform tasks☐ Access to task assignments to promote advanced competency progression in identified areas☐ A minimum of one hour per week of dedicated field instruction☐ Feedback based upon direct observation or designated recording method☐ Designated back-up supervision and coverage when unavailable☐ Timely, direct communication to student and Field Consultant when concerns arise☐ Timely, thorough submission of evaluation documents at the end of each semester

Optional AgreementsThe agency and/or field instructor also agree to provide the following:

☐ Stipend Amount: ☐ Work-Study Amount: ☐ Travel Reimbursement Amount: ☐ Use of Agency Car☐ Other Resources – Describe:

This is an e-signature form. By checking the signature box and typing your name and date in the boxes, you indicate that you have read this document, agree to it, and have not altered any sections authored by another party without their permission.

☐ Field Instructor’s Signature Name: Date:

☐ Student’s Signature Name: Date:

☐ Field Consultant’s Signature Name: Date:

Electronic Submission Instructions: When saving this document, please title the file name by student’s last name, first name, LA, and year. After the Field Instructor and student have discussed this agreement and applied their e-signature, please email directly to the UC Berkeley Field Consultant named above. Thank you!

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Instructions for Developing the Learning Agreement: The learning agreement outlines the full range of assigned field activities for the entire academic year, identifying what activities will assist the student in developing all twelve competencies with a focus on direct practice. The attached format outlines several required categories of Field Activities in Column I. For each category, students and field instructors should identify specific task assignments in Column II and, if relevant, how student progress will be observed. These assignments should account for the student's interests and readiness, the identified competencies, and the available activities in the agency. In column III, corresponding competency or competencies should be identified (1-12); every competency needs to be linked back to at least one task assignment. In column IV, indicate the anticipated timeline for the activity. This document is a fillable form and the text fields will expand as needed.

Identified Competencies:It is expected that second year direct practice students will demonstrate an increased mastery and refinement of competencies and greater initiative and autonomy than first year students.

The 12 identified field education competencies which should guide direct practice task assignment are as follows:

1. Engagement with Individual, Families, Groups, Organizations, and/or Communities: Establishes contact, builds rapport, forms working relationships, and invites a diverse array of clients, stakeholders, and/or community partners to participate in clinical services and/or administrative projects.

2. Consultation, Coordination, and Collaboration: Obtains information from a variety of collaterals, stakeholders, and/or other sources and integrates into a coordinated service and/or project plan.

3. Assessment of Individuals, Families, Groups, Organizations, and/or Communities: Collects, analyzes, and applies relevant information to promote the effective delivery of clinical services and/or the effective execution of administrative and planning projects.

4. Intervention Planning: Develops clinical and/or administrative project goals that include input from clients, multiple stakeholders, and/or information sources. Identifies specific, measurable, and achievable goals and integrates the best available evidence and/or knowledge.

5. Implementation and Evaluation: Executes activities and interventions consistent with the intervention plan in a thoughtful, sequenced, and responsive manner. Modifies activities, pacing, methods, and/or goals so as to increase the likelihood of reaching the intended outcome(s).

6. Systemic Intervention: Demonstrates interest, understanding, and/or effective participation in the organizational, institutional, and/or community contexts that shape the delivery of social work services.

7. Evaluation of Systemic Efforts and/or Interventions: Collects, analyzes, and applies data on the effectiveness of program, system, and/or community-wide efforts so as to shape the overall delivery of social work services.

8. Planning for Completion or Transition: Facilitates endings and transitions to clinical and/or administrative projects in a timely, smooth, and thoughtful manner so as to promote continuity of care and/or project success.

9. Written and Verbal Communication Skills: Communicates orally and in writing in an organized, complete, and timely manner. Delivers communication in an effective manner given its purpose and context.

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10. Professional Ethics: Recognizes ethical conflicts, applies the applicable social work ethical codes, and arrives at principled decisions.

11. Professional Conduct: Demonstrates professional behavior, appearance, and communication in accordance with standards identified by the School of Social Welfare, field agency, and professional codes.

12. Professional Growth and Development: Initiates and takes responsibility for learning. Invites, considers, and integrates feedback from instructors. Demonstrates commitment to continual professional development and life-long learning.

Evaluation and ModificationThe learning agreement should be reviewed at least monthly by the student and the field instructor with progress thoroughly reported at the end of each semester in a detailed evaluation form. Student final evaluations are competency-based, not activity-based. Consequently, it is important to monitor the student’s level of mastery over each practice competency and to balance competency acquisition with reviewing task assignments.

We require field instructors to provide timely, structured feedback to the student intern based upon no less than two direct observations or designated recording methods. Please specify which type of direct observation or recording method will be used in the task assignment column (Column II). Feedback should identify strengths, improvements, and further needs.

Although the learning agreement maps the planned learning experience, we also recognize that in the real world of agency-based practice, chance often creates uncharted opportunities to learn and renders some planned activities unfeasible. Professional social workers need to be able to adapt quickly to changing demands while upholding the core values, knowledge, and approaches of the profession. As such, the learning agreement is viewed as dynamic and can be changed as the practicum proceeds. Major changes should be documented on the First Semester Progress Review and/or communicated to the Field Consultant by email.

The Field Consultant will arrange an on-site conference, usually in the Fall semester, during which this agreement will be collaboratively reviewed, discussed, and finalized by all parties. We seek to balance student’s interests and needs and the agency’s available activities with attention to all 12 school-identified professional competencies.

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Briefly describe the nature of the setting and the student’s primary overall learning goals:

COLUMN IRequired Field

Activities

COLUMN IISpecific Task Assignments and

Designated Observation, Recording, or Assessment Methods

COLUMN IIICompetencies

Addressed

COLUMN IVTimeline

ORIENTATION

Students are expected to receive a planned, 3-4 week during which an educational assessment is completed. Students are not permitted to assume any major responsibilities beyond observation before this period has concluded.

1. Review agency mission, history, and all relevant policy and procedure manuals including review of all safety and risk reduction policies;

2. Understand how the agency is funded, the political climate related to funding, and what the target outcomes are and how they are measured or evaluated;

3. Understand what laws, regulations, and ethical codes govern decision-making in the agency;

4. Understand who agency’s clients are, mechanisms of referral, assessment strategy, common interventions and services provided, and how clients experience the system and quality of service;

5. Understand the various roles and/or disciplines in the agency, how and when management and related communication occur, and formal and informal agency rules;

6. Meet with at least one agency executive and program-level director;

7. Understand how the agency or unit fits into an overall system of care and complete site visits to collaborators and/or frequent referral sources;

8. Observe the tasks that will be eventually assigned being conducted by a capable employee and review in detail including documentation standards;

9. Become oriented to agency’s IT and record-keeping systems;

10. Establish a strong learning environment between field instructor and student with attention to different styles of learning and teaching, expectations, and a commitment to early identification and resolution of problems and conflicts.

Specific Orientation Tasks or Additional Activities:

1: Engage2: Collaborate3: Assess6: Systemic Intervention11: Professional Conduct

9/4-10/4

CASE AND/ORCLINICAL WORK

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Activities




Addressed

COLUMN IVTimeline

WITH INDIVIDUALS AND/OR FAMILIES

Student will carry a caseload of individuals and/or families from diverse backgrounds. Student will be responsible for providing clinical services related to all or most of the intervention cycle including engagement of the client and relevant collaterals, comprehensive assessment, development and implementation of a coordinated service or intervention plan, evaluation and modification, as needed, and appropriate transition or termination.

GROUP, FAMILY, AND/OR

INTERDISCIPLINARY WORK

Student will be responsible for developing, co-leading, and/or evaluating a clinical group and/or facilitating family meetings, contributing to interdisciplinary conferences, making public presentations, and/or other activities that require working with a variety of persons likely to hold

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Activities




Addressed

COLUMN IVTimeline

different perspectives so as to increase the likelihood of attaining desired clinical outcomes.

COMMUNITY, AGENCY, OR

SYSTEM IMPROVEMENT

PROJECT(S)

Student will participate in at least one community-based, collaborative, and/or system improvement project with the purpose or improving service delivery, access to services, and/or attainment of outcomes.

PARTICIPATION IN FIELD INSTRUCTION

Student will prepare for and meet with the field instructor for a minimum of one dedicated hour per week.

Student will participate in other types of instruction (secondary supervision or group supervision, seminars, training) if available.

OPTIONAL MANAGEMENT,

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Activities




Addressed

COLUMN IVTimeline

PLANNING, OR EVALUATION

PROJECT

Student may devote up to 20% of time (5 hours per week) engaged in a management, planning, and/or evaluation project with agency and field consultant approval.

If evaluation project is to be used for student’s final research assignment (SW 282A and B), the proposed project must be approved by the agency and field consultant, must not pre-empt other clinical learning assignments, and must provide valuable information to the field agency for the purposes of needs assessment, quality assurance, and/or program improvement.

OTHER

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