G524: Practicum in Counseling

Student Information Packet and Application

Counseling and Counselor Education Program

Indiana University-Purdue University at Indianapolis


Revised January 2003


Submit application to:

Alexa Griffith, Field Placement Coordinator

ES 3161

Phone: (317) 274-6827

e-mail: griffita@iupui.edu




Dr. Floyd Robison, Faculty Director of Field Experiences


Phone: (317)274-6815

e-mail: flip@iupui.edu

fax: (317)274-6864

Please submit the following:


Practicum in Counseling (G524)


The Practicum in Counseling is designed to provide students with closely supervised counseling practice at approved field sites in schools or agencies. This field experience requires a major commitment of time and energy and many students find it helpful to reduce their course loads while completing the practicum.

Application Deadlines:


Submit applications at least 3 months prior to the beginning of the practicum semester.


Please indicate on the attached practicum application if you must perform your practicum in the evening only (available for agency sites only). You should be aware that "evening only" practicum sites are limited and it may not be possible to arrange such a placement for you during the term you request. "Evening only" practicum placements may not be available during the summer sessions.



Before enrolling in G524, students must have completed the following courses with grades of "B" or higher:


G502: Professional Orientation and Ethics

G522: Counseling Theory

G523: Laboratory in Counseling


Additionally, G505 (Individual Appraisal); G532 (Group Counseling); and G552 (Career Counseling) must be taken prior to or concurrently with the practicum. The Director of Field Experiences must approve any exceptions.




Requirements for the practicum include departmental requirements, site-specific requirements, and faculty supervisors' requirements. Departmental requirements are described below, but may be modified or extended by site or faculty supervisors:


1. Minimum of 100 hours on site (does not include group and individual supervision at IUPUI). The specific minimum requirements include:


  1. Forty (40) hours of direct service (individual counseling, group counseling, parent conferences, related direct service activities) including a minimum of 10 hours of group work;
  2. One hour per week of individual supervision by the on-site supervisor (usingaudiotape, videotape, and/or direct observation);

c. Remaining hours should include activities such as professional development activities, participating in workshops as a learner, and involvement in other activities that would be expected of a staff member at the site.

2. In addition to the 100 hours on site: Ninety (90) minutes per week of group supervision through regular attendance at the weekly practicum seminar class conducted by the practicum instructor and one hour per week of individual supervision by the faculty supervisor.



3. Maintain a log detailing time spent at the practicum site, including specific activities.


At the conclusion of the practicum experience, a complete log for the course must be submitted to the Field Placement Coordinator.


4. Maintain client case notes appropriate to the school/agency and faculty supervisor requirements. A sample format for preparing client case notes is included in this packet. You may use another format desired by your practicum site or faculty instructor. Be sure to check on your site's policies concerning case notes and any restrictions on carrying them from the site. Ethical standards require that case notes and all other information about clients be maintained in a secure manner.

5. Video or audio tape samples of client sessions for review by faculty supervisor and site supervisor.

6. Complete all work assigned by the faculty supervisor at satisfactory levels.

  1. Participate in activities of the site and follow the site's policies and procedures in a satisfactory manner.
  2. All field experience students are required to have professional liability insurance in effect before beginning work at the site. The required minimum coverage for professional liability is $1,000,000 each incident / $3,000,000 annual aggregate. Low cost insurance rates are available through student membership in the American Counseling Association (ACA). ACA Insurance Trust, Inc. can be contacted at 800-347-6647 or online at www.acait.com. Please consult with the field placement coordinator or your faculty advisor for other insurance options.


Steps to Applying for a Practicum Placement:

1. MS degree students must meet with their faculty advisor and complete a Program Outline For MS Degree In Counseling form before submitting the practicum application. This form may be obtained from your faculty advisor or outside of ES 3111 and must be signed by the faculty advisor.

2. Complete the attached practicum application and have your G522/G523 professor sign where indicated. If you are currently enrolled in G522/G523, submit the application without the signature.

3. Prepare a current copy of your professional resume. The resume should include information about your educational (post-high school) background, counseling courses completed or enrolled in, professional work experience, career objectives, and any other information you believe to be relevant. If you are unsure how to prepare your resume, please consult with your faculty advisor.


4. Submit your completed application, a copy of your Program Outline and two copies of your resume to the Field Placement Coordinator (ES3101) listed on the cover page of this document. Submit your materials by the deadline for the academic term during which you wish to perform your practicum (see preceding page for deadlines).

5. Do not contact a site on your own. You will be notified when to contact a site to arrange an interview. Keep in mind that, prior to acceptance by a site, you may participate in one or more preliminary interviews at the site. These interviews should be treated as if they were employment interviews. Following your interview(s), the site will notify this department as to whether or not you have been accepted for a practicum.

  1. When a site has accepted you, complete the attached Final Site Placement Form and obtain the necessary information and signatures. Return the completed form to the Field Placement Coordinator or your faculty supervisor by the first practicum class meeting.

7. Submit verification of your professional liability insurance to the Field Placement Coordinator before beginning any work at the site.


Client Case Notes Form


Identification: ________________________________ Date: ________________



1. Presenting Problem




2. Summary of Session









3. Assessment Information, Hypotheses





4. Goals Established, Plans made




5. Additional Counselor Comments


Practicum/Internship Hours Log Counseling — School Track


Name_____________________________________ G524 or G550 (circle one) Month/Year______


Name of School___________________________________________ Level: Elem MS HS


I. Hours of Professional Service (direct client contact)


Week ___



Week ___



Week ___



Week ___



Week ___



Individual Counseling


Group Counseling


Academic Advising


Parenting Conferences


Mediation/Conflict Resolution


Classroom Guidance/Intervention


Crisis Intervention


Career Counseling




Other Categories:



Total direct contact hours: This month: ________ Semester: ________

II. Hours of Educational Activities (Indirect service hours)

Individual Supervision


Professional/Educational Presentations




Research/Professional Reading


Staff Meetings


Report Writing/Case Notes


Case Conference/Staffing


Other Categories:



Total indirect contact hours: This month: _________ Semester: _________


___________________ _____________________ ___________________________

On Site Supervisor Signature Faculty Supervisor Signature Intern’s Signature


Turn in signed copies of this log to your faculty supervisor each month. Turn in a complete copy of all monthly logs to the Field Placement Coordinator at the completion of either G524 or G550 (at end of both semesters). Be sure to keep a copy for your own permanent files.




Student's Name: ______________________________________________________

School or Agency: ______________________________________________________

School/Agency Address: ______________________________________________________


School/Agency Phone: ______________________________________________________

Site Supervisor : ______________________________ Phone: _________________

e-mail: _________________________


Dates of Practicum Experience: _______________ to _______________

The above named student has been accepted for a practicum experience at this site during the time period specified above. I have read the "Counseling Practicum Program Guidelines" document (contact Alexa Griffith, Coordinator of Field Placement, at (317) 274-6827 or at griffita@iupui.edu if this document has not been received) and my questions about the practicum requirements have been answered to my satisfaction. I agree to abide by the terms of this document.

_____________________________________ ___________

School Principal or Agency Director (date)

_____________________________________ ___________

School or Agency Site Supervisor (date)


Site supervisors not employed by Indiana University are entitled to an honorarium payment. In order to process honorarium forms the following information is needed:

Site Supervisor's Full Legal Name: ________________________________________

Social Security Number: _____________________________________________

Present Home Address: _____________________________________________



Counseling Practicum (G524) Application


Student Name: ____________________________________

Social Security Number: _______________________



Phone: ___________________ __________________ e-Mail: ______________________

(work) (home)


Practicum requested for: Fall_____ Spring_____ Summer_____ 20_____


Setting desired: Particular Interests: (check all that apply)

____ elementary school ____ marriage and family counseling

____ middle school ____ addictions counseling

____ high school ____ group counseling

____ social service/mental health ____ gerontological counseling

agency ____ other ________________________


Other comments or requests concerning practicum site placement:




Can you reliably travel outside Indianapolis? YES NO






Please list all counseling courses completed or enrolled in, along with dates and grades (if equivalent course was taken at another institution, list course number, title, and institution):


Course Semester/Yr Enrolled Grade












This student has successfully completed G522/G523

and is recommended for enrollment in G524. ____________________________________

G522/G523 Professor's Signature