CSWE Standard: SOCIAL WORK VALUES AND ETHICS



University of Wisconsin-Milwaukee

The Helen Bader School of Social Welfare Field Program

PERFORMANCE-BASED LEARNING PLAN / DIRECT PRACTICE – CLINICAL / 721 & 722)

Field Course (please check): 421 422 423

721 722 821 822 921

Student Name: Ima S. Worker Student ID 000 - 00 - 0000

Agency Wherever Behavioral Health Outpatient Clinic

Agency Address 0000 S. Wherever Street - Milwaukee, WI Agency Phone 000 - 000 - 0000

Agency Fax 111-111-1111

Agency Field Instructor S. Freud, MSW, LCSW Field Instructor Email sfreud@

University Field Liaison (select)

Semester Fall Spring Summer

Weekly Schedule @ Agency:

|Monday |Tuesday |Wednesday |Thursday |Friday |Saturday | |

| | | | | | |Sunday |

Field Semester at this Agency: 1st 2nd 3rd 4th

Student will begin this semester on 09 - 01 - 0000 and end this semester on 12 - 22 - 0000

(date) (date)

(*Please consult with assigned Field Liaison if dates vary from those designated on UWM Semester Calendar)

Weekly supervision day and time: Monday / 10 AM - 11 AM

(The school requires scheduling a minimum of one-hour of individual supervision per week.)

Group supervision time (if applicable): Not Applicable.

Mid-Term Evaluation Due Date

(421/422/423 at 125 completed hours; 721/722 at 130 completed hours; 821/822 at 160 completed hours) 10 - 01 -0000 (fill in date due)

Final Evaluation Due Date

(421/422/423 at 256 completed hours; 721/722 at 260 completed hours; 821/822 at 320 completed hours) 12 - 22 -0000 (fill in date due)

INSTRUCTIONS

The Learning Plan identifies the learning objectives mutually agreed upon between the student and Field Instructor at the beginning of each semester. This plan should serve as a map for the student’s learning experiences and expected performance for the semester. You should be as specific as possible when developing the learning plan, and amend the plan as necessary throughout the semester. The plan should be developed in conjunction with the field education course objectives located on the field website. hbsswfield.uwm.edu

The following table identifies the primary learning objective categories for the field education course. More detailed information related to each objective is located on the Field Department website located at the above-referenced weblink. On the table below identify your learning activities for the semester. The evaluation criteria utilized for the evaluation of student performance at mid-term and end of the semester are consistent with the social work objectives for this course.

|Learning Objective Categories |Agency responsibilities, duties and expectations that address |Written Assignments (assignments totaling 5 points submitted to |

| |the Learning Objectives |Field Instructor for discussion in supervision and submitted to |

| | |the Field Liaison; ½ of field assignments due to Field Liaison |

| | |by mid-term) |

| Select from the Assignment List |

|hbsswfield.uwm.edu |

| |

|Students do not have to have assignments listed for every objective category. |

|Professional Development |Student will utilize supervision to discuss any issues / |      |

| |questions encountered in communication with other professionals.| |

| |Student will learn and use the clinic's | |

| |system (SOAP) of recording progress notes. | |

| | | |

| |Student will establish and adhere to | |

| |deadlines & timeframes for field work. | |

| | | |

| |Student will come to supervision pre- | |

| |pared to initiate discussion of issues | |

| |encountered in the practicum and how | |

| |they related to field course objectives. | |

| | | |

| |Student will be open to incorporating | |

| |the supervisory feedback from the Field Instructor & staff. | |

|Social Work Values and |Student will learn and adhere to NASW |      |

|Ethics |Code of Ethics as it applies to this clinical social work | |

| |setting. | |

| | | |

| |Student will establish ethical boundar- ies re: confidentiality,| |

| |interaction with | |

| |clients & staff, and personal disclosure. | |

| | | |

| |Student will inform clients of treatment options and rights / | |

| |limitations of confi- | |

| |dentiality including HIPAA provisions. | |

| | | |

| |Student will initiate discussion with Field Instructor / staff | |

| |regarding any | |

| |ethical concerns. | |

|Diversity |Student will develop awareness of per- |Written Paper on the Use of Self- |

| |sonal reactions / biases to clients & staff who are different |Awareness in Social Work Practice / |

| |from student. |(6 - 9 pages for 2 points) |

| | | |

| |Student will initiate discussion with | |

| |Field Instructor regarding how | |

| |these personal reactions / biases are | |

| |affecting the student's relationship development with clients | |

| |and staff. | |

|Populations at Risk and |Student will identify the issues of poverty, racism, sexism, & |      |

|Social and Economic Justice |ageism that make clients of this clinic vulnerable to | |

| |AODA & mental health problems. | |

| | | |

| |Student will initiate discussion with Field Instructor on | |

| |appropriate ways to | |

| |address these issues with clients in | |

| |treatment & discharge planning. | |

|Human Behavior and the |Student will review client's history from records and interviews|      |

|Social Environment |in order to understand how the client's social environment may | |

| |have affected their AODA & behavioral health issues. | |

|Social Work Practice Skills |Student will learn how to develop | |

| |rapport / relationships with clients through the use of Empathic| |

| |/ Reflective Listening and Motivational Inter- viewing. | |

| |Student will learn how to identify the | |

| |strengths and needs of the client during the Initial Intake and | |

| |On-going |Written Social Assessment Report / Social History (2 points) |

| |Assessment. | |

| | | |

| |Student will learn how to incorporate | |

| |the strengths and needs of the client | |

| |in the Treatment Plan. | |

| | | |

| |Student will observe individual & group therapy. | |

| | | |

| | |Recording For Learning of an observed individual therapy session|

| | |(1 point) |

|Social Welfare Policy and Services |Student will learn the requirements |      |

| |that must be met for a client to receive | |

| |behavioral health treatment under Title 19 / Medicaid. | |

| | | |

| |Student will learn the benefits and potential negative | |

| |consequences to | |

| |having a behavioral health disability. | |

|Research |Student will review and discuss in supervision one published | |

| |article providing research results on the use of Motivational | |

| |Interviewing. | |

| | | |

| |Student will discuss in supervision how | |

| |these research results can be incorporated in the student's | |

| |relationship development with a client. | |

Date:

Student’s Signature:

Field Instructor’s Signature:

Field Liaison Signature (for major assignment):.

Revised 11/14/08

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