Field Practicum Interest Form

*Required fields

*Agency/Program Name:

*Address Line 1:

 Address Line 2:

*City:

State: Select One Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

*Zip:

Contact Person Title: (e.g., Mr., Ms., Dr.)

*First Name:  

Middle Name/Initial:  

*Last Name:

List degrees earned:

Phone: - -

Fax: - -

*E-Mail Address:

Agency Program Description - Population Served - Services Provided

Site appropriate for and will accept (please check all that apply):
BSW
MSW (Foundation Year - 1st Year)
MSW (Direct Practice - 2nd year)
MSW (Admin. Practice & Planning - 2nd Year)
MSW (Child Welfare - 2nd Year)

BSW Field Practicum Activities (please check all that apply):
Administrative Duties
Basic Interviewing 
Case Management
Case Staffing  
Client Referrals/Resources 
Court Proceedings/Observations
Discharge Planning  
Groups (Types )
Home Visits    
Individual/Family
In-Service Training
Intakes/Observation
Investigations (Types )
Linkages/Collaboration with other agencies
Outside Training
Prepare treatment plans
Psychosocial assessments/Observation
Report Writing
Staff meetings
Others

MSW Field Practicum Activities-General (please check all that apply):
Case Management
Case Staffing
Client Referrals/Resources
Court Proceedings/Observations
Crisis Intervention
Diagnosis with DSM/IV
Discharge Planning
Evaluation of intervention outcomes
Groups (Types )
Home Visits
Ind./Family psycotherapy
In-Service Training
Intakes/Screening
Investigations (Types )
Linkages/Collaboration with other agencies
Outside Training
Prepare treatment plans
Psychosocial assessments/Observation
Report Writing
Staff meetings
Testing
Others

MSW Field Practicum Activities – Administrative (please check all that apply):
Board Meetings
Community advocacy
Community resource development
Conduct Focus Groups
Grant writing
Needs assessment
Policy development
Program development
Program evaluation
Staff meetings
Special project implementation
Research presentations
Research statistical/ethnographics activities
Others

Describe any unique experiences or opportunities your agency can offer to students:

Does your agency offer a student stipend?
Yes
No

Interest Statement
Please review the conditions below before submitting the form.

The criteria for the selection of field agencies is as follows:

1. An established social welfare program with a clear-cut sanction from the community
2. Commitment to the goals of professional social work education.
3. Willingness to support the School's educational objectives.
4. Commitment to and the ability to provide the resources (space, time, and other support) needed by agency staff and students involved in the activities of instructional field practice.
5. Availability of qualified staff to supervise BSW / MSW candidates.

The criteria for the selection of agency field instructors is as follows:

1. Master of Social Work degree.
2. Two (2) years post-masters experience in the field.
3. Six (6) months experience with the current agency.
4. Licensed to practice professionally in the State of Nevada or state in which practicum is set.
5. Reputation for professional competence.
6. Attitude of respect for students' competencies and needs.
7. Ability and desire to teach social work theories and their practical application to professional practice.
8. Demonstrated identification with the social work profession.
9. Thorough knowledge of the purposes, policies, and procedures of the agency.
10. Willingness to advance professional development as demonstrated by participation in continuing education and field instruction seminars as available.

UNLV provides an orientation for which attendance is mandatory for all field instructors. The purpose of the orientation is to:

1. Promote general consistency in the training of students across agencies.
2. Foster a network of communication between field instructors and with the School.
3. Disseminate the most current information reflecting generally accepted principles of field supervision.

General problem-solving procedure – recommended steps and available resources:

1. For relatively minor conflicts or problems, the School supports appropriate resolution worked out between the student and the field instructor with the incident or problem used as an opportunity for professional growth.
2. More complex or involved issues may be brought to the attention of the assigned Field Liaison by the student or by the field instructor. The Field Liaison will take steps or make recommendations to resolve the matter with an emphasis on fostering the student's educational development. The Field Liaison may notify the Field Director of the status of the situation.
3. When resolution of a problem is not successful at the Field Liaison level, the Field Director must be notified. Upon consulting with the parties involved, the Field Director will make recommendations regarding the placement experience. Changing placements is a very last resort that will not be considered until all other options have been exhausted.
4. Documentation of problems or conflicts should be noted in standard supervisoryrecords .

If you accept the conditions of the Interest Form, click on the SUBMIT button. You must accept the conditions to submit the form.