Authentic Counselling Training
Certificate in Counselling
[Under construction: 10 June 2005 ]
Counselling Practice Assessment Form
|
Name
of student |
|
Date |
|
|
Name
of watching tutor |
|
Video,
audio, none |
|
|
Describe the non-verbal communication |
Nodding |
|
|
|
Posture |
|
Facial
expression |
|
|
Hand
movement |
|
Smiling |
|
|
Body
movement |
|
Eye
contact |
|
|
Describe the non-verbal communication |
Time
to 1st intervention |
|
|
|
Audibility |
|
Subsequent
frequency |
|
|
Conciseness |
|
Pacing
with speaker |
|
|
Classify
each intervention by type (reflection, etc.) |
8 |
|
|
|
1 |
|
9 |
|
|
2 |
|
10 |
|
|
3 |
|
11 |
|
|
4 |
|
12 |
|
|
5 |
|
13 |
|
|
6 |
|
14 |
|
|
7 |
|
15 |
|
|
How were the three core conditions communicated? |
Empathic understanding: working only in the
speaker's frame of reference |
|
|
|
|
Unconditional positive
regard: |
|
|||
|
Genuineness: |
|
|
||
|
List
what the listener did (or refrained from doing) that enhanced the practice
interview |
|
1 2 3 |
|
List
what the listener did that conflicts
with tutor guidance |
|
1 2 3 |
|
List
what appear to be the listener's strengths as a listener |
|
1 2 3 |
|
List
those areas on which the listener might most profitably focus future learning
and practice |
|
1 2 3 4 5 |
|
Any
other comments |
|
|
|
Listener's
private comments and observations (including about the feedback) |
|
|
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