Skill Evaluation Form:

Counseling Skills and Techniques

Student Name: ___________________________________________ Person Completing Evaluation: _______________________________________

Instructions:
• Clearly write your score in the far right column titled “Score”. Place an “X” in the “Score” column if the standard was not observed.
• When this form is completed, turn it into the CES administrator for data entry.
• Counseling Skills and Techniques is the first formal place in the master’s program to evaluate students counseling skills. There will be other
places such as practicum and internship that formally assess counseling skills as well. During Counseling Skills and Techniques, items scored
as 3 and 4 are considered acceptable. It is not expected that students receive a score of “5” on any of the items in this evaluation because
they are considered to be beyond what is expected at this point in their development. If any items are scored as 1 or 2, the instructor should
discuss specific concerns with the student and ways the student can improve.
• All scores contribute to the overall grade in this course.
Standard 1 2 3 4 5 Score
1. d. Self-care The student cannot he student cannot The student can verbalize The student integrates The student continually
strategies appropriate verbalize a need for verbalize strategies for self-care strategies but self-care strategies integrates and adapts
to the counselor role self-care self-care does not or cannot but not continually new self-care strategies
implement the strategies
5.B. Counselor characteristics and behaviors that influence helping processes
The verbal and When the student The expressions of the The responses of the The student’s responses
behavioral responds, they do so in student are essentially student add noticeably to add significantly to the
expression by the such a way that it interchangeable with the client in such a way feeling and meaning of
student does not subtracts noticeable those of the client in that to express feeling levels the client expression and
5. b. 1 Empathy attend to and affect from the they express the same deeper than those when the client is in
detract significantly communications of the affect and meaning expressed by the client ongoing deep self-
from the client client exploration, the student
remains immediate to
that experience
Does not show Shows one of three of Shows two of three of the Shows three of the Student is ABLE to show
ANY ability to the following qualities; following qualities; suspend following qualities (but consistently across clients
suspend suspend judgmental judgmental thinking, value not consistently across the ability to suspend
5. b. 2 Unconditional judgmental thinking, value clients as clients as individuals, and clients); suspend judgmental thinking,
Positive Regard thinking, value individuals, and think think positively about them judgmental thinking, value clients as
clients as positively about them value clients as individuals, and think
individuals, and individuals, and think positively about them
think positively positively about them
Is about them
incongruent Is aware of incongruence Begins to take action in Takes regular action in Demonstrates consistent
5. b. 3 Congruence among, self, among self, thoughts, client sessions to be more client sessions to be congruence among self,
thoughts, and and actions congruent in their more congruent in their thoughts, and actions
actions experience of the client experience of the client
5.C. Essential interviewing and counseling skills
Shows no pattern Starts counseling Starts counseling Starts counseling Demonstrates a complete
for establishing a relationship with relationship with relationship with process of establishing a
counseling introduction but w/o introduction but misses introduction but misses a counseling relationship
5. c. 1 Establishing relationship structured ethical many components of a few components of a with a complete ethical
Relationships introduction structured ethical structured ethical introduction
(professional disclosure, introduction (professional introduction (professional disclosure,
fees, cancellation, disclosure, fees, (professional disclosure, fees, cancellation,
orientation, cancellation, orientation, fees, cancellation, orientation,
confidentiality, informed confidentiality, informed orientation, confidentiality, informed
consent, questions) consent, questions) confidentiality, informed consent, questions)
consent, questions)
Does not practice Shows some inaccurate Attending behavior is Attending behavior is Attending behavior is
attending behavior and inconsistent accurate but inconsistent; mostly consistent and accurate and complete
5. c. 2 Attending attending behaviors; visual contact, verbal accurate; visual contact,
visual contact, verbal tracking, vocal qualities, verbal tracking, vocal
tracking, vocal qualities, body language qualities, body language
body language
Asks few questions Selects open and closed Selects open and closed Include questions
or the questions do Uses unintentional pattern ended questions ended questions appropriately; using
5. c. 3 Questions not appear to follow of questions and does not appropriately; does not appropriately and mostly closed and open ended
any logical pattern; follow logical pattern of follow client verbal tracking tracks client questions and closely
does not verbally client verbal tracking follows verbal tracking
track client

Revised May 2017

 Standard 1 2 3 4 5 Score
Makes no use of Demonstrates some Uses observation skills Uses appropriate Uses appropriate
observation skills observational skills but but rarely uses immediacy observation skills with observation skills and
5. c. 4 Observation Skills does not show in presenting them to the occasional immediacy is able to show
immediacy in response to client immediacy with them
the client when working with a
client
Makes no use of Rarely uses encouraging Uses primarily non- verbal Uses a range of Intentionally uses a
encouraging skills comments to client or minimal encouragers encouragers (head nods, range of
5. c. 5 Encouraging with client uh-huh, keywords, and appropriate/timely
short statements with encouraging skills with
client) a client
Paraphrases w/o Paraphrases and misses Paraphrases getting key Paraphrases w/ check- Paraphrases using
intentionally using key points in client verbal verbal tracking but missing out but lacks full breath sentence stem,
5. c. 6 Paraphrasing any of the four tracking and components check-out and use of key of the client story keywords, essence,
dimensions; sentence of the four dimensions words and check-out
stem, keywords,
essence, and check-
out
Summarizes w/o Summarizes and misses Summarizes getting key Summarizes w/ check-out Summarizes using
intentionally using key points in client verbal verbal tracking but missing but lacks full breath of sentence stem,
5. c. 7 Summarizing any of the four tracking and components check-out and use of key the client story keywords, essence,
dimensions; sentence of the four dimensions words and check-out
stem, keywords,
essence, and check-
out
Makes no use of Summarizes end of Summarizes end of Summarizes w/ checkout, Does complete
skills to end a session; there is little session; includes check- may miss one of the summary, check-out,
session process other than to out with client. student following components; strengths, and
5. c. 8 Ending a explain parts of what may or may not assign client strengths and continuity plan with
Session happened in the session; homework but w/o continuity plan for next client as part of
student assigns homework client involvement session. May or may not summary
w/o client involvement assign homework and
does so with client
involvement
Does not reflect Attempts to reflect Reflects feelings Consistently reflects Consistently reflects
5. c. 9 Reflection of feelings feelings but does so inconsistently with feelings appropriately feelings appropriately
Feelings inaccurately varying levels of and integrates it into
appropriateness case conceptualization
CES 1 Ability to structure Never Rarely Sometimes Often Always
a session intentionally

CES 2 Integrates multiple Never Rarely Sometimes Often Always

micro- skills fluidly

The evaluator MUST check one of the following:

• Based on the above standards, I recommend this student for advancement to practicum
• Based on the above standards, I recommend this student for advancement to practicum with reservations
• Based on the above standards, I do not recommend that this student advance to practicum

Student Signature: ___________________________________________________________________________ Date: ______________

Evaluator Signature: ___________________________________________________________________________ Date: ______________

NOTE: As an addition to this evaluation, supervisors may include a written summary, list of recommendations, etc. and attach it to this form.
 Skill Evaluation Form:
Counseling Skills and Techniques

Student Name: ___________________________________________________ Person Completing Evaluation: __________________________________

Instructions:
• Please place a check in the appropriate box.
• When this form is completed, turn it into the CES administrator for data entry.
• Professional behavior is expected of all CES students during class, while working in the Counseling and Human Development Center, and
while working with other students on class assignments. If a student’s professional behavior is deemed as questionable, programmatic
remediation may need to occur. If any item is marked as 1-3, please inform the CES Master’s Programs Coordinator and remediation will be
determined. However, there are multiple levels of severity of professional behavior and remediation could occur even if there was only once
correction.
• All scores contribute to the overall grade in this course.

Never Occurs Occurs Occurs Occurs

Always Not
After Multiple After After Few After One
Section A: Professional Behavior Corrections Multiple Corrections Correction
occurs Applicable
Corrections
1 2 3 4 5 X
Dresses Appropriately
Is on time for appointments
Is on time to site
Interacts with colleagues in a professional manner
Interacts with office staff in a professional manner
Has professional demeanor on telephone with clients/parents
Completes record keeping in a timely manner
Treats clients with respect in waiting areas
Comes to site on agreed dates and times
Calls to report inability to come to site in a timely and professional manner
Comes prepared for supervision
Assists colleagues when appropriate and needed
Follows site guidelines / policies
Accepts feedback
Comes prepared for client sessions
Takes initiative on projects when appropriate
Has proper personal hygiene

Section B: Professional Behavior Serious Concern Always

Discusses client cases only in appropriate settings
Maintains client confidentiality through proper record handling
Is respectful of all clients regardless of any differences
Complies with supervisor directions
Seeks supervision when needed

The evaluator MUST check one of the following:

• Based on professional behavior, I recommend this student for advancement to practicum
• Based on professional behavior, I recommend this student for advancement to practicum with reservations
• Based on professional behavior, I do not recommend that this student advance to practicum

Student Signature: ___________________________________________________________________________ Date: ______________

Evaluator Signature: ___________________________________________________________________________ Date: ______________

NOTE: Please attach any written narrative that may help contextualize this evaluation.

Content in this evaluation taken from Ivey & Ivey (2008); Carkhuff, (1972); and Stoltenberg, McNeill, & Delworth (1998).
Revised May 2017