Professional Documents
Culture Documents
Student Name:
1. Who was present, when and where did the interaction take place; full names
should not be used in recordings in order to protect confidentiality, use
initials.
2. What was the purpose of the interaction?
3. What phase of the helping process are you in, what are you hoping to
accomplish?
Content-Dialogue
Students Gut-Level
Feeling/Response
Students
Analysis/Assess
ment
Analyze your
interventions;
what did you
do? Why? What
are the client
systems needs,
issues, affect?
Identify skills
you are using
(refer to the
Social Work Skill
Sets); Assess
your work. What
is your plan for
the next
intervention or
contact?
Supervisors
Comments
The field instructor
can make
comments and give
feedback right
opposite the
interaction or
feelings/reactions the
student records.