Basic and Advanced Pastoral Counseling Practicum Manual

Basic and Advanced

Pastoral Counseling Practicum Manual


















Care and Counseling Center of Georgia

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PASTORAL COUNSELING PRACTICUM
MANUAL
2003-2004

The Pastoral Counseling Training Program of the Care and Counseling Center of Georgia
teaches the theory and practice of pastoral counseling. Training in pastoral counseling takes
place in three different ways:

*
through the basic practicum in which residents involved are enrolled either in a
doctoral or masters degree program through one of the seminaries of the Atlanta
Theological Association;

*
through an advanced practicum in which residents have completed their academic
work and are working toward increasing their counseling skills;

*
through individual contractual arrangements with CCCG staff.

This manual covers procedures in the basic and advanced practicum.

1.0
PASTORAL COUNSELING: DEFINITION AND SUPERVISORY GOALS

Pastoral counseling is a theological discipline. Faith in God has implications for the counseling
practitioner. Its impact is felt in our values, in our esteem for others, in our manner of relating to
our clients, in our view of human nature, in our thinking about psychological ills and their
healing, and the hopes we hold for those who seek our help. Implicit in our vocation as pastoral
counselors are certain responsibilities. First is our responsibility to have a thorough knowledge
of our respective theological traditions. Second, we must be able to integrate our theological and
psychological understandings. Third, we must engage in self-examination to discern how our
practice reflects what we believe. Thus, we are constantly in a position to revise our statements
of belief and to change the way we practice so that our professed faith and our practice come into
harmony. The training program is a context in which this theological activity can take place.

From a psychological perspective, pastoral counseling, as taught by the CCCG practicum staff,
can be thought of as interpersonal psychotherapy. It is based upon the belief that the most
important element is the establishment of a healing relationship between the therapist and client.
The theoretical foundation for this psychotherapy is psychodynamic, including object relations
theory, self psychology and attachment theory. This psychotherapy can be seen as facilitating
such processes as increasing self-acceptance, personal growth, resolution of blocked
developmental processes, increased freedom and the ability to choose, and improved personal
relationships. Both the therapist and client will experience healing in the process.

In the supervisory process, residents are expected to integrate the theoretical material that is
presented in the didactic portion of the practicum in such a way that they are able to relate
authentically and spontaneously to their clients. Residents will also be expected to integrate their

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theology and pastoral identity into their experience as pastoral counselors. This will require an
intensive personal therapeutic experience for residents in addition to the supervision provided by
the CCCG staff.


2.0
GENERAL ADMINISTRATIVE INFORMATION

2.1
Calendar

The practicum generally follows the academic calendar of the participating seminaries. The
practicum continues in a reduced form during the summer. Residents are expected to continue to
see their clients during breaks. The exact calendar and schedule for the practicum will be
available several weeks prior to the beginning of each semester.

2.2
Practicum Tuition

Residents who are getting course credit for the practicum pay tuition for the practicum to the
seminary in which they are enrolled. The seminaries then pay a portion of that tuition to CCCG.
Residents who are not receiving course credit pay CCCG directly. CCCG’s tuition is based on
the amount of tuition residents pay to the seminaries. Since that tuition does not meet CCCG's
expenses in providing the practicum, the fees which residents get from their clients are used to
pay the full amount of the tuition. Because of that, residents are expected to carry a caseload of
at least 3-5 clients per week, assuming referrals are available. For those residents who pay
CCCG directly, tuition must be paid within the first week of the semester unless a payment plan
is arranged with the Business Manager. If a payment agreement is signed, the first payment is
due the first week of class. Tuition may be fully refunded for residents who withdraw from the
program within the first week of the semester, 60% in the second week, 40% in the third week,
and no refund for residents who withdraw after the fourth week. Although residents do not get
academic credit for summer semester, they are expected to continue with their clients and in
supervision. All residents must pay summer tuition directly to CCCG. The tuition policy stated
above also applies to summer semester.


2.3
Relation of Practicum to Academics

For residents who are participating in an advanced degree program, the practicum and the
academic requirements of the seminaries are complementary. The content and structure of the
clinical teaching of the practicum presumes that residents appropriate that material presented
through the core curriculum of the Th.D. program. The didactic seminar of the practicum is
intended to supplement the theological emphasis of the core curriculum with psychotherapeutic
and personality theories. Residents receive nine hours of credit each year for successful
completion of the practicum. As with any graduate level course, residents are expected to meet
high standards of performance, e.g., reading material relevant to the practicum beyond that
which is required for the didactic seminar.

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2.4
Attendance

Practicum residents are expected to be present and on time for all components of the training
program. Tardiness and/or absences can result in grade reduction or termination from the
program. Residents should notify supervisors or training staff group leaders (e.g., didactic
leader) about expected or sudden absences. Absences that eliminate a scheduled presentation
must be covered by finding another resident to present at that time. When absences are to be
extended, residents must arrange for emergency coverage for their clients and inform the clients
of this arrangement. That information must be on your voice mail message and shared with your
supervisor.


3.0
PERSONAL ADMINISTRATIVE INFORMATION

3.1
Relationship to AAPC

All first-year residents who are seeking AAPC certification should apply for student member
with AAPC. The pastoral counseling curriculum and the number of hours spent in individual
supervision, case conferences, and small group supervision meet the current Standards for
Member Associate in AAPC. Residents are responsible for keeping accurate records of hours of
counseling and supervision. Accreditation by AAPC requires documentation of the number of
hours in each of these categories. Contact AAPC at 703-385-6967 or info@aapc.org.

3.2
Licensing

State licensure has become a critical issue for our ability to offer credible pastoral counseling. A
law regulating licensure for marriage and family therapists and professional counselors went into
effect July 1, 1993 replacing a title protection law with a practice protection law. This law states
that anyone who practices marriage and family therapy or professional counseling must be
licensed by the state. Although persons doing such therapy in church-related agencies may be
exempted, it is not clear that they are. This law is the manifestation of a national trend toward
licensure. Most pastoral counselors are heeding this trend by becoming licensed. In the
environment of managed care, licensure is clearly one requirement for any therapist who wants
to be included in third-party reimbursement, and it is now the norm in mental health care.

Although the Care and Counseling Center of Georgia seeks to provide an opportunity for
residents to meet as many of the licensing requirements as possible, it cannot include offerings
that meet all of them. The law and its associated regulations change frequently, and residents
should make themselves aware of these requirements and make provision for those that cannot
be met in this training program. Since licensing laws are frequently changed, residents should
call The Georgia Composite Board and get the current laws and rules or download those from the
internet.

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3.3
Ethics

The Care and Counseling Center of Georgia adheres to the Codes of Ethics of AAPC, AAMFT,
and The Georgia Composite Board. Residents' professional conduct is subject to these Codes.
Before seeing their first client, residents are expected to be thoroughly familiar with these
documents which are included in the Appendix.


3.4
Record Keeping

Residents will adhere to CCCG’s record keeping policy and to the following:

1.
Residents should use the sample form included in the Appendix for keeping
routine process notes. These notes should be kept up to date and provided for
your supervisor at each supervisory session.

2.
Your supervision presentation form should be destroyed and your tapes for
supervision erased once they have been used.

3.
You must get permission from your clients to tape your interviews and you must
inform them that you are a resident. Use the Authorization for Resident Clinical
Services form for that purpose. It must be signed both by you and your client(s)
during the first interview. That form, along with the Intake form, must be given
to the receptionist immediately after the first interview.


4.
Client records must be kept in the building, and care must be taken to maintain
confidentiality.

5.
Case conference reports should be prepared prior to presenting in case conference
with a copy given to the case conference supervisor and consultant prior to the
presentation. After your presentation, give a copy to the Administrative Manager.
Copies will then be made for your supervisor and your training file.

3.5
Personal Therapy

Residents are strongly urged to be in personal psychotherapy at their own expense while in the
training program. This is consistent with the AAPC requirement that applicants have had
sufficient therapy to protect their clients from the residents' issues, and it is also essential in
learning how to do psychotherapy. The therapist should be someone whose therapeutic approach
is congruent with that of the CCCG training program, i.e., psychoanalytically oriented
psychotherapy. Residents should

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consult their supervisor in choosing a therapist. The therapist must not be someone with whom a
dual relationship is possible, such as a CCCG staff person or a seminary professor. Residents
must have established a therapy relationship by the second semester of the first year.

3.6
Complaint Procedure

Any resident who has a complaint regarding the training program should first attempt to resolve
the complaint with his/her immediate supervisor and secondly with the Director of Training. If
the complaint is against the Director of Training, the complaint should be directed to the
Executive Director of the Care and Counseling Center of Georgia.

The resident should submit his/her complaint in writing with any substantiating documents to the
Director of Training. Any supervisor or supervisors towards whose action the complaint is
directed will submit, in turn, his/her responses in writing to the Director. If the complaint is
against the Director of Training, all written documents will be submitted to the Executive
Director of CCCG.

4.0
CLINICAL INFORMATION

4.1
Referrals

Referrals are of two kinds--general and specific. General referrals are those which come to the
center with no reference to a particular counselor. These are generally allotted to residents
according to the need of the resident and the need of the client. Specific referrals are those
which are made to a particular counselor and are given directly to that counselor. Residents who
expect to get referrals must check their voice mail at least twice a day.

Residents are expected to carry a case load of at least 3-5 hours a week. A caseload less than this
minimum will not provide enough of an experience in therapy for optimal learning to occur.
Residents are expected to develop their own referral sources as CCCG is not able to provide all
the referrals necessary for an adequate caseload. They must represent themselves as pastoral
counselors in training. The resident’s ability to develop and maintain a caseload will be
regularly evaluated and become a part of the final grade.

4.2
Room Scheduling

Counseling rooms are scheduled by making entries on the room schedule chart and in
consultation with the receptionist. Entries should be accurate and current. Space is at a premium
and should not be overbooked.

4.3
Forms

Residents will use the following standardized forms which are available in the Workroom and
upstairs in the printer cabinet by the snack bar.

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Forms which must be used during the first interview are:

General Information Sheet

Client Information Sheet -- The original is to be given to the receptionist immediately
after the first interview. Residents must keep copies for their personal files. The
requested administrative information is self-explanatory.

Authorization for Resident Clinical Services -- New clients are to be informed that
their counselor is a resident and that their interview will be taped and used for
supervision. Both clients and residents must sign this form which will be placed in the
permanent client file.

Other forms which must be used as needed:

Fee Schedule -- Residents will use the Resident Pastoral Counseling Fee Scale as a
guideline in setting client fees.

Daily Report -- A daily report will be filed for each counseling day. This report will
include client file number, type of service, client name, check number, and fee charged.
Receipts will be filled in by the office staff. Reports must be filed on the day in which
the counseling takes place.

Standardized Process Note Form -- Residents will use this form to keep process notes
for supervision and for the client files.

Release of Information -- Before information is shared with another professional, this
form must be signed by the client and cleared with your supervisor.

Referral Slip -- This form will be filled in by the office staff and given to the resident to
provide what information is available about the person(s) being referred.

Telephone Slip -- All long distance calls, including those related to counseling clients,
must be reported to the Manager of Accounting using this form.

Supervision Presentation Form -- To be used in individual supervision.

Letter of Agreement -- For residents working in a satellite center.

Insurance Information Form



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4.4
Audio or Video Recording

Residents are required to make audio or video recordings of all counseling interviews. These are
to be used in group and individual supervision and are to be promptly erased when no longer
needed for supervision. Recordings must be audible and should be cued to the portion that
demonstrates the issue that the resident is presenting for supervision. Signed permission must be
granted by clients for recording. This is given on the Authorization for Resident Clinical
Services Form. Counseling may not begin until this is accomplished.

Audible recordings depend on both technique and equipment. Inexpensive recorders usually
work well, but a powered booster microphone greatly enhances the quality of the recording.
Sound pickup varies exponentially with distance, so the microphone should be placed as close to
the source as possible. Microphone placement should be tested prior to the client's entering the
room.

4.5
Intake and Client Evaluation

Each client must be presented at the case conference held on Thursday mornings. The case
conference is a group seminar led by a CCCG staff person and one CCCG consultant with
participation by all the residents regarding the case presented. At the conclusion of the intake,
which should run no more than four sessions and which involves a thorough history taking and
diagnostic considerations, the resident presents the client at case conference. The case
conference report must be completed before presenting in case conference with copies given to
the case conference supervisor and consultant. There are two different formats to be used for
presentation in the case conference. One format is to be used when Anne-Marie Meehan, Ph.D.,
is the consultant (Case Conference Presentation Format). The other is to be used when Brian
Teliho, M.D., is the consultant (Psychiatric Case Conference Format). These formats can be
found in the Appendix. Each resident is expected to present twice each semester and once in the
summer and will be graded on the quality of the presentation.

4.6
Fees

The procedure for the setting and collecting of fees by residents from their clients will be
reviewed by the training faculty at the beginning of the resident's training. Briefly, that
procedure is as follows: (1) The fee should be set during the first interview, using the Resident
Fee Scale. Any deviation from the scale must be cleared with one’s individual supervisor. (2)
The fee should be collected at each session and turned in to CCCG using the forms provided by
CCCG. (3) No basic practicum resident may charge more than the Resident Fee Scale
maximum. Advanced Practicum residents may not charge more than Resident Fee Scale
maximum until they pass the performance exam and become members of AAPC or a similar
accrediting agency.


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4.7
Supervision

Clinical supervision is done in individual and group settings. Individual supervision consists of
one or two students per session. The Director of Pastoral Counseling Training assigns a primary
supervisor on a yearly basis for overall training responsibility, including weekly individual
sessions. The supervisor explains the resident's various responsibilities and oversees the
resident's work. Residents are expected to complete a supervision presentation form prior to
each individual supervision session with a copy for the supervisor. Residents’ copies of these
forms should be destroyed when the client terminates. Group supervision is structured for
weekly clinical and didactic training. All supervisors are Diplomates or Fellows of the American
Association of Pastoral Counselors or have equivalent status in their discipline. All supervisors
also are licensed and AAMFT approved.

4.8
Calling In

Practicum residents must call in at least twice daily to check for Voice Mail messages. When
residents are going to be absent, the office staff must be informed and the Voice Mail must be
changed to reflect your absence and the availability of emergency coverage.

4.9
CCCG Clinical Policies

Residents in the practicum are expected to become familiar with and follow CCCG’s clinical
policies. Your supervisor has a copy of the manual and will orient you to these policies.


5.0
EVALUATIONS AND GRADES

5.1 Evaluations

Formal evaluations of each resident are conducted at the end of each semester using a format
provided by the training faculty. The evaluation is both written and oral, and both aspects of the
exam are considered in the resident's grade for the semester. The resident's overall performance
for the semester is also considered in the grade that is given. An informal mid-term evaluation
may also be given. Residents should give their written work to each member of their evaluation
committee at least two days prior to the evaluation

5.2 Grades

Residents are graded in the following areas: Individual supervision, group supervision, case
conference, didactic, and final evaluation. The final grade comes from averaging the supervision
grade, the didactic grade, and the final evaluation grade.

6.0
PERFORMANCE EXAM


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The performance exam is a summary evaluation of the resident's overall performance. It is one
of the qualifying exams for admission to candidacy for the Th.D. degree and for completion of
other degrees. To successfully complete the exam, residents must demonstrate a thorough grasp
of pastoral counseling theory and pastoral theology and have the ability to integrate those into
pastoral counseling practice. Residents are expected to demonstrate that other aspects of their
degree curriculum, e.g., systematic theology, theological method, etc., are being integrated into
their pastoral counseling theory and practice. All residents are expected to meet the same
standards for completion of the practicum whether or not they are in a degree program.

The performance exam may be taken at the end of the second year of training at the earliest and
must be taken by the end of the third year. Residents, in consultation with their supervisors and
upon approval by the faculty, are responsible for determining the exact time for the exam,
selecting a committee, and assuring that all committee members can be present at the time
selected.

The performance exam is conducted by a committee. The committee for the performance exam
should consist of the resident's current supervisor, one other supervisor, the academic advisor,
and one other faculty person from the seminary where the resident is enrolled. An open
invitation is automatically extended to any other practicum faculty who wish to attend as well as
to seminary pastoral counseling faculty (and the Th.D. Committee for residents in the Th.D.
program).

Three weeks before the exam date, residents will be given two or three questions which will be
answered with a ten to fifteen page paper. Residents will also submit an audio or video
recording which presents their capability as a therapist. The tape and paper are provided to the
committee at least one week before the exam. All committee members receive the paper and two
members receive tapes to review. One tape should be given to a clinical faculty person (not the
resident's supervisor) and one to an academic faculty person. When residents meet the
committee for the allotted one and one-half hours, they will be asked to present themselves
however they desire. Usually, residents will describe and play a pertinent portion of the tape that
demonstrates their capability as therapists. The committee then responds to the tape presented
and the paper previously reviewed. After discussion, residents will be asked to leave the room,
and the committee will deliberate and reach a decision. Residents then will be called back to
hear the results and any comments.

Residents who do not pass the exam, upon the recommendation of the examining committee,
may be allowed to take the exam a second time as specified by the committee.








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